Florida, Missouri and Texas now account for 40% of new coronavirus cases in U.S.

https://www.yahoo.com/news/florida-missouri-and-texas-now-account-for-40-percent-of-new-us-coronavirus-cases-172032337.html

NEW COVID-19 HOT SPOTS EMERGE AS DELTA VARIANT CIRCULATES

Just three states are now driving the pandemic in the United States, as the divide between vaccinated and unvaccinated regions of the country becomes ever more stark, as the more transmissible Delta variant of the coronavirus spreads.

Forty percent of all new cases this week have been recorded in Florida, Texas and Missouri, White House pandemic response coordinator Jeff Zients revealed at a press briefing Thursday.

Florida alone accounts for 20 percent of all new cases nationally, Zients pointed out, a trend that has stretched into its second week.

Zients added that “virtually all” hospitalizations and deaths — a full 97 percent — are among unvaccinated people. “The threat is now predominantly only to the unvaccinated,” he said. A few vaccinated people do experience so-called breakthrough infections, but they tend to experience only mild COVID-19 illness, or no illness at all.

Encouragingly, Zients said the five states that have experienced the most significant rise in infections — Arkansas, Louisiana, Florida, Nevada and Missouri — all also saw vaccination rates beat the national average for a second week in a row. But because immunity takes two weeks to develop, and the Delta variant spreads so rapidly, the benefits of the increased uptake of vaccinations may not be evident right away.

Singling out the three states where infections are now spiking could have the effect of putting pressure on elected officials there to do more to encourage vaccinations.

Florida’s governor, Ron DeSantis, is a Donald Trump loyalist who is widely expected to seek the presidency in 2024. His handling of the pandemic is coming under new scrutiny with the recent rise in cases.

Gov. Greg Abbott of Texas, also a GOP presidential aspirant, has recently said he will not impose new mask mandates. Both he and DeSantis have also signed measures striking down requirements that people produce proof of vaccination.

As the pandemic has surged back in parts of the country, other Republicans have deviated from that approach. The governor of Arkansas, Asa Hutchinson — a Republican who, like DeSantis and Abbott, is rumored to have presidential ambitions of his own — has recently pushed for more vaccinations in his state.

Rep. Steve Scalise, a member of Republican leadership in the House of Representatives and a close Trump ally, rolled up his sleeve last Sunday and was vaccinated. Scalise represents a district in Louisiana, another state with a low rate of vaccination that is experiencing a surge in new cases.

There were 46,318 new cases of the coronavirus reported nationwide on Tuesday, Centers for Disease Control and Prevention Director Rochelle Walensky said at Thursday’s briefing. That is a marked increase from the lows of late May and early June. Hospitalizations and deaths are also rising, after plummeting earlier this summer.

“If you are not vaccinated,” Walensky said, “please take the Delta variant seriously.”

Trinity Health mandates COVID-19 vaccination for all 117,000 employees, business partners

https://www.fiercehealthcare.com/hospitals/trinity-health-mandates-covid-19-vaccination-for-all-117-000-employees-business-partners

Trinity Health is the latest—and now the largest—U.S. provider organization to roll out a COVID-19 vaccination requirement for all of its employees.

Announced Thursday and effective immediately, the nonprofit, Catholic healthcare system said the policy will extend across its entire workforce of more than 117,000 employees, including clinical staff, remote employees, contractors and “those conducting business in its healthcare facilities.”

Trinity said it will approve exemptions for religious or health reasons that are formally requested and documented. Others who don’t meet the criteria for exemption and fail to provide proof of vaccination “will face termination of employment,” according to the announcement.

Trinity said an estimated 75% of its employees have already received at least one dose of a COVID-19 vaccine, and it hopes the new policy will bring that number closer to 100%.

“Safety is one of our core values. We feel it is important that we take every step available to us to stop the spread and protect those around us—especially the most vulnerable in our communities who cannot be vaccinated including young children and the more than 10 million people who are immunocompromised,” Trinity Health President and CEO Mike Slubowski said in a statement.

