Author Archives: Thomas D Gotowka

A View from My Porch: A Primer on Vaccines, Part 2.5: Where Are We With Vaccines? CT’s Distribution Plan, Immunity Questions & More

Posted on by
Reply

Editor’s Note: This is a previously unplanned third of three parts of a highly topical essay titled, “A Primer on Vaccines,” by Thomas D. Gotowka. Part 2.5 reviews Connecticut’s readiness to distribute the vaccine, identifies some of the side effects that may be experienced, and considers the acquisition of individual immunity. Read the previous parts of the essay at these links:
A View from My Porch: A Primer on Vaccines: Part 1; “Still Running to Daylight”

A View from My Porch — A Primer on Vaccines: Part 2; “Approaching Daylight”

When Part 2 of this series was published in mid-December, only the Pfizer vaccine had received emergency use authorization (EUA); the FDA then granted Moderna’s EUA on Dec. 18. As a result, we are now in the earliest stages of a massive vaccination campaign that will span the United States; and millions of Americans will reach the vaccination on-deck circle in 2021. 

The COVID “playbook” is still evolving; and guidance will change as the scientific and medical communities discover more about this virus and its reaction to the vaccines. That’s a good thing. 

The COVID Data Remain Troubling:

The first autopsy-confirmed COVID-related death in the United States occurred on Feb. 6, 2020 in Santa Clara County, Calif. Just 10 months later, i.e., by year’s end, over 345,000 Americans had been killed by the virus; and, incredibly, we surpassed 20 million cases, with an increase of more than a million cases in the last week of the year.

Unfortunately, this trend will continue through this dark winter; and, by this morning, Jan. 7, we’ve reached nearly 364,000 American fatalities. Finally, COVID hospitalizations are increasing in Connecticut, and may be evidence of another post-holiday spike.

New Vaccines:

Photo by Daniel Schludi on Unsplash.

Last week, Great Britain became the first country to authorize the use of Astra Zeneca’s COVID-19 vaccine. In addition, a promising vaccine candidate from Johnson & Johnson is proceeding through clinical trials. However, for the foreseeable future, Americans will receive the Pfizer or the Moderna vaccines, both of which require two doses, three or four weeks apart, respectively.

Poorly Executed Federal Vaccine Rollout:

The Centers for Disease Control and Prevention (CDC) has reported that Operation Warp Speed’s promise to vaccinate 20 million Americans by the end of December fell remarkably short of goal; and only about 2.8 million people were provided the vaccine — primarily front-line health care workers, and nursing home residents.

Earlier in December, General Gustave Perna, COO of Operation Warp Speed, apologized for a “planning error” that caused dozens of states to receive substantially fewer vaccine doses than were originally promised.

Predictably, the outgoing Administration then announced that, like testing, vaccine distribution will now be the responsibility of the individual states. Transition to the states occurred rapidly, and with only limited assistance and oversight.  There is no plan for logistical support.

They essentially told the states that “this is now your responsibility, figure it out.” Many states will have significant difficulty in meeting this challenge. However, the Coronovirus Relief Bill, which was reluctantly signed into law by the outgoing president at the end of December, includes some financial assistance for the states’ vaccination rollout.  

Vaccine Distribution in CT:

Connecticut began preparing for vaccine distribution well before the candidate vaccines were on the threshold of the United States Food and Drug Administration (FDA) emergency use authorization. 

Governor Lamont had appointed a broad-based Vaccine Advisory Group, who worked with the state’s Department of Health (CT DPH), the local health departments, CDC, and a group of providers and healthcare institutions to develop a phase-based program, which the Governor presented last October. The Governor also stated, at that time, that the state’s goal was to have everyone in the state “who wants a dose” to be vaccinated by early fall of 2021.

You can review the details of CT’s vaccination plan at Phases (ct.gov) . 

At present, Connecticut is vaccinating people who meet Phase 1a eligibility, which includes front-line healthcare workers, and residents and staff of long-term care facilities. CVS Pharmacy teams began to administer the first dose of the Pfizer vaccine in Connecticut skilled nursing facilities on Dec. 21. 

By the end of that month, they had administered more than 50,000 vaccine doses. The role of CVS in Connecticut’s vaccination program is reviewed in: A View from My Porch — A Primer on Vaccines: Part 2; “Approaching Daylight” (LymeLine.com)

By the end of December 2021, more than 50,000 vaccine doses of Coronavirus vaccine had been administered. Photo by Kristine Wook on Unsplash.

