Delta variant: Everything you need to know -- Tomas Pueyo

‘Delta is a deadly variant. It spreads like wildfire and kills efficiently. We need to be careful.

If you’re an individual

‘If you’re vaccinated, you’re mostly safe, especially with mRNA vaccines. Keep your guard up for now, avoid events that might become super-spreaders, but you don’t need to worry much more than that. If you’re not vaccinated though, this is a much more dangerous time than March 2020. The transmission rate is higher than it used to be, and if you catch Delta, you’re much more likely to die—or get Long COVID. You should be extra careful, only hang out with other vaccinated people, and avoid dangerous events.’

If you’re a community leader

‘If you’re in charge of a community, you have two goals:

1. ‘Vaccinate, vaccinate, vaccinate. The lives of your community depend on it. Any vaccine that works is better than none. If people are opting out, try to lure them in. Most are not anti-vaxxers, but rather they’re on the fence, or simply don’t see the benefit worth the cost. So change their calculation. Create lotteries. The Ohio one, among the first, probably didn’t work, but the cost is paltry compared to the cost of deaths and closing the economy this Fall.
2. ‘Keep Delta at bay as much as you can while vaccinations proceed. An elimination strategy will be best. Good border fences and test-trace-isolate programs are your best tools. Super-spreader events should still be avoided. Masks indoors and in crowds should be mandatory. Great ventilation is a must. 

‘However, if you have vaccinated everybody that wants to be vaccinated, and the rest simply doesn’t want to get vaccinated, then the calculation changes drastically. If your location values the freedom of its people to make the wrong decisions (as long as they don’t impact others), then you might consider opening up the economy. Delta will tear through those unvaccinated, but that’s their prerogative. Maybe the reality will hit better then.

‘But it really depends on each society. Opening up without full vaccination would infect some of those vaccinated, about 10% of them would get long COVID7, and about 0.3% of them would die8.

‘So here each society needs to decide. Say 40% don’t want to vaccinate. Is the freedom of 40% to not vaccinate worth the deaths and Long COVID of those vaccinated? Otherwise, are you willing to force people to vaccinate? Are you going to keep the country closed until there’s a booster vaccine? Will you be able to get your fences and test-trace-isolate programs to work?’

If you’re in charge of vaccine policy

‘An R0 of 8 is bad news for herd immunity. It puts its threshold at ~90% of people protected, which is impossible to reach if vaccines are only 65% protective of infection. Booster shots are necessary. Let’s accelerate their testing, approval, release, and deployment.

‘Also, support vaccine mix-and-match. In most countries, today, if you need a boost you are forced to take the same vaccine. But mixing types likely protects you better and is as safe as using the same type.’

If you’re in a developing country

‘We don’t pay enough attention to developing countries. Most of the science and media focuses where the money is, in developed economies. But Delta is very hard in developing countries, especially in dense urban areas where the poor are forced to work but live in close quarters with many others. India, Argentina, Tunisia, South Africa, and Indonesia are very sad examples of this. 

‘Unfortunately, there’s not many special tricks that poor countries can pull. They tend to have a younger population, which helps. The one thing they have going on for them is that they tend to be warmer and more humid, which helps against COVID. Also, thanks to a warmer weather, they can have more events outdoors. This is the one thing they can leverage: have as many of your gatherings outside, while you do everything you can to vaccinate your population, and delay as much as you can the arrival of Delta with strong fences. 

‘Let’s hope vaccine production keeps growing and people the world over can get vaccinated before the fall.’

Read here (Uncharted Waters, Aug 11, 2021)

How do faithless people like me make sense of this past year of Covid?

‘Many of us yearn for meaning. But in our individualistic, secular society we lack even the flimsiest of narratives to guide us...

‘Long before Covid’s arrival, it was clear this was something too many people were losing touch with. Through decades of secularisation, cheered on by irreligious liberals, not nearly enough thought was ever given to what might take on the social roles of a church. The demise of the factory and the collectivised lives that went with it marked another loss. And now, long years of cuts have obliterated many of the shared spaces we had left, from libraries and Sure Starts to community centres.

