Tag: public health

Vote for Democracy #14

your vote and gun safety

(Photo by Lucas Sankey on Unsplash)

It’s another sad “day after” here in the United States.

Yesterday, a 14-year-old student, just a few weeks into his high school years, opened fire at Apalachee High School in Georgia with an AR-style assault weapon, killing two students and two teachers and wounding nine others. The school resource officer (police officer assigned to the school) confronted him and he surrendered and was arrested. It’s already been announced that he will be tried as an adult.

Only in America.

It’s telling that I have already written about guns and violence three times in the prior 13 posts, after the mass shooting at Donald Trump’s rally, on Surgeon General Vivek Murthy declaring firearm violence a public health crisis, and on political violence.

It was good that during the Biden presidency there was a bipartisan gun safety bill passed and signed into law, but there is much more to be done that has widespread public support. Stronger universal background checks. Age restrictions for gun ownership. Safe storage rules. Red flag laws, which remove firearms from places where there is a risk of violence or mental health difficulties. Stronger laws against gun trafficking. Banning ghost guns which do not have serial numbers. Restrictions on carrying guns in public, both openly and under concealment. Banning military-style assault weapons, such as the AR-15, which are designed to kill people as quickly and brutally as possible. Banning bump stocks and large-capacity magazines. These laws need to be national to avoid what we have now, where guns, gun accesories, and ammunition get into a state with stricter gun laws from neighboring states with more lax laws. For example, my state, New York, has much stricter gun laws than our neighbor, Pennsylvania. The teen-aged perpetrator in the Buffalo supermarket mass murder, who lived in my county, purchsed large clips of ammunition from Pennsylvania becuase New York only allows clips up to ten rounds.

The shooting in Georgia is even more tragic in that it could have been prevented. As an eigthth-grader, the student had allegedly threatened a school shooting online and there was an investigation but no action. More immediately, that morning, there was a telephone threat received of a series of five school shootings, beginning with Apalachee. This child was suffering from mental illness and did not receive treatment that would have helped him and prevented him from gaining access to his father’s gun and killing and injuring people.

I do not agree with the decision to try a 14-year-old as an adult. Adolescents, especially young adolescents, do not have the brain development and judgement of adults. They also aren’t as able to recognize changes that may be symptoms of mental health problems. Yes, this is a horrible crime, but it was carried out by a mentally ill child. Charging and trying him as an adult does not make him one.

After these tragedies, there are always calls for “thoughts and prayers” for the victims and affected communities. There are often calls for action in terms of legislation, but these seldom make it through legislatures.

This post is part of my Vote for Democrary ’24 series to remind all eligible US voters to look at local, state, and national candidates’ position on firearms and public safety and only vote for those who will stand up for protecting public health and safety. While we certainly want to prevent murder, we also want to protect people from taking their own lives, which is the most prevalent kind of gun death. The vast majority of Americans, including gun owners, want these protections in place.

Vote as if your life and the lives of your loved ones depend on it.

It may literally be true.

Vote for Democracy ’24 #10

on gun violence and public health

(Photo by Lucas Sankey on Unsplash)

Today, the United States Surgeon General Vivek Murthy declared firearm violence a public health crisis. His advisory gives an overview of gun violence, contributing factors, and impacts on communities, children, adolescents, and families. It concludes with a section on taking a public health approach to reducing risk and preventing gun violence.

I’m grateful that Dr. Murthy has called out the scourge of firearm violence in the United States and framed it in the context of public health. While mass shootings are surely horrific and generate the most press coverage, most gun deaths and injuries in the US are either self-inflicted or among families/communities. The trauma they cause lasts for years. It is very much in the interests of public health to work to avert as many instances of gun violence as possible.

One of the criteria I use in evaluating candidates is their views and record on gun safety and violence reduction. Two years ago today, President Biden signed the Bipartisan Safer Communities Act, which has increased prosecution for gun trafficking, made more firearm sales subject to background checks, and funded community safety programs and red flag law initiatives. President Biden favors further tightening of background checks and a ban on civilian ownership of military-style assault weapons. By contrast, Donald Trump spoke at the National Rifle Association convention in May and promised to roll back any of the Biden administration initiatives on guns.

It is also important to look at the views about guns expressed by candidates for Congress, given that national legislation is the clearest way to protect people and communities. The Supreme Court has overturned executive orders and state level laws that were meant to promote gun safety but national law is likely to be more durable.

