Bearing Witness to the Pandemic May 2021

May 1-8, 2021

The month begins with over 32.5 million cases and 575,000 deaths from COVID in the US. However, good news keeps coming as daily new case counts continue to fall in the US below an average of 50,000 for the first time in over 6 months. Daily death rates are averaging well less than 1,000, down from nearly 3 times that in the fall.

A renewed since of hope and optimism is occurring across the country as if we have turned to corner. People have returned to the streets, shops, restaurants, theaters, stadiums. and airports. The economy is rebounding and jobs are going unfilled. President Biden’s rating for handling the pandemic is in the 60s as a very painful one-year nightmare is starting to fade.

Nearly 60% of adults, over 150 million, have received at least one shot and over 40% are fully vaccinated. However, with vaccination rates falling experts now believe that the US will not reach the magic herd immunity number of 70-80%. Some who have suffered from COVID may think they don’t need the shots, but they are wrong, officials warn. The antibodies created from the vaccinations have been found to be more potent as well as longer lasting

What a tragedy that in India they go begging for vaccinations with over 400,000 new cases and 4,000 deaths now being reported each day. The country has reported over 200,000 deaths from over 20 million cases. Some world health officials say the actual numbers are much larger. It seems no matter where you go in the world the death rates are running 1-2%. Hospitals are reported to be over run and supplies like oxygen scarce with some patients said to have died in their beds from a lack of oxygen. Streets are full of bodies being prepared for cremation in massive sites of separate pyres. It is a sad sad human tragedy. The surge is being caused by a new variant known as a double mutant.

The FDA has approved the Pfizer COVID vaccine for youth ages 12-15. New studies have confirmed that the vaccine remains effective against newer and more contagious variants from the UK, South Africa, and New York. While its efficacy against infections was reported to be 72-75% for the UK variant, it was still said to be 94% effective at keeping away serious illness, hospitalizations, and death.

The number of flu cases in the US this season is reported to be one tenth of a normal year; only 2,000 compared to an average of 200,000. That is certainly good news as many flu-related deaths were likely averted. But officials say that next year’s flu season will be worse and the vaccines may be less effective.

The jump in the death rate per 100,000 in the US last year was the highest ever recorded in federal statistics, nearly 16%. COVID was said to be responsible for 10% of all deaths in 2020.

A new study from the University of Washington reports that the number of people in the US who have died from COVID is over 50% higher than that reported by officials, and is closer to 900,000. It also suggests that the total worldwide count is 7 million instead of the reported 3.2 million.

With a year’s worth of mortality data in, the risk of dying from COVID increases by 9-10% per year of age. For people of color, the death rate is about two times that of white people, and they die at younger ages.

A new study has found that over one third of COVID long-haulers are suffering from mental, cognitive, mood, neurological or psychological disorders. Not surprising, the pandemic has caused an increase in alcohol consumption. In one study over half of the respondents said they were drinking more than before the crisis.

May 9-15

Virus infections and deaths continue to head downward in the US with averages dropping to 35,000 and 600 per day, respectively. Fatalities have not been this low since almost a year ago. What a relief.

In a surprise announcement the CDC announced that fully vaccinated people may forgo the wearing of masks all together and give up social distancing. That is except in the most crowded or or vulnerable locations like hospitals, airports, prisons, nursing homes,  shelters, and public transportation. Only unvaccinated persons should continue to wear them. The country has been wearing face coverings since April of 2020. President Biden pronounced this a “great day for America.”

The problem with this new guidance is that less than half of the country adults, about 120 million, are fully vaccinated. Some 60 million adults are slow, hesitant, or opposed to get a shot. Vaccination rates vary a great deal by socioeconomic status, education levels, income, and geographic region. We are still a long way from herd immunity, especially with new variants appearing and running wild in other countries. And those who resist taking a shot are also the most likely to resist wearing a mask and lying about their status. Finally, death rates still are stubbornly substantial, remaining at over 500 per day.

So in a shop or office who exactly will ensure the unmasked patron or colleague next to us is vaccinated? No one. That is why many people are expected to continue to wear masks, even though we understand masks won’t keep someone from getting COVID, it keeps them from giving it to others. Speaker of the House Nancy Pelosi feels the same way that she will mandate mask wearing until all representatives are willing to be vaccinated.

The virus continues to rage in India infecting an average of 400,000 a day with 4,000 deaths. The sight of massive outdoor crematories with funeral pyres burning will be remembered as one of the most tragic heartbreaking sights of the pandemic.

Despite this, many fully developed countries like Japan and Australia report dismally low vaccination rates. Japan is less than 1% despite hosting the Olympics this summer.

