COVID-19 Update

 Hurray for Governor Bloodstain!

🥳 Let's hear it, kids! 🎉

NYT: (pay wall)

Cases and Deaths in Florida Hit Record Highs

The Delta variant of the coronavirus is spreading rapidly in the state.

More people in Florida are catching the coronavirus, being hospitalized and dying of Covid-19 now than at any previous point in the pandemic, underscoring the perils of limiting public health measures as the Delta variant rips through the state.

This week, 227 virus deaths were being reported each day in Florida, on average, as of Tuesday, a record for the state and by far the most in the United States right now. The average for new known cases reached 23,314 a day on the weekend, 30 percent higher than the state’s previous peak in January, according to a New York Times database. Across the country, new deaths have climbed to more than 1,000 a day, on average.

And hospitalizations in Florida have almost tripled in the past month, according to federal data, stretching many hospitals to the breaking point. The surge prompted the mayor of Orlando to ask residents to conserve water to limit the strain on the city’s supply of liquid oxygen, which is needed both to purify drinking water and to treat Covid-19 patients.

Even as cases continue to surge, with more than 17,200 people hospitalized with the virus across Florida, Gov. Ron DeSantis, a Republican, has held firm on banning vaccine and mask mandates. Several school districts have gone ahead with mask mandates anyway.

Overall, 52 percent of Floridians are fully vaccinated, but the figure is less than 30 percent in some of the state’s hardest-hit counties.

On Monday, dozens of doctors and hospital employees in Palm Beach County gathered for an early morning news conference to beseech the unvaccinated to get shots, emphasizing that the surge was overwhelming the health care system and destroying lives.

“We are exhausted,” said Dr. Rupesh Dharia, an internal medicine specialist. “Our patience and resources are running low.”

A growing proportion of the people inundating hospitals and dying in Florida now are coming from younger segments of the population, particularly those ages 40 to 59, which were less vulnerable in earlier waves of the pandemic. The Delta variant is spreading among younger people, many who thought they were healthy and did not get vaccinated.

Dr. Chirag Patel, the assistant chief medical officer of UF Health Jacksonville, a hospital system in Northeast Florida, said the patients hospitalized with the virus during this latest surge tended to be younger and had fewer other health issues, but were nearly all unvaccinated. Of those who have died, including patients ranging in age from their 20s to their 40s, more than 90 percent were not inoculated, Dr. Patel said.

“We’ve had more patients this time around that have passed away at a younger age with very few if any medical problems,” he said. “They simply come in with Covid, and they don’t make it out of the hospital.”

Two months ago, the number of Covid-19 patients admitted at the system’s two University of Florida hospitals in Jacksonville was down to 14. On Tuesday morning, 188 coronavirus patients were in the hospitals, including 56 in the intensive care units.

One of the hardest parts of his job, Dr. Patel said, is having to tell family members that their unvaccinated loved one had succumbed to the virus. “It’s just such a senseless and preventable way of ultimately dying,” he said.

Since the first ("official") death on 06Feb2021,

COVID-19 has killed one American every 77 seconds

Today's Tweet

Life here in good ol' USAmerica, Inc.

From a friend: "My mother spent just a little over two weeks on a ventilator with COVID before being stable enough to move to another hospital for continued treatment. That first hospital bill was just over half a million dollars."

Freedom, right?

— Bob Cesca (@bobcesca_go) August 26, 2021

 

Our National Pathology

Jordan Klepper Fingers NYC

And in case you've been wondering where all that weird shit comes from, here's a look from the perspective of some people who actually know something about what goes on in all that gelatinous mush between our ears.

PsyPost:

COVID-19 rule breakers characterized by extraversion, amorality and uninformed information-gathering strategies

Scientists have uncovered a cluster of psychological characteristics associated with people who refuse to comply with COVID-19 safety regulations. Their new findings, published in the journal PLOS One, shed light on the individual factors and attitudes underlying deviant behavior during the pandemic.

