We’re gonna keep it!: RI retains both House seats in 2020 Census

US House seat allocation by state, prior to 2020 Census results
(Source: Wikimedia Commons, public domain)

RI will keep both of its two seats in the US House of Representatives based upon the results of the 2020 Census released today. Defying expectations in the last two decennial censuses ( “We’re Gonna Lose It! RI likely to lose one of two US House seats after 2020”, by Michael Bilow, Apr 3, 2019), RI this time came within 19,127 people of losing its second seat, a relatively close call constituting 1.742% of its total 1,098,163 population. According to Election Data Services, the universally acknowledged private consulting firm with expertise on this issue, this was enough for RI to claim House seat number 428 out of the 435 available. RI would need another 770,793 people to acquire a third seat, a virtual impossibility.

That put RI into a surprisingly safe range, with the “bubble” allocating the last seat number 435 to Minnesota by a razor-thin 26 people out of 5,709,752 population, or 0.0004554%, and failing to allocate the hypothetical next seat number 436 to New York by 89 people out of 20,215,751 population, or 0.0004403%. Both Montana, gaining a second seat by 6,371 people out of 1,085,407 (0.5870%), and Ohio, losing its 16th seat by 11,462 people out of 11,808,848 (0.0971%), had allocations decided by fewer people than RI.

Most states, as always, retained the same number of House seats, but there was a net shift of seven seats. Texas gained 2 for a total of 38, Colorado gained 1 for 8, Florida gained 1 for 28, Montana gained 1 for 2, North Carolina gained 1 for 14, and Oregon gained 1 for 6. California lost 1 for now 52, Illinois lost 1 for 17, Michigan lost 1 to 13, New York lost 1 to 26, Ohio lost 1 to 15, Pennsylvania lost 1 to 17, and West Virginia lost 1 to 2.

Massachusetts safely retained its 9th seat by a margin of 204,963 people out of 7,033,469 (2.914%), the 399th seat allocated out of 435.

After RI qualified for the 428th House seat, seats 429 through 435 went to, in order, Alabama, North Carolina, Oregon, Colorado, California, Montana, and Minnesota, all effectively closer calls than RI.

While RI is the smallest state by land area, it is far from the smallest by population, with Wyoming (577,719), Vermont (643,503), Alaska (736,081), North Dakota (779,702), South Dakota (887,770), Delaware (990,837) and Montana (1,085,407) all having fewer people.

Because the Electoral College that chooses the president and vice-president is constitutionally allocated the number of electors from each state by adding Senate seats (always two) plus House seats, three electoral votes would have shifted from Biden to Trump based upon which states they carried in 2020.




J&J vaccine use to resume next week, CDC committee recommends

Janssen vaccine policy adopted by Advisory Committee on Immunization Practices of the US CDC, April 23, 2021

Use of the Janssen (also known as Johnson & Johnson) COVID-19 vaccine should resume next week after a “pause” begun on April 13. At the end of a six-hour meeting today, the Advisory Committee on Immunization Practices (ACIP) of the US Centers for Disease Control and Prevention (CDC) voted, 10-4-1, to recommend resumption of the use of the Janssen vaccine with no specific restriction by age or sex. By Tuesday, the CDC director is expected to decide whether to accept the recommendation, ordinarily a formality, and if so it will be published by the agency as formal guidance for public health systems throughout the nation.

The pause was in response to six cases of an unusual blood clotting condition accompanied by a drop in blood platelet count, all in women ages 18 to 49, an incidence below one-in-a-million out of nearly seven million doses. (See “Don’t panic! J&J vaccine pause and rare blood clots: One-in-a-million risk”, by Michael Bilow, Apr 14, 2021.) During the pause the total of identified cases increased to 15, of which three were fatal.

Asked for comment by Motif, the RI Department of Health (RIDOH) responded this evening, “RIDOH is aware that the Advisory Committee on Immunization Practices (ACIP) has made a recommendation about continued use of the Johnson & Johnson (Janssen) vaccine. We will review all of the information and data and will make a decision next week. RIDOH is storing roughly 5,000 doses of Johnson & Johnson vaccine, as we were instructed to do. We would not expect to get another shipment of Johnson & Johnson vaccine for another two to three weeks. We do not expect this to have any impact on Rhode Island’s COVID-19 vaccination efforts because the state’s weekly allocation of Pfizer and Moderna vaccines has been increasing.”

The ACIP quickly dispensed with other options on the table, including stopping use of the Janssen vaccine entirely. The ACIP concluded that restricting the vaccine to men would be unwise, both in terms of practical constraints on how to do that at points of dispensing (PODs) and because the tiny number of cases made it impossible to quantify the risk to men as opposed to women.

Eventually the ACIP reached a consensus that individuals should be given the choice whether to accept the Janssen vaccine, subject to informed consent about its known risk, in consultation with their healthcare provider, and therefore decided against restricting use to age 50 and older. In the end, members of the committee differed only as to whether their recommendation should explicitly mention that women younger than 50 may want to consider choosing an alternative vaccine, but there were concerns this would be misinterpreted and no such proviso was appended.

The ACIP made clear that there was an understanding patients who receive the Janssen vaccine in the future would be given explicit warning using language approved by the US Food and Drug Administration (FDA) listing the symptoms of the rare blood clot reaction, detailing what to watch for and what do.

Janssen vaccine warning by FDA to patients, exhibited at CDC ACIP meeting, Apr 23, 2021.
Janssen vaccine warning by FDA to clinicians, exhibited at CDC ACIP meeting, Apr 23, 2021.

Because the Janssen vaccine is the only one authorized by the FDA for use in the US that needs a single dose and can be stored in ordinary refrigerators rather than deep freezers, it is valuable for providers dispensing small numbers of doses, especially in rural areas, and for reaching populations for whom it would be difficult to arrange a second dose, such as the home-bound, the homeless, migrants, transients and the incarcerated. As a result, the CDC internally concluded that the loss of use of the Janssen vaccine could result in more deaths due to the virus than cases of the rare blood clotting reaction, as well as tens of times more intensive care unit (ICU) unit admissions and hundreds of times more hospitalizations.

The ACIP meeting included a half-hour of public comments, limited to three minutes each, chosen by lottery from applicants in advance. A significant number of the commenters appeared to be anti-vaccine conspiracy theorists, and the members of the ACPI made no response beyond the moderator thanking them for their comments.




Don’t panic! J&J vaccine pause and rare blood clots: One-in-a-million risk

The national pause isn’t cause for panic

In “pausing” use of the Janssen vaccine, one of only three COVID-19 vaccines currently authorized for use in the US, RI is following national guidance from the federal Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC), the RI Department of Health (DoH) said in an early morning statement on Tuesday, April 13. The Janssen vaccine is also known as the Johnson and Johnson vaccine after the parent company.

The national pause results from cases of an unusual combination of blood clots and decreased platelet counts seen in six women, age 18 to 48, with onset 6 to 13 days after vaccine injection, three senior federal government doctors explained in a telephone conference call with press later Tuesday morning. One of the women died, apparently because she was given the standard treatment for blood clots, an anticoagulant or blood thinner, which in this unusual situation is likely to make the patient worse, they said, and one major reason for the pause is to get information out to the healthcare community how to treat this unusual condition if encountered; that is, blood thinners such as heparin or even aspirin, should not be given.

Nicole Alexander-Scott, RI Department of Health director, at press briefing on Janssen vaccine pause, Apr 13, 2021.

In a Tuesday afternoon press briefing, Nicole Alexander-Scott, director of RI DoH, said that 31,500 doses of Janssen had been administered in the state prior to the pause, which RI COVID-19 czar Tom McCarthy said represented about 5% of the total. Alexander-Scott emphasized that the adverse reaction is extremely rare and that it had been detected quickly. “It’s important to be able to relay to Rhode Islanders that the robust monitoring system that we have talked about from the beginning is demonstrating its full effect here in our ability to do this with access to data among millions of individuals who have been vaccinated. Because, again, this is a result of six cases out of 6.85 million doses nationally that have been administered.”

