20 Years Since 9/11: Why the U.S. Should Vaccinate the World

When will a coronavirus vaccine be ready? | Coronavirus | The Guardian

Earlier this week, David States and Bill Gardner argued that the U.S. should lead the developed nations in a program to immunize the entire human population. The Washington Post reported that President Biden is expected to call for a global vaccine summit conference.

David and Bill wrote that we should do this because it would save many lives. Perhaps this is all that needs to be said. We also argued that the U.S. stood to benefit if we could substantially reduce the number of global covid cases. This would reduce U.S. coronavirus exposure and slow the rate of evolution of new coronavirus variants. The economic cost to the U.S. of a more severe pandemic could easily be greater than the cost of making and distributing the vaccine. If so, the global vaccination effort would pay for itself.

There is, however, another moral argument for global vaccination, this one tied to 9/11 and the ensuing global war on terror. Since 9/11, the U.S. has engaged in 20 years of warfare in countries across the world.

The consequences of that war have been catastrophic. According to the Watson Institute at Brown University,

At least 801,000 people have been killed by direct war violence in Iraq, Afghanistan, Syria, Yemen, and Pakistan… The U.S. post-9/11 wars have forcibly displaced at least 38 million people in and from Afghanistan, Iraq, Pakistan, Yemen, Somalia, the Philippines, Libya, and Syria. This number exceeds the total displaced by every war since 1900, except World War II.

Of course, much of that violence was committed by al-Qaeda, ISIS, or the Syrian government. Some of the civil wars that have followed 9/11 might have happened anyway. Nevertheless, Americans failed to limit their 9/11 response to the specific individuals who carried out the attacks. This was a principal cause of the ensuing death and displacements.

So now, the U.S. is known not only for baseball and democracy but also for drone strikes and torture. If we led an effort to vaccinate the world, it would be one of the largest humanitarian actions in history. We should do this to set an example and balance the effects of the global war on terror.

CommonSpirit Health mandates COVID-19 vaccination for employees in 21 states

About Us | Serving the Common Good | CommonSpirit Health

CommonSpirit Health is requiring full COVID-19 vaccination for its 150,000 employees, the Chicago-based health system said Aug. 12. 

The requirement applies to employees at CommonSpirit’s 140 hospitals and more than 1,000 care sites and facilities in 21 states. It includes physicians, advanced practice providers, volunteers and others caring for patients at health system facilities. 

“As healthcare providers, we have a responsibility to help end this pandemic and protect our patients, our colleagues and those in our communities —  including the most vulnerable among us,” Lloyd H. Dean, CEO of CommonSpirit, said in a news release. “An abundance of evidence shows that the vaccines are safe and highly effective. Throughout the pandemic we have made data-driven decisions that will help us best fulfill our healing mission, and requiring vaccination is critical to maintaining a safe care environment.”

The compliance deadline for the vaccination requirement is Nov. 1, although the implementation date will vary by region in accordance with local and state regulations. Employees who are not in compliance and do not obtain a medical or religious exemption risk losing their jobs.

How the delta variant took over the US

https://thehill.com/policy/healthcare/567843-how-the-delta-variant-took-over-the-us

3 Things You Need to Know About the Delta Variant - COVID-19, Featured,  Health Topics - Hackensack Meridian Health

The delta variant has overtaken the U.S. in a matter of weeks as it spreads around the world in what President Biden’s chief medical adviser Anthony Fauci called a “global outbreak” of the strain.

The highly contagious variant of COVID-19 is considered at least two times more contagious than the previously dominant alpha strain, and experts say the increased transmissibility has likely fueled the surge in COVID-19 cases, hospitalizations and deaths nationwide.

But much is still unknown about delta as scientists scramble to better understand the strain.

Here’s what we know about the delta strain and how it blunted earlier momentum in the fight against the coronavirus.


Delta is more transmissible than previous COVID-19 strains

Delta’s contagiousness is considered key to its domination, having spread to at least 117 countries after first being detected in India. Like other viruses, COVID-19 is evolving, particularly through unplanned mutations.

A study from the United Kingdom in May suggested the delta strain could be 60 percent more transmissible than the alpha variant, which was already more contagious than the original strain.

But experts are split on that figure, with some saying delta could be more transmissible and others saying it could be less.

“You don’t necessarily want to attribute that all to the virus. You know, a lot of it may reflect the people as well,” said David Dowdy, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health.

Researchers aren’t certain about what makes the delta variant more transmissible, but there are some clues.