“Over the last year, Trinity Health has counted our own colleagues and patients in the too-high coronavirus death toll. Now that we have a proven way to prevent COVID-19 deaths, we are not hesitating to do our part,” he said.

Livonia, Michigan-based Trinity operates 91 hospitals and 113 continuing care locations serving more than 30 million people across 22 states. The system reports $19.4 billion in annual operating revenues and is on track to top that number having recently reported $15.1 billion in operating revenues for the nine-month period between July 2020 and March 2021.  

Trinity said that most of its locations will be requiring employees to submit their proof of vaccination by Sept. 21. Should it be determined that COVID-19 vaccine boosters will be necessary down the line, the hospital said that it would similarly require employees to submit proof of their receipt “as needed.”

“The science has shown us that the COVID-19 vaccine is the single most effective tool in slowing, and even stopping, the spread of the virus,” Dan Roth, M.D., Trinity Health executive vice president and chief clinical officer, said in a statement. “As a Catholic Health Ministry—even if we work remotely or do not regularly encounter patients—we view ourselves as caregivers, and it’s important that we do everything we can to end the pandemic and save lives.”

Trinity is among the growing number of provider organizations taking a hard stance on employee COVID-19 vaccination. Among the larger of these to announce mandatory policies over the last few months are St. Louis-based MercyDetroit-based Henry Ford Health SystemSt. Louis-based SSM Health and the member hospitals of the Connecticut Hospital Association (PDF).

But perhaps the best known of the bunch has been Houston Methodist, which drew a line in the sand on June 8 and has since cut loose 153 employees who did not comply with the vaccine mandate.

That policy led to protests from the dissenting employees as well as a lawsuit that argued the system was “forcing its employees to be human ‘guinea pigs’ as a condition for continued employment.” The case was dismissed by a U.S. district judge and quickly appealed by the employees.

Other organizations such as Mass General Brigham have signaled support for a mandatory COVID-19 vaccination policy but said that they would not enforce the requirement until a COVID-19 vaccine receives formal approval from the FDA.

Earlier this year, the U.S. Equal Employment Opportunity Commission paved the way for employer-mandated COVID-19 vaccine policies with guidance permitting the requirements “so long as employers comply with the reasonable accommodation provisions of the [Americans with Disabilities Act] and Title VII of the Civil Rights Act of 1964 and other [Equal Employment Opportunity] considerations.”

Pandemic of the Unvaccinated

COVID-19 vaccine

COVID-19 cases are up by nearly 70% over the past seven days due to huge spikes of cases in low vaccinated areas, Biden administration officials said Friday.

“This is becoming a pandemic of the unvaccinated,” said Rochelle Walensky, M.D., director of the Centers for Disease Control and Prevention, during a briefing Friday. “We are seeing outbreaks of cases in parts of the country that have low vaccination coverage because unvaccinated people are at risk. Communities that are fully vaccinated are generally faring well.”

The seven-day average of cases was 26,300 per day, an increase of nearly 70% from the last seven-day average, Walensky said.

Hospitalizations are also up to 2,790 per day, an increase of 36% from the previous seven-day period.

Deaths, a metric that has declined since prior surges earlier in the year, have also started to increase. The seven-day average increased by 26% to 211 per day, Walensky said.

“Our biggest concern is we are going to see preventable cases, hospitalizations and, sadly, deaths among the unvaccinated,” she said.

A major driver of the increases has been the highly transmissible Delta variant of COVID-19, but Walensky said that 97% of the patients hospitalized right now with the virus are unvaccinated.

The Biden administration is ramping up efforts to increase vaccinations in areas that have stubbornly low rates. The administration is sending more than 100 people to states to help enhance vaccine access and boost outreach efforts, said Jeff Zients, the White House coronavirus response coordinator, during the briefing.

States with the highest cases are starting to see their vaccination rates go up, Zients said.

“In the past week, the five states with the highest case rates had a higher rate of people getting newly vaccinated compared to the national average,” he added.

He added that so far the CDC and the Food and Drug Administration have not recommended a booster shot for the fully vaccinated.

