Amita Health, Chicago’s biggest health system, is splitting up

“Leaders of both sponsoring organizations have determined that going forward separately is in their collective best interest in order to more nimbly meet the changing needs and expectations of consumers in the rapidly evolving healthcare environment,” Amita said in a statement today. “There will be no disruption to patient care.”

While Amita is the largest local chain by hospital count, it’s the third-largest by revenue behind Advocate Aurora Health and Northwestern Medicine, with $3.6 billion in 2020 net patient revenue.

Amita doubled in size in 2018 after absorbing Presence Health, a local Catholic chain with 10 hospitals that Ascension acquired.

Keith Parrott joined as CEO in January 2020. Soon after, one of his 19 Chicago-area hospitals, Amita Health St. Alexius Medical Center in Hoffman Estates, was treating the second confirmed COVID-19 case in the U.S.

Moving forward, Parrott will lead Ascension’s local hospitals and clinics while Thor Thordarson, currently Amita’s chief operating officer, will lead AdventHealth’s local hospitals clinics, Amita spokeswoman Olga Solares said in an email. She didn’t comment on the timeline for the separation.

WHO chief says it was ‘premature’ to rule out COVID lab leak

BERLIN (AP) — The head of the World Health Organization acknowledged it was premature to rule out a potential link between the COVID-19 pandemic and a laboratory leak, and he said Thursday he is asking China to be more transparent as scientists search for the origins of the coronavirus.

In a rare departure from his usual deference to powerful member countries, WHO Director-General Tedros Adhanom Ghebreyesus said getting access to raw data had been a challenge for the international team that traveled to China earlier this year to investigate the source of COVID-19. The first human cases were identified in the Chinese city of Wuhan.

Tedros told reporters that the U.N. health agency based in Geneva is “asking actually China to be transparent, open and cooperate, especially on the information, raw data that we asked for at the early days of the pandemic.”

He said there had been a “premature push” to rule out the theory that the virus might have escaped from a Chinese government lab in Wuhan – undermining WHO’s own March report, which concluded that a laboratory leak was “extremely unlikely.”

“I was a lab technician myself, I’m an immunologist, and I have worked in the lab, and lab accidents happen,” Tedros said. “It’s common.”

In recent months, the idea that the pandemic started somehow in a laboratory — and perhaps involved an engineered virus — has gained traction, especially with President Joe Biden ordering a review of U.S. intelligence to assess the possibility in May.

China has struck back aggressively, arguing that attempts to link the origins of COVID-19 to a lab were politically motivated and suggesting that the virus might have started abroad. At WHO’s annual meeting of health ministers in the spring, China said that the future search for COVID-19’s origins should continue — in other countries.

Most scientists suspect that the coronavirus originated in bats, but the exact route by which it first jumped into people – via an intermediary animal or in some other way – has not yet been determined. It typically takes decades to narrow down the natural source of an animal virus like Ebola or SARS.

Tedros said that “checking what happened, especially in our labs, is important” to nailing down if the pandemic had any laboratory links.

“We need information, direct information on what the situation of this lab was before and at the start of the pandemic,” the WHO chief said, adding that China’s cooperation was critical. “If we get full information, we can exclude (the lab connection).”

Throughout the pandemic, Tedros has repeatedly praised China for its speed and transparency despite senior WHO officials internally griping about obfuscation from their Chinese counterparts.

Last year, The Associated Press found that WHO was frustrated by a lack of details from China during the early stages of the coronavirus’ spread and showed that China was clamping down on the hidden hunt for the pandemic’s origins.

Numerous public health experts have also called for an independent examination of COVID-19’s origins, arguing WHO does not have the political clout to conduct such a forensic analysis and that the U.N. agency has failed after more than a year to extract critical details from China.

Jamie Metzl, who has led a group of scientists calling for a broader origins investigation, welcomed Tedros’ comments but said it was “deeply unfortunate and dangerous” that there were no current plans for a probe led by experts beyond the U.N. health agency.

“Everyone on earth should be demanding that international investigators have the type of full access to all relevant records, samples, and personnel in China which the Chinese government has so far blocked,” said Metzl, who also sits on a WHO genome editing advisory group.

Any WHO-led mission to China also requires government approval for all experts who travel to the country, as well as permission to visit field sites and final approval on any trip report. WHO emergencies chief Dr. Michael Ryan has previously said the agency works by consensus and cannot compel countries to cooperate.