Michael Farzan, head of the Department of Immunology and Microbiology at Scripps Research, said one of the variant’s advantages is that it can more strongly attach to a certain receptor when spreading in the body.

“This is one of the reasons why the virus … in a person gets made at a higher level, meaning that there’s a lot more being spit out or coughed out, meaning that it’s more likely to hit the next person,” he said.

The Centers for Disease Control and Prevention (CDC) has its own figures illustrating how the strain became so prevalent this summer. The agency’s latest projection is that 97.4 percent of all coronavirus cases come from all the different lineages of the delta variant, as of the week ending last weekend.

That marks an astronomical increase from the 1.6 percent estimated at the beginning of May and the 14.1 percent from the beginning of June.

Most people infected with COVID-19 at this point won’t know for sure whether they contracted the delta strain since available testing doesn’t make the distinction between strains — it only shows whether the virus itself is present.


It has a higher magnitude of viral loads

Health experts are examining the delta variant’s viral load, the measure of how much virus a person carries and can potentially transmit, compared to previous COVID-19 strains.

A study from China suggested that the strain’s viral load could be more than 1,000 times higher than the original strain, which Fauci on Thursday said “is a mechanistic reason why you have such a tremendous increase in transmissibility.”

Basically a higher viral load can make it more likely that an infected person can “shed” the virus, allowing someone nearby to contract it.

“If a little droplet that you sent out, it has more particles and that means it’s more likely to infect the next person over and it’s more likely to infect the next person over more times,” Farzan said.

Dowdy of Johns Hopkins cautioned that other variables, including people’s behavior, may be influencing how scientists understand delta’s viral load. With more people relaxing their COVID-19 precautions and interacting with others indoors, those same people could contract more of the virus than they might otherwise.

A study of a Massachusetts outbreak indicated that delta led to fully vaccinated people having a similar viral load compared to the unvaccinated, sparking the CDC to update its mask guidance late last month.

The outbreak on Cape Cod, where nearly three-quarters of confirmed cases were among fully vaccinated people, suggested that vaccinated people could potentially transmit and spread the delta variant. But researchers said at the time that microbiological studies would be needed to confirm whether vaccinated individuals can transmit the strain.


Vaccines are still effective against delta

Studies have found that at least five vaccines, including all three used in the U.S., are effective against the delta variant in lab and real-world settings, Fauci said on Thursday.

It was previously unclear whether the Johnson & Johnson vaccine, which requires only one dose instead of two, was equally effective. But a study released last week found the immune response lasted at least eight months, resulting in the first real-world data for the vaccine, Fauci said.

Recent studies have indicated that vaccines may see a very slight dip in effectiveness against symptomatic versions of the coronavirus caused by the delta variant. The COVID-19 vaccines, like any other, are also not perfect at preventing all delta infection and illness.

But scientists agree that studies have demonstrated that the vaccinated population is less likely to get infected and much less likely to be hospitalized or die from the delta variant than the unvaccinated.

“The only reason our case numbers are lower now than they were back in December is because half of our population has been fully vaccinated,” Dowdy said.


Still more to learn
 

Experts acknowledge there is much more to learn about the delta variant.

“A big thing is we still don’t know how much of what we’re seeing is due to the virus versus due to behavior,” Dowdy said. “That makes a big difference because things that are due to the virus, we can’t really change as a society.”

Although there’s a growing number of studies, not all scientists are certain that the variant itself necessarily causes more serious illness among the unvaccinated, leading to more hospitalizations and deaths. It’s also unclear whether the strain is sparking more severe illness among children as pediatric hospital admissions have picked up.

Additionally, scientists have more analysis to do on under-researched mutations that may give the virus more of an advantage, Farzan said.

Driven by the Delta Variant, the Fourth Wave of COVID-19 in the U.S. Could Be Worse Than the Third. In Some States, It Already Is

Why the delta variant is hitting kids hard in the U.S. and how we can  prevent that in Canada | CBC News

Just a month ago, even as signs of a fourth wave of COVID-19 infections in the U.S. were blossoming in the lower Midwest, the memory of a long, miserable winter kept us warm. Even places with burgeoning case rates were far below their catastrophic peaks over the holidays, when a combination of cold weather and defiant travelers contributed to a third wave in infections and deaths that drowned out the previous two spikes in April and July of 2020.

This is regrettably no longer the case. In four states—Hawaii, Louisiana, Mississippi and Florida—the current number of daily new COVID-19 infections, averaged across seven days, has surpassed that winter peak, even with a substantial percentage of the population having received a complete dosage of the COVID-19 vaccine (though not nearly as many as public officials would prefer).

