Where’s The Vaccine?

https://puttrx.medium.com/wheres-the-vaccine-cb71195ddf49

2021. So far for pharmacies, it’s been a wild ride. The much-anticipated advent of the COVID vaccine(s) has spawned additional issues with rollout and availability capabilities — many of which can be tied back to misinformation, corporate territorialism, and lack of proper planning.

Does anyone else hear a common PBM theme here?

States that are excelling in the vaccination effort are those including their local independent pharmacies in all phases of distribution. In an MSNBC interview this month, West Virginia Governor Jim Justice noted that “instead of letting vaccines sit on shelves we saw that our elderly wanted to go to their local pharmacies and clinics… We incorporated everybody together… and said we’re not going to let vaccines sit on shelves.” And, in a January interview on Face the Nation, Arkansas Governor Asa Hutchinson remarked, “Our independent pharmacies are doing a better job of getting it (the vaccine) out. They’re acting with more urgency than the chain pharmacies.”

The facts are that the CVS/Walgreens partnership was allocated more than 4.7 million doses of the Pfizer and Moderna vaccines, but as of mid-January — a month after rollout began in many states — had only administered a quarter of those vaccines. In states like Mississippi, that translated to only 5% of the state’s initially allocated shots administered to their most vulnerable populations. Statistics that abysmal can only be construed as either the chains are saving doses for second round inoculations, or incapable of doing the job they were contracted to accomplish. And while one would hope that it’s the former, not the latter, even saving doses isn’t necessary. Both Pfizer and Moderna have made clear that new shipments will cover those second rounds .. so why is there a shortage?

It has long been reported by even their own employees that major chains like CVS and Walgreens are understaffed to the point of patient danger, and large numbers of what they themselves call “retail locations” (as opposed to ‘pharmacies’) obviously do not translate into the amount of trained medical personnel necessary to effectively administer vaccines to the single portion of the population they were contracted to vaccinate. Whether or not this factors into their ongoing vaccination rollout issues, we may never know.

The truth is that if CVS/Walgreens were not either “holding back” doses for second round inoculation or caught in a web of their own ineptitude with regards to their LTC government contract, far more shots could have gone into arms — and far more shots would be available to our swiftly dying population. Look at the independent pharmacy rollouts in West Virginia, North Dakota, and Louisiana. They’re not holding back doses, or lacking the ability to get doses administered. They’re getting them into the arms of the population that needs them most — and receiving the doses for second rounds. The statistics prove it. West Virginia alone has achieved a 50% drop in hospitalizations and a 45% drop in deaths since the inception of their vaccine rollout — a substantial difference over states who choose to rely solely on giant corporation-driven control.

Patients trust their local independent pharmacies, and have for generations. When it comes to easily accessible advice on medication-related questions and issues, their local pharmacy is a patient’s preferred go-to. Not a chain ‘retail’ store that places more importance on superstore mentality than individualized patient care — which may explain CVS and Walgreens’ claims that lack of consent is a large part of the reason they’ve been unsuccessful.

The PBM-owned pharmacies at the helm of America’s vaccine effort are, in essence, proving the necessity of PBM reform. Independent pharmacies nationwide are licensed, willing, Trusted partners in the ‘arms race’ on one of the most important vaccines in history. Giant corporations playing territorial hardball are not the answer. As The Washington Post recently wrote, “The strong performance by local pharmacies in distributing lifesaving vaccines makes that clear.”

