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Javier E

COVID-19 Changed Science Forever - The Atlantic - 0 views

www.theatlantic.com/...617262

science history crisis pandemic

shared by Javier E on 17 Dec 20 - No Cached
  • New diagnostic tests can detect the virus within minutes. Massive open data sets of viral genomes and COVID‑19 cases have produced the most detailed picture yet of a new disease’s evolution. Vaccines are being developed with record-breaking speed. SARS‑CoV‑2 will be one of the most thoroughly characterized of all pathogens, and the secrets it yields will deepen our understanding of other viruses, leaving the world better prepared to face the next pandemic.
  • But the COVID‑19 pivot has also revealed the all-too-human frailties of the scientific enterprise. Flawed research made the pandemic more confusing, influencing misguided policies. Clinicians wasted millions of dollars on trials that were so sloppy as to be pointless. Overconfident poseurs published misleading work on topics in which they had no expertise. Racial and gender inequalities in the scientific field widened.
  • At its best, science is a self-correcting march toward greater knowledge for the betterment of humanity. At its worst, it is a self-interested pursuit of greater prestige at the cost of truth and rigor
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  • Traditionally, a scientist submits her paper to a journal, which sends it to a (surprisingly small) group of peers for (several rounds of usually anonymous) comments; if the paper passes this (typically months-long) peer-review gantlet, it is published (often behind an expensive paywall). Languid and opaque, this system is ill-suited to a fast-moving outbreak. But biomedical scientists can now upload preliminary versions of their papers, or “preprints,” to freely accessible websites, allowing others to immediately dissect and build upon their results. This practice had been slowly gaining popularity before 2020, but proved so vital for sharing information about COVID‑19 that it will likely become a mainstay of modern biomedical research. Preprints accelerate science, and the pandemic accelerated the use of preprints. At the start of the year, one repository, medRxiv (pronounced “med archive”), held about 1,000 preprints. By the end of October, it had more than 12,000.
  • The U.S. is now catching up. In April, the NIH launched a partnership called ACTIV, in which academic and industry scientists prioritized the most promising drugs and coordinated trial plans across the country. Since August, several such trials have started.
  • Researchers have begun to uncover how SARS‑CoV‑2 compares with other coronaviruses in wild bats, the likely reservoir; how it infiltrates and co-opts our cells; how the immune system overreacts to it, creating the symptoms of COVID‑19. “We’re learning about this virus faster than we’ve ever learned about any virus in history,” Sabeti said.
  • Similar triumphs occurred last year—in other countries. In March, taking advantage of the United Kingdom’s nationalized health system, British researchers launched a nationwide study called Recovery, which has since enrolled more than 17,600 COVID‑19 patients across 176 institutions. Recovery offered conclusive answers about dexamethasone and hydroxychloroquine and is set to weigh in on several other treatments. No other study has done more to shape the treatment of COVID‑19.
  • SARS‑CoV‑2’s genome was decoded and shared by Chinese scientists just 10 days after the first cases were reported. By November, more than 197,000 SARS‑CoV‑2 genomes had been sequenced. About 90 years ago, no one had even seen an individual virus; today, scientists have reconstructed the shape of SARS‑CoV‑2 down to the position of individual atoms
  • Respiratory viruses, though extremely common, are often neglected. Respiratory syncytial virus, parainfluenza viruses, rhinoviruses, adenoviruses, bocaviruses, a quartet of other human coronaviruses—they mostly cause mild coldlike illnesses, but those can be severe. How often? Why? It’s hard to say, because, influenza aside, such viruses attract little funding or interest.
  • COVID‑19 has developed a terrifying mystique because it seems to behave in unusual ways. It causes mild symptoms in some but critical illness in others. It is a respiratory virus and yet seems to attack the heart, brain, kidneys, and other organs. It has reinfected a small number of people who had recently recovered. But many other viruses share similar abilities; they just don’t infect millions of people in a matter of months or grab the attention of the entire scientific community
  • Thanks to COVID‑19, more researchers are looking for these rarer sides of viral infections, and spotting them.
  • These factors pull researchers toward speed, short-termism, and hype at the expense of rigor—and the pandemic intensified that pull. With an anxious world crying out for information, any new paper could immediately draw international press coverage—and hundreds of citations.
  • “There’s a perception that they’re just colds and there’s nothing much to learn,” says Emily Martin of the University of Michigan, who has long struggled to get funding to study them. Such reasoning is shortsighted folly. Respiratory viruses are the pathogens most likely to cause pandemics, and those outbreaks could potentially be far worse than COVID‑19’s.
  • Their movements through the air have been poorly studied, too. “There’s this very entrenched idea,” says Linsey Marr at Virginia Tech, that viruses mostly spread through droplets (short-range globs of snot and spit) rather than aerosols (smaller, dustlike flecks that travel farther). That idea dates back to the 1930s, when scientists were upending outdated notions that disease was caused by “bad air,” or miasma. But the evidence that SARS‑CoV‑2 can spread through aerosols “is now overwhelming,”
  • Another pandemic is inevitable, but it will find a very different community of scientists than COVID‑19 did. They will immediately work to determine whether the pathogen—most likely another respiratory virus—moves through aerosols, and whether it spreads from infected people before causing symptoms. They might call for masks and better ventilation from the earliest moments, not after months of debate
  • They will anticipate the possibility of an imminent wave of long-haul symptoms, and hopefully discover ways of preventing them. They might set up research groups to prioritize the most promising drugs and coordinate large clinical trials. They might take vaccine platforms that worked best against COVID‑19, slot in the genetic material of the new pathogen, and have a vaccine ready within months
  • the single-minded focus on COVID‑19 will also leave a slew of negative legacies. Science is mostly a zero-sum game, and when one topic monopolizes attention and money, others lose out.
  • Long-term studies that monitored bird migrations or the changing climate will forever have holes in their data because field research had to be canceled.
  • negligence has left COVID‑19 long-haulers with few answers or options, and they initially endured the same dismissal as the larger ME community. But their sheer numbers have forced a degree of recognition. They started researching, cataloging their own symptoms. They gained audiences with the NIH and the World Health Organization. Patients who are themselves experts in infectious disease or public health published their stories in top journals. “Long COVID” is being taken seriously, and Brea hopes it might drag all post-infection illnesses into the spotlight. ME never experienced a pivot. COVID‑19 might inadvertently create one
  • Other epistemic trespassers spent their time reinventing the wheel. One new study, published in NEJM, used lasers to show that when people speak, they release aerosols. But as the authors themselves note, the same result—sans lasers—was published in 1946, Marr says. I asked her whether any papers from the 2020 batch had taught her something new. After an uncomfortably long pause, she mentioned just one.
  • The incentives to trespass are substantial. Academia is a pyramid scheme: Each biomedical professor trains an average of six doctoral students across her career, but only 16 percent of the students get tenure-track positions. Competition is ferocious, and success hinges on getting published
  • Conservationists who worked to protect monkeys and apes kept their distance for fear of passing COVID‑19 to already endangered species.
  • Among scientists, as in other fields, women do more child care, domestic work, and teaching than men, and are more often asked for emotional support by their students. These burdens increased as the pandemic took hold, leaving women scientists “less able to commit their time to learning about a new area of study, and less able to start a whole new research project,
  • published COVID‑19 papers had 19 percent fewer women as first authors compared with papers from the same journals in the previous year. Men led more than 80 percent of national COVID‑19 task forces in 87 countries. Male scientists were quoted four times as frequently as female scientists in American news stories about the pandemic.
  • American scientists of color also found it harder to pivot than their white peers, because of unique challenges that sapped their time and energy.
  • Science suffers from the so-called Matthew effect, whereby small successes snowball into ever greater advantages, irrespective of merit. Similarly, early hindrances linger. Young researchers who could not pivot because they were too busy caring or grieving for others might suffer lasting consequences from an unproductive year. COVID‑19 “has really put the clock back in terms of closing the gap for women and underrepresented minorities,”
  • In 1848, the Prussian government sent a young physician named Rudolf Virchow to investigate a typhus epidemic in Upper Silesia. Virchow didn’t know what caused the devastating disease, but he realized its spread was possible because of malnutrition, hazardous working conditions, crowded housing, poor sanitation, and the inattention of civil servants and aristocrats—problems that require social and political reforms. “Medicine is a social science,” Virchow said, “and politics is nothing but medicine in larger scale.”
  • entists discovered the microbes responsible for tuberculosis, plague, cholera, dysentery, and syphilis, most fixated on these newly identified nemeses. Societal factors were seen as overly political distractions for researchers who sought to “be as ‘objective’ as possible,” says Elaine Hernandez, a medical sociologist at Indiana University. In the U.S., medicine fractured.
  • New departments of sociology and cultural anthropology kept their eye on the societal side of health, while the nation’s first schools of public health focused instead on fights between germs and individuals. This rift widened as improvements in hygiene, living standards, nutrition, and sanitation lengthened life spans: The more social conditions improved, the more readily they could be ignored.
  • The ideological pivot away from social medicine began to reverse in the second half of the 20th century.
  • Politicians initially described COVID‑19 as a “great equalizer,” but when states began releasing demographic data, it was immediately clear that the disease was disproportionately infecting and killing people of color.
  • These disparities aren’t biological. They stem from decades of discrimination and segregation that left minority communities in poorer neighborhoods with low-paying jobs, more health problems, and less access to health care—the same kind of problems that Virchow identified more than 170 years ago.
  • In March, when the U.S. started shutting down, one of the biggest questions on the mind of Whitney Robinson of UNC at Chapel Hill was: Are our kids going to be out of school for two years? While biomedical scientists tend to focus on sickness and recovery, social epidemiologists like her “think about critical periods that can affect the trajectory of your life,” she told me. Disrupting a child’s schooling at the wrong time can affect their entire career, so scientists should have prioritized research to figure out whether and how schools could reopen safely. But most studies on the spread of COVID‑19 in schools were neither large in scope nor well-designed enough to be conclusive. No federal agency funded a large, nationwide study, even though the federal government had months to do so. The NIH received billions for COVID‑19 research, but the National Institute of Child Health and Human Development—one of its 27 constituent institutes and centers—got nothing.
  • The horrors that Rudolf Virchow saw in Upper Silesia radicalized him, pushing the future “father of modern pathology” to advocate for social reforms. The current pandemic has affected scientists in the same way
  • COVID‑19 could be the catalyst that fully reunifies the social and biological sides of medicine, bridging disciplines that have been separated for too long.
  • “To study COVID‑19 is not only to study the disease itself as a biological entity,” says Alondra Nelson, the president of the Social Science Research Council. “What looks like a single problem is actually all things, all at once. So what we’re actually studying is literally everything in society, at every scale, from supply chains to individual relationships.”
Javier E

How the West Got Covid So Wrong. Covid is a Test of Civilization, and… | by u... - 0 views

eand.co/ot-covid-so-wrong-766772322a3b

western civilization eastern civilization(s) east west civilization leadership history crisis Culture politics pandemic freedom responsibility

shared by Javier E on 01 Nov 20 - No Cached
  • In Britain, Covid now “exceeds the worst-case scenario.” In America, a thousand people die a day, and cases are skyrocketing. In Europe, the numbers are exploding. Covid is ripping savagely across the West. But in the East, meanwhile, life is slowly returning to some semblance of normality.
  • That’s a remarkable development — the West, after all, is made up of the world’s richest, most powerful societies. And yet it seems they couldn’t defeat something as tiny as a virus. The East is far poorer, less developed — and yet, it was able to defeat Covid, while the West is in the grip of the pandemic, all over again, worse than before.
  • So how did the West get Covid so wrong?
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  • Now, to the East, this behaviour is both jaw-dropping and bewildering. It goes beyond mere irresponsibility, and is considered something more like stupidity, ignorance, malice, deceit, or all four
  • That is what civilization is, and where it begins: the presence of the very first kind of enlightened mind, which can nourish, protect, and elevate another
  • What does Mead’s Femur have do with the West’s stunning failure that let Covid spiral out of control? As it turns out, everything.
  • These days, the tourists are gone, mostly. But — and here’s the point — the bars, restaurants, and clubs are still full. I pass by them on my daily walk to the park and wonder: what are these people doing? How are they sitting there so close to one another, with no social distancing in place, laughing, joking in the middle of a literal pandemic that’s exploding all around them? What the?
  • The people I pass by in the bars are made of two social groups, largely. Young people, and the working class. That’s the same group, in a sense, since most young people are working class, until they amass enough wealth to rise beyond it
  • They have made a choice. Their beer and burger or cocktail and steak matters more than stopping the spread of a deadly disease. What the?
  • This group is putting the most vulnerable in society at profound risk. Those who are already ill, and immunocompromised. Those even lower down the socioeconomic ladder than them — minorities, the underclass, and so forth, among whom death rates are astronomical. The elderly, the frail, the aged.
  • Certain groups in Western society have made the decision that the vulnerable’s lives matter less than their right to party, to have a beer and a burger, a cocktail and a steak, a laugh at the pub with friends. What the?
  • The groups who are now apparently completely indifferent to spreading Covid seem to have taken their cues from leaders. Young people and the working class seem to have no conscience or compunction left whatsoever about spreading Covid
  • To act in such a way as to put your elders, or the ill, especially, at risk, is something that is a grave violation of social norms. Easterners can’t understand why Westerners are behaving like…spoiled children. Are they right?
  • There is a kind of toxic indifference that seems to have spread through Western societies. Life itself is treated with a kind of shrugging fatalism — especially those of the vulnerable. It is literally valued less than a night out at the pub by much of society.
  • The attitude of toxic indifference is what the West seems to share in common now, and that is why it has been brought to its knees by Covid.
  • the West” is not monolithic. Certainly, toxic indifference is not at the same level across all of it
  • let me discuss the most extreme examples — America and Britain — to highlight where toxic indifference comes from: leadership.
  • In Britain and America, Covid cases have now exploded well past their first peak. America is approaching 100,000 cases per day — the point at which social breakdown will begin. Britain is hitting more than that, on a per capita basis. And yet neither of these societies has a national lockdown.
  • uccessful societies — New Zealand, Taiwan, Vietnam, and many more — deliberately crunched the curve. Their strategy was to eradicate Covid, through what’s now a global template of best practices — lock down, test, trace, quarantine, isolate, and so forth.
  • The approach of Western leaders, in other words, was reactive, hesitant, and cautious, not decisive, swift, and proactive:
  • Margaret Mead once said that the beginning of human civilisation was found in a healed femur. That that single, simple discovery meant that someone took the time to invest in healing someone else’s broken leg — without which they surely would have died
  • Western leaders, in other words, modelled toxic indifference for their societies. They gave people a license to be indifferent, by acting largely indifferent themselves.
  • Young people justify it by saying that “they need to have social lives” — as if they weren’t spending most of their social lives online before Covid, and the working class by saying they need to work. Both of those arguments are partially true. But it’s truer to say that these are groups which have become dangerously indifferent to preserving the value of the lives of the vulnerable.
  • The young and the working class are punching down, as American leftists would put it.
  • More formally, more accurately, Covid has made Western societies predatory ones. The young and working class are exploiting and abusing those more powerless than them
  • Neither group seems to consider the possibility much that society needs to come together to defeat the pandemic, once and for all, and the only way that can be done is to put the vulnerable first.
  • America treating Covid indifferently is no surprise, after all — it’s a nation where kids are gunned down in schools, diabetics are simply left to die, people beg strangers online for money to pay for crippling healthcare costs
  • But it’s more surprising to see Europe turning predatory due to Covid, or having Covid expose its vulnerability to becoming predatory
  • I don’t mean to single the young and working class out. That is missing my point. What I am saying is that toxic indifference is trickling down in the West. From elites, like leaders, to the bourgeois — that’s been the case for the last few decades
  • Indifference is trickling down from the elite and the bourgeois, to the working class and the young.
  • we know where a society of indifference ends. It ends in America. In stupidity, ignorance, violence, hate, racism, brutality, and the poverty and despair which underlies it all.
  • The indifferent cannot act collectively, therefore they cannot invest, transform, change, unite, come together, and therefore they cannot live in a modern, functioning society, with an expansive, sophisticated, supportive, generous social contract
  • So what about climate change? Mass extinction? Ecological collapse? The massive waves of depression and ruin those will unleash — in the next decade? How can societies that can’t unite, act wisely, behave responsibly to fight Covid come together to do much about even larger catastrophes?
  • Covid reveals the decivilizing of the West. As I mentioned, Margaret Mead said the fundamental test of civilization is the healed femur: that someone took the time and effort to heal someone else. It is the absence of indifference and the presence of care, in other words
  • What made the West special, once upon a time, was not its brutality, but its idea of civilization, as the elevation and nourishment of every life, with dignity, purpose, belonging, truth, justice, and, more crucially, the idea that freedom was a society that was able to act in a civilised way.
  • freedom became free-dumb: the idea that my right to be abusive, exploitative, ignorant, violent, selfish — to carry a gun to Starbucks or deny you healthcare and retirement — came to prevail
  • If the pattern of the West’s decaying attitudes, the spread of the foolish American idea of free-dumb as “freedom,” is what Covid has revealed — I punch down, on the person below me, I exploit and abuse the person even lower than me in the socioeconomic hierarchy, because that is what I must do to survive, or at least what I have been taught to do to feel good and worthy — then the simple fact is that the West has little future
  • Their failure teaches us something. Civilization matters. When a society gives up on the idea of being civilized, it collapses harder and faster than its most learned wise men often imagine. That is because no society can withstand a tidal wave of stupidity and violence. Is that where the West is headed?
  • In a simpler way, maybe the simplest, what I am talking about is a lack of simple human goodness. That is what Mead’s Femur points to — the presence of goodness — and it is what is missing in America and Britain. They are now societies with a massive, gaping, jaw-dropping lack of human goodness, and Covid is just the latest example. But that deficit spells real trouble — it isn’t some kind of abstract moral concern.
  • Covid is a cold wind, and it shows that the flame is flickering. If anything, it shows us the future of civilization — in Mead’s sense, as the absence of violence, and the presence of decency, dignity, care, nourishment, equality, of human goodness realized — may lie in the East.
Javier E

