The Olympic Games will formally open in Tokyo on Friday with much less pomp and much more circumstance than originally planned. If staging an Olympiad in the middle of a pandemic was an utter impossibility in 2020, staging one in the throes of a semi-subdued pandemic in 2021, at stadiums and venues devoid of spectators, is not proving to be much easier. Accompanying the medal counts will be another statistic: positive tests for the SARS-CoV-2 virus.Testing and tracing will be an Olympian effort in itself.

For the non-Olympians, the summer is not turning out to be the disease-free joyride many had hoped for and anticipated. The tide of COVID-19 cases, hospitalizations and deaths in the U.S., driven by the momentum-gathering Delta variant (now accounting for an estimated 83% of US cases) is rising rather than ebbing.

There were 10,000 new cases in one week in Los Angeles County, where an indoor mask mandate is back in place. The American Academy of Pediatrics on Monday recommended that all children over age 2, regardless of COVID-19 vaccination status, wear a mask in school. National Nurses United, the largest union of RNs, is asking the Centers for Disease Control and Prevention to reinstate masking recommendations in public for all.

Communities with subpar rates of COVID-19 vaccination are the equivalent of low-lying areas in a flood zone, while the fully vaccinated occupy a higher, safer ground. CDC director Dr. Rochelle Walensky says we are witnessing a “pandemic of the unvaccinated,” as 97% of recent COVID-19 hospitalizations occurred among the shotless.

To be sure, we can point to notable successes. Nearly 60% of US adults are fully vaccinated, including 80% of seniors. The flip side of that coin: 40%, or some 100 million individuals, remain unvaccinated, a number of them resolutely or defiantly so. As Cliff Young, president of Ipsos U.S. Public Affairs puts it, some are nudge-able and others are unbudge-able. “From a public health standpoint,” Young said, “they’ve got to figure out how you nudge the nudge-able.”

As the vaccination rollout moves from the ready and willing to the uncertain and resistant, communication strategies must become local and personal, Lecia Bushak reports in MM+M. “One at a time, one conversation at a time, is the way this is going to work,” said Lorna Thorpe, a population health expert at NYU Langone. As one Biden administration aide told Politico, “The first 180 million were much easier than the next 5 million.” In its latest weekly COVID-19 data update, the CDC explains why “location, location, location” matters so much in this pandemic.

Grassroots efforts require a more finely tuned understanding of what drives skepticism among individuals and groups, Bushak reports, whether in regard to political or religious beliefs, concerns about safety or lack of information and access to vaccines. “What we’ve had to do as a public health industry is better understand what builds trust and what is leading to potential distrust, and then create programs, campaigns and spokespeople to address the nuances. It’s a very powerful emotion and a tall charge,” explained Real Chemistry president Michele Schimmel.

One festering source of hesitancy, according to U.S. Surgeon General Vivek Murthy, is an abundance of misinformation, as social media platforms serve as bully pulpits for the wrong kind of bull. In his first official advisory of this administration, Dr. Murthy described healthcare misinformation as “an urgent threat to public health” that is causing confusion, sowing mistrust and undermining the effort to end the pandemic.

Murthy, who also served as Surgeon General in the Obama years, noted that more than two-thirds of unvaccinated adults have heard at least one COVID-19 vaccine myth and either believed it or were not sure of its veracity. False news stories, he added, are 70% more likely to be shared on social media than true ones.

Even brief exposure to misinformation makes people less likely to want a COVID-19 vaccine. Murthy called for an “all-of-society” response to confronting and curbing health misinformation, from the tech and social media companies that make it abundantly available to the individuals who copiously share. The Surgeon General’s full report is available here.

In MM+M, Bushak reports that YouTube is now making an effort to prioritize health information from medical schools, departments of public health and other credible sources. The platform is also developing partnerships with academic centers such as Cleveland Clinic and Mass General Brigham and drawing upon National Academy of Medicine guidelines for countering misinformation. Meanwhile, Twitter temporarily suspended the account of Georgia Congresswoman Marjorie Taylor Greene for sharing COVID-19 vaccine misinformation.

In moving from mass appeal to one-on-one dialogue, the vaccination campaign is drawing on techniques that have worked politically. Phone callers, for example, are turning to behavioral psychology approaches that have been successful in getting out the vote or encouraging people to complete census forms, notes John Jameson, founder of the political persuasion firm Winning Connections. Jameson, who has worked with the nonprofit Healthier Colorado on COVID-19 vaccination efforts, explains in Medpage Today: “Trained callers might ask: ‘When you go to get your vaccine, will you drive, walk or take a bus?’ This might be followed by, ‘Will you go alone or with a family member or friend?’ Getting individuals to visualize how they will carry out a future activity makes them more likely to do it.”