Alexander-Scott distinguished the mild flu-like symptoms that often occur in the first few days after vaccination from the more severe symptoms of the rare blood clotting problem that can occur at least six days and up to three weeks after vaccination, with a median onset of nine days. “It’s a combination of the clotting, the low platelets, and the symptoms that patients would watch for: of severe headache, abdominal pain, leg pain or shortness of breath,” she said. “It’s also important to note that the symptoms that I’ve mentioned as a part of this presentation are very different from the mild flu-like symptoms that people experience within a few days after receiving vaccine… Usually the the mild flu-like symptoms that can occur are within that very short window, those few days right after vaccination.

“We would not want to have everyone who’s had Johnson and Johnson just rushing to their provider to be evaluated because of how rare this seems to be. However, we do want to ensure that both patients and providers are informed and equipped with the information of what to monitor for,” said Alexander-Scott, cautioning against public alarm especially among those recently receiving the Janssen vaccine.

Anyone already given the Janssen vaccine, Alexander-Scott said, should not panic. “If you were vaccinated with the Johnson and Johnson vaccine more than a month ago, that’s before March 13, your risk is extremely low for having any sort of complications or challenges… The time frame of six days to 13 days after vaccination makes it such that if you are significantly past that, more than a month ago, of getting vaccinated, your risk is extremely low. If you have been vaccinated with Johnson and Johnson vaccine in the last three weeks, your risk is also very low, given that overall data point, one for every million vaccinated.”

Both Alexander-Scott and McCarthy agreed that the pause would have little practical effect in RI. In response to a question from Motif whether even the temporary loss of the only authorized single-dose vaccine would make it harder to vaccinate people for whom getting them to the second dose might be challenging, especially those in lower socio-economic strata, in hard-hit communities, prisoners, home-bound individuals and the homeless, “We anticipate and certainly look forward to this pause being brief so that it has minimal impact on how valuable Johnson and Johnson is for being able to provide some of the protections in, across the board, the individuals that have had very allergic reactions to vaccines in the past and just want one [dose] or those who are home-bound or hospitalized, or otherwise. We are anticipating that, in the long term, we’ll be able to continue with the appropriate safety mechanisms in place, but, if that were to not be the case, we would be prepared to adjust as we needed to and as we were planning to prior to Johnson and Johnson being available, working with our partners and determining ways that would allow us to ensure that would help ensure that people are able to return to get their second dose,” Alexander-Scott said. “Whether it’s Johnson and Johnson, Moderna or Pfizer, we will make it work.”

Tom McCarthy, RI COVID-19 czar, at press briefing on Janssen vaccine pause, Apr 13, 2021.

McCarthy said, “As we’ve shared over the last few weeks, the amount of Johnson and Johnson vaccine coming into Rhode Island has decreased significantly. Two weeks ago we received 16,000 doses, last week that number decreased to about 6,000, and this week we’re only receiving 2,000 doses of Johnson and Johnson. Now those 2,000 doses are in addition to 1,400 of the Johnson and Johnson vaccine that we’ve carried over from last week for a total of 3,400 doses that are currently in the state.” Most of the patients scheduled for the Janssen vaccine would be switched to one of the others at the same time and place, McCarthy said, with the exception of about 300 appointments at three local pharmacies or clinics without the cold storage and other facilities needed for the other vaccines, naming the Rhode Island Free Clinic, Green Line Pharmacy, and White Cross Pharmacy; those patients were being contacted individually. He said he had no concern about waste of vaccine as a result of the pause: “No, none at all. The team has done a fantastic job. Our waste is well below even one-tenth of a percent at this point.”

Janet Woodcock, acting FDA commissioner, said on the morning call that she expected the pause to be brief. “The time frame will depend obviously, on what we learn in the next few days. However, we expect it to be a matter of days for this pause.”

Although only six individual cases have been reported in the US out of nearly 7 million doses administered of the Janssen vaccine, fewer than one per million, US regulators are recommending the national pause because the unusual adverse reaction essentially never occurs naturally and appears to be similar to an adverse reaction to the AstraZeneca-Oxford (AZ-O) vaccine observed in 222 cases out of 34 million dose administrations as of April 4, a rate of about one per 100,000 recipients; the AZ-O vaccine is not yet authorized for use in the US, but as of March 22 European regulators had conducted reviews of 86 of the cases, of which 18 were fatal.

“The combination here, that’s the real thing that is so notable here,” said Peter Marks, the director of the FDA Center for Biologics Evaluation and Research, on the call. “Those two things [blood clots and low platelet counts] can occur. It’s their occurrence together that makes a pattern, and that pattern is very, very similar to what was seen in Europe with another vaccine. So I think we have to take the time to make sure we understand this complication, and we address it properly.” He emphasized that it was critical to avoid the use of blood thinners in treating the unusual adverse reaction: “Together, the CDC and the FDA are reviewing data involving six reports of a rare type of blood clot called cerebral venous sinus thrombosis, or CVST, in combination with low levels of platelets in the blood, called thrombocytopenia… Treatment of this specific type of blood clot is different from typical treatments for other types of blood clots, which usually involve an anticoagulant called heparin. With cerebral venous sinus thrombosis, heparin may be dangerous and alternative treatments need to be given, preferably under the guidance of physicians experienced in the treatment of blood clots.”

In fact, before the emergence of what is coming to be called “vaccine-induced immune thrombotic thrombocytopenia” or “VITT,” almost all previously observed cases of the same unusual combination of blood clotting and low platelet count was caused by heparin, a rare autoimmune syndrome known as “heparin-induced thrombocytopenia” or “HIT.”

Alexander-Scott was even more emphatic about the need for the pause to allow reaching out to patient-facing health care providers: “One of the elements that is different about the thrombosis that has been identified in these six cases is, clinically, we would usually treat thrombosis with the medication referred to as heparin. Being able to pause with just the six that we have to get the message out to all providers that this presentation is leading to not using heparin as a treatment option. Being able to get that message to providers has been a critical element of this and warranted the pause so that we could make that clear, because that is a definitive shift from how we would usually treat such a condition identified.”

None of the worldwide cases occurred in anyone age 50 or older, and many countries have resumed use of the AZ-O vaccine with an age floor between 50 and 60 depending upon the country, based upon an assessment of risks versus benefits, taking into consideration that older people are more vulnerable to hospitalization and death from COVID-19 as well as apparently less susceptible to the particular adverse reaction.

The CDC will convene its Advisory Committee on Immunization Practices (ACIP), an independent panel of outside experts, on Wednesday, April 14, said Anne Schuchat, principal deputy director of the CDC, on the morning call, and they could choose to recommend age or other restrictions for the Janssen vaccine as other countries have done for the AZ-O vaccine. The meeting will be broadcast live on the web – ustream.tv/channel/VWBXKBR8af4 – 1:30-4:30pm ET. [UPDATE: After running long by an hour, at 5:30pm the ACIP reached a consensus that there was insufficient data to vote on any recommendation, and so decided to allow the pause to continue until they could schedule another meeting to be held in 7 to 10 days, hoping that clearer quantitative evidence of risks would develop.]

“We are committed to an expeditious review of the available information and to an aggressive outreach to clinicians so that they know how to diagnose, treat and report. One of the things that the ACIP deliberation will do is review the data on the cases and the context of risks, benefits and possible subsets of the population that may be in a different category. So I think our intent is, in the days ahead, to provide an update regularly and that the pause provides us time for deliberation and assuring appropriate diagnosis and treatment,” she said.

