Corona Virus: It's a Marathon, Not a Sprint

[Daehawk]

Saw this about the singer Meat Loaf today. Im a bit shocked actually.

He was critical of the COVID-19 lockdowns during the COVID-19 pandemic, telling the Pittsburgh Post-Gazette in August 2021, "I hug people in the middle of COVID ... I understood stopping life for a little while, but they cannot continue to stop life because of politics." He opposed mask mandates and described a person who called for people on airplanes to wear masks as a "Nazi" and "power-mad". Meat Loaf then said: "If I die, I die, but I'm not going to be controlled."

Seems he died but wasn't controlled.

On the evening of January 20, 2022 admist the COVID-19 pandemic in the United States, Meat Loaf had reportedly serious ill and died of COVID-19 complications in Nashville, Tennessee, at the age of 74.[5][161][162] After his health rapidly declined, his two daughters rushed to see him in hospital with his wife being beside him as he died from virus.[163] His daughter had posted to Instagram in early this month that: "We are not sick, but we have too many friends and family testing positive, but doing OK"

I did find this funny...

Meat Loaf was a vegetarian from 1981 to 1992. Discussing the confusion caused by his contrasting stage name and dietary habits, he once told Entertainment Weekly, "There've been vegetarians who wouldn't speak to me because of my name. I was sitting with Jon Bon Jovi at one of those awards things, and I say, 'Oh, man, I love k.d. lang. I'd really like to meet her.' They went to find out if it was okay, and she goes, 'No. His name is Meat Loaf.' I stopped being a k.d. lang fan after that."

[Smoove_B]

Saw this about the singer Meat Loaf today. Im a bit shocked actually.

You need to adjust your time traveling crystals.

[LawBeefaroni]

https://twitter.com/nytimes/status/1504424902681628678

President Biden’s Covid czar, Jeffrey Zients, is stepping down. His replacement, Ashish Jha, could signal a new pandemic approach for Mr. Biden.

Probably not. Dr. Jha is a medical doctor with a public health add-on degree. He has no practical experience working in "boots on the ground" public health - the kind of skillset we need right now to be in charge. He's definitely someone that should be at the federal table right now providing guidance, but as the person in charge? Not convinced this is a good move. Better than Zients, but color me skeptical over this change.

If I've learned anything in 25+ years on the job it's that leadership doesn't necessarily need to know the down and dirty as long as they are willing to admit they don't know and hire the right team. No idea what kind of leader Jha is but lack of applicable degree/career focus isn't necessarily a disqualifier. I mean the perfect leader has both but they're hard to find.

[Smoove_B]

Right - he could be effective. However, he's not a relatable / known actor to anyone working in local/county/state public health - he has no connection to the people that are on the front lines and have been grinding for 2 years now. If he surrounds himself with people that are going to support and elevate locals? I'll happily eat crow. But for now, I'm still skeptical as he's pushed out some real hot takes on Twitter, especially during this last surge. I'm not at all surprised he was nominated just based on some of the things he's said. Again, better than Zients, but I'm still highly, highly skeptical anything is going to actually change.

EDIT: I should also probably clarify that a big theme for the last 2+ years (in the public health profession - what we talk about) is that non-public health people are leading the pandemic response and shaping the conversation. On the surface, this looks to be more of the same, but maybe I'm wrong.

[Unagi]

Saw this about the singer Meat Loaf today. Im a bit shocked actually.

You need to adjust your time traveling crystals.

Classic

[LawBeefaroni]

EDIT: I should also probably clarify that a big theme for the last 2+ years (in the public health profession - what we talk about) is that non-public health people are leading the pandemic response and shaping the conversation. On the surface, this looks to be more of the same, but maybe I'm wrong.

The problem with big picture public health is that it's beholden to the politicians who control the purse strings. Any politically uncomfortable reality of public health can hurt politicians' approval rating/reelection chances so they want someone in charge who minimizes those uncomfortable realities.

[Grifman]

Great analysis of on the Omicron BA2 variant and what it means:

https://twitter.com/jburnmurdoch/status ... 13765?s=21

[Daehawk]

Saw this about the singer Meat Loaf today. Im a bit shocked actually.

You need to adjust your time traveling crystals.

Its not the travel ones its the memory and record ones. I may have to switch to dilithium.

[Max Peck]

Apparently a lot of people have decided that it is, in fact, a sprint.

America Is Zooming Through the Pandemic Panic-Neglect Cycle

All epidemics trigger the same dispiriting cycle. First, panic: As new pathogens emerge, governments throw money, resources, and attention at the threat. Then, neglect: Once the danger dwindles, budgets shrink and memories fade. The world ends up where it started, forced to confront each new disease unprepared and therefore primed for panic. This Sisphyean sequence occurred in the United States after HIV, anthrax, SARS, Ebola, and Zika. It occurred in Republican administrations and Democratic ones. It occurs despite decades of warnings from public-health experts. It has been as inevitable as the passing of day into night.