Infectious disease expert Anthony Fauci, MD, said Friday that the federal government is looking into evidence accumulated on a daily basis on the need for a booster.

“At this particular time right now, we don’t recommend that there be boosters for people,” Fauci said.

Cartoon – Some things never change, they just recycle. Stupidity has no season nor expiration date.

May be a cartoon of 1 person, standing and text

US’s largest registered nurses union calls on CDC to bring back universal mask guidelines

Nurses' Union Condemns C.D.C.'s New Mask Advice - The New York Times

The largest union for registered nurses in the U.S. called on the Centers for Disease Control and Prevention (CDC) to bring back recommendations for universal masking in public regardless of people’s vaccination status. 

The National Nurses Union (NNU) in a Monday letter to CDC Director Rochelle Walensky requested that the agency reinstitute guidelines for all people to wear masks in public and in close proximity to those outside their household.

NNU Executive Director Bonnie Castillo pointed to a 16 percent uptick in U.S. COVID-19 cases from last week, according to CDC data, as well as rises in case counts in more than 40 states and hospitalizations in more than 25 states as reasons to return to previous, stricter guidelines.

“NNU strongly urges the CDC to reinstate universal masking, irrespective of vaccination status, to help reduce the spread of the virus, especially from infected individuals who do not have any symptoms,” Castillo wrote in the letter. “Our suggestions are based on science and the precautionary principle and are made in order to protect nurses, other essential workers, patients, and the public from Covid-19.”

The union also cited the World Health Organization’s (WHO) call for vaccinated people to continue wearing masks in public amid the spread of the highly transmissible delta variant. Several U.S. officials and experts have said the WHO’s guidance reflects the state of the pandemic worldwide, which overall has seen lower vaccination rates than the U.S.

Castillo acknowledged that COVID-19 vaccines are effective at preventing severe illness and death but noted “no vaccine is 100 percent effective, and the emergence and spread of variants of concern may reduce vaccine effectiveness.”

The NNU in its letter also appeals for the CDC to update its guidance to “fully recognize aerosol transmission,” mandate tracking and reporting of cases among health care and essential workers, and keep records of cases, including mild and asymptomatic infections, among fully vaccinated people to measure the shots’ effectiveness. 

The CDC did not immediately return a request for comment on the letter, but officials have consistently defended the updated mask guidance, saying fully vaccinated individuals are protected against the virus.

The NNU vocally opposed the CDC’s current mask guidance updated in May to permit fully vaccinated individuals to go maskless in virtually all settings. The union has argued that the change in recommendations endangered patients, front-line workers and nurses as the pandemic continues.

In the Monday letter, the union wrote that the CDC’s relaxation of mask guidance “failed to account for” the possibility of fully vaccinated people contracting and spreading the virus. It also said the agency’s guidelines do not protect people, including children, who cannot get the vaccine.

The NNU sent the letter days after the CDC urged schools to reopen for full in-person learning in the fall, saying that fully vaccinated teachers and students do not need to wear masks.

It also comes after Los Angeles County and St. Louis County recommended their residents to wear masks in public indoors.

New COVID-19 cases up 94 percent in two weeks: NYT

Overnight Health Care: New COVID-19 cases up 94 percent in two weeks |  Nurses union calls on CDC to bring back universal mask guidelines | Texas  sued over law that lets citizens

The average number of new daily COVID-19 cases has increased 94 percent over the past two weeks, according to data from The New York Times, as worries over outbreaks climb nationwide.

The U.S. recorded a seven-day average of more than 23,000 daily cases on Monday, almost doubling from the average two weeks ago, as less than half of the total population is fully vaccinated.

Monday’s count of 32,105 newly confirmed cases pushed the seven-day average up from its Sunday level of more than 19,000 new cases — a 60 percent increase from two weeks prior.

All but four states — West Virginia, Maine, South Dakota and Iowa — have seen increased daily averages in the past 14 days, and the average in 16 states at least doubled in that period.

This comes as the highly transmissible delta variant was declared the dominant strain in the U.S. last week.

