Mid-April doesn’t exactly have the happiest reputation among times of the year. The Titanic sank in the early hours of April 15, 1912 off the coast of Newfoundland, claiming the lives of more than 1,500 passengers and crew. President Lincoln died of his gunshot wounds in the early morning hours of April 15, 1865.
The litany of bad stuff happening mid-April is downright unsettling if not eerie: San Francisco earthquake (April 18, 1906); Oklahoma City bombing (April 19, 1995); Virginia Tech shooting (April 16, 2007); Boston Marathon bombing (April 15, 2013); the fire at Notre Dame cathedral in Paris (April 15, 2019).
And then, of course, income taxes are due April 15—except that they aren’t. The IRS pandemic-extended deadline for filing returns is now May 17.
Taking into account the negative minefield that surrounds us, we will seek to convey mostly positive news in this edition of the Coronavirus Briefing, which is 2,728 words long and will take you 9 minutes to read.
Opening shot
The positive way to look at the sudden pause in the use of J&J’s COVID-19 vaccine is to say it is “an indication that our safety monitoring system is working.” That is the essential message from a number of thought leaders in medicine, including Barbara Alexander, president of the Infectious Diseases Society of America.
The pause allows the FDA and CDC time to investigate the occurrence of rare but severe blood clots in combination with low platelets in vaccine recipients, and to do so with transparency—ie, while the whole world is watching.
In casting a vote of confidence for transparency, Alexander added, “It is important that the public continue to receive clear, accurate and up-to-date information, as well as answers to their questions, so that we can maintain and build trust and confidence in COVID-19 vaccines. The risk of becoming infected with COVID-19, and the potential for severe illness or death, remains a serious concern, and we urge everyone who is eligible to take the opportunity to be vaccinated with one of the currently available options.”
The CDC’s Advisory Committee on Immunization Practices met for more than four hours yesterday and declined to take a vote on the use of J&J vaccine, saying they need more time and more data. The group hopes to reconvene in the next week to 10 days. The J&J pause becomes part of a broader inquiry, here and in Europe, into blood clot/low platelet events reported with both the J&J and AstraZeneca/Oxford vaccine.
An ounce of prevention and maybe a pound of cure
It never hurts to accentuate the positive.
· Can treatment offer prevention as well? The Regeneron monoclonal antibody cocktail reduced the risk of symptomatic COVID-19 by 81% in healthy household contacts of infected persons, Alicia Lasek notes in McKnight’s Long-Term Care News. The combination of casirivimab and imdevimab is currently authorized to treat people with mild to moderate COVID-19 at risk for progression to severe disease. Regeneron will now ask the FDA to clear the combo for use as a preventive.
· Keep an eye on molnupiravir, an oral antiviral for treatment of COVID-19 developed by Merck and Miami-based Ridgeback Biotherapeutics. In March the companies reported promising preliminary findings from a Phase 2a study, and this week followed up with news that a Phase 3 trial would proceed with outpatient but not inpatient use of the drug.
· In Endocrinology Advisor, Amy Reyes explores why COVID-19 vaccination is so important for patients with diabetes and other chronic medical conditions.
· PatientPoint has launched a COVID-19 vaccine awareness and education campaign that will reach the offices of nearly 150,000 healthcare providers across the country. The initiative will tap into the messages of the national Ad Council/Covid Collaborative campaign with a video titled What Happens Next as well as educational content to appear on screens in the waiting room and exam rooms.
· The American Academy of Pediatrics has released PSAs celebrating “superhero” parents who get their children vaccinated against childhood diseases such as polio, measles, mumps, and whooping cough. The kids are superheros too. In 2020 the pandemic disrupted the normal parade of visits to the doctor for routine immunizations, down by as much as 26%, according to Blue Cross Blue Shield, which translates to millions of missed doses.
· The psychological impact of the pandemic is not entirely negative. There’s such a thing as post-traumatic psychological growth (PTG), characterized by increased personal strength, greater appreciation of life, and improved social relationships. Researchers with the VA and other institutions found evidence of PTG in 43% of veterans surveyed late in 2020.
· Jeff Weston, VP/creative director for Area 23 and a stay-at-home guitarist in Brooklyn, has created a pandemic-era music video with his childhood pal Mike Moore, now a physics professor and stay-at-home keyboarder in Michigan. MM+M has the story of this five-and-a-half-minute video, which “is like watching an ‘80s time capsule.”
· Young doctors around the world, working together as Team Halo, are posting short videos on TikTok and Instagram to talk about their work in COVID-19 vaccine development. They’ve generated more than 50 million social media views along with admiration and respect beyond measure.
· Santa Clara County teamed up with the San Francisco 49ers to provide vaccinations for more than 250 Special Olympics athletes at Levi’s Park.
