Not unrelated to my post of last week, the editors of the Washington Post call out one of the run-on effects of the COVID-19 pandemic—a spike in the number of deaths due to tuberculosis:
With reduced access to diagnosis and treatment, deaths are on the rise. The WHO’s annual tuberculosis report, released Thursday, estimates that last year there were 1.3 million deaths, marking a return to the 2017 level and the first year-on-year increase since 2005. Also worrisome is that treatment for drug-resistant tuberculosis fell, as well as preventive treatment. Global spending on tuberculosis diagnostics, treatment and prevention declined, too.
The tuberculosis story is almost certainly going to be repeated with other global health campaigns, including the fights against polio, malaria, HIV/AIDS and more. The WHO and UNICEF report that 23 million children missed out on basic vaccines through routine immunization services last year, which is 3.7 million more than in 2019. Most of these, up to 17 million children, probably did not receive a single vaccine during the year.
In 1900 before antibiotic treatment about 200 people per 100K population died of tuberculosis. My back-of-the-envelope calculations tell me that’s considerably worse than deaths due to COVID-19. We don’t want to go back to those days and the more people contract TB and the more who are inadequately treated the greater is the likelihood that will happen.
So many knock on effects. The sole focus has always been on cases and deaths. This was largely due to political considerations, and secondarily due to the “no risk; or no risk vs reward considerations” stance of those who actually care about covid mortality and morbidity.
Unfortunately we still have the same dynamic at work. Vaccinate, vaccinate, vaccinate. And vilify those who differ. We have learned nothing.
One has to ask why this maniacal, single focused effort exists. The cynic in me says its because Team Biden ran and hangs its hat on covid control and statistics. Political. That’s what a sympathetic media will focus on. And these knock on effects and the lives of people affected be damned. There are precious few pointing out the knock on effects.
“The sole focus has always been on cases and deaths.”
No. I have here and doctors in general have pointed deaths are not the only problem. Two weeks in an ICU is a big deal, even if you live.
“Vaccinate, vaccinate, vaccinate. And vilify those who differ.”
it is the medically appropriate approach. The main reason large numbers of people are not getting vaccinated is political. I have always agreed we should not vilify people, but not really sure it makes much difference anyway. A lot of this is just playing the victim which you on the right like to do so much. Most of the rest of it comes from social media. From the medical community w heave largely tried to avoid this though there are individual cases where people boil over. It is hard to take seriously the people who are taking “supplements” which is a long running grift especially popular on the right. (See Alex Jones, or Ben Carson as examples.)
“In 1900 before antibiotic treatment about 200 people per 100K population died of tuberculosis. ”
At least 23 countries already exceed that.
https://www.statista.com/statistics/1104709/coronavirus-deaths-worldwide-per-million-inhabitants/
Steve
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8481107/
The money paragraph:
The sole reliance on vaccination as a primary strategy to mitigate COVID-19 and its adverse consequences needs to be re-examined, especially considering the Delta (B.1.617.2) variant and the likelihood of future variants. Other pharmacological and non-pharmacological interventions may need to be put in place alongside increasing vaccination rates. Such course correction, especially with regards to the policy narrative, becomes paramount with emerging scientific evidence on real world effectiveness of the vaccines.
For instance, in a report released from the Ministry of Health in Israel, the effectiveness of 2 doses of the BNT162b2 (Pfizer-BioNTech) vaccine against preventing COVID-19 infection was reported to be 39% [6], substantially lower than the trial efficacy of 96% [7]. It is also emerging that immunity derived from the Pfizer-BioNTech vaccine may not be as strong as immunity acquired through recovery from the COVID-19 virus [8]. A substantial decline in immunity from mRNA vaccines 6-months post immunization has also been reported [9]. Even though vaccinations offers protection to individuals against severe hospitalization and death, the CDC reported an increase from 0.01 to 9% and 0 to 15.1% (between January to May 2021) in the rates of hospitalizations and deaths, respectively, amongst the fully vaccinated [10].
