COVID-19 MESS: AMERICA CELEBRATES JULY 4TH IN THE MIDDLE OF PANDEMIC

As America celebrates July 4^th in the midst of COVID-19, “America is done with COVID-19 however, COVID-19 isn’t done with America” – Jeffery Kluger & Chris Wilson summed up.  According to the publication, they went further to say, “It’s been months now since U.S. President Donald Trump predicted his miracle. That was back in February, during the early days of the COVID-19 pandemic, when the president announced that come April, when the weather got warmer, the coronavirus would “miraculously [go] away.” It didn’t. And nor has it been reduced to “ashes,” as Trump claimed on June 5 when, arguing for a rapid reopening of the economy, he said, “We want the continued blanket lockdown to end for the states. We may have some embers or some ashes, or we may have some flames coming, but we’ll put them out. We’ll stomp them out.” Instead, the U.S. is very much on fire, well into a second phase of the crisis, with the COVID-19 caseload steadily rising to more than 2 million confirmed cases and more than 113,000 deaths. According to a TIME analysis, 23 states are continuing to see case counts grow day by day. Four of those states—Arizona, California, Mississippi and North Carolina—have yet to decline for any extended window even temporarily; the rest appear to have initially bent the curve downward and are now experiencing a second wave of infections. And in many of those cases, the second phase is worse than the first, or on track to erase any encouraging declines in the past month. In Oregon, for example, the state appeared to flatten the curve very early, peaking at 1.76 cases per 100,000 people on April 2 and declining to 0.8 by May 24. In the intervening two weeks, a resurgent wave has pushed that figure past its previous peak to 2.3 as of June 8—and still likely to grow.

According to sources from Johns Hopkins Center for Systems Science and Engineering. Figures are a seven-day rolling average of new daily cases per 100,000 residents in each state and Washington, D.C. These disparate trends are invisible on a national level. Improvements in some areas—New York, New Jersey and other parts of the Northeast—have been offset by worsening conditions elsewhere, leaving the entire U.S. stubbornly plateaued at about 6 cases per 100,000 people. In Texas, the seven-day average of new COVID-19 cases per day has been over 1,000 since May 25. This development led Governor Greg Abbott to concede on a local news broadcast, “I am concerned, but not yet alarmed.” He should be, though. On May 14, the state’s seven-day average crested at 1,305 cases per day and then started to fall. But in recent weeks, it’s climbed back up, and is now at 1,703 or worst.  These alarming spikes are apparent even when a state never enjoyed a temporary lull. Arizona, which has yet to appear to peak even momentarily, has seen 7,700 new cases in the first week of June, with patient load tripling in the past three weeks in hospitals owned by Banner Health, the state’s largest hospital provider. Yet the pandemic, if not remotely yesterday’s news, has begun to fade as a front-of-mind issue, pushed out both by the recent demonstrations against police brutality and systemic racism, triggered by the May 25 murder of George Floyd, and perhaps a sort of cultural numbing to all things COVID. The White House Coronavirus Task Force, whose press conferences were daily fixtures in the early months of the crisis, now convenes three times a week instead of daily—with Vice President Mike Pence, the group’s chair, attending only one of those three regular sessions—and there has not been a press conference in the last month. On June 12, the U.S. Centers for Disease Control and Prevention had its first media telebriefing since March 9; previously these were held at least  weekly.

Dr. Tom Inglesby, director of John Hopkins’ Center for Health Security at the Bloomberg School was quoted to have said, “I’m worried that people have kind of accepted where we are as a new normal, and it is not normal,” He regrettably added, “Some states have hundreds or even thousands of new COVID cases every day, and we can do better than this. Some countries have driven their [daily] cases down to zero.” The U.S. most certainly hasn’t, but the pain is not spread evenly across the map. New infections are falling precipitously in some states, including New York, Connecticut, Delaware, New Jersey and Kansas, while resuming a rise after initially plateauing or falling elsewhere, including in Washington, Oregon, Nevada and Texas. President Trump was not alone in optimistically predicting that a combination of warm weather and a period of sheltering in place would be enough to snuff the COVID-19 wildfire by summer. Every state in the country, plus Washington D.C., imposed some kind of quarantine rules, the earliest going into effect in mid-March—and, since the middle of springtime, all of them have slowly been reopening, pressed by a combination anxiety over the economy, a restive population, and no small amount of epidemiological hope. That hope has not always been fulfilled. If there is concern among residents and leaders of affected states, it’s hard to spot.

