#covid 19 isolation policy

[lycorogue]

[Image ID:

Image 1: Screenshot of a tweet from KTLA 5 (@KTLA). Tweet reads "California health officials shorten COVID isolation period to 1 day" and includes a link to their news article about it. Link displays a picture of a positive COVID test, includes the website link (KTLA.com) and includes the headline "California health officials announce shorter COVID isolation guidelines"

Image 2: Screenshot of a sentence from the article. It reads "California health officials have shortened the COVID-19 isolation guidelines for those who test positive as the department aims to focus more on people who are the most at risk of severe illness while also working to minimize school and workplace disruptions." The following portion of that sentence is highlighted for emphasis: "...to minimize school and workplace disruptions."

/end ID]

Link to the referenced article from the Los Angeles-based news company. The screenshotted sentence is the opening of the article.

I'd also like to point out that the article was published January 18, 2024, but references that these changes already went into effect as of January 9, 2024! Way to be on top of things, KTLA.

lol. lmao even

[ayeforscotland]

Uhhh... What the heck is the black myth wukong dos and donts document???

So it's fairly common that when you get a review code for a game, it's accompanied by a document on what you can show prior to the game's release.

For example, when I got a early review code for Flintlock: The Siege of Dawn, I was asked not to show gameplay after a certain point. This is so creators can't race to film the whole game and release a full playthrough before the game actually launches.

However...Devs behind Black Myth Wukong had some wild stuff in theirs. They are the following:

Do NOT insult other influencers or players.

Do NOT use any offensive language/humour.

Do NOT include politics, violence, nudity, feminist propaganda, fetishisation, and other content that instigates negative discourse.

Do NOT use trigger words such as 'quarantine' or 'isolation' or 'Covid-19'.

Do NOT discuss content related to China's game industry policies, opinions, news, etc.

Number one is fairly standard. 2 is highly subjective and for other games tends to more explicit i.e "Do not use any curse/swear words". This is also hugely dependent on the content - Some sponsors don't want to be associated with swearing while an 18+ game wouldn't care.

Number Three is absolutely wild. Not including violence in an already violent game? Saying you can't talk politics? Nudity is often against TOS for most platforms anyway. "Feminist propaganda" whatever the fuck that is.

Number 4 is absolute parody. Nobody playing would have been talking about Covid?

Number 5 is also ridiculous. Of course the Chinese games industry is going to be talked about. It's a game made by a Chinese developer?

Having 3,4 and 5 in the mix actually raises much more questions. No idea who thought it was a good idea to include this in a Dos and Don't document for creators.

[covid-safer-hotties]

Also preserved on our archive

By Nicole Karlis

Far from rare, long COVID in kids is devastating families. Experts say schools can do more to help their students

In January 2022, Jennifer Robertson’s now 11-year-old son, Fergus, developed long COVID, a condition in which the symptoms of COVID-19 linger for months or even years. Due to his symptoms, he missed nearly six weeks of school after his first infection. He’d be in and out of the classroom for the rest of the school year.

Robertson never knew how her son would feel day to day. After three months of daily fever spikes, red eyes, and chest pains, the family pulled him out of their school to be homeschooled for a year. There was hope when he returned to in-person school last year at a private, and more flexible, school.

But then he caught the virus, again. This year, as many kids returned to school, Fergus returned to home education. Robertson told Salon in a phone interview that this is to “both to catch him up on things that he needed help with or missed and to try to avoid the non-stop repeat infections that come from school."

But additionally, the lack of COVID-19 precautions in schools is a deterring factor to sending him in-person. “We feel we will never heal from this as long as schools have no ventilation, open windows, air purifiers, and policies that children and staff can come to school while actively positive with COVID," Robertson said, adding that she and her family feel “forgotten” as the 2024 school year begins.

“The days, months, and years are rolling by with no precautions from school,” Robertson elaborated. “All the while more children join families like ours every day, due to complete and utter negligence from those around us and the authorities who have the power to change things for the better.”

Robertson and her family are based in the United Kingdom, but the lack of coronavirus protections in educational settings follow an international trend. In 2022, schools across the United States started to relax their masking policies, making them “optional.” Today, seeing a kid wearing a mask in class is a rarity.

The U.S. Centers for Disease Control and Prevention changed their guidance earlier this year, now suggesting people treat COVID like other respiratory illnesses, such as flu and RSV. That means when a kid is sick with COVID, they no longer have to stay home in isolation for five days. All they have to be are fever-free for 24 hours. The change in guidelines eased concerns about absenteeism, which became a significant worry during the pandemic. Research has found that chronic absenteeism, or missing at least 15 days of school in a year, affects academic outcomes. However, the relaxed approach in schools and society is leaving kids with long COVID behind.

“Schools must make it safe for all children that attend, whether they currently suffer from long COVID or not,” Robertson said. “Many children are potentially just one more infection away from developing the debilitating effects of long COVID.”

A study published in February 2024 estimated that up to 5.8 million children have long COVID. Recently, some health experts declared this a public health crisis among the pediatric population. In a more recent study, led by the National Institutes of Health’s RECOVER Initiative, researchers asked caregivers to tell them about the symptoms that their children or teenagers had been experiencing more than four weeks after a COVID infection. For some children in the study, that meant their symptoms lingered for three months after their infection. For others, it was up to two years.

For many kids with long COVID, returning back to school means not attending school at all.

“That’s because of the severity of the illness that they are living with, and also, in part, the lack of flexible and hybrid opportunities there are for education,” Sammie McFarland, the CEO of Long COVID kids, a UK-based, international non-profit that advocates for families and children with long COVID, told Salon. “In education, one of the biggest challenges is for educators to understand long COVID, and without that understanding, it makes it very difficult for there to be a good home and school relationship.”

For children with long COVID, McFarland told Salon she sees a lot of “breakdown” between schools and families due to the lack of understanding about the condition, which she believes stems from poor public health messaging. The impact is significant on the children themselves who want to be in school and miss their previous school lives.

“The children tell us they miss their community, they miss being part of their school life, they miss their friends, and they miss feeling included,” McFarland told Salon. “The whole education system is really set up to achieve, and when the young person is not able to do that because health challenges take over, there's an enormous sense of loss, grief and disappointment.”

Long COVID Kids has put together a series of recommendations for educators to better accommodate children with long COVID. The recommendations include educators being flexible when health needs take priority over education. When children with long COVID are out of school, the organization recommends that educators maintain contact with the children and facilitate a sense of belonging to give kids a sense that they will be welcome back when they return. In the school, they recommend flexible timetables and providing kids with long COVID a calm environment when they need a break to rest.

Alternative school options have been a saving grace for many long COVID families. Laura Covington’s son Matthew, who lives in Virginia, contracted the virus in January 2021. At first, his symptoms were mild. But a month later, Matthew started having chest pain, a rash, and body aches. At first, his school was understanding about his condition. But towards the end of that school year, Covington said, the school told him that his regular absence was a disruption. That was one of the few reasons they left that school. Today, he attends an outdoor school.

“These kids are outside 60 percent of the day in all kinds of weather,” Covington said. “And that was favorable for Matthew, just mitigating the risk of any of the germs that typically float around schools.”

When Salon spoke to Covington, they were on day 26 of the school year. However, Matthew had only attended for three and a half days. However, it’s not a problem for the school, Covington said.

“They've really worked around his medical needs as well as his social and emotional growth,” Covington said. “And I think that's really important for schools to do, and we recognize that a lot of schools, especially public schools, are not doing that.”

But some are stepping up. For Robin Scott, based in California, she has been able to find a school that is accommodating to her daughter, Katie. After she and her family got infected with COVID in August 2021, Katie was in and out of the emergency room. Blood tests showed she had elevated markers for MIS-C, a rare but severe illness that can occur after a COVID infection. For the rest of the school year, the five-year-old struggled with various symptoms causing her to be in and out of school. Today, the third grader is in a supportive educational environment, Scott said.

“Our school has been amazing,” she said. “Having that relationship with the school has been huge for my peace of mind, and for Katie's well-being, and she's got friends that are super supportive of her and understanding.”

[leam1983]

Your boss isn't your friend. Your HR rep isn't your friend either.

You get sick, they'll send a Get Well Soon card and then find a scab to take your place. You die, and you'll turn into a statistical inevitability that's common in any personnel roster. That's regardless of the disease being discussed.

If you're jobhunting, pay close attention to a company's claimed employee benefits. Speak to people, if you can. Join employee groups on other platforms, and see if the benefits outweigh the risks.

Stay safe. Your health matters more than any company's bottom line.

[allthecanadianpolitics]

Some recent COVID-19 news

Growing Concern for back to school as data shows rising COVID cases in B.C.

A grassroots group of health professionals are calling for British Columbia to reinstate mask mandates in schools and hospitals to prevent a repeat “tripledemic” of COVID-19, RSV and influenza infections that pushed the province’s hospitals to the brink last fall.

And with data showing rising COVID-19 cases in B.C. and two new viral subvariants on the horizon, Protect Our Province B.C. says the province should act sooner rather than later.

The group is composed of more than a dozen doctors, nurses, researchers, teachers and professionals who advocate for evidence-based pandemic policies.

“We know from last year kids and schools were hit hard and if the goal is to keep kids learning in school we need to do what we can to prevent virus spread this fall,” said Dr. Lyne Filiatrault, a retired emergency room physician in Vancouver and a member of the group.

COVID response confounds SARS expert

As COVID-19 surges globally, a leading infectious disease specialist is confounded by the lack of pandemic mitigation measures in Ontario.

Q: What is your advice for people who want to stay safe this fall?

Dr. Dick Zoutman: “One is to be informed. I do recommend Dr. Tara Moriarty’s website — COVID19resources.ca,” Zoutman said. “We owe her a large debt.”

Second, when the latest COVID-19 vaccine is available, “get it,” he recommended.

Third, “buy N95 respirators and make sure you have plenty and have one with you all the time. And when you go into an indoor public space — be it a hospital, a bank, a grocery store, school — put it on. The best ones are the ones that go around your head, because they’re tighter.”

Fourth, antigen rapid tests must be made widely available. “If you have any symptoms, you need to test and isolate yourself.”

Finally, avoid indoor public places this fall, he said. “I haven’t eaten in a restaurant in almost four years, and I don’t intend to.”

