Category Archives: Covid-19

Japanese Emperor Naruhito and Empress Masako, wearing face masks, arrive at the National Theatre to attend the national memorial service for the victims of the March 11 earthquake and tsunami, in Tokyo, Japan March 11, 2021. Rodrigo Reyes Marin/Pool via REUTERS

TOKYO, June 24 (Reuters) - Japanese Emperor Naruhito "appears concerned" about the possibility the Olympic Games could cause the coronavirus to spread as feared by many members of the public, the head of the Imperial Household Agency (IHA) said on Thursday.

While the emperor's concern was framed as the official's impression rather than something he explicitly expressed, the rare insight into the monarch's thinking on the Games lit up social media, with many wondering whether there would be a formal address on the topic.

"The emperor is extremely worried about the current status of coronavirus infections," IHA Grand Steward Yasuhiko Nishimura told a regular news conference on Thursday.

"Given the public's worries, he appears to me to be concerned about whether the Olympics and Paralymics event, for which he is honorary patron, would cause infections to spread."

As news of the chamberlain's comment spread, "IHA Grand Steward" and related key words were tagged on tens of thousands of posts on Twitter.

The emperor has no political power but is widely respected as a figurehead in Japan, although it is rare for him to make public statements. His attendance at the opening ceremony on July 23 has not been decided, the IHA said.

Asked about the comment, Tokyo 2020 CEO Toshiro Muto told reporters he did not believe that the chamberlain's remarks indicated that there were any problems with preparations for the Games, which were delayed for a year by the pandemic.

"Our responsibility is to alleviate the concerns of the public and ensure that the Games are held in a safe and secure manner, and we will continue to work at that," Muto said.

Many Japanese remain sceptical about the possibility of holding even a scaled-down Games safely during the pandemic. Organisers have excluded foreign spectators and limited the number of domestic ones for the event. Alcohol, high-fives and talking loudly will also be banned. read more

'SITUATION STILL DIRE'

Japan has largely avoided the kind of explosive coronavirus outbreaks that have devastated other countries, but its vaccine roll-out was initially slow and the medical system has been pushed to the brink in some places.

On Thursday, advisers to the Tokyo metropolitan government warned that people were moving around more after the government lifted a state of emergency in the capital and elsewhere this week, and that could cause infections to creep up.

The medical system remained stretched to the limit as health workers were also busy vaccinating the public, one expert said.

They also warned of signs that more infectious variants could spread rapidly in coming weeks and months.

"Although we're now in a 'quasi' state of emergency, the situation is still very dire," Tokyo Vice Governor Mitsuchika Tarao told reporters, standing in for Governor Yuriko Koike, who was hospitalised this week to recover from fatigue.

Underscoring such concerns, a second member of the Ugandan team tested positive for the coronavirus on Wednesday, several days after the team member had tested negative upon arrival in Japan.

Earlier in the week, the World Health Organization's head of emergencies programme, Mike Ryan, noted that infection rates in Japan had been falling, and said they compared favourably to other countries that were hosting big events. read more

Reporting by Chang-Ran Kim; Editing by Himani Sarkar

Our Standards: The Thomson Reuters Trust Principles.

Excerpt from:

Emperor 'appears concerned' about COVID-19 spread by Games, says steward - Reuters

News Release

Wednesday, June 23, 2021

Researchers will evaluate antibody responses in vaccinated participants and their infants.

A new observational study has begun to evaluate the immune responses generated by COVID-19 vaccines administered to pregnant or postpartum people. Researchers will measure the development and durability of antibodies against SARS-CoV-2, the virus that causes COVID-19, in people vaccinated during pregnancy or the first two postpartum months. Researchers also will assess vaccine safety and evaluate the transfer of vaccine-induced antibodies to infants across the placenta and through breast milk.

The study, called MOMI-VAX, is sponsored and funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. MOMI-VAX is conducted by theNIAID-funded Infectious Diseases Clinical Research Consortium (IDCRC).

Tens of thousands of pregnant and breastfeeding people in the United States have chosen to receive the COVID-19 vaccines available under emergency use authorization. However, we lack robust, prospective clinical data on vaccination in these populations, said NIAID Director Anthony S. Fauci, M.D., The results of this study will fill gaps in our knowledge and help inform policy recommendations and personal decision-making on COVID-19 vaccination during pregnancy and in the postpartum period.

Pregnant people with COVID-19 are more likely to be hospitalized, be admitted to the intensive care unit, require mechanical ventilation, and die from the illness than their non-pregnant peers. Severe COVID-19 during pregnancy also may put the infant at risk for complications such as preterm birth. Individuals who are pregnant or breastfeeding can choose to receive authorized COVID-19 vaccines, and studies to gather safety data in these populations are ongoing. So far, COVID-19 vaccines appear to be safe in these populations. The NIAID study will build on these studies by improving the understanding of antibody responses to COVID-19 vaccines among pregnant and postpartum people and the transfer of antibodies to their infants during pregnancy or through breast milk. Experience with other diseases suggests that the transfer of vaccine-induced antibodies from mother to baby could help protect newborns and infants from COVID-19 during early life.

Investigators will enroll up to 750 pregnant individuals and 250 postpartum individuals within two months of delivery who have received or will receive any COVID-19 vaccine authorized or licensed by the U.S. Food and Drug Administration. Their infants also will be enrolled in the study. Vaccines are not provided to participants as part of the study protocol. Currently, three COVID-19 vaccines are available in the United States under emergency use authorization: the Moderna and Pfizer-BioNTech mRNA vaccines and the Johnson & Johnson adenoviral vector vaccine. The study is designed to assess up to five types of FDA-licensed or authorized COVID-19 vaccines, should additional options become available.

Participants and their infants will be followed through the first year after delivery. To assess the development and durability of vaccine-induced antibodies overall and by vaccine type and vaccine platform, researchers will analyze blood samples collected from pregnant and postpartum participants. These samples will be collected at study enrollment; at delivery for participants who enrolled during pregnancy; and two, six, and 12 months after delivery. Pregnant participants enrolled in the study prior to receiving the vaccine will have blood drawn at enrollment as well as approximately one month after vaccination. To assess transfer of antibodies through the placenta and the levels and durability of antibodies in infants, researchers will perform antibody testing on samples from umbilical cord blood collected at delivery and blood samples collected from infants two and six months after delivery.

Investigators also will assess the potential effects on maternal immune responses and transfer of antibodies across the placenta according to the mothers age, the trimester of pregnancy during which the vaccine was received, the mothers health, and the mothers COVID-19 risk status. Additionally, mothers will have the option of providing breast milk samples at approximately two weeks, two months, six months, and 12 months after delivery. The investigators will evaluate breast milk antibodies to assess the potential for protection against COVID-19 in breastfed infants. Study staff also will gather information on COVID-19 illnesses in pregnant and postpartum participants, birth and neonatal outcomes, and COVID-19 illnesses in infant participants.

The work is led by principal investigators Flor M. Munoz, M.D., of Baylor College of Medicine in Houston and Richard H. Beigi, M.D., of University of Pittsburgh Medical Center. The study will be conducted at up to 20 clinical research sites nationwide. More information about the study, including a list of sites, is available on the IDCRC website.

NIAID conducts and supports researchat NIH, throughout the United States, and worldwideto study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID website.

About the National Institutes of Health (NIH):NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

NIHTurning Discovery Into Health

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NIH begins study of COVID-19 vaccination during pregnancy and postpartum - National Institutes of Health

Objective To estimate changes in life expectancy in 2010-18 and during the covid-19 pandemic in 2020 across population groups in the United States and to compare outcomes with peer nations.