If the governors of the stricken states aren’t feeling skittish yet, the markets are, the reporters opined.  Federal Reserve Chairman Jerome Powell said in a June 10 news conference. “This is the biggest economic shock in living memory. The extent of the downturn remains extraordinarily uncertain.” But that recovery is fragile. According to New York Governor Andrew Cuomo, at a June 11 briefing. “You can make a mistake today that wipes out everything we’ve done so far, so we have to stay smart,” The biggest of those mistakes may involve timing. Overall, as a TIME analysis of state-by-state data found, the date that states closed and reopened had at least some effect on how severe their second wave has been—or whether they have had one at all. From closing schools to mandatory stay-at-home orders, the Northeast was both the earliest region in the country to institute interventions, and the most hesitant to roll them back. More telling is how many of these intervention measures remain in place as states cautiously crack open once-shuttered doors.

One-third of working mothers in two-parent households reported they were the only ones providing care for their children, compared to one-tenth of working fathers, according to a recent study. Anew analysis of USC’s Understanding Coronavirus in America Study has found that women, particularly those without a college degree, suffered more job losses than men and bore significantly greater responsibility for child care during the COVID-19 pandemic – Jenesse Miller. “Considering women already shouldered a greater burden for childcare prior to the pandemic, it’s unsurprising the demands are now even greater,” said Zamarro, who is also a professor at the University of Arkansas. “While men are more likely to die from infection by COVID-19, overall the pandemic has had a disproportionately detrimental impact on the mental health of women, particularly those with kids.”

Pandemics can be stressful. The coronavirus disease 2019 (COVID-19) pandemic may be stressful for people. Fear and anxiety about a new disease and what could happen can be overwhelming and cause strong emotions in adults and children. Public health actions, such as social distancing, can make people feel isolated and lonely and can increase stress and anxiety. However, these actions are necessary to reduce the spread of COVID-19. Coping with stress in a healthy way will make you, the people you care about, and your community stronger.

Mental health is an important part of overall health and wellbeing. It affects how we think, feel, and act. It may also affect how we handle stress, relate to others, and make choices during an emergency.

People with pre-existing mental health conditions or substance use disorders may be particularly vulnerable in an emergency. Mental health conditions (such as depression, anxiety, bipolar disorder, or schizophrenia) affect a person’s thinking, feeling, mood or behavior in a way that influences their ability to relate to others and function each day. These conditions may be situational (short-term) or long-lasting (chronic). People with preexisting mental health conditions should continue with their treatment and be aware of new or worsening symptoms. If you think you have new or worse symptoms, call your healthcare provider.

Suicide: Different life experiences affect a person’s risk for suicide. For example, suicide risk is higher among people who have experienced violence, including child abuse, bullying, or sexual violence. Feelings of isolation, depression, anxiety, and other emotional or financial stresses are known to raise the risk for suicide. People may be more likely to experience these feelings during a crisis like a pandemic. However, there are ways to protect against suicidal thoughts and behaviors. For example, support from family and community, or feeling connected, and having access to in-person or virtual counseling or therapy can help with suicidal thoughts and behavior, particularly during a crisis like the COVID-19 pandemic.

The science is screaming.  Americans are in turmoil. More than 80% of U.S. adults report the nation’s future is a significant source of stress, according to a report Thursday from the American Psychological Association. Americans are the unhappiest they’ve been in 50 years, according to a COVID Response Tracking Study released Monday. And a survey published this month in the medical journal JAMA found three times as many U.S. adults reporting symptoms of serious psychological distress in April as they did two years earlier.

