COVID Long Haulers ask for HELP

COVID-19 long-haulers plead for government action

BY JUSTINE COLEMAN - 10/03/21 06:00 AM EDT 7,981

COVID-19 long-haulers and advocates are stepping up their calls for state and federal officials to take action and dedicate funding to those who have endured the mysterious condition that stems from the coronavirus.

After months of sharing their stories of ongoing symptoms, long-haulers are appealing to elected officials for assistance and begging them to provide help.

“We need to have more legislation for survivors like ourselves and not just keep telling our stories because there's a bazillion stories out there now,” said Maya McNulty, a long hauler from New York. “We're not like some Netflix series that you can just binge watch and then the problem goes away. We are living with this … disease, and there is no hope.”

The grassroots, nonpartisan group COVID Survivors for Change launched a week of action on Friday, with delegations from all 50 states dedicated to illustrating how the virus has changed the lives of long-haulers and families who’ve lost loved ones.

Advocates said they plan to contact officials, including Michigan Gov. Gretchen Whitmer (D), Pennsylvania Gov. Tom Wolf (D), Montana Gov. Greg Gianforte (R), Kentucky Gov. Andy Beshear (D) and Alaska Gov. Mike Dunleavy (R), to push for initiatives to support COVID-19 survivors.

Their requests range from direct funding for long-haulers to a 9/11-style commission to investigate how the pandemic led to hundreds of thousands of deaths and potentially millions of long COVID-19 cases.

The delegations plan to photograph empty chairs to signify all of those who’ve died of COVID-19 and long-haulers who experience persisting symptoms. The chairs are meant to serve as a “powerful” symbol highlighting the community and calling on elected officials to listen to “what they need and respond accordingly,” said Chris Kocher, the executive director of COVID Survivors for Change.

“We really wanted to show the strength and power of the movement by taking action in all 50 states and communities all across the country to highlight just how many people have had their lives devastated by COVID and how important it is that we need our government to continue to step up and take action to support all those who have been impacted by COVID,” Kocher said.

The effort follows a temporary memorial that was erected on the National Mall last month, with one white flag representing every COVID-19 death in the U.S. Sunday is the last day of the memorial "In America: Remember."

Reuters reported that the U.S. exceeded 700,000 coronavirus deaths on Friday.

Rock Island, Ill., resident Jennifer Johnson, who has suffered from long COVID-19 for seven months, set up her chair to be photographed with medical equipment, a cane and medications that she now needs to use.

“It's one thing to see a chair with nobody in it, but then it's a whole different experience to have to see what people are dealing with on a daily basis,” she told The Hill.

Johnson, a 46-year-old single parent of two teenagers, said she has six providers for her various symptoms, including inflammation, muscle weakness, decreased lung capacity and memory problems. She said that immediately following a suspected stroke two months ago, “I couldn’t tell you my name.”

But she is worried about the financial costs of her extensive health care needs as “a full-time employee” who is “not able to work full-time” and expects to lose “significant income.”

“I don’t want to be carried financially for the rest of my life,” she said. “I want to work, I want to be productive. But this just isn’t a work issue. This is an entire quality of life issue.”

BY THEWALLETGURU.COM

McNulty of Niskayuna, N.Y., has characterized long-haulers like herself as “a new breed of survivors” and launched Covid Wellness Clinic that’s dedicated to helping long COVID-19 patients.

The 48-year-old long-hauler contracted COVID-19 in March 2020 and ended up hospitalized for 69 days, including 30 days in a medically induced coma. She spent months relearning to eat, walk and talk and has returned to the emergency room four times due to long COVID-19 symptoms.

McNulty is requesting “significant” and “dedicated” funding for long-haulers, although she said she worries that money will funnel to “people that don’t need it.”

“We demand more care for us because we're being forgotten,” she said.

As part of the week of action, certain delegations of COVID Survivors for Change are also planning to rally with teachers to back safe school reopenings, write letters to the editors of their local newspapers and set up and request memorials for COVID-19 victims, including long-haulers.

Junction City, Kan., resident Mary Snipes, 52, said she will send letters and emails to state elected officials this week calling for them to collaborate and spread more awareness about the potential outcomes of COVID-19.

Snipes, who was hospitalized for COVID-19 in December for almost two weeks, still uses oxygen to breath and has endured chest pain, headaches, brain fog, joint pain and high blood pressure.

“It gets frustrating because I am a type of person that would go, go, go, go,” she said.  “And now it's like I am at a standstill because I am so weak and fatigued and just [have] no energy.”

Doctors and scientists have been perplexed by the conditions of long COVID-19 as it’s developed throughout the pandemic. They’ve conducted research attempting to determine how often it occurs among COVID-19 patients, with a recent study saying 37 percent had at least one long-term symptom three to six months after infection, suggesting millions nationwide could have long COVID-19.

The National Institutes of Health announced last month that it dedicated almost $470 million to develop a national study population to investigate the long-term effects of the virus, with the hope of recruiting between 30,000 and 40,000 participants.

David Putrino, director of rehabilitation innovation for the Mount Sinai Health System, said it’s been “really challenging” as his clinic has cared for almost 1,600 long-haul patients throughout the pandemic. In a survey of patients, 60 percent said they had a change in employment status due to their symptoms.

“We're doing our best to manage their symptoms and provide good evidence-based care,” Putrino said. “But obviously with a novel condition, evidence-based care is tough. And obviously it's also just not easy to provide reassurance when you can't say in good faith that you know precisely what's happening to a patient.”

