The Trump Administration and the New Covid-19 Wave: A Rejoinder for the Obama-Biden Coalition and the Post-Omega Era
The administration diverted vaccine doses from state stockpiles. It created a working group across agencies to spread successful ideas. It put federal clinics in Black and Latino neighborhoods. It helped set up clinics at churches, barbershops and beauty salons. “In more affluent communities,” Webb said, “people had choices about where they felt confident getting vaccinated.”
The Trump administration had seemed uninterested in combating those inequities, leaving it up to states. President Biden made closing the gaps a priority. “We built our Covid response with equity at the heart of it,” Ron Klain, the White House chief of staff, told me.
A new Covid-19 wave appears to be brewing in Europe as cooler weather arrives, with public health experts warning that vaccine fatigue and confusion over types of shots available will likely limit booster uptake.
But these subvariants will land at a time when population immunity is higher than ever, thanks to vaccines and infections. It is not like the Omicron outbreak which happened a year ago, and that will help damp any future waves.
Covid is coming: How the vaccines have been distributed in Europe and what the public health message has been saying about the recent pandemic in the United States
There were 1.5 million cases in the European Union last week, up 8% from the previous week, despite a dramatic fall in testing. Globally, case numbers continue to decline.
But infections and even hospitalizations have started rising in some of the same parts of New England, as well as some other northern areas, such as the Pacific Northwest, according to Dr. David Rubin, the director of the PolicyLab at Children’s Hospital of Philadelphia, which tracks the pandemic.
The new Omicron-adapted vaccines, which address theBA.1 and the BA.4/5, went on sale in Europe as of September. The BA.1-tailored shots have only been allowed in Britain.
European and British officials have endorsed the latest boosters only for a select groups of people, including the elderly and those with compromised immune systems. The choice of vaccine as a booster will complicate matters further, public health experts said.
The lack of major publicity campaign and the fact that it is all over will be seen as a reason to not take preventative action for those who are less concerned. I worry that the amount of people will be quite a bit lower.
Penny Ward, visiting professor in pharmaceutical medicine at King’s College London, said: “Another confounder is that quite a high proportion of the population might have also had a Covid episode in recent months.”
Since September 5, when the roll-out of new vaccines began in the European Union, about 40 million vaccine doses produced by Pfizer-BioNTech and Moderna have been delivered to member states, according to data from the European Centre for Disease Prevention and Control (ECDC).
Schaffner said he had almost had to remind people. We have had two very low flu years. And of course, everyone’s been preoccupied with Covid, and they want to put Covid behind them and get on with their lives.”
Italy’s Gimbe science foundation said the government, soon to be replaced after an election, was ill prepared for the autumn-winter season, and highlighted that a publication on the government’s management of the pandemic had been blocked.
British officials warned last week that renewed flu and a resurgence in Covid-19 could put pressure on the already stretched National Health Service.
The US had the most Covid-19-related deaths in the first week of December. Even with vaccines and treatments widely available, the CDC reported nearly 3,000 deaths for that week.
What is happening in Europe is the first clue of what’s to come. Infections have been rising in many European countries, including the U.K., France, and Italy.
“In the past, what’s happened in Europe often has been a harbinger for what’s about to happen in the United States,” says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “So I think the message that we need to convey to our citizens is: We have to be prepared for what they are beginning to see in Europe.”
“We look around the world and see countries such as Germany and France are seeing increases as we speak,” says Lauren Ancel Meyers, director of the UT COVID-19 Modeling Consortium at the University of Texas at Austin. That brings me to my senses. There is uncertainty around what we can expect over the next couple of months.
There is a chance that the U.S. experience will not be the same as Europe’s, according to a sociologist at the University of North Carolina.
That’s because it’s not clear whether Europe’s rising cases are related to people’s greater susceptibility to new subvariants they’ve not yet been exposed to. In addition, different countries have different levels of immunity.
New research indicates a country’s vaccine rate matters more than any other factor when it comes to effects on a population.
What is the demand for a Covid-19 vaccine in the last few years, and why is it important to change the formula? A report from the Center for Disease Control and Prevention
“We are keeping an eye on something that is happening but it’s really too early to say something big is happening” said Amy Kirby, lead at the Centers for Disease Control and Prevention.
Rubin said that there is evidence of increasing transmission in the northern part of the country. “The winter resurgence is beginning.”
The surge will likely not get as severe as the last two years due to no dramatically different new variant emerging.
“We have a lot more immunity in the population than we did last winter,” says Jennifer Nuzzo, who runs the Pandemic Center at the Brown University School of Public Health.
“Not only have people gotten vaccinated, but a lot of people have now gotten this virus. Some people have gotten it more than once. And that does build up [immunity] in the population and reduce overall over risk of severe illness,” Nuzzo says.
The amount of people getting one of the new bivalent omicron boosters is a key variable that could affect the impact of infections.
Uptake for the updated Covid-19 booster has also been lackluster: Fewer than 1 in 7 eligible people have gotten one since it was authorized in the fall, according to CDC data.
And the demand for the newest boosters is pretty lethargic so far. Less than 8 million people have gotten one of the new boosters since they became available over the Labor Day weekend even though more than 200 million are eligible.
Marks said that the advisory panel would meet in May or June to determine if it was necessary to change the vaccine’s formula or to only include one strain of the disease. This is an important scientific question, says Ranney — but in the meantime, “especially if you’re older or have chronic conditions, a booster is better than no booster when you’re in the middle of a surge”.