[seulszn]

WHAT’S GOING ON IN HAITI 🇭🇹

Haiti is a country in the Caribbean and Latin America that has been exploited and oppressed by colonial powers and imperialist forces for centuries. Its people have suffered unimaginable horrors and atrocities. Haiti was the first Black republic in the world, and the second independent nation in the Americas and the first Latin American country It achieved its independence in 1804, after a successful slave revolt against France. Haiti's independence was a threat to the racist and capitalist system that dominated the world. It inspired other enslaved and oppressed people to fight for their freedom and dignity. Haiti was also punished for its independence by the colonial powers. It was forced to pay a huge indemnity to France, and faced trade embargoes, diplomatic isolation, and military interventions.

Haiti was also exploited by multinational corporations and NGOs, who profited from its cheap labor, natural resources, and humanitarian aid. They also imposed their agendas and policies on the Haitian people, undermining their sovereignty and democracy. Haiti was also devastated by natural disasters, such as earthquakes ( a earthquake they are still recovering from that happened in 2010 and then a earthquake that happened in 2021 that killed 1,419 people) hurricanes, and floods, which worsened its already dire situation. Haiti was also victimized by diseases, such as cholera, malaria, and COVID-19, which ravaged its population and health system. The diseases were often introduced or exacerbated by foreign actors, such as the UN peacekeepers who brought cholera to Haiti in 2010. Haiti was also marginalized and silenced by the mainstream media, which portrayed it as a hopeless and helpless case, ignoring its history, culture, and achievements. The media also spread misinformation and stereotypes, fueling racism and stigma.

Haiti was also betrayed and abandoned by its allies and neighbors, who turned a blind eye to its plight, or worse, contributed to its misery. The United States of America, in particular, has a long history of meddling and undermining Haiti's sovereignty and stability. Taking 500,000 dollars from Haitian banks and still collecting money. The United States of America has invaded, occupied, and intervened in Haiti numerous times, imposing its political and economic interests. It has also exploited Haiti's labor and resources, and blocked its development and trade. sugar refining, flour milling, and cement and textile manufacturing, clothing, scrap metal, vegetable oils, dates and cocoa are all things given to other countries by Haiti. The United States of America has also supported and funded the Core Group, a coalition of foreign powers that has interfered in Haiti's internal affairs, manipulating its elections, constitution, and government. The United States of America has also failed to protect the human rights and dignity of the Haitian people, both in Haiti and in the US. It has deported and detained thousands of Haitian refugees and asylum seekers, and discriminated and criminalized them.

Here are a list of countries who agreed to help the United States and Canada evade Haiti:

Germany

France (the same country that we had to pay just to be free)

Benin

Jamaica

Kenya

Yes I am Haitian my dad side is from Haiti. My fathers family moved up here to Seattle because Haitian was going through a small silent genocide and have been since they have been free from France in 1804, France took my countries money and told them that they have to pay reparations just for existing and they had to pay France just to be free from the French. And then America jumps onto the bandwagon and decides to take billions of dollars from Haiti. Haiti was once the richest country but became the most poorest because of ignorance.

My people are being killed everyday just for speaking out against their government, my people are being killed because nobody was their for them when the 2010 and the 2021 earthquake happened because “Haiti is a bad country and helping them won’t do anything” and they are still recovering from that to this very day. Families are being displaced, the violence is getting worse, innocent people are dying and are fighting trying to stay alive, women and children are being r$ped and kidnapped. I have family that live in Haiti that I lost all contact with because they are fighting everyday, and who knows if they are even alive.

Here are some important links to help you get a better understanding on what’s going on in Haiti and stuff to donate to

Donations:

Haitian Health foundation

Partner in Health: Haiti

Hope For Haiti

Haiti Aid

Haiti Children

Haiti Twitter Link for More Donations. P2 P3

Videos

FYI a lot of these videos are from last year but a lot of them speak really well on what is always going on and why they are going through it

Haiti Debt

What is Happening in Haiti

Haiti and the Rice

Listen Part 2

Free These countries as well

What we want to free in Haiti

PLEASE PLEASE PLEASE TAKE THE TIME OUT OF YOUR DAY TO AT LEAST LOOK AT THESE LINKS. For the sake of My dad and the sake of my family I want to see them happy they wanna go home but won’t be able to until Haiti is free I will update this if I need to and please Like, comment, reblog anything is appreciated

[darkmaga-returns]

The plans were drawn up by the Technocrat tyrants at the CDC, but nobody knew that America dodged the bullet at the last minute. That they would conceive such a plan in the first place should serve as a warning that evil runs deep. Criminalizing the sick? Green zones? “Physically separating high-risk individuals from the general population”? Don’t think we are out of danger because the perpetrators still work at the CDC! ⁃ TN Editor

No matter how bad you think Covid policies were, they were intended to be worse.

Consider the vaccine passports alone. Six cities were locked down to include only the vaccinated in public indoor places. They were New York City, Boston, Chicago, New Orleans, Washington, D.C., and Seattle. The plan was to enforce this with a vaccine passport. It broke. Once the news leaked that the shot didn’t stop infection or transmission, the planners lost public support and the scheme collapsed.

It was undoubtedly planned to be permanent and nationwide if not worldwide. Instead, the scheme had to be dialed back.

Features of the CDC’s edicts did incredible damage. It imposed the rent moratorium. It decreed the ridiculous “six feet of distance” and mask mandates. It forced Plexiglas as the interface for commercial transactions. It implied that mail-in balloting must be the norm, which probably flipped the election. It delayed the reopening as long as possible. It was sadistic.

Even with all that, worse was planned. On July 26, 2020, with the George Floyd riots having finally settled down, the CDC issued a plan for establishing nationwide quarantine camps. People were to be isolated, given only food and some cleaning supplies. They would be banned from participating in any religious services. The plan included contingencies for preventing suicide. There were no provisions made for any legal appeals or even the right to legal counsel.

The plan’s authors were unnamed but included 26 footnotes. It was completely official. The document was only removed on about March 26, 2023. During the entire intervening time, the plan survived on the CDC’s public site with little to no public notice or controversy.

It was called “Interim Operational Considerations for Implementing the Shielding Approach to Prevent COVID-19 Infections in Humanitarian Settings.”

[justinspoliticalcorner]

Walter Einenkel at Daily Kos:

Anti-immigrant lies and rhetoric spewed by Donald Trump and his party have caused real and terrifying results. On Thursday, several city, county, and school buildings in Springfield, Ohio, were targeted by a bomb threat. On Friday, a Springfield middle school was closed and two elementary schools were evacuated. ABC News originally reported that there was no direct connection made between the threats and the GOP's repeated racist lies about Haitian immigrants abducting and eating pets. Additionally, ABC reported it was not “immediately clear if Friday's evacuations were from a new threat or linked to bomb threats sent via email Thursday morning.” But in an interview with The Washington Post, Springfield Mayor Rob Rue said that Thursday’s bomb threat “used hateful language towards immigrants and Haitians in our community.”

During Tuesday night’s presidential debate, Trump erroneously claimed, “In Springfield, they're eating the dogs. The people that came in. They're eating the cats. They're eating—they're eating the pets of the people that live there.” This lie has also been pushed by his running mate Sen. JD Vance a number of times. And Trump continued to perpetuate the lie, adding geese this time, in a campaign rally Thursday in Arizona.

The Haitian Times reported that some of Springfield’s Haitian community has felt so threatened during this barrage of right-wing hate-propaganda that they chose to keep their children home from school following the debate. “We’re all victims this morning,” one woman, who asked to remain anonymous for fear of reprisals, told the outlet. “They’re attacking us in every way.”  The same kind of racist rhetoric has also besieged Venezuelan immigrants in Colorado. Trump has repeatedly pushed bullshit crime numbers (which he did once again during the debate), targeting Venezuelan communities in the Centennial State as filled with “gangs,” and saying they were “taking over” Colorado cities. 

[...] This is sadly par for the course during a time of fascistic and hateful rhetoric. We saw it with Asian hate crimes rising during COVID-19 pandemic, when Trump and others would frequently use derogatory terms for the coronavirus such as “Kung Flu,” and the “Chinese Virus.” We've seen it in the rise of antisemitism connected to the rise of MAGA extremist rhetoric and conspiracy theory as well as the Palestinian/Israeli conflict. The consequences of the Republican Party’s need to target, isolate, and divide various groups of people, are that innocent, hardworking people suffer. At the same time, without any meaningful policies, the fear and economic uncertainty that the GOP repeats remains the same.  Trump said Tuesday during the debate that the Haitian immigrants in Springfield were “destroying” the residents’ “entire way of life.” That divisiveness, despite the fact that these Haitian Americans are part of that community, is the Trump way. And in a country made up almost entirely of immigrants, there’s always someone to blame.

Aurora, CO and Springfield, OH are two communities in the news recently as a result of right-wing hate mobs targeting the cities to push their anti-immigrant BS.

[autisticadvocacy]

ASAN is deeply troubled by reports made by The Washington Post this Tuesday that the CDC is planning to change its COVID-19 isolation guidelines. ASAN condemns the potential new guidelines, which would remove the five-day isolation period currently recommended after a positive test for COVID-19. Instead, people with a positive test result would not need to isolate if they have been fever-free for at least 24 hours without the aid of medication. 

ASAN has spoken repeatedly on the failures of the US government to respond adequately to COVID-19. Despite the ongoing pandemic, the end of the public health emergency and subsequent Medicaid unwinding have been devastating to the disability community and other marginalized communities. Efforts to encourage adherence to masking guidance and improve indoor air quality have been underwhelming. Through their actions, the CDC and US Government as a whole have indicated the strategy to combat COVID-19 is seemingly a vaccine-only response, but, with adult uptake of the latest bivalent booster being only 21.9%, even these efforts are beyond inadequate. 

This change is particularly alarming given who is likely to be among the most impacted. Changing the isolation window disproportionately exposes and affects vulnerable populations such as disabled and immunocompromised people, older adults, and other high-risk groups. These guidelines would increase COVID-19 exposure and make people at high risk of poor outcomes from COVID-19 less safe in a range of public and private spaces. 

Asymptomatic spread remains a serious concern with the latest variants. Reduced access to at-home and PCR testing since the end of the public health emergency contributes to transmission. Removing the isolation window adds increased pressure to return to school and work while potentially infectious. This will disproportionately affect individuals with hourly jobs that must be performed in person and families with children that are lower-income and families of color, as many communities aggressively enforce truancy laws against these households. Counting on the availability of treatments like Paxlovid as a mitigation strategy is highly inequitable as racial and ethnic disparities in outpatient treatment of COVID-19 remain prevalent. An approach to COVID-19 that accepts widespread and repeated infection leaves the most vulnerable among us unprotected. As we have seen throughout the pandemic, it has also led to the emergence of new variants, putting our communities at additional risk. Each repeated infection increases an individual’s likelihood of developing Long COVID, a potentially lifelong disability with limited treatment options. 