Opinion | With Covid, Is It Really Possible to Say We Went Too Far? - The New York Times - 0 views

www.nytimes.com/...covid-lockdown-failure.html

covid response backlash revisionist history crisis culture policy

shared by Javier E on 16 Nov 23 - No Cached
  • In 2020, many Americans told themselves that all it would take to halt the pandemic was replacing the president and hitting the “science button.”
  • In 2023, it looks like we’re telling ourselves the opposite: that if we were given the chance to run the pandemic again, it would have been better just to hit “abort” and give up.
  • you can see it in Bethany McLean and Joe Nocera’s book “The Big Fail: What the Pandemic Revealed About Who America Protects and Who It Leaves Behind,” excerpted last month in New York magazine under the headline “Covid Lockdowns Were a Giant Experiment. It Was a Failure.”
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  • we can’t simply replace one simplistic narrative, about the super power of mitigation policy, for another, focused only on the burdens it imposed and not at all on the costs of doing much less — or nothing at all.
  • Let’s start with the title. What is the big failure, as you see it?
  • McLean: I think it gets at things that had happened in America even before the pandemic hit. And among those things were, I think, a failure to recognize the limits of capitalism, a failure of government to set the right rules for it, particularly when it comes to our health care system; a focus on profits that may have led to an increase in the bottom line but created fragility in ways people didn’t understand; and then our growing polarization that made us incapable of talking to each other
  • How big is the failure? When I look at The Economist’s excess mortality data, I see the U.S. had the 53rd-worst outcome in the world — worse than all of Western Europe, but better than all of Eastern Europe.
  • McLean: I think one way to quantify it is to take all those numbers and then put them in the context of our spending on health care. Given the amount we spend on health care relative to other countries, the scale of the failure becomes more apparent.
  • o me, the most glaring example is the schools. They were closed without people thinking through the potential consequences of closing down public schools, especially for disadvantaged kids.
  • to compound it, in my view, public health never made the distinction that needed to be made between the vulnerabilities of somebody 70 years old and the vulnerabilities of somebody 10 years old.
  • In the beginning of the book you write, in what almost feels like a thesis statement for the book: “A central tenet of this book is that we could not have done better, and pretending differently is a dangerous fiction, one that prevents us from taking a much needed look in the mirror.”
  • This claim, that the U.S. could not have done any better, runs against your other claim, that what we observed was an American failure. It is also a pretty extreme claim, I think, and I wanted to press you on it in part because it is, in my view, undermined by quite a lot of the work you do in the book itself.
  • Would the U.S. not have done better if it had recognized earlier that the disease spread through the air rather than in droplets? Would it not have done better if it hadn’t bungled the rollout of a Covid test in the early months?
  • McLean: Everything that you mentioned — the point of the book is that those were set by the time the pandemic hit.
  • in retrospect, what we were doing was to try to delay as much spread as we could until people got vaccinated. All the things that we did in 2020 were functionally serving or trying to serve that purpose. Now, given that, how can you say that none of that work saved lives?
  • McLean: I think that the test failure was baked into the way that the C.D.C. had come to operate
  • But the big question I really want to ask is this one: According to the C.D.C., we’ve had almost 1.2 million deaths from Covid. Excess mortality is nearly 1.4 million. Is it really your contention that there was nothing we might’ve done that brought that total down to 1.1 million, for instance, or even 900,000?
  • McLean: It’s very — you’re right. If you went through each and every thing and had a crystal ball and you could say, this could have been done, this could have been moved up by a month, we could have gotten PPE …
  • When I came to that sentence, I thought of it in terms of human behavior: What will humans put up with? What will humans stand for? How do Americans act? And you’ve written about Sweden being sort of average, and you’ve written about China and the Chinese example. They lock people up for two years and suddenly the society just revolts. They will not take it anymore. They can’t stand it. And as a result, a million and a half people die in a month and a half.
  • Well, I would tell that story very differently. For me, the problem is that when China opened up, they had fully vaccinated just under two-thirds of their population over 80. So to me, it’s not a failure of lockdowns. It’s a failure of vaccinations. If the Chinese had only achieved the same elderly vaccination rate as we achieved — which by global standards was pretty poor — that death toll when they opened up would have been dramatically lower.
  • What do you mean by “lockdown,” though? You use the word throughout the book and suggest that China was the playbook for all countries. But you also acknowledge that what China did is not anything like what America did.
  • Disparities in health care access — is it a dangerous fiction to think we might address that? You guys are big champions of Operation Warp Speed — would it not have been better if those vaccines had been rolled out to the public in nine months, rather than 12
  • . But this isn’t “lockdown” like there were lockdowns in China or even Peru. It’s how we tried to make it safer to go out and interact during a pandemic that ultimately killed a million Americans.
  • McLean: I think that you’re absolutely right to focus on the definition of what a lockdown is and how we implemented them here in this country. And I think part of the problem is that we implemented them in a way that allowed people who were well off and could work from home via Zoom to be able to maintain very much of their lives while other people couldn’t
  • And I think it depends on who you were, whether you would define this as a lockdown or not. If you were a small business who saw your small business closed because of this, you’re going to define it as a lockdown.
  • n the book you’re pretty definitive. You write, “maybe the social and economic disasters that lockdowns created would have been worth it if they had saved lives, but they hadn’t.” How can you say that so flatly?
  • I think there are still open questions about what worked and how much. But the way that I think about all of this is that the most important intervention that anybody did anywhere in the world was vaccination. And the thing that determined outcomes most was whether your first exposure came before or after vaccination.
  • Here, the shelter-in-place guidelines lasted, on average, five to seven weeks. Thirty nine of the 40 states that had issued them lifted them by the end of June, three months in. By the summer, according to Google mobility data, retail and grocery activity was down about 10 percent. By the fall, grocery activity was only down about 5 percent across the country
  • Nocera: Well, on some level, I feel like you’re trying to have it both ways. On the one hand, you’re saying that lockdowns saved lives. On the other hand, you said they weren’t real lockdowns because everybody was out and about.
  • I don’t think that’s having it both ways. I’m trying to think about these issues on a spectrum rather than in binaries. I think we did interrupt our lives — everybody knows that. And I think they did have an effect on spread, and that limiting spread had an effect by delaying infections until after vaccination.
  • Nocera: Most of the studies that say lockdowns didn’t work are really less about Covid deaths than about excess mortality deaths. I wound up being persuaded that the people who could not get to the hospital, because they were all working, because all the doctors were working on Covid and the surgical rooms were shut down, the people who caught some disease that was not Covid and died as a result — I wound up being persuaded about that.
  • We’re in a pandemic. People are going to die. And then the question becomes, can we protect the most vulnerable? And the answer is, we didn’t protect the most vulnerable. Nursing homes were a complete disaster.
  • There was a lot of worry early on about delayed health care, and about cancer in particular — missed screenings, missed treatments. But in 2019, we had an estimated 599,600 Americans die of cancer. In 2020, it was 602,000. In 2021, it was 608,000. In 2022, it was 609,000.
  • Nocera: See, it went up!But by a couple of thousand people, in years in which hundreds of thousands of Americans were dying of Covid.
  • Nocera: I think you can’t dispute the excess mortality numbers.I’m not. But in nearly every country in the world the excess mortality curves track so precisely with Covid waves that it doesn’t make sense to talk about a massive public health problem beyond Covid. And when you add all of these numbers up, they are nowhere near the size of the footfall of Covid. How can you look back on this and say the costs were too high?
  • Nocera: I think the costs were too high because you had school costs, you had economic costs, you had social costs, and you had death.
  • McLean: I think you’re raising a really good point. We’re making an argument for a policy that might not have been doable given the preconditions that had been set. I’m arguing that there were these things that had been put in place in our country for decades leading up to the pandemic that made it really difficult for us to plant in an effective way, from the outsourcing of our PPE to the distrust in our health care system that had been created by people’s lack of access to health care with the disparities in our hospital system.
  • How would you have liked to see things handled differently?Nocera: Well, the great example of doing it right is San Fran
  • I find the San Francisco experience impressive, too. But it was also a city that engaged in quite protracted and aggressive pandemic restrictions, well beyond just protecting the elderly and vulnerable.
  • McLean: But are we going to go for stay-at-home orders plus protecting vulnerable communities like San Francisco did? Or simply letting everybody live their lives, but with a real focus on the communities and places like nursing homes that were going to be affected? My argument is that we probably would’ve been better off really focusing on protecting those communities which were likely to be the most severely affected.
  • I agree that the public certainly didn’t appreciate the age skew, and our policy didn’t reflect it either. But I also wonder what it would mean to better protect the vulnerable than we did. We had testing shortages at first. Then we had resistance to rapid testing. We had staff shortages in nursing homes.
  • Nocera: This gets exactly to one of our core points. We had spent 30 years allowing nursing homes to be owned by private equity firms that cut the staff, that sold the land underneath and added all this debt on
  • I hear you saying both that we could have done a much better job of protecting these people and that the systems we inherited at the outset of the pandemic would’ve made those measures very difficult, if not impossible, to implement.
  • But actually, I want to stop you there, because I actually think that that data tells the opposite story.
  • And then I’m trying to say at the same time, but couldn’t we have done something to have protected people despite all of that?
  • I want to talk about the number of lives at stake. In the book, you write about the work of British epidemiologist Neil Ferguson. In the winter of 2020, he says that in the absence of mitigation measures and vaccination, 80 percent of the country is going to get infected and 2.2 million Americans are going to die. He says that 80 percent of the U.K. would get infected, and 510,000 Brits would die — again, in the abs
  • In the end, by the time we got to 80 percent of the country infected, we had more than a million Americans die. We had more than 200,000 Brits die. And in each case most of the infections happened after vaccination, which suggests that if those infections had all happened in a world without vaccines, we almost certainly would have surpassed two million deaths in the U.S. and almost certainly would’ve hit 500,000 deaths in the U.K.
  • In the book, you write about this estimate, and you endorse Jay Bhattacharya’s criticism of Ferguson’s model. You write, “Bhattacharya got his first taste of the blowback reserved for scientists who strayed from the establishment position early. He co-wrote an article for The Wall Street Journal questioning the validity of the scary 2 to 4 percent fatality rate that the early models like Neil Ferguson’s were estimating and that were causing governments to panic. He believed, correctly as it turns out, that the true fatality rate was much lower.”
  • Nocera: I know where you’re going with this, because I read your story about the nine pandemic narratives we’re getting wrong. In there, you said that Bhattacharya estimated the fatality rate at 0.01 percent. But if you actually read The Wall Street Journal article, what he’s really saying is I think it’s much lower. I’ve looked at two or three different possibilities, and we really need some major testing to figure out what it actually is, because I think 2 percent to 4 percent is really high.
  • He says, “if our surmise of 6 million cases is accurate, that’s a mortality rate of 0.01%. That is ⅒th the flu mortality rate of 0.1%.” An I.F.R. of 0.01 percent, spread fully through the American population, yields a total American death toll of 33,000 people. We have had 1.2 million deaths. And you are adjudicating this dispute, in 2023, and saying that Neil was wrong and Jay was right.
  • hird, in the Imperial College report — the one projecting two million American deaths — Ferguson gives an I.F.R. estimate of 0.9 percent.
  • Bhattacharya’s? Yes, there is some uncertainty around the estimate he offers. But the estimate he does offer — 0.01 percent — is one hundred times lower than the I.F.R. you yourselves cite as the proper benchmark.
  • Nocera: In The Wall Street Journal he does not say it’s 0.01. He says, we need to test to find out what it is, but it is definitely lower than 2 to 4 percent.
  • Well, first of all, the 2 percent to 4 percent fatality rate is not from Neil Ferguson. It’s from the W.H.O.
  • But I think that fundamentally, at the outset of the pandemic, the most important question orienting all of our thinking was, how bad could this get? And it turns out that almost all of the people who were saying back then that we shouldn’t do much to intervene were extremely wrong about how bad it would be
  • The argument then was, more or less, “We don’t need to do anything too drastic, because it’s not going to be that big a deal.” Now, in 2023, it’s the opposite argument: “We shouldn’t have bothered with restrictions, because they didn’t have an impact; we would have had this same death toll anyway.” But the death toll turned out to be enormous.
  • Now, if we had supplied all these skeptics with the actual numbers at the outset of the pandemic, what kind of audience would they have had? If instead of making the argument against universal mitigation efforts on the basis of a death toll of 40,000 they had made the argument on the basis of a death toll of more than a million, do you think the country would’ve said, they’re right, we’re doing too much, let’s back off?
  • McLean: I think that if you had gone to the American people and said, this many people are going to die, that would’ve been one thing. But if you had gone to the American people and said, this many people are going to die and a large percentage of them are going to be over 80, you might’ve gotten a different answer.
  • I’m not arguing we shouldn’t have been trying to get a clearer sense of the true fatality rate, or that we shouldn’t have been clearer about the age skew. But Bhattacharya was also offering an estimate of fatality rate that turned out to be off by a factor of a hundred from the I.F.R. that you yourselves cite as correct. And then you say that Bhattacharya was right and Ferguson was wrong.
  • And you, too, Joe, you wrote an article in April expressing sympathy for Covid skeptics and you said ——Nocera: This April?No, 2020.Nocera: Oh, oh. That’s the one where I praised Alex Berenson.You also cited some Amherst modeling which said that we were going to have 67,000 to 120,000 American deaths. We already had, at that point, 60,000. So you were suggesting, in making an argument against pandemic restrictions, that the country as a whole was going to experience between 7,000 and 60,000 additional deaths from that point.
  • when I think about the combination of the economic effects of mitigation policies and just of the pandemic itself and the big fiscal response, I look back and I think the U.S. managed this storm relatively well. How about each of you?
  • in this case, Congress did get it together and did come to the rescue. And I agree that made a ton of difference in the short term, but the long-term effects of the fiscal rescue package were to help create inflation. And once again, inflation hits those at the bottom of the socioeconomic distribution much harder than it does those at the top. So I would argue that some of what we did in the pandemic is papering over these long-term issues.
  • I think as with a lot of the stuff we’ve talked about today, I agree with you about the underlying problems. But if we take for granted for a moment that the pandemic was going to hit us, when it did, under the economic conditions it did, and then think about the more narrow context of whether, given all that, we handled the pandemic well. We returned quickly to prepandemic G.D.P. trends, boosted the wealth of the bottom half of the country, cut child poverty in half, pushed unemployment to historical lows.
  • What sense do you make of the other countries of the world and their various mitigation policies? Putting aside China, there’s New Zealand, Australia, South Korea — these are all places that were much more aggressive than the U.S. and indeed more than Europe. And had much, much better outcomes.
  • Nocera: To be perfectly honest, we didn’t really look, we didn’t really spend a lot of time looking at that.
  • McLean: But one reason that we didn’t is I don’t think it tells us anything. When you look at who Covid killed, then you have to look at what the pre-existing conditions in a country were, what percentage of its people are elderly. How sick are people with pre-existing conditions?
  • I just don’t think there’s a comparison. There’s just too many factors that influence it to be able to say that, to be able to compare America to any other country, you’d have to adjust for all these factors.
  • But you do spend a bit of time in the book talking about Sweden. And though it isn’t precisely like-for-like, one way you can control for some of those factors is grouping countries with their neighbors and other countries with similar profiles. And Sweden’s fatality rate in 2020 was 10 times that of Norway, Finland and Iceland. Five times that of Denmark. In the vaccination era, those gaps have narrowed, but by most metrics Sweden has still done worse, overall, than all of those countries.
  • On the matter of omniscience. Let’s say that we can send you back in time. Let’s put you both in charge of American pandemic response, or at least American communication about the pandemic, in early 2020. What would you want to tell the country? How would you have advised us to respond?
  • McLean: What I would want is honesty and communication. I think we’re in a world that is awash in information and the previous methods of communication — giving a blanket statement to people that may or may not be true, when you know there’s nuance underneath it — simply doesn’t work anymore
  • o I would’ve been much more clear — we think masks might help, we don’t know, but it’s not that big of an ask, let’s do it. We think the early data coming out of Italy shows that these are the people who are really, really at risk from Covid, but it’s not entirely clear yet. Maybe there is spread in schools, but we don’t know. Let’s look at this and keep an open mind and look at the data as it comes in.
Javier E