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Janna Friedly, the medical director of University of Washington Medicine’s post-COVID-19 Rehabilitation and Recovery clinic, said she supports more government support for long-haulers as they deal with an “increasing burden” of costs.

Friedly, who previously experienced long COVID-19 symptoms for nine months, said the clinic “desperately” needs more resources to care for patients, especially those with 10 or more different symptoms who require multiple specialists.

“I think we're just starting to really scratch the surface in understanding the financial and economic impact of long COVID on patients themselves, but also on the health care system and in the workforce,” she said.

Above is from:  https://thehill.com/policy/healthcare/574984-covid-19-long-haulers-plead-for-government-action

Copyright protection didn’t stop Trump

Trump Still Has To Face The Music On 'Electric Avenue' Copyright Lawsuit

• 

Mary Papenfuss

Sat, October 2, 2021, 7:26 AM

In this article:

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  Eddy Grant

  Guyana born British reggae musician

Explore the topics mentioned in this article

Former President Donald Trumplost his bid this week to jettison a lawsuit that accuses him of copyright infringement for helping himself to music for a campaign video mocking Joe Biden.

The suit was filed by musician Eddy Grant last year over his popular tune “Electric Avenue.” Trump used the music as background in an odd video posted to Twitter featuring an animated version of Biden driving an old-fashioned railway handcar.

Twitter removed the video a year ago after Grant complained. He had his attorneys issue a cease-and-desist order, and then sued Trump.

“Electric Avenue” was written in 1983 by Grant, a Guyanese-British singer, about the 1981 Brixton race riots.

“They have sought to encapsulate my intellectual property into derogatory political rhetoric, further encapsulated in a video production that can only be construed at best as being wicked, thereby causing me considerable emotional distress,” Grant said last year.

Trump’s motion to dismiss claimed that he had a right to “Electric Avenue” because it had been “transformed” for another use other than to disseminate or sell the music.

The ad used the music for a “comedic, political purpose — a different and transformed purpose from that of the original Song,” the motion argued.

But U.S. District Judge John Koeltl of the Southern District of New York ruled Wednesday that the motion “misapprehends” the “transformative use” argument. He referred to the Trump campaign’s “wholesale copying of music to accompany a political campaign ad.”

“Where a secondary work does not obviously comment on or relate back to the original or use the original for a purpose other than that for which it was created, the bare assertion of a ‘higher or different artistic use,’ is insufficient to render a work transformative,” Koeltl ruled.

So the suit will continue.

Trump has been accused of copyright infringement by several musicians furious that he has commandeered their music without permission to use at campaign rallies by a man and for messages they despise.

Those complaining have included Neil Young, Adele, Rihanna, the Rolling Stones, Aerosmith, Elton John, and the estates of Tom Petty and Prince.

This article originally appeared on HuffPost and has been updated.\

Above is from:  https://www.yahoo.com/news/trump-still-face-music-electric-122606467.html

Ted Cruz blocking Bidden diplomacy

Ted Cruz Spitefully Delaying Biden Ambassador Nominees Over Russia Pipeline

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Ted Cruz - Credit: AP

As of now, only one Biden administration ambassador has been confirmed. And the president has Sen. Ted Cruz (R-Texas) to thank for the hold-up. The senator has been singlehandedly slow-walking 59 nominees for ambassadorships and is threatening to delay more, all over the issue of a Russian gas pipeline, The New York Times reported Saturday.

It’s a move one Democratic lawmaker, Sen. Bob Menendez (D-N.J.), called “unprecedented” and an “undermining of the… national security process” in a statement to the paper. Cruz isn’t just delaying ambassadors’ confirmations, he is also blocking other nominees, some in key national security positions that remain empty. Currently, only approximately one in four key national security jobs have been filled, although the Times points out that the Biden administration was slow to submit many foreign policy nominees.

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Why is Cruz doing this? He is opposed to Biden’s actions regarding the Nord Stream 2 gas pipeline project that would run between Russia and Germany while bypassing Ukraine. The senator believes by allowing the pipeline to go forward, as Biden did when he waived sanctions Congress placed on the project, that the president is showing “weakness” toward Russia. Thus began Cruz’s intentional delays of even the most routine Biden nominations.

Cruz is accomplishing this by objecting to the traditional way Congress handles these nominees, through “unanimous consent.” With his objections, Cruz forces the process to take hours of Senate floor time.

Defending Cruz’s actions, the senator’s press secretary Dave Vasquez told the Times that Cruz “has worked day in and day out to craft and advance compromises.” Vasquez added that the White House “could get its nominees through tomorrow by simply implementing the law.”

But Menendez believes that leaving these positions vacant could affect national security.

“It’s really an undermining of the nation’s national security process,” Menendez, chairman of the Senate Foreign Relations Committee, told the Times. “What we have here is an unprecedented, blanketed holding of all nominees — regardless of whether they have anything to do with the policy issues at stake.”

“That is not something I have seen in 30 years of doing foreign policy work” in Congress, Menendez added.

Above is from:  https://www.yahoo.com/news/ted-cruz-spitefully-delaying-biden-165705639.html

Will Americans ever follow the Portuguese?