In a first for a presidential candidate, due to his 34-count felony conviction in New York, Trump’s firearms license has been revoked. This would stay in effect during any appeals process. Of course, as a former president, the Secret Service protects him at all times. Still, I find it sobering that he is legally barred from owning a gun. If he is not trustworthy enough to own a gun, how could he be trustworthy enough to decide important matters about public safety – or anything else?

COVID into the fifth year

Four years ago, here in the US, things were pretty much shut down due to the COVID-19 pandemic. B was working from home. I was the household’s designated shopper and would go, masked, to the grocery store every other week to stock up, although I’d sometimes have to visit more than one store because supply was a problem. We managed to keep ourselves safe, although we were horrified at the death toll in the US and around the world and at the people who became very ill. Over time, we also saw that some people had lasting damage to their lungs or other organs and others had symptoms that debilitated them for months.

Now, things are much better, due to vaccines and other precautions that have cut down on serious illnesses, although the US has slipped on vaccination, even as the virus has mutated in ways that make SARS-CoV-2 more infectious and immune-evasive. There are still way too many people getting sick and suffering long-term damage or death. While there are studies and some treatments on-going, there are still a lot of people suffering from long COVID.

We finally had our first case of COVID in our house last November, when B contracted it at a rare, in-person event for work. He isolated in part of our house and daughter T and I remained infection-free.

I don’t know how much longer we will be able to manage that status.

I was disappointed when the Centers for Disease Control and Prevention changed their guidance about isolating when infected with COVID. The new recommendations are for respiratory viruses in general and say that people can resume normal activities when their symptoms are improving and they have been without fever for 24 hours without being on fever-reducing medication. People are supposed to use masking, distancing, and other strategies to protect others from infection for five days afterward.

While I appreciate CDC’s reasoning, which is based on statistics, I don’t find it personally useful. It is typical that a person with COVID is infectious for ten days. It’s entirely possible to be fever-free and have improving symptoms and still be infectious. I’m afraid that most people won’t hear or won’t follow through on the part of the recommendation for masking and taking precautions to avoid exposing others after they leave isolation. This is especially troubling to me because so many people are not current on their vaccinations and/or are vulnerable due to age or health conditions. It’s great that the immunity level in the population halved the rate of serious illness and death, but that’s cold comfort if you expose a loved one, neighbor, co-worker, etc. and they become seriously I’ll or die.

If/when I contract COVID, I will isolate and mask until I test negative and am reasonably sure I can’t transmit the virus to anyone else. I want to protect my family and my community, especially our elders and those with medical issues, from contracting a virus that could cause them severe symptoms.

Please remember, when you see someone wearing a mask in public, to be kind and understanding. It’s entirely possible that they are trying to protect your health, not just their own.

(COVID Photo by Martin Sanchez on Unsplash)

Current COVID stats

Update to my COVID post from earlier in the week: Those Nerdy Girls newest post tells us that, using wastewater surveillance, current estimates are that 5% of people in the United States are currently infected with COVID, the largest proportion since the initial Omicron wave two years ago. In the United Kingdom, JN.1 caused a similar wave just before Christmas, with London having an even higher infected rate of almost 6%.

Those Nerdy Girls remind us that about 1,500 people in the United States are dying from COVID every week, making COVID much deadlier than the flu. They also remind us that the COVID vaccine that became available in September ’23 is effective against JN.1 and urge people to receive it if they haven’t already. They also remind people that masking, ventilation, testing, and staying home when you are sick help in avoiding spread not only of COVID but also flu and other viruses.

Please do what you can to keep yourself and others safe and healthy!
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JN.1

It’s been four years since the first cases of COVID-19 were confirmed in the US but it’s still a major health issue. While vaccines, treatments, and preventative measures have made the current situation less severe than the initial onslaught of SARS-CoV-2, people are still getting sick, with some needing to be hospitalized and some, unfortunately, succumbing to the disease, including the person I referenced in this post. In the week of Dec. 31, 2023-January 6, 2024, COVID caused 4% of all deaths in the United States.

The virus continues to mutate. The current strain that is dominant in the United States and globally is JN.1, which is related to the BA.2.86 variant of Omicron. The good news is that the most recent vaccine, which is based on the related XBB lineage, is a good match for JN.1, so the vaccine significantly reduces the risk of severe symptoms, hospitalization, and death while offering some protection against infection. The bad news is that, in the United States, only about 8% of children and 19% of adults are estimated to have received the newest vaccine, contributing to a surge of cases, amplified by holiday travel and gatherings.

