Biden’s vaccine mandate has cargo giants in a pre-holiday panic

“A trade group for air cargo giants like UPS and FedEx is sounding the alarm over an impending Dec. 8 vaccine deadline imposed by President Joe Biden, complaining it threatens to wreak havoc at the busiest time of the year — and add yet another kink to the supply chain.”

“The deadline has been hailed by public health officials as a way of increasing vaccination rates as the country continues to struggle with the Covid-19 pandemic. But business groups and conservatives have warned that it could have damaging economic impacts. The deadline brushes right up against the peak holiday season and as some of the biggest cargo distribution companies, including UPS and FedEx, are already battling unprecedented labor shortages.”

The US was a world leader in vaccination. What went wrong?

“The United States started its vaccination drive with a structural advantage. It had the most generous supply of Covid vaccines, along with Israel, thanks to investments made to procure doses before the vaccines were approved for emergency use by the US Food and Drug Administration.”

“Demographics may also be holding the US back to a degree. America has more young people than most Western European countries: About 16 percent of Germany’s population is under 18 versus about 22 percent of the US’s, to give one example. Children under 12 are still not eligible for vaccines in the US (or anywhere else), which may be partly depressing its vaccination share.
But there is more to the story than supply quirks or demographic trends.

Compared to a country like Portugal, now a world leader in Covid vaccinations, the United States’ vaccination rates for its eligible population are not particularly strong, either. In Portugal, 99 percent of people over age 65 are fully vaccinated; in the US, the share is closer to 80 percent. Those disparities persist in the younger age cohorts: 85 percent of Portuguese people ages 25 to 49 are fully vaccinated versus less than 70 percent of the Americans in the same age range.

Another big difference that explains that divergence is one of culture and politics. Covid vaccinations have become, like so much of America’s pandemic response, polarized along political lines. As of July, 86 percent of Democrats said they were vaccinated, according to a Kaiser Family Foundation survey, while only 54 percent of Republicans said the same. One in five Republicans said they would “definitely not” get the vaccine.

“This political divide over vaccines has contributed to the US falling behind European countries when it comes to coverage levels,” Josh Michaud, associate director of global health policy at the Kaiser Family Foundation, told me.

There are pockets of vaccine hesitancy in Europe, especially in Germany and France, but nothing on the scale of what we have seen in the United States. In Portugal, as reflected in its exemplary vaccination rate, skeptics have a very low public profile.

“We don’t need to convince people to get vaccinated,” Gonçalo Figueiredo Augusto, who studies public health at NOVA University Lisbon, told me over Zoom. “People want to.””

Florida’s mysterious Covid-19 surge

“Toward the end of the summer, Florida became the epicenter for America’s recent Covid-19 wave — reporting more hospitalizations and deaths than any other state in the country. But there was and still is surprisingly little certainty, among experts, over one question about Florida’s surge: Why did it happen?

The most common explanation for the outbreaks in the South that we saw over the recent summer was the low vaccination rates across the region. It’s true vaccination rates are low across the South: Seven of the 10 states with the lowest vaccination rates are in the region. And lower vaccine rates do correlate with more Covid-19 cases and deaths.

But Florida defies the regional trend. The state ranks 20th for full vaccination in the US, with 56 percent of people fully vaccinated — not great, but a little above the national rate. At the peak of its outbreak in mid-August, Florida had fully vaccinated about 51 percent of its population — again, not great, but in line with the national rate.

Maybe Florida loosened restrictions too quickly and more aggressively? It’s certainly true that Gov. Ron DeSantis has taken a more hands-off approach than leaders in blue states, but it’s not clear if this actually led to differences in how the public behaved.

According to Google’s mobility data, Floridians around mid-August were about 14 percent less likely to travel to retail and recreational outlets compared to pre-pandemic times. That’s almost the same as Californians, and actually lower than New Yorkers. Neither New York (about 59 percent fully vaccinated at the time) nor California (about 54 percent fully vaccinated at the time — not much higher than Florida) saw surges anywhere as bad as Florida’s in August.

The same trend holds for other metrics that measure precaution. Based on Carnegie Mellon University’s COVIDcast, through August, Floridians were more likely to mask up than New Yorkers or residents in other states that didn’t see nearly as big Covid-19 surges.

Based on OpenTable’s restaurant reservation data, Florida was back to pre-pandemic numbers for restaurant reservations around mid-August, but that wasn’t too different from the US as a whole. Some states, like New Jersey and Connecticut, equaled or surpassed their pre-pandemic baseline for restaurant reservations and didn’t see anywhere near the surge that Florida did (although both benefited from significantly higher vaccination rates than Florida).”