In Portugal, There Is Virtually No One Left to Vaccinate

LISBON, PORTUGAL - SEPTEMBER 29: Tourists check their cellphones outside Belem Tower by the Tagus River at the end of the afternoon during the COVID-19 Coronavirus pandemic on September 29, 2021 in Lisbon, Portugal. The use of protective mask outdoors has not been longer mandatory as of September 13, but according to the measures of the third phase of the deconfinement associated with the pandemic, as of October 01 the use of masks is still mandatory in shops, schools (except at outdoor playgrounds), theaters, cinemas, congress halls, event venues, health establishments and services, residential or foster care facilities, or home support services for vulnerable populations, elderly people, or people with disabilities. (Photo by Horacio Villalobos#Corbis/Corbis via Getty Images)More

Marc Santora and Raphael Minder

Sat, October 2, 2021, 9:11 AM

Portugal’s health care system was on the verge of collapse. Hospitals in the capital, Lisbon, were overflowing and authorities were asking people to treat themselves at home. In the last week of January, nearly 2,000 people died as the virus spread.

The country’s vaccine program was in a shambles, so the government turned to Vice Adm. Henrique Gouveia e Melo, a former submarine squadron commander, to right the ship.

Eight months later, Portugal is among the world’s leaders in vaccinations, with roughly 86% of its population of 10.3 million fully vaccinated. About 98% of all of those eligible for vaccines — meaning anyone over 12 — have been fully vaccinated, Gouveia e Melo said.

“We believe we have reached the point of group protection and nearly herd immunity,” he said. “Things look very good.”

On Friday, Portugal ended nearly all of its coronavirus restrictions. There has been a sharp drop in new cases, to about 650 a day, and vanishingly few deaths.

Many Western nations fortunate enough to have abundant vaccine supplies have seen inoculation rates plateau, with more than 20% of their populations still unprotected. So other governments are looking to Portugal for possible insights and are watching closely to see what happens when nearly every eligible person is protected.

False dawns in the coronavirus pandemic have been as common as new nightmare waves of infection. So Portugal could still see a setback as the delta variant continues to spread globally.

There have been worrying signs from Israel and elsewhere that protection offered by vaccines can fade over time, and a worldwide debate is raging over who should be offered booster shots and when.

Portugal may soon start offering boosters to older people and those deemed clinically vulnerable, Gouveia e Melo said, and he was confident they could all be reached by the end of December.

But for the moment, as bars and nightclubs buzz with life, infections dwindle and deaths plummet, the country’s vaccination drive has succeeded even after encountering many of the same hurdles that caused others to flounder.

The same flood of misinformation about vaccines has filled the social media accounts of the Portuguese. The country is run by a minority left-wing government, a reflection of its political divisions. And, according to public opinion polls, there was widespread doubt about the vaccines when they first arrived.

Gouveia e Melo has been credited with turning it around. With a background working on complicated logistical challenges in the military, he was named in February to lead the national vaccination task force.

Standing 6 feet, 3 inches, the admiral made it a point to wear only his combat uniform in his many public and television appearances as he sought to essentially draft the nation into one collective pandemic-fighting force.

“The first thing is to make this thing a war,” Gouveia e Melo said in an interview, recalling how he approached the job. “I use not only the language of war, but military language.”

While politicians around the world have invoked a similar martial rhetoric, he said it was critical to his success that he was widely seen as detached from politics.

He quickly assembled a team of some three dozen people, led by elite military personnel — including mathematicians, doctors, analysts and strategic experts from Portugal’s army, air force and navy.

Asked what other countries can do to bolster their own vaccination efforts, he did not hesitate to offer his best advice.

“They need to find people who are not politicians,” he said.

Before the pandemic, Portugal was fortunate to have a robust national vaccination program. It grew out of the country’s devastating experience battling polio, which was still affecting the country after Gouveia e Melo was born in 1960. He recalls when the daughter of a family friend fell ill from the disease and the suffering that followed.

Manuela Ivone da Cunha, a Portuguese anthropologist who has studied anti-vaccination movements, said that “vaccine doubters and anti-vaxxers are in the minority in Portugal, and they are also less vocal” than they are in many other countries.

Leonor Beleza, a former Portuguese health minister who is now the president of the Champalimaud medical foundation, said Portugal’s rollout clearly benefited from the discipline stemming from the nomination of a military officer.

“He formulated a communications policy about what was happening that gave credibility and trust,” she said.

As the task force devised the most efficient system to safely stream the most people through inoculation centers, they used troops to build confidence in the system. People could see the vaccines were safe as soldier after soldier got shots.

At the same time, the task force made a point of showing doctors and nurses getting their shots, as well, to drive home the message of vaccine safety.

While other countries have featured doctors, nurses, police officers and soldiers in their vaccine campaigns, Gouveia e Melo said the consistency of the messaging was critical.

Still, as the campaign moved onto younger age groups over the summer — with less than half of the public vaccinated — there were signs that resistance was building.

In a submarine, the admiral said, you are in a slow ship trying to catch faster ships.

“You have to position yourself and be smart about how to do it,” he said, “and seize the opportunity when it arrives.”

In July, Gouveia e Melo seized such an opportunity.

Protesters were blocking the entrance to a vaccination center in Lisbon, so he donned his combat uniform and went there with no security detail.

“I went through these crazy people,” he said. “They started to call me ‘murderer, murderer.’”

As the television cameras rolled, the admiral calmly stood his ground.

“I said the murderer is the virus,” Gouveia e Melo recalled. The true killer, he said, would be people who live like it is the 13th century without any notion of reality.

“I attempted to communicate in a very true and honest way about all doubts and problems,” he said.

But not everybody welcomed his approach.

“We don’t really have a culture of questioning authorities,” said Laura Sanches, a clinical psychologist who has criticized Portugal’s mass vaccination rollout as too militaristic and called for it to exclude younger people.

