America has lost the plot on Covid

‘We know how this ends: The coronavirus becomes endemic, and we live with it forever. But what we don’t know—and what the U.S. seems to have no coherent plan for—is how we are supposed to get there. We’ve avoided the hard questions whose answers will determine what life looks like in the next weeks, months, and years: How do we manage the transition to endemicity? When are restrictions lifted? And what long-term measures do we keep, if any, when we reach endemicity?

‘The answers were simpler when we thought we could vaccinate our way to herd immunity. But vaccinations in the U.S. have plateaued. The Delta variant and waning immunity against transmission mean herd immunity may well be impossible even if every single American gets a shot. So when COVID-related restrictions came back with the Delta wave, we no longer had an obvious off-ramp to return to normal—are we still trying to get a certain percentage of people vaccinated? Or are we waiting until all kids are eligible? Or for hospitalizations to fall and stay steady? The path ahead is not just unclear; it’s nonexistent. We are meandering around the woods because we don’t know where to go.’

Read here (The Atlantic, Nov 1, 2021)

Doctors treating unvaccinated Covid patients are succumbing to compassion fatigue

“Compassion fatigue is the feeling, ‘It’s hard to care when you’re overloaded but still dedicated to the task,’” Dr Kernan Manion, executive director of the Center for Physician Rights, said. “Moral injury occurs when the nurse or doctor feels that, ‘The patients I’ve dedicated my life to treating are now here because of their own negligence and now they’re imposing upon me and my team to treat them, while also exposing us to continued danger from this virus.’”

These days, Meck knows that first-hand. She is seeing more children with Covid-19 at her Missouri hospital than ever before. At 46%, Missouri has one of the lowest rates of full vaccination in the country. “I don’t even get the chance to try to show you all the split-second decisions and critical thinking and compassion I’m capable of,” Meck said. “Practising mindfulness is not going to fix moral injury.”

Read here (The Guardian, Sept 18, 2021)

Health officials quietly moved the date of the 1st US COVID-19 death to January 2020

‘The first recorded death from COVID-19 in the U.S. occurred a month earlier than previously thought: A Kansas woman's death certificate was recently amended to say she died from the disease in January 2020, according to news reports.

‘The 78-year-old woman, Lovell "Cookie" Brown, died on Jan. 9, 2020 in Leavenworth, Kansas, several weeks before the first cases of COVID-19 were identified in the U.S., according to The Mercury News. Initially, Brown's death certificate said she died of a stroke and chronic obstructive lung disease. But in May 2021, her doctors quietly updated the certificate to add "COVID-19 pneumonia" as a cause of death, The Mercury News reported...

‘Before her death, Brown had experienced symptoms of headache, fever, diarrhea and body aches, and on Christmas Day 2019, her family remembered Brown saying that her favorite foods tasted bland, The Mercury News reported. When she began gasping for air, Brown was rushed to the hospital, where she spent a week in the ICU before her death.’

Read here (LiveScience, Sept 4, 2021)

Millions are saying no to the vaccines. What are they thinking?

‘So what will change their minds? I cannot imagine that any amount of hectoring or shaming, or proclamations from the public-health or Democratic communities, will make much of a difference for this group. “I’ve lost all faith in the media and public-health officials,” Myles Pindus, a 24-year-old in Brooklyn, said. “It might sound crazy, but I’d rather go to Twitter and check out a few people I trust than take guidance from the CDC, or WHO, or Fauci,” Baca, the Colorado truck driver, told me. Other no-vaxxers offered similar appraisals of various Democrats and liberals, but they were typically less printable.

‘From my conversations, I see three ways to persuade no-vaxxers: make it more convenient to get a shot; make it less convenient to not get a shot; or encourage them to think more socially.’

Read here (The Atlantic, May 3, 2021)

Physical inactivity is associated with a higher risk for severe Covid-19 outcomes: a study in 48,440 adult patients

What are the findings?

‘Patients with COVID-19 who were consistently inactive during the 2 years preceding the pandemic were more likely to be hospitalised, admitted to the intensive care unit and die than patients who were consistently meeting physical activity guidelines. Other than advanced age and a history of organ transplant, physical inactivity was the strongest risk factor for severe COVID-19 outcomes.

