Even with a vaccine, the virus is here to stay. The number of tests done decreased in some states, including Florida. This is a fight against the virus, but also a fight against becoming numb to the horrifying toll. We have one of the highest cumulative death rates of all wealthy countries. New financial modeling by @iccwbo warns of the cost of vaccine nationalism: $9.2 trillion, with nearly half, $4.5 trillion, incurred by wealthy economies including the United States. There is no magic bullet. The Novavax vaccine, also soon to be rolled out, uses an engineered protein and an adjuvant, and is nearly as good as the mRNA vaccines. We will then need to parse everything we know about “underlying conditions,” using scientific and medical judgment and not just data, to prioritize those who will get the greatest benefit from vaccination. Don’t focus on individual variants. Scientific knowledge should be in the public domain. In. In crowded indoor spaces, Covid can spread widely, but it’s much less infectious than measles. ​Here’s some great new data on self-reported mask-wearing. Unless we take urgent action, at least 100,000 residents of America’s nursing homes will die in the next year, and there could potentially be hundreds of thousands of deaths in all congregate facilities, including among those who work in these locations. Dexamethasone and other steroids—cheap, available meds—reduce the likelihood of death by as much as a third. Covid will be with us for years. Diagnosed cases have been in the 150,000–200,000 range, but there are likely at least half a million new infections each day. Sensible decarceration is a public health and ethical imperative. Because turnover of residents is high, including people moving between facilities, vaccination of people when they are admitted to nursing homes is essential and needs to be routine. . Test positivity is at low levels in the northeast and some other states, but very few places are finding where most spread is occurring - most sources of infection, and even fewer -- maybe none -- are quarantining most contacts effectively. By investing in public health protection, we will honor those lost to this pandemic and protect those at risk from the next. If we’re divided, the virus will continue to conquer us. An interesting data survey summarized by Covid Exit Strategy shows that in states with more than 90% mask wearing, less than 20% of people know someone who is sick. Every US region and most counties for which there are data are at the highest level in terms of case incidence — more than 200 cases per 100,000 a week. We will look back and ask why we didn’t do more. It’s great that CDC and HHS have FINALLY been allowed to release some of the information they have. First, let’s discuss the latest epidemiology. Covid is skyrocketing across the country, but some areas are being hit much harder than others. 9 of 10 people understand the importance of masking up. in the South, Southwest, and West, offsetting the decline in New England, Mid-Atlantic, and Midwest. Although there have been 7.4 million reported infections in the United States with the virus that causes Covid, estimates suggest that the number of actual infections is about 40 million, at least. We may learn from that. This should, of course, be voluntary and provide appealing, temporary housing. We need to get back to that perspective, urgently, to protect ourselves and our families. Ebola, also known as Ebola virus disease (EVD) or Ebola hemorrhagic fever (EHF), is a viral hemorrhagic fever of humans and other primates caused by ebolaviruses. On balance, what we’ve learned is good news, but there are important caveats and implications. Should be high on the priority list of all governments. This modeling site has performed better than most, using solely deaths and machine learning. Here’s the key point: the per capita hospitalization rates for Covid range from 500 per million to <50/million. A new tool using HHS data shows the percentage of beds with Covid patients, which is a more reliable indicator than the percentage of ICU beds filled, since ICU beds can be added more easily than hospital beds (by converting surgical recovery suites, anesthesia rooms, etc). New syringes to get the sixth dose out of Pfizer vials should be available soon. There’s not yet enough data to know if the rapid increase in cases in that city is due to reinfection among people previously infected with other strains (due to waning immunity or immune escape), increased transmissibility of this new variant, or some combination. article about how to hug grandparents and other elderly loved ones. We certainly don’t want to be #1 in death. More than 20,000 died last week. Deaths are increasing. We should be getting better information each week, but we aren’t. Incidence numbers are of little use without knowing testing intensity (which ranges from <100 to 10,000 per 100K) and the percent of PCR tests that are positive. And VOTING. What is contact tracing, why is it important, and how is it done? We’re sending our troops into battle without the armor a competent government would have provided. Wide swaths of the country remain at extremely high risk, with only isolated pockets of low or even medium risk. In South and North Dakota, an estimated 1 in 11 people have Covid. I outlined how we can make progress using a one-two punch strategy with more nuanced closures and more effective testing and isolation. It takes rigor, discipline, patience, and working together. Some keys to successful vaccination programs: Empower trusted community members and develop tailored messages, Provide reminders and ensure convenience (hours, locations, time), Avoid hidden costs (for example, reimburse travel to vaccination sites). . The road ahead is long and bumpy and there are no shortcuts, but there’s a good new start. It’s crucial that we take action to stop spread in hotspots. First the good news. The Thanksgiving surge is ebbing, just in time for the next holiday surge. For example: What antibodies should be used? The failure of federal