Science
CDC shifts pandemic goals away from reaching herd immunity
Because the earliest days of the pandemic, there was one collective aim for bringing it to an finish: reaching herd immunity. That’s when so many individuals are resistant to a virus that it runs out of potential hosts to contaminate, inflicting an outbreak to sputter out.
Many Individuals embraced the novel farmyard phrase, and with it, the projection that when 70% to 80% or 85% of the inhabitants was vaccinated in opposition to COVID-19, the virus would go away and the pandemic can be over.
Now the herd is stressed. And specialists on the Facilities for Illness Management and Prevention have put aside herd immunity as a nationwide aim.
The prospects for assembly a transparent herd-immunity goal are “very sophisticated,” mentioned Dr. Jefferson Jones, a medical officer on the CDC’s COVID-19 Epidemiology Job Pressure.
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“Considering that we’ll be capable to obtain some sort of threshold the place there’ll be no extra transmission of infections will not be attainable,” Jones acknowledged final week to members of a panel that advises the CDC on vaccines.
Vaccines have been fairly efficient at stopping instances of COVID-19 that result in extreme sickness and dying, however none has proved dependable at blocking transmission of the virus, Jones famous. Latest proof has additionally made clear that the immunity offered by vaccines can wane in a matter of months.
The result’s that even when vaccination had been common, the coronavirus would in all probability proceed to unfold.
“We’d discourage” pondering by way of “a strict aim,” he mentioned.
To Dr. Oliver Brooks, a member of the CDC’s Advisory Committee on Immunization Practices, it was a sobering new message, with doubtlessly worrisome results.
With simply 58.5% of all Individuals totally vaccinated, “we do want to extend” the uptake of COVID-19 pictures, mentioned Brooks, chief medical officer of Watts Healthcare in Los Angeles. Sadly, he mentioned, Jones’ sudden admission “virtually makes you much less motivated to get extra individuals vaccinated.”
Brooks mentioned he worries that because the CDC backs off a particular goal for herd immunity, it should take the air out of efforts to run up vaccination ranges.
And if public well being officers cease speaking concerning the “herd,” individuals might lose sight of the truth that vaccination is not only an act of non-public safety however a method to defend the group.
A public tack away from the promise of herd immunity might also additional undermine the CDC’s credibility in the case of preventing the coronavirus.
On points starting from using masks to how the virus spreads, the company has made some dramatic about-faces over the course of the pandemic. These reversals had been prompted by new scientific discoveries about how the novel virus behaves, however they’ve additionally offered ample gasoline for COVID-19 skeptics, particularly these in conservative media.
“It’s a science-communications drawback,” mentioned Dr. John Brooks, chief medical officer for the CDC’s COVID-19 response.
“We mentioned, based mostly on our expertise with different ailments, that once you stand up to 70% to 80%, you usually get herd immunity,” he mentioned.
However the SARS-CoV-2 virus didn’t get the memo.
“It has plenty of tips up its sleeve, and it’s repeatedly challenged us,” he mentioned. “It’s unimaginable to foretell what herd immunity will probably be in a brand new pathogen till you attain herd immunity.”
The CDC’s new strategy will replicate this uncertainty. As an alternative of specifying a vaccination goal that guarantees an finish to the pandemic, public well being officers hope to redefine success by way of new infections and deaths — and so they’ll surmise that herd immunity has been achieved when each stay low for a sustained interval.
“We wish clear, simple solutions, and typically they exist,” John Brooks mentioned. “However on this one, we’re nonetheless studying.”
Herd immunity was by no means so simple as many Individuals made it out to be, mentioned Kathleen Corridor Jamieson, director of the Annenberg Public Coverage Middle on the College of Pennsylvania and an professional on the challenges of speaking science to more and more skeptical — and infrequently conspiracy-minded — residents.
It’s an concept that emerged a few century in the past from the sector of livestock medication. Epidemiologists now calculate it with a typical equation. However like many instruments that mannequin a fancy course of with math, it makes some simplifying assumptions.
For example, it assumes an unrealistic uniformity within the habits of people and teams, and within the virus’ skill to unfold from individual to individual.
So it doesn’t replicate the variety of inhabitants density, dwelling preparations, transportation patterns and social interactions that makes Los Angeles County, as an illustration, so completely different from Boise County, Idaho. Nor does it account for the truth that Boise County, the place lower than 35% of adults are totally vaccinated, will get no safety from L.A. County’s 73% vaccination fee amongst adults.
“People usually are not a herd,” Jamieson mentioned.
Public well being leaders would have been higher served by framing their vaccination campaigns across the want for “group immunity,” she mentioned. That will have gotten individuals to suppose in additional native phrases — those that basically matter in the case of an individual’s danger of an infection, she added.
