Fauci: The US is still in the first wave of COVID-19

https://finance.yahoo.com/news/fauci-the-us-is-still-in-the-first-wave-160137351.html

The U.S. is well into its third peak of the coronavirus, marking a new record for daily cases at more than 83,000 over the weekend.

The total case count has surpassed 8.6 million and the death toll rose above 225,000. Globally, more than 43 million have been affected with more than 1.1 million dead.

In recent days, some experts and reports have referred to this as a third wave, while others refer to it as either an elongated first wave or a second wave.

Dr. Anthony Fauci, the nation’s top infectious disease expert, settled the debate with Yahoo Finance this Monday at its annual All Markets Summit.

“I look at it more as an elongated — and an exacerbation of — the original first wave,” Fauci said.

He explained that while the Northeast has been able to reduce its outbreak, the national baseline never fell to a more manageable number like 10,000 cases per day. Instead it’s stayed high at about 20,000 cases per day.

In addition, for areas which chose to open up after the initial brief national lockdown, some states did not follow strict guidelines.

“We started to see a peak that brought us up to around 70,000 per day,” Fauci said, adding that, “Now as we’re getting into the cold weather, we came back up again to the worst that we’ve ever had, which was over 80,000 per day.”

We’ve never really had waves in the sense of up and then down to a good baseline. It’s been wavering up and down. So now, we’re at the highest baseline. … [It’s] kind of semantics. You want to call it the third wave or extended first wave. No matter how you look at it, it’s not good news,” he added.

A similar debate ensued in the summer, with many pointing to the surge hitting parts of the country that had yet been unaffected, thereby making it the first wave. Some experts say they are used interchangeably, and others say the differentiation is actually only between the local and national levels.

Dr. Shira Doron, an infectious disease physician at Tufts Medical Center echoed Fauci’s declaration of an elongated first wave.

“Only when looking back at the shape of a curve can you truly call something a peak or wave. It’s also important to mention that the overall U.S. graph looks very different than individual state graphs,” Doron said.

“The U.S. as a whole, however, never declined to low levels after its first peak, which is why some people say we are still in the ‘first wave,’” she said.

“Overall, I think it’s more a matter of semantics than something scientific.”

Cartoon – Greatest Threat to America?

Editorial Cartoons for Wednesday from Times Wire Services

Cartoon – Caught Not Wearing a Face Mask

Granlund cartoon: Face coverings - Opinion - Daily Review Atlas - Monmouth,  IL

An early pardon for overweight turkeys?

https://mailchi.mp/f2794551febb/the-weekly-gist-october-23-2020?e=d1e747d2d8

Thanksgiving's new leftovers: Turkeys too big for farmers to sell - The  Washington Post

Overweight patients infected with COVID-19 have a higher risk of severe disease—but it turns out the pandemic may have brought a reprieve for overweight turkeys. According to a recent Washington Post piece, turkey farmers are facing a glut of, ahem, larger birds, as social distancing and reduced travel are expected to result in fewer people around the Thanksgiving dinner table, and fewer families springing for a 20-pound bird.

Farmers commit to their chicks as early as January, making a bet on the ratio of larger (male) toms versus smaller (female) hens to meet holiday demand, so many were locked into their plans before the pandemic hit. Demand for larger birds has also been hit by fewer orders for piece parts: with fall Renaissance festivals canceled, demand for turkey legs cratered. (Spare a thought for mead brewers as well.) Sadly, these soon-to-be-spared holiday heavyweights are unlikely to spend the winter roaming free—look for a rise in ground turkey supply a few months down the road. 

How to safely celebrate Thanksgiving during the pandemic

Smaller birds for smaller gatherings: just another way our “Pandemic Thanksgiving” will look like none we’ve experienced before.

COVID response leads voters’ healthcare concerns

https://mailchi.mp/f2794551febb/the-weekly-gist-october-23-2020?e=d1e747d2d8

The upcoming election has huge implications for healthcare, far beyond how COVID is managed, ranging from how care is covered to how it’s delivered. The graphic above shows a continuum of potential policy outcomes of the November 3rd vote.