Even so, it’s not meant to happen this quickly. When I first wrote about the panic-neglect cycle five years ago, I assumed that it would operate on a timescale of years, and that neglect would set in only after the crisis was over. The coronavirus pandemic has destroyed both assumptions. Before every surge has ended, pundits have incorrectly predicted that the current wave would be the last, or claimed that lifesaving measures were never actually necessary. Time and again, neglect has set in within mere months, often before the panic part has been over. The U.S. funds pandemic preparedness “like Minnesota snow,” Michael Osterholm, an epidemiologist at the University of Minnesota, told me in 2018. “There’s a lot in January, but in July it’s all melted.”

Or, as it happens, in March.

[Kraken]

No more than 5% of my fellow grocery shoppers were masked today. Transmission is very low right now so they'll probably all be fine. At least I didn't get the stinkeye for wearing one, unlike when I was in MI last week.

I wonder if this will improve when omicron 2 hits in a few weeks, or if we'll all just say "eh, masks are so last year."

[Smoove_B]

You have to love how the message has changed:

“We are closely watching the recent rise in global COVID numbers and, given both previous trends with regard to spread and our location as an international nexus for travel and trade, we do anticipate that we will eventually see an increase in the number of cases in New Jersey,” Murphy and state Health Commissioner Judith Persichilli said in a statement.

That's good - you're acknowledging what will likely happen.

“However, at this time, we do not anticipate any need to reinstate universal statewide mandated protective measures,” they added.

Of course not. Why would we do anything to stop it? Just let it wash over you. And still, f all those kids under 5!

But this? This right here:

“We are not going to manage COVID to zero nor are we impervious to the virus,” they added. “We expect COVID to continue to mutate and cases to continue to ebb and flow. Moving to an endemic status still means we must all take personal responsibility to protect ourselves and our loved ones.”

COVID zero is a non-starter. We are not in nor are we transitioning to an endemic status - still in a pandemic. But the cap here - pushing the personal responsibility narrative? A memo has clearly been circulated and I'm expecting very similar messages to start spreading from (D) governors. It's so gross. Public health is not "taking personal responsibility". Again, this is me giving up.

[Max Peck]

I like how The Powers That Be everywhere have redefined "endemic" as "we've stopped caring about controlling the disease."

[Smoove_B]

It really is ponderous. For people that like numbers, this is making the rounds today and I think it offers excellent perspectives tied to metrics we can all understand:

https://twitter.com/jeremyfaust/status/ ... 5338803211

My reasoning is that if our goal is to protect the most immune-compromised members of the community—people in whom vaccines provide zero protection against infection let alone severe disease—then perhaps it would be acceptable to drop indoor mask mandates when case counts are low enough that the highest-risk adults can attend to something like daily living and have less than a 1% chance of becoming infected with SARS-CoV-2 in a 4-month period.

...

Here's what I came up with: for a person doing all of the activities above (or similar), we’d need to keep SARS-CoV-2 under 50 cases per 100,000 people weekly, if one-way N95 masking in those public settings were to be safe enough that the 4-month risk of infection would be under 1% for an immune-compromised person in whom vaccines offer no protection.

That figure is striking—almost uncanny—because it falls right at the upper limit of the CDC’s old “moderate transmission” category, which was the agency’s previously stated threshold (from July 2021) for advising universal indoor masking regardless of vaccination status. It’s also the exact proposal that Dr. Gregg Gonsalves had proposed to me a couple weeks ago! For the United States, it would mean around 25,000 new cases per day (I already baked in the assumption that we miss 2 out of 3 infections).

Can we get there? We actually achieved that during the end of May, June, and into July last year (but at that time N95 masks were not so widespread, and Evusheld was not available). That means that, yes, this metric is achievable.

I’d also propose that if we were below 50 cases per 100,000 people weekly for a while but inched back up over that threshold (into the CDC’s old “substantial transmission” territory), we could temporarily strongly suggest/advise public indoor masking, but keep it strictly optional. Enough concerned people would voluntarily mask that we’d keep the 4-month infection risk below 1% for the high-risk immune-compromised people we’re worried about. But if case counts got too high, say above 100 cases per 100,000 people per week (the CDC’s previous “high transmission” zone), mandates would again be necessary.

[stessier]

I like that analysis.

My community is at <5/100k and has been for several weeks.

[Daehawk]

Im almost to the point of F it. Almost. It is drawing near. The only thing that prevents it now is fear of long Covid.

[Blackhawk]

Officials, at this point, no longer have the option to take the necessary steps. At one point they were choosing to do so, and some tried. But at this point the issue has been decided for them by politics.

Any measure most of them could take would simply be overruled or ignored.

