Cartoon – What your Face Mask says about you
Category Archives: Mortality
Cartoon – Sheep at a Crossroads
FDA ends emergency use authorization for hydroxychloroquine
The FDA ended Monday its emergency use authorizations for two controversial drugs, hydroxychloroquine and chloroquine, as a potential coronavirus treatment.
Why it matters: Despite gaining President Trump’s adamant support and use, the drugs have failed in several clinical trials and have been found to possibly cause serious heart problems.
What they’re saying: The FDA said it believes the drugs “are unlikely to be effective in treating COVID-19” under the emergency use authorization.
- It also said that “in light of ongoing serious cardiac adverse events and other serious side effects, the known and potential benefits of [the drugs] no longer outweigh the known and potential risks for the authorized use.”
Read the letter and memo regarding the revocation:
Masks Help Stop The Spread Of Coronavirus, Studies Say—But Wearing Them Still A Political Issue
TOPLINE
Despite a raft of data suggesting that wearing face masks (in conjunction with hand washing and social distancing) is effective in preventing person-to-person transmission of the coronavirus, the practice is still a partisan political issue in some places even as new cases continue to rise.
KEY FACTS
A new review published in The Lancet looked at 172 observational studies and found that masks are effective in many settings in preventing the spread of the coronavirus (though the results cannot be treated with absolute certainty since they were not obtained through randomized trials, the Washington Post notes).
Another recent study found that wearing a mask was the most effective way to reduce the transmission of the virus.
90% of Americans now say they’re wearing a mask in compliance with the CDC’s recommendations, up from 78% in April, according to a new poll conducted by NORC at the University of Chicago for the Data Foundation.
But despite the conclusive research and what seems to be a public consensus, masks remain a divisive subject.
As new coronavirus cases surge in Arizona, where cases have jumped 300% since the beginning of May, for instance, Governor Doug Ducey has not made it mandatory to wear masks in public, and in Orange County, California, officials on Friday rescinded a mask mandate after public backlash, even as cases rise; when cases peaked in April, on the other hand, New York made wearing a mask mandatory when people could not socially distance from others, and other states passed similar restrictions.
Part of the politicization of masks may have to do with resistance to heavy-handed government mandates, which in this case could cause people who are already skeptical of wearing face coverings to dig in their heels.
CRUCIAL QUOTE
Lindsay Wiley, an American University Washington College of Law professor specializing in public health law and ethics, told NPR last month that stringent mask requirements “can actually cause people who are skeptical of wearing masks to double down.” And in turn, that “reinforce[s] what they perceive to be a positive association with refusing to wear a mask … that they love freedom, that they’re smart and skeptical of public health recommendations.”
KEY BACKGROUND
Masks have also become a heavily politicized issue in recent weeks: Senate Majority Leader Mitch McConnell (R-Ky.) last month voiced his support of mask wearing in public, for instance, in contrast to President Trump and other GOP leaders who have portrayed masks as a sign of weakness. Trump infamously refused to wear a face mask as he toured a Ford facility in Michigan last month. When asked about the mask, he said that he wore one in private but “didn’t want to give the press the pleasure of seeing it.” House Speaker Nancy Pelosi has voiced her support for the practice: “real men wear masks,” she said earlier this month.
TANGENT
A video posted to Twitter on Friday showed a street in New York City’s East Village that was packed with people ignoring social distancing guidelines, most of whom were not wearing masks, drew widespread criticism. “When there’s a new spike people will blame the (masked) protests, but it’s really gonna be maskless crap like this,” one Twitter user wrote.
New York Governor Andrew Cuomo even weighed in on the scene. “Don’t make me come down there,” he tweeted.
Here Are All The States Where Coronavirus Cases Are Spiking
TOPLINE
Some states are seeing a dramatic surge in new coronavirus infections even as reopening measures continue across the country, raising tough questions about whether those reopening efforts were premature and how officials will balance maintaining public safety with preventing more economic damage.
KEY FACTS
Texas and Florida—two of the first states to reopen—both hit new daily highs last week.
California also hit a record daily high last week, though one official attributed the spike to increased testing (Florida’s governor has also attributed his state’s spike to more testing).
Arkansas, Alabama, North Carolina, South Carolina, Utah and Alaska have also seen surging case numbers over the last week.
On Friday, the CDC released new forecasts that singled out six states—Arizona, Arkansas, Hawaii, North Carolina, Utah and Vermont—where the coronavirus death toll is likely to rise over the next month.
