We Are Not Properly Preparing For The Next Pandemic

 The following op-ed is by Bill Gates in The New York Times:

Imagine there’s a small fire in your kitchen. Your fire alarm goes off, warning everyone nearby about the danger. Someone calls 911. You try to put the fire out yourself — maybe you even have a fire extinguisher under the sink. If that doesn’t work, you know how to safely evacuate. By the time you get outside, the fire truck is already pulling up. Firefighters use the hydrant in front of your house to extinguish the flames before any of your neighbors’ homes are ever at risk of catching fire.

We need to prepare to fight disease outbreaks just as we prepare to fight fires. If it is left to burn out of control, a fire poses a threat not only to one home, but to an entire community. The same is true for infectious diseases, except on a much bigger scale. As we know all too well from Covid, an outbreak in one town can quickly spread across an entire country and then around the world.

When the World Health Organization first described Covid-19 as a pandemic just over three years ago, it marked the culmination of a collective failure to prepare for pandemics despite many warnings. And I worry that we’re making ‌‌those same mistakes again. The world hasn’t done as much to get ready for the next pandemic as I’d hoped. But ‌‌it’s not too late to stop history from repeating itself. The world needs a well-funded system that is ready to spring into action at a moment’s notice when danger emerges. ‌We need a fire department for pandemics.

I’m optimistic about a network that the W.H.O. and its partners are building called the Global Health Emergency Corps. This network of the world’s top health emergency leaders will work together to get ready for the next ‌‌pandemic. Just as firefighters run drills to practice responding to a fire, the Emergency Corps plans to run drills to practice for outbreaks. The exercises will make sure that everyone — governments, health care providers, emergency health workers — knows what to do when a potential outbreak emerges.

One of the corps’ most important jobs will be to ‌‌take quick action to stop the spread of a pathogen. The speed of action requires countries to have large-scale testing capabilities that identify potential threats early. Environmental surveillance like sewage testing is key, since many pathogens show up in human waste. If a sewage sample comes back positive, a rapid response team would deploy to the affected area to find people who might be infected, implement a response plan‌‌ and kick off the necessary community education about what to look for and how to stay protected.

As C‌ovid-19 demonstrated, a pandemic is a trillion-dollar problem, and mitigating this challenge should not depend on volunteers. We need a corps of professionals from every country and region, and the world needs to find a way to compensate them for the time they spend preparing for and responding to transnational threats. They must be able to deploy teams of professionals on standby to help control outbreaks where they start.

To be successful, the Emergency Corps must build on existing networks of experts and be led by people like the heads of national public health agencies and their leads for epidemic response. ‌It’s difficult ‌‌for any one country to stop a disease from spreading on its own — many of the most meaningful actions require‌‌ coordination from the highest levels of government. The world needs to prepare for a multiple-alarm fire — the type of fire response that requires different units and departments. These kinds of blazes are rare, but when they happen, there’s no time to waste. Local responders need to know they can count on a surge of well-trained firefighters who will work seamlessly together. They can’t arrive on the scene only to discover that their hoses don’t fit on the closest hydrant or that they have a completely different approach from the other units. The Emergency Corps will make sure countries and health systems are coordinated in advance of an emergency, so that everything runs smoothly during times of crisis.

This is where practice makes perfect. By running drills and simulations, the corps will uncover the areas where ‌countries and leaders are not ready and help us fix them now. ‌It’s important to practice for lots of different types of pathogens, too. Human respiratory diseases are a huge concern, because they can go global so quickly. (Just look at how fast Covid spread.) But they are far from the only threat. What if the next pandemic-potential pathogen spreads through surface droplets? Or if it is sexually transmitted like H.I.V.? What if it’s the result of bioterrorism? Each scenario requires a different response, and the Emergency Corps can help the world get ready for all of them.

We can’t afford to get caught flat-footed again. The world must take action now to make sure Covid-19 becomes the last pandemic, and one of the biggest moves we can make is to support the world’s principal health experts — the W.H.O. — and invest in the Global Health Emergency Corps so it can live up to its full potential.

This will require two things: First, public health leaders from all countries need to participate. The next ‌pandemic could emerge anywhere, and so the Emergency Corps must have expertise from every corner of the globe, including from national disease and research agencies like the C.D.C. and the N.I.H. in the United States. Second, we need wealthier countries to step up and provide funding to make this a reality.

‌‌I believe the W.H.O. remains our best tool for helping countries stop disease outbreaks, and the Global Health Emergency Corps will represent massive progress toward a pandemic-free future. The ‌question ‌‌is whether we have the foresight to invest in that future now before it’s too late.

We Are Not Prepared For A Future Pandemic

We should have learned a valuable lesson from this pandemic -- how to prepare for the next one. But we didn't. It was nothing more than an opportunity for our politicians to play politics with American lives. We must do better, but that won't happen until Republicans are diminished enough to stop blocking preparedness.

Here is what the editorial board of The Washington Post says we need to do:

There are many reforms Congress and the White House should embrace.

The federal government must overcome the fragmentation of the nation’s public health system. The 10th Amendment to the Constitution and many Supreme Court rulings have given state governments primary authority to control the spread of dangerous diseases within their jurisdictions. But the dedicated workers in this patchwork of localities are overburdened and underfunded. The Commonwealth Fund reportcalls for creating a national public health system that would provide more leadership, resources and direction, perhaps led by a new undersecretary or assistant secretary of Health and Human Services. While it wouldn’t replace the work in states and localities, a national public health system would help ensure state and local health departments gain basic capabilities and resources to protect their communities, however different. The report says that government funding for core public health functions remains “grossly insufficient.”