Jeremy Counts, PharmD

Main Street Pharmacy

Blacksburg, VA

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Steve – The House is holding a hearing today on H.R. 40 – a bill that would set up a commission to examine the institution of slavery and its impact and make recommendations for reparations to Congress. We need your help to push this critical legislation forward: Please send a message to your representative and tell them to support H.R. 40 now. Today’s hearing will feature one of the Japanese Americans who successfully pushed for redress after their family was rounded up by the U.S. government and locked in prison camps, and will enforce an important message: That our country has provided reparations in the past, and H.R. 40 is a realistic mechanism to begin discussion on addressing the fundamental injustices of institutional slavery in the U.S. We cannot adequately repair harms that we have not fully examined and discussed as a national priority. It’s time our country accounts for hundreds of years of brutal mistreatment of Black people during chattel slavery, Jim Crow segregation, and the enduring structural racism endemic to our society. H.R. 40 would create the framework for that necessary process of atonement. And if the latest rise of white supremacist expression shows us anything, it’s that this crucial conversation must happen now. We must pass H.R. 40. During slavery, Black people were ripped from their families and nations and forced to labor for the enrichment of America. After its “abolition,” the emancipated were left to face the terrorism of widespread lynchings and targeted massacres. Those who survived were denied dignity in nearly every arena of life from criminal justice to economic security to health care – all harmful disparities that continue to pervade our systems and society to this day. Reparations are not a symbolic act in response to these atrocities. Passing H.R. 40 provides a real and necessary demand for justice that has support and momentum. Steve, if we ever hope to achieve racial justice in America, we must examine the impact of slavery and its legacy and make strides toward reparations. With a new Congress and new President, we have the opportunity to make this happen – through H.R. 40. Please, urge your representative to support this important bill now. Thanks for taking action, Jennifer Bellamy Pronouns: She, her, hers ACLU Senior Legislative Counsel, fighting for racial justice P.S. If you’ve already contacted your member of Congress about H.R. 40 and reparations, thank you. Your consistent support and advocacy on this issue is so important to this fight – and the more your representative hears from you, the more they’ll listen. So please, send another message now.

Donate Now

This email was sent to: steve@steveariens.com Sign up for ACLU texts | Unsubscribe Please note: If you forward or distribute, the links will open a page with your information filled in. We respect your right to privacy – view our policy. This email was sent by: American Civil Liberties Union 125 Broad Street, 18th Floor New York, NY 10004, USA

This bill (HR 40)  was introduced by https://www.congress.gov/member/sheila-jackson-lee/J000032

Interesting … ACLU sent out this letter and DIDN’T MENTION WHO INTRODUCED THIS BILL.

Maybe the chronic pain community and the mental health community should seek  reparations for all the abuse/discrimination that has been inflicted on these communities since Pres Nixon signed into law the Controlled Substance Act in 1970.  The Civil Rights Act – which includes/covers disabled people – was signed into law in 1965.

Over the years, how many chronic pain pts have reached out to the ACLU for assistance to stop the discrimination that those in the community has have to endure and how many pts have been told by the ACLU that they don’t have the resources – or just doesn’t have the interest – in how some specific groups – are being discriminated against…  NOT CENTURIES AGO, but here and now.

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The assumption is feckless doctors not knowing what they are doing have overprescirbed and this has caused more overdose deaths and addiction so CDC has told us what to do, to make it safe and cut down on these problems.

It did not work. Deaths are up. Addiction is the same as always.

But millions of very tragic consequences have occurred with people forcibly discontinued from the the control of their permanent painful diseases to solve the Heroin multidrug overdose problems, Ask CDC who exactly is dying and why they separated multidrugs to make it look like it was prescription drugs- a terrible mistake,

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This Burger King commercial was very popular at a time when our daughter was in early grade school… you know when a parent can “easily embarrass” kids in this age group… I use to sing along with the commercial modifying the end of the commercial  “NAKED BURGERS DON’T UPSET US !” 

Every week, I get contacted by chronic pain pts … typically concerning their inability to get their pain management medication. Sometimes it is denied by their insurance/PBM company, sometimes it is the pharmacy that they have patronized for years, sometimes it is their doctor.

In this country we are use to patronizing where/whom we wish  to purchase products/services from.  When I started working in a pharmacy as a pharmacy student (1967), there was no DEA, no PBM/drug cards, bank charge cards were in their infancy. There was a Federal Narcotic Bureau that only dealt with Opiates, that were not prescribed in quanities as they are today.  Transaction at the Rx counter was CASH or STORE CHARGE   The physician that we use, when I was a kid, was paid in CASH for a office visit.