Phase 1b:

The Governor has confirmed that Connecticut remains on track to complete Phase 1a by the end of January; and the CDC recently reported that Connecticut is ahead of most states in vaccine distribution. Phase 1b is expected to begin immediately after completing Phase 1a objectives, and will probably extend into June. 

The Governor’s Vaccine Advisory Group has just recommended that Phase 1b target frontline essential workers, residents of congregate settings and those aged 75 and older. This will include teachers, grocery store workers, police officers, food service workers and sanitation workers. 

Congregate settings include homeless shelters, prisons, psychiatric facilities and group homes. The Advisory Group has not yet decided whether this next phase will also include residents, who are under the age of 75, but have underlying health conditions that place them at high-risk of serious illness from COVID-19. It appears that heathy people, ages 65 to 74 years old, may, otherwise, be deferred to Phase 1c.

Side Effects:

The most common side effects for both vaccines include pain and swelling in the arm where you received the injection; fever, chills, fatigue, and headaches, and muscle and joint pain. There was some early concern regarding a few claims of “Bell’s Palsy” following receipt of the Pfizer or Moderna vaccine in the clinical trials. (“Bells” is a condition that causes temporary and mild weakness or paralysis of the facial muscles).

This was not considered significant, however, because the incidence rate of the condition in the clinical trial was very comparable to the incidence of Bell’s Palsy in the general population.

Note that the CDC and FDA are monitoring adverse reactions, using a national data collection system. Healthcare professionals are required to report certain adverse events; and vaccine manufacturers are required to report all adverse events that come to their attention. Vaccine Adverse Event Reporting System (VAERS) (hhs.gov)

Even you have received the first shot of vaccine, keep wearing your mask until one to two weeks after your second dose.  Photo by engin akyurt on Unsplash.

Immunity ETA:

As noted above, the Pfizer and Moderna vaccines both require two doses, three or four weeks apart, respectively. Based on the current literature, you will have some protection about 12 days after the first dose. 

However, you will not receive the strongest immunity until after the second dose — at least seven days after the second for the Pfizer vaccine; but at least 14 days after the second for the Moderna vaccine. Therefore, it is important that you continue wearing a face mask, practice social distancing until one to two weeks after your second dose.

Questions (Always) Remain:

There is still a need for continuing study. We do not yet know how long vaccines will confer immunity. Although the vaccine may be more than 90 percent effective in blocking the symptoms of COVID-19 at the individual level; it is still unclear whether it will reduce transmission and stop the symptomless spread that accounts for a large portion of cases

Some Final Thoughts:

Vaccinations for the general public are not expected to begin until late-summer but, by then, vaccines will be available in a wide range of healthcare sites: physician’s offices, hospitals, pharmacies, community health centers, and other locations that would normally administer influenza vaccines. Note that Connecticut is not mandating vaccination.  So, it’s an extremely important public health program that requires we “rely on the kindness of strangers.”

As I write this, I am distracted by the televised play-by-play of a violent attack on the Capitol by a group of domestic terrorists, which was apparently instigated and applauded by the outgoing Executive Branch. 

All that said, I believe that Connecticut is well-prepared to carry out this massive vaccination program. Other states are woefully unprepared. For example, Florida has what appears to be a poorly organized, “first come, first served” program.

We must make certain, however — and especially as other states reach readiness — that the vaccine supply line is continually sufficient to meet immediate requirements. 

I’ll close by paraphrasing Queen Elizabeth II: 2020 was without question an “annus horribilis.” Let’s not allow its ‘horrible-ness‘ to spill over any further into 2021.

This is the opinion of Thomas D. Gotowka.

Tom Gotowka

About the author: Tom Gotowka’s entire adult career has been in healthcare. He’ will sit on the Navy side at the Army/Navy football game. He always sit on the crimson side at any Harvard/Yale contest. He enjoys reading historic speeches and considers himself a scholar of the period from FDR through JFK.

A child of AM Radio, he probably knows the lyrics of every rock and roll or folk song published since 1960. He hopes these experiences give readers a sense of what he believes “qualify” him to write this column.

A View from My Porch — A Primer on Vaccines: Part 2; “Approaching Daylight”

Posted on by
1

Editor’s Note: This is the second of two parts of a highly topical essay titled, “A Primer on Vaccines,” by Thomas D. Gotowka. Part 2 considers the complexities of reaching vaccine distribution. The author’s goal is that the reader obtains a fundamental understanding of the vaccine approval process, and recognizes that Americans will be provided a vaccine that is safe and effective. Read the first part of the essay at this link.