“When Sydney first went into lockdown, I couldn’t do my regular in-lab research projects, including novel ways of measuring resilience and investigating individual differences in decision-making,” said study author Sabina Kleitman, an associate professor at the University of Sydney and director of the Cognitive and Decision Sciences Research Lab.

“I felt confused by different messages and information available from official and non-official sources. After feeling a little depressed and disoriented, I realized that I no longer need a simulation to research resilience and decision-making. I can explore all sorts of human behaviors using the unique circumstances that the COVID-19 pandemic presents.”

Her co-author, professor Lazar Stankov, added: “From the beginning of the pandemic, it became clear that some people are likely to resist complying with the experts’ advice. The reasons for choosing not to comply appeared to be motivated partly by political outlooks. Others expressed views reminiscent of ‘fake news’ that they seemed to have obtained via social media.”

“Psychological processes studied by cognitive, clinical and social psychologists are implicated in deciding whether to act one way or another. I thought that emerging worldwide threats would provide an opportunity to study human decision-making behavior in a real-life situation.”

For their study, the researchers surveyed 1,575 participants from Australia, the United States, the United Kingdom, and Canada in March and April 2020, during the first wave of the pandemic.

The extensive survey included both self-reported questionnaires and psychological tests. The researchers collected data on information consumption, physical health, psychological resilience, personality traits, right-wing authoritarianism, and other factors. The participants also indicated their compliance with public health guidelines, such as washing hands more frequently, self-isolation if feeling sick and social distancing.

“Compliance vs. non-compliance were the most important decisions that people had to make during the different stages of a pandemic. I spoke to my colleagues, and this research resulted from an international collaboration between University of Sydney, University of New South Wales, and the University of Saskatchewan (Canada),” Kleitman said.

Using a statistical technique known as latent profile analysis, which allows for individuals with similar patterns of responses to be grouped together, the researcher classified 10% of the participants as the non-compliant group. The other 90% of participants were mostly compliant with public health guidelines.

The non-compliant group was more concerned with the social and economic costs of COVID-19 health measures compared to the compliant group, and less concerned with the virus itself. The two groups did not differ in their use of casual information sources, such as social media, to obtain information about the virus. However, the non-compliant group was less likely to check the legitimacy of sources and less likely to obtain information from official sources.

“It was not age, intelligence and decision-making metrics that separated compliant and non-compliant individuals,” Kleitman told PsyPost. “It was primarily personality characteristics, attitudes towards protective measures, levels of worry about COVID-19, and information gathering strategies, as some demographic characteristics like sex that were different between the two groups. Worries, attitudes and beliefs can be shaped and changed! And this is a positive message.”

The researchers found several differences in personality traits between the non-compliant and compliant group. The non-compliant group was more extraverted, but less agreeable and less open to new experiences and ideas. Non-compliant people were also more likely to report using denial, substance use, and behavioral disengagement to cope with problems.

“There are indeed some psychological characteristics that non-compliant group shared. To me, the most important is low openness/intellect to experience that possibly led to the utilization of maladaptive coping strategies, tendency to trust and check the news less and use official sources less,” Stankov said.

In line with previous research, non-compliant group also scored higher on reactance, or the tendency to experience unpleasant arousal when asked to follow orders. They also reported looser cultural norms and scored higher on a measure of amorality.

“What might be a perfectly adaptive personality trait before/after pandemic (extraversion), in combination with some other personality traits (being less considerate and less open to new ideas/experiences), coupled with negative attitudes towards protective behaviors, lesser worries associated with COVID-19, and uninformed information-gathering strategies, formed a dangerous and maladaptive cluster of psychological characteristics and behaviors which non-compliant individuals shared,” Kleitman explained.

“In the non-compliant group, these characteristics clustered together with what I’m tempted to call ‘COVID-19 dark triad’: prioritizing one’s self-interests, being more reactant towards new rules and regulations, and thinking social norms are flexible.”

