How and if we can learn to live with COVID

Post Reply New Topic

Having had that disease once, Covid is only a big deal because everything about it is being magnified about it. It’s just enough of a pest to have dirty politicians playing games and having more political freedom than ever before!

Having had that disease once, Covid is only a big deal because everything about it is being magnified about it. It’s just enough of a pest to have dirty politicians playing games and having more political freedom than ever before!

I wish they could do lungs and brain imaging on me, but they are refusing. They insist it won't show anything anyway since my case was mild and I have recovered.

Video S.E. Cupp Confused Covid-19 messaging is exhausting us all

Right on.

Former health advisers to President Joe Biden say the US strategy for the Covid-19 pandemic needs to be updated to face a "new normal" of living with the virus, rather than aiming to eliminate it.

In three pieces published in the Journal of the American Medical Association on Thursday, six former Biden advisers proposed a new plan and detailed strategies for testing, mitigation, vaccines and treatments.

"Without a strategic plan for the 'new normal' with endemic COVID-19, more people in the US will unnecessarily experience morbidity and mortality, health inequities will widen, and trillions will be lost from the US economy," wrote Dr. Ezekiel Emanuel, a former Obama health adviser now with the University of Pennsylvania; Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota; and Dr. Celine Gounder, an infectious disease expert at Bellevue Hospital Center and at Grossman School of Medicine at New York University.

For this new strategy, "humility is essential," they wrote. There remain unknowns about the virus and its future, and "predictions are necessary but educated guesses, not mathematical certainty." Leaders will have to communicate specific goals and benchmarks, and national plans will need to be adapted for local use.

In the article on testing, surveillance and mitigation strategies, Emanuel, David Michaels of the Milken Institute School of Public Health, and Rick Bright, a former Biomedical Advanced Research and Development Authority official now with the Rockefeller Foundation, called the initial response to the virus "seriously flawed."

"Even now, testing results are not reliably linked with sociodemographic data, vaccination status, or clinical outcomes; the availability of reliable rapid tests remains limited; and prices are too high."

The authors called for low-cost and accessible testing with immediate advice when someone receives a positive result; improved air and wastewater surveillance and genomic sequencing; and a voucher program for accessing N95 and KN95 masks.
The first step in viral mitigation, they said, is to keep people away from those who are sick.

"This requires systematic access to testing and paid sick and family medical leave for all US workers, especially low-wage, temporary, freelance, contractor, and gig economy workers."

In a third piece, Dr. Luciana Borio, a former US Food and Drug Administration official now with the Council on Foreign Relations, Bright and Emanuel call for vaccine mandates, variant-specific vaccines and accelerated efforts to develop a universal coronavirus vaccines, as well as rapid development of effective oral antivirals.

okay so have been hospitalized with the worst symptoms,full on pnuemonia in all lobes of the lungs. when was initially not understanding what was going on with me , had to call a ambulance
at 6:00 am Could not get air into me. during hospital stay after i became aware of my situation.
Was in strict isolation . confined to bed . As was suffering had some minor but ongoing visual hallucinations . was seeing double and walls looked wrong, out of dimension. And i did not want to tell anyone . Eventually could not get my head to feel clear and my masking ability went to zero.
Even my speech returned to absolutely flat . Although as treatment progressed breathing got better but even weeks out, from the hospital . My upper airway feels irritated almost daily and head feels NOT clear . was discharged without oxygen, O2 level are at 97-96 % was in quaranteen with nothing but canned food. did get a care box of unuseable packaged goods from a hospital support organization. which was desperately trying to use. Am not able to focus on things well
anymore . Apetite is unpredictable. These are my current experiences with post infection situation. just a FYI for you all. Am understanding after the fact that it was a very lose call.

okay so have been hospitalized with the worst symptoms,full on pnuemonia in all lobes of the lungs. when was initially not understanding what was going on with me , had to call a ambulance
at 6:00 am Could not get air into me. during hospital stay after i became aware of my situation.