‘The pandemic has shone unforgiving light on the consequences. A British Academy report on “the long-term societal impacts of Covid-19” found that the age group most likely to experience loneliness during the first lockdown was 16- to 24-year-olds. In the past decade, spending in England and Wales on youth services has been cut by 70%. As life after Covid unfolds, such choices will look not just reckless but downright cruel.

‘Three years ago, Anthony Costello – a former director of maternal and child health at the World Health Organization – published a book titled The Social Edge, focused on the so-called “sympathy groups” that sit between the state and the individual. “Religious or therapy groups have always offered solace and peace and relaxation and friendship,” he wrote. “They help us in our spiritual quest for meaning and wellbeing.” Church groups, choirs, sport and dance clubs, he went on, “bring harmony and relaxation to tired minds” and give people “a greater sense of being alive”.

‘Costello proposed using similar structures to tackle loneliness in old age, prisoner recidivism, “stress in motherhood” and much more. Now, in the context of Covid and its long-term social effects, this sounds like something millions of us might sooner or later need. Whatever our experiences, what we have all been through is huge. And as an act of post-pandemic healing, encouraging the growth of such initiatives would surely not be too hard. Fund and create public spaces – parks, halls, arts venues, meeting rooms – and revive the most grassroots aspects of local government, and you would create roughly the right conditions.’

Read here (The Guardian, Mar 28, 2021)

Equity in vaccination: A plan to work with communities of colour toward Covid-19 recovery and beyond -- Introduction

‘The coronavirus disease 2019 (COVID-19) pandemic has had tragic and disproportionate adverse effects on Black, Indigenous, and People of Color (BIPOC) communities across the United States. The number of cases, hospitalizations, and deaths related to this disease is significantly higher in these groups. Additionally, members of BIPOC communities are among those hit the hardest by the economic and social upheavals caused by the pandemic.

‘As the COVID-19 vaccination campaign begins, it is critical that vaccines be delivered fairly and equitably—so that everyone has the same level of access to this lifesaving technology. Just as pressing is the need to address longstanding disparities that have created the unequal situation that BIPOC communities are now in.

‘This plan provides elected and appointed officials with the tools to create, implement, and support a vaccination campaign that works with BIPOC communities to remedy COVID-19 impacts, prevent even more health burdens, lay the foundation for unbiased healthcare delivery, and enable broader social change and durable community-level opportunities.

‘The 5 key principles and their associated action items in the plan are:

‘Iteration: Repeated engagement with BIPOC communities is necessary. There is a race to get as many people vaccinated as soon as possible, and this urgency must be balanced with the need to build real trust in BIPOC communities. In many areas, this trust is low or nonexistent, which means that building trust will take time. It will require committing to engaging with BIPOC communities, including organizing productive “listen-and-plan” sessions in which community members have the opportunity to explain their thoughts on COVID-19 vaccination and where officials have the opportunity to listen and hear what is being said, and in partnership, put these ideas into action.

 ‘Involvement: Moving forward, BIPOC community representatives and advocates must become active collaborators in the public health process. This will involve implementing mechanisms for 2-way communication (particularly with trusted leaders, influencers, and pillar institutions in local BIPOC communities) and engaging with these key representatives as partners, not as audiences to persuade or subordinates to command. One way this can be done is by encouraging BIPOC individuals and community organizers to actively participate in the COVID-19 vaccination campaign in ways that respect their self-determination and strengthen their self-reliance. A longer-term approach is to ensure BIPOC individuals are in positions of power in government and public health.

 ‘Information: Effective communication with BIPOC community members is essential in the ongoing COVID-19 vaccination effort. Applying best practices for communication during this time will be useful for moving forward. As a starting point, it is important to recognize that vaccination messages must be tailored to address the specific concerns of local BIPOC communities. This can be done in one of the following ways (or through a combination of these approaches): identify and support trusted BIPOC individuals and organizations who can relay information and help set community norms related to COVID-19 vaccination, apply learning from “listen-and-plan” sessions to frame COVID-19 vaccination in the communities’ own terms, and enlist allies to blanket BIPOC communities with accurate information that can drown out misinformation.

