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Showing posts with label vaccine. Show all posts
Showing posts with label vaccine. Show all posts

Sunday, January 31, 2021

Covid-19: The Worst Is Yet to Come, Unless We Stop it


Refrigerated containers at the Los Angeles County coroner’s complex. (Brian van der Brug / Los Angeles Times)

“It always seems impossible until it’s done.”
-Nelson Mandela

I still remember the day the population of the world breathed a collective sigh of relief; it was 9th November, 2020 when the media announced that Pfizer and BioNTech had developed vaccines that showed greater than 90% effectiveness in large scale clinical trials.

Of course, at this time we were still weeks away from getting the first vaccine dose into the arms of healthcare workers, leave alone the general population, but still human nature being what it is, many people started to behave like they had already been vaccinated.

We immediately saw a surge in Thanksgiving travel in the US, with more than a million people passing through TSA checkpoints. This naturally led to an alarming surge in Covid-19 cases across the US with positive cases approaching over 200,000 a day.

The next hope-giving milestone was 14th December, when New York nurse Sandra Lindsay became the first American to be vaccinated. She said "I feel like healing is coming" but should have added that Americans need to wait for the healing to come to their arm before they start to behave like they too have been inoculated.

You guessed it, around 85 million Americans decided to travel over Christmas. No doubt to celebrate nurse Lindsay’s inoculation and to shatter travel records that they had just set over the Thanksgiving holiday.

Naturally, Christmas travel led to another massive surge in positive cases and deaths all across the country, leading to almost every state in America ordering some variation of mask mandates and forced closures. Not to mention that the sheer volume of cases also put the healthcare systems in Arizona, California and Rhode Island on the brink of collapse.

We are now at the end of January and only 7.9% of people in America have been vaccinated, which puts the US in fifth place. We are behind Bahrain (10%), UK (12.3%), UAE (30.4%) and Israel (52.6). The fact is that we have not finished administering the vaccine to healthcare workers, and have already run short of doses with numerous states having to turn away people and cancel appointment, as they work to broaden the criteria to anyone over 65 years old.

Most Americans are now even more hopeful that the new Biden administration will be better organised than Trump’s and thus be able to more expediently get the jab into their arms. However, we must remember that vaccinating 330 million people is still no small or simple logistical task. No to mention the issues we will continue to face with vaccine production and distribution, especially when it comes to lack of healthcare access in rural areas.

Meanwhile, the EU central authority, which has spectacularly fumbled its vaccine rollout across Europe, has now gotten into a very public brawl with vaccine maker AstraZeneca, blaming them for the acute shortage and threatening to use legal means to block the vaccine maker from exporting its COVID-19 vaccine to non-EU countries.

In many parts of the world, we are seeing new, more-highly transmissible mutating variants emerge that also seem more deadly. In Britain we saw the death rate triple since December as the B.1.1.7 mutant strain took hold. Denmark, which has been conducting genomic sequencing on every positive case, says that cases involving the new variant, first found in the UK, are increasing 70 percent a week despite a strict lock down.

Madrid is having to halt all vaccinations due to the EU supply shortage right when new cases across Spain are said to be double what they were in the second wave and four times as bad as the first wave. Portugal, which just last year was considered a model of success in their handling of COVID-19, now has new cases that make it the highest in the world in proportion to its population, going from seven deaths per million to more than 24 now.

In Brazil, the city of Manaus which was the hardest hit last May with the healthcare system collapsing, had 348 people die in the worst month last year. Now, through just the first three weeks of January, that number stands at 1,333. In the US we had 300,000 deaths since the start of the pandemic but between 22nd December and January 19 we added 100,000 more.

Researchers identified another variant in California known as CAL.20C which originally showed up in July last year, but then lay dormant until November when it went on a rampage and was shown to be responsible for more than half of the virus genome samples collected in Los Angeles laboratories on January 13.

