May – week 2
May 9: If Someone Shares the ‘Plandemic’ Video, How Should You Respond? (The Atlantic)
A widely discredited video clip from a documentary called “Plandemic” was circulating online before Facebook and YouTube removed it. The clip included a number of false and harmful claims about COVID-19, such as the idea that wearing a protective mask can make people sick and that the coronavirus probably originated in a lab in China. If someone sends you a link to the video, or to other content pushing a conspiracy theory about the pandemic, be empathetic, but offer to provide more information, experts said. “First validate” people’s fears about the pandemic “and then pivot,” said preparedness fellow Rachael Piltch-Loeb.
May 9: Coronavirus testing numbers improving but still lag (The Hill)
Although the percentage of COVID-19 tests coming back positive is falling—a sign that the pandemic could be slowing—the U.S. is still not doing enough testing, experts say. “We’re barely scratching the surface in terms of getting people who just want to be tested able to be tested,” said Michael Mina, assistant professor of epidemiology. “We’re doing better now than I thought we would be just five or six weeks ago, but it’s still not optimal.” The U.S. conducted an average of 250,000 tests a day during the first week of May, but the Harvard Global Health Institute (HGHI) estimates that roughly 900,000 per day are needed—an increase from previous estimates because, as states reopen their economies, more infections are likely to occur.
May 9: F.D.A. Approves First Antigen Test for Detecting the Coronavirus (New York Times)
A new antigen test that can quickly detect whether someone has been infected by the coronavirus has been approved by the Food and Drug Administration. Although the tests cannot detect all active infections and have a higher chance of false positives than the type of tests that are typically used—polymerase chain reaction, or PCR tests—antigen tests will help boost testing capacity in the U.S., experts said. “I am very enthusiastic about antigen testing because of its ability to be scaled up to millions of tests a day, and because it has a much more rapid turnaround,” said HGHI director Ashish Jha. “A lot of us have been looking forward to this moment.”
In Massachusetts, the overall mortality rate during the early weeks of the coronavirus pandemic was highest in cities, towns, and ZIP codes with widespread economic segregation and heavy concentrations of poverty, people of color, and crowded housing, according to a new analysis from Harvard Chan School researchers. Co-authors Nancy Krieger, professor of social epidemiology, and research assistant Jarvis Chen were quoted.
May 8: Without CDC Guidance, Reopenings Follow a Patchwork of Rules (Bloomberg)
Businesses across the U.S. are beginning to reopen during the COVID-19 pandemic with a patchwork of guidelines. They don’t have access to guidance from the Centers for Disease Control and Prevention (CDC), because the Trump administration shelved a document the agency had prepared with detailed recommendations, saying it needed revision. The CDC draft would have answered very specific questions that “everybody is asking,” said Howard Koh. “The CDC is the go-to agency for any public health crisis. The public looks to them for any guidance, particularly as we consider the very difficult decisions about reopening.”
Loosening COVID-19 restrictions will lead to more deaths by summer, say public health experts. That’s because many states are reopening their economies without having enough tests or contact tracers. “We are nowhere near herd immunity, and when the physical distancing interventions that have slowed transmission loosen, we expect to see a resurgence of cases and deaths,” said Caroline Buckee, associate professor of epidemiology and associate director of the Center for Communicable Disease Dynamics. “Without testing to closely follow and trace cases, states should not be re-opening in my opinion.” Epidemiologist William Hanage commented on the likelihood that some activities will move outdoors to lower transmission risk. “Haircuts outside might be sweaty in Georgia and there would still be transmission risk, but less than in a poorly ventilated indoor space,” he said.
May 8: Battling the ‘pandemic of misinformation’ (Harvard Gazette)
There’s been a proliferation of bad information circulating about COVID-19. Health communication expert Kasisomayajula “Vish” Viswanath said that the sheer volume of misinformation and disinformation online is “crowding out” accurate public health guidance. He said public officials are confusing people with contradictory information. He advised the public to closely scrutinize what they read or hear, especially online. But he added that it’s “unfair and it won’t work” to put all the responsibility on the public; he said social media platforms should take more responsibility for what appears on their sites.
May 8: How to Return to Work Safely (Elemental)
The most important way to curb the spread of COVID-19 in the workplace would be to bring back only critical workers at first, according to Joseph Allen, assistant professor of exposure assessment science. Other measures include improving sanitization, improving ventilation and filtration, and reducing workplace density. “There’s no silver bullet here,” said Allen. “We should be throwing everything we have at this virus, which includes controls for all modes of transmission.”
