The degree of protection afforded by any vaccine can be understood in terms of its efficacy and its effectiveness. The distinction between the two terms is important. Efficacy refers to the reduction in biologically proven illness (detected serologically or via culture of the virus from the patient), whereas effectiveness refers to the reduction in clinical consequences, which, for infectious disease like influenza or Covid-19, includes pneumonia, hospitalization, and death.
The influenza vaccine has a variable efficacy; it is not terrific at preventing infections (50%) in years where the vaccine is not well matched to circulating strains of the virus, better (90%) when it is. But the more important purpose of getting vaccinated is in preventing hospitalizations and death. The flu vaccine reduces hospitalization by 90% in healthy adults. More importantly, it decreases the risk of death in the elderly, where most deaths occur, by 20-50%.
The stimulus is necessary medicine | The Healthiest Goldfish
Imagine the day you, the reader, get the COVID-19 vaccine. Think about what that day will look like. You will wake up in your home or apartment. You will shower. You will eat breakfast. You will get in your car, perhaps using your smartphone for directions to the vaccination site. Then you will go get the vaccine. Which of these activities will be most supportive of health? You might say getting the vaccine. But imagine what your day would be like if you got the vaccine, but took none of the other actions. Imagine you do not wake up in a home because you do not have one, or perhaps you have one but it lacks the reliable water and heating that allow you to shower and stay warm in winter. Imagine you skip breakfast because you have no food. Imagine you walk to the vaccination site (say, three or four miles) because you have no car. Imagine you spend an extra hour outside because you get lost without a smartphone to help you navigate. You get the shot, but how healthy can you really be, if you get it in such a context? Important as the vaccine is for you, it is clear that if your life continues to unfold amid such deprivation, it will not be healthy, and may not even continue very long.
Political Decisions and Science | The Turning Point
The Boston Globe, our local newspaper, led with a story last month entitled “A warning on relaxing too soon," subtitled “Epidemiologists say take it slow after Baker eases some pandemic restrictions." The article noted that, citing an improvement in the pandemic curve, Massachusetts Governor Baker announced an overnight advisory for residents and that he would relax rules requiring many restaurants to close at 9:30 PM. The article went on to quote several experts about this, all of whom warned that this adjustment came too soon. Tellingly to our mind, one of the experts quoted was “not privy to all the data the Baker administration has and acknowledged that there are economic and psychological factors to consider when it comes to assessing restrictions.”
We could not agree more and argue strongly that fundamentally decisions about societal actions — including around Covid-19 — have to be political decisions that include the science but also must balance a range of other considerations. In the same weekend for example, we saw stories about surges in suicides among school-age children in Las Vegas, resulting in school re-opening, a scenario long anticipated by the CDC. Surely such reports should be a consideration in decisions made to maintain or relax restrictions.
What Science Can and Cannot Do in a Time of Pandemic | Scientific American
Authored by Nason Maani and Sandro Galea.
The COVID-19 pandemic is at the core of a triple crisis facing the U.S. population. The economic impact, both as a direct consequence of the pandemic and from the cost of accompanying mitigation measures, is the second element of the crisis; it has manifested in lingering high levels of unemployment, with some 26.8 million workers, almost 16 percent of the entire U.S. workforce, either unemployed, otherwise prevented from working by COVID-19, or employed but on reduced pay.
Linked to both are the exacerbating effects of the third element of the crisis: the civil unrest and protests linked to systemic racism. While these emerged last year in response to the killing of Black Americans at the hands of police, long-standing racial inequities have also resulted in the overrepresentation of minoritized groups among those exposed to COVID-19, those experiencing severe infections and deaths, and the ranks of the unemployed.
How to get healthier and wealthier during a pandemic | The Healthiest Goldfish
There are many ways in which Congress falls short of representing the American population. For example, 22% of members of the 116th congress are racial or ethnic minorities, even though non-whites are 39% of the country. Women are approximately 25% of congress, despite being 51% of the population. But perhaps the most remarkable identity difference between members of congress and the country they represent is on a different axis: education. 5% of members of congress do not have a 4-year college degree. 65% of Americans do not have a 4-year degree. Of course, we know that persons without a college degree are scarcely found in a broad range of lead institutions—including courts, newspapers, universities—where consequential decisions are made, or where the ideas and stories that inform those decisions are articulated.
Now there are many reasons, some good, for this discrepancy. We may want our elected leaders to be well educated, presuming that that education provides wisdom and perspective that has utility in governance. We know that to have a career in universities or media organizations one has to have gone to college, both to achieve the credentials that have one accepted into the relevant “guild”, and simply because everyone in those institutions does, making this a required “badge” for admission.
Who Goes First? | The Turning Point
The rollout of the Salk polio vaccine did not go smoothly. In April 1955, it faced critical shortages. When the vaccine was approved, the Secretary of Health, Education, and Welfare did not have a single injection available; the campaign to cure polio was to be funded by charitable donations. But the polio vaccine rollout did have one element well worked out: there was a clear priority system, a waiting line with the youngest and most vulnerable kids first. Everyone else had to wait.
The situation is different with the rollout of the Covid vaccine. We do know that children, reasonably enough given the epidemiology of the disease, are not a priority. But who is? While most states have health care workers at the front of the list, followed by those with severe health risks, it is not at all clear how we should prioritize within each group. Should people of color be offered the front of each line? Are risks additive? Should an elderly essential worker go ahead of someone who is merely elderly? Do we prioritize recent hot spots?
Looking Ahead, with Hope | SPH This Week
One of the enduring highlights of working at a school is the regular return of the academic seasons, and, with it, the chance to welcome our community back for a new semester, and to welcome the students who are joining us for the first time this spring. This year, the joy of welcome is tinged with sadness. Last week, the number of COVID-19 deaths in the US exceeded 400,000, a toll of sorrow which adds to the overall weight of sickness and death this disease has brought to the world. Yet even, perhaps especially, in the midst of challenge, we are grateful to be connected, and to pursue the goal of a healthier world. So, welcome to all, and, especially, to our newest students.
We begin our Spring semester at a moment of transition. The inauguration of President Joe Biden and Vice President Kamala Harris represents a political sea change, and, with Vice President Harris and the many firsts her rise reflects, a win for representation in government. Concurrent with this transition, we have also seen a potential turning of the tide in this pandemic. Sadly, ending COVID-19 cannot be accomplished as quickly as a presidential transition. However, the emergence of vaccines, and the new administration’s commitment to their effective distribution, represents what we will hopefully soon be able to say was the beginning of the end of this crisis. So, while the hour remains difficult, we have finally reached a point where we can see the dawn of a better day for health.
Why health, why here, and why now | The Healthiest Goldfish
I would like to talk to you about health.
This is, of course, practically all we have been doing for the past year, as the Covid-19 pandemic has raged. However, I would argue we are at a unique point in our history, a time for a new focus on our conversation about health.
This week, the US saw both the inauguration of a new president and its Covid-19 death toll surpass 400,000. With the pandemic looming so large, it is possible to forget that other issues even exist outside of Covid-19. But it is precisely because this moment is so acute that I think it is important to step back, and focus on some of these very issues that will be with us long after Covid-19 has passed by.
My overall approach is told perhaps most efficiently by way of a story, one you may have heard before, if you have read my work or attended one of my public talks.