The Janssen and AZ-O vaccines use similar delivery vectors to produce immune response in the body, although using different carrier adenoviruses. The Pfizer-BioNTech and Moderna vaccines, the only remaining COVID-19 vaccines currently authorized for use in the US, both use a messenger RNA (mRNA) delivery vector and not an adenovirus. Marks said that the adverse reaction was strongly likely to be induced by vaccine rather than coincidence, given its near-zero occurrence naturally. “It’s plainly obvious to us already that what we’re seeing with the Janssen vaccines looks very similar to what was being seen with the AstraZeneca vaccines. The AstraZeneca is a chimpanzee adenoviral-vectored vaccine. The Janssen is a human adenoviral-vectored vaccine. So I think we can’t make some broad statement yet. But obviously, they are from the same general class of viral vectors.”

There are hypotheses about the cause of the unusual adverse reaction but little is known with confidence. Marks said, “We don’t have a definitive cause, but the probable cause that we believe may be involved here that we can speculate is a similar mechanism that may be going on with the other adenoviral-vectored vaccine [AZ-O] is that this is an immune response that occurs very, very rarely after some people receive the vaccine, and that immune response leads to activation of the platelets and these extremely rare blood clots.” Woodcock agreed, “The person being vaccinated makes an immune response potentially that actually involves their own platelets or other parts of the coagulation system, and can cause this problem. And that’s the sort of leading theory or hypothesis about what’s going on here.”

“Just to remind clinicians and the public that 121 million people have been vaccinated with at least one dose of one of the three vaccines, and the vast majority of the doses were of the other two products, the Pfizer and Moderna products. With our intensive safety monitoring, we have not detected this type of syndrome with the low platelets among the other vaccines” authorized in the US, Schuchat said.

Despite all of the US cases so far occurring in women of child-bearing age, Marks said, the vaccine-induced adverse reaction is unlikely to be associated with that, because the type of blood clots sometimes seen as side effects from oral contraceptives are substantially different in both loci and absence of correlation with low platelet count. “It’s not clear that there’s any association with the oral contraceptive pill, birth control, in the individuals who had these blood clots,” Marks said, pointing out that generalizing from only six cases was impossible. “Additionally, I think it’s too early to make any speculation on how many cases will come out.”

Schuchat agreed with Marks, “We’re working right now from a small number, from the six events that have been reported here in the US, and so while we’re seeing them in women under 50, I think we are going to need to take some time and have our Advisory Committee on Immunization Practices take additional time to review. My understanding is that there weren’t predisposing conditions for these events in at least some of those individuals.” Asked to clarify, she said, “What I tried to say is there were not [predisposing conditions] in all of them. So not to say that there may have been in some, but I think my main point is that review of six is difficult to make generalizations from. We’re going to have our expert committee take a careful look, and we’re, of course, trying to assure that providers will report suspect episodes so that they can be further investigated, because the numbers are quite small, small enough that it’s hard to generalize, but large enough that we wanted to take the action with the pause.”

In response to a question from Motif whether the Janssen pause could increase vaccine hesitancy, even if fears were irrational and unfounded given the one-in-a-million risk, and what effect that might have in RI on his previously stated goal of reaching 70% of everybody eligible to be vaccinated by May 15 and 70% of the entire population by June 5, especially because in order to reach 70% of the entire population of the state we have to reach about 84-85% vaccine take-up in those eligible to be vaccinated, McCarthy said, “Absolutely, and that’s something that’s top of mind for me. It’s ambitious but it’s absolutely achievable, and why I am confident in it is that among those groups of Rhode Islanders that are currently eligible, we have seen uptake rates around that mid-80th percentile. So I think it’s absolutely doable and achievable, but the important thing is we all have a part to play, whether it be getting vaccinated, having conversations with your loved ones, your neighbors, folks in the community, to make sure that people are educated, they have the facts, I find that there’s a tremendous amount. It’s something we’ve seen throughout the pandemic, just based on how dynamic it is and how quickly things change. There is a lot of information out there, making sure we get the right information, the facts to build that confidence, is going to be important. Again, before even this consideration, we knew that it was going to have to take a deliberate intentional community effort to achieve those goals. I don’t think that has changed. I do think though this gives us an opportunity to focus some of our conversations even more about some of the specific safety and impacts of the different vaccines.”




What’s Cooking?: Vaccination goals in RI are a recipe for failure

At the weekly COVID-19 press conference on Thursday, April 8, Gov. Daniel McKee and RI Department of Health (DoH) Director Nicole Alexander-Scott made clear that economic reopening plans were conditioned upon a goal of vaccinating 70% of everyone in the state to approach herd immunity. While a laudable aspirational goal, it is in my opinion unrealistic and unlikely. The RI vaccination effort is doing well by any measure, consistently in the top 10 among the states, but it may soon hit a wall.

“The two key dates that we’re watching right now are May 15 and June 5,” Alexander-Scott said. “By May 15, we expect that 70% of Rhode Islanders 16 and older will have had at least one dose of vaccine and have had two weeks pass since that point so that they can experience the partial vaccination coverage that’s important. Getting 70% of our population to that mark of being two weeks after their first dose is a milestone for us. And that’s that May 15 target, being able to reach that allows us to have the confidence as we continue to make the changes and expansion in reopening our economy.”

As of April 8 according to the US Centers for Disease Control and Prevention (CDC), 399,063 people in RI received at least one COVID-19 vaccine dose out of a total population of 1,059,361, or 37.7%.

“And by June 5, we expect that 70% of all Rhode Islanders who could get a dose – out of all Rhode Islanders: children, adults, and all – that, it will be two weeks after all of those individuals have had at least one dose,” Alexander-Scott continued. “Let’s work with everyone around you to get us to that May 15 point so that anyone who is eligible, 16 and older, is able to have at least one vaccine administered to them and receive the protection from that two weeks from there. That’s our May 15 date. And by June 5, it’s out of all Rhode Islanders, it’s 70% of all Rhode Islanders that we’re aiming for. With those dates in mind, and everyone centered on getting as many people around you that you know to get vaccinated, that’s the confidence we can have to move forward in reopening our economy incrementally, safely and effectively.”

At present, no vaccine is authorized for administration to anyone younger than age 16, and only one (Pfizer) of the three vaccines authorized by the US Food and Drug Administration (FDA) for emergency use in the US can be administered to anyone younger than age 18. There are currently no applications in the FDA pipeline for expansion of age criteria, although Pfizer is known to have compiled trial data for age 12 to 15 and is expected to file for authorization within the next few weeks. The most optimistic scenario is for an emergency use authorization for age 12 and older before school reopening in September, but authorization for younger children is unlikely before 2022. Practical as well as ethical considerations limit the speed at which clinical trials can be conducted and reviewed.

As of the most recent US Census data from 2019, there are 179,661 people younger than age 16 in RI out of a total population of 1,059,361, leaving 879,700 age 16 or older eligible to be vaccinated. To vaccinate 70% of the entire population of 1,059,361, it would be necessary to vaccinate 741,553 people, which is 84.3% of those age 16 and older eligible to be vaccinated.

Vaccine hesitancy reasons
(Source: https://surgoventures.org/newsroom-all/analysis-us-general-population-survey-on-covid-19-vaccine-uptake)

Vaccine administration has for months been limited by supply far short of demand, but everyone knows that will reverse soon. I asked RI COVID-19 planning czar Tom McCarthy on March 30 when he expected that to happen, and he predicted the last week of June or the first week of July. Nationally, however, leading non-profit think tank Surgo Ventures predicts vaccine demand will plateau by the end of April, forcing a shift in strategy by public health agencies to convince people to want to be vaccinated rather than struggle to deliver enough physical doses.