Design Simulations of provisional mortality data.

Setting US and 16 other high income countries in 2010-18 and 2020, by sex, including an analysis of US outcomes by race and ethnicity.

Population Data for the US and for 16 other high income countries from the National Center for Health Statistics and the Human Mortality Database, respectively.

Main outcome measures Life expectancy at birth, and at ages 25 and 65, by sex, and, in the US only, by race and ethnicity. Analysis excluded 2019 because life table data were not available for many peer countries. Life expectancy in 2020 was estimated by simulating life tables from estimated age specific mortality rates in 2020 and allowing for 10% random error. Estimates for 2020 are reported as medians with fifth and 95th centiles.

Results Between 2010 and 2018, the gap in life expectancy between the US and the peer country average increased from 1.88 years (78.66 v 80.54 years, respectively) to 3.05 years (78.74 v 81.78 years). Between 2018 and 2020, life expectancy in the US decreased by 1.87 years (to 76.87 years), 8.5 times the average decrease in peer countries (0.22 years), widening the gap to 4.69 years. Life expectancy in the US decreased disproportionately among racial and ethnic minority groups between 2018 and 2020, declining by 3.88, 3.25, and 1.36 years in Hispanic, non-Hispanic Black, and non-Hispanic White populations, respectively. In Hispanic and non-Hispanic Black populations, reductions in life expectancy were 18 and 15 times the average in peer countries, respectively. Progress since 2010 in reducing the gap in life expectancy in the US between Black and White people was erased in 2018-20; life expectancy in Black men reached its lowest level since 1998 (67.73 years), and the longstanding Hispanic life expectancy advantage almost disappeared.

Conclusions The US had a much larger decrease in life expectancy between 2018 and 2020 than other high income nations, with pronounced losses among the Hispanic and non-Hispanic Black populations. A longstanding and widening US health disadvantage, high death rates in 2020, and continued inequitable effects on racial and ethnic minority groups are likely the products of longstanding policy choices and systemic racism.

In 2020, covid-19 became the third leading cause of death in the United States1 and was thus expected to substantially lower life expectancy for that year (box 1). The US had more deaths from covid-19 than any other country in the world and among the highest per capita mortality rates.5 This surge in deaths prompted speculation that the US would have a larger decrease in life expectancy in 2020 than peer nations, but empirical evidence has not been published. Americans entered the pandemic at a distinct disadvantage relative to other high income peer nations: improvements in overall life expectancy have not kept pace with those in peer countries since the 1980s,6 and in 2011, life expectancy in the US plateaued and then decreased for three consecutive years, further widening the gap in mortality with peer nations.7

Life expectancy is a widely used statistic for summarizing a populations mortality rates at a given time.2 It reflects how long a group of people can expect to live were they to experience at each age the prevailing age specific mortality rates of that year.3 Estimates of life expectancy are sometimes misunderstood. We cannot know the future age specific mortality rates for people born or living today, but we do know the current rates. Computing life expectancy (at birth, or at ages 25 or 65) based on these rates is valuable for understanding and comparing a countrys mortality profile over time or across places at a given point in time. Estimates of life expectancy during the covid-19 pandemic, such as those reported here, can help clarify which people or places were most affected, but they do not predict how long a group of people will live. This study estimated life expectancy for 2020. Life expectancy for 2021 and subsequent years, and how quickly life expectancy will rebound, cannot be calculated until data for these years become available. Although life expectancy is expected to recover in time to levels before the pandemic, past pandemics have shown that survivors can be left with lifelong consequences, depending on their age and other socioeconomic circumstances.4

The effect of the pandemic on life expectancy extends beyond deaths attributed to covid-19.8 Studies have found an even larger number of excess deaths during the pandemic, inflated by undocumented deaths from covid-19 and by deaths from non-covid-19 causes resulting from disruptions by the pandemic (eg, reduced access to healthcare, economic pressures, and mental health crises).9101112 Some racial and ethnic populations and age groups have been disproportionately affected.131415 Research on how the pandemic has affected life expectancy is only just emerging.1617 Few studies have examined reductions in 2020 life expectancy across racial and ethnic groups, and none has compared the decline in the US with other countries.

We estimated life expectancy at birth and at ages 25 and 65, examining the US population (in aggregate and by sex, and by race and ethnicity) and the populations of 16 high income countries (in aggregate and by sex). Estimates of life expectancy for 2010-18 were calculated from official life tables and were modeled for 2020. Estimates for 2019 would have been preferable to determine the effect of the covid-19 pandemic but life table data were unavailable for many peer countries. Life expectancy in the US is estimated to have increased by only 0.1 years between 2018 and 2019,18 however, and therefore the changes seen in life expectancy between 2018 and 2020 are largely attributable to the events of 2020.

Data for peer countries did not include information on race or ethnicity. US data were examined for three racial and ethnic groups that constitute more than 90% of the total population: Hispanic, non-Hispanic Black, and non-Hispanic White populations. Although many US individuals self-identify as Latino or Latina, we used Hispanic to maintain consistency with data sources. White and Black populations in this study refer to people in these racial groups who do not identify as Hispanic or Latinx.19 Estimates for other important racial groups, such as Asian, Pacific Islander, and Native American (American Indians and Alaskan Natives) could not be calculated because the National Center for Health Statistics does not provide official life tables for these populations.

US life tables for 2010-18 were obtained from the National Center for Health Statistics.202122232425262728 Weekly age specific death counts for all men and women in the US and for Black, White, and Hispanic men and women in the US for the years 2018 and 2020 were obtained from the National Center for Health Statistics AH (ad hoc) Excess Deaths by Sex, Age, and Race file.29 Mid-year population estimates by age, sex, and race and ethnicity for men and women in the US for 2015-19 were obtained from the US Census Bureau.30 Population counts for 2020 were estimated from age specific trends in US population estimates for 2015-19. The National Center for Health Statistics and US Census data were merged at ages 0-14, 15-19, . . . 80-84, 85 to calculate age specific death rates (mx) for 2018 and 2020 for men and women in the US in aggregate and by race and ethnicity.

Peer countries included 16 high income democracies with adequate data for analysis: Austria, Belgium, Denmark, Finland, France, Israel, Netherlands, New Zealand, Norway, South Korea, Portugal, Spain, Sweden, Switzerland, Taiwan, and the United Kingdom. Taiwan was treated as a country for our analysis although many countries do not recognize it as an independent country. Australia, Canada, Germany, Italy, and Japan were not included because of incomplete mortality data. To estimate life expectancy in these countries, five year abridged life tables for male and female populations of the peer countries were obtained for 2010-18 from the Human Mortality Database31 (direct sources3233 were used for Israel and New Zealand because current data were lacking in the Human Mortality Database). Weekly death counts in 2018 and 2020 by country for ages 0-14, 15-64, 65-74, 75-84, and 85 were obtained from the Human Mortality Database Short Term Mortality Fluctuations files.