Those in the non-compliant group were also more likely than the compliant group to anticipate leaving their home for non-essential reasons, such as for religious reasons, to meet with friends or family, because they were bored, or to exercise their right to freedom. These non-essential motivations “can lead to serious problems in trying to contain the spread, especially of the very dangerous delta variant,” Kleitman told PsyPost. “The important message here: the non-compliant individuals need to be helped/educated/nudged to realize that it is better to be bored, frustrated, and restricted for a short period of time than dead, and/or dragging this lockdown out for a long period of time.”

But the study — like all research — includes some limitations.

“I am concerned about the representativeness of the samples from the four countries included in our study,” Stankov told PsyPost. “Also, the data were collected at the early stages of the pandemic, and questions may be raised about the relevance of our findings for what has happened since. How has information about the spread of the pandemic been influential? For example, what were the effects of lockdowns? Did the emergence of new strains of the virus change the behavior of the non-compliers?

“I think it will be essential to determine if there is a ‘general tendency’ to be non-complier,” he continued. “In other words, do non-compliers in one area (pandemic) tend to be non-compliers in another area (engage in other rule-breaking behaviors?)”

“Research is urgently needed into the current non-compliance prevalence rates and psychological characteristics behind it,” Kleitman said. “We now live in a world in which prolonged compliance with some rules and regulations will be needed in addition to mass vaccination. We need to understand what drives people to endanger their own lives and the lives of people around them. We need to understand the role of COVID-19 fatigue on mental wellbeing and compliance more. We urgently need to understand the complex nature of decisions surrounding vaccination as well.”

“We have further research we are currently writing up from data collected during different pandemic stages in Australia with a focus on mental well-being, cognitive fitness and quality of life, as well as compliance,” she added. “Some exciting results are coming out from these studies. Watch this space.”

The study, “To comply or not comply? A latent profile analysis of behaviours and attitudes during the COVID-19 pandemic“, was authored by Sabina Kleitman, Dayna J. Fullerton, Lisa M. Zhang, Matthew D. Blanchard, Jihyun Lee, Lazar Stankov, and Valerie Thompson.

COVID-19 Update

Reporting seems to be making a bit of a comeback as only a few of the smaller states didn't put up numbers for yesterday. (seems to be settling into a pattern)

The "good news" continues to be that the vaccination rate is picking up (12% increase over last week), even though yesterday's 600K vaccinations was less than the previous day.

The bad news of course is the increase in cases and deaths, making it look pretty obvious that we are in fact in a new (5th?) wave.

And that pulls the calendar forward to mid-October in terms of when we can expect to top 700,000 Dead Americans.

Yesterday's numbers, such as they are:

Two new items in the press.

1. Janssen / J&J vaccine boosters
2. New and potentially very promising therapeutics & preventatives

WaPo:

A second shot of the Johnson & Johnson coronavirus vaccine generates a protective response beyond the response from a single dose, the company said in a news release Wednesday.

In two studies that have not gone through scientific peer review, submitted to the preprint site Medrxiv, people who had a second shot of the J&J vaccine produced lots of immune molecules known as antibodies, which bind to and neutralize an invading virus. Their antibody levels were ninefold higher than the levels in people four weeks after a single shot.

This interim data came from what are referred to as Phase 1/2a clinical trials, which are smaller than the Phase 3 trials designed to show the efficacy of a vaccine. Johnson & Johnson is also studying a two-dose vaccine in as many as 30,000 people in a Phase 3 trial, the results of which have not yet been released.

The booster dose “further increases antibody responses among study participants who had previously received our vaccine,” Mathai Mammen, head of research and development at Johnson & Johnson subsidiary Janssen, said in a statement. “We look forward to discussing with public health officials a potential strategy for our Johnson & Johnson covid-19 vaccine.” The second shot would come eight or more months after a first dose.

First - New approach, new drug - Jerusalem Post:

An innovative treatment for COVID-19 uses a molecular "super cork" to jam the entry point used by the SARS-CoV-2 virus to enter the cell, bypassing issues that could arise with other treatments which target a spike protein on the virus, Weizmann Institute of Science announced on Wednesday.