“We don’t know everything about why Covid-19 cases rise, and we don’t know everything about why they fall, either. David Leonhardt and Ashley Wu at the New York Times recently demonstrated that the coronavirus appears to follow two-month cycles in its rises and falls.”

“This isn’t to say that nothing matters in the fight against Covid-19. We know vaccines work to protect people from severe illness, including against the delta variant. Social distancing, masking, and restrictions do, too. Chances are Florida’s surge would have been much smaller if it had done better on all these fronts.

But Florida’s example complicates any story of recent Covid-19 surges that focuses solely on reopenings and vaccinations. Something else seems to be going on, and experts aren’t totally sure what. “There are things that, to be honest, we don’t fully understand,” Ashish Jha, dean of the Brown University School of Public Health, told me.”

Unfortunately, Ivermectin Is Not a Miracle Cure for COVID-19

“So what do researchers know about the effectiveness of ivermectin, approved for human use but best known as a horse deworming medicine, in treating COVID-19? At the beginning of the pandemic, scientists around the globe began testing thousands of existing medications in test tubes to see if they could be repurposed to fight against the novel coronavirus. In very preliminary research, researchers found that ivermectin significantly inhibited COVID-19 coronaviruses in cell cultures.

Encouraged by these petri dish findings, some desperate clinicians began administering ivermectin to their COVID-19 patients. The result was a number of hopeful observational studies by clinicians reporting that ivermectin appeared to be effective—in some cases, highly effective—in preventing COVID deaths. Observational studies are notoriously subject to researcher biases and confounders that can mislead clinicians into thinking an intervention works when actually a third factor is responsible.

Nevertheless, a prominent group of American physicians calling themselves the Front Line COVID-19 Critical Care Alliance (FLCCC) combined these preliminary observational and epidemiological studies into a November 13, 2020, preprint meta-analysis asserting that ivermectin “has highly potent real-world, anti-viral, and anti-inflammatory properties against SARS-CoV-2 and COVID-19.” Among other findings, the FLCCC pointed to reports that widespread distribution of ivermectin in Peru had correlated with steep declines in COVID-19 cases and mortality there. According to the group, cases and deaths began to rise dramatically in the same country after the government ceased distributing the drug.”

“research on ivermectin’s efficacy in treating COVID-19 has been ongoing. Has this subsequent research validated Kory’s claim that ivermectin is a miracle drug against COVID-19? It’s complicated, but the answer is largely no.

First: Those dramatic Peruvian results are highly confounded. The steep rise in COVID-19 cases and deaths in that country can most likely be blamed on the breakout of the highly infectious lambda variant rather than to a halt in ivermectin distribution. Meanwhile, the newly reported results of a highly anticipated randomized controlled study of ivermectin in next door Brazil finds that the medicine had “no effect whatsoever” on the disease.

A lot of the hope that ivermectin would be a COVID-19 silver bullet arose from the findings of various meta-analyses, including the one conducted by the FLCCC, that combined the results of various observational studies and small randomized controlled trials. One of the more prominent recent ones was posted as a preprint in May by a team of British public health researchers led by the Newcastle University statistician Andrew Bryant. But other scientists have faulted that study for significant methodological failures.

Also, though it’s not the preprint’s researchers fault, one of the most important studies bolstering their conclusion has been withdrawn because its results appear to be fraudulent. Once the data from that study are removed, the Bryant meta-analysis finds essentially no efficacy for treating COVID-19 with ivermectin.

On July 28, 2021, the authors of a more painstaking meta-analysis of ivermectin COVID-19 treatment studies, published by the Cochrane Library, concluded:

“Based on the current very low‐ to low-certainty evidence, we are uncertain about the efficacy and safety of ivermectin used to treat or prevent COVID‐19. The completed studies are small and few are considered high quality. Several studies are underway that may produce clearer answers in review updates. Overall, the reliable evidence available does not support the use of ivermectin for treatment or prevention of COVID‐19 outside of well‐designed randomized trials.”

The FLCCC folks are surely sincere, but the best evidence suggests that they are sincerely wrong. The bottom line is that while ivermectin might have some marginal efficacy, it is certainly not a “miracle drug” when it comes to treating COVID-19.”

Could Covid-19 finally end hunger in America?

“A peculiar thing happened last year during the Covid-19 pandemic: As large swaths of the U.S. economy shut down and unemployment skyrocketed, hunger rates held steady and poverty rates went down.

From the pandemic’s earliest days, Washington showed it had learned the lessons of past crises like the 2008 financial collapse, when policymakers responded with too little too late to help people get by and the economic recovery was hampered as a result. So as the country faced a once-in-a-century pandemic and the sharpest economic downturn since the Great Depression, Congress threw trillions at the double disaster, sending unprecedented levels of aid to American families and businesses.

