COVID-19 Flashcards
COVID Vaccines: Evidence They Work - Forbes - January 2023
- Vaccines reduce the risk of severe illness, hospitalization, and death, though they are not 100% effective at preventing infection.
- A November 2022 study showed that vaccinated individuals were less likely to spread the omicron variant compared to the unvaccinated, especially those who were both vaccinated and previously infected. The November 2022 study on the Pfizer-BioNTech bivalent booster examined its effectiveness against Covid-19, particularly the omicron variant, showing it provided better protection than the original monovalent vaccine. The study likely involved comparing groups of individuals who received the bivalent booster with those who received the original vaccine or were unvaccinated, tracking Covid infections, hospitalizations, and severe illness over time. Researchers analyzed the data, adjusting for variables like age and prior infections, to measure the bivalent booster’s improved efficacy in reducing infection, severe illness, and transmission. - This study, released in November 2022 by the CDC, analyzed data collected through the national pharmacy testing program. The National Pharmacy Testing Program is a U.S. initiative developed to make COVID-19 testing widely accessible by partnering with pharmacy chains nationwide. Launched as part of the federal government’s efforts to expand testing access, this program allowed individuals to get tested at participating pharmacies like CVS, Walgreens, and Walmart, among others, regardless of their insurance status. The program was particularly helpful for gathering real-world data on COVID-19 trends, such as infection rates, effectiveness of vaccines, and variant spread.
- An April 2022 study found that bivalent boosters significantly increased protection against Covid-19, though the effect diminished over time.
- Pfizer-BioNTech’s bivalent booster was more effective against Covid than the original monovalent vaccine, particularly in protecting against the omicron variant.
- Long Covid refers to lingering symptoms after a Covid infection, and vaccination reduces the risk of developing this condition.
- A study found that mRNA vaccines were safe for children aged 5 to 11, offering strong protection against severe Covid outcomes.
- A study showed that two doses of an mRNA Covid vaccine are highly effective against the delta variant and moderately effective against omicron, with benefits for infants of vaccinated pregnant women. The study showed that two doses of an mRNA vaccine given during pregnancy resulted in 95% effectiveness in preventing hospitalization due to the delta variant and 97% effectiveness in preventing severe outcomes in infants. Against the omicron variant, maternal vaccination provided 53% protection against infection in infants and 73% protection against hospitalization. This study highlighted the added benefits of maternal vaccination in safeguarding infants from Covid-19 complications.
- Vaccines are estimated to have prevented 3.2 million deaths and 18.5 million hospitalizations in the U.S. from December 2020 to November 2022. It cites a research report by the Commonwealth Fund, which estimated that between December 2020 and November 2022, vaccines prevented 3.2 million deaths and 18.5 million hospitalizations in the U.S. alone. The vaccines, particularly the mRNA vaccines from Pfizer-BioNTech and Moderna, provided strong protection against severe illness, reducing the risk of hospitalization and death even for individuals who contracted the virus. The Commonwealth Fund is a private, non-profit foundation based in the United States that focuses on healthcare research and policy. Founded in 1918, its mission is to promote a high-performing healthcare system that achieves better access, improved quality, and greater efficiency, especially for low-income, uninsured, and vulnerable populations. The fund conducts research, issues reports, and provides grants to support initiatives aimed at improving healthcare delivery and outcomes, both in the U.S. and globally.
The Commonwealth Fund is well-known for its annual health system performance rankings, comparing U.S. healthcare with other high-income countries. It often advocates for policy reforms that expand healthcare access, improve care coordination, and enhance affordability, with a particular focus on underserved communities.
9. Four Covid vaccines are approved by the FDA, with different boosters available, and most Americans have received at least one dose. 10. Covid vaccines use different mechanisms (mRNA, viral vector, or protein subunit) to train the immune system to recognize and fight the virus. 11. Although Covid vaccines were developed quickly, prior research on related viruses and mRNA technology enabled rapid development without skipping critical safety steps. 12. While adverse events like myocarditis, anaphylaxis, and Guillain-Barré syndrome have occurred following vaccination, they are rare, and the risks from Covid infection are generally higher. 13. The FDA is considering simplifying the Covid vaccination process to align with the seasonal flu vaccine approach, with regular updates based on circulating strains. The article emphasizes that serious side effects from Covid vaccines are extremely rare compared to the risks of severe illness from the virus itself. Here’s a breakdown of the key side effects mentioned: 1. Myocarditis (inflammation of the heart): Rare, occurring in about 1,626 cases out of nearly 192.4 million vaccinated individuals. It’s more common in young men after the second vaccine dose but is less severe than myocarditis caused by a Covid infection. 2. Anaphylaxis (severe allergic reaction): Also very rare, occurring in about 5 cases per 1 million doses administered. 3. Guillain-Barré Syndrome (GBS): Linked to the Johnson & Johnson vaccine, with a rare occurrence, mostly in men over 50. 4. Thrombosis with Thrombocytopenia Syndrome (TTS): Also associated with the Johnson & Johnson vaccine, occurring in 4 cases per 1 million doses.