The treatment, described in a study published in Nature Microbiology, was developed by Weizmann researchers in collaboration with the Pasteur Institute in France and the National Institutes of Health (NIH) in the US.

Most treatments and vaccines for SARS-CoV-2 target the spike protein on the virus's outer envelope, but this protein could mutate in future variants, negatively effecting the efficacy of such treatments. The Weizmann researchers decided to take a different approach, targeting the angiotensin-converting enzyme 2 (ACE2) receptors through which the virus enters the cell. This approach is not susceptible to new variants.
ACE2, attached to the membrane of cells on the surface of the lungs and other tissues, is an enzyme which is important for regulating blood pressure, meaning that researchers couldn't just block the receptor and disrupt ACE2's function. In order to get around this issue, the team, led by Prof. Gideon Schreiber of Weizmann’s Biomolecular Sciences Department, began developing a small protein molecule that could bind to ACE2 better than the coronavirus, without affecting the enzyme's function.

The researchers first identified the virus's binding domain, where the spike protein physically binds to ACE2. Dr. Jiří Zahradník, a postdoctoral fellow in Schreiber's group, then performed several rounds of "evolution-in-a-test-tube" on a genetically engineered strain of baker's yeast, which is easily manipulated. This allowed Zahradník to rapidly scan millions of different mutations that accumulated in the course of the artificial evolution.

The scanning process also supplied strong evidence in favor of the hypothesis that the novel coronavirus becomes more contagious as it mutates to have an improved fit to ACE2. After the first round of selection, the lab-made variants with tighter binding capabilities to the enzyme mimicked the mutations present in the binding domains of the most contagious SARS-CoV-2 strains circulating naturally. The Delta variant, however, relies on a different trick to be more infectious by partially evading detection by the immune system.

Zahradník eventually isolated a small protein fragment with a binding capability 1,000 times stronger than that of the original binding domain from which it evolved, fitting the ACE2 enzyme exactly while conserving its function.
Schreiber's team collaborated with Prof. Yinon Rudich of Weizmann’s Earth and Planetary Sciences Department to develop a potential method to administer the molecule as a drug, creating an aerosol-based spray that would allow the molecule to be administered by inhalation to patients.

The treatment has so far been tested on hamsters infected with the coronavirus at the NIH. Preliminary results show that the treatment significantly reduces disease symptoms, with more preclinical studies are planned to take place at the NIH in the near future.

Second - Old drug, new application, Jerusalem Post again:

$15 drug gets COVID patients off oxygen support in under week – study
Fenofibrate could dramatically shorten the treatment time for severe COVID patients.

Fourteen out of 15 severe COVID-19 patients who were treated in an investigator-initiated interventional open-label clinical study of the drug TriCor (fenofibrate) didn’t require oxygen support within a week of treatment and were released from the hospital, according to the results of a new Hebrew University of Jerusalem study.

Fenofibrate is an FDA-approved oral medication. The results were published on Researchsquare.com and are currently under peer review.

Specifically, the team that was led by HU’s Prof. Yaakov Nahmias carried out the study at Israel’s Barzilai Medical Center in coordination with the hospital’s head of the Infectious Disease Unit, Prof. Shlomo Maayan, and with support from Abbott Laboratories.
The 15 treated patients all had pneumonia and required oxygen support. They were also older with multiple comorbidities, ranging from diabetes and obesity to high blood pressure.

In addition to standard of care, the patients were given 145 mg/day of fenofibrate for 10 days.

“The results were dramatic,” Nahmias told The Jerusalem Post. “Progressive inflammation markers, which are the hallmark of deteriorative COVID-19, dropped within 48 hours of treatment. Moreover, 14 of the 15 severe patients didn’t require oxygen support within a week of treatment.” The 15th patient was off oxygen within 10 days.
When looking at the data on other similar severe patients, less than 30% of them on average are removed from oxygen support within a week. In other words, fenofibrate could dramatically shorten the treatment time for severe COVID patients.