To calculate life expectancy estimates for 2020, we used data from the National Center for Health Statistics and US Census Bureau to estimate rate ratios between the age specific mortality rates of 2018 (2018 mx) and 2020 (2020 mx) for US populations. For populations in peer countries, values for 2018 mx and 2020 mx, taken from data in the Human Mortality Database Short Term Mortality Fluctuations files, were estimated for ages 0-14, 15-64, 65-74, 75-84, and 85. Age specific mortality rate ratios between 2020 mx and 2018 mx data in the Human Mortality Database Short Term Mortality Fluctuations were estimated for each peer country in aggregate and by sex. Age specific probabilities of death in 2020 (qx), for ages 0-1, 1-4, 5-9, . . . 90-94, 95-99, 100, were estimated separately for men and women in the US and for men and women in specific race and ethnic group populations by multiplying 2018 mx28 by the 2020-18 rate ratio estimates derived from data from the National Center for Health Statistics and US Census Bureau, and calculating qx=(mxn)/(1+mxax), where qx is the age specific probability of death, mx is the age specific mortality rate, n is the width of the age interval, and ax is the age specific person years lived by the deceased.34 Probabilities of death for each peer country in 2020 were estimated by multiplying qx in the Human Mortality Database life tables by the 2020-18 rate ratios in the Human Mortality Database Short Term Mortality Fluctuations data.

We used Python (version 3.9.1) to simulate 50000 five year abridged 2020 life tables for each US subpopulation, with the estimated qx for 2020, ax derived from 2018 official life tables,28 and random 10% error in the qx estimate. For each peer country population, 50000 five year abridged 2020 life tables were simulated with the estimated 2020 qx and 2018 ax values in the Human Mortality Database 2018 life tables, and random 10% error in the qx estimate. We present median estimates of 2020 life expectancy at birth and at ages 25 and 65; fifth and 95th centiles are presented in the tables. The supplementary material provides further details on methods.

Involving patients or the public in the design, conduct, reporting, or dissemination plans of our research was not possible because of the urgency of the analysis and its focus on decedents.

After a small increase of 0.08 years between 2010 and 2018, life expectancy in the US at birth decreased by an estimated 1.87 years (or 2.4%) between 2018 and 2020 (fig 1 and supplementary fig 1). The proportional decrease in life expectancy at ages 25 and 65 was even greater (3.4% and 5.7%, respectively) (table 1). US men had a larger decrease in overall life expectancy than women, in both absolute (2.16 years v 1.50 years) and relative (2.8% v 1.8%) terms.

Life expectancy at birth in the United States, by race and ethnicity, and in peer countries, for years 2010-18 and 2020. Data obtained from the National Center for Health Statistics, US Census Bureau, and Human Mortality Database. Data for 2019 could not be calculated because life table data were unavailable for many peer countries

Life expectancy in the United States at birth, and at ages 25 and 65, by sex, for years 2010, 2018, and 2020

Between 2018 and 2020, life expectancy in the US decreased disproportionately among Black and Hispanic populations (table 2). In the Black population, life expectancy decreased by 3.25 years (4.4%), 2.4 times the decrease in the White population (1.36 years, 1.7%), with larger reductions in men (3.56 years, 5.0%) than women (2.65 years, 3.4%). In 2020, life expectancy in Black men was only 67.73 years. The decrease in life expectancy among Hispanic individuals was even larger (3.88 years, 4.7%), 2.9 times the decrease in White people, with larger reductions in men (4.58 years, 5.8%) than women (2.94 years, 3.5%).

Life expectancy in the United States at birth, and at ages 25 and 65, by sex, race, and ethnicity, for years 2010, 2018, and 2020

The disproportionate decrease in life expectancy in the US Black population during 2018-20 reversed years of progress in reducing the gap in mortality between Black and White populations. Although the gap in life expectancy between Black and White populations decreased from 4.02 years in 2010 to 3.54 years in 2014, the gap increased to 3.92 years in 2018, and to 5.81 years in 2020. Historically, the US Hispanic population has had a longer life expectancy than the White population.3536 Although that advantage widened between 2010 and 2017, from 2.91 years to 3.30 years, the gap decreased to 3.20 years in 2018 and then decreased sharply to 0.68 years in 2020 (table 2); the advantage reversed entirely in Hispanic men (from 2.88 years in 2018 to 0.20 years in 2020).

Figure 1 presents estimates of life expectancy for 2010-18 and 2020 for the US and the average for 16 high income countries. The US began the decade with a 1.88 year deficit in life expectancy relative to peer countries. This gap increased over the decade, reaching 3.05 years in 2018. Between 2018 and 2020, the gap widened substantially to 4.69 years: the 1.87 year decrease in life expectancy in the US was 8.5 times the average decrease in peer countries (0.22 years). Table 3 presents the estimates of life expectancy for peer countries at birth, and at ages 25 and 65 in 2010, 2018, and 2020.

Average life expectancy in peer countries at birth, and at ages 25 and 65, by sex, for years 2010, 2018, and 2020

Changes in life expectancy varied substantially across peer countries. Six countries (Denmark, Finland, New Zealand, Norway, South Korea, and Taiwan) had increases in life expectancy between 2018 and 2020. Among the other 10 peer countries, decreases in life expectancy ranged from 0.12 years in Sweden to 1.09 years in Spain, but none approached the 1.87 year loss seen in the US.

Figure 2 (and supplementary fig 2) contrasts changes in life expectancy in the US in 2010-18 and 2018-20 with those of peer countries, based on sex, and on race and ethnicity. Figure 3 (and supplementary fig 3) shows how these changes contributed to the gap between the US and peer countries. For example, figure 2 shows that life expectancy for US women increased by 0.21 years in 2010-18, but because life expectancy in women in the peer countries increased even more (0.98 years), the gap increased by 0.77 years (fig 3). The gap increased by another 1.36 years during 2018-20, largely because of the pandemic. Overall, the gap between the US and peer countries for women increased by 2.14 years (fig 3), from 1.97 years in 2010 (81.04 v 83.01 years) to 4.11 years (79.75 v 83.86 years) in 2020 (table 1 and table 3). The gap between the US and peer countries for men increased even more (3.37 years) (fig 3). In 2020, life expectancy for US men was 5.27 years (74.06 v 79.33 years) shorter than the peer country average for men.

Changes in life expectancy at birth in US populations and peer country average, for years 2010-18 and 2018-20. For example, life expectancy in the US for women increased by 0.21 years in 2010-18 and then decreased by 1.50 years in 2018-20. Data derived from the National Center for Health Statistics, US Census Bureau, and Human Mortality Database

Increasing gap in life expectancy between the United States and peer country average, for years 2010-18 and 2018-20. For example, the gap between life expectancy for men in the US men and the average life expectancy for men in peer countries increased by 1.50 years in 2010-18 and by a further 1.87 years in 2018-20. Data derived from the National Center for Health Statistics, US Census Bureau, and Human Mortality Database. Sums might differ because of rounding

The demographic composition and ethnic inequities of peer countries varied considerably, making it difficult to identify analogous reference populations to compare with the US racial and ethnic groups. But the peer country average provides a useful benchmark for showing the disproportionately large decreases in life expectancy in Black and Hispanic populations in the US (fig 1,fig 2, and fig 3). For example, among Black men and women in the US, the decrease in life expectancy between 2018 and 2020 was 12.3 times and 20.3 times greater, respectively, than the average decrease for men and women in peer countries. The corresponding values were even larger for the Hispanic population in the US, with estimated declines in life expectancy 15.9 times and 22.5 times higher among men and women, respectively, compared with their counterparts in peer countries.