Excess Deaths Associated with COVID-19 in 2021/2022 - United Nations
New World Health Organization (WHO) estimates reveal that the COVID-19 pandemic caused approximately 14.9 million excess deaths between January 2020 and December 2021. This includes both direct COVID-19 fatalities and indirect deaths resulting from the pandemic’s impact on healthcare systems. The majority of excess deaths occurred in Southeast Asia, Europe, and the Americas, with middle-income countries experiencing 81% of the losses.
Excess deaths refer to the number of deaths during a specific period that exceed the expected number of deaths based on historical trends. For example, during the COVID-19 pandemic, excess deaths included not only those who died from the virus but also people who couldn’t receive timely medical care for other conditions due to the strain on hospitals.
Excess deaths are measured by comparing the actual number of deaths during a crisis to the expected number of deaths in the absence of that crisis. The expected death rate is typically derived from historical data, such as death rates from previous years, adjusted for factors like population growth and aging.
The World Health Organization (WHO) derives its data on excess deaths from a combination of sources. These include:
Official National Data: WHO collects mortality data from countries where reliable death registration systems are in place. These records reflect the number of deaths reported during the pandemic period.
Statistical Models: For countries where reliable data is unavailable or incomplete, WHO uses statistical models. These models estimate excess deaths by comparing the number of observed deaths during the pandemic to pre-pandemic trends, adjusted for population size and age distribution.
Health System and Crisis Data: Excess mortality includes not just direct deaths from COVID-19 but also deaths indirectly caused by strained healthcare systems and disruptions to essential services.
There is no evidence to suggest that the World Health Organization (WHO) has intentionally lied about data. However, the organization has faced criticism over its handling and communication of certain health crises, particularly during the early stages of the COVID-19 pandemic. For instance, some accused WHO of relying too heavily on information provided by China and being slow to declare a public health emergency. Critics argued that this may have delayed global responses.
However, it’s important to differentiate between intentional deception and errors or delays in communication due to political, logistical, or informational challenges. WHO operates in a complex environment where it depends on data from member countries, which can vary in quality and timeliness. Transparency and trustworthiness are core to its operations, but like any large organization, it can face challenges, especially in real-time crises.
Hospitals Hitting Record Highs in 2020 - NPR
COVID-19 hospitalizations have reached record highs, with nearly 62,000 patients admitted nationwide, surpassing previous surges from earlier in the pandemic. However, the burden is not evenly distributed, with the West and Midwest experiencing severe strain. Health experts warn of multiple hotspots forming across the country, which could overwhelm hospitals and limit the ability to redistribute resources. In some states, COVID-19 patients now occupy more than 10% of hospital beds, signaling a growing risk to healthcare systems. Hospitals are also facing critical shortages in ICU space, staff, and equipment, which could force difficult decisions like rationing care. Some hospitals, particularly in rural areas, are nearing capacity and may struggle to manage the surge without external support.
COVID Overwhelming Hospitals in 2021 - The BMJ
The American Hospital Association (AHA) has urged the federal government to release over $48 billion to help U.S. hospitals cope with a 43% surge in COVID-19 hospitalizations, particularly in poorly vaccinated Southern states. In a letter to Health and Human Services Secretary Xavier Becerra, AHA President Richard Pollack described the alarming rise in cases and ICU occupancy, which is stretching hospital resources. The delta variant, now causing over 90% of new cases, is overwhelming hospitals, with younger unvaccinated patients filling ICU beds. Texas faces a severe shortage of nurses and has requested federal assistance to manage the crisis.
The American Hospital Association (AHA) is generally considered a credible and trustworthy organization. As a representative body of over 5,000 hospitals in the United States, it plays a key role in advocating for policies that benefit the healthcare system and improve patient care. The AHA provides resources, data, and policy recommendations based on the collective needs of hospitals and healthcare systems.
The American Hospital Association (AHA) has been involved in some controversial issues, particularly regarding transparency and healthcare pricing. One notable incident is its opposition to a federal rule requiring hospitals to make their prices public, which led to a lawsuit. The AHA argued that the rule would burden hospitals, but it lost the legal battle, drawing criticism for resisting transparency efforts. In 2023, the AHA also sued the Biden administration over a policy related to the collection of patient data, claiming it exceeded the scope of the Health Insurance Portability and Accountability Act (HIPAA).