At the same time, vaccinations have stalled, with the daily rate reaching its lowest point during President Biden’s tenure on Sunday at slightly more than 506,000. Monday saw a small uptick in the average rate to more than 527,000 per day, according to Our World in Data.

The rise in case counts comes as the Centers for Disease Control and Prevention says just 48 percent of the total population is fully vaccinated. Officials have said fully vaccinated people are protected from the virus, while unvaccinated people are at much higher risk for serious illness and death. 

This leaves a majority of Americans still vulnerable to the virus, particularly children under 12 years old, who are not authorized to get the vaccine. More than 56 percent of the eligible population aged 12 and older is fully vaccinated. 

The Biden administration has strived to boost vaccination numbers over the past few months and signaled a new strategy focused on grassroots campaigning to promote the vaccine last week. The country fell short of the president’s goal to get 70 percent of adults at least one dose by the Fourth of July.

Increases in COVID-19 cases have previously signaled during the pandemic an upcoming rise in hospitalizations and deaths. The Times data shows that average deaths are still decreasing, but average daily hospitalizations are climbing, with a 16 percent increase from two weeks ago.

Still, case counts are much lower than the devastating peak that hit the U.S. in January, and experts say the country will not reach that level of infection again, as vulnerable populations have gotten vaccinated. Seventy-nine percent of those aged 65 and older are considered fully vaccinated.

Delta spreads 225% faster than original virus — this may be why

Why The Delta Variant Is So Contagious: A New Study Sheds Light : Goats and  Soda : NPR

Mounting evidence suggests the delta variant is the most contagious strain in the world, spreading about 225 percent faster than the original version of the virus. A small study published online July 7 may help explain why, NPR reported.

The delta variant, first identified in India, grows faster in people’s respiratory tracts and to much higher levels, according to researchers at the Guangdong Provincial Center for Disease Control and Prevention in China.

They analyzed virus levels in 62 people infected during China’s first delta variant outbreak between May 21 and June 18. They compared their findings to virus levels in 63 patients infected in 2020 by an earlier version of the virus.

On average, viral load was about 1,000 times higher for people infected with delta, compared to those infected with the earlier strain, researchers found. It also took about four days on average for delta to reach detectable levels in study participants, compared to six days for the other strain. This finding suggests people with delta likely become infectious sooner and are spreading the virus earlier in the course of their infection, researchers said. 

To view the full study, click here.

More than 3,997,000 people have died from the coronavirus worldwide

Coronavirus Outbreak: Live Updates and News for Apr. 10, 2020 - Bloomberg

The coronavirus has killed nearly 4 million people since it first emerged in Wuhan, China, in 2019, according to data compiled by Johns Hopkins University.

New confirmed cases of covid-19, the disease caused by the virus, remain high, and the world struggles with unequal vaccine rollouts and new threats posed by fast-spreading variants.

“The pandemic is a long way far from over,” World Health Organization Director General Tedros Adhanom Ghebreyesus warned in May. “It will not be over anywhere until it’s over everywhere.”

Some countries have already found that the spread of the virus is outpacing their vaccination plans, especially in the face of proliferating variants. In India, new daily cases topped 400,000 in early May — a global record but probably an undercount.

China now leads the world in the number of vaccine doses given out, though some other nations have vaccinated far more of their population. The vaccines were developed and rolled out at record speed, and studies show most have impressive efficacy.

More than a billion doses have been administered around the world, far more than the number of confirmed cases of the coronavirus since the start of the pandemic — though a large number of cases were likely never recorded, experts caution.

But the vaccine rollout has been persistently unequal, with problems with global supply and pockets of opposition in many nations. Covax, a program to distribute vaccines fairly backed by the World Health Organization, only belatedly began distributing doses to low-income nations.

“I can’t say it’s surprising,” said Thomas J. Bollyky, a senior fellow at the Council on Foreign Relations. “In every previous pandemic where we have our global health crisis, where there has been limited supplies of medical intervention, wealthy nations have hoarded.”

The United States, which continues to have the highest cumulative number of confirmed cases and deaths globally. More than 590,000 deaths from covid-19 have been recorded across the country.