How America’s Future Starts Now: The Last Two Years of Care System Problems for a Woman’s Obessive Childhood. My Last Newsletter
First, a programming note: This is my last newsletter before starting a book leave. I’ll be back in late January. In the meantime, The Morning is being written by other Times journalists, and I’m looking forward to seeing their work.
A worrisome pattern has emerged with Paxlovid and other drugs that reduce the severity of Covid: Many people who would benefit most are not receiving the treatments, likely causing hundreds of unnecessary deaths every day in the U.S.
Editor’s Note: This roundup is part of the CNN Opinion series “America’s Future Starts Now,” in which people share how they have been affected by the biggest issues facing the nation and experts offer their proposed solutions. The views expressed in these commentaries are the authors’ own. CNN has more opinion.
The last two years have shown that there are a lot of problems with the American health care system. She writes that she became who she wanted to be when she advocated for her own health.
“[M]y new life, which includes days of pain, brain fog, exhaustion and persistent eye issues, has left me unable to teach the students I cherished. After exhausting all my leave benefits, I laugh at the money in my bank account. And, some days, crying is all I can do.”
Physicians are the canaries in the mine for patient health: Addressing the hospital staffing crisis through a federal mandated physician-owned nurse ratio system
The crisis in nurse staffing arose largely because many health care entities prioritize profits over healing. A profit generator may be seen as a cost center rather than a cost center because nurses comprise the biggest labor pool of any hospital. Eliminating nursing positions gives hospitals an easy way to cut their labor costs. A nurse cannot do the job of two nurses, so care managed within a capitalist framework will inevitably be less safe.
To save nursing, and patient care, we need federally mandated staffing ratios of nurses to patients in the hospital. California implemented ratio systems in 2004, without putting big hospital systems out of business. The Center for Medicare and Medicaid recently imposed nurse staffing requirements in skilled nursing facilities. Economic support for hospitals could help their staff.
Patients fare better as nurses fare, they are the canaries in the mine for patient health. Patients deserve to have safe curative care prioritized over excessive health care profits.
Theresa Brown, nurse and New York Times bestselling writer, is the author of “Healing: When a Nurse Becomes a Patient,” and “The Shift: One Nurse, Twelve Hours, Four Patients’ Lives.”
According to the Kaiser Family Foundation (KFF), over 91% of Americans possess insurance coverage, yet according to data from the US Census Bureau nearly one in five still struggle to afford medical care. With the federal government’s deficit totaling $217 billion in the month of August 2022 alone, and economy-wide inflation at 8.2% in September, policymakers can lower health care costs for patients and increase access without increasing governmental spending by injecting a dose of competition into hospital markets.
By lifting the physician self-referral ban in managed Medicare or managed Medicaid settings that have checks and balances to avoid waste and abuse, physician-owned and operated enterprises would be in a position to compete with corporate enterprises. Corporate monopolies would face increased competition from new physician-owned hospitals and clinics. It could be a matter of life or death, and hospital monopoly power can be addressed if it’s tied to outcomes.
With robust evidence demonstrating that competition in outpatient care markets lower costs, policymakers could reform Stark Law, which prohibits physician referral for designated health services to facilities in which the physician or a family member has a financial interest. Corporate self-referral is not subject to these restrictions and corporate health systems often force internal referrals.
Brian J. Miller, MD, MBA, MPH is a nonresident fellow at the American Enterprise Institute and an assistant professor of medicine at the Johns Hopkins University School of Medicine. He served as a Special Advisor to the Federal Trade Commission in 2015.
First, building trust in science requires a human connection. We need to leverage trusted messengers in all the communities and start from a place of dialogue. Even with a fancy health official title, you’re doomed to fail if you can’t make a personal connection with the people you’re trying to keep healthy. This is where local health departments play a significant role. They are more knowledgeable about their communities than federal entities.
Now could be the time to act. The public-health community’s response to COVID-19 was a great success, limiting the spread of many infectious diseases. In spite of the Zimbabwe outbreak, Durrheim says the lowest number of Measles cases he has ever seen are in many countries. The importance of this mission only gets greater as more and more countries decide whether or not to put the epidemic behind them. “We either have to really invest now and close those immunity gaps,” says Durrheim, “or what will come will be devastating.”
Real or False? How Washington Has Helped to Reform the Affordable Care Act and Expand Medicaid to Ensure Health Care for Uninsured Americans
Americans are often confused about whether to believe the real or fake, causing an epidemic of misinformation that can spread much quicker and further than the truth.
The senior director of the NYC Health + Hospitals special pathogens program is a faculty member at Boston University’s Center for Emerging Infectious Diseases Policy and Research. She is also a fellow at the Belfer Center for Science and International Affairs. She tweets @syramadad.
It’s no secret that it can be hard to get things done in Washington. Health care reform is the same as every other reform. Legislation to lower prescription drug prices was passed by Congress in the face of opposition from the GOP and Big pharma. Biden’s plan to expand Medicare to include dental, hearing, and vision benefits failed because there was not enough support from Democrats and Republicans.
The Affordable Care Act empowered states to expand Medicaid to cover almost all adults with incomes up to 138% of the federal poverty line. It was a huge success in red and blue states. Medicaid expansion has radically reduced the number of uninsured Americans and boosted health outcomes, including fewer premature deaths, among older adults. It has contributed to a reduction in health care costs for women and people of color according to the Kaiser Family Foundation.