Long before covid-19, the US was at a disadvantage relative to other high income nations in terms of health and survival.63738394041 In 2013, a report by the National Research Council and Institute of Medicine showed that from the 1980s, the US had higher rates of morbidity and mortality for multiple conditions relative to other high income countries.6 A recent report by the National Academies of Sciences, Engineering, and Medicine found that this gap widened further through 2017 and that the greatest relative increase in mortality in the US occurred in young and middle aged adults (aged 25-64). Increased mortality in this age group was largely because of deaths from drug use, suicide, cardiometabolic diseases, and other chronic illnesses and injuries.42 Between 2014 and 2017, whereas life expectancy continued to increase in other countries, life expectancy in the US decreased by 0.3 years,7 a three year decline that generated considerable public concern43 but is now overshadowed by the large 2020 declines reported here. Even countries with much lower per capita incomes outperform the US.44454647 According to data for 36 member countries of the Organization for Economic Cooperation and Development (OECD), the gap in life expectancy between the US and the OECD average increased from 0.9 to 2.2 years between 2010 and 2017.4849

This study shows that the gap in life expectancy in the US increased markedly between 2018 and 2020. The decrease in life expectancy in the US was 8.5 times the average loss seen in 16 high income peer nations and the largest decrease since 1943 during the second world war.50 The conditions that produced a US health disadvantage before the arrival of covid-19 are still in place, but the predominant cause for this large decline was the covid-19 pandemic: in 2020, all cause mortality in the US increased by 23%.12

We found large differences in the reductions in life expectancy during the covid-19 pandemic based on race and ethnicity. Decreases in life expectancy among Black and Hispanic men and women were about two to three times greater than in White people, and far larger than those in peer countries. Decreases in life expectancy of US Black and Hispanic men were 12-16 times greater than those in men from other high income countries. Corresponding decreases in life expectancy among US Black and Hispanic women were 20-23 times greater than those for women in peer countries. Progress made between 2010 and 2018 in reducing the gap in life expectancy between Black and White populations in the US was erased between 2018 and 2020. Life expectancy in Black men fell to 67.73 years, a level not seen since 1998.51 The US Hispanic life expectancy advantage was erased in men and nearly disappeared in women.

Our study estimated the effect of the covid-19 pandemic on life expectancy in the US for 2020, and compared life expectancy in the US with other high income countries. The study used a new method for these calculations, detailed in the supplementary appendix. The study also had several limitations. First, life expectancies for 2020 were simulated with preliminary mortality data, which are subject to errors (eg, undercounting, and mismatching between death and population counts) and often vary across racial and ethnic populations and countries. Second, the 2020 qx values used to generate life tables for peer populations could have been biased by the wide age ranges used in the Human Mortality Database Short Term Mortality Fluctuations files. Third, definitions for peer countries vary; our list differs from the 16 high income countries used in several cross national comparisons.63738 Five large high income democracies (Australia, Canada, Germany, Italy, and Japan) were excluded because of incomplete data. Fourth, we compared life expectancy in 2020 with 2018 values; the effect of the pandemic would be better determined by comparisons with life expectancy in 2019, but data for many peer countries were unavailable for this calculation Fifth, for reasons explained in the supplementary material, data on race and ethnicity for the US population and for 2020 deaths were incomplete,52 likely underestimating racial inequalities. Reports suggest that covid-19 and all cause mortality in 2020 were very high in American Indian and Alaskan Native populations.53 Finally, we used the average for peer countries; values for individual countries varied.

This study aligns closely with previous research. An analysis of deaths between January and June 2020 found that US life expectancy decreased by 1.0 years between 2019 and 2020, including reductions of 0.8 years in White people and reductions of 2.7 years and 1.9 years in Black and Hispanic individuals, respectively.17 Andrasfay and Goldman estimated that life expectancy from January to mid-October 2020 was 1.1 years below expected values, including a reduction of 0.7 years in White populations and reductions of 2.1 and 3.1 years in Black and Hispanic populations, respectively.16 Neither study examined changes in life expectancy in other countries or estimated life expectancy in the US for the whole of 2020.

The decreases in life expectancy that we found and the excess deaths reported in several studies of 2020 death counts9101112 could reflect the combined effects of deaths attributed to covid-19, deaths where SARS Co-V-2 infection was unrecognized or undocumented, and deaths from non-covid-19 health conditions, exacerbated by limited access to healthcare and by widespread social and economic disruptions produced by the pandemic (eg, unemployment, food insecurity, and homelessness).854 These adverse outcomes are products of national, state, and local policy decisions, and actions and inactions that influenced viral transmission and management of the pandemic.555657585960 These policies span healthcare, public health, employment, education, and social protection systems. Many organizations are tracking these decisions internationally for ongoing research and development.61626364

The large number of covid-19 deaths in the US reflects not only the countrys policy choices and mishandling of the pandemic555657585960 but also deeply rooted factors that have put the country at a health disadvantage for decades.676566 For much of the public, it was the pandemic itself that drew attention to these longstanding conditions, including major deficiencies in the US healthcare and public health systems, widening social and economic inequality, and stark inequities and injustices experienced by Black, Hispanic, Asian, and Indigenous populations and other systematically marginalized and excluded groups. Many studies have reported that rates of covid-19 infections, admissions to hospital, and deaths are substantially higher in Black and Hispanic populations compared with White people, because of greater exposure to the virus, a higher prevalence of comorbid conditions (eg, diabetes), and reduced access to healthcare and other protective resources.6768

Evidence of disproportionate reductions in life expectancy among racial and ethnic groups in the US, such as the disparities reported here, draws attention to the root causes of racial inequities in health, wealth, and wellbeing. Foremost among these root causes is systemic racism; extensive research has shown that systems of power in the US structure opportunity and assign value in ways that unfairly disadvantage Black, Hispanic, Asian, and Indigenous populations, and unfairly advantage White people.69707172737475 Many of the same factors placed these populations at greater risk from covid-19.1314157677787980 The higher prevalence of comorbid conditions in many racial or marginalized groups is a reflection of unequal access to the social determinants of health (eg, education, income, and justice) and not their race, ethnicity, or other socially determined constructs. Low income communities and women have also been disproportionately affected by the social, familial, and economic disruptions of the pandemic.8182 Reduced access to covid-19 vaccines, and vaccine hesitancy rooted in a communitys distrust of systems that have mistreated them, might exacerbate these disparities. Structural factors affect not only Black and Hispanic populations but other marginalized people and places. American Indians and Alaskan Natives, for example, have some of the worst health outcomes of any group in the US, but data limitations precluded separate calculations for these important populations.

The mortality outcomes examined in this study, in the research literature, and in the daily news represent only part of the burden of covid-19; for every death, a larger number of infected individuals experience acute illness, and many face long term health and life complications.83 Whether some of these long term complications will affect how quickly life expectancy in the US will rebound in the coming years is unclear. Morbidity and mortality during the pandemic have wider effects on families, neighborhoods, and communities. One study estimated that each death leaves behind an average of nine bereaved family members.84 The pandemic will have short and long term effects on the social determinants of health, changing living conditions in many communities, and altering life course trajectories across age groups. Fully understanding the health consequences of these changes poses a daunting but important challenge for future research.

Because of systemic factors in the United States, the gap between life expectancy in the US and other high income countries has been widening for decades

In 2020, the US had more deaths from the covid-19 pandemic than any other country, but no study has quantified how the years large number of deaths affected life expectancy in the US or the gap with peer countries

Between 2018 and 2020, largely because of the covid-19 pandemic, life expectancy in the US decreased by 1.87 years, 8.5 times the average decrease in peer countries, widening the gap in life expectancy with peer countries to 4.69 years

In the US, decreases in life expectancy in Hispanic and non-Hispanic Black people were about two to three times greater than in the non-Hispanic White population, reversing years of progress in reducing racial and ethnic disparities, and lowering the life expectancy of Black men to 67.73 years, a level not seen since 1998

Ethical approval: Not required.

Data sharing: Requests for additional data and analytic scripts used in this study should be emailed to RKM (Ryan.Masters@colorado.edu).