The Good News First:

On Dec. 10, an independent Advisory Panel to the United States Food and Drug Administration (FDA), comprised of scientists and medical experts, voted overwhelmingly to endorse Pfizer’s Emergency Use Authorization (EUA) request. This brings the US to the threshold of a massive vaccination effort against a virus that has now killed over 300,000 Americans.

The Panel concluded that the vaccine appears safe and effective for emergency use in adults, and teenagers, 16 years, and older. Specifically, the Panel ruled that the vaccine’s potential benefits outweigh its risks. 

A day later, FDA staff scientists, as expected, corroborated the Panel’s endorsement, and “greenlighted” use of the Pfizer vaccine.

UPS and FedEx trucks left Pfizer’s Michigan facility at Kalamazoo Sunday morning (Dec. 13), and began delivering the vaccine to nearly 150 distribution centers across the United States; the states began receiving the vaccine early this week. Moderna’s EUA request will be considered on Dec. 17. 

The Panel’s endorsement came, despite allergic reactions observed in two individuals who received the vaccine after Britain launched their emergency vaccination program. A Panel member, Dr. Paul Offit of Children’s Hospital of Philadelphia, said, “There are still some unknowns, but in an emergency, the question is whether you know enough.”

Pfizer has said they have seen no signs of allergic reactions in their trial.

The President-elect called the FDA decision, “A

bright light in a needlessly dark time.”

Distribution Factors:
i) Cold Storage

Although all three of the leading vaccine candidates (i.e., Pfizer, Moderna, and Astra Zeneca) must be kept at low temperatures. Pfizer’s vaccine presents some challenges; and must be kept at minus 94 degrees F, or lower. 

ii) Quantity of Vaccines Available/Number of Doses Required

Both the Pfizer and the prospective Moderna vaccines require two doses, three or four weeks apart, respectively.

Because the results from clinical trials were so favorable, both Pfizer and Moderna began production and warehousing of their vaccines in advance of FDA approval. Pfizer has said it will have about 25 million doses of the two-shot vaccine for the U.S. by the end of December.

Initial supplies will be limited and reserved primarily for health care workers and nursing home residents, with other vulnerable groups next in line until the vaccine becomes more widely available, which will probably not happen until the spring. Moderna will have 20 million doses available. These have been very fluid predictions. 

Distribution Plans:

Last September, the U.S. Department of Health and Human Services (HHS), released a plan for distribution of vaccines across the United States. HHS has contracted with about a dozen pharmacy chains to administer the vaccination programs. 

CVS and Walgreens will be involved in the early stages of the rollout to help vaccinate residents of long-term care facilities. Other participating pharmacies are expected to start later, when more doses become available. Working with pharmacies, most of which already have local patient relationships, will facilitate community-based vaccination programs. 

As in mitigation, the states will have a very large role in vaccination. Governor Lamont presented CT’s plan for distribution of the vaccine on October 3rd. CT’s goal is to have everyone in the state “who wants a dose” to be vaccinated by early fall of 2021. The plan was developed by his Vaccine Advisory Group, with oversight from CT DPH. CT DPH has also been actively working with local health departments to organize CT’s distribution and vaccination plan. 

Preparing to vaccinate. Photo by Kristine Wook on Unsplash.

From Here to Immunity:

The World Health Organization has indicated that 70 percent of the population of the United States must be immunized to reach “herd immunity; but because the vaccines are not effective all of the time, the threshold would likely need to be nearly 80 percent, in order to reach a 70 percent rate of successful vaccination.

However, we also know that, even assuming full participation, and full compliance with the two- dose regimen, it will not be until the end of 2021, or early 2022, before we have been able to vaccinate that much of the U. S. population. 

During that extended period, Americans will continue to die unless we stop the spread by simply observing the behaviors that our medical and public health experts have stressed for nearly a year: wear a mask, wash your hands frequently, disinfect common surfaces, avoid crowds, especially indoors, and keep a safe space between yourself and other people who are not from your own household.

I believe that individuals can assume that immunity will occur about two weeks after the second dose of the vaccine. 

Pfizer has said it will have about 25 million doses of the two-shot vaccine for the U.S. by the end of December. Initial supplies will be limited and reserved primarily for health care workers and nursing home residents, with other groups next in line after the vaccine becomes more widely available, which will probably not happen until the spring.

Unanswered Questions:

We do not yet know how long vaccines will confer immunity. The Panel stressed that, although the vaccine’s efficacy is very high, and may be more than 90 percent effective in blocking the symptoms of COVID-19 at the individual level; it is still unclear whether it will reduce transmission and stop the symptomless spread that accounts for a large portion of cases.