“And the way he always presented himself in camouflage army suits — as if he was fighting a war — together with the language used by the media and the politicians, has contributed to a feeling of fear that also makes us more prone to obey and not question,” she said.

Still, the public messaging campaign — including an aggressive television and media blitz — made steady progress.

“In the beginning, we had some 40% who were unsure,” Gouveia e Melo said. Now, according to polls, he said, only 2.2% do not want the vaccine.

As he stepped down from the task force this week, the admiral said he felt the country was on a good course. But, ever the submariner, he cautioned that vigilance would remain essential to ensuring that this war was won.

© 2021 The New York Times Company

Do police belong in America's schools?

Do police belong in America's schools?

Mike Bebernes

·Senior Editor

Fri, October 1, 2021, 4:05 PM

“The 360” shows you diverse perspectives on the day’s top stories and debates.

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What’s happening

An 18-year-old woman in Long Beach, Calif., who was shot in the head by a school safety officer earlier this week, was taken off life support on Friday, according to a family attorney. Mona Rodriguez, the mother of a 5-month-old child, was allegedly involved in an altercation near a local high school on Monday that prompted the officer to intervene. As Rodriguez and two others attempted to leave the scene, the officer fired at least two shots into the back of the car they were riding in, video of the incident shows.

Rodriguez’s shooting has brought national attention to the ongoing debate over whether police officers belong in schools. Over the past few decades, school police officers — typically known as school resource officers (SROs) or school safety officers — have become an increasingly common presence on America’s elementary and high school campuses.

In 1975, only 1 percent of schools reported having officers on site. But a series of deadly mass shootings, starting with the Columbine massacre in 1999, and a broad “tough on crime” approach to policing have led more administrators to rely on armed law enforcement officers. By 2018, SROs were present in at least 58 percent of U.S. schools, including 72 percent of high schools.

There has been strong opposition to police in schools for years, but the movement to remove them has gained significant momentum in the wake of racial justice protests sparked by the murder of George Floyd by a Minneapolis police officer in May 2020. In the 12 months following Floyd’s death, at least 33 school districts got rid of school police officers. Others — including New York, Chicago and Los Angeles — have either reduced the budgets for SROs or moved to redefine their roles in schools.

Why there’s debate

Supporters for removing police from schools point to a growing body of research that suggests SROs do little to reduce on-campus violence, and their presence can take a significant toll on students. Research shows that schools with SROs can actually have higher rates of behavioral incidents and more student arrests and disciplinary cases. This impact is felt disproportionately by students of color, who are substantially more likely to be disciplined or arrested by SROs — a trend that criminal justice reform advocates say fuels the “school-to-prison pipeline.”

Schools that have eliminated or reduced the role of SROs often invest the money they had been spending on law enforcement into other resources like counselors, psychologists, social workers and training for teachers. Reformers argue that these student support roles help address the root causes that lead to violence, whereas police can only respond after the fact.

Defenders of school resource officers say they are necessary to keep students safe, both from mass shootings and from more common acts of violence that plague many schools. While most say they support increasing the ranks of counselors and other support staff, they argue that can be accomplished while also keeping police on campus as protection.

What’s next

The name of the officer who shot Rodriguez has not yet been released. The Long Beach Police Department and the Los Angeles County district attorney’s office say they are investigating the incident.

Perspectives

Police don’t actually make schools safer

“Police in schools are symbolic. They provide an easy answer to fears about violence, guns, and mass shootings. They allow policymakers to demonstrate their commitment to school safety. And for a time, they make teachers and parents ‘feel’ safe. But those who have studied school policing tell us this is a false sense of security. Schools with school resource officers are not necessarily any safer.” — Kristin Henning, Vox

Children deserve to attend crime-free schools

“Let's be creative in addressing non-violent offenses. No, let’s not involve law enforcement too soon when no one is under threat. But the simple fact is that some kids should face arrest. Some kids should have criminal records. In trying to protect these kids from themselves, school districts are making innocent students and teachers more vulnerable. That’s an unacceptable tradeoff.” — David French, National Review

School funding should go toward creating proven student support systems

“Every dollar spent on police, metal detectors, and surveillance cameras is a dollar that would be better invested in trained professionals that support, not criminalize children. Children deserve spaces where they can learn, thrive, and feel safe to just be. Until then, the fight continues.” — Judith Browne Dianis, Education Week

Improving support services doesn’t have to come at the expense of safety

“Retraining of safety officers is well and good, as is bulking up the ranks of guidance counselors, who are in much too short supply. But it’s folly to believe that happy talk and social supports are the only answer when some teenagers bring knives and guns and illegal narcotics and ill intent to schools. To protect children, someone should stand guard.” — Editorial, New York Daily News

School officers often turn normal childhood behavior into a criminal matter

“​​Allowing police officers to handle minor infractions in schools needlessly marks a student’s first contact with the criminal justice system, potentially setting them up for a lifetime of collateral consequences.” — Ryan King and Marc Schindler, Brookings

The presence of police makes students of color feel unwelcome in their own schools

“Officers, armed or not, are agents of authorized power with a legacy of violence. Where officers go, the message also goes that one had better watch their step. No child can learn when they do not feel safe, and no school police officer patrolling the halls denotes safety; rather, they denote a walking threat.” — Zachary Wright, Philadelphia Inquirer

School police are needed to prevent mass shootings

“How exactly can students fight for their lives against an armed and crazed gunman who enters their school midday and begins a shooting spree? More importantly, how does the school board believe students should defend themselves, when there is an option of having a paid, armed police force?” — Nicole Russell, Washington Examiner

School shootings are exceedingly rare occurrences

“I think we’re seeing that school leaders, policymakers and probably parents, to some extent, have sort of this outsized fear of gun violence in schools. … Even though we hear about gun violence in schools on nearly a weekly or monthly basis over the last few years, these are still very statistically rare events. But they have such emotional salience because they are so tragic that no school leader wants it to happen in their schools.” — Ben Fisher, criminology researcher, to NBC News

Is there a topic you’d like to see covered in “The 360”? Send your suggestions to the360@yahoonews.com.

