• Good News: Omicron Is Waning. Bad News: It’s Still Really Bad.

    A drive-up Covid testing siteHoptocopter/Getty

    The Omicron variant of Covid-19, which has overwhelmed hospitals and set new pandemic case records, is starting to wane in states that saw late surges—a sign that the worst of the highly contagious variant wave may have passed in the United States.

    The latest available numbers reveal that Omicron is following a pattern from rapid acceleration to quick drop-off. In South Africa, where the variant was first identified, infections are down 87 percent from a mid-December peak. In the US, Omicron first hit the northeast. According to New York Times data, infections in those states started coming down as quickly as they rose—though new infection rates remain above last winter’s record. Now, the Times reports, rates are finally falling in the last states where Omicron surged:

    In Arizona, the seven-day average of daily cases fell from a peak of 20,778 on Monday to 18,208 on Friday, a roughly 12 percent decrease over five days, according to a New York Times database. Cases in Utah have declined 35 percent and in Mississippi 25 percent since peaking on January 19. Cases in North Dakota have fallen 19 percent since a Jan. 22 peak.

    The bad news is that hospitals remain overwhelmed. Since Covid-related hospitalizations and deaths lag behind infection rates, the pain this wave will inflict is probably at least a few weeks from dissipating. When it finally ends, the question will be whether there’s a new variant—and just how bad it might be. One contender nicknamed “stealth omicron” has already popped up in Europe. The future remains as uncertain as ever.

  • The Grinch Has a New Name: Omicron

    A worker dons a Grinch mask while waiting to help to direct travellers in the terminal of Denver International Airport Friday, Dec. 24, 2021, in Denver. More than 200 flights were cancelled by carriers out of Denver International because COVID-19 issues have created a shortage of workers. David Zalubowski/AP Photo

    Last week, the Omicron variant of the novel coronavirus swept across the United States just as millions of people were preparing to visit family for the holidays. The spike in Covid infections hit the airline industry hard, causing employees to call in sick at high rates during the busiest time of the year. Predictably enough, a cascade of flights had to be canceled, leaving tens of thousands of passengers stranded in airports. 

    “Airlines canceled hundreds more flights Sunday, citing staffing problems tied to Covid-19, as the nation’s travel woes extended beyond Christmas, with no clear indication when normal schedules would resume,” the Associated Press reported Sunday afternoon. 

    Omicron is also hammering hospitals. As the New York Times reported Christmas Day, “[H]ospitals in Ohio running low on beds and staff recently took out a full-page newspaper advertisement pleading with unvaccinated Americans to finally get the shot. It read, simply: ‘Help.'” 

    The situation there is dire. The state “now has the country’s highest rate of Covid-19 hospitalization, and doctors say emergency rooms and I.C.U.s are running out of beds,” the Times notes. “They are being forced to call people in from holiday vacations as growing breakthrough infections whittle away at their staff levels.

    And other regions of the country are moving in the wrong direction as well, with surges reported in Arkansas, California, Delaware, Florida, Missouri, New Jersey, New York, and more.

    The newest new Covid wave comes at a time when efforts to fully vaccinate the nation have stalled, hitting a wall of anti-vaccine sentiment. More than 39 million American adults—15 percent of the adult population— remain unvaccinated, and a recent Kaiser poll found that 87 percent of unvaccinated Americans say the new variant won’t spur them to get the jab. It’s unvaccinated people who are causing the spike in hospitalizations. 

    But stubborn US anti-vaxxers aren’t the only obstacle to a return to normal. In much of the globe, vaccines are still largely unavailable. “About 73 percent of shots that have gone into arms worldwide have been administered in high- and upper-middle-income countries,” the New York Times’ global vaccine tracker web page reports. “Only 0.9 percent of doses have been administered in low-income countries.”

    The global anti-poverty charity Oxfam recently calculated that “more doses of Covid-19 vaccines have been delivered to the EU, the UK, and the US in the six-week run-up to Christmas than African countries have received all year.” With more than 40 percent of the world’s population unvaccinated, the virus has ample opportunity to mutate and generate an entire Greek alphabet of variants that can spread globally, ruining very much more than just Christmas travel. 

  • The Biden Administration Is Ramping Up Its Omicron Response

    Justin L. Stewart/Zuma

    The Biden administration announced a new set of measures Tuesday for tackling the Omicron variant, which has rapidly become the most dominant coronavirus variant in the United States.

    President Biden’s plan involves setting up new federal testing sites, sending 1,000 military medical professionals to overburdened hospitals, and buying and distributing 500 million free rapid tests to the public. The new plan is a significant step up from the actions that the Biden administration announced it would take to combat the coronavirus three weeks ago. That plan promised that private insurers would reimburse consumers for the cost of rapid at-home COVID tests—starting January 15.

    Earlier this month, Press Secretary Jen Psaki drew criticism when she asked at a press conference, “Should we just send [a test] to every American?” Now, it appears that that’s exactly what the Biden administration is poised to do. But not until after the holidays—the 500 million tests will not be available until January. Many major cities are seeing long lines at COVID testing sites, days-long waits for PCR test results, and a shortage of at-home rapid tests.

    At a press conference this afternoon, Biden acknowledged that the Omicron variant increases the risk of breakthrough infections, but also stressed the importance of vaccinations and booster shots to reduce the severity of any potential illness. “A case of COVID-19 for a fully vaccinated and boosted person will most likely mean no symptoms or mild ones similar to the common respiratory viruses,” he said. “Over 200 million Americans share the peace of mind that they did not have in March 2020. They’re protected from hospitalization and are protected from death.”

    This article has been updated with details from Biden’s afternoon press conference.

  • Omicron, However You Pronounce It, Is Out of Control Right Now

    John Nacion/STAR MAX/IPx 2021/AP

    For the last week, every passing day in New York has felt a little more ominous. Upstate counties are facing overwhelmed hospitals, and Covid-19 cases are surging in the city, even among the fully vaccinated, due in part to the new Omicron variant. Lines for PCR testing in my neighborhood stretch for blocks, and response times for those test results seem to be lagging. Restaurants shut their doors. Parties were canceled. The Brooklyn Nets were so desperate for healthy players they reactivated the vax-less Kyrie Irving—who was promptly forced to quarantine. And now we have the numbers to show for it: On Friday, New York state posted its highest recorded number of positive Covid-19 tests since the pandemic began.

    There are a few big caveats to that number. The first is that in the Spring of 2020, when New York City was the epicenter of the global pandemic, testing was so limited it almost felt like a scandal that an entire NBA team could get them—so there’s no comparison with that moment. The second, of course, is that most of the adult population is vaccinated, and a significant number of people have gotten booster shots, and they seem to have a good deal of protection against the variant’s worst effects. This isn’t March of 2020, no matter how ominous the tick-tick-tick of canceled sporting events and disrupted travel plans might be.

    But it still sucks. It’s been almost two years of this. It’s the holidays! Everyone’s traveling and people are trying to catch up on the cheer they missed last year. And even while many aspects of the pandemic are greatly improved—we have better treatment options, and vaccines, and understandings of how it spreads, and lots of masks, and tests—there are still familiar hang-ups. Tests are embarrassingly expensive (in the UK they’ll send you tests for free), and the Biden administration—which once mocked the notion of sending out free tests—has rolled out a Rube Goldberg-ish process to curb costs. Per the New York Times:

    The administration has said that it plans to issue its rules for reimbursement by Jan. 15, and the plan will go into effect sometime after that.

    The administration has already said that the plan will not provide retroactive reimbursement for tests that have already been purchased, which means that any tests you buy for the holidays will not be covered.

    January 15th!?

    Stay safe, everyone. Get tested before you travel. And get that booster yesterday.

  • 800,000 People in the United States Have Died of COVID-19

    An art installation no the National Mall commemorating all Americans who have died of COVID-19 on September 24, 2021. Yasin Ozturk/Anadolu Agency/Getty

    When the United States hit 100,000 COVID-19 deaths in May of 2020, it was a pretty big deal. The New York Times mourned the “incalculable loss” in a full page headline. Even Donald Trump grudgingly acknowledged the toll.

    On Sunday, with far less fanfare, the US hit 800,000 COVID deaths, according to a Reuters tally. That appalling milestone comes with deaths and cases again rising amid cold weather and continued vaccine refusal, and with the highly transmissible Omicron variant poised to contribute to the surge.

    Eight hundred thousand is roughly the same as the number of Rwandans estimated to have been killed in the 1994 genocide there. It’s more than the population of North Dakota. Worldwide, meanwhile, COVID has killed at least 5.3 million people, according to a New York Times estimate. The real number is probably much higher.

    Official COVID deaths, those that hospitals or coroners say were caused by the virus, will pass one million next year, maybe in the spring at current rates. But public health experts argue that COVID’s actual toll has already reached that grim milestone. Measures of excess mortality, a measurement of deaths from all causes above the number public health experts expected, jumped in many US communities as COVID surged. These measures suggest the actual death toll is about 20 percent higher than the official tally. Some of those added deaths aren’t from COVID—they could be people who failed to get medical treatment due to hospitals being overwhelmed. But these are real losses linked to the pandemic.

    And the deaths are concentrated among people of color. They surged “in place like Albuquerque, New Mexico; Miami-Dade County, Florida; Jersey City, New Jersey; and New York City,” researchers from the Brown Institute for Media Innovation and MuckRock’s Documenting COVID-19 project wrote last week. 

    If you count those people, “the number of Americans who have died from the virus could be closer to 1 million,” the researchers wrote.

    Deaths mount while the Republican Party makes resistance to vaccine mandates a key plank ahead of what are expected to be big gains in the 2022 midterm elections. On December 8, every Senate Republican, along with two Democrats, voted to overturn President Joe Biden’s proposed mandate for large private companies to require workers to either get vaccinated or to undergo regular COVID testing.