In summary, even as efforts should be made to encourage populations to get vaccinated it should be done so with humility and respect. Stigmatizing populations can do more harm than good. Importantly, other non-pharmacological prevention efforts (e.g., the importance of basic public health hygiene with regards to maintaining safe distance or handwashing, promoting better frequent and cheaper forms of testing) needs to be renewed in order to strike the balance of learning to live with COVID-19 in the same manner we continue to live a 100 years later with various seasonal alterations of the 1918 Influenza virus.
And what is Team Biden and their clapping seals in media engaged in? But then I’m sure the Harvard researcher is a raging MAGA-ite.
Surely you can do better than cite Alex Jones, steve. You beclown yourself.
I can do better than Alex Jones, the issue is that your side cannot. He is one of your leading lights and one of many on the right making money off of selling supplements. And you put Carson in a Cabinet office! You probably forgot that so maybe you should buy some of those memory improvement supplements.
https://www.cbsnews.com/news/ben-carson-denies-relationship-still-plugs-product/
Anyway, not an especially informative citation as they are just reiterating what many others have said. Everyone who is serious about Covid agrees we need good therapeutics, it is just that vaccines are the most effective, cheapest and probably safest option. Regeneron is about $2000 for the drug. Molnupiravir will probably come in around $500-$800 per treatment though it doesnt require an infusion so a big win there.
While case numbers have gone up, and note that in areas with low vaccination rates they are also less likely to test, what we have clearly seen is that hospitalizations and deaths are occurring very predominately in the unvaccinated. Maintaining safe distancing? Arent you guys opposed to that? Israel is always an interesting place because of what they do, but most people dont know their demographics. They have a lot fo young people. So while a high percentage of eligible people are vaccinated only about 58%-60% of the total population is vaccinated. (From the very paper you cited. Follow the footnotes. I am sure you did that didnt you?)
I totally agree that we need to learn olive with Covid. Vaccinations are the first step. If we had “everyone” vaccinated, meaning everyone who should reasonably be vaccinated, then we should do away with all of the mitigation efforts, even the distancing you just suggested. Keep working on therapeutics. Accept that we have done what we can and move on.
Steve
FWIW the UK is having another spike in cases.
Here is a rendering of the facts as I see it.
1) There are multiple studies, in different polities, that show the efficiency of the vaccine against symptomatic illness / spread is about 50% after 5 months or so. They do continue to have an efficiency of 90% against hospitalization/deaths out to about 9 months or so (vaccines are so new they don’t have data beyond that).
2) Even with a 90% risk reduction, given how dangerous COVID is for the elderly or those with “risk factors”, catching COVID even with vaccination is a danger for this population. Colin Powell is a tragic testament to that fact.
3) Given the contagious of delta, and vaccines limited effectiveness against spread; even vaccination of 100% of the population won’t drive its R to 1 or below; so exponential spread occurs among the population, including the vulnerable. As an example, take Singapore; they vaccinated 86.4% of population (and that includes kids < 12 who are not eligible for vaccines). They are in the middle of their worse surge yet of cases and deaths.
The difference with flu is even after vaccines, COVID is still far more contagious (almost guaranteed to reach vulnerable populations), and is likely far more dangerous to those vulnerable populations.
Hence my recommendations for better vaccines and better therapeutics. We also need better education about the risks still left. It might drive a lot people to vaccinate if they were told herd immunity isn't occurring anytime soon.
” It might drive a lot people to vaccinate if they were told herd immunity isn’t occurring anytime soon.”
Do you really believe that or are you just expressing hope? I dont think anything is changing the minds of the committed. If you have a real interest in the topic you already knew this. If you dont have a real interest and are just reading what you see in your bubble, and mostly just the headlines at that, you arent going to believe it anyway.
Steve
BTW, it is now politically incorrect to ask patients or talk to pts about vaccinations unless they bring it up. Hurts their feelings dont you know.
Steve
Out here in the sticks where nothing happens that has a bearing on anything, vaccination rates are up, I believe because more people now know someone laid low by it.
They may not believe it works, but fear, you know.
Maybe we can outsource vaccinations to some group that understands they have value.
https://www.theguardian.com/global-development/2021/oct/19/afghanistan-to-restart-polio-vaccination-programme-with-taliban-support
Steve