It’s urgent for those 12 states that haven’t expanded Medicaid. 383,000 people in these states could be left without affordable coverage if the PHE ends, while expanded Medicaid would provide financial security and access to health care for millions of people.
Source: https://www.cnn.com/2022/10/18/opinions/health-care-solutions-expert-roundup/index.html
Preventing Black Hole Discrimination by Improving the Access to Medical Education: The Case of the U.S. Department of Health
Max Richtman is president and CEO of the National Committee to Preserve Social Security and Medicare. He was formerly the staff director of the US Senate Special Committee on Aging.
To encourage more minority students to pursue medical school, there needs to be a systemic overhaul in admissions policies for undergraduate and graduate medical education, commitment to debt reduction and forgiveness, institutional policies that explicitly protect minority physicians from racism encountered on the job and pipeline programs that give students of color opportunities to bridge to medicine, which some schools have already adopted.
The goal is to make a diverse community of doctors that represents the populations they serve. There are studies showing minority patients benefit from having minority doctors and the current US doctor workforce is not representative of population estimates. For example, African Americans constitute about 14% of the US population, yet only 5% of physicians are Black, according to 2018 data from the Association of American Medical Colleges.
Then, the next generation of doctors will be able to recognize inequities and the elements of our health care system that encourages them – like racist guidelines or medications and biometric calculators that inappropriately adjust for race – and dismantle them.
13 million people who buy their own coverage on the open market will be able to continue to afford it thanks to the Inflation Reduction Act, according to the Kaiser Family Foundation. The tax credits should be made permanent.
A relief package passed in March of 2020 prevented states from kicking Medicaid people off in the middle of a public health emergency. Medicaid enrollment has skyrocketed to a record 90 million people since then, and millions are expected to lose coverage once states began culling the rolls.
According to the Georgetown University Health Policy Institute, only 27 states and the District of Columbia have publicly shared their plan to prepare for the end of the PHE. State leaders should act now to ensure every Medicaid enrollee knows how to stay covered and should work to simplify renewal processes, such as using electronic data sources to verify eligibility.
Americans with private insurance have not been charged for monoclonal antibody treatment since they were prepaid by the federal government, though patients may be charged for the office visit or administration of the treatment. But that is not tied to the public health emergency, and the free treatments will be available until the federal supply is exhausted. Some of the treatments have already been run out by the government so those with private insurance may be picking up some of the cost.
So, it is essential that policymakers continue to explore policies to mitigate the high prices of drugs and therapeutics, such as prohibiting drugmakers from shifting costs to non-Medicare consumers and establishing a federal reinsurance program for high-cost drugs.
What can we do about vaccination, vaccines and vaccinating? The challenge of connecting public health agencies to the needs of high-risk populations
Better data will also be crucial to helping the health-care community to quickly identify places where intervention is needed to prevent immunization levels from dipping too low. O’Brien says that the WHO has been working with member nations to adopt the agency’s district health information system, called DHIS2, which makes it easier to share granular within-country information about vaccine administration and coverage. She notes that the biggest challenge will be catching the zero-dose children, those who live below the poverty line in settlements with inadequate housing and basic services, rural villages and conflict zones. She says they are uncounted and unseen because they are born outside of a facility. It is hard to plan out and vaccine children who you don’t know exist. The WHO estimates that by halving the number of zero-dose children, it could save 50 million lives over the next 10 years.
Improving worker safety has been another missed opportunity. Everyone in a workplace benefits if colleagues feeling flulike symptoms remain home. But this will happen only with a change in culture around sickness and, more important, the provision of paid sick leave to workers, especially for those in low-income jobs and the gig economy. Paid sick leave is particularly important in the health care, hospitality, public transportation and retail industries, where infections can most easily spread. Despite the spread of respiratory infections in the workplace, Congress has not passed legislation requiring paid sick and family medical leave for many employers.
Strategies also are still badly needed to connect public health agencies with high-risk but hard-to-reach populations. During the early days of the company, engagement with the public by health agencies was passive. Americans had to stand in line or sign up online for vaccines or masks or to order tests and sometimes request reimbursement from their insurers. This approach works for people who have time, broadband access and computer skills. But it is much more challenging for disabled people, older people living alone, individuals with low health literacy, non-English speakers and rural residents.
Source: https://www.nytimes.com/2022/10/19/opinion/covid-pandemic-failures.html
Seasonal Viruses Are Coming Back With A Boost: An Immunology Logistically Energetic Analysis of the Northern Hemisphere
N95 face covering, gloves and disposable gowns are examples of personal protective equipment that the government does not have a stable domestic production capacity for.
Nor has it fixed the system of clinical research, which proved slow in generating useful results on a range of concerns, such as optimal vaccine schedules and the evaluation of drugs to lessen Covid symptoms and prevent hospitalizations. The reliable clinical results proving the benefits of steroids and the problems with hydroxychloroquine tended to come from Britain and other countries. The National Institute of Health has not changed how they organize, fund and reward scientists for participating in large, pragmatic clinical trials.
COVID-19 restrictions mean we are more susceptible to these viruses. What’s behind the current surge in the Northern Hemisphere, and what will the new normal be?