Tedros’ appeal for transparency was echoed by German Health Minister Jens Spahn, who urged Chinese officials to allow the investigation into the origins of the virus to proceed.

“We do appreciate the cooperation of the Chinese government so far for the first mission,” Spahn said. “But that’s not yet enough.”

Feds order hospitals to pay PTO for COVID-19 vaccinations

Health providers must start paying employees for time to get vaccinated and recover from any side effects under an emergency temporary standard orderfrom the Biden administration. They’ll also have to put in physical barriers where social distancing isn’t possible.

The Occupational Safety and Health Administration’s standards put new enforcement teeth on prior recommendations, and may add administrative burden and costs to health systems. 

OSHA’s guidelines are tailored to just healthcare providers, including hospitals, nursing homes, home health workers and ambulatory care facilities and will impact an estimated 10.3 million workers. 

The agency received the most workplace-related COVID-19 complaints from healthcare workers, according to James Frederick, OSHA’s acting assistant secretary of labor. 

“These are the workers who go into work day in and day out to take care of us and we must make sure that we do everything in our power to return the favor to protect them while they care for us,” Frederick said. 

Providers must now provide paid time off for staff to be vaccinated and ride out side effects. Vaccination rates among healthcare workers vary widely. As of early March, about 48% of frontline healthcare workers hadn’t received a vaccine dose. More than half of workers nationwide working in hospitals and outpatient clinics had received a dose, compared to a quarter of home healthcare workers, according to a Kaiser Family Foundation poll published in April.

Healthcare employers can apply for a refundable tax credit under the American Rescue plan to be reimbursed for the vaccination costs going forward. 

OSHA also mandated health providers install physical barriers where social distancing isn’t possible indoors within 30 days. Healthcare employees who are fully vaccinated are exempt from mask and social distance requirements, nor must they use barriers if there aren’t suspected or confirmed COVID-19 patients.

“Because of these exceptions [with vaccinated workers], it does appear to be that you could create various areas where the emergency temporary standards just may not apply if you’re checking the right boxes,” said Kaiser Chowdhry, an associate at Morgan Lewis who advises clients on employment law issues. 

Providers will have to maintain logs for employees with COVID-19 who contracted the virus even outside of work. They will also have to report COVID-19 related worker hospitalizations to OSHA within 24 hours. These changes are a shift from what’s been recommended, and will likely extra attention to compliance assurance. 

“There’s administrative burdens with this, and then there’s also the possibility for some confusion because there’s going to be some lag time for entire work sites and management to get caught up to speed on how to implement all of this stuff,” Chowdhry said. 

OSHA’s guidance also codified existing recommendations, such as screening incoming patients and visitors for COVID-19 and enforcing six-feet social distancing practices.

“Most healthcare employers, at least the larger ones that are more sophisticated that have the resources, they likely have written COVID-19 plans in place that address most of these requirements,” Chowdhry said.

The standards, according to OSHA, will change when there’s new Centers for Disease Control and Prevention guidance and as vaccination rates increase. 

“While we are heartened by the pace of vaccinations and the current trajectory of the virus, not all workers are protected yet,” Frederick said. “It is important that as vaccination efforts continue, every worker has the protections they deserve.”

Free rides and beer: Incentives are added to vaccine drive

Free beer, pot and doughnuts. Savings bonds. A chance to win an all-terrain vehicle. Places around the U.S. are offering incentives to try to energize the nation’s slowing vaccination drive and get Americans to roll up their sleeves.

These relatively small, mostly corporate, promotion efforts have been accompanied by more serious and far-reaching attempts by officials in cities such as Chicago, which is sending specially equipped buses into neighborhoods to deliver vaccines. Detroit is offering $50 to people who give others a ride to vaccination sites, and starting Monday will send workers to knock on every door in the city to help residents sign up for shots.

Public health officials say the efforts are crucial to reach people who haven’t been immunized yet, whether because they are hesitant or because they have had trouble making an appointment or getting to a vaccination site.

“This is the way we put this pandemic in the rearview mirror and move on with our lives,” said Dr. Steven Stack, Kentucky’s public health commissioner.