Photo illustration: Yahoo News; photos: Irfan Khan/Los Angeles Times via Getty Images

October 1: Johns Hopkins COVID 19 Report

COVID-19 Situation Report

EDUCATIONAL OPPORTUNITIES The Johns Hopkins Center for Health Security provides education and academic training focused on Health Security for students at the Johns Hopkins Bloomberg School of Public Health. For academic year 2022-23, the Center will provide 2 Masters of Public Health scholarships and fund 2 PhD candidates for the Health Security PhD track at the Johns Hopkins Bloomberg School of Public Health. These opportunities are now accepting applications. Find more information and application details here.

EPI UPDATE The WHO COVID-19 Dashboard reports 233.5 million cumulative cases and 4.77 million deaths worldwide as of October 1.

After plateauing since late July and recording slightly fewer than 800 deaths per day, Russia set a new national record this week for daily mortality (816.4), surpassing 800 daily deaths for the first time since the onset of the pandemic. Russia also reported a new single-day record (852 deaths) on September 28. Russia’s daily incidence has been increasing steadily since mid-September, up from approximately 18,000 new cases per day to nearly 22,000 (+22%) over that period. Russia’s highest average daily incidence was 28,500 new cases per day in late December 2020. Russia has fully vaccinated nearly 30% of its population, but daily vaccinations have steadily declined to less than 25% of its record high in mid-July.

Global Vaccination

The WHO reported 6.14 billion cumulative doses of SARS-CoV-2 vaccines administered globally as of September 29. A total of 3.51 billion individuals have received at least 1 dose, and 2.55 billion are fully vaccinated. Analysis from Our World in Data indicates that the overall trend in global daily vaccinations continues to decline, remaining at or below 30 million doses per day since September 22*. The global trend continues to closely follow the trend in Asia. Our World in Data estimates that there are 3.57 billion vaccinated individuals worldwide (1+ dose; 45.3% of the global population) and 2.65 billion who are fully vaccinated (33.7% of the global population). As we observed previously with 1+ dose coverage, Oceania’s full vaccination coverage (32.3%) is quickly approaching the global average (33.7%). Oceania could surpass this benchmark in the next several days, which would leave Africa (4.4%) as the only continent below the global average. Oceania and Africa were reporting similar full vaccination coverage as recently as late May, but vaccination efforts in Oceania have progressed rapidly over the past several months.

*The average daily doses administered may exhibit a sharp decrease for the most recent data, particularly over the weekend, which indicates effects of reporting delays. In an effort to reflect the longer-term trends, the numbers reported here may not correspond to the most recent data.

The WHO’s Regional Office for Africa (AFRO) announced that only 15 African countries surpassed 10% full vaccination coverage by the target date of September 30. The goal was set by the World Health Assembly in May 2021. Despite accounting for 17% of the global population, only 2% of SARS-CoV-2 vaccine doses administered globally have been in Africa, illustrating the magnitude of ongoing disparities in vaccine access. These countries represent nearly one-third of African nations—compared to nearly 90% of high-income countries—but only about 11% of the African population (1.3 billion). Most of the countries that surpassed the 10% benchmark have small populations, and more than half of all African countries are reporting full vaccination coverage of 2% or less. Seychelles and Mauritius remain at the top of African countries in terms of full vaccination coverage, with 72% and 63%, respectively. Morocco surpassed 50% coverage, Tunisia is reporting 32%, and Cape Verde* is reporting nearly 25%. Vaccination progress is accelerating, however, with monthly distributions increasing 10-fold from June to September. The target by the end of 2021 is 40% coverage, but it is unlikely that more than a small handful of African countries will reach that benchmark.

*Or Cabo Verde.

UNITED STATES

The US CDC reports 43.3 million cumulative COVID-19 cases and 694,701 deaths. Daily incidence continues to decline at the national level, down to approximately 106,000 new cases per day, which is the lowest average since early August. Daily mortality appears to have passed a peak and started to decline. While the average decreased over the second half of September—down to 1,476 per day—the single-day total for September 29 was more than 2,000 deaths, the third-highest since February. At the current pace, the US could surpass 700,000 cumulative deaths in the next 4 days*.

*Changes in state-level reporting may affect the accuracy of recently reported data, particularly over the weekend or for states that are reporting mortality by date of death. In an effort to reflect the longer-term trends, the numbers reported here may not correspond to the most recent dates.

US Vaccination

The US has administered 393 million cumulative doses of SARS-CoV-2 vaccines. The daily vaccination trend continues to decline from the most recent peak on August 29*, from approximately 850,000 doses per day to slightly more than 600,000. There are 214.3 million individuals who have received at least 1 dose, equivalent to 64.6% of the entire US population. Among adults, 77.3% have received at least 1 dose, as well as 14.6 million adolescents aged 12-17 years. A total of 184.6 million individuals are fully vaccinated, which corresponds to 55.6% of the total population. Approximately 66.9% of adults are fully vaccinated, as well as 11.9 million adolescents aged 12-17 years. The CDC recently updated its vaccination tracking dashboard to include booster doses. To date, 4.03 million individuals have received booster doses, the majority of whom are aged 50 years and older (3.35 million), including 2.50 million aged 65 years and older.