For the past 20 years, the adult film industry has required all performers to be tested for HIV and other sexually transmitted diseases every 14 days, and has dealt with issues such as keeping databases of private medical information secure, preventing the forging of test results, dealing with false positives, and educating workers about the need for repeated testing. Experts say that the industry could provide guidance on how to reopen workplaces during the coronavirus pandemic. “In many ways, what they are doing is a model for what we are trying to do with Covid,” said HGHI director Ashish Jha, who has been calling for widespread national testing. “What the adult film industry has produced has worked, and really could be the kind of tool we need. People can’t get distracted because it’s from a business they don’t approve of.”
May 8: ‘No one should feel completely safe’: what experts think of California’s reopening plan (The Guardian)
Experts said that no U.S. state has enough coronavirus testing and surveillance to ensure that the virus won’t flare up when stay-at-home measures are eased. But they said that California’s cautious plan to allow businesses to reopen some at a time, with strict safety protocols, makes sense. Health policy resesarcher Thomas Tsai noted that state and local leaders should be prepared to reinstate social distancing if the number of coronavirus cases surges. “Social distancing isn’t an on-off switch,” he said. “What it needs to be is a dial, which can be turned up or down depending on what the data show on the ground in terms of how the Covid-19 epidemic is progressing.” He added, “Reopening is going to be a very complicated process, and it should be complicated. Because this is about making sure that people don’t end up in the hospital or dying.”
May 8: Which Covid-19 Data Can You Trust? (Harvard Business Review)
Epidemiologist Caroline Buckee and Satchit Balsari, fellow at the François-Xavier Bagnoud (FXB) Center for Health and Human Rights at Harvard University, were co-authors of this article offering advice on how to sort good data from misleading data regarding the COVID-19 pandemic. They advised looking out for data that’s too broad, too specific, or lacking context; for unvetted data-gathering technologies; and for models produced and presented without appropriate expertise.
COVID-19 has struck black Americans particularly hard. Because of years of structural racism, blacks are more likely than whites to have diabetes, obesity, and asthma—all underlying health problems that make it more likely they’ll develop severe COVID-19 complications, have to be hospitalized, or die. “This is not genetic,” said Mary Bassett, director, respectively of the FXB Center for Health and Human Rights at Harvard University. “This is related to the way in which we structured our society.”
May 8: This Is the Future of the Pandemic (New York Times)
Experts say that the novel coronavirus will be around for many months, and will come in waves. Three Harvard Chan School experts—Marc Lipsitch, professor of epidemiology and director of the Center for Communicable Disease Dynamics, research fellow Stephen Kissler, and doctoral student Christine Tedijanto—discussed possible scenarios, based on recent analyses they conducted.
May 7: How far are we from a vaccine? Depends on who ‘we’ is (Harvard Gazette)
Barry Bloom discussed where COVID-19 vaccine efforts stand. For example, some volunteers are already getting an experimental vaccine as part of trials. Priority populations like health care workers and first responders could get a vaccine sometime next year. But people in developing nations may have to wait years, he said. Until a vaccine or treatment is available for COVID-19, social distancing, personal protective equipment, and other measures will be the only available tools for curbing the spread of disease, said immunologist Yonatan Grad.
May 7: New Hampshire testing falls short, say Harvard, national media (New Hampshire Union Leader)
The average number of COVID-19 tests New Hampshire is conducting daily—998—is only 38% of the recommended number, 2632, according to calculations from the Harvard Global Health Institute (HGHI). Yet the state is planning to ease restrictions on businesses. HGHI director Ashish Jha said, “Testing is outbreak control 101, because what testing lets you do is figure out who’s infected and who’s not. And that lets you separate out the infected people from the non-infected people and bring the disease under control.”
May 7: Facebook post shares flawed COVID-19 survival statistic (PolitiFact)
A recent Facebook post claiming that the current COVID-19 survival rate is 98.54% is only “half-true,” according to PolitiFact—partly because data is preliminary during an ongoing pandemic. Epidemiologist Michael Mina said it’s important to know the total number of deaths and the total numbers of people infected, not just the confirmed numbers.
New testing sites are opening in California to help provide the information about COVID-19 infections that’s needed to help the state reopen. The state has based its testing goals on metrics provided by the Harvard Global Health Institute (HGHI), which estimated how much testing each U.S. state would need before relaxing stay-at-home orders. “California has done really well, and I think it is a shining example of a state that has been proactive in using data to guide their decisions,” said Thomas Tsai, an HGHI researcher.
The state of Tennessee has decided to pay for every single coronavirus test. HGHI director Ashish Jha said that it’s money well-spent, because a lot of testing is needed to safely reopen businesses. “If the state says, we’ll just pay everybody a hundred bucks every time you do a test, that strikes me as very smart policy,” he said.