We’ve entered a new phase in the Covid-19 pandemic, which we can call bipartisan, unilateral surrender. From liberal and conservative pundits and politicians on both sides of the aisle to the celebrity docs who show up on cable news or in supermarket magazines, we’re being told SARS-CoV-2 is endemic now—which of course has nothing to do with the technical term, but has become popular shorthand for “it’s over.” We’re vaxxed-and-done now and we should be allowed, with no more mask requirements or other efforts to mitigate spread, to resume our pre-pandemic lives with the “urgency of normal.”

I’ve spent two years railing about the irresponsibility and cruelty of many Republicans and their cavalier response to the pandemic, endangering millions with policies destined to simply make people sick: suggesting that vaccination and freedom are incompatible concepts, that grandparents were willing to die for the economy—the whole horrible litany of lies and misinformation churned out by the party and its proxies.

But now it’s different. People who were scrupulous about following public health advice in 2020 are now too tired, frustrated, and fed-up to care. Those still masking, doing some social distancing, trying to do their part to stem the tide of the pandemic are being treated as if they are holdouts in a war that is long over. Or risk-averse scaredy-cats, ridiculed as out-of-touch liberal elites by commentators on the right like Ross Douhtat; as deluded, too-far-to-the-left zealots by centrist pundits like David Leonhardt. Both of whom write for that touchstone of very serious people everywhere, The New York Times, so it must be true.

Except the pandemic is not over by a long shot. We’ve been seeing 1,000 deaths a day in the United States for months now; over the past few weeks, as Omicron deaths catch up to the vast number of infections diagnosed weeks earlier, we’ve had far more than that. The last day of January saw over 2,500 deaths in this country. Hospitals are still reeling in many places, and both health care and public health workers on the front line are just burned out and losing their s**t. And that word—endemic—which in epidemiological terms connotes a pathogen that has stabilized at a long-term equilibrium in a population—hasn’t really arrived yet, with the pandemic still raging across the globe, even as Omicron numbers start to decline in some places. Then there’s the belief—now popular in the press—that Omicron is the “last” variant of any real concern. We’ll all have been exposed to the virus or vaccinated against it soon enough, and any subsequent strains that may wash over us will be mild, no worse than the flu or the common cold.

I’m not suggesting that we need to be on a state of high alert forever. But we need to shape Covid-19 policies according to the data, not by wishful thinking among people who should know better. To sound the all-clear now or imply that we can in the next few weeks is presumptuous at best. If we want to learn from history, we can simply look at the 20th century’s most fearsome pandemics for guidance. John Barry, the historian of the great influenza of 1918, reminds us that the deadly fourth wave of that catastrophe only occurred in 1920, when millions had already been exposed to the virus, when the lethality of the third wave was subsiding, most people had let down their guard, and no public official was interested in pushing mitigation efforts in the face of the indifference and weariness of a nation. Barry also reminds us that “natural immunity” and vaccination after the influenza pandemics in the late 1950s didn’t stop the virus from cutting a large swath of death in 1960 when it returned with a vengeance. A similar scenario played out in Europe in 1968 and 2009 flu pandemics, when, after a first round of infections and vaccinations, influenza’s second wave crested and washed over the weary continent.

What we’re seeing now is a combination of what we saw with influenza and with HIV. First, it’s capitulation based on misguided or at least premature hope, frustration, and anger that this has gone on for so long, disrupting our lives.

While pundits try to spin this as a debate about risk management at an individual level—claiming that some of us are being too cautious as we enter the golden age of endemicity—it’s far more like what happened with HIV: Once people feel like they’re safe enough, the safety of others doesn’t really matter that much.

Perhaps we’ll all get lucky. Maybe the disease will die out over the next few months, or over the next year or so, and while new variants will emerge, they’ll be of little clinical consequence. It all sounds wonderful, doesn’t it?

I’ve strangely hoped that we would find a way to rally to this greatest of challenges facing us—a once-in-a-century pandemic. But that was never going to happen, was it? The American way isn’t about building a system that works for all of us, protects everyone.

In America, if you don’t make it, or fall, or stumble, it’s your own fault, because here we are all self-made men and women. Those who survive are meant to do so. The rest of us are simply collateral damage, in a social Darwinism that is American as apple pie.

New Jersey Gov. Phil Murphy (D) said on Sunday that his state will need to "learn how to live" with the COVID-19 pandemic.

"We're not going to manage this to zero. We have to learn how to live with this," Murphy said of the pandemic on NBC's "Meet the Press."

