Reducing Covid’s Toll – The New York Times

The BA.2 subvariant – an even more contagious version of Omicron – has already caused Covid-19 cases to rise across much of Europe. In the US, the number of cases has been flat over the past week, ending two months of sharp declines, with many experts expecting a rise soon.

Today’s newsletter looks at four promising strategies for minimizing the toll of Covid in the coming months.

dr. Aaron Richterman, an infectious disease specialist in Philadelphia, regularly sees patients who have been vaccinated against Covid but have not received a booster vaccination. Some do not know that they are eligible for a booster. Others have heard about boosters but are not interested. “I just feel like I don’t need it,” one patient — an elderly man — recently told Richterman.

That attitude is common. According to studies by the Kaiser Family Foundation, nearly a quarter of adults in the US have been vaccinated but have not received booster vaccinations. (Any American vaccinated more than six months ago is eligible.)

These vaccinated, but not fortified, Americans are clearly open to receiving a Covid shot. And many would benefit significantly from a boost. Without a booster, immunity tends to wane. With a booster, people are even better protected than shortly after receiving a second injection, data shows.

Consider the figures from California, which publishes detailed data by vaccination status. For every million Californians boosted, fewer than two have been hospitalized with Covid recently:

“I continue to be most concerned about the lack of booster uptake in the elderly and immunocompromised,” Jennifer Nuzzo, an epidemiologist at Johns Hopkins University, told me.

However, many Americans still have not received this message. What could help? A prominent public service campaign specifically targeting booster shots rather than vaccination could. So was the encouragement of politically conservative voices. Less than 30 percent of Republican adults have been boosted; many Republicans haven’t even gotten a first shot.

“The most powerful weapon we have is vaccination,” Richterman told me, “and that includes first doses, second doses, and third doses.”

What about fourth doses (ie, second booster shots)? The Biden administration will soon be offering them to anyone 50 or older. The evidence suggests that these injections may provide additional protection, but are less important than the first booster shots, as Katelyn Jetelina, an epidemiologist, has explained in her newsletter.

For a small percentage of Americans, vaccination is either impossible or ineffective. This group includes people who are receiving cancer treatments and people who have had certain organ transplants.

Fortunately, there is now a drug that can help many of them. It’s an injection called Evusheld, developed by AstraZeneca with help from government funding. It appears to provide months of protection, and the Biden administration has ordered enough doses to treat 850,000 people.

But about 80 percent of available doses lie unused in warehouses, pharmacies and hospitals, my colleagues Amanda Morris and Sheryl Gay Stolberg have reported. One of the reasons: Many patients are unaware of the existence of Evusheld. Some doctors are unsure about who qualifies. Some hospitals refuse to provide it to eligible patients, keeping it for people they think would benefit more.

“The biggest problem is that there is absolutely no guidance or prioritization or any rollout,” Dr. Dorry Segev of NYU Langone Health to The Times. “It’s been a mess.”

Biden administration officials have been working with state officials, hospitals, doctors and patient advocates to assuage the uncertainty. They still have a long way to go.

A knowledge gap is also hindering the spread of Paxlovid – a post-infection treatment from Pfizer that appears to greatly reduce the chances of a Covid disease becoming serious. It’s most effective when prescribed soon after symptoms start, but many Americans don’t know it exists.

The good news is that Paxlovid has become more widely available in recent weeks. If you belong to a risk group and become infected with Covid, you should immediately consult a doctor. (Here’s an explanation.)

One thing to keep in mind: So far, the government has only approved Paxlovid for people at high risk, such as those over 65 or those with serious underlying medical conditions. I know that many Americans, especially liberal Democrats, are nervous about their own Covid risk and may be tempted to seek out Paxlovid.

But the risk of developing severe Covid for most people who get a boost remains very low, as the chart above shows. And the current supply of Paxlovid isn’t large enough to treat around anyone who becomes infected, especially as cases increase. “Our offer is fragile,” Dr. Scott Dryden-Peterson of Brigham and Women’s Hospital in Boston told Bloomberg News

If many younger, otherwise healthy people rush to get a Paxlovid prescription, they may be taking effective doses from vulnerable people.

Broad mask mandates have not done much to prevent the spread of Omicron. Too many people wear low quality masks or sometimes take them off, and Omicron is so contagious that it takes advantage of these gaps.

But masks can still help reduce the spread of Covid:

  • They are especially useful in hospitals and nursing homes, where high-quality masks may be required and where many people are vulnerable.

  • Masks also make sense for people returning to work or school five to 10 days after a Covid infection, Dr. Shira Doron of Tufts Medical Center say

  • Anyone personally concerned about Covid for any reason can also wear a mask, notes Dr. Tom Frieden, a former CDC executive, op. A high quality mask will protect the wearer even if others nearby are maskless.

All four of these steps have small costs and big benefits.

They avoid contributing to the ongoing crisis of isolation and disruption of the pandemic, such as closing classrooms and keeping children from school for weeks at a time. And they can save lives. The official Covid death toll in the US has already exceeded 975,000. But given the availability of vaccine shots and other treatments, the vast majority of deaths are now avoidable.

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Decades after his death, Andy Warhol is still everywhere. The artist is the subject of an exhibition at the Brooklyn Museum, several theater works and a Netflix documentary series. A London play, “The Collaboration” – about his relationship with Jean-Michel Basquiat – is being adapted for the big screen.

While the Brooklyn Museum exhibit, which runs through June 19, spotlights Warhol’s faith and Catholic upbringing, the Netflix series “The Andy Warhol Diaries” offers a glimpse into his romantic relationships and queer identity. “Together,” writes Laura Zornosa in The Times, “the works create a kaleidoscopic portrait of man under the white wig.”


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