Every virus or bacteria has a genetic blueprint. With advances in bioinformatics, scientists can use genetic sequencing to identify the variant, spot mutations and chart possible spread among people. This ought to be harnessed into a nationwide — or even global — trip wire for disease among humans, animals and plants. We already rely on early-warning systems to watch for hurricanes and tornadoes; radars and satellites keep watch for ballistic missile threats; prompt warning is critical to intelligence gathering and financial markets. But so far, early-warning systems exist only in fragments for disease. Also, there’s a crying need to build better data-sharing systems to improve the link between genomics (genetic blueprints), health care (what doctors, hospitals and emergency rooms are seeing among people) and epidemiology (the patterns of disease in the population).

The nation’s capabilities to create and manufacture vaccines must be strengthened. Operation Warp Speed showed what can be done. With years of previous research, and a mountain of government money, the mRNA coronavirus vaccines were developed and manufactured in record time and saved millions of lives. But the mRNA vaccines are not a long-term answer; their effectiveness wanes. We need a second massive research and development effort, an Operation Warp Speed 2.0, to overcome many hurdles to a coronavirus vaccine that would work against all variants and for a long duration. It won’t be easy. A universal flu vaccine has been an elusive goal for years. In parallel, we need an organized effort to create platforms for future vaccines with enough science and resources behind them to kick-start development as soon as a pandemic flares — to be ready to deploy shots rapidly.

The recent announcement of an overhaul at the CDC made a point to shift the agency’s culture to be more action-oriented in the face of emergencies. The idea is a good one for more than just the CDC. The emergency side of public health should be organized like the military, with money, staffing, a clear command structure, exercises and a mission of urgency.

Finally, the nation’s public health authorities must rebuild trust. In an emergency, public trust is fragile — when broken, it is extremely difficult to regain. Transparency, promptness and clarity were too often missing during this pandemic, and online disinformation further corroded public confidence. A concerted effort must be made to rebuild public trust in the digital age.

The prospects for wide-scale reform do not look good. Partisan conflict on Capitol Hill has stymied further funding to respond to the current pandemic, not to mention prepare for the next one. Where is the willpower that arose after 9/11? Where is the bipartisan consensus that existed during the Cold War? Clearly, the political scene has been clouded by pandemic fatigue and looming elections. But the need for preparedness is not going away.

A transformation in public health requires a sea change in thinking. We must value this endeavor for our own protection, rather than continue to neglect it. We have been warned.

No Matter How Bad You Want It - The Pandemic Is Not Over

Most of us are wanting the pandemic to be over, and many people are acting like it already is. But they are wrong! Here's the truth from the editorial board of The Washington Post: 

The pandemic is a relentless race against Mother Nature. Waves of infection took millions of lives, and only highly effective vaccines prevented even more deaths. Now, the coronavirus is speeding up once again, mutating, evading immunity and still on the march. The arrival of subvariant BA.5 should be a reminder that the finish line in this race is nowhere to be seen.

What’s BA.5? This is the latest subvariant of omicron, which stormed the planet late last year and caused a huge wave of infection. As of now, BA.5 and a closely related variant, BA.4, account for about 70 percent of all infections in the United States, according to estimates by the Centers for Disease Control and Prevention, based in part on modeling. These two newcomers are easing out an earlier variant, BA.2.

The obscure names should not hide the punch of BA.5. Eric Topol, professor of molecular medicine at Scripps Research, says that BA.5 “is the worst version of the virus that we’ve seen.” He adds, “It takes immune escape, already extensive, to the next level, and, as a function of that, enhanced transmissibility,” well beyond earlier versions of omicron. There has not been a marked increase in hospitalizations and deaths, he reports, because there is so much immunity built up from the winter omicron wave. But there are aspects of this new variant very much worth keeping an eye on as the United States remains stuck at an uncomfortably high plateau of pandemic misery. And the new variants are driving a case surge in Europe.

At the core of the BA.5 difference is its biology. Evolution has given it more fitness, a term that incorporates its ability to transmit, grow and evade immunity; the variant shows “marked difference from all prior variants,” reports Dr. Topol. One way it does so is by evading the body’s immune system, and BA.4 and BA.5 together are “the most immune-evasive variants” seen in multiple studies to date.

Whether BA.5 will lead to more severe disease isn’t clear yet. But knowing that the virus is spreading should reinforce the need for the familiar mitigation measures: high-quality face masks, better air filtration and ventilation, and avoiding exposure in crowded indoor spaces.

An important question is whether the next boosters should include the new variants. Does a booster with an earlier version of the virus make any sense if that variant has disappeared from the population? The Food and Drug Administration has recommended manufacturers build a bivalent or two-component vaccine, with old and new variants as the target. It certainly makes sense to be flexible — as Wayne Gretzky put it, to skate where the puck is going, not where it has been. But time is short, and who knows what variants will be present later this year? In the longer term, variant chasing is hardly ideal. The greatest need is for next-generation vaccines that are more broadly protective, more durable (with longer-lasting immunity) and that can dampen transmission. There is a major research effort underway to achieve this, but the finish line is not yet in sight.

Gates Says Pandemic Therapies Must Be Developed Faster

The following is just part of a guest op-ed in The New York Times by Bill Gates. He has a point. We need to be able to develop therapeutic treatments faster when hit by a pandemic. He writes:

Today, drug discovery still relies on a mixture of good science and good luck. Unfortunately, when an outbreak appears to be headed toward a pandemic, there’s no time to count on luck. The next time we’re faced with a contagion, scientists will need to develop treatments as fast as possible, much faster than they did for Covid.