Surgo previously warned in February that vaccine hesitancy would present a significant obstacle with only 40% eager to be vaccinated, 17% unwilling to be vaccinated under any circumstances, and 43% “persuadable.” Surgo divided this last group into three sub-groups labeled the “Watchful” 20% of people waiting to see what others they knew did, the “Cost-Anxious” 14% who worried about access issues such as appointment scheduling, transportation, or lost time at work, and the “System Distrusters” 9% consisting of those, often people of color, concerned they would not be treated fairly by the healthcare system. Hesitancy can and likely will decline over time, but how much and how soon are hard to forecast. Of the 17% not persuadable, 84% falsely believe that COVID-19 is exploited by government to control people, 65% falsely believe COVID-19 was caused by a ring of people who secretly manipulate world events, and 36% falsely believe microchips are implanted with the COVID-19 vaccine.

RI COVID-19 data tracker, as of Apr 9, 2021
(Source: https://ri-department-of-health-covid-19-data-rihealth.hub.arcgis.com/)

What disturbed me most about the April 8 press conference was that everyone except Alexander-Scott, including McCarthy, McKee, and Commerce Secretary Stefan Pryor, talked about the goal of 70% by June 5 as if they not only expect it to happen, but are depending upon it to justify a substantial reopening of the economy, allowing large gatherings for proms, commencements, weddings, concerts and festivals. By contrast, Alexander-Scott, a highly competent and respected medical professional and scientist, chose her words carefully, making no promises amidst all of the happy talk from her state government colleagues. She opened her remarks by conceding the data were not good: RI has seen increasing cases for weeks, with hospitalizations increasing as a lagging indicator following cases, and community spread in municipalities not previously hard hit, naming Bristol, Middletown and West Warwick, attributing the increasing incidence in part to the inference that more transmissible mutated variants of the virus were infecting younger people under age 40 who have not yet been vaccinated – precisely the vulnerable demographic most likely to attend those large events. Reading between the lines, Alexander-Scott may be laying down markers for where the numbers need to be with vaccination in order to allow reopening, preparing to test those markers against actual results. The problem with this approach is it will be hard to backpedal from promised reopening, with everything from weddings to parades and major music festivals already given the go-ahead signal.

To emphasize, the June 5 goal of vaccinating 70% of the total population of the state, which mathematically implies vaccinating 84.3% of those eligible to be vaccinated, will be effectively impossible: there simply will not be enough people willing to be vaccinated. Remember, we’re now only at 37.7%, a long way from 70%. If meeting that goal is prerequisite for reopening the economy, it is a recipe for failure.




Picking on Poor People: Outlawing minibikes and ATVs

Providence and Cranston seem to regard themselves as cities under siege from two-wheeled minibikes and four-wheeled all-terrain vehicles (ATVs) on their streets.

“The use of dirt bikes and ATVs on our streets is illegal and is a serious danger,” said Providence Mayor Jorge O. Elorza in a statement on the city’s official website.

But why are they illegal? And are they really dangerous?

In terms of safety, minibikes are not inherently more dangerous than motorcycles if operated with proper equipment, particularly a helmet. If anything, their smaller engine sizes likely make them safer, all other factors being equal. My inference is that they are illegal only because they are illegal: RI General Laws §31-3.2-1(8) defines the prohibited class “’Recreational vehicle’ means a motor vehicle including minibikes designed to travel over unimproved terrain and which has been determined by the division of motor vehicles as unsuitable for operation on the public way and not eligible for registration for such use.” But that clause goes on to allow “golf mobiles or golf carts, riding lawn mowers, or garden tractors, which are not registered as farm vehicles,” before again explicitly prohibiting “any three (3) wheel driven vehicle and any other four (4) wheel driven vehicle, regardless of type or design, including all classes of all-terrain vehicles.”

Aside from the horrifically bad drafting – you can’t do this, except you can do this, but you can’t do that – the distinguishing criterion seems to be the demographics of the users. If you can afford a car or conventional motorcycle, you’re legal; if you can’t afford it, you’re not.

Of course, to obtain a motorcycle license, a RI resident has to pay $195 and take a 13-hour course consisting of 3 hours of lectures and two 5-hour riding sessions. The state supplies the motorcycles, but students must supply their own protective gear, including certified helmet and gloves. I have a motorcycle license: I’ll be the first to admit the course is an excellent value and the gear is necessary, but it’s not cheap.

Chicago Scooter “Go” 50cc
(Courtesy: The Scooter Palace)

If you’re looking for relatively inexpensive legal transportation there is the motor scooter, and for engine size under 50cc only an ordinary car driving license is required but not a motorcycle license. Phillip Deducca, owner of the Scooter Palace in Tiverton, told Motif, “That’s the out-the-door price, as they say: All set up, ready to go, with the documentation and all the paperwork you need to register it. They start at $1,400 all the way up to $3,000, depending on the model.” Most of his customers are buying a scooter for fun, but “we have a growing number of people that are using them for transportation, because of the fact that autos are really expensive. Add the insurance and costs – fuel mileage, and parking – so you’ve got a lot of people that are in that first job kind of situation: they don’t have much money but they need a vehicle to get back and forth to work. It’s a good alternative for people to get started.” Scooters get up to 90 miles per gallon fuel economy, he said. If you lack transportation to get to his shop, he said he’ll deliver in Tiverton for free and anywhere else in RI for $40.

Deducca sympathizes with the urban riders of minibikes and ATVs because, he said, the state is failing to meet its obligations to them. “Each state is supposed to take part of the tax money to provide places because, when you buy fuel, there’s tax on there to maintain roads. When you’re buying fuel for your off-road vehicle, they’re supposed to be using that money to maintain a trail system.”

Tom Rosa, administrative officer with RI Parks and Recreation, confirmed to Motif that no such facilities exist in the state: “The only legal place to operate vehicles like that is on private property with the land owner’s permission. There is no public property that allows that.”

“Straight Outta Little Compton: Rollin’ in my tweed, wearin’ knickers with attitude.” (Photo: Michael Bilow)

If you’re handy with tools, kits are available for as little as $130 that put a gasoline motor onto an ordinary pedal bicycle. Is it street-legal? I couldn’t get that question answered by the RI DMV, but I know a number of people who have built these and none of them get hassled by the police for riding what looks like an unremarkable bicycle. The pedals still work, and in fact are needed to start the motor. RI General Laws §31-3-2.2(a) requires that “[e]very motorcycle, motorized bicycle, and motorized tricycle” must be registered, but it would be a challenge trying to do that: Your homebrew moped made from a pedal bicycle will have no title, no paperwork and no certifications.

But this same legal clause provides, “An electric personal assistive mobility device (‘EPAMD’) and electric motorized bicycles shall not be required to register under this chapter; provided, however, that an EPAMD and/or electric motorized bicycles shall not be operated in this state by a person under the age of sixteen (16) years.” Setting aside the EPAMD, which is essentially an electric wheelchair or Segway, why exempt electric motorized bicycles but not gasoline motorized bicycles? You can buy an electric motor kit for about the same price as a gasoline motor kit, although batteries are not included.

If you need inexpensive transportation, the state will let you have a golf cart but not an ATV, a motorcycle but not a minibike, and an electric moped but (maybe) not a gas moped. Is the difference in the vehicles, or is it in the riders?

Jeremy Costa, an activist with BikeLife Lives Matter, wrote in our pages on December 2, 2020, “In 2017, the Providence town council wrote an ordinance that allows Providence police to confiscate and destroy illegally ridden ATVs and dirt bikes. This October, the City of Providence, in a show of enforcement, publicly demolished 33 dirt bikes and ATVs. One week later, during a ride-out on October 18, 24-year-old Jhamal Gonsalves was involved in a vehicular incident with the Providence Police that put him in a coma where he remains today.”