COVID Is More Like Smoking Than the Flu - The Atlantic - 0 views

www.theatlantic.com/...622819

pandemic flu smosing analogy analysis

shared by Javier E on 23 Feb 22 - No Cached
  • The “new normal” will arrive when we acknowledge that COVID’s risks have become more in line with those of smoking cigarettes—and that many COVID deaths, like many smoking-related deaths, could be prevented with a single intervention.
  • The pandemic’s greatest source of danger has transformed from a pathogen into a behavior. Choosing not to get vaccinated against COVID is, right now, a modifiable health risk on par with smoking, which kills more than 400,000 people each year in the United States.
  • if COVID continues to account for a few hundred thousand American deaths every year—“a realistic worst-case scenario,” he calls it—that would wipe out all of the life-expectancy gains we’ve accrued from the past two decades’ worth of smoking-prevention efforts.
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  • The COVID vaccines are, without exaggeration, among the safest and most effective therapies in all of modern medicine. An unvaccinated adult is an astonishing 68 times more likely to die from COVID than a boosted one
  • Yet widespread vaccine hesitancy in the United States has caused more than 163,000 preventable deaths and counting
  • Even in absolute numbers, America’s unvaccinated and current-smoker populations seem to match up rather well: Right now, the CDC pegs them at 13 percent and 14 percent of all U.S. adults, respectively, and both groups are likely to be poorer and less educated.
  • Countries such as Denmark and Sweden have already declared themselves broken up with COVID. They are confidently doing so not because the virus is no longer circulating or because they’ve achieved mythical herd immunity from natural infection; they’ve simply inoculated enough people.
  • data suggest that most of the unvaccinated hold that status voluntarily at this point
  • The same arguments apply to tobacco: Smokers are 15 to 30 times more likely to develop lung cancer. Quitting the habit is akin to receiving a staggeringly powerful medicine, one that wipes out most of this excess risk.
  • If everyone who is eligible were triply vaccinated, our health-care system would be functioning normally again.
  • We should neither expect that every stubbornly unvaccinated person will get jabbed before next winter nor despair that none of them will ever change their mind. Let’s accept instead that we may make headway slowly, and with considerable effort
  • With a vaccination timeline that stretches over years, our patience for restrictions, especially on the already vaccinated, will be very limited. But there is middle ground. We haven’t banned tobacco outright—in fact, most states protect smokers from job discrimination—but we have embarked on a permanent, society-wide campaign of disincentivizing its use.
  • Long-term actions for COVID might include charging the unvaccinated a premium on their health insurance, just as we do for smokers, or distributing frightening health warnings about the perils of remaining uninoculated
  • And once the political furor dies down, COVID shots will probably be added to the lists of required vaccinations for many more schools and workplaces.
  • nother aspect of where we’re headed with COVID. Tobacco is lethal enough that we are willing to restrict smokers’ personal freedoms—but only to a degree. As deadly as COVID is, some people won’t get vaccinated, no matter what, and both the vaccinated and unvaccinated will spread disease to others.
  • anti-COVID actions, much like anti-smoking policies, will be limited not by their effectiveness but by the degree to which they are politically palatable.
  • Without greater vaccination, living with COVID could mean enduring a yearly death toll that is an order of magnitude higher than the one from flu.
  • this, too, might come to feel like its own sort of ending. Endemic tobacco use causes hundreds of thousands of casualties, year after year after year, while fierce public-health efforts to reduce its toll continue in the background. Yet tobacco doesn’t really feel like a catastrophe for the average person.
  • Losing a year or two from average life expectancy only bumps us back to where we were in … 2000.
  • We still care for smokers when they get sick, of course, and we reduce harm whenever possible. The health-care system makes $225 billion every year for doing so—paid out of all of our tax dollars and insurance premiums
  • Hospitals have a well-honed talent for transforming any terrible situation into a marketable “center of excellence.”
  • But we shouldn’t forget the most important reason that the coronavirus isn’t like the flu: We’ve never had vaccines this effective in the midst of prior influenza outbreaks, which means we didn’t have a simple, clear approach to saving quite so many lives. Compassionate conversations, community outreach, insurance surcharges, even mandates—I’ll take them all. Now is not the time to quit.
Javier E

The Steep Cost of Ron DeSantis's Vaccine Turnabout - The New York Times - 0 views

www.nytimes.com/...ron-desantis-covid.html

Florida vaccine pandemic policy effects politics us history

shared by Javier E on 23 Jul 23 - No Cached
  • While Florida was an early leader in the share of over-65 residents who were vaccinated, it had fallen to the middle of the pack by the end of July 2021. When it came to younger residents, Florida lagged behind the national average in every age group.
  • That left the state particularly vulnerable when the Delta variant hit that month. Floridians died at a higher rate, adjusted for age, than residents of almost any other state during the Delta wave, according to the Times analysis. With less than 7 percent of the nation’s population, Florida accounted for 14 percent of deaths between the start of July and the end of October.
  • Of the 23,000 Floridians who died, 9,000 were younger than 65. Despite the governor’s insistence at the time that “our entire vulnerable population has basically been vaccinated,” a vast majority of the 23,000 were either unvaccinated or had not yet completed the two-dose regimen.
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  • A high vaccination rate was especially important in Florida, which trails only Maine in the share of residents 65 and older. By the end of July, Florida had vaccinated about 60 percent of adults, just shy of the national average
  • Had it reached a vaccination rate of 74 percent — the average for five New England states at the time — it could have prevented more than 16,000 deaths and more than 61,000 hospitalizations that summer, according to a study published in the medical journal The Lancet.
  • in Florida, unlike the nation as a whole — and states like New York and California that Mr. DeSantis likes to single out — most people who died from Covid died after vaccines became available to all adults, not before.
  • Mr. DeSantis and his aides have said that his opposition was to mandates, not to the vaccinations themselves. They say the governor only questioned the efficacy of the shots once it became evident that they did not necessarily prevent infection — which prompted him to criticize experts and the federal government.
  • The governor had early success in following his instincts. In 2020, the state supplied its nearly 4,000 long-term care homes with Covid tests and isolated Covid patients, avoiding New York’s mistake of releasing Covid patients from hospitals to nursing homes where they infected others. Florida’s death rate in the pandemic’s first year, adjusted for age, was lower than all but 10 other states’.
  • Florida was also one of only four states to require schools to hold in-person classes in the fall of 2020, a move that Mr. DeSantis has said defied the nation’s public health experts
  • In fact, Dr. Anthony S. Fauci, a federal infectious disease expert on former President Donald J. Trump’s task force, said repeatedly that summer and fall that schools could open safely with the right precautions. Nonetheless, facing strong opposition from teachers’ unions, nearly three-fourths of the nation’s 100 largest school districts offered only remote learning that fall.
  • At the same time, though, the governor was embracing more extreme views, including those of Dr. Scott W. Atla
  • Both he and Dr. Bhattacharya argued that people who were not at risk of severe consequences should not face Covid restrictions. If they were infected, they would develop natural immunity, which would eventually build up in the population and cause the virus to fade away, they said.
  • Many public health experts were alarmed by this strategy, which was articulated in a document known as the Great Barrington Declaration. They said it would be impossible to ring-fence the vulnerable, or even to clearly communicate to the public who they were. Besides older Americans, as many as 41 million younger adults were considered to be at high risk of severe disease if infected because of underlying medical conditions like obesity.
  • Dr. Atlas, however, argued that the virus was not dangerous to an overwhelming majority of Americans. Both he and Dr. Bhattacharya said the Covid death rate for everyone under 70 was very low. Dr. Atlas claimed that children had “virtually zero” risk of death.
  • As of this summer, more than 345,000 Americans under 70 have died of the virus, and more than 3.5 million have been hospitalized
  • The disease has killed nearly 2,300 children and adolescents, and nearly 200,000 have been hospitalized.
  • Mr. DeSantis gave him a platform at a series of public events in Florida at the end of the summer of 2020. He would go on to echo Dr. Atlas’s views, sometimes in modified form, throughout the pandemic.
  • Mr. DeSantis subsequently promoted the shots in 27 counties. Florida offered the vaccine to everyone 65 and older, an eligibility system simpler than an early one recommended by the Centers for Disease Control and Prevention, and adopted by many states, that prioritized essential workers and those over 75.
  • But his enthusiasm for shots waned fast, tracking the growing hostility toward them among the party’s conservative activists. In late February, when Mr. DeSantis hosted a gathering of such activists for the Conservative Political Action Conference in Orlando, he boasted that Florida was an “oasis of freedom” in a nation led by misguided health authorities.
  • By the time all adults became eligible for the vaccines in April of that year, Mr. DeSantis was rarely promoting them.
  • “Some are choosing not to take it, which is fine,” he said in March, at a 100-minute public event on Covid in which he did not once urge people to get vaccinated. In dozens of appearances on Fox News in the first half of 2021, he was carefully neutral about shots, except for those over 65.
  • “Younger people are just simply at very little risk for this,”
  • A few months later, he told Fox News that he had concluded early on that Covid “was something that was risky for elderly people,” but that it posed minimal risks for people “who were in reasonably good health, who were, say, under 50.”
  • The data-driven governor also turned away from Covid case data.
  • In May 2021, Florida closed its 27 state-run testing centers. The next month, on orders from the governor’s office, the Health Department halted daily reports on infections and deaths, switching to weekly reports that drew less attention.
  • Both polls and political events showed that Republicans were not as excited as Democrats about the shots. At an Alabama political rally that August, Mr. Trump recommended the vaccine — and was booed. When a reporter asked Mr. DeSantis later that year if he had gotten a booster shot, he responded that he had gotten “the normal shot.”
  • After the highly contagious Delta variant began spreading in Florida that summer, Mr. DeSantis insisted that his approach had worked. Younger adults were driving the surge but “they’re not getting really sick from it or anything,” he said, adding: “They will develop immunity as a result of those infections.”
  • But they were getting sick. And vaccinations, which Mr. DeSantis suddenly began recommending again in late July, took weeks to confer protection
  • With hospitalizations rising, he began a campaign to offer monoclonal antibody treatments — a triage response to the pandemic’s frightening resurgence.
  • The drug cost vastly more than shots and required more medical staff to administer. Within about six weeks, the state had administered more than 90,000 treatments and probably kept 5,000 people out of the hospital, Dr. Rivkees said.
  • Mr. DeSantis accused the media in early August of “lying” about Covid patients’ flooding hospitals. Two weeks later, Mary C. Mayhew, head of the Florida Hospital Association, said: “There can be no question that many Florida hospitals are stretched to their absolute limits.”
  • “Our patients are younger and sicker,” Mr. Smith wrote. Of 17 patients on ventilators in intensive care on Aug. 13, 2021, more than half were younger than 55. Only one was vaccinated.
  • “People say that the decision about vaccination is a personal one and it doesn’t affect anyone else,” Mr. Smith wrote. “Tell that to the kids who lost their mom.”
  • When shots became available last year for children under 5, Florida did not preorder them because, Mr. DeSantis said, he did not consider them “appropriate.” Florida’s vaccination rates are well below the national average for children under 5. The state also trails in booster shots.
  • After Dr. Ladapo issued misleading claims about the risks of Covid shots for young men, the heads of the C.D.C. and the Food and Drug Administration sent a scathing four-page rebuttal. Such misinformation “puts people at risk of death or serious illness,” they said.
  • While the pandemic waned, leaving more than 80,000 Floridians and 1.13 million Americans dead, the governor continued to push policies that kept him at the vanguard of the anti-vaccine and anti-mandate conversation. A new state law, signed by Mr. DeSantis in May, bans government agencies, businesses and schools from requiring Covid testing, vaccination or mask wearing.
  • “Everything involving Covid — I think there needs to be major, major accountability,” he said in Iowa this month. “Because if there’s not, if you don’t have a reckoning, they are going to do it again.”
Javier E

What Does It Mean to Care About COVID Anymore? - The Atlantic - 0 views

www.theatlantic.com/...672186

pandemic covid protection safety

shared by Javier E on 30 Nov 22 - No Cached
  • “People who are vaccinated and relatively healthy who are getting COVID are not getting that sick,” Lisa Lee, an epidemiologist at Virginia Tech, told me. “And so people are thinking, Wow, I’ve had COVID. It wasn’t that bad. I don’t really care anymore.”
  • Still, there are many reasons to continue caring about COVID. About 300 people are still dying every day; COVID is on track to be the third-leading cause of death in the U.S. for the third year running. The prospect of developing long COVID is real and terrifying, as are mounting concerns about reinfections.
  • when so few people feel that the potential benefit of dodging an infection is worth the inconvenience of precautions, what does it even mean to care about COVID?
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  • In an ideal epidemiological scenario, everyone would willingly deploy the full arsenal of COVID precautions, such as masking and forgoing crowded indoor activities, especially during waves. But that kind of all-out response no longer makes sense. “It’s probably not realistic to expect people to take precautions every time, perpetually, or even every winter or fall, unless there is a particularly concerning reason to do that,
  • ow more than ever, we must remember that COVID is not just a personal threat but a community one.
  • people over 50 account for 93 percent of COVID-related deaths in the U.S., even though they represent just 35.7 percent of the population. As long as the death rate remains as high as it is, caring about COVID should mean orienting precautions to protect them.
  • Barring another Omicron-esque event, we thankfully won’t ever return to a moment where Americans obsess over COVID en masse. But this virus isn’t going away, so we can’t escape having a population that is split between the high-risk minority and the low-risk majority
  • Right now, Nuzzo told me, the language we use to describe one’s position on COVID is “black-and-white, absolutist—you either care or you don’t.” There is space between those extremes. At least for now, it’s the only way to compromise between the world we have and the world we want.
Javier E