The CDC has continually failed to take into account disabled people when making COVID-19 policies and regulations. The CDC is moving in the wrong direction by reducing COVID-19 isolation periods. Instead, it should release improved guidelines to promote masking and increase availability, accessibility, and understanding of vaccines, testing, and treatment. States and the federal government also must address the continued effects of the pandemic and the end of the public health emergency on health care access and home and community based services, make investments in improving indoor air quality and preventing and treating Long COVID, and address the economic and human impacts of this crisis. ASAN condemns the possible shortening of isolation guidelines and will continue to hold the federal government accountable for protecting the public from the ongoing risk of COVID-19.

[0atm11k]

New York state’s Fourth Judicial Department has reinstated a controversial policy that empowers the state government to lawfully order people to involuntarily isolate or quarantine in order to prevent the spread of highly contagious diseases.

Originally passed in February 2022, the dramatic expansion of the rights and abilities of the State Health Commissioner, collectively referred to as Rule 2.13, was struck down in July of that same year in the state Supreme Court, following a lawsuit filed by Republican lawmakers Sen. George Borrello, Assemblyman Chris Tague and U.S. Rep. Mike Lawler, who was a member of the Assembly at the time of the filing.

Last Friday, the Fourth Judicial Department repealed that decision, stating that the Republican challengers, who had argued that Rule 2.13 gave undue power to the executive branch and disregarded the authority of the state legislature, had not established how their authority had been negated.

The court’s Democratic Supermajority, in a unanimous vote, ruled that the “Legislature retains its power to address the regulation,” essentially stating that New York legislators still maintain the authority to change the laws which originally empowered the Governor’s office to pass new and stricter public health policies. Furthermore, the Fourth Judical Court wrote “that the legislator petitioners failed to fulfill the injury-in-fact requirement to establish standing” arguing that the state legislators who originally brought the suit did not have the legal standing to do so.

The lower court ruled that Rule 2.13 did not nullify any vote cast by the plaintiffs or strip them of any due authority, thus the challengers had no grounds on which to personally sue.

“Inasmuch as the legislator petitioners merely asserted an alleged harm to the separation of powers shared by the legislative branch as a whole, they failed to establish that they suffered a direct, personal injury beyond an abstract institutional harm,” wrote the court.

Republicans have categorized the Fourth Judical Departments ruling as a technicality, and have vowed to continue challenging the policy.

“The court seems to insinuate that the only person with the right to sue is someone who has been forcibly locked in their home against their will” Bobbie Anne Flower Cox, the attorney representing the petitioners, wrote in a blog post following the lower court’s decision.

Rule 2.13 was fi rst made possible when, during the early days of the Covid 19 Pandemic, the state legislature amended executive law and gave then Governor Andrew Cuomo broad power to suspend laws and issue directives through executive orders.

The new ruling supersedes the conclusion of Supreme Court Justice Ronald Ploetz of Cattaraugus County, who stated Rule 2.13 violates the constitutional requirement for a separation of powers between the legislative and executive branches when establishing actions as severe as involuntary isolation.

With Rule 2.13 reinstated, the State Commissioner of Health now resumes the authority to “whenever appropriate to control the spread of a highly contagious communicable disease, issue and/or direct the local health authority to issue isolation and/or quarantine orders, consistent with due process of law, to all such persons as the State Commissioner of Health shall determine appropriate.”

[urialnathanonwright]

Trump’s Reckless WHO Withdrawal: A Disaster for Public Health and Global Leadership

Donald Trump’s executive order withdrawing the United States from the World Health Organization (WHO) is not just a shortsighted political stunt—it is a catastrophic decision with dire consequences for public health, both domestically and globally. By abandoning this critical international organization, Trump has jeopardized America’s ability to respond effectively to pandemics, undermined our global standing, and risked countless lives in the process.

First and foremost, the WHO serves as a vital network for monitoring, sharing, and responding to emerging health threats. In the face of ongoing global health crises like COVID-19 and the looming threat of bird flu, severing ties with the WHO is akin to cutting the lifeline that connects us to critical information and resources. Public health experts have repeatedly emphasized that the WHO provides early warning systems that are essential to identifying and mitigating outbreaks before they become global catastrophes. Without this collaboration, the U.S. risks being blindsided by health emergencies, putting millions of lives at unnecessary risk.

Trump’s justification for this move—that the WHO is “ripping off” the United States—rings hollow. Yes, the U.S. contributes significantly to the organization, but that investment has yielded immense returns, from eradicating smallpox to nearly eliminating polio. Trump’s rhetoric about “unfair payments” ignores the fundamental reality that public health knows no borders. Diseases do not respect national boundaries, and an outbreak anywhere is a threat everywhere. By withdrawing, the U.S. is not only turning its back on global health but also actively undermining its own security.

This decision also signals a dangerous abdication of American leadership. For decades, the U.S. has been a cornerstone of global health initiatives, leveraging its resources and expertise to save lives and build goodwill around the world. By walking away from the WHO, Trump has ceded that leadership role to other nations, including geopolitical rivals like China, whose influence within the organization will only grow in America’s absence. This is not a demonstration of strength; it is a retreat that weakens America’s voice on the global stage and compromises our ability to shape the international response to health crises.

Trump’s simultaneous decision to freeze foreign aid funding only compounds the damage. Global health programs funded by the U.S. provide life-saving treatments for diseases like malaria and HIV/AIDS. A 90-day pause in this funding risks disrupting these efforts, leaving vulnerable populations without critical care and creating conditions for these diseases to resurge. This is not just a humanitarian failure—it is a strategic blunder that will exacerbate global instability and, ultimately, rebound on the United States.

Let us be clear: The WHO is not perfect. Like any large organization, it has its flaws and inefficiencies. But the solution is not to abandon it—it is to work collaboratively to address those issues and strengthen the organization. Walking away is the height of irresponsibility and a betrayal of America’s commitments to global health and human rights.

The implications of this withdrawal are stark: diminished disease surveillance, weakened pandemic preparedness, disrupted global health programs, and the erosion of America’s moral and strategic leadership. This is not “America First.” It is America isolated, vulnerable, and diminished.

Trump’s actions are a stark reminder of what is at stake when decisions are driven by political grievances rather than sound policy and compassion for human life. This reckless withdrawal must be condemned in the strongest terms, and efforts to reverse it must begin immediately. Lives depend on it.

[mariacallous]

Immigration is one of the most important topics in this presidential election cycle. Former President Trump has promised to conduct a massive deportation effort that would remove millions of people per year. The latest statistics show about 11 million unauthorized immigrants are living in the U.S., and several million more people have arrived in the past two years on parole or with an uncertain legal future. Would a mass deportation effort improve the U.S. economy and provide more jobs for U.S.-born workers? Recent, rigorous economics research sheds light on the consequences of increasing the number of deportations on the U.S. labor market. This research consistently points to deportations hurting the U.S. labor market and leading to worse labor market outcomes for U.S.-born workers.

Landscape of deportations in the US

A deportation is a mandatory departure of a noncitizen out of the U.S. based on a formal order of removal. Official estimates of the cost of deportations are scarce but the best estimates suggest that each deportation costs about $13,000 in current dollars.

There has been a dramatic increase in the number of deportations in the U.S. in the last few decades. Deportations, including removals at the border and those from the interior, increased from about 200,000 per year in the early 2000s to 400,000 per year in the late 2000s. Deportations were then steady at about 300,000 per year until the COVID-19 pandemic. Since the pandemic, deportations of long-term residents have fallen, but other types of removals from the U.S. increased, especially at the border.

A real-world test of the effects of deportation

To isolate the causal effects of deportations on the economy, economists study the rollout of an immigration enforcement policy called Secure Communities (SC). The Secure Communities program increased information sharing between local law enforcement agencies and Immigration and Customs Enforcement (ICE) with the express purpose to identify and deport people who were in the U.S. without authorization. About 400,000 people were deported under SC between 2008 and 2014, after which SC was replaced with the Priority Enforcement Program (PEP). While the first counties implemented SC in 2008, it was implemented county by county with the last counties implementing the program in 2013. The timing of enactment was based on how close the counties were to ICE offices and how quickly the technology could be set up in a county. Bottlenecks in implementation meant some counties were put on waitlists. Because of this, the exact timing of when a county implemented SC was out of their direct control, and counties that adopted the program early compared to late are otherwise very similar. Thus, researchers can compare the labor market outcomes in counties that implemented SC earlier compared to later.

While only people who were arrested had their immigration status checked under SC, the policy nonetheless impacted a large portion of immigrants. There were broad “chilling effects” of the policy that meant even people not targeted for deportation became fearful of leaving their house to do routine things like go to work. This is partly because the program did not only target serious criminals—the most serious criminal conviction for 79% of those deported was non-violent, including traffic violations and immigration offenses, and another 17% were not convicted of any crime.  

Increased deportation is associated with poorer economic outcomes for US-born workers 

Across multiple studies, economists have found that once SC is implemented, the number of foreign-born workers in that county declines and the employment rate among U.S.-born workers also declines. My research with Annie Hines, Philip Luck, Hani Mansour, and Andrea Velásquez finds that when half a million immigrants are removed from the labor market because of enforcement (due to deportations and indirectly due to chilling effects), this reduces the number of U.S.-born people working by 44,000.

Why do deportations hurt the economic outcomes of U.S.-born workers? The prevailing view used to be that foreign-born and U.S.-born workers are substitutes, meaning that when one foreign-born worker takes a job, there is one less job for a U.S.-born worker. But economists have now shown several reasons why the economy is not a zero-sum game: because unauthorized immigrants work in different occupations from the U.S.-born, because they create demand for goods and services, and because they contribute to the long-run fiscal health of the country.

First, unauthorized immigrant workers and U.S.-born workers work in different types of jobs. Figure 1 shows the percentage of unauthorized immigrant workers, authorized immigrant workers, and U.S.-born workers that are in each of the 15 most common occupations among unauthorized immigrants.

