COVID Again

January 25, 2022

Publicity is being given to the thinking of Dr. Conrad Vine of Adventist Frontier Missions in regard to COVID and the SDA Church. The following website discusses his thinking. On a personal basis, as a military chaplain, I have an extensive background in working to obtain religious rights. A fundamental issue that Dr. Vine misunderstands is this: Such exemptions are granted on the basis of sincere individual belief, as dictated by statute and case law. They are not granted on the basis of a denominational request for exemption. Dr. Vine simply does not understand the legal background in the United States.

https://atoday.org/assessing-conrad-vines-vaccination-arguments/

January 31, 2022

COVID-19 Incidence and Death Rates Among Unvaccinated and Fully Vaccinated Adults with and Without Booster Doses During Periods of Delta and Omicron Variant Emergence — 25 U.S. Jurisdictions, April 4–December 25, 2021

On January 21, 2022, this report was posted online as an MMWR Early Release.

https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e2.htm?

January 31, 2022

22 minutes ago, phkrause said:

COVID-19 Incidence and Death Rates Among Unvaccinated and Fully Vaccinated Adults with and Without Booster Doses During Periods of Delta and Omicron Variant Emergence — 25 U.S. Jurisdictions, April 4–December 25, 2021

On January 21, 2022, this report was posted online as an MMWR Early Release.

https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e2.htm?

How does the CDC square with Israel:? One report can't be all that accurate

Israel: A Profile in Vaccine failure and a Warning to the World - American Thinker

February 11, 2022

New C.D.C. data shows the power of boosters.

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Preparing vaccines in Rochester Hills, Mich.Emily Elconin for The New York Times

Irrational skepticism

The C.D.C. has begun to publish data on Covid outcomes among people who have received booster shots, and the numbers are striking:

Based on 25 U.S. jurisdictions. | Source: C.D.C.

As you can see, vaccination without a booster provides a lot of protection. But a booster takes somebody to a different level.

This data underscores both the power of the Covid vaccines and their biggest weakness — namely, their gradual fading of effectiveness over time, as is also the case with many other vaccines. If you received two Moderna or Pfizer vaccine shots early last year, the official statistics still count you as “fully vaccinated.” In truth, you are only partially vaccinated.

Once you get a booster, your risk of getting severely ill from Covid is tiny. It is quite small even if you are older or have health problems.

The average weekly chance that a boosted person died of Covid was about one in a million during October and November (the most recent available C.D.C. data). Since then, the chances have no doubt been higher, because of the Omicron surge. But they will probably be even lower in coming weeks, because the surge is receding and Omicron is milder than earlier versions of the virus. For now, one in a million per week seems like a reasonable estimate.

That risk is not zero, but it is not far from it. The chance that an average American will die in a car crash this week is significantly higher — about 2.4 per million. So is the average weekly death rate from influenza and pneumonia — about three per million.

With a booster shot, Covid resembles other respiratory illnesses that have been around for years. It can still be nasty. For the elderly and immunocompromised, it can be debilitating, even fatal — much as the flu can be. The Omicron surge has been so terrible because it effectively subjected tens of millions of Americans to a flu all at once.

For the unvaccinated, of course, Covid remains many times worse than the flu.

‘Heartbreaking’

I’m highlighting these statistics because there is still a large amount of vaccine skepticism in the U.S. I have heard it frequently from readers in the past week, after our poll on Covid attitudes and partisanship, as well as the “Daily” episode about the poll.

This vaccine skepticism takes two main forms. The more damaging form is the one that’s common among Republicans. They’re so skeptical of vaccines — partly from misinformation coming from conservative media figures and Republican politicians — that many remain unvaccinated.

Look at this detail from the Kaiser Family Foundation’s latest portrait of vaccination: Incredibly, there are more unvaccinated Republican adults than boosted Republican adults.

From a survey of 1,536 adults in Jan. 2022. | Source: Kaiser Family Foundation

This lack of vaccination is killing people. “It’s cost the lives of people I know, including just last week a friend of 35 years, a person I met on one of the first weekends of my freshman year of college,” David French, a conservative writer who lives in Tennessee, wrote in The Atlantic. “I can’t tell you how heartbreaking it is to see person after person fall to a virus when a safe and effective shot would have almost certainly not just saved their life but also likely saved them from even having a serious case of the disease.”

Dr. Peter Hotez, a vaccine expert at the Baylor College of Medicine, estimates that in the second half of last year, 200,000 Americans needlessly lost their lives because they refused Covid vaccines. “Three doses of either Pfizer or Moderna will save your life,” Hotez told me. “It’s the only way you can be reasonably assured that you will survive a Covid-19 infection.” (Young children, who are not yet eligible for the vaccines, are also highly unlikely to get very sick.)

The vaccines don’t prevent only death. Local data shows the risks of hospitalization are extremely low, too. Vaccination also reduces the risk of long Covid to very low levels.

Healthy and anxious

The second form of vaccine skepticism is among Democrats — although many would recoil at any suggestion that they are vaccine skeptics. Most Democrats are certainly not skeptical about getting a shot. But many are skeptical that the vaccines protect them.

About 41 percent of Democratic voters say they are worried about getting “seriously sick” with Covid, according to a Kaiser Family Foundation poll released last week. That’s a very high level of anxiety for a tiny risk.

Here’s the proof that much of the fear is irrational: Young Democrats are more worried about getting sick than old Democrats, even though the science says the opposite should be true.

From a survey of 1,536 adults in Jan. 2022. | Source: Kaiser Family Foundation

The most plausible explanation for this pattern is political ideology. Younger Democrats are significantly more liberal than older Democrats, according to the Pew Research Center (and other pollsters, too). Ideology tends to shape Covid views, for a complex mix of often irrational reasons. The more liberal you are, the more worried about Covid you tend to be; the more conservative you are, the less worried you tend to be.

I know that many liberals believe an exaggerated sense of personal Covid risk is actually a good thing, because it pushes the country toward taking more precautions. Those precautions, according to this view, will reduce Covid’s death toll, which truly is horrific right now. In a later newsletter this week, I will consider that argument.

For now, I’ll simply echo the many experts who have pleaded with Americans to get vaccinated and boosted.

Answers and convenience

What might help increase the country’s ranks of vaccinated? Vaccine mandates, for one thing — although many Republican politicians, as well as the Republican appointees on the Supreme Court, oppose broad mandates. Private companies can still impose mandates on their employees and customers.

Without mandates, the best hope for increased vaccination is probably community outreach. While many unvaccinated Americans are firmly opposed to getting a shot, others — including some Democrats and independents — remain agnostic. If getting a vaccination is convenient and a nurse or doctor is available to answer questions, they will consider it.

“I cannot count how many people I’ve spoken to about the Covid vaccine who have been like, ‘No, I don’t think so. No,’” Dr. Kimberly Manning of Emory University told The Atlanta Journal-Constitution. “Then I run into them two weeks later and they tell me they got vaccinated.”

Related: “You have to scratch your head and say, ‘How the heck did this happen?’” Dr. Anthony Fauci told Michael Barbaro on today’s episode of “The Daily,” about the partisan gap in Covid attitudes. Fauci also predicted that people who were anxious about Covid would become less so as caseloads fell.

In Times Opinion, James Martin, a Jesuit priest, argues that schadenfreude over vaccine skeptics’ suffering warps the soul.

February 11, 2022

A ‘stealth’ Omicron subvariant is now spreading, worrying experts

Here's what the science shows so far about whether the BA.2 virus is more transmissible and how it holds up against available vaccines.

https://www.nationalgeographic.com/science/article/a-stealth-omicron-subvariant-is-now-spreading-worrying-experts?

February 11, 2022

COVID-19 variants will keep coming until everyone can access vaccines

The emergence of Omicron underscores the consequences of vaccine inequity. Experts say it will take more than donations to fix the problem.

https://www.nationalgeographic.com/science/article/covid-19-variants-will-keep-coming-until-everyone-can-access-vaccines?

February 11, 2022

9 big questions about Omicron explained

Why is the CDC changing its isolation guidance? Which type of test is best? And how long should you isolate or quarantine? Experts weigh in to help clear confusion.

https://www.nationalgeographic.com/science/article/9-big-questions-about-omicron-explained?

Just incase you can't log into there website!! Here is the info:

9 big questions about Omicron explained

Why is the CDC changing its isolation guidance? Which type of test is best? And how long should you isolate or quarantine? Experts weigh in to help clear confusion.

Published January 6, 2022

10 min read

As scientists learn what makes Omicron different from other versions of the SARS-CoV-2 virus, guidance about how to deal with the variant is changing fast. In the U.S., where Omicron is now the dominant variant, the Centers for Disease Control and Prevention have come under fire for their shifting guidelines, including a recently updated recommendation that halves the isolation period for people who test positive from 10 days to five.

What is the science behind the changing guidance, and how can people best protect themselves as Omicron spreads? Here’s what experts say you need to know.