If We Knew Then What We Know Now About Covid, What Would We Have Done Differently? - WSJ - 0 views

www.wsj.com/...covid-lessons-learned-9dd5566f

politics us history crisis culture policy trump pandemic response

shared by Javier E on 12 Mar 23 - No Cached
  • A small cadre of aerosol scientists had a different theory. They suspected that Covid-19 was transmitted not so much by droplets but by smaller infectious aerosol particles that could travel on air currents way farther than 6 feet and linger in the air for hours. Some of the aerosol particles, they believed, were small enough to penetrate the cloth masks widely used at the time.
  • For much of 2020, doctors and public-health officials thought the virus was transmitted through droplets emitted from one person’s mouth and touched or inhaled by another person nearby. We were advised to stay at least 6 feet away from each other to avoid the droplets
  • The group had a hard time getting public-health officials to embrace their theory. For one thing, many of them were engineers, not doctors.
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  • “My first and biggest wish is that we had known early that Covid-19 was airborne,”
  • , “Once you’ve realized that, it informs an entirely different strategy for protection.” Masking, ventilation and air cleaning become key, as well as avoiding high-risk encounters with strangers, he says.
  • Instead of washing our produce and wearing hand-sewn cloth masks, we could have made sure to avoid superspreader events and worn more-effective N95 masks or their equivalent. “We could have made more of an effort to develop and distribute N95s to everyone,” says Dr. Volckens. “We could have had an Operation Warp Speed for masks.”
  • We didn’t realize how important clear, straight talk would be to maintaining public trust. If we had, we could have explained the biological nature of a virus and warned that Covid-19 would change in unpredictable ways.  
  • In the face of a pandemic, he says, the public needs an early basic and blunt lesson in virology
  • “The science is really important, but if you don’t get the trust and communication right, it can only take you so far,”
  • and mutates, and since we’ve never seen this particular virus before, we will need to take unprecedented actions and we will make mistakes, he says.
  • Since the public wasn’t prepared, “people weren’t able to pivot when the knowledge changed,”
  • By the time the vaccines became available, public trust had been eroded by myriad contradictory messages—about the usefulness of masks, the ways in which the virus could be spread, and whether the virus would have an end date.
  • , the absence of a single, trusted source of clear information meant that many people gave up on trying to stay current or dismissed the different points of advice as partisan and untrustworthy.
  • We didn’t know how difficult it would be to get the basic data needed to make good public-health and medical decisions. If we’d had the data, we could have more effectively allocated scarce resources
  • For much of the pandemic, doctors, epidemiologists, and state and local governments had no way to find out in real time how many people were contracting Covid-19, getting hospitalized and dying
  • Doctors didn’t know what medicines worked. Governors and mayors didn’t have the information they needed to know whether to require masks. School officials lacked the information needed to know whether it was safe to open schools.
  • people didn’t know whether it was OK to visit elderly relatives or go to a dinner party.
  • just months before the outbreak of the pandemic, the Council of State and Territorial Epidemiologists released a white paper detailing the urgent need to modernize the nation’s public-health system still reliant on manual data collection methods—paper records, phone calls, spreadsheets and faxes.
  • While the U.K. and Israel were collecting and disseminating Covid case data promptly, in the U.S. the CDC couldn’t. It didn’t have a centralized health-data collection system like those countries did, but rather relied on voluntary reporting by underfunded state and local public-health systems and hospitals.
  • doctors and scientists say they had to depend on information from Israel, the U.K. and South Africa to understand the nature of new variants and the effectiveness of treatments and vaccines. They relied heavily on private data collection efforts such as a dashboard at Johns Hopkins University’s Coronavirus Resource Center that tallied cases, deaths and vaccine rates globally.
  • With good data, Dr. Ranney says, she could have better managed staffing and taken steps to alleviate the strain on doctors and nurses by arranging child care for them.
  • To solve the data problem, Dr. Ranney says, we need to build a public-health system that can collect and disseminate data and acts like an electrical grid. The power company sees a storm coming and lines up repair crews.
  • If we’d known how damaging lockdowns would be to mental health, physical health and the economy, we could have taken a more strategic approach to closing businesses and keeping people at home.
  • t many doctors say they were crucial at the start of the pandemic to give doctors and hospitals a chance to figure out how to accommodate and treat the avalanche of very sick patients.
  • The measures reduced deaths, according to many studies—but at a steep cost.
  • The lockdowns didn’t have to be so harmful, some scientists say. They could have been more carefully tailored to protect the most vulnerable, such as those in nursing homes and retirement communities, and to minimize widespread disruption.
  • Lockdowns could, during Covid-19 surges, close places such as bars and restaurants where the virus is most likely to spread, while allowing other businesses to stay open with safety precautions like masking and ventilation in place.  
  • If England’s March 23, 2020, lockdown had begun one week earlier, the measure would have nearly halved the estimated 48,600 deaths in the first wave of England’s pandemic
  • If the lockdown had begun a week later, deaths in the same period would have more than doubled
  • The key isn’t to have the lockdowns last a long time, but that they are deployed earlier,
  • It is possible to avoid lockdowns altogether. Taiwan, South Korea and Hong Kong—all countries experienced at handling disease outbreaks such as SARS in 2003 and MERS—avoided lockdowns by widespread masking, tracking the spread of the virus through testing and contact tracing and quarantining infected individuals.
  • Had we known that even a mild case of Covid-19 could result in long Covid and other serious chronic health problems, we might have calculated our own personal risk differently and taken more care.
  • Early in the pandemic, public-health officials were clear: The people at increased risk for severe Covid-19 illness were older, immunocompromised, had chronic kidney disease, Type 2 diabetes or serious heart conditions
  • t had the unfortunate effect of giving a false sense of security to people who weren’t in those high-risk categories. Once case rates dropped, vaccines became available and fear of the virus wore off, many people let their guard down, ditching masks, spending time in crowded indoor places.
  • it has become clear that even people with mild cases of Covid-19 can develop long-term serious and debilitating diseases. Long Covid, whose symptoms include months of persistent fatigue, shortness of breath, muscle aches and brain fog, hasn’t been the virus’s only nasty surprise
  • In February 2022, a study found that, for at least a year, people who had Covid-19 had a substantially increased risk of heart disease—even people who were younger and had not been hospitalized
  • respiratory conditions.
  • Some scientists now suspect that Covid-19 might be capable of affecting nearly every organ system in the body. It may play a role in the activation of dormant viruses and latent autoimmune conditions people didn’t know they had
  •  A blood test, he says, would tell people if they are at higher risk of long Covid and whether they should have antivirals on hand to take right away should they contract Covid-19.
  • If the risks of long Covid had been known, would people have reacted differently, especially given the confusion over masks and lockdowns and variants? Perhaps. At the least, many people might not have assumed they were out of the woods just because they didn’t have any of the risk factors.
lilyrashkind

Lives Cut Short: COVID-19 Takes Heavy Toll on Older Latinos | Healthiest Communities He... - 0 views

www.usnews.com/...es-heavy-toll-on-older-latinos

US communities

shared by lilyrashkind on 02 Jun 22 - No Cached
  • LOS ANGELES – In December 2020, about 10 months into the COVID-19 pandemic, Javier Perez-Torres boarded a bus from Los Angeles to Tijuana, Mexico, to buy a bracelet for the upcoming birthday of one of the five granddaughters who lived with him and his wife. Perez-Torres, 68, a Mexican immigrant, liked the selection of inexpensive jewelry available in the city just south of the U.S. border, so he made the trek, which lasted more than four hours round-trip.
  • For more than a month, Miron went to the hospital to see her husband, who’d been intubated. But nurses – following COVID-19 safety protocols – wouldn’t let her in. She’d sit on a bench outside the hospital for hours, then go home, and repeat the process.In early February of last year, a nurse called to let her know her partner of more than 40 years had died. She could now see him. “I said, ‘Why would I want to see him now?’” Alicia recalls in an interview in Spanish.
  • Overall, mortality from COVID-19 is some two to three times higher for Latinos than for non-Hispanic whites, says Dr. Michael Rodriguez, vice chair in the Department of Family Medicine at the David Geffen School of Medicine at UCLA. Rodriguez also is a professor in the Department of Community Health Sciences in UCLA’s Fielding School of Public Health.
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  • Latinos have maintained this type of edge despite generally having lower incomes, less access to health care and a greater prevalence of some chronic health issues, such as diabetes and obesity. Some researchers believe the life expectancy advantage is tied to the fact that many Latino immigrants to the U.S. are younger and healthier than many older Latinos, and have lower rates of smoking.
  • The researchers used projections of COVID-19 mortality to reach their conclusions, and a follow-up study arrived at similar findings. A CDC analysis showing provisional life expectancy estimates also pointed to a three-year drop in life expectancy for Latinos, and a shrinking gap between Latinos and whites.
  • Latino subgroups have an array of political and cultural differences. But one cultural norm that cuts across all groups is the primacy of family. Whatever country they’re descended from, it’s not uncommon for Latinos in the U.S. to live in multigenerational households that often include young children, their adult parents and a grandparent or grandparents.When young children and adults – many of whom are essential workers – live with elderly grandparents, “that increases the risk for the older people in the household,” says Dr. Luis Ostrosky, chief of the Division of Infectious Diseases at the McGovern Medical School at UTHealth Houston. “If the younger people in the household contract COVID-19, they may be OK, because younger people have stronger immune systems and tend to be healthier. Older people – who tend to be not as healthy and have chronic diseases – may become severely ill, with increased risk of hospitalization and mortality.”
  • “Once you put all those together, what you find is you have the disappearing of the Latino paradox,” Saenz says.While older Latinos have continued to have a higher rate of COVID-19 mortality than their white counterparts during each year of the pandemic, the difference in death rates has diminished over time. During the first year of the crisis, Latinos age 65 and older died of COVID-19 at 2.1 times the rate of older whites, Saenz and Garcia’s research shows. In 2021, older Latinos died at 1.6 times the rate of older whites, and into late April of this year, older Hispanics had died at 1.2 times the rate of older whites. Saenz attributes the narrowing difference to COVID-19 death rates among older whites in red states where vaccination rates are lower.
  • Transportation, language and employment. A study in 2020 from the UCLA Latino Policy & Politics Initiative found Latinos (and Blacks) in Los Angeles County and New York City were roughly twice as likely to die of COVID-19 as non-Hispanic whites as of July 20 of that year, and noted that carpooling or taking public transportation to work may raise the risk of coronavirus exposure. The study also found that 34% and 37% of the populations in Los Angeles County and New York City were foreign-born, respectively, with Latinos making up the largest share of that population in each area. Approximately 13% of the foreign-born do not speak English, according to the report, which poses a challenge to their obtaining important health information.
  • “A three-year reduction in life expectancy is huge in historical terms. We usually have not seen reductions this large except during times of war or major pandemics,” says Theresa Andrasfay, a postdoctoral scholar at the Leonard Davis School of Gerontology at USC and one of the PNAS study’s researchers. “Of course, it’s really sad to think about the individuals who died of COVID, but it also has broader implications for the family members of those who died.”COVID-19 has not only claimed the lives of many older Latinos, but many younger, working-age Latinos as well, leaving behind children, siblings, parents and grandparents who depended on them, Andrasfay says. She says she and other researchers are working on an update, tracking the effect of COVID-19 on life expectancy in 2021: “We’re finding a similar pattern (to 2020), with Latinos having the largest reduction in life expectancy.”
  • Though he wasn’t in the best of health, Salvador Macias, 83, enjoyed going to a neighborhood community center for senior activities in Long Beach, a beachside city about 25 miles south of downtown Los Angeles. He lived in a modest, tidy house with his wife, Manuela, and their adult daughter, Julie.Salvador suffered from three chronic health conditions: diabetes, high cholesterol and high blood pressure, says his son, Joe Macias.In August 2020 – four months before health care workers received the first COVID-19 vaccine – the elder Macias became ill with the disease, suffering from fatigue and severe shortness of breath. After several days, Salvador died at home. Manuela, who doesn’t have the chronic health conditions her husband had, also contracted COVID-19. She was hospitalized for a week, but survived.
Javier E

We're That Much Likelier to Get Sick Now - The Atlantic - 0 views

www.theatlantic.com/...676173

covid flu RSV infectious season epidemiology

shared by Javier E on 15 Dec 23 - No Cached
  • Although neither RSV nor flu is shaping up to be particularly mild this year, says Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security, both appear to be behaving more within their normal bounds.
  • But infections are still nowhere near back to their pre-pandemic norm. They never will be again. Adding another disease—COVID—to winter’s repertoire has meant exactly that: adding another disease, and a pretty horrific one at that, to winter’s repertoire.
  • “The probability that someone gets sick over the course of the winter is now increased,” Rivers told me, “because there is yet another germ to encounter.” The math is simple, even mind-numbingly obvious—a pathogenic n+1 that epidemiologists have seen coming since the pandemic’s earliest days. Now we’re living that reality, and its consequences.
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  • ‘Odds are, people are going to get sick this year,’”
  • In typical years, flu hospitalizes an estimated 140,000 to 710,000 people in the United States alone; some years, RSV can add on some 200,000 more. “Our baseline has never been great,” Yvonne Maldonado, a pediatrician at Stanford, told me. “Tens of thousands of people die every year.”
  • this time of year, on top of RSV, flu, and COVID, we also have to contend with a maelstrom of other airway viruses—among them, rhinoviruses, parainfluenza viruses, human metapneumovirus, and common-cold coronaviruses.
  • Illnesses not severe enough to land someone in the hospital could still leave them stuck at home for days or weeks on end, recovering or caring for sick kids—or shuffling back to work
  • “This is a more serious pathogen that is also more infectious,” Ajay Sethi, an epidemiologist at the University of Wisconsin at Madison, told me. In the past year, COVID-19 has killed some 80,000 Americans—a lighter toll than in the three years prior, but one that still dwarfs that of the worst flu seasons in the past decade.
  • Globally, the only infectious killer that rivals it in annual-death count is tuberculosis
  • Rivers also pointed to CDC data that track trends in deaths caused by pneumonia, flu, and COVID-19. Even when SARS-CoV-2 has been at its most muted, Rivers said, more people have been dying—especially during the cooler months—than they were at the pre-pandemic baseline.
  • This year, for the first time, millions of Americans have access to three lifesaving respiratory-virus vaccines, against flu, COVID, and RSV. Uptake for all three remains sleepy and halting; even the flu shot, the most established, is not performing above its pre-pandemic baseline.
  • COVID could now surge in the summer, shading into RSV’s autumn rise, before adding to flu’s winter burden, potentially dragging the misery out into spring. “Based on what I know right now, I am considering the season to be longer,” Rivers said.
  • barring further gargantuan leaps in viral evolution, the disease will continue to slowly mellow out in severity as our collective defenses build; the virus may also pose less of a transmission risk as the period during which people are infectious contracts
  • even if the dangers of COVID-19 are lilting toward an asymptote, experts still can’t say for sure where that asymptote might be relative to other diseases such as the flu—or how long it might take for the population to get there.
  • it seems extraordinarily unlikely to ever disappear. For the foreseeable future, “pretty much all years going forward are going to be worse than what we’ve been used to before,”
  • although a core contingent of Americans might still be more cautious than they were before the pandemic’s start—masking in public, testing before gathering, minding indoor air quality, avoiding others whenever they’re feeling sick—much of the country has readily returned to the pre-COVID mindset.
  • When I asked Hanage what precautions worthy of a respiratory disease with a death count roughly twice that of flu’s would look like, he rattled off a familiar list: better access to and uptake of vaccines and antivirals, with the vulnerable prioritized; improved surveillance systems to offer  people at high risk a better sense of local-transmission trends; improved access to tests and paid sick leave
  • Without those changes, excess disease and death will continue, and “we’re saying we’re going to absorb that into our daily lives,” he said.
  • And that is what is happening.
  • last year, a CDC survey found that more than 3 percent of American adults were suffering from long COVID—millions of people in the United States alone.
  • “We get used to things we could probably fix.” The years since COVID arrived set a horrific precedent of death and disease; after that, this season of n+1 sickness might feel like a reprieve. But compare it with a pre-COVID world, and it looks objectively worse. We’re heading toward a new baseline, but it will still have quite a bit in common with the old one: We’re likely to accept it, and all of its horrors, as a matter of course.
Javier E