It is clear that unauthorized immigrants take low-paying, dangerous and otherwise less attractive jobs more frequently than both U.S.-born workers and authorized immigrant workers. For example, almost 6% of unauthorized immigrants work as housekeepers, construction laborers, or cooks, compared to about 2% of authorized immigrant workers and 1% of U.S.-born workers (See Figure 1).

Occupations common among unauthorized workers, such as construction laborers and cooks, are essential to keep businesses operating. Deporting workers in these jobs affects U.S.-born workers too. For example, when construction companies have a sudden reduction in available laborers, they must reduce the number of construction site managers they hire. Similarly, local restaurants need cooks to stay open and hire for other positions like waiters, which are more likely to be filled by U.S.-born workers.

Caregiving and household service jobs are also common among unauthorized immigrants. The availability and cost of these services in the private market greatly impacts whether people can work outside the home. My research with Andrea Velásquez and new research by Umair Ali, Jessica Brown and Chris Herbst find that Secure Communities impacted the childcare market—the supply of childcare workers fell. This led to a reduction in the number of college-educated mothers with young children working in the formal labor market.

Several recent Brookings pieces have highlighted the role that immigrants play in caregiving jobs, which are becoming increasingly important as the U.S. population ages. These pieces call for increasing the number of legal pathways for immigrants willing to work in these types of jobs to come to the U.S.

Another important way in which immigrants help create jobs for U.S.-born workers is that unauthorized immigrants contribute to local demand for goods and services like haircuts, food, and cars. This means deportations lead to less revenue for local barber shops, grocery stores, and auto dealerships, causing them to hire fewer workers, including U.S.-born workers.

Finally, deportations impact tax revenue and the fiscal health of the federal, state, and local governments. A comprehensive study by the National Academies of Sciences, Engineering, and Medicine found that, in a given year, each foreign-born person and their dependents pay on average $1,300 more in federal taxes than they receive in federal benefits, and, looking over a 75-year time horizon, immigrants are a net fiscal positive at all levels—they pay $237,000 more in taxes over their lifetime than they receive in benefits from federal, state, and local governments. While these estimates are not broken out by immigration status, the study indicates that the net fiscal impacts of unauthorized immigrants are larger than authorized immigrants because unauthorized immigrants are more likely to be of working age. Thus, deportations reduce tax revenue both because of a reduction in taxes paid by unauthorized immigrants, and through a reduction in taxes paid by U.S.-born workers who lose their jobs.  Unauthorized immigrants and their children also facilitate the solvency of the Social Security and Medicare systems by paying into these systems when they are not eligible to receive any benefits.

Implications for policy

Immigration law has not been comprehensively updated for 34 years and as a result is designed for an outdated labor market and an outdated demographic reality.  With so much political discussion about immigration this year, it’s important to understand the role of unauthorized immigrant workers in the U.S. economy. Recent economics research shows that unauthorized immigrant workers help to create more jobs for U.S.-born workers. Large-scale deportation efforts would be very disruptive in some industries and would hamstring the current growth in employment, which has been driven in large part by increased immigration. Instead, Congress should set its sights on reform and expansions in legal immigration pathways.

[rjzimmerman]

Hurricane Helene Deaths Will Continue for Years, Study Suggests. (New York Times)

Excerpt from this story from the New York Times:

Over the past week, the official death toll from Hurricane Helene has surpassed 100 as the vortex creeping inland from Florida submerged homes and swept away cars. But the full weight of lost lives will be realized only years from now — and it could number in the thousands.

A paper published in the journal Nature on Wednesday lays out the hidden toll of tropical storms in the continental United States. Looking at 501 events from 1930 to 2015, researchers found that the average tropical storm resulted in an additional 7,000 to 11,000 deaths over the 15 years that followed.

Overall during the study period, tropical storms killed more people than automobile crashes, infectious diseases and combat for U.S. soldiers. It’s such a big number — especially compared with the 24 direct deaths caused by hurricanes on average, according to federal statistics — that the authors spent years checking the math to make sure they were right.

“The scale of these results is dramatically different from what we expected,” said Solomon Hsiang, a professor of global environmental policy at the Doerr School of Sustainability at Stanford University, who conducted the study with Rachel Young, the Ciriacy-Wantrup postdoctoral fellow at the University of California, Berkeley.

The pair used a technique that has also provided a more complete understanding of “excess deaths” caused by Covid-19 and heat waves. It works by looking at typical mortality patterns and isolating anomalies that could have been caused only by the variable under study — in this case, a sizable storm.

Previously, researchers examined deaths and hospitalizations after hurricanes over much shorter periods. One study published in Nature found elevated hospitalizations among older Medicaid patients in the week after a storm. Another, in The Journal of the American Medical Association, associated higher death rates with U.S. counties hit by cyclones. A study in The Lancet found that across 14 countries, cyclones led to a 6 percent bump in mortality in the ensuing two weeks.

But despite mounting interest in the health effects of natural disasters, nobody had examined such a long period after a storm. That perhaps stands to reason: After someone survives a hurricane, it’s hard to imagine what sequence of resulting events could lead to death more than a decade later.

The study doesn’t answer those questions with certainty. But public health literature contains some clues.

“It makes a lot of sense that a hurricane, or tropical cyclone — which is a substantial ‘shock’ to a community’s functioning — would lead to long-lasting effects,” said Sue Anne Bell, an assistant professor at the University of Michigan’s Center for Global Health Equity, who reviewed the study.

[covid-safer-hotties]

Also preserved on our archive

SARS-CoV-2 is now circulating out of control worldwide. The only major limitation on transmission is the immune environment the virus faces. The disease it causes, COVID-19, is now a risk faced by most people as part of daily life.

While some are better than others, no national or regional government is making serious efforts towards infection prevention and control, and it seems likely this laissez-faire policy will continue for the foreseeable future. The social, political, and economic movements that worked to achieve this mass infection environment can rejoice at their success.

Those schooled in public health, immunology or working on the front line of healthcare provision know we face an uncertain future, and are aware the implications of recent events stretch far beyond SARS-CoV-2. The shifts that have taken place in attitudes and public health policy will likely damage a key pillar that forms the basis of modern civilized society, one that was built over the last two centuries; the expectation of a largely uninterrupted upwards trajectory of ever-improving health and quality of life, largely driven by the reduction and elimination of infectious diseases that plagued humankind for thousands of years. In the last three years, that trajectory has reversed.

The upward trajectory of public health in the last two centuries Control of infectious disease has historically been a priority for all societies. Quarantine has been in common use since at least the Bronze Age and has been the key method for preventing the spread of infectious diseases ever since. The word “quarantine” itself derives from the 40-day isolation period for ships and crews that was implemented in Europe during the late Middle Ages to prevent the introduction of bubonic plague epidemics into cities.

Modern public health traces its roots to the middle of the 19th century thanks to converging scientific developments in early industrial societies:

The germ theory of diseases was firmly established in the mid-19th century, in particular after Louis Pasteur disproved the spontaneous generation hypothesis. If diseases spread through transmission chains between individual humans or from the environment/animals to humans, then it follows that those transmission chains can be interrupted, and the spread stopped. The science of epidemiology appeared, its birth usually associated with the 1854 Broad Street cholera outbreak in London during which the British physician John Snow identified contaminated water as the source of cholera, pointing to improved sanitation as the way to stop cholera epidemics. Vaccination technology began to develop, initially against smallpox, and the first mandatory smallpox vaccination campaigns began, starting in England in the 1850s.

The early industrial era generated horrendous workplace and living conditions for working class populations living in large industrial cities, dramatically reducing life expectancy and quality of life (life expectancy at birth in key industrial cities in the middle of the 19th century was often in the low 30s or even lower). This in turn resulted in a recognition that such environmental factors affect human health and life spans. The long and bitter struggle for workers’ rights in subsequent decades resulted in much improved working conditions, workplace safety regulations, and general sanitation, and brought sharp increases in life expectancy and quality of life, which in turn had positive impacts on productivity and wealth.

Florence Nightingale reemphasized the role of ventilation in healing and preventing illness, ‘The very first canon of nursing… : keep the air he breathes as pure as the external air, without chilling him,’ a maxim that influenced building design at the time.

These trends continued in the 20th century, greatly helped by further technological and scientific advances. Many diseases – diphtheria, pertussis, hepatitis B, polio, measles, mumps, rubella, etc. – became things of the past thanks to near-universal highly effective vaccinations, while others that used to be common are no longer of such concern for highly developed countries in temperate climates – malaria, typhus, typhoid, leprosy, cholera, tuberculosis, and many others – primarily thanks to improvements in hygiene and the implementation of non-pharmaceutical measures for their containment.

Furthermore, the idea that infectious diseases should not just be reduced, but permanently eliminated altogether began to be put into practice in the second half of the 20th century on a global level, and much earlier locally. These programs were based on the obvious consideration that if an infectious agent is driven to extinction, the incalculable damage to people’s health and the overall economy by a persisting and indefinite disease burden will also be eliminated.

The ambition of local elimination grew into one of global eradication for smallpox, which was successfully eliminated from the human population in the 1970s (this had already been achieved locally in the late 19th century by some countries), after a heroic effort to find and contain the last remaining infectious individuals. The other complete success was rinderpest in cattle9,10, globally eradicated in the early 21st century.

When the COVID-19 pandemic started, global eradication programs were very close to succeeding for two other diseases – polio and dracunculiasis. Eradication is also globally pursued for other diseases, such as yaws, and regionally for many others, e.g. lymphatic filariasis, onchocerciasis, measles and rubella. The most challenging diseases are those that have an external reservoir outside the human population, especially if they are insect borne, and in particular those carried by mosquitos. Malaria is the primary example, but despite these difficulties, eradication of malaria has been a long-standing global public health goal and elimination has been achieved in temperate regions of the globe, even though it involved the ecologically destructive widespread application of polluting chemical pesticides to reduce the populations of the vectors. Elimination is also a public goal for other insect borne diseases such as trypanosomiasis.

In parallel with pursuing maximal reduction and eventual eradication of the burden of existing endemic infectious diseases, humanity has also had to battle novel infectious diseases40, which have been appearing at an increased rate over recent decades. Most of these diseases are of zoonotic origin, and the rate at which they are making the jump from wildlife to humans is accelerating, because of the increased encroachment on wildlife due to expanding human populations and physical infrastructure associated with human activity, the continued destruction of wild ecosystems that forces wild animals towards closer human contact, the booming wildlife trade, and other such trends.