- more -

Do Us A Favor - Don't Help

A jillion years ago, when I worked in the service bays at Zupe's Standard, we posted a sign:

I guess these two ass hats needed some cred, or they wanted to score a few bi-partisan points - or whatever the fuck was going on in their little pea brains - so they decided to go show-boatin' around south Asia, making hard things harder for the people who're trying to keep a lid on it, and maybe not get everybody killed on their way out.

Fuckin' congress critters - and ex-military to boot.

WaPo: (pay wall)

Two members of Congress made an unauthorized whirlwind trip to Kabul early Tuesday, leaving less than 24 hours later on a flight used for evacuating U.S. citizens, allies and vulnerable Afghans.

The visit by Reps. Seth Moulton (D-Mass.) and Peter Meijer (R-Mich.) — which was not approved as part of the normal process for congressional fact-finding trips — served as a distraction for military and civilian staffers attempting to carry out frenzied rescue efforts, according to two people familiar with the trip who spoke on the condition of anonymity because they were not authorized to talk about the matter.

It is not clear how the lawmakers, both of whom served in Iraq before being elected to Congress, first entered Afghanistan. Moulton’s office did not confirm the trip until the plane evacuating the members of Congress left Afghanistan’s airspace. Meijer’s office did not respond to an email seeking comment.

The cloak-and-dagger trip infuriated some officials at the Pentagon and the State Department, where diplomats, military officers and civil servants are working around-the-clock shifts in Washington and at the Kabul airport to evacuate thousands of people from the country every day.

“It’s as moronic as it is selfish,” said a senior administration official who spoke on the condition of anonymity to provide a frank assessment of their trip. “They’re taking seats away from Americans and at-risk Afghans — while putting our diplomats and service members at greater risk — so they can have a moment in front of the cameras.”

In a joint statement from Moulton and Meijer emailed to The Washington Post by Moulton spokesman Tim Biba, the two pushed back on the notion that their trip caused a distraction.

“We have been on the other side of this argument while we were serving and it just isn’t accurate,” Moulton and Meijer said. “Trust us: the professionals on the ground are focused on the mission. Many thanked us for coming.”

From securing the airport to stamping visas to processing biometric data, U.S. officials in Kabul are racing to rush U.S. citizens and allies out of the country in a dire security environment. The threat of a terrorist attack on the airport by the Islamic State is “real” and “acute,” national security adviser Jake Sullivan warned Sunday.

U.S. officials in Afghanistan are also under pressure to meet President Biden’s stated Aug. 31 deadline to accommodate tens of thousands of Americans, Afghans and others seeking to leave. The Taliban has vowed to impose “consequences” if U.S. operations extend beyond that date, though the White House said Tuesday that contingency plans were being readied if U.S. troops needed to stay longer.

Officials expressed disgust at having to divert resources and accommodate sitting members of Congress while racing to get evacuees out of the country. “It’s one of the most irresponsible things I’ve heard a lawmaker do,” said one diplomat familiar with the matter who was not authorized to discuss it and spoke on the condition of anonymity. “It absolutely deserves admonishment.”

House Speaker Nancy Pelosi (D-Calif.) said in a letter sent to House members Tuesday afternoon, “I write to reiterate that the Departments of Defense and State have requested that Members not travel to Afghanistan and the region during this time of danger.”

The two lawmakers began their journey to Kabul via a commercial flight to the United Arab Emirates, paying for the tickets using their own funds, Biba said. From there they “figured out a way onto an empty military flight going into Kabul,” Biba said, without providing additional specifics. They landed at Hamid Karzai International Airport around 4 a.m. Washington time, according to a person familiar with their travel.

It was unclear how the pair had initially planned to get out of the country.

Biba said the lawmakers pledged to leave only on a plane with at least three empty seats — their way of ensuring that the flight they took out had extra capacity. When they boarded to return home about 2:30 a.m. Kabul time, he said, they sat in seats designated for crew members.

“They ensured the flight was not going to be full,” Biba said. “They also believe this method of travel, which will take them to an area where evacuees have been temporarily relocated, will provide them with additional information and increase their ability to provide oversight.”

