When the highly transmissible Omicron variant of the coronavirus arrived in the United States last fall, it pushed new case numbers to previously unseen peaks.
Even then, the record wave of recorded infections was a significant undercount of reality.
In New York City, for example, officials logged more than 538,000 new cases between January and mid-March, representing roughly 6 percent of the citys population. But a recent survey of New York adults suggests that there could have been more than 1.3 million additional cases that were either never detected or never reported and that 27 percent of the citys adults may have been infected during those months.
The official tally of coronavirus infections in the United States has always been an underestimate. But as Americans increasingly turn to at-home tests, states shutter mass testing sites and institutions cut back on surveillance testing, case counts are becoming an increasingly unreliable measure of the viruss true toll, scientists say.
It seems like the blind spots are getting worse with time, said Denis Nash, an epidemiologist at the CUNY Graduate School of Public Health & Health Policy who led the New York City analysis, which is preliminary and has not yet been published.
That could leave officials increasingly in the dark about the spread of the highly contagious new subvariant of Omicron known as BA.2, he said, adding, We are going to be more likely to be surprised. On Wednesday, New York officials announced that two new Omicron subvariants, both descended from BA.2, have been circulating in the state for weeks and are spreading even faster than the original version of BA.2.
The official case count can still pick up major trends, and it has begun to tick up again as BA.2 spreads. But undercounts are likely to be a bigger problem in the weeks ahead, experts said, and mass testing sites and widespread surveