When days are dark, we crave even the briefest glimmer of light. You can see it in the TV coverage of the unrelenting siege of Ukraine, in the moment when the Ukrainians insist on singing “Happy Birthday” to anyone’s son or daughter, even as the bombs fall above their underground shelter.
And such is the need for relief that, after too many months of our COVID crisis, we can conjure light, even to the point of ignoring the darkness that hasn’t really disappeared.
Richard Kessin, in his March 23 Berkshire Edge article, offers an important look at some of the latest critical developments that science and medical researchers are providing: “There are currently 18 advanced trials of different vaccines, 64 possible new treatments, and 23 potential or approved anti-viral drugs. The mRNA vaccines from Pfizer and Moderna provide robust protection … Beyond vaccines, there are 64 new treatments in development that block or slow infection or some of its consequences, like inflammation. Inflammation makes blood vessels leaky; defensive cells, which rush to the site of infection, squeeze out of the circulation, and infiltrate the lungs.”
Before I take a look at our many challenges — largely because human behavior hasn’t yet matched the achievements of our scientific efforts — allow me one quick comparison. While we’re watching Ukrainians of all ages summon up extraordinary reserves of courage, absorbing an unending barrage of brutality, fighting for their freedom, here in the States, many Americans conjure up the language of liberty to justify their self-absorbed boorishness. We’ve seen airline stewards physically struck for asking flyers to abide by their airlines’ mask policy, maître d’s and restaurant hostesses being screamed at.
Now, the American Journal of Public Health has published a study by researchers at Johns Hopkins University, “Pandemic-Related Workplace Violence and Its Impact on Public Health Officials, March 2020‒January 2021.” They studied media reports and conducted “a national survey of local health departments (LHDs) in the United States, to identify harassment against public health officials.”
The results: “At least 1,499 harassment experiences were identified by LHD survey respondents, representing 57% of responding departments. We also identified 222 position departures by public health officials nationally, 36% alongside reports of harassment. Public health officials described experiencing structural and political undermining of their professional duties, marginalization of their expertise, social villainization, and disillusionment.”
We’re repeatedly told that refusing to take vaccines or wear masks, and actively working to discourage or even prevent children from wearing masks in our schools is about personal freedom. But what kind of freedom is it that comes at the expense of others’ freedom. Like most ideologues, they have a better idea than “the others” of what’s really important.
Meanwhile, medical experts are more convinced than ever that whatever short term gains we’ve made against the COVID pandemic is fragile at best, and that data in Europe and China points to the very real possibility that with sub-variant BA.2 or perhaps others that may follow, we’ll experience another jump in cases. And their job is to do the best they can to protect, not merely themselves, but the entire community, the children, the elderly, and those with compromised immune systems. It’s terribly painful to see nurses, doctors, and hospital workers abused and attacked. More than almost any of us, these people are completely unable to turn away from the reality of COVID, treating, in incredibly difficult conditions, those whose bodies are compromised by the virus. Those on the frontlines don’t have time for pedantic arguments about how much money Dr. Fauci might have made, or the constant barrage of mis- and disinformation, and manipulated statistics that distort the adverse effects of vaccines while ignoring the overwhelming, peer-reviewed evidence that the vaccinated have fared much better than the unvaccinated.
So, despite the vehement certitude of the vocal minority, what is also very apparent to those willing to examine the most recent evidence, is that the combination of full vaccination, including boosting and masking, can make a real difference when it comes to effectively dealing with the most severe consequences of COVID, prevent the need for ICU treatment, and deny deaths. And one can hope that by strengthening these measures, we will make a significant difference dealing with what might be around the corner.
Judy Woodruff of PBS, when she spoke to the president’s chief medical advisor, Dr. Anthony Fauci, did a great job of summing up our good news/bad news COVID reality:
Woodruff: “The number of new cases, hospitalizations, and deaths are all down substantially, and, just about everywhere, restrictions have been loosened, and masking is optional. But the U.S. is still losing more than 1,000 people a day, on average, to the virus, 1,000-plus. And as cases are seen rising in Europe and other countries, some experts wonder if there will be a surge here in just a few weeks.”
Dr. Fauci: “…one thing is for sure, that we’re still, as a country, going in the right direction with regard to the downward trajectory of cases, hospitalizations, and deaths. The caveat about that is, is that we generally follow the European Union, but particularly the U.K., by a few weeks, usually three or so weeks.
“And if you look at what’s going on, for example, in the U.K., when you combine the increased transmissibility of the BA.2, which is a sublineage variant of the original Omicron, together with the relaxation of some of the restrictions like mask-wearing and indoor concern about making sure people are vaccinated, and then you talk about the waning of immunity, they’re starting to see an increase in case and, to some extent, an increase in hospitalization, even though they are not seeing an increase in — necessarily in severity of disease.
“So I would not be surprised, Judy, if, in the next few weeks, we do see an uptick in cases. The really important issue is that, will that be manifested in an increase in severe disease that would lead to hospitalization?”