Again, it isn't a battle that can be won. I can't really blame them for letting go when their hands are effectively tied.

[Zaxxon]

Officials, at this point, no longer have the option to take the necessary steps. At one point they were choosing to do so, and some tried. But at this point the issue has been decided for them by politics.

Any measure most of them could take would simply be overruled or ignored.

Again, it isn't a battle that can be won. I can't really blame them for letting go when their hands are effectively tied.

This. I'm as annoyed at our D leaders as Smoove is, but the ship has sailed on 'correct' responses being on the table. We're left with what we're seeing now vs 'doing' more (and being largely ignored) followed by crushing midterm defeats.

[Smoove_B]

Reality marches on

https://twitter.com/BNODesk/status/1505261914905063427

New York state reports 2,642 new coronavirus cases, an increase of 47% from last week

[Smoove_B]

Since I know this keeps coming up, an overview of studies related to vaccination and long COVID:

https://twitter.com/ahandvanish/status/ ... 3470510083

The summary: vaccination definitely seems to reduce the risk of #LongCovid, often by 40-50%.

*But* solidly 9.5%-14% of breakthroughs still result in Long Covid.

These figures make sense to me, given the estimated rate of LC in unvaccinated people (~10-30%).

A caveat: many of these studied people who had been vaccinated relatively recently, so as always, we can expect these findings to change a bit as immunity wanes.

...

In summary: get vaccinated to reduce your risk of #LongCovid, but be aware that if you get a breakthrough, the risk is still high!

It goes on for another ~17 post, but I've highlighted the summaries.

[Defiant]

Thanks.

[Grifman]

Good thread on the upcoming BA2 variant surge based upon the European experience:

https://twitter.com/cha_myoung/status/1 ... 64162?s=21

It’s not good.

[Smoove_B]

It's not, but the number of different variables is such that I'm still not exactly sure we can expect things to unfold the same. Like others, I'm confident there will be more cases, but with a reported ~45% of Americans that had Omicron over the last 3 months + vaccinated (fully/partially), it's anyone's guess as to how this will unfold.

But as he points out, removing all the barriers we had in place (especially in schools) is likely going to make this much worse than it has to be.

I think the point to remember is not to believe anyone that indicates no one saw this coming. It's been reported in multiple locations by at least a dozen different people. It was seen; no one cared.

[Max Peck]

Hey, the people in position to make the big decisions care. About upcoming elections.

When the Ontario provincial government announced that most public mask mandates were being dropped as of today, the head of the provincial "science table" (the weird name for the provincial COVID-19 science advisory working group) explicitly stated that it was not a science-driven decision, although he stopped short of answering a direct question as to whether it was a political decision. Coincidental with this step proceeding as scheduled, he has announced that he is stepping down "for family reasons" to accept an academic position over in the UK.

[Pyperkub]

This is interesting:

A Phase 2 clinical trial is testing the new drug’s ability to reduce mortality in older people hospitalized with COVID-19. By directly targeting immune aging, BGE-175 could effectively treat emerging COVID variants that evade vaccine-based immunity.

The immune system deteriorates with age, making COVID-19 particularly deadly in older people — but to date, no clinically available medication addresses this key risk factor. A study published today (March 21, 2022) in Nature shows that an oral drug that reverses multiple aspects of immune aging effectively prevents death in a mouse model of COVID-19, suggesting that the medication could be used to protect the elderly patients who are at greatest risk in the pandemic.

[LordMortis]

In things Smoove won't accept news. I'm looking like I might be wrong and cases and hospitalizations are both still dropping. I'm expecting the bottom of the trough about now and I'm happily wrong where we're just statistically "flattening" not bouncing. Two more weeks of this and I'm ready to let my state of constant guard down a bit.

https://www.bridgemi.com/michigan-coron ... s-and-maps

[Defiant]

Im a little wary of trusting the national numbers dropping, given reports that some states will only be reporting once or twice a week (we'll need to see the pattern over a longer period of time to tell).

[stessier]

Im a little wary of trusting the national numbers dropping, given reports that some states will only be reporting once or twice a week (we'll need to see the pattern over a longer period of time to tell).

SC switched to reporting only once a week on Tuesday and the data is from the previous Sun-Sat. Annoying.

[Smoove_B]

Not only has the reporting process been changed, but with the loss of federal funding, government funded testing sites are also being closed nationwide. Cynical Smoove could almost believe there was a coordinated effort to make sure there were multiple variables in play to make it look like circulating virus levels are decreasing.

[LordMortis]

Im a little wary of trusting the national numbers dropping, given reports that some states will only be reporting once or twice a week (we'll need to see the pattern over a longer period of time to tell).