Why did the CDC change its recommended isolation period?

The short answer? Practicality, says Gregory Poland, a vaccinologist and internal medicine specialist at the Mayo Clinic in Rochester, Minnesota. Because Omicron spreads so easily, cases have skyrocketed to more than 540,000 per day for the past seven days. And if hundreds of thousands of people all must isolate for 10 days, it becomes challenging to staff and operate critical businesses, including hospitals.

“What do you do if you have 20 percent or more of your healthcare workforce not able to work because they test positive?” says Poland. “You see a rapid rise in death and complications for whoever is in the hospital, because there are an inadequate number of healthcare workers.”

But there is also solid science behind the change. Studies have measured the concentration of live (and therefore contagious) virus in the noses of infected people and how levels change over time. They show that a person’s ability to transmit the virus typically peaks between a day or two before symptoms begin and two to three days after, says Jill Weatherhead, an infectious disease expert at the Baylor College of Medicine in Houston. So five days after a positive test, the amount of virus an infected person sheds drops sharply.

The new guidelines are a tradeoff, adds Abraar Karan, an infectious diseases doctor at Stanford University in Palo Alto. “The benefit is that we avoid huge losses in labor capacity,” he says. “The cost is that we send people back when they could still be infectious, although potentially far less so than earlier in their disease course.”

So five days after I test positive, I’m free?

Not exactly. The five-day recommendation only applies to people who are asymptomatic or whose symptoms are diminishing at that point.

A negative test around the five-day mark also doesn’t necessarily mean you’re in the clear, Karan says. “You could still be infectious, even if you test negative on an antigen test,” Karan says. “But you are likely less contagious than when your antigen was positive.”

People who are immunocompromised take longer to get rid of their infections, experts say, and should stay in isolation for up to 20 days. For people who have healthy immune systems and whose symptoms are declining, masking will reduce the risk of transmitting the virus after the fifth day. Even after five days of isolation, people should wear well-fitting, high-quality masks snugly over their mouths and noses.

“The idea with the updated guidance is that you're really covered during that peak time of contagiousness to protect from transmitting the virus,” Weatherhead says. “And in case you are a person that continues to shed virus after those five days, continuing to wear a mask will provide another layer of protection to prevent transmission.”

How do I count down the days in isolation?

To isolate properly and reduce risk, day zero begins when your first symptoms appear, even if you tested positive before symptoms started. Day one is the first full day after your symptoms begin. If you never get symptoms, day one is the first full day after your positive test.

Isolation only applies to people who have tested positive, according to the CDC. This means staying away from other people, even other household members, preferably in a “sick room” or area with its own bathroom.

If you find out you’ve been exposed to someone who tested positive, the CDC recommends that you quarantine. This also means staying away from others for a while, but the details depend on your vaccination status. If you have been boosted, if you have received your second Moderna shot within the last six months, your second Pfizer shot within the last five months, or if you have received the Johnson & Johnson vaccine within the last two months, you don’t need to quarantine, but you should wear a mask around other people for 10 days.

If you are unvaccinated or you are not within the recommended time windows for vaccines and boosters, the CDC recommends staying home for five days, then wearing a mask around other people for five more days. If you can’t quarantine, wear a mask for 10 days everywhere you go. Anyone who is a close contact of someone who tests positive should test on day five if possible. And if symptoms appear, get tested and stay home.

When will I stop testing positive?

The answer depends on which type of test you get, among other factors.

PCR tests detect genetic material from the SARS-CoV-2 virus. In some people, genetic remnants can linger in the nose for weeks or even months after the virus is no longer able to cause infections, Weatherhead says. Poland has a colleague who tested positive 16 weeks after their infection began.

Rapid antigen tests, on the other hand, detect viral proteins that are produced by live, active viruses. Those types of tests are unlikely to stay positive after levels of the virus are too low to cause infection.

A positive test of either kind doesn’t reveal how contagious you are, Weatherhead points out. Even though it may be tempting to interpret a faint line on a rapid test as a decline in infectiousness, faintness could simply be a result of how much virus you managed to pick up with the swab. “You're getting a ‘yes or no’ answer, not a ‘how much’ answer,” she says.

Do rapid tests even detect Omicron?

Available evidence suggests that yes, they do, Weatherhead says. Sensitivity might be slightly lower with the new variant, the FDA said in a statement in late December. Compared to PCR tests, rapid tests are less likely to detect infections in their earliest stages. But a U.K. Health Security Agency briefing analyzed the performance of rapid antigen tests at detecting Omicron, and it found no change in their performance with Omicron.

Will I start getting negative tests sooner if I’m vaccinated and boosted?

Theoretically yes, experts say. In a December 2021 study of people infected with several variants, including Delta and Alpha but not Omicron, researchers reported that vaccinated people with breakthrough cases cleared their infections in an average of 5.5 days. By contrast, unvaccinated people took 7.5 days to clear even though peak viral load was the same in both groups. Studies also show that fully vaccinated people are less likely to develop severe cases of COVID-19, including those who catch Omicron.

Vaccination “certainly reduces your risk of developing severe disease and requiring hospitalization, because the immune system [is] primed to reduce the viral burden,” Weatherhead says. “Whether that translates into how quickly you convert from a positive antigen test to a negative antigen test, I don't think we have that data yet.”

Do I need to have a negative test result to stop isolation?

Although many public health experts think it would be a good idea, the CDC is holding firm on its decision not to recommend a negative test before leaving isolation.

The best answer might depend on whether you are trying to make policy decisions or individual ones, Poland says. On a population level, it might make sense to require negative tests to prevent potentially infectious children from going to school, for example.

But in your personal life, Weatherhead says, what you choose to do depends on your own level of risk tolerance and the vulnerability of people around you. “If you're around people who are unvaccinated or who have underlying health conditions who are at high risk of disease, maybe it's better to take that test or wait the full 10 days beforehand,” she says.

If I test negative, do I still need to wear a mask?

If you're vaccinated, boosted, and healthy, you have dramatically lowered the chance that you will have severe disease, be hospitalized, or die, Poland says. But you have only moderately decreased the risk that you'll get infected with the Omicron variant. Given how transmissible the variant is, Poland recommends wearing a mask if you're gathering in an indoor setting with people not in your household.

Plenty of people can become infected without ever knowing it and pass the virus onward, Karan adds. Masking can slow transmission between people who may be infectious but are without symptoms.

Ultimately, people will need to consider their health conditions, risk tolerance, vaccination status, and COVID-19 levels in the community when making masking decisions, Weatherhead says. “In general, if everyone is fully vaccinated, asymptomatic and has a negative PCR test, the risk will be low and people do not universally need to wear a mask, particularly if gathering outdoors,” she says. People “who have underlying health conditions or are at high risk of progressing to severe disease if they become infected with SARS-CoV-2 may choose to continue to wear masks even around fully vaccinated groups.”

How will I know if I have Omicron?

Around the U.S., Omicron now accounts for more than 95 percent of new cases, according to data released this week by the CDC which uses a national surveillance system to get a sampling of circulating variants. But Delta is still around, and at-home tests won’t tell you which variant you have.

February 11, 2022

Why are Americans so slow to get booster shots?

Administering a booster in Washington, D.C.Kenny Holston for The New York Times

The enemy of the good

The United States has a vaccination problem. And it is not just about the relatively large share of Americans who have refused to get a shot. The U.S. also trails many other countries in the share of vaccinated people who have received a booster shot.

In Canada, Australia and much of Europe, the recent administering of Covid-19 booster shots has been rapid. In the U.S., it has been much slower. Compare the slopes of these lines:

Sweden data available only since Jan. 20. | Source: C.D.C.; Our World in Data

This is a different problem from outright skepticism of the vaccine. The unvaccinated skew heavily Republican, according to the Kaiser Family Foundation. The vaccinated-but-unboosted more closely resemble the country as a whole. Millions of Americans who have already received two vaccine shots — eagerly, in many cases — have not yet received a follow-up. The unboosted include many Republicans, Democrats and independents and span racial groups.

This booster shortfall is one reason the U.S. has suffered more deaths over the past two months than many other countries, as my colleagues Benjamin Mueller and Eleanor Lutz have explained.

Source: New York Times database; Johns Hopkins University

The most urgent problem involves the unboosted elderly. (About 14 percent of Americans over 65 eligible for a booster had not received one as of mid-January, according to Kaiser.) But some younger adults are also getting sick as their vaccine immunity wears off.

A recent study from Israel, published in The New England Journal of Medicine, was clarifying. For both the elderly and people between 40 and 59, severe illness and death were notably lower among the boosted than the merely vaccinated. For adults younger than 40, serious illness was rare in both groups — but even rarer among the boosted: Of the almost two million vaccinated people ages 16 to 39 in the study, 26 of the unboosted got severely ill, compared with only one boosted person.

“Boosters reduce hospitalization across all ages,” Dr. Eric Topol of Scripps Research has said. As Dr. Leana Wen wrote in The Washington Post, “The evidence is clear that it is at least a three-dose vaccine.”