The vaccine trials excluded pregnant or breastfeeding women; and largely excluded children under 12 years old.  Consequently, it is not yet clear when the immunizations would be safely available for them. 

Pfizer will provide six months’ follow-up data about safety and side effects as it pursues full approval. “Americans want us to do a scientific review, but I think they also want us to make sure we’re not wasting time on paperwork, in lieu of moving forward to the decision,” FDA Commissioner Stephen Hahn said before the Pfizer EUA review meetings.

Was it Too Fast?  

This was not “miraculous.” Rather, “the speed is a reflection of years of work that went before,” stated Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases.

Long before COVID-19 was even on the radar, the groundwork was laid in large part by two different streams of research, one at the NIH, and the other at the University of Pennsylvania. In addition, scientists had already learned a great deal about other coronaviruses from prior SARS and MERS outbreaks. 

“Science and data guided the FDA’s decision,” Commissioner Hahn recently said. “We worked quickly, only because of the urgency of this pandemic, not because of any unwarranted external pressure.” (see below.)

What Happens Now?

The FDA and CDC will monitor the use of the vaccine long after its release, and conduct “active surveillance” of the health care workers and residents of long-term care facilities who were early recipients of the vaccine. The purpose of this monitoring is to identify the rare side effects and adverse reactions that were not seen, even in the very large clinical trials conducted by Pfizer. 

Further, because the trials excluded some groups who might have different types of side effects (above), monitoring enables an additional review of those excluded trial groups who actually then received the vaccine as distribution expanded, presumably with medical advice.

Some Final Thoughts:

America’s systems worked. Teams of scientists and medical experts made vaccine development their highest priority early in this pandemic; and America’s highly respected public health agencies, which include NIH, FDA, and CDC, also stepped up, and acted as though we were in the midst of this century’s greatest threat to the nation’s health. 

This was “deep state”, with all its expertise, moving ahead at optimum speed, despite an Executive Branch throwing brickbats, and unable to acknowledge the growing number of dead Americans. 

Again, we need to develop education and communication strategies to overcome “vaccine hesitancy” (sometimes called anti-vaccination or anti-vax”), if we are ever to reach the threshold required for “herd immunity”.

There has been some concern that vaccine approval was accelerated to fulfill a political goal; and, unfortunately, the outgoing Administration did make threats regarding the timing of the approval.

The Commissioner had already stated “Let me be clear; our career scientists have to make the decision, and they will take the time that’s needed to make the right call”.

After the Panel’s endorsement was announced, The President-elect said “I want to make it clear to the public: You should have confidence in this. There is no political influence. These are first-rate scientists, taking their time, looking at all of the elements that need to be looked at,” Biden told reporters Friday at an event introducing several members of his Cabinet and White House staff.

I am concerned that maskless states like South Dakota, who was content with last week’s 47 percent test positivity rate, will make no effort to educate and encourage vaccination.

The new Administration will also need to deal with the availability of therapeutics for Americans. Some of these experimental drugs, which have been occasionally used on political celebrities, are in such short supply, that some states have set up lotteries to determine which patients would receive a dose.

In closing, we should acknowledge the tens of thousands of volunteers who participated in clinical trials. Pfizer had 44,000; Moderna, 30,000; and Astra Zeneca, 23,000.

This is the opinion of Thomas D. Gotowka.

Tom Gotowka

About the author: Tom Gotowka’s entire adult career has been in healthcare. He’ will sit on the Navy side at the Army/Navy football game. He always sit on the crimson side at any Harvard/Yale contest. He enjoys reading historic speeches and considers himself a scholar of the period from FDR through JFK.

A child of AM Radio, he probably knows the lyrics of every rock and roll or folk song published since 1960. He hopes these experiences give readers a sense of what he believes “qualify” him to write this column.

A View from My Porch: A Primer on Vaccines: Part 1; “Still Running to Daylight”

Posted on by
1

When will the first COVID-19 vaccine be given in the US? Great Britain began their vaccination program, Tuesday, Dec. 8. Photo by CDC on Unsplash.

This essay begins an examination of the development and distribution of a COVID-19 vaccine in the United States.

Part 1 reviews the key terminology that one may encounter in the media; and the intense evaluation and approval process that is required for these vaccines before they can be used on Americans. I also identify the important developers and discuss their progress.  

My goal is that, after these two essays, the reader has a basic understanding of the vaccine development process, and recognizes that Americans will be provided vaccines that are safe and effective. Part 2 will cover the complexities of distribution.

