Independence holiday shadowed by viral variant and deep national divides

clevelandmask-300x236With every recent holiday, health officials have warned the public to exercise great caution and to maybe even avoid celebrations in hopes of holding down the spread and deadly consequences of the coronavirus pandemic. But not today.

Independence Day, 2021, is different. Optimism prevails across the country about the quelling pandemic. Tens of millions of Americans hit the roads and took to the skies, traveling with gusto for summer vacations. Gatherings, many of them huge and public, are common.

Will this hustle and bustle cause a difficult and divisive surge in coronavirus cases, hospitalizations, and deaths? And will July 4, 2021, mark not only the country’s 245th  birthday, but also the deeper divide of the United States into two nations — one vaccinated and with significant safety from a killer illness, and the other going without vaccines and their protection?

Recommended precautions in L.A.

In Los Angeles County, face coverings have returned — with mostly quiet resignation and with authorities rising concern about the fast-spreading Delta variant, a coronavirus mutation first detected in India but now sweeping this country.

Officials have not sounded alarms on the West Coast, where Delta cases are becoming the predominant strain diagnosed. But sprawling L.A., where large communities of the poor and people of color, remains vulnerable to major pandemic problems, even as it has high vaccination rates and has suffered earlier surges that likely left millions with some coronavirus protection.

The Biden Administration, which fell just short of its goal of getting 70% of Americans vaccinated with at least one dose by July 4, sought over the holiday weekend to both celebrate the progress made against the coronavirus while also recognizing its harms have not ended. Federal, state, and local officials are continuing the push to get the unvaccinated half of the country over its reluctance, resistance, or access challenges.

Federal officials also are working in “surge teams,” jetting to areas seeing coronavirus surges, particularly those involving the Delta variant, as the Washington Post reported:

“’These are dedicated teams working with communities at higher risk for, or already experiencing, outbreaks due to the spread of the Delta variant and their low vaccination rate,” White House coronavirus coordinator Jeff Zients told reporters at a news briefing. The Delta variant now represents about one-quarter of all confirmed coronavirus cases in the United States, and is now the predominant variant in Arkansas, Colorado, Missouri, and Utah, say public health experts. ‘In some regions of the country, nearly one in two sequences is the Delta variant,’ said Centers for Disease Control and Prevention Director Rochelle Walensky.

“The highly transmissible variant, first identified in India, is the ‘greatest threat’ to ending the U.S. outbreak, posing special risk to unvaccinated people, the nation’s top infectious-disease expert, Anthony S. Fauci, said last week … The White House-coordinated teams will include a mix of virtual support and on-the-ground personnel, helping deploy additional supplies as requested by local officials, such as testing or therapeutics. Staff will come from the [Centers for Disease Control and Prevention], the Federal Emergency Management Agency and the Office of the Assistant Secretary for Preparedness and Response in the Department of Health and Human Services. The White House also may ramp up paid promotions about the benefits of vaccination in areas that officials deem high risk.”

Vaccinations rise and they work

As of July 2, ~173 million Americans or ~67% of the population 18 and older had gotten at least one vaccine dose, and ~58% of this group is now fully vaccinated, federal officials reported. They also said that more than 78% of those 65 and older are fully vaccinated.

Vaccinations have proven themselves to be a powerful way to quash the pandemic, with the decision to first inoculate those most vulnerable — older Americans — proving a notable success, officials insist.

Persuading the unvaccinated has become a slow, person-by-person slog, with states in the South, Midwest, and Mountain West lagging in vaccinations and creating high-risk zones, experts say.

Critics are stepping up their pressure not only on the unvaccinated but also federal regulators, notably at the federal Food and Drug Administration. They say the agency is needlessly dragging its feet now in granting vaccines (especially those from Pfizer and Moderna) full approval, replacing the emergency authorizations granted for the products’ use.

Those vaccines, (and those from AstraZeneca), have been administered to tens of millions of patients around the globe, with recipients varying in sex, age, race, nationality, and ethnicity. Documented cases involving serious side-effects or deaths have been remarkably rare. Sure, the super cautious could wait yet more to see if long-term issues erupt with vaccines. But medical scientists say it would be highly unusual for such problems to suddenly show up, as vaccine problems usually appear quickly or not at all.

So, why doesn’t the FDA act? Critics have assailed the agency for the way it just expedited approval of a prescription drug targeted at Alzheimer’s patients. That approval was given with light and dubious evidence, with the agency also allowing widespread administration of the costly drug, though it was tested only in patients in the early stages of illness.

The full FDA approval of coronavirus vaccines would, for many, remove a last objection to the products’ use, notably among resistant groups, say, of health workers and first responders, critics say.

They also have not hesitated to suggest, especially with the rise of the Delta variant, that it may be past time for the “m” word to come into play — that is, for states and local governments to mandate coronavirus vaccinations, just as other shots are required for students in public schools, workers at many jobs, and travelers headed overseas.

Vaccination, of course, has become a political hobby horse, notably for Republicans and die-hard supporters of former President Trump. The counter factual, anti-science, and evidence-free opposition to vaccines is a significant reason, public polling shows, why the country has split over not only coronavirus shots but where the pandemic is or isn’t fading.

As the CDC has reminded: nearly all deaths now blamed on the coronavirus are occurring among the unvaccinated. Virtually all cases involving coronavirus cases serious enough to require hospitalization involved the unvaccinated.

In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damages that can be inflicted on them by an array of awful circumstances and things, including:

In these cases, a crowd of problem people and institutions — these can include doctors, hospitals, insurers, regulators, and politicians — may press victims to move on, settle up, and they fast forget the lonely agony of the suffering. It can, however, take a long time for patients to recover from terrible illness or injury. Harms can last a lifetime. Patients may need medical services, as well as financial and other support for months or years. They also need closure and justice for wrongs done, as well as the sense that they may be able to help others avoid the problems that afflicted them.

We are not done with the coronavirus and the huge trauma it has inflicted on us all — more than 600,000 deaths and tens of millions of infections. Please get vaccinated. All medical interventions carry risk. But vaccines’ benefits long have been shown to far outweigh their harms.

Photo credit: wearer of patriotic face covering, courtesy cleveland.com
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