"You got to preempt this, clearly, and we're now getting caught up as a country," he added, noting that COVID-19 cases are coming down in New Jersey and New York, which were "hit earliest by all of these waves."

Arkansas Gov. Asa Hutchinson (R) voiced a similar sentiment during an appearance on "Meet the Press."

"I do believe that we need to move from a pandemic status and mode of operation to more endemic," he said. "I think we need to move out of the panic mode. I think we need to handle this and make sure that we continue with our normal lives," Hutchinson added, noting that COVID-19 cases in Arkansas peaked last week.

Meanwhile, a Kaiser Family Foundation poll published last week found that 75 percent of Americans said they were tired of the pandemic.

Seventy-four percent of Democrats, 72 percent of Republicans and 80 percent of independents said they were tired of COVID-19, and more than 70 percent of each group said they were frustrated by the pandemic.

Senior U.S. health officials have sought to reassure a pandemic-weary public that the country is moving closer to a time when Covid-19 won’t dominate our daily lives, as an unprecedented surge of infections and hospitalizations declines in many parts of the country.

White House chief medical advisor Dr. Anthony Fauci said in an interview this week the U.S. is heading out of the “full-blown pandemic phase” of Covid-19. Fauci has made clear the U.S. won’t eradicate Covid, but he’s confident the nation can bring the virus under control so it no longer threatens to push hospitals to their breaking point or disrupt the economy. At that moment, people could return to a semblance of normal life after two years of disruption and uncertainty following repeated waves of infection.

Doctors and infectious disease experts in South Africa, in a recent study, said the variant’s rapid surge and decline in that country demonstrated a significantly different trajectory than past strains. They say it could be a sign the pandemic will transition into an endemic phase that is less disruptive to society.

“Endemic in general means where you have disease that occurs at a regular and predictable level,” said Dr. James Lawler, an infectious disease expert at the University of Nebraska. “There’s endemic flu and then there’s epidemics of flu every season. Those epidemics generally are predictable and occur within a forecasted range.”

There isn’t a precise definition of endemic. The World Health Organization generally defines pandemic as uncontrolled spread of a virus across the globe, and an epidemic is when the spread is limited to a country or region. A steady level of transmission that doesn’t result in a widespread outbreak is generally considered endemic.

This steady level of transmission is typically reached when the virus’s reproductive rate is one or less. That means everyone who gets the virus infects roughly one other person. The original Covid strain had a reproductive rate of about two, while people with delta typically infected five or more other people, according to the Centers for Disease Control and Prevention. Omicron is estimated to be more than three times as contagious as delta, according to a study by Japanese researchers.

The emergence of omicron, with its ability to infect people who are vaccinated and even boosted, has challenged notions of when a sustained endemic phase will come and what it will look like in the context of Covid.

Omicron has also proven adept at reinfecting people, with a recent study in the U.K. finding that two-thirds of people who caught the variant said they had Covid before. This makes herd immunity even more elusive than originally thought. In the first year of the pandemic, government officials hoped of the global vaccination campaign would help eradicate Covid by reaching herd immunity, where enough people have natural or vaccine-induced protection that the virus doesn’t have new hosts to infect.

“The notion of natural herd immunity without vaccination is a scientific untruth,” according to Ottar Bjornstad, a professor at Pennsylvania State University who researches disease outbreaks. Though breakthrough infections have become common with omicron, the vaccinated shed less of the virus than people who haven’t gotten their shots, he said.
There is a hope, however, that between vaccination and mass exposure to omicron, there will be enough immunity in the population that the number of people susceptible to falling ill from the virus rapidly diminishes as the latest wave subsides, according to Dr. Kelly Cawcutt, an infectious disease expert at the University of Nebraska.

Though the risk isn’t zero, children are generally less susceptible to severe disease from Covid than adults, according to the CDC. This indicates that the virus will, over time, result in more mild disease perhaps resembling the common cold once children are the main group left without exposure, according to Lavine.

Separate from the question of immunity, the pandemic could also end if the virus itself simply evolves to become inherently less severe.

“The whole idea that viruses by definition always evolve to be less pathogenic and less severe — that’s the stuff of fairy tales,” Lawler said.