    Around 60 million adults older than 12 in the US remain unvaccinated. Those people face a far greater risk of serious illness or death from the disease. A Texas study found last month that unvaccinated people are 13 times more likely to get COVID and 40 times more likely to die of it compared to those who are vaccinated.

  • Report: Facebook’s Own Research Confirms It Is a Hotbed of Vaccine Denial

    Kevin Dietsch/Getty

    In July, after President Joe Biden said coronavirus misinformation on Facebook was “killing people,” an anonymous company official jawed back, saying Facebook would “not be distracted by accusations which aren’t supported by the facts.”

    But behind the scenes, Facebook employees were already beginning to reckon with a flood of false anti-vaccine claims on the platform. According to a company memo obtained by the Wall Street Journal and released this morning, around the time COVID-19 vaccines became widely available last spring, “roughly 41% of comments on English-language vaccine-related posts risked discouraging vaccinations.” The document and other internal memos show, the Journal writes, “that Facebook has often made minimal or ineffectual efforts to address the issues and plays them down in public.”

    Facebook’s efforts to crackdown on anti-vaccine content—like its laggard response to its role in spreading falsehoods and hate, including political disinformation and QAnon conspiracies—ran into several hurdles. Although CEO Mark Zuckerberg personally supported making the platform a haven for credible, public health information, users didn’t, and quickly flooded private Facebook Groups and the comments of major posts with misinformation.

    Anti-vaccine content was twice as prevalent in comment sections as in posts, one memo found, but the company’s ability to detect and take down problematic comments was “bad in English, and basically non-existent elsewhere,” a Facebook data scientist wrote in one memo. The company’s systems didn’t always make it easy to remove or demote posts. After Facebook employees singled out a viral post that claimed vaccines “are all experimental & you are in the experiment,” it remained up because “Facebook’s systems mistakenly thought it was written in Romanian.” 

    While Facebook’s role in spreading vaccine-related misinformation has been a topic of public discussion throughout the pandemic, even as internal researchers identified the problem, the company avoided public acknowledgment and generally remained defensive. Guy Rosen, Facebook’s vice president of integrity, argued in a July blog post that “vaccine acceptance among Facebook users in the US has increased.” Responding directly to Biden’s criticism of the company, Rosen said, “The data shows that 85% of Facebook users in the US have been or want to be vaccinated against COVID-19. President Biden’s goal was for 70% of Americans to be vaccinated by July 4. Facebook is not the reason this goal was missed.”

    But internally, the Journal reported, “Facebook documents show it had been playing catch-up for months, trying to manage the flood of misleading and false information aimed at undermining the vaccine effort.” Upcoming congressional hearings could bring further revelations; as the Journal points out, “Facebook officials have become concerned that Mr. Zuckerberg or Chief Operating Officer Sheryl Sandberg may face questions from lawmakers about how their past public statements on these issues square with the company’s internal assessments.”

  • As COVID Surges, We’re Not in the Endgame, We’re Mired in Uncertainty

    Medical staff move COVID-19 patient who died onto a gurney to hand off to a funeral home van, at the Willis-Knighton Medical Center in Shreveport, La., Wednesday, Aug. 18, 2021. Gerald Herbert/AP

    Just three months ago, the United States averaged fewer than 25,000 COVID infections a day, with an average of 627 COVID deaths over a seven-day period. It was the end of May and it seemed as if the light at the end of the proverbial COVID tunnel was near just as the “hot vax summer” was about to begin. 

    Then, as more and more Americans became vaccinated, too many—to the tune of 47 percent of Americans as of Sunday—have refused. And among that group of people, the more transmissible Delta variant spread like wildfire. Now, at summer’s end, as the nation averages more than 160,000 infections per day, more than 100,000 daily hospitalizations, and more than 1,500 deaths, the highest rates since March, epidemiologists, public health officials, and, frankly, many Americans are asking: When will this end?

    In places where vaccinations are low, the wave of infections has pushed hospitals to the brink of a crisis. In Mississippi, just 38 percent of residents are fully vaccinated, and the surge in cases and hospitalizations, particularly among children, have strained hospitals. At the University of Mississippi Medical Center, the state’s only level one trauma center, the emergency room and ICU are beyond capacity, with exhausted hospital workers treating patients in a “logjam” of beds scattered in the hallways and in triage rooms. During a recent news conference, Dr. LouAnn Woodward, the head of that medical center, said, “We, as a state, as a collective, have failed to respond in a unified way to a common threat.”

    In Florida, where Republican Gov. Ron DeSantis has been aggressively antagonistic toward mask mandates and measures that would curtail COVID’s spread, the state is seeing its deadliest period in the pandemic, averaging 244 deaths per day, higher than its peak last summer. Just 44 percent of residents are vaccinated in nearby South Carolina where the state is averaging 5,400 new COVID cases per day, the highest infection rate in the country. Steve Benjamin, Democratic mayor of Columbia, the state’s capital, announced he planned essentially to defy the Republican governor’s ban of mask mandates by imposing a local state of emergency and order students to wear masks if COVID cases keep rising.  

    What’s more, the CDC recently found that unvaccinated people are 29 times more likely to be hospitalized from COVID than those who are vaccinated, further burdening hospital resources. Part of the issue, of course, is that only kids 12 years and older can currently get vaccinated, and the reopening of schools for in-person learning has amplified concerns over the spread among children, teachers, and their families. CDC research found that between mid-June and late August, COVID hospitalizations rose fivefold among children and teenagers.

    But the story of unvaccinated versus vaccinated children could be considered a microcosm of the unfolding of the pandemic generally. Even though children under age 12 cannot be vaccinated, Dr. Anthony Fauci, the nation’s top infectious disease expert, recently said that they likely won’t begin to be until “hopefully by the mid, late fall and early winter.” But for those who can get vaccinated, it’s clear that the shots work to curtail hospitalizations. The rate of COVID hospitalizations was 10 times higher among unvaccinated children compared to vaccinated ones. And tellingly, pediatric hospitalizations were roughly four times higher in states with the lowest vaccination rates than in those with the highest, further showing that vaccines curtail severe disease even among children.

    What does this all mean? It means we’re in the midst of yet another period of uncertainty that’s likely to continue if we fail to vaccinate enough people and take actions such as mask mandates to curb the virus spread. A Washington Post/ABC News poll showed that 52 percent of Americans supported vaccine mandates from businesses and two-thirds of those polled supported school districts requiring mask wearing for students, teachers, and staff. Even so, that same poll found that even though they are more concerned than in June, more than 60 percent of unvaccinated Americans saw “low” to “no” risk of contracting COVID. 

    “People are pretty burned out 18 months into this thing,” Ezekiel Emanuel, professor of medical ethics and health policy at the University of Pennsylvania, told the Washington Post. “And the exhaustion has been made worse by the rapid seesaw we’re having—take your masks off, put them back on. It’s all very confusing, but we have to be honest: We don’t know when, we don’t know how. We don’t know.”

  • Pediatric COVID Cases Are Skyrocketing—Yet Some Parents Still Rage Against Virus Guidelines

    Paul Hennessy/Sipa USA via AP

    As the school year starts for millions of children across the country, coronavirus cases among kids are on the rise. The American Academy of Pediatrics is reporting that between August 5 and August 26, 500,000 children tested positive for COVID-19—a five-fold increase since July. The alarming rise in cases comes as many students are returning to in-person classrooms and conservative parents protests against mask and vaccine mandates designed to keep kids safe.

    Despite the rollout of the vaccine, the Delta variant of the coronavirus is surging across the country, particularly in states where vaccine rates remain low. The vast majority of the people getting infected, hospitalized, and dying from the virus are the unvaccinated—which includes children under 12 who are not yet eligible for the vaccine. Because the youngest among us cannot be inoculated, we have to rely on other measures to keep them safe, like masking, distancing, testing, and ventilation.

    The consequences of ignoring public health restrictions are grim. More than 220 children’s hospitals are pleading with the Biden administration for help as the increasing number of child patients are straining the staff and their facilities. “Our children’s health care safety net is under unprecedented strain,” Children’s Hospital Association CEO Mark Wietecha said in a press release. “Children’s hospitals and their dedicated staffs are doing their part, and we hope every American, the White House and Congress can help.”

    Unfortunately, not everyone is concerned about the safety of children. An alarming number of parents have tried to interfere with public health protocols at schools. On Thursday, an Arizona elementary school called a parent of a child at the school to inform him that his child had been exposed to the coronavirus and needed to quarantine at home. The child’s father, instead, showed up to the school with two other men and zip ties.

    When they arrived, according to the Washington Post, they told school staff that they were there to arrest the principal. “If you insist on this, I’ll have you arrested,” one of the unidentified men said. “We’re ready to make a citizen’s arrest if necessary.” The principal informed the men that he was simply following guidance from the county health department and called the police. The men left before law enforcement arrived. 

  • Boosters Before the World Is Vaccinated Isn’t Just Unjust. It Could Prolong the Pandemic for Everyone.

    A health care worker draws up a dose of the Moderna COVID-19 vaccine in Novato, California.David Paul Morris/Bloomberg/Getty

    As the Delta variant spreads across the country, and breakthrough cases among vaccinated people are on the rise, health officials in the United States are rolling out plans for booster shots—even as much of the world waits for their chance at the first shot.

    The Biden administration announced that boosters should be available to those who have received the Pfizer or Moderna vaccine as soon as September 20. Studies are underway to determine the importance of supplemental doses for those who received Johnson & Johnson, with experts thinking boosters for the single-dose shot will likely be needed, too. Which means that more than 5 million Americans—with priority given to health care workers, nursing home residents, and elderly adults—might be eligible to receive third shots later next month, and even more Americans are soon to follow after that. Already, in Israel, extra doses are available to many immunocompromised individuals as well as people over 50; Germany, France, and the UK have begun to make plans to offer boosters this fall.

