Once a huge source of controversy, there is a growing national consensus on the effectiveness and necessity of masks.  Republicans and democrats alike are now imploring the public to mask up. Even President Trump has changed his tune, just recently coming out with a strong endorsement and calling wearing a mask ‘patriotic.’  Public health experts have been explaining for a while that wearing a mask is a basic and essential part of curbing the spread of COVID-19 as we head into what promises to be a very dark fall.

 

When worn by 80% of a population, masks have been shown to be more effective than a strict lockdown.  The Institute for Health Metrics and Evaluation estimated that if 95% of people wore masks, we could save 40,000 lives by November. While several promising vaccines are in development, there will be no vaccine to save us this year and a natural herd immunity has been shown to be unrealistic due to the sheer size of our population and the rapidness at which COVID-19 antibodies disappear.  YOU CAN GET REINFECTED.

Testing is also expected to be overburdened this fall as large numbers are expected to increase the amount of tests needed as people attempt to distinguish between the flu, common colds and COVID-19. The White House is moving to block more money for the CDC and testing.  With no vaccine, no real federal support and limited testing, our last hope is that Americans are able to come together and adopt mask wearing, not as some type of politicized act, but to save our country from what might well be what the director of the CDC is saying will be one of the most difficult times we’ve ever experienced in American public health.

It’s time for American to mask up.

 

Yours in Strength,

The Take Back Control Team

Herd immunity has been touted as a strategy to deal with COVID-19, preferably through a vaccine, but also naturally as a last resort if the virus continues to spread unmitigated.  What does this mean and will herd immunity be enough to keep us safe?

 

What is herd immunity?

 

Herd immunity refers to when enough of the population has been inoculated to a virus that it can no longer be a threat.  If someone gets a virus that others in their circle have already had and recovered from, or otherwise have been vaccinated against, it will stop there and not continue to spread due to others’ immunity. Because COVID-19 is a particularly deadly virus, at least 10x more deadly than the flu, exposing the populace to it as a way to get through it faster would have deadly consequences, especially if measures aren’t taken to protect the most vulnerable among us, and if there isn’t effective and well run public health infrastructure.

 

How is it achieved?

 

Herd immunity is usually achieved either through a vaccine or if enough of the population has become immune.  For example, measles requires 19 out of 20 people to have been vaccinated for effective herd immunity.  Ideally, with a virus as highly contagious as SARS-CoV-2, cases would be controlled and the spread of the virus mitigated through public policies such as lockdowns, social distancing protocol and mask mandates until a viable vaccine is created.

 

Is herd immunity possible with COVID-19?

 

Here is the underlying issue.  COVID-19 antibodies don’t seem to stick around for long.  This is bad for people and governments hoping that growing immunity would eventually stop the virus.  So far, there is no evidence that if you get COVID-19, that you can’t get it again.  On April 24th, the World Health Organization said that “there is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection.”

 

What does this mean for a vaccine?

 

There are currently 21 vaccines in clinical trials and 139 other vaccines in preclinical evaluation. Eventually we will get a safe and effective vaccine, preferably with a 75% efficacy rate by early 2021. However, Dr. Fauci has said that if 25% or more of the population refuses the vaccine, which is likely given the anti-science, anti-establishment, anti-vax prevalence in this country, a 75% effective vaccine will not be enough to reach herd immunity.  And that’s with the assumption that the vaccine would be that highly effective and that immunity would last.  More likely is a scenario of an initial vaccine with 40% efficacy and periodic boosters necessary to maintain immunity.  The end goal would be to “identify the best vaccine strategies able to overcome these problems and stimulate a large, sustained, optimal, immune response in the way the virus failed to do,” says Prof Danny Altmann, the British Society for Immunology spokesperson and Professor of Immunology at Imperial College London.

 

We don’t want to have the virus sweep through our entire population, killing the most vulnerable and decimating our communities until we reach a point where the majority (that’s left) is immune. But thanks to a lack of federal coordination and intervention, that is now what we are involuntarily hurtling towards.

 

In the back of our collective minds, there is an assumption that even if it is horrific and comes at the cost of many preventable deaths, there will at least be an eventual end to the chaos.  But that’s where we may be wrong. Current research shows that COVID-19 antibodies may last for as little as two months, and having had the virus is no guarantee that you won’t be reinfected–which leaves us with no definitive end in sight.