RI Attorney General Peter Neronha announced on January 7, 2021, that none of the police officers involved in the Jhamal Gonsalves crash would face charges. Several police officers were disciplined: Kyle Andres, who drove the police car that hit the stop sign that caused Gonsalves serious head injury, was suspended for two days; three officers will be counseled for not activating their body cameras; a number of officers will be retrained after improperly administering naloxone on the mistaken assumption that Gonsalves was under the influence of opiods.

But the municipal campaign against small, affordable motorized vehicles continues.




Bail Bonds: Criminal Injustice for the Poor

Bail bonds require posting money by or on behalf of someone charged with a crime in exchange for their release before trial. In theory, the money backs a promise by the accused to appear in court as scheduled and to be of good behavior. If the accused violates the terms of release, by fleeing the jurisdiction or committing another crime, they can be imprisoned and required to forfeit the bond.

Rep. Anastasia Williams
(Source: RI General Assembly)

In RI, State Rep. Anastasia Williams (D-9, Providence) is the lead sponsor of H.5291 that would prohibit the imposition of bond for misdemeanor defendants except in cases of domestic violence or if the court makes a finding that there is a likely risk of flight or obstruction of justice by, for example, threatening witnesses. In an interview with Motif, Williams said, “The intent of the bill is two-fold: one, not to financially burden an individual to come up with money that they don’t have; and, two, remove the burden off the taxpayers when, in fact, this individual must remain in jail because they can’t put up the bail for the minor infraction that he or she is there for.”

Even short stints in jail of a few days can be devastating to poor people, Williams said. “You have these individuals who, for whatever reason, end up committing a crime, it’s their first one. They’re working at a minimum wage job, it’s the only means for daily survival. They don’t have a bank account with any type of reserve, and they’re held in the prison for the weekend: They end up losing their job, they end up not having the money to pay bail, then when they get their court hearing the stuff is dismissed. There goes, that person lost everything.”

In most cases, RI requires only a “surety” bond, posting 10% of the bond amount. (Where the charge involves a debt arising from a criminal sentence, such as failing to pay fines or restitution, a “cash” bond of 100% of the debt can be imposed.) Some people have enough money to post the surety amount from their own cash, and others may have non-cash assets, such as real estate, that they can use for this purpose. Some people can borrow money or assets from parents, relatives or friends. People who are short of cash but have acceptable credit can arrange to borrow the money from a bail bond agent and pay back the loan over time with interest. (For-profit bail bond agency is illegal in some states, but allowed in RI.)

People with access to none of these resources – neither cash, nor assets, nor credit – cannot post bond and must instead remain in jail awaiting trial. Because of this, the bail bond system has become controversial because of its effect on poor people, who are disproportionately racial and ethnic minorities, and the potentially life-destroying consequences of being caught up in it.

“How many people do they get on a daily basis, or weekly or monthly, go to jail? You don’t see a whole bunch of white folks,” Williams said.

At the request of Motif, J.R. Ventura, chief of information and public relations officer at the RI Department of Corrections, provided a snapshot of prisoners awaiting trial counted by race. (Prisons keep track of race in order to protect the prisoners from inter-racial violence.) As of March 15, 2021, those awaiting trial were 37.50% white, 29.77% Black, 26.97% Hispanic, 2.47% other, 1.81% Amer-Indian, and 1.48% Asian. By contrast, the population of RI is 71.4% white (non-Hispanic), 16.3% Hispanic, 8.5% Black, 3.7% Asian, and 1.1% Amer-Indian.

RI ACI prisoners awaiting trial by race, as of Mar 15, 2021
(Source: RI Dept of Corrections; Chart: Michael Bilow)

Everyone charged with a crime is presumed innocent until proven guilty, and the alternative to posting bond is known as “personal recognizance” where no money need be posted in advance, but violating the terms of pre-trial release can result in being jailed and required to forfeit the amount specified. For example, a defendant released subject to $10,000 bond must post $1,000 to stay out of jail and forfeit $10,000 if they violate terms of release, but a defendant released subject to $10,000 personal recognizance must post nothing to stay out of jail but forfeit $10,000 if they violate terms of release.

At a February 9, 2021, House Judiciary committee hearing on Williams’ H.5291 bill, the Office of the Rhode Island Public Defender offered testimony in support; by law, the office represents indigent criminal defendants who are, because of their indigence, most likely to have trouble coming up with money to post bond.

In an interview with Motif, Assistant Pubic Defender Michael DiLauro said that the office had filed Access to Public Records Act (APRA) requests to determine how long defendants stay in jail while trying to post bond. “How many people get detained because they can’t post bail? So the easy conclusion to draw was that a very, very, very high percentage bordering on, bumping up against, 100% of people charged only with misdemeanors post bail within 14 days of their arraignment. The troubling thing is the amount of time that it took them to make bail. Everybody’s gonna get out. The point, I think then, is why are we detaining them in the first place? That to me is the issue here in Rhode Island. When you look at those numbers, you can see that a pretty significant number get held one day, then a few get out; two days, a few more get out; three days, a few more get out; and probably by day five or six, 90-plus percent of the people are out of jail. Which again begs the question: Why are they being detained in the first place?”

DiLauro echoed Williams’ concern about these short stays in jail of only a few days having disastrous consequences. “Because they’re all going to get out anyway, what’s the point? The damage is done. We know from the research that the damage that is done is pretty, pretty, pretty, pretty severe: housing, employment, all those types of things. That was our proposal to try to get our system to work better, to strengthen the presumption of personal recognizance that’s already a part of Rhode Island law.”

At the same hearing, the RI American Civil Liberties Union (ACLU) entered a statement by Steven Brown, executive director: “For individuals who are lower income, the burden of cash bail is often something that they are unable to overcome, even when the amount may seem relatively small. Without an immediate cash flow, or without the use of predatory for-profit bail businesses, they are oftentimes forced to stay in jail until their case is heard, while wealthier individuals who can post bail are permitted to go home while awaiting their hearings. The effects can be devastating. Even a stay of just a few days in jail can lead to a person’s loss of their job, missed payments and other life disruptions that can be very hard to undo, no matter the outcome of the criminal charges. It can force a person to plead to a crime that they are not guilty of. It can make it harder for them to prepare a defense. The list of direct and collateral consequences goes on and on.”

Asked by Motif for their position on the bill, even the office of Attorney General Peter Neronha, responsible for nearly all criminal prosecutions in the state, was broadly supportive: “An individual’s financial status should not prevent him or her from qualifying for pre-trial release when he or she would otherwise meet the legal criteria for release. We need a holistic approach to cash bail reform that accounts for the views of all stakeholders in the criminal justice system, as well as evidence and data from other states that have enacted such reforms.”

As of this writing, H.5291 remains in committee “held for further study.” If reported out favorably, it would be voted by the full House, and if passed begin a similar journey at the Senate Judiciary Committee.

On the one hand, everybody acknowledges that some criminal defendants are flight risks or too dangerous to be released pending trial, but there is an emerging national consensus that distinguishing who should and should not be released pre-trial has no rational relationship to how much money they have. Bail bonds have a long history dating back to English Common Law in the American Colonial Era, and the Bill of Rights in the US Constitution provides in the Eighth Amendment that “excessive bail should not be imposed,” echoing a similar provision from the earlier English Bill of Rights of 1689.

California is one state that tried bail reform, with the legislature eliminating money bonds entirely in 2019, but this was overturned by referendum in 2020; on March 25, 2021, the state Supreme Court ruled that money bonds are unconstitutional. “The common practice of conditioning freedom solely on whether an arrestee can afford bail is unconstitutional,” the court said in a unanimous opinion. “Other conditions of release – such as electronic monitoring, regular check-ins with a pretrial case manager, community housing or shelter, and drug and alcohol treatment – can in many cases protect public and victim safety as well as assure the arrestee’s appearance at trial.”