Scott Hensley, an immunologylogist at the University of Pennsylvania in Philadelphia, stated that the viruses are coming back with a vengeance. This year could very well be the granddaddy of them all in terms of flu.
The population is naive and more so than most years. Normally, children get infected by their second birthday. Now, “you’re going to end up having kids that are three, four years of age right now who have never seen RSV”.
Older children and adults who have been previously bitten are at risk of waning immunity. There is no exposure to a virus that reduces the incidence of Antibody levels decline. John Tregoning says a small amount of the virus can be passed on to your body to fight it off. But “that kind of asymptomatic boosting maybe hasn’t happened in the last few years”.
There is a lot researchers don’t know about seasonal viruses. For example, COVID-19 restrictions seemed to have little impact on one type of seasonal virus, rhinoviruses — which are the most common cause of colds — for reasons that aren’t entirely understood. That might be because of their hardiness, Miller says. They’re less prone to desiccation and can persist for longer in the environment.
There are some questions about how these Viruses compete and interfere with one another. Infection with one virus can raise a strong innate immune response that might prevent infection with another virus. Hensley points out that last year’s first wave of influenza declined soon after the Omicron surge began. Perhaps Omicron infection provided some short-lived protection against flu. The Omicron surge might have made people keep their distance.
Is this going to be the last strange winter for Covid-19 in the U.S.? The case of Helix and BQ.1
Pitzer is of the opinion that next year’s peaks and valleys may be more similar to those that occurred before the epidemic. She isn’t placing any bets. This winter is probably going to be the last strange one, according to her.
“We have seen, in some regions, RSV numbers starting to trend downward. There are still flu numbers on the rise. And we are concerned that after holiday gathering, lots of people coming together, that we may see increases in Covid-19 cases as well,” Dr. Rochelle Walensky, director of the US Centers for Disease Control and Prevention, said Tuesday on CNN.
The associate director of bioinformatics at the genetic testing company said that infectious disease positivity is going up. “It’s increasing fastest among 18- to 24-year-olds” in the Helix sampling.
It is possible that the transmission of Covid-19 tests is on the rise because test positivity increases when it increases.
We should expect more cases, according to Luo. I think in general, you should see more people who are sick when you measure them. I’m definitely doing so.
Increasing cases may not be picked up as quickly by official counts because people are mostly testing for Covid-19 at home and not reporting their results – if they test at all.
All that’s not to say that BQ.1 and BQ.1.1 won’t have any impact. They have shown marked resistance to the immunity of the people who are vulnerable to Covid-19 infections. There are good reasons to be cautious if they have weakened immune systems or are around someone who does.
It is not clear what the B Q variant will look like. Many experts say they feel hopeful that we won’t see the big waves of winters past – certainly nothing like the original Omicron variant, with its jaw-dropping peak of nearly a million new daily infections.
Bill Hanage thinks our behavior may be a bigger indicator of whether or not cases will rise than the variant in the lead.
Andrew Pekosz, a virologist at the Johns Hopkins Bloomberg School of Public Health, says that’s probably because BQ.1’s advantages are incremental, not drastic.
He said it is gradual replacement without a large change in the number of Covid-19 cases.
Scientists at Los Alamos National Labs recently completed a study delving into what drove the effects of 13 dominant variants of coronavirus as they transitioned from one to another in 213 countries. The data up to September was included in the study and published as a preprint before the peer review.
Source: https://www.cnn.com/2022/11/24/health/covid-19-thanksgiving-bq/index.html
How do masks change demographics in a country? Insights from Korber’s studies of alpha, BQ and other variants
The number of previous cases in a country, the percentage of people who wore masks, average income and the percentage of the population older than 65 ran a distant second, third, fourth and fifth, respectively.
The number of other variations in the mix when a new one starts to increase is an important factor, says senior study author Bette Korber.
By the time Alpha reached the United States, we were evolving our own variants out of California and New York “that were very distinctive and had a competitive edge compared to what it had to come up against in England,” Korber said, which probably slowed its roll here.
Korber is not making any predictions. It is difficult to know what is going to happen, she stated, pointing to Asia.
The US has not seen much of a presence by the XBB, a subvariant that has caused waves in Asian countries. The BQ version arrived later, but she said they looked really good against XBB.
“To me, it’s a good time, when it’s possible, to wear masks,” she said. The mask protects the person as well as others around them. “And get the booster if you’re eligible and it’s the right moment for you,” especially as we gather around the table to feast with our friends and family.
Korber said it was a good time to make the wave smaller in order to prevent it from happening.
The Covid death epidemic is a “pandemic of the old,” says a spokesperson of the National Institute for Allergy and Infectious Diseases
That is a very decent deal. A twice-boosted 87-year-old is like a never-vaccinated 70 year-old when it comes to Covid death. Which is to say there’s a real risk. If it was ever comfortable to say that the unconscionable levels of American deaths were a “pandemic of the unvaccinated,” it is surely now accurate to describe the ongoing toll as a “pandemic of the old.”
The answer is that as a country, we prefer to not see the number of deaths in a day. We don’t need to understand who is dying or why in part because we don’t want to reckon with the fact that around 300 Americans are now dying from Covid-19 every day, at a rough pace of about 100,000 per year, making it the country’s third leading cause of death. This is normalization at work, but it is also a familiar pattern: We don’t exactly track the ups and downs of cancer or heart disease either.