May 7: U.S. Was Behind On Payments To WHO Before Trump’s Cutoff (WGBH)
Even before President Trump announced he would cut off funding for the World Health Organization (WHO)—because of what he called its failure to challenge Chinese government accounts about when the coronavirus began spreading there—the U.S. was behind on previous promised payments to the health agency. In spite of not paying some back dues, the U.S. has made some recent payments to WHO, including a balance from 2018, part of membership dues for 2019, and a contribution to WHO’s COVID-19 response fund. These mixed signals on payments suggest that President Trump is simply seeking to make WHO a scapegoat, said HGHI director Ashish Jha. “I don’t think that there is any real appetite in the U.S. government to walk away from WHO for the long run,” he said. “This is much more political posturing, so part of me just sort of says we should take the president and his bluster a little less seriously.”
There is still a high plateau of coronavirus cases in the U.S. There were more than 25,000 new COVID-19 infections nearly every day in April, and more than 1,000 people have died each day since April 2. While some states and cities are making progress against the virus, others are seeing cases increase. Meanwhile, about 30 states have started to ease restrictions aimed at slowing the spread of the virus—but experts say doing so could lead to a resurgence of cases. “I’m somewhat sympathetic, as I think everyone is, to the impulse to try to open up,” said epidemiologist Marc Lipsitch. But he added, “I don’t think at this point that it’s good public health advice to reopen in most parts of the United States, because case numbers are high, and testing is poor.”
A new analysis from the Harvard Global Health Institute and NPR found that only nine states in the U.S. are doing the bare minimum amount of testing for the coronavirus considered necessary to begin reopening their economies. HGHI director Ashish Jha said he expects cases of COVID-19 to climb in the coming weeks. “Ultimately, I am deeply worried that four, six, eight weeks down the road, we’re going to find ourselves in the exact same place we were in in early March, and we will have to shut the economy down again,” he said.
May 7: Public health expert decries ‘total abdication of federal leadership’ on COVID-19 testing (PBS News Hour)
“The president’s own guidelines … suggest that states have to dramatically reduce the number of [coronavirus] cases and then have adequate testing, tracing and isolation infrastructure … but very few states have the kind of testing necessary to really safely reopen,” said HGHI director Ashish Jha in this interview with PBS’ Judy Woodruff. He also responded to news that the White House quashed a Centers for Disease Control and Prevention document with guidelines for local authorities on how to reopen their economies, essentially leaving the planning to states. “This is a total abdication of federal leadership,” he said.
May 7: We’ve known how to make healthier buildings for decades (The Verge)
Experts say scientists already have the tools to make buildings healthier for people and less hospitable to pathogens like the coronavirus. Strategies include having as many people as possible work from home during outbreaks, upgrading ventilation and filtration systems, monitoring humidity levels, and improving office layouts. Healthy buildings expert Joseph Allen said that while such strategies haven’t been fully deployed until now, it’s possible that the COVID-19 pandemic will change that. “In a pandemic with no silver linings, maybe there’s a glimmer of light here,” he said.
May 7: A Harvard study tying coronavirus death rates to pollution is causing an uproar in Washington (Washington Post)
Trump administration officials and industry allies have criticized a recent Harvard Chan School study that found that air pollution can make COVID-19 more deadly. They said the study, which has not yet been peer-reviewed, is too premature. But critics of President Trump’s environmental policies, which aim to roll back pollution rules for cars and coal plants, have championed the study. Co-author Francesca Dominici, Clarence James Gamble Professor of Biostatistics, Population, and Data Science, acknowledged the study’s limitations but said it was important to publish the findings ahead of peer review so that “places that were highly contaminated and breathing high pollution levels could be prepared.” She said that recent updates to the study results are normal because the COVID-19 threat is evolving. “It is my responsibility as a public health professional to communicate the science as the science evolves,” she said.
May 7: Florida emerges as bright spot in COVID-19 fight (The Hill)
Florida is less of a hot spot for the coronavirus than other heavily impacted states, and is beginning the first phase of its reopening on May 11. Some experts think people’s willingness to self-quarantine may have played a role in slowing the spread of the virus in the state. Or it could be luck. “It [the virus] hasn’t gotten to some places yet, but it may still be on its way,” said Roger Shapiro, associate professor of immunology and infectious diseases. He warned that Floridians should not have a false sense of security.
On this episode of WBUR’s “On Point,” experts discussed a new report suggesting that the coronavirus was circulating outside of China as early as late last year, and how that changes what is known about the virus. Epidemiologist William Hanage was one of the guests on the show.
May 7: Trump administration buries detailed CDC advice on reopening (Associated Press)
The Centers for Disease Control and Prevention created a document with step-by-step guidelines for local authorities on how and when to reopen restaurants and other public places during the coronavirus pandemic, but it was shelved by the Trump administration. The CDC has traditionally provided guidance to the public and to local officials during public health crises, but has been mostly silent during the current pandemic. Howard Koh said, “The standard in a crisis is to turn to [the CDC] for the latest data and the latest guidance and the latest press briefing. That has not occurred, and everyone sees that.”