‘Meeting US Physical Activity Guidelines was associated with substantial benefit, but even those doing some physical activity had lower risks for severe COVID-19 outcomes including death than those who were consistently inactive.’

How might it impact on clinical practice in the future?

‘The potential for habitual physical activity to lower COVID-19 illness severity should be promoted by the medical community and public health agencies.’

Read here (BMJ British Journal of Sports Medicine, April 13, 2021)

How Covid-19 vaccines are being weaponised as countries jostle for influence

‘A new hybrid Cold War is underway, with US, China and pivotal states engaging in a power play, says NUS Business School’s Alex Capri...

‘[V]accine diplomacy has shed light on an even more fundamental truth: A hybrid cold war is underway, involving the US, China and other pivotal states. Its by-product is hybrid warfare, a mix of diplomatic, economic, cyber and information-related actions, all of which fall below the threshold of armed conflict but are, nonetheless, disruptive to the workings of the international system.

‘There will be no returning to the kind of globalisation the world experienced over the past four decades. Consequently, state and non-state actors must adapt.’

Read here (Channel News Asia, Apr 8, 2021)

The hidden toll of remote work

‘Switching to Zoom forever might be convenient, but it’s a recipe for loneliness.

‘Between one-third and one-half of American employees worked in person throughout the pandemic, with or without a say in the matter, and some at great personal risk. Most of the rest of us were forced to work from home, also without necessarily wanting to. And in fact, almost two-thirds of people in a poll last fall felt that the cons of working from home outweighed the pros, and nearly a third said they had considered quitting their jobs since being banned from the workplace. In another poll, about 70 percent said that mixing work and other responsibilities had become a source of stress, and about three in four American workers in the early days of the pandemic confessed to being “burned out”.’

Read here (The Atlantic, Apr 1, 2021) 

The pandemic’s wrongest man [in the US]

‘In this crowded field of wrongness, one voice stands out. The voice of Alex Berenson: the former New York Times reporter, Yale-educated novelist, avid tweeter, online essayist, and all-around pandemic gadfly. Berenson has been serving up COVID-19 hot takes for the past year, blithely predicting that the United States would not reach 500,000 deaths (we’ve surpassed 550,000) and arguing that cloth and surgical masks can’t protect against the coronavirus (yes, they can).

‘Berenson has a big megaphone. He has more than 200,000 followers on Twitter and millions of viewers for his frequent appearances on Fox News’ most-watched shows. On Laura Ingraham’s show, he downplayed the vaccines, suggesting that Israel’s experience proved they were considerably less effective than initially claimed. On Tucker Carlson Tonight, he predicted that the vaccines would cause an uptick in cases of COVID-related illness and death in the U.S...’

Read here (The Atlantic, Apr 1, 2021)

Opioid deaths in America reached new highs in the pandemic

‘Last year (2020) was a woeful time for people suffering from a drug addiction. Government shutdowns brought job losses and social isolation—conditions that make a transportive high all the more enticing. Those who had previously used drugs with others did so alone; if they overdosed, no one was around to call for help or administer naloxone, a medication that reverses opioid overdoses.

‘Fatal overdoses were marching upwards before the pandemic. But they leapt in the first part of last year as states locked down, according to provisional data from the Centres for Disease Control and Prevention. Deaths from synthetic opioids—the biggest killer—were up by 52% year-on-year in the 12 months to August, the last month for which data are available. Those drugs killed nearly 52,000 Americans during the period; cocaine and heroin killed about 16,000 and 14,000, respectively (see chart). Once fatalities are fully tallied for 2020, in a few months’ time, it is likely to be the deadliest year yet in America’s opioid epidemic.’

Read here (The Economist, Mar 30, 2021)

‘I’m scared’: Top US official shares sense of ‘doom’ as Covid cases rise

‘The US faces “impending doom” from a resurgent coronavirus pandemic, the head of the federal Centers for Disease Control and Prevention (CDC) warned on Monday. “Right now I’m scared,” Rochelle Walensky said in an emotional and unscripted moment during a White House briefing. “I’m speaking not necessarily as your CDC director, and not only as your CDC director, but as a wife, as a mother, as a daughter to ask you to just please hold on a while longer.”

