“Before the pandemic, the flu alone could sometimes push hospital systems into crisis mode, where they cancel elective procedures and limit other kinds of care. Now there’s Covid-19, which has done the same thing on its own.
Suddenly conjuring more hospital capacity every winter to handle the expected surges of flu and Covid-19 is not going to happen. Thousands of additional hospital beds are not coming in the next few years, and the US would not have the doctors and nurses to staff them anyway. It will take much longer — years or maybe decades — to improve the gaps in America’s health care infrastructure and workforce that have been exposed during Covid-19.
This means the imperative to “flatten the curve,” to limit the spread of these viruses to stop hospitals from being overwhelmed, will be with us for a long time. But the makeup of the curve will change, measuring multiple diseases instead of one.”
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“Vaccination is the best way to stop a bad Covid-and-flu season before it starts.”
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“Surveillance is critical, starting with early-warning systems. Public health institutions have long monitored the flu and they are already tracking Covid-19 in a similar manner. Monitoring the amount of virus detected in local wastewater has proven to be a reliable leading indicator of new Covid-19 waves during the pandemic. And widespread, reliable testing will be essential — including at-home tests for both Covid-19 and the flu.”
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“Frequent testing lets people know that they should isolate. If they are at higher risk of severe illness, they can get on antivirals quickly. The current therapies are most effective at stopping serious symptoms that could require hospitalization if they are taken within the first few days of an illness. Research in the last decade has found that flu antivirals are too often underprescribed for patients who would benefit most; improving prescription rates is only more critical now that the health system will be contending with both the flu and Covid-19 going forward.”
“about 600 Americans under the age of 18 have died of COVID-19 during the pandemic. A new study from the Centers for Disease Control and Prevention (CDC) took a closer look at young people who were hospitalized for COVID-19 in July and August, while the delta variant wave took hold, and largely found that healthy young people continue to mostly evade the worst of COVID-19.
The study found that most young people who suffer severe COVID-19 outcomes had underlying health conditions. The most common, especially for teenagers, was obesity.”
“The highly contagious omicron variant of the COVID-19 virus often does an end run around the immunological protections of vaccination or prior infection. But recent data from the U.K. and Canada indicate that these breakthrough omicron infections are much less dangerous than first-time infections in unvaccinated people.
Ontario public health authorities report that as of yesterday, 2,093 and 288 people are being treated for omicron variant infections in hospitals and intensive care units (ICUs), respectively. The hospitalization rate per million among unvaccinated people stands at 532.7; it’s 105.9 for folks vaccinated with at least two doses. This means that the reduction of hospitalization risk for those inoculated with at least two doses is 80.1 percent.
The ICU occupancy rate per million is 135.6 for unvaccinated people and just 9.2 for those who have gotten two doses of COVID-19 vaccines. So vaccination reduces the ICU risk by 93.2 percent.”
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“These British and Canadian findings mirror those most recently reported by the New York State Health Department. It finds that the daily rate per 100,000 of COVID-19 hospitalizations stands at 4.56 for fully vaccinated people, compared to 58.27 for unvaccinated people. That means vaccinations are 92.3 percent effective at preventing hospitalization from COVID-19.”
“The Biden administration’s response to the omicron variant is belatedly kicking into gear. The White House announced Wednesday that it would soon ship 400 million N95 masks to US pharmacies and community health centers to be given away. Americans can submit their bills for at-home tests to their health insurer for reimbursement, and on Tuesday, a new federal website launched that lets people order a few free at-home coronavirus tests.
Free tests and free masks are finally here — after some public health experts have been calling for them since omicron was first detected around Thanksgiving or even earlier. But the tests and masks might not arrive in Americans’ hands until the end of the month.
“By the time the masks and tests get there, the surge will probably be over,” Monica Gandhi, an infectious diseases doctor at the University of California San Francisco, told me. It’s possible — but far from certain — that the omicron wave has already peaked. The average number of daily cases has dropped by 50,000 in the last week, a 6 percent decline.”
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“Experts point to three main factors in the US government’s slow response to omicron: an over-reliance on vaccines, a failure to develop contingency plans, and the fracturing of the expert consensus on what the appropriate public health interventions would be.”
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“There are limits on what the federal government can do under our federalist system of government. Mask mandates and social distancing restrictions are largely the purviews of state and local authorities. The Biden administration did attempt to take sweeping actions, such as a vaccine mandate for large employers, that got tied up in the courts.”
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“Public health experts were never a monolith. But early in the pandemic, there was a fairly clear consensus about what to do about Covid-19: Close some businesses, ban most large gatherings, mandate masks, and develop a vaccine. A New York Times survey of hundreds of epidemiologists found in the summer of 2020 that more than half were in agreement about the timeline for resuming many activities that had been stopped because of Covid-19, such as vacationing within driving distance or eating out at a restaurant.
But as the pandemic has dragged on, expert opinions diverged. In spring 2021, the Times ran another survey of epidemiologists, asking them how long people would need to wear masks indoors, the answers varied wildly; 20 percent said half a year or less, while another 26 percent said people would wear masks indefinitely, at least in certain situations. As the Biden administration debated booster shots this summer and fall, some experts were full-throated supporters of giving everybody an additional dose, while other prominent experts argued boosters made sense only for certain people.”
“The omicron variant has helped drive the United States into uncharted territory for the pandemic. The country was reporting an average of more than 400,000 new Covid-19 cases every day as of January 3, easily eclipsing last winter’s record of 250,000. And infections are still spiking, with the number of newly reported cases quadrupling since the beginning of December.
There is still a lot of uncertainty with the omicron variant: We’re still learning exactly how transmissible it is, how likely it is to cause severe disease and for whom. But we know more now than we did when it first began spreading in the US.
All the early indications were that omicron was even more transmissible than its predecessors, at least in part because of its ability to partially evade preexisting immunity, and that has proven to be true. While earlier CDC estimates that the variant took over in the US in mid-December turned out to be overstated, omicron now appears to have surpassed the previously dominant delta variant in its share of new US cases.
With cases rising, so is the number of patients in the hospital with Covid-19. But, at least so far, hospitalizations are not rising as rapidly as infections, lending credence to the theory that omicron leads to less severe disease, particularly for vaccinated people. Deaths have barely budged over the last month, with about 1,250 new deaths being reported every day as of January 3, essentially unchanged from the 1,125 daily average on December 3. While there is always a time lag between new reported cases and the data showing more serious illness, the evidence, including biological research findings, that omicron poses less of a threat to each individual patient is only growing.”
“Studies in the US and around the world have found that student learning suffered when classes were remote, and many teachers were no fan of the system either, with educators ranking the challenges of virtual instruction among their top pandemic stressors in one recent study. At the same time, some fear that in-person school during omicron may simply become untenable. Sheikh’s school has one nurse for 2,500 students, making it nearly impossible to do any real contact tracing. “There’s no way to contain these Covid cases,” she said.”
“The coronavirus pandemic has fully exposed the flaws in the US health care system and deepened many of its disparities. Yet there is a serious possibility, now that Sen. Joe Manchin (D-WV) has rendered the current version of the Build Back Better Act dead, that the current Congress will not pass any long-term provisions to cover more people, make health care more affordable, or better prepare the nation for the next pandemic.
Though they have not attracted as much attention as other parts of the legislation, Democrats had written a wide-ranging health care section in Build Back Better. They were planning to patch up holes in the Affordable Care Act, extending assistance to middle-class families as well as people in poverty; to reduce drug costs for millions of Americans; and to make investments in the country’s health care infrastructure, with the goal of better preparing the US for the inevitable next pandemic.”