A highly publicized case in New York has been the inspiration for a national bail reform movement, that of Kalief Browder. Placed on probation for joyriding at age 16 but charged as an adult under New York law, when Browder was arrested 10 days before his 17th birthday and accused of stealing a backpack two weeks earlier, he was denied bail and held awaiting trial in prison at Riker’s Island. He was repeatedly offered plea bargains that would have gotten him out of prison immediately, but he insisted that he was innocent and refused to plead guilty. Because of repeated delays at the overworked and backlogged prosecutor’s office, he was finally freed four days after his 20th birthday: The charges were dropped because the complainant had gone back to Mexico and could not be found to testify. Of the more than three years Browder spent in prison, two were spent in solitary confinement because of fights with other inmates, guards were recorded on video beating him while he was handcuffed, and he tried several times to kill himself. The long incarceration, especially in solitary confinement, left Browder with serious psychological problems, including depression and paranoia, and he was in and out of mental hospitals. Finally, a few days after his 22nd birthday, he committed suicide by hanging himself outside his mother’s apartment. His family settled with the City of New York for $3.3 million.




Their Bad: Thousands notified in error of end of RI Unemployment Insurance eligibility

Motif previously reported (“Unemployment insurance runs out for hundreds in RI”, by Michael Bilow, Mar 1, 2021) that 213 beneficiaries had exhausted their available Pandemic Unemployment Assistance (PUA), but further information emerged on Wednesday, March 3, from the RI Department of Labor and Training (DLT), which administers the program, that many more were notified in error, setting off near panic for thousands.

The count of 213 was correct, DLT spokesman Margaux Fontaine confirmed to Motif, but many more apparently received a notice after completing their weekly re-certification on the DLT website that read, “Your certification has been successfully recorded.. However, you have exhausted your benefits balance. If you are still in need of assistance, you will need to file a new claim to have your eligibility determined.”

Screen capture from RI DLT web site of benefits exhaustion notice, often sent in error.

Adding to the panic, the DLT telephone help line, the only way for claimants to obtain information about their unemployment insurance status, has been overwhelmed to the point of inaccessibility, hanging up on callers and telling them to call back later.

Late on Tuesday, March 2, DLT sent an e-mail message explicitly countermanding their benefits exhaustion notice on the web (emphasis added): “This [e-mail] notice is to inform you that you have collected 46 weeks out of the 50 weeks available through Pandemic Unemployment Assistance (PUA). This means that you currently have four (4) weeks of benefits left. Note: If you received a message on UI Online that said you exhausted your benefits, you can disregard it. For the next four weeks, you may continue certifying as usual on UI Online or over the phone beginning Sunday, March 7, 2021. You will receive this week’s payment by Wednesday. The U.S. Congress is currently considering a bill that would extend PUA benefits. If that bill passes, DLT will work to implement the additional weeks as quickly as possible. There is no need to contact the UI Call Center.”

“People should only disregard the [web] message if they specifically received that e-mail, which confirms that they are at 46 weeks,” Fontaine told Motif in response to an inquiry. “We sent the email out to all 2,740 people who were at 46 weeks as a precaution.”

Asked to explain what happened, Fontaine told Motif, “Claimants are notified a week ahead of any benefits exhausting when they certify. We will also keep claimants informed of what happens with the bill in Congress (depending on when/if the bill passes, this may [be] an email or a message on our website and social media). Rhode Island has consistently been one of the fastest states at implementing federal programming changes so we anticipate being able to add additional weeks quickly, should they pass. We are currently working on creating an online system that will give claimants a lot more insight into their claims. This is set to launch later this spring.”

PUA is a new program created to cope with the COVID-19 pandemic by the federal CARES Act that became law on March 27, 2020, extending unemployment insurance to those not previously eligible, primarily formerly self-employed, contract and gig workers. It is distinct from the regular unemployment insurance program, which was also separately extended by Pandemic Emergency Unemployment Compensation (PEUC) that provided an additional 13 weeks for those who have otherwise exhausted unemployment benefits. Both are distinct from Federal Pandemic Unemployment Compensation (FPUC) that boosted weekly benefits by $600 until July 2020.




Unemployment insurance runs out for hundreds in RI

UPDATE: Important information in follow-up “Their Bad: Thousands notified in error of end of RI Unemployment Insurance eligibility”, by Michael Bilow, Mar 3, 2021.

As the latest pandemic relief bill crawls through Congress with a provision that would extend the program, Pandemic Unemployment Assistance (PUA) benefits have ended for many individual recipients. According to spokeswoman Margaux Fontaine of the RI Department of Labor and Training (DLT) that administers unemployment insurance, “To date, 213 people have completely exhausted all 50 weeks of PUA.” This has been widely reported to have occurred without warning as recipients received notice only as they submitted their required weekly re-certifications of eligibility that their benefit payments this week (attributable to the prior week) would be their last.

Acting Director Matt Weldon of DLT told Motif, “Pandemic Unemployment Assistance (PUA) is a federal program that currently provides each claimant with up to 50 weeks of benefits. As we approach the one-year mark of the COVID shutdowns, unfortunately this means some PUA claimants are beginning to exhaust their benefits. We hope Congress will act soon to extend this essential program. If additional weeks become available to claimants, the Department will notify them as soon as possible.” The RI DLT Twitter feed echoed Weldon’s comments.

Tweet from RI DLT about PUA benefit exhaustion.
(Source: https://twitter.com/RI_DLT/status/1366375520213086212)

Weldon also cited a previously issued statement that warned of the problem in general terms after the most recent pandemic relief bill was signed into law on Dec 27, 2020 (emphasis added): “Pandemic Unemployment Assistance (PUA) claimants were previously eligible for up to 39 weeks of benefits. Now, they will be eligible for up to 50 weeks of benefits. The program will be extended through 4/10/21. Please note that you may exhaust your individual benefits before that date, depending on how many weeks you have left. No new applications will be accepted after 3/13/21.”

RI DLT statement on exhaustion of PUA benefits (highlight added).
(Source: https://dlt.ri.gov/emergencyui/covidupdates122720.pdf)

PUA is a new program created to cope with the COVID-19 pandemic by the federal CARES Act that became law on March 27, 2020, extending unemployment insurance to those not previously eligible, primarily formerly self-employed, contract, and gig workers. It is distinct from the regular unemployment insurance program, which was also separately extended by Pandemic Emergency Unemployment Compensation (PEUC) that provided an additional thirteen weeks for those who have otherwise exhausted unemployment benefits. Both are distinct from Federal Pandemic Unemployment Compensation (FPUC) that boosted weekly benefits by $600 until July 2020.

In response to a question from Motif, “Can someone who has exhausted PUA switch to PUEC?” Fontaine replied, “Unfortunately, they cannot. Per federal guidelines, PEUC is only available to regular UI claimants, not PUA claimants.” Fontaine said that the pending bill could address the problem: “At present, Congress is considering a bill that would extend PUA from 50 weeks to 74 weeks. If that passes and is signed into law, we will work as quickly as possible to implement those additional weeks.”

Tweet reply thread from Bob Giusti to RI DLT about exhaustion of PUA benefits.
(Source: https://twitter.com/lambgiuse/status/1366387452043231234)

Many were publicly critical of how RI handled the situation. Well-known local musician Bob Giusti (@lambgiuse) replied to RI DLT on Twitter, saying “Same thing happened to me – no warning – I would have planned differently in spending leading up (not that there’s any extra) I didn’t even apply until April last year so it definitely wasn’t 50 weeks.” Twitter user Jaydeez (@Jimdeez78) replied to Giusti, “NO heads up nothing… What a joke.. Like we don’t have enough anxiety… MA has a sweet app shows you the balance of your acct.”

