Even with vaccines widely available and better data available about COVID-19, there are still some who are having trouble coming out of lockdown. While some states are ending restrictions, others are moving into a vaccine-passport model, requiring proof of vaccination & continuing mask adherence at large events. Elsewhere, experts suddenly don’t seem to know what herd immunity looks like. There is an outbreak in Oregon where they are going back to COVID restrictions, and in Seychelles, which currently has a COVID outbreak despite being the most vaccinated country. In England and Australia, people are going back over COVID data and looking for the truth about deaths and lockdowns.
In other news:
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Lurking among the jubilant americans venturing back out to bars and planning their summer-wedding travel is a different group: liberals who aren’t quite ready to let go of pandemic restrictions. For this subset, diligence against COVID-19 remains an expression of political identity—even when that means overestimating the disease’s risks or setting limits far more strict than what public-health guidelines permit. In surveys, Democrats express more worry about the pandemic than Republicans do. People who describe themselves as “very liberal” are distinctly anxious. This spring, after the vaccine rollout had started, a third of very liberal people were “very concerned” about becoming seriously ill from COVID-19, compared with a quarter of both liberals and moderates, according to a study conducted by the University of North Carolina political scientist Marc Hetherington. And 43 percent of very liberal respondents believed that getting the coronavirus would have a “very bad” effect on their life, compared with a third of liberals and moderates.
Last year, when the pandemic was raging and scientists and public-health officials were still trying to understand how the virus spread, extreme care was warranted. People all over the country made enormous sacrifices—rescheduling weddings, missing funerals, canceling graduations, avoiding the family members they love—to protect others. Some conservatives refused to wear masks or stay home, because of skepticism about the severity of the disease or a refusal to give up their freedoms. But this is a different story, about progressives who stressed the scientific evidence, and then veered away from it.
For many progressives, extreme vigilance was in part about opposing Donald Trump. Some of this reaction was born of deeply felt frustration with how he handled the pandemic. It could also be knee-jerk. “If he said, ‘Keep schools open,’ then, well, we’re going to do everything in our power to keep schools closed,” Monica Gandhi, a professor of medicine at UC San Francisco, told me. Gandhi describes herself as “left of left,” but has alienated some of her ideological peers because she has advocated for policies such as reopening schools and establishing a clear timeline for the end of mask mandates. “We went the other way, in an extreme way, against Trump’s politicization,” Gandhi said. Geography and personality may have also contributed to progressives’ caution: Some of the most liberal parts of the country are places where the pandemic hit especially hard, and Hetherington found that the very liberal participants in his survey tended to be the most neurotic.
Updated guidelines for spectator events and churches in Washington now allow venues to designate “vaccinated sections” within their facilities that can be seated at full capacity.
Under the new guidelines, spectators must present proof they’re fully vaccinated in order to be admitted to the vaccinated-only section. Vaccination cards, a photo of a vaccination card or an immunization record will be accepted as proof.
Physical distancing won’t be required in vaccinated-only sections. People seated in those sections may be seated directly next to other groups. Vaccinated spectators are still required to wear face masks unless actively eating or drinking.
Children between two and fifteen years old may present a negative COVID-19 test result that was taken within 72 hours of admission. Children under the age of 2 need to be accompanied by a vaccinated adult.
Vaccinated spectators must enter facilities in a separate line from un-vaccinated ticket holders, according to the guidelines
Of all the moving goal posts in the COVID-19 pandemic, herd immunity may be the most difficult to pin down — and it may even be the wrong metric to track.
Herd immunity is the concept that once a majority of the population has been vaccinated or has natural immunity to an infectious disease, in this case SARS-CoV-2, life will shift back to normal.
But to listen to Dr. Anthony Fauci, President Joe Biden’s chief medical adviser and the head of the National Institute of Allergy and Infectious Diseases, is to hear him downplay the focus on this “elusive” concept and instead urge Americans to pay attention to other figures like vaccination rates.
“We should not get so fixated on this elusive number of herd immunity,” Fauci said March 15. “We should just be concerned about getting as many people vaccinated as quickly as we possibly can because herd immunity is still somewhat of an elusive number.”
Fauci has referred to herd immunity as an “elusive” concept at least seven times over the last two months during the White House’s COVID-19 briefings.