The vast majority of pts that reach out to me, want me to tell them how they can make “them” prescribe, fill, or paid for their prescription. When the Pharmacist tells the pt that “they are not comfortable”…  that is not a valid reason.. that is an EXCUSE.  When the Pharmacist tell the pt that they are “out of stock” or they have a order coming arriving in a few days and when the pt returns in a few days and is told that “supplier didn’t send the medication” ..  is most likely a LIE.

Often the best – quickest – way to get a resolution is to switch providers…. if you are on Medicare/Medicaid you can file a complaint by calling 800- MEDICARE… you may or may not get  resolution, but the more pts that complain about a vendor the more likely the dollars that they are reimbursed will be reduced and they can have their “star rating” reduced.

If you are going to file a complaint against a medical practitioner or Pharmacist/pharmacy… some states let pts file the complaint directly with the AG office and may eliminate the particular board from “filing” the complaint and no really doing anything about the pt’s complaint.  These medical boards only have “legal authority” over the practitioner’s license, everything else is handled by the state’s AG office.

Do not expect anything to be done promptly from a complaint to the medical licensing board and/or AG’s office… normally action/response takes 6 to 24 months.

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How Deadly Is the U.K. Variant?

https://www.medpagetoday.com/infectiousdisease/covid19/91202

Updated analyses support worse clinical outcomes

Evidence continues to mount that the so-called U.K. variant is “likely” deadlier and results in more hospitalizations than non-variant COVID-19 cases, according to data released on a British government website.

The report compiled research from major universities and studies and found “increased severity” of COVID-19 cases from the B.1.1.7 variant compared to “non-variants of concern,” with B.1.1.7 cases anywhere from 30% to 70% deadlier than the original wild-type strain.

These concerns were initially raised in January, when the British government’s New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) presented initial data, suggesting cases with B.1.1.7 were likely deadlier than non-variant cases, but they noted then that “data will accrue in coming weeks, at which time the analyses will become more definitive.”

The report detailed why these updated analyses were indeed more definitive, noting earlier reports using linked community testing and mortality data were all based on the same datasets, and thus the same biases.

“More recent analyses have added a wider range of data sets and been able to control for additional confounders, increasing confidence in the association of the [variant of concern] with increased disease severity,” they wrote.

Of note, London School of Hygiene & Tropical Medicine found a relative hazard of death within 28 days was 1.58 (95% CI 1.40.1.79) for variant-infected individuals versus non-variant-infected individuals, while Imperial College London found the mean ratio of case fatality for variant cases was 1.36 with a case-control weighting method.

Public Health England performed a matched cohort analysis, and found a “death risk ratio” of 1.65 (95% CI 1.21-2.25) for variant individuals versus non-variant individuals.

Several other studies examined the effect of the variant on hospitalization, with Public Health Scotland using the S-gene target failure as a proxy to determine variant cases. They found risk of hospitalization was higher among S-gene target failure cases versus S-gene positive cases (risk ratio 1.63, 95% CI 1.48-1.80). Research from Intensive Care National Audit and Research Centre (ICNARC) and QRESEARCH also found a higher risk of ICU admission for variant versus non-variant cases (HR 1.44, 95% CI 1.25-1.67).

However, the consensus was not unanimous, and the government included data from COVID-19 Clinical Information Network (CO-CIN), which found no evidence suggesting variants are linked with higher in-hospital case fatality rates. An analysis from Office for National Statistics (ONS) noted that while the hazard ratio suggested higher risk of all-cause mortality, “the number of deaths are too low for reliable inference.”

The report also noted several limitations to the data, including representativeness, power, potential biases in case ascertainment, unmeasured confounders, and secular trends. They added that the majority of studies tried to control for confounding by nursing home status, but there was a potential for residual confounding due to unidentified nursing home residence in hospital datasets.

“There are potential limitations in all datasets used but together these analyses indicate that it is likely that … B.1.1.7 is associated with an increased risk of [hospitalization] and death compared to infection with non-[B.1.1.7] viruses,” the authors concluded.