So let’s suppose we’re in that situation: There’s a new virus that looks like it could go global, and we need a treatment. How will scientists go about making an antiviral?

The first step is to map the virus’s genetic code and figure out which proteins are most important to it. These essential proteins are known as the “targets,” and the search for a treatment essentially boils down to defeating the virus by finding things that will keep the targets from working the way they should.

Until the 1980s, researchers trying to identify promising compounds had to rely on slow trial and error to identify the right ones. Today, using 3-D modeling and robotic machines that run thousands of experiments at a time, companies can test millions of compounds in a matter of weeks — a task that would otherwise take a team of humans years to complete.

Once a promising compound is identified, the scientific teams will analyze it to determine whether it’s worth further exploration. Once they’ve found a good candidate, they will typically spend several years in the “preclinical” phase, studying it to determine whether it is safe and triggers the desired response. The first studies will be done in animals. (Finding the right animal is not easy. Researchers have a saying: “Mice lie, monkeys exaggerate and ferrets are weasels.”)

If all goes well in the preclinical phase, the drug will move into the riskiest and most expensive part of the process: clinical trials in humans. With permission from a government regulator — in the United States, it’s the Food and Drug Administration — scientists will start a small trial involving a few dozen healthy adult volunteers. They will be looking to see whether the drug causes any adverse effects and to zero in on a dosage that’s high enough to be beneficial but not so high that it makes the patient sick.

Assuming all goes well once again, it will move on to larger and larger trials. Finally, after three phases, if they believe the drug is safe and effective, the scientists will go back to the regulatory agency and apply for approval. Then — assuming they get the green light — it’s time to start manufacturing.

At this point, a team of chemists will work on finding a consistent way to produce the key part of the drug, known as the “active ingredient.” Then, the scientific team will address the next big question: How to make sure it actually reaches everyone who needs it. Not at all an easy problem to solve.

As you can see, drug development is a complex and labor-intensive science, and each step is fraught with scientific and logistical obstacles — but we need to accelerate the process. The faster researchers are able to produce safe, effective drugs for quick-spreading pathogens like Covid, the more lives will be saved and the more we can reduce the burden on health care systems. Fortunately, there are ways to speed up and streamline the process without sacrificing safety.

One of the keys to ensuring that health care workers have better treatment options in the next big outbreak than they did for Covid will be investing in large libraries of drug compounds that researchers can quickly scan to see whether existing therapies work against new pathogens. Some of these libraries exist already, but the world needs more. We need libraries that cover many types of drugs, but the most promising, in my view, are those known as pan-family and broad-spectrum therapies — either antibodies or drugs that can treat a wide range of viral infections, especially those that are likely to cause a pandemic.

Researchers could also find better ways of activating what’s known as “innate immunity,” which is the part of your immune system that kicks in just minutes or hours after it detects any foreign invader — it’s your body’s first line of defense. By boosting your innate immune response, a drug could help your body stop an infection before it takes hold.

To deliver on these promising approaches, the world needs to invest more into understanding how various dangerous pathogens interact with our cells. Scientists are working on ways to mimic these interactions so that they can quickly figure out which drugs might work in an outbreak.

A few years ago, I saw a demonstration of a “lung on a chip,” an experimental device you could hold in your hand that operated just like a lung, allowing researchers to study how different drugs, pathogens and human cells affect one another. With advances in artificial intelligence and machine learning, it’s now possible to use computers to identify weak spots on pathogens that we already know about, and we’ll be able to do the same when new pathogens arise. These technologies are also speeding up the search for new compounds that will attack those weak spots.

With adequate funding, various groups could take the most promising new compounds through Phase 1 studies even before there’s an epidemic, or at least have several leads that can be turned into a product quickly once we know what the target looks like.

In short, although therapeutics didn’t rescue us from Covid, they hold a lot of promise for saving lives and preventing future outbreaks from crippling health systems. But to make the most of that promise, the world needs to invest in the research and systems we’ll need to find treatments much faster. That’s why my foundation has supported a therapeutics accelerator at Duke University, but broader initiatives will be necessary to make lasting change. This will require substantial investment to bring together academia, industry and the latest software tools. But if we succeed, the next time the world faces an outbreak, we’ll save millions more lives.

Stop Pretending The Pandemic Is Over - It's NOT!

 

From the editorial board of The New York Times comes a warning America would do well to heed. Here is a part of that they wrote:

The worst of the Covid-19 pandemic may be behind us, but pretending that it is over will not make it so. A new Omicron subvariant, BA.2, is driving up coronavirus case counts in Europe and Asia, and experts predict it soon will account for the majority of new cases in the United States. The impact is uncertain. On the one hand, many Americans have already been infected by a similar strain of the virus. On the other hand, BA.2 arrives as people increasingly are resuming prepandemic behaviors, and according to the Centers for Disease Control and Prevention, roughly one-third of Americans have not completed their initial round of vaccinations, and more than 70 percent have not received booster shots.

In the face of this uncertainty, it would be reckless for the government to reduce its efforts to minimize new cases and help those who fall ill. Yet that is exactly what is happening after Congress recently failed to approve $15.6 billion for tests, treatments and vaccines.

Denied the funding it needs, the Biden administration is curtailing its efforts to combat the virus. Last week, the administration said that it would reduce the distribution of highly effective monoclonal antibody treatments by more than 30 percent and that it would be forced to end shipments this spring. It also stopped accepting reimbursement claims for Covid-19 tests and treatments from uninsured Americans; vaccine reimbursements will be accepted only through April 5. And the government said that it lacked sufficient funds to place an order for enough doses of vaccines to ensure the availability of booster shots later this year.