Because it is much easier to stop an outbreak when it is still in its early stages of spreading through the population than to eradicate an endemic pathogen, the governing principle has been that no emerging infectious disease should be allowed to become endemic. This goal has been pursued reasonably successfully and without controversy for many decades.

The most famous newly emerging pathogens were the filoviruses (Ebola, Marburg), the SARS and MERS coronaviruses, and paramyxoviruses like Nipah. These gained fame because of their high lethality and potential for human-to-human spread, but they were merely the most notable of many examples.

Such epidemics were almost always aggressively suppressed. Usually, these were small outbreaks, and because highly pathogenic viruses such as Ebola cause very serious sickness in practically all infected people, finding and isolating the contagious individuals is a manageable task. The largest such epidemic was the 2013-16 Ebola outbreak in West Africa, when a filovirus spread widely in major urban centers for the first time. Containment required a wartime-level mobilization, but that was nevertheless achieved, even though there were nearly 30,000 infections and more than 11,000 deaths.

SARS was also contained and eradicated from the human population back in 2003-04, and the same happened every time MERS made the jump from camels to humans, as well as when there were Nipah outbreaks in Asia.

The major counterexample of a successful establishment in the human population of a novel highly pathogenic virus is HIV. HIV is a retrovirus, and as such it integrates into the host genome and is thus nearly impossible to eliminate from the body and to eradicate from the population (unless all infected individuals are identified and prevented from infecting others for the rest of their lives). However, HIV is not an example of the containment principle being voluntarily abandoned as the virus had made its zoonotic jump and established itself many decades before its eventual discovery and recognition, and long before the molecular tools that could have detected and potentially fully contained it existed.

Still, despite all these containment success stories, the emergence of a new pathogen with pandemic potential was a well understood and frequently discussed threat, although influenza viruses rather than coronaviruses were often seen as the most likely culprit. The eventual appearance of SARS-CoV-2 should therefore not have been a huge surprise, and should have been met with a full mobilization of the technical tools and fundamental public health principles developed over the previous decades.

The ecological context One striking property of many emerging pathogens is how many of them come from bats. While the question of whether bats truly harbor more viruses than other mammals in proportion to their own species diversity (which is the second highest within mammals after rodents) is not fully settled yet, many novel viruses do indeed originate from bats, and the ecological and physiological characteristics of bats are highly relevant for understanding the situation that Homo sapiens finds itself in right now.

Another startling property of bats and their viruses is how highly pathogenic to humans (and other mammals) many bat viruses are, while bats themselves are not much affected (only rabies is well established to cause serious harm to bats). Why bats seem to carry so many such pathogens, and how they have adapted so well to coexisting with them, has been a long-standing puzzle and although we do not have a definitive answer, some general trends have become clear.

Bats are the only truly flying mammals and have been so for many millions of years. Flying has resulted in a number of specific adaptations, one of them being the tolerance towards a very high body temperature (often on the order of 42-43ºC). Bats often live in huge colonies, literally touching each other, and, again, have lived in conditions of very high density for millions of years. Such densities are rare among mammals and are certainly not the native condition of humans (human civilization and our large dense cities are a very recent phenomenon on evolutionary time scales). Bats are also quite long-lived for such small mammals – some fruit bats can live more than 35 years and even small cave dwelling species can live about a decade.

These are characteristics that might have on one hand facilitated the evolution of a considerable set of viruses associated with bat populations. In order for a non-latent respiratory virus to maintain itself, a minimal population size is necessary. For example, it is hypothesized that measles requires a minimum population size of 250-300,000 individuals. And bats have existed in a state of high population densities for a very long time, which might explain the high diversity of viruses that they carry. In addition, the long lifespan of many bat species means that their viruses may have to evolve strategies to overcome adaptive immunity and frequently reinfect previously infected individuals as opposed to the situation in short-lived species in which populations turn over quickly (with immunologically naive individuals replacing the ones that die out).

On the other hand, the selective pressure that these viruses have exerted on bats may have resulted in the evolution of various resistance and/or tolerance mechanisms in bats themselves, which in turn have driven the evolution of counter strategies in their viruses, leading them to be highly virulent for other species. Bats certainly appear to be physiologically more tolerant towards viruses that are otherwise highly virulent to other mammals. Several explanations for this adaptation have been proposed, chief among them a much more powerful innate immunity and a tolerance towards infections that does not lead to the development of the kind of hyperinflammatory reactions observed in humans, the high body temperature of bats in flight, and others.

The notable strength of bat innate immunity is often explained by the constitutively active interferon response that has been reported for some bat species. It is possible that this is not a universal characteristic of all bats – only a few species have been studied – but it provides a very attractive mechanism for explaining both how bats prevent the development of severe systemic viral infections in their bodies and how their viruses in turn would have evolved powerful mechanisms to silence the interferon response, making them highly pathogenic for other mammals.

The tolerance towards infection is possibly rooted in the absence of some components of the signaling cascades leading to hyperinflammatory reactions and the dampened activity of others.

An obvious ecological parallel can be drawn between bats and humans – just as bats live in dense colonies, so now do modern humans. And we may now be at a critical point in the history of our species, in which our ever-increasing ecological footprint has brought us in close contact with bats in a way that was much rarer in the past. Our population is connected in ways that were previously unimaginable. A novel virus can make the zoonotic jump somewhere in Southeast Asia and a carrier of it can then be on the other side of the globe a mere 24-hours later, having encountered thousands of people in airports and other mass transit systems. As a result, bat pathogens are now being transferred from bat populations to the human population in what might prove to be the second major zoonotic spillover event after the one associated with domestication of livestock and pets a few thousand years ago.

Unfortunately for us, our physiology is not suited to tolerate these new viruses. Bats have adapted to live with them over many millions of years. Humans have not undergone the same kind of adaptation and cannot do so on any timescale that will be of use to those living now, nor to our immediate descendants.

Simply put, humans are not bats, and the continuous existence and improvement of what we now call “civilization” depends on the same basic public health and infectious disease control that saw life expectancy in high-income countries more than double to 85 years. This is a challenge that will only increase in the coming years, because the trends that are accelerating the rate of zoonotic transfer of pathogens are certain to persist.

Given this context, it is as important now to maintain the public health principle that no new dangerous pathogens should be allowed to become endemic and that all novel infectious disease outbreaks must be suppressed as it ever was.

The death of public health and the end of epidemiological comfort It is also in this context that the real gravity of what has happened in the last three years emerges.

After HIV, SARS-CoV-2 is now the second most dangerous infectious disease agent that is 'endemic' to the human population on a global scale. And yet not only was it allowed to become endemic, but mass infection was outright encouraged, including by official public health bodies in numerous countries.

The implications of what has just happened have been missed by most, so let’s spell them out explicitly.

We need to be clear why containment of SARS-CoV-2 was actively sabotaged and eventually abandoned. It has absolutely nothing to do with the “impossibility” of achieving it. In fact, the technical problem of containing even a stealthily spreading virus such as SARS-CoV-2 is fully solved, and that solution was successfully applied in practice for years during the pandemic.

The list of countries that completely snuffed out outbreaks, often multiple times, includes Australia, New Zealand, Singapore, Taiwan, Vietnam, Thailand, Bhutan, Cuba, China, and a few others, with China having successfully contained hundreds of separate outbreaks, before finally giving up in late 2022.

The algorithm for containment is well established – passively break transmission chains through the implementation of nonpharmaceutical interventions (NPIs) such as limiting human contacts, high quality respirator masks, indoor air filtration and ventilation, and others, while aggressively hunting down active remaining transmission chains through traditional contact tracing and isolation methods combined with the powerful new tool of population-scale testing.

Understanding of airborne transmission and institution of mitigation measures, which have heretofore not been utilized in any country, will facilitate elimination, even with the newer, more transmissible variants. Any country that has the necessary resources (or is provided with them) can achieve full containment within a few months. In fact, currently this would be easier than ever before because of the accumulated widespread multiple recent exposures to the virus in the population suppressing the effective reproduction number (Re). For the last 18 months or so we have been seeing a constant high plateau of cases with undulating waves, but not the major explosions of infections with Re reaching 3-4 that were associated with the original introduction of the virus in 2020 and with the appearance of the first Omicron variants in late 2021.

It would be much easier to use NPIs to drive Re to much below 1 and keep it there until elimination when starting from Re around 1.2-1.3 than when it was over 3, and this moment should be used, before another radically new serotype appears and takes us back to those even more unpleasant situations. This is not a technical problem, but one of political and social will. As long as leadership misunderstands or pretends to misunderstand the link between increased mortality, morbidity and poorer economic performance and the free transmission of SARS-CoV-2, the impetus will be lacking to take the necessary steps to contain this damaging virus.

Political will is in short supply because powerful economic and corporate interests have been pushing policymakers to let the virus spread largely unchecked through the population since the very beginning of the pandemic. The reasons are simple. First, NPIs hurt general economic activity, even if only in the short term, resulting in losses on balance sheets. Second, large-scale containment efforts of the kind we only saw briefly in the first few months of the pandemic require substantial governmental support for all the people who need to pause their economic activity for the duration of effort. Such an effort also requires large-scale financial investment in, for example, contact tracing and mass testing infrastructure and providing high-quality masks. In an era dominated by laissez-faire economic dogma, this level of state investment and organization would have set too many unacceptable precedents, so in many jurisdictions it was fiercely resisted, regardless of the consequences for humanity and the economy.

None of these social and economic predicaments have been resolved. The unofficial alliance between big business and dangerous pathogens that was forged in early 2020 has emerged victorious and greatly strengthened from its battle against public health, and is poised to steamroll whatever meager opposition remains for the remainder of this, and future pandemics.

The long-established principles governing how we respond to new infectious diseases have now completely changed – the precedent has been established that dangerous emerging pathogens will no longer be contained, but instead permitted to ‘ease’ into widespread circulation. The intent to “let it rip” in the future is now being openly communicated. With this change in policy comes uncertainty about acceptable lethality. Just how bad will an infectious disease have to be to convince any government to mobilize a meaningful global public health response?

We have some clues regarding that issue from what happened during the initial appearance of the Omicron “variant” (which was really a new serotype) of SARS-CoV-2. Despite some experts warning that a vaccine-only approach would be doomed to fail, governments gambled everything on it. They were then faced with the brute fact of viral evolution destroying their strategy when a new serotype emerged against which existing vaccines had little effect in terms of blocking transmission. The reaction was not to bring back NPIs but to give up, seemingly regardless of the consequences.