According to the National Association of County and City Health Officials, there are plenty of people in this country who do not believe that the flu and the Covid vaccine are safe. “Flu is serious in our country, and it kills a lot of people, and it hospitalizes a lot of people, and it attacks the young and old. And so we should pay more attention to it.”
Only about 14% of eligible Americans have gotten an updated Covid-19 booster, and 1 in 5 people in the US remain completely unvaccinated, according to the CDC.
The savings may be much higher if you take into account the cases of long Covid, which can be prevented by vaccines.
It’s a success and an achievement, because of the emergency of highly TransmissibleVariants and immune-evadingVariants like Omicron.
“Don’t wait. The director of the National Institute of Allergy and Infectious Disease said at an event Friday that if you wait, you put yourself at risk. “We’re entering the colder months of the late fall and the early winter. We will come together with our families and friends for the holidays. If you are updated, that’s great. If you aren’t, then get the vaccine now.
A Conversation with Anthony Fauci: Vaccining for HIV and How to Identify It During a Pandemic and an Emerging Epidemic
Case numbers are now below those of earlier waves, but about 14% of the US population is in an area that meets the US Centers for Disease Control and Prevention’s criteria for a “high” Covid-19 community level, up from less than 5% last week. New York City, Los Angeles County and Phoenix’s Maricopa County are among those areas.
Anthony Fauci will step down as the director of the NIAID after more than 38 years in his post and 54 years with the US National Institutes of Health. He has led the institute under seven US presidents and overseen its research and response to the HIV/AIDS epidemic, the Ebola outbreak that began in 2014 and the COVID-19 pandemic. During the H1N1, the 81-year- old physician-scientist became a household name, and he was revered as a trusted source of advice by some and disliked by others, including former US president Donald Trump. Musk took over the social-media platform in October and attacked him on 11 December. Fauci spoke to Nature about Musk’s comments, the pandemic and his own legacy.
One of the most important is in the area of HIV. When we first became aware of the cases of HIV in 1981 it was a disease of unknown etiology that killed most of the people who had it. It was one of the darkest periods of my or anybody’s professional career in infectious diseases. We went from that bleak time of not knowing what was killing all of these mostly young gay men to getting the [underlying virus], a diagnostic test and, within a few years, an entire series of drugs, which when used in combination, have completely transformed the lives of people with HIV. We have developed highly effective prevention methods, such as pre-exposure prophylactics, and can treat people who are in this situation, so they don’t transmit it to anyone else.
A safe and effective vaccine for HIV is one of the most exciting topics in infectious-disease research. We have made huge advances in the treatment and prevention of disease. A safe and effective vaccine is one that we have been missing out on. So that’s one of the things we look forward to. There is a chance that you can have a cure for HIV if you don’t need further therapy, as long as you are already free of the virus. We don’t have that point yet, but that is anaspirational goal.
Yes, we do. You do it by doing it. It’s not that difficult to incorporate a discipline of social sciences into the discipline of the hard sciences of developing vaccines. In our nation, more than 75% of the population have had the primary vaccine for COVID. Only half of them have received a boost. Despite that, only a small amount of eligible population have received an effective BA.4/5 bivalent updated booster. It’s shocking that we have low enthusiasm for getting a life-saving vaccine.
Source: https://www.nature.com/articles/d41586-022-04432-7
COVID-19 and the future of global public health: What did America do in response to a new global outbreak or a possible new epidemic?
Another aspect that has been brought to the fore by COVID-19 is the importance of mental health, and paying attention to the stresses that [the pandemic] has put on society: not only on health-care workers, doctors and nurses, but also on the general population, including children. There have been many changes in their development due to missing school, losing parents, and the stress of being away from home. The negative impact on mental health of that has been huge.
That is not possible to answer. If there are countries or groups that are not transparent, that’s a big hindrance to the global public-health effort. And I would hope that all the countries of the world come to a realization that we’ve got to be completely cooperative, collaborative and transparent in everything we do, because there’s no such thing as a pandemic, particularly of an infectious disease spread by the respiratory route, that’s going to stay in one country. We saw how quickly Carbonide spread in the world and has already led to close to seven million deaths, so it is likely a gross underestimate.
The question of whether or not we have learned anything from the last one is obvious as a second H1N1 might be on the horizon. Is it conceivable that the country’s response to a new global outbreak, like H5N1 or something else, would be more cohesive with new political leadership? To the contrary. All the ways in which America failed to do all the things it should have done when it was returning to normal are suggested by mentioning the possibility of a new epidemic in the near future.
What can you do about public health? How you can get a flu vaccine without having to go through it all without paying attention. What do you do when you don’t?
I don’t pay attention to it, and I don’t think I need to respond. I don’t tweet. I don’t have a handle on the social networking site. I don’t worry about a lot of that stuff because it’s a cesspool of misinformation.
Of course it’s at risk. All the time, I have armed federal agents with me. A lot of people are angry because somebody like that is on a social media platform.
They should not be deterred from getting into public service because the satisfaction and degree of contribution that you can make to society is incomparable. It is really amazing. It overcame all of the bad stuff. We are in the unfortunate situation where we are attacking public-health officials. The accomplishments you can achieve in the field are wonderful. And it certainly supersedes all that other stuff.
Public health leaders say it has been difficult to get people to get a flu vaccine this year because they want to stop getting shots.
Trying to persuade people to do something new can add to the hesitancy that’s already become so pervasive and make them less likely to come in at all. People will usually accept the offer of a flu vaccine at an appointment that they are scheduling to get a Covid-19 vaccine booster.