Congress must approve more funding immediately. Ensuring that Covid tests, treatments and vaccines remain readily available is the best way to prevent new waves of infections and to preserve the progress so far toward the end of the pandemic.

Failing to maintain adequate public funding means Americans increasingly will have to rely on their own resources. In effect, the United States is reverting to its usual approach to health care: Those with money and insurance will be able to get tests and treatments; those without may not. The price for a dose of monoclonal antibody treatment can approach $2,000, and even the relatively modest cost of test kits or vaccinations can discourage people from taking the basic steps necessary to protect themselves and others. . . .

It is worth underscoring that much of what the Biden administration is requesting should not require emergency funding. The United States ought to maintain funding for public health, including the resources to monitor infectious diseases and to develop new vaccines and treatments, in the same way that it maintains funding for other forms of national defense. The gaping holes in the nation’s public health infrastructure, which the pandemic exposed, were created by exactly the kind of shortsightedness now on display.

2 Years Into Pandemic 43% Feel Worse About Others

 

The chart above reflects the results of the new Yahoo News / YouGov Poll -- done between March 10th and 14th of a nationwide sample of 1,623 adults, with a 2.7 point margin of error.

After two years of the pandemic, 43% of Americans say they now have a worse view of their fellow citizens. Only 10% say they have a better view.

Many Health Care Workers Say Worst Of Pandemic Is Over

 

The chart above is from the Morning Consult Poll -- done between January 31st and February 11th of a nationwide sample of about 1,000 health care workers, and has a 3 point margin of error.

The State Of The Pandemic In The United States

 

There have been 52 million Americans that have come down with a COVID-19 illness, and more than 800,000 have died from that illness. And as the charts above show (from the December 27th Washington Post), the pandemic is not over. It will continue to infect people and kill many of them at least through this winter -- and probably significantly longer.

Many of us had hoped the pandemic would be over by now. Instead, it looks like it may shift from a pandemic to an endemic (a disease we will have to live with for many more years -- perhaps forever).

Why is this true? First, even though we have several vaccines that are very effective, those vaccines have not been distributed to all the world. And as long as the virus raging through other, mostly unvaccinated countries, it will remain a danger to this country.

But there is another reason -- perhaps even more important in this country. There is a political effort to keep the pandemic going. Right-wing Republicans are opposing vaccinations, wearing masks, and social distancing (even though they are very effective in preventing the virus from spreading). And their followers are refusing vaccinations, masks, and social distancing.

Why are the GOP politicians doing this. They know that refusing those measures will make people sick and kill many of them. But they don't care about that. They think if they can keep the pandemic going until November of 2022, they will do well in the next elections. They think voters will blame President Biden for the pandemic and vote for Republicans (even though the pandemic was helped by the incompetence of a Republican president and continued by the denials of Republican politicians).

I hope they are wrong. It is immoral for them to endanger the American public and then benefit from it.

"America First" Is A Dangerous Idea In A Global Pandemic

Why does the United States give aid to other countries? Is it altruism? That would be nice, but that has never been the reason. U.S. politicians dole out aid to other countries because it is in the interests of this country. A country that is getting money (or other aid) from the United States is far more likely to go along with U.S. wishes and policy that a country not getting that aid.

We should consider helping the world to get vaccinated in the same way. It is in our own self-interest.

Even if we could vaccinate 100% of our population (which seems to be impossible), it would not insure we are protected against the COVID-19 virus.

As long as there are other countries with significant portions of their population that are unvaccinated, the virus will continue. And as the virus continues to rage, it will mutate -- very possibly into more easily transmissible and more lethal forms. And it is possible that a mutation could occur that would be immune to the currently available vaccines. That would open up even highly vaccinated countries to a resurgence of the disease.

And anyone who thinks we could keep those mutated viruses out of this country is living in a dream world. In this globally-interconnected world, that would be impossible.

I understand, and support, the desire to get our own population vaccinated, but that would not end the pandemic. We must not only continue to send vaccines to other countries, but also support giving those other countries the knowledge and tools to produce their own vaccines. 

The global pandemic will not end until their is global herd immunity, and that can only be achieved by making sure most people get vaccinated in every country.

In a global pandemic, "America First" is a stupid and dangerous idea.

Vaccine Mandates Improve Public Health & The Economy

 

Right-wingers are howling that President Biden's vaccine mandates are a violation of personal rights. As usual, they are wrong! The mandates are necessary to end the pandemic and improve the economy -- and THEY WORK!

The following is part of a column on this by Paul Krugman in The New York Times:

Three weeks ago President Biden announced plans to require Covid-19 vaccinations — or, in some cases, weekly testing as an alternative — for most U.S. workers. There were immediate predictions that the move would backfire, that it would only stiffen vaccine resistance. Indeed, some surveys suggested that as many as half of unvaccinated workers would quit their jobs rather than take their shots.

But such threats are proving mostly empty. Many state and local governments and a significant number of private employers have already imposed vaccine mandates — and these mandates have been very successful. Compliance has been high, and only a relative handful of workers have quit or had to be fired.

To understand why vaccine mandates seem to work so well, we need to think about the real nature of vaccine resistance. Most of the people refusing to take their shots don’t really believe that the vaccines contain tracking microchips or that they have severe side effects.

Instead, everything we’ve seen suggests that many vaccine resisters are like the people who in the past raged about seatbelt laws and bans on phosphates in detergents, or more recently refused to wear masks. That is, they’re people who balk at being asked to accept what they imagine to be a cost or inconvenience on behalf of the public good. . . .