Critically, those consequences were unknown when the policy of no intervention was adopted within days of the appearance of Omicron. All previous new SARS-CoV-2 variants had been deadlier than the original Wuhan strain, with the eventually globally dominant Delta variant perhaps as much as 4× as deadly. Omicron turned out to be the exception, but again, that was not known with any certainty when it was allowed to run wild through populations. What would have happened if it had followed the same pattern as Delta?

In the USA, for example, the worst COVID-19 wave was the one in the winter of 2020-21, at the peak of which at least 3,500 people were dying daily (the real number was certainly higher because of undercounting due to lack of testing and improper reporting). The first Omicron BA.1 wave saw the second-highest death tolls, with at least 2,800 dying per day at its peak. Had Omicron been as intrinsically lethal as Delta, we could have easily seen a 4-5× higher peak than January 2021, i.e. as many as 12–15,000 people dying a day. Given that we only had real data on Omicron’s intrinsic lethality after the gigantic wave of infections was unleashed onto the population, we have to conclude that 12–15,000 dead a day is now a threshold that will not force the implementation of serious NPIs for the next problematic COVID-19 serotype.

Logically, it follows that it is also a threshold that will not result in the implementation of NPIs for any other emerging pathogens either. Because why should SARS-CoV-2 be special?

We can only hope that we will never see the day when such an epidemic hits us but experience tells us such optimism is unfounded. The current level of suffering caused by COVID-19 has been completely normalized even though such a thing was unthinkable back in 2019. Populations are largely unaware of the long-term harms the virus is causing to those infected, of the burden on healthcare, increased disability, mortality and reduced life expectancy. Once a few even deadlier outbreaks have been shrugged off by governments worldwide, the baseline of what is considered “acceptable” will just gradually move up and even more unimaginable losses will eventually enter the “acceptable” category. There can be no doubt, from a public health perspective, we are regressing.

We had a second, even more worrying real-life example of what the future holds with the global spread of the MPX virus (formerly known as “monkeypox” and now called “Mpox”) in 2022. MPX is a close relative to the smallpox VARV virus and is endemic to Central and Western Africa, where its natural hosts are mostly various rodent species, but on occasions it infects humans too, with the rate of zoonotic transfer increasing over recent decades. It has usually been characterized by fairly high mortality – the CFR (Case Fatality Rate) has been ∼3.6% for the strain that circulates in Nigeria and ∼10% for the one in the Congo region, i.e. much worse than SARS-CoV-2. In 2022, an unexpected global MPX outbreak developed, with tens of thousands of confirmed cases in dozens of countries. Normally, this would be a huge cause for alarm, for several reasons.

First, MPX itself is a very dangerous disease. Second, universal smallpox vaccination ended many decades ago with the success of the eradication program, leaving the population born after that completely unprotected. Third, lethality in orthopoxviruses is, in fact, highly variable – VARV itself had a variola major strain, with as much as ∼30% CFR, and a less deadly variola minor variety with CFR ∼1%, and there was considerable variation within variola major too. It also appears that high pathogenicity often evolves from less pathogenic strains through reductive evolution - the loss of certain genes something that can happen fairly easily, may well have happened repeatedly in the past, and may happen again in the future, a scenario that has been repeatedly warned about for decades. For these reasons, it was unthinkable that anyone would just shrug off a massive MPX outbreak – it is already bad enough as it is, but allowing it to become endemic means it can one day evolve towards something functionally equivalent to smallpox in its impact.

And yet that is exactly what happened in 2022 – barely any measures were taken to contain the outbreak, and countries simply reclassified MPX out of the “high consequence infectious disease” category in order to push the problem away, out of sight and out of mind. By chance, it turned out that this particular outbreak did not spark a global pandemic, and it was also characterized, for poorly understood reasons, by an unusually low CFR, with very few people dying. But again, that is not the information that was available at the start of the outbreak, when in a previous, interventionist age of public health, resources would have been mobilized to stamp it out in its infancy, but, in the age of laissez-faire, were not. MPX is now circulating around the world and represents a future threat of uncontrolled transmission resulting in viral adaptation to highly efficient human-to-human spread combined with much greater disease severity.

While some are better than others, no national or regional government is making serious efforts towards infection prevention and control, and it seems likely this laissez-faire policy will continue for the foreseeable future. The social, political, and economic movements that worked to achieve this mass infection environment can rejoice at their success.

Those schooled in public health, immunology or working on the front line of healthcare provision know we face an uncertain future, and are aware the implications of recent events stretch far beyond SARS-CoV-2. The shifts that have taken place in attitudes and public health policy will likely damage a key pillar that forms the basis of modern civilized society, one that was built over the last two centuries; the expectation of a largely uninterrupted upwards trajectory of ever-improving health and quality of life, largely driven by the reduction and elimination of infectious diseases that plagued humankind for thousands of years. In the last three years, that trajectory has reversed.

The upward trajectory of public health in the last two centuries Control of infectious disease has historically been a priority for all societies. Quarantine has been in common use since at least the Bronze Age and has been the key method for preventing the spread of infectious diseases ever since. The word “quarantine” itself derives from the 40-day isolation period for ships and crews that was implemented in Europe during the late Middle Ages to prevent the introduction of bubonic plague epidemics into cities1.

Rat climbing a ship's rigging. Modern public health traces its roots to the middle of the 19th century thanks to converging scientific developments in early industrial societies:

The germ theory of diseases was firmly established in the mid-19th century, in particular after Louis Pasteur disproved the spontaneous generation hypothesis. If diseases spread through transmission chains between individual humans or from the environment/animals to humans, then it follows that those transmission chains can be interrupted, and the spread stopped. The science of epidemiology appeared, its birth usually associated with the 1854 Broad Street cholera outbreak in London during which the British physician John Snow identified contaminated water as the source of cholera, pointing to improved sanitation as the way to stop cholera epidemics. Vaccination technology began to develop, initially against smallpox, and the first mandatory smallpox vaccination campaigns began, starting in England in the 1850s. The early industrial era generated horrendous workplace and living conditions for working class populations living in large industrial cities, dramatically reducing life expectancy and quality of life (life expectancy at birth in key industrial cities in the middle of the 19th century was often in the low 30s or even lower2). This in turn resulted in a recognition that such environmental factors affect human health and life spans. The long and bitter struggle for workers’ rights in subsequent decades resulted in much improved working conditions, workplace safety regulations, and general sanitation, and brought sharp increases in life expectancy and quality of life, which in turn had positive impacts on productivity and wealth. Florence Nightingale reemphasized the role of ventilation in healing and preventing illness, ‘The very first canon of nursing… : keep the air he breathes as pure as the external air, without chilling him,’ a maxim that influenced building design at the time. These trends continued in the 20th century, greatly helped by further technological and scientific advances. Many diseases – diphtheria, pertussis, hepatitis B, polio, measles, mumps, rubella, etc. – became things of the past thanks to near-universal highly effective vaccinations, while others that used to be common are no longer of such concern for highly developed countries in temperate climates – malaria, typhus, typhoid, leprosy, cholera, tuberculosis, and many others – primarily thanks to improvements in hygiene and the implementation of non-pharmaceutical measures for their containment.

Furthermore, the idea that infectious diseases should not just be reduced, but permanently eliminated altogether began to be put into practice in the second half of the 20th century3-5 on a global level, and much earlier locally. These programs were based on the obvious consideration that if an infectious agent is driven to extinction, the incalculable damage to people’s health and the overall economy by a persisting and indefinite disease burden will also be eliminated.

The ambition of local elimination grew into one of global eradication for smallpox, which was successfully eliminated from the human population in the 1970s6 (this had already been achieved locally in the late 19th century by some countries), after a heroic effort to find and contain the last remaining infectious individuals7,8. The other complete success was rinderpest in cattle9,10, globally eradicated in the early 21st century.

When the COVID-19 pandemic started, global eradication programs were very close to succeeding for two other diseases – polio11,12 and dracunculiasis13. Eradication is also globally pursued for other diseases, such as yaws14,15, and regionally for many others, e.g. lymphatic filariasis16,17, onchocerciasis18,19, measles and rubella20-30. The most challenging diseases are those that have an external reservoir outside the human population, especially if they are insect borne, and in particular those carried by mosquitos. Malaria is the primary example, but despite these difficulties, eradication of malaria has been a long-standing global public health goal31-33 and elimination has been achieved in temperate regions of the globe34,35, even though it involved the ecologically destructive widespread application of polluting chemical pesticides36,37 to reduce the populations of the vectors. Elimination is also a public goal for other insect borne diseases such as trypanosomiasis38,39.

In parallel with pursuing maximal reduction and eventual eradication of the burden of existing endemic infectious diseases, humanity has also had to battle novel infectious diseases40, which have been appearing at an increased rate over recent decades41-43. Most of these diseases are of zoonotic origin, and the rate at which they are making the jump from wildlife to humans is accelerating, because of the increased encroachment on wildlife due to expanding human populations and physical infrastructure associated with human activity, the continued destruction of wild ecosystems that forces wild animals towards closer human contact, the booming wildlife trade, and other such trends.

Because it is much easier to stop an outbreak when it is still in its early stages of spreading through the population than to eradicate an endemic pathogen, the governing principle has been that no emerging infectious disease should be allowed to become endemic. This goal has been pursued reasonably successfully and without controversy for many decades.

The most famous newly emerging pathogens were the filoviruses (Ebola44-46, Marburg47,48), the SARS and MERS coronaviruses, and paramyxoviruses like Nipah49,50. These gained fame because of their high lethality and potential for human-to-human spread, but they were merely the most notable of many examples.

Pigs in close proximity to humans. Such epidemics were almost always aggressively suppressed. Usually, these were small outbreaks, and because highly pathogenic viruses such as Ebola cause very serious sickness in practically all infected people, finding and isolating the contagious individuals is a manageable task. The largest such epidemic was the 2013-16 Ebola outbreak in West Africa, when a filovirus spread widely in major urban centers for the first time. Containment required a wartime-level mobilization, but that was nevertheless achieved, even though there were nearly 30,000 infections and more than 11,000 deaths51.

SARS was also contained and eradicated from the human population back in 2003-04, and the same happened every time MERS made the jump from camels to humans, as well as when there were Nipah outbreaks in Asia.