*Due to delays in reporting, estimates for the average daily doses administered are less accurate for the most recent 5 days. The most current average provided here corresponds to 5 days ago.

VACCINE MANDATES Evidence from several states and private companies that have implemented SARS-CoV-2 vaccine mandates shows the requirements are working to boost vaccination rates among healthcare workers and other employees. In California, major health systems reported a statewide mandate helped increase vaccination rates among their employees to 90% or more, and in New York, 92% of hospital and long-term care facility employees have received at least 1 dose of vaccine after a mandate took effect on September 27, an increase of about 10 percentage points over 1 week ago. However, hospitals in New York continue to fear staff shortages. New York Governor Kathy Hochul signed an executive order earlier this week aimed at providing short-term relief to healthcare systems impacted by staff shortages, but no facilities have closed since the mandate went into effect.

Private employer vaccine mandates are becoming more common, but opposition remains. United Airlines announced this week the company would terminate nearly 600 of its 67,000 employees if they continue to refuse to comply with its vaccination requirement. The company, one of the first large US corporations to impose a mandate, said 99% of its workforce is vaccinated and it is working with employees who decide to get vaccinated after the initiation of their termination proceedings. Tyson Foods, which announced a vaccine mandate for employees in August, said this week that 91% of the company’s 120,000 workers are now vaccinated. Tyson’s frontline workers now have until November 1 to get vaccinated or request an exemption, whereas its 6,000 office workers’ deadline is today. Earlier this month, US President Biden announced a federal vaccine mandate for companies with 100 or more employees, to be enforced by the Occupational Safety and Health Administration (OSHA). The US Armed Forces also are requiring vaccinations for active duty personnel. On September 30, a group of 10 plaintiffs, including US Air Force officers and a Secret Service agent, filed a lawsuit seeking an injunction halting federal vaccination requirements, claiming the mandates violate the First Amendment.

SCHOOL MASK POLICIES Children across the US have had a tumultuous start to the new school year, with more than 900,000 students in 44 states having been affected by COVID-19-related closures between August 1 and mid-September. In 2 new analyses published in the US CDC’s Morbidity and Mortality Report (MMWR), the agency adds to the growing evidence that school mask mandates can help prevent COVID-19 outbreaks in classrooms. Using information from 520 US counties, representing 16.5% of the nation’s total counties, researchers found that pediatric COVID-19 case rates rose more sharply in counties without school mask requirements between July 1-September 4, 2021, when compared with counties that had school mask mandates. The daily case rates remained lower in schools requiring masks even after controlling for covariates. Another analysis examined the association between mask policies and school-associated COVID-19 outbreaks in 2 large Arizona counties that returned to in-person, K-12 schooling in late July/early August 2021. The researchers found that schools without mask mandates were 3.5 times more likely to have a school-related COVID-19 outbreak than those that instituted early mask mandates.

Regardless, legal disputes over mask requirements in schools continue in several states. The US government on September 30 filed a formal statement with the federal district court in Austin, Texas, saying the state’s ban on school mask mandates violates the rights of students with disabilities if it prevents them from safely attending public school in-person. In Iowa, the American Academy of Pediatrics (AAP) and its state chapter filed an amicus brief on behalf of a group of parents and disability rights advocates who filed a federal lawsuit against Governor Kim Reynolds seeking to reverse a law prohibiting school boards from imposing mask mandates. The AAP warned that pediatric COVID-19 cases have risen sharply since the beginning of the school year. Legal proceedings over a law in Arizona banning schools from implementing mask requirements are ongoing, with the state Supreme Court on September 29 setting a briefing schedule to hear arguments. And in Michigan, several local health departments are working to understand language that appears to ban school mask mandates contained within the state’s budget signed this week by Governor Gretchen Whitmer. Although she issued a statement saying a provision that strips state funding from local health departments with school mask mandates is unconstitutional, some districts are rescinding mask requirements over fear of lawsuits.

VACCINE EFFICACY & EFFECTIVENESS REVIEW Researchers from Johns Hopkins University (US) led a systematic review of the efficacy and effectiveness of existing SARS-CoV-2 vaccines. The study (preprint) evaluated clinical trial and observational data for all vaccines that submitted applications for Emergency Use Listing (EUL) from the WHO by August 15, 2021, including data published in peer-reviewed journals and via preprint servers, government public health and regulatory websites and databases, news media, and manufacturers’ websites. The researchers accounted for differences in study population, case definition, follow-up duration, presence of variants of interest or concern (VOIs/VOCs), epidemiological situation (eg, degree of community transmission), and study design.

The study included 24 vaccine products, including multiple vaccine platform technologies, of which 13 had published Phase 3 clinical trial results or data and 6 had received an EUL from the WHO. The researchers provide an overview of the available data and highlight outstanding gaps, including specific types of analysis (eg, effectiveness in previously infected individuals, efficacy/effectiveness against the Gamma variant) and individual products (eg, Sputnik V. Sinopharm-Beijing). Of the 24 products, Phase 3 clinical trial data were available for 15, but only 9 had been subjected to peer review. The researchers also include a set of figures that illustrate the timing of Phase 3 clinical trials in the context of the daily COVID-19 incidence in various countries, which can affect the quality of study data and the duration of clinical trials. Overall, the vaccines currently in use have demonstrated high efficacy/effectiveness against symptomatic COVID-19 disease, severe disease, and death, and analysis exists that also shows some degree of protection against infection. The results vary between products, but among those with available estimates, the efficacy/effectiveness against symptomatic disease was greater than 65% for all of them (and none of the confidence intervals fell below 50%).