Mental health care providers confirm what we all knew that rates of emotional distress rose substantially during the pandemic. Some 4 in 10 adults reported anxiety and depression compared to 1 in 10 a year before. To compound the suffering, access to mental health care professionals was a crisis in itself due to shortage of providers, reduced hours, and closed treatment centers and care programs.

May 16-22

The great pandemic of 2019-2020 continues to wind down, at least in the United States. Daily new cases have dropped below 30,000 and 500 deaths. Numbers have not been this low in almost a year. Yet, we all remember the fear we felt when only 100 were dying each day.  Have we become desensitized to it all?

Total confirmed cases have now passed 33 million, about 10% of the nation’s population. Some experts estimate the true count may be twice that number.  Total deaths are just under 600,000.

President Biden announced he will provide 20 million doses with the rest of the world as part of a commitment of 80 million.

With only 125 million Americans full vaccinated, the rate of vaccination have stalled in many parts of the country. Some rural areas of the heartland and deep south report a less than 25% fully vaccinated rate. And in urban areas health officials have lowered their expectations to a 60%. These people seem not to understand that they are giving a runway to allow new variants to emerge which may thwart the effectiveness of vaccines in those who took the shot(s).

Case counts in Europe have dropped by over 60% in the past month, but the numbers are still large with close to 700,000 new cases per week. The EU has moved to reopen closed borders and relax travel bans for fully vaccinated visitors, including those from the US.  Yet, vaccination rates in much of Europe are similar to that of southern states in the US, 25-35%.

Mask and social distancing rules continue to be dropped across the country. Event venues and sport stadiums are returning to full seating. This despite, vaccine efficacy rates for some of the newer variants are still risky, around 60% for the Brazil and South Africa strains.

Millions of immunocompromised individuals in the US are still at risk, even with vaccines. They are often told by their doctors to act as if they did not get a shot, continue to wear masks and practice social distancing.  Those with blood cancers, transplants, rheumatoid arthritis, and diseases like HIV are said to be at risk with lower vaccine effectiveness.

Those patients who report having survived COVID, as well as family members of those who died, are now reporting their struggles with insurance claims and paying medical providers. While many insurers waived out of pocket costs for patients with COVID, what expenses were due to COVID is often contested. It is not unusual that some patients incurred costs of many hundreds of thousands of dollars while in the ICU for weeks at a time.

May 23-31

Average daily cases and deaths continue to fall by double digits across the US.  Nevertheless, the total number of Covid-related deaths is nearing 600,000

More progress on the vaccine front as another provider, Moderna, announced  its vaccine was effective for 12 to 17 year-olds.

Worldwide, of the over 1 billion doses administered less than 1% were in poor countries. The level of vaccination in much of the developing world is stuck in the low single digits. Over 7 billion people of the nearly 8 billion world population have yet to be vaccinated.

No where is the situation more dire than in India.  The government reports some 27 million cases and just over 300,000 deaths. However, world health experts believe the true number of infections is in the hundreds of millions with death estimates ranging from a conservative 500,000 to a staggering death count in the millions. The WHO believes that worldwide, cases and deaths have been undercounted by a factor of 2-3, which others believe is too conservative.

Large portions of the population will soon be coming up on six months of the date of their full vaccination. Health care experts are busy studying the data as to how long the vaccines are effective and when booster shots will be needed. Initial expectations are that most will need a second round anywhere from 6-12 months. Some recent studies have shown that antibodies and immunity may last a year or more. Also being researched in trials is whether mixing the type of vaccine for the booster shot provides a broader band of coverage against virus variants.

President Biden has reopened an investigation into the origins of the coronavirus; such as whether it could have been due to an accident at the Chinese Wuhan laboratory.  China continues to stonewall this line of questioning asserting that the investigation is complete.

The official number of breakthrough cases in the US where vaccinated people became infected with the virus is said to be just over 10,000. This is 1/100th of 1 percent of the over 100 million vaccinated. Of those cases, about 10% ended up hospitalized and less than 2% total died.

Yet, in a surprising and controversial announcement, the CDC said that it would stop investigating breakthrough infections except for the most serious cases that are hospitalized or die. Without this data we can never be fully sure just how effective the vaccines were in practice, or understand the unique scenarios that causes it or future vaccines to be ineffective in some people.

Americans, largely unmasked, came out to celebrate the first weekend of the summer and first holiday, Memorial Day, after 16 long painful months of the pandemic. Travel across the US has rebounded with gusto although global borders are still largely closed to leisure travelers.

The above news items have been taken from a number of local, regional, national and international news media  including print, broadcast, and digital sources, but no social media. Additional editorial opinions and comments about these news items are those of this author.

The featured image is from the CDC COVID Data Tracker showing daily trends in the number of new COVID cases reported.

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