Why healthcare workers are quitting in droves

‘About one in five health-care workers has left their job since the pandemic started. This is their story—and the story of those left behind...

‘Health-care workers aren't quitting because they can’t handle their jobs. They’re quitting because they can’t handle being unable to do their jobs. Even before COVID-19, many of them struggled to bridge the gap between the noble ideals of their profession and the realities of its business. The pandemic simply pushed them past the limits of that compromise...

‘Several health-care workers told me that, amid the most grueling working conditions of their careers, their hospitals cut salaries, reduced benefits, and canceled raises; forced staff to work more shifts with longer hours; offered trite wellness tips, such as keeping gratitude journals, while denying paid time off or reduced hours; failed to provide adequate personal protective equipment; and downplayed the severity of their experiences.’

Read here (The Atlantic, Nov 16, 2021)

What even counts as science writing anymore? Ed Yong

‘The pandemic made it clear that science touches everything, and everything touches science...

‘To the extent that the pandemic has been a science story, it’s also been a story about the limitations of what science has become. Perverse academic incentives that reward researchers primarily for publishing papers in high-impact journals have long pushed entire fields toward sloppy, irreproducible work; during the pandemic, scientists have flooded the literature with similarly half-baked and misleading research. Pundits have urged people to “listen to the science,” as if “the science” is a tome of facts and not an amorphous, dynamic entity, born from the collective minds of thousands of individual people who argue and disagree about data that can be interpreted in a range of ways. The long-standing disregard for chronic illnesses such as dysautonomia and myalgic encephalomyelitis meant that when thousands of COVID-19 “long-haulers” kept experiencing symptoms for months, science had almost nothing to offer them. The naive desire for science to remain above politics meant that many researchers were unprepared to cope with a global crisis that was both scientific and political to its core. “There’s an ongoing conversation about whether we should do advocacy work or ‘stick to the science,’” Whitney Robinson, a social epidemiologist, told me. “We always talk about how these magic people will take our findings and implement them. We send those findings out, and knowledge has increased! But with Covid, that’s a lie!”

https://www.theatlantic.com/science/archive/2021/10/how-pandemic-changed-science-writing/620271/

Read here (The Atlantic, Oct 2, 2021)

We’re already barreling toward the next pandemic: Ed Yong

‘This one is far from over, but the window to prepare for future threats is closing fast...

“To be ready for the next pandemic, we need to make sure that there’s an even footing in our societal structures,” Seema Mohapatra, a health-law expert at Southern Methodist University, in Dallas, told me. That vision of preparedness is closer to what 19th-century thinkers lobbied for, and what the 20th century swept aside. It means shifting the spotlight away from pathogens themselves and onto the living and working conditions that allow pathogens to flourish. It means measuring preparedness not just in terms of syringes, sequencers, and supply chains but also in terms of paid sick leave, safe public housing, eviction moratoriums, decarceration, food assistance, and universal health care. It means accompanying mandates for social distancing and the like with financial assistance for those who might lose work, or free accommodation where exposed people can quarantine from their family. It means rebuilding the health policies that Reagan began shredding in the 1980s and that later administrations further frayed. It means restoring trust in government and community through public services. “It’s very hard to achieve effective containment when the people you’re working with don’t think you care about them,” Arrianna Marie Planey, a medical geographer at the University of North Carolina at Chapel Hill, told me. 

Read here (The Atlantic, Sept 29, 2021)

Six rules that will define our second pandemic winter

The pandemic keeps changing, but these principles can guide your thinking through the seasons to come.

• The role of vaccines has changed (again)
• The proportion of vaccinated people matters, but who they are and how they cluster also matters
• The people at greatest risk from the virus will keep changing
• As vaccination increases, a higher proportion of cases will appear in vaccinated people—and that’s what should happen
• Rare events are common at scale
• There is no single “worst” version of the coronavirus

Read here (The Atlantic, Sept 20, 2021)

How the pandemic now ends: Ed Yong

‘Pandemics end. But this one is not yet over, and especially not globally. Just 16 percent of the world’s population is fully vaccinated. Many countries, where barely 1 percent of people have received a single dose, are “in for a tough year of either lockdowns or catastrophic epidemics,” Adam Kucharski, the infectious-disease modeler, told me. The U.S. and the U.K. are further along the path to endemicity, “but they’re not there yet, and that last slog is often the toughest,” he added. “I have limited sympathy for people who are arguing over small measures in rich countries when we have uncontrolled epidemics in large parts of the world.”