More good vaccine news. This large study from Sweden concludes that vaccination reduces the risk of developing long COVID and that additional vaccine doses reduce risk even more. As someone who has particular concerns about long COVID, I appreciate that these studies are continuing to increase our understanding.

Another recent study shows that the Omicron variants don’t cause peak viral loads until day 3-4, much later than the earlier strains of the virus. The practical implication of this is that at-home COVID tests may not pick up a positive reading until several days into the illness, during which time the person could be infecting others. It also has implications for prescribing anti-virals, which need to begin within the first five days of symptoms to be effective. For me, this is a reminder to mask around other people whenever I have symptoms, as an early negative test might not be accurate.

A study published just a few days ago seems to put some science behind what we have all experienced, that SARS-CoV-2 doesn’t have a “season” in the way that some other viruses, like influenza, do. Changes in temperature and humidity don’t appear to have significant influence in transmission. This seems to go along with what we have experienced in the United States, with major waves happening in different seasons of the year. We’ve had waves in the heat of summer as well as the cold of winter. This suggests that our current winter wave is due more to low vaccination rates and holiday travel and gatherings than to the fact that it is winter. It also highlights the importance of increasing ventilation and using masks in crowded indoor spaces, as both summer heat and winter cold tend to drive people to gather indoors.

Four years in, I’ve written a lot of COVID-19 posts. From my days as part of the Pfizer/BioNTech vaccine trials through the present, I’ve always tried to give the most updated information and public health guidance available. It’s frustrating that there is less information from the Centers for Disease Control and Prevention than when the state of emergency was still in effect but some useful recent data can be found here. A lot of the information in this post came to my attention through this post from Dr. Katelyn Jetelina, writing as “Your Local Epidemiologist” and this post from Those Nerdy Girls.

Through all these challenges, especially when spouse B had the first case of COVID in our house in November, I’ve managed to avoid infection, unless I had a totally asymptomatic case at some point. I use my research to make decisions about vaccination, masking, crowd avoidance, etc. that are right for me and my family. I don’t think that advocating for health measures ought to be seen as controversial or political. There are, though, forces in the US that have warped disease prevention into a political test. It’s very sad that Republicans are more likely to die from COVID than non-Republicans. Please, don’t put your health and the health of your family and neighbors at risk over politics. COVID-19 is still out there. Take care of your health and your loved ones.
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One-Liner Wednesday: booster

Today, I’m getting my sixth dose of Pfizer/BioNTech COVID-19 vaccine, this one targeting Omicron variant XBB.1.5 and shown to be effective against other currently circulating Omicron sub-variants. Please consider joining me if your health professional or public health agency recommends it for you.
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This public health message is brought to you as part of Linda’s One-Liner Wednesdays. Join us! Find out more here: https://lindaghill.com/2023/09/20/one-liner-wednesday-the-ultimate-404-error/

help from Two Nerdy Girls

This past Sunday, I couldn’t make mass at my usual parish, so I attended another Catholic church in the area which shall remain nameless.

I was dismayed that the homily veered into anti-trans pseudo-science which I will not recount so as not to spread further misinformation. I was upset, though, that I had no viable way to counteract this hurtful message. I hoped that there were no members of the LGBTQIA+ community in attendance, although, statistically, it’s likely.

Later in the week, I ran across this Two Nerdy Girls post, entitled “What does the science say about gender identity?” I learned a lot from it and thought it was a good summary of the topic from two public health experts which included links to the underlying scientific findings.

I was able to find a contact form for the church I had attended and sent the link to the homilist. I don’t know if he will read it – or believe it, if he does – but, at least, I tried.

Even if it is too little, too late.

What comes after emergency?

As someone who participated in a COVID vaccine clinical trial, who has other vulnerable people in my life, and who tries to be a diligent and responsible community member, I’ve been following the science, public health information, and news about the pandemic over these last, long 3.5 years. I’ve done so many blog posts about it, I’ve lost count.

As you may know, the World Health Organization and the United States are winding down their public health emergency declarations.

This does not mean, though, that the pandemic itself has ended. COVID-19 is still widespread across the world and hundreds die every day as a result. There is still the potential for new variants and COVID is not yet seasonal, like influenza. Eventually, COVID will become endemic, as the flu is, but we aren’t there yet.