The Current Environment:

At the end of November, the Centers for Disease Control and Prevention (CDC) published its national “ensemble forecast”, which predicted that COVID deaths in the United States will surge to between 294,000 and 321,000 deaths by Christmas. Further, CDC Director Robert R. Redfield stated that “this winter could be ‘the nation’s most difficult time in our public health history.” 

Nevertheless, there is some very good news ahead. Teams of scientists and medical experts in the United States and Europe made vaccine development their highest priority early in this pandemic and vaccines are on the near horizon. Note that the speed at which these teams progressed from the first cases identified in the United States to vaccine delivery, a little less than a year, is an extraordinary accomplishment.

Dr. Anthony Fauci, the nation’s foremost infectious disease expert, recently estimated that the first American vaccinations may occur before the end of December, and then continue through the end of 2021. 

The CDC’s advisory panel of medical experts has drafted recommendations regarding groups considered high priority for vaccination. Clearly, there’s more to come on this, but expect that higher priority will be given to those who face the greatest risk: first responders and frontline healthcare workers first; then, residents of long-term care facilities, the elderly, and those with underlying medical conditions; and finally, those involved in essential and critical industries.

Admiral Brett Giroir of the U.S. Public Health Service, stated, “We have to immunize for impact; the rest of America will get it in the second, or third quarter of 2021, but we can maximize our impact right now.” 

Some Important Terminology:

An “ensemble forecast” (above) is a sophisticated analytic technique that combines several independently-developed forecasts into one single, aggregate prediction; which increases the forecast’s reliability and statistical power.  It is similar to a “meta-analysis,” which also combines results from several independent studies to determine overall trends. Note that these both are widely-accepted methods of analysis, and not “smoke and mirrors.”

A “vaccine” stimulates the immune system to produce antibodies in a manner that’s similar to being naturally exposed to the disease; and so, immunity to that disease develops. Vaccines may contain the same causal agents that produce the disease; but in either weakened or dead form (e.g., measles vaccine contains the measles virus.) Some vaccines may contain only a part of the microorganism’s genetic or physical structure. 

“Immunity” is simply protection from an infectious disease. If you are immune to a disease, you are able to resist it, and can be exposed without becoming infected. 

Vaccine “efficacy” is a measure of how well a vaccine works to prevent disease among vaccinated persons, as compared to those who were not vaccinated, but in well-controlled clinical trials.  A 95 percent efficacy means that 95 out of 100 people who received the vaccine in that clinical trial were protected. Another important measure is “effectiveness”, or how well the vaccine actually achieved protection in the real world, with all its vagaries. This may be a lower number.

“Clinical trials” are studies performed by scientists with human subjects, and are aimed at assessing a medical, surgical, or behavioral intervention.

Achieving “herd immunity” is the goal of these vaccine programs; and will occur when a “significant” portion of the population (the “herd”) has been vaccinated. 

Vaccine experts say that the threshold at which enough people have been vaccinated or naturally infected by the virus to reach a herd immunity, won’t be achieved if only 40 or 50 percent of the population receives the vaccine. According to the World Health Organization (WHO), herd immunity against measles requires that 95 percent of the population be vaccinated; for polio, the threshold is closer to 80 percent. They have also stated that 70 percent of the population will need to be immunized to reach “herd immunity” for COVID-19. 

Food and Drug Administration (FDA) Center for Drug Evaluation and Research (CDER):

The CDER is the nation’s primary watchdog for vaccine development. 

Before a drug or a vaccine can be tested in people, the pharmaceutical company must perform laboratory and animal tests to determine how the proposed vaccine works, and whether it’s likely to be safe and work well in humans. If those results show promise, CDER will then authorize a series of tests in people.

Once the test vaccine has been cleared for human tests, at least three additional phases of clinical trials are conducted on volunteers to test vaccine efficacy, determine appropriate dosage, and to assess adverse side effects, etc. The last phase may involve a test group comprising thousands of human volunteers. Note that the Center doesn’t actually test drugs or vaccines itself.

An expert team of physicians, statisticians, chemists, pharmacologists, and other scientists reviews the company’s data; and if this independent review establishes that the vaccine’s health benefits outweigh its risks, the vaccine is approved for use. 

After approval, the FDA will continue to closely monitor the vaccine; and may review batches of the vaccine through the production process, and evaluate the facilities for safety. The FDA will also continue to track vaccine reactions and side effects.