These controversies do not necessarily indicate that the AHA manipulates data, but they show the organization’s willingness to challenge policies that could affect hospital operations.
Hospital Being More Overwhelmed by the Flu and RSV in 2022 - CNN
Hospitals in the U.S. are experiencing their highest occupancy levels of the pandemic, with over 80% of beds in use nationwide, due to a surge in respiratory viruses like the flu and RSV. While COVID-19 accounts for only 6% of occupied beds, the flu has driven a sharp increase in admissions, especially among older adults and young children. Workforce shortages and a backlog of patients who delayed care during the pandemic are further straining hospital capacity. Pediatric hospital beds have been especially full, with 76% occupancy, and some states are reporting critical staff shortages.
RSV stands for Respiratory Syncytial Virus, a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover within a week or two, but RSV can be serious, especially for infants, older adults, and people with weakened immune systems. It is a leading cause of respiratory illness in young children and is also known to cause infections in the lungs and respiratory tract.
The high surge of flu and RSV hospitalizations seen in the aftermath of COVID-19 likely would not have been as severe if not for the pandemic. Several factors contributed to the unusually high hospital burden:
- Reduced Immunity: During the pandemic, widespread measures like mask-wearing, social distancing, and lockdowns significantly reduced exposure to common viruses like flu and RSV. This led to a decline in natural immunity in the population because people were not getting exposed to these viruses as much. When restrictions were lifted, immunity had waned, leading to a sharp increase in cases as people became more susceptible.
- Delayed Exposure in Children: Many young children had little to no exposure to RSV and the flu during the pandemic, which delayed their first encounters with these viruses. This led to an increase in cases, particularly among infants and toddlers who were encountering RSV for the first time during the 2022-2023 season.
- Healthcare Strain and Workforce Shortages: The pandemic caused ongoing strain on healthcare systems. Many healthcare workers retired or left the profession due to burnout, and hospitals were left understaffed. This workforce shortage made it more difficult to handle any surge, including one driven by flu and RSV.
- Delayed Medical Care: People avoided or delayed medical treatment during COVID-19 surges, which led to worsened health conditions that required more intensive care when they finally did seek help. This backlog added to the burden hospitals faced as respiratory viruses surged.
Use of Stay-at-Home Orders and Mask Mandates to Control COVID-19 Transmission — Blackfeet Tribal Reservation, Montana, June–December 2020 - CDC
The study highlights how targeted community mitigation measures significantly reduced COVID-19 incidence in the Blackfeet Tribal Reservation. After the first COVID-19 case was reported on June 16, 2020, the Blackfeet Tribal Business Council implemented several strategies, including stay-at-home orders and a mask mandate. Following the issuance of a strictly enforced stay-at-home order on September 28, COVID-19 incidence dramatically decreased from a peak of 6.40 cases per 1,000 residents per day on October 5 to 0.19 on November 7.
The analysis noted that the early implementation of health measures, such as widespread testing, contact tracing, and strict enforcement of public health guidelines, contributed to maintaining low incidence rates during the summer months. However, a rise in cases occurred after relaxation of these measures and community gatherings, leading to a significant spike in infections. The subsequent strict enforcement of a stay-at-home order and mask mandate were critical in reversing the trend and reducing transmission.
The Blackfeet Tribal Reservation, located in northern Montana, is home to the Blackfeet Nation, one of the largest Native American tribes in the United States. Covering approximately 1.5 million acres, the reservation is known for its stunning landscapes, including the Rocky Mountains and Glacier National Park, which borders its western edge. The Blackfeet people have a rich cultural heritage that includes traditional practices, language, and governance.
Established through treaties in the 19th century, the reservation was originally much larger but was reduced in size due to various legal and political pressures. Today, the population is estimated to be around 10,629, primarily consisting of individuals who identify as American Indian or Alaska Native. The Blackfeet Nation is governed by a Tribal Business Council that oversees various aspects of community life, including health, education, and economic development .
The tribe engages in numerous initiatives to promote cultural preservation, economic sustainability, and community health, including the recent measures taken during the COVID-19 pandemic to protect its members.
The CDC study on COVID-19 incidence among the Blackfeet Nation was conducted through a comprehensive approach that included data collection, case investigations, and analysis of community mitigation measures. Here are the key components of the study:
Data Collection: The study utilized deidentified laboratory and case investigation data gathered from multiple local health entities, including tribal health clinics, the Indian Health Service, and other healthcare facilities. This data encompassed various patient demographics, such as age, sex, race, and exposure history.