 

All hope is not lost.  New Zealand has declared the country free of any active COVID-19 cases.  Just yesterday, New York City, once the epicenter of the outbreak in the US, reported no new COVID-19 deaths.  This was achieved without a vaccine or herd immunity and if they can do it, other parts of the nation can do it, too.

 

Wear a mask, wash your hands, social distance and avoid poorly ventilated indoor spaces whenever possible.

 

Yours in Strength,

The Take Back Control Team

COVID-19 has pushed many national emergencies into the background. One of the major issues that has taken a backseat in the midst of pandemic chaos is the opioid epidemic. While it doesn’t have the same fear inducing numbers as the pandemic, in 2018, 47,600 people died from opioid related overdoses.  With the coronavirus dominating our collective resources, headlines and energy, it is difficult to quantify exactly how much the virus is worsening the opioid epidemic, but media in regions all across America are reporting increasing opioid related fatalities. Fentanyl and cocaine cut with fentanyl are responsible for much of the overdoses.

Take Dupage County in Illinois just West of Chicago.  Dupage County has reported a sharp spike in overdose deaths this past May. “In the past three weeks, we have had 20 overdose deaths, mainly due to opioids,” said Richard Jorgensen, MD, the DuPage County coroner.

This trend can be seen in areas across the country.  Why is this happening?

There are a few potential reasons.  First, it is possible that there is a new, deadlier drug combination circulating.  Fentanyl and drugs cut with fentanyl is often consumed unknowingly and is incredibly deadly.

Second, while the emergence of the widespread usage of telehealth in lieu of in person check-ups has increased access for some, lack of internet and/or computers has made it more difficult to receive treatment for others. The American Medical Association has issued a report that details what actions states can take to help those battling with opioid addiction during the COVID-19 crisis.  Some of these steps include the following:

• Governors must adopt the new SAMHSA and DEA rules and guidance in-full for the duration of the national emergency—this includes flexibility for evaluation and prescribing requirements using telemedicine;
• States must enact as part of their own Emergency Orders and other actions a complete removal of prior authorization, step therapy and other administrative barriers for medications used to treat opioid use disorder;
• States must remove existing barriers for patients with pain to obtain necessary medications. This includes removing arbitrary dose, quantity and refill restrictions on controlled substances; and
• States must enact, implement and support harm reduction strategies, including removing barriers to sterile needle and syringe services programs.

For more information, you can read the full report here.

Social distancing, isolation and stress have also increased the onset of mental health disorders and precipitated relapses among many who suffer from substance abuse, and can make current usage heavier in those currently struggling with addiction.  “As you may have seen, Friday night to Saturday night our county saw 28 nonfatal overdoses—this is a high number for our county,” said Anahi Ortiz, MD, referencing Franklin County, Ohio. “COVID-19 has showed us the vulnerabilities and deficiencies in our addiction services—in addition, it has increased the mental health needs of this population.”

As mentioned, the current reigning chaos makes it difficult to fully understand the scope of the problem and its eventual impact.  Increases in suicide, substance abuse, non-COVID-19 deaths from an overburdened and failing private medical system, people who died from COVID-19 at home and never made it to a hospital, the opioid epidemic–the impact of all of these will be something we are left to attempt to quantify and understand in the aftermath of the pandemic.  We do, however, have concrete and actionable items that states can take in order to mitigate the effect of COVID-19 on those already suffering from another deadly public health crisis.

To read more about how COVID-19 is worsening the opioid epidemic, click here.

Yours in Strength,

The Take Back Control Team

Perhaps more than anything else, the pandemic has revealed America’s weak spots; cracks in our societal infrastructure that have been ready to crumble for quite some time.  One of these exploited fissures that is now strained to the point of breaking is childcare.  Even before COVID-19 decimated the economy and public health system, childcare was an issue demanding national attention.  With the average childcare worker making $10.72 an hour and it being more expensive in half of states to enroll a child in daycare than public universities, it is a system destined to fail without significant reform.  Birth rates in the US have hit a 32 year low and according to potential parents, financial instability and the enormous costs associated with children is the main reason why.

 

Enter COVID-19.

 

So far the virus has caused at least 336,000 childcare workers to lose their jobs.  61% of parents say that their childcare provider has closed.  And those that remain have increased costs due to new safety protocols and less children enrolling.  Childcare workers continue to make less than 98% of other American workers despite their designation as essential workers. As COVID-19 cases reach past 50,000 new cases a day with 100,000 daily cases in the forecast, it doesn’t look like schools will be reopening at full capacity in the fall.  Many schools are looking into hybrid options–offering a combination of significantly reduced class time and remote learning.  Which leaves both the childcare industry and parents at loose ends.