Meanwhile, more activities are resuming around the U.S. as case numbers come down. Disneyland is set to open Friday after being closed for over a year, while Indianapolis is planning to welcome 135,000 spectators for the Indy 500 at the end of May.

Still, rising hospitalizations and caseloads in the Pacific Northwest prompted Oregon’s governor to impose restrictions in several counties, and her Washington counterpart was expected to follow suit.

Demand for vaccines has started to fall around the country, something health officials expected would happen once the most vulnerable and most eager to get the shot had the opportunity to do so. Now the vaccination drive is moving into a new, more targeted phase.

“This will be much more of an intense ground game where we have to focus on smaller events, more tailored to address the needs and concerns of focused communities,” Stack said.

Nationally, 82% of people over 65 and more than half of all adults have received at least one dose of vaccine, according to the Centers for Disease Control and Prevention.

But while vaccinations hit a high in mid-April at 3.2 million shots per day on average, the number had fallen to 2.5 million as of last week.

As demand slows to a trickle at mass vaccination sites such as stadiums, some state and local governments are no longer asking for their full allotment of vaccine from Washington. And many large vaccination sites and pharmacies are letting people walk in, no appointment necessary.

With the shift away from larger sites to pharmacies and medical providers, Pfizer on Thursday said that at the end of May, it will start shipping its two-dose COVID-19 vaccine in smaller packages. The new packages will hold 25 vials with six doses each, rather than trays of 195 vials.

The slowdown in the U.S. stands in stark contrast to the situation in the many poorer corners of the world that are desperate for vaccine.

Demand has dropped precipitously in the rugged timberland of northeastern Washington state, where Matt Schanz of Northeast Tri County Health District is at a loss for what to try next.

Seventy-six percent of residents remain unvaccinated in Pend Oreille County and 78% in Ferry County, and a whopping 80% in Stevens County have not had even one shot. On Wednesday, only 35 people in all three counties booked a first dose through the health agency, down from a peak of 500 daily appointments a few weeks ago.

Schanz ticks off the efforts so far in the three counties where he is the health agency’s administrator: Newspaper ads, signs and mailers sent with utility bills. Drive-thru vaccination sites at fairgrounds and fire stations. A call center and online scheduling. Outreach to pastors, Republican elected leaders, employers in the lumber industry and an aluminum boat manufacturer. TV and radio interviews.

“Have we reached that point of saturation?” Schanz asked. “How many people do we have who are going to be the hard no’s, and how many are the hesitators and the wait-and-see folks?”

Uncertainty about the vaccine is the biggest barrier, he said: “People say, ‘Jeez, I don’t want to be a government experiment.'”

Chicago officials are planning vaccination sites at festivals and block parties and are working with barber shops and hair and nail salons to pair free services with vaccination.

“The idea here is to bring the party, bring the vaccine and really have this be a convenient way for people to get vaccinated,” Chicago Health Commissioner Dr. Allison Arwady said.

Several companies have announced that employees can take paid time off to get vaccinated. In Houston, 31-year-old Elissa Hanc works for one of them, 3 Men Movers.

Her employer started offering the benefit before President Joe Biden announced a tax credit for small businesses to provide paid time off for those getting vaccinated or recovering from the side effects.

“I have a few friends who work where management is not making it a priority to get the vaccine,” Hanc said. “They’ve let me know in no uncertain terms how lucky I am to work where I do.”

Dr. Eric Topol, head of the Scripps Research Translational Institute, said that employers should give paid time off and that other incentives are needed to boost vaccinations. He pointed to West Virginia, which is giving $100 savings bonds to young adults who get their shot.

“We also need health systems and universities to mandate vaccination — that no one can be employed or on campus/medical facilities without having been vaccinated,” Topol said in an email. He also said the nation needs to mount a “counteroffensive” against anti-vaccination websites and activists.

Other companies are getting into the spirit with marketing pitches.

Krispy Kreme began offering a free doughnut a day to anyone showing proof of having been vaccinated. In Cleveland, a movie theater is supplying free popcorn through the end of this month.

Several marijuana dispensaries around the country are giving out cannabis treats or free rolled joints. On April 20, marijuana advocates offered “joints for jabs” to encourage people to get vaccinated in New York City and Washington.

Some breweries around the country are offering “shots and a chaser.”