To a large degree, a return to life that resembles people’s pre-pandemic routines depends on how much risk individuals are willing to tolerate, and how much disease society is willing to accept.

Lawler said in some ways the virus would meet the definition of endemic right now, in the sense that it has been circulating in populations across the world for two years. Whether society chooses to call it endemic or not, however, doesn’t change the reality that it continues exact a huge toll in lives lost, he said.

“It’s a synonym for surrender is what it is — it’s a convenient way to just give up,” Lawler said about the conversation on the virus becoming endemic.

Denisse Takes’s world is very small these days. She makes a living by producing songs from her living room, plays “Animal Crossing” online with friends and leaves her home in Burbank, Calif., only occasionally to walk her dog.

Even as her social media feeds are flooded with friends and family members returning to their normal lives, she sees no one except for her husband, who donated his kidney in 2015 so that Ms. Takes, 37, could receive a compatible donor’s kidney in return.

The medication that keeps her immune system from rejecting the organ also suppresses it from creating antibodies in response to a coronavirus vaccine. Her body is so bad at fighting off infection that she has gone to the emergency room with common colds, she said. She is certain that Covid-19 would kill her.

But the isolation and depression — amplified as the rest of the world seemingly moves on from the pandemic without her — have also taken their toll. “I keep trying to hold on for my husband, honestly,” Ms. Takes said.

Millions of Americans with weakened immune systems, disabilities or illnesses that make them especially vulnerable to the coronavirus have lived this way since March 2020, sequestering at home, keeping their children out of school and skipping medical care rather than risk exposure to the virus. And they have seethed over talk from politicians and public health experts that they perceive as minimizing the value of their lives.

As Year 3 of the pandemic approaches, with public support for precautions plummeting and governors of even the most liberal states moving to shed mask mandates, they find themselves coping with exhaustion and grief, rooted in the sense that their neighbors and leaders are willing to accept them as collateral damage in a return to normalcy.

More than seven million adults in the United States, or about 3 percent, are characterized by health professionals as immunocompromised because of a disease, medication or other treatment that weakens their body’s immune response, meaning that diseases such as Covid-19 can be more deadly to them, and that vaccines offer less protection,

Tens of millions more Americans have at least one medical condition, such as asthma or diabetes, that puts them at greater risk from Covid. How much greater can vary widely; many live with little worry, while others at higher risk have felt the need to isolate from society.

That is not what Aaron Vaughn, now 12, of East Lynne, Mo., hoped for when he received a heart transplant in June 2020. Born with half a heart, he thought a transplant would give him more freedom after years of long hospital stays. But with the virus still circulating, he has not been to school or a restaurant — his last trip was to Pizza Hut, his favorite at the time — since early 2020, and sees no one but his family and doctors

His parents said they had received hate mail for asking neighbors to wear masks or get vaccinated — some of the same neighbors who rallied around and prayed for Aaron when he needed a transplant

The rollback of mask mandates in states such as New York, Illinois and California is the latest source of stress for vulnerable Americans, who fear that the rest of the country is shedding precautions without any consideration of how to keep them safe.

“Having everyone mask indoors always is not a forever strategy,” said Dr. Megan Ranney, an emergency physician and academic dean at the School of Public Health at Brown University, noting that immunocompromised people and others with vulnerabilities have always faced risks. But, she added, “We need to make sure that we have more stringent protections in place in places where people don’t have a choice about whether or not they go there.”

The fear and anger felt by many high-risk Americans burst into public view last month in response to remarks from the C.D.C. director, Dr. Rochelle Walensky. Citing a study that said only 0.003 percent of vaccinated people had died of Covid-19, she told ABC News that 75 percent of those who had died despite vaccination had “at least four comorbidities, so, really, these are people who were unwell to begin with.”

Dr. Cameron Webb, the senior policy adviser for equity on the White House Covid-19 Response Team, said the backlash had led the Biden administration to re-examine its approach to people with vulnerabilities. “There’s a lot of pain,” he acknowledged, adding, “We want to do better.”

He pointed to recent guidance from the Department of Health and Human Services saying that patients cannot be deprioritized on the basis of disability, even when hospitals enact crisis standards of care. He said the administration would announce more actions this week, including a working group of advocates.