Two explanations

What explains the American booster shortfall? I think there are two main answers, both related to problems with the American health system.

First, medical care in the U.S. is notoriously fragmented. There is neither a centralized record system, as in Taiwan, nor a universal insurance system, as in Canada and Scandinavia, to remind people to get another shot. Many Americans also do not have a regular contact point for their health care.

As a result, preventive care — like a booster shot — often falls through the cracks.

The second problem is one that has also bedeviled other aspects of U.S. Covid response: Government health officials, as well as some experts, struggle to communicate effectively with the hundreds of millions of us who are not experts.

They speak in the language of academia, without recognizing how it confuses people. Rather than clearly explaining the big picture, they emphasize small amounts of uncertainty that are important to scientific research but can be counterproductive during a global emergency. They are cautious to the point of hampering public health.

As an analogy, imagine if a group of engineers surrounded firefighters outside a burning building and started questioning whether they were using the most powerful hoses on the market. The questions might be reasonable in another setting — and pointless if not damaging during a blaze.

A version of this happened early in the pandemic, when experts, including the C.D.C. and the World Health Organization, discouraged widespread mask wearing. They based that stance partly on the absence of research specifically showing that masks reduced the spread of Covid.

But obviously there had not been much research on a brand-new virus. Multiple sources of scientific information did suggest that masks would probably reduce Covid’s spread, much as they reduced the spread of other viruses. Health officials cast aside this evidence.

Tests, vaccines, boosters

Similar problems have occurred since then, especially in the U.S.:

Regulators were slow to give formal approval to the Covid vaccines while they waited for more data — even as those same regulators were pleading with people to get shots.
Regulators were slow to approve rapid tests — even as Britain and Germany were using rapid tests effectively.
U.S. officials were slow to tell people who had received the Johnson & Johnson vaccine to get a follow-up shot — even as some experts were persuaded enough by the data to do so themselves.

As a result, Americans were slower to put on masks and slower to be vaccinated than they could have been. The pattern is repeating itself with boosters. Across Europe, Canada and Australia, health officials are urging adults of all ages to receive booster shots. Israel and several other countries are even giving second booster shots to vulnerable people.

In the U.S., some officials and experts continue to raise questions about whether the evidence is strong enough to encourage boosters for younger adults. Two top F.D.A. officials quit partly over the Biden administration’s recommendation of universal boosters. The skeptics say they want to wait for more evidence.

I don’t fully understand why statistical precision seems to be a particularly American obsession. In the case of boosters, political beliefs seem to play a role, as is often the case with Covid debates: Some booster skeptics are bothered that rich countries like the U.S. are giving third shots before many people in poorer countries have received first shots. But discouraging booster shots in the U.S. has not helped increase vaccine uptake abroad.

Officially, the skeptics have lost the debate. President Biden and Dr. Rochelle Walensky, the C.D.C. director, have strongly encouraged all eligible people to get boosted. Still, the expert skepticism does seem to have fueled public skepticism, which in turn has led to fewer booster shots. This chart is based on Kaiser’s most recent poll:

From a survey of 530 vaccinated adults who had not already received a booster, Jan. 2022 | Source: Kaiser Family Foundation

The public skepticism, in turn, is one reason that the U.S. is suffering more Covid hospitalizations and deaths than many other countries.

The mask debate

At a recent high school sports event in my community, I ran into a teenager whom I have known for years. We gave each other enthusiastic hellos and started to have a conversation. But it was impossible.

There was some background noise in the gym, and he has a disability that affects how he communicates. Usually, it does not keep us from talking at length. This time — with both of us masked — neither of us could follow what the other was saying. We smiled and gave up.

It was not a big deal, but it reminded me that masks have both benefits and costs. They can slow the transmission of the Covid-19 virus, especially medical-grade masks worn properly. They also impede human communication. Talking with a mask on, as Kathleen Pike, a psychology professor at Columbia University has written, “is like talking on your phone in a zone with weak cell service.”

If you scroll through social media, you will find no shortage of people proclaiming that mask wearing is easy for them. I don’t doubt it. But it is not so easy for many other people, including young children, people with learning disabilities and people who are hard of hearing.

The national debate over mask mandates in schools is picking up again. Yesterday, Democratic governors in Connecticut, Delaware, New Jersey and Oregon all announced the end of their statewide mandates, to take effect in coming weeks. It’s a sign that more Americans — and not just Republicans — are ready to move to a new phase of the pandemic.

The end of the statewide mandate is a “huge step toward normalcy,” New Jersey’s governor, Philip Murphy, said. “We can responsibly live with this thing.”

Still, parts of the partisan divide will continue. In some left-leaning communities, school mandates will probably remain even after Democratic governors lift statewide rules.

In a newsletter last week, I promised to revisit our recent poll on partisan Covid attitudes — and to consider a response from some liberal readers. The debate over school masking offers a way to do so.

Communal risk

The poll found that many Democrats, especially younger Democrats, seem to be overstating their personal risk from Covid. In response, some readers argued that exaggerating individual risk is actually a good thing, because it leads to more support for Covid mitigation policies, like mask mandates and limits on public gatherings.

The real problem, according to this view, is that the U.S. has done too little to protect people from Covid; if exaggerating individual risk can reduce Covid’s communal risk, isn’t that a good thing?

There is some logic to this line of thinking, because the U.S. has indeed done too little to battle Covid. But the argument depends on the assumption that almost all Covid restrictions improve public health, and that isn’t necessarily true. Nearly every restriction has both benefits and costs. The question is, when do the benefits outweigh the costs?

With the vaccines and boosters, the answer is clear. The benefits (a huge reduction in the risk of death, hospitalization and other symptoms) vastly outweigh the costs (a day or two of potentially feeling crummy). With many other mitigation strategies, however, the answer is murkier. The disruption and isolation of the past two years have contributed to increases in educational inequality, mental-health problems, blood pressure, drug overdoses, violent crime and other serious ills.

Masks are an intriguing tool because they allow people to be together while also protecting themselves. Yet a growing number of Americans are nonetheless deciding that the costs of masks often fall short of the benefits, especially in schools.

Let’s dig into both the costs and benefits of school mask mandates.

The empathy gap

The benefits of universal masking in schools remain unclear. Studies — in Florida and in England, for example — tend to find little effect on caseloads. One study that did find an effect has been largely debunked.

Some experts still favor masks in schools, saying they likely have an effect, even if few studies have yet shown it. A lot of other evidence suggests masking matters. Until the Omicron wave ends and both hospitalizations and deaths fall much further, masks should stay on, these experts say.

Other experts believe mandated school masking is almost worthless. “It doesn’t work,” Michael Osterholm, a University of Minnesota epidemiologist, told me. Among the reasons: Medical masks are designed for adults, not children, Osterholm notes. Even masks designed for children slip off their faces. Children take off their masks to eat. Add in Omicron’s intense contagiousness, and the benefits of mandates may be tiny.

It’s also relevant that teachers and students who want to continue wearing masks can do so. One-way masking, with medical masks, provides protection, experts note.

Of course, the costs of mandates may also be small for many children, especially older ones. For others, though, the costs seem larger. NPR’s Anya Kamenetz has cataloged them: Students can’t always understand teachers; young children, unable to see faces in classrooms, may not be developing emotional skills; and children of all ages are having a harder time making connections.

“They’re not developing empathy,” Stephanie Avanessian, a Los Angeles mother, told NPR. “It’s taken six months for my fifth grader to make friends because it’s so hard to tell what people are doing.”

For reasons like this, Europe’s infectious disease agency does not recommend masking for children under 12, and many countries avoid masking preschoolers. The U.S. stands out for its aggressive use of masks on young children.

The bottom line

The evidence suggests that the benefits of mandated school masking are modest and that the costs are meaningful for some children, particularly after two years of pandemic life. This combination suggests that the removal of statewide mandates will probably do more good than harm, given that Covid cases are now plummeting.

But there is an important caveat: If another big Covid wave comes — and it may — the argument for a temporary return of masking will become stronger. When hospitals are overwhelmed, even small differences in caseloads can save lives. Different moments call for different Covid policies.

What are your Covid questions? Sign up for an online event — The Morning at Night — that I’m hosting with two experts on March 9.

February 11, 2022

Why “follow the science” fails to answer many questions.

Masks in New York City yesterday.Justin Lane/EPA, via Shutterstock

Put down that burger

The C.D.C. describes medium-rare hamburgers as “undercooked” and dangerous. The agency also directs Americans to avoid raw cookie dough and not to eat more than a teaspoon or so of salt every day. And the C.D.C. tells sexually active women of childbearing age not to drink alcohol unless they are on birth control.

If you happen to be somebody who engages in any of these risky activities, I have some bad news for you this morning: You apparently do not believe in following the science.