    As wealthier nations race to roll out boosters, many global health experts have cautioned against the rush. Only 1.3 percent of people in low-income countries have received at least one dose. 

    Administering boosters in the US while much of the world cannot access vaccines isn’t just ethically dubious. Experts say this could drag the pandemic on even longer, especially while Delta and other variants continue to travel. As long as vaccination rates are low in other parts of the world, more robust variants will continue to crop up.

    It’s possible that some of these evolutionarily fit viruses could evolve to escape immunity acquired through prior infection or vaccines. Biden’s former chief COVID-19 adviser, Andy Slavitt, explained it well in this thread: 

    Some experts say the boosters could delay the pandemic by at least another year:

    Earlier this month, WHO Director General, Tedros Adhanom Ghebreyesus called for a global moratorium on vaccine boosters at least until September. On Monday he cautioned that “vaccine injustice and vaccine nationalism” in wealthier countries will allow more time for variants to mutate and spread. The organization’s Africa director, Matshidiso Moeti, blasted wealthy countries that have begun administering extra shots, saying the decision “makes a mockery of vaccine equity.”

    Michael Ryan, the emergencies chief at the WHO, added that “we’re planning to hand out extra life jackets to people who already have life jackets while we’re leaving other people to drown.”

    Pitting boosters against global equity is simply a “false choice,” said White House Press Secretary Jen Psaki. She noted that the US has donated more than 110 million vaccines to other countries.

    What’s more important might be that five days after the initial announcement about pursuing boosters, the White House released data that showed that protection from vaccines against symptomatic infection wanes after six months. With that information available, some experts have argued, it would have been hard for the Biden administration not to justify boosters for Americans. 

    Even before Biden announced that the US will begin administering boosters, many Americans were taking extra inoculation into their own hands, often with a “mix and match” approach, despite WHO’s advice against making your own vaccine cocktail. The CDC reported that around 1.1 million people have already received unauthorized third doses of Pfizer or Modern vaccines. 

    But with a limited global supply of vaccines, Madhukar Pai, a global health researcher at McGill, said it really is a “zero-sum game.”

    In many other countries, barely 1 million have been able to receive vaccines. In Cameroon, for example, a country with 26 million people, only a little over 395,000 have gotten vaccinated. Or take Bangladesh, one of the world’s most populous countries, where less than 10 percent of the population has gotten the jab. 

    “The most vulnerable everywhere in the world should be kept safe from COVID as soon as reasonably possible,” Jerome Singh, a professor of public health who specializes in ethics in global health at the University of Toronto told me.

    Singh noted that previous policies, like the United States’ ban on exporting raw materials needed for vaccine production in April (which has since been lifted), had a “paralyzing impact” on vaccine availability worldwide.

    “It’s ethically problematic to suggest that vulnerable people in the US should be prioritized for a third dose when equally vulnerable people in many low- and middle-income countries have yet to receive their first dose. The lives of vulnerable people everywhere have equal moral worth.”

  • CDC Study: Black and Latinx Adults Died at Startlingly Higher Rates During the Pandemic

    People wait for a distribution of masks and food from the Rev. Al Sharpton in the Harlem neighborhood of New York. Bebeto Matthews/AP

    During the COVID pandemic, life expectancy for Black Americans fell by 2.9 years. Latinx Americans, who typically live longer than Black Americans and whites, lost three years of their lives. Now, a new Centers for Disease Control and Prevention study published Friday found that Black, Latinx, and Native Americans/Alaskan Native adults have died at startlingly higher rates during the COVID pandemic than in typical years, illuminating the disparate suffering communities of color have faced in the last year and a half.

    In the CDC’s Morbidity and Mortality Weekly Report, researchers looked at the excess mortality incidence rates, a wonky term that means the number of people who have died in a population above their community’s expected number of deaths. They assessed the number of excess deaths per 100,000 people across the US between December 2019 and January 2021 by race and age and observed changes in death trends over the course of the pandemic. 

    The researchers found that for adults older than 65 years old, Black Americans died at an excess rate of 1,033 per 100,000 people while Latinx adults died at an excess rate of 1,007 per 100,000—a far cry from white Americans, who died at an excess rate of 500.1 per 100,000. And for Black adults over 65 years old, 78.7 percent of excess deaths were directly attributed to COVID. For Latinx adults over 65, the percentage was 85 percent. And for white Americans over 65, that percentage stood at 93 percent. 

    As researchers zoomed in on younger adults, though, the disparities in excess death rates became starker. While white Americans between 25 years old and 64 died at an excess rate of 51.2 per 100,000, Latinx Americans died at nearly 99 per 100,000 and Black Americans died at a startling excess rate 133 per 100,000. What’s more, excess deaths among Alaskan Natives and Native American adults between 25 and 64 occurred at a staggering rate of 221 per 100,000. 

    This is a lot to digest. Let me share a graph with you.

    The numbers are complicated, but the resulting message isn't. Researchers concluded that the findings could help "guide targeted public health messaging and mitigation efforts to reduce [COVID] disparities" and "highlight the importance of timely data to address inequities in social determinants of health that increase the risk for death from COVID-19 among racial/ethnic minority groups." The CDC study affirmed what Black, Latinx, and Native American/Alaskan Native communities have experienced since early 2020: Unprecedented death and despair, thanks in large part to a pandemic that has exposed just how unequal the country is. 

  • Louisiana Has Among the Highest Daily COVID Infections in the World

    Passengers wait in a long line to get a COVID-19 test to travel overseas at Fort Lauderdale-Hollywood International Airport. Marta Lavandier/AP

    In recent weeks, hospitals across the country have felt overwhelmed with the surge of coronavirus cases. On Saturday, Florida reported nearly 24,000 new cases, an all-time single-day record for the state. Meanwhile, in the last seven days, Louisiana, at 693 cases per 100,000 people, has the highest number of new cases per capita in the United States, followed by Florida (627) and Arkansas (502). Dr. Joe Kanter, the state’s top health officer, told the Associated Press that 1 percent of Louisiana’s population contracted COVID-19 in the past two weeks.

    Zoom out, and one can see an even more troubling trend: When compared to other countries with populations over 1 million people in the last seven days, Louisiana is tied with Botswana for the highest daily case average per capita in the world—at 99 cases per 100,000 people, according to the New York Times‘ coronavirus case tracker for the United States and the world. Florida, meanwhile, is not far behind with a daily average of 90 per 100,000 people, ahead of nearby Cuba (81 per 100,000). “If Louisiana and Florida were countries, and not states, Louisiana would be the highest incidence country in the world and Florida would be the fourth one,” epidemiologist Michael Osterholm said on MSNBC last week.

    The troubling surge comes as GOP governors like Florida’s Ron DeSantis and Texas’s Greg Abbott have imposed statewide bans on mask mandates in schools as their states’ hospitals grapple with the surge in COVID cases. In Louisiana, where just 37 percent of people are fully vaccinated, Democratic Gov. John Bel Edwards has reissued a statewide mask mandate, even as his Republican attorney general undermined it.

    But some Republican lawmakers have shifted gears as their states suffered from the Delta variant. On Sunday, more than three months after he signed a law barring local mask mandates, Arkansas Gov. Asa Hutchinson said on CBS’s Face the Nation that his decision was an “error,” adding: “Facts change, and leaders have to adjust to the new facts and the reality of what you have to deal with.” And Louisiana Republican Sen. Bill Cassidy, a physician who contracted COVID, told CNN’s Dana Bash on State of the Union that he disagreed with DeSantis’s ban, noting: “When it comes to local conditions, if my hospital is full and my vaccination rate is low and the infection rate is going crazy, we should allow local officials to make those decisions best for their community.” 

  • The US Is a Failed COVID State

    Jae C. Hong/AP

    The United States has returned to the grim milestone of 100,000 new coronavirus infections per day. As the highly transmissible Delta variant surges and vaccination rates remain low in some parts of the country, infection rates are returning to levels not seen since last winter, before vaccines were available.

    Fifty percent of Americans are vaccinated and 70 percent of adults have at least received one dose of the vaccine. Children under 12 are still not eligible for the vaccine. But despite widely available vaccines, many states across the south, such as Florida and Tennessee, have dismal vaccine uptake, leaving their populations vulnerable to the new variant.

    Florida is making up 20 percent of the nation’s new infections and hospitalizations, as Republican Gov. Ron DeSantis does everything but fight the virus. The 2024 hopeful has played footsies with anti-vaxxers and has complained that the federal government is trying to curb individual “freedom” at the mere suggestion that he take action to curb the spread of coronavirus in his state. 

    This latest surge comes right as the school year is set to begin. Adults refusing to get vaccinated combined with officials weary of imposing mask mandates at schools across the country has created a nightmare for parents, teachers, and students attempting to stay safe from the virus. DeSantis threatened to withhold funding from Broward County schools after the district tried to implement a mask mandate for the school year. In Tennessee, the state House Speaker Cameron Sexton threatened to call a special legislative session to provide vouchers for parents to change schools if any district shuts down or imposes a mask mandate. Meanwhile, the number of children infected with coronavirus is on the rise.

    It’s not just new infections. The vaccines have so far proven to largely prevent serious illness and hospitalization, but the unvaccinated are causing a surge in hospitalizations too. The Southeast has seen a 50 percent increase in hospitalizations, leaving health care workers overworked and hospitals overrun. Florida, Georgia, Louisiana, and Mississippi account for 40 percent of hospitalizations—in those states doctors are worried about running out of beds and turning patients away eerily reminiscent of the early days of the pandemic. “We are seeing a surge like we’ve not seen before in terms of the patients coming,” Dr. Marc Napp, a Florida doctor told the Associated Press earlier this week. “It’s the sheer number coming in at the same time. There are only so many beds, so many doctors, only so many nurses.”