 

Was childcare always like this? Expensive, underappreciated, barely limping forward? The answer is no, it wasn’t.  In fact, there is great precedent for a well funded, federally subsidized national childcare system. In 1940 the Lanham Act was passed to accommodate the increase of working mothers due to World War II. The historic bill provided federally subsidized childcare centers nationwide.  They included medical clinics and infirmeries and provided shoppers to pick up items on personalized grocery lists for the working mothers. Children enrolled in these programs grew up to be more likely to be employed and earn higher salaries. 90% of those who participated in a survey at the time said that the centers should be even more widely established. However, funding was stopped and the program shut down after the war ended.  In 1971 we once again came close to passing federally subsidized childcare across the nation but Nixon vetoed it.  In contrast to the efforts of the past, the White House’s proposed 2018 fiscal budget cut $100 million for military childcare programs and the childcare act that was introduced was based on tax deductions that both parties found mostly benefited the rich.

 

Several senators have called for funding childcare centers through the crisis. Sen. Patty Murrey was instrumental in getting $3.5 billion included in the CARES Act for nationwide childcare assistance for low income families and has since introduced legislation with Rep. Rosa L. DeLauro and Rep. Robert C. Scott that would establish a $50 billion Child Care Stabilization Fund.  Republicans, however, have so far blocked any attempts to pass any proposal that would aid the American people, dragging their feet on a second stimulus bill and refusing to pass the HEROES Act introduced by the Democrats.  It is clear that without further aid, the childcare system in the United States will not make it through to the other side of this crisis and until schools are able to reopen fully, parents, and subsequently their jobs and the economy, will suffer.

 

We’ve included some quotes from parents and childcare providers below about their current predicament.  To read more accounts, click here.

 

“I want Congress and policymakers to know that child care providers have been forgotten as heroes and essential workers. I see support for front line medical staff, and grocery employees, mail carriers and teachers (rightfully so!). But who is thanking the people who open their programs to the children of these people? Who is acknowledging the risk these men and women put themselves and their families in direct contact with by accepting these children, every day? And who is talking about how LITTLE these men and women are compensated for as they continue to teach and address the social-emotional needs of these children? I can afford to pay my child care provider while not attending, but only just. And I know that she is not getting paid what she deserves. I would love for Congress and policymakers to know that child care providers are an abused resource to the communities they serve, and I would love to see them get the spotlight they deserve as they step up (as they’ve ALWAYS done) in this time of crisis.” -– Chelsea, parent from Rochester, NY.

 

“As a small private child care provider serving few essential workers, we made the difficult decision to close for the protection and safety of our children, families, and staff. Our future is uncertain, and we need fiscal relief for our employees and our ability to sustain this circumstance.” – Michele, child care provider from Tracy, CA.

 

Yours in Strength,

The Take Back Control Team

Question: What steps does the White House take to ensure COVID-19 doesn’t come near the president?

Answer:

• Daily COVID-19 tests for the President and staff
• Daily temperature checks
• Regular deep cleaning
• Social distancing protocol
• Testing of all guests
• Voluntary face coverings encouraged

What you can do at home:

What can you learn from this and how can you apply White House protocol to your home?  You probably can’t receive daily, or even regular, COVID-19 tests but if tests are free and available in your area, get tested and know your status and the status of those in your household.  Click here to find a testing location in your area.

Social distancing might not be possible, especially in apartments or smaller households but if you or anyone else you live with is exhibiting symptoms, do your best to self-isolate the sick individual if possible and disinfect common areas and frequently touched surfaces.

Daily temperature checks are possible! Get a thermometer and regularly check the temperature of all residents.  You can even check the temperature of guests before they enter your house if you’re socializing outside of your housemates. Be sure to disinfect the thermometer between uses or use separate thermometers.

Regular deep cleaning is a lot to ask of most people and you probably don’t have White House staff to come in and make everything spic and span.  But regularly wiping down frequently touched surfaces with EPA approved products and keeping common areas clean is a must!  Click here to learn how to make your own EPA approved disinfectants.

It’s unlikely that people will wear masks inside (unless someone you live with has tested or is suspected to be COVID-19 positive) but you should absolutely wear face coverings if you are venturing outside or in crowds.  Remember to stay 6 feet back from other people whenever possible.

We hope you implement these measures and take the White House COVID-19 prevention protocol as a good example of what American households should be doing to protect themselves.

Yours in Strength,

The Take Back Control Team