‘Eventually, humanity will enter into a tenuous peace with the coronavirus. COVID-19 outbreaks will be rarer and smaller, but could still occur once enough immunologically naive babies are born. Adults might need boosters once immunity wanes substantially, but based on current data, that won’t happen for at least two years. And even then, “I have a lot of faith in the immune system,” Marion Pepper, the immunologist, said. “People may get colds, but we’ll have enough redundancies that we’ll still be largely protected against severe disease.” The bigger concern is that new variants might evolve that can escape our current immune defenses—an event that becomes more likely the more the coronavirus is allowed to spread. “That’s what keeps me up at night,” Georgetown’s Shweta Bansal told me.

‘To guard against that possibility, the world needs to stay alert. Regular testing of healthy people can tell us where the virus might be surging back.’

Read here (The Atlantic, August 12, 2021)

Longform podcast: Ed Yong of The Atlantic

‘Ed Yong spent 2020 covering the pandemic for The Atlantic. His latest feature is "How Science Beat the Virus." He says: “I am trying to give readers a platform that they can stand on to observe this raging torrent that is the pandemic, this cascade of information that is threatening to sweep us all away. I’m trying to give people a rock on which they can stand so that they can observe what is happening without themselves being submerged by it. But I am trying to construct that platform while also being submerged in it.”

Listen to the podcast here (Longform, Dec 23, 2020)

How science beat the virus... And what it lost in the process

“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.”

‘The scientific community spent the pre-pandemic years designing faster ways of doing experiments, sharing data, and developing vaccines, allowing it to mobilize quickly when COVID‑19 emerged. Its goal now should be to address its many lingering weaknesses. Warped incentives, wasteful practices, overconfidence, inequality, a biomedical bias—COVID‑19 has exposed them all. And in doing so, it offers the world of science a chance to practice one of its most important qualities: self-correction.’

Read here (The Atlantic, Dec 14, 2020)

‘No one is listening to us’

‘More people than ever are hospitalised with COVID-19. Health-care workers can’t go on like this...

‘For many health-care workers, the toll of the pandemic goes beyond physical exhaustion. COVID-19 has eaten away at the emotional core of their work. “To be a nurse, you really have to care about people,” Neville said. But when an ICU is packed with COVID-19 patients, most of whom are likely to die, “to protect yourself, you just shut down. You get to the point when you realise that you’ve become a machine. There’s only so many bags you can zip.”...

‘As hard as the work fatigue is, the “societal fatigue” is harder, said Hatton, the Utah pulmonary specialist. He is tired of walking out of an ICU where COVID-19 has killed another patient, and walking into a grocery store where he hears people saying it doesn’t exist. Health-care workers and public-health officials have received threats and abusive messages accusing them of fearmongering. They’ve watched as friends have adopted Donald Trump’s lies about doctors juking the hospitalization numbers to get more money. They’ve pleaded with family members to wear masks and physically distance, lest they end up competing for ICU beds that no longer exist. “Nurses have been the most trusted profession for 18 years in a row, which is now bullshit because no one is listening to us,” Neville said.’

Read here (The Atlantic, Nov 13, 2020)

What strength really means when you’re sick

‘The metaphors that Trump and others use when talking about COVID-19 are making the pandemic worse... Equating disease with warfare, and recovery with strength, means that death and disability are linked to failure and weakness. That “does such a disservice to all of the families who have lost loved ones, or who are facing long-term consequences,” says Megan Ranney, an emergency physician at Brown University. Like so much else about the pandemic, the strength-centered rhetoric confuses more than it clarifies, and reveals more about America’s values than the disease currently plaguing it.’

Read here (The Atlantic, Oct 9, 2020)

Bill Gates: The pandemic has erased years of progress

‘The US had a lot of assets going into this. We weren’t ground zero, so the US had more time to get ready. The US has more PCR [polymerase chain reaction] machines than all other countries per capita. We are very blessed with an expensive medical infrastructure. And we have groups like the CDC [Centers for Disease Control and Prevention] and BARDA [the Biomedical Advanced Research and Development Authority]. So the US had done more to get ready than other countries had in advance...