CDC modeling in mid-January estimated the U.K. variant would become the dominant strain of COVID-19 in the U.S. by the end of March. Another recent modeling study suggested incidence of variant cases are doubling every 10 days in this country.

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Chain Pharmacy Greed is Damaging the COVID-19 Immunization Program, And Increasing Prescription Errors!

https://pharmacistactivist.com/2021/February_2021.shtml

The efforts to develop, distribute, and administer COVID-19 vaccines are a race against time in reducing the number of deaths and other consequences. Problems have and will continue to occur, but some are preventable. The federal government awarded huge contracts to CVS and Walgreens to immunize residents of nursing homes and assisted-living facilities in deals that are potentially so lucrative that one financial analyst estimated that CVS could make $1billion in gross profits over the next year. Although CVS and Walgreens moved very quickly to obtain the federal contracts, they have not given the same priority to distributing and administering the vaccines on a timely basis. Their greed and management failures have resulted in chaos in their programs and substantial delays in providing life-protecting immunizations for the most vulnerable patients in nursing homes. Their ineptitude in providing adequate staffing and resources, and adequate workplace protections for their pharmacists and other front-line employees must not be tolerated. Now you can get medicines and essentials like La Roche-Posay Ireland get delivered online. You might also be familiar with other cosmetic products online like the inkey list.

News releases from CVS and Walgreens have stated that they are hiring tens of thousands of new employees (pharmacists, technicians, etc), the vast majority of whom are technicians. The lack of commitment and respect of CVS for its pharmacists is evident in its advertisement: “Staff Pharmacist Floater Part-time Temporary Seasonal Jobs Hiring.” To be completely clear, this commentary is NOT a criticism of the front-line pharmacists and other employees at CVS and Walgreens. Rather it is directed at management that is responsible for the understaffed, stressful workplace environment that often does not provide sufficient protections for its employees, and increases the risk of vaccine and medication errors.

There has been an avalanche of social media posts and news stories that are highly critical of CVS and Walgreens. Examples include the following:

A great program in W. Virginia

“W. Virginia a vaccine success story,” is the title of a recent news story (Cuneyt Dil; Associated Press/The Philadelphia Inquirer, Jan. 18, 2021). It provides an inspiring account of the excellent leadership and immunization services of the independent pharmacists in West Virginia Excerpts are provided below:

Congratulations and thank you to the pharmacists, government officials, and residents of West Virginia! This is a wonderful example for those of us living in the other 49 states to emulate!

Addendum

I wrote this editorial on Tuesday, February 2. Soon after I completed it, I looked at today’s issue of the Wall Street Journal and the story, “Retailers To Take Key Role in Vaccine,” (Sharon Terlep and Jaewon Kang; pB1). It includes the following comments:

CVS and Walgreens were entrusted with this responsibility already and they failed. They can’t be trusted to do it right this time and they should not be permitted to participate. Our national pharmacy associations must send a strong message to the CDC promoting the West Virginia experience in using independent pharmacies. Pharmacists should do the same with their legislators and state health departments. Like West Virginia, other states should reject the federal partnership with chain pharmacies and work with their independent pharmacists who know so many of the residents of their communities.

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You stop contributing to society at 75 ?

Dr. Ezekiel Emanuel  who was part of the committee that put ACA (Obamacare) together came out in 2014 and stated that everyone should just stop all health/medical treatments and save our society a LOT OF MONEY… become less of a “taker” and hopefully you will just die and society will not have to support your existence on earth.