In this video interview, Lorelei Mucci, professor of epidemiology, and Philip Kantoff of Memorial Sloan Cancer Center discussed some of the potential overlaps between TMPRSS2—a gene associated with prostate cancer progression—and COVID-19. A recent article by Mucci, Kantoff, and colleagues explored whether TMPRSS2 plays a role in the higher prevalence of severe COVID-19 infection in men.
May 6: Harvard study says warm weather probably won’t slow COVID-19 transmission (Pix 11 News)
Summertime weather might slow the spread of the coronavirus a bit, but warm weather is not likely to play a major role, said research fellow Stephen Kissler, lead author of a recent study that looked at scenarios regarding the future spread of disease.
May 6: Trump Versus the CDC; The City Reaches Out to People With Disabilities; Dignifying Work; Mutual Aid (WNYC’s Brian Lehrer Show)
May 6: Will Kentucky Be Able To Test Enough People To Reopen Safely? (WFPL Louisville)
Kentucky is planning to gradually reopen businesses beginning in mid-May. The state has not met a White House guideline for reopening—14 days of declining cases of COVID-19—but Gov. Andy Beshear says that the state will be able to meet the White House’s goal of testing 2% of the total population per month, which will make it safe for people to return to work. Health policy researcher Thomas Tsai said that if the number of positive cases increases after reopening, then social distancing may have to be put in place again.
Some countries report that they have no coronavirus cases. Most nations with no cases are isolated island chains in the Pacific. Health policy expert Thomas Tsai said the lack of cases on these islands is due to the fact that countries in Asia were quickly locked down, preventing travel and tourism.
May 6: 25 Investigates: Experts say we need more testing to safely reopen Mass. economy (Boston 25 News)
Although Massachusetts has greatly expanded its coronavirus testing capacity, some say more is still needed to shed light on the true infection rate. “Now we are at a stage where we can think about opening up and increasing the number of tests and changing our whole approach to testing, so we’re actually casting a much wider net,” said health policy expert Thomas Tsai.
As the U.S. begins to reopen its economy, hospital intensive care units (ICUs) across the country still need more capacity to handle new COVID-19 cases, according to a new analysis from Harvard Chan School researchers and colleagues. “Without efforts to slow the spread of the virus, hospitals, especially ICU beds in major cities around the U.S., will likely be overwhelmed,” said study co-author Ruoran Li, a doctoral student. Epidemiologist Marc Lipsitch, senior author of the study, said, “The data I’ve seen from China indicates that patients stay in intensive care for quite a long time with this disease, so it’s not just the number of people in intensive care, but the duration of their stay” that could overwhelm the system.
May 6: Evidence mounts that outside is safer when it comes to COVID-19 (The Hill)
Experts say that the risk of becoming infected with the coronavirus is much lower outside than inside. “It definitely spreads more indoors than outdoors,” said infectious diseases expert Roger Shapiro. “The virus droplets disperse so rapidly in the wind that they become a nonfactor if you’re not really very close to someone outdoors—let’s say within six feet.”
May 6: Florida doesn’t have enough coronavirus contact tracers. Here’s how you can help. (South Florida Sun Sentinel)
People who have symptoms that may be COVID-19 should try to get tested, but in the meantime, experts say it’s a good idea for them to do their own contact tracing—to start telling family and friends to take precautions, such as wearing a mask indoors around them or completely isolating. “To make contact tracing useful, you have to get ahead of the virus; you have to identify people when they’re sick and tell their contacts to isolate quickly,” said epidemiologist Michael Mina.
May 6: The next phase of America’s coronavirus failure has begun (Axios)
A number of U.S. states are beginning to reopen their economies, even though the nation is still seeing roughly 30,000 new coronavirus cases each day, there’s not enough testing, contact tracing, or capacity to isolate the sick, and there’s no treatment or vaccine. Experts say that some places that have built up their public health infrastructure may do better in the coming months. “We may nationally be in for a nightmare, but it’s going to be much worse in some places than others,” said HGHI director Ashish Jha.
“Social bubbles”—small groups of people allowed to see each other socially outside of their own households—are being floated as a way to ease COVID-19 social distancing restrictions. Some experts question the idea. Epidemiologist William Hanage said that social bubbles are “certainly a component of how, once the initial outbreak is under control, measures could be refined.” But the bigger the group, the greater the probability of infection, he said.
May 5: Op-ed: Parks are essential — especially during the coronavirus pandemic (Boston Globe)
During the COVID-19 pandemic, parks are more important than ever, according to this opinion piece co-authored by former Harvard Chan School student Julia Africa. “We must shift our thinking to repurpose public spaces during times of crisis, restore their ecologies when the crisis abates, and adapt our parks to better accommodate urban populations (especially those who have been historically underserved) for the future,” the authors wrote.