If President Trump wins a second term and Republicans control at least one house of Congress, there will likely be more attempts to dismantle the ACA, as well as continued privatization of Medicare coverage.

 If Democrats win the presidency and sweep Congress, actions to expand the Affordable Care Act (ACA), or even create a national public option, are on the table—although major healthcare reform seems unlikely to occur until the second half of a Biden term.

In the short term, we’d expect to see more policy activity in areas of bipartisan agreement, like improving price transparency, ending surprise billing and lowering the cost of prescription drugs, regardless of who lands in the White House.
 
While healthcare emerged as the most important issue for voters in the 2018 midterm elections, the COVID pandemic has overshadowed the broader healthcare reform platforms of both Presidential candidates heading into the election. As shown in the gray box, many Americans view the election as a referendum on the Trump administration’s COVID response. Managing the pandemic is one of the most important issues for voters, especially Democrats, who now rank the issue above reducing the cost of healthcare or lowering the cost of drugs. 

In many aspects, the COVID policies of Biden and Trump are almost diametrically opposed, especially concerning the role of the federal government in organizing the nation’s pandemic response.

The next administration’s actions to prevent future COVID-19 surges, ensure safe a return to work and school, accelerate therapies, and coordinate vaccine delivery will remain the most important aspect of healthcare policy well into 2021.

Heading into a “third wave” of the pandemic

https://mailchi.mp/f2794551febb/the-weekly-gist-october-23-2020?e=d1e747d2d8

The US broke its record for the highest number of new coronavirus cases in  a day - Vox

In Thursday’s second and final Presidential debate, former Vice President Joe Biden warned that a “dark winter” lies ahead in the coronavirus pandemic, and with cases, hospitalizations, and deaths on the rise across the country, it now appears that we are headed into a “third wave” of infections that may prove worse than both the initial onset of COVID on the coasts and the summertime spike in the Sun Belt.

Yesterday more than 71,600 new cases were reported nationwide, nearing a late-July record. Thirteen states hit record-high hospitalizations this week, measured by weekly averages, most in the Midwest and Mountain West. Several Northeastern states, which had previously brought the spread of the virus under control, also experienced substantial increases in infections, leading schools in Boston to suspend all in-person instruction. Of particular concern is hospital capacity, which is already being strained in the more rural areas now being hit by COVID cases. With infection spikes more geographically widespread than in earlier waves, fewer medical workers are available to lend support to hospitals in other states, leading to concerns about hospital staffing as admissions rise.
 
As hospitalizations increase, so too will demand for therapeutics to help shorten the course and moderate the impact of COVID. This week, Gilead Sciences’ antiviral drug remdesivir, previously available under an Emergency Use Authorization (EUA) from the federal government, became the first drug to win full approval from the Food and Drug Administration (FDA) to treat patients hospitalized with COVID-19. The approval was based on clinical studies that showed that remdesivir can reduce recovery time, and also includes use for pediatric COVID patients under the age of 11.

Meanwhile, the FDA cleared AstraZeneca to resume US clinical trials of its coronavirus vaccine, which had been suspended for a month following an adverse patient event. It’s widely expected that one or more drug companies will submit their vaccine candidates for EUA sometime next month, although new polling data released this week indicates that the American public is growing more skeptical in their willingness to take an early vaccine against the virus, with only 58 percent of respondents saying they would get the shot when it first becomes available, down from 69 percent in August. (Only 43 percent of Black respondents say they would get the vaccine, compared to 59 percent of Whites—a racial divide that reveals deep distrust based on the history of inequities in the US healthcare system.) 

A long, dark winter': Experts worry about mental health in first full COVID  winter - NEWS 1130

In many respects, the coming month will surely prove to be a pandemic turning point, revealing the magnitude of the next wave of COVID, the direction of US public health policy, the prospects for reliable therapeutics, and the timing of a safe and effective vaccine. We’ll soon know whether we are, indeed, headed for a winter of darkness.