On familiarity breeds contempt, and why it doesn’t breed a contemptuous image: Dr. Michael Hackell on pandemic inademic vaccines
It has been said that familiarity breeds contempt. Well, perhaps that’s a bit strong, but familiarity does seem to breed a certain nonchalance,” he said.
There are some encouraging signs when it comes to bird flu: federal discussion of a mass poultry-vaccination program and the “rapid” rollout of existing avian-influenza vaccines for humans. We would probably spend the early stage of a new pandemic repeating debates over the previous one, even if each of these projects took at least six months. You can see the fault lines already, with those who believe the country’s Covid response went too far taking to social media to mock the suggestion that any of the same measures — social distancing, masking, school closures — might be imposed to hold off a new contagion, as though it were irrelevant that this new one might be many times deadlier.
Hackell believes that if the vaccine was effective and not repeated, it would be different. I think that when there is controversy going on, it spills over, and that is why we have to compare it to Covid and flu vaccines.
I believe providers also suffer fatigue, moral injury, and that they call it burnout on the part of them. We’re not pushing it as hard,” said Hackell, who is also chair of the American Academy of Pediatrics Committee on Practice and Ambulatory Medicine. “It gets very difficult to keep having these unproductive conversations over and over again. When your office is filled with sick kids, it makes sense to have these long discussions.
Covid-19 Spreading in America Needs to Get More Vaccines Together, Not Just the One? A CNN Interview with White House Director Dr. Ashish Jha
But despite the convenience of getting both shots at once, there’s evidence that linking the two isn’t the best way to boost coverage rates for either.
“We give multiple vaccines to our kids at the same time, but we haven’t typically done that for adults,” said Tan, former liaison to the CDC’s vaccine advisory committee for the American Medical Association.
In order to give some confidence to the patient, it is necessary to have direct interaction with the health-care provider. The patient gets the vaccine after a personal conversation with the provider. It’s a testimony also to our remarkable health-care providers.”
The message might finally be sticking. At Walgreens locations, co-administration of the flu and Covid-19 vaccine is 70% higher this year than it was last year, according to data shared with CNN.
“At least we’ve got the uptick now, as opposed to this continuous decline that we were seeing four weeks ago,” he said. “But while I’m sounding positive, I want to remind us all that we need to be better than we currently are.”
In an interview with CNN laying out the White House’s launch of a new public campaign on Thursday aimed at preparing Americans ahead off what is expected to be a continued rise in Covid-19 cases this winter, White House Covid-19 response coordinator Dr. Ashish Jha stressed that the stakes are even higher as the United States confronts a trio of threats.
What Do You Don’t Know About Covid-19 and How Should You Do if You Think You Have it? A Simple Rule of Thickness to Keep Your Way through the Winter Holiday Dinner
Evidence suggests thatRSV has peaked and case numbers will soon come down. Still, it will be a while before the impact of the virus is diminished, he said.
The Biden administration’s renewed push to encourage people to use all of the necessary tools to keep Covid-19 at bay is an example of the ultimate goal of the White House.
The administration is restarting the free at- home Covid-19 test program, giving every American a chance to order up to four free tests this winter. It is also offering federal resources to local health departments, putting an extra focus on high-risk individuals including by providing a winter playbook for nursing homes and other long-term care facilities, and permitting nursing home staff to administer vaccinations.
Jha declined to predict how many Covid-19 cases there might be this winter, but said data from the past few weeks make clear that numbers have been on the rise, likely driven in part by indoor gatherings during the Thanksgiving holiday and the beginning of the winter holiday season.
If someone gets a vaccine tomorrow, they’ll have some protection by Christmas. But it’s not like Christmas Day is the last day people socialize over winter,” Jha said. “So getting vaccinated as quickly as possible so you have protection for as much time as possible, is critical.”
The CDC has some guidelines for what to do if you test positive for Covid-19, and they are more conservative than those for the flu orRSV. When a person is ill, the spread of the twoviruses largely happens and Covid-19 can be transmitted a lot more even when there is no symptoms.
He encourages Americans to follow this simple rule of thumb, if they have Covid-19 or something else, if they are feeling sick.
In other words, don’t cough your way through a family holiday dinner even if you don’t believe you have Covid-19: “You don’t know what virus you have and there’s no value in spreading it to other people,” Jha said.
Just when you thought it was safe for a holiday visit with your Auntie Mary and her fragile health, RSV and the flu reared their heads – and now Covid-19 numbers are creeping up again.
The availability of the protective measures, tests and treatments that health officials say will be key to preventing a repeat of the Covid-19 surge in the past two winters is being emphasized.
Older people are the most vulnerable to Covid-19 illnesses, and have been on the rise since November. Hospitalization rates are four times higher for seniors than for any other age group.
The Omicron coronaviruses variant spiked during the last Covid-19 season, but the White House said Thursday that it won’t happen again.
White House Covid-19 response coordinators Dr. Ashish Jha stated at the briefings that they have the know- how to manage this moment.
The Biden administration has been in close contact with state and local public health leaders. And the federal government has medical personnel, supplies and other resources ready if states and communities need them.
People who test positive for Covid-19 should be evaluated for treatment especially those 50 and older, says Jha on CNN.
If people use the tools that are available, we could make it through the Covid-19 season.