The point is that most vaccine resistance isn’t about deep concerns, but it often involves assertions of the right to give (misguided perceptions of) self-interest priority over the public interest. So, luckily, many resisters fold as soon as the calculus of self-interest reverses, and refusing to take their shots has immediate, tangible financial costs. . . .

But why have so many Republicans refused to take their shots? Some, of course, have bought into the wild claims about side effects and sinister conspiracies that circulate on social media. But they’re probably a small minority.

Almost surely, mainstream right-wing media outlets, especially Fox News, have played a much bigger role. These outlets generally steer away from clearly falsifiable assertions — they have to worry about lawsuits. But they nonetheless want to do all they can to undermine the Biden administration, so they have done their best to raise doubts about the vaccines’ safety and effectiveness.

The effect has been to encourage many Republicans to think of getting vaccinated as an imposition, a cost they’re being asked to bear rather than a benefit they’re being offered — and, of course, something they’re primed to oppose precisely because it’s something Democrats want to see happen. Medical experts may say that going unvaccinated greatly increases your risk of getting seriously ill or dying, but hey, what do they know?

As I said, there probably aren’t very many Americans, even among self-identified Republicans, who really believe the vaccine horror stories — or are willing to make large, visible personal sacrifices in the name of “freedom.” So as soon as the cost of going unvaccinated stops being about statistics and becomes concrete — refuse the shot, lose your job — most vaccine resistance evaporates.

All of this has a clear policy implication for the Biden administration and for other leaders like governors and mayors — namely, full speed ahead. Vaccine mandates won’t cause mass resignations; they will cause a sharp rise in vaccination rates, which is key both to finally getting Covid under control and to achieving sustained economic recovery.

And Democrats shouldn’t fear the political fallout. Almost nobody will vote Republican because they’re enraged by public health rules, since such people are most likely to vote Republican anyway. What really matters for Democrats’ political fortunes is that life in America be visibly getting much better by next fall — and getting shots in arms is the way to make that happen.

Politics Is The Biggest Factor In Response To The Pandemic

Our national response to the continuing pandemic has been disappointing. Too many people are refusing to wear masks or get vaccinated. But the difference between the masked/vaccinated and the unmasked/unvaccinated doesn't have much to do with age, gender, race, religion,  sexual preference, or national origin. The biggest factor of all is sadly -- POLITICS. Republicans and red-states are far more likely to refuse to wear masks or get vaccinated, while Democrats and blue-states are far more likely to do both -- and that is born out by the statistics.

The following is from Philip Bump in The Washington Post:

It’s obvious that there’s an overlap of vaccination rates, party identity and pandemic outcomes that intertwines the discussion about the pandemic with partisan politics. It is inescapably the case that, even if party doesn’t play a significant role in pandemic outcomes, the debate is largely framed through a partisan lens anyway — often to a hyperbolic degree.

One reason for that is that there is an obvious string of correlations here. More deaths from the virus occur in places where there are more cases. There are more cases in places where vaccination rates are lower. Vaccination rates are lower in places that voted more heavily Republican in 2020. . . .

For example, here (top chart) is the relationship between cases, deaths, vaccinations and 2020 vote as of Thursday. Of the 23 states that have new case totals per capita higher than the nation overall, 21 voted for Donald Trump in November. Sixteen are among the 17 states that have the lowest rates of vaccination. Of the 18 states that have new death totals higher than the national ratio, 14 voted for Trump and 12 are among the 17 least-vaccinated states.

It’s also important to note that the pandemic is not unfolding the way it did last summer. If we take the difference between each state’s per-capita cases and deaths relative and the national figure and average it by 2020 vote, we see that red states are doing much worse relative to the country on the whole than are blue states. The vertical dashed lines below (middle chart) indicate Sept. 9, 2020, and Sept. 9, 2021 — that is, now and one year ago. Not only are cases and deaths now higher relative to the country overall than they were then, but the figures in blue states are much lower.

If we look at the same patterns using the vaccination-rate groupings (bottom chart), we see that it’s the least-vaccinated states that are being hit hardest, followed by the middle group and then the most-vaccinated states. . . .

Again, the chain of correlation here is indisputable: Republicans have been less concerned about the virus, less likely to embrace practices such as masking, more likely to express opposition to vaccination and (obviously) voted more heavily for Trump — and now, after vaccinations have been made broadly available, states that are seeing the most new cases and deaths are states that are less heavily vaccinated and were more supportive of Trump last year. All of that is obviously and provably true, making it much harder to assert that politics is not playing any role. . . .

The Pew Research Center regularly polls Americans to gauge the demographic identifiers that spur the broadest disagreement on issues. You might think that it’s gender or age or race. It isn’t. It’s party, by a mile. That party is now intertwined with the extent to which America is willing to tamp down on a deadly virus is, to put it mildly, disadvantageous.

Transcript Of The President's 9/9 Speech On The Pandemic

The President has begged and cajoled Americans into protecting themselves with masks and getting vaccinated. We could have the COVID-19 pandemic under control by now, and he knows it. But too many people refuse to cooperate, preferring to play politics instead of joining with their fellow Americans to fight the pandemic. President Biden is tired of the ignorance and stupidity of these people, and he's now taking action. Here is the transcript of his September 9th speech on the pandemic and the actions he is taking:

Good evening, my fellow Americans.  I want to talk to you about where we are in the battle against COVID-19, the progress we’ve made, and the work we have left to do.

