Pandemic May Not End If We Don't Address Anti-Vax Hysteria

The quickest way to end the Covid-19 pandemic is by reaching herd immunity, which is to say, getting enough people immune to the disease that it no longer spreads easily, thus protecting everyone, including those few who still haven't acquired immunity. Typically, there are two ways to reach herd immunity: mass vaccination programs, which have effectively eradicated many deadly diseases in the U.S. (e.g., small pox, tetanus, polio, diphtheria) and mass infection. Problem is, unlike influenza, chickenpox, mumps, measles and many other familiar diseases, Covid-19 infection does not appear to produce long-lasting or robust immunity, meaning people could, theoretically, catch it multiple times and continue spreading it through the community. This leaves mass vaccination as our best hope.

Anthony Fauci said he was cautiously optimistic that by the end of 2020, we would have data confirming that at least one of the current vaccines being tested for Covid 19 was safe and effective. In theory, that could mean we'd have enough doses by mid-2021 to vaccinate a sufficient number of Americans to reach herd immunity, thus bringing an end to the pandemic. (For the current status of vaccine trials, click here).

Problem is, 20% of Americans say they will refuse to take the vaccine, and another 31% say they are unsure. So, even if the vaccine was 100% effective (no vaccine is), that would mean only 49% of American would develop immunity, which is not enough to reach herd immunity. Consequently, the virus would continue to spread through communities, sickening and killing people. In reality, a vaccine could be approved if it is at least 50% effective. So, worst-case scenario, we get a 50% effective vaccine, with only 49% of Americans taking it, and we end up with only 24.5% immunity, far far away from the 60-75% needed to reach herd immunity.

While it is easy to disparage these anti-vaxxers as stupid or selfish (the behavior certainly is), doing so won't browbeat or shame them into changing their behavior and is, therefore, unproductive. And at this critical time, it is imperative to find solutions that are effective. If the 31% of Americans who are on the fence can be convinced to change their minds, we'd have 80% of Americans willing to take the vaccine, and that COULD bring us to herd immunity (assuming the vaccine was 75% effective).

Part of the problem, of course, is STUPID and SELFISH behavior by politicians, particularly Trump, which have contributed to the misperception that this disease is not that serious or that it's a hoax. As long as people believe this, why should they want to do anything inconvenient or unpleasant (like wear masks & socially distance themselves), or that they erroneously believe is risky (like get vaccinated)? So, the first challenge will be getting all leaders and media to start listening to, respecting and complying with the health experts and encouraging the rest of us to do so, too.

However, there were already plenty of Americans who were terrified of vaccines well before the current pandemic started. So, even if all leaders were to suddenly start wearing masks and telling everyone to comply with social distancing policies, these people might still refuse to take the vaccine, thus perpetuating the pandemic. Therefore, we also need a well-researched and well-executed public health campaign that acknowledges their fears, but then convinces them of the safety of the vaccines and encourages them to participate in the mass vaccination program, not only for their own health and safety, but because it will help end the pandemic and return us to normal more quickly.

Crisis Continues to Worsen

Over the past week, the U.S. surpassed 4 million covid infections, more than 25% of the world's total, despite having only 4.3% of the world's population. We are also on track to surpass 150,000 deaths by the end of the day. These grim milestones can be blamed on oligarchy's relentless drive to force people back to work under unsafe conditions and their unwillingness to provide any financial relief to the millions of unemployed and underemployed Americans, as well as Donald Trump's continual lies about safety, the science of covid, and his undermining of the scientific experts.

There are now 12 states in the Critical Red zone (>25 new daily infections per 100,000 residents), with California poised to join this rogue's gallery soon, and 23 in the orange. According to Harvard's Path to Zero website, regions in the Red need to implement immediate lock downs, and those in the Orange are strongly recommended to do so, both to bring down cases to a manageable level and not overwhelm hospitals, but also to reach the Green zone, where an opening of the economy can be more effectively monitored and controlled. This means that 70% of the country needs to immediately lock down (compared with 64% just 5 days ago). Indeed, health experts have been saying for days that the entire country needs to shut down.

California, which once led the nation in caution, now has had more covid cases than any other state, including New York. 71% of its counties are now in the Critical Red or Dangerous Orange zones and require immediate lock down.