Adjustments within the coronavirus itself have additionally made herd immunity a transferring goal.
The calculation that produced a herd immunity estimate of 70% to 85% rests closely on the innate transmissibility of SARS-CoV-2. However with the emergence of latest viral strains just like the Alpha and Delta variants, the virus’ skill to leap from individual to individual has escalated dramatically within the final 12 months.
As well as, herd-immunity calculations presume that when individuals acquire immunity, they continue to be immune for a recognized time frame. Nevertheless it’s turn into clear that neither vaccination nor pure an infection confers lasting safety. Booster pictures or a “breakthrough” case may, however for a way lengthy remains to be unknown.
That’s simply the best way science works, mentioned Raj Bhopal, a retired public well being professor on the College of Edinburgh who has written concerning the maddening complexity of herd immunity.
For any company engaged in public messaging, “it’s very laborious to convey uncertainty and stay authoritative,” Bhopal mentioned. “It’s a pity we will’t take the general public together with us on that highway of uncertainty.”
Science
Cluster of farmworkers diagnosed with rare animal-borne disease in Ventura County
A cluster of workers at Ventura County berry farms have been diagnosed with a rare disease often transmitted through sick animals’ urine, according to a public health advisory distributed to local doctors by county health officials Tuesday.
The bacterial infection, leptospirosis, has resulted in severe symptoms for some workers, including meningitis, an inflammation of the brain lining and spinal cord. Symptoms for mild cases included headaches and fevers.
The disease, which can be fatal, rarely spreads from human to human, according to the U.S. Centers for Disease Control and Prevention.
Ventura County Public Health has not given an official case count but said it had not identified any cases outside of the agriculture sector. The county’s agriculture commissioner was aware of 18 cases, the Ventura County Star reported.
The health department said it was first contacted by a local physician in October, who reported an unusual trend in symptoms among hospital patients.
After launching an investigation, the department identified leptospirosis as a probable cause of the illness and found most patients worked on caneberry farms that utilize hoop houses — greenhouse structures to shelter the crops.
As the investigation to identify any additional cases and the exact sources of exposure continues, Ventura County Public Health has asked healthcare providers to consider a leptospirosis diagnosis for sick agricultural workers, particularly berry harvesters.
Rodents are a common source and transmitter of disease, though other mammals — including livestock, cats and dogs — can transmit it as well.
The disease is spread through bodily fluids, such as urine, and is often contracted through cuts and abrasions that contact contaminated water and soil, where the bacteria can survive for months.
Humans can also contract the illness through contaminated food; however, the county health agency has found no known health risks to the general public, including through the contact or consumption of caneberries such as raspberries and blackberries.
Symptom onset typically occurs between two and 30 days after exposure, and symptoms can last for months if untreated, according to the CDC.
The illness often begins with mild symptoms, with fevers, chills, vomiting and headaches. Some cases can then enter a second, more severe phase that can result in kidney or liver failure.
Ventura County Public Health recommends agriculture and berry harvesters regularly rinse any cuts with soap and water and cover them with bandages. They also recommend wearing waterproof clothing and protection while working outdoors, including gloves and long-sleeve shirts and pants.
While there is no evidence of spread to the larger community, according to the department, residents should wash hands frequently and work to control rodents around their property if possible.
Pet owners can consult a veterinarian about leptospirosis vaccinations and should keep pets away from ponds, lakes and other natural bodies of water.
Science
Political stress: Can you stay engaged without sacrificing your mental health?
It’s been two weeks since Donald Trump won the presidential election, but Stacey Lamirand’s brain hasn’t stopped churning.
“I still think about the election all the time,” said the 60-year-old Bay Area resident, who wanted a Kamala Harris victory so badly that she flew to Pennsylvania and knocked on voters’ doors in the final days of the campaign. “I honestly don’t know what to do about that.”
Neither do the psychologists and political scientists who have been tracking the country’s slide toward toxic levels of partisanship.
Fully 69% of U.S. adults found the presidential election a significant source of stress in their lives, the American Psychological Assn. said in its latest Stress in America report.
The distress was present across the political spectrum, with 80% of Republicans, 79% of Democrats and 73% of independents surveyed saying they were stressed about the country’s future.
That’s unhealthy for the body politic — and for voters themselves. Stress can cause muscle tension, headaches, sleep problems and loss of appetite. Chronic stress can inflict more serious damage to the immune system and make people more vulnerable to heart attacks, strokes, diabetes, infertility, clinical anxiety, depression and other ailments.
In most circumstances, the sound medical advice is to disengage from the source of stress, therapists said. But when stress is coming from politics, that prescription pits the health of the individual against the health of the nation.