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RI COVID-19 vaccinations open for age 75-plus now, age 65-74 next week

COVID-19 vaccination reservations can now be made for everyone age 75 or older who lives, works, or goes to school in Rhode Island, the RI Department of Health (DoH) announced this morning. Actual vaccination appointments begin tomorrow, Thursday, February 18, at the two state-run points of dispensing (PODs), Dunkin Donuts Center POD, 1 La Salle Square, Providence, and Sockanosset POD, 100 Sockanosset Cross Road, Cranston.

Reservations for those age 65-74 will open Monday, February 22. In a press briefing this afternoon, RI DoH Director Nicole Alexander-Scott confirmed in response to a question from Motif that actual vaccinations for this age group would begin the following day, Tuesday, February 23.

Each eligible age group can schedule a vaccination appointment on the web – VaccinateRI.org – and, although the web is preferred, voice telephone is available for others – 844-930-1779 (weekdays 7:30am–7:00pm, weekends 8:00am–4:30pm) – unable to use the web. It is possible to make an appointment for oneself or for another eligible person using either system.

Alexander-Scott said that the website is a work in progress for which significant improvements are planned. “Another thing that I wanted to share is that the customer experience is going to be a little different today than it will be in the near future. Today, when you go into the system, you have to submit all your information. And then once you do that, you can see if any slots are available. We recognize that is not ideal, especially for someone who is going to be repeatedly looking in the system for an appointment. We are working to adjust that process so that it’s a little more user-friendly, wanting to get started first, and then we’ll continue to make the improvements as we go.”

“As of 12:30pm today [Wednesday, February 17], we have made 1,331 appointments, 86 of those over the phone and the rest of them online… at the two state-run sites we have activated,” Alexander-Scott said. “On the topic of the speed of vaccinating, another piece of good news is that we got a little bump in our allocation of vaccine. We had been at the mark of 16,000 doses a week, for the last few weeks. We found out yesterday that our weekly allocation from the feds is going to be increasing to 22,500 first doses. Part of this is an actual increase in Pfizer vaccine and part of it is that Pfizer made a change that allows six doses to be drawn from vials that we were previously getting five doses from. Again, very good news.”

The telephone system also is planned for improvement, Alexander-Scott said. “Right now when you call, the system is automated: You will be prompted to enter your phone number and then you will get a call back. Our goal is to get it set up so that when you call you get a live person right away; we expect to have this in place soon. Like everything with this pandemic, we’re looking forward and making improvements every step of the way as we go.”

“Appointments are currently open through February 27. Additional appointments may be added through the week as slots open. Appointments are expected to fill up quickly,” DoH said in a statement. In the next few weeks, RI expects to bring additional state-run sites into operation in the northern and southern regions, with a goal of doubling the daily capacity at state-run sites from 1,400 to 2,800.

The Dunkin Donuts Center POD is using the Pfizer vaccine and the Sockanosset POD is using the Moderna vaccine, both of which require two doses separated by 3 to 4 weeks: this is not important for first doses, but each recipient must get a second dose of the same type as their first dose. On the website, Alexander-Scott said, users are “signing up for the first dose as the starting point, and then as they are getting that first dose, we have as many steps in place as possible to help ensure that they enroll for the second dose right then and there, so that they’re able to come back.”

Screen capture of RI COVID-19 vaccine reservation web site for Sockanosset POD
Screen capture of RI COVID-19 vaccine reservation web site for Sockanosset POD

In addition to the two state-run PODs, vaccination is available from select retail pharmacies, and those 75 and older can schedule appointments at a retail pharmacy location: either CVS.com, using the CVS Pharmacy phone app, or calling 800-746-7287; or Walgreens.com/ScheduleVaccine or calling any local Walgreens. Municipalities are managing the scheduling process for additional local and regional clinics; contact each city or town directly.

Alexander-Scott said that the goal is to move eligibility in lock-step across all vaccination methods, opening up to each cohort at the same time. “We want to ensure that when we move to the next eligibility group, it is done consistently the same across all three channels from the pharmacies, as well as the local-regional approach, as well as the state run approach,” she said.

For those age 65 or older, Alexander-Scott recommends using the larger-capacity state-run PODs in order to reserve smaller-capacity local and regional for those age 75 or older who may have difficulty traveling or using the web. “I do want to encourage that for going to 65-plus, we really push people toward the larger volume sites with the state-run approach that is activated. Now, when that opens on Monday [for age 65 or older], it’s really ideal to go there because it is designed to move through hundreds of individuals with vaccinating. We want our local-regional approach – our municipalities have been doing a fantastic job – really catering to those 75 years of age and older, supporting them in accessing vaccine and being able to register as they need to, making sure that they can stay local and where they need to go. I just left the call with the municipal leaders where we’re continuing to say to keep that going, make sure that they are filling all of their 75-plus slots because they’ve done a great job getting vaccine out to them, and we really want to encourage those 65 and older to go to the state run sites. We’re activating it for high volume, we want to do it as quickly and as streamlined as possible,” Alexander-Scott said. DoH spokesman Joseph Wendelken said that the daily capacity at the Sockanosset POD is 900 doses and at the Dunkin Donuts Center POD is 500 doses.

It is not necessary to schedule more than one appointment because everyone scheduled is guaranteed to be vaccinated in their assigned time slot, so making multiple reservations disadvantages others eligible for access to the extremely limited supply of vaccine.

After those age 65 and older, vaccination will be available to everyone between 16 and 64 with an underlying health condition (kidney disease, heart disease, diabetes, lung disease, immuno-compromised) that puts them at high risk of complications from COVID-19 and then by age strata for otherwise healthy people. Everyone not immediately eligible to schedule a vaccination (that is, everyone 16 to 64) can sign up to be notified when they are eligible at portal.ri.gov – where many people already have an account if they previously signed up for COVID-19 testing.

Under the RI COVID-19 vaccination plan, persons age 75 or older are covered in the 5th and final sub-phase of Phase 1, and persons age 65-74 are covered in the 1st sub-phase of Phase 2. Moving into each sub-phase does not require completing any prior sub-phase; for example, persons age 65-74 will become eligible while some age 75 and older will not yet have been vaccinated.

In response to a question from Motif, Alexander-Scott said that for those younger than age 65, “Going to the next level should be sometime in March. We can certainly move that up as we continue to accelerate our ability to push vaccine out and have additional supply to be able to do that… So for right now we’re in that same mid-March time, but certainly with each day we’ll continue to assess as we’re pushing it out, we’ll hope to speed it up. So no updates yet, but we’ll certainly be making that known as we have it.”

Responding to criticism about the slow pace of vaccination compared to other states – as of yesterday, according to data from the US Centers for Disease Control and Prevention (CDC), RI is tied for 48th place in doses administered per 100,000 population – DoH in a statement said, “Phase 1 of Rhode Island’s vaccination campaign has been focused on preserving the healthcare system and reaching groups most likely to be hospitalized – nursing home and other congregate residents, people in high-density communities, and older Rhode Islanders. While targeting these high-risk groups took more time than opening appointments to the general population from the outset, it also had the intended effect of preventing more severe cases of COVID-19, more significantly decreasing hospitalizations, and speeding up the reopening of our economy. Over the past month, Rhode Island saw a 46% decrease in hospitalizations, compared to 32% nationally and 22% in our neighboring states. And the decrease is even more significant among those in targeted groups. Because of this positive impact from Phase 1, Rhode Island can now move into Phase 2 and begin vaccinating every Rhode Islander by age group. This will allow for a significantly faster pace of vaccination.”

Alexander-Scott said at today’s press briefing, “We know that treatment with monoclonal antibodies is having a big impact. We know that our leadership with testing is an important component as well. But there is also clarity on the fact that our strategy is meeting the main objectives of the first portion of our vaccination campaign in Rhode Island. The first was to protect people in our nursing homes and other congregate settings, and the second was to make sure we have a health care workforce. Nursing homes are where we have seen the vast majority of our unfortunate deaths. And we need a healthcare workforce so that emergency care is there when you need it.”