 ‘Investment: All of the efforts described above will require investments of time, attention, and funding. At the same time, the vaccination process itself can be viewed as an opportunity for economic revitalization, with the potential to lead communities out of the pandemic and its economic hardships. This type of revitalization is particularly important to BIPOC communities that historically, and presently, are often economically challenged. Practical suggestions for investment include: pull together the necessary resources to ensure COVID-19 vaccination is equitable (meaning, easily available to the most marginalized individuals in the community) and then fight to keep these resources in place moving forward; creatively finance nonprofit and for-profit entities with BIPOC community roots to strengthen the vaccination enterprise; and enlist the help of private capital to support vaccination, for example, by getting transportation companies to commit to providing free rides to and from vaccination sites or by having a local grocery store sponsor a “get vaccinated” poster contest for schoolchildren.

 ‘Integration: Looking forward to the end of the pandemic, it is important to recognize that recovery will take time. COVID-19 will have long-lasting physical, psychological, and financial effects, especially in BIPOC communities. Because of this, the COVID-19 vaccination campaign cannot be viewed as a final step in returning to “normalcy.” Instead, it needs to be seen as a step toward a more complete recovery that can, and should, include meaningful social change. This can take place as the recommendations outlined above—including “listen-and-plan” sessions, empowering BIPOC individuals and communities, and investing in equitable public health—are integrated into ongoing community initiatives and as government and public health officials commit to ensuring durable social change and community benefits that include adequate housing, food security, living wages, and leadership opportunities.

‘This approach will be challenging. Some may argue that a lack of time or funding or interest are barriers that make such an approach unrealistic, especially in the middle of a pandemic that is challenging on every front. However, it is important to keep in mind that challenges like the one we are currently facing often stem from social inequity and provide opportunities to change and improve. Some actions may be more appropriate to prioritize in the near term, but many actions that are crucial for the long term will have more of an overall impact if those efforts are initiated now.

‘COVID-19 vaccination is the most likely way out of the current pandemic. It is also an opening to create equity and durable benefits for BIPOC communities, who have been devalued and too often cut out of opportunities in the United States. We hope that you consider this and the specific recommendations made in this report as you begin to implement COVID-19 vaccination campaigns in your own towns, cities, and states.’

Download PDF here (John Hopkins Center for Health Security, Feb 09, 2021) 

CommuniVax: A coalition to strengthen the community’s involvement in an equitable vaccination rollout

‘CommuniVax is a national alliance of social scientists, public health experts, and community advocates who seek lasting solutions to a serious problem: in the United States, historically underserved Black, Indigenous, and Latino populations have endured negative health and economic impacts from the COVID-19 pandemic at tragic and disproportionate rates. While these communities could benefit greatly from safe and effective COVID-19 vaccines, longstanding biases and barriers hinder their access to and acceptance of vaccination.

‘The coalition is strengthening national and local COVID-19 vaccination efforts in the United States by putting communities of color at the center of those endeavors. The coalition is listening to Black, Indigenous, and Latino/Latinx individuals on how best to promote awareness of, access to, and acceptability of COVID-19 vaccines in their respective communities; and developing longstanding, local governance systems that enable underserved groups to exercise collective agency over their own health and wellness, during this pandemic and going forward. Funding for CommuniVax is provided by the Chan Zuckerberg Initiative.

‘CommuniVax relies on efforts from 3 groups: local teams, a central working group, and national stakeholders.

• Local Teams are composed of resident researchers, grassroots leaders, and public health implementers. They will engage local communities of color to identify improvements needed to vaccine delivery and communication strategies in their communities.
• The Central Working Group includes experts in public health, public policy, medical science, anthropology, and public involvement. With input from diverse stakeholders, the working group will coordinate the local research processes and ensure the implementation of findings nationwide
• National Stakeholders represent groups with political, technical, cultural, and social justice perspectives on vaccine delivery and uptake. These associations will amplify information generated from local teams within their networks and provide feedback to the central working group.

Read here (John Hopkins Center for Health Security, Feb 2021)

School openings across globe suggest ways to keep coronavirus at bay, despite outbreaks

“Outbreaks in schools are inevitable,” says Otto Helve, a pediatric infectious disease specialist at the Finnish Institute for Health and Welfare. “But there is good news.” So far, with some changes to schools’ daily routines, he says, the benefits of attending school seem to outweigh the risks—at least where community infection rates are low and officials are standing by to identify and isolate cases and close contacts.