The misery of the Covid-19 pandemic — with its death, illness, isolation and frustration — has left many Americans desperate for clear guidance on how to live safely. People want to protect themselves, their family and their communities, especially the most medically vulnerable members of it. This instinct is both understandable and profoundly decent.

But it has led to a widespread misunderstanding. Many people have come to believe that expert opinion is a unitary, omniscient force. That’s the assumption behind the phrases “follow the science” and “what the science says.” It imagines science almost as a god — Science — who could solve our dilemmas if we only listened.

When Donald Trump was president and making false statements to downplay Covid, “follow the science” began to gain popularity. Now, it also serves as a response to the many incorrect statements that vaccine opponents make. President Biden likes to promise that he will follow the science, to signal his difference from Trump and deference to the C.D.C.

The phrase does have its uses. It’s a rejection of myth and a recognition that some aspects of the pandemic are unambiguous: Covid is more deadly for the unvaccinated than almost any virus in decades, and the vaccines are remarkably effective at preventing serious illness.

Many other Covid questions, however, are complicated. What does the science say about them? It says many things. Above all, science makes clear that public health, like the rest of life, usually involves trade-offs.

Hard choices

If you want to minimize your risk of getting sick from food, you probably need to eat less tasty food than you now do. If you want to minimize your chance of dying today, you should not get inside a vehicle. If you want to minimize your children’s chance of going to an emergency room, don’t allow them to ride a bike or play sports.

Unfortunately, none of these statements provide answers about what to do. People have to weigh the risks and benefits. They let their kids play sports, but maybe not violent ones. They don’t drive in a snowstorm. They ignore the C.D.C.’s advice about medium-rare burgers and heed its warnings about medium-rare chicken.

The current stage of the pandemic presents its own set of hard choices and trade-offs. If you wade into the angry, polarized Covid debates on social media and cable television, you will find people who try to wish away these trade-offs. They pretend that science offers an unambiguous answer, and it happens to be the answer they favor.

Proponents of an immediate return to normalcy claim, implausibly, that masks and social distancing do nothing to reduce the spread of Covid and that anyone who says otherwise doesn’t care about schoolchildren. Proponents of rigorous Covid mitigation claim, just as implausibly, that isolation and masking have no real downsides and that anyone who says otherwise doesn’t care about the immunocompromised.

The truth is that Covid restrictions — mask mandates, extended quarantines, restrictions on gatherings, school closures during outbreaks — can both slow the virus’s spread and have harmful side effects. These restrictions can reduce serious Covid illness and death among the immunocompromised, elderly and unvaccinated. They can also lead to mental-health problems, lost learning for children, child-care hardships for lower-income families, and isolation and frustration that have fueled suicides, drug overdoses and violent crime.

Balancing the two is unavoidably vexing. “We need to be better at quantifying risk, and not discussing it in a binary way,” Dr. Aaron Carroll, the chief health officer at Indiana University, told me. (This essay by Carroll made me aware of the C.D.C.’s advice on cookie dough and salt, and I also recommend this Times essay of his.)

As you think about your own Covid views, I encourage you to remember that C.D.C. officials and other scientists cannot make these dilemmas go away. They can provide deep expertise and vital perspective. They are also fallible and have their own biases.

C.D.C. officials tend to react slowly to changing conditions and to view questions narrowly rather than holistically. They often urge caution in the service of reducing a specific risk — be it food-borne illness, fetal alcohol syndrome or the Covid virus — and sometimes miss the big picture. The C.D.C. was initially too slow to urge mask use — and then too slow to admit that outdoor masking has little benefit.

As Matt Glassman, a political scientist at Georgetown University, wrote this week, “Don’t trust substantive experts to make policy decisions that balance competing values or stakeholder interests.”

College basketball fans in Berkeley, Calif., in December.John Hefti/Associated Press

When facts change

There is no one correct answer to our Covid dilemmas. People are going to disagree passionately, and that’s frequently how it should be. Most policy options have both benefits and drawbacks. The same applies to other areas of public health: We could also reduce flu deaths with permanent mask mandates, but this fact doesn’t mean that mandates would be wise.

One of the few Covid truisms is that policies should change as reality changes. A world without vaccines calls for more restrictions than a world with vaccines. When cases are surging and hospitals are overwhelmed, as was the case last month, more restrictions make sense. If hospitalizations and deaths keep falling, continued steps toward normalcy will make sense.

“We have to be able to act differently when the situation changes,” Carroll said. Or as Janet Baseman, a University of Washington epidemiologist, told me, “We need to be having this conversation.”

It really is a conversation. The answer will not spring forth from Science.

Related podcasts: Josh Barro and I talked about expertise and values on the latest episode of “Very Serious,” and my colleague Lisa Lerer explained why New Jersey is loosening Covid restrictions on “The Daily” yesterday.

February 12, 2022

Can COVID-19 alter your personality? Here's what brain research shows.

Alzheimer’s, Parkinson’s, and traumatic brain injury can cause changes in behavior by altering brain anatomy. Now it seems the coronavirus can too.

Photojournalist Jalal Shamsazaran documented his father’s battle with Alzheimer's disease. In this photograph Shamsazaran's mother reminds him that this is the house he built many years ago. Neuroscientists have noted that some long COVID symptoms mirror those of...

Photograph by Jalal Shamsazaran, NVP Images

Published December 29, 2021

13 min read

At the height of the COVID-19 tsunami that engulfed New York City in early 2020, a highly respected emergency room doctor, Lorna Breen, died by suicide. She had been serving as medical director at Manhattan’s NewYork Presbyterian Allen Hospital, and she was regarded as brilliant, energetic, and organized. She had no history of mental illness. But that changed after Breen contracted the virus.

The 49-year-old doctor first showed symptoms on March 18. After a 10-day illness, she returned to work. Her family was alarmed: She was confused, hesitant, nearly catatonic, exhausted. Something was wrong. They brought her home to Charlottesville, and Breen checked into a psychiatric ward at University of Virginia Medical Center. Soon after she was released on April 26, she took her own life.

“She had COVID, and I believe that it altered her brain,” her sister Jennifer Feist said on NBC’s Today show.

At the time, doctors were just learning that this new coronavirus doesn’t target only the lungs and heart. It also impacts other organs, including the brain. “People arrived at the hospital with severe depression, hallucinations, or paranoia—and then we diagnosed them with COVID,” says Maura Boldrini, a neuroscientist and psychiatrist at Manhattan’s Columbia University Irving Medical Center.

Now, almost two years into the pandemic, it’s become clear that neurological problems from COVID-19 can linger or intensify. After recovering from the virus, an alarming number of patients remain shrouded in brain fog, suffering from anxiety or depression, unable to think straight or hold on to memories, and fumbling for words. Not all had been hospitalized; some had only mild infections.

Today these neurological problems are an established element of a larger syndrome known as long COVID that includes at least 203 symptoms in 10 organ systems.

Boldrini notes that some long COVID symptoms mirror those caused by various chronic brain- and personality-altering conditions, including other viral infections, traumatic brain injuries, and neurodegenerative diseases such as Parkinson’s, Alzheimer’s, and Huntington’s. These conditions can radically change how people experience, interpret, and understand the world; destabilize emotions; and influence how people think about themselves or interact with others.

While little is known about the mechanisms behind many of these symptoms, researchers increasingly believe that inflammation may play a key role. With COVID-19, a storm of inflammatory cytokine proteins can trigger an out-of-control immune response that might permanently damage or destroy brain cells.

And with damage to the brain, Boldrini says, “we may not be the same person anymore.”

Personality, behavior, and the brain

Human personality is the set of deeply ingrained characteristics and habits that influence how people think, feel, and behave. It’s created by a complex interaction of nature and nurture: Inherited traits encoded in our DNA are influenced by our social environment and modified during early developmental experiences.

“The brain is obviously so important in defining who we are. It's our ego; it’s everything about our identity,” says Ann McKee, who studies repetitive head trauma as a neurologist, neuropathologist, and head of Boston University’s Chronic Traumatic Encephalopathy (CTE) Center. “It’s a highly specialized organ, with each part doing fantastically specific things.”

While basic personality tends to remain constant throughout adult life, conditions that disrupt brain function can induce extreme shifts in personality—and evidence is mounting that this happens for some people who contract COVID-19.

Some patients have developed impulsive or irrational behavior, like Ivan Agerton. The 50-year-old former Marine and documentary photographer experienced psychosis in early 2021 after he recovered from a COVID-19 infection. He grew paranoid, terrified that people were following him and convinced that a SWAT officer was encamped outside his Seattle home. He was ultimately hospitalized in a psychiatric ward, twice.

For some patients, this so-called COVID psychosis resolves with time. By June, Agerton said he’d fully recovered. But no one knows how long such COVID-induced symptoms might persist. A study of 395 people who were hospitalized with COVID-19 found that 91 percent had cognitive issues, fatigue, depression, anxiety, sleep problems, or struggled with routine activities six months after they returned home.

Healthcare workers and researchers are on the hunt for ways to treat these long-lasting symptoms, and that starts with figuring out why they happen in the first place.