Hawaii is something of an anomaly, as its winter peak was not nearly as high as in colder, more accessible regions. But several other states threaten to join this quartet in the near future. Oregon’s daily rate of new infections is at 36.5 per 100,000 residents, or 99% of the peak value on Dec. 3, 2020. Nationwide, the rate is 37.7, just under 50% of the winter peak of 76.5.

While plenty of states remain far below the winter peaks, as the Delta variant tears across the country, we can expect more and more states to experience a fourth wave that crests higher than the third, even as new outbreaks are inspiring more vaccine holdouts to hold out their biceps and breakthrough infections, while frightening and non-trivial, remain reasonably rare.

What is perhaps most sobering about this surge is that COVID-19-related deaths, which typically lag behind case surges by about two weeks, are starting to rise again. No state has yet surpassed the winter peak in deaths, but at 65%, Louisiana very well may. That figure is still 15% nationwide, well below the Jan. 13, 2021 peak of 1.04 fatalities per 100,000 people. It is currently at 0.16.

When it comes to the pandemic, no one wants to sound like Chicken Little. The sky might not be falling. But neither is the national case rate, or the number of people dying.

Story of Two Chest X-Rays

Dr. Jesse O’Shea, an infectious disease physician, posted this x-ray showing the difference between two of his patients; one with and one without the vaccination. Very telling and compelling visual, and we wanted to share.

To follow his page, please visit: https://www.instagram.com/jesseosheamd“A Story of Two Chest X-Rays. One patient with a vaccine and one patient without. Version 2—for the crowd that wants specifics without violating patient privacy (these are published cases).

The top picture is a 47-year-old man who received Pfizer vaccine (1) and developed COVID19 2 weeks after. He was overweight (BMI = 29), but without any known comorbidities. He had runny nose, mild body aches, mild cough. His chest X ray is relatively normal.

The bottom picture is a 50-year-old active female patient without obesity and not on medications. Her chest X-ray shows diffuse opacities, consolidations in both lungs with lung damage (all the fluffy white) and a pattern that looks like the worst feared complication of COVID19—acute respiratory distress syndrome (ARDS). She needed intubation, mechanical ventilation, and ECMO (extra-corporal membrane oxygenation) – the most life support we can offer.

The mRNA vaccines are effective at preventing severe disease and death— even with the Delta variant.

Our ICUs are starting to fill up with unvaccinated COVID19 patients again.

“To my fellow healthcare workers, keep your head up!”

Delta fears grip economy as cases jump across the country

https://thehill.com/policy/healthcare/563769-delta-fears-grip-economy-as-cases-jump-across-the-country?userid=12325

Covid-19: Delta Variant Reported In 85 Countries; Expected To Become  Dominant Lineage, Says Who

The delta variant of the coronavirus is sweeping through the United States, raising the average number of cases to 30,000-per-day, crowding hospitals in areas with large number of unvaccinated people and spurring questions about the nation’s recovery from the pandemic.

Stocks tanked on Monday, with the Dow Jones Industrial average dropping 725 points after being down more than 900 points at one time.

It was the worst one-day performance in the Dow since last October, and followed losses in markets around the world as investor fears about how the delta virus might slow both the health and economic recovery took hold.

Health officials have described the latest stage of the coronavirus as a pandemic of the unvaccinated while emphasizing that those who have had their shots are relatively safe.

Yet Los Angeles County on Saturday reinstated a mask mandate for indoor public settings, a sign that local communities may decide to reimpose restrictions as a safety measure.

An Olympic gymnast and an Olympic women’s basketball player both announced they had tested positive as they prepared for the Games, which is being held in a state of emergency in Tokyo where the rate of vaccinations is behind the United States.

Canada had also been well behind the U.S. in its vaccination rate but surpassed its southern neighbor on Monday, a sign of how much more slowly the vaccination rate now is in the United States. A big reason is that many people who are unvaccinated do not want to get the vaccine, something the Biden administration has increasingly blamed on social media and some conservative media outlets.

While the 30,000 cases per day on average is more than double the 13,000 average at the end of June, that rate is still well below highs from last fall and earlier this year.

Still, deaths are also ticking back up, at around 240 per day. 

Because vaccinated people are still overwhelmingly protected, especially from severe outcomes, case and death numbers are likely to stay well below the worst of last winter’s surges, before vaccines were widely available. 

