Epi Weekly Review: No Fairy-Tale Ending to The Covid Pandemic
Less testing, less information on tests, apparently less Covid. Positivity decreased 5.2 to 4.8% per CovidView. Testing decreased for multiple reasons, including antigen test results not being reliably tracked.
1/6
In the past week, most diagnosed cases in TX, CA, FL, IL, GA, MO, WI; these 6 states account for nearly half of diagnosed cases. But diagnosed cases only roughly a fifth of total infections. Virus spreading on campuses will spread to homes, parents, grandparents, and others. 2/6
3/6 @nytimes tracks counties with the highest rates. Here are top 28. They look pretty....red...to me. The virus doesn’t see red or blue states, only people it can infect. In too many places, the virus is still winning. If we work together but stay apart, we can stop the spread.
In most of the US, we continue to not do case investigation and contact tracing well. Too many cases to trace in some places. Too few cases reached quickly. Too few contacts named. Contacts not quarantining. These are all hard problems to solve - but they are all solvable.
4/6
Companies published protocols for vaccine studies; now we await rigorous external review. CDC cleaned some amateur, harmful, politically-directed material off their website; now to see if they regain scientific independence. We hope for a safe, effective vaccine we can trust.
5/6
6/6 Thanks @profdalefisher for the phrase: vaccine won’t bring a fairy-tale end to the pandemic. Even with a vaccine, we will need a comprehensive response to reduce spread (closures, adaptations, 3W's), find it fast (test), stop it soon (isolation, contact tracing, quarantine).
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CDC is not a Democratic or Republican agency. It's an American agency. One in three employees have been lost in recent months. This is dismantling of our health protections, not reform.
The administration talks about making America healthier, about transparency and quality science. But the plain truth is that they’re doing the opposite.
They're systematically destroying the systems that keep Americans safe from diseases and health threats, making and reversing life-and-death decisions with no transparency or discussion, and undermining science.
We’re still learning about the steep cuts to CDC, but I want to focus on the particularly dangerous and misguided elimination of CDC’s tobacco control program. If it’s not reversed, this would have devastating consequences and put American lives at risk.
Although FDA regulates tobacco products, setting rules on manufacturing, requiring warning labels, and overseeing how tobacco products are advertised and marketed, FDA alone can’t prevent tobacco addiction.
CDC plays a distinct and essential role—tracking tobacco use, analyzing the burden of tobacco-related disease, and sharing vital data with communities, researchers, and policymakers.
Updated Covid booster recommendations and the unwinding of the public health emergency in the United States have raised questions and highlighted lingering challenges. How should we be thinking about these developments? Who should get a booster this spring? 1/thread
Covid hasn’t gone away, but it no longer poses the same threat to most people it did in the first years after its emergence. This is due, in large part, to lifesaving vaccinations and treatment, and also to prior infections, which reduce the risk too. 2/
Our wall of immunity, built up from both vaccinations and infection, is strong—but it’s not impervious. Protection wanes, and the virus continues to mutate. Even now, older adults and medically vulnerable people remain susceptible to severe illness and death. 3/
In New York City, Covid killed more people than any other cause in the pandemic’s first year and caused life expectancy to drop by 4.6 years on average, according to the newly released annual report of NYC vital statistics. Confirmation of a devastating toll. 1/thread
What gets measured can be managed, which is why reports like this are crucial. More than 200 New Yorkers die every day, including >50 people under age 65, a data point I tracked closely as NYC Health Commissioner and focused intently on bringing down. bit.ly/41cFZcm 2/
Every life counts. A moving piece published last week in @nytimes shows vividly the necessity—and challenge—of tracking all births and deaths. 3/ bit.ly/3Gmll1O
The past three years of fighting Covid feel like a fog of war. Although everyone wants to move on, we must reckon with how bad the pandemic was—and how much worse it could have been. 1/thread
20 million excess deaths have occurred during the Covid pandemic—more than all but the two other leading causes of death, cardiovascular disease and cancer. Without vaccination, measures to reduce infections and lifesaving medical care so many more lives would have been lost. 2/
Those who are intent on undermining public health action argue that there was nothing we could have done to counter Covid, that all of the infections and deaths were inevitable. But they ignore that some places had much lower rates of infections, hospitalizations and deaths. 3/
Masks have been an effective tool throughout the Covid pandemic, despite erroneous claims to the contrary. 1/thread
The widely cited Cochrane review on masks was poorly done and even more poorly communicated. Regrettably, researchers analyzed the wrong datasets, in the wrong way, and overstated their conclusions—leading to sweeping and inaccurate characterizations. 2/
Many nuances around mask type, setting, behavior, and policy are explained in this helpful piece by @dr_kkjetelina. bit.ly/3ErwuNN 3/