“I’m worried about people totally withdrawing from politics because it’s unpleasant,” said Aaron Weinschenk, a political scientist at the University of Wisconsin–Green Bay who studies political behavior and elections. “We don’t want them to do that. But we also don’t want them to feel sick.”
Modern life is full of stressors of all kinds: paying bills, pleasing difficult bosses, getting along with frenemies, caring for children or aging parents (or both).
The stress that stems from politics isn’t fundamentally different from other kinds of stress. What’s unique about it is the way it encompasses and enhances other sources of stress, said Brett Ford, a social psychologist at the University of Toronto who studies the link between emotions and political engagement.
For instance, she said, elections have the potential to make everyday stressors like money and health concerns more difficult to manage as candidates debate policies that could raise the price of gas or cut off access to certain kinds of medical care.
Layered on top of that is the fact that political disagreements have morphed into moral conflicts that are perceived as pitting good against evil.
“When someone comes into power who is not on the same page as you morally, that can hit very deeply,” Ford said.
Partisanship and polarization have raised the stakes as well. Voters who feel a strong connection to a political party become more invested in its success. That can make a loss at the ballot box feel like a personal defeat, she said.
There’s also the fact that we have limited control over the outcome of an election. A patient with heart disease can improve their prognosis by taking medicine, changing their diet, getting more exercise or quitting smoking. But a person with political stress is largely at the mercy of others.
“Politics is many forms of stress all rolled into one,” Ford said.
Weinschenk observed this firsthand the day after the election.
“I could feel it when I went into my classroom,” said the professor, whose research has found that people with political anxiety aren’t necessarily anxious in general. “I have a student who’s transgender and a couple of students who are gay. Their emotional state was so closed down.”
That’s almost to be expected in a place like Wisconsin, whose swing-state status caused residents to be bombarded with political messages. The more campaign ads a person is exposed to, the greater the risk of being diagnosed with anxiety, depression or another psychological ailment, according to a 2022 study in the journal PLOS One.
Political messages seem designed to keep voters “emotionally on edge,” said Vaile Wright, a licensed psychologist in Villa Park, Ill., and a member of the APA’s Stress in America team.
“It encourages emotion to drive our decision-making behavior, as opposed to logic,” Wright said. “When we’re really emotionally stimulated, it makes it so much more challenging to have civil conversation. For politicians, I think that’s powerful, because emotions can be very easily manipulated.”
Making voters feel anxious is a tried-and-true way to grab their attention, said Christopher Ojeda, a political scientist at UC Merced who studies mental health and politics.
“Feelings of anxiety can be mobilizing, definitely,” he said. “That’s why politicians make fear appeals — they want people to get engaged.”
On the other hand, “feelings of depression are demobilizing and take you out of the political system,” said Ojeda, author of “The Sad Citizen: How Politics is Depressing and Why it Matters.”
“What [these feelings] can tell you is, ‘Things aren’t going the way I want them to. Maybe I need to step back,’” he said.
Genessa Krasnow has been seeing a lot of that since the election.
The Seattle entrepreneur, who also campaigned for Harris, said it grates on her to see people laughing in restaurants “as if nothing had happened.” At a recent book club meeting, her fellow group members were willing to let her vent about politics for five minutes, but they weren’t interested in discussing ways they could counteract the incoming president.
“They’re in a state of disengagement,” said Krasnow, who is 56. She, meanwhile, is looking for new ways to reach young voters.
“I am exhausted. I am so sad,” she said. “But I don’t believe that disengaging is the answer.”
That’s the fundamental trade-off, Ojeda said, and there’s no one-size-fits-all solution.
“Everyone has to make a decision about how much engagement they can tolerate without undermining their psychological well-being,” he said.
Lamirand took steps to protect her mental health by cutting social media ties with people whose values aren’t aligned with hers. But she will remain politically active and expects to volunteer for phone-banking duty soon.
“Doing something is the only thing that allows me to feel better,” Lamirand said. “It allows me to feel some level of control.”
Ideally, Ford said, people would not have to choose between being politically active and preserving their mental health. She is investigating ways to help people feel hopeful, inspired and compassionate about political challenges, since these emotions can motivate action without triggering stress and anxiety.
“We want to counteract this pattern where the more involved you are, the worse you are,” Ford said.
The benefits would be felt across the political spectrum. In the APA survey, similar shares of Democrats, Republicans and independents agreed with statements like, “It causes me stress that politicians aren’t talking about the things that are most important to me,” and, “The political climate has caused strain between my family members and me.”
“Both sides are very invested in this country, and that is a good thing,” Wright said. “Antipathy and hopelessness really doesn’t serve us in the long run.”
Science
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