State of the State: RI Gov. Raimondo cites “courage to lead” in valediction

The State of the State message on Wednesday, February 3, an annual tradition that usually provides the governor with an opportunity to lay out plans for the coming year, instead took on a valedictory tone for Gina Raimondo, expected to resign and be succeeded by Lieutenant Governor Dan McKee as soon as she is confirmed by the US Senate in a matter of days or weeks as Secretary of Commerce in the new administration of President Joe Biden. Her nomination was advanced earlier in the day on a bipartisan 21-3 vote in the US Senate Commerce Committee.

Due to pandemic precautions addressing a nearly empty House chamber occupied only by her immediate family and House speaker K. Joseph Shekarchi and Senate president Dominick Ruggerio, in the course of about 40 minutes Raimondo avoided most of the usual topics, not even mentioning the budget for the coming year that will now be the headache of McKee.

Considerable criticism has been directed at Raimondo who, presumably at the instructions of the Biden political team worried she would say something that could endanger her chances of Senate confirmation, has avoided public appearances and has not taken a question from the press for almost two months. The contrast between Raimondo’s accessibility at daily press conferences months ago earlier in the pandemic has caused some to describe her lately as “missing in action.” While that may not be entirely fair, the public perception is important.

RI Gov. Gina Raimondo enters the nearly empty House chamber to give her 2021 State of the State address
(Source: RI Capitol TV)

Raimondo in 2020, because of the pandemic that caused massive unemployment and economic contraction, faced the worst crisis of any Rhode Island governor in at least a century, and arguably since the Civil War of the 1860s. Acknowledging this, she emphasized that she was looking forward, saying “2021 will be our year of rebuilding.” Raimondo went out of her way to praise McKee, whom she has for years marginalized and excluded from any serious power or influence, at one point months ago responding to press questions about criticism of her from McKee by saying he was welcome to call her office like anybody else. She was far more conciliatory now: “There’s a lot of work to do, but I stand here confident that we have laid the foundation for a stronger and more equitable Rhode Island, and I know that Lt. Governor McKee is prepared to lead our state. He’s passionate, he’s experienced, he’s committed to public service, and he’s going to do a great job. I want you to know that there will be no disruption to our state’s COVID-19 response, and Lt. Governor McKee has committed to maintaining the entire statewide response team. I also want you to be reassured, as I am, that we are in a good, stable place.”

Raimondo repeatedly returned to the horrors of 2020, noting the families affected by deaths from the virus. “Let’s begin by recognizing the nearly 2,200 families across our state that have lost a loved one to COVID-19. This virus robbed so many of you of the chance to properly say goodbye.”

Acknowledging the shared pain, Raimondo said, “Every single day I heard from healthcare professionals working overnight shifts without a day off; parents balancing work with virtual learning; waiters, waitresses, cashiers and clerks out-of-work, surviving on unemployment insurance, worried about when, or whether, their jobs would come back; small business owners who wanted to stay open and make payroll but didn’t know how much longer they could hold on…”

Noting that much of the burden of the pandemic has fallen disproportionately on women and on racial and ethnic minorities, Raimondo quoted Biden’s campaign slogan – “Build Back Better” – in advocating that equity should focus economic recovery. “Rhode Island is prepared to meet this moment. I know that because of the work we have done together over the past six years to make our state stronger. We have made investments in Rhode Islanders – in skills and education, job creation, infrastructure, healthcare, equity and sustainability. On this foundation, we will build back better. And we’ll make sure that no one is left behind. It will take all of us to rebuild this economy, and that means everyone must reap the rewards.” Of course, Raimondo is not expected to be around when it comes time to realize those goals, so her words are effectively an exhortation to McKee and others.

Of her accomplishments in six years as governor, Raimondo emphasized educational policy. “We quadrupled the number of public Pre-K classes and made all-day kindergarten a reality for every child. We became the first state in America to teach computer science in every public school. We increased the number of high-quality career and technical training programs in our high schools by 60%… We took bold steps to make community college tuition-free for every high school graduate. At the time we did that, few states had taken this path. Now our country looks to us as a model. And since we started offering that scholarship to young people in Rhode Island, the two-year graduation rate at CCRI has tripled, and we’ve seen a 500% increase among students of color.”

One of the bigger political risks Raimondo took was asking voters to remove “Providence Plantations” from the official name of the state, narrowly passed in 2020 after being shot down in flames a decade earlier by a lopsided negative vote. “For too long, our state’s name was dragged down by a word so closely associated with the ugliest time in our history. We can’t change our past, but we must acknowledge it and commit to a more inclusive future. Last year, the people of Rhode Island came together and made history, voting to finally remove the word ‘plantations’ from the official name of our great state.”

To the surprise of no one, Raimondo made an almost obligatory farewell. “It is very difficult for me to leave Rhode Island. If I am confirmed as Commerce Secretary, it will be a privilege to serve in President Biden’s cabinet as we rebuild America and lift up those who have been left behind – a continuation of the work we have done together these past six years.”

As the first woman to serve as governor since Rhode Island was settled in 1636, Raimondo was conscious of her role for posterity. “I’d like to end tonight with a special message for girls and young women across Rhode Island. This world needs you. We need your voice. We need your ideas. We need you to lead. When I was first asked to serve as Commerce Secretary, I was unsure. But it was the women in my life – my mother, my sister, and even my teenage daughter – who gave me the push I needed. They told me it was okay to be nervous, but that I had to look within myself and summon the courage to lead. So, to all the young women out there, I want to leave you with their words. Look within yourself, and summon the courage to lead. There will be plenty of times when you’re unsure. In those moments, we need you to push aside your doubt and fear, and to say yes. Know that you can be anything you want to be. You are strong and smart and capable. And I’m looking forward to the day when one of you is our governor.”

Minority response

RI Senate minority whip Jessica de la Cruz gives the Republican response to the 2021 State of the State address
(Source: RI Capitol TV)

The Republican response, delivered by Senate minority whip (the second-ranking Republican) Jessica de la Cruz, in a quick eight minutes identified five key points. She said “the legislature’s refusal to reconvene or conduct basic oversight of the governor allowed continual, unilateral and unchecked power by the executive branch, which is tasked with enforcing the law, not making it.” She proposed a new law that will give family members the right to visit their relatives in nursing homes with appropriate medical protections, instead of the blanket visitation bans imposed a few months ago.

De la Cruz condemned restrictions or moratoriums on charter schools, an issue on which McKee, a strong advocate for charter schools, is likely to be sympathetic. “Whether it’s through school choice, educational freedom or an educational savings account, Republicans have repeatedly affirmed that access to a quality education is the civil rights issue of our time. We can no longer allow a child’s ZIP code or a family’s wealth to determine the quality of their education,” she said.

Explicitly accusing Raimondo of misallocating federal pandemic relief funds, de la Cruz said, “The heart of Rhode Island’s economy has been shattered, with as many as 40% of Rhode Island small businesses closing last year. This represents lost wages, lost health insurance and broken dreams. Our state diverted federal monies to shore up the state budget instead of prioritizing these small businesses; Republicans will fight to make sure that any future federal relief monies are distributed to where they belong in our neighborhood small businesses.”

The state’s “ballooning budget is unsustainable,” de la Cruz said. “As businesses and nonprofits suffered great losses last year, Rhode Island’s outlandish budget grew to $13 billion. That’s $13,000 for every man, woman and child in our state. And while there are talks of new taxes, you can’t squeeze water from a rock. And you can’t squeeze more money out of Rhode Islanders and businesses beleaguered by taxes, fees and cumbersome regulations. Republicans call for state budget reform, we must end unsustainable spending practices, while still protecting core government services.”