The good news is that preliminary data from Israel shows that the vaccines work and show a 33 to 66 percent decline in infections, just fourteen days after the first dose is given. We also know that the current vaccines do offer varying levels of protection against the new strains. For example, Johnson & Johnson’s new vaccine that is about to come to market showed an efficacy rate of 72 percent in the United States, but dropped to 57 percent in South Africa, where a highly contagious mutant variant is driving cases.

The important thing to remember is that even if a vaccine does not offer 90% effectiveness against every new strain. Studies on non-human primates have shown that even lower effectiveness can protect you from getting Covid-19 or if you get sick, it will save your life by making the illness is less severe.

My mother says nobody loves a pessimist, so I want to be clear that I am EXTREMELY optimistic that we will beat this pandemic, but only if we don’t let our guard down at this point.

Yes, I can see the light, but we must never forget the night is darkest before the dawn. Now is the time to double mask and remind people that we are so close to the finish line that if we give up now and stop wearing masks, or start mingling again, then we will see this pandemic swell and kill many more people before we are able to vaccinate enough people.

Let’s make sure that our optimism does not wash over our common sense and let's not give this insidious and silent enemy the opportunity to snatch any more of our friends and family from us.


Thursday, December 31, 2020

Looking Ahead at 2021 (not predictions)

 (Photo by Danil Aksenov on Unsplash)

“Optimism means better than reality; pessimism means worse than reality. I'm a realist.”
Margaret Atwood

I am an eternal optimist and feel confident that our future is bright. I envision that we will build a more equitable and just world over the next few decades, but the journey to get there will not be without hardship. However, the next few years are likely to get rockier, based on the current cultural, political and economic realities.  

There are five realities that exist and, based on how we navigate these or allow them to unfold, we will determine if the New Year turns out to deliver on the optimism we are feeling, with covid-19 vaccines rolling out and a new, more stable and predictable US President taking office, or if it ends up being no better, or even worse, than the previous year.

One: Vaccine Rollout and Anti-Vaxx Movement
Vaccinating 330 million Americans is going to be a Herculean task, not to mention vaccinating 7.8 billion people. Nothing on this logistical scale has been attempted 
since WWII. Adding to the complication is the fact that some vaccines will require two doses or need to be stored at temperatures that most storage and medical facilities are unable to accommodate, especially in poorer countries.  In America, we are already seeing major hiccups in the rollout with states not receiving the promised number of doses, healthcare workers turning on each other to cut in line and even one clinic accidentally giving patients antibodies instead of the vaccine. The Trump administration’s goal of vaccinating 20 million people by the end of December will fall woefully short with only 2.1 million doses being administered as of 29th December.

Even if the Biden administration ensures a smoother rollout and everything goes according to plan, which it never does, it will take until the third quarter before 90% Americans are vaccinated, to enable herd immunity. This does not account for the growing anti-vaccine movement around the globe and here in the US. The latest Gallup poll found that only 58% of Americans say they trust and are willing to take the Covid-19 vaccine.

Since wealthy countries have hoarded the initial available vaccines, their populations will be vaccinated by end 2021. Other high-income countries like China, India, Brazil and Russia will take until mid-2022 to vaccinate their populations. As a result, low-income countries will not be able to procure vaccines until mid to late 2022, and will take till end 2023 if not early 2024 before they can able deliver mass vaccinations. And we are still months away from developing a vaccine for young adults and children, who have not been a part of the initial clinical trials.

It is easy to forget that there can be no return to normalcy until the majority of the world has been vaccinated, given our interconnectedness through trade and travel. We saw record-breaking Christmas travel in the US, showing that people are starting to let their guard down when we can least afford to. At the same time we are witnessing the worst global spike in cases and deaths since the virus was detected, and have also discovered a new mutation that is 70 % more transmissible than the previous strain. It was first found in the UK but has already shown up in South Africa, India, United States and thirty other countries. Based on these realities, before things get better, I fear the worst of the virus is yet to come in early 2021.