· Seniors remain atop the vaccination leaderboard; nearly 80% of them in the U.S. have had at least one shot and 63% are fully vaccinated, translating to notably fewer emergency department visits and hospitalizations in that age group.
· Visits to virtual reality are helping seniors cope with isolation and loneliness in the real reality, Amy Novotney notes in McKnight’s Senior Living. The AARP is among those exploring VR technology, which can allow seniors to share experiences with friends and family, whether it’s touring Paris, swimming with dolphins in the Pacific, or playing checkers. AARP says studies have shown that prolonged isolation is the health equivalent of smoking 15 cigarettes a day.
· The British government is running ads urging people to take “the next step safely” and do free, rapid, in-home COVID tests twice a week to protect themselves, their families, friends and colleagues, Emmet McGonagle reports in Campaign. The ad notes that one in three infected individuals has no symptoms and can transmit the disease without knowing.
The Takeaway:
The good news is always there if you look for it. With any luck, you won’t have to look too hard.
Getting back to where we used to be
We are not so much trying to live life as it used to be but as we now reimagine it.
· Phil Jones, managing director of tech company Brother U.K., shares “Three ways the pandemic proved me wrong about my leadership” in Management Today. (1) We could have moved farther and faster to support remote working (2) Communication pre-pandemic was too infrequent and too formal. “What started as crisis communications has now become everyday habits” and (3) We need to be more aware of big risks–the so-called “black swan events”–and plan and rehearse accordingly.
· Publicis Groupe is planning a return to a reimagined office, date not yet determined, using an AI-powered digital platform named Marcel to connect home and office environments. In Campaign, Alison Weissbrot has details as to how the hybrid model will be implemented.
· Florida is suing the CDC to allow cruise ships to sail once again. Actually, the ships plan to cruise again this summer, not from ports in Florida but from the Bahamas, Jamaica, and the Dominican Republic. The CDC issued a do-not-sail order in March 2020 followed by a conditional sail order in November, then updated it this month, requiring prior approval of a safety plan that includes a few test runs.
· At least two cruise lines are planning to require COVID-19 vaccination of passengers and crew—but Florida Governor Ron DeSantis says his executive order forbidding vaccine passports in the state applies to the big boats as well. See you in court, indeed.
· Coney Island’s two amusement parks reopened last weekend, at a third of capacity, after a full year of being closed. Back in action are the famed Cyclone, a wooden roller coaster built in 1927, and Deno’s Wonder Wheel, built by the Eccentric Ferris Wheel Company in 1920, at the tail end of the flu pandemic. A new roller coaster is appropriately named The Phoenix.
· Fun factoid: Coney Island used to be an island but became a peninsula decades ago when a construction boom in Brooklyn filled in Coney Island Creek. Calling it the “Coney Peninsula,” however, just doesn’t cut it.
· Campaign’s Kate Umfreville lists “10 considerations for hosting post-COVID live experiences.” Among them: events may be stretched out over more days to stagger the comings and goings and thus allow for physical distancing. Also: hybrid events will become the norm, with guests enjoying the festivities from both near and far.
· A New Jersey assisted living center has set aside three apartment-style units as a “rehab hotel” for people living in private homes who need care for persistent medical issues after recovering from COVID-19. Alicia Lasek has details in McKnight’s Long-Term Care News. After a stay of one or two weeks, care of the individual pivots to telehealth.
· California is planning a full re-opening of its economy on June 15, if hospitalization rates are stable and low and if supply is sufficient to vaccinate everyone 16 and older who wants a shot. The Hollywood Bowl, home of the Los Angeles Philharmonic, will host free concerts in May as a thank you for healthcare workers, first responders, and essential workers.
· In Michigan, where 40% of new COVID-19 outbreaks have been linked to schools or youth programs, the state is proposing regular testing of young athletes, while a parents group called Let Them Play Michigan is taking the matter to court. Tamara Hew-Butler, a professor of exercise and sports science at Detroit’s Wayne State University, offers a compromise: Let them play, but with firm rules in place, including: Embrace the concept of shared sacrifice.
The Takeaway:
Attempts to resume previous patterns of working, playing, and living are, in a way, like a massive Phase 4 post-marketing trial of the vaccines.
Challenges remain
We’d love to report only positive news, but the real world beckons.
· What’s happening in Brazil can be considered a cautionary tale for the rest of the world. The pandemic is regarded as out of control, a perfect storm of surging cases, a rampant viral variant, a sluggish vaccination rollout, lapses in social distancing, endless political squabbling, and mounting deaths (more than 360,000, second only to the U.S. with more than 560,000).
· Reports released Monday by the CDC show that ethnic and racial minorities continue to be overrepresented in COVID-19 emergency department visits and hospitalizations. “These disparities were not caused by the pandemic, but they were certainly exacerbated by them,” said CDC Director Rochelle Walensky.