How Will the Coronavirus End? - The Atlantic - 0 views

www.theatlantic.com/...608719

strategies effects pandemic culture politics history crisis

shared by Javier E on 25 Mar 20 - No Cached
  • A global pandemic of this scale was inevitable. In recent years, hundreds of health experts have written books, white papers, and op-eds warning of the possibility. Bill Gates has been telling anyone who would listen, including the 18 million viewers of his TED Talk.
  • We realized that her child might be one of the first of a new cohort who are born into a society profoundly altered by COVID-19. We decided to call them Generation C.
  • “No matter what, a virus [like SARS-CoV-2] was going to test the resilience of even the most well-equipped health systems,”
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  • To contain such a pathogen, nations must develop a test and use it to identify infected people, isolate them, and trace those they’ve had contact with. That is what South Korea, Singapore, and Hong Kong did to tremendous effect. It is what the United States did not.
  • That a biomedical powerhouse like the U.S. should so thoroughly fail to create a very simple diagnostic test was, quite literally, unimaginable. “I’m not aware of any simulations that I or others have run where we [considered] a failure of testing,”
  • The testing fiasco was the original sin of America’s pandemic failure, the single flaw that undermined every other countermeasure. If the country could have accurately tracked the spread of the virus, hospitals could have executed their pandemic plans, girding themselves by allocating treatment rooms, ordering extra supplies, tagging in personnel, or assigning specific facilities to deal with COVID-19 cases.
  • None of that happened. Instead, a health-care system that already runs close to full capacity, and that was already challenged by a severe flu season, was suddenly faced with a virus that had been left to spread, untracked, through communities around the country.
  • With little room to surge during a crisis, America’s health-care system operates on the assumption that unaffected states can help beleaguered ones in an emergency.
  • That ethic works for localized disasters such as hurricanes or wildfires, but not for a pandemic that is now in all 50 states. Cooperation has given way to competition
  • Partly, that’s because the White House is a ghost town of scientific expertise. A pandemic-preparedness office that was part of the National Security Council was dissolved in 2018. On January 28, Luciana Borio, who was part of that team, urged the government to “act now to prevent an American epidemic,” and specifically to work with the private sector to develop fast, easy diagnostic tests. But with the office shuttered, those warnings were published in The Wall Street Journal, rather than spoken into the president’s ear.
  • Rudderless, blindsided, lethargic, and uncoordinated, America has mishandled the COVID-19 crisis to a substantially worse degree than what every health expert I’ve spoken with had feared. “Much worse,”
  • “Beyond any expectations we had,” said Lauren Sauer, who works on disaster preparedness at Johns Hopkins Medicine. “As an American, I’m horrified,” said Seth Berkley, who heads Gavi, the Vaccine Alliance. “The U.S. may end up with the worst outbreak in the industrialized world.”
  • it will be difficult—but not impossible—for the United States to catch up. To an extent, the near-term future is set because COVID-19 is a slow and long illness. People who were infected several days ago will only start showing symptoms now, even if they isolated themselves in the meantime. Some of those people will enter intensive-care units in early April
  • A “massive logistics and supply-chain operation [is] now needed across the country,” says Thomas Inglesby of Johns Hopkins Bloomberg School of Public Health. That can’t be managed by small and inexperienced teams scattered throughout the White House. The solution, he says, is to tag in the Defense Logistics Agency—a 26,000-person group that prepares the U.S. military for overseas operations and that has assisted in past public-health crises, including the 2014 Ebola outbreak.
  • The first and most important is to rapidly produce masks, gloves, and other personal protective equipment
  • it would also come at a terrible cost: SARS-CoV-2 is more transmissible and fatal than the flu, and it would likely leave behind many millions of corpses and a trail of devastated health systems.
  • This agency can also coordinate the second pressing need: a massive rollout of COVID-19 tests.
  • These measures will take time, during which the pandemic will either accelerate beyond the capacity of the health system or slow to containable levels. Its course—and the nation’s fate—now depends on the third need, which is social distancing.
  • There are now only two groups of Americans. Group A includes everyone involved in the medical response, whether that’s treating patients, running tests, or manufacturing supplies. Group B includes everyone else, and their job is to buy Group A more time. Group B must now “flatten the curve” by physically isolating themselves from other people to cut off chains of transmission.
  • Given the slow fuse of COVID-19, to forestall the future collapse of the health-care system, these seemingly drastic steps must be taken immediately, before they feel proportionate, and they must continue for several weeks.
  • Persuading a country to voluntarily stay at home is not easy, and without clear guidelines from the White House, mayors, governors, and business owners have been forced to take their own steps.
  • when the good of all hinges on the sacrifices of many, clear coordination matters—the fourth urgent need
  • Pundits and business leaders have used similar rhetoric, arguing that high-risk people, such as the elderly, could be protected while lower-risk people are allowed to go back to work. Such thinking is seductive, but flawed. It overestimates our ability to assess a person’s risk, and to somehow wall off the ‘high-risk’ people from the rest of society. It underestimates how badly the virus can hit ‘low-risk’ groups, and how thoroughly hospitals will be overwhelmed if even just younger demographics are falling sick.
  • A recent analysis from the University of Pennsylvania estimated that even if social-distancing measures can reduce infection rates by 95 percent, 960,000 Americans will still need intensive care.
  • There are only about 180,000 ventilators in the U.S. and, more pertinently, only enough respiratory therapists and critical-care staff to safely look after 100,000 ventilated patients. Abandoning social distancing would be foolish. Abandoning it now, when tests and protective equipment are still scarce, would be catastrophic.
  • If Trump stays the course, if Americans adhere to social distancing, if testing can be rolled out, and if enough masks can be produced, there is a chance that the country can still avert the worst predictions about COVID-19, and at least temporarily bring the pandemic under control. No one knows how long that will take, but it won’t be quick. “It could be anywhere from four to six weeks to up to three months,” Fauci said, “but I don’t have great confidence in that range.”
  • there are three possible endgames: one that’s very unlikely, one that’s very dangerous, and one that’s very long.
  • The first is that every nation manages to simultaneously bring the virus to heel, as with the original SARS in 2003. Given how widespread the coronavirus pandemic is, and how badly many countries are faring, the odds of worldwide synchronous control seem vanishingly small.
  • The second is that the virus does what past flu pandemics have done: It burns through the world and leaves behind enough immune survivors that it eventually struggles to find viable hosts. This “herd immunity” scenario would be quick, and thus tempting
  • The U.S. has fewer hospital beds per capita than Italy. A study released by a team at Imperial College London concluded that if the pandemic is left unchecked, those beds will all be full by late April. By the end of June, for every available critical-care bed, there will be roughly 15 COVID-19 patients in need of one.  By the end of the summer, the pandemic will have directly killed 2.2 million Americans,
  • The third scenario is that the world plays a protracted game of whack-a-mole with the virus, stamping out outbreaks here and there until a vaccine can be produced. This is the best option, but also the longest and most complicated.
  • there are no existing vaccines for coronaviruses—until now, these viruses seemed to cause diseases that were mild or rare—so researchers must start from scratch.
  • The first steps have been impressively quick. Last Monday, a possible vaccine created by Moderna and the National Institutes of Health went into early clinical testing. That marks a 63-day gap between scientists sequencing the virus’s genes for the first time and doctors injecting a vaccine candidate into a person’s arm. “It’s overwhelmingly the world record,” Fauci said.
  • The initial trial will simply tell researchers if the vaccine seems safe, and if it can actually mobilize the immune system. Researchers will then need to check that it actually prevents infection from SARS-CoV-2. They’ll need to do animal tests and large-scale trials to ensure that the vaccine doesn’t cause severe side effects. They’ll need to work out what dose is required, how many shots people need, if the vaccine works in elderly people, and if it requires other chemicals to boost its effectiveness.
  • No matter which strategy is faster, Berkley and others estimate that it will take 12 to 18 months to develop a proven vaccine, and then longer still to make it, ship it, and inject it into people’s arms.
  • as the status quo returns, so too will the virus. This doesn’t mean that society must be on continuous lockdown until 2022. But “we need to be prepared to do multiple periods of social distancing,” says Stephen Kissler of Harvard.
  • First: seasonality. Coronaviruses tend to be winter infections that wane or disappear in the summer. That may also be true for SARS-CoV-2, but seasonal variations might not sufficiently slow the virus when it has so many immunologically naive hosts to infect.
  • Second: duration of immunity. When people are infected by the milder human coronaviruses that cause cold-like symptoms, they remain immune for less than a year. By contrast, the few who were infected by the original SARS virus, which was far more severe, stayed immune for much longer.
  • scientists will need to develop accurate serological tests, which look for the antibodies that confer immunity. They’ll also need to confirm that such antibodies actually stop people from catching or spreading the virus. If so, immune citizens can return to work, care for the vulnerable, and anchor the economy during bouts of social distancing.
  • Aspects of America’s identity may need rethinking after COVID-19. Many of the country’s values have seemed to work against it during the pandemic. Its individualism, exceptionalism, and tendency to equate doing whatever you want with an act of resistance meant that when it came time to save lives and stay indoors, some people flocked to bars and clubs.
  • “We can keep schools and businesses open as much as possible, closing them quickly when suppression fails, then opening them back up again once the infected are identified and isolated. Instead of playing defense, we could play more offense.”
  • The vaccine may need to be updated as the virus changes, and people may need to get revaccinated on a regular basis, as they currently do for the flu. Models suggest that the virus might simmer around the world, triggering epidemics every few years or so. “But my hope and expectation is that the severity would decline, and there would be less societal upheaval,”
  • After infections begin ebbing, a secondary pandemic of mental-health problems will follow.
  • But “there is also the potential for a much better world after we get through this trauma,”
  • Testing kits can be widely distributed to catch the virus’s return as quickly as possible. There’s no reason that the U.S. should let SARS-CoV-2 catch it unawares again, and thus no reason that social-distancing measures need to be deployed as broadly and heavy-handedly as they now must be.
  • Pandemics can also catalyze social change. People, businesses, and institutions have been remarkably quick to adopt or call for practices that they might once have dragged their heels on, including working from home, conference-calling to accommodate people with disabilities, proper sick leave, and flexible child-care arrangements.
  • Perhaps the nation will learn that preparedness isn’t just about masks, vaccines, and tests, but also about fair labor policies and a stable and equal health-care system. Perhaps it will appreciate that health-care workers and public-health specialists compose America’s social immune system, and that this system has been suppressed.
  • Attitudes to health may also change for the better. The rise of HIV and AIDS “completely changed sexual behavior among young people who were coming into sexual maturity at the height of the epidemic,”
  • Years of isolationist rhetoric had consequences too.
  • “People believed the rhetoric that containment would work,” says Wendy Parmet, who studies law and public health at Northeastern University. “We keep them out, and we’ll be okay. When you have a body politic that buys into these ideas of isolationism and ethnonationalism, you’re especially vulnerable when a pandemic hits.”
  • Pandemics are democratizing experiences. People whose privilege and power would normally shield them from a crisis are facing quarantines, testing positive, and losing loved ones. Senators are falling sick. The consequences of defunding public-health agencies, losing expertise, and stretching hospitals are no longer manifesting as angry opinion pieces, but as faltering lungs.
  • After COVID-19, attention may shift to public health. Expect to see a spike in funding for virology and vaccinology, a surge in students applying to public-health programs, and more domestic production of medical supplies.
  • The lessons that America draws from this experience are hard to predict, especially at a time when online algorithms and partisan broadcasters only serve news that aligns with their audience’s preconceptions.
  • “The transitions after World War II or 9/11 were not about a bunch of new ideas,” he says. “The ideas are out there, but the debates will be more acute over the next few months because of the fluidity of the moment and willingness of the American public to accept big, massive changes.”
  • One could easily conceive of a world in which most of the nation believes that America defeated COVID-19. Despite his many lapses, Trump’s approval rating has surged. Imagine that he succeeds in diverting blame for the crisis to China, casting it as the villain and America as the resilient hero.
  • One could also envisage a future in which America learns a different lesson. A communal spirit, ironically born through social distancing, causes people to turn outward, to neighbors both foreign and domestic. The election of November 2020 becomes a repudiation of “America first” politics. The nation pivots, as it did after World War II, from isolationism to international cooperation
  • The U.S. leads a new global partnership focused on solving challenges like pandemics and climate change.
  • In 2030, SARS-CoV-3 emerges from nowhere, and is brought to heel within a month.
  • On the Global Health Security Index, a report card that grades every country on its pandemic preparedness, the United States has a score of 83.5—the world’s highest. Rich, strong, developed, America is supposed to be the readiest of nations. That illusion has been shattered. Despite months of advance warning as the virus spread in other countries, when America was finally tested by COVID-19, it failed.
katherineharron

US coronavirus: America is at a crossroads in this pandemic as Covid-19 deaths near 500... - 0 views

www.cnn.com/...index.html

covid

shared by katherineharron on 22 Feb 21 - No Cached
  • On the brink of a devastating milestone -- 500,000 US Covid-19 deaths -- the US is at a crossroads in the course of this pandemic.
  • And while vaccinations slowly increase, some Americans say they won't get a Covid-19 vaccine -- hurting the chances of herd immunity and hindering a return to normal life.
  • More than 43.6 million Americans have received at least one dose of their two-dose vaccines, according to the US Centers for Disease Control and Prevention. close dialogCovid-19Your local resource.Set your location and log in to find local resources and information on Covid-19 in your area.Please enter aboveSet Locationclose dialog/* effects for .bx-campaign-1191325 *//* custom css .bx-campaign-1191325 *//* custom css from creative 50769 */.bx-custom.bx-campaign-1191325 .bx-row-validation .bx-input {border-color: white !important;border-width: 1px !important;background-color: white !important;box-shadow: 0px 2px 8px 1px rgba(0,0,0,0.12) !important;}.bx-custom.bx-campaign-1191325 .bx-row-validation .bx-vtext { color: #e53841 !important; font-size: 11px !important; position: absolute !important; bottom: -1.8em !important;} @media screen and (max-width:736px) { .bx-custom.bx-campaign-1191325 .bx-row-validation .bx-vtext {font-size: 10px !important; }}.bx-custom.bx-campaign-1191325 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  • ...15 more annotations...
  • About 18.8 million have been fully vaccinated. That's about 5.7% of the US population -- far less than the estimated 70% to 85% of Americans who would need to be immune to reach herd immunity.
  • To speed up vaccinations, some experts have suggested delaying second vaccine doses to get more first doses into people's arms.
  • Both vaccines on the US market -- developed by Pfizer-BioNTech and Moderna -- require two doses, the second of which are intended to be administered 21 days and 28 days after the first, respectively.
  • Nationwide, the rates of new Covid-19 cases, hospitalizations and deaths are declining.The number of patients hospitalized with Covid-19 has fallen for the 40th day in a row, according to the COVID Tracking Project.
  • Fauci hopes that doesn't happen, he said, adding it's "possible" people may be wearing masks in 2022.
  • And daily new cases have dropped 23% over the same time period, according to Johns Hopkins. (But testing is also down by 17%, according to the COVID Tracking Project.)
  • Daily deaths have declined 24% this past week compared to the previous week
  • Experts with the University of Washington's Institute for Health Metrics and Evaluation said over the weekend that while the B.1.1.7 strain likely accounts for less than 20% of current infections in the US, that number will likely soar to 80% by late April.
  • "Managing the epidemic in the next four months depends critically on scaling up vaccination, trying to increase the fraction of adults willing to be vaccinated above three-quarters, and strongly encouraging continued mask use and avoiding situations where transmission is likely, such as indoor dining, going to bars, or indoor gatherings with individuals outside the household," the team wrote.
  • "With new, more contagious variants of the virus circulating throughout the U.S., now is not the time to let your guard down and scale back on the measures that we know will work to prevent further illness and deaths -- wearing masks, practicing physical distancing, and washing hands," a joint statement said.
  • About 1,700 cases of variant strains first spotted in the UK, South Africa and Brazil have been reported in the US, according to the Centers for Disease Control and Prevention.
  • "I do think we're looking at some new normals. I think the handshake, for example, is probably going away," she said."I do think masks in the cough/cold/flu season in the winter months would make a lot of sense. That clearly, really insulated the Southeast Asian countries from some of the worst of this, understanding the importance of wearing masks."
  • "It's estimated that about 70% of Americans must be vaccinated before we get to herd immunity through vaccination," CNN medical analyst Dr. Leana Wen said. "That's the point where enough people have the immune protection that the virus won't spread anymore."
  • "The evidence was pretty compelling by last March or April that uniform wearing of masks would reduce transmission of this disease," National Institutes of Health Director Dr. Francis Collins told Axios on HBO on Sunday.
  • "A mask is nothing more than a life-saving medical device, and yet it got categorized in all sorts of other ways that were not factual, not scientific and frankly, dangerous," he added. "And I think you can make a case that tens of thousands of people died as a result."
Javier E