But unvaccinated people are at increasing risk, especially given the rise of the highly transmissible delta variant, and the vaccination campaign is hitting a wall, leaving more than 30 percent of adults without any shots and exposed to the full dangers of the virus.

States with lower vaccination rates are seeing the worst outbreaks. Arkansas, Missouri, Florida and Louisiana are the four states with the highest per capita new cases per day, according to data from the Covid Act Now tracking site. The percentage of the population with at least one shot in those states is 44 percent, 47 percent, 56 percent, and 40 percent, respectively. 

In contrast, Vermont and Massachusetts, where the vaccination rate is over 70 percent, are faring much better. 

Vaccine resistance among some leading conservative commentators and lawmakers is raising fears that many of the remaining unvaccinated may never get the shots.

Sten Vermund, a professor at the Yale School of Public Health, said he is “not particularly worried” about COVID-19 for himself, because he is fully vaccinated.

“What worries me is my fellow Americans who for a variety of reasons choose not to get vaccinated; they continue to be in harm’s way,” Vermund said.

In the rare instances where vaccinated people do get COVID-19 cases, symptoms are likely to be much milder.

CDC Director Rochelle Walensky said Friday that 97 percent of people entering the hospital with COVID-19 are unvaccinated, part of why she said it “is becoming a pandemic of the unvaccinated.”

Conservative resistance to vaccination is stiffening. A Washington Post-ABC News poll released earlier this month found that 47 percent of Republicans said they were unlikely to get vaccinated, compared to just six percent of Democrats. Among Republicans, 38 percent said they definitely would not get the shots.

Former President Trump has previously encouraged people to get vaccinated, though he has not made a forceful push, for example by recording a public service announcement or getting his own shots in public.

On Sunday, though, Trump appeared to justify people not taking the vaccine, blaming President Biden.

“He’s way behind schedule, and people are refusing to take the Vaccine because they don’t trust his Administration, they don’t trust the Election results, and they certainly don’t trust the Fake News, which is refusing to tell the Truth,” Trump said in a statement.

Asked if Biden would request Trump film a public service announcement on vaccination, White House press secretary Jen Psaki said “we don’t believe that requires an embroidered invitation to be a part of.”

“Certainly any role of anyone who has a platform where they can provide information to the public that the vaccine is safe, it is effective, we don’t see this as a political issue,” Psaki said. “We’d certainly welcome that engagement.”

She also emphasized, though, that the administration is focusing on local doctors and community leaders to try to boost vaccination rates, not national officials.

The effort is hitting its limits, though. The pace of vaccinations has fallen to around 500,000 per day, down from over 3 million at the peak in April, according to Our World in Data.

“I’m not that hopeful that we’re going to get to people who have refused to be vaccinated,” said Preeti Malani, an infectious disease expert at the University of Michigan.

Experts increasingly say the best remaining hopes of reaching the remaining unvaccinated are school and employer mandates for their workers or students to get vaccinated.

France is experiencing a surge in vaccinations after President Emmanuel Macron announced this month that proof of vaccination, or a negative test, would be required for everyday activities like going to restaurants. The Biden administration has repeatedly ruled out a national vaccine passport in the U.S., though, and Republicans have rebelled against the idea.

Full approval of the vaccines from the Food and Drug Administration, as opposed to the current emergency authorization, could also help assuage some people’s fears, and some experts have called on the FDA to move faster on issuing a full approval.

The Biden administration has stepped up its calls for Facebook and other technology companies to do more to fight vaccine misinformation on their platforms.

Biden on Friday said social media companies are “killing people” with misinformation. On Monday, though, he dialed the criticism back down, instead pointing to 12 people responsible for much of the disinformation.

“Facebook isn’t killing people, these 12 people are out there giving misinformation,” Biden said.

“My hope is that Facebook, instead of taking it personally, that somehow I’m saying Facebook is killing people, that they would do something about the misinformation, the outrageous misinformation about the vaccine,” Biden added. “That’s what I meant.”

For its part, Facebook said over the weekend, before Biden’s walk-back, that the administration was “finger pointing” and the company was not the reason the president’s goal of getting 70 percent of adults at least one shot by July 4 was missed.

Los Angeles County’s move to return to an an indoor mask mandate, even for vaccinated people,

got mixed reviews from experts, but either way, it is unlikely to be replicated in places that are the hardest hit, given that places that are resistant to vaccines tend to also be resistant to masks.

“Vaccines are really the only way out,” Malani said. “We can’t live in masks forever.”

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.

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.

Cartoon – Anti-Vaccine or Pro-Disease?

Vaccine hesitancy among the top 10 global health threats