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Focus on Facts and Restrict the Flow of Misinformation

With more than 756 million cases and 6.8 million deaths worldwide as of February 2023, the SARS-CoV-2 (COVID-19) pandemic is one of the most significant pandemics in recent history. In the United States, deaths due to this virus have surpassed the 1918 H1N1 pandemic, the most lethal flu pandemic in the last century.
Identifying Drug Candidates for COVID-19 with Large-Scale Drug Screening or Int J Mol Sci. 2023 Feb 23;24(5):4397. doi: 10.3390/ijms24054397

In general terms, COVID-19 monitoring/testing has much lower priority across the U.S. than in 2020-2022. Reductions in monitoring can dramatically mask the scope of disease impacts. For example, Trevor Bedford of the Fred Hutchinson Cancer Center / Howard Hughes Medical Institute reported in July 2023 that "roughly 1 in 3 (COVID-19) infections were detected in 2021, while only 1 in 40 in 2023..." and that a material burden imposed by COVID-19 disease remains endemic -- reporting that the "U.S. has seen 40,000 COVID-19 deaths from Jan 1 to Jun 10," 2023.

See the [CDC's Excess Deaths Associated with COVID-19]](https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm) visualization of monthly deaths attributable to COVID-19. The numbers are material.

Action on COVID-19 at home and abroad is **still** needed to save lives.  
Get vaccinated.  Help your family and friends do the same.  
Get boosted.  Help your family and friends do the same.  
Ventilate shared spaces.  
Avoid crowds.  
Don't hesitate to use masks in crowded enclosed places.  
Test if you have symptoms.  
Isolate if you are positive or cannot access a test until you have not had a fever for 24 hours (the same recommendation for the flu and other respiratory illnesses).  
Use masks if you are ill.  
Support global vaccine distribution.  Pockets of unvaccinated, regardless of their location, are reservoirs for the virus, where it most effectively replicates and mutates, and where new variants evolve.  Vaccinations reduce human suffering both locally and globally.

Trump's Team and U.S. Health Secretary Robert F. Kennedy Jr. (long time anti-vaccine and sometimes anti-science activist) appear to be constraining COVID-19 vaccine availability arguing that it is unsafe and does not work. Health and Human Services Secretary Robert F. Kennedy Jr. announced on Aug. 27 on X/Twitter that emergency-use authorizations for COVID-19 vaccines have been terminated and that the Moderna, Pfizer and Novavax immunizations are approved for “those at high risk.” Under the updated approvals, only those over 65 and people with existing health problems will be recommended for the COVID-19 vaccine, according to federal guidelines. Then he added that these vaccines were available for all patients who could pay full retail price (*assuming that public and private insurers would not pay for a vaccination that wasn't recommended by the CDC for given customers -- i.e., everyone less than 65 years old.

Kennedy recently appointed Retsef Levi to the Advisory Committee on Immunization Practices (ACIP) and its COVID-19 immunization workgroup. Under the cover of a professorship at MIT, "critic of COVID-19 lockdowns and mRNA vaccines, and COVID-19 vaccine skeptic" Levi said:

“At this point in time, all COVID mRNA vaccination program should stop immediately. They should stop because they completely fail to fulfill any of their advertized promise regarding efficacy, and more importantly, they should stop because of the mounting and indisputable evidence that they cause (an) unprecedented level of harm, including the death of young people and children.”

In the context of serious public health science about COVID-19 vaccine safety and efficacy, Levi's rant seems like extremest wailing from a professional fact-distortionist & anti-vaxer...

That is in the face of years of multi-faceted hard science measuring the safety and efficacy of the COVID-19 vaccines. Eight billion doses of COVID-19 vaccines were administered globally by 16 Feb 2022 and scientists found 55 cases of death after COVID-19 vaccination reported in the literature. After careful analysis these scientists concluded that:

"Given the small number of severe adverse reactions and deaths reported, it is beyond doubt that the benefits of vaccination outweigh the risks."

CDC vaccine safety monitoring is real. They run a variety of safety and effectiveness monitoring programs. For example, my wife and I participated in V-Safe after each of our COVID-19 vaccinations. V-Safe is a vaccine safety monitoring system run by the CDC, and collects first person data for varying lengths of time after given vaccinations. Are there more deaths likely attributable (at least in part) to the administration of a COVID-19 vaccination? In that pool of more than 8 billion shots, certainly more than the 55 mentioned above, but equally probable that the numbers are still so small as to be offset by the populations who remain alive because of their participation in COVID-19 vaccination programs.