Insulin In Canada cost 10% of the USA price… Insurance/PBM industry is the reason but the Pharma industry gets the blame

Trump’s Executive Orders Will Make Prescription Drugs More Affordable

Trump’s four executive orders to lower drug prices: What to know

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2.5 Tons of Methamphetamine and 100,000 Fentanyl Pills Interdicted/seized by DEA

https://www.dea.gov/press-releases/2021/02/05/25-tons-methamphetamine-and-100000-fentanyl-pills-interdicted

Two Mexican Drug Traffickers Charged out of the Southern District of New York with Conspiring to Import Large Quantities of Narcotics into the United States

NEW YORK – Ray Donovan, Special Agent in Charge of the U.S. Drug Enforcement Administration New York Division, Audrey Strauss, the United States Attorney for the Southern District of New York, Peter C. Fitzhugh, Special Agent in Charge of the New York Division of Homeland Security Investigations, and Dermot Shea, Commissioner of the New York City Police Department, announced that Jose Loreto Gastelum-Torres and Fredy Alejandro Gastelum-Vega were charged in a criminal complaint in Manhattan federal court with conspiring to import approximately 2.5 tons of methamphetamine and 100,000 fentanyl pills into the United States.  The charge arises from a January 29, 2021 seizure by Mexico’s Secretaría de Marina (the “Mexican Navy”) of approximately 2.5 tons of methamphetamine and 100,000 fentanyl pills in Sinaloa, Mexico.

“There is a tidal wave of fentanyl and methamphetamine being pushed from Mexico into the United States,” said DEA Special Agent in Charge Ray Donovan.  “Case in point, these two traffickers were allegedly caught red-handed with over $90 million dollars’ worth of fentanyl and methamphetamine.  Traffickers see opportunities when drug overdoses rise, and they are trying to flood American markets with these synthetic, highly addictive, and dangerous drugs.  DEA and our law enforcement partners will continue to target drug networks to keep Americans safe and save lives.”

Manhattan U.S. Attorney Audrey Strauss said:  “Thanks to the DEA, HSI, the NYPD, and the rest of our OCDETF New York Strike Force partners, as well as the Mexican Navy, a major shipment of potentially lethal drugs was interdicted before it could addict, poison, and potentially kill untold numbers of people in the United States.”

“Those arrested allegedly sought to traffic thousands of fentanyl pills and multiple tons of methamphetamine, which would only exacerbate the plague currently devastating our community while steadily increasing addictions and overdose deaths,” said HSI Special Agent in Charge Peter C. Fitzhugh.  “The Strike Force has been a proven model for success in dismantling transnational narcotics trafficking organizations.  HSI showcased our unique value at the Strike Force in this case by leveraging our border resources to not only effectively address threats and vulnerabilities but moreover promote collaboration in furthering these investigations, making timely and significant arrests, and stopping deadly drugs from flooding our streets.”

Police Commissioner Dermot Shea said:  “Today’s charges demonstrate that the investigative efforts of the NYPD in coordination with our law enforcement partners are far-reaching and focused.  As long as individuals, wherever they may be, are involved in illegal narcotics trafficking, the NYPD and our partners will relentlessly work to end the threat to public safety.  I commend and thank the NYPD investigators, members of the Organized Crime Drug Enforcement Strike Force Initiative, agents from the New York Division of the U.S. Drug Enforcement Administration, and the attorneys at the United States Attorney’s Office, Southern District, for their dedication to this investigation.

As alleged in the Complaint unsealed in federal court[1]:

On or about January 29, 2021, the Mexican Navy located and began tracking an outboard‑powered boat traveling from Las Arenitas, Sinaloa, Mexico, northwest through the Gulf of California.  Approximately several hours later, the Mexican Navy interdicted the vessel in or around Topolobampo, Sinaloa, Mexico, and arrested Gastelum-Torres and Gastelum-Vega.  Mexican Navy officers seized approximately 960 plastic containers from the boat, which contained approximately 2.5 tons of methamphetamine and 100,000 pills of fentanyl.

Gastelum-Torres, 53, and Gastelum-Vega, 33, of Mexico, are charged with conspiring to import at least 500 grams of methamphetamine and at least 400 grams of fentanyl into the United States, which carries a mandatory minimum sentence of 10 years in prison and a maximum sentence of life in prison.  The maximum potential sentences in this case are prescribed by Congress and are provided here for informational purposes only, as any sentencing of the defendants would be determined by the judge.