  • As COVID Breaks Records in Arkansas, Its GOP Governor Regrets Ban on Mask Mandates

    Tom Williams/ZUMA

    As the spread of the highly contagious Delta variant shatters coronavirus case records in Arkansas, its Republican governor is scrambling to reverse a ban on local mask mandates he signed into law just months ago. But as Gov. Asa Hutchinson admitted in a press conference Monday, rolling it back will be difficult—and something he probably can’t do without broader support from his party’s lawmakers.

    “In hindsight, I wish that had not become law,” Hutchinson told reporters. “But it is the law and the only chance we have is either to amend it or for the courts to say it has an unconstitutional foundation.” The governor, who last week declared a public health emergency amid surging COVID cases, is now calling for a special legislative session to amend the ban. But Hutchinson’s admission of regret may not be enough to convince the state’s GOP-controlled legislature.

    Resistance to vaccines has exacerbated the crisis, with Arkansas communities accounting for some of the country’s lowest vaccination rates. Last week, Hutchinson faced vaccine hesitancy firsthand when he was roundly booed on stage after challenging the lie that vaccines cause fertility issues.

    While Hutchinson was just one of many GOP governors to enthusiastically embrace a ban on mask mandates earlier in the pandemic, he is the first to try to roll back such an order. His move stands in stark contrast to other Republican governors still doubling down on them, as in Florida, Mississippi, and Texas, even as their states see cases explode. As I wrote earlier:

    On Saturday, Florida recorded 21,683 new cases of COVID-19, breaking its one-day record for new cases. But even as the state swells with fresh infections, Republican Gov. Ron DeSantis remains hellbent on his war against mask mandates. He even recently barred school districts from instituting mask mandates when classes reconvene in August. 

    DeSantis is far from alone in his bitter fight against mask-wearing, a measure health officials say is critical in the fight to contain the highly contagious Delta variant. In Mississippi, where ICU beds are nearing capacity with a surge of unvaccinated individuals, Republican Gov. Tate Reeves blasted the CDC’s mask guidelines as “foolish” and claimed that it reeked of “political panic.”

    “It has nothing, let me say that again: It has nothing to do with rational science,” Reeves said on Thursday. 

    On Monday, President Biden directly called out Republican governors who are blocking schools and businesses in their states from instituting mask mandates, telling them to “get out of the way.” 

    “Some governors aren’t willing to do the right things to make this happen,” Biden told reporters. “I say to these governors, please help. If you aren’t going to help, at least get out of the way of the people who are trying to do the right thing. Use your power to save lives.”

  • The Real Reason Behind the Misinformation Epidemic in Online Moms’ Groups

    Mother Jones illustration; Getty

    The rollout of children’s COVID vaccines has begun: On Monday, the FDA approved the Pfizer shot for 12- to 15-year-olds. That’s just the beginning—last week, the New York Times reported that children as young as 2 could be eligible as soon as September. The mass vaccination of children could herald the end of the most catastrophic social costs from the pandemic in the United States: Schools and day care facilities will be able to resume normal operations, which means parents will no longer have to perform the nearly impossible act of juggling simultaneous work demands and child care. Cue the collective sigh of parental relief: It’s the moment we’ve all been waiting for!

    Well, maybe not all of us. According to an April poll by the Kaiser Family Foundation, nearly a quarter of parents surveyed said they definitely wouldn’t get their child vaccinated, and an additional 15 percent said they would only have their child vaccinated if their school required it. About a third said they didn’t plan to get their children vaccinated right away; instead they planned to wait and monitor for side effects.

    In some ways, this was to be expected. The vaccines are new, and they were approved under an emergency-use authorization during a historic pandemic. Nathan Chomilo, a pediatrician in Minnesota and a spokesperson for the American Academy of Pediatrics, told me that parents of his patients have expressed very understandable concerns—that the trials seemed rushed, for instance (they weren’t), and questions about whether kids really need the vaccine, given their relative unlikelihood of severe COVID. (Most experts agree they do.) Chomilo notes the importance of language in describing what’s going on. “I’ve really tried to use the term ‘vaccine deliberation’ when it comes to the COVID-19 vaccine versus lumping it in with this broader, longer-term issue of ‘vaccine hesitancy,’” he said. 

    But where Chomilo sees a need for nuanced conversations, anti-vaccine advocates likely see a grand opportunity to broaden their base with a group of parents—people who may never have thought twice about keeping up with the standard schedule of vaccines for infants and children but now are questioning the safety of a new shot. Experts have observed an uptick in anti-vaccine organizing over the last year. Rupali Limaye, a Johns Hopkins public health researcher who studies vaccine hesitancy, told me via email that she is “worried about the growing following behind some prominent antivaxx groups.” She sees these forces not only as barriers to mass vaccination against COVID but also as direct threats to herself and her colleagues. She added, “There seems to be more coordination among those that have these attitudes, and this has led to coordinated attacks/take downs of public health officials.” 

    Even before the COVID vaccines were approved for teens, anti-vaccine groups were already out in force in online parenting communities. A few viral posts round up entries from the Vaccine Adverse Event Reporting System, the federal database where people can report any symptoms they’ve experienced after a vaccine. These posts are compelling—like this one from an anti-vaccine advocate purporting to find a pattern of heart problems in 16-year-olds who have received a COVID vaccine.

    What the people behind the posts don’t disclose is that VAERS reports aren’t verified independently, nor are they official medical reports: Anyone can submit an entry. But this is a perfect template for how misinformation works: Its spreaders omit key context or details and hope readers will have an emotional reaction without thinking too hard about the veracity of what they’re reading.

    That’s just one tactic, of course. Throughout the pandemic, I’ve reported on the proliferation of anti-vaccine sentiment in online parenting communities. I’ve examined how anti-vaxxers took over homeschool moms’ groups, and how coronavirus deniers and QAnon conspiracy theorists won over moms’ communities on social media. As the year wore on, I’ve noticed a few patterns of misinformation that are repeated in these groups, and I expect to see them crop up again during the rollout of vaccines for children. In the coming weeks, you’re likely to see posts designed to appeal to the Whole Foods shopper types (“Do you really know what’s in those vaccines?”), the anti-corporate types (“Big pharma’s making bank on these vaccines!”), and the Libertarians (“Don’t let the government tell you what to put in your kid’s body!”).

    You’ll see more subtle posts, too, which will appeal to one’s sense of identity as a caring and vigilant parent. Are you the kind of parent who will unquestioningly do what you’re told? Or are you the more savvy kind who will rely on your own intuition about what’s best for your family? Aren’t you the kind of parent who will do your own research?

    This last category of these posts may be the most important because psychologically it can be the most effective. The reasons that moms’ groups are particular targets of anti-vaxxers are complex, but there’s one dynamic that I think deserves more attention. I’m going to go on a little tangent here, but bear with me—I promise this is relevant to vaccines. A few weeks back, Katie J.M. Baker wrote in Lux about the proliferation of anti-trans sentiment in UK moms’ groups. Baker observed members seeing trans people who bore children as a threat to their burgeoning identity as moms, as if moms’ group members required exclusive ownership of the physicality of motherhood. Baker quotes one group member: “Carrying my child and birthing my child was not a fucking social construct.” She chronicles how this kind of outrage gets whipped up in the groups with trans people becoming the scapegoats.

    Of course, Baker is writing about something entirely different, but vaccine misinformation can follow a similar pattern. In these groups, the physical acts of motherhood—like unmedicated childbirth and breastfeeding—are powerful markers of identity. These acts are often talked about as “superpowers.” Many mothers, and perhaps especially the ones who spend a lot of time in Facebook groups, can feel vulnerable, lonely, and overwhelmed. They may have scant family leave and little help at home. Sometimes, their real concerns about their own health and their babies’ wellbeing have been dismissed by doctors.

    For years, purveyors of misinformation about alternative health have exploited these forums to promote theories and practices that aren’t backed by science and can be dangerous. Some of the greatest hits: Ultrasounds can harm your developing fetus; Tamiflu will kill your toddler; a mere sip of formula will destroy your infant’s microbiome; and you should eat your placenta to ward off postpartum depression. The unifying theme for all of them is that the savvy parent “does her own research” to guard against profiteering hospitals and pharma-aligned doctors. It’s not a big intellectual leap to get from that mindset to vaccine skepticism. 

    Much of this misinformation can be found interspersed with inspirational feel-good messages in the public Facebook group Natural Parenting Mommas. With 143,000 followers, the group lists among its subjects of interest attachment parenting, baby-wearing, holistic health, and natural birth methods. Typical posts range from TikTok videos defending the right to breastfeed in public to memes criticizing standard obstetric practices such as cervical exams. Many of the posts have a feminist vibe; there are countless memes about the thankless work of mothering. You can imagine readers murmuring tearfully, “I feel so seen!” “What men don’t understand is…nobody cooks for her,” reads one. “Nobody cleans for her. Nobody makes her meals. Nobody does her laundry. Nobody makes sure she’s okay. Nobody caters to her, period. A woman is always instantly looked at as someone who needs to take care of everyone.” Some of the memes that the group shares are full of cathartic anger about sexual violence. One recent post:

    I wish men understood that when women are talking about feminism and rape culture and shit, it’s not just a political conversation. It’s not about being a “social justice warrior” or whatever. It’s about our actual lives being shaped by misogyny since childhood, and the daily reality of living in fear of violence. This isn’t a fucking game or philosophical debate. This is our fucking lives.

    An overarching theme is the paramount importance of parenting. “Your job will forget you ever worked there,” reads one post. “Your child will never forget you weren’t there.”