ADDITIONAL VACCINE DOSE SAFETY People who received a third dose of an mRNA SARS-CoV-2 vaccine experienced similar adverse events compared with the second dose, according to a report published September 28 in the US CDC’s Morbidity and Mortality Weekly Report (MMWR). Individuals with moderate-to-severe immune-compromising conditions became eligible for an additional dose on August 12, when the US FDA amended the Emergency Use Authorizations (EUAs) for both the Pfizer-BioNTech and Moderna vaccines. The report’s data come from voluntary V-SAFE registrants who completed check-ins for all 3 doses. According to data from 12,591 vaccinees who recorded information for a third dose from August 12-September 19, 2021, 79.4% reported local reactions compared to 77.6% of individuals after a second vaccine dose. Systemic reactions were reported by 74.1% of people after a third dose compared with 76.5% after the second dose. The most frequently reported symptoms included injection site pain, headache, and fatigue, and most commonly occurred the day after vaccination. Overall, no unexpected patterns of side effects were reported among more than 22,000 individuals who received a third vaccine dose and reported to V-SAFE between August 12 and September 19, and their recorded symptoms were categorized as mild or moderate. 

PREGNANCY & VACCINATION The US CDC issued a Health Alert Network (HAN) advisory recommending urgent action aimed at vaccinating pregnant individuals against SARS-CoV-2. The advisory encourages those who are pregnant, recently pregnant (including lactating individuals), who are trying to become pregnant, or who may become pregnant in the future to get vaccinated. The advisory comes after the highest reported number of COVID-19-related deaths in pregnant people (n=22) occurred in August 2021, the agency noted, with more than 125,000 laboratory-confirmed cases and 22,000 hospitalizations among pregnant people since January 2020. A similar directive was issued last month, but this is one of the agency’s strongest recommendations yet for pregnant individuals. Vaccination coverage among pregnant individuals remains low, at 32%, but varies by race/ethnicity. The lowest rate for fully vaccinated pregnant persons is among non-Hispanic Black individuals at 17%, followed by Hispanic or Latino individuals at 27%. Asian pregnant individuals have the highest rate of vaccination at 47%. Non-Hispanic White individuals and those in the ‘other’ category fall in at 35% and 32%, respectively.

LONG COVID Ongoing studies are helping to better characterize and determine the prevalence of so-called long COVID, also known as post-acute sequelae of SARS CoV-2 infection (PASC). In a study published in PLOS Medicine, researchers led by scientists with the University of Oxford conducted a retrospective cohort study based on linked electronic health records (EHRs) data from 81 million patients including 273,618 COVID-19 survivors, primarily in the US, and included 114,449 patients with influenza as a control. The researchers found that nearly 37% of COVID-19 patients studied reported having at least 1 or more features of long COVID between 3 and 6 months after their initial diagnosis, a higher percentage than the 10%-30% reported in previous studies and significantly higher than after influenza. The most commonly reported symptoms included abnormal breathing; fatigue; chest, throat, or other pain; headache; abdominal symptoms; and anxiety or depression. While lingering symptoms occurred more frequently among people who had more severe acute COVID-19, including those who were hospitalized, and older individuals, the researchers stressed that people who had mild disease and children and young adult survivors also experienced long COVID.

In a study published September 29 in JAMA Network Open, researchers interviewed 2,433 COVID-19 patients who were discharged from 2 hospitals in Wuhan, China, between February 12 and April 10, 2020. Notably, 45% of patients reported at least 1 symptom at 1-year follow-up, with the most common symptoms being fatigue, sweating, chest tightness, anxiety, and muscle pain. Patients who experienced more severe COVID-19 cases and who were older were more likely to have at least 3 lingering symptoms. In yet another study, posted to the preprint server medRxiv, researchers found that SARS-CoV-2 infection, even mild cases, could reduce gray matter thickness in the brain, possibly contributing to long-term neurological damage. Taken together, the studies highlight the fact that the health impacts from COVID-19 extend far beyond the acute phase, and contribute more knowledge about the risk of long COVID, for both unvaccinated and vaccinated individuals, that could help identify those at greatest risk, plan necessary ongoing health services support, and help develop treatments for the condition.

COVAX 2022 STRATEGY The governing body for Gavi, The Vaccine Alliance, met this week to discuss its primary objective of expanding routine immunization but also welcomed participation of the Co-Chairs of the AMC Engagement Group and the COVAX Shareholders’ Council to assess the vaccine initiative’s “critical challenges” and make progress toward developing the 2022 COVAX strategy. The Co-Chairs and Board members expressed support for COVAX’s urgent call to lift all SARS-CoV-2 vaccine export restrictions; manufacturers to deliver on their commitments to COVAX with transparency on schedules and supply chains; countries with high vaccination coverage rates to relinquish their place in line to allow more vaccine supply to go to COVAX and low- and middle-income countries (LMICs) in need; and global donations to be expanded, fast-tracked, and standardized. With more than 311 million doses shipped, the Board highlighted the importance of quickly scaling up vaccine deliveries, as supply is significantly increasing. Echoing the results of the meeting, Gavi Board Chair José Manuel Barroso, a former president of the European Commission, writing in an opinion piece published in POLITICO Europe on September 30, called on wealthy countries’ governments and manufacturers to do more to “close today’s unacceptable gap in vaccine equity.”