Though cases dipped after January, a new wave began only a few months later, prompting President Biden to urge governors to reinstate mask mandates and other virus-related restrictions. “This is deadly serious,” Biden said in March.

Behind the United States, India, Brazil, France and Turkey have the largest number of cases.

India’s record-setting surge this spring meant the country accounted for about 1 in 3 of all new confirmed cases. The spike, which has been blamed on complacency and the lifting of restrictions, along with the spread of variants, has seen the country’s health-care system overwhelmed amid widespread oxygen shortages.

Even after the spike in new cases subsided in mid-May, India still set records for the number of new daily deaths with more than 4,500 deaths from covid-19 reported in a single 24-hour period.

In India, as in Britain and Brazil before it, some of the spread of the virus has been blamed on fast-spreading variants rampant in the country.

The variant widespread in India, known by the name B.1.617.2, has spread far beyond its borders. In May, British officials warned that it would likely become dominant across Britain unless more was done to control its spread.

Sharon Peacock, director of the U.K.’s Covid-19 Genomics Consortium, told reporters that a fast-spreading variant such as B.1.617.2 had “a biological passport for international travel and global spread” — making its spread difficult, if not impossible, to fully contain.

Some countries have seen success at controlling the virus.

In New Zealand, which closed its borders and ordered people to stay home as a first wave hit in the spring of 2020, confirmed infections went down to zero for a time. Taiwan and Singapore have kept their outbreaks far smaller than those in other parts of the world, which some experts attribute to their early responses and sophisticated tracking and tracing.

China, the early epicenter of the crisis, has seen much of daily life return to normal. In the early months of the outbreak, it reported more cases than any other country. Its tally of new infections peaked in mid-February of 2020 and approached zero by mid-March, although questions surround the accuracy of its data.

Wuhan, the virus’s initial epicenter, ground to a standstill in January 2020 as the coronavirus spiraled out of control. But after months without a confirmed case of domestic transmission, about 1.4 million children in the city returned to classrooms at the start of September, and crowded events have resumed.

Countries that have successfully rolled out vaccines are also seeing important gains. Britain, one of the hardest-hit countries in terms of cases and deaths, has excelled in the distribution of coronavirus vaccines. It was the first country to roll out a fully tested vaccine to the general public in December, when it began distributing the vaccine developed by Pfizer and Moderna.

Data released by Public Health England in March suggested that vaccinations had saved over 6,000 lives among people over 70, if not more.

Israel, which has seen several waves of the virus, had raced ahead of other nations and given the first doses of Pfizer’s two-dose vaccine to more than a third of its population by the end of January. Data from Israel indicated that the Pfizer vaccine was around 94 percent effective at stopping asymptomatic infection.

Early signs from the country suggest that the large scale of vaccinations has had an impact on the spread of the virus.

But global health experts have cautioned that despite the success of vaccines, the virus remains a potent threat and returning to normal life too early could ultimately extend the length of the pandemic and lead to fresh new cases.

Though wealthy countries have taken some steps to ensure vaccines are shared around the world, such as by donating through Covax or supporting waivers on intellectual property such as the Biden administration has done, experts say they are worried by the ongoing level of spread.

“Sadly, unless we act now, we face a situation in which rich countries vaccinate the majority of their people and open their economies, while the virus continues to cause deep suffering by circling and mutating in the poorest countries,” United Nations Secretary General António Guterres said at a meeting of the World Health Assembly on May 24.

Why COVID-19’s Death Toll Will Climb Long After the Pandemic Is Over

https://view.newsletters.time.com/?qs=464492495579fee5d3c608cdd155b00d077c2d6165f6b6b14e9d553d560ec5b27857696f63855c68b13f88434959642bcdcc8dac9257442b779a5412129b1605d1ce7f1efb7a2875a84f1625c7b54a9c

Covid-19 Cases, Death Rates Are Declining Six Months Into Pandemic - WSJ

If you were anything like my family over the July 4 holiday, there were bowls of potato salad, casseroles of baked beans and platters of hotdogs, hamburgers and chicken all pulled from the grill and served family-style. For a lot of us, it was the first time seeing a wide net of our family in more than a year and we took advantage of ditching the masks, probably wrongly assuming our circles were vaccinated at higher levels than they were and maybe even handing kids lighters for sparklers they shouldn’t be wielding.