In Alaska, which traditionally has low vaccine confidence, the Norton Sound Health Corp., with a hospital in Nome and 15 clinics across western Alaska, has given away prizes, including airline tickets, money toward the purchase of an all-terrain vehicle, and $500 for groceries or fuel.

Johnson & Johnson COVID-19 vaccine batch fails quality check

A batch of Johnson & Johnson’s COVID-19 vaccine failed quality standards and can’t be used, the drug giant said late Wednesday.

The drugmaker didn’t say how many doses were lost, and it wasn’t clear how the problem would impact future deliveries.

A vaccine ingredient made by Emergent BioSolutions—one of about 10 companies that Johnson & Johnson is using to speed up manufacturing of its recently approved vaccine—did not meet quality standards, J&J said.

J&J said the Emergent BioSolutions factory involved had not yet been approved by the Food and Drug Administration to make part of the vaccine.

Emergent, which has been producing bulk drug substance at one of its factories in Baltimore, declined to comment.

J&J had pledged to provide 20 million doses of its vaccine to the U.S. government by the end of March, and 80 million more doses by the end of May. Its statement on the manufacturing problem said it was still planning to deliver 100 million doses by the end of June and was “aiming to deliver those doses by the end of May.”

President Joe Biden has pledged to have enough vaccines for all U.S. adults by the end of May. The U.S. government has ordered enough two-dose shots from Pfizer and Moderna to vaccinate 200 million people to be delivered by late May, plus the 100 million shots from J&J.

A federal official said Wednesday evening the administration’s goal can be met without additional J&J doses.

A J&J spokesman said earlier Wednesday that J&J met the end-of-March goal, but did not respond to questions about whether the Emergent plant had been cleared by the FDA.

As of Wednesday, J&J had provided about 6.8 million doses, according to the Centers for Disease Control and Prevention’s online vaccine tracker. Some additional doses may not yet have been recorded as delivered, and the CDC said Wednesday that another 11 million doses of the vaccine would be available for shipments starting on Thursday.

It was not immediately clear where those 11 million doses originated, but J&J has been shipping finished vaccines from its factory in the Netherlands to the U.S.

The FDA said it was aware of the situation but referred questions to J&J.

The problem with the vaccine batch was first reported by the New York Times. Original source for this editorial is Modern Health.

Biden plans include sending COVID shots to Mexico and Canada

The U.S. is planning to send a combined 4 million doses of the AstraZeneca COVID-19 vaccine to Mexico and Canada in its first export of shots, the White House said Thursday.

Press secretary Jen Psaki said the Biden administration is in the process of finalizing efforts to distribute 2.5 million doses to Mexico and 1.5 million to Canada as a “loan.” The details are still being worked out.

“Our first priority remains vaccinating the U.S. population,” Psaki said at the daily briefing. But she added that “ensuring our neighbors can contain the virus is a mission critical step, is mission critical to ending the pandemic.”

The AstraZeneca vaccine has not been authorized for use in the U.S. but has been by the World Health Organization. Tens of millions of doses have been stockpiled in the U.S. should it receive emergency use authorization, sparking an international outcry that lifesaving doses were being withheld when they could be used elsewhere.

Psaki said multiple nations have requested access to the U.S. vaccines, but she didn’t have anything to add on further distributions.

Mexican Foreign Affairs Secretary Marcelo Ebrard said via Twitter that Mexico was receiving the vaccine as a result of the conversation between President Joe Biden and President Andrés Manuel López Obrador earlier this month. “Good news!” he wrote.

“God bless America they are coming to our rescue,” said Ontario Premier Doug Ford, the leader of Canada’s most populous province. He thanked Biden for his willingness to share the vaccines.

“And once I get them I will call you a champion, but I need to get the delivery first, so thank you. I appreciate it. We’ve been waiting. That’s what true neighbors do. They help each other in a crisis,” he said. “We will take all the vaccines you can give us, so that’s fabulous news.”

The Biden administration has said that once U.S. citizens are vaccinated, the next step is ensuring Canada and Mexico are able to manage the pandemic so the borders can reopen.

Although Canada’s economy is tightly interconnected with the U.S., Washington hasn’t allowed any of the hundreds of millions of vaccine doses made in America to be exported until now, and Canada has had to turn to Europe and Asia.

The vaccine supply chain difficulties have forced Canada to extend the time between the first shot and the second by up to four months so that everyone can be protected faster with the primary dose. The hope is to get all adults at least one shot by the end of June.