Oregon has reimposed restrictions on public gatherings as Covid-19 cases rise again, a reminder that even as 100 millions Americans are now fully vaccinated, states are still seeing localized outbreaks.
Fifteen of Oregon’s 36 counties are now considered at “extreme risk” for coronavirus spread. This designation bans indoor dining and significantly reduces capacity at gyms and entertainment venues.
“I was presented with data showing two paths Oregon could take,” Governor Kate Brown said on Friday, adding that tightening restrictions would save “hundreds of lives” and prevent as many as 450 hospitalizations in the next three weeks.
“As your governor, I chose to save lives,” said Brown, a Democrat.
Cases in Oregon have risen 21% in the last week, a fifth week in a row of increases greater than 20%.
Seychelles, which has fully vaccinated more of its population against the coronavirus than any other country, has closed schools and canceled sporting activities for two weeks as infections surge.
The measures, which include bans on the intermingling of households and the early closure of bars, come even as the country has fully vaccinated more than 60% of its adult population with two doses of Covid-19 vaccines. The curbs are similar to those last imposed at the end of 2020.
“Despite of all the exceptional efforts we are making, the Covid-19 situation in our country is critical right now, with many daily cases reported last week,” Peggy Vidot, the nation’s health minister, said at a press conference Tuesday.
It’s nice to see that Anthony Fauci is beginning to earn the solid international reputation that he deserves. Yen Makabenta, an acute observer and regular contributor to the Manila Times, recently acknowledged Dr Fauci as COVID’s “fearmonger-in-chief.” At long last, a departure from treating Fauci as an infallible demigod.
Dr Fauci’s panic patina started to become obvious as his much feared post-2020 holiday season “surge on top of a surge” failed to materialize. Rather than an objective and dispassionate scientist, it began to appear that Fauci is more a brilliant cheerleader for catastrophe, unerringly finding and fanning the flames of fear for the worst-of-all-possible-worlds scenario.
Over the opening months of 2021 Dr. Fauci’s gleaming ineptitude has been further burnished by repeated warnings of “impending doom” (to borrow from his colleague, Dr. Walensky):
The satirist Ambrose Bierce once defined prophecy as the “art and practice of selling one’s credibility for future delivery.” Covid-19 has produced no shortage of doomsaying prophets whose prognostications completely failed at future delivery, and yet in the eyes of the scientific community their credibility remains peculiarly intact.
No greater example exists than the epidemiology modeling team at Imperial College-London (ICL), led by the physicist Neil Ferguson. As I’ve documented at length, the ICL modelers played a direct and primary role in selling the concept of lockdowns to the world. The governments of the United States and United Kingdom explicitly credited Ferguson’s forecasts on March 16, 2020 with the decision to embrace the once-unthinkable response of ordering their populations to shelter in place.
Ferguson openly boasted of his team’s role in these decisions in a December 2020 interview, and continues to implausibly claim credit for saving millions of lives despite the deficit of empirical evidence that his policies delivered on their promises. Quite the opposite – the worst outcomes in terms of Covid deaths per capita are almost entirely in countries that leaned heavily on lockdowns and related nonpharmaceutical interventions (NPIs) in their unsuccessful bid to turn the pandemic’s tide.
Last week, the Centers for Disease Control and Prevention (CDC) released new guidance to help summer camps mitigate their coronavirus risk. Given that summer camps involve both children and the outdoors—two factors that render COVID-19 significantly less worrisome—and will be opening in the wake of widespread vaccination, one might have expected the CDC to depart from its characteristic over-caution.
Nope: This is among the most restrictive, unrealistic guidance the agency has released during the pandemic. It’s more limiting than the CDC’s guidance for vaccinated people exercising outside more generally. If followed, summer campers would be miserable, deprived of physical contact, and in considerable danger of overheating. The government has essentially recommended that summer camps treat kids like prisoners.
On April 30, the Centers for Disease Control and Prevention reported that 100 million Americans are now fully vaccinated—roughly half the adult U.S. population. More than 147 million have received at least one jab. Vaccination‐induced immunity combined with the roughly 32 million confirmed COVID cases in the U.S. (the actual number of cases may be several times that number), are why U.S. case and hospitalization rates continue their downward trend, and why some degree of herd immunity may be not far away. As if to add an exclamation point to the good news, Disneyland opened its doors that same day, after being closed for over a year.