Dr. Daniela J. Lamas, a pulmonary and critical-care physician at Brigham and Women’s Hospital in Boston reports that:

"Nearly four years after the World Health Organization’s declaration of a pandemic, the coronavirus is still with us. It likely always will be. And it is still resulting in 500 to 1,500 deaths every week as of the last month — higher than the mortality from influenza, though lower compared to previous years. There is also the persistent threat of [long Covid](https://www.nytimes.com/2024/02/18/opinion/long-covid-research-funding.html, the debilitating symptoms that can persist after an initial infection."

in July 2022 CDC officials said between 26 million and 37 million adults in the U.S. haven't had a single COVID-19 vaccine dose

By October 2022 the Covid pandemic had killed nearly as many Americans as U.S. troops died in battle during all of our wars combined. (This is a near-quote from Dr. Craig Spencer in the NYT)

230,637,348 people in the U.S. are considered fully vaccinated with the original COVID-19 vaccine. That is 70% of the 333.29 million people in the U.S. in 2022. Only 63.5% of Iowans reached that fully vaccinated status, and only 35.4% of Iowans have received a booster or additional dose. Iowa Gov. Kim Reynolds rejects most science-based pandemic mitigation strategies vowing in an August 2023 statement: “Not on my watch.” Her approach to pandemic response has helped fuel broader anti-vaccine skepticism. Requests for the new COVID 19 vaccines are at all-time lows, and federal health data shows vaccination rates among U.S. kindergartners for diseases such as measles and polio have declined over the past two years. In late December 2023 Michaela Ramm and Samantha Hernandez reported in the Des Moines Register that:

Just 2.9% of children in Iowa between the ages of 6 months and 17 years have an updated COVID-19 shot as of Dec. 2, according to the the U. S. Centers for Disease Control and Prevention. Meanwhile, 27.8% of adults age 18 and older in Iowa have received the new vaccine. In Polk County, just 12.4% of residents are up to date on COVID-19 vaccinations, the county health department says. As of Monday, 30% of the state’s population have received a flu shot, according to state data. Twenty- six percent of Polk County residents have received the latest flu shot so far this year, a drop from the roughly 40% average flu shot rate among county residents over the past 6 years, local health officials say.
By late April 2024 Michaela Ramm reported in the Des Moines Register that:
Iowa is far below the recommended vaccination rate. As of last week, only about 15% of the state’s population were fully vaccinated against COVID-19, and about 34% of all Iowans had received a flu shot.

It is possible that Reynolds' approach to this topic also plays a role in her state's increasing death rate. In 2022, the age-adjusted death rate in the US was 833.6 deaths per 100,000 people for the Nation and slightly higher 836.7 per 100,000 people for Iowa. Nation-wide, that is 13.8% higher than in 2012, a decade before. Compare that with states like New York at 685.3 or New Jersey at 708.6 or nearby Minnesota at 750.3. Another way to look at increasing Iowan deaths during the COVID-19 crisis is to simply look at the graphs of deaths 2019-2024 on the state's new "Health Statistics" page under the heading "Death" and notice the material increase in the number of deaths in the fall-winter 2020-2021 and again in 2021-2022 -- given the relatively consistent pattern of other years, these excess deaths seem reasonably attributable to COVID-19 and its downstream effects -- especially when you see the very low COVID-19 immunization rates across Iowa. The impacts of Gov. Reynolds' pandemic leadership and that of her political peers are not evenly distributed throughout the U.S. population.

According to a study published by the National Bureau of Economic Research in September 2022, rates of excess deaths were 76 percent higher among Republicans than Democrats throughout the pandemic. The gap was much smaller in 2020; it then grew almost sevenfold with the arrival of vaccines. David Wallace-Wells, NYT. April 24, 2023

An authoratative study published in The Lancet, April 2023, reported that "our results show that states where a greater fraction of the population voted for the Republican Party's 2020 presidential candidate, on average, had more infections and more total COVID-19 deaths (per 100,000) for the entire study period. Those findings are consistent with other studies." The authors found that higher education appears to be a material antidote to materially negative partisan healthcare behaviors: "An important exception emerged in our results: we found an association between strong health systems and vaccine coverage in Republican-leaning states with higher mean years of education](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00461-0/fulltext#back-bib74).

Although these facts have been covered widely in the news and on social media. They appear to have little to no impact on well documented partisan healthcare behaviors, along with related impacts.