Read here (The Guardian, Mar 30, 2021)

Covid: From boom to bust - Why lockdown hasn't led to more babies

‘For those who thought that lockdown would leave couples with little else to do than procreate, there was a surprise - not a baby boom but a baby bust. Research shows that the US is facing the biggest slump in births in a century and in parts of Europe the decline is even steeper. For those who study population the baby bust was not a revelation. "Having seen how bad the pandemic was I'm not surprised," says Philip N Cohen, professor of sociology at the University of Maryland. "But it is still just shocking to see something like this happen in real time."

‘In June last year economists at the Brookings Institute in the United States estimated that US births would fall by 300,000 to half a million babies. At the same time a survey of fertility plans in Europe showed 50% of people in Germany and France who had planned to have a child in 2020 were going to postpone it. In Italy 37% said they had abandoned the idea altogether. A US Centers for Disease Control and Prevention (CDC) report indicates an 8% drop in births in the month of December.’

Read here (BBC, Mar 17, 2021)

Analysis: How for-profit health care worsened the pandemic

‘The U.S. remains the only one of the 25 wealthiest countries to not provide universal health care, and the health care system’s focus on profits and not health has cost Americans their lives. Despite having less than 5% of the world’s population, the U.S. has had 25% of the world’s confirmed cases and 20% of the deaths. Public Citizen’s new report demonstrates how:

• Before the pandemic, approximately 87 million Americans were uninsured or underinsured. About one-third of COVID-19 deaths and 40% of infections were tied to a lack of insurance;
• About half of Americans receive their health care through their employer. With more than 22 million Americans losing their job during the pandemic, millions have lost their health insurance;
• Racial health disparities, including access to care, have led to disproportionate deaths in communities of color;
• We have the highest rate of unmet need of any comparably wealthy country, with one-third of Americans reporting that they or a family member has avoided going to the doctor when sick or injured in the past year due to cost;
• Americans are significantly more likely to die of chronic respiratory disease, cardiovascular disease, diabetes or cancer than people in comparably wealthy countries with universal health care systems; and
• A lack of essential funding led to insufficient hospital capacity. The U.S. had only around half the hospital beds per capita of peer nations and far fewer than countries like Japan or Germany.’

Read here (Public Citizen, Mar 16, 2021)

Coronavirus economic relief: Are we getting value for the money thrown at the pandemic? - Andrew Sheng

‘The US fiscal deficit rose from 6.4 per cent of GDP in 2019 to 17.5 per cent in 2020. This is an increase of 11.1 percentage points in GDP fiscal support to defend a decline of 5.8 percentage points in GDP growth...

‘The Biden administration is betting that the largest US stimulus package since World War II will restore American competitiveness and heal the nation. But much of this is not funded by domestic savings, such as taxing the rich, but by borrowing on the US dollar. 

‘The rest of the world will not fund the dollar forever, certainly not at near-zero interest rates. And if interest rates rise, the fiscal costs would be substantially higher. So bet on the Fed doing more to keep rates low. The truth of US debt is that it is not debt, but the rest of the world’s equity. America is the world’s too-big-to-fail borrower. If Biden fails, we will lose.’

Read here (South China Morning Post, Mar 13, 2021)

US and allies (India, Australia and Japan) promise one billion jabs for South East Asia

‘The leaders of the US, Australia, India and Japan have agreed to deliver one billion doses of coronavirus vaccine to much of Asia by the end of 2022. The joint commitment was made following the first leaders' meeting of the so-called Quad - a group formed in 2007. The vaccines - expected to be the single-dose Johnson & Johnson product - are set to be manufactured in India.’

Read here (BBC, Mar 13, 2021)

There is no one pandemic anniversary

‘Disaster anniversaries are powerful in part because they’re communal. The bomb went off in an instant. The tornado tore through town in an afternoon. The earthquake rocked the whole region at once. The pandemic, though, did not come to everyone on the same day, or even in the same month, and nor will its anniversary. In this way, as in so many others, this is not an ordinary disaster.

‘For each of the country’s more than 526,000 dead, nine people grieve. Hundreds of thousands have spent time in the ICU, an experience that can bring its own unique trauma. And then there are the smaller losses, the ones that did not threaten lives but still changed them. Today is the day I missed my mother’s funeral. The day I would have gone to prom. Met my grandson. Gotten married.’