Canadian regulators have approved the Pfizer, Moderna, AstraZeneca and Johnson & Johnson vaccines, but acquiring them has proven difficult.

Canada ranks about 20th in the number of doses administered, with about 8% of the adult population getting at least one shot. That compares with about 38% in the U.K. and 22% in the U.S.

Mexico has fully vaccinated more than 600,000 people and more than 4 million have received a single dose. Mexico’s total population is 126 million.

AstraZeneca is among the vaccines that have received emergency approval in Mexico, and Mexico already has 870,000 doses of that vaccine. It also has Pfizer, SinoVac and Sputnik V for a total of more than 8 million doses. One million doses of SinoVac arrived from Hong Kong on Thursday.

The U.S. stockpiling of the AstraZeneca vaccine has been controversial with other allies as well. The 27-nation European Union had found it difficult to approach Biden on sharing supplies of the vaccine so the disease could be stopped overseas, which would not only help save lives but also improve global economic growth.

Nurses applaud introduction of CalCare bill to implement a single-payer system in California

Renewing its commitment to the larger fight for health care justice, the California Nurses Association (CNA) is pleased to sponsor Assembly Bill 1400 (Kalra), the California Guaranteed Health Care for All Act (CalCare), which would guarantee comprehensive, high-quality health care to all California residents as a human right. The establishment of the CalCare program is an improved Medicare for All-type health care system.

Despite the gains made under the Affordable Care Act, nearly 3 million Californians have no health insurance, while millions more have insurance that they can’t afford to use because their copays and deductibles are too high. Meanwhile, for-profit insurance companies are reporting record-breaking profits, even while the Covid-19 pandemic continues to ravage California and medical bankruptcies are at an all time high.

Sponsored by CNA and authored by Assemblymember Ash Kalra, AB 1400 will ensure that all Californians, regardless of employment, income, immigration status, race, gender, or any other considerations, can get the health care they need, free at the point of service.

“From our experiences caring for patients, we nurses have known the need for and fought for decades for everyone to have guaranteed health care through a system like CalCare,” said Bonnie Castillo, RN and executive director of California Nurses Association and the national nursing organization with which it is affiliated, National Nurses United. “The Covid pandemic has just underscored the desperate societal need for this program NOW. CalCare will ensure that public health is the priority of our health care system, not making a buck for insurance corporations.”

CNA nurses have been at the forefront of the fight to guarantee health care as a right for all Californians since 1994, when they led the charge for Prop. 186, a ballot measure that would have implemented a single-payer system in California. Since then, nurses have continued to advocate for guaranteed health care for all, knowing all too well the failings that come with a health care system that places profits ahead of patients. 

“Thank you to Assemblymember Kalra for his leadership in proposing CalCare, a program that will transform the lives of all people in California, bringing them security, stability, and health care as the human right we all agree it is,” said Stephanie Roberson, government relations director for California Nurses Association. 

Most recently, CNA launched the campaign to win CalCare with a day of action on Feb.  6, working with volunteers throughout California to host 23 car caravans throughout the state, which attracted more than a thousand participants in total.

The CalCare program would be a truly transformative change to California’s health care system. In addition to guaranteeing health care to all Californians, it would save families and businesses thousands in annual health care costs by cutting out the bloat, waste, and inefficiencies of our fragmented, for-profit insurance system.

Californians overwhelmingly support the transition to a single-payer health care system: 57 percent of all Californians supported replacing private insurance with guaranteed coverage provided by the government  — even before the Covid-19 pandemic caused millions of Californians to lose their jobs and employer-provided health insurance. 

“A single-payer health system represents the belief that health care is truly a human right. Our current system results in unjust outcomes and these inequities are underscored especially now, exacerbating economic downturns for working families who have lost their income and meaningful access to health care,” said Assemblymember Ash Kalra. “We will have a long fight ahead in fixing our broken system, but this bill will set us on a real path towards a single-payer system and affirms the policy that would save lives, decrease suffering, and improve public health in California.”

Mass vaccination event could be a model in Nebraska

(AP) A mass vaccination event in Lincoln that helped Nebraska record one of its most productive days in its campaign to distribute shots could serve as a model for future events.