Fauci expressed the hope that more than the current 67% of our total population would get vaccinated, and that more than the 50% would get boosted.
I suspect that the desire for good news often comes at the expense of facing, better preparing for, and implementing best practices to confront the bad news. Dr. Fauci is one of many experts who have noted the time lag between what is happening in Europe and the United Kingdom and what will often come our way. A recent report for the UK Guardian highlighting remarks from Chris Whitty, Chief Medical Officer of England, offers a view of the most recent COVID reality there: “The NHS is coming under ‘significant’ pressure amid a rise in COVID cases in virtually every area of England, the chief medical officer has warned … ‘COVID cases are now rising quite rapidly — from quite a high base — and this is driven by a number of different factors, of which BA.2, the new Omicron variant, is a large part. Rates are high and rising in virtually all parts of England.’ While the rise in cases was not leading to a surge in deaths, Whitty added, the NHS was seeing increasing numbers of people requiring hospital treatment for COVID.”
The increasing numbers of COVID infections has had a noticeable effect in the UK school system. The Guardian reports a tripling of COVID absences in two weeks. Noting that “Figures published by the Department for Education (DfE) on Tuesday showed 202,000 pupils were off school on 17 March because of the virus — a dramatic jump from 58,000 two weeks earlier, when attendance was described as returning to ‘something approaching normal’. According to the latest government data, 159,000 pupils were off with a confirmed case of the COVID last week, up from 45,000 on 3 March, with a further 16,000 pupils absent with a suspected case of coronavirus, up from 6,000 earlier in the month.”
Much like the United States, the United Kingdom is cutting back on COVID testing: “Free universal testing for the virus will come to an end on 31 March in England, with free tests only being made available to the most vulnerable. Officials have previously said the number of free tests available each day would be capped to manage demand as the government scales back free testing in England.”
Sadly, if we do mirror the recent trends seen in Europe and the UK, COVID exhaustion coupled with the unrelenting public pressure coming from activists and mostly right-wing politicians and media personalities, has ironically undermined the best protection for the public: getting more people and children vaccinated and re-considering rigorous masking and social distancing.
Unfortunately, as the New York Times recently put it, “U.S. vaccination rates have stalled with another potential uptick coming.” The Times noted: “When the COVID vaccine first became widely available a year ago, it was a hopeful time, with demand exceeding capacity and millions of Americans jockeying for the nearest appointment slot. But, as of Monday, about a quarter of eligible adults were still not fully vaccinated, according to the Centers for Disease Control and Prevention.
“Since last summer, the U.S. inoculation campaign has sputtered, undermined by vaccine skepticism, partisan politics and misinformation. And warnings of another potential surge, fueled by the new Omicron subvariant, BA.2, may have little impact on vaccination rates.”
Sadly, it appears that the cultish war on science has taken its toll not only on the American public but on public officials like Dr. Fauci, as well. Dr. Fauci acknowledges that public exhaustion must be considered when revising public health policy: “If we want to continue this, as I call it, tiptoeing back to normality, we want to make sure that we do everything within our power to prevent the kinds of things that will set us back. I think, psychologically, the country is just not ready to get set back again.”
The notion, as Fauci told ABC News radio that “people are kind of done with COVID,” explains his defense of the CDC decision to loosen its recommendation on masks and focus more on hospitalizations and deaths, the more severe outcomes, and less on the daily number of cases.
He noted: “You can go ahead and continue to tiptoe towards normality, which is what we’re doing, but at the same time, be aware that you may have to reverse,” Fauci said.
If only COVID cared about human psychology! COVID certainly doesn’t know it’s done. When I began writing this article, according to data from the CDC, this new BA.2 variant was responsible for 23% of all cases in the U.S. It’s now up to a third. And according to the New York Times,“BA.2 made up about 86 percent of cases reported to the W.H.O.”
In Carl Zimmer’s March 18, 2022 article for the New York Times, “‘Stealth’ Omicron Is Stealthy No More: What’s Known About the BA.2 Variant,” Carl Zimmer explained that Omicron is more transmissible than the earlier COVID variants we’ve dealt with, and that it was able to better evade some of the protection offered by vaccines: “But recently BA.2 has spread even faster than BA.1 … In Denmark, for example, scientists found that people infected with BA.2 were substantially more likely to infect people they shared a house with than those with BA.1. In England, researchers found that it took less time on average for someone with BA.2 to infect another person, accelerating its spread through communities. And in a study in Hong Kong, researchers estimated that during an outbreak of BA.2 in a public housing complex, the virus doubled every 1.28 days.”
And so while much of the U.S. is focused on a renewed sense of freedom, of being done, and putting aside their masks, people in Europe are trying to adjust to the reality that they might be beginning all over again. Karen Weintraub reports for USA Today: “Five times in the last two years COVID-19 cases spiked in Europe a few weeks before they climbed in the United States.