Some states and cities have walked back reopening measures in response to surging cases: Oregon’s governor put the reopening process on pause on Friday after the state saw its highest level of new cases since the start of the pandemic; Utah’s governor issued a similar order, as did the mayor of Nashville, Tennessee.
According to data compiled by Johns Hopkins, more than 2 million Americans have contracted Covid-19, the disease caused by the coronavirus, since the beginning of the pandemic, and more than 114,000 have died.
KEY BACKGROUND
Even though news of states hitting record levels of coronavirus cases day after day might make it seem like the U.S. is headed for a second wave of the virus, the country is still situated very firmly within the “first wave.” New infections peaked around 36,000 cases a day in April, according to New York Times data, and over the last month the number of new daily cases has held relatively steady around 20,000. Cases in former hot spots like New York and New Jersey have fallen dramatically while cases in many areas of the South and West continue to rise. For a true “second wave” of the virus to be possible, the virus would need to subside and then reappear.
CRUCIAL QUOTE
“We really never quite finished the first wave,” Dr. Ashish Jha, a professor of global health at Harvard University, told NPR. “And it doesn’t look like we are going to anytime soon.”
Fauci Says ‘Real Normality’ Unlikely For A Year As U.S. Continues Pandemic Slog
TOPLINE
Dr. Anthony Fauci told a British newspaper Sunday that something resembling normal life in the U.S. would likely return in “a year or so,” with the coronavirus pandemic expected to require social distancing and other mitigation efforts through the fall and winter, although political divisiveness, reopening efforts and the George Floyd protests could add more layers of difficulty to the country’s recovery.
KEY FACTS
“I would hope to get to some degree of real normality within a year or so. But I don’t think it’s this winter or fall,” Fauci, director of the National Institute of Allergy and Infectious Diseases, told The Telegraph Sunday.
Fauci also told the newspaper that the travel ban from the U.K., the European Union, China and Brazil will likely stay in place for “months,” based on “what’s going on with the infection rate.”
Within the U.S., Florida, California and Texas hit all-time daily highs in reported Covid-19 cases, while the Centers for Disease Control predicted six states (Arizona, Arkansas, Hawaii, North Carolina, Utah and Vermont) will see higher death tolls over the next month.
U.S., where states that aren’t making them mandatory, like California, are seeing cases spike while New York, where the protective gear is required, has the country’s lowest spread rate.
“We’re seeing several states, as they try to reopen and get back to normal, starting to see early indications [that] infections are higher than previously,” Fauci said.
BIG NUMBER
Over 2 million. That’s how many confirmed coronavirus cases are in the U.S., which leads the world both in the number of infections and casualties from the disease, according to data from Johns Hopkins University.
WHAT TO WATCH FOR
Despite Fauci’s immediate conservative outlook on when life can return to normal, he’s hopeful that multiple Covid-19 vaccines could be found by the end of 2020. “We have potential vaccines making significant progress. We have maybe four or five,” he told The Telegraph. Although “you can never guarantee success with a vaccine,” Fauci added, from “everything we have seen from early results, it’s conceivable we get two or three vaccines that are successful.”
SURPRISING FACT
The U.S. is not facing a second wave of coronavirus. “We really never quite finished the first wave,” according to Dr. Ashish Jha, a global health professor at Harvard. In an NPR interview, Jha said the first wave is unlikely to be finished “anytime soon.”
KEY BACKGROUND
The World Health Organization designated the coronavirus outbreak as a pandemic on March 11, 2020. As of Sunday, the pandemic is approaching its fifth month, and few countries have had success in beating back their outbreaks. New Zealand has essentially returned to normal life after eliminating coronavirus, while countries like the U.S., the U.K. and Brazil, among others, continue to see new cases and report deaths.
Within the U.S., efforts to reduce cases and deaths, like mask wearing, have become partisan political issues. Desires both from elected officials and some citizens to reopen economies have also impacted the pandemic, as states that reopened earlier, like Florida, are seeing numbers of cases spike. Concerns that recent protests sparked by George Floyd’s killing will also further spread the coronavirus are present, but have not yet been proven, as symptoms can take up to 14 days to develop.
Beijing goes into ‘wartime mode’ as virus emerges at market
“We would like to warn everyone not to drop their guard even for a second in epidemic prevention control; we must be prepared for a prolonged fight with the virus,” Xu Hejian, a spokesman for the Beijing municipal government, said at a news conference Saturday.
