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Javier E

Opinion | Omicron Is Not the Final Variant - The New York Times - 0 views

www.nytimes.com/...covid-variant-omicron.html

pandemic policy history response analysis projection

shared by Javier E on 21 Jan 22 - No Cached
  • To mitigate the impact of future variants, the world needs to establish and strengthen virus monitoring and surveillance systems that can identify emerging variants quickly so that leaders can respond.
  • Here’s how it works: Scientists regularly get samples of the virus from people who are infected and sequence those samples. This helps scientists pick up on notable changes in the virus. Spikes in cases in certain areas can also alert scientists to look deeper. When researchers find something notable, they can alert colleagues for further study.
  • Networks of laboratories worldwide should be equipped to study the properties of any new variant to assess its potential impact on available tests, vaccines’ effectiveness and treatments.
  • ...7 more annotations...
  • Scientists in South Africa and Botswana who are already doing this kind of routine surveillance of the coronavirus were able to rapidly warn their research networks and the rest of the world about Omicron. Going forward, such findings must also trigger an effective collective response.
  • When concerning variants are identified, there needs to be a global agreement on how countries should jointly react to mitigate any health and economic harms.
  • Every country must also ramp up its testing infrastructure for the coronavirus.
  • Most important, the global vaccination effort must be scaled up to blunt the continued circulation of the virus.
  • During surges, countries need to increase access to the measures that can lower risk of infection, like masks. The right mask, worn properly and consistently in indoor public spaces, can provide some protection against all variants
  • Now that there are drugs available to treat infections, country leaders and drug companies must ensure that there’s plenty of supply and that it is available to everyone.
  • The world got lucky with Omicron. It’s unimaginable what would have happened if that highly contagious variant had caused disease as severe as Delta has
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.
Javier E

Life Is Worse for Older People Now - The Atlantic - 0 views

www.theatlantic.com/...673507

agism age health culture crisis policy history pandemic

shared by Javier E on 25 Mar 23 - No Cached
  • A major reason older people are still at risk is that vaccines can’t entirely compensate for their immune systems. A study recently published in the journal Vaccines showed that for vaccinated adults ages 60 and over, the risk of dying from COVID versus other natural causes jumped from 11 percent to 34 percent within a year of completing their primary shot series
  • A booster dose brings the risk back down, but other research shows that it wears off too. A booster is a basic precaution, but “not one that everyone is taking,”
  • Unlike younger people, most of whom fully recover from a bout with COVID, a return to baseline health is less guaranteed for older adults. In one study, 32 percent of adults over 65 were diagnosed with symptoms that lasted well beyond their COVID infection
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  • For every COVID death, many more older people develop serious illness. Risk increases with age, and people older than 70 “have a substantially higher rate of hospitalizations” than those ages 60 to 69,
  • Persistent coughs, aches, and joint pain can linger long after serious illness, together with indirect impacts such as loss of muscle strength and flexibility, which can affect older people’s ability to be independent, Rivers said. Older COVID survivors may also have a higher risk of cognitive decline. In some cases, these ailments could be part of long COVID, which may be more prevalent in older people.
  • The antiviral Paxlovid was supposed to help blunt the wave of old people falling sick and ending up in the hospital—and it can reduce severe disease by 50 to 90 percent. But unfortunately, it is not widely used; as of July, just a third of Americans 80 or older took Paxlovid.
  • The reality is that as long as the virus continues to be prevalent, older Americans will face these potential outcomes every time they leave their home. That doesn’t mean they will barricade themselves indoors, or that they even should. Still, “every decision that we make now is weighing that balance between risk and socialization,”
  • Where America has landed is hardly a new way of life but rather one that is simply more onerous. “One way to think about it is that this is a new risk that’s out there” alongside other natural causes of death, such as diabetes and heart failure,
  • Before the pandemic, the association between loneliness and higher mortality rates, increased cardiovascular risks, and dementia among older adults was already well established. Increased isolation during COVID amplified this association.
  • Even older adults who have weathered the direct and indirect effects of the pandemic still face other challenges that COVID has exacerbated. Many have long relied on personal caregivers or the staff at nursing facilities. These workers, already scarce before the pandemic, are even more so now because many quit or were affected by COVID themselves
  • “Long-term care has been in a crisis situation for a long time, but it’s even worse now,” Muramatsu said, noting that many home care workers are older adults themselves
  • Older people won’t have one single approach to contending with this sad reality. “Everybody is trying to figure out what is the best way to function, to try to have some level of everyday life and activity, but also keep your risk of getting sick as low as possible,”
  • Again, many of these people did not have it great before the pandemic, even if the rest of the country wasn’t paying attention. “We often don’t provide the basic social support that older people need,” Kenneth Covinsky, a clinician-researcher at the UCSF Division of Geriatrics, said. Rather, ageism, the willful ignorance or indifference to the needs of older people, is baked into American life.
  • It is perhaps the main reason older adults were so badly affected by the pandemic in the first place, as illustrated by the delayed introduction of safety precautions in nursing homes and the blithe acceptance of COVID deaths among older adults. If Americans couldn’t bring themselves to care at any point over the past three years, will they ever?
Javier E