Our increasing return to normal makes it easy to believe the pandemic is almost over. Sure, we still had to wear masks on the flights, trains and buses. Grocery markets and big-box stores in some communities still asked that we wear them, too. The staff at Nationals Park here in D.C. and Progressive Field in Cleveland wore theirs as I visited both for MLB games. But the worst of the pandemic feels behind us here in the U.S., as vaccinations are climbing, deaths and new cases are sinking and headlines seem to be shifting to more run-of-the-mill topics like tropical storms.

A new and unusually long report from Congress’ independent think-tank is a stark warning to the U.S. government that even COVID-19 seems over, it actually isn’t, particularly when it comes to Americans’ well being. Released on Friday, the wonks at the Congressional Research Service (CRS) urged officials going into the long holiday weekend to remember amid the celebrations that we still don’t know the final toll of the pandemic, especially when it comes to long-term consequences for behavioral and mental health. Its notes about substance-abuse challenges are particularly worrying, given that lawmakers cannot ignore the already troubling fight against opioids.

Anecdotally, we know the last 18-or-so-months have taken a toll on our friends, colleagues and neighbors. Those of us lucky enough to have been allowed to work from home adapted in fits and starts. My colleagues with children or dependents were stretched to the points of breaking, but most have made it to the other side. Those in complete isolation actually came to look forward to Zoom meetings and telemedicine appointments. And tech-slow people like my grandmother probably wouldn’t have made it through without the good folks at the local public library loading her loans into the trunk through a touch-free lending system.

But you cannot make public policy on anecdotes alone, which is why the CRS report offers a roadmap for lawmakers. Noting upfront that the data is still coming in and comparisons so quickly after—and during, really—a so-recent period are imprecise, there are still warning signs that America has not healed the way we’d like to believe. The share of Americans suffering simultaneously from depression and anxiety grew five-fold, year-over-year, in just the first three-months of the pandemic-mandated lockdown, from April to June 2020, when the death toll still hovered around 120,000. Fatal overdoses grew 11% between March and May last year, and non-fatal overdoses rose 19% during that same short window. In the three months that followed, there were almost equal levels of depression or anxiety among households that had lost jobs and those that had not. No one was spared, but the hit came hardest for less-educated, essential and lower-paid workers.

Why is this Washington’s problem? An estimated 10% to 20% of Americans who needed mental-health services during the pandemic received no treatment. Another survey cited in the report estimates that up to a quarter of adults with depression or anxiety went untreated. As many as 27,000 Americans who survived COVID-19 may end up dead over the next decade as a result of behavioral health-related challenges, and that number may ultimately reach more than 154,000. At the moment, federal law does not require mental health services to be treated on par with treatments for physical health. Not Medicare. Not CHIP. Not even fancy private insurance plans.

There were, believe it or not, a few upsides to the COVID-19 pandemic that the CRS report notes. Under emergency powers granted in one of the relief bills, the Department of Health and Human Services waived the in-person requirement for some treatments, including mental health and substance abuse counseling. For now doctors can be paid for that phone call consultation rather than requiring patients to make a brick-and-mortar visit to qualify for Medicare and Medicaid money. The Department of Veterans Affairs allowed taxpayer dollars to help with mental health services via tech platforms, too. In all, billions of dollars were included in the raft of COVID-19 stimulus plans to shore up mental health and substance abuse programs.

But those were the bright spots. Not all of Washington’s urgent changes were for the better. The Drug Enforcement Agency allowed doctors to prescribe medicine without a physical appointment, Health and Human Services’ civil rights unit turned a lot of blind eyes to patients’ privacy rights as public health data seemed ubiquitous, and the Small Business Administration shoved piles of cash out the door to health clinics and larger rafts of money to hospitals with minimal upfront scrutiny.