Case Definition: A COVID-19 case was defined as a resident of the Blackfeet Tribal Reservation who received a positive result from a SARS-CoV-2 test, whether a nucleic acid amplification test or a rapid antigen detection test.
Community Mitigation Measures: The study assessed the impact of three specific community mitigation resolutions enacted by the Blackfeet Tribal Business Council. These included mandatory and recommended stay-at-home orders, as well as a mask use mandate. The enforcement of these measures was crucial, with penalties for violations increasing significantly for the third order.
Statistical Analysis: Incidence rates were calculated as the daily number of new COVID-19 cases per 1,000 residents. Data were analyzed using statistical software (SAS version 9.4), allowing researchers to examine trends in COVID-19 cases before and after the implementation of the mitigation measures.
Surveillance and Follow-Up: The local public health nurses were responsible for abstracting case investigation data, monitoring exposures, and conducting follow-ups on confirmed cases.
Limitations and Considerations: The study acknowledged several limitations, including potential misclassification of cases due to the use of different testing methods and incomplete exposure data. It highlighted the importance of considering multigenerational households, which might contribute to transmission dynamics in the community.
Facemasks and Lockdowns Slow the Spread of COVID - 2020 - Reuters
Numerous studies have shown that wearing face masks effectively reduces the spread of COVID-19. A CDC study in January 2021 demonstrated that combining a cloth mask with a surgical mask, or knotting and tucking the surgical mask, can reduce exposure to infectious aerosols by over 90% in lab settings. Additionally, a Kansas study found that counties with mask mandates experienced declining COVID-19 rates compared to those without mandates. Similarly, the Proceedings of the National Academy of Sciences reported significant shifts in infection trends in Northern Italy and New York City after implementing mask-wearing rules. Regarding lockdowns, experts from Johns Hopkins University confirmed that lockdowns do reduce SARS-CoV-2 transmission, advocating for more targeted restrictions to balance public health and economic concerns. As of 2021, COVID-19 has led to over 28 million cases and over 500,000 deaths in the U.S., marking a significant decline in average life expectancy.
The Kansas study, conducted by researchers from the University of Kansas and published in Nature Human Behaviour, compared COVID-19 rates in counties with mask mandates to those without between June 1 and August 23, 2020. The findings showed that counties with mask mandates experienced a decline in COVID-19 rates, while those without mandates saw a rise in cases. This indicated that mask mandates were effective in reducing the spread of the virus.
The study published in the Proceedings of the National Academy of Sciences (PNAS) investigated the effects of mask-wearing mandates in New York City and northern Italy during the COVID-19 pandemic. The research found that infection trends significantly changed following the implementation of mask mandates in these regions.
In New York City, mask mandates were introduced on April 17, 2020, while in northern Italy, they were implemented on April 6, 2020. After these mandates were put in place, researchers observed a notable decline in the transmission rates of COVID-19. This was particularly significant because both areas were among the hardest hit during the early stages of the pandemic.
The Johns Hopkins study on lockdowns reviewed the effectiveness of various public health measures, including lockdowns, in reducing the spread of COVID-19. Researchers, including Dr. Elizabeth Stuart and Dr. Stuart Ray, affirmed that lockdowns are effective in decreasing the transmission of the virus. They emphasized the importance of a “targeted” or “proportional” approach, which balances the need for restrictions to limit infections with considerations for economic and mental health impacts.
Even with improved treatments, COVID’s death rate is still 60% higher than for the flu - 2023 - Fortune
A study conducted by researchers at the Veterans Affairs St. Louis Health Care System found that COVID-19 was 60% deadlier than influenza, with a mortality risk of about 6% among adults hospitalized in the U.S. last winter, compared to the flu’s death rate of 3.7%. Despite improvements in immunity and treatment, COVID-19 continues to result in more hospitalizations than influenza, with patients experiencing severe complications such as acute kidney injury, septic shock, and cardiovascular issues. The analysis, published in JAMA, highlighted the increased mortality risk for unvaccinated individuals, underscoring the importance of vaccination in reducing COVID-related deaths.
COVID has frequently drawn comparisons with influenza, another viral respiratory disease, including by former U.S. president Donald Trump. The Centers for Disease Control and Prevention estimates that about 22,000 Americans died from influenza in the 2019–2020 flu season, whereas COVID killed about 350,000 in 2020.
Compared with flu patients, those hospitalized with COVID had a greater risk of acute kidney injury, severe septic shock, life-threatening blood clots, and a range of dangerous cardiovascular complications, Al-Aly showed in a study in 2020.
