San Francisco Chronicle (opinion): Biden says the COVID pandemic is over. He could have fooled me

Not sure exactly where to post this article since it covers a lot of things! This forum seemed best because of the title (pandemic), but please move if there's a better place. Perhaps the forum for Long Covid news?

This article is a response to Biden's statement on 60 Minutes that the pandemic is over. It talks about COVID, Long Covid, and ME/CFS, among other things.

Biden says the COVID pandemic is over. He could have fooled me

https://www.sfchronicle.com/opinion/openforum/article/biden-covid-pandemic-over-17460322.php

(bolding is mine)

EDIT: I just realized that this also mentions the MEAction protest at the White House.

 

In Dr. Daniel Griffin's podcast this week (he's on microbe TV), he gave his opinion that declaring the pandemic over was way too US-centric, that millions globally lack vaccines and immuno-modulating drugs (like Paxlovid) to treat more serious cases.

 

In some ways I wonder if Biden saying the pandemic was over was a good thing? (Am I finally losing it?) I have seen more pushback against this and coverage of the fact that it is not over than I have in a long time. Many people seem to see that it is manifestly not over, and it got more focus on the Millions Missing protest as well.

 

A semantic rather than scientific issue, to quote Fauci from 2020:

“It really is borderline semantics, to be honest with you,” Fauci said. He added that there could be arguments on either side as to whether the coronavirus outbreak could be described as a pandemic.
“I think you could have people arguing each end of it,” he said. “Pandemics mean different things to different people.”

Epidemic has more certain scientific clarity: WHO = "An epidemic is more than a normal number cases of an illness, specific health-related behavior or other health-related events in a community or region." Pandemic is an etymological extension of Epidemic: WHO = "worldwide spread of a new disease."

The number of fatalities isn't a measure of pandemic, rather it's a question of novelty and scope of spread, at some point COVID 19 ceases to be a pandemic because a) it stops being 'new' and b) because it has no where left to spread. Whether it remains a serious health issue is another matter. Case reporting is now as much a function of testing rates as it is of infection and so it's difficult to have any certainty of what the disease burden actually is: the US is reporting lower new case numbers than France, Germany and Japan and US daily deaths are below 300, in context that's around 1/7th the number of US daily deaths from Heart disease, or 2.5 times the number of daily traffic deaths.

COVID 19 stats: https://www.worldometers.info/coronavirus/#countries

 

According to the NHS website Paxlovid can be prescribed in the UK but only if you are considered to be vulnerable. Everyone else can get stuffed.

https://www.nhs.uk/medicines/paxlovid/about-paxlovid/
https://www.nhs.uk/conditions/coron...s-for-coronavirus/treatments-for-coronavirus/

The very last sentence in that quote is funny. It's impossible to get an appointment with the NHS these days, unless you can wait for an answer on the phone for at least an hour at 8am, and even then you can end up being told that there are no appointments left - they've all gone while you were waiting for someone to answer the phone. And if you do get an appointment the vast majority of appointments are for telephone appointments only and the doctor not only can't examine you, they can't even see you. Oh, and when you get a phone call the person on the end might not even be a doctor. Once I ended up with someone who was a paramedic talking to me, and another time - when I was actually seen - I was seen by an "Advanced Nurse Practitioner" not a doctor.

 

I saw yesterday that the US booster program has less than 2% uptake. The entire strategy to avoid serious disease depends on vaccines, having abandoned all other priorities. It requires a constant renewal of immunity as it wanes quickly and variants escape prior immunity anyway.

2%. Continuing to treat a public health emergency as a public relations issue is not a smart idea when the most important thing to do in a public health emergency is to tell the truth. At least that's what the textbook says. I wonder how often the textbook says one thing and everyone does the opposite. I doubt it's especially rare. The textbooks also say to respect informed consent, to treat the person, not lab results, and a bunch of other things that are clearly not true.

It's surprising how little reaction there's been to the most important drop of life expectancy ever recorded, in the US it's nearly 5 years. Decades of progress cancelled by hubris, and the most significant loss of credibility any profession has ever experienced. Pretty much all because of toxic positivity, belief in nocebo and expectation effects and all that nonsense. An entire profession cheapened because of 19th century beliefs. Amazing.