And it starts with understanding this: Even as the Delta variant 19 [sic] has — COVID-19 — has been hitting this country hard, we have the tools to combat the virus, if we can come together as a country and use those tools.

If we raise our vaccination rate, protect ourselves and others with masking and expanded testing, and identify people who are infected, we can and we will turn the tide on COVID-19.

It will take a lot of hard work, and it’s going to take some time.  Many of us are frustrated with the nearly 80 million Americans who are still not vaccinated, even though the vaccine is safe, effective, and free.

You might be confused about what is true and what is false about COVID-19.  So before I outline the new steps to fight COVID-19 that I’m going to be announcing tonight, let me give you some clear information about where we stand.

First, we have cons- — we have made considerable progress
in battling COVID-19.  When I became President, about 2 million Americans were fully vaccinated.  Today, over 175 million Americans have that protection. 

Before I took office, we hadn’t ordered enough vaccine for every American.  Just weeks in office, we did.  The week before I took office, on January 20th of this year, over 25,000 Americans died that week from COVID-19.  Last week, that grim weekly toll was down 70 percent.

And in the three months before I took office, our economy was faltering, creating just 50,000 jobs a month.  We’re now averaging 700,000 new jobs a month in the past three months.

This progress is real.  But while America is in much better shape than it was seven months ago when I took office, I need to tell you a second fact.

We’re in a tough stretch, and it could last for a while.  The highly contagious Delta variant that I began to warn America about back in July spread in late summer like it did in other countries before us.

While the vaccines provide strong protections for the vaccinated, we read about, we hear about, and we see the stories of hospitalized people, people on their death beds, among the unvaccinated over these past few weeks. 

This is a pandemic of the unvaccinated.  And it’s caused by the fact that despite America having an unprecedented and successful vaccination program, despite the fact that for almost five months free vaccines have been available in 80,000 different locations, we still have nearly 80 million Americans
who have failed to get the shot. 

And to make matters worse, there are elected officials actively working to undermine the fight against COVID-19.  Instead of encouraging people to get vaccinated and mask up, they’re ordering mobile morgues for the unvaccinated dying from COVID in their communities.  This is totally unacceptable.

Third, if you wonder how all this adds up, here’s the math:  The vast majority of Americans are doing the right thing.  Nearly three quarters of the eligible have gotten at least one shot, but one quarter has not gotten any.  That’s nearly 80 million Americans not vaccinated.  And in a country as large as ours, that’s 25 percent minority.  That 25 percent can cause a lot of damage — and they are.

The unvaccinated overcrowd our hospitals, are overrunning the emergency rooms and intensive care units, leaving no room for someone with a heart attack, or pancreitis [pancreatitis], or cancer.

And fourth, I want to emphasize that the vaccines provide very strong protection from severe illness from COVID-19.  I know there’s a lot of confusion and misinformation.  But the world’s leading scientists confirm that if you are fully vaccinated, your risk of severe illness from COVID-19 is very low. 

In fact, based on available data from the summer, only one of out of every 160,000 fully vaccinated Americans was hospitalized for COVID per day.

These are the facts. 

So here’s where we stand: The path ahead, even with the Delta variant, is not nearly as bad as last winter.  But what makes it incredibly more frustrating is that we have the tools to combat COVID-19, and a distinct minority of Americans –supported by a distinct minority of elected officials — are keeping us from turning the corner.  These pandemic politics, as I refer to, are making people sick, causing unvaccinated people to die. 

We cannot allow these actions to stand in the way of protecting the large majority of Americans who have done their part and want to get back to life as normal. 

As your President, I’m announcing tonight a new plan to require more Americans to be vaccinated, to combat those blocking public health. 

My plan also increases testing, protects our economy, and will make our kids safer in schools.  It consists of six broad areas of action and many specific measures in each that — and each of those actions that you can read more about at WhiteHouse.gov.  WhiteHouse.gov.

The measures — these are going to take time to have full impact.  But if we implement them, I believe and the scientists indicate, that in the months ahead we can reduce the number of unvaccinated Americans, decrease hospitalizations and deaths, and allow our children to go to school safely and keep our economy strong by keeping businesses open.

First, we must increase vaccinations among the unvaccinated with new vaccination requirements.  Of the nearly 80 million eligible Americans who have not gotten vaccinated, many said they were waiting for approval from the Food and Drug Administration — the FDA.  Well, last month, the FDA granted that approval.

So, the time for waiting is over.  This summer, we made progress through the combination of vaccine requirements and incentives, as well as the FDA approval.  Four million more people got their first shot in August than they did in July. 

But we need to do more.  This is not about freedom or personal choice.  It’s about protecting yourself and those around you — the people you work with, the people you care about, the people you love.

My job as President is to protect all Americans. 

So, tonight, I’m announcing that the Department of Labor is developing an emergency rule to require all employers with 100 or more employees, that together employ over 80 million workers, to ensure their workforces are fully vaccinated or show a negative test at least once a week.

Some of the biggest companies are already requiring this: United Airlines, Disney, Tysons Food, and even Fox News.

The bottom line: We’re going to protect vaccinated workers from unvaccinated co-workers.  We’re going to reduce the spread of COVID-19 by increasing the share of the workforce that is vaccinated in businesses all across America.

My plan will extend the vaccination requirements that I previously issued in the healthcare field.  Already, I’ve announced, we’ll be requiring vaccinations that all nursing home workers who treat patients on Medicare and Medicaid, because I have that federal authority.

Tonight, I’m using that same authority to expand that to cover those who work in hospitals, home healthcare facilities, or other medical facilities –- a total of 17 million healthcare workers.