It is clear from the map that U.S. and South America are the hardest hit regions of the world, but the WHO just announced on Friday that Europe's premature lifting of restrictions is driving a resurgence of infections there. Eastern Europe has been particularly hard hit, with record or near record daily infections in Romania and Ukraine, and 5,000 or more daily infections in Russia.

From Bad to Dire: 64% of U.S Requires Immediate Stay-at-Home Orders

As you can see from the map, the U.S. no longer has any green states (On Track for Containing the Virus), whereas less than 2 weeks ago, we still did. 32 states are now in the Red (>25 new daily infections per 100,000 residents) or Orange zones (10-24 new daily infections per 100,000 residents), or 64% of the country, and should implement Stay-at-Home orders, according to Harvard's Path to Zero website. This is a 10% increase over 4 days ago, and a 52% increase in the past week!

California now has 16 counties in the critical red zone (a 33% increase over 4 days ago), and 20 countries in the dangerous orange zone, for a total of 36 counties (61% of the state) requiring immediate mandatory lock downs in order to bring the infection rate back to a manageable rate. Additionally, while the state had 6 counties in the green zone (less than 1 new daily infection per 100,000 residents, and on track for containment) just 4 days ago, it now has only 3, indicating that even its most remote and sparsely populated regions are getting slammed and that the state is moving further away from containment.

U.S. on Track to Hit 8 Million Covid Cases By Labor Day

It took 99 days to reach 1 million Covid-19 infections in the U.S.

It took only 43 days to reach 2 million.

And only 28 days to reach 3 million.

And only 14 days to hit 4 million.

Will we reach 5 million by the end of the month?

Even more alarming, we doubled from 1 million to 2 infections in roughly 40 days, and doubled again to 4 million in roughly another 40 days. Does that mean we'll hit 8 million infections by Labor Day?

Tracking the Covid Surge

In just 4 days, the U.S. has gone from having a total of 21 states in the critical Red/Orange zone (10 or more daily infections per 100,000 residents), to 29 states in the critical Red/Orange zone, as of 7/18/20. This is a 16% increase. Of the states in the Orange zone, California and Arkansas are both poised to enter the Red soon, with over 20 infections per 100,000 each.

California has not changed significantly over the past week: they had 12 counties in the Red as of 7/10. They now (as of 7/18/20) have 13 counties in the Red and 25 counties in the Orange.

Contrary to common misperception, things are not so rosy in the rest of the world. As you can see from this map, most of South America is in the dangerous Orange zone, and several countries are in the Critical red, including Panama and French Guyana. Many people also erroneously believe that Israel has somehow dodged the worst of it, but their infection rate (18.5 new daily infections per 100,000 residents) is nearly identical to that of the U.S. (20.2), and higher than Brazil's 16.5 daily infections per 100,000 residents. Netanyahu is so reviled for his pathetic covid response that thousands of Israelis are braving water cannons and tear gas to protest him. Like Trump, Netanyahu has placed the interests of the oligarchs above the health and safety of the rest of Israel. And like Trump, he has blamed the protests on bizarre conspiracies (in this case, the deceased pedophile Jeffrey Epstein). Interestingly, the West Bank and Gaza, together, have an infection rate of 8.1, less than half that of Israel. This may be due, in part, to the fact that the West Bank and Gaza have no Ultra-Orthodox Jews, whose infection rate is four times that of the rest of Israel.

Europe is not escaping the latest surge either, despite having significantly reduced their infection rates since May.  Luxemburg had an infection rate of nearly 13 new daily infections per 100,000 residents (as of 7/18/20), well within the dangerous Orange zone. Montenegro was also in the orange. The UK is still chalking up more than 500 new infections per day. Turkey had over 900 new infections yeasterday. And Sweden, Portugal, Romania and Bulgaria are now seeing new surges, each with more than 4 new daily infections per 100,000 residents over the past 2 weeks, while much of the Balkans is now well over 7 daily infections and approaching the dangerous Orange zone. 