We're three times a week and have been for some time. I'm more leery of people not testing making numbers look better than I am of 3 day a week reporting. I think that is why I'm more interested in hospitalizations than I am cases. Of course hospitalizations are a trailing indicator which is good in some respects but not as good in others. I won't help me see what's hot, but it will help me see when I can generally relax a bit more if I don't fall in to a hot zone.

[Zarathud]

I figure 2 weeks after St. Patrick’s Day is the time to reevaluate. But since I’m going to a gaming conference (vaccination or clear test required), I’ll give it another week.

Then I’m in tax season crunch anyway.

[LordMortis]

I figure 2 weeks after St. Patrick’s Day is the time to reevaluate. But since I’m going to a gaming conference (vaccination or clear test required), I’ll give it another week.

Then I’m in tax season crunch anyway.

St Patricks celebration begins the weekend before though March Madness did not this year so maybe another week before re-evaluation is advised. Two years of isolation is just a long time and I'm so past being ready and I'm already the last guy to the party.

[LawBeefaroni]

Today I learned that "COVID virgin" is a thing. I was having beers with a friend of mine. He broke up with his girlfriend in December 2019 and said he was a "COVID virgin": hasn't had sex since COVID lockdowns started. He said he's ready to get back out there. The bartender is taking him to Reno next week so that's probably the end of that.

[Zaxxon]

Today I learned that "COVID virgin" is a thing. I was having beers with a friend of mine. He broke up with his girlfriend in December 2019 and said he was a "COVID virgin": hasn't had sex since COVID lockdowns started. He said he's ready to get back out there. The bartender is taking him to Reno next week so that's probably the end of that.

At first I thought you were heading toward anyone who's yet to have contracted COVID. Since that population is dwindling these days.

[Max Peck]

Huh. I'd've guessed that COVID virgin meant someone who hasn't been infected yet.

[Zaxxon]

Huh. I'd've guessed that COVID virgin meant someone who hasn't been infected yet.

[Max Peck]

Huh. I'd've guessed that COVID virgin meant someone who hasn't been infected yet.

[Smoove_B]

America! F YEAH!

Free COVID-19 tests ending for uninsured Americans:

Quest Diagnostics, one of the largest testing companies in the country, told ABC News that patients who are not on Medicare, Medicaid or a private health plan will now be charged $125 dollars ($119 and a $6 physician fee) when using one of its QuestDirect PCR tests either by ordering a kit online or visiting one of the 1,500 Quest or major retail locations that administer the tests, such as Walmart or Giant Eagle.

More than 30 million Americans had no insurance during the first half of 2021, according to CDC estimates.

I'm sure the overlap between people at elevated risk for COVID and people without access to health insurance is the world's worst Venn diagram.

[malchior]

This is squarely because Congress is flat out broken. I mentioned it at the time but the Republicans refused to fund any more pandemic prevention/response. This led to Democrats coming up with a scheme to take allocated money back from states which caused the individual states to balk sending state reps scrambling to kibosh the effort. Because everything related to budget is not functioning in any normal way this all was last minute and involved tons of brinkmanship so they didn't have time to fix it. Oh and they had a leadership retreat they needed to get to. So I am picking up what you are putting down. It is just poor people facing the consequences so no ones cares.

[Smoove_B]

Above and beyond all that, it's also going to make it look like cases are lower - because without easy, free access, a significant number of people aren't going to be testing anymore - certainly not tests that are going to make it into government counts.

It would be like declaring high blood pressure or colon cancer rates have dropped dramatically after the federal government takes steps to increase the barrier to access for primary prevention activities.

Here, politicians then are "rewarded" in multiple ways. Not only do they get to claim they are being fiscally responsible, but they also get to show how circulating virus levels are dropping - even after mask mandates have been removed.

I know it's been 2+ years now and I keep saying it, but I *still* don't know how to process what I'm seeing. I genuinely want to be put into stasis and revived in a 150 years to see what future (water breathing? CHUD?) humans think about all this. Its such a perfect storm of various social, political and now community health circles converging and instead of us emerging stronger and better, we're now squeezing certain segments of society in such a way that can only be thought of as targeted and intentionally cruel.

[Kraken]

Next Saturday is my packie's Spring Wine Tasting.

They've been doing these twice a year for decades, and before the pandemic I'd never missed one. Hundreds of free wine samples at 20+ tables, free food, and the place is packed. Of course all tastings ended in 2020. They tried holding the fall grand tasting offsite last year and it was a dramatic flop. (The spring tasting is nicknamed "Oceans of Swill" because it emphasizes cheaper wines, while the Grand Tasting features more upscale wines.)

As much as I hate to pass this up, it's waaaay beyond my comfort level. Even though transmission levels are currently at the lowest level since the pandemic began (comparable to last summer, before delta), I still wear a mask when I make my weekly quick in-and-out packie run.

I wonder if I will *ever* be comfortable with crowded indoor events again.