It could be a while before people are comfortable with air travel during the coronavirus pandemic, say experts. While some airlines are considering issuing informal “immunity passports” to passengers who can prove they’ve already been infected, HGHI director Ashish Jha said that antibody tests may be inaccurate, and it’s not clear that having antibodies means a person can’t be reinfected. Temperature checks at airports are also problematic because people with COVID-19 are sometimes asymptomatic. Without aggressive testing, tracing, and isolation, he said it will be challenging for airlines to reassure travelers that it’s safe to fly.
May 5: Video: U.S. is in for a bumpy ride with virus, says doctor (MSNBC’s “Morning Joe”)
In this television interview, HGHI director Ashish Jha said that the coronavirus will not “disappear over the summer. We’re in … for a bumpy ride—unfortunately, a lot of people getting sick and dying over the upcoming weeks and months.” He called the gradual economic reopening in many U.S. states “a grand experiment, and unfortunately the cost of getting the experiment wrong is that people are going to lose [their] lives and we’re going to have to shut our economy down again.” He stressed that significantly more coronavirus testing is needed, and that states—realizing that the federal government is not going to help with that—are slowly making progress on their own.
May 5: How to deal with coronavirus-related stress: Harvard expert gives tips (Boston Herald)
Many are under significant stress because of the coronavirus. Psychiatric epidemiologist Karestan Koenen offered some ideas on ways to cope: For parents, pick battles with children carefully and model good mental health behaviors; consider extra phone calls, video chats, and small gifts for elderly people who are isolated; and take personal time for activities such as listening to a podcast or taking a relaxing shower.
May 5: Op-ed: End stigma behind mental illness so front-line doctors can get help (USA Today)
In this opinion piece, Harvard Chan School Dean Michelle Williams and Arianna Huffington called for more support for the mental, physical, and emotional health of frontline health care workers. Citing the recent suicide of emergency room doctor Lorna Breen—who had been dealing for weeks with severely ill COVID-19 patients at New York-Presbyterian Allen Hospital—and struggles faced by other frontline workers, they urged hospitals and health care organizations to recognize and address burnout, to support health care workers in prioritizing their own well-being, and to remove stigma around seeking mental health treatment.
May 5: Harvard Public Health Expert: At Least 40 States ‘Are Either Flat Or Going Up’ In Terms Of Coronavirus Cases (WGBH Greater Boston)
With some U.S. states beginning to ease restrictions aimed at curbing the spread of COVID-19, HGHI director Ashish Jha expects that deaths will rise. “Everybody agrees that without a big ramp-up on testing, and tracing, and isolation, if we relax restrictions, [the] number of cases are going to go up, [and the] number of deaths are going to go up,” he said.
May 5: Are we now coming down from the coronavirus plateau? (Boston Globe)
Hospital chiefs and epidemiologists are cautiously optimistic that COVID-19 infections and hospitalizations are slowly going down in Massachusetts. Paul Biddinger, director of the Emergency Preparedness Research & Evaluation Program (EPREP) at Harvard Chan School and chief of emergency preparedness at Massachusetts General Hospital, said, “For the foreseeable future we’re watching our [emergency department] presentations and our hospital admissions very, very closely in case there is another wave. But we’re eager to be able to accommodate the care that’s still needed, and in fact are very concerned about the number of people that have deferred their care during this outbreak.”
May 5: At the center of the outbreak (Harvard Gazette)
Katharine Robb, DrPH ’19, a postdoctoral research fellow at the Bloomberg Harvard City Leadership Initiative, part of Harvard Kennedy School’s Ash Center for Democratic Governance and Innovations, has been studying housing and health in Chelsea, Mass. In this Q&A, she noted that overcrowded conditions in Chelsea make it hard to maintain social distancing and proper sanitary practices to curb the spread of COVID-19. She added that many Chelsea residents living in overcrowded or substandard conditions are more likely to have underlying health conditions, putting them at higher risk from the disease. “Pandemics like this really expose so many underlying vulnerabilities and shine a light on the unacceptable disparities within our communities,” she said.
May 5: Bubble bursts on Cuomo’s hope of ‘immunity’ testing (Politico)
Although political leaders like New York Gov. Andrew Cuomo had hoped that antibody tests could show that people previously infected with the coronavirus had developed immunity, experts say there’s little evidence that having antibodies prevents people from being re-infected or from passing the virus on to others. Studies to show if antibodies confer immunity “are beginning now,” said epidemiologist Michael Mina. But they are going to take some time.” Epidemiologist Marc Lipsitch said that “almost everyone” he knows in the field is working on the problem.