The KFF reports that there remains dramatic differences in the acceptance of COVID-19 vaccines between Democrats and Republicans through September 2023. With an additional view of that data here.

COVID-19 strains continue to circulate widely. The KFF COVID-19 Vaccine Monitor (January 17-24, 2023) reported that nearly four in ten say that they or someone in their household were sick with either COVID-19, RSV, or flu over the past month.

COVID-19 Remains a Leading Cause of Death in the U.S.

Age-adjusted deaths per 100,000 people, by leading cause of death as of October 2023

Cause Age-adjusted deaths per 100,000
Heart disease 175.4
Cancer 147.5
Accidents 59.5
COVID-19 46.5
Cerebrovascular diseases 41.8

NOTE: COVID-19 "Age-adjusted deaths per 100,000" were higher in the 2020-2022 period: 85.0 in 2020, 104.1 in 2021, and 46.6 in 2022.
FROM: https://wonder.cdc.gov/controller/saved/D176/D345F898 "Provisional Mortality Statistics, 2018 through Last Week Results Deaths occurring through October 07, 2023 as of October 15, 2023." Centers for Disease Control and Prevention, National Center for Health Statistics. National Vital Statistics System, Provisional Mortality on CDC WONDER Online Database. Data are from the final Multiple Cause of Death Files, 2018-2021, and from provisional data for years 2022-2023, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10-provisional.html on Oct 23, 2023 9:26:11 AM
Cerebrovascular disease is a term for conditions that affect blood flow to your brain. Conditions include stroke, brain aneurysm, brain bleed and carotid artery disease.
In December 2023, Victoria Reyna-Rodriguez and Stephanie Innes reporting in the Des Moines Register on "What are the leading causes of death in Iowa?" wrote that:

"According to 2021 data from the CDC, here are Iowa’s top 5 leading causes of death: 1 Heart disease 2 Cancer 3 COVID-19 4 Accidents 5 Chronic lower respiratory diseases"
...Moving COVID-19 below "accidents" as a cause of death sometime after 2021.

Current COVID-19 Data:

COVID-19 Data from Wastewater Testing:

Iowa COVID-19 Tracker: https://iowacovid19tracker.org/
CDC Wastewater COVID-19 State and Territory Trends: https://www.cdc.gov/nwss/rv/COVID19-statetrend.html
COVID-19 Wastewater Monitoring Data from biobot.io: https://biobot.io/data/covid-19

Use of Wastewater Metrics to Track COVID-19 in the US." By Meri R. J. Varkila, MD; Maria E. Montez-Rath, PhD; Joshua A. Salomon, PhD; et al (July 26, 2023) https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2807632

"Wastewater surveillance offers a potential solution to the problem of accurate SARS-CoV-2 surveillance because it is agnostic to symptomatic, diagnosed, or reported disease. High-resolution sequencing of wastewater can also identify emerging variants of concern4 and estimate the effective reproductive number,5 a key predictor of future transmission."

"Wastewater-based epidemiology predicts COVID-19-induced weekly new hospital admissions in over 150 USA counties." By Xuan Li, Huan Liu, Li Gao, et al. (28 July 2023) Nature Communications volume 14, Article number: 4548 (2023) https://www.nature.com/articles/s41467-023-40305-x

"WBE-based (wastewater-based epidemiology) models accurately predicted the county-level weekly new admissions, allowing a preparation window of 1-4 weeks. In real applications, periodically updated WBE-based models showed good accuracy and transferability, with mean absolute error within 4-6 patients/100k population for upcoming weekly new hospitalization numbers. Our study demonstrated the potential of using WBE as an effective method to provide early warnings for healthcare systems."

"Get Immunized"

Iowa Status:

Notable Historical Facts:

  • COVAX delivered nearly 2 billion doses of vaccines to 146 economies, averting an estimated 2.7 million excess deaths in lower-income participating economies will close 31 December 2023. See the full story at https://www.unicef.org.... Quote:

COVAX, the multilateral mechanism for equitable global access to COVID-19 vaccines launched in 2020, will draw to a close on 31 December. Jointly led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance (Gavi), UNICEF and the World Health Organization (WHO), COVAX has so far supplied nearly 2 billion COVID-19 vaccine doses and safe injection devices to 146 economies. Its efforts are estimated to have helped avert the deaths of at least 2.7 million people in the COVAX Advance Market Commitment (AMC) low- and lower middle-income participating economies (lower-income economies) that received free doses through the mechanism, alongside nearly US$ 2 billion in critical support to turn vaccines into vaccinations.