The Washington PostDemocracy Dies in Darkness

The Health 202: The United States is now beating the coronavirus on three key metrics

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with Alexandra Ellerbeck

The federal government’s new mask-lifting guidance elicited a range of reactions over the weekend, praised by some people while disparaged by others.

But this much is clear: The United States is now beating the coronavirus pandemic.

The three major U.S. pandemic indicators are highly encouraging.

We’re talking about the average daily rates of cases, hospitalizations and deaths. These are the most basic numbers epidemiologists have used to track how the country is managing the highly infectious virus and where hotspots are.

“We are doing extremely well in the U.S. and are well on our way of moving past the pandemic,” said Monica Gandhi, professor of medicine at the University of California at San Francisco.

Consider the following trends over the past week:

Average daily deaths fell 16.5 percent. They’re now below 580 deaths per day — a level only ever achieved for 17 days last June and July since the pandemic took off in the United States.

Average daily hospitalizations fell 12.6 percent. For every 100,000 people, 10 are hospitalized and three are in ICUs.

Average daily cases fell 19.2 percent. Fewer than 35,000 new cases are being diagnosed each day.

Those metrics are still higher than where the country needs to be, health experts note. Carlos del Rio, a professor of medicine at Emory University, said his goal is for daily new cases to fall below 20,000 and the number of daily deaths to be less than 100.

Sixty percent of American adults have received at least one vaccine dose.

And 47 percent have been fully vaccinated.

Epidemiologists agree those figures are stunning, given that it has been only 14 months since the coronavirus pandemic took off in earnest in the United States, and many had predicted there wouldn’t even be a vaccine available at this point.

“I do think we are moving in the right direction … but there are also some worrying signs ahead,” del Rio wrote me in an email.

To del Rio's point, daily vaccinations are sloping downward. The trend was briefly interrupted for a few days last week, when vaccinations started ticking upward again. But they’ve declined 3 percent compared to last week, with fewer than 2 million Americans now getting a shot each day.

Jesse Goodman, professor of medicine and infectious diseases at Georgetown University, said that given that trend — and the rapid global spread of a more infectious variant from India — it “would be highly premature to declare victory even in the U.S.”

“We remain in a race between vaccines and the variants so we need to continue to overcome hesitancy and ramp up vaccination rates here and, at least as important, do much better to get vaccines produced and distributed worldwide,” he wrote me.

Governors and mayors are getting creative.

As demand dwindles, public officials across the country are offering an array of incentives for people to get vaccinated, Joel Achenbach and colleagues write. According to them:

  • New York Mayor Bill de Blasio (D) tried to market the vaccines by offering burgers and fries from Shake Shack, which he dutifully, awkwardly ate on camera while trying to keep a straight face.
  • Ohio Gov. Mike DeWine (R) is offering $1 million to five adults, provided they are vaccinated. That’s $1 million each. They’ll be chosen by lottery once a week, starting May 26. Separately, he’ll hand out full-ride scholarships at a public state university to five vaccinated teenagers.
  • New Jersey Gov. Phil Murphy (D) has endorsed a “Shot and a Beer” incentive program, in tandem with breweries, in which people who get a first vaccine dose will get a free beer.

And the Biden administration is getting into the game. “It has teamed up with some of the country’s largest corporations to offer incentives. The deals include 10 percent off a grocery bill at Safeway or Albertsons, a $5 Target coupon, and a free snack or beverage at a Vitamin Shoppe,” our colleagues write.

Private groups are also offering incentives.
  • In D.C., a group called DC Marijuana Justice gave away more than 4,200 joints at vaccination sites on April 20. 
  • In Memphis, a “Shot for Shot Sweepstakes” offers a free car to a lucky winner with an official vaccination card. 
  • And at a southern Illinois recreational shooting facility, anyone getting a shot from a mobile vaccination unit there can receive 100 targets of trap, skeet or sporting clays.

The bottom line is that incentives have been shown to work, University of North Carolina professor Noel Brewer told our colleagues. Studies show that vaccination uptake increases by a median of eight percentage points when people are offered incentives, she said.

Ahh, oof and ouch

AHH: The CDC’s abrupt reversal on masks caught the White House by surprise.

During a Senate Health, Education and Labor and Pensions Committee hearing last Tuesday, CDC Director Rochelle Walensky defended the agency’s advice on mask-wearing from charges it was too conservative. Lawmakers didn't know Walensky had already signed off the day before on new guidance allowing vaccinated people to forgo masks in all but a few settings. 

The new guidance, announced publicly on Thursday after a final agency review, represented a major shift in public health messaging and came as a shock to many.