This article discusses the following:

• How likely are children to catch and transmit the virus?
• Should children play together?
• Should kids wear masks?
• What should schools do when someone tests positive?
• Do schools spread the virus to the wider community?
• What lies ahead?

Read here (Science Magazine, July 7, 2020)

India's female Corona-warriors: Underpaid and unappreciated

‘Asha workers connect their communities with the public health system. While technically volunteers, they perform crucial tasks, including recording data about births, deaths, marriages and child immunisations; providing information about nutrition, sanitation, maternal and child health; accompanying pregnant women and sick children to health care centres; and helping treat diarrhoea, fevers and tuberculosis.

‘The Covid-19 outbreak added to their duties. Ashas are now expected to educate people about precautions against infection, monitor quarantined households, trace contacts of infected people and help with testing. They have no holidays.’

Read here (Straits Times, June 27, 2020)

Fearing second Covid-19 wave, Europe aims to train ‘army’ of medics

‘Europeans are enjoying the gradual easing of coronavirus lockdown measures, but in hospitals, they are already preparing for the next wave of infections. Some intensive care specialists are trying to hire more permanent staff. Others want to create a reservist "army" of medical professionals ready to be deployed wherever needed to work in wards with seriously ill patients. European countries have been giving medics crash courses in how to deal with Covid-19 patients, and are now looking at ways to retrain staff to avoid shortages of key workers if there is a second wave of the novel coronavirus.’

Read here (Straits Times, June 22, 2020)

Thailand had the world's first coronavirus case outside China. Here's how it avoided disaster

‘James Wise, a former Australian ambassador to the country and author of Thailand: History, Politics and the Rule of Law, said the Village Health volunteers were "enormously important". "The key factor is they were well prepared for it," Mr Wise said... "[The volunteers] work closely with the local communities and then once coronavirus comes along you've got an army of foot soldiers who can be quickly briefed on the coronavirus and then can go out into the communities, spread information, dispel misinformation and check people's symptoms. And that's what they did".’

Read here (ABC News, June 22, 2020)

Tale of Covid-19 in two Indian cities: Dharavi, Mumbai, a rare success, and Delhi which was “messed up”

‘Asia's largest slum Dharavi was being seen as a 'Covid-engine' that will drive Mumbai in the wrong direction. But with conscious efforts, the slum's Covid doubling rate has come down to 44 days, twice as good as Mumbai’s 22. Delhi sadly is a study in contrast with India’s highest test positivity rates. In episode 496 of ThePrint's #CutTheClutter, Shekhar Gupta talks about the lessons from Dharavi & new plan for Delhi.’

Watch here (Youtube, June 14, 2020)

Why are Africa's coronavirus successes being overlooked?

‘Take the two African countries I have called home – Senegal and Ghana... Senegal is in a good position because its Covid-19 response planning began in earnest in January, as soon as the first international alert on the virus went out... As a result, this nation of 16 million people has had only 30 deaths... Ghana, with a population of 30 million, has a similar death toll to Senegal, partly because of an extensive system of contact tracing, utilising a large number of community health workers and volunteers, and other innovative techniques such as “pool testing”, in which multiple blood samples are tested and then followed up as individual tests only if a positive result is found. The advantages in this approach are now being studied by the World Health Organization.’

Read here (The Guardian, May 21, 2020)

The coronavirus slayer! How Kerala's rock star health minister helped save it from Covid-19

‘On 20 January, KK Shailaja phoned one of her medically trained deputies. She had read online about a dangerous new virus spreading in China. “Will it come to us?” she asked. “Definitely, Madam,” he replied. And so the health minister of the Indian state of Kerala began her preparations.

‘Four months later, Kerala has reported only 524 cases of Covid-19, four deaths and – according to Shailaja – no community transmission. The state has a population of about 35 million and a GDP per capita of only £2,200. By contrast, the UK (double the population, GDP per capita of £33,100) has reported more than 40,000 deaths, while the US (10 times the population, GDP per capita of £51,000) has reported more than 82,000 deaths; both countries have rampant community transmission.’