Social media, vaccine hesitancy, and the pandemic of vaccines: How much do South Africans think about social media?
School children in Philadelphia will have to wear masks for 10 days when they come back from winter break because the district wants to prevent the spread of Covid-19 and other respiratory illnesses.
The risks of allowing these infections to flourish are clear. Zimbabwe is currently working to contain a huge measles outbreak that claimed the lives of more than 750 children between April and October. And poliovirus has recently re-emerged in the United States after decades of successful elimination, prompting a state of emergency in New York.
But vaccination is a continuous process, not a one-time victory, and further progress proved a challenge (see ‘Lost progress’). Jonathan Mosser, an epidemiologist at the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, says that in the years leading up to the pandemic, “we really saw a stagnation of coverage for many of these long-established vaccines”. Furthermore, regional- or national-level statistics can mask considerable inequality at the local level. Duduzile Ndwandwe, a vaccinologist at the South African Medical Research Council in Cape Town points out that although the pre-pandemic coverage for routine childhood vaccines in South Africa was on the order of 85%, there were wide disparities within the country. “The poorest provinces like Eastern Cape, Limpopo and Mpumalanga were not doing that well,” Ndwandwe says. “They would be bordering on 60–70%.” This is not enough to make a huge difference in vaccine-preventable diseases.
And the possibility remains that this mistrust will spread globally. According to an anthropologist from the London School of Hygiene and Tropical medicine, there is a global coordinated, very deep, negative network out there that promotes a broader anti-vaccine agenda through social networks such as Facebook. In South Africa, Ndwandwe sees such vaccine hesitancy propagating mainly in more affluent communities that have the time and resources to find information — and misinformation — on the Internet. TikTok is one of the more dangerous platforms that I have seen. A lot of these things are happening there. The conversation in poorer communities can be driven by radio broadcasts, religious leaders or poster campaigns.
This is in keeping with what the musician had experienced in South Africa. She says that mothers who already routinely engage with medical systems often trust their physician’s or nurse’s guidance that an immunization is important, even at the height of a pandemic. In poorer communities, people often need to make tradeoffs to get even routine care. She says that you are talking about competing priorities. Do I want to go to work for $10 a hour and spend a day in a clinic, or do I want to go home and eat dinner with my kids?
There were positive statements. In January, Danish Prime Minister Mette Frederiksen declared that SARS‑CoV-2 no longer poses a threat to society. In September, US President Joe Biden remarked during an interview that the pandemic was over. The director-general of the World Health Organization hopes COVID-19 will end as a global emergency in 2023.
Infections and death are giving way to a constant thrum of loss as well as debilitation caused by long COVID. A focus on COVID-19 has also affected the fights against AIDS, malaria and tuberculosis. Death rates are higher in many countries still despite difficult counts.
Experts warn a resurgence is possible as people travel and gather for the holidays even though the seven-day rolling average has come down in recent weeks.
Influence of the pandemic on the Primary and Booster Compositions of COVID-19 Vaccines and Implications for Diseases with Uniqueness
Congestion and coughing are common symptoms of the flu and other respiratory illnesses. But some are unique. For example, Covid can cause wheezing or decreased appetite and for that matter, the respiratory syncytial cystitis orRSV. Health experts say testing can help determine which illness is at play so that they can be treated in a timely manner. For example, the antiviral Tamiflu can help treat flu, while Paxlovid is available for Covid patients.
At the same meeting, the vaccine advisory panel unanimously endorsed the agency’s proposal to adopt a single COVID-19 vaccination composition for primary and booster doses. Currently, people in the United States complete a primary COVID-19 vaccination series — at least two doses of the vaccines made by Pfizer–BioNTech, Moderna or Novavax, or a single jab of a Johnson & Johnson vaccine — all of which should then be followed by a booster two months later. The companies Pfizer–BioNtech and Moderna initially offered an extra dose of their original vaccine for the booster but now only offer a single strain of the disease.
But administering the jab before the winter surge could avert a rush of hospitalizations, noted Peter Marks, head of the FDA’s Center for Biologics Evaluation and Research in Silver Spring, Maryland. In winter, clinics are swamped with people infected with influenza and respiratory syncytial virus (RSV), which led to some US hospitals nearing capacity this season.
The bivalent vaccine could become the main vaccine for people who haven’t yet had a primary series if the composition of the vaccine is changed.
The bivalent boosters that are utilized in the United States and the United Kingdom target both of the strains circulating during the time of the Pandemic. CDC data shared at the advisory meeting show that people aged 5 and above who received just a single-strain booster are twice as likely to die from COVID-19 as those who get a bivalent booster. However, any booster still reduces overall chances of death from COVID-19.
A White House official pointed to a successful vaccination campaign and reductions in Covid cases, hospitalizations and deaths as a rationale for lifting the emergency declarations. The official said that a final extension would allow for a smooth transition for health care providers and patients and noted that health care facilities have begun preparing for that transition.
It is anticipated that this wind down would match the previous commitments of the Administration to give 60 days notice prior to ending the public health emergency.
The statement added, “To be clear, continuation of these emergency declarations until May 11 does not impose any restriction at all on individual conduct with regard to COVID-19. They do not impose mask mandates or vaccine mandates. They don’t limit school or business operations. They do not require the use of any medicines or tests in response to cases of COVID-19.”