Covid hospital bills arrive for patients as insurers restore deductibles and copays - T... - 0 views

www.washingtonpost.com/...tal-bills-insurance-deductible

hospital costs Covid-19 health care insurance

shared by Javier E on 19 Sep 21 - No Cached
  • Nationally, covid hospitalizations under insurance contracts on average cost $29,000, or $156,000 for a patient with oxygen levels so low that they require a ventilator and ICU treatment,
  • The calculus in place in 2020 changed with the advent of vaccines, which now makes most hospitalizations preventable,
  • Hospitals along the Connecticut River, the border between Vermont and New Hampshire, draw patients from both states. Vermont health plans are waiving deductibles and co-pays into 2022. In New Hampshire, where Anthem Blue Cross Blue Shield has a dominant presence, insurance companies have reinstated cost-sharing.
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  • Marvin Mallek, a doctor who treats covid patients from both sides of the river at Springfield Hospital in Vermont, said New Hampshire covid patients are now facing business as usual from insurers, suffering the same sort of financial stress that routinely affects patients with cancer, heart disease and other serious ailments.
  • “The inhumanity of our health-care system and the tragedies it creates will now resume and will now cover this one group that was exempted,'' he said. “The U.S. health-care system is sort of like a game of musical chairs where there are not enough chairs, and some people are going to get hurt and devastated financially.”
  • Hospitals also are in the position of having to resume billings and collections for individuals who may have been laid off because of the pandemic or been too sick to work, experts said.
  • “These waivers ended in January as we all had gained a better understanding of the virus, and people and communities became more familiar with best practices and protocols for limiting COVID-19 exposure and spread,” the company said in a statement. “Also, at this time vaccines, which are proven to be the safest and most effective way to protect oneself from COVID-19, were starting to become readily available.”Anthem took in $4.6 billion in profits in 2020, compared to $4.8 billion in 2019.
  • The reintroduction of cost-sharing mainly affects people with private or employer-based insurance. Patients with no insurance can have 100 percent of their expenses covered by the federal government, under a special program set up by the government for the pandemic, with hospitals reimbursed for care at Medicare rates.
  • Covid patients with Medicaid, the government plan for lower-income people that is paid for by states and the federal government, continue to be protected from cost-sharing, insurance specialists said
  • Patients on Medicare, the federal plan for the elderly, could face out-of-pocket costs if they do not have supplemental insurance.
  • Last year, according to the Kaiser Family Foundation, 88 percent of people covered by private insurance had their co-pays and deductibles for covid treatment waived. By August 2021, only 28 percent of the two largest plans in each state and D.C. still had the waivers in place, and another 10 percent planned to phase them out by the end of October,
  • general, a person with Azar’s type of plan would have an in-network deductible of $1,500 and an in-network out-of-pocket maximum of $4,000,
  • “We still don’t know where the numbers will land because the system makes the family wait for the bills,” s
  • Bills related to her stay at the out-of-network rehab hospital in Tennessee could climb as high as $10,000 more, her relatives have estimated, but they acknowledged they were uncertain this month what exactly to expect, even after asking UnitedHealthcare and the providers.
  • In 2020, as the pandemic took hold, U.S. health insurance companies declared they would cover 100 percent of the costs for covid treatment, waiving co-pays and expensive deductibles for hospital stays that frequently range into the hundreds of thousands of dollars.But this year, most insurers have reinstated co-pays and deductibles for covid patients, in many cases even before vaccines became widely available.
Javier E

Opinion | We Should Have Known So Much About Covid From the Start - The New York Times - 0 views

www.nytimes.com/...vid-pandemic-michael-mina.html

covid summary overview lessons history policy pandemic culture

shared by Javier E on 11 Dec 23 - No Cached
  • I spoke to Mina about what seeing Covid as a textbook virus tells us about the nature of the pandemic off-ramp — and about everything else we should’ve known about the disease from the outset.
  • you can get exposed or you can get vaccinated. But either way, we have to keep building our immune system up, as babies do. That takes years to do. And I think it’s going to be a few more years at least.
  • And in the meantime?We’ve seen a dramatic reduction in mortality. We’ve even seen, I’d say, a dramatic decline in rates of serious long Covid per infection.
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  • But I do think it’s going to be a while before this virus becomes completely normal. And I’ve never been convinced that this current generation of elderly people will ever get to a place where it is completely normal. If you’re 65 or 75 or even older — it’s really hard to teach an immune system new tricks if you’re that age
  • And so while we may see excess mortality in the elderly decline somewhat, I don’t think we’ll see it ever disappear for this generation who was already old when the pandemic hit. Many will never develop that robust, long-term immunological memory we would want to see — and which happens naturally to someone who’s been exposed hundreds of times since they were a little baby.
  • There’s a similar story with measles. There is no routine later-life sequelae, like shingles, for measles. But what we do see is that, in measles outbreaks today, there are some people who were vaccinated who get it anyway. Maybe 5 to 15 percent of cases are not immunologically naïve people, but vaccinated people.
  • Is it really the case that, as babies, we are fighting off those viruses hundreds of times?The short answer is yeah. We start seeing viruses when we’re 2 months old, when we’re a month old. And a lot of these viruses we’ve seen literally tens, if not hundreds of times for some people by the time we’re adults. People tend to think that immunity is binary — you’re either immune or you’re not. That couldn’t be farther from the truth. It’s a gradient, and your protection gets stronger the more times you see a virus.
  • We used to think we just had this spectacular immune response when we first encountered the virus at, say, age 6, and that the immune response lasted until we were 70. But actually what we were seeing was the effect of an immune system being retrained every time it came into contact with the virus after the initial infection — at 6, and 7, and 8, and so on. Every time your friend got chickenpox, or your neighbor, you got a massive boost. You were re-upping your immune response and diversifying your immunological tools — potentially multiple times a year, a kind of natural booster.
  • But now, in America, kids get chickenpox vaccines. So you don’t have kids in America getting chickenpox today, and never will. But that means that older Americans, who did get it as kids, are not being exposed again — certainly not multiple times each year. And it turns out that, in the absence of routine re-exposures, that first exposure alone isn’t nearly as good at driving lifelong immunity and warding off shingles until your immune system begins to fall apart in old age — it can last until you’re in your 30s, for example but not until your 70s.
  • With Covid, when it infects you, it can land in your upper respiratory tract and it just start replicating right there. Immediately, it’s present and replicating in your lungs and in your nose. And that alone elicits enough of an immune response to cause us to feel really crappy and even cause us to feel disease.
  • But we could have just set the narrative better at the beginning: Look, you might get sick again, but your risk of landing in the hospital is going to be really low, and if you get a booster, you might still get sick again, but your risk of landing in the hospital is going to be even lower. That’s something I think humans can deal with, and I think the public could have understood it.
  • But it’s why we don’t see the severe disease as much, with a second exposure or an exposure after vaccination: For most people, it’s not getting into the heart and the liver and stuff nearly as easily.
  • But it doesn’t have to. It’s still causing symptomatic disease. And maybe mucosal vaccines could stop this, but without them we’re likely to continue seeing infections and even symptomatic infections.
  • through most of 2020 and into 2021, though. Back then, I think the conventional wisdom was that a single exposure — through infection or vaccination — would be the end of the pandemic for you. If this is basic virology and immunology, how did we get that so wrong?
  • The short answer is that epidemiologists are not immunologists and immunologists are not virologists and virologists are not epidemiologists. And, in general, physicians don’t know anything about the details.
  • But this failure had some pretty concrete impacts. When reinfections first began popping up, people were surprised, they were scared, and then, to some degree, they lost trust in vaccines. And the people they were turning to for guidance — not only did they not warn us about that, they were slow to acknowledge it, as well.
  • It had dramatic impacts and ripple effects that will last for years to limit our ability to get populations properly vaccinated.
  • the worst thing we can do during a pandemic is set inappropriately high expectations. These vaccines are incredible, they’ve had an enormously positive impact on mortality, but they were never going to end the pandemic.
  • And now, there’s a huge number of people questioning, do these vaccines even do anything?
  • For babies born today, though, I really think they’re not going to view Covid as any different than other viruses. By the time they are 20, it will be like any other virus to them. Because their immune systems will have grown up with it.
  • Instead, we set society up for failure, since people feel like the government failed everyone, that biology failed us, and that this was a crazy virus that has broken all the rules of our immune system, when it’s just doing what we’ve always known it would do.
  • How do you wish we had messaged things differently? What would it have meant to communicate early and clearly that Covid was a textbook virus, as you say?I think the biggest thing would have been just to say, we understand the enemy.
  • To say that this is a textbook virus, it doesn’t mean that it’s not killing people. Objectively, it’s still killing more people than any other infectious disease
  • What it means is that we could’ve taken action based on what we knew, rather than waiting around to prove everything and publish papers in Nature and Science talking about things we already knew.
  • We could have prepared for November and December of 2020 and then for November and December of 2021. But everyone kept saying, we don’t know if it’s going to come back. We knew it was going to come back and it makes me want to cry to think about it. We did nothing and hundreds of thousands of people died. We didn’t prepare nursing homes because we all got to the summer of 2020 and we said, cross our fingers.
  • We knew how tests worked. We knew about serial testing and why it was important for a public health approach. We knew that vaccines could have really good impacts once they were around. And if you were looking through the correct lens, we even knew that they weren’t going to stop transmission.
  • We didn’t have to live in a world where we were flying blind. We could have lived in a world where we’re knowledgeable. But instead, we chose almost across the board to will ourselves into this state of fear and anxiety.
  • And that really started in the earliest days. Almost the first experience I had was a lot like that movie with Jennifer Lawrence —Don’t Look Up.
  • none of this was complicated. You just had to ask a simple question: what would happen if you took away all immunity from an adult? Well, once you control for no immunity, adults are going to get very, very sick.
  • Of course, by and large, babies didn’t get very sick from this disease.Babies are immunologically naïve, but they are also resilient. A virus can tear up a baby, but a baby can repair its tissue so fast. Adults don’t have that. It’s just like a baby getting a cut. They’ll heal really quick
  • An adult getting a cut — you go by age, and every decade of age that you are, it’s going to take exponentially longer for that wound to heal. Eventually get to 80 or 90 and the wound can’t even heal. In the immunology world, this is called “tolerance.”
  • why are all these organ systems getting damaged when other viruses don’t seem to do that? It’s natural to think, it’s Covid — this is a weird disease. But it’s much more a story about immunity and how it develops than about the virus or the disease. None of our organ systems had any immune defenses around to help them out. And I think that the majority of post-acute sequelae and multi-organ complications and long Covid — they are not the result of the virus being a crazy different virus, but are a result of this virus replicating in an environment where there were such absent or exceedingly low defenses.
  • Is it the same whenever we encounter a virus for the first time?Think about travelers. Travelers get way more sick from a local disease than people who grew up with that virus. If you get malaria as a traveler, you’re much more likely to get really sick. You don’t see everyone in Nicaragua taking chloroquine every day. But you definitely see travelers taking it, because malaria can be deadly for adults.
  • What about, not severity, but post-acute complications — do we have long malaria? Do we have liver complications from dengue?
  • The really hard part of answering that question is there’s just not enough data on the frequency of long-term effects, because nothing like this has ever happened at such scale. It’s like everyone in Europe and North America suddenly traveled to a country where malaria was endemic.
  • Or think about H.I.V. It essentially kills your immune system, and once the immune barriers are down, other viruses that used to infect humans would get into tissues that we didn’t like them to get into. If there wasn’t such a clear signal of a loss of CD-4 T cells to explain it, people might still be scratching their heads and going, man, I wonder why all these patients are getting fungal infections. Well, there’s a virus there that’s depleting their immune system.
  • Covid is absolutely waking the world up to this — to the fact that there are really weird long-term sequelae to viruses when they infect organ systems that would normally be protected. And I think we’re going to find that more and more cancers are being attributed to viral infections.
  • It wasn’t that long ago that we first learned that most cases of cervical cancer were caused by H.P.V. — I think the 1980s. And now we have a vaccine for H.P.V. and rates of cervical cancer have fallen by two-thirds.
  • what about incidence? We’ve talked at a few points about how important it is to think about all of these questions in terms of the scale. What is the right scale for thinking about future long Covid, for instance, or other post-acute sequelae?
  • I think the absolute risk, per infection, is going down and down and down. That’s just true.
  • he U.K.’s Office of National Statistics, which shows a much lower risk of developing long Covid now, from reinfection, than from an initial infection earlier in the pandemic.
  • the worst is definitely behind us, which is a good thing, especially for people who worry that the problems will keep building and a lot of people — or even everyone — will get long Covid symptoms. I don’t think there’s a world where we’re looking at the babies of today dealing with long Covid at any meaningful scale.
  • a lot of the fear right now comes from the worst cases, and there’s a lot of worst cases. Even one of the people that I know well, I know in their mind they’re worried that they’ll never recover, but I think objectively they are recovering slowly. It might not be an eight month course. It might be a year and a half. But they will get better. Most of us will.
Javier E