    Over the last year, though, ominous messages about public health during the pandemic have been woven into posts about the sanctity of motherhood. Recent posts warn members about the psychological damage that mask mandates will cause in children. “Protecting kids from dangerous things like forced masking, traumatizing isolation, toxic injections, harmful foods & oppressive government isn’t a #conspiracy theory, that’s just called good parenting,” one March post read. Another recent post is a message in a frame of brightly colored feathers reminiscent of a Native American dreamcatcher. It reads: “Your daily reminder: Don’t take the COVID vaccine.” (When asked about the group’s stance on COVID vaccines and mask mandates, a spokesperson for Natural Parenting Mommas wrote back, “Considering there are multiple admins for the page, all with varying degrees of opinions on the COVID vaccines and mask mandates, we will be unable to confirm anything for you at this moment in time.”)

    Women come to moms’ groups for the reassuring memes about how hard and lonely parenting can be, and they stay for the righteous indignation about the government presuming that it knows what’s best for their families. “New parents are left alone, without meaningful conversations from trusted, credible sources,” Seema Yasmin, a Stanford physician who studies medical misinformation, told me this week. Many people are drawn into social media groups in the vulnerable postpartum period, when they’re just forming their identity as parents. That early influence is powerful, and it can persist for years. “That’s how you end up with people really deeply entrenched in a parenting groups on Facebook, with conspiracy theories about everything from ‘if you eat your placenta, you won’t get postpartum depression’ to ‘don’t vaccinate your kid.’”

    The pressure on parents is even greater with the added burden of the coronavirus, said Jennifer Reich, a sociologist at the University of Colorado, Denver, who studies the anti-vaccine movement. “During the pandemic, as people have felt more isolated, online communities have become more important than ever,” she told me. “Parents in general and mothers specifically have relied on online communities for a long time for advice and support.”

    Katy Strang, who moderates a Facebook moms’ groups in Camarillo, California, told me she has observed this dynamic in her own group. She and her fellow moderators try to remove posts that pass on unverified information, but as she told me last fall, during the pandemic, it’s become a nearly impossible task. When I caught up with her this week, she said the incredible strain of pandemic parenting has made the situation worse. “To our detriment,” she wrote me in an email, “the isolated, exhausted mamas who look to these groups for support at all hours of the days and nights may be susceptible to internalizing misinformation that is being shared by armchair experts.”

    The slow cascade in online groups from alternative health to COVID misinformation is not easy to fix, especially since its very proliferation serves to normalize the content. It won’t go away if social media platforms simply label posts as misinformation. The moderators I’ve interviewed have told me that even their efforts to delete misinformation haven’t worked; the deleted posts just pop up in the comments section on seemingly unrelated posts. The fundamental reason these tactics won’t work is that they’re not addressing the right problem, which is not a lack of knowledge, but a lack of support.

    There are some things that might actually counteract misinformation, and they have nothing to do with offering facts as an argument. Instead, programs such as paid family leave, affordable and accessible child care, and universal basic income for women who choose to remain home could be antidotes to all the alienation at the core of these groups. Yasmin notes that simply improving postpartum care and training doctors to take parents’ concerns seriously could also diminish the roles that online forums play in parents’ lives. “Historically, we’ve not done a great job of supporting new parents, especially when it comes to health areas that all are already stigmatized,” she said. “I worry that we’ll just lose many more people. And we will foster more distrust against the medical field.”

    In the context of the pandemic, that distrust is intensified, and it’s evident in the spaces I report on. As the world gears up for children’s COVID vaccines, this will persist. You’ll hear people blaming online moms’ groups for being anti-science, for being hotbeds of misinformation. When you do, remember this: It’s not that the mothers are dumb or overly credulous—it’s that they’re desperate.

  • Hundreds of Schools Are Using This Air Purifier to Fight COVID. A Lawsuit Says It Releases Toxic Chemicals.

    Frederic J. Brown/Getty

    Researchers have long known that the coronavirus is airborne, lingering in floating particles that spread whenever an infected person coughs, sneezes, or simply exhales. It’s the reason public health authorities have been urging schools to improve ventilation as part of their reopening plans: Bringing in more clean outside air can dilute the virus in classrooms, hallways, and cafeterias, helping to prevent spread. But thousands of schools across the country have gone a step further, using high-tech air cleaning systems in an attempt to fight COVID-19—often paying for air purifiers with federal CARES Act money intended to make schools safer during the pandemic.

    Now, a top seller of one of the most popular high-tech air purification technologies among schools is facing a federal class action lawsuit claiming that its devices could produce toxic chemicals in classroom air and do not work as advertised to fight COVID, according to a court filing

    “Global Plasma Solutions Inc. preys on people desperate to cleanse the air and protect themselves from ailments including the COVID-19 virus,” alleges the complaint filed in US District Court in Delaware on May 7. “Defendant’s ‘profits over people’ scheme won the company acclaim, publicity, and generated hundreds of millions of dollars in sales.” 

    Global Plasma Solutions (GPS) is one of the country’s top manufacturers of purifiers that use a technology called bipolar ionization: small machines, usually installed in air ducts, that zap passing air molecules and give them a positive or negative electrical charge. According to the company, those charged molecules, called ions, spread through the room, destroy pathogens, and eliminate other harmful contaminants. GPS claims its devices can eliminate 99.4 percent of the coronavirus from surfaces in 30 minutes and 98.3 percent of the coronavirus from the air in 60 minutes. Schools have found the pitch compelling: GPS says over 1,300 K-12 schools have installed its devices, and demand has only increased over the last year. The lawsuit, which was filed by Robert Garner, a Maryland resident who bought a GPS ionizer for $750.67 in March, estimates that GPS has sold “tens of thousands of units” at minimum. 

    The company’s claims about COVID are “deceptive,” overstating the purifiers’ ability to fight COVID and “instilling customers with a false sense of security through misleading claims,” according to the lawsuit. Testing that GPS touts as “independent” is actually paid for by the company itself and employs unrealistic experimental conditions, the complaint adds. It cites an investigation published last week by Kaiser Health News, which found that one of the company’s COVID tests amounted to blasting the virus with 27,000 ions per cubic centimeter in a chamber the size of a shoebox. (In a full-sized room, the complaint adds, the machine would generate a concentration of 13 times fewer ions.) A GPS spokesperson says that further tests in larger chambers, with lower ion concentrations, still reduced airborne coronavirus by more than 90 percent. While 2,000 ions per cubic centimeter is a “minimum goal,” she adds, some real world spaces using the company’s technology reach more than 40,000 ions per cubic centimeter.

    All in all, the lawsuit paints a picture of an air purification company whose products make the air worse, not better. “Defendant’s misrepresentations and false statements were woven into an extensive and long-term advertising campaign,” the complaint says, citing company webpages and other marketing portraying the ionizers as safe and effective. “The misleading representations grew like a virus.” 

    Back in March, I interviewed Delphine Farmer, a chemist at Colorado State University who was at the time working with other scientists on one of the only peer-reviewed studies on bipolar ionization in real-life environments. Farmer warned about the unintended consequences of using what she described as an unproven technology

    As an environmental chemist, I think about the precautionary principle, where you say, “Well, if this might do harm, and you don’t need to do it, then you just shouldn’t use it.” You have to prove that something is benign—that it’s not going to hurt the environment, and it’s not going to hurt people before you use it. And I think this rush to market these air cleaning devices is very concerning. I think we’re creating devices that might—not guaranteed—but they might create some some dangerous byproducts. And they certainly haven’t been proven to be effective.

    Farmer’s study, which was published in the journal Building and Environment later that month, tested GPS devices in an experimental chamber and an occupied office building. While the experimenters didn’t test for the coronavirus, they found the machines did little to remove particulate matter from the air and actually appeared to produce some concerning byproducts. The class-action lawsuit filed Friday argued that GPS machines are not as safe as the company’s advertising would make it seem, because the gaseous byproducts detected by researchers included “harmful toxins including Acetone, Ethanol, Toluene, and Butyraldehyde.” 

    The study by Farmer and her collaborators had immediate consequences for communities struggling with how to safely open schools: During a school board meeting in Montclair, New Jersey, last month, it fueled questions from parents worried about the GPS ionizers recently installed in local schools. (According to the local newspaper, the district has decided to turn off the machines until they can be researched further.)

    GPS, meanwhile, has gone on the offensive, publishing a rebuttal to the Building and Environment study and pointing to what the company says are flaws in the experimental design. Since March, GPS also filed defamation and product disparagement lawsuits against two indoor air engineering consultants who have publicly criticized the company’s products and testing, including one who likened the air purifiers to cigarettes. “We intend to aggressively defend our technology and claims,” a GPS spokesperson told me. “Testing in independent labs and feedback from thousands of installations demonstrate that GPS technology works, is safe and can play an important role in making comprehensive air cleaning and filtration systems even more effective. We will review the complaint and respond accordingly.”

    A judge has yet to rule on whether the lawsuit, which claims more than $5 million in damages for consumers nationwide, can proceed as a class action. Yet it all but ensures that the question of whether GPS bipolar ionizers work—and whether they are dangerous—will be litigated in court, with potentially devastating results for GPS. After all, the company now finds itself standing in the same shoes once occupied by the Sharper Image, whose signature product (along with massage chairs) was an ionizing air purifier called the Ionic Breeze, which used an earlier version of the technology now employed by GPS’s devices. In 2005, a series of articles in Consumer Reports claimed that the Ionic Breeze did little to clean particulates from the air, but produced harmful byproducts—in this case, ozone. Like GPS, the Sharper Image fought back with a defamation and product disparagement lawsuit. It lost. And soon, like GPS, Sharper Image was facing a nationwide class action lawsuit that helped drive it into bankruptcy.