America is a nation unmoored, and experts say for many people the negative mental health impacts will outlast the current crises. Research suggests the extreme stress triggered by these events may even lead to longer-term psychiatric disorders. The nation must prepare, experts say, for the mental health crisis that looms next. “We are facing a culmination of crises unlike anything we have seen in our lifetimes – in coronavirus, economic turmoil and racism,” said Jaime Diaz-Granados, deputy chief executive officer and acting chief scientific officer at the American Psychological Association (APA). “Each of these crises are taking a heavy psychological toll on Americans and particularly our African American citizens and other people of color. The health consequences could be dire. As we look toward the future, we need to consider the long-term implications of the collective trauma.”

LESSON 1: Scientific ignorance can be fatal—particularly if it starts with the U.S. president and trickles down from there. It was scientifically incorrect for Donald Trump to dismiss the coronavirus as no worse than the seasonal flu, as he did on February 26. It was incorrect to advise U.S. citizens to engage in business as usual, which he did as late as March 10. It was incorrect to imply, as he did in a press briefing on March 19, that the malaria drugs hydroxychloroquine  is a promising remedy for COVID-19—something that has not been verified. Dissemination of such inaccurate information helped to spread the novel coronavirus in America faster by delaying the adoption of social distancing. Ignorance served as a potent disease vector.

LESSON 2: A leader tells hard truths in times of crisis, not falsehoods such as “Anybody that wants a test can get a test,” as Trump said on March 6 at the Centers for Disease Control and Prevention. A leader does not assume the mantle of expertise in areas where he or she has none. A leader accepts responsibility for personal and organizational failures. A leader cares more about saving lives than about winning reelection.

LESSON 3: “America first” is a singularly poor survival strategy in the middle of a global pandemic. No nation is safe from a microscopic agent that can hitch a ride on any airplane, ship, train or car. Building effective international organizations and alliances is a far better way of surviving a global health crisis than going it alone.

Supreme Court to hear another conservative challenge to Obamacare in the fall

The Supreme Court may never consider a more important case in a more precarious national moment than the one that 18 Republican states and President Donald Trump’s Justice Department have forced onto the docket this fall. Tens of millions of Americans could lose their access to health care and hundreds of millions could lose health care protections they’ve never needed more, as a result of the determination to repeal the Affordable Care Act.

If the GOP is successful, the case would have us return to the days when access to health insurance is no longer guaranteed and insurance companies decide who and what to cover and how much to charge. Elements of the ACA that are part of the fabric of our country would all be gone — protected coverage for preexisting conditions, a ban on lifetime coverage limits, allowing children to remain on parents’ plans until age 26, free preventive benefits, and requiring coverage for essential services like mental health and prescription drugs.

Wearing a mask all the time affects how we interact with each other. But how?

In the first days of the coronavirus pandemic, we were told masks weren’t necessary, maybe even counterproductive, even though they’d been common in Asia for years. Then a chorus of medical experts began raising alarm bells: Yes, of course we should wear masks, they argued, in the pages of the New York Times and the Washington Post and the Boston Globe. In early April, the Centers for Disease Control and Prevention (CDC) amended its guidelines, recommending that people wear “cloth face coverings in public settings where other social distancing measures are difficult to maintain.” In June, the World Health Organization stated that the public should wear masks “on public transport, in shops, or in other confined or crowded environments,” with medical masks preferred for people over age 60 or with preexisting conditions.

If healthcare workers wear surgical masks, there is good evidence that it limits the spread of respiratory viral infections in hospitals. But there is no clear evidence that surgical masks protect members of the public from getting or passing on these sorts of infections – most likely because of incorrect use. For cloth masks worn by the public, the picture is even murkier. Surgical masks are made up of several layers of non-woven plastic and can effectively filter very small particles, such as droplets of SARS-CoV-2 (the virus that causes COVID-19). The masks typically contain an external waterproof layer and an internal absorbent layer.  Although masks made from scarves, T-shirts or other fabrics can’t provide the same level of protection and durability as surgical masks, they can block some of the large droplets exhaled by the wearer, hence protecting others from viral exposure. But their ability to filter droplets depends on their construction. Multi-layered cloth masks are better at filtering but harder to breathe through. And they become wetter quicker than single-layer masks.