May 5: Coronavirus: Why is there a US backlash to masks? (BBC)
Although health experts encourage the use of face masks to curb the spread of COVID-19, some Americans are pushing back against this advice. Experts say that part of the problem is that there are mixed messages from the government—the Centers for Disease Control advises Americans to wear face masks, but President Trump said the advice is “voluntary” and that he wouldn’t wear one. There’s also a tradition of American resistance to government mandates. Healthy buildings expert Joseph Allen said that wearing a mask indicates social trust. “If you’re going for a walk and no one is around, I still think you should have your mask with you,” he said. “It should be seen as a courtesy if somebody else approaches that you pull your mask up.”
May 5: Trump Skips Face Mask at Honeywell Mask-Making Plant (Bloomberg)
Even though the Centers for Disease Control and Prevention recommended on April 3 that Americans wear face masks in public to prevent the spread of COVID-19, President Trump has said he doesn’t need to wear one, and he didn’t during recent tour of a Honeywell plant in Arizona making N95 respirators for health care workers. Health communication expert Kasisomayajula “Vish” Viswanath said that the president’s behavior, contradicting the government’s own recommendations, confuses people. “At the very worst, it might even cause them to question if these rules apply to them or if the message is really that critical,” he said.
May 5: New Studies Add to Evidence that Children May Transmit the Coronavirus (New York Times)
New evidence suggests that children can transmit the coronavirus, which means that, if schools reopen in the fall in the U.S., COVID-19 cases could soar, according to experts. Although one recent study suggested that children play only a small role in the spread of the coronavirus, epidemiologist William Hanage said that the study was not well designed. “Assumptions that children are not involved in the epidemiology, because they do not have severe illness, are exactly the kind of assumption that you really, really need to question in the face of a pandemic,” he said. “Because if it’s wrong, it has really pretty disastrous consequences.”
May 5: Viral Post Alleging Obama-Era Device Tax Caused Current PPE Shortage Is Way Off (Politifact )
A recent Facebook post claimed that President Obama had signed a “medical appliance tax bill” into law and that the law was forcing companies to manufacture medical devices and personal protective equipment overseas. Politifact said the claim is false. Although there was a 2.3% medical device excise tax set in January 2013 as part of the Affordable Care Act, the tax was designed deliberately to avoid forcing manufacturers to move their production overseas, according to John McDonough, professor of the practice of public health. The tax was put on hold in 2016 and repealed by President Trump in 2019.
May 5: The Medicaid Cliff (Tradeoffs)
This podcast explored what might happen to Medicaid, the public health assistance program for low-income people and those with disabilities, during the current economic downturn caused by the COVID-19 pandemic. During the Great Recession, states were forced to trim Medicaid budgets and many people lost benefits. Although data from that period is minimal, Benjamin Sommers, professor of health policy and economics, has studied what happened when Medicaid expanded under the Affordable Care Act, and found that people with access to the program were more likely to be financially stable and healthier. His research suggests that, during the current downturn, “there will be substantial health impacts if millions of people lose coverage.”
Scientists and politicians in countries around the world are grappling with decisions regarding COVID-19 restrictions, and are trying to strike a balance between the need to protect health and the need to protect the economy. Scientists like Sara Bleich, professor of public health policy, say the primary focus should be on science. “If we want COVID-19 to be a bad memory and not a current nightmare, scientific advice must be prioritized in all political decisions, period,” she said. President Trump, on the other hand, has openly supported people protesting lockdowns, sometimes contradicting his own scientific experts. “President Trump cannot control his political instinct,” said Robert Blendon, professor of health policy and political analysis. “In his view, if this doesn’t change, he’s going to lose the presidency.”
May 4: Social distance makes the heart grow lonelier (Harvard Gazette)
Experts say there are ways to cope with loneliness stemming from COVID-19 physical distancing restrictions. Psychiatric epidemiologist Karestan Koenen called loneliness “toxic to health, not just mental health but physical health.” Jeremy Nobel, an adjunct faculty member in the Department of Health Policy and Management, recently founded The UnLonely Project and created a website called “Stuck at Home (together)” to provide free, arts-based support for people struggling with isolation. He said that being creative can have positive health effects, especially when those creations are shared. “Making art even a doodle or an arranged bouquet of flowers, gives you an artifact you can share with another human being and that person can have some sense of you,” he said. “It’s reliably powerful, like closing an electric circuit, and both people are connected.”
The White House’s “testing blueprint”—issued April 26 as an addendum to its guidelines for reopening the U.S.—falls short on details about how to ramp up testing for COVID-19, wrote HGHI director Ashish Jha in this op-ed. He said that much more testing is needed if the country is to safely reopen. “The Guidelines for Opening Up America Again ask states to move through the plan’s phases for opening depending on their numbers of cases,” he wrote. “Yet the only way to know the true number of cases in any state is by implementing ubiquitous, on-demand testing.” The U.S. is currently performing roughly 200,000 COVID-19 tests per day, but a minimum of 500,000 is needed, Jha wrote.