US PANDEMIC PREPAREDNESS More than 20 stakeholder organizations this week sent a letter to the US Congress urging them to provide at least US$16 billion in pandemic preparedness funding included in a version of the Build Back Better Act passed by the US House Committee on the Budget. The funding would go toward efforts to improve the country’s pandemic defenses, including the ability to produce diagnostics, vaccines, and treatments for known and future biological threats; track and monitor potential outbreaks; provide sufficient medical supplies; improve indoor air quality; and build a stronger public health infrastructure. But as journalist Ed Yong highlights in a piece in The Atlantic, much more will have to be accomplished in order to protect the nation from the next pandemic, or natural disaster, or climate change impact. Most importantly, those efforts must include improving equity—in education, labor wages, food security, healthcare access, and other social factors—in order to buffer against the next crisis.

SOCIAL MEDIA & VACCINE MISINFORMATION YouTube on September 29 announced the video platform is expanding its medical misinformation policies, including new guidelines for any vaccine that is approved and confirmed to be safe and effective by local and global health authorities. Since last year, the Google-owned company has removed more than 130,000 videos for violating its COVID-19 vaccine policies, but the new guidelines extend beyond the current pandemic and apply to videos claiming proven vaccines are not effective; including misinformation about vaccines’ ingredients; or claiming that vaccines cause autism, cancer, or infertility, or that they contain tracking devices. YouTube also announced it is removing several channels associated with high-profile anti-vaccine proponents, including Joseph Mercola, Sherri Tenpenny, and Robert F. Kennedy Jr. There are exceptions to the rules, as YouTube will continue to allow content providing scientific discussions on vaccine policies, clinical trials, or historic vaccine successes and failures, as well as testimony about personal experiences with vaccines, as long as it doesn’t spill over into advocating against vaccines. The expanded guidelines mark a turning point for YouTube, which has shown some hesitancy against broadening its policing of content, and brings its policies more in line with other social media platforms, including Facebook and Twitter. While many of the so-called Disinformation Dozen continue to have active accounts across social media platforms, misinformation researchers hope YouTube’s policies will help staunch the flow of false vaccine information, as videos from the channel often lead to viral posts on Facebook and Twitter. Some researchers warn that anti-vaccine activists will simply move to other, newer platforms that have fewer restrictions, including Telegram or Gab.

ANTIVIRAL TREATMENT & PREVENTIVE TRIALS Pharmaceutical companies are pushing to develop more effective, easily administered therapeutics for COVID-19, some of which are being studied for the prevention of SARS-CoV-2 infection. This morning, Merck announced that its investigational oral antiviral molnupiravir, which is being developed with Ridgeback Biotherapeutics, significantly reduced the risk of hospitalization or death among non-hospitalized adult COVID-19 patients with mild-to-moderate symptoms who were considered high risk due to other health conditions such as obesity, diabetes, or heart disease. Among patients who took a 5-day course of the drug, 7.3% (28/385) were hospitalized or died compared with 14.1% (53/377) of patients who took a placebo, according to the interim analysis of the Phase 3 MOVe-OUT trial. Merck said it will file an application for Emergency Use Authorization (EUA) with the US FDA as soon as possible, as well as filing applications for marketing with regulatory agencies globally. Over the summer, the US government announced plans to purchase 1.7 million courses of molnupiravir from Merck for about US$1.2 billion, pending US FDA authorization or approval. If authorized, the drug would become the first oral medication available to treat COVID-19.

Pfizer announced on September 27 that it has begun a large Phase 2/3 clinical trial—named EPIC-PEP (Evaluation of Protease Inhibition for COVID-19 in Post-Exposure Prophylaxis)—to evaluate its investigational oral antiviral drug candidate PF-07321332, administered with a low-dose of the antiviral ritonavir, for the prevention of SARS-CoV-2 infection. The global trial is a randomized, double-blind, placebo-controlled study that intends to enroll up to 2,660 healthy adult participants who live in the same household as someone with confirmed, symptomatic COVID-19 disease. In a different study, Pfizer is testing the experimental antiviral among non-hospitalized, symptomatic adult COVID-19 patients.

Swiss pharmaceutical company Roche also is reportedly developing similar treatments for COVID-19. So far, the FDA has approved only Gilead’s antiviral Veklury (remdesivir) for the treatment of COVID-19 in hospitalized patients. However, the drug’s intravenous or injection administration presents challenges to widespread use, so the authorization or approval of an effective orally administered COVID-19 treatment or preventive could help to lower the burden of patients on hospitals.

WINTER OLYMPICS Less than 2 months from the end of the 2020 Summer Olympic Games—which took place a year late due to the COVID-19 pandemic—organizers are formulating pandemic countermeasures for the upcoming 2022 Olympic and Paralympic Winter Games, set to take place in February and March in Beijing. This week, the International Olympic Committee announced some spectators will be allowed to attend events, but only if they are from mainland China. Athletes and team members will not be required to be fully vaccinated to attend, but those who are not will be subject to a 21-day quarantine upon arrival in Beijing. Additionally, an Olympics bubble, or “closed-loop management system,” including required daily testing, will be established like it was in Tokyo in order to help improve safety. During this summer’s Games in Tokyo, at least 430 people tested positive for SARS-CoV-2, including athletes, officials, journalists, employees, contractors, and volunteers.