Weekly coronavirus-related chat, questions, and minor updates - week of March 14

Ed Yong: The coronavirus funding collapse is a disaster

All epidemics trigger the same dispiriting cycle. First, panic: As new pathogens emerge, governments throw money, resources, and attention at the threat. Then, neglect: Once the danger dwindles, budgets shrink and memories fade. The world ends up where it started, forced to confront each new disease unprepared and therefore primed for panic. This Sisphyean sequence occurred in the United States after HIV, anthrax, SARS, Ebola, and Zika. It occurred in Republican administrations and Democratic ones. It occurs despite decades of warnings from public-health experts. It has been as inevitable as the passing of day into night.

Even so, it’s not meant to happen this quickly. When I first wrote about the panic-neglect cycle five years ago, I assumed that it would operate on a timescale of years, and that neglect would set in only after the crisis was over. The coronavirus pandemic has destroyed both assumptions. Before every surge has ended, pundits have incorrectly predicted that the current wave would be the last, or claimed that lifesaving measures were never actually necessary. Time and again, neglect has set in within mere months, often before the panic part has been over.

This week, Congress nixed $15 billion in coronavirus funding from a $1.5 trillion spending bill, which President Joe Biden then signed on Tuesday. The decision is catastrophic, and as the White House has noted, its consequences will unfurl quickly. Next week, the government will have to cut shipments of monoclonal-antibody treatments by a third. In April, it will no longer be able to reimburse health-care providers for testing, vaccinating, or treating millions of uninsured Americans, who are disproportionately likely to be unvaccinated and infected. Come June, it won’t be able to support domestic testing manufacturers. It can’t buy extra doses of antiviral pills or infection-preventing treatments that immunocompromised people are banking on but were already struggling to get. It will need to scale back its efforts to improve vaccination rates in poor countries, which increases the odds that dangerous new variants will arise. If such variants arise, they’ll likely catch the U.S. off guard, because surveillance networks will have to be scaled back too. Should people need further booster shots, the government won’t have enough for everyone.

as I've said before - Trump's legacy will be a ton of terrible things, mishandling covid will only be one of them. Biden may have mishandling covid as the single defining legacy of his presidency.

White House begs Congress for Covid funding amid concern about Omicron sister variant

After lawmakers’ plan to provide $22.5 billion in Covid-19 funding imploded last week over disagreements about how the new spending should be paid for, the White House has been faced with cutting back on its pandemic response activities because its budget is nearly exhausted. It’s unclear whether additional funding is on the way.

The Biden administration on Tuesday laid out a roadmap of the cutbacks and shortages that could happen if no more funding is provided. Specifically, senior administration officials said they would need to wind down some Covid-19 surveillance investments, and that testing capacity could crater after June.

“With reduced capability to perform adequate surveillance, the country will be prone to being ‘blindsided’ by the next variant,” the White House said in a summary of the cutbacks.

Other consequences of the funding shortage include limits on the availability of monoclonal antibody treatments, therapies used by immunocompromised patients, and antiviral pills, and cutbacks in research on next-generation countermeasures that could be more effective.

The US is making some similar mistakes as last June, it seems.

@BarackObama

I just tested positive for COVID. I’ve had a scratchy throat for a couple days, but am feeling fine otherwise. Michelle and I are grateful to be vaccinated and boosted, and she has tested negative.

It’s a reminder to get vaccinated if you haven’t already, even as cases go down.

Looking at Washington Post numbers again:

US cases:

• US down 19% to 11 cases per 100k. California matches the US average. New York down 13% to 8. There's not that much change so this is still about where we were mid-July.
• Looking at other states, Alaska is the worst with 51 per 100k, up 49%. (No change in hospitalizations, though.) Iowa and Washington were bad last week but they're declining again. (Iowa down 82%.)

US Hospitalizations:

• US down 22% to 7.9 per 100k. This also corresponds to mid-July. California at 6.5, New York at 7.5. Nearly all states down or flat except Georgia, up 31% to 21.

US Deaths:

• US down 15% to 1310 (seven day average), which corresponds to .39 per 100k. California down 18% to 135 (.34 per 100k) and New York down 45% to 6 per day (.08 per 100k). This is probably because the east coast went through the Omicron wave first.

Worldwide:

Things looked very bad in many countries until I realized that the Washington Post shows weekly totals outside the US, making it harder to compare. So, 100 per 100k on the US corresponds to 700 per 100k on their international page. I'm going to stop here and look into it more later.

Edit: no, I had it right the first time. Things really are that bad.

On Twitter, John Burn-Murdoch compares Hong Kong to New Zealand stats.

After accounting for lag between infection & death, 1 in 20 cases in Hong Kong currently ends in death.

To put that into context, HK’s case fatality rate (NB different to infection fatality rate) is currently higher than England’s pre-vaccine peak. Two years into the pandemic.

As China’s covid outbreak expands, whole cities and provinces are sealed off and key industries closed (Washington Post)

In Shenzhen, officials ordered the city’s more than 17 million people to stay at home starting on Monday through March 20, after just 150 new cases were reported over the weekend.

The city is home to key Chinese companies like Huawei, electric carmaker BYD and Tencent. Apple supplier Foxconn suspended operations, as did circuit board makers Sunflex and Unimicron, also a supplier to Apple and Intel.

[...]

Several officials have been punished for the latest outbreak, underlining the political importance of containing the virus. In the manufacturing hub of Dongguan in Guangdong, six officials have been fired, while in Laixi, in Qingdao, the deputy mayor was dismissed less than two weeks after she had been appointed. In Jilin province, three officials including the party secretary of Changchun and mayor of Jilin City were removed.

When will one-way masking be safe enough for everyone?

My reasoning is that if our goal is to protect the most immune-compromised members of the community—people in whom vaccines provide zero protection against infection let alone severe disease—then perhaps it would be acceptable to drop indoor mask mandates when case counts are low enough that the highest-risk adults can attend to something like daily living and have less than a 1% chance of becoming infected with SARS-CoV-2 in a 4-month period.

I don't know about the specific numbers they use, but this seems like a good framework for thinking about the problem.

This is from November and Ukraine has worse problems now. But if you were wondering about vaccinations there:

Vaccine Hesitancy in Ukraine: The Sign of a Crisis in Governance?

Despite risks to their health and their family’s health, only one in five Ukrainians have received a full course of COVID-19 vaccine—the lowest rate in Europe. At the same time, the mortality from the infection in Ukraine is unacceptably high. Nor is this situation likely to improve: almost half the country's population does not plan to be vaccinated, sociologists say.

[...]

According to Ukrainian authorities, one of the main reasons is a targeted misinformation campaign by Russia [...] This official explanation is too simple and only partially true. It is easy to see that professionally tailored information campaigns against vaccination have gained currency in Ukraine. However, the antivaccination movement started fifteen years ago [...]

During the 2010–2013 routine vaccination campaign, there were many cases of complications among children, which were well reported in the mass media. It subsequently turned out that serious protocol violations had occurred in storing and administering the vaccine. The authorities at the time either kept silent about the resulting injuries or actively covered up the incidents. The start of widespread distrust in the public health care system and the growing refusal of any vaccination can be traced to this episode.

I was shocked to see the US drop to 8th place and South Korea, Germany & Vietnam in the top 3 places (ordered by case numbers over the last month).

It strikes as odd that the death rate is so comparatively high in the US. I imagine it's vaccine avoidance causing that.