Two: Stock and Big Tech Unreality vs. Small Business Apocalypse

(Source: New York Times)

This one chart says it all. The red line indicates stocks, while the blue and green show GDP and job growth, respectively. While all three took an unprecedented hit at the start of the pandemic, stocks have now climbed back to historic highs, while GDP and jobs lag substantially behind their pre-pandemic levels.

Since the 1920s average Americans and politicians viewed the stock market as a proxy for the US economy, with its peaks suggesting brighter days and troughs indicating tougher times ahead. However, this pandemic has made it clear that Wall Street is now completely detached from Main Street. With access to cheap capital through bond markets, deep cash reserves and global reach, these larger corporations can withstand economic shocks and remain profitable in ways that small businesses simply cannot.

Consider that the five largest listed companies Microsoft, Apple, Amazon, Alphabet and Facebook have all seen double digit profit increases this year, and each will exit the crisis in a more market dominant position than prior to it. Contrast this with small businesses that have suffered disproportionately, with over 43% reporting significant to severe impact.

Recent data shows that 60% have closed permanently, which is a 23% increase in the number of closures since mid-July. One of the worst hit sectors has been the restaurant and service industry, accounting for 82% of the jobs lost since February. In California alone, due to the severe lock downs, the National Restaurant Association predicts that 43% of restaurants will permanently close. Given that small businesses account for 48% of private sector employees in the US, the economic devastation of this crisis will linger for years to come. 

Three: Uneven Economic Hardship & Social Instability
Some ten million Americans are unemployed, and over one million filed new state and federal unemployment claims in the last week of December. More than four million people left the workforce, between February and November, meaning that they are no longer actively seeking employment. According to economists this skews unemployment numbers, showing a drop when it is actually a reduction in labour force participation.

Another worrying trend is the increasing number of people who have been out of work for more than six months. About one-third of the total unemployed are now long-term unemployed. That people are actively looking for work but still unable to find employment indicates a problem in the labour market’s ability to match skills with goods and service needs. Not a good sign.

This crisis has also disproportionately affected women and minorities. Women’s job losses account for 54% of overall net jobs lost. Of the 12.1 million women’s jobs lost, more than 2 in 5 have not yet returned, according to the National Women’s Law Center. Among Black men the unemployment rate is around 11.3 percent, which is 5 percent higher than the rate for white men. To put this in perspective, never during the Great Recession did overall unemployment rates surpass 10 percent.  

 In addition, the crisis has exacerbated the wealth gap that already existed between minorities and whites, with job losses concentrated among minorities and low wage earners, according to the Brookings Institute.  

This widespread economic hardship is represented in the fact that the number of Americans living in poverty has grown by more than 8 million since April this year. Nearly 1 in 4 households are now experiencing food insecurity. An analysis by Northwestern found that food insecurity has tripled in households with children; reaching an all-time high of 29.5%.

In addition, there is growing housing insecurity. Millions of homeowners are now struggling with mortgage payments. A Harvard study finds that more than 6 million homeowners entered mortgage forbearance this year due to loss of income, and nearly half (44%) of these households earn $25,000 or less per year.

Many of these issues represent deeper systemic problems that cannot be fixed by a vaccine or simple policy prescriptions. The reality is that we may be three to four years away from gaining back the jobs that have been lost during this pandemic. Economists are already warning us about a K–shaped recovery that worsens and exacerbates pre-existing economic and wealth disparities. 

Four: Growth of Trumpism & Our Deepening Divide
Far from being a decisive victory for Democrats, the 2020 election showed a resilience of Trumpism. Biden won the presidency with the same number of Electoral College votes as Trump did in 2016. Far from witnessing a Blue Wave, we instead saw Democrats lose ground in national, state and local legislatures.

Latino voters flocked to Trump in Florida, Texas and New Mexico. A Wall Street Journal analysis found that Trump improved his performance in every Texas County with a Latino population over 75 percent. Trump also measurably increased his support among Black voters, including over 18 percent of Black men, 34 percent of Asians and 28 percent of the gay, lesbian and transgender community. Even in New York, a solidly Blue state, Mr. Trump increased his vote share within immigrant rich districts in Queens and the Bronx.