We thank Steven Martin, Urban Institute, for reviewing our methodology; Cassandra Ellison, art director for the Virginia Commonwealth University Center on Society and Health, for her assistance with graphic design; and Catherine Talbot, University of Colorado Boulder, for her advice with Python simulations. These individuals received no compensation beyond their salaries.

Contributors: SHW led the production of this manuscript and had primary responsibility for the composition. He is guarantor. RKM contributed revisions and had primary responsibility for data acquisition and analysis, the modeling results that form the basis for this study, and production of the supplementary material. LYA contributed revisions and had primary responsibility for dealing with the studys policy implications in the discussion section. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

Funding: SHW received partial funding from grant UL1TR002649 from the National Center for Advancing Translational Sciences. RKM received support from the University of Colorado Population Center grant from the Eunice Kennedy Shriver Institute of Child Health and Human Development (CUPC project 2P2CHD066613-06). There was no specific funding for this study.

Competing interests: All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/coi_disclosure.pdf and declare: no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work.

The lead author (SHW) affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned have been explained.

Dissemination to participants and related patient and public communities: Print, broadcast, and social medial will be used to disseminate the results of this study to journalists and the public, and summaries will be shared with policy makers, social justice organizations, and other relevant stakeholders.

Provenance and peer review: Not commissioned; externally peer reviewed.

Woolf SH, Aron L, eds. U.S. Health in International Perspective: Shorter Lives, Poorer Health. Panel on Understanding Cross-National Health Differences Among High-Income Countries. National Research Council, Committee on Population, Division of Behavioral and Social Sciences and Education, and Board on Population Health and Public Health Practice, Institute of Medicine. National Academies Press, 2013.

Rossen LM, Branum AM, Ahmad FB, Sutton P, Anderson RN. Excess deaths associated with COVID-19, by age and race and ethnicity. United States, January 26-October 3, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1522-27.

Arias E, Tejada-Vera B, Ahmad F. Provisional life expectancy estimates for January through June, 2020. Vital Statistics Rapid Release; no 10. Hyattsville, MD: National Center for Health Statistics. 2021. doi:10.15620/cdc:100392.

Arias E. United States life tables, 2002. National Vital Statistics Reports; vol 53 no 6. National Center for Health Statistics, 2004; volume 53, No 6.

Council on Foreign Relations. Improving Pandemic Preparedness: Lessons From COVID-19. Independent Task Force Report No 78. Council on Foreign Relations, 2020.

Preston S, Vierboom Y. Why do Americans die earlier than Europeans? The Guardian, May 4 2021.

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Effect of the covid-19 pandemic in 2020 on life expectancy across populations in the USA and other high income countries: simulations of provisional...

Oakland County residents who haven't received a COVID-19 vaccine yet can get a $50 gift card from the county health division if they get one by the Fourth of July.

The incentivekicks off Thursday and is forcounty residents age 12 and older who are eligible for a vaccine,with officials hoping to entice younger adults and teens as only 54% of county residents ages 16to 29 have received their first shot.

RN Danielle White with the Oakland County Health Department, left, administers the Pfizer Covid vaccine to third year pre-med student Gerard Knittel, 20, of Almont as Oakland University holds a Covid vaccine clinic at their Recreation Center for 18-24-year olds Tuesday, April 13, 2021.(Photo: Mandi Wright, Detroit Free Press)

The gift card will be for any county residentwho receives at least one dose ofa COVID-19 vaccine from a health division clinic oranother COVID-19 vaccine provider in Michigan, while supplies last. Those under age 18 are eligible to receive a gift card with the consent of their parent or legal guardian, according to a news release Wednesday.

"Vaccination remains the best tool to beat this pandemic, County Executive Dave Coulter said. We have made great strides in our efforts but there is still work to be done, and with more and more of our residents getting vaccinated, Im confident all of our summer plans will be back to normal very soon.

Residents who get vaccinated at a provider other than the health divisioncan get their gift card by completing a survey at OaklandCountyVaccine.com. Those who don't have internet access can contact theNurse on Call at 800-848-5533. Residents also canuse thoseresources to find a vaccination clinic.

The gift card will be mailed after the heath division verifies the person's vaccination status.

A stack of vaccination cards.(Photo: Kimberly P. Mitchell, Detroit Free Press)

The announcement came the same day that a U.S. Centers for Disease Control and Prevention advisory committee metto review reports of heart complications among teens and young adults after they were immunized with either a Pfizer or Moderna COVID-19 vaccine.

The CDCs Advisory Committee on Immunization Practices acknowledged there likely is an association between myocarditis inflammation of the heart muscle and pericarditis inflammation of thepericardium, the thin membrane around heart among 12- to 39-year-olds following vaccination.

Cases have been reported at a rate of 12.6 per million people within 21 days after a second dose of the vaccine, though some cases have also been reported after the first dose as well. The complication is more likely to occur in boys and young men, and the condition is most likely to appear within the first five days after vaccination.

Through June 11, 39.3 million mRNA vaccines were administered in the U.S. to 12- to 39-year-olds. There were 527 reports of myocarditis/pericarditis submitted to the federal Vaccine Adverse Events Reporting System (VAERS) within seven days of receiving a second dose of a vaccine.

Still, the committee found that the risk of severe COVID-19 illness and hospitalization among unvaccinated adolescents and young adults was higher in every age group than the risk of myocarditis or pericarditis. And most people who developed the heart complication post-vaccination have made full recoveries.

Currently, the benefit still clearly outweighs the risks for COVID vaccinations in adolescents and young adults, said Dr. Sara Oliver, lead for the COVID-19 Vaccines ACIP Work Group.

Prepared COVID-19 vaccines(Photo: Junfu Han, Detroit Free Press)

President Joe Biden is hoping for 70% of adult Americans to have had at least one dose of vaccine by July 4, but federal officials said Tuesday they may fall short of that goal.

Most COVID-19 restrictions in Michigan, including maskand gathering orders, were lifted Tuesday as cases and hospitalizations fall. Just over61%(more than 4.9 million) residents age 16 andolder have received at least one dose of vaccine, according to the state's COVID-19 vaccine dashboard.

More: Whitmer reopens state: 'Our pure Michigan summer is back'

More than 68% of Oakland County residents age 16 and older have received at least their first dose of vaccine. The county is shooting to reach the 70% mark by the Fourth of July.

Vaccination also helps slow the spread of COVID-19 virus variants circulating in our state, including the concerning Delta variant, said Dr. Russell Faust, Oakland County's medical director. I urge everyone age 12 and up who has not yet received their vaccine to get it as soon as possible so we keep the presence of COVID-19 in our communities low.

More: Michigan confirms 25 cases of COVID-19's highly contagious delta variant

More: Uncooperative Bay County hair stylist made tracking P.1 variant in Michigan even harder

Two cases of the delta variant have been identified in Oakland County. That is the strain that originated in India and is highly transmissible and may cause more serious infection.

As of Wednesday, 32 cases of the delta variant have been identified in sevenMichigan counties and the city of Detroit. Eleven of thecases were identified in out-of-state people who were tested in Michigan, said Lynn Sutfin, a spokesperson for the Michigan Department of Health and Human Services.

In addition to Oakland County, the delta variant has been identified in seven cases in Wayne County, four each in Branch and St. Joseph countiesand one each in Lapeer, Livingston and Macomb counties as well as the city of Detroit, she said.

Dr. Anthony Fauci, chief medical adviser to Biden, said Tuesday that the delta variant is now doubling in prevalence every two weeks and accounts for 20.6% of sequenced cases nationally.