 

It doesn't make sense until it's appreciated that the biggest danger to public health is the sheer number of people, people going around doing things, producing things, consuming things, people simply existing.

We have somehow managed to produce a system where a heavily armed psychopath living in the woods, slaughtering and consuming local tourists, is probably less dangerous to humanities chances, than some guy, quietly commuting to the office, paying his taxes, obeying laws, keeping up with what social media tells him he should be doing/buying etc.

Such a person would probably have a large negative carbon footprint vs the large positive carbon footprint of the more conventional/legal lifestyle.

Unless of course there is a film crew involved.

A public health strategy that tells people things are safe when they aren't, does make a fair amount of sense, if the aim is to substantially reduce the number of people, so as to make everyone, everyone that is considered 'people' anyway, safer.

 

Of the 425-450 US people dying per day, half are vaccinated. Dr. Griffin (latest microbe TV podcast 9/18/22) said that if Paxlovid (which he says is given out by doctors to only 1.5% of the eligible in the US) were given to these vaccinated symptomatic patients (200 or so per day), the death rate would drop to 20 per day in the vaccinated. He didn't elaborate on the unvaccinated.

The problem is, that despite its availability, the average US doctor, is not up to par on the efficacy of anti-virals and not doing what they should in preventing hospitalization and death.

 

Everyone is making the same mistake: having the tools isn't enough, those tools have to be available where they are needed, as they are needed, on a continuous basis that is not so restrictive that they end up being used too little to make a difference. And the tools aren't enough, most tools require a constant flow of resources to be of any use. But the tools are changing constantly so there's no way to make this process efficient and economical. And that's on top of training and maintenance.

We see the same things with vaccines: only the rich countries have them. But even if we all had 100% vaccination rates, if the pandemic continued unchecked in the rest of the world it will inevitably produce the same outcomes.

We have working nuclear fusion, still years away from being a viable product. But it's all treated as a PR problem so only PR solutions are being deployed.

 

Despite the current stats on COVID deaths and Long COVID, people are harassed for wearing masks.

 

Not sure of the date for those numbers but the current number of daily deaths in the USA is higher than that.

@shak8 posted a range of of 425-450 daily which seems about right.

I just looked at the Johns Hopkins Coronavirus Resource Center and the 7 day average, as of Sept. 23, is 494 deaths per day.

 

@shak8

That number is terrible. COVID is still a monster.

 

I might have been a bit lazy in relying on the worldometer figures. The JHU figures are slightly but consistently higher than the CDC figures: https://covid.cdc.gov/covid-data-tracker/#trends_dailydeaths_select_00 but both show a similar 6 month pattern for the US with COVID deaths hitting a 7 day average low of <300 in June and then rising to <500 in July & August with a decline into September - JHU and CDC seem to disagree on the September slope. However both show a massive difference between April/September 2021 and April/September 2022 and while there will likely be further 'holiday' peaks and a substantial Winter peak taking the 2022 September figures as a starting point, the expectation must be that the winter 21/22 figures will not be repeated.

COVID deaths are strongly related to low income, existing poor health, older age, lack of vaccination and lack of health care access - we are likely to see developing disparities between countries based on those factors contrasted with infection rates, endemic factors taking over from a pandemic impact.

 

A friend of mine was harassed in a parking lot for wearing a mask. She told the guy, it's my choice and walked away. I would have been tempted to say, my body, my choice, an idea that is anathema to some people when it comes from a woman. But it's better to just not engage.

Our leaders are doing a poor job of communicating to the public the gravity of continued covid. I think they need to be more concrete and tell people the number of deaths from covid in relation to other leading causes of death such as Alzheimer's, cancer, and stroke as well as covid deaths by age group. It would be easier to understand what a threat covid still is.

I think this article, although dated now, presents covid death ranking in the U.S. well, especially the 3rd table. Surely some public health official could make this kind of information more succinct and get it into the public sphere.

https://www.healthsystemtracker.org/brief/covid-19-leading-cause-of-death-ranking/#Top 5 leading causes of death in the U.S. (number of deaths in the month), by age, January 2022

 

Researchers from the State University of Londrina found that people who reported “antisocial traits,” such as low levels of empathy and high levels of callousness and risk-taking, were less-likely to comply with Covid-19 prevention measures, such as wearing a mask and social distancing.