The Coronavirus in America: The Year Ahead - The New York Times - 0 views

www.nytimes.com/...oronavirus-america-future.html

pandemic response strategies US

shared by Javier E on 19 Apr 20 - No Cached
  • More than 20 experts in public health, medicine, epidemiology and history shared their thoughts on the future during in-depth interviews. When can we emerge from our homes? How long, realistically, before we have a treatment or vaccine? How will we keep the virus at bay
  • The path forward depends on factors that are certainly difficult but doable, they said: a carefully staggered approach to reopening, widespread testing and surveillance, a treatment that works, adequate resources for health care providers — and eventually an effective vaccine.
  • The scenario that Mr. Trump has been unrolling at his daily press briefings — that the lockdowns will end soon, that a protective pill is almost at hand, that football stadiums and restaurants will soon be full — is a fantasy, most experts said.
  • ...76 more annotations...
  • They worried that a vaccine would initially elude scientists, that weary citizens would abandon restrictions despite the risks, that the virus would be with us from now on.
  • Most experts believed that once the crisis was over, the nation and its economy would revive quickly. But there would be no escaping a period of intense pain.
  • Exactly how the pandemic will end depends in part on medical advances still to come. It will also depend on how individual Americans behave in the interim. If we scrupulously protect ourselves and our loved ones, more of us will live. If we underestimate the virus, it will find us.
  • More Americans may die than the White House admits.
  • The epidemiological model often cited by the White House, which was produced by the University of Washington’s Institute for Health Metrics and Evaluation, originally predicted 100,000 to 240,000 deaths by midsummer. Now that figure is 60,000.
  • The institute’s projection runs through Aug. 4, describing only the first wave of this epidemic. Without a vaccine, the virus is expected to circulate for years, and the death tally will rise over time.
  • Fatality rates depend heavily on how overwhelmed hospitals get and what percentage of cases are tested. China’s estimated death rate was 17 percent in the first week of January, when Wuhan was in chaos, according to a Center for Evidence-Based Medicine report, but only 0.7 percent by late February.
  • Various experts consulted by the Centers for Disease Control and Prevention in March predicted that the virus eventually could reach 48 percent to 65 percent of all Americans, with a fatality rate just under 1 percent, and would kill up to 1.7 million of them if nothing were done to stop the spread.
  • A model by researchers at Imperial College London cited by the president on March 30 predicted 2.2 million deaths in the United States by September under the same circumstances.
  • China has officially reported about 83,000 cases and 4,632 deaths, which is a fatality rate of over 5 percent. The Trump administration has questioned the figures but has not produced more accurate ones.
  • The tighter the restrictions, experts say, the fewer the deaths and the longer the periods between lockdowns. Most models assume states will eventually do widespread temperature checks, rapid testing and contact tracing, as is routine in Asia.
  • In this country, hospitals in several cities, including New York, came to the brink of chaos.
  • Only when tens of thousands of antibody tests are done will we know how many silent carriers there may be in the United States. The C.D.C. has suggested it might be 25 percent of those who test positive. Researchers in Iceland said it might be double that.
  • China is also revising its own estimates. In February, a major study concluded that only 1 percent of cases in Wuhan were asymptomatic. New research says perhaps 60 percent were.
  • The virus may also be mutating to cause fewer symptoms. In the movies, viruses become more deadly. In reality, they usually become less so, because asymptomatic strains reach more hosts. Even the 1918 Spanish flu virus eventually faded into the seasonal H1N1 flu.
  • The lockdowns will end, but haltingly.
  • it is likely a safe bet that at least 300 million of us are still vulnerable.
  • Until a vaccine or another protective measure emerges, there is no scenario, epidemiologists agreed, in which it is safe for that many people to suddenly come out of hiding. If Americans pour back out in force, all will appear quiet for perhaps three weeks.
  • The gains to date were achieved only by shutting down the country, a situation that cannot continue indefinitely. The White House’s “phased” plan for reopening will surely raise the death toll no matter how carefully it is executed.
  • Every epidemiological model envisions something like the dance
  • On the models, the curves of rising and falling deaths resemble a row of shark teeth.
  • Surges are inevitable, the models predict, even when stadiums, churches, theaters, bars and restaurants remain closed, all travelers from abroad are quarantined for 14 days, and domestic travel is tightly restricted to prevent high-intensity areas from reinfecting low-intensity ones.
  • In his wildly popular March 19 article in Medium, “Coronavirus: The Hammer and the Dance,” Tomas Pueyo correctly predicted the national lockdown, which he called the hammer, and said it would lead to a new phase, which he called the dance, in which essential parts of the economy could reopen, including some schools and some factories with skeleton crews.
  • Even the “Opening Up America Again” guidelines Mr. Trump issued on Thursday have three levels of social distancing, and recommend that vulnerable Americans stay hidden. The plan endorses testing, isolation and contact tracing — but does not specify how these measures will be paid for, or how long it will take to put them in place.
  • On Friday, none of that stopped the president from contradicting his own message by sending out tweets encouraging protesters in Michigan, Minnesota and Virginia to fight their states’ shutdowns.
  • China did not allow Wuhan, Nanjing or other cities to reopen until intensive surveillance found zero new cases for 14 straight days, the virus’s incubation period.
  • Compared with China or Italy, the United States is still a playground.Americans can take domestic flights, drive where they want, and roam streets and parks. Despite restrictions, everyone seems to know someone discreetly arranging play dates for children, holding backyard barbecues or meeting people on dating apps.
  • Even with rigorous measures, Asian countries have had trouble keeping the virus under control
  • But if too many people get infected at once, new lockdowns will become inevitable. To avoid that, widespread testing will be imperative.
  • Reopening requires declining cases for 14 days, the tracing of 90 percent of contacts, an end to health care worker infections, recuperation places for mild cases and many other hard-to-reach goals.
  • Immunity will become a societal advantage.
  • Imagine an America divided into two classes: those who have recovered from infection with the coronavirus and presumably have some immunity to it; and those who are still vulnerable.
  • “It will be a frightening schism,” Dr. David Nabarro, a World Health Organization special envoy on Covid-19, predicted. “Those with antibodies will be able to travel and work, and the rest will be discriminated against.”
  • Soon the government will have to invent a way to certify who is truly immune. A test for IgG antibodies, which are produced once immunity is established, would make sense
  • Dr. Fauci has said the White House was discussing certificates like those proposed in Germany. China uses cellphone QR codes linked to the owner’s personal details so others cannot borrow them.
  • As Americans stuck in lockdown see their immune neighbors resuming their lives and perhaps even taking the jobs they lost, it is not hard to imagine the enormous temptation to join them through self-infection
  • My daughter, who is a Harvard economist, keeps telling me her age group needs to have Covid-19 parties to develop immunity and keep the economy going,”
  • It would be a gamble for American youth, too. The obese and immunocompromised are clearly at risk, but even slim, healthy young Americans have died of Covid-19.
  • The virus can be kept in check, but only with expanded resources.
  • Resolve to Save Lives, a public health advocacy group run by Dr. Thomas R. Frieden, the former director of the C.D.C., has published detailed and strict criteria for when the economy can reopen and when it must be closed.
  • once a national baseline of hundreds of thousands of daily tests is established across the nation, any viral spread can be spotted when the percentage of positive results rises.
  • To keep the virus in check, several experts insisted, the country also must start isolating all the ill — including mild cases.
  • “If I was forced to select only one intervention, it would be the rapid isolation of all cases,”
  • In China, anyone testing positive, no matter how mild their symptoms, was required to immediately enter an infirmary-style hospital — often set up in a gymnasium or community center outfitted with oxygen tanks and CT scanners.
  • There, they recuperated under the eyes of nurses. That reduced the risk to families, and being with other victims relieved some patients’ fears.
  • Still, experts were divided on the idea of such wards
  • Ultimately, suppressing a virus requires testing all the contacts of every known case. But the United States is far short of that goal.
  • In China’s Sichuan Province, for example, each known case had an average of 45 contacts.
  • The C.D.C. has about 600 contact tracers and, until recently, state and local health departments employed about 1,600, mostly for tracing syphilis and tuberculosis cases.
  • China hired and trained 9,000 in Wuhan alone. Dr. Frieden recently estimated that the United States will need at least 300,000.
  • There will not be a vaccine soon.
  • any effort to make a vaccine will take at least a year to 18 months.
  • the record is four years, for the mumps vaccine.
  • for unclear reasons, some previous vaccine candidates against coronaviruses like SARS have triggered “antibody-dependent enhancement,” which makes recipients more susceptible to infection, rather than less. In the past, vaccines against H.I.V. and dengue have unexpectedly done the same.
  • A new vaccine is usually first tested in fewer than 100 young, healthy volunteers. If it appears safe and produces antibodies, thousands more volunteers — in this case, probably front-line workers at the highest risk — will get either it or a placebo in what is called a Phase 3 trial.
  • It is possible to speed up that process with “challenge trials.” Scientists vaccinate small numbers of volunteers, wait until they develop antibodies, and then “challenge” them with a deliberate infection to see if the vaccine protects them.
  • Normally, it is ethically unthinkable to challenge subjects with a disease with no cure, such as Covid-19.
  • “Fewer get harmed if you do a challenge trial in a few people than if you do a Phase 3 trial in thousands,” said Dr. Lipsitch, who recently published a paper advocating challenge trials in the Journal of Infectious Diseases. Almost immediately, he said, he heard from volunteers.
  • The hidden danger of challenge trials, vaccinologists explained, is that they recruit too few volunteers to show whether a vaccine creates enhancement, since it may be a rare but dangerous problem.
  • if a vaccine is invented, the United States could need 300 million doses — or 600 million if two shots are required. And just as many syringes.
  • “People have to start thinking big,” Dr. Douglas said. “With that volume, you’ve got to start cranking it out pretty soon.”
  • Treatments are likely to arrive first.
  • The modern alternative is monoclonal antibodies. These treatment regimens, which recently came very close to conquering the Ebola epidemic in eastern Congo, are the most likely short-term game changer, experts said.
  • as with vaccines, growing and purifying monoclonal antibodies takes time. In theory, with enough production, they could be used not just to save lives but to protect front-line workers.
  • Having a daily preventive pill would be an even better solution, because pills can be synthesized in factories far faster than vaccines or antibodies can be grown and purified.
  • Goodbye, ‘America First.’
  • A public health crisis of this magnitude requires international cooperation on a scale not seen in decades. Yet Mr. Trump is moving to defund the W.H.O., the only organization capable of coordinating such a response.
  • And he spent most of this year antagonizing China, which now has the world’s most powerful functioning economy and may become the dominant supplier of drugs and vaccines. China has used the pandemic to extend its global influence, and says it has sent medical gear and equipment to nearly 120 countries.
  • This is not a world in which “America First” is a viable strategy, several experts noted.
  • “If President Trump cares about stepping up the public health efforts here, he should look for avenues to collaborate with China and stop the insults,”
  • If we alienate the Chinese with our rhetoric, I think it will come back to bite us,” he said.“What if they come up with the first vaccine? They have a choice about who they sell it to. Are we top of the list? Why would we be?”
  • Once the pandemic has passed, the national recovery may be swift. The economy rebounded after both world wars, Dr. Mulder noted.
  • In one of the most provocative analyses in his follow-up article, “Coronavirus: Out of Many, One,” Mr. Pueyo analyzed Medicare and census data on age and obesity in states that recently resisted shutdowns and counties that voted Republican in 2016.
  • He calculated that those voters could be 30 percent more likely to die of the virus.
  • In the periods after both wars, Dr. Mulder noted, society and incomes became more equal. Funds created for veterans’ and widows’ pensions led to social safety nets, measures like the G.I. Bill and V.A. home loans were adopted, unions grew stronger, and tax benefits for the wealthy withered.
  • If a vaccine saves lives, many Americans may become less suspicious of conventional medicine and more accepting of science in general — including climate change
katherineharron

Rural Alaska is getting Covid-19 vaccinations right. Here's what the rest of the US can... - 0 views

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covid

shared by katherineharron on 09 Mar 21 - No Cached
  • The immovable challenges of living in Alaska would, in theory, make it a nightmare to vaccinate all of its 731,000-plus residents: It's the largest state in the US in terms of land size, has some of the most extreme weather of any state and many resident Alaska Natives, who are disproportionately dying from Covid-19, live in the remote throes of the state.
  • And yet, at 40 doses administered per 100 people, Alaska is one of the leading states in the US when it comes to Covid-19 vaccinations.
  • What works in Alaska won't work everywhere -- it's over 660,000 square miles, after all, and not every state requires health care workers to travel by dog sled to administer vaccines. But the rest of the US can take cues from the state's unique approach to its unique problems.
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  • Alaska's public health structure was built for complications -- its size and tendency for inclement weather require it. So when it came time to start vaccinating residents, the state didn't have to build a robust public health system from scratch like some others, said Dr. Anne Zink, Alaska's chief medical officer.
  • A localized approach to vaccination hasn't worked everywhere, but it's worked in Alaska, Zink said. The state distributes vaccines to different regions but doesn't give directives, she said -- it's up to the communities to decide how to administer vaccines based on their needs.
  • Because so much power has been turned over to different regions of Alaska and the health care providers trusted in those areas, health care workers have been able to "meet people where they're at," Zink said: That means they'll deliver vaccines by boat, dog sled, helicopters and small planes, or go door-to-door in small communities to vaccinate as many community members as possible.
  • Vaccine eligibility in Alaska is more expansive than it currently is in most other states: Vaccines are available to anyone 55 years or older, people with certain underlying conditions, essential workers, residents of a multigenerational household, anyone who assists a senior in getting vaccinated and anyone who lives in a community where 45% of houses don't have pipes or septic tanks.
  • In areas where the population is mostly Alaska natives, there's a greater amount of people living in multigenerational housing. That qualifies young people who may live with an at-risk elderly person to get vaccinated, too, said Dr. Bob Onders, administrator of the Alaska Native Medical Center in Anchorage. And since 25% of rural Alaska doesn't have running water or sewage, which can heighten residents' risk for respiratory illness, it didn't make sense to exclude rural residents from the first round of vaccinations, Onders said.
  • Alaska Natives have borne the brunt of Covid-19 in the state -- the Kaiser Family Foundation's Covid-19 data tracker shows that Alaska Natives make up more than a quarter of Covid-19 cases but 15% of the population, compared to White residents, who made up 38% of cases but 68% of the population.
  • "Rather than a top-down mechanism, where someone from outside of Alaska or rural Alaska is dictating how things are going, it's much more about giving them supplies," Onders said.
  • Alaska asked the federal government to be treated "like a territory instead of state," so it would receive a monthly allocation of vaccines versus a weekly or biweekly lot. That made it easier to plan ahead and deliver vaccines "creatively," Zink said.
  • It can be costly to transport vaccines to some remote reaches of Alaska -- over $15,000 for one trip, in some cases, Zink said. To make vaccinations more cost-efficient, some areas that are less densely populated receive their entire vaccine allotment, which makes it possible to vaccinate entire communities in one go.
  • "We've been doing redistribution of vaccines for years," said Dr. Anne Zink, Alaska's chief medical officer. "It was pretty easy for us to stand up our existing [public health] structure."
  • Invest in protecting minority communities. Alaska expanded its eligibility for the first round of vaccines to include Alaska Natives and low-income residents of the state that are more vulnerable to Covid-19. While there's still work to do to alleviate that disproportionate risk, Onders said so far, it's working.
  • Another way to alleviate that burden is to prioritize zip codes in addition to age and health status, Karmarck said. Vaccinating residents of low-income neighborhoods or areas where the majority of residents are Black, indigenous or people of color could reduce Covid-19's disproportionate impact, though backlash is likely: In Dallas, county officials axed their plan to prioritize residents in "vulnerable zip codes" after the state threatened to reduce its vaccine allocation, the Texas Tribune reported in January.
  • Enlist trusted members of communities to educate. In communities where residents are hesitant to get the vaccine, particularly among Black and Latino Americans, sharing information about vaccine access is crucial to address Covid-19 racial disparities, Karmarck said.
  • Customize the approach. States that were lagging in vaccinations are catching up, Karmarck said, as they formalize an approach to vaccination that best fits their state. In Massachusetts, for example, large vaccination sites have opened up at Fenway Park and Gillette Stadium to accommodate more people and storage the vaccines require. It's improved the state's vaccination rates, she said.
aidenborst

US Coronavirus: A year after the pandemic was declared, US Covid-19 numbers are way too... - 0 views