More: Whitmer: COVID-19 vaccine lottery isn't legal in Michigan

Oakland County joins the city of Detroit in offering an incentive to get a COVID-19 vaccine.Since May 3, the city of Detroit has offered a $50 pre-paid debit card to Good Neighbor drivers who pre-register to bring a Detroiter to his or her first-dose vaccination.

Good Neighbor driversget $50 per shot for each appointment, but are not paid for taking anyone under age 18. There is a limit of three residents per vehicle per appointment trip, according to the city's website.

Good Neighbors can make unlimited trips, but if they make more than $600 they will be required to complete a W-9 form and receive a 1099 from the city to file with their 2021 tax return, according to the website. It states theeffort is funded by a state grant for COVID-19 vaccine programs.

Many businesses in Michigan and nationally also are offering incentives to get more shots in arms as COVID-19 inoculations wane.

Other states are offering lotteries and other items, such as West Virginia giving away new custom-outfitted trucks, five custom hunting rifles and five custom hunting shotguns among other prizes to vaccinated residents age 18 and older.

Contact Christina Hall: chall@freepress.com. Follow her on Twitter: @challeporter.

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Oakland County to give $50 gift card to those who get COVID-19 shot by July 4 - Detroit Free Press

Detroiters, you don't have to leave your house to get a COVID-19 vaccine.

The city willbring the shot to you.

The city health department announced Thursday that it is expanding its home vaccination efforts to all Detroiters age 12 and older, not just those who are homebound and can't get to a vaccination clinic.

We want to make sure everyone who wants a vaccine can get one and this latest effort is taking it one step further, Chief Public Health Officer Denise Fair said. This is an even more personalized and public health approach. We are making house calls to anyone who wants to get vaccinated.

Registered Nurse Precious McCormick administers a dose of the Moderna COVID-19 vaccine to a Detroit resident outside of the Neighborhood Service Organization in Detroit on Wednesday, April 28, 2021. Central City Integrated Health paired up with The Salvation Army during their Bed & Bread Club delivery route as they deliver meals to those in need to help supply access to the COVID vaccine to Detroit residents who might not have transportation.(Photo: Ryan Garza, Detroit Free Press)

Fair saidthe effort is a big undertaking, but is key to continuing the city's efforts to remove barriers and get more residents inoculated.

The city's vaccinationrate is among the lowest in the state with 37.5% of eligible residents age 12 and older receiving at least one doseof COVID-19 vaccine and 30.5% of Detroiters fully vaccinated, according to thestate's vaccine dashboard.

The dashboard indicates more than 4.9 million Michiganders age 16 and older (61.3% of the population) have received at least one dose ofCOVID-19 vaccine as of Wednesday.

More: Oakland County to give $50 gift card to those who get COVID-19 shot by July 4

More: Whitmer reopens state: 'Our pure Michigan summer is back'

Teams in the city began vaccinating homebound residents earlier this month and thateffort will continue.

But nowany Detroiterwho wants to receive a COVID-19 vaccine at home can call 313-230-0505 to schedule an appointment.

Teams also will go door-to-door letting Detroiters know of the opportunity to get a vaccine at home. Anyone interested can make an appointment or get vaccinated at that time.

Team members will be in uniforms and have identification when they arrive.

Kenya Meriedy, a nurse from Get Ready Vaccine, prepares COVID-19 vaccines in Bloomfield Hills on May 5, 2021.(Photo: Junfu Han, Detroit Free Press)

The city health department continues to offer walk-in locations throughout Detroit where residents can get inoculated with or without an appointment. For a list of locations and hours, go to http://www.detroitmi.gov.

More: Detroit to inoculate homebound residents in new COVID-19 vaccine push

More: 'I am very, very happy to get it,' homebound Redford Twp. woman says of COVID-19 vaccine

Demand for COVID-19 vaccines outpaced supply in the early months of the vaccination effort at the beginning of the year.Now,supply is outpacing demand as interest in the vaccines has waned.

Michigan lifted most of its COVID-19 restrictions, including mask and gathering orders, on Tuesday as its vaccination effort continues and COVID-19 cases and hospitalizations fall.

Officials are urging eligible residents to get vaccinated, especially with the delta variant circulating. That strain originated in India and is highly transmissible and may cause more serious infection.

There were 32 cases of the delta variant identified in Michigan as of Wednesday, with 11 of the cases identified in out-of-state people who were tested in Michigan, said Lynn Sutfin, a spokeswomanfor the state health department.

More: Michigan confirms 25 cases of COVID-19's highly contagious delta variant

Dr. Anthony Fauci, chief medical adviser to President Joe Biden, said Tuesday that the delta variant is now doubling in prevalence every two weeks and accounts for 20.6% of sequenced cases nationally.

Biden was hoping that 70% of adult Americans would have at least one dose of vaccine by July 4, but federal officials acknowledged earlier this week they may be short of that goal. Biden also previously announced a mayors challenge to see which city could grow its vaccination rate the most by the Fourth of July.

Mayors in Detroit, Sterling Heights and Westland are among 114mayors from dozens of states and Washington, D.C.whojoined the challenge, according to the U.S. Conference of Mayors website.

Staff writer Kristen Jordan Shamus contributed to this report.

Contact Christina Hall: chall@freepress.com. Follow her on Twitter: @challreporter.

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Detroiters don't have to leave home, city will bring COVID-19 vaccine to them - Detroit Free Press

To test that theory, the researchers ran simulations that showed there would have been no difference in mortality rates had Black patients gone to hospitals that treated disproportionately more white patients.

Our analyses tell us that if Black patients went to the same hospitals white patients do, and in the same proportions, we would see equal outcomes, Nazmul Islam, a statistician at OptumLabs who coauthored the study, said in a statement.

The study found that 1,450 Blacks (13.48 percent) died or were transferred to hospice care, compared with 4,304 whites (12.86 percent) who were admitted for COVID-19 at 1,188 hospitals across 41 states that had treated patients of both races. The simulation showed the rate for Black patients would have declined from the observed 13.48 percent to 12.23 percent.

Researchers who conducted the study suggest long-standing racial disparities have led to worse performing hospitals serving Black communities.

Because patients tend to go to hospitals near where they live, these new findings tell a story of racial residential segregation and reflect our countrys racial history that has been highlighted by the pandemic, study coauthor, David Asch, M.D., the executive director of Penn Medicines Center for Health Care Innovation, said in a statement.

Asch noted a National Community Reinvestment Coalition study that found economic hardships persist in many of the majority Black neighborhoods that experienced redlining (systemic denials of home loans) decades earlier.

In a Washington Post column, Asch and Werner wrote that hospitals located in poorer neighborhoods tend to treat more patients who are uninsured or insured by Medicaid with inadequate reimbursement rates.

In effect, doctors and hospitals in the United States are paid less to take care of Black patients than they are paid to take care of white patients. When we talk about structural racism in health care, this is part of what we mean, they wrote.

In an editorial in JAMA Network Open that accompanied the study, David W. Baker, M.D., agreed that a long legacy of structural racism has contributed to the financial challenges and limited resources faced by many hospitals in predominantly Black communities.

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Blacks Hospitalized for COVID-19 Face Higher Odds of Death - AARP

The FDA green-lit its first antibody test that doesnt use blood samples to check for evidence of a COVID-19 infection and instead relies on simple, painless mouth swabs.

Developed by Diabetomics, the rapid, lateral-flow diagnostic received an agency emergency authorization allowing it to be used at the point of care for adults and children. Designed to deliver a result within 15 minutes, the CovAb test also does not require any additional hardware or instruments.

When administered at least 15 days after the onset of symptoms, when the bodys antibody response reaches higher levels, the test demonstrated a false-negative rate of less than 3%and a false-positive rate of nearly 1%, according to the company.