Most of California Now in Danger Zone, Newsom Shuts Down Schools

12 California counties are now in the highest alert red zone (as of 7/16/20), with over 25 new infections daily per 100,000 people, while an additional 28 counties are now in the dangerous orange zone (10-24 new daily infections per 100,000 residents), including San Francisco, which shot up from around 7 last week to well over 10 this week. (Data as of 7/16/20, from Harvard's Path to Zero website)

That's 40 counties in the red/orange combined. Governor Newsom has declared 33 of these counties to be on the "watchlist" severely limiting which businesses can be open. Further, he mandated that all schools, public and private, must be closed to in-person learning if located in one of these 33 counties. That means that both Marin and Orange Counties, which had both recently declared schools to be open this fall, will have to back down and close their schools, since they are both on the watch list.

California has been chalking up over 8,000 new infections daily for the past week and is on track to catch up with New York, though their mortality rate is substantially lower.

Pandemic Spiraling Out of Control

Four days ago, there were 7 states in the critical Red Zone (over 25 daily new infections per 100,000 residents) averaged over the past seven days, a critical situation which researchers at Harvard say should trigger automatic mandatory lockdowns. In none of these states has a statewide lockdown been implemented. Now there are 11 states in the red zone (as of 7/14/20), with Arkansas and California poised to join this group by the end of the week. Yesterday, the nation broke the world's one-day record with 71,750 new infections, according to Worldometer, while California, Florida and Texas chalked up 9,687, 10,181 and 12,235 new infections respectively.

The number states entering the dangerous Orange Zone, where the Harvard researchers say statewide lockdowns are highly recommended, has also been on the rise. Four days ago, there were 14 states in the orange, or 21 states in the red/orange zones combined. Now there are 26 states in the red/orange zones combined, or more than half the country that should be in lockdown.

Why Do the AAP, NEA and AFT Continue to Demand a Reopening of Schools?

This week (7/10/2020), the American Academy of Pediatrics (AAP) and the two largest teachers’ unions, the National Education Association (NEA) and the American Federation of Teachers AFT) released a joint statement calling for the return to live, in-person instruction this fall, even as the number of new covid infections skyrockets throughout the country. “Educators and pediatricians share the goal of children returning safely to school this fall. Our organizations are committed to doing everything we can so that all students have the opportunity to safely resume in-person learning.”

Here is a critique of the AAP’s position and how it is being inappropriately promoted.

The fact they put out this statement now, when daily new cases are rising in 36 states and the country has been recording over 60,000 new cases daily for the past week, shows their complete disregard for the health and safety of the children and teachers for whom they advocate, not to mention a complete disregard for the recommendations of the health experts, and a complete disregard for the health and safety of the students’ family members.

Indeed, pandemic experts at Harvard recommend the immediate lockdown (including schools) of any region recording more than 10 new infections per 100,000 (more than 60% of the states are already at this point). Similarly, pandemic expert, Michael Osterholm, is calling for a complete national lockdown, followed by thorough testing and contact tracing to bring the pandemic back under control and allow for a subsequent gradual resumption of life, as has been effectively accomplished in places like China, Hong Kong, South Korea, Japan, Germany, Italy. And, more specifically with respect to schools, the CDC has said that reopening the schools is the highest risk for increasing the spread of Covid-19.

If they were truly concerned with the health and safety of children and their teachers and families, why not put out a statement that says, “We will do everything possible to ensure high quality distance learning until it is truly safe to resume live, in-person instruction,” rather than continuing to push for in-person learning this fall, when it is clear that the pandemic will still be raging?

Even if we locked down the nation now, as Osterholm has recommended, it will take months to bring infection rates down to where they were in May, after the first set of lockdowns were implemented, back when infection rates were only a fraction of what they are today. It should also be clear there is no way to resume in-person learning with all the recent budget cuts. With the myriad logistical problems, like lack of space to physically distance students, lack of sufficient custodians to sanitize rooms, lack of soap, paper towels and PPE, lack of nurses, and lack of money to purchase of these resources. With the unwillingness of teachers to come back under the current, unsafe conditions. With the numerous large districts, including LAUSD, the nation’s largest, already stating they will not reopen this fall. With the likelihood that each positive case that arises will result in scores of teachers, staff and students being sent home and placed in quarantine. With the likelihood that schools will be forced to shut down again soon after reopening because of the surge of new infections.

So, why is the nation’s largest association of children’s doctors still pushing this deadly plan, rather than upholding their oath to do no harm? Why are the nation’s teachers’ unions still pushing for a policy that their members oppose? Why continue promoting a criminal proposal that is starting to die on its own because of the intractable logistical impediments to its implementation?