So as Washington turns slowly toward the post-pandemic policies of this country, lawmakers have plenty to consider, especially if it wants to return America to its Before Times footing. As much as it may feel like the United States is rounding a corner—and it’s tough not to when you see big crowds gathering maskless for fireworks and paradesthe reality is this: there’s still a lot of trauma under the surface that is all too easy to miss unless D.C. is looking for it.

Benjamin Franklin’s fight against a deadly virus: Colonial America was divided over smallpox inoculation, but he championed science to skeptics

Benjamin Franklin's fight against a deadly virus: Colonial America was divided  over smallpox inoculation, but he championed science to skeptics

Exactly 300 years ago, in 1721, Benjamin Franklin and his fellow American colonists faced a deadly smallpox outbreak. Their varying responses constitute an eerily prescient object lesson for today’s world, similarly devastated by a virus and divided over vaccination three centuries later.

As a microbiologist and a Franklin scholar, we see some parallels between then and now that could help governments, journalists and the rest of us cope with the coronavirus pandemic and future threats.

Smallpox strikes Boston

Smallpox was nothing new in 1721. Known to have affected people for at least 3,000 years, it ran rampant in Boston, eventually striking more than half the city’s population. The virus killed about 1 in 13 residents – but the death toll was probably more, since the lack of sophisticated epidemiology made it impossible to identify the cause of all deaths.

What was new, at least to Boston, was a simple procedure that could protect people from the disease. It was known as “variolation” or “inoculation,” and involved deliberately exposing someone to the smallpox “matter” from a victim’s scabs or pus, injecting the material into the skin using a needle. This approach typically caused a mild disease and induced a state of “immunity” against smallpox.

Even today, the exact mechanism is poorly understood and not much research on variolation has been done. Inoculation through the skin seems to activate an immune response that leads to milder symptoms and less transmission, possibly because of the route of infection and the lower dose. Since it relies on activating the immune response with live smallpox variola virus, inoculation is different from the modern vaccination that eradicated smallpox using the much less harmful but related vaccinia virus.

The inoculation treatment, which originated in Asia and Africa, came to be known in Boston thanks to a man named Onesimus. By 1721, Onesimus was enslaved, owned by the most influential man in all of Boston, the Rev. Cotton Mather.

etching of an 18th century man in white wig
Cotton Mather heard about variolation from an enslaved West African man in his household named Onesimus. Bettman via Getty Images

Known primarily as a Congregational minister, Mather was also a scientist with a special interest in biology. He paid attention when Onesimus told him “he had undergone an operation, which had given him something of the smallpox and would forever preserve him from it; adding that it was often used” in West Africa, where he was from.

Inspired by this information from Onesimus, Mather teamed up with a Boston physician, Zabdiel Boylston, to conduct a scientific study of inoculation’s effectiveness worthy of 21st-century praise. They found that of the approximately 300 people Boylston had inoculated, 2% had died, compared with almost 15% of those who contracted smallpox from nature.

The findings seemed clear: Inoculation could help in the fight against smallpox. Science won out in this clergyman’s mind. But others were not convinced.

Stirring up controversy

A local newspaper editor named James Franklin had his own affliction – namely an insatiable hunger for controversy. Franklin, who was no fan of Mather, set about attacking inoculation in his newspaper, The New-England Courant.

frontpage of a 1721 newspaper
From its first edition, The New-England Courant covered inoculation. Wikimedia Commons

One article from August 1721 tried to guilt readers into resisting inoculation. If someone gets inoculated and then spreads the disease to someone else, who in turn dies of it, the article asked, “at whose hands shall their Blood be required?” The same article went on to say that “Epidemeal Distempers” such as smallpox come “as Judgments from an angry and displeased God.”

In contrast to Mather and Boylston’s research, the Courant’s articles were designed not to discover, but to sow doubt and distrust. The argument that inoculation might help to spread the disease posits something that was theoretically possible – at least if simple precautions were not taken – but it seems beside the point. If inoculation worked, wouldn’t it be worth this small risk, especially since widespread inoculations would dramatically decrease the likelihood that one person would infect another?