Read here (The Guardian, May 14, 2020)

Kerala's unique way to promote social distancing: Use umbrellas

‘Amid the outbreak of novel coronavirus in India, the government and state authorities have been rigorously urging the citizens to ensure social distancing among one another. In a similar manner, the Thanneermukkom gram panchayat in Alappuzha has come up with a unique idea to enforce social distancing in the area. The authorities have mandated everyone residing there to hold an umbrella when they go out. “Two opened umbrellas, not touching each other, will ensure minimum distance of 1 meter from one another,” said state finance minister Thomas Isaac.’

Read here (Live Mint, April 26, 2020)

‘There is a reason the rest of India cannot be Kerala’

This is not a Covid-19 story, however, it gives the social backdrop to the state’s successful response to the virus... ‘Modern India has been trying to be more like Mumbai. It is raising congested cities out of villages, shrinking homes, building amoeba-shaped golf courses for a few and calling it progress. Instead, maybe India should try to be a Kerala? Modern Kerala, which is misunderstood as a communist region, is in reality a post-capitalist state. A lot of things have gone into the making of its character. Mere policy cannot transform the rest of India into Kerala.’

Read here (Live Mint, April 19, 2020)

Covid-19 and human rights: We are all in this together

Human rights are key in shaping the pandemic response, both for the public health emergency and the broader impact on people’s lives and livelihoods. Human rights put people centre-stage. Responses that are shaped by and respect human rights result in better outcomes in beating the pandemic, ensuring healthcare for everyone and preserving human dignity. But they also focus our attention
on who is suffering most, why, and what can be done about it. They prepare the ground now for emerging from this crisis with more equitable and sustainable societies, development and peace.

Download here (WHO, April 2020)

‘Kerala model is nothing but focus on education and welfare’

This opinion piece covers (1) what Kerala did right in fighting coronavirus? (2) Kerala model: Left, right and centre (3) Kerala sticks to WHO guidelines & executes them efficiently (4) No time for political one-upmanship

Read here (The Quint, April 15, 2020)

Leaders in Africa, South Asia, and Latin America need to look carefully at alternative policies

‘Some possibilities include:

• A universal mask-wearing requirement when workers leave their homes (as masks and homemade face coverings are comparatively cheap, and such a policy is likely feasible for almost all countries to implement); 
• Targeted social isolation of the elderly and other at-risk groups, while permitting productive individuals with lower-risk profiles to continue working; 
• Improving access to clean water, hand-washing, and sanitation, and other policies to decrease the viral load; and 
• Widespread social influence and information campaigns to encourage behaviours that slow the spread of disease but do not undermine economic livelihoods. This could include restrictions on the size of religious and social gatherings or programs to encourage community and religious leaders to endorse safer behaviours and communicate them clearly.’

Read here (Foreign Policy, April 10, 2020)

Kerala’s Covid-19 approach: Less disruptive, less costly and more effective than most others

‘Some key features of Kerala’s response, undertaken by a government with very limited fiscal resources, are instructive:

1. All-of-government approach: involving a range of relevant state government ministries and agencies to design measures to improve consistency, coordination and communication, and to avoid confusion.
2. Whole-of-society approach: wide community consultations, including experts, to find the most locally appropriate modes of limiting infections, along with means to monitor and enforce them.
3. Social mobilisation: communities were provided essential epidemiological information to understand the threat and related issues, ensure compliance with prescribed precautionary measures, and avoid panic.
4. No one left behind: adequate supply of essential commodities, particularly food and medicines, has been ensured, especially to protect the most vulnerable sections of society.’

Read here (IPS News, April 9, 2020)

Kerala: An often overlooked region of India is a beacon to the world for taking on the coronavirus

‘KK Shailaja is the health minister in the Left Democratic Front government in Kerala, the state in the southwest of India that has a population of 35 million people. On January 25, 2020, she convened a high-level meeting to discuss the outbreak of COVID-19 in Wuhan, China. What had particularly worried her is that there were many students from Kerala studying in that province of China.

‘Shailaja had won widespread praise for the swift and efficient way she had steered her department through the Nipah virus that hit Kerala in 2018. She recognised that there was no time to be lost if the virus spread from Wuhan; the government had to set up mechanisms for identifying possibly infected persons, and then for testing, mitigation, and treatment. On January 26, 2020, her department set up a control room to coordinate the work...’

Read here (Citizen Truth, March 24, 2020)