In their statement, Moulton and Meijer cited their military experience when explaining why they chose to make the trip.

“America has a moral obligation to our citizens and loyal allies, and we wanted to make sure that obligation is being kept,” they said. “As members of Congress we have a duty to provide oversight on the executive branch. There is no place in the world right now where oversight matters more. We conducted this visit in secret to minimize the risk to the people on the ground.”

The two lawmakers said that they met with service members and State Department officials during their brief time at the airport and said that they believe Biden should extend the Aug. 31 deadline for evacuating Americans, allies and vulnerable Afghans. “After talking with commanders on the ground today and seeing the situation for ourselves, it is obvious that because we started the evacuation so late, no matter what we do, we won’t get everyone out on time, even by 9/11,” they said.

Congressional fact-finding trips are not typically authorized when the House is in session, as it is now. Both lawmakers arranged to vote by proxy this week, including for Tuesday’s House vote approving a $3.5 trillion budget.

Moulton is a member of the House Armed Services Committee and has pushed in recent years to expand and hasten special immigrant visas for Afghans who the Taliban could target. His last trip to Afghanistan was in 2016, and he requested a trip to the country after Biden’s April announcement that troops would be withdrawn, according to Biba.

He has been one of his party’s most outspoken critics of Biden’s handling of the situation in Afghanistan, privately raising the prospect of whether Biden should fire Sullivan, according to two Democrats with knowledge of the situation.

Publicly, he has also been sharply critical of the president’s response. “To say that today is anything short of a disaster would be dishonest,” Moulton said in a statement released Aug. 15, the day Kabul fell. “Worse, it was avoidable.”

Meijer enlisted in the Army Reserves after graduating from college and deployed to Iraq as a noncommissioned officer, according to a biography on his congressional website.

He was one of 10 Republicans who voted to impeach President Donald Trump earlier this year.

In an Aug. 16 interview with WUOM, a Michigan public radio station, Meijer was also critical of Biden’s handling of Afghanistan.

“The U.S. has been embarrassed at the way in which intelligence signals were ignored, in which assumptions that were made were found to be baseless, and the sad reality is that thousands of Afghans are going to pay for their lives for our mistakes and incompetence,” he said on the program.

Today's Tweet

There's really only a coupla ways this COVID shit's gonna go for ya.

How 'bout it, punk - do you feel lucky?

Left: Fitness coach Bill Phillips pre-covid

Right: Bill, 70 pounds lighter, barely surviving COVID-19 after deciding not to get the vaccine.

He’s getting discharged from St. Anthony Hospital on Wednesday with a new outlook on life and the shot. #9News pic.twitter.com/MfQKbf04Mq

— Kelly Reinke (@KellyReinkeTV) August 24, 2021

Today's Deep Thought

Fun Fact:

Jeff Bezos has more money than he has brain cells

Bojutsu Bear

At the Hiroshima Zoo - practice practice practice

On Our Differences

Just once, I'd like to see an article like,

"Extroverted? Here are some tips on how you can shut the fuck up and leave people alone."

hat tip = @tomandlorenzo

COVID-19 Update

If we can get about ⅔ of the presumed 90 million Vax-Reluctant Americans talked into getting their shots, we can hit that all-important 80% immunized level, and that could - could - mean we'll finally have the monster on the run.

Fauci says he thinks we can get there by Spring 2022. 

But of course, the problem is that the 80% will be a national average, which means there will be some remaining hotspots where people insist on behaving stupidly, which means the monster will continue to have opportunities to mutate and evolve, which could lengthen the timeframe, if not put us all the way back to square one, because the longer it takes to get to herd immunity, the more likely it is that the virus to come up with a variant that doesn't care about your little vaccination thingie.

So let's not make the mistake (again) of pretending to be on the verge of winning something.

We'll know more as we go, but stay humble, cuz we dunno jack shit right now.

WaPo:

Opinion: Pfizer’s vaccine is fully authorized. It’s time for excuses to end and mandates to start.