Read here (The Atlantic, Mar 12, 2021)

How the US pandemic response went wrong — and what went right — during a year of Covid

‘Among the biggest shocks was that the U.S. fared worse than most other countries, with more than 29 million cases and nearly 530,000 deaths as of this writing. “We absolutely can’t say that we had the most robust response to the pandemic, up till this point, because we have had a higher death rate per capita than so many other places,” says Monica Gandhi, a professor of medicine at the University of California, San Francisco.

‘As the country raced to react to this new and terrifying scourge, mistakes were made that together cost hundreds of thousands of lives. Yet the tireless efforts of health care workers, along with an unprecedented vaccine push, have saved countless others. Scientific American interviewed scientists and public health experts about the biggest mistakes in the U.S.’s response, some of the key successes and the lingering questions that still need to be answered.’

Read here (Scientific American, Mar 11, 2021)

Multitude of coronavirus variants found in the US — but the threat is unclear

‘For the scientists who have spent the past year poring over hundreds of thousands of coronavirus genomes, the United States has been an enigma. Despite having world-leading genome sequencing infrastructure and experiencing more COVID infections than any other country, the United States has until recently lagged far behind in sequencing coronavirus genomes and spotting worrisome variants.

‘But in recent weeks, US researchers have identified a host of new variants, including in California, New York State, Louisiana and elsewhere. And they are continuing to ramp up SARS-CoV-2 sequencing efforts.

‘That has brought another challenge: making sense of the variants that are discovered. They carry potentially worrying mutations and might be becoming more common, but a dearth of data on how the variants are spreading means the threat they pose is unclear.’

Read here (Nature, Mar 6, 2021)

US Catholic group tells followers to avoid Johnson & Johnson vaccine

‘An American Catholic church body on Tuesday urged its followers to avoid the coronavirus vaccine developed by Johnson & Johnson, alleging that it was “developed, tested and produced using abortion-derived cell lines.”

‘The US Conference of Catholic Bishops (USCCB) urged Catholics to choose between the alternatives offered by Pfizer and Moderna because the J&J vaccine raised questions about “moral permissibility.”

“The approval of Johnson & Johnson’s Covid-19 vaccine for use in the United States again raises questions about the moral permissibility of using vaccines developed, tested, and/or produced with the help of abortion-derived cell lines,” said Bishop Kevin C Rhoades, chairman of USCCB.’

Read here (Independent, Mar 3, 2021) 

Children’s hospitals grapple with young Covid ‘long haulers’

‘While statistics indicate that children have largely been spared from the worst effects of covid, little is known about what causes a small percentage of them to develop serious illness. Doctors are now reporting the emergence of downstream complications that mimic what’s seen in adult “long haulers.”

‘In response, pediatric hospitals are creating clinics to provide a one-stop shop for care and to catch any anomalies that could otherwise go unnoticed. However, the treatment offered by these centers could come at a steep price tag to patients, health finance experts warned, especially given that so much about the condition is unknown.

‘Nonetheless, the increasing number of patients like Delaney is leading to a more structured follow-up plan for kids recovering from covid, said Dr. Uzma Hasan, division chief of pediatric infectious diseases at St. Barnabas Medical Center in New Jersey.’

Read here (KHN News, Mar 2, 2021)

The end of Covid-19 pandemic? Johns Hopkins’ Dr Makary says probably

‘A February 18 Opinion piece in the Wall Street Journal is raising hopes, and possibly healthy skepticism, with its title and thesis being: “We’ll Have Herd Immunity by April.” The author is Dr. Martin Makary, a professor of health policy and management and public health expert at Johns Hopkins University. He notes that the media is under reporting on the dramatic fact that COVID-19 cases are down 77 percent just in the last six weeks. Largely this is, “because natural immunity from prior infection is far more common than can be measured by testing.” 

‘Applying some statistics to the case data, we could deduce the around 55 percent in the US have natural immunity. At the same time, vaccinations have been rolling out, and 15 percent of Americans have gotten a vaccine with the percentage rising fast. Based on these factors, “There is reason to think the country is racing toward an extremely low level of infection. As more people have been infected, most of whom have mild or no symptoms, there are fewer Americans left to be infected. At the current trajectory, I expect Covid will be mostly gone by April, allowing Americans to resume normal life.”

Read here (TrialSiteNews, Feb 20, 2021)