I feel the same goes for people who harass others who choose to wear a mask. It's not normal behaviour to step in other people's safe space.

 

I've planned my snappy comeback if I am ever reproached about my mask:

"I'm immuno-compromised."

 

@Mij, I agree that it's anti-social behaviour. All of it. And, I also agree, best not to engage. Just walk away. People can't count on things not escalating, not in this day and age (if they ever really could).

However, bad behaviour is now a significant portion of "normal" behaviour. Rudeness, self-absorption, greed, and just plain ignorance seem quite common. It's encountered everywhere, everyday.

A couple examples are tail-gaiting.

And, ever been tail-gated in a grocery store? Literally been pushed by another customer impatiently wielding their shopping cart in line.

And, the exorbitant cost of things. Not just now with inflation, but 10, 20 years ago. Gouge the customer for as much as you can.

The list goes on....

 

Is the responsibility for public health in the US not split between Federal Government and the individual States, so while Washington deals with the big stuff it's down to the States to get out health messaging at the citizen level ? Was this not how Tobacco smoking was taken on - ultimately down to the States to cut the rates, with individual States suing the Tobacco companies on behalf of citizens ? Or have I misunderstood ?

The relative risk issue is complicated - with a pandemic at its height it is indeed easy to show how dangerous a new disease can be - it tends to kill and/or disable a lot of people very quickly so the figures are stark. As the mortality rate falls, even if there is high relative risk the lower mortality becomes less distinguishable from the background rate of deaths, this is demonstrated by the: Excess Death rate

With an infectious disease like COVID 19, separating it out from the normal death rate is problematic because those who die from COVID 19 tend to be people who are older and/or with existing health problems who have a high probability of death in the time period being measured. There is a further problem in that a pandemic can cause downstream Excess Deaths that are not related to infection, for example in the UK delays in the health system caused by disruption via the COVID response are leading to increased mortality in people who would otherwise be effectively treated. I don't know what the disruption effects in the US are but these can't be discounted from playing a role in the US Excess Death figure for April to August. Excess Death rate

So yes while it may be true that in simple terms in the US in September 2022, COVID 19 is three time as dangerous as road traffic accidents, the number of deaths overall seen in the US may not be substantially greater than the background, and that may make a public health message hard to get across. If the public don't see vastly more people than usual dying, - especially in younger age groups - and those deaths are not unequivocally linked to COVID 19 infection, then a sense of immediate threat is lost.

 

@CRG, yes, public health responsibility is split between federal government and the individual states, but I think messaging is more dominant at the federal level. Many pay attention to its analyses and recommendations of the CDC. In Texas I don't see nearly as much public health messaging from the state as I do from federal agencies like the CDC.

But it's probably different in other states. Texas has become very conservative politically (it was a blue state when I moved here in 1980, but is now as red as can be), and public health here has been woefully underfunded for a long time. Also, covid denial and downplaying was mainstream in Texas's dominant political party. I heard few public health messages from the state other than at the height of the pandemic. I assume the blue states were better at this.

When it comes to messaging about the prevalence of covid deaths, I know it's very complicated by factors like the prevalence of deaths in particular states and statistics among age groups, and the incidence of covid deaths related to people who already had compromised health. We still need public messaging that people can relate to, so ideally, it would be simple enough that everybody could understand. Many people will listen to the punchline, not the nuance.

This is such a contrast to something as clear cut as getting the public to accept seat belts. In the U.S. seat belts were not mandatory in new cars until 1968. Even after they became mandatory, a lot of people really resisted using them for years.

There was a lot of effort to get public acceptance. I remember a very effective public service announcement on TV when I was a child. I think it was a nationwide PSA. It came on when commercials aired and showed a lady getting into a car and debating whether to use her seat belt or not. She didn't want it to wrinkle her dress. She drives without a seat belt, and then there's the sound of brakes slamming and the shattering of the windshield. Covid messaging at this stage is much trickier than this, unfortunately. Too bad the pandemic was so mishandled earlier when people could see skyrocketing deaths and severe illnesses, making many more receptive to containment recommendations.