While some US programs, such as tracking hospitalization rates and wastewater testing, will continue, others will end. I will miss the COVID maps and risk ratings that the CDC has been providing. Besides the overall community risk assessment, the transmission rate maps were important to me in deciding how much public masking I needed to do or whether large, indoor gatherings were advisable at all. It’s true that, with so many COVID cases discovered through home testing and never officially recorded, the statistics are not as comprehensive as they were during the months of testing centers, but, for example, it’s helpful for me to know that my county has a moderate transmission rate but the county to our east is currently at the highest transmission rate level, two notches higher than here. Having that information could inform a decision between using a drive-through or dining in on my way through the county, as well as alerting me that the higher infection levels could spread in my direction. After Thursday, that information will not be readily available to me.

I’ll still follow the science and public health advice as best I can and will get my next booster when recommended. I’ll test at home if I have symptoms and avoid being in public when I’m sick with anything, COVID or not. I’ll keep a supply of KF94 masks in my size nearby for high-risk situations that may arise. I’ll try to do all the things we should be doing all the time, like eating well, getting enough rest, and practicing good hygiene.

I still, though, don’t want to get COVID if I can help it. To the best of my knowledge, I’ve never been infected, although I could have had an asymptomatic case at some point. I know very few people who are in that category these days.

Will the end of the emergency declarations and the resulting decline in data be a factor in my eventually contracting COVID?

Impossible to predict, but fingers crossed.

One-Liner Wednesday: from Dr. Paul Farmer

I’m not cynical at all. Cynicism is a dead end.

Dr. Paul Farmer

Dr. Farmer co-founded Partners in Health and brought health care to some of the world’s most impoverished communities. He died this week at the age of 62.

Join us for Linda’s One-Liner Wednesdays! Find out more here: https://lindaghill.com/2022/02/23/one-liner-wednesday-numbers/

politics and/or science

Over the course of the pandemic, I’ve posted frequently about it, the Pfizer/BioNTech vaccine trial in which B, T, and I are participating, the evolving science on the SARS-CoV-2 virus and its variants, the similarly evolving public health recommendations, and how these are being implemented here in my home state of New York and elsewhere in the United States. I do sometimes comment on the pandemic in the UK and globally, but I know best what happens close to home.

Throughout the pandemic, New York had been in the vanguard of following the recommendations of public health experts, avoiding the tendency we have seen in so many other states to ignore the benefits of masking, distancing, limiting crowds, getting vaccinated, isolating if infected, etc.

That ended this week.

Governor Hochul bowed to public and political pressure and lifted the mask mandate for businesses. While it is true that statewide the peak of the Omicron wave has passed and the vaccination rate is decent, my county’s risk is still rated as very high, with 44.7 per 100,000 daily cases. Technically, New York as a state is also in the very high category with 31.2/100,000 today (February 11), but it is counties like mine that are keeping the state in that risk category rather than dropping into the (merely) high category. Medium and low risk are a long way off at this point.

Meanwhile, the national Centers for Disease Control and Prevention are recommending not only that everyone age two and over wear a mask while in public but also that those masks be N95 or similarly protective types because Omicron is so highly contagious. Alarmingly, an even more contagious omicron sub-variant has reached the US, making protective masks that much more important.

Does this sound like the proper time to end mask mandates for businesses in New York State?

Certainly not, if one is truly following the science.

The problem is that many people are tired of having to deal with the pandemic and are complaining very loudly. The politicians who had been following the science hear them and loosen the rules that had been helping to get their residents through the current wave with as little hospitalization and death as possible. This could extend the current omicron wave and increase the likelihood of yet another new variant that has the potential to be even more transmissible or evade current vaccines and treatments or cause more severe disease.

Regardless of New York State rules, I am continuing to follow medical advice, to avoid crowds, and wear an N95 when in public. Because I am vaccinated and boosted, I will still visit with people who are similarly protected without a mask. I had hoped to return to church services this weekend but have decided that I can’t do so with the daily case rate still being so high; being stationary in a room with that many people for over an hour is too much risk for me, even masked.

Sigh.

At some point, the pandemic will end and I will follow medical and scientific advice on what my “new normal” will be. I had hoped that our state policies would be an aid in this, as they had been through most of these past months, but that remains to be seen.

I’m just hoping that this latest relaxation of protections doesn’t cause even more cases than we have already suffered.

Update: Almost immediately after publishing this post, I saw reports of this study from the CDC, which shows that booster effectiveness wanes significantly after four months. Given that B, T, and I all had our boosters on the early side due to our participation in the Pfizer/BioNTech vaccine trial, I’m all the more resolute in my vigilance regarding masking, distancing, etc. While we are all still likely to avoid severe disease or hospitalization due to our longer-than-four-months-ago boosters, I prefer to try to avoid infection entirely.