‘Certainly humility is called for because the damage—whether it’s economic, educational, mental health—is so large. Other than a world war, this is the worst thing that’s happened in over a century. And so we should all say, “Wow, we didn’t understand about masks; we didn’t understand about asymptomatics.” Even the medical profession. We haven’t taken understanding these different respiratory diseases quite as seriously as we should. So everyone has lessons here.’

Read here (The Atlantic, Sept 21, 2020)

The core lesson of the Covid-19 heart debate

‘Autopsies have found traces of the coronavirus’s genetic material in the heart, and actual viral particles within the heart’s muscle cells. Experiments have found that SARS-CoV-2 can destroy lab-grown versions of those cells. Several studies have now shown that roughly 10 to 30 percent of hospitalized COVID-19 patients had high levels of troponin—a protein released into the blood when the heart’s muscle cells are damaged. Such patients are more likely to die than others with no signs of heart injury.

‘This is worrying for people with severe symptoms, but more recently, a few studies suggested that COVID-19 can cause heart inflammation, or myocarditis, even in people who showed mild symptoms, or had recovered. These results were controversial but concerning. Myocarditis is frequently caused by viruses, and resolves on its own in many cases. But it can progress to more severe heart problems, and is one of the leading causes of sudden death in young adults. These studies contributed to decisions by two college football conferences—the Big Ten and the Pac-12—to cancel their fall season. (The Big Ten has since reversed its call, and the Pac-12 is considering doing the same)’

Read here (The Atlantic, Sept 21, 2020)

America is trapped in a pandemic spiral

‘The country is now trapped in an intuition nightmare: Like the spiraling ants [army ants that sometimes walked in circles until they died of hunger and dehydration because they followed pheromone trails of others], Americans are walled in by their own unhelpful instincts, which lead them round and round in self-destructive circles. “The grand challenge now is, how can we adjust our thinking to match the problem before us?” says Lori Peek, a sociologist at the University of Colorado at Boulder who studies disasters. Here, then, are nine errors of intuition that still hamstring the U.S. pandemic response, and a glimpse at the future if they continue unchecked. The time to break free is now. Our pandemic summer is nearly over. Now come fall, the season of preparation, and winter, the season of survival.’

The nine errors:

1. A serial monogamy of solutions
2. False dichotomies
3. The comfort of theatricality
4. Personal blame over systemic fixes
5. The normality trap
6. Magical thinking
7. The complacency of inexperience
8. A reactive rut
9. The habituation of horror

On point 9: ‘The US might stop treating the pandemic as the emergency that it is. Daily tragedy might become ambient noise. The desire for normality might render the unthinkable normal. Like poverty and racism, school shootings and police brutality, mass incarceration and sexual harassment, widespread extinctions and changing climate, COVID-19 might become yet another unacceptable thing that America comes to accept.’

Read here (The Atlantic, Sept 9, 2020)

Long-haulers are redefining Covid-19

‘The physical toll of long COVID almost always comes with an equally debilitating comorbidity of disbelief. Employers have told long-haulers that they couldn’t possibly be sick for that long. Friends and family members accused them of being lazy. Doctors refused to believe they had COVID-19. “Every specialist I saw—cardiologist, rheumatologist, dermatologist, neurologist—was wedded to this idea that ‘mild’ COVID-19 infections last two weeks,” says Angela Meriquez Vázquez, a children’s activist in Los Angeles. “In one of my first ER visits, I was referred for a psychiatric evaluation, even though my symptoms were of heart attack and stroke.”

Read here (The Atlantic, August 19, 2020)

How the pandemic defeated America

‘It is hard to stare directly at the biggest problems of our age. Pandemics, climate change, the sixth extinction of wildlife, food and water shortages—their scope is planetary, and their stakes are overwhelming. We have no choice, though, but to grapple with them. It is now abundantly clear what happens when global disasters collide with historical negligence.

‘COVID‑19 is an assault on America’s body, and a referendum on the ideas that animate its culture. Recovery is possible, but it demands radical introspection. America would be wise to help reverse the ruination of the natural world, a process that continues to shunt animal diseases into human bodies. It should strive to prevent sickness instead of profiting from it. It should build a health-care system that prizes resilience over brittle efficiency, and an information system that favors light over heat. It should rebuild its international alliances, its social safety net, and its trust in empiricism. It should address the health inequities that flow from its history. Not least, it should elect leaders with sound judgment, high character, and respect for science, logic, and reason.