Recognizing changes in the brain

In 1906 psychiatrist and neuroanatomist Alois Alzheimer detailed the results of a brain autopsy on a 55-year-old woman named Auguste D. In the years before her death, she’d progressively lost her connection to reality, becoming an aggressive insomniac beset by increasing paranoia and suspicions about her family. She’d also suffered profound loss of memory.

Upon examination, Alzheimer observed that her brain had shrunk dramatically. It was riddled with sticky clumps of plaque, abnormal deposits that nearly 80 years later would become the hallmark of Alzheimer’s disease. These jumbles of beta-amyloid protein had accumulated between neurons in the brain. We now know that they block electrical signals from reaching other parts of the brain, muscles, and organs. Alzheimer also found tangles of another protein, tau, that also disrupted communication between neurons.

As neurons stop functioning and die, the brain shrinks and a person’s behavior becomes more erratic. With fewer neurons in the brain’s learning and memory regions, these functions begin to suffer, Boldrini says. People with Alzheimer’s disease forget where they put things and become disoriented. They become easily upset, confused, angered, belligerent, or lash out at loved ones or caregivers, whom they may not recognize.

Damage to the cerebral cortex then impacts language, reasoning, and social behavior; it ultimately spreads and destroys much of the brain. The dementia becomes debilitating, and the disease eventually proves fatal, says Antonio Terracciano, a professor in the department of geriatrics at Florida State University.

Alois Alzheimer’s discovery was a milestone in neurological research, linking changes in behavior to changes in the brain. Since Alzheimer’s seminal observations, researchers have recognized that many diseases can spark shifts in personality or mood disorders.

Huntington’s, an inherited disease that breaks down neurons in a brain region called the basal ganglia, can cause people to lose their inhibitions or become more impulsive. It’s part of the reason why suicide rates among people with Huntington’s are up to 10 times the national average.

In Parkinson's disease, which is likely caused by a combination of genetics and environmental factors, neurons that produce the neurotransmitter dopamine break down or die. Without enough dopamine, the disease’s hallmark tremors appear, and movements become slow.

Parkinson’s also lowers levels of a neurotransmitter called serotonin, which regulates mood, appetite, and sleep. These changes in brain chemistry can cause neurological symptoms that frequently manifest years before the tremors begin, says Jeff Bronstein, who directs the Movement Disorders Program at the David Geffen School of Medicine at University of California, Los Angeles.

Patients may grow anxious, struggle to concentrate or shift between tasks. About half of patients grow depressed, Bronstein says. He has also seen patients slump into apathy, pulling into themselves. As their speech suffers or they grow forgetful, they avoid conversations with family and friends, becoming more withdrawn as depression deepens.

Uncharacteristic irritability or mood swings can also signal Lyme disease. This bacterial infection from a tick bite causes inflammation that can set off swelling of the brain or its lining, inducing short-term memory loss, difficulty focusing, and symptoms such as anxiety and depression.

Many viruses are already known to wreak havoc in the brain. Boldrini recounted what happened in the early days of the HIV epidemic, before antiviral medications were available that blocked replication of the pathogen and reduced viral load.

“We used to see people who had HIV-AIDS with paranoia, hallucinations, but also cognitive symptoms, memory problems, concentration problems,” Boldrini says. As the viral infection spread through the brain, the membranes of the brain and spinal column swelled, and this AIDS dementia complex worsened.

Many of the changes in behavior seen in COVID long-haulers also mirror those from traumatic brain injuries incurred in a car crash, a concussion from a contact sport like football or rugby, or from wartime military service. Damage to the frontal lobes, which sit behind the forehead, can impair executive functioning: organizing, planning, and multitasking. Memory and self-awareness may slip, and patients may not be aware of what they’ve lost.

Some head injury survivors lose emotional control, says Boston University’s McKee, including young, previously easy-going people. She’s seen cognitive changes in athletes as young as 17 who play contact sports, and playing football before the age of 12 increases the odds.

The COVID connection

One common theme among these conditions is a sustained inflammatory process. It’s been implicated in head injuries and in neurological diseases such as Alzheimer’s, where it causes additional loss of brain cells and exacerbates the formation of plaques.

When the immune system launches an attack against a virus or another invader, waves of inflammatory cells circulate through the bloodstream like foot soldiers. With COVID-19 and other conditions, those immune cells may permeate the normally protective blood-brain barrier. If inflammation gets out of hand, the process may kill neurons, Bronstein says.

Kriegstein notes that “most of the neurological manifestations of SARS-CoV-2 infection appear to be the result of indirect effects likely mediated through inflammation or immune responses.”

Inflammation also seems to interfere with brain metabolism. Researchers suspect that the process interrupts the flow of serotonin and prompts the body to instead produce a cascade of substances that are toxic to neurons.

Boldrini was among the first to examine the brains of humans and research animals who’d died of COVID-19 to see what was happening on a cellular level. Under a microscope, Boldrini and her team examined brain samples stained with brightly colored dyes to characterize different types of cells. They observed changes to the hippocampus, a brain region that is embedded deep in the temporal lobe and plays a major role in learning and memory. She and her team counted about a tenth as many new neurons as are normally present in the hippocampus.

“The brain fog made a lot of sense to me when I saw that there is loss of these neurons from COVID,” Boldrini says. The team also found damage to the medulla, which controls respiration and movement. Boldrini notes that they will continue to examine other brain regions for possible damage.

Other researchers using brain imaging data from the U.K. recently discovered evidence of tissue damage, a thinner cortex, and loss of gray matter in people who had tested positive for the virus. The authors noted that there was “significantly greater cognitive decline” in patients who had been hospitalized.

In addition to causing inflammation, the virus may be able to directly infect brain cells. “We discovered evidence that certain cells within the brain are capable of being infected with SARS-CoV-2, where the virus can replicate and infect other cell types,” says Joseph G. Gleeson, a neurologist at the University of California, San Diego.

Other researchers have found that key support cells in the brain called astrocytes were the main cell types vulnerable to infection, says Madeline Andrews, a postdoctoral neuroscience scholar at the University of California, San Francisco. These star-shaped cells, abundant in the brain and spinal cord, regulate how neurons communicate, ensure that the barrier between the brain and the rest of the body is intact, and more.

“Infected astrocytes may function differently and might not be able to maintain their typical roles in healthy brain homeostasis,” says Andrews.

The virus that causes COVID-19 may also reduce blood flow to neurons by constricting capillaries—tiny blood vessels—or by interfering with their function. This may explain why the virus induces strokes: by starving the brain of oxygen. “The brain is very delicate, and alterations to blood flow or cellular health can lead to permanent changes to brain function,” Gleeson says.

Many questions remain, though, including how to prevent the virus from causing significant cognitive damage. The key, Boldrini says, is to not let the immune system fight too long or too aggressively.

Various treatments are being used to prevent the immune system from overreacting. Remdesivir, an intravenous antiviral treatment is approved for hospitalized patients; two new oral antivirals, Merck’s molnupiravir andPfizer's Paxlovid, have been shown to reduce hospitalizations and death in patients at risk of serious illness. These drugs prevent the virus from reproducing, which may prevent an overactive immune response.

Other drugs are used specifically to modulate the response: corticosteroids, Interleukin-6 inhibitors, and Janus kinase inhibitors.

Understanding how COVID-19 affects the brain may have far broader implications. Boldrini has preserved a few dozen brains from patients who died of the virus. By comparing tissues from patients who had experienced neurological symptoms with those who hadn’t, she hopes to shed light on the role of inflammation in a wide swath of neurodegenerative diseases.

“As devastating as this disease is,” she says, “maybe it will help us better understand how the brain works.”

February 12, 2022

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February 13, 2022

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February 14, 2022

We offer a guide to protecting vulnerable people — the elderly, immunocompromised and unvaccinated — from Covid.

N95 masks were distributed to farm workers in Oregon.Jordan Gale for The New York Times

Precision tools

With the Omicron wave receding, many places are starting to remove at least some of their remaining pandemic restrictions.

This shift could have large benefits. It could reduce the isolation and disruption that have contributed to a long list of societal ills, like rising mental-health problems, drug overdoses, violent crime and, as Substack’s Matthew Yglesias has written, “all kinds of bad behavior.”

But the removal of restrictions has downsides, too. Millions of Americans remain vulnerable to Covid. The largest group of the vulnerable, by far, is the unvaccinated, who have the ability to protect themselves and have chosen not to.

Another group of people, however, have done what they can to stay healthy — by getting vaccinated — and yet remain vulnerable. They include the elderly and people with immunodeficiencies that put them at greater Covid risk. According to the C.D.C., more than 75 percent of vaccinated people who have died from Covid had at least four medical risk factors.

Today’s newsletter focuses on five steps that can help protect the vulnerable as society moves back toward normal.