Similarly, Adrian Montgomery, CEO of Enthusiast Gaming, says his company is working with the Ad Council to develop vaccination messaging for Gen Z. In 2020, the Biden presidential campaign hired Montgomery’s company to mobilize the vote among young people. The key to reaching people, both then and now, is not to attempt direct persuasion but rather encourage people to learn more about vaccines and give them an opportunity to opt in, Montgomery stresses. This approach is right in the Ad Council’s “It’s Up to You” wheelhouse, not so much leading a horse to water as offering a healthy stream of helpful information.

Reaching out

·  At this point, the chorus of vaccine advocates is not singing one song but tailoring specific tunes to specific audiences. In Campaign, Mariah Cooper tells the story behind “One Decision for Us,” a lyrical four-minute spot featuring spoken word artist Justice Davis designed to appeal to Black and Hispanic communities. The William Julius Wilson Institute at Harlem Children’s Zone worked with VaynerMedia to produce the video.

·  Colorado health officials are taking creative approaches to reaching the Latino community, bringing a vaccination van to a soccer match between the U.S. and Mexico and hosting pop-up clinics at shopping centers and farmers’ markets. The state has hosted more than 1,500 “vaccine equity clinics,” partnered with businesses to provide vaccinations at worksites, and reached out with a Spanish language Facebook page and COVID website.

·  Leaders of local Muslim communities are working to dispel misinformation and promote vaccination, National Geographic reports. One organization, Somali Family Service of San Diego, has held a number of virtual town hall meetings where doctors, nurses and imams present scientific evidence in a culturally competent manner.

·  Research by Kaiser Family Foundation suggests that your family and friends—and your family doctor—are the voices most likely to change a No vote on COVID-19 vaccination to a Yes.

Source: Getty Images.

Push comes to shove

·  Citing the “alarming resurgence” in COVID-19 infections, the Association of American Medical Colleges urged its member institutions to require vaccination of their employees. The AAMC’s members include 155 medical schools in the U.S., 17 medical schools in Canada, more than 400 teaching hospitals and health systems (including the VA network) and more than 70 academic societies.

·  At Fort Rucker, Alabama, unmasked uniformed military personnel must be ready to provide proof of COVID-19 vaccination status while on active duty, according to an order from the base commander.

·  Indiana University’s vaccine mandate survived its first legal challenge, with more likely to come. A federal judge refused to issue a preliminary injunction sought by eight students who want the mandate invalidated. Indiana is one of nearly 600 colleges adopting some form of vaccination requirement. Purdue University, also in Indiana, is giving students a choice between getting vaccinated or being tested regularly and quarantining if exposed to COVID-19.

·  Bookmark these state and local battlegrounds for future reference: Vaccination of minors without parental consent, mask mandates in schools and vaccination mandates by employers and educators. At least seven states—Alabama, Arkansas, Florida, Indiana, Montana, Oklahoma and Utah—have enacted legislation to restrict public schools from requiring COVID-19 vaccination or documentation of vaccination status, a CNN analysis found.

Opening up

·  Canada will allow fully vaccinated Americans to come visit starting August 9 and will welcome the rest of the (fully vaccinated) world by September 7. With few exceptions, the 5,500-mile U.S./Canada border has been shut to non-essential travel since March of last year.

·  The Toronto Blue Jays, who haven’t played a home game in Toronto since September 2019, are going back to the Rogers Centre on July 30. They’ve been playing “home” games in Buffalo, 100 miles away on the other side of Niagara Falls, and in their spring training facility in Florida.

·  As the U.K. lifts most COVID-19 restrictions this week, the government is telling nearly 4 million people who are considered “clinically extremely vulnerable” to the disease to consult their doctor for guidance. Emma Bower reports in GP that the 3.8 million people on the “shielded patient list” represent 6.8% of the country’s population.

·  The U.S. State Department and the CDC are advising Americans not to travel to the U.K., where cases are rising by 50,000 a day.

·  Diane Lightfoot, CEO of the Business Disability Forum, suggests that employers use the return to the office as an opportunity to create a more physically accessible and culturally inclusive environment for people with disabilities. Writing in People Management, Lightfoot says that “67% of executives believe they create environments in which employees with disabilities can thrive, but just 41% of employees agree.”

·  In the emerging era of hybrid work schedules, people tend to like spending the first part of the week at home and coming into the office at mid-week, observes Jose-Luiz Moura, SVP and COO at Salesforce U.K. and Ireland. In other words, he notes in Management Today, Thursday is the new Monday. Moura sees a need for leadership that has “the resilience to manage hybrid teams with largely contrasting work styles, goals, and personal situations” while creating an environment where all colleagues can thrive.

Source: Getty Images.

The challenges

·  The gap between Americans who trust key health institutions and those who don’t is widening, according to a new study from the Annenberg Public Policy Center at the University of Pennsylvania.