If you’re seeking care at a health facility, you should be able to know that the people treating you are vaccinated.  Simple.  Straightforward.  Period.

Next, I will sign an executive order that will now require all executive branch federal employees to be vaccinated — all.  And I’ve signed another executive order that will require federal contractors to do the same.

If you want to work with the federal government and do business with us, get vaccinated.  If you want to do business with the federal government, vaccinate your workforce. 

And tonight, I’m removing one of the last remaining obstacles that make it difficult for you to get vaccinated.

The Department of Labor will require employers with 100 or more workers to give those workers paid time off to get vaccinated.  No one should lose pay in order to get vaccinated or take a loved one to get vaccinated.

Today, in total, the vaccine requirements in my plan will affect about 100 million Americans –- two thirds of all workers. 

And for other sectors, I issue this appeal: To those of you running large entertainment venues — from sports arenas to concert venues to movie theaters — please require folks to get vaccinated or show a negative test as a condition of entry.

And to the nation’s family physicians, pediatricians, GPs — general practitioners –- you’re the most trusted medical voice to your patients.  You may be the one person who can get someone to change their mind about being vaccinated. 

Tonight, I’m asking each of you to reach out to your unvaccinated patients over the next two weeks and make a personal appeal to them to get the shot.  America needs your personal involvement in this critical effort.

And my message to unvaccinated Americans is this: What more is there to wait for?  What more do you need to see?  We’ve made vaccinations free, safe, and convenient.

The vaccine has FDA approval.  Over 200 million Americans have gotten at least one shot. 

We’ve been patient, but our patience is wearing thin.  And your refusal has cost all of us.  So, please, do the right thing.  But just don’t take it from me; listen to the voices of unvaccinated Americans who are lying in hospital beds, taking their final breaths, saying, “If only I had gotten vaccinated.”  “If only.”

It’s a tragedy.  Please don’t let it become yours.

The second piece of my plan is continuing to protect the vaccinated.

For the vast majority of you who have gotten vaccinated, I understand your anger at those who haven’t gotten vaccinated.  I understand the anxiety about getting a “breakthrough” case.

But as the science makes clear, if you’re fully vaccinated, you’re highly protected from severe illness, even if you get COVID-19.  

In fact, recent data indicates there is only one confirmed positive case per 5,000 fully vaccinated Americans per day.

You’re as safe as possible, and we’re doing everything we can to keep it that way — keep it that way, keep you safe.

That’s where boosters come in — the shots that give you even more protection than after your second shot.

Now, I know there’s been some confusion about boosters.  So, let me be clear: Last month, our top government doctors announced an initial plan for booster shots for vaccinated Americans.  They believe that a booster is likely to provide the highest level of protection yet.

Of course, the decision of which booster shots to give, when to start them, and who will give them, will be left completely to the scientists at the FDA and the Centers for Disease Control.

But while we wait, we’ve done our part.  We’ve bought enough boosters — enough booster shots — and the distribution system is ready to administer them.

As soon as they are authorized, those eligible will be able to get a booster right away in tens of thousands of site across the — sites across the country for most Americans, at your nearby drug store, and for free. 

The third piece of my plan is keeping — and maybe the most important — is keeping our children safe and our schools open.  For any parent, it doesn’t matter how low the risk of any illness or accident is when it comes to your child or grandchild.  Trust me, I know. 

So, let me speak to you directly.  Let me speak to you directly to help ease some of your worries.

It comes down to two separate categories: children ages 12 and older who are eligible for a vaccine now, and children ages 11 and under who are not are yet eligible.

The safest thing for your child 12 and older is to get them vaccinated.  They get vaccinated for a lot of things.  That’s it.  Get them vaccinated.

As with adults, almost all the serious COVID-19 cases we’re seeing among adolescents are in unvaccinated 12- to 17-year-olds — an age group that lags behind in vaccination rates.

So, parents, please get your teenager vaccinated.

What about children under the age of 12 who can’t get vaccinated yet?  Well, the best way for a parent to protect their child under the age of 12 starts at home.  Every parent, every teen sibling, every caregiver around them should be vaccinated.  

Children have four times higher chance of getting hospitalized if they live in a state with low vaccination rates rather than the states with high vaccination rates. 

Now, if you’re a parent of a young child, you’re wondering when will it be — when will it be — the vaccine available for them.  I strongly support an independent scientific review for vaccine uses for children under 12.  We can’t take shortcuts with that scientific work. 

But I’ve made it clear I will do everything within my power to support the FDA with any resource it needs to continue to do this as safely and as quickly as possible, and our nation’s top doctors are committed to keeping the public at large updated on the process so parents can plan.

Now to the schools.  We know that if schools follow the science and implement the safety measures — like testing, masking, adequate ventilation systems that we provided the money for, social distancing, and vaccinations — then children can be safe from COVID-19 in schools.

Today, about 90 percent of school staff and teachers are vaccinated.  We should get that to 100 percent.  My administration has already acquired teachers at the schools run by the Defense Department — because I have the authority as President in the federal system — the Defense Department and the Interior Department — to get vaccinated.  That’s authority I possess. 

Tonight, I’m announcing that we’ll require all of nearly 300,000 educators in the federal paid program, Head Start program, must be vaccinated as well to protect your youngest — our youngest — most precious Americans and give parents the comfort.

And tonight, I’m calling on all governors to require vaccination for all teachers and staff.  Some already have done so, but we need more to step up. 

Vaccination requirements in schools are nothing new.  They work.  They’re overwhelmingly supported by educators and their unions.  And to all school officials trying to do the right thing by our children: I’ll always be on your side. 