‘The pandemic has been both tragedy and teacher. Its very etymology offers a clue about what is at stake in the greatest challenges of the future, and what is needed to address them. Pandemic. Pan and demos. All people.’

Read here (The Atlantic, August 4, 2020)

Covid-19 can last for several months

I interviewed nine of them [“long-termers” or “long-haulers” who have suffered symptoms for months] for this story, all of whom share commonalities. Most have never been admitted to an ICU or gone on a ventilator, so their cases technically count as “mild.” But their lives have nonetheless been flattened by relentless and rolling waves of symptoms that make it hard to concentrate, exercise, or perform simple physical tasks. Most are young. Most were previously fit and healthy. “It is mild relative to dying in a hospital, but this virus has ruined my life,” LeClerc said. “Even reading a book is challenging and exhausting. What small joys other people are experiencing in lockdown—yoga, bread baking—are beyond the realms of possibility for me.”

Read here (The Atlantic, June 4, 2020)

The problem with stories about dangerous coronavirus mutations

‘There’s no clear evidence that the pandemic virus has evolved into significantly different forms—and there probably won’t be for months...

‘As if the pandemic weren’t bad enough, on April 30, a team led by scientists at Los Alamos National Laboratory released a paper that purportedly described “the emergence of a more transmissible form” of the new coronavirus, SARS-CoV-2. This new form, the team wrote, “began spreading in Europe in early February.” Whenever it appeared in a new place, including the U.S., it rapidly rose to dominance. Its success, the team suggested, is likely due to a single mutation, which is now “of urgent concern.”

‘The paper has not yet been formally published or reviewed by other scientists. But on May 5, the Los Angeles Times wrote about it, claiming that “a now-dominant strain of the coronavirus could be more contagious than [the] original.” That story quickly went … well … viral.

‘But “the conclusions are overblown,” says Lisa Gralinski of the University of North Carolina, who is one of the few scientists in the world who specializes in coronaviruses. “To say that you’ve revealed the emergence of a more transmissible form of SARS-CoV-2 without ever actually testing it isn’t the type of thing that makes me feel comfortable as a scientist.” She and other virologists I’ve spoken with who were not involved in the Los Alamos research agree that the paper’s claims are plausible, but not justified by the evidence it presents. More important, they’re not convinced different strains of the coronavirus exist at all.’

Read here (The Atlantic, May 6, 2020)

How the pandemic will end

‘The US may end up with the worst COVID-19 outbreak in the industrialised world. This is how it’s going to play out...

‘Three months ago, no one knew that SARS-CoV-2 existed. Now the virus has spread to almost every country, infecting at least 446,000 people whom we know about, and many more whom we do not. It has crashed economies and broken health-care systems, filled hospitals and emptied public spaces. It has separated people from their workplaces and their friends. It has disrupted modern society on a scale that most living people have never witnessed. Soon, most everyone in the United States will know someone who has been infected. Like World War II or the 9/11 attacks, this pandemic has already imprinted itself upon the nation’s psyche.’

Read here (The Atlantic, March 25, 2020)

How will the Covid-19 pandemic end?

This long article discusses the near-term effects, end-game and aftermath of the Covid-19 crisis in the US. It concludes that the lessons that America draws from this experience are hard to predict but there could be two extreme scenarios, with many variations in between. As the most powerful socio-economic and political entity in the world, whichever path it takes, it will affect the entire world. 

NEGATIVE ENGAGEMENT: ‘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. During the second term of his presidency, the U.S. turns further inward and pulls out of NATO and other international alliances, builds actual and figurative walls, and disinvests in other nations. As Gen C grows up, foreign plagues replace communists and terrorists as the new generational threat.’

POSITIVE ENGAGEMENT: ‘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 neighbours 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. Buoyed by steady investments and an influx of the brightest minds, the health-care workforce surges. Gen C kids write school essays about growing up to be epidemiologists. Public health becomes the centerpiece of foreign policy. The US leads a new global partnership focused on solving challenges like pandemics and climate change.’

Read here (The Atlantic, March 25, 2020)