At this point in the pandemic, there is a strong argument that a targeted approach — lifting restrictions while taking specific measures to protect the vulnerable — can maximize public health. The right approach, Jennifer Nuzzo, an epidemiologist at Johns Hopkins University, told me, involves “moving away from broad, blunt tools to more precision tools.”

The public conversation often misses this middle ground. It can sometimes seem to be a debate between doing everything to slow the spread of Covid and doing nothing, said Katelyn Jetelina of the University of Texas, who writes a helpful newsletter about public health. In truth, she said, “There has to be a balance.”

1. Vaccines and boosters

I want to start by emphasizing the importance of the vaccines, including the booster shots. Consider this chart, based on C.D.C. data:

Based on data from 14 U.S. jurisdictions. | Source: Centers for Disease Control and Prevention

Yes, some Americans remain so opposed to a Covid vaccination that there is little chance of persuading them. But others may still choose to receive shots if they are readily available. Booster shots are vital, too, to overcome waning protection. Boosters are especially important for the vulnerable vaccinated — the elderly and immunocompromised.

“Vaccination is the most valuable intervention we can do,” William Hanage, an infectious-disease expert at Harvard, told me.

2. High-quality masks

For the vulnerable vaccinated, the best approach is what epidemiologists calls “the Swiss cheese model.” It’s a multifaceted approach in which each strategy, including vaccines, has holes. But when the strategies are layered on top of one another, the holes tend to disappear.

One such layer is masking with an N95 or KN95 medical mask, even if others are maskless. “One-way masking works,” as Olga Khazan of The Atlantic has written.

Joseph Allen of Harvard has argued that somebody wearing an N95 mask and talking to an unmasked person is at less risk than somebody who’s wearing a standard surgical mask and talking to another person wearing a standard mask. “Let’s dispense with the notion that masks are only protective if everyone is wearing them,” Allen wrote in The Washington Post.

Here’s a Wirecutter guide to buying N95 and KN95 masks, and here’s how to spot a fake.

3. A preventive drug

In December, the F.D.A. authorized a drug called Evusheld, made by AstraZeneca. It is designed to be an additional layer of protection on top of the vaccines, to prevent Covid in immunocompromised people.

The Biden administration has bought 1.7 million doses, which is not enough to protect every American who could benefit but is significant. A larger immediate problem is confusion around the distribution. Many people don’t know Evusheld exists or don’t know how to find out if they’re eligible and how to get a shot.

Rob Relyea, an engineer at Microsoft whose wife has cancer, has created an online resource, in the absence of information from official sources. The country needs a “better communication plan around Evusheld,” Relyea tweeted. “Each hospital should proactively reach out to immunocompromised patients.”

The confusion around Evusheld is another example of how the fragmented U.S. health care system harms people.

4. Rapid tests

One piece of recent good news is the increased availability of rapid Covid tests, at drugstores and elsewhere.

Rapid tests are an important tool for allowing the elderly and immunocompromised to socialize confidently with friends and family. Stefanie Friedhoff of Brown University’s School of Public Health has written about a friend of hers who leaves a batch of tests in her hallway for people to take before they visit her husband, who has Parkinson’s disease.

5. Post-infection treatments

Rapid tests can also help vulnerable people find out when they have contracted Covid — and quickly begin a treatment to reduce its severity. “Time is critical, as close to symptom onset as possible,” Dr. Paul Sax of Brigham and Women’s Hospital in Boston notes.

Although some post-infection treatments no longer work against Omicron, others, like remdesivir, seem to. The most effective treatment may be Paxlovid, a Pfizer drug designed to fight Covid.

Unfortunately, these treatments can also be difficult to locate. My colleague Rebecca Robbins has written about her maddening search to find one for her mother, who’s 73 and has had cancer. Rebecca had to locate Paxlovid herself, at a Rite Aid 60 miles from her mother’s home, and hire an Uber driver to pick it up.

The supply of Paxlovid, in both the U.S. and other countries, will expand rapidly in coming months, which should help. Yet some of the logistical hurdles will surely remain. (Related, from Times Opinion: “Covid drugs may work well, but our health system doesn’t.”)

The bottom line

Vulnerable people — and their families — can take some big steps to protect themselves, including high-quality masks and rapid tests. But government agencies, hospitals and doctor’s offices can also play a crucial role, helping people locate potentially lifesaving treatments. “It’s incumbent upon policymakers to give people the tools to do that,” Dr. Scott Gottlieb, a former F.D.A. commissioner, said on CBS yesterday.

One final point: Some of these issues are not unique to Covid. The flu, for example, kills more than 30,000 Americans a year, most of them elderly or immunocompromised. If Covid can focus the country on finding better ways to protect them in the future, it would be one silver lining from a tragic pandemic.

More virus news:

The number of daily Covid cases in the U.S. has fallen more than 75 percent from the January peak, and hospitalizations have fallen 40 percent.
The U.S. will reimburse some funeral expenses for deaths related to the virus.

February 15, 2022

Traffic deaths are surging during the pandemic.

Deepshikha Nag Chowdhury and Aditya Bhattacharya’s son Pronoy Bhattacharya died while crossing the street with his family.Adria Malcolm for The New York Times

‘Social disengagement’

The United States is enduring its most severe increase in traffic deaths since the 1940s.

It is a sharp change from the recent norm, too. Deaths from vehicle crashes have generally been falling since the late 1960s, thanks to vehicle improvements, lower speed limits and declines in drunken driving, among other factors. By 2019, the annual death rate from crashes was near its lowest level since cars became a mass item in the 1920s.

But then came the Covid-19 pandemic.

Crashes — and deaths — began surging in the summer of 2020, surprising traffic experts who had hoped that relatively empty roads would cause accidents to decline. Instead, an increase in aggressive driving more than made up for the decline in driving. And crashes continued to increase when people returned to the roads, later in the pandemic.

Per capita vehicle deaths rose 17.5 percent from the summer of 2019 to last summer, according to a Times analysis of federal data. It is the largest two-year increase since just after World War II.

Source: National Highway Safety Administration

This grim trend is another way that two years of isolation and disruption have damaged life, as this story — by my colleague Simon Romero, who’s a national correspondent — explains. People are frustrated and angry, and those feelings are fueling increases in violent crime, customer abuse of workers, student misbehavior in school and vehicle crashes.

‘Erratic behavior’

In his story, Simon profiles one of the victims, a 7-year-old boy in Albuquerque named Pronoy Bhattacharya. Like Pronoy, many other victims of vehicles crashes are young and healthy and would have had decades of life ahead of them if only they had not been at the wrong place at the wrong time.

Pronoy was killed as he crossed the street with his family in December, after visiting a holiday lights display. The driver had run a red light.

“We’re seeing erratic behavior in the way people are acting and their patience levels,” Albuquerque’s police chief, Harold Medina, told Simon. “Everybody’s been pushed. This is one of the most stressful times in memory.”

Art Markman, a cognitive scientist at the University of Texas at Austin, said that the emotions partly reflected “two years of having to stop ourselves from doing things that we’d like to do.” He added: “When you get angry in the car, it generates energy — and how do you dissipate that energy? Well, one way is to put your foot down a little bit more on the accelerator.”

Rising drug abuse during the pandemic seems to play an important role, as well. The U.S. Department of Transportation has reported that “the proportion of drivers testing positive for opioids nearly doubled after mid-March 2020, compared to the previous 6 months, while marijuana prevalence increased by about 50 percent.” (Mid-March 2020 is when major Covid mitigations began.)

Other factors besides the pandemic also affect traffic deaths, of course. But those other factors tend to change slowly — and often counteract each other. Improving technology and safety features reduce traffic deaths, while the growing size of vehicles and the rise of distracted driving lead to more deaths. The only plausible explanation for most of the recent surge is the pandemic.

Rising inequality

Vehicle crashes might seem like an equal-opportunity public health problem, spanning racial and economic groups. Americans use the same highways, after all, and everybody is vulnerable to serious accidents. But they are not equally vulnerable.

Traffic fatalities are much more common in low-income neighborhoods and among Native and Black Americans, government data shows. Fatalities are less common among Asian Americans. (The evidence about Latinos is mixed.) There are multiple reasons, including socioeconomic differences in vehicle quality, road conditions, substance abuse and availability of crosswalks.

These patterns mean that the rise in vehicle crashes over the past two years has widened racial and class disparities in health. In 2020, overall U.S. traffic deaths rose 7.2 percent. Among Black Americans, the increase was 23 percent.

One factor: Essential workers, who could not stay home and work remotely, are disproportionately Black, Destiny Thomas, an urban planner, told ABC News.

Another factor: Pedestrians are disproportionately Black, Norman Garrick of the University of Connecticut noted. “This is not by choice,” Garrick told NBC News. “In many cases, Black folks cannot afford motor vehicles.” As Simon’s story notes, recent increases in pedestrian deaths have been especially sharp.

The increasing inequality of traffic deaths is also part of a larger Covid pattern in the U.S.: Much of the burden from the pandemic’s disruptions has fallen on historically disadvantaged groups. (Deaths from Covid itself have also been somewhat higher among people of color.)