Health officials in Lincoln said roughly 2,400 health care workers received the vaccine Friday at the event held at the Pinnacle Bank Arena. That helped the state administer 8,701 doses of the vaccine on Friday in what was the second-busiest day of the campaign so far.

Jan. 5 — when 13,660 doses of the vaccine were administered — is the busiest day so far. The state has been averaging about 4,500 shots a day over the past two weeks as it works to speed up distribution of the vaccine.

Pat Lopez, director of the Lincoln-Lancaster County Health Department, said Friday’s mass vaccination event was successful with most people able to get their shots and get out of the arena in less than 30 minutes.

Currently, the state is receiving about 23,500 doses of coronavirus vaccines each week that are distributed statewide.

The state said 599 cases of the virus were reported Saturday. A total of 186,854 cases and 1,879 deaths have been recorded so far.

The number of people hospitalized with the virus dipped below 400 for the first time since October Saturday when 390 people were being treated.


Heat to use COVID-19-sniffing dogs to screen fans at games

1:14 PM CT on 1/24/21

(AP) The Miami Heat are bringing back some fans, with help from some dogs.

The Heat will use coronavirus-sniffing dogs at AmericanAirlines Arena to screen fans who want to attend their games. They’ve been working on the plan for months, and the highly trained dogs have been in place for some games this season where the team has allowed a handful of guests — mostly friends and family of players and staff.

Starting this week, a limited number of ticket holders will be in the seats as well, provided they get past the dogs first.

“If you think about it, detection dogs are not new,” said Matthew Jafarian, the Heat’s executive vice president for business strategy. “You’ve seen them in airports, they’ve been used in mission critical situations by the police and the military. We’ve used them at the arena for years to detect explosives.”

The first Heat game with ticket holders is set for Thursday against the Los Angeles Clippers. Monday is the first day that season ticket holders will be able to start securing their seats.

The Heat have sold out 451 consecutive games, the sixth-longest streak in NBA history. Sellouts obviously aren’t happening this year. The Heat will keep attendance under 2,000 for now, or less than 10% of the arena’s typical capacity.

“Please note that seating will be very limited, as we will be observing proper physical distancing,” the team said in its letter to season ticket holders.

The coronavirus-sniffing dog idea has been put into place at airports in Dubai, United Arab Emirates, and Helsinki, Finland, in recent months. At Heat games, fans arriving for the game will be brought to a screening area and the detection dogs will walk past. If the dog keeps going, the fan is cleared; if the dog sits, that’s a sign it detects the virus and the fan will be denied entry.

Other protocols the Heat will use: A health screening questionnaire will be mandatory for all guests, masks must be worn continually and only soda and water will be sold. All transactions will be cashless and if a fan feels ill during a game, isolation rooms will be available.

And if a fan is allergic to or afraid of dogs, the Heat are offering an option to skip the dog screening and submit to a rapid antigen test instead. The Heat say those tests can be processed in less than 45 minutes.

The move comes at a time where some arenas in Florida — such as Amalie Arena in Tampa, home of the NHL’s Tampa Bay Lightning and temporary home of the NBA’s Toronto Raptors — are not allowing any fans, despite doing so earlier this season. The NHL’s Florida Panthers, who play about a half-hour north of Miami, have allowed fans.

It also comes during a month when the NBA has postponed 19 games because of virus-related issues such as positive tests or multiple players on a team being flagged by contact tracing.

Pfizer to deliver less vaccine allotment to States

Several states say they have been told to expect far fewer doses of the Pfizer-BioNTech COVID-19 vaccine in its second week of distribution, prompting worries about potential delays in shots for healthcare workers and long-term care residents.

But senior Trump administration officials on Thursday downplayed the risk of delays, citing a confusion over semantics, while Pfizer said its production levels have not changed.

The first U.S. doses were administered Monday, and already this week, hundreds of thousands of people, mostly healthcare workers, have been vaccinated. The pace is expected to increase next week, assuming Moderna gets federal authorization for its vaccine.

Efforts to help ward off the coronavirus come amid a staggering death toll that surpassed 300,000 on Monday. Johns Hopkins University says about 2,400 people are dying daily in the U.S., which is averaging more than 210,000 cases per day.

In recent days, governors and health leaders in at least a dozen states have said the federal government has told them that next week’s shipment of the Pfizer-BioNTech vaccine will be less than originally projected.