To answer this, one might consider last week’s “School Reopening Roundtable,” hosted by the AFT, where Elizabeth Warren dismissed the worries of teachers over the risks of reopening and told them the best thing they could do was vote for Joe Biden in November. Yet why would voting Democrat change anything? All across the country, Democratic governors (including Maine, California, N. Carolina, Kansas), prematurely reopened their economies when infection rates were still on the rise. And House Democrats overwhelming supported the CARES Act’s multitrillion dollar corporate bailout, funded in part through cuts to education and other social services. And what about Biden’s role in the Obama Administration, which slashed education funding and promoted privately run charter schools? Does anyone really believe that, as president, Biden will restore education funding to its pre-2008 levels?

Ironically, Covid-19 is now inversely related to the markets, thanks to the $3 trillion funneled into the markets by the Fed, a policy supported by nearly every Democrat in their support for the CARES Act. The irrational exuberance of traders hinges upon the criminal drive to get workers back to work, which itself is dependent on getting schools to reopen to provide “free” babysitting.

Maybe the AAP, AFT and NEA are okay with a few thousand kids dying, out of the millions who attend K-12 schools, but what about the millions of vulnerable educators and family members who they will infect? Is their goal to help cull America of its older and medically vulnerable workers, so health insurance companies no longer have to pay for their expensive cancer, diabetes, heart, arthritis and blood pressure medicines? Is their goal to help school districts and corporations reduce insurance costs by reducing their share of higher-risk employees? Is their goal to reduce payroll costs by reducing the number of higher wage veteran employees?

The irony is that the more we let this spin out of control, the longer it will take for the economy to recover.

Everyone wants a return to normal, but not at the risk of death. Everyone agrees that live, in-person education is better than remote, online learning, but not when a pandemic is raging out of control.

Unfortunately, we are going to have to suck it up for a while longer and continue living lives of social isolation and privation. It means schools and teachers’ unions must start planning for better quality distance learning than was provided last spring, even though this should have started months ago, as it did with the University of California and CSU systems. It means the pediatricians need to start advocating for ways to improve children’s mental and physical health while sheltering in place, instead of wantonly trying to force them into apocalyptic schools where they won’t be able to see any smiles, touch anyone, get close to anyone, get hugs when they’re hurt, share toys and equipment, interact with friends and family members in other classrooms. Where they’ll have to stand in line daily for temperature checks and have adults constantly warning them to put their masks back on and get away from that person they’ve gotten too close to. It means the politicians, including the Democrats, must commit to providing everyone with the money and resources they need to survive until the pandemic ends, and ensure there is sufficient PPE and safety protocols in place for all truly essential workers. It means implementing a national lock down and mandatory mask-wearing, and spending the money to dramatically increase testing and contact tracing, so that once the infections start to decline, quarantines can be implemented to prevent new flare-ups from turning into full blown outbreaks.

Continued Worsening: 8 States Now in the Red; CA & NV Poised to Join Club

Data from 7/11/20

Things Worsening Quickly: 7 States in Dangerous Red Zone, Require Mandatory Lock Downs

AZ, FL, LA, SC, GA, TX, AL in the red zone (>25 cases/100k residents avg over past 7 days)

According to Harvard's Path to Zero Covid Tracker website, in order to be on track for containing the pandemic, a region must get their rate of new infections down to 1 or less per 100,000 residents, averaged over a 7-day period. Fewer and fewer states and counties are meeting this goal. In the past several days, the number of states in the Dangerous Red zone (25 or more new infections per 100,000 residents) has in creased from 4 to 7. In California, the number of counties in the Red Zone has recently jumped from 7 to 12.  According to the website, regions in the red zone are at the Tipping Point and Stay-at-Home orders are necessary to prevent catastrophe. However, even those regions in the orange (10-24 new cases per 100,000 residents) are strongly recommended to impose Stay-at-Home orders. If we combine those states in the red and the orange, that's 21 states, nearly half the country that should be sheltering place!

Imperial, Stanislaus, San Joaquin, Tulare, Merced, Orange, Riverside, San Bernardino, Fresno, Madera, Colusa, LA counties are now in the red zone

Do Educators Die of Covid? Yes They Do! Do Children Die of Covid? Yes, They Do, Too!