The major counterexample of a successful establishment in the human population of a novel highly pathogenic virus is HIV. HIV is a retrovirus, and as such it integrates into the host genome and is thus nearly impossible to eliminate from the body and to eradicate from the population52 (unless all infected individuals are identified and prevented from infecting others for the rest of their lives). However, HIV is not an example of the containment principle being voluntarily abandoned as the virus had made its zoonotic jump and established itself many decades before its eventual discovery53 and recognition54-56, and long before the molecular tools that could have detected and potentially fully contained it existed.

Still, despite all these containment success stories, the emergence of a new pathogen with pandemic potential was a well understood and frequently discussed threat57-60, although influenza viruses rather than coronaviruses were often seen as the most likely culprit61-65. The eventual appearance of SARS-CoV-2 should therefore not have been a huge surprise, and should have been met with a full mobilization of the technical tools and fundamental public health principles developed over the previous decades.

The ecological context One striking property of many emerging pathogens is how many of them come from bats. While the question of whether bats truly harbor more viruses than other mammals in proportion to their own species diversity (which is the second highest within mammals after rodents) is not fully settled yet66-69, many novel viruses do indeed originate from bats, and the ecological and physiological characteristics of bats are highly relevant for understanding the situation that Homo sapiens finds itself in right now.

Group of bats roosting in a cave. Another startling property of bats and their viruses is how highly pathogenic to humans (and other mammals) many bat viruses are, while bats themselves are not much affected (only rabies is well established to cause serious harm to bats68). Why bats seem to carry so many such pathogens, and how they have adapted so well to coexisting with them, has been a long-standing puzzle and although we do not have a definitive answer, some general trends have become clear.

Bats are the only truly flying mammals and have been so for many millions of years. Flying has resulted in a number of specific adaptations, one of them being the tolerance towards a very high body temperature (often on the order of 42-43ºC). Bats often live in huge colonies, literally touching each other, and, again, have lived in conditions of very high density for millions of years. Such densities are rare among mammals and are certainly not the native condition of humans (human civilization and our large dense cities are a very recent phenomenon on evolutionary time scales). Bats are also quite long-lived for such small mammals70-71 – some fruit bats can live more than 35 years and even small cave dwelling species can live about a decade. These are characteristics that might have on one hand facilitated the evolution of a considerable set of viruses associated with bat populations. In order for a non-latent respiratory virus to maintain itself, a minimal population size is necessary. For example, it is hypothesized that measles requires a minimum population size of 250-300,000 individuals72. And bats have existed in a state of high population densities for a very long time, which might explain the high diversity of viruses that they carry. In addition, the long lifespan of many bat species means that their viruses may have to evolve strategies to overcome adaptive immunity and frequently reinfect previously infected individuals as opposed to the situation in short-lived species in which populations turn over quickly (with immunologically naive individuals replacing the ones that die out).

On the other hand, the selective pressure that these viruses have exerted on bats may have resulted in the evolution of various resistance and/or tolerance mechanisms in bats themselves, which in turn have driven the evolution of counter strategies in their viruses, leading them to be highly virulent for other species. Bats certainly appear to be physiologically more tolerant towards viruses that are otherwise highly virulent to other mammals. Several explanations for this adaptation have been proposed, chief among them a much more powerful innate immunity and a tolerance towards infections that does not lead to the development of the kind of hyperinflammatory reactions observed in humans73-75, the high body temperature of bats in flight, and others.

The notable strength of bat innate immunity is often explained by the constitutively active interferon response that has been reported for some bat species76-78. It is possible that this is not a universal characteristic of all bats79 – only a few species have been studied – but it provides a very attractive mechanism for explaining both how bats prevent the development of severe systemic viral infections in their bodies and how their viruses in turn would have evolved powerful mechanisms to silence the interferon response, making them highly pathogenic for other mammals.

The tolerance towards infection is possibly rooted in the absence of some components of the signaling cascades leading to hyperinflammatory reactions and the dampened activity of others80.

Map of scheduled airline traffic around the world, circa June 2009 Map of scheduled airline traffic around the world. Credit: Jpatokal An obvious ecological parallel can be drawn between bats and humans – just as bats live in dense colonies, so now do modern humans. And we may now be at a critical point in the history of our species, in which our ever-increasing ecological footprint has brought us in close contact with bats in a way that was much rarer in the past. Our population is connected in ways that were previously unimaginable. A novel virus can make the zoonotic jump somewhere in Southeast Asia and a carrier of it can then be on the other side of the globe a mere 24-hours later, having encountered thousands of people in airports and other mass transit systems. As a result, bat pathogens are now being transferred from bat populations to the human population in what might prove to be the second major zoonotic spillover event after the one associated with domestication of livestock and pets a few thousand years ago.

Unfortunately for us, our physiology is not suited to tolerate these new viruses. Bats have adapted to live with them over many millions of years. Humans have not undergone the same kind of adaptation and cannot do so on any timescale that will be of use to those living now, nor to our immediate descendants.

Simply put, humans are not bats, and the continuous existence and improvement of what we now call “civilization” depends on the same basic public health and infectious disease control that saw life expectancy in high-income countries more than double to 85 years. This is a challenge that will only increase in the coming years, because the trends that are accelerating the rate of zoonotic transfer of pathogens are certain to persist.

Given this context, it is as important now to maintain the public health principle that no new dangerous pathogens should be allowed to become endemic and that all novel infectious disease outbreaks must be suppressed as it ever was.

The death of public health and the end of epidemiological comfort It is also in this context that the real gravity of what has happened in the last three years emerges.

After HIV, SARS-CoV-2 is now the second most dangerous infectious disease agent that is 'endemic' to the human population on a global scale. And yet not only was it allowed to become endemic, but mass infection was outright encouraged, including by official public health bodies in numerous countries81-83.

The implications of what has just happened have been missed by most, so let’s spell them out explicitly.

We need to be clear why containment of SARS-CoV-2 was actively sabotaged and eventually abandoned. It has absolutely nothing to do with the “impossibility” of achieving it. In fact, the technical problem of containing even a stealthily spreading virus such as SARS-CoV-2 is fully solved, and that solution was successfully applied in practice for years during the pandemic.

The list of countries that completely snuffed out outbreaks, often multiple times, includes Australia, New Zealand, Singapore, Taiwan, Vietnam, Thailand, Bhutan, Cuba, China, and a few others, with China having successfully contained hundreds of separate outbreaks, before finally giving up in late 2022.

The algorithm for containment is well established – passively break transmission chains through the implementation of nonpharmaceutical interventions (NPIs) such as limiting human contacts, high quality respirator masks, indoor air filtration and ventilation, and others, while aggressively hunting down active remaining transmission chains through traditional contact tracing and isolation methods combined with the powerful new tool of population-scale testing.

Oklahoma’s Strategic National Stockpile. Credit: DVIDS Understanding of airborne transmission and institution of mitigation measures, which have heretofore not been utilized in any country, will facilitate elimination, even with the newer, more transmissible variants. Any country that has the necessary resources (or is provided with them) can achieve full containment within a few months. In fact, currently this would be easier than ever before because of the accumulated widespread multiple recent exposures to the virus in the population suppressing the effective reproduction number (Re). For the last 18 months or so we have been seeing a constant high plateau of cases with undulating waves, but not the major explosions of infections with Re reaching 3-4 that were associated with the original introduction of the virus in 2020 and with the appearance of the first Omicron variants in late 2021.

It would be much easier to use NPIs to drive Re to much below 1 and keep it there until elimination when starting from Re around 1.2-1.3 than when it was over 3, and this moment should be used, before another radically new serotype appears and takes us back to those even more unpleasant situations. This is not a technical problem, but one of political and social will. As long as leadership misunderstands or pretends to misunderstand the link between increased mortality, morbidity and poorer economic performance and the free transmission of SARS-CoV-2, the impetus will be lacking to take the necessary steps to contain this damaging virus.

Political will is in short supply because powerful economic and corporate interests have been pushing policymakers to let the virus spread largely unchecked through the population since the very beginning of the pandemic. The reasons are simple. First, NPIs hurt general economic activity, even if only in the short term, resulting in losses on balance sheets. Second, large-scale containment efforts of the kind we only saw briefly in the first few months of the pandemic require substantial governmental support for all the people who need to pause their economic activity for the duration of effort. Such an effort also requires large-scale financial investment in, for example, contact tracing and mass testing infrastructure and providing high-quality masks. In an era dominated by laissez-faire economic dogma, this level of state investment and organization would have set too many unacceptable precedents, so in many jurisdictions it was fiercely resisted, regardless of the consequences for humanity and the economy.

None of these social and economic predicaments have been resolved. The unofficial alliance between big business and dangerous pathogens that was forged in early 2020 has emerged victorious and greatly strengthened from its battle against public health, and is poised to steamroll whatever meager opposition remains for the remainder of this, and future pandemics.

The long-established principles governing how we respond to new infectious diseases have now completely changed – the precedent has been established that dangerous emerging pathogens will no longer be contained, but instead permitted to ‘ease’ into widespread circulation. The intent to “let it rip” in the future is now being openly communicated84. With this change in policy comes uncertainty about acceptable lethality. Just how bad will an infectious disease have to be to convince any government to mobilize a meaningful global public health response?

We have some clues regarding that issue from what happened during the initial appearance of the Omicron “variant” (which was really a new serotype85,86) of SARS-CoV-2. Despite some experts warning that a vaccine-only approach would be doomed to fail, governments gambled everything on it. They were then faced with the brute fact of viral evolution destroying their strategy when a new serotype emerged against which existing vaccines had little effect in terms of blocking transmission. The reaction was not to bring back NPIs but to give up, seemingly regardless of the consequences.

Critically, those consequences were unknown when the policy of no intervention was adopted within days of the appearance of Omicron. All previous new SARS-CoV-2 variants had been deadlier than the original Wuhan strain, with the eventually globally dominant Delta variant perhaps as much as 4× as deadly87. Omicron turned out to be the exception, but again, that was not known with any certainty when it was allowed to run wild through populations. What would have happened if it had followed the same pattern as Delta?

In the USA, for example, the worst COVID-19 wave was the one in the winter of 2020-21, at the peak of which at least 3,500 people were dying daily (the real number was certainly higher because of undercounting due to lack of testing and improper reporting). The first Omicron BA.1 wave saw the second-highest death tolls, with at least 2,800 dying per day at its peak. Had Omicron been as intrinsically lethal as Delta, we could have easily seen a 4-5× higher peak than January 2021, i.e. as many as 12–15,000 people dying a day. Given that we only had real data on Omicron’s intrinsic lethality after the gigantic wave of infections was unleashed onto the population, we have to conclude that 12–15,000 dead a day is now a threshold that will not force the implementation of serious NPIs for the next problematic COVID-19 serotype.