Learning losses have been largest for Black and Latino children, as well as children who attend high-poverty schools. Drug overdoses have soared, and they are heavily concentrated among working-class and poor Americans.

As I’ve written before, there are few easy answers on Covid. Continuing the behavior restrictions and disruptions of the past two years does have potential benefits: It can reduce the spread of the virus. But those same restrictions and disruptions have large downsides.

Many workplaces remain closed. Schools aren’t operating close to normally (as my colleague Erica Green has described). Millions of adults and children must wear masks all day long. These changes have created widespread frustration and anxiety — and the burdens of them do not fall equally across society.

Dr. David Spiegel, who runs Stanford Medical School’s Center on Stress and Health, has a clarifying way of describing the problem. People are coping with what he calls “social disengagement.” — a lack of contact with other people that in normal times provides pleasure, support and comfort. Instead, Spiegel said, “There’s the feeling that the rules are suspended and all bets are off.”

Programming note: We heard that yesterday’s newsletter — about ways to protect people vulnerable to Covid — went into some readers’ spam folders. You can read it here.

February 18, 2022

We have an update on the “red Covid” story.

Barnegat Light, N.J.Karsten Moran for The New York Times

Still growing, more slowly

Ocean County, in central New Jersey, is a mixture of beach towns like Barnegat Light and exurban towns like Toms River and Lakewood. Household income in the county exceeds the U.S. average.

Yet Ocean County is among the least vaccinated places in the Northeast. Only 53 percent of residents have received at least two doses of a Covid-19 vaccine (or one dose of Johnson & Johnson). Only 26 percent have received a booster shot.

The large number of unvaccinated residents in Ocean County has led to a horrific amount of Covid illness and death. Nearly one out of every 200 residents has died from the virus. That is worse than the toll in Mississippi, the U.S. state with the largest amount of Covid death per capita, and worse than in any country except for Peru.

What explains the vaccine skepticism in Ocean County? Politics, above all. The county is heavily Republican. Donald Trump won it by almost 30 percentage points in 2020, and many Republicans — including those who are older than 65 and vulnerable to severe Covid illness — are skeptical of the vaccines.

This partisan divide has led to the “red Covid” phenomenon that I have described in previous newsletters. Today, I have an update.

Blue, then red

First, some background: In the pandemic’s initial months, Covid cases and deaths were higher in Democratic areas, probably because they are home to several major international airports. The virus entered this country on the West Coast and in the Northeast. But it didn’t stay there. By the end of Covid’s first year in the U.S., the virus had swept across the country, and there was no significant partisan divide in deaths.

Only after the vaccines became widely available, in early 2021 — and liberals were much more willing to get shots than conservatives — did Covid become a disproportionately Republican illness. By the summer of 2021, the gap was soaring:

Data as of Feb. 13. | Source: New York Times database; Edison Research

As the chart makes clear, the toll has been even worse in counties where Trump won by a landslide than in counties that he won narrowly.

This phenomenon is an example of how the country’s political polarization has warped people’s thinking, even when their personal safety is at stake. It is a tragedy — and a preventable one, too.

A new study by four Harvard epidemiologists estimates that 135,000 unvaccinated Americans died unnecessarily in the last six months of last year. The Texas Tribune recently profiled a young unvaccinated couple: She spent 139 days in intensive care; he asked, “Was this my fault?” They have both since been vaccinated.

Natural immunity

There is one big new development. When I last wrote about red Covid, in November, I told you that the month-to-month partisan mortality gap might be peaking, for two main reasons.

One, the availability of highly effective post-infection treatments, like Pfizer’s Paxlovid, has been expanding; if they reduce deaths, the drop may be steepest where the toll is highest. Two, red America has probably built up more natural immunity to Covid — from prior infections — than blue America, given that many Democrats have tried harder to avoid getting the virus.

Sure enough, the partisan gap in Covid deaths is no longer growing as fast it had been, as you can see from the new closeness among these lines:

In Trump and Biden counties, one candidate won at least 70 percent of the vote; in swing counties, both won at least 45 percent.

During the Omicron wave, deaths have risen less in red counties than in blue or purple counties. The most likely explanation seems to be that the number of Trump voters vulnerable to severe illness — which was still very large earlier last year — has declined, because more of them have built up some immunity to Covid from a previous infection.

But don’t make the mistake of confusing a gap that’s no longer growing as rapidly as it was with a gap that is shrinking. The gap between red and blue America — in terms of cumulative Covid deaths — is still growing. The red line in that second chart is higher than the blue line, which is a sign that more Republicans than Democrats or independents have needlessly died of Covid in recent weeks.

Another point to remember: Even in deeply blue counties, an outsize number of deaths are occurring among people who are unvaccinated or unboosted. The vaccines offer incredible protection from a deadly virus, yet many Americans have chosen to leave themselves exposed.

Related: Vaccinating and boosting more elderly people is probably the single best strategy for reducing deaths, The Atlantic’s Sarah Zhang writes. One way to do so: Increase Medicare payments to doctors and hospitals that make progress.

Virus developments:

California laid out a plan to treat Covid as a manageable risk that “will remain with us for some time, if not forever.”
This moment feels particularly hard for immunocompromised people. “It’s like living behind a veil.”

February 20, 2022

Misinformation About Face Masks

Since the beginning of the pandemic, there has been a raging — sometimes ill-informed — debate over the effectiveness of face masks as protection against SARS-CoV-2, the virus that causes COVID-19.

https://www.factcheck.org/2021/08/scicheck-misinformation-about-face-masks/

February 20, 2022

COVID-19 in babies and children

Children of all ages can get the coronavirus disease 2019 (COVID-19) and experience its complications.

https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-in-babies-and-children/art-20484405

February 21, 2022

HOW CAN I BOOST
MY KID'S MENTAL HEALTH
BY GOING OUTSIDE?

Sunday, February 20, 2022

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PHOTOGRAPH BY CAVAN IMAGES / GETTY IMAGES

By Rachel Buchholz, KIDS AND FAMILY Editor in Chief

Hey, winter—We. Are. Done.

As COVID-19 infection rates continue to fall throughout the country, most of us are preparing to (safely) leave the home caves we’ve been sheltering in for nearly two years. Winter, of course, doesn’t make that easy.

But getting outside is critical to mental health, especially for children dealing with the pandemic. Organizations like the American Psychological Association are even saying that the public health crisis has caused a mental health crisis in kids, and parents are scrambling to make sure their little ones come through OK.

Some therapists actually prescribe “getting outside” when treating young patients. Others include a dose of mindfulness. So it makes sense that combining the two—what many experts call “ecotherapy”—can help even more. And parents can try some of the techniques to help boost their children's moods. For instance:

• Creative minds. Have children do an art project outside, paying close attention to the colors and sounds around them. Try these DIY activities, like making watercolor paint and sidewalk chalk.

• Quiet time. Challenge kids to take off their headphones on a bike ride or hike and instead focus on their surroundings. This article provides tips on how to encourage those silent moments.

• Dig deeper. Even if it’s not quite warm enough where you live to start an outdoor garden, an indoor garden still allows kids to get in touch with their senses by feeling soil on their fingers and smelling sprouting seeds. Check out these tips to get one started.

This article has other ideas to combine outdoor activity with mindfulness. Fingers crossed that in just a few weeks, we won’t have to keep adding so many layers of clothing in order to find some outdoor goodness.

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WHAT YOU NEED TO KNOW

PHOTOGRAPH BY JOSE LUIS PELAEZ INC., GETTY IMAGES

Liar, liar, pants on fire. So this made me laugh: Just a week before publishing this article about why kids lie, a friend told me about her own tyke, who tried to convince her that, nope, there was no change after buying two candy bars with a $20 bill. It turns out that as a child’s brain develops, so, too, does their ability to lie—so you could say lying is an important developmental milestone in kids. It’s still a mortifying moment, though, so check out these expert tips on how to deal with your clever little Pinocchios.

Bunker babies. Many parents of very young children were dismayed last week after the FDA announced it would wait for more data before deciding whether to authorize COVID-19 vaccines for children under five. These kids, sometimes called “bunker babies” because lockdown life is all that many of them have ever known, are the last big group to be ineligible for vaccinations, and experts worry about the toll it’s taking. With stunning photography, this Nat Geo article takes a look at some of those children’s stories.

February 22, 2022

As the Center for Infectious Disease Research and Policy (CIDRAP) reported on Wednesday, the World Health Organization (WHO) released a new report this week showing that the omicron subvariant BA.2 now accounts for more than 1 in 5 new coronavirus infections detected worldwide, and the variant is rising both in countries where cases are increasing and declining.

As the American Medical Association explains, the BA.2 variant is sometimes referred to as “stealth” omicron because it has genetic mutations that could make it harder to distinguish from the delta variant using PCR tests, as compared to the original version of omicron.