COVID-19 Vaccine Developers:

There are currently three leading candidates competing for FDA approval. The front runners include:

  1. Pfizer, and its German collaborator, BioNTech, whose (BNT162b2) vaccine has an efficacy of 95 percent.
  2. Moderna, a Cambridge, Mass.-based biotechnology company, whose (mRNA-1273) vaccine also reports an efficacy of 95 percent.
  3. AstraZeneca, collaborating with Oxford University in England, whose (ChAdOx1) vaccine has reported an efficacy of 90 percent, based on “interim results” from trials in the UK and Brazil.

The above three are among nearly a dozen companies that had the opportunity to receive some financial support from United States taxpayer dollars for vaccine development as part of “Operation Warp Speed” (OWS). Government financial support was available both to subsidize research and development, or to subsidize production of the vaccine. It has been reported that Moderna received some funding for R&D whereas Pfizer did not.

Current Status:

Both Pfizer and Moderna have applied for Emergency Use Authorizations (EUAs) from the FDA for their respective vaccines; which, although short of a full-scale approval, is an accelerated review process that would allow them to distribute their vaccines during this public health emergency. The FDA is scheduled to convene on December 10th to consider this the Pfizer request, and a week later for Moderna. 

EUAs are temporary; and the process to receive full FDA approval continues, irrespective of the EUA. 

Some experts had initially expressed concern about using an EUA for a vaccine that would be given to millions of people; but their fear has become more muted as the pandemic continues to kill thousands of Americans. 

The United Kingdom’s Medicines and Healthcare products Regulatory Agency has just approved the Pfizer vaccine for emergency use and is expected to quickly initiate their vaccination program in Great Britain. See the Editor’s Note below for latest news on the British vaccination program.

Some Final Thoughts:

This past week, COVID-19 surpassed heart disease as the leading cause of death in United States; and today, Johns Hopkins University reported 285,564 Americans dead from the virus. Despite the calendar, we have been in the midst of what Dr. Fauci referred as a “bleak, dark winter”. 

The courage exhibited by many State governors must be acknowledged. Many implemented those inconvenient mitigation behaviors, while the Executive Branch, in apparent public denial, was sending out conflicting messages that actually endangered State officials. There was no doubt that “the buck stopped there,” right in the State House. 

We will also need to develop strategies to overcome “vaccine hesitancy”, which is sometimes called anti-vaccination or “anti-vax”. This reluctance, or refusal to be vaccinated, or to have one’s children vaccinated against contagious diseases, was identified in 2019 by the WHO as one of the top 10 global health threats. 

To set the record straight:

  • Pfizer did not alter its development schedule and hold their announcement until after the Nov. 3 election.
  • The FDA has not lengthened their review process to postpone vaccine distribution until after the inauguration.

Stephen Hahn, FDA Commissioner, stated unequivocally, “Let me be clear; our career scientists have to make the decision and they will take the time that’s needed to make the right call on this important decision”.

Finally, in the best of all possible Americas, the outgoing president should re-focus his energy through the remainder of his transition out of the White House towards informing us all that we should prepare to receive the vaccine, even if it occurs during the next Administration. 

As always, God save the United States of America.

Editor’s Note: Margaret Keenan, a 90-year-old British grandmother, became the first person in the world to receive a fully-tested COVID-19 vaccine yesterday. She was given the Pfizer/BioNTech shot and that event marked the start of the biggest vaccination campaign in the history of the United Kingdom’s National Health Service ever to be undertaken. 

This is the opinion of Thomas D. Gotowka.

Tom Gotowka

About the author: Tom Gotowka’s entire adult career has been in healthcare. He’ will sit on the Navy side at the Army/Navy football game. He always sit on the crimson side at any Harvard/Yale contest. He enjoys reading historic speeches and considers himself a scholar of the period from FDR through JFK.

A child of AM Radio, he probably knows the lyrics of every rock and roll or folk song published since 1960. He hopes these experiences give readers a sense of what he believes “qualify” him to write this column.

A View from My Porch: The ‘Aristocrat of the Silent Screen’, the ‘Bee & Thistle’ … and Other Thoughts

Posted on by
Reply

Plans have been announced for the former ‘Bee and Thistle Inn’ to become the new home of the Roger Tory Peterson Estuary Center. But do you know how this gracious residence ever came to be an inn?  If not, read on …

The recent announcement that the Connecticut Audubon Society had reached an agreement to purchase the Bee & Thistle Inn, and plans to renovate it as the future headquarters for the Roger Tory Peterson Estuary Center, piqued my curiosity regarding the Inn’s history.