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politics US history crisis Culture Policy Pandemic covid-19 pandemic-recovery vaccine

shared by aidenborst on 11 Mar 21 - No Cached
  • More than 29 million cases have been reported in the US since the World Health Organization declared the novel coronavirus a pandemic one year ago.
  • The virus plunged America into grief and crisis.
  • Spikes in deaths drove some communities to call in mobile units to support their morgues.
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  • The US has lost more than 529,000 people to the virus, Johns Hopkins University data shows. It's more than the number of Americans killed in World War I and World War II combined. And the death toll is rising by the thousands each week.
  • Now, the country is at a pivotal point.
  • "While these trends are starting to head in the right direction, the number of cases, hospitalizations and deaths still remain too high and are somber reminders that we must remain vigilant as we work to scale up our vaccination efforts across this country," Walensky said.
  • So far, almost one in 10 Americans have been fully vaccinated -- a number that is still too low to suppress the spread of the virus. And some experts have warned another possible surge could be weeks away, fueled by a highly contagious variant spreading across the country.
  • "We must continue to use proven prevention measures to slow the spread of Covid-19," Walensky added. "They are getting us closer to the end of this pandemic."
  • For Americans who have been fully vaccinated, the new guidance released by the Centers for Disease Control and Prevention earlier this week marks a small first step toward a return to pre-pandemic life, the agency's director and other colleagues wrote in a JAMA Viewpoint article published Wednesday.
  • "As vaccine supply increases, and distribution and administration systems expand and improve, more and more people will become fully vaccinated and eager to resume their prepandemic lives," Walensky and CDC officials Drs. Sarah Mbaeyi and Athalia Christie wrote.
  • "With high levels of community transmission and the threat of SARS-CoV-2 variants of concern, CDC still recommends a number of prevention measures for all people, regardless of vaccination status," they wrote.
  • "What we have seen is that we have surges after people start traveling. We saw it after July 4, we saw it after Labor Day, we saw it after the Christmas holidays," Walensky said in the briefing. "Currently 90% of people are still unprotected and not yet vaccinated. So we are really looking forward to updating this guidance as we have more protection across the communities and across the population."
  • More than 62 million Americans have received at least one dose of a Covid-19 vaccine, CDC data shows. Roughly 32.9 million are fully vaccinated.
  • As vaccination numbers climb, more state leaders are loosening the requirements for who can get a shot.
  • At least 47 states plus DC are allowing teachers and school staff to receive Covid-19 vaccines. By next Monday, teachers will be eligible in all 50 states.
  • In Georgia, officials announced the state will expand its vaccine eligibility starting March 15 to include people 55 and older as well as individuals with disabilities and certain medical conditions.
  • "Provided supply allows, vaccine eligibility is expected to open to all adults in April," Gov. Brian Kemp's office said in a statement.
  • Other states also announced expanded vaccine eligibility this week, including Alaska, who took it the furthest by making vaccines available to everyone living or working in the state who is at least 16. It's the first state in the nation to do so.
  • The guidance allows for indoor visitation regardless of the vaccination status of the resident or visitor, with some exceptions.
  • For example, visitations may be limited for residents with Covid-19 or who are in quarantine or for unvaccinated residents living in facilities where less than 70% of residents are fully vaccinated, in a county that has a Covid-19 positivity rate greater than 10%.
  • "CMS recognizes the psychological, emotional and physical toll that prolonged isolation and separation from family have taken on nursing home residents, and their families," CMS Chief Medical Officer Dr. Lee Fleisher said in a statement.
  • "That is why, now that millions of vaccines have been administered to nursing home residents and staff, and the number of COVID cases in nursing homes has dropped significantly, CMS is updating its visitation guidance to bring more families together safely."
hannahcarter11

Democrats spar over COVID-19 vaccine strategy | TheHill - 0 views

thehill.com/...over-covid-19-vaccine-strategy

democrats vaccine Black community minorities

shared by hannahcarter11 on 11 Mar 21 - No Cached
  • Publicly, House Democrats are largely united behind a simple message surrounding COVID-19 vaccines: Get one as soon as you can and take whichever one is offered.   
  • Speaker Nancy PelosiNancy PelosiGOP senator applauds restaurant stimulus money after voting against relief bill McCarthy calls on Pelosi to return Capitol to pre-pandemic operations Jayapal asks for ethics investigation into Boebert, Gosar, Brooks MORE (D-Calif.) has sided with those Black Caucus leaders, arguing on a recent conference call that underserved communities, including Black and brown populations, should get to pick which vaccine they receive, according to sources on the call.  
  • Rep. Kim SchrierKimberly (Kim) Merle SchrierThe Hill's Morning Report - Presented by the National Shooting Sports Foundation - At 50 days in charge, Democrats hail American Rescue Plan as major win Democrats spar over COVID-19 vaccine strategy Democrats point fingers on whether Capitol rioters had inside help MORE (D-Wash.), a pediatrician, issued a stern warning to her colleagues that demanding choice would not only buck the advice of public health experts and muddle the Democrats’ vaccine message, it would also heighten the the doubts of many Americans already skeptical about taking vaccines — doubts that threaten the arrival of herd immunity and a return to social normalcy.
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  • The Democrats’ message, Schrier said, should be clear and simple: All vaccines are good. And the best thing American can do to protect themselves and their loved ones is to get a shot.
  • Pelosi spokesman Henry Connelly said the Speaker was simply reflecting concerns in her diverse caucus about whether minority communities were being treated equitably in the aggressive push to vaccinate all Americans.
  • That disparity has been attributed, in part, to the fact that the earlier Moderna and Pfizer vaccines each require two shots and colder refrigeration, complicating storage and distribution. That’s created additional barriers for getting the vaccine to poorer, historically underserved populations and rural communities.
  • Black people are nearly three times more likely to be hospitalized with COVID-19 than white people and nearly two times more likely to die from the disease; Hispanics are more than three times more likely to be hospitalized with COVID-19 than whites and 2.3 times more likely to die. 
  • White people have been vaccinated for COVID-19 at two times the rate of Black people, according to a New York Times analysis. The figures are worse for Hispanics. 
  • The disagreement among Democrats comes during a pivotal moment in the fight against the coronavirus pandemic as states like Texas and Mississippi end their mask mandates and lift restrictions on businesses, and health experts worry about a surge in cases driven by COVID-19 variants.
  • Because the new Johnson & Johnson vaccine requires only one shot and regular refrigeration levels, some officials like New Jersey Gov. Phil Murphy (D) have ordered that shipments of that vaccine be prioritized for harder-to-reach Black and brown communities. 
  • But while Pfizer and Moderna vaccines have an overall efficacy of about 95 percent in preventing moderate to severe disease, that number for the Johnson & Johnson version is just 66 percent — though experts point out the J&J vaccine was being tested after more contagious variants had begun spreading in the U.S., unlike the Pfizer and Moderna versions. 
  • That's led to some in those minority communities voicing concerns in recent days that they are being given a less-effective vaccine than more affluent, white communities.
  • Rep. André Carson (D-Ind.), another CBC member, noted that those suspicions have historic roots, pointing to the infamous Tuskegee syphilis study — a deadly federal research project that targeted poor Black people in rural Alabama in 1930s — as evidence of the "painful history" of biomedical mistreatment of African Americans in the United States. 
  • Despite such reservations, the broad consensus in the caucus appears to favor efforts to maximize vaccinations in the shortest possible time, regardless which shot is available in a given community.
  • On Wednesday, Kelly is set to join Rep. Joyce BeattyJoyce Birdson BeattyDemocrats spar over COVID-19 vaccine strategy Black Caucus backs Biden's pick to head DOJ Civil Rights Division Sole GOP vote on House police reform bill says he 'accidentally pressed the wrong voting button' MORE (D-Ohio), head of the Black Caucus, in an online forum with medical experts designed to educate minority communities on best vaccine practices. 
  • Rep. Anthony BrownAnthony Gregory BrownOvernight Defense: Pentagon chief to press for Manchin's support on Colin Kahl | House Dems seek to limit transfer of military-grade gear to police Democrats spar over COVID-19 vaccine strategy 140 lawmakers call for Biden administration to take 'comprehensive' approach to Iran MORE (D-Md.) said officials should monitor the distribution of vaccines to identify “patterns” that might indicate prejudices in the dispensation. But he’s also encouraging all of his constituents to get whatever vaccine is available first, and he highlighted the advantages of the one-dose Johnson & Johnson shot, particularly in hard-to-reach populations like the homeless. 
carolinehayter

US coronavirus: For the first time in over a year, the US records a daily average of fe... - 0 views

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politics us Pandemic policy Culture

shared by carolinehayter on 01 Jun 21 - No Cached
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  • The US just recorded a seven-day average of fewer than 20,000 new daily Covid-19 cases for the first time since March 2020.
  • Still, it's a stunning milestone that comes after more than a year of loss and suffering across the country and the world. And it's one worth pausing for, to acknowledge both that devastation but also the progress the US has made.
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  • n March of last year, Covid-19 infection and hospitalization numbers started climbing rapidly -- and deaths followed. At least 80% of the country's population was under stay-at-home orders.That was the first of several crushing surges. More than 33 million Americans have been infected with coronavirus, according to Johns Hopkins University, and more than 594,000 have died -- both numbers likely undercounts of the pandemic's true toll.
  • But now, the US is heading in the right direction, thanks to a powerful ally in the battle against the pandemic: Covid-19 vaccines.
  • Moderna said Tuesday it's seeking full approval for its vaccine from the US Food and Drug Administration.
  • Governors nationwide have eased Covid-19 restrictions, and nearly every state that had a mask mandate has now lifted it. But the pandemic certainly isn't over.
  • We all have more work to do," White House Covid-19 Response Team senior adviser Dr. Marcella Nunez-Smith said recently.
  • More than 50% of the US population has received at least one Covid-19 vaccine dose, CDC data shows, and more than 40% of the country is fully vaccinated.
  • Experts say they expect vaccine protection will last much longer than six months, to be confirmed as more data come in.
  • Both Pfizer and Moderna are also studying their vaccines in children as young as 6 months. Last month, the FDA granted Pfizer's vaccine an emergency use authorization for children 12 to 15.
  • But in practical terms for the public, there's not a big difference between emergency use authorization and full FDA approval, said Dr. Paul Offit, a member of the FDA's Vaccines and Related Biological Products Advisory Committee.
  • Both the Moderna and Pfizer vaccines have shown to be extremely safe in both clinical trials and in the real world, he said. Throughout the history of vaccines, he said, any serious side effects have happened within two months after inoculation.
  • For the first time in more than a year, millions of vaccinated Americans safely enjoyed close holiday gatherings without masks on Memorial Day.
  • But the majority of Americans still aren't fully vaccinated -- threatening the possibility of yet another post-holiday Covid-19 spike.
  • Any country that thinks the pandemic is over is wrong, said World Health Organization Director-General Tedros Adhanom Ghebreyesus.
  • "We're very encouraged that cases and deaths are continuing to decline globally, but it would be a monumental error for any country to think the danger has passed," he said.
hannahcarter11

Why The Record-Breaking COVID Count In India Is Likely An Undercount : Goats and Soda :... - 0 views

www.npr.org/...-deaths-how-many-is-it-missing

India Covid Peak

shared by hannahcarter11 on 02 May 21 - No Cached
  • "There's a shortage of coronavirus tests. Nobody's getting tested! So the government's numbers for our district are totally wrong," he told NPR on a crackly phone line from his village. "If you're able to get tested, results come after five days."
  • This village's ordeal is not atypical. Across India, there are shortages of testing kits, hospital beds, medical oxygen and antiviral drugs as a severe second wave of the pandemic crushes the health infrastructure. The country has been breaking world records daily for new cases. On Friday, India's Health Ministry confirmed 386,453 infections – more than any country on any day since the pandemic began.
  • Part of the reason for the huge numbers is India's size: a population of nearly 1.4 billion. The rate of known coronavirus infections per capita is still less than the United States endured at its peak.
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  • But survivors, funeral directors and scientists say the real numbers of infections and deaths in India may be many times more than the reported figures. The sheer number of patients has all but collapsed the health system in a country that invests less on public health — just above 1% of its gross domestic product — than most of its peers. (Brazil spends more than 9% of its GDP on health; in the U.S., the figure is nearly 18%.)
  • Each day, he goes to every crematorium and burial ground in his district of the capital, tallying deaths from COVID-19. Of his 11 staff members, five currently have COVID-19, he said.
  • Last year, at the height of the pandemic's first wave in India, Sirohi said he was counting about 220 COVID-19 deaths a day. When NPR spoke to him Wednesday, he counted 702 for that day. He passes those numbers up the chain of command. But the death figures the government ultimately publishes for his region have been at least 20% lower than what he's seeing on the ground, he said.
  • He attributed this disparity to administrative chaos.
  • There is another reason why India's coronavirus numbers may be skewed: hubris. In early March, India's health minister declared that the country was in the "endgame of the COVID-19 pandemic." Daily cases had hit record lows of about 8,000 a day in early February, down from a peak of nearly 100,000 cases a day in September.
  • But over the winter, as cases began creeping up, some politicians didn't pay attention — or perhaps didn't believe the coronavirus could return.
  • There have also been allegations that some politicians tried to suppress inconvenient news about rising case numbers.
  • Fewer positive results mean fewer confirmed infections and fewer deaths attributed to the coronavirus. India's total pandemic deaths this week crossed the 200,000 mark. But that's still lower than the overall death tolls in the United States, Brazil and Mexico, according to data compiled by Johns Hopkins University.
  • There are reasons why fewer Indians might die from COVID-19. India is a very young country. Only 6% of Indians are older than 65. More than half the population is under 25. They're more likely to survive the disease.
  • By analyzing total excess deaths – i.e., the difference between total deaths in Mumbai one year, compared with the year before — he estimates that the number of deaths attributed to COVID-19 would have to have been undercounted by at least two-thirds to account for the higher 2020 death tally.
  • Those calculations are based on data from Mumbai, India's richest major city, where access to health care is better than elsewhere. So the number of undercounted deaths could be even higher in less well-off parts of the country — such as in Santosh Pandey's village.
  • Scientists said recorded infections are even more of an underestimate. But they have a better idea of how much infections have been undercounted because they have serological data from random antibody tests that authorities conducted across large swaths of the country.
  • Results of a third national serological survey conducted in December and January showed that roughly a fifth of India's population had been exposed to the virus. That meant for every recorded coronavirus case, almost 30 went undetected.
  • She's a biostatistician at the University of Michigan who's designed models that show India's reported infections will peak in late May. She predicts India could be confirming as many as 1 million new cases a day and 4,500 daily deaths by then.
  • The institute's director, Chris Murray, told NPR that India may be detecting only 3% or 4% of its daily infections.
  • India's deaths in this latest wave would peak around the third week of May, according to the institute's model.
  • That could mean more shortages, fewer hospital beds and more tragedy on top of what India has already endured in recent weeks.
yehbru

Opinion: The one unforgivable thing about the Covid-19 response - CNN - 0 views

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Trump Biden Covid Pandemic Vaccine US Politics

shared by yehbru on 02 Jan 21 - No Cached
  • The first case of Covid-19 in the United States was reported 11 months ago, on January 20, 2020. Since that time, more than 18 million Americans have been diagnosed and more than 329,000 have died.
  • The trouble started first in the Northeast during the spring, and then spread in other major urban areas, quickly overwhelming hospitals and nursing homes. High death rates were due in part to a lack of knowledge on how to treat the infection.
  • This last upturn in cases, unlike the first two, has not waned. Instead, the spread of the virus has only accelerated, with the nation going into Covid-19 overdrive in the last month. The rate of new cases and deaths across the country makes it impossible now to attribute a single cause to the alarming surge.
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  • Covid-19 is crushing the healthcare system, with the California Department of Public Health reporting around 39,000 daily new cases and hundreds of deaths a day as of December 23
  • First and foremost, it is important to adhere to the key public health measures: masks, social distancing, avoidance of crowds. This approach remains effective, even if it has been adopted unevenly across the country. After 11 months, however, adhering to these measures can be extremely tedious and at times seemingly intolerable -- even for the most ardent public health fans, including myself.
  • Yes, it has given hope to the world, but it also may seduce people into thinking wrongly that it will be OK to ease up on preventative measures before the vaccine is widely available.
  • Forgoing masks and social distancing will only compound this national tragedy. We are currently seeing roughly 200,000 daily new cases and more than 2,500 deaths in the U.S. per day
  • Of the Trump administration's many Covid-19 failures, its inability to develop a modern, convenient and reliable national testing program is the most unforgivable.
  • Germany and South Korea have made this the cornerstone of their effective control programs, while Hong Kong has placed test kit vending machines in subway stations. And professional sport leagues have made testing several times a week a core approach to their containment strategy.
  • Yet we are only performing averages of less than 2 million tests per day in the U.S. While this is about double the rate in September, it still falls far short of what is necessary. In April, experts called for at least 5 million tests a day by early June to ensure a safe social opening, and 20 million tests a day by mid-summer to remobilize the economy. Others have hoped for even more aggressive goals to "test nearly everyone, nearly every day."
  • President-elect Joe Biden appears to understand the value of this strategy, which could bridge the many vulnerable months between now and the development of vaccine-induced herd immunity.
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