    This story has been updated to provide more context about GPS’s coronavirus testing.

  • FEMA Offers Cash to House Local Homeless, But Cities Aren’t Claiming It

    A man walks past tents housing the homeless in Los Angeles.Frederic J. Brown/AFP/Getty

    This story was originally published by Grist and is reproduced here as part of the Climate Desk collaboration.

    Two weeks after the United States began its first coronavirus lockdown in March 2020, then-President Donald Trump instructed the Federal Emergency Management Agency, or FEMA, to reimburse cities, counties, and tribes for 75 percent of costs related to housing homeless people in unoccupied hotels, as well as administering COVID-19 tests to those without housing. When Joe Biden assumed the presidency in January, he increased coverage to include fees related to vaccinating homeless populations and also guaranteed that reimbursements would now retroactively cover 100 percent of related expenses. 

    In theory, the program would both curb the spread of the novel coronavirus and also protect the more than 580,000 people experiencing homelessness at any given time from the variety of threats that come without steady access to housing. For the 225,000 homeless people living without formal shelter of any kind on a given night, encounters with extreme weather eventspollution, and policing can be uniquely deadly. 

    But as Winter Storm Uri descended upon the South in mid-February, leaving millions of people without water and electricity across at least seven states, more than half of Texas’ 500,000 hotel rooms were unoccupied and not a single municipality in the state had requested funds to house people living on the streets. As temperatures in the Lone Star State dropped to 20 degrees F, dozens of unhoused people were left frostbitten and hospitalized and at least six were found dead.  

    Texas wasn’t the only place where localities neglected the program. According to reimbursement request records released to Grist after a Freedom of Information Act request, one year into the program only 23 local governments, including one federal tribe, had submitted funding requests. Roughly 80 percent of the requests, which altogether total just over $600 million, came from just four major urban counties: Los Angeles County, California; Denver County, Colorado; Cook County, Illinois; and King County, Washington. (The data is current as of April 7; a comprehensive list of the requesters is available here.)

    Of the top 10 major metropolitan areas with the highest levels of homelessness per capita, according to data from the Department of Housing and Urban Development, only three submitted reimbursement requests.

    Officials from New York City, where nearly 15 percent of all unhoused people in the U.S. shuffle through the city’s vast shelter system, did not respond to Grist’s requests for comment about why the city did not participate in the program to relieve the threats posed by congregate living during the pandemic. But leaked reports show that dysfunction within city leadership led to the city passing on funds while COVID-19 spread through at least 94 percent of the city’s shelters, and 60 people living in the facilities died.

    In San Francisco, where there are more than 8,000 people experiencing homelessness on a given night, county leaders hinted at the possibility of taking advantage of the funding following Biden’s increased coverage, but no requests had been submitted as of April 7. San Francisco officials did not respond to Grist’s requests for comment.

    The program and its funding were made available through the 1988 Stafford Act, a federal law designed to help facilitate a uniform federal approach to state and local disaster relief. Unlike other coronavirus funding, the program is not earmarked for a certain dollar amount, so FEMA resources can be scaled to meet all eligible needs. But like other coronavirus relief programs, this particular deployment of the Stafford Act is a temporary fix, set to end on September 30.

    Interviews with policy experts and municipal leaders suggest that poor governing relationships between federal and local governments, a difficult reimbursement process, and decentralized planning left the program to be largely ignored—and the country’s unsheltered population unprotected from the spread of COVID-19 and a slew of recent severe weather events. 

    John Beard, a former city council member in Port Arthur, Texas, learned the inner workings of FEMA’s reimbursement process while helping to lead his city out of the destruction caused by Hurricane Harvey in 2017. He said the processes to obtain federal funding favor large cities and undermines the reason the money was made available in the first place: to help people no matter where they live. Larger cities that have regular communication with the federal government are more likely to know of the many different funding options available, he told Grist.

    “It’s a failure at the federal level to not get [the money] out to the cities, because they know which cities need it the most,” Beard said. “And it’s a failure by cities for not amplifying their needs and making the requests.”

    “A lot of cities simply don’t have the wherewithal or resources,” he added. “Bigger cities can afford consultants who spend every day searching for funding opportunities, but smaller cities don’t have anybody watching the clock, so everyday paperwork expires and funds dry up.”

    Steve Sanders, a former director of the sustainable communities program at the nonprofit Institute for Local Government, said that, with too many issues and not enough resources, many localities prioritize areas where there is a widely understood economic benefit or a powerful constituency to satisfy—neither of which is obviously the case when it comes to providing housing to those without.

    “The reality is development decisions are based on return on investment—and these aren’t flashy investments,” Sanders said. “When there is scarce political power for the key actors who care about the underlying issues of environmental justice and housing justice, don’t bet on seeing positive outcomes.”

    Three jurisdictions with some of the country’s highest rates of homelessness—Honolulu, Hawaii, and California’s San Diego and Santa Cruz Counties—told Grist that they were either unaware of the FEMA program’s existence or declining to use it. All three jurisdictions had locally funded homeless projects in place during the pandemic. In Santa Cruz County, people qualifying for California’s public assistance program were offered subsidized hotel rates if they were experiencing homelessness.

    In Honolulu and San Diego County, leaders used the federal Coronavirus Aid, Relief, and Economic Security Act, or CARES Act—which appropriated $12 billion to be used for homelessness and rent support—to extend their shelter services and make COVID-19 testing and vaccination more accessible to unhoused residents. However, the $12 billion was spread over a wide range of activities, including everything from mortgage assistance and home rehabilitation to the maintenance of traditional shelters, meaning it’s unclear how much actually went toward providing safe, private housing for those without shelter. After Grist’s correspondence with San Diego County, reports surfaced that the county plans to utilize the FEMA program to “free up” CARES money to be used for other social services.

    Even in cities that took advantage of FEMA funding during the program’s first year, success was fleeting. In Los Angeles at the program’s peak, only around 4,300 individuals—less than 7 percent of people experiencing homelessness in the county—were housed before county leaders withdrew their support for the program altogether. In Washington state’s King County, where Seattle is located, critics have argued that the government continues to leave federal funds on the table, and suburban opposition has slowed program implementation.

    For other cities, a complex reimbursement process has made it extremely difficult to receive funds, according to Rajan Bal, a campaign manager at the National Homelessness Law Center.

    “It’s a complicated application process that hasn’t necessarily been conveyed as best and easy as it should be, especially under Trump,” Bal told Grist. Bal said that initially there was confusion around which populations of people qualified for housing; it was unclear if those temporarily displaced by disasters or people experiencing temporary, transitional homelessness qualified for support. (Current guidelines say they do.) FEMA and White House officials did not respond to Grist’s requests for comment. 

    While Bal believes the FEMA program has had some effectiveness as a temporary solution, he said that municipalities should be “using the opportunity to inject local communities with cash to provide more housing solutions for people right now, as a springboard to combat the long term homelessness crisis and protect this vulnerable population from freezing or melting on the streets.”

    This way, he said, jurisdictions can follow San Diego County’s lead and free up other funding streams, such as CARES funding, to pay for other social services and move toward funding more permanent housing solutions such as supportive housing, which allows people experiencing chronic homelessness the opportunity to have their own space while still receiving social support services.

    Instead, Bal continued, many municipalities are pursuing policies such as encampment sweeps that are exposing unhoused people to coronavirus and potentially even landing them in jail.

    “There are elected officials actively pursuing the criminalization of homelessness and are actively choosing not to use available funding sources like FEMA reimbursement for shelters,” he said. “They’re spending taxpayer dollars to criminalize people instead of relying on these options that address homelessness.” 

    Unhoused people are disproportionately threatened by air pollutiontoxic waste, and severe weather, so solutions have to be direct and targeted, said Beard, the former city council member whose Southeast Texas region has experienced an uptick in homelessness since Hurricane Harvey.

    “At the end of the day, there is money to help people and it’s going unclaimed,” the former politician said. “Elected officials are chosen to look out for people, but there is help readily available and they let it slip past.

  • I Hate Seeing Myself on Zoom. Turns Out, I’m Not Alone.

    woman staring at her reflection on a computer

    Mother Jones illustration; Getty

    Since the arrival of COVID-19, our lives have shifted in ways big and small. Most likely, the pandemic will not end with a bang—we’ll be dealing with some version of it for years to come. As we slowly adapt to our new normal, we’ll embrace some changes and resent others. A few of us at Mother Jones wrote about some of the shifts we’ve noticed in our personal lives and the world around us—from the “love it” to the “leave it” to the we’re-still-figuring-it-out. Read the rest of the essays here

    Molly Schwartz

    For the first time in my life, I understand why so many people who make their livings in front of the camera—reality show personalities, news anchors, movie stars—get plastic surgery. I empathize with them. I get it. I, too, have had the experience of spending an inordinate amount of time looking at myself—not with millions of others on Bravo, but with a select group of colleagues on Zoom.

    When I first installed Zoom, I didn’t think too much about the personal implications. As with much of the rest of the world, the pandemic forced my work life online, so I got the tool that allowed me to have meetings and see co-workers while we stayed physically apart. But I could never have imagined how hours and hours of looking at myself would affect me psychologically. I’m someone whose makeup routine takes five minutes max, who doesn’t wear high heels as a matter of principle, and who avoids taking selfies or looking at photos of myself. For most of my life, this hasn’t been a problem.

    But slowly, during my Zoom-focused, quarantined life I’ve felt my occasionally ambivalent but generally self-confident sense of my appearance erode. Day in and day out I was forced to stare at the puffy bags under my eyes, the unfortunate spattering of adult acne on my chin, the way my face looks when I laugh too hard (which I usually do). It became impossible not to critically dissect my appearance, to silence my hectoring inner Anna Wintour. After one particularly Zoom-heavy day, I googled eye-lift procedures and how much they cost. (Around $3,000 with a recovery time of two weeks.) 