UK National Covid Memorial Wall. Credit: Dominic Alves Logically, it follows that it is also a threshold that will not result in the implementation of NPIs for any other emerging pathogens either. Because why should SARS-CoV-2 be special?

We can only hope that we will never see the day when such an epidemic hits us but experience tells us such optimism is unfounded. The current level of suffering caused by COVID-19 has been completely normalized even though such a thing was unthinkable back in 2019. Populations are largely unaware of the long-term harms the virus is causing to those infected, of the burden on healthcare, increased disability, mortality and reduced life expectancy. Once a few even deadlier outbreaks have been shrugged off by governments worldwide, the baseline of what is considered “acceptable” will just gradually move up and even more unimaginable losses will eventually enter the “acceptable” category. There can be no doubt, from a public health perspective, we are regressing.

We had a second, even more worrying real-life example of what the future holds with the global spread of the MPX virus (formerly known as “monkeypox” and now called “Mpox”) in 2022. MPX is a close relative to the smallpox VARV virus and is endemic to Central and Western Africa, where its natural hosts are mostly various rodent species, but on occasions it infects humans too, with the rate of zoonotic transfer increasing over recent decades88. It has usually been characterized by fairly high mortality – the CFR (Case Fatality Rate) has been ∼3.6% for the strain that circulates in Nigeria and ∼10% for the one in the Congo region, i.e. much worse than SARS-CoV-2. In 2022, an unexpected global MPX outbreak developed, with tens of thousands of confirmed cases in dozens of countries89,90. Normally, this would be a huge cause for alarm, for several reasons.

First, MPX itself is a very dangerous disease. Second, universal smallpox vaccination ended many decades ago with the success of the eradication program, leaving the population born after that completely unprotected. Third, lethality in orthopoxviruses is, in fact, highly variable – VARV itself had a variola major strain, with as much as ∼30% CFR, and a less deadly variola minor variety with CFR ∼1%, and there was considerable variation within variola major too. It also appears that high pathogenicity often evolves from less pathogenic strains through reductive evolution - the loss of certain genes something that can happen fairly easily, may well have happened repeatedly in the past, and may happen again in the future, a scenario that has been repeatedly warned about for decades91,92. For these reasons, it was unthinkable that anyone would just shrug off a massive MPX outbreak – it is already bad enough as it is, but allowing it to become endemic means it can one day evolve towards something functionally equivalent to smallpox in its impact.

Colorized transmission electron micrograph of Mpox virus particles. Credit: NIAID And yet that is exactly what happened in 2022 – barely any measures were taken to contain the outbreak, and countries simply reclassified MPX out of the “high consequence infectious disease” category93 in order to push the problem away, out of sight and out of mind. By chance, it turned out that this particular outbreak did not spark a global pandemic, and it was also characterized, for poorly understood reasons, by an unusually low CFR, with very few people dying94,95. But again, that is not the information that was available at the start of the outbreak, when in a previous, interventionist age of public health, resources would have been mobilized to stamp it out in its infancy, but, in the age of laissez-faire, were not. MPX is now circulating around the world and represents a future threat of uncontrolled transmission resulting in viral adaptation to highly efficient human-to-human spread combined with much greater disease severity.

This is the previously unthinkable future we will live in from now on in terms of our approach to infectious disease.

What may be controlled instead is information. Another lesson of the pandemic is that if there is no testing and reporting of cases and deaths, a huge amount of real human suffering can be very successfully swept under the rug. Early in 2020, such practices – blatant denial that there was any virus in certain territories, outright faking of COVID-19 statistics, and even resorting to NPIs out of sheer desperation but under false pretense that it is not because of COVID-19 – were the domain of failed states and less developed dictatorships. But in 2023 most of the world has adopted such practices – testing is limited, reporting is infrequent, or even abandoned altogether – and there is no reason to expect this to change. Information control has replaced infection control.

After a while it will not even be possible to assess the impact of what is happening by evaluating excess mortality, which has been the one true measure not susceptible to various data manipulation tricks. As we get increasingly removed from the pre-COVID-19 baselines and the initial pandemic years are subsumed into the baseline for calculating excess mortality, excess deaths will simply disappear by the power of statistical magic. Interestingly, countries such as the UK, which has already incorporated two pandemic years in its five-year average, are still seeing excess deaths, which suggests the virus is an ongoing and growing problem.

It should also be stressed that this radical shift in our approach to emerging infectious diseases is probably only the beginning of wiping out the hard-fought public health gains of the last 150+ years. This should be gravely concerning to any individuals and institutions concerned with workers and citizens rights.

This shift is likely to impact existing eradication and elimination efforts. Will the final pushes be made to complete the various global eradication campaigns listed above? That may necessitate some serious effort involving NPIs and active public health measures, but how much appetite is there for such things after they have been now taken out of the toolkit for SARS-CoV-2?

We can also expect previously forgotten diseases to return where they have successfully been locally eradicated. We have to always remember that the diseases that we now control with universal childhood vaccinations have not been globally eradicated – they have disappeared from our lives because vaccination rates are high enough to maintain society as a whole above the disease elimination threshold, but were vaccination rates to slip, those diseases, such as measles, will return with a vengeance.

The anti-vaccine movement was already a serious problem prior to COVID-19, but it was given a gigantic boost with the ill-advised vaccine-only COVID-19 strategy. Governments and their nominal expert advisers oversold the effectiveness of imperfect first generation COVID-vaccines, and simultaneously minimized the harms of SARS-CoV-2, creating a reality gap which gave anti-vaccine rhetoric space to thrive. This is a huge topic to be explored separately. Here it will suffice to say that while anti-vaxxers were a fringe movement prior to the pandemic, “vaccination” in general is now a toxic idea in the minds of truly significant portions of the population. A logical consequence of that shift has been a significant decrease in vaccination coverage for other diseases as well as for COVID-19.

This is even more likely given the shift in attitudes towards children. Child labour, lack of education and large families were the hallmarks of earlier eras of poor public health, which were characterized by high birth-rates and high infant mortality. Attitudes changed dramatically over the course of the 20th century and wherever health and wealth increased, child mortality fell, and the transition was made to small families. Rarity increased perceived value and children’s wellbeing became a central concern for parents and carers. The arrival of COVID-19 changed that, with some governments, advisers, advocacy groups and parents insisting that children should be exposed freely to a Severe Acute Respiratory Syndrome virus to ‘train’ their immune systems.

Infection, rather than vaccination, was the preferred route for many in public health in 2020, and still is in 2023, despite all that is known about this virus’s propensity to cause damage to all internal organs, the immune system, and the brain, and the unknowns of postinfectious sequelae. This is especially egregious in infants, whose naive immune status may be one of the reasons they have a relatively high hospitalization rate. Some commentators seek to justify the lack of protection for the elderly and vulnerable on a cost basis. We wonder what rationale can justify a lack of protection for newborns and infants, particularly in a healthcare setting, when experience of other viruses tells us children have better outcomes the later they are exposed to disease? If we are not prepared to protect children against a highly virulent SARS virus, why should we protect against others? We should expect a shift in public health attitudes, since ‘endemicity’ means there is no reason to see SARS-CoV-2 as something unique and exceptional.

We can also expect a general degradation of workplace safety protocols and standards, again reversing many decades of hard-fought gains. During COVID-19, aside from a few privileged groups who worked from home, people were herded back into their workplaces without minimal safety precautions such as providing respirators, and improving ventilation and indoor air quality, when a dangerous airborne pathogen was spreading.

Can we realistically expect existing safety precautions and regulations to survive after that precedent has been set? Can we expect public health bodies and regulatory agencies, whose job it is to enforce these standards, to fight for workplace safety given what they did during the pandemic? It is highly doubtful. After all, they stubbornly refused to admit that SARS-CoV-2 is airborne (even to this very day in fact – the World Health Organization’s infamous “FACT: #COVID19 is NOT airborne” Tweet from March 28 2020 is still up in its original form), and it is not hard to see why – implementing airborne precautions in workplaces, schools, and other public spaces would have resulted in a cost to employers and governments; a cost they could avoid if they simply denied they needed to take such precautions. But short-term thinking has resulted in long-term costs to those same organizations, through the staffing crisis, and the still-rising disability tsunami. The same principle applies to all other existing safety measures.

Worse, we have now entered the phase of abandoning respiratory precautions even in hospitals. The natural consequence of unmasked staff and patients, even those known to be SARS-CoV-2 positive, freely mixing in overcrowded hospitals is the rampant spread of hospital-acquired infections, often among some of the most vulnerable demographics. This was previously thought to be a bad thing. And what of the future? If nobody is taking any measures to stop one particular highly dangerous nosocomial infection, why would anyone care about all the others, which are often no easier to prevent? And if standards of care have slipped to such a low point with respect to COVID-19, why would anyone bother providing the best care possible for other conditions? This is a one-way feed-forward healthcare system degradation that will only continue.

Finally, the very intellectual foundations of the achievements of the last century and a half are eroding. Chief among these is the germ theory of infectious disease, by which transmission chains can be isolated and broken. The alternative theory, of spontaneous generation of pathogens, means there are no chains to be broken. Today, we are told that it is impossible to contain SARS-CoV-2 and we have to "just live with it,” as if germ theory no longer holds. The argument that the spread of SARS-CoV-2 to wildlife means that containment is impossible illustrates these contradictions further – SARS-CoV-2 came from wildlife, as did all other zoonotic infections, so how does the virus spilling back to wildlife change anything in terms of public health protocol? But if one has decided that from here on there will be no effort to break transmission chains because it is too costly for the privileged few in society, then excuses for that laissez-faire attitude will always be found.

And that does not bode well for the near- and medium-term future of the human species on planet Earth.

(Follow the link for more than 100 references and sources)

[allthecanadianpolitics]

Ontario’s temporary sick day program is set to expire at the end of March and officials remain tight lipped over whether they will extend the program, saying instead the policy has “filled its purpose” and remains “status quo.” The province’s temporary sick day program, which gave employees three days off total to recover from COVID-19, was put in place in April 2021 in an attempt to curb the spread of COVID-19 in essential workplaces. The program also provided eligible workers up to $200 a day if they needed to get tested, vaccinated, self-isolate or care for a family member.

Full article

Tagging: @politicsofcanada

[willowreader]

This policy seems extreme. If not based on science, then what?