leadership means we’re not tracking the right indicators. More to come on this. Personally, I can’t wait to get back to the gym. Testing is up 8.6%, while cases are up 24%. Two weeks after 40% of those over 60 who had been vaccinated, the number of critically ill in the age 60+ group grew by 7% compared with the previous week’s growth of over 30%. October 5 weekly Epi Update. The data on. We need to test asymptomatic contacts. Tom Frieden, former head of the Centers for Disease Control and Prevention, warns that this strategy would kill at least 500,000 more Americans. describing how LA’s Dodger Stadium has been transformed into a high throughput vaccination center) – but it’s important not to reduce post-vaccination observation time to less than 15 minutes in case of very rare but potentially serious allergic reactions, Going back to nursing homes, if we’re successful, deaths that occur in these facilities will decline as a proportion of all deaths, then plummet dramatically during March. We still don’t know how infectious the disease is and will remain, but it certainly has been infectious. of our Weekly Science Review by the wonderful Dr. Cyrus Shahpar. With a vaccine and treatment, even more progress will be possible. We do this through rapid isolation, complete contact tracing, and supportive quarantine. Read my latest op ed about where we are and what we can do for the holidays. But this time next year, I hope to be writing about our successes in stopping Covid and our progress improving our health care and public health systems so that we’ll be able to rapidly and effectively confront the next, inevitable threat. It’s shameful and inexcusable that the federal government is not publishing data it has on the pandemic. Schools, healthcare, workplaces, stores can open more safely. Imagine you’ve been on a dangerous sea voyage. The post-holiday flood is cresting, but cases, hospitalizations, and deaths remain astronomically high. Lower doesn’t mean low. This could become an important early warning system for Covid. We haven’t seen any serious adverse events, but we need to track for this when millions are vaccinate. is not in our favor here. If the US had given the same proportion of distributed doses as West Virginia, another 8 MILLION vaccines would have been given by the end of the week last week! In states with 80% or less mask wearing, 30-54% know someone who is sick. every state should collect and publicly share to inform decision-making and provide accountability and transparency in vaccine rollout. Kudos to Philadelphia for. Rates of infection are vastly higher in Native American, Latinx, and Black communities. County-specific test positivity, which should be open source but at least is available here (image below -- I wish they had zip code lookup).​. Hint: the same folks who aren’t likely to wear masks are also not likely to get vaccines. Let’s hope the CDC website gets corrected. California, Utah, and many other states are seeing intermediate levels of spread; the population of California means large numbers of cases there. It makes me SO ANGRY. (The published data from Mississippi has been whipsawing.)​. Tom Frieden is Senior Fellow for Global Health and the Council on Foreign Relations and President and Chief Executive Officer of Resolve to Save Lives, an initiative of the global health organization Vital Strategies.0 LIKES SHARE, During the 2014-2016 Ebola epidemic, the CDC produced a weekly dashboard of the most important interventions, objectively grading each in every affected country as red, yellow or green. for at least 3 months, but the data are messy and have not yet been peer-reviewed. The White House cluster isn’t over. Hospital beds are being filled by Covid patients. That means not more of the same, but better of the same. Epidemics are guided missiles attacking disenfranchised people. We shouldn’t assume that more infectious strains will be less lethal. States should also report the proportion of unduplicated people who tested positive, cross-referencing the two types of test. Disparities and inequalities must be fought everywhere they exist. That means not more of the same, but better of the same. I felt safe. Will this happen with a small proportion of people vaccinated? Now, the disheartening numbers. First must come making vaccination free, convenient, and sensitive, and addressing staff concerns. And we have to make sure that those who have been neglected so far – Blacks, Latinx, Native Americans, the poor, and, surprisingly, primary care doctors – are also prioritized to receive vaccines. However, as is the case with other vaccines, it appears to be less effective (but not ineffective) against some of the newer and more transmissible strains, in particular the B.1.351 variant first identified in South Africa. by the Kaiser Family Foundation, with some key findings below. Not every state had a bump — protection protocols save lives. To remedy this, we should offer housing for the infectious period for all with COVID-19. This week. Read my. Reported cases fluctuate by day. Never forget this in the midst of your diagrams and equations.”. At Resolve to Save Lives, we released a toolkit this week sharing evidence, tools, and best practices for policymakers and communities to promote mask-wearing, which I summarized in the Washington Post. To protect our country by improving global health security. It's a continuum, not a dichotomy. First-come, first-served is a recipe to further exacerbate persistent inequalities. As we sow, so shall we reap. The US is seeing record high cases, hospitalizations, and deaths – with continued increases. We should know testing rates for each race/ethnic group and ensure all results come back within 48 hours. It’s preventable. Data from Massachusetts shows the gap. It’s always better to underpromise and overdeliver. The percentage of positive tests continues to decrease, as do trends for the proportion of outpatient visits for ILI and CLI (influenza-like illness and COVID-like illness). 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