Tag: public health

Justin Trudeau’s battle has less to do with truckers and more to do with an unwillingness to concede that COVID-19 is endemic

On By The Social CriticIn Health & Environment, Politics & Public Policy, Technology & ScienceLeave a comment

Canadian Prime Minister Justin Trudeau has invoked emergency rule in response to “Freedom Convoy” protests. Even as Trudeau unapologetically paints anyone and everyone who supports protestors’ as swastika-brandishing Nazi sympathizers, police have begun to arrest truckers, who have occupied Capitol-area streets since mid January in a bid to end to COVID-19 restrictions. Elsewhere in Canada and across much of the United States, political leaders have begun to acknowledge that COVID-19’s well-established propensity to mutate faster than vaccines can keep pace with calls for a smarter strategy.

Acknowledging that COVID-19 is here to stay (endemic) does not mean wholesale surrender. It will remain necessary to protect the vulnerable, in part by adopting CDC’s recently updated mask recommendations. Endemic COVID-19 also pushes to the forefront the necessity for early home treatment options to prevent infections from becoming severe enough to require hospitalization. Endemic COVID-19 also signifies that government reliance upon expanded emergency authority is an unsustainable response to a virus that Moderna’s CEO described to investors a year ago as something we must learn to live with “forever”.

Although COVID-19 waves may continue to break over us, rule-by-executive fiat cannot — providing we do not want our respective representational democracies to become the ultimate pandemic casualty.

Promising research is underway on vaccination via a different route — inhalation — which may offer a significant improvement over intramuscular COVID-19 jabs because the immune response will instead begin in the upper respiratory tract where infections such as cold, flu and coronaviruses get their start. Unlike current vaccines, which favor an immune system response once the virus has established itself well enough to impact the bloodstream, inhaled vaccines may one day do a superior job slowing the spread.

At present, however, vaccine mandates/passports make less sense with each passing day. For one, 2020 COVID-19 vaccines are outdated. A “notably lower” capacity for vaccine-induced antibodies to neutralize COVID-19 infection was first observed last year upon the emergence of Delta variant. While vaccines continue to reduce risk of hospitalization — although that assumption has been challenged, too — faced with Omicron vaccines are no longer highly effective at preventing infection. This matters because without the capacity to dramatically reduce infection and thus break transmission chains, mandates are of limited public health utility. Even more salient to the mandate debate, however, is the matter of “herd immunity“.

Herd immunity is the point at which a sufficient portion of a population — through naturally-acquired infection, vaccination or a combination of the two — are no longer vulnerable to illness, thus choking off a virus’ ability to spread. A high-functioning vaccine will perform well enough that the risks of interacting with unvaccinated individuals are of little consequence to non-immunocompromised people for much the same reason the vaccinated do not lose sleep for fear of contracting measles, mumps or polio.

Unfortunately, COVID-19 vaccines do not yet meet this high bar in spite of reports that attempt to imply otherwise.

We have little choice now but to face reality: Mass vaccination, even under idealized circumstances in which COVID-19 vaccines do not provoke hesitancy and are not also perilously “leaky”, has always been an uphill battle in a world ~7B people strong. Reduced COVID-19 transmission demands not only better vaccines but vastly improved access throughout the Third World. The latter has not happened and it is unlikely to happen within our lifetimes. Perhaps this is why Dr. Larry Brilliant, who is credited with helping eradicate smallpox, disputes the notion that mass vaccination was ever the best approach. In news that went largely unnoticed by U.S. media, Dr. Brilliant urged a COVID-19 vaccine “rethink” to make smarter use of the jabs.

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Healthcare Insecurity: American who Returns Sick from Liberia Fails to Inform Hospital about Travel

On By The Social CriticIn Health & EnvironmentLeave a comment

A year ago, the Ebola crisis in West Africa became all too real as American healthcare workers from afflicted regions returned for treatment in the U.S., and a visiting West African national took ill and later died at a Texas hospital.

Although Ebola was successfully contained, a recent incident in New Jersey points to a gap in healthcare security that remains as troublesome as ever.

According to a May 25 Associated Press article, an American suffering from symptoms that very well could have been confused with Ebola — Lassa fever — allegedly failed to inform hospital workers in New Jersey that he had recently returned from a trip to Liberia.

Hospital officials said they had asked the man about his travel history and that he did not say he had recently been to West Africa, CDC officials said.

Lassa fever, a West African hemorrhagic illness that is typically milder than Ebola, spreads in much the same way: direct contact with infected bodily fluids. Severe cases may lead to death, proceeded by fever, vomiting, organ failure, shock and bleeding from the eyes, nose and gums. The unidentified New Jersey man died of organ failure before he could receive antiviral treatment at the second NJ hospital he checked into after taking ill, the report says.

The CDC is currently in the process of tracking down people who came in close contact with the returning traveler on his way back to New York via a Morocco flight. The mystery is, why didn’t the patient himself notify hospital workers that he had recently returned from West Africa?

Ebola, Lassa fever or something else entirely — in whatever form the next infectious disease story takes shape — illustrates that the American healthcare system remains a “sitting duck” for infectious diseases imported by ordinary travelers, let alone terrorists.

Efforts to monitor infectious diseases are only a first step. This story begs the question as to why we do not have a proactive public health safety strategy in place. There ought to be a nationwide searchable database that doctors and hospital administrators can access at any point of entry into the healthcare system to verify international travel history on patients who are either too ill to disclose their travel history or for reasons only they understand choose to withhold such critical information.

The CDC and Congress needs to act now to make passport activity available to healthcare workers in much the same way law enforcement may run a license plate check to determine if there are outstanding warrants on an individual during a traffic stop.

Police officers are not forced to rely upon the people they pull over or arrest to self-disclose prior run-ins with the law, nor should healthcare workers be forced to rely on patients to volunteer their international travel history. In today’s globalized world, we can no longer afford to leave critical health and safety information to chance.

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