The diagnostic, which detects IgA, IgG and IgM antibodies, previously received a CE Mark in Europe. In the U.S., the test is marketed by the companys COVYDx subsidiary.

RELATED: NIH antibody study suggests COVID-19 spread across U.S. earlier than originally known

Diabetomics pivoted its efforts toward the COVID-19 pandemic after working to develop a saliva-based test for estimating weekly glucose levels in people with Type 2 diabetes. It is also working on a blood-based test for the early detection of Type 1 diabetes in children and adults; both have yet to be FDA-approved.

The company previously launched a point-of-care test for detecting preeclampsia during the first trimester of pregnancy. The potentially dangerous complication is associated with high blood pressure and organ damagebut may show few other symptoms.

RELATED: NIH antibody study uncovers millions of hidden, uncounted COVID-19 cases

Recently, antibody tests have begun to paint a clearer picture of the earliest months of the COVID-19 pandemic, providing evidence that the coronavirus reached U.S. shores long before it was considered a national emergency, and that millions to tens of millions of potentially asymptomatic cases went undetected.

This research, performed by the National Institutes of Health, relied on archived and dried blood spot samples collected from tens of thousands of participants.

One study, using specimens originally collected during the first months of 2020 for the NIHs All of Us population research program, found COVID antibodies that pointed toward active infections across the U.S. as early as December 2019, if not before. Those findings build on reports from the American Red Cross, which found antibodies in blood donations given around that time.

A separate study, which recruited more than 240,000 participants, found the official case count as of last summer could be off by nearly 20 million. Researchers estimated that for every COVID infection that was confirmed, nearly 5 slipped by undiagnosed, based on the number of people testing positive for antibodies

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FDA greenlights its first saliva-based COVID-19 antibody test - FierceBiotech

People think that COVID is gone, perhaps naturally," said Dr. Janak Patel who supports the status share. "They don't know how much the role of vaccine has been."

GALVESTON COUNTY, Texas The Galveston County Health District is now sharing the vaccination status of people whove died from COVID-19.

The detail is added to a list of information like a persons age range, whether or not they had pre-existing conditions and the persons ethnicity and race.

Based on GCHD press releases and posts shared on their social media pages, it seems the first time the health district included vaccination information was three days ago.

On Facebook, the Galveston County Health District reported the June 9 death of an unvaccinated man between 41 and 51 years old who had preexisting donations conditions.

KHOU 11 was unable to reach anyone within the health district who could answer questions as to why the vaccination status is now listed among identifying information, but Dr. Janak Patel, who is the Director of Infection Control & Healthcare Epidemiology for UTMB, thinks sharing the detail is critical to getting more people vaccinated.

People think that COVID is gone, perhaps naturally. They don't know how much the role of vaccine has been in this entire battle against COVID, Dr. Patel said.

As more time passes, more research can be done to study the impact of each COVID-19 vaccine. The Associated Press reports that its journalists analyzed all publicly available data on COVID-19 for the month of May. The AP is reporting breakthrough COVID-19 infections of fully vaccinated people accounted for .1 percent COVID hospitalizations. Of the 18,000 COVID-19 deaths in May, the AP counted 150 people as fully vaccinated.

I think is a very important message. People should hear that that it is true. And that we can show it in our own community, Dr. Patel said.

According to the U.S. Census, more than 342,000 people live within Galveston County. According to the Texas Department of State Health Services, more than 144,000 Galveston County residents are fully vaccinated as of Thursday.

The Galveston County Health District confirms 86 breakthrough infection cases so far. COVID-19 vaccines are widely available across America for everyone 12 and up.

They are nearly 100 percent effective against severe disease and death, said CDC Director Rochelle Walensky during a press briefing on Tuesday. Meaning nearly every death due to COVID-19 is particularly tragic.

So to those who dont want to get a COVID-19 vaccine because they think there are enough medications and therapies to fight the disease, Dr. Patel said, despite all the advances we have made, it is not pleasant to be in a hospital with the infection. Yes, you might survive, but you may have significant problems while you're in the hospital. You may have complications. You may have lingering health problems for days to come.

Patel hopes to see more young adults get vaccinated. Galveston County Health Districts change in communication just might help.

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The vaccination status of people who die from COVID-19 in Galveston Co. is now being shared publicly - KHOU.com

(WHTM) For some, it may feel like the COVID-19 pandemic is already over. For others, it may feel like it will never end. We know from history that pandemics do have to end eventually, but when exactly will this one be over, and what does it take to finally get back to normal?

The World Health Organization officially declared COVID-19 a pandemic in March of 2020. In his remarks on March 11, 2020, the WHO Director-General Dr. Tedros Adhanom Ghebreyesus said, Pandemic is not a word to use lightly or carelessly. It is a word that, if misused, can cause unreasonable fear, or unjustified acceptance that the fight is over, leading to unnecessary suffering and death.

A specific and consistent definition of pandemic is fairly difficult to track down, but sources generally agree that a disease becomes a pandemic if it is widespread across countries, continents, and/or regions and if it can easily spread from person to person, infecting a significant number of people.

Simply put, A pandemic is anytime a disease spreads rapidly throughout the world, says Casey Pinto, assistant professor of public health sciences at the Penn State College of Medicine.

So a pandemic starts with a disease typically a novel disease like COVID-19 spreading quickly around the globe. But when and how does it end?

Thats a fantastic question that experts around the world are really kind of figuring out right now because its really hard to tell when a pandemic ends, says Pinto.

Contributing to the challenge of clearly determining the criteria for the end of the COVID-19 pandemic, the WHO Director-General says that there has never before been a pandemic caused by a coronavirus.

The WHO defines several phases of an influenza pandemic, one of which is the post-pandemic period. In this phase, Levels of influenza activity have returned to the levels seen for seasonal influenza in most countries with adequate surveillance, according to the WHO.

COVID-19 is caused by a coronavirus, which is different from an influenza virus, but that post-pandemic definition may provide some guidance as to when this pandemic will finally be over.

While the specifics are hazy, the key takeaway for when a pandemic ends is when we can say the virus stops readily spreading among a population, says Pinto.

There are several factors that contribute to reaching the point when the virus stops easily spreading, but one big one is achieving herd immunity, Pinto says, and not just achieving herd immunity in one state or even one country. Because we are a society that is just so connected, we fly everywhere in the world, this is going to continue to manifest, says Pinto.

Achieving herd immunity in one place wont prevent the virus from continuing to spread in other areas. On top of that, we dont yet know how long immunity from the COVID-19 vaccines lasts, says Pinto, or whether the virus will eventually be able to circumvent the vaccines or the immunity previously infected individuals developed.

People are going to travel between states and between countries, so herd immunity will need to be reached around the nation and the world in order for the pandemic to end, Pinto hypothesizes. Although the exact threshold for herd immunity is unknown, experts estimate that we will need at least 70% of people to be immune to the virus.

Researchers can approximate the percentage of people who need to be immune to the virus in order to achieve herd immunity by comparing COVID-19 with other better-known diseases that are similarly contagious, explains Pinto.

So like measles, we know that we need about 93% of the population to be vaccinated or have natural immunity through being exposed in order to prevent an outbreak of measles. With COVID, because its nearly as contagious as measleswe know that we need about 90% [of people to be immune], Pinto says.

According to CDC data from June 23, 45.4% of the total U.S. population has been fully vaccinated, and just over 53% of Americans 12 years and older have been fully vaccinated.