If there is any doubt about the broad appeal of Trumpism among the working class and minority voters, we need look no further than Robeson County. It is the largest county in North Carolina and possibly the most diverse in the nation. Robeson is 42.3 percent Native American, 30.6 percent white, 23.6 percent black, and has a growing Hispanic population. It came as a shock when Trump won this formerly Democratic county in 2016, with 67 percent vote share, but in 2020 he increased it to a whopping 81 percent.

On a national level, rather than seeing a healing of divisions that came into sharper focus during the divisive 2016 election, the 2020 election map shows a more entrenched electorate with far fewer counties flipping from one party to the other. In the last election 237 counties changed allegiances from Obama to Trump, in this election only 77 counties flipped.

American’s divisions are not just political but also seep into bi-partisan institutions that require trust for our democracy to thrive. Only 10% of Republicans polled by Gallup say that they trust the media. This is a dramatic decline even from the 30% and 36% who did during eight years of the Obama and Bush administrations, respectively. According to Gallup we now have the largest gap recorded between the two parties since they started conducting this poll in the 1970’s.

As we head into 2021 we can expect these differences to become even more extreme at a time when the left does not believe that the New York Times is ‘woke’ enough, and the right is abandoning Fox News for not being far-right enough.

Five: Democratic Party Civil War
Any party that fields 27 candidates for their presidential primaries, which is the largest number in history, is both leaderless and visionless. Republicans only had 18 candidates during their disastrous 2016 primaries which ended with a hostile takeover of the party by Donald Trump. Imagine a company stating that they have 27 candidates vying for the CEO’s job during a leadership succession – would you invest in them?

Much like the Republican Party, the rifts we see in the Democratic Party have been growing for a number of years. Like the Tea Party who targeted and removed moderate Republicans, this rebel group, who call themselves Democratic Socialists, are intent on remaking the soul of the Democratic Party from the inside. Waleed Shahid, a Bernie Sanders campaign alumnus who now recruits progressive candidates for Congress, was asked if this far-left group was the equivalent of the House Freedom Caucus, his answer was unequivocal: “Yes, it is”.

Even before the new administration takes office, Alexandria Ocassio-Cortez, the most outspoken member of the Squad, has called for the ouster of current Democratic leadership. In the past she threatened her moderate colleagues, saying she would put them on a list to oust them in primaries if they made attempts to reach or work across the aisle.

After a poor showing by Democrats in the 2020 election, despite facing an unpopular and polarising incumbent, the knives have come out and the battle lines drawn between the moderate and progressive wings. The divisions were best summed up by Rep. Spanberger (D-Va.) when she said: “We need to not ever use the word ‘socialist’ or ‘socialism’ ever again. … We lost good members because of that”. President elect Biden too was heard on tape asking civil rights activists to stay quiet about overhauling police, echoing what many in the party believe; “That’s how they beat the living hell out of us across the country, saying that we’re talking about defunding the police”.

It is easy to forget that Progressive Democrats had written Biden off during the primaries, and were also not happy about his selection of Kamala Harris, who is viewed as being too establishment friendly. It is true that Progressives grudgingly coalesced around Biden in order to defeat Trump, but any group that is simply united by hatred for an enemy and not by a common vision is in danger of self-destructing when it comes time to govern. 

The bottom line is that at a time when the Democratic caucus is about as divided as it has ever been in its history, they also have a razor thin majority in Congress. They have 222 members with 218 being the bare minimum votes needed to pass legislation. With the smallest majority any party has had in two decades and given the deep internal divisions, it leaves them vulnerable to losing a handful of members. There is also a strong possibility that Republicans will regain control of the Senate after the runoff races in Georgia, They just need to win one of those races for the wily Mr. McConnell to remain as the Senate Majority Leader.