Bring on the vaccination mandates! If reason, patriotism and clear self-interest won’t convince reluctant Americans to protect themselves and their communities against covid-19, maybe the threat of not being able to work, go to school or lead anything like a normal life will do the trick.

Now that the Food and Drug Administration has given full approval to the Pfizer vaccine for use by those 16 and older, the last remotely plausible rationalization for refusing to get vaccinated is gone. The fact that the Pfizer, Moderna and Johnson & Johnson jabs have until now been administered under emergency use authorization was always a fairly flimsy reason to refuse them. Now, at least for the Pfizer vaccine, that fig leaf has been shredded. The people who were hiding behind it need to roll up their sleeves today.

I realize that not everyone will respond to Monday’s FDA decision in a reasonable way, unfortunately.

There are reportedly some adults in Mississippi — where only 37 percent of the population is fully vaccinated — who reject the vaccines because “they were developed so fast” or because “we don’t know what’s in them.” Neither of these rationalizations are true: The ingredients are clear, and the development processes that contributed to them are long-standing. And even worse, some of these refuseniks are following loony-bin advice and trying to ward off covid-19 with ivermectin, a veterinary drug used to rid livestock of worms and other parasites. I don’t know how federal or state officials can reach those who have gone so far down the anti-vaccine rabbit hole.

But their employers might bring them back to reality, or at least grudging compliance, with a simple message: Now that the Pfizer vaccination has full approval, with other options on the way, we have being vaccinated against covid-19 as a condition of employment. Get vaccinated by a certain date, and be able to prove it, or you can’t work here anymore.

Some companies — including The Post — have already made coronavirus vaccination mandatory as a condition of continued employment, with few case-by-case exemptions for those with legitimate medical or religious objections. It is understandable that some cautious employers might have felt they were on shaky ground requiring vaccines that were less than fully, finally approved for safety and effectiveness. But now, at least for the two-shot Pfizer vaccine, that reason to hesitate is gone.

Government leaders at all levels, from President Biden down to local school boards across the country, should require employees to be vaccinated — not “vaccinated or regularly tested,” as has become a popular way to impose a non-mandatory mandate, but “vaccinated, period.” All universities should join the University of Virginia, the University of Michigan and many others in requiring all students coming to campus this term to be vaccinated or face the prospect of being disenrolled.

The Biden administration should use all appropriate power at its disposal to keep ambitious Republican governors such as Ron DeSantis of Florida and Greg Abbott of Texas from burnishing their faux-populist credentials by trying to thwart needed mandates. For example, if governors withhold state funding from school districts that impose vaccine or mask mandates, why couldn’t the Education Department use federal funds to make those districts whole?

And all of this needs to happen immediately.

To say we are heading in the wrong direction on the coronavirus is a gross understatement. The delta variant looked like bad news when it arrived weeks ago, but now it looks calamitous. After a glorious early-summer lull when it looked as if the worst of covid-19 might be behind us, the nation is back to averaging around 140,000 new cases and 1,000 deaths each day, according to Johns Hopkins University.

We now know that vaccinated individuals can be infected and can pass the virus on to others. But that is not a reason to conclude that the vaccines don’t work, because we also know that they give tremendous protection against hospitalization and death. The victims who are filling intensive care units in Florida, Texas, Louisiana, Alabama, Mississippi and other states with relatively low vaccination rates are largely unvaccinated. Those who are dying are almost all unvaccinated.

With more than 90 million eligible Americans still unvaccinated, there will surely be much more suffering and death — a tragedy that we have more than enough vaccine doses to prevent.

I, for one, am eager to line up for the booster shot that the Centers for Disease Control and Prevention now recommends. If we end up having to get occasional boosters against covid-19 the way we do against tetanus, say, I don’t have a problem with that. I don’t see why anyone should.

We already require children to be vaccinated against a host of diseases before they can enroll in public schools. Let’s use that precedent to require coronavirus vaccination. Want to work and earn a paycheck? Get the shot.