    Why not merely select the “hide self” function on Zoom, you might reasonably ask. Because now that I have the option to stare at myself in action, I need to know what everyone else sees my face do. During the pre-pandemic days of uncomplicated indoor dining, when I found myself eating at a restaurant with a mirror on the wall opposite my seat, I couldn’t help checking myself out. It’s too tempting to try to plumb the depths of that impossible question: What do other people see when they see me? And how can I fix it so that what they see looks like I want it to?

    Turns out, I’m not alone. 

    Plastic surgeons are reporting that interest in plastic surgery has markedly increased during the pandemic, especially for the whole menu of facial procedures, from rhinoplasty to face lifts, cheek implants, ear surgery, eye lifts, forehead lifts, neck lifts, botox, and fillers. They’ve even given the phenomenon a name: the “Zoom Boom.”

    The market research firm Equation Research surveyed more than 1,000 women across the United States and found that interest in plastic surgery has gone up by 11 percent among women over the last year, though we don’t know the age breakdown. (The absence of men in the survey is glaring—certainly they’re not exempt.) Although almost all cosmetic procedures decreased overall during the pandemic due to office closures, facial procedures decreased by the smallest percentage.

    A survey conducted by the American Society of Plastic Surgeons (ASPS) of their nearly 8,000 members revealed that nose reshaping (352,555 procedures), eyelid surgery (352,112 procedures), and face lifts (234,374 procedures) were the top three cosmetic surgical procedures in 2020. When accounting for the fact that most plastic surgeon were closed for an average of eight weeks in the year, the demand for each of these procedures actually rose by 12 percent, 7 percent, and 4 percent respectively. Demand for the most popular body-focused procedures, by contrast, dropped. Breast augmentation surgeries were down by 18 percent, liposuction was down by 5 percent, tummy tucks were down by 2 percent, and breast lifts were down by 6 percent. During these days spent sitting and staring at the screen, why bother fixing anything from the neck down? (Though demand for butt implants has notably soared!)

    I decided to talk to some experts about this—just as a reporter of course. So I tracked down Dr. Lynn Jeffers, a plastic surgeon and chief medical officer at the St. John’s Pleasant Valley Hospital in Camarillo, California, to ask what this Zoom Boom is all about. (Jeffers has also been working overtime running the vaccine rollout at her hospital.) She thinks there are three main factors. People had more disposable income during the pandemic because they were saving money on things like travel and dining out. Also, working from home made recovering from surgery easier and more discreet. And the only factor I could personally relate to: “We were suddenly all on Zoom, and our faces were so big in front of us, and most of us didn’t have great lighting or great webcams and so forth,” says Jeffers. “A number of people attributed the increased interest in facial procedures, as well as Botox and fillers, because that’s what everybody was seeing.”

    While Zoom fatigue has been a struggle for many of us, the effects have been especially distressing for the roughly 2 to 3 percent of Americans who struggle with body dysmorphic disorder (BDD). “Skin, nose, lots of different facial features tend to be the focus of concern in BDD,” says Dr. Hilary Weingarden, a practicing psychologist and clinical researcher at Massachusetts General Hospital who specializes in OCD and related disorders, such as BDD. She explained to me that any concerns I might have about my facial appearance can take on a heightened, or even distorted, presence in my self-perception when I see myself on Zoom for long periods of time. 

    “When you sit on Zoom, you’re staring at them all day long, and so we can tend to over-focus on that body part of concern,” she says. “When we look at ourselves in that way, we can start to actually distort our perception. And it starts to look more blown out of proportion.”

    Weingarden points out that when people focus on small flaws about themselves, they are seeing a very different picture from what other people see, which is more holistic. Also, Zoom is a particularly strange and unforgiving vehicle in that it literally lines our faces up next to other faces, which creates a situation that’s ripe for unflattering comparisons—a dangerous rabbit hole, as anyone with a propensity for late-night Instagram scrolling will tell you.

    Of course, there are lots of reasons to want to tweak or alter appearance, but my own obsessive dissection of my face just made me feel bad. Self-conscious about laughing or smiling. Deflated by a bad hair day. But more than anything, I’ve felt disappointed in myself that I can be troubled by an issue that is so damn superficial when, yes, I have much to be grateful for. I don’t value other people based on their appearance. Why can’t I extend that same courtesy to myself? 

    But I think it goes deeper than that. OCD disorders like body dysmorphia have strong ties to anxiety and depression. The obsessive checking and rituals around perceived issues are a channel for anxieties around much bigger things: like the fear of social exclusion, or illness, or dying, or other catastrophic, irreparable calamities—that the pandemic brought to all of our lives to a certain extent. It should be noted that BDD is a severe disorder with high rates of co-morbid depression, high rates of suicidal thoughts and suicidal attempts, and, in severe cases, a paralyzing fear of leaving the house. I do not have OCD or BDD, but I think the ties to anxiety are interesting.

    “Most of us have aspects of our physical appearance that we don’t like, that we worry about. And that’s normal to being human,” says Weingarden. “So that experience of worrying about physical appearance, and even engaging in some of these ritual behaviors—we all do some of that to some extent. It can vary anywhere from very mild to full-blown BDD, and everything in between.”

    If someone had offered to install a mirror in my computer so that I can stare at myself all day, I never would have agreed to it. Yet somehow that’s what I got. That’s what we’ve all got. Among the innumerable aspects of the pandemic that have been unnatural, add functioning under the constant surveillance of a virtual mirror.

    Flow theory posits that people achieve peak performance when they are engrossed in an activity to the point that they lose their sense of self. It’s like being in the zone, or in a groove. For me the best feeling is when my self-awareness fades into the background and I am fully immersed in editing, or reading a good book, or listening to a friend’s story. 

    When I confided to a friend about my Zoom Appearance Crisis (ZAC!), she pointed out that Narcissus stared at himself all day every day and it didn’t work out so well for him. Sitting at the edge of a lake and engrossed in his own reflection, he ultimately lost all interest in his worldly surroundings and turned into a flower. Clearly, this is not an ideal picture of engagement with the world—much less baseline productivity.

    But maybe we got the message from the myth all wrong. Maybe Narcissus didn’t expire because he loved looking at himself. Maybe he just couldn’t look away.

  • How PPP Loan Distribution Became the New Redlining

    A Philadelphia street in May 2020.Matt Rourke/AP

    The Paycheck Protection Program was supposed to help small businesses struggling from the crippling financial effects of the coronavirus pandemic. But the benefits, as with other government responses to the crisis, flowed disproportionately to white communities.

    A new investigation from Reveal, which analyzed the distribution of more than five million PPP loans, found that the program was plagued with widespread racial disparities. The findings show a persistence of the type of structural racism—exemplified by the racial covenants and redlining policies of 20th century—that has long prevented communities of color from thriving. Reveal found, for example, that in the “vast majority” of major metropolitan regions, businesses in majority-white neighborhoods were approved for loans at much higher rates than those in majority Latino, Black, or Asian ones. According to the investigation, published in partnership with the Los Angeles Times:

    Los Angeles had some of the worst [disparities] in the nation. Although communities of color were hit far harder by COVID-19, businesses in majority-White areas received loans at twice the rate that majority-Latinx tracts received, one and a half times the rate of businesses in majority-Black areas and 1.2 times the rate in Asian areas. 

    The New York metro area, which includes Newark and Jersey City in New Jersey, saw equally striking disparities, with White areas receiving loans at twice the rate of Latinx areas, 1.8 times the rate for Black areas and 1.2 times the rate in Asian areas.

    In other metro areas, including Dallas, San Francisco, San Diego, Las Vegas and Phoenix, businesses in majority-White areas also received loans at about twice the rate as those in majority-Latinx areas. 

    The first batch of loans, totaling $349 billion, went out last spring, days after Congress passed the CARES Act. But amid the hasty rollout, a lack of federal guidance meant that, as Reveal put it, “any obstacle, such as missing paperwork or a lack of an existing relationship with a bank, risked leaving a business last in line.”  

    In early April, Malik Muhammad, the owner of a Los Angeles bookstore specializing in African American literature, reached out to Wells Fargo—a bank that “effectively starved communities of color of PPP money,” Reveal reports. Muhammad heard nothing about his loan request for weeks. In early June, he received a form letter: “We cannot confirm that all applications will be submitted and processed by the SBA before the funds are depleted, and we anticipate that demand will exceed available funding.” He never received any follow-up communication from Wells Fargo, though he later managed to get a small loan from Square. “I know we’re not big business, but we deserve a call,” he said

    The CARES Act had instructed the federal Small Business Administration to prioritize “socially and economically disadvantaged individuals,”  according to an October 2020 congressional subcommittee report cited by Reveal. But the SBA, the Treasury Department, and the big banks administering the PPP loans ignored that guidance. In fact, the subcommittee found, Treasury had privately encouraged the banks to limit their initial loans to existing customers, excluding many minority and women-owned businesses.

    None of the lenders the subcommittee interviewed recalled any guidance from the Trump administration on how to prioritize underserved communities, and several set up lending programs in which large commercial clients enjoyed a “separate, faster process.” In some cases, PPP loans for wealthier clients were processed at twice the speed of loans for truly needy small businesses.

    Reveal had reported back in April 2020 that the owners of small businesses in Republican states without stay-at-home orders were more likely to have gotten PPP loans than those in Democratic states where COVID hit hard first. In December, the New York Times and Washington Post both reported that the majority of PPP money had flowed to big businesses, including dozens of national chains, many publicly traded. The same month, when Congress passed its second COVID relief package, the legislation included a bipartisan provision that helped all PPP recipients, but was most beneficial for the companies with the biggest loans, resulting in an estimated $120 billion tax break for America’s richest business owners.  