Let me be blunt.  My plan also takes on elected officials and states that are undermining you and these lifesaving actions.  Right now, local school officials are trying to keep children safe in a pandemic while their governor picks a fight with them and even threatens their salaries or their jobs.  Talk about bullying in schools.  If they’ll not help — if these governors won’t help us beat the pandemic, I’ll use my power as President to get them out of the way. 

The Department of Education has already begun to take legal action against states undermining protection that local school officials have ordered.  Any teacher or school official whose pay is withheld for doing the right thing, we will have that pay restored by the federal government 100 percent.  I promise you I will have your back. 

The fourth piece of my plan is increasing testing and masking.  From the start, America has failed to do enough COVID-19 testing.  In order to better detect and control the Delta variant, I’m taking steps tonight to make testing more available, more affordable, and more convenient.  I’ll use the Defense Production Act to increase production of rapid tests, including those that you can use at home. 

While that production is ramping up, my administration has worked with top retailers, like Walmart, Amazon, and Kroger’s, and tonight we’re announcing that, no later than next week, each of these outlets will start to sell at-home rapid test kits at cost for the next three months.  This is an immediate price reduction for at-home test kits for up to 35 percent reduction.

We’ll also expand — expand free testing at 10,000 pharmacies around the country.  And we’ll commit — we’re committing $2 billion to purchase nearly 300 million rapid tests for distribution to community health centers, food banks, schools, so that every American, no matter their income, can access free and convenient tests.  This is important to everyone, particularly for a parent or a child — with a child not old enough to be vaccinated.  You’ll be able to test them at home and test those around them.

In addition to testing, we know masking helps stop the spread of COVID-19.  That’s why when I came into office, I required masks for all federal buildings and on federal lands, on airlines, and other modes of transportation.  

Today — tonight, I’m announcing that the Transportation Safety Administration — the TSA — will double the fines on travelers that refuse to mask.  If you break the rules, be prepared to pay. 

And, by the way, show some respect.  The anger you see on television toward flight attendants and others doing their job is wrong; it’s ugly. 

The fifth piece of my plan is protecting our economic recovery.  Because of our vaccination program and the American Rescue Plan, which we passed early in my administration, we’ve had record job creation for a new administration, economic growth unmatched in 40 years.  We cannot let unvaccinated do this progress — undo it, turn it back. 

So tonight, I’m announcing additional steps to strengthen our economic recovery.  We’ll be expanding COVID-19 Economic Injury Disaster Loan programs.  That’s a program that’s going to allow small businesses to borrow up to $2 million from the current $500,000 to keep going if COVID-19 impacts on their sales. 

These low-interest, long-term loans require no repayment for two years and be can used to hire and retain workers, purchase inventory, or even pay down higher cost debt racked up since the pandemic began.  I’ll also be taking additional steps to help small businesses stay afloat during the pandemic. 

Sixth, we’re going to continue to improve the care of those who do get COVID-19.  In early July, I announced the deployment of surge response teams.  These are teams comprised of experts from the Department of Health and Human Services, the CDC, the Defense Department, and the Federal Emergency Management Agency — FEMA — to areas in the country that need help to stem the spread of COVID-19. 

Since then, the federal government has deployed nearly 1,000 staff, including doctors, nurses, paramedics, into 18 states.  Today, I’m announcing that the Defense Department will double the number of military health teams that they’ll deploy to help their fellow Americans in hospitals around the country. 

Additionally, we’re increasing the availability of new medicines recommended by real doctors, not conspir- — conspiracy theorists.  The monoclonal antibody treatments have been shown to reduce the risk of hospitalization by up to 70 percent for unvaccinated people at risk of developing sefe- — severe disease. 

We’ve already distributed 1.4 million courses of these treatments to save lives and reduce the strain on hospitals.  Tonight, I’m announcing we will increase the average pace of shipment across the country of free monoclonal antibody treatments by another 50 percent.

Before I close, let me say this: Communities of color are disproportionately impacted by this virus.  And as we continue to battle COVID-19, we will ensure that equity continues to be at the center of our response.  We’ll ensure that everyone is reached.  My first responsibility as President is to protect the American people and make sure we have enough vaccine for every American, including enough boosters for every American who’s approved to get one. 

We also know this virus transcends borders.  That’s why, even as we execute this plan at home, we need to continue fighting the virus overseas, continue to be the arsenal of vaccines. 

We’re proud to have donated nearly 140 million vaccines over 90 countries, more than all other countries combined, including Europe, China, and Russia combined.  That’s American leadership on a global stage, and that’s just the beginning.

We’ve also now started to ship another 500 million COVID vaccines — Pfizer vaccines — purchased to donate to 100 lower-income countries in need of vaccines.  And I’ll be announcing additional steps to help the rest of the world later this month.

As I recently released the key parts of my pandemic preparedness plan so that America isn’t caught flat-footed when a new pandemic comes again — as it will — next month, I’m also going to release the plan in greater detail.

So let me close with this: We have so- — we’ve made so much progress during the past seven months of this pandemic.  The recent increases in vaccinations in August already are having an impact in some states where case counts are dropping in recent days.  Even so, we remain at a critical moment, a critical time.  We have the tools.  Now we just have to finish the job with truth, with science, with confidence, and together as one nation.

Look, we’re the United States of America.  There’s nothing — not a single thing — we’re unable to do if we do it together.  So let’s stay together.

God bless you all and all those who continue to serve on the frontlines of this pandemic.  And may God protect our troops.

Get vaccinated.