Changing nature of COVID: Is it just a regular winter bug now? - 2023 - BBC
There is plenty of evidence to suggest the virus is on its way to becoming just another respiratory bug to contend with, alongside flu and others maybe lesser known, such as respiratory syncytial virus (RSV), rhinorvirus and adenovirus.
All carry risks - particularly to those with certain health conditions and compromised immune systems, who are advised to take precautions, including getting the available vaccinations and limiting contact with people with symptoms.
Last winter there were estimated to be more flu deaths than Covid ones, in England - just over 14,000 compared with 10,000 - according to the UK Health Security Agency.
The immunity to serious illness built up from vaccination and infection means the death rate per Covid infection is now well below that of flu, he says.
Although there was a lot more Covid around in 2022, with a series of peaks over the 12 months, rather than it being largely confined to the winter months like other respiratory viruses - so for the year as a whole, the Covid death toll would outstrip that of flu.
But, crucially, that trend has not been repeated in 2023. Instead, there is a much more seasonal pattern to the virus, with a long lull during spring and summer.
The colder months tip the balance, he says, because of more indoor mixing and lower temperatures, which affect susceptibility to infection as well as allowing the virus to survive for longer outside.
It is also hard to judge to what extent Covid deaths are coming on top - or instead - of flu. Combined, the number of Covid and flu deaths last winter was on a par with the worst two winters of the past decade.
The changing nature of Covid also poses an interesting question about testing - is there any point to it?
The era of free Covid tests may be over but plenty of people still test when they feel ill. Although, the experts have their doubts about whether this is entirely necessary.
The fact that there were more flu deaths than COVID-19 deaths in certain periods does not mean that COVID-19 was insignificant. While it’s true that the flu has historically caused substantial mortality, especially in specific seasons, several factors highlight the ongoing threat posed by COVID-19.
Comparative Mortality Rates: Although COVID-19 deaths may have been lower in certain seasons, the overall mortality rate for COVID-19 has been significantly higher than that of the flu. For instance, a study noted that last winter saw around 10,000 COVID-19 deaths compared to over 14,000 flu deaths in England . However, prior to vaccination, COVID-19 had a much higher mortality risk per infection, and it was associated with more severe complications .
Long-term Effects: COVID-19 can lead to long-term health issues (often referred to as “long COVID”), which are not as common with the flu. This includes complications affecting multiple organ systems, which can have lasting effects on health .
Hospitalization Rates: The hospitalization rate for COVID-19 was also much higher than for influenza, which indicates a greater burden on healthcare systems during peak infection periods .
Emerging Variants and Public Health: The potential for new variants to arise and lead to increased transmissibility or resistance to vaccines remains a concern. Public health experts warn that dismissing COVID-19 as merely another flu could lead to complacency and hinder preparedness for future outbreaks .
COVID-19 vs. Flu Mortality Rates
A recent analysis of Veterans Affairs data found that patients hospitalized with COVID-19 had a higher mortality rate than those hospitalized with influenza during the fall and winter of 2023-2024. Among over 11,000 hospitalized patients, 5.7% of COVID-19 patients died within 30 days of admission, compared to 4.24% of influenza patients. After adjusting for variables, the risk of death for COVID-19 patients was 35% higher than for influenza patients. Despite the higher COVID mortality, researchers noted a decrease in its relative deadliness compared to the previous season when it was 60% more deadly than the flu. Importantly, the COVID-19 hospitalizations were nearly double those for influenza during the same period, indicating a continued significant burden from COVID-19, especially with a substantial portion of patients having received multiple vaccinations. The study also reported no significant difference in mortality risk associated with the emergence of the JN.1 variant of SARS-CoV-2, suggesting it may not be more severe than prior variants. However, the authors acknowledged the limitations of their study, which included a predominantly older and male population, which may affect the generalizability of the results.
In the winter of 2023, the estimated flu deaths in England exceeded COVID-19 deaths, with reports indicating around 14,000 flu-related deaths compared to about 10,000 for COVID-19 . However, while the total number of flu deaths was higher, recent studies indicate that patients hospitalized with COVID-19 still faced a greater risk of mortality compared to those hospitalized with influenza .
The analysis of Veterans Affairs data revealed that the death rate for hospitalized COVID-19 patients was 5.7% within 30 days, compared to 4.24% for those with influenza, indicating a 35% higher risk of death for COVID-19 patients. Thus, even though more people may have died from the flu overall during that specific period, COVID-19 still posed a higher risk for those who were hospitalized.