·  Eighty percent of skilled nursing facilities in the U.S. have failed to meet an industry-set benchmark of vaccinating 75% of their staff, Kathleen Steele Galvin reports in McKnight’s Senior Living. The data, from AARP, show that about 56% of nursing home healthcare staff across the country are fully vaccinated, ranging from 41% in Louisiana to 84% in Hawaii.

·  A congressionally authorized nonprofit organization, the Patient Centered Outcomes Research Institute, is investing $11 million to find ways to boost COVID-19 vaccination rates in long-term care workers, Danielle Brown and Alicia Lasek report in McKnight’s Long-Term Care News. One study will recruit 6,000 employees at facilities in Washington state and Georgia, while a second one based at Dartmouth College will enroll 1,800 workers across the country. Approaches will include webinars facilitated by peer leaders and group discussions of curated social media content.

·  Meanwhile, Brown reports that consumer groups are pressing for more user-friendly presentation of COVID-19 vaccination rates of nursing home residents and staff on Medicare/Medicaid websites.

·  71% of those surveyed in a new Harris Poll support mandatory vaccination of healthcare workers.

·  Protestors are taking to the streets in France and Greece, Reuters reports, as governments limit use of public indoor venues to the vaccinated or to the unvaccinated who can present a negative test for the virus. The countries are also preparing to mandate vaccination of healthcare workers.

·  The two largest population hubs in Australia, Sydney and Melbourne (former sites of the Olympic Games in 2000 and 1956, respectively), have imposed lockdowns following spikes in Delta-fueled COVID-19.

·  One of the top corporate sponsors of the Olympics, Toyota Motors, has decided not to advertise in Japan during the Games and won’t attend the opening ceremonies, Sabrina Sanchez reports in Campaign. A state of emergency is still in effect in Japan and public sentiment against the Games is strong.

·  Health officials have traced recent clusters of COVID-19 cases in Singapore to karaoke lounges, the BBC reports.

The vaccine dashboard

·  The FDA has granted priority status to Pfizer/BioNTech’s application for full licensure of their COVID-19 vaccine in people aged 16 and older. The FDA said that review of the application “is among the highest priorities of this agency” and will be completed “far in advance” of the formally scheduled decision date of January 2022.

·  Nearly a third (31%) of unvaccinated adults surveyed by the Kaiser Family Foundation said they would be more inclined to roll up their sleeves if the vaccines had full FDA approval. Kimberly Marselas has more on the timing and impact of the FDA decision in McKnight’s Long-Term Care News.

·  The CDC’s Advisory Committee on Immunization Practices meets Thursday to discuss the need for COVID-19 booster vaccines. Also on the agenda: Reviewing rare cases of Guillain-Barre syndrome in people who have received the J&J vaccine.

·  On the next horizon: Vaccination of children under 12. Pfizer may seek emergency use authorization for its vaccine in children ages 5 to 11 in September and plans to have trial results for children ages 2 to 5 in the fall. The FDA wants four months of safety data for these age groups, versus the two months for clinical trials in adults.

Source: Getty Images.

The rest

·  JAMA Pediatrics has retracted a study, published online on June 30, reporting that children wearing facemasks inhaled unhealthy amounts of carbon dioxide.

·  Statins may help prevent severe disease and deaths in patients hospitalized with COVID-19, Brian Park reports in MPR, especially in those with a history of hypertension or heart disease.

·  Complications in various organ systems develop in half of patients hospitalized with COVID-19, Natasha Persaud reports in Renal & Urology News. Complications occur in all age groups and in previously healthy people as well as those with underlying conditions.

·  In case you missed it, World Emoji Day was last Saturday, July 17. :=)

·  Department of Corrections: In last week’s newsletter we erroneously turned Missouri Governor Mike Parson into a Rick. Our apologies for the flub, and many thanks to Missourian Tressa Robbins for the heads-up.

Parting shot

NYC-based Improv Everywhere describes itself as “a group that specializes in large-scale surprise moments in public spaces.” After a pandemic-induced hiatus, a fully vaccinated cast and crew of 100 were back in action in Central Park’s Grand Army Plaza. They placed what looked like a yellow social distancing decal on the ground that said “Stand Here for Dance Party.” When a passerby obliged, the party began, boombox and dancers and all. The troupe staged eight impromptu parties in an hour and half. The project was a collaboration with the Museum of the City of New York. Many thanks to B.L. Ochman for the news tip.

…and some songs, by Canadians

A Case of You, Diana Krall (written by fellow Canadian Joni Mitchell)

Constant Craving, k.d. lang

Summer of ’69, Bryan Adams

If I Had a Million Dollars, Barenaked Ladies

Takin’ Care of Business, Bachman-Turner Overdrive

Blinding Lights, The Weeknd

Hallelujah, Leonard Cohen

Tom Sawyer, Rush

Don’t Let It Bring You Down, Neil Young

Acadian Driftwood, The Band

Thank you so much for tuning in. Keep it on this channel and come back next week for more. COVID is taking no summer vacation.