“We have to stay alert to the risks of imported cases and to the fact that epidemic control in our city is complicated and serious and will be here for a long time,” he said.
Coronavirus surges across the U.S.
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Coronavirus cases and hospitalizations are reaching alarming levels in some states.
What they’re saying: “Arizona is the new national hotspot for COVID-19 with more than 4,400 new cases in just the last 72 hours. Per capita, Arizona’s infection rate is now more than three times higher than New York state. It’s spreading like wildfire,” Rep. Greg Stanton tweeted last night.
The big picture: Several states have seen record numbers of new cases over the last few days, including Alabama, Alaska, Arizona, Arkansas, California, Florida, North Carolina, Oklahoma and South Carolina, Reuters reports.
- On Saturday, Texas reported 2,242 coronavirus hospitalizations — a record for the state, per the Houston Chronicle. Health officials are becoming concerned about hospital capacity.
- Arkansas, North Carolina and Utah also had record numbers of patients enter the hospital on Saturday, per Reuters.
- “South Carolina recorded nearly 800 new coronavirus cases on Sunday, setting another single-day record and raising the state’s seven-day average for the 17th day straight,” the Post and Courier reports.
The bottom line: There’s never been any reason to think that states with mild outbreaks in April weren’t at risk of having a crisis in June, especially states that haven’t taken lockdowns or social distancing as seriously.
- “This is not the second wave of the pandemic in states like Arizona, Texas, Utah, California, and Florida. Unlike in New York, the first wave never ended in these places,” the Kaiser Family Foundation’s Larry Levitt tweeted.
Infectious disease expert says coronavirus won’t slow down until ‘about 60% or 70%’ of American population is infected, points out US is at ‘about 5%’
https://www.insider.com/expert-us-is-in-an-unsure-moment-with-coronavirus-2020-6
- The director of the Center for Infectious Disease Research and Prevention said the US is in an “unsure moment” regarding the effects of states reopening and protests during the novel coronavirus pandemic.
- Dr. Michael Osterholm told “Fox News Sunday” that it’s too early to tell if protests have been a source of widespread infections, but early data suggests the demonstrations aren’t responsible for rises in 22 states.
- The Centers for Disease Control and Prevention predicted on June 12 that the US coronavirus death toll could increase to 130,000 by July 4.
Dr. Michael Osterholm, the director of the Center for Infectious Disease Research and Prevention, said Sunday that the US is in an “unsure moment” as states reopen and new cases emerge.
“We have to be humble and say we’re in an unsure moment,” Osterholm said on “Fox News Sunday,” adding that states across the country are in varied stages of the pandemic as 22 have recorded an increase in coronavirus cases, eight in plateaus, and 21 with decreasing cases.
Osterholm was speaking as states have been reopening businesses for weeks, Americans flocked to warm weather, and widespread protests drew people to the streets in cities across the country. The first few weeks of June have seen sharp rises in new cases and hospitalizations.
The US hit a grim milestone two weeks into June as it marked more than 2 million infected and 115,000 dead from the virus. Centers for Disease Control and Prevention predicted on June 12 that the US coronavirus death toll could increase to 130,000 by July 4.
“About 5% of the US population has been infected to date with the virus, this virus is not going to rest until it gets to about 60% or 70%,” Osterholm said. “When I say rest, I mean just slow down, so one way or another we’re going to see a lot of additional cases.”
The expert told host Chris Wallace that the increase cannot only be attributed to increasingly available testing, and it’s too early to tell if protests have been a source of widespread infections, but early data suggests not.
“These next weeks, the two weeks are going to be the telling time, we just don’t know,” he said. “We’re not driving this tiger, we’re riding it.”
“My biggest concern is if cases start to disappear across the country, suggesting we are in a trough” that would lead to a second wave of the virus, Osterholm said.
Dr. Anthony Fauci has recently downplayed concerns that the recent rise in cases of the novel coronavirus in the US doesn’t a “second spike” of infections, and a seasonal resurgence was “not inevitable.”
Though Fauci told CNN on June 12 that indicators like hospitalizations could still spell concern for officials, increased testing and CDC capabilities could counter a possible resurgence in cases.
A few superspreaders transmit the majority of coronavirus cases
The coronavirus has traveled the globe, infecting one person at a time. Some sick people might not spread the virus much further, but some people infected with the SARS-CoV-2 are what epidemiologists call “superspreaders.”