The three vaccines available in the U.S. deserve most of the credit for the good news. The unprecedented efficacy and the excellent safety profile of these vaccines should allay the concerns of the vaccine‐hesitant. Yet a steadfast 20 percent of adults tell a Kaiser Family Foundation survey they refuse to get vaccinated or will only do so if compelled.
Earlier that same week the CDC announced it is safe for fully vaccinated people to walk outdoors without a mask provided they are not in crowded situations. The CDC announcement came in the wake of several studies over the past year showing the risk of outdoor transmission—even among unvaccinated people—is extremely low.
Yet, while walking alone towards my car in a parking lot the other day, I was chastised by a woman who was several yards away from me because I was not wearing a mask. The woman was double‐masked and also wearing a face shield. I told her about the CDC’s new outdoor mask guidelines and that I was fully vaccinated. The woman replied that she too was fully vaccinated but knows better than to walk outside without wearing a mask. Realizing that there was nothing to be gained from continuing the conversation I got into my car and drove off.
The consequences of COVID-19 in those who recover from acute infection requiring hospitalisation have yet to be clearly defined. We aimed to describe the temporal trends in respiratory outcomes over 12 months in patients hospitalised for severe COVID-19 and to investigate the associated risk factors.
In this prospective, longitudinal, cohort study, patients admitted to hospital for severe COVID-19 who did not require mechanical ventilation were prospectively followed up at 3 months, 6 months, 9 months, and 12 months after discharge from Renmin Hospital of Wuhan University, Wuhan, China. Patients with a history of hypertension; diabetes; cardiovascular disease; cancer; and chronic lung disease, including asthma or chronic obstructive pulmonary disease; or a history of smoking documented at time of hospital admission were excluded at time of electronic case-note review. Patients who required intubation and mechanical ventilation were excluded given the potential for the consequences of mechanical ventilation itself to influence the factors under investigation. During the follow-up visits, patients were interviewed and underwent physical examination, routine blood test, pulmonary function tests (ie, diffusing capacity of the lungs for carbon monoxide [DLCO]; forced expiratory flow between 25% and 75% of forced vital capacity [FVC]; functional residual capacity; FVC; FEV1; residual volume; total lung capacity; and vital capacity), chest high-resolution CT (HRCT), and 6-min walk distance test, as well as assessment using a modified Medical Research Council dyspnoea scale (mMRC).
Between Feb 1, and March 31, 2020, of 135 eligible patients, 83 (61%) patients participated in this study. The median age of participants was 60 years (IQR 52–66). Temporal improvement in pulmonary physiology and exercise capacity was observed in most patients; however, persistent physiological and radiographic abnormalities remained in some patients with COVID-19 at 12 months after discharge. We found a significant reduction in DLCO over the study period, with a median of 77% of predicted (IQR 67–87) at 3 months, 76% of predicted (68–90) at 6 months, and 88% of predicted (78–101) at 12 months after discharge. At 12 months after discharge, radiological changes persisted in 20 (24%) patients. Multivariate logistic regression showed increasing odds of impaired DLCO associated with female sex (odds ratio 8·61 [95% CI 2·83–26·2; p=0·0002) and radiological abnormalities were associated with peak HRCT pneumonia scores during hospitalisation (1·36 [1·13–1·62]; p=0·0009).
In most patients who recovered from severe COVID-19, dyspnoea scores and exercise capacity improved over time; however, in a subgroup of patients at 12 months we found evidence of persistent physiological and radiographic change. A unified pathway for the respiratory follow-up of patients with COVID-19 is required.
Nearly one third of recently registered Covid deaths in England and Wales are people who died primarily from other causes, the latest figures show.
Weekly death data from the Office for National Statistics (ONS) shows that, for nearly 33 per cent of people included in the overall coronavirus death figures, Covid was not an underlying cause of death.
The number of people who are not principally dying from Covid but are still being included in the official figures has been creeping up steadily as the pandemic has declined.
It had been running at around 10 per cent for most of the crisis but had risen to nearly a quarter by mid-April and is continuing to increase.