Soon, a pattern was evident, thanks in part to real-time monitoring by the U.S. Census Bureau: When Washington doled out federal aid, hardship declined. When Washington let aid expire, hardship ticked back up.

In essence, the pandemic triggered a country-wide policy experiment aimed at keeping families fed and financially afloat. There have been big increases in food stamps and unemployment benefits. Three rounds of stimulus checks. Universal free meals at schools and new grocery benefits for kids who are learning virtually, or out of school during the summer. Hundreds of millions of food boxes flooded into churches and other nonprofits.

The latest tranche of aid may carry the biggest bang yet: six monthly child tax credit payments that will be dispersed through the end of the year. The first two rounds of payments that went out in July and August fueled a dramatic reduction in the rate of American households with kids who report sometimes or often not having enough to eat in the past week, according to the Census Bureau.

All that aid appears to have worked.

“Lo and behold, if you give people money, they are less poor,” said Elaine Waxman, an economist and senior fellow at the Urban Institute who has closely monitored how low-income households have fared throughout the crisis.”

“the U.S. has long been seen as an outlier for its comparatively limited safety net, and is sometimes referred to as “the reluctant welfare state.” Other wealthy countries, like Canada and the United Kingdom, have more generous unemployment programs and provide allowances to help with the costs of raising children, on top of providing health care and other benefits that are broadly available, even to middle-income households.

By contrast, in the United States, there has been a much greater focus on ensuring aid goes primarily to low-income households that have met strict eligibility and income requirements. America’s two biggest safety net programs, Medicaid and the Supplemental Nutrition Assistance Program, or SNAP, (still known to many as “food stamps”), have fairly low income caps and are squarely aimed at providing in-kind benefits like medical coverage and food — not giving people money to spend how they see fit.”

America needs to decide how much Covid-19 risk it will tolerate

“Particularly with the rise of the delta variant, a consensus has formed that the coronavirus likely can’t be eliminated. Like the flu, a rapidly shapeshifting coronavirus will continue to stick around in some version for years to come, with new variants leading to new spikes in infections. Especially as it becomes unlikely that 100 percent of the population will get vaccinated, and as it becomes clear that the vaccines provide great but not perfect protection, the virus is probably always going to be with us in some form, both in America and abroad.

That doesn’t mean the US has to accept hundreds of thousands of deaths annually in the coming years. While the vaccines have struggled at least somewhat in preventing any kind of infection (including asymptomatic infection), they have held up in preventing severe illness, hospitalization, and death — reducing the risk of each by roughly 90 percent, compared to no vaccine. Research has also found stricter restrictions reduce Covid-19 spread and death, and that masks work.

But it’s also become clear most Americans aren’t willing to tolerate drastic deviations from the pre-pandemic normal — lockdowns, staying at home, and broadly avoiding interactions with other people — for long. While social distancing staved off the virus in the pre-vaccine pandemic days, it also wrought economic, educational, and social devastation around the world. It’s the intervention that, above all, most people want to avoid going forward.”

“the balance, as the coronavirus becomes endemic, will require accepting some level of Covid-19 risk — both to individuals and to society. America already does that with the flu: In some years, a flu season kills as many as 60,000 people in the US, most of whom are elderly and/or people with preexisting health conditions, but also some kids and previously healthy individuals. As a cause of death, the flu can surpass gun violence or car crashes, but it’s a tolerated cost to continuing life as normal.”

“With about half the country vaccinated, the Covid-19 death rate is still much higher than that of the flu — the more than 120,000 deaths over the past six months is still more than double the number of people even the worst flu seasons have recently killed. But as more people get vaccinated and others develop natural immunity after an infection, the death rate will likely come down.”

“How many deaths are Americans willing to tolerate?”

“Are 30,000 to 40,000 deaths a year too many? That’s generally what the country sees with gun violence and car crashes — and American policymakers, at least, haven’t been driven to major actions on these fronts.

Are as many as 60,000 deaths a year too many? That’s what Americans have tolerated for the flu.

Are 90,000 deaths a year too many? That’s the death toll of the ongoing drug overdose crisis — and while policymakers have taken some steps to combat that, experts argue the actions so far have fallen short, and the issue doesn’t draw that much national attention.

Is the current death toll — of more than 1,500 a day, or equivalent to more than 500,000 deaths a year — too much? Many people would say, of course, it is. But in the middle of a delta variant surge, Americans may be revealing their preferences as restaurant reservations are now around the pre-pandemic normal — a sign the country is moving on. “The loudest voices on social media and in public are way more cautious than the average American,” Jha said.”