Franklin, the Courant’s editor, had a kid brother apprenticed to him at the time – a teenager by the name of Benjamin.

Historians don’t know which side the younger Franklin took in 1721 – or whether he took a side at all – but his subsequent approach to inoculation years later has lessons for the world’s current encounter with a deadly virus and a divided response to a vaccine.

Independent thought

You might expect that James’ little brother would have been inclined to oppose inoculation as well. After all, thinking like family members and others you identify with is a common human tendency.

That he was capable of overcoming this inclination shows Benjamin Franklin’s capacity for independent thought, an asset that would serve him well throughout his life as a writer, scientist and statesman. While sticking with social expectations confers certain advantages in certain settings, being able to shake off these norms when they are dangerous is also valuable. We believe the most successful people are the ones who, like Franklin, have the intellectual flexibility to choose between adherence and independence.

Truth, not victory

etching of Franklin standing at a table in a lab
Franklin matured into a well-known scientist and statesman, with many successes aided by his open mind. Universal History Archive/Universal Images Group via Getty Images

What happened next shows that Franklin, unlike his brother – and plenty of pundits and politicians in the 21st century – was more interested in discovering the truth than in proving he was right.

Perhaps the inoculation controversy of 1721 had helped him to understand an unfortunate phenomenon that continues to plague the U.S. in 2021: When people take sides, progress suffersTribes, whether long-standing or newly formed around an issue, can devote their energies to demonizing the other side and rallying their own. Instead of attacking the problem, they attack each other.

Franklin, in fact, became convinced that inoculation was a sound approach to preventing smallpox. Years later he intended to have his son Francis inoculated after recovering from a case of diarrhea. But before inoculation took place, the 4-year-old boy contracted smallpox and died in 1736. Citing a rumor that Francis had died because of inoculation and noting that such a rumor might deter parents from exposing their children to this procedure, Franklin made a point of setting the record straight, explaining that the child had “receiv’d the Distemper in the common Way of Infection.”

Writing his autobiography in 1771, Franklin reflected on the tragedy and used it to advocate for inoculation. He explained that he “regretted bitterly and still regret” not inoculating the boy, adding, “This I mention for the sake of parents who omit that operation, on the supposition that they should never forgive themselves if a child died under it; my example showing that the regret may be the same either way, and that, therefore, the safer should be chosen.”

A scientific perspective

A final lesson from 1721 has to do with the importance of a truly scientific perspective, one that embraces science, facts and objectivity.

19th-century photo of a smallpox patient
Smallpox was characterized by fever and aches and pustules all over the body. Before eradication, the virus killed about 30% of those it infected, according to the U.S. Centers for Disease Control and Prevention. Sepia Times/Universal Images Group via Getty Images

Inoculation was a relatively new procedure for Bostonians in 1721, and this lifesaving method was not without deadly risks. To address this paradox, several physicians meticulously collected data and compared the number of those who died because of natural smallpox with deaths after smallpox inoculation. Boylston essentially carried out what today’s researchers would call a clinical study on the efficacy of inoculation. Knowing he needed to demonstrate the usefulness of inoculation in a diverse population, he reported in a short book how he inoculated nearly 300 individuals and carefully noted their symptoms and conditions over days and weeks.

The recent emergency-use authorization of mRNA-based and viral-vector vaccines for COVID-19 has produced a vast array of hoaxes, false claims and conspiracy theories, especially in various social media. Like 18th-century inoculations, these vaccines represent new scientific approaches to vaccination, but ones that are based on decades of scientific research and clinical studies.

We suspect that if he were alive today, Benjamin Franklin would want his example to guide modern scientists, politicians, journalists and everyone else making personal health decisions. Like Mather and Boylston, Franklin was a scientist with a respect for evidence and ultimately for truth.

When it comes to a deadly virus and a divided response to a preventive treatment, Franklin was clear what he would do. It doesn’t take a visionary like Franklin to accept the evidence of medical science today.