    The botched rollout of a program supposedly intended to help small businesses and their employees has proved devastating for many—particularly Black owners, who are far more likely to be sole proprietors. Reveal cites a study by the Federal Reserve Bank of New York, which found that from February through April 2020, the number of active businesses plummeted by 22 percent, but the number of Black and Latino businesses dropped by 41 percent and 32 percent, respectively.

  • Fully Vaccinated People Can Stop Wearing Masks Outdoors, Unless in Crowded Spaces

    Joseph Prezioso/Getty

    The Centers for Disease Control and Prevention on Tuesday released new guidelines on outdoor mask-wearing, greenlighting fully vaccinated people to engage in outdoor activities, including running, hiking, and walking—without a mask—if they are alone or with members of their household. Attending small outdoor gatherings and dining outdoors without a mask are also considered safe, federal officials said. 

    But in situations where crowds are likely and social distancing presents a challenge, masking, even if fully vaccinated, is still recommended.

    “Today is another day we can take another step to the normalcy of before,” CDC Director Rochelle Walensky said in a White House news conference.

    “The examples today show that when you are fully vaccinated, you can return to many activities safely,” Walensky added. “And most of them, outdoors and unmasked, can begin to get back to normal. The more people who are vaccinated, the more steps we can take toward spending time with people we love, doing the things we love to enjoy.”

    The updated guidance comes as nearly half of the country reports being vaccinated with at least the first dose. But public health experts remain cautious, with vaccination rates slowing recently following months of rapid growth, while some areas of the country continue to see alarming surges of the virus and its new variants.  

    It’s been long established that outdoor contact poses significantly less risk in the spread of COVID-19 than indoors. But in recent weeks, questions over the necessity of outdoor mask-wearing have sparked some debate, with those on the right expressing special hostility towards the measure. On Monday, before the CDC’s announcement, Fox News’ Tucker Carlson went so far as to instruct viewers to contact child protective services if they see a kid wearing a mask outdoors. He also compared the practice of children wearing masks outside to child abuse.

    “What you’re looking at is abuse,” Carlson said, “it’s child abuse and you are morally obligated to attempt to prevent it. If it’s your own child being abused, then act accordingly.” (Just to be clear: unnecessarily calling child protective services, in situations where the child is not in direct danger, can have long-lasting, traumatizing effects on both children and families.)

    But Tucker and similarly-minded conservatives who are now professing outrage over outdoor masks appear to deliberately misinterpret the CDC’s previous guidelines, which never mandated strict outdoor mask-wearing. Instead, the CDC has always acknowledged that the outdoors provides greater ventilation—a key component to reducing COVID transmission—and wearing a mask while you are outside by yourself or with others in your household may not be necessary.

  • A Top Epidemiologist Explains Why We Can’t Let Our Guard Down

    Sebastian Gollnow/DPA/Zuma

    Even though roughly half of the United States population has received at least one COVID shot, coronavirus cases have surged in states such as Michigan, prompting concerns among some public health officials that parts of the nation may be reopening too quickly.

    Dr. Michael Osterholm, an epidemiologist and director of the Center for Infectious Disease Research and Policy (CIDRP) at the University of Minnesota, used to advocate strongly for the return of in-person learning. But with new outbreaks largely fueled by the B.1.1.7 variant first detected in the United Kingdom, which seems to affect children at a higher rate than other strains do, Osterholm has changed his tune. I caught up with Osterholm to ask about transmission among kids and the path to herd immunity for the rest of us.

    How does our current vaccination rate bode for school reopenings this fall?

    I think it’s going to be a mixed situation. And what I mean by that is that we’re going to see, hopefully, vaccines available down to as young as age 12, maybe 10. So when we look at transmission, it’s one of those things where how much vaccine is there is going to make a determination of how big the problems are going to be.

    Do you think vaccines for children will have to be fully FDA approved, or will they be able to get emergency use authorization?

    I think they will get emergency use authorization. Part of the challenge we have right now is the issue of just how much infection is in the community. Because that’s going to drive how well the studies are going to be able to determine how well the vaccine works, and the safety issues. None of us wants to have people get infected, but frankly, that’s how we get vaccines approved: with efficacy and safety data. And so, if we see substantial transmission in kids, then we’re going to have a much faster timeline to understanding what these vaccines could do and can’t do.

    Once this is in schools, the challenge is in the community and the schools. Right now, trying to get kids back in with quarantine, we’re seeing many in-person learning experiences abbreviated quickly, because all you need is just to have a few of these [infected] kids in the school and you have large numbers of people quarantined at home. From an intervention standpoint, there just hasn’t been any data yet to support that cloth face coverings on young kids do anything to prevent transmission. That’s never been studied or addressed.

    Why would that be different for children than adults?

    Even in the rest of the population, we don’t really have any good studies showing face cloth coverings work. [Centers for Medicare and Medicaid Services] actually has an ongoing evaluation of studies looking at cloth face coverings, and they basically say there’s no discernible data yet to show that they reduce transmission.

    With N-95 respirators, you get less than 1 percent leakage in or out. If you look at surgical masks, it’s anywhere from 30 to 50 percent leakage in and out. You get to cloth face coverings, it’s in the 60 to 70 percent range. You know, they’re like seatbelts. They can surely reduce your likelihood of having a bad outcome, but it’s all about dose and time. For example, the recent CDC study looking at double masking was criticized for several reasons, but one of them was that they didn’t do anything about dose and time. It’s like an instantaneous hit and that’s it.

    Environments such as school kids today, where we’re now using three feet [social distancing]—which we also challenge—means you double the number of people in the schoolroom. What does your HVAC system do to handle that? And cloth face coverings would have no biological reason to filter out or stop the small aerosol particles. So that’s one of the other things that has been kind of accepted as a fait accompli, and it’s not true.

    The other thing is, hygiene theater has to stop. That has been such a big challenge. The CDC, finally, after a year, came out and said that this week. I’ve watched millions and millions of dollars be spent on these deep sanitizings that had nothing to do with reducing COVID-19 transmission. I’ve been saying this since last spring.

    How can we overcome the partisan divide on willingness to get vaccinated?

    First of all, you have to understand who it is you’re concerned about with vaccine hesitancy or reluctance. I’m part of a group that’s led by Dr. Stephen Thomas, one of the most prominent Black public health professors in the country. He works in Maryland, and he started a program there called the Black Barbers and Beauty Shop program. It’s basically taking barbers and beauticians and really educating them on a number of aspects of health, hypertension, diabetes, etc. And they have served as a major source of information on COVID-19 in their communities. And they are highly trusted; they’re very, very good. And when you actually have a peer like that, or someone that people look up to, explaining to them about this, the number of people willing to take the vaccines goes up dramatically. I think that is an example of the kind of programs we need. That’s not going to work if I’m a pregnant health care worker who is fearful of getting the vaccine. That’s a whole separate issue, and a critical one. And so you need to have the data and the programs to address that group, too.

    One of the challenges we have is the billboard that just says “get vaccinated” really has little to no impact. Almost all the time, it’s really about answering specific questions and messages. That’s one where you can surely help them turn around. But I don’t have an answer on this partisan political issue.

    The average number of vaccines administered per day is starting to fall. How big of a risk does vaccine hesitancy pose in terms of generating new vaccine-resistant variants?

    We have to be very careful. Michigan’s immunization levels are among some of the higher in the country. The Southern Sun Belt states, which have been through this twice now—big waves, one last July, once in January—still have many, many people that are highly vulnerable. The vaccination rate in those states is significantly lower than what we’re seeing in many other states.

    Well, if Michigan can have the problem it has, there are a number of states that can have the same problem. People often say, “Well, the vaccine is going to knock it down.” Surely it has an impact, but the amount of vaccination we have right now, as demonstrated in Michigan, is not enough to keep infections from surging. And I think that’s a big challenge for people. They don’t still believe that. And so we can’t get enough people vaccinated quickly enough right now, from my perspective, to try to deal with what is still the potential for other Michigans to occur in the country. It’s a huge issue. We think about this all the time here at CIDRAP.

    What sort of public health surveillance systems do we have to detect breakthrough infections in people who have already been vaccinated?

    A lot of our surveillance right now is held together by baling wire and twine. I mean, the number of locations still using fax machines to support case reporting! It is really a serious challenge, and if there’s no other lesson from the pandemic, it’s the fact that how critical real-time information is from a public health perspective, and how it has to be made a priority to get systems in place to do that.

    Second, you have to have the systems in place to work with private sector and public sector organizations, such that right now we’re seeing a problem where somebody goes and gets tested, they’re positive. Turns out, they’re a breakthrough case but the lab testing them didn’t know that. By the time the health department gets the information and identifies this person as a breakthrough, they contact the lab and the sample has already been thrown away. It’s as simple as that, yet as complicated as that. How do you get that sample for sequencing? Who does the sequencing? When? We’re seeing in many locations two to four weeks before you get sequencing data back. If you’re trying to look at breakthroughs, and you’re trying to understand, is it due to the virus? Or is it just due to the natural experience you’re going to have with a vaccine that is 90, 95 percent effective for most people? What’s happening? We don’t have a good system in place for that.

    I know that the administration knows that, but now’s the time where we’ve got to really work with state and local health departments. We’ve got to work with our laboratories, whether they be private or public. And we’ve got to have a much better system in place to identify and capture these samples before they’re lost. And then we got to have quick turnaround on them getting sequenced.

    It’s not sequence capacity. We have sequence capacity in this country! It’s the system to get it done. Imagine if every time you tried to use your bank card, you had to run a mile around the bank before you could use it. It’d be a big challenge to get your money out.