“Now, cases are rising again in at least a dozen European countries from Finland to Greece. And they’re skyrocketing in South Korea, Hong Kong and parts of mainland China. Experts here worry some of these countries may be predicting our future.
“‘We’re learning a lot about the next wave that’s going to happen in the U.S.,’ said Dr. Eric Topol, director of the Scripps Research Translational Institute in La Jolla, California. ‘It’s going to happen. It’s unavoidable.’ Researchers say they’re not yet sure if the United States is heading for another tsunami of cases or just a bit of a bump. ‘It’s going to be a surge of some kind, the magnitude of which is unclear,’ Topol said.”
Weintraub continues: “Compared to Asia, the current situation in Europe is more similar to ours — and therefore more predictive of our future, the experts said. As here, most of Europe recently lifted mask mandates and other social distancing requirements. BA.2 is gaining ground or already dominant across Europe.
Weintraub interviewed Jeffrey Shaman, director of the Climate and Health Program at the Columbia University Mailman School of Public Health. “The earlier you intervene to short circuit or disrupt that exponential growth or at least lower it, the better off you are, the more you’ll flatten the curve,’ he said. But it may be politically and socially impossible to get ahead of this one, Shaman said, because Americans are so sick of restrictions and mandates.”
Dr. Joshua Schiffer, an infectious disease expert at the Fred Hutchinson Cancer Research Center in Seattle, acknowledged to Weintraub that one person’s decision to wear a mask may not do much to derail the surge, the fact that many people are masked, especially at large indoors events, potential super-spreader occasions, could make an important impact at a time when cases are rising. ‘It is an incredibly effective tool if used at scale and importantly, if people use the best mask possible,’ Schiffer said, adding that he understands that it’s not a simple issue to ask people to don masks again so soon.”
America has paid the price before of not paying attention to early warning signs, such as cases in Europe and rising wastewater levels. Eric Topol said he doesn’t see any indication that we’ve learned from those past mistakes. “‘Who isn’t sick of (the pandemic)? Who doesn’t want this to be over once and for all?’ he said. But ‘you can’t ignore the signals. They’re unequivocal.’”
Beyond the issue of the severity of the strain, as U.S. Pharmacist reports, is the reality that a new CDC study reveals that while ICU stays and deaths were down during the last Omicron surge, the strain on hospital systems was severe.
“While in-hospital severity indicators, including LOS [length of stay] and ICU admission, were similar to and lower, respectively, during the Omicron period compared with those during previous high-transmission periods for children, high relative increases in ED visits, and hospitalizations were worrisome … The authors suggest the severity of cases in pediatric cases could be related to lower vaccination rates in children compared with those in adults, especially among children aged 0 to 4 years who are currently not eligible for vaccination.
“The study concludes that ‘receipt of a third mRNA vaccine dose was found to be highly effective at preventing urgent care encounters, ED visits, and hospital admissions during both Delta and Omicron periods. Booster doses were also found to be effective at preventing infection during the early Omicron period, particularly among persons aged >50 years.”
The following is a CDC graph showing COVID hospitalization rates from September 4, 2021–January 29, 2022, taken from data in 13 states:
As we are getting so much better at preventing the worst COVID medical realities — ICU ventilation and death — it’s especially important to maintain a vigilance, that while inconvenient and annoying, could prevent another dreadful surge. While U.S. COVID deaths in blue are steadily headed downward, COVID deaths in the UK are headed up.
And still people are dying. As I’m finishing up, CNBC is reporting: “As mainland China battles its worst COVID-19 outbreak since early 2020, local governments increasingly say the new omicron BA.2 variant is to blame. That’s the new COVID subvariant, which preliminary research indicates is even more transmissible than the original omicron variant — but doesn’t necessarily cause more severe illness. Mainland China has reported well over 1,000 new confirmed COVID cases a day since March 12, with the number holding above 2,000 for the last three days.”
Here in America, we are about to see what our collective desire to tiptoe past the bad news of COVID has brought us. Yes, we are ready to be done with COVID. Less willing to get the booster. Less willing to wear that mask.
As Katherine J. Wu puts it in her essay for The Atlantic, “America Is About to Test How Long ‘Normal’ Can Hold:”
“However it manifests, the next American surge will be a stress test of the nation’s new COVID strategy, a plan that focuses on mitigating severe disease and death, and almost nothing else. Places that follow the CDC’s lead will let infections climb, and climb, and climb, until they’ve seeded a rash of hospitalizations, with more to follow. Only then will our new guidelines say that’s enough. The Biden administration’s sights have clearly been set on minimizing disruptions to American life. The cost? By the time the government says that it’s time to act, any wave we experience will be well under way. Whatever happens next, we’re living the reality the CDC’s guidance bargained for. The country’s new COVID rules have asked us to sit tight, wait, and watch. We may soon see the country’s true tolerance for disease and death on full display.”
I, for one, am not crazy about the new policy on focusing mainly on severe disease and death. And nothing else. If it were up to me, I’d be doing everything else.