This essay briefly reviews the life of an individual who was fairly instrumental in its founding, the talented and infamous Elsie Ferguson. Note that I had originally written “notorious,” but I believe only one woman in our recent history is deserving of that descriptor. My goal with this essay is to provide readers with something light, given the dismal news regarding the COVID crisis, but please read to the end as I feel obliged to return to that topic there.

Known as “The Aristocrat of the Silent Screen,” this (Public Domain) photo shows Elsie Ferguson in 1913. Image by Herman Mishkin – The Theatre, Vol. 18, July 1913.

Ms. Ferguson was considered by many as the leading Broadway and silent screen actress for much of the first half of the 20th century. She made her debut as a chorus girl in 1900 at the Madison Square Theatre in the musical comedy “The Belle of New York.”

She then starred, or was a cast member, in a remarkable number of productions on Broadway and in London, becoming known as one of the most beautiful and talented women ever to appear on the American stage. She became “the aristocrat of the silent screen”, partly because so many of her roles were elegant society women, and also for her utterly arrogant attitude. 

During the first world war, several Broadway stars organized a campaign to sell Liberty Bonds, both before performances and at events occurring at important New York City venues. Ms. Ferguson once sold $85,000 in bonds in less than an hour, which is about a million and a half today!

After appearing in “The Merchant of Venice” in 1916, she signed her first movie contract with Paramount Pictures, and in a 1917 release, made her silent screen debut in “Barbary Sheep.” After some 25 films made between 1917 and 1929, she made her first and only “talkie”, “Scarlet Pages”, in 1930. 

She was definitely “divaesque” and working with her was difficult. She actually dabbled in socialism in the 1920s, and once stated in an interview, that “… people are struggling and fretting their lives away over questions of food and education. When a man has accumulated more than, say, a million, the moneys made should revert back to those who have contributed to the amassment.” This was ironic, because she was very well-compensated for her work, and had “amassed” a large fortune.

Her personal life was marked with some turmoil; and she was even involved, albeit on the periphery, in events that triggered the murder of architect Stanford White, an utter scoundrel; the news of those events contributed to the novel and eventual Broadway musical, “Ragtime”.

Connecticut:

In 1934, the then 51-year-old Elsie Ferguson married her fourth husband, the wealthy Irish “sportsman” Victor Egan. They bought a farm in Connecticut that same year. They also maintained a home on the French Riviera, splitting their time between the two. 

The Ferguson Farm:

A “Profile” of Ms. Ferguson, published in 2013 by the Florence Griswold Museum, tracked her life to some “welcome seclusion” on that scenic 100-acre estate in East Lyme, “White Gate Farms.” She told a reporter from “The Milwaukee Journal” that she sold 150 of her farm’s eggs each day to the Government. The reporter described the surroundings as “bucolic and luxurious.” During her tenure at White Gate, she was known only as Mrs. Victor Egan. 

When the World War II theater blackout on Broadway lifted in 1943, she made her final appearance, at the age of 60, in “Outrageous Fortune”, which was written by an East Lyme neighbor, Rose Franken. She told the reporter covering her return to the theater that “once people [in Connecticut] recognized her, she would have to be very careful about how she looked; hair and all that sort of thing.”

Victor Egan died in France in 1956, and ‘Widow Ferguson’ spent her remaining years in Connecticut.

The Bee and Thistle Inn:

Her friend and contemporary, Henrietta Greenleaf Lindsay, a Hartford designer, had opened a shop in Old Lyme, and lived nearby in a large home just north of what is now the Florence Griswold Museum. She was also a widow, and rented a few extra bedrooms to guests. Ms. Ferguson suggested that Ms. Lindsay formalize her guest room business and convert her gracious home wholly to a hotel. 

Ms. Lindsay followed that advice, and opened an Inn to the public. In recognition of her friend’s encouragement, the Ferguson Clan’s crest, which included a bee on a thistle, gave the inn its name.”

Elsie Ferguson died in November, 1961, aged 78, at Lawrence & Memorial Hospital in New London with no surviving heirs. Her will directed that her $1.5 to $2 million estate be divided primarily amongst several animal welfare organizations, including NYC’s Animal Medical Center, Bide-A-Wee Home, the ASPCA, and Orphans of the Storm.

She is interred in Old Lyme’s Duck River Cemetery and her grave marker includes the first few lines of Byron’s “She Walks in Beauty.”

Some Final Thoughts: 

I began this piece on Nov. 19, when we had just passed the one-quarter million mark of Americans dead from COVID-19; and were looking forward to a very “low-touch” Thanksgiving. 