Thats quite a distance from that 70-90% goal, but it cant just be 90% in the U.S., says Pinto, and this is where were going to run into trouble.

According to Our World in Data, about 10% of people worldwide are fully vaccinated, and the distribution of these vaccinations is not even across countries. Our World in Data reports that just 0.9% of people in low-income countries have received at least one dose of a COVID-19 vaccine.

Going from 10% to 70-90% of people vaccinated may feel impossible, but if weve learned one thing from past pandemics, its that they do eventually end.

Something else we can learn from previous pandemics, says Pinto, is that this coronavirus will probably never completely disappear.

Since the COVID-19 pandemic began, people have been comparing it to the 1918 flu. That pandemic took about 18-20 months to fully end, but that virus did not go away, and thats the same thing we think were going to see with COVID, Pinto says.

Much like the flu, experts like Pinto think COVID-19 will become endemic, meaning it will regularly occur in our population. And, just like with the flu, Pinto expects well need to periodically get revaccinated against the coronavirus to prevent serious illness.

However, the virus will hopefully be less deadly if it does stick around. Viruses want to live, explains Pinto, so if they quickly kill their hosts, they harm themselves, as well. Pinto anticipates that COVID-19 will mutate to become less deadly in the future.

Regardless of the future of COVID-19, Pinto reminds people that the pandemic is not over yet. Pinto encourages continued social distancing and thorough hand washing, and she notes that individuals who feel unwell should stay home to protect others, such as children who are not yet able to get vaccinated.

Pinto also encourages individuals to get vaccinated in order to protect themselves and to help the world get closer to herd immunity. We have no reported deaths from the COVID vaccine, but in the U.S. we have 600,000 deaths from COVID, Pinto says.

[The pandemic] will end, but we are not there yet, says Pinto. Were all doing our best. We can get through this together.

Continued here:

When will the COVID-19 pandemic really be over? - ABC27

With the July Fourth holiday approaching, the White House acknowledged this week that Biden will fall shy of his 70% goal and an associated aim of fully vaccinating 165 million adults in the same time frame. The missed milestones are notable in a White House that has been organized around a strategy of underpromising and overdelivering for the American public.

White House officials, while acknowledging they are set to fall short, insist theyre unconcerned. We dont see it exactly like something went wrong, press secretary Jen Psaki said this week, stressing that Americans lives are better off than they were when Biden announced the goal.

As of Wednesday, 65.6% of Americans age 18 and older had received at least one shot, according to the Centers for Disease Prevention and Control. The figure is expected to be over 67% by July 4.

A half-dozen officials involved in the vaccination campaign, speaking on condition of anonymity to discuss the missed target candidly, pointed to a combination of factors, including the lessened sense of urgency that followed early success in the vaccination campaign; a decision to reach for a higher goal; and unexpectedly strong recalcitrance among some Americans toward getting a shot.

Nonetheless, the White House says its not letting up on its vaccination efforts. Biden flew to Raleigh, North Carolina, on Thursday to urge people to roll up their sleeves as part of a nationwide month of action to drive up the vaccination rate before the holiday. The White House is rolling out increasingly localized programs to encourage specific communities to get vaccinated.

The best way to protect yourself against the virus and its variants is to be fully vaccinated, Biden said after he toured a mobile vaccination unit and met with frontline workers and volunteers. It works. It's free. It's safe. It's easy.

The White House always expected a drop-off in vaccination rates, but not as sharp as has proved to be the case. The scale of American reluctance to get vaccinated remains a source of global curiosity, particularly as many nations are still scrambling for doses to protect their most vulnerable populations.

When the 70% goal was first announced by Biden seven weeks ago, more than 800,000 Americans on average were getting their first vaccine dose each day down from a high of nearly 2 million per day in early April. Now that figure is below 300,000.

Paradoxically, officials believe the strong response to the early vaccination campaign has served to reduce motivation to get a shot for some. One of the most potent motivators was the high rate of COVID-19 cases and deaths. Now that those figures have dropped to levels not seen since the onset of the pandemic, officials say its become harder to convince Americans of the urgency to get a shot particularly for younger populations that already knew they were at low risk of serious complications from the virus.

Separately, two officials involved in the crafting of the 70% goal said that officials knew 65% would have been a safer bet, but that the White House wanted to reach for a figure closer to experts projections of what would be needed for herd immunity to bring down cases and deaths. Aiming for the higher target, the officials said, was seen as adding to the urgency of the campaign and probably increased the vaccination rate above where it would have been with a more modest goal.

Other officials said the White House, which has always cast the vaccination campaign as hard, nevertheless failed to grasp the resistance of some Americans to getting a shot when it set the 70% goal.

The hesitation among younger Americans and among Trump voters has been too hard to overcome, said GOP pollster Frank Luntz, who has worked with the White House and outside groups to promote vaccinations. They think they are making a statement by refusing to be vaccinated. For Trump voters, its a political statement. For younger adults, its about telling the world that they are immune.

Of the White House, Luntz said, I think they did as good a job as they could have done."

The White House points to all that the nation has achieved to play down the significance of the goals it will miss.

Back in March, Biden projected a July Fourth holiday during which Americans would be able to safely gather in small groups for outdoor barbecues a milestone reached months ago. Nearly all states have lifted their virus restrictions, businesses and schools are open and large gatherings are resuming nationwide.

The most important metric at the end of the day is: What are we able to do in our lives? How much of normal have we been able to recapture? said Surgeon General Vivek Murthy. And I think what we are seeing now is that we have exceeded our expectations.

The White House also has taken to crunching the vaccination numbers in new ways to put a positive spin on the situation. On Tuesday, the administration announced that 70% of adults 30 and over have been vaccinated removing the most hesitant population from its denominator. But even that statistic glosses over lower vaccination rates among middle-aged adults (62.4% for those aged 40-49) and millennials (52.8% for those aged 25-39).

The administration's predicament is all the more notable given what had been an unbroken streak of fulfilled vaccination goals. Before taking office, Biden pledged to vaccinate 100 million Americans in the first 100 days of his presidency a rate that the U.S. was exceeding by the time he was sworn in. Within days he suggested a goal of 150 million and ultimately easily met a revised goal of 200 million shots in the first 100 days.

Bidens 70% goal also was achievable, officials say if in retrospect too ambitious but critically relied less on the government's ability to procure shots and build capacity to inject them and more on individuals' willingness to get vaccinated.

We did that as a team, relying very heavily or exclusively on the docs and scientists, White House COVID-19 coordinator Jeff Zients said Tuesday on how the targets were selected.

More significant than the 70% statistic, officials said, is the vast regional disparities in vaccination, with a state like Vermont vaccinating more than 80% of its population while some in the South and West are below 50%. Within states, there's even greater variation. In Missouri, some southern and northern counties are well short of 40% and one county is at just 13%.

With the delta variant first identified in India taking hold in the U.S., officials say the next vaccination boost may not come from incentives like lotteries or giveaways, but out of renewed fears of preventable illness and death. Other officials project a significant increase in vaccine uptake once the shots, which have received emergency-use authorization from the Food and Drug Administration, receive final approval from the agency.

Heading into the end of the month, another Biden goal also was in doubt.

The president last month set a target of shipping 80 million COVID-19 excess vaccine doses overseas by the end of June. U.S. officials say the doses are ready to go, but that regulatory and legal roadblocks in recipient countries are slowing deliveries.

About 10 million have been shipped so far, including 3 million sent Wednesday to Brazil. Shipments are expected to pick up, but meeting the goal by June 30 appears unlikely.

Excerpt from:

Falling short: Why the White House will miss its COVID-19 vaccination target - The Boston Globe