· We’ve lost more than 3,600 U.S. healthcare workers to COVID-19, an investigation by Kaiser Health News and The Guardian reveals. Workers in nursing homes are disproportionately represented in these deaths, Alicia Lasek notes in McKnight’s Long-Term Care News. The government doesn’t track healthcare worker deaths but is being urged to do so.
· The extent of untreated chronic pain during the pandemic is not yet fully appreciated, Lauren Biscaldi writes in Clinical Pain Advisor. “The ‘decimation’ of multiple health care services, including interventional pain management techniques and elective surgeries, may ultimately lead pain patients to seek alternate, potentially inappropriate or harmful treatments.”
· The care of patients with advanced (Stage 3 to 4) chronic kidney disease has suffered as well, Natasha Persaud reports in Renal & Urology News, creating gaps that telehealth could not fill. In addition, Persaud notes, patients undergoing dialysis and patients with a functioning kidney transplant were at increased risk of hospitalization and death.
· Drugs of abuse, especially opioids, can damage the cardiopulmonary system and the immune system, putting people with substance use disorders at higher risk of getting infected and dying of COVID-19. Mary Beth Maslowski shares insights from top federal health officials in Psychiatry Advisor. Drug overdose deaths have surged during the pandemic.
· In Bloomberg Businessweek, Sarah Frier and Sarah Kopit explain how “Facebook Built the Perfect Platform for Covid Vaccine Conspiracies,” including a claim that the shots cause infertility.
The Takeaway:
Bad stuff will happen. We need to take it in stride.
The rest
· April is Mathematics and Statistics Awareness Month. Haven’t we just had a full year of it?
· A video game that is approved as a therapy for ADHD is now being tested to see if it can help people experiencing COVID “brain fog.”
· Most of the 423 sites in the National Park System are open, with some limitations, but you need to check with each location for specifics. At Yosemite, for example, you need to make a reservation to drive into the park if you’re visiting from May 21 to September 30.
· The pandemic forced world-class cellist Yo-Yo Ma to suspend his plan to perform Bach’s six suites for solo cello in 36 locations around the world. He intends to start up again this year (he’s fully vaccinated). In the meantime, Ma and pianist Kathryn Stott released an album for the pandemic-weary titled Songs of Comfort and Hope. You can also listen to him for free in Beginner’s Mind, an audible mix of memoir and music.
· An immersive digital exhibit of Van Gogh art is making its way around the country, to Los Angeles, San Francisco and Chicago, and heading for New York in June, where it is sold out until August. The organizers say the exhibit attracted 170,000 people in Toronto without a case of COVID-19, making it “a safe place to Gogh” (their words not ours).
The resources
· Messaging around the pandemic has contributed to polarization of thought and behavior, says the nonprofit de Beaumont Foundation. In a 26-minute podcast, pollster Frank Luntz and de Beaumont president and CEO Brian Castrucci explore how to improve communications.
· An 11-minute animated video from JAMA Network’s Learning hub explains what we know—so far—about variants and vaccines and the implications for public health policy.
· The CDC has lots of data on its Covid Tracker web pages, but it’s also recently added an interpretive weekly review, updated every Friday. The latest, “Vigilance Matters When Viruses Vary,” explains how the CDC classifies SARS-CoV-2 variants to determine whether they are of interest, concern, or high consequence. Fortunately, there are none in the latter category just yet.
Parting shot:
The Columbia Journalism Review offers a thoughtful take on the J&J pause and the media’s role in communicating degrees of risk, interpreting the complex science of COVID-19 and helping the world deal with uncertainty. The impact of this news on the overall vaccination campaign will depend to some extent on how it is portrayed and explained in public communications.
Kimberly Marselas, senior editor at McKnight’s Long-Term Care News, admits to feeling “wobbly” after hearing the news of the J&J pause but adds, “In my silly little head, the government pause shows our safeguards work as they should.” She says, “I’m going to keep on trusting the system as officials figure out next steps” but is also placing trust in the nurses, doctors, and pharmacists who are out there every day, vaccinating us. “Would these healthcare professionals really be putting shots in arms if they didn’t trust the science? … Let’s expect a little less perfection (albeit no less safety) from massive bureaucracies and start thinking a little more of the people in our communities doing the hard work meant to protect us all.”
… and some songs
· Money for Nothing, Dire Straits
· Money (That’s What I Want), Barrett Strong
· My Heart Will Go On, Celine Dion
· Bridge Over Troubled Water, Simon & Garfunkel
A busy week. Take a deep breath and move on to a new day. We’ll see you here next Wednesday with a Vaccine Project Newsletter. Have a peaceful weekend and, for those who celebrate, a blessed Ramadan.