May 4: Tucker Carlson says coronavirus isn’t as deadly as we thought. Experts disagree (Politifact)
Although Fox News host Tucker Carlson said on April 27 that the coronavirus isn’t as deadly as originally thought, experts said his statement was misleading. That’s because it’s hard to know exactly how many cases—and how many deaths—from COVID-19 are occurring. “Every responsible epidemiologist has been saying that the number of cases is certainly more than those we know about, especially in the U.S., where testing has been inadequate,” said epidemiologist Marc Lipsitch.
May 4: Contact tracing, explained (Vox)
Contact tracing will be a key factor in preventing future spikes of COVID-19, say experts. Contact tracers are “disease detectives” who interview people diagnosed with the disease, find out who they’ve been in contact with, and then inform those people they may have been exposed and advise them to self-isolate and get tested. Before the pandemic began, there were roughly 2,000 contact tracers working for state and local health departments in the U.S., but experts say between 100,000 and 300,000 will be needed to adequately track COVID-19. “I tend to be somewhat on the pessimistic side about contact tracing as a general control strategy,” said epidemiologist Marc Lipsitch. “What we are pretty sure about is that contact tracing works well when you have relatively few cases, you have the resources to do it and when you have even fewer cases that are unknown. Neither of those is true right now in most parts of the United States.”
May 4: For communities of color, air pollution may heighten coronavirus threat (Bay Journal)
Recent research from Harvard Chan School suggests that people who live in areas with high levels of air pollution are at higher risk of dying from COVID-19. They tend to be low-income individuals and people of color, and they are more likely to have existing health issues that put them at greater risk from the disease, according to experts. “COVID amplifies the injustices in our society,” said Aaron Bernstein, interim director of the Center for Climate, Health, and the Global Environment (C-CHANGE).
May 4: Trump cheers on governors even as they ignore White House coronavirus guidelines in race to reopen (Washington Post)
A number of U.S. states are relaxing social distancing guidelines aimed at stemming the spread of COVID-19 even though they haven’t met benchmarks set by the White House to ensure safety during the pandemic—and they’re being encouraged by President Trump. HGHI director Ashish Jha said that most governors who’ve decided to lift restrictions are not following the White House guidelines, such as robust testing for frontline workers and a two-week decline in COVID-19 cases. “The first part of the criteria is sustained decline,” he said. “And we don’t see that.”
May 4: Study: Higher humidity helps reduce transmission of seasonal viruses (Santa Fe New Mexican )
Although it’s possible that the spread of COVID-19 could slow in the summer, it is likely to pick up again every fall and winter, according to a study from Harvard Chan School researchers. “We can expect more people to get infected from year to year,” said study co-author Stephen Kissler, a research fellow. “The big question is whether the severity [of that infection] will change. Over time, the severity of the illness often declines because of a partial immunity that we build up.”
May 4: Seattle Has a Sane Plan to End Lockdown. It Might Not Work. (The Daily Beast)
Washington state is pursuing a cautious strategy as it begins to lift COVID-19 restrictions, including plans to continually evaluate adjustments and make changes if necessary. Health policy expert Thomas Tsai said that the state is using the right approach. “It needs to be a dynamic process, with the understanding that you may need to take a step back if testing data show cases starting to increase again,” he said. As for other states, he warned that even if they have “flattened their curves”—kept their hospitals from being overwhelmed with COVID-19 patients—“there will be a new wave of non-COVID patients who have been deferring their care coming back to the hospitals. The demand is going to change dramatically after states reopen.”
After two months of an economic shutdown in the U.S. to slow the spread of COVID-19, President Trump and a number of governors are focused on reopening businesses. But experts say that most states ending their shutdowns have not met thresholds set by the White House for testing, tracing, and a sustained drop in new COVID-19 cases. Epidemiologist Michael Mina cautioned against opening up too quickly. Any one of thousands of transmission chains “could potentially ignite new outbreaks,” he said. “That’s how a second wave can potentially be more disruptive, more damaging and larger than the initial phase of the epidemic.”
May 4: This Mental Health App Is Tailor-Made for Your Pandemic Woes (Wired)
A mental health app called Covid Coach, from the National Center for PTSD, is aimed at helping people manage stress during the pandemic. The app offers breathing exercises, guidance for dealing with loneliness and irritability, and resources for getting help with problems such as substance abuse or domestic violence. Psychiatric epidemiologist Karestan Koenen said that a key ingredient to creating PTSD is uncertainty — “having stressors where it’s uncertain, uncontrolled, and unpredictable” — which, in the case of COVID-19, stems from the fact that it’s unclear what might happen next during the pandemic.