“Democrats were concerned about the optics of voting against Republicans winding down the public health emergency, absent an understanding of whether and how we intended to do so from the White House,” the aide said. The White House is obviously concerned by this bill as soon as we saw it. So, it was important for them to weigh in.”
The administration thinks the bills are unnecessary since they intend to end the emergencies anyway. The White House also noted the passage of the measures ahead of May 11 would have unintended consequences, such as disrupting the administration’s plans for ending certain policies that are authorized by the emergencies.
The administration is actively reviewing flexible policies that were authorized under the public health emergency to determine which can remain in place after it is lifted on May 11.
The aide told CNN that it will be up to every member to decide what is best for their district and how they will vote on the legislation this week. The declaration of an end to the public health emergency will lead to the lifting of the border restriction called Title 42, which will set up a fight on Capitol Hill.
Jen Kates is a senior vice president for the Kaiser Family Foundation and she said that people would have to start paying for things they didn’t need during an emergency. “That’s the main thing people will start to notice.”
The Extension of Public Assistance to Covid-19 and the End of the Public Health Emergency: How Congress Suppressed the Fiscal Year 2023 Connection
Private insurers could charge someone if a test is ordered by a provider. Vaccinations will continue to be free for those with private insurance who go to in-network providers, but going to an out-of-network providers could incur charges.
The uninsured had been able to access no-cost testing, treatments and vaccines through a different pandemic relief program. However, the federal funding ran out in the spring of 2022, making it more difficult for those without coverage to obtain free services.
Pfizer and Moderna have already announced that the commercial prices of their Covid-19 vaccines will likely be between $82 and $130 per dose – about three to four times what the federal government has paid, according to Kaiser.
The public health emergency has also meant additional funds for hospitals, which have been receiving a 20% increase in Medicare’s payment rate for treating Covid-19 patients.
Medicare Advantage plans have been required to bill patients who are at out-of-network facilities the same as patients who are at in-network facilities.
Enhancements to public assistance programs can still be meaningful, even if they’re not tied to the public health emergency. Congress severed the connection as part of its fiscal year 2023 funding package.
State will now be able to start processing Medicaid re-determinations and disenrolling residents who have ceased to qualify starting on April 1. They have 14 months to review the eligibility of their beneficiaries.
During the public health emergency, people on food stamp received a boost. In a 2020 relief package, Congress increased food stamp benefits to the maximum for family size.
The Biden administration expanded the boost in the spring of 2021 so that households already receiving the maximum amount and those who received only a small monthly benefit get a supplement of at least $95 a month.
Source: https://www.cnn.com/2023/01/30/politics/may-11-end-of-covid-and-public-health-emergencies/index.html
Telehealth and the Crisis of Democracy: Eight Years of Congress in the G.O.P. Campaign Against the 2024 Republican Presidential Candidate
More Medicare enrollees are able to get care via telehealth during the public health emergency. The service is no longer limited just to those living in rural areas. They are able to conduct the telehealth visit at home, instead of going to a healthcare facility. It’s easier for beneficiaries to receive more services via Telehealth, as they can use their phones.
The largely party-line votes to block the government from requiring health care workers to take the coronavirus vaccine and to end the public health emergency declared at the start of the pandemic were the start of a flurry of legislative activity by the G.O.P. this week that has virtually no chance of yielding any new laws, since the measures cannot make it through the Democratic-controlled Senate or to Mr. Biden’s desk, where he would be all but certain to veto them.
They were part of a plan by Republicans to use their majority in Congress to portray Democrats as overreaching bureaucrats who imposed too many restrictions on people, wreaking havoc with the economy and costing people their jobs. It is a theme that taps into the grievances of parents who were furious about school closures and the resentments of Americans angry about how the pandemic destabilized their lives, and one that is already shaping the nascent 2024 Republican presidential primary.
The Georgia Republican who was banned from her account on social media after violating the company’s policy on coronaviruses has been assigned to a subcommittee to investigate the origin of Covid-19. “Not just in a physical way, but very much in a financial way and in an emotional way.”
Donald Trump was against Hillary Clinton for president because he was against the Republican idea of economic nationalism and because he wanted to break with the bipartisan enthusiasm for globalization.
Seven years later, President Biden just gave a State of the Union speech whose key themes and most enthusiastic riffs could have been lifted — albeit with more Bidenisms and fewer insults — from Trump’s populist campaign.
Tax only the rich, don’t touch Social Security and Medicare, spend infinitely on education are the most familiar of Democratic themes. Meanwhile, Roe v. Wade and the supposed crisis of democracy, so central to the Democrats’ midterm campaigns, were invoked as partisan rallying cries but mostly pushed deep into the speech, long after the president was finished with his main pitch — an argument for a new economic nationalism, brought to you by Blue Collar Joe Biden.
When will the pandemic end? Experts’ weighed in on some of the most pressing questions of the recent epidemic in the U.S.
When will the pandemic end? We have gathered hundreds of questions from readers recently, and we asked three experts to weigh in about some of them, including whether getting covid is just inevitable and how to make sense of booster and test timing.
How will the virus continue to change? A group of scientists say that there is no reason that the virus won’t evolve, even if there is no biological reason for it.
What would Covid look like? 100,000 Americans could die each year from the coronaviruses according to David Wallace Wells. Stopping that will require a creative effort to increase and sustain high levels of vaccination. New vaccines that are delivered in the nose may be part of the answer, writes Akiko Iwasaki.