India Is Passing China in Population. Can Its Economy Ever Do the Same? - The New York Times - 0 views

www.nytimes.com/...india-china-population.html

india china population economy history crisis politics culture policy economics

shared by Javier E on 19 Apr 23 - No Cached
  • The two nations share several historical parallels. The last time they traded places in population, in the 18th century or earlier, the Mughals ruled India and the Qing dynasty was expanding the borders of China; between them they were perhaps the richest empires that had ever existed
  • But as European powers went on to colonize most of the planet and then industrialized at home, the people of India and China became among the world’s poorest.
  • As recently as 1990, the two countries were still on essentially the same footing, with a roughly equal economic output per capita. Since then, China has shaken the world by creating more wealth than any other country in history. While India, too, has picked itself back up in the three decades since it liberalized its economy, it remains well behind in many of the most basic scales.
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  • Today, China’s economy is roughly five times the size of India’s. The average citizen of China has an economic output of almost $13,000 a year, while the average Indian’s is less than $2,500
  • In human-development indicators, the contrast is even sharper, with infant mortality rates much higher in India, life expectancy lower and access to sanitation less prevalent.
  • The divergence, analysts say, comes down largely to China’s central consolidation of policy power, an earlier start in opening up its economy to market forces starting in the late 1970s, and its single-minded focus on export-led growth.
  • China took the first-mover advantage and then compounded its dominance as it pursued its plans relentlessly.
  • India started opening its quasi-socialist economy nearly a decade later. Its approach remained piecemeal, constrained by tricky coalition politics and the competing interests of industrialists, unions, farmers and factions across its social spectrum.
  • “There is that element where China is a natural role model — not for its politics, but for the sheer efficiency,”
  • The world now has a radically different power structure than it did in 1990. China has already made itself the world’s factory, all but closing off any path India could take to competitive dominance in export-driven manufacturing.
  • A “Make in India” campaign, inaugurated by Mr. Modi in 2014, has been stuttering ever since. Wage costs are lower in India than in China, but much of the work force is poorly educated, and the country has struggled to attract private investment with its restrictive labor laws and other impediments to business, including lingering protectionism.
  • service-sector growth can go only so far in reaping India’s promise of a demographic dividend, or blunt the peril of an unemployment crisis. Hundreds of millions of people can’t find jobs or are underemployed in work that pays too little.
  • the employment entrance exams at government agencies. These jobs are still coveted as private sector work remains limited and less stable.
  • 650,000 students will apply for just 600 or 700 jobs in the national civil service this year.
  • The civil service is a tiny part of the work force, but it is prestigious — in part because it comes with job security for life. Most applicants spend years, and a big chunk of their family’s savings, and still fail to make the cut.
  • “Here there is no enterprise, no companies,” Mr. Kumar said. For any young person, “the question comes, ‘What next? What can I do?’”
  • The lessons Mr. Modi is taking from China are most apparent in his push for infrastructure development, investing heavily in highways, railways and airports to improve supply chains and connectivity.
  • India has quintupled its annual spending on roads and railways during Mr. Modi’s nine years in power
  • As Mr. Modi has boxed in opponents, cowed the press and overwhelmed independent elements of civil society, his government has lashed out at expressions of concern from abroad as evidence of a colonial plot to undermine India or a lack of understanding of India’s “civilizational” approach — both elements that diplomats had long heard in China’s own defensiveness.
  • All the while, the increasing militancy of his Hindu nationalist supporters, as arms of the state hang back and give perpetrators a free pass, exacerbates India’s religious fault lines and clashes that threaten to disrupt India’s rise.
  • Even as India tries to align its growing technological and economic capacity to capitalize on the Western tensions with China, it is determined to stick to its neutrality and maintain a balancing act between the United States and Russia. There is also the question of whether the West’s shift from China, the linchpin of the global economy, is a temporary recalibration or a more fundamental one.
  • “China took advantage of a favorable geopolitical moment to really transform itself by having access to technology, to capital, to markets led by the United States. It took advantage of that to build itself up,” Mr. Saran said. “This could be that moment for India.”
Javier E