Many people will experience stress and anxiety during the COVID-19 pandemic, and some, such as frontline health care workers or those who lose loved ones to the disease without being able to be with them, will go through trauma, say experts. Psychiatric epidemiologist Karestan Koenen described some of the mental health impacts to expect from the pandemic, as well as some coping mechanisms.
Any plan to reopen schools in September must include plans to test students for COVID-19 and keep up with social distancing, such as eliminating assemblies and possibly fall sports, said HGHI director Ashish Jha. “I’m not Pollyannish about this,” he said. “If we are super aggressive on testing, if we put into place moderate social distancing when possible, if we have a therapy that works for people who get very sick … if we do all that, I think we can keep schools open all year. It’s going to be very hard to pull off, but we are more than capable to pull it off.”
May 4: Op-ed: ‘Serology’ is the new coronavirus buzzword. Here’s why it matters. (Washington Post)
Epidemiologist Marc Lipsitch explained why serologic studies for COVID-19, which determine whether people carry antibodies to the virus, are so important. Such studies may be able to shed light on who is immune to COVID-19 — information that could help inform decisions about who can return to work — and on why disadvantaged groups have higher rates of disease, he wrote.
With research labs shut down across the U.S. because of COVID-19, scientists are grappling with the loss of experiments, and worrying about future funding and their career paths. They say that, for some labs, it will take months to a year for research to fully resume. Eric Rubin, Irene Heinz Given Professor of Immunology and Infectious Diseases and editor-in-chief of the New England Journal of Medicine (NEJM), said that he expects there will be a significant amount of work — including retesting equipment and regrowing bacterial cultures — before experiments will be able to get off the ground again in his laboratory, which focuses on Mycobacterium tuberculosis.
May 4: The Key to Handling Stress and COVID-19 (SFGate)
This opinion piece, co-authored by Harvard Chan School Dean Michelle Williams, outlines the links between aging, chronic illness, low-grade inflammation, and low-grade anxiety and depression, and argues that these factors can increase people’s risk of hospitalization and death from COVID-19. To reduce the risk, the authors suggested that complementary practices such as deep breathing, yoga, and meditation can help by calming anxiety, reducing the stress response, regularizing the heartbeat, and lowering blood pressure — all benefits that have been associated with reducing low-grade inflammation.
May 4: What If Covid-19 and Fly Both Flare Up This Fall? (Elemental)
Infectious disease experts are worried that there will be a second wave of COVID-19 in the fall that coincides with the flu season. “Once we start opening things back up, we’re going to have a lot of individual cases that are still brewing under the surface,” said epidemiologist Michael Mina. “If we don’t put out all the flames, then we’ll have this smoldering number of people that will all be able to ignite outbreaks at once.” Epidemiologist Marc Lipsitch said the health care system could be even more overwhelmed than it has been this spring. If the flu and another COVID-19 wave hit at the same time, it’s possible that one viral infection could prevent a person from getting another, said Mina. It’s also possible that people could catch both viruses. On the positive side, “If we take aggressive measures” against any possible reemergence of coronavirus this fall, “we could inadvertently prevent wide-scale transmission of influenza,” he said.
May 4: All In This Together, Yet Alone In Our Grief (Thrive Global)
Psychiatric epidemiologist Karestan Koenen wrote about the many losses we are suffering because of COVID-19. In addition to being unable to adequately mourn deaths in our families, we are also dealing with universal losses — the “stunning loss of life … the loss of 30 million jobs, multitudes facing bankruptcy and eviction, and nationwide cancelations of graduations, weddings, bat mitzvahs and other rites of passage,” Koenen wrote. She called for “leadership at the national and local level that acknowledges the full extent of our collective grief — perhaps a national day of remembrance and healing.”
May 3: Maine reopening with ‘bare minimum’ testing strategy (Portland Press Herald)
Maine’s phased plan to ease COVID-19 restrictions and reopen its economy relies on detecting and isolating people infected with the disease, but experts say the state’s testing plan isn’t extensive enough. Maine plans to boost its testing capacity from about 1,000 tests per day to 2,000 to 3,000. But health policy expert Thomas Tsai said he thinks Maine would need to test about 8,800 each day to keep the disease in check. He called that number “the bare minimum” requirement.
May 3: Massachusetts researchers are on front lines of coronavirus antibody testing (Boston Globe)
Antibody testing, or serology testing — which can show if someone has been infected with the coronavirus — is key to measuring the reach of the COVID-19 pandemic and potentially shedding light on whether or not people become immune after contracting the disease. Epidemiologist Michael Mina and colleagues are launching serology surveys to provide crucial data. He warned against direct-to-consumer antibody tests, given that many of them have been found unreliable. “People shouldn’t consider them as anything more than a toy,” he said.