Little explanation was offered, leaving many state officials perplexed.

“This is disruptive and frustrating,” Washington Gov. Jay Inslee, a Democrat, wrote on Twitter Thursday after learning from the Centers for Disease Control and Prevention that the state’s allocation would be cut by 40%. “We need accurate, predictable numbers to plan and ensure on-the-ground success.”

California, where an explosion in cases is straining intensive care units to the breaking point, will receive 160,000 fewer vaccine doses than state officials had anticipated next week — a roughly 40% reduction.

California hospitals began vaccinations this week from the first Pfizer shipment of 327,000 doses and had expected even more to arrive next week. Instead, officials have been told to expect about 233,000 doses, said Erin Mellon, a spokeswoman for Gov. Gavin Newsom.

Missouri’s health director, Dr. Randall Williams, said his state will get 25% to 30% less of the vaccine next week than anticipated. A statement from the Iowa Department of Public Health said its allocation will be “reduced by as much as 30%, however we are working to gain confirmation and additional details from our federal partners.”

Michigan’s shipment will drop by about a quarter. Connecticut, Georgia, Illinois, Montana, Kansas, Nebraska, New Hampshire and Indiana also have been told to expect smaller shipments.

Gov. Brian Kemp on Thursday said Georgia is in line to receive 60,000 doses next week after initially expecting 99,000. Still, the Republican governor has had little but praise for the vaccination effort and did not strongly object to the decreased amount.

“I wish it were a lot more, but it could be zero right now if you look at the past history of vaccines,” Kemp said.

In Washington, D.C., two senior Trump administration officials who spoke on condition of anonymity to discuss internal planning said states will receive their full allocations, but misunderstandings about vaccine supply and changes to the delivery schedule may be creating confusion.

One official said the initial numbers of available doses that were provided to states were projections based on information from the manufacturers, not fixed allocations. Some state officials may have misunderstood that, the official said.

The two officials also said that changes the federal government made to the delivery schedule, at the request of governors, may be contributing to a mistaken impression that fewer doses are coming. The key change involves spacing out delivery of states’ weekly allocations over several days to make distribution more manageable.

“They will get their weekly allocation, it just won’t come to them on one day,” one official said.

Pfizer made it clear that as far as production goes, nothing has changed.

“Pfizer has not had any production issues with our COVID-19 vaccine, and no shipments containing the vaccine are on hold or delayed,” spokesman Eamonn Nolan said in an email. “We are continuing to dispatch our orders to the locations specified by the U.S. government.”

The company said in a written statement that this week it “successfully shipped all 2.9 million doses that we were asked to ship by the U.S. Government to the locations specified by them. We have millions more doses sitting in our warehouse but, as of now, we have not received any shipment instructions for additional doses.”

The senior administration officials said Pfizer’s statement about doses awaiting shipping instructions, while technically accurate, conveniently omits the explanation: It was planned that way.

The federal officials said Pfizer committed to provide 6.4 million doses of its vaccine in the first week after approval. But the federal Operation Warp Speed had already planned to distribute only 2.9 million of those doses right away. Another 2.9 million were to be held at Pfizer’s warehouse to guarantee that individuals vaccinated the first week would be able to get their second shot later to make protection fully effective. Finally, the government is holding an additional 500,000 doses as a reserve against unforeseen problems.

Pfizer said it remains confident it can deliver up to 50 million doses globally this year and up to 1.3 billion doses in 2021.

Sanford ends merger talks with Intermountain after CEO’s abrupt departure

The merger talks are off between Sanford Health and Intermountain Healthcare, just a month after an agreement was announced and just over a week after Sanford’s CEO abruptly stepped down. 

Former Sanford CEO Kelby Krabbenhoft left Nov. 24 in what the board called a mutual decision after making the controversial claim that he didn’t need to wear a mask because he can’t transmit COVID-19 after contracting the coronavirus. Sioux Falls, S.D.-based Sanford cited the leadership change in its decision to pause current merger and acquisition activity while they address other needs. 

Sanford has 46 hospitals and operates in North Dakota, South Dakota, Northwest Iowa and Western Minnesota. The system drew almost $7 billion in total revenue in 2019. Intermountain, which drew $7.6 billion in revenue last year, has 24 hospitals and operates in Utah, Idaho and Nevada.