This case is part of an Organized Crime Drug Enforcement Task Forces Strike Force Initiative, which provides for the establishment of permanent multi-agency task force teams that work side-by-side in the same location.  This co-located model enables agents from different agencies to collaborate on intelligence-driven, multi-jurisdictional operations to disrupt and dismantle the most significant drug traffickers, money launderers, gangs, and transnational criminal organizations. 

This investigation was conducted by the OCDETF New York Strike Force in partnership with the DEA’s law enforcement partners.  The OCDETF New York Strike Force is comprised of federal, state, and local law enforcement agencies supported by OCDETF and the New York/New Jersey High Intensity Drug Trafficking Area.  The Strike Force is affiliated with the DEA’s New York Division and includes agents and officers of the DEA; the New York City Police Department; the New York State Police; Immigration and Customs Enforcement – Homeland Security Investigations; the U. S. Internal Revenue Service Criminal Investigation Division; the Bureau of Alcohol, Tobacco, Firearms and Explosives; U.S. Customs and Border Protection; U.S. Secret Service; the U.S. Marshals Service; New York National Guard; the Clarkstown Police Department; U.S. Coast Guard; Port Washington Police Department; and New York State Department of Corrections and Community Supervision.       

Ms. Strauss praised the outstanding investigative work of the OCDETF New York Strike Force and Mexico’s Secretaría de Marina.

The case is being handled by the Office’s Terrorism and International Narcotics Unit.  Assistant United States Attorneys Alexander Li, Benjamin Woodside Schrier, and Kyle A. Wirshba are in charge of the prosecution.

The charge contained in the Complaint is merely an allegation, and the defendants are presumed innocent unless and until proven guilty.

Probably just ONE OF SEVERAL such illegal drugs that come into our country EVERY DAY.  My money is on …. the DEA just “got lucky” this day  – right place… right time ?

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Imagine this Biden now contradicts some of his statements on the campaign trail

https://www.foxbusiness.com/politics/biden-china-economic-threat-xi-jinping-campaign-2019

President Biden warned that China will “eat our lunch” on Thursday after speaking with Chinese President Xi Jinping for the first time Wednesday night since becoming president – a sentiment that seemed to contradict some of his statements on the campaign trail.

“Last night I was on the phone with for two straight hours with Xi Jinping,” Biden told reporters in the Oval Office. “It was a good conversation, I know him well, we spent a lot of time together over the years I was vice president, but if we don’t get moving, they’re going to eat our lunch. They have major, major new initiatives on rail, they already have rail that goes 325 miles per hour with ease. They are working very hard to do what I think we’re gonna have to do.”

“The auto industry is already there. So is labor. They’re working very hard to try to move in a position where they end up being the source of a new way in which to power automobiles, which they’re going to invest a lot of money. They’re investing billions of dollars in dealing with a whole range of issues that relate to transportation and the environment … so we just have to step up,” Biden continued.

Biden’s comments on Thursday seemed in direct opposition to his position in 2019.

“China is going to eat our lunch? Come on, man!” Biden said at a rally in 2019.

He was critical of former President Donald Trump’s tariff battle with China.

In this photo released by China’s Xinhua News Agency, Chinese President Xi Jinping speaks during the annual Central Economic Work Conference in Beijing. (Huang Jingwen/Xinhua via AP) (AP)

“The president has done nothing but increase the tariffs, the debt and the trade deficit. The way we have to proceed is we have to have our allies with us. It’s not just us. We have to keep the world together,” Biden said in 2019.

In a statement Wednesday night, the White House said Biden “shared his greetings and well wishes with the Chinese people on the occasion of Lunar New Year.”

“President Biden affirmed his priorities of protecting the American people’s security, prosperity, health and way of life, and preserving a free and open Indo-Pacific,” the White House said. “President Biden underscored his fundamental concerns about Beijing’s coercive and unfair economic practices, crackdown in Hong Kong, human rights abuses in Xinjiang, and increasingly assertive actions in the region, including toward Taiwan.”

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