BA.2 is now prevalent in 10 countries: Bangladesh, Brunei, China, Denmark, Guam, India, Montenegro, Nepal, Pakistan, and the Philippines. The WHO says that early evidence indicates that the variant is more transmissible, but at this point there is no evidence that BA.2 is more harmful, and vaccines seem to be just as effective against it as they are against the original omicron strain.

New research suggests that BA.2 may have features that make it as capable of causing serious illness as previous variants such as delta, as reported by CNN.

According to a preprint study, researchers said that “our data suggest the possibility that BA.2 would be the most concerned variant to global health … we propose that BA.2 should be recognised as a unique variant of concern, and this SARS-CoV-2 variant should be monitored in depth.”

RELATED: Get Up-to-Date COVID-19 News in the Daily Coronavirus Alert

Data received by the WHO as of February 14 showed that the number of global new COVID-19 cases reported has continued to fall, with 2.7 million new cases last week, a 16 percent decline compared with the previous week. The number of new deaths reported also fell, with 81,000 new deaths reported last week, a 10 percent decline as compared to the previous week.

As medical news site Healio reported last week, the Centers for Disease Control and Prevention has begun reporting the proportion of COVID-19 cases in the United States caused by BA.2, and although the subvariant accounted for just 3.6 percent of infections in the country for the week ending February 5, that percentage is triple the amount it accounted for the week prior.

Figures presented by the The New York Times on Thursday indicated that infections are climbing in Belarus, Latvia, and Slovakia. Cases have risen 79 percent in two weeks in Russia.

CIDRAP adds that this week South Korea’s daily infections have soared past 90,000 for the first time, Hong Kong broke its daily case total by hitting 4,000, Singapore tallied a new daily high of more than 19,000 new cases, and Indonesia also reported a record high, with daily cases surpassing 57,000.

In a live Q&A on Wednesday, Maria Van Kerkhove, the WHO’s COVID-19 technical lead, warned that testing rates have changed around that world and that could be skewing numbers. “We need to be careful about interpreting this downward trend; it’s likely that there is a large number of cases that we’re missing,” she said. She is also concerned that the death tallies are still very high. “At this point in the pandemic when we have tools that can save people’s lives, it is far, far too many.”

For now, the WHO is still concerned that there is too much virus circulating at an intense level. Van Kerkhove warned, “If you have huge numbers of cases like we are seeing, the opportunity for even more variants is higher.”

February 22, 2022

US virus cases, hospitalizations continue steady decline

Average daily COVID-19 cases and hospitalizations are continuing to fall in the U.S., an indicator that the omicron variant’s hold is weakening across the country.

https://apnews.com/article/coronavirus-pandemic-health-new-york-infectious-diseases-buffalo-1a11bbba3693c38a3ac6d7069496244f?

February 25, 2022

CDC to significantly ease pandemic mask guidelines Friday

The Biden administration will significantly loosen federal mask-wearing guidelines to protect against COVID-19 transmission on Friday, according to two people familiar with the matter, meaning most Americans will no longer be advised to wear masks in indoor public settings.

https://apnews.com/article/coronavirus-pandemic-health-pandemics-centers-for-disease-control-and-prevention-0be4f20f94f125c511dbca42ae317546?

February 27, 2022

New research points to Wuhan market as pandemic origin

Scientists released a pair of extensive studies Saturday that point to a market in Wuhan, China, as the origin of the coronavirus pandemic. Analyzing data from a variety of sources, they concluded that the coronavirus was very likely present in live mammals sold in the Huanan Seafood Wholesale Market in late 2019 and suggested that the virus twice spilled over into people working or shopping there. They said they found no support for an alternate theory that the coronavirus escaped from a laboratory in Wuhan.

https://theworldnews.net/jp-news/new-research-points-to-wuhan-market-as-pandemic-origin

February 28, 2022

We look at the surprising number of recent classroom shutdowns in the U.S.

Noelle Rodriguez working from home in Fresno, Calif.Tomas Ovalle for The New York Times

One in four

The debate over Covid-19 school closures can sometimes seem to be settled. There is now a consensus that children learned much less than usual — and that their mental health suffered — when schools were shut for months in 2020 and 2021. This consensus helps explain why very few school districts fully closed during the Omicron surge.

But Covid-related school shutdowns did not really end during Omicron. They instead became more subtle, often involving individual schools, classrooms or groups of students, rather than entire districts.

My colleagues at The Upshot recently conducted a poll, in collaboration with the survey firm Dynata, of almost 150,000 parents around the country. The results reveal much more lost school time during the Omicron wave than many people understood.

I was genuinely surprised by the numbers: In January, more than half of American children missed at least three days of school. About 25 percent missed more than a week, while 14 percent of students missed nine or more days. For tens of millions of American children last month, school wasn’t anywhere close to normal.

Source: Dynata survey of 148,400 parents.

The data, as my colleagues Claire Cain Miller and Margot Sanger-Katz write, “demonstrates the degree to which classroom closures have upended children’s education and parents’ routines, even two years into the pandemic. Five days of in-person school each week used to be virtually guaranteed. Some parents are now wondering if they’ll get that level of certainty again.”

These quiet closures have large costs. Even brief school disruptions can cause students to fall behind, research has found, with the effects largest among boys and children from low-income families, Claire and Margot note. “Routine is really important for young children’s sense of stability,” said Anna Gassman-Pines, a Duke University professor who specializes in psychology and neuroscience.

The disruptions also create problems for parents, especially working-class parents who cannot do their jobs remotely as easily as many white-collar professionals can. Noelle Rodriguez, a hair stylist in Fresno, Calif., moved her salon to her house, installing a sink and buying a hair dryer chair, because she assumed her children would not reliably be going to school. Her husband could not watch them, because he is a sheet metal foreman who cannot work from home.

Rodriguez was right to assume school would be disrupted: Her third-grade daughter was home for two weeks at one point, and Rodriguez could not see customers. “I cannot collect unemployment, I don’t get any sick pay, I’m self-employed, so I had zero income during that time,” she said.

Unavoidable trade-offs

The obvious question is whether these partial school shutdowns are doing more good or more harm.

Unfortunately, there is no simple answer. The Omicron surge led to a sharp increase in Covid-19 hospitalizations and deaths. If schools had allowed children, teachers and other staff members to go to school while they had Covid — and were contagious — they could have made the toll even worse.

But many districts went further than requiring only contagious people to stay home. Some also told people to stay home if they had been exposed to Covid even if they hadn’t tested positive — or told them to stay home for many days after a positive test, likely beyond the window of infectiousness. These policies sometimes left schools without enough staff to function.

In justifying the policies, school administrations have frequently said that they are acting out of an abundance of caution. It’s not so simple, though. Being abundantly cautious about Covid has other downsides. It can sometimes require a lack of caution in other areas, like children’s educational progress and mental health, as well as their parents’ jobs.

“It means a lot of anxiety, and it’s just not sustainable for the long haul,” said M. Cecilia Bocanegra, a psychotherapist in the Chicago area and mother of three who has been frustrated by the disruptions. (The Upshot’s story recreates the chaotic calendars of a few families.)

A recent poll by the Pew Research Center indicates that Bocanegra’s attitude is becoming more common. Most parents told Pew that they wanted districts to give priority to students’ academic progress and emotional well-being when deciding whether to keep schools open. By contrast, in the summer of 2020 — before vaccines were available — most parents instead wanted schools to put a higher priority on minimizing Covid risks.

As has often been the case during the pandemic, there are some partisan differences here. Democratic areas have been quicker on average to disrupt classrooms than Republican areas, the Dynata survey suggests:

Source: Dynata survey of 148,400 parents.

Burbio, a research firm that tracks school closures, has found a similar pattern. And the Pew poll found that Democratic parents wanted schools to give similar weight to Covid risks, academic progress and students’ emotional well-being; Republican parents wanted schools to put more weight on academics and mental health than on Covid exposure.

What now?

Whatever your views are, I think it’s worth remembering that both approaches have public health benefits and costs.

If schools make reducing Covid cases the top priority, they will probably be able to reduce cases — but will also cause more learning loss and family disruption. The strongest argument for this approach is that it protects unvaccinated, immunocompromised and elderly people while a deadly virus is still causing widespread harm.

If schools make returning to normal the top priority, they will probably reduce learning loss and family disruptions — but will also create more Covid exposure. The strongest argument for this approach is that it protects children and less-affluent families at a time when most severe Covid illness is occurring among unvaccinated people who have voluntarily accepted that risk.

With Omicron receding, this dilemma is becoming easier to resolve: School disruptions have declined in recent weeks. But the dilemma has not disappeared. Many schools are still not functioning normally, and future Covid surges — which would force a new round of hard choices — remain possible.

“We may be moving into a new phase of the pandemic,” Bree Dusseault of the Center on Reinventing Education at Arizona State University, told Claire, “where schools are generally kept open but there are sporadic bursts of disruption to smaller groups of students.”

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