“[T]he huge policy turnaround caught senior White House and administration officials, medical experts, elected officials and business leaders completely off guard, and prompted some physicians to criticize the move as premature. Some Democratic governors were angered by the White House’s rollout, arguing the move effectively passed the buck to states and businesses to implement the new rules without any assistance,” Lena H. Sun, Tyler Pager, Yasmeen Abutaleb and Annie Linskey report

On May 16, Rochelle Walensky, director of the U.S. Centers for Disease Control and Prevention, spoke about the agency’s change on mask-wearing. (Video: The Washington Post)

The CDC didn't inform the White House about the updated guidance until late Wednesday, and some White House officials felt the health agency lacked basic answers about what the new guidance mean for businesses and children not yet eligible for vaccines. 

Anthony S. Fauci, the government’s top infectious-disease expert, acknowledged on CBS’s “Face the Nation” there was “some merit” to questions about whether the CDC could have better laid the groundwork for the new mask guidance.

Yet Walensky defended the agency’s approach, insisting it stemmed from new scientific evidence. 

OOF: Sanofi and GlaxoSmithKline said they may seek coronavirus vaccine authorization later this year.

The two companies teased promising results from their Phase 2 vaccine trials and said they would soon begin a Phase 3 trial with more than 35,000 participants. They predicted that regulators could approve their shots in the fourth quarter of 2021, The Post's Dan Diamond reports.

“We believe that this vaccine candidate can make a significant contribution to the ongoing fight against COVID-19 and will move to Phase 3 as soon as possible to meet our goal of making it available before the end of the year,” said Roger Connor, president of GSK Vaccines. The companies also said they would test the possibility of booster shots.

OUCH: The Biden administration is rerouting billions in health funding to the border.

The Department of Health and Human Services has diverted more than $2 billion from money that Congress originally allocated for the  national emergency stockpile and coronavirus testing to instead use for the care of unaccompanied immigrant children at the border, Politico’s Adam Cancryn reports

“The reshuffling, which HHS detailed to congressional appropriators in notices over the last two months, illustrates the extraordinary financial toll that sheltering more than 20,000 unaccompanied children has taken on the department so far this year, as it scrambled to open emergency housing and add staff and services across the country,” Adam writes.

HHS Secretary Xavier Becerra can shift money inside the department as long as he notifies Congress, but the latest transfers come even as the administration is asking for more money to shore up testing and the national stockpile.

“On its own, the $2.13 billion in diverted money exceeds the government’s annual budget for the unaccompanied children program in each of the last two fiscal years. It is also far above the roughly half-billion dollars that the Trump administration shifted in 2018 toward sheltering a migrant child population that had swelled as a result of its strict immigration policies, including separating children from adults at the border,” Adam writes.

More in coronavirus news

Covid “long-haulers” are pushing for a national registry.

“State and federal lawmakers, with the support of unions, are looking to survivor registries created after 9/11 as a model for helping potentially millions of people with often-debilitating long-term symptoms of Covid-19,” Politico’s Alice Miranda Ollstein and Dan Goldberg report.

“The efforts would center on creating data troves that so-called ‘long-haulers’ could access to make informed decisions about their care, allow medical providers to study the coronavirus’ still-mysterious long-term effects on the body, and help them qualify for state or federal benefits,” they write.

Federal lawmakers are pushing legislation to give government agencies $100 million for research efforts on long-haul covid and $30 million for a voluntary patient registry. At the state level, New York lawmakers have drafted legislation to create a voluntary registry modeled after a city registry of 9/11 survivors and first responders.

Biden's health policy

Biden revoked an order on immigrants who could not afford health care.

The president struck down a 2019 Trump proclamation that required immigrants to prove they would obtain qualifying health insurance within 30 days of arriving in the United States or they had sufficient financial resources to cover medical costs, the Hill's Morgan Chalfant reports.

“My Administration is committed to expanding access to quality, affordable healthcare,” Biden said in a statement. “We can achieve that objective, however, without barring the entry of noncitizens who seek to immigrate lawfully to this country but who lack significant financial means or have not purchased health insurance coverage from a restrictive list of qualifying plans.”

Biden's push to remove lead from drinking water could have a big public health impact.

“Lead pipes have long delivered drinking water to older municipalities in the Northeast and Midwest, along with the risk that they could leach lead. The water-contamination debacle in Flint, Mich., one of the nation’s worst public health disasters, highlighted the threat after thousands of children were exposed. Now, half a dozen years later, President Biden has put a sweeping remedy at the center of his plans to rebuild the nation’s infrastructure…in minority and low-income communities,” The Post’s Dino Grandoni reports.

The president has proposed spending $45 billion in grants and low-interest loans to replace lead-service pipes throughout the country. A CBS News poll showed that the proposal is one of the most popular elements of Biden's $2.3 trillion infrastructure plan. The Natural Resources Defense Council estimates that from 2018 to 2020, more than 61 million people were served by water systems with lead levels exceeding 5 parts per billion, the limit set for bottled water.

Sugar rush

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