Elizabeth McGraw, the director of the Center for Infectious Disease Dynamics at Pennsylvania State University, explains the evidence and why superspreaders can be crucial to a disease’s transmission.
What is a superspreader?
Early in the outbreak, researchers estimated that a person carrying SARS-CoV-2 would, on average, infect another two to three people. More recent studies have argued, however, that this number may actually be higher.
As early as January, though, there were reports out of Wuhan, China, of a single patient who infected 14 health care workers. That qualifies him as a super spreader: someone who is responsible for infecting an especially large number of other people.
Since then, epidemiologists have tracked a number of other instances of SARS-CoV-2 superspreading. In South Korea, around 40 people who attended a single church service were infected at the same time. At a choir practice of 61 people in Washington state, 32 attendees contracted confirmed COVID-19 and 20 more came down with probable cases. In Chicago, before social distancing was in place, one person that attended a dinner, a funeral and then a birthday party was responsible for 15 new infections.
During any disease outbreak, epidemiologists want to quickly figure out whether superspreaders are part of the picture. Their existence can accelerate the rate of new infections or substantially expand the geographic distribution of the disease.
What are the characteristics of a superspreader?
Whether someone is a superspreader or not will depend on some combination of the pathogen, the patient’s biology and their environment or behavior.
Some infected individuals might shed more virus into the environment than others if their immune system has trouble subduing the invader. Additionally, asymptomatic individuals – up to 50% of all those who get COVID-19 – will continue their normal activities, inadvertently infecting more people. Even people who ultimately do show symptoms are capable of transmitting the virus during a pre-symptomatic phase.
A person’s behaviors, travel patterns and degree of contact with others can also contribute to superspreading. An infected shopkeeper might come in contact with a large number of people and goods each day. An international business traveler may crisscross the globe in a short period of time. A sick health care worker might come in contact with large numbers of people who are especially susceptible, given the presence of other underlying illnesses.
Public protests – where it’s challenging to keep social distance and people might be raising their voices or coughing from tear gas – are conducive to superspreading.
How big a part of COVID-19 are superspreaders?
Several recent preprint studies, which haven’t yet been peer-reviewed, have shed light on the role of superspreading in COVID-19’s dispersion around the globe.
Researchers in Hong Kong examined a number of disease clusters by using contact tracing to track down everyone with whom individual COVID-19 patients had interacted. In the process, they identified multiple situations where a single person was responsible for as many as six or eight new infections.
The researchers estimated that only 20% of all those infected with SARS-CoV-2 were responsible for 80% of all local transmission. Importantly, they also showed that these transmission events were associated with people who had more social contacts – beyond just family members – highlighting the need to rapidly isolate people as soon as they test positive or show symptoms.
Another study by researchers in Israel took a different approach. They compared the genetic sequences of coronavirus samples from patients inside the country to those from other places. Based on how different the genomes were, they could identify each time SARS-CoV-2 entered Israel and then follow how it spread domestically.
These scientists estimated that 80% of community transmission events – one person spreading the coronavirus to another – could be tracked back to just 1-10% of sick individuals.
And when another research group modeled the variation in how many other SARS-CoV-2 infections a single infected person tends to cause, they also found there were occasionally individuals who were very infectious. These people accounted for over 80% of transmissions in a population.
When have superspreaders played a key role in an outbreak?
There are a number of historical examples of superspreaders. The most famous is Typhoid Mary, who in the early 20th century purportedly infected 51 people with typhoid through the food she prepared as a cook.
During the last two decades, superspreaders have started a number of measles outbreaks in the United States. Sick, unvaccinated individuals visited densely crowded places like schools, hospitals, airplanes and theme parks where they infected many others.
Superspreaders have also played a key role in the outbreaks of other coronaviruses, including SARS in 2003 and MERS in 2015. For both SARS and MERS, superspreading mainly occurred in hospitals, with scores of people being infected at a time.
Can superspreading occur in all infectious diseases?
Yes. Researchers have identified superspreaders in outbreaks of diseases caused by bacteria, such as tuberculosis, as well as those caused by viruses, including measles and Ebola. Just as appears to be the case with the coronavirus, some scientists estimate that in an outbreak of any given pathogen, 20% of the population is usually responsible for causing over 80% of all cases of the disease.
The good news is that the right control practices specific to how pathogens are transmitted – hand-washing, masks, quarantine, vaccination, reducing social contacts and so on – can slow the transmission rate and halt a pandemic.
HENRY KOTULA 