Opinion | Biden's course correction on China is smart and important - The Washington Post - 0 views

www.washingtonpost.com/...den-china-trade-policy-caution

china us rivalry threat

shared by Javier E on 21 Apr 23 - No Cached
  • French President Emmanuel Macron might have been too blunt about his worries about Europe becoming a “vassal” of the United States, but his views are in fact widely shared in Europe and beyond. The war in Ukraine has hurt Europe by raising its energy costs while benefiting the United States, which is the world’s top producer of hydrocarbons and sells many at low cost. European companies are shifting investment to the United States, lured in part by the Inflation Reduction Act’s generous subsidies. A German CEO said to me recently, “You cannot expect us to forgo cheap Russian energy as well as the Chinese market. That would be suicide for Europe.”
  • More broadly, if geopolitical tensions win out and economic ties continue to weaken, we will move into a very different world, marked by much greater chaos and disorder at every level. One sign of this can be seen in the impasse over debt restructuring. Dozens of the world’s most vulnerable economies are in or at high risk of debt distress. (Lebanon, for example, has been in default for three years.) Yet the International Monetary Fund cannot bail out these countries because China (which is one of the world’s largest creditors) cannot come to an agreement with Western nations on the terms of relief. The two sides blame each other and hundreds of millions of people suffer.
  • The last time two major world powers tried to manage a relationship of economic interdependence and rising geopolitical rivalry was Britain and Germany in the period from the 1880s to 1914. That experiment ended very badly, with a war that destroyed much of the industrialized world. Both sides should try to ensure we do better this time
Javier E

There Is Literally Nothing Trump Can Say That Will Stop Republicans from Voting for Him | The New Yorker - 0 views

www.newyorker.com/...epublicans-from-voting-for-him

trump GOP cult personality cult politics

shared by Javier E on 24 May 24 - No Cached
  • These days, you’re more likely to find Trump’s words in one of Biden’s campaign ads than in anything put out by his many G.O.P. cheerleaders. Trump’s crazy quotes generate support for Democrats; Republicans like Haley just cringe and change the subject.
  • It was, of course, exactly because of this phenomenon that far too many failed to take seriously Trump’s reckless incitements after he refused to accept the results of the 2020 election.
  • If anything, he’s getting even more of a pass in this election. Little that he has said or done seems to have made any appreciable impact on an increasingly amnesiac electorate, even as the things he says or does get ever more unbelievable.
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  • As a result, Trump’s threats of revenge and retribution have become the background noise of the election year—it’s just more blah-blah-blah from a master of it
  • CREW, a good-government group in Washington, D.C., which reviewed more than thirteen thousand of Trump’s Truth Social posts for a report released this week.
  • They found that Trump had threatened to unleash the powers of the federal government on Biden twenty-five times in the past two years. Other targets against whom Trump called for vengeance included senators, judges, and members of Biden’s family. “IF YOU GO AFTER ME, I’M COMING AFTER YOU!”—a blunt Trump social-media post from last year cited in the report
  • yet Congress, even when it was under full Democratic control in the first two years of Biden’s Presidency, has failed to pass measures that might insulate the Justice Department and other parts of the executive branch from efforts to politicize it during a second Trump term, such as reforming the Insurrection Act to make it harder to deploy the military on U.S. soil or passing legislation to make it more difficult for the White House to interfere in federal law-enforcement investigations.
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