My next essay, “A Primer on Vaccines and Vaccination,” will be the first, in a series focusing on our response to COVID-19; and each successive column will be a thoughtful analysis of the implications of the data published in LymeLine and other media and as such will be the “color commentary.”

We have a massive public health problem, and it’s worsening daily. As I complete this essay on Monday, Nov. 23, We’ve reached 260,402 dead Americans; and yesterday, there were 142,732 new confirmed cases. The seven-day rolling average of 170,856 new cases per day grew nearly 50 percent from two weeks ago. The prediction of a “dark winter” is playing out.  

We are fortunate, however, because vaccines are approaching distribution; but unfortunately, the still-current president remains unwilling to even acknowledge this crisis and model behaviors in front of his constituency that will assist in curbing the further spread of the disease. 

There’s finally some good news regarding the election. Despite the unrelenting and outrageous interference, the states have all certified the election results, and the recalcitrant GSA Administrator has finally checked her math and enabled the formal transition. So, the President-elect finally really is the President-elect.

John Cleese couldn’t have scripted a more ridiculous theater of the absurd than the “The Bad Loser’s Guide to A Peaceful Transition,” which has been shown nearly constantly in primetime before and since the election. 

I pray that Americans’ trust in the election process has not been irrevocably damaged, and that there has been no damage done to the new administration.

As always, God save the United States of America.

This is the opinion of Thomas D. Gotowka.

Tom Gotowka

About the author: Tom Gotowka’s entire adult career has been in healthcare. He’ will sit on the Navy side at the Army/Navy football game. He always sit on the crimson side at any Harvard/Yale contest. He enjoys reading historic speeches and considers himself a scholar of the period from FDR through JFK.

A child of AM Radio, he probably knows the lyrics of every rock and roll or folk song published since 1960. He hopes these experiences give readers a sense of what he believes “qualify” him to write this column.

Letter to the Editor: A Thanksgiving COVID Retrospective — Running to Daylight

Posted on by
3

To the Editor:

Paraphrasing Thomas Paine, “These were the times that tried our souls.”

Looking back, the first COVID-19 case in the United States was diagnosed in Washington State, just seven weeks after last Thanksgiving [2019]; the patient had recently returned home from Wuhan, China. Yesterday [Nov. 25], that state’s total cases exceeded 158,000, confirmed; with over 2,800 deaths.

On March 8th of this year, Governor Lamont announced that CT DPH had confirmed CT’s first case in a Wilton resident who had just returned from CA; and was under treatment at Danbury Hospital.

The Bad News:

We are currently in a public health crisis, and it’s worsening daily. This week, we reached 265,740 dead Americans; and 142,732 new confirmed cases, nationwide. CT’s case total now exceeds 109,000, with 4,926 deaths.

The seven-day rolling average of 170,856 new cases per day grew nearly 50 percent in the last two weeks. We now have more than 88,000 people hospitalized with Covid-19, the highest number the nation has ever experienced. Scientists have predicted this fall surge for months, and now, have also warned us that it’s extending into a dark winter. “dark winter”.

Public health officials have stressed, for months, some simple behaviors that should help to curb the further spread of the disease: Wear a mask, wash your hands frequently, avoid crowds, especially indoors, keep a safe space between yourself and other people who are not from your household — a piece of cake? Some elected officials have absolutely refused to promulgate, or model these accepted behaviors; and some new jargon, “super-spreader events” has become part of the epidemiologic lexicon.

Unbelievably (to me), seven Republican lawmakers in New Hampshire have called for the NH House Judiciary Committee to begin an investigation to determine whether Governor Sununu, also a Republican, can be impeached for requiring people to wear a mask in public places.

I always review the data from South Dakota, whose “cowboy culture” (their term), makes anything, but free choice, unacceptable. This week, SD reported more COVID-19 deaths per capita than anywhere else in the United States, and it also had the highest per capita rate of COVID-19 hospitalizations. Two weeks ago, SD’s test positivity rate reached a frightening 60 percent, second only in the U.S. to neighboring Wyoming. SD hospitals are approaching their breaking point.

The Daylight:

There is some very good news. Scientists and boffins on both sides of the Atlantic have made vaccine development their highest priority, and have moved forward “All Ahead, Flank, Cavitate”! (This is Southeast Connecticut, just ask a submarine driver.)

Distribution and vaccination are on the horizon.

Sincerely,

Thomas D. Gotowka,
Old Lyme.