Chalkbeat reports that 78 educators have already died from Covid in NYC, just from the first wave of the pandemic to hit the city. Health experts are warning that NY will likely see a resurgence, like the rest of the country, threatening the lives of countless more educators.

Of those 78 deaths, 38% were among paraprofessionals, even though paraprofessional represent only 17% of the education workforce. They are also disproportionately people of color.

And in Arizona, 3 teachers caught Covid after sharing a classroom for Summer School & one of them died.

Despite the mounting evidence that kids, even very young ones, not only catch covid at the same rate as adults, but can also transmit it to others, and despite averaging close to 10,000 new covid infections daily for the past week, Florida has mandated that all schools be open for live, in-person instruction in the fall. A seventeen-year old has already died of the virus in Florida, and more are likely to die as Governor Desantis allows the pandemic to rage out of control in his state. Florida is also seeing rising numbers of the deadly multi-system inflammatory syndrome (MIS-C) in children, a problem that will also likely rise with the reopening of schools and the failure to initiate a mandatory state-wide shelter in place, as recommended by many health experts.

In New York, over 80 kids were diagnosed with MIS-C as of early May, and 5 had died. If they reopen their schools to live, in person lessons in the fall, they, too, will likely see a tragic increase in MIS-C diagnoses and deaths, as well as the deaths of more teachers and paraprofessionals.

Why It's Hard for Americans to Trust the Experts

Is it any wonder that Americans don’t trust politicians, American institutions, even scientists? That they continue to go to crowded public places without masks, deny that covid infects children or that they can spread it to vulnerable adults, in spite of the solid evidence to the contrary?

Why should they trust the scientists when the scientists keep changing the “science?”

Certainly, part of the problem is the general public’s lack of understanding of how science works: Scientists makes hypotheses based on current data and then constantly revise and improve those hypotheses as new data comes in. Thus, what was considered the best explanation in February could look significantly different today, now that we have so much more data on how covid-19 spreads and how it affects the body. This can be confusing and frustrating to the lay person, particularly when politicians and the media continue to hype the now discredited preliminary data. Consider how many people still believe that vaccines cause autism, even after this myth has been repeatedly disproven in controlled scientific studies, (an excellent article on this topic here) and even after its main proponent, Andrew Wakefield, had his medical license revoked for publishing the fraudulent data behind this myth.

But there is a bigger problem when supposedly objective scientists make public statements about what is considered best scientific practice that are NOT based on scientific evidence at all, but on the dictates of politicians and capitalists, which is exactly what the Centers for Disease Control (CDC) seemed to be doing this week by buckling to the demands of Donald Trump and agreeing to change their guidelines for how to reopen K-12 schools, thus facilitating Trump’s dictate that ALL SCHOOLS MUST REOPEN ASAP.

In a glaring example, CDC director Robert Redfield said there’s no evidence that children drive the spread of coronavirus. While it is true there are many factors driving this pandemic (e.g., stupid back-to-work policies that force workers and consumers together without adequate PPE; people cramming into bars without masks; poorly trained and equipped employees at assisted living facilities and prisons), to say that children do not drive the pandemic is scientifically inaccurate and misleading. It implies that we don’t need to worry about sending our kids into crowded classrooms, that they are not going to bring the virus home and expose vulnerable family members, and that reopening schools will have little or no effect on the number of new infections.

It is so misleading and dangerous that even Trump’s own controversial health advisor, Deborah Birx, had to back away from Redfield’s statement, saying there isn’t enough data to arrive at that conclusion; the data is complete. Not enough children have been tested.

But we do have compelling evidence that kids catch the virus at the same rate as adults from two different studies, one from Germany and one from China. And this study from Switzerland, published on the CDC’s own website just last week, shows that symptomatic children shed just as much virus as adults, indicating they can, indeed, spread the virus to others. (Which makes one wonder if the CDC director even looks at his agency’s own website, let alone reads the latest scientific studies).

We also have considerable anecdotal evidence of the virus spreading in schools and daycare facilities, including among children. There were 950 infections at Texas childcare centers as of the end of June, with a third of the cases occurring among the children. And, as the UK reopened, schools there quickly become the second leading source of new outbreaks, after home care centers. France and Israel had to close schools soon after reopening because of new outbreaks among kids. There was also a cluster of juvenile infections after a high school swim party in Arkansas. And nearly an entire class in Quebec contracted covid, despite physical distancing and hygiene measures, after an infected student came to class, which strongly supports the hypothesis that children can, indeed, drive the spread.

Many back-to-school proponents argue that kids don’t get as sick as adults and rarely ever die. While this is true, statistically-speaking, it does not justify reopening schools. First, and most significantly, if kids can transmit the disease, and the evidence shows that they can, then they can spread it to vulnerable staff and family members. With one-third of all teachers being at elevated risk of severe symptoms and death due to age and underlying health conditions, not to mention all the children living with grandparents, and all those living with family members who have diabetes, heart disease, cancer, kidney and liver disease, reopening the schools would be criminal!

However, kids do catch the virus and sometimes get quite ill and die. Based on the preliminary and incomplete data we have, in many parts of the U.S. and Europe, mortality rates for children age 10-19 are in the range of 0.1-0.5%. These numbers probably reflect only the minority of infections that were symptomatic and bad enough to require treatment and/or hospitalization. Consequently, the sample sizes are small and the percentages are likely inflated. But if we divide these percentages by 10, since it’s estimated that there are 10 times as many infections as are currently documented, that would bring the mortality rate down to 0.01-0.05%. With roughly 50 million K-12 students in the U.S., if 50% of them contracted the virus, and 0.01-0.05% died, there would be 2,500-12,500 juvenile deaths. This, too, should make us question the safety and efficacy of reopening the schools.

If it wasn’t safe to go to school in May, when most of the nation’s schools were first shut down and infection rates were miniscule compared with today, then why would it be safe to return to school in August and September, when infection rates are going out the roof? Especially with watered down “safety” protocols?

Last night, I watched a San Francisco Unified School District Town Hall Meeting on Reopening, in which an unprepared and incompetent representative from San Francisco’s Department of Public Health bumbled incoherently through a set of talking points on school “safety” measures she clearly had never seen before. The guidelines she read were only recommendations and they only applied when conditions permitted. For example, students were to have 9 feet between them, except when this wasn’t possible. Then they could be as close as 3 feet from each other, which is only half of the standard 6 feet, which is, itself, insufficient to protect against aerosolized particles. Windows were to be opened, except in the numerous rooms that lack windows. Schools could choose to do temperature checks, or trust parents to do it at home. If someone passed the health screening at the beginning of the day, and got sick later, they’d be sent home (but apparently, all those who were in contact with that individual would remain).

It was absolutely appalling to witness SFUSD and the health dept being so ill-prepared on a recorded public forum with thousands of live viewers, but even more so when you consider the stakes. It gave me absolutely no confidence that either institution could be trusted to protect the health and safety of my child, or his teachers and school staff. Many of the families participating asked questions like, “Would the district base its decision to reopen on the recommendations of the CDC?” But if the CDC is weakening its recommendations to appease Trump and Wall Street, then they’re not going to keep our children and their teachers safe either.

The only safe and rational option is to:

·       Keep schools closed to live, in-person instruction until the pandemic is over

·       Provide sufficient teacher training, time and extra pay to develop higher quality remote learning experiences

·       Provide parents training and resources to help them support their children in their remote lessons and with their mental health and social development

·       Keep ALL workers home who are not truly essential for our day to day survival (e.g., workers who help produce food, utility services, emergency services and healthcare), or who cannot be provided a safe, uncrowded, well-ventilated work environment with adequate PPE

·       Provide everyone with the money and resources necessary to survive, including protection from evictions and foreclosures and utilities shut-offs

·       Provide safe childcare options to parents who are essential workers, including support for their children’s remote learning experiences

Nearly 50% of California is Orange or Red-Why Isn't It Under Lockdown?

A new Covid tracker from Harvard maps out the number of new daily infections U.S. counties per 100,000 residents. Regions with at least 25 new daily infections per 100,000 people are designated code-red and stay-at-home orders are necessary. Regions with 10-24 new daily cases per 100,000 residents are designated code-orange and it is highly recommended that they, too, implement stay-at-home orders. 

Looking at this map of California, it is clear that nearly half the state is in the orange or red zone (24 counties), while 34 are in the yellow or green (as of 7/2/20). However, of the counties in the yellow, four of them are at 9.5 or higher, and are therefore very close to slipping into the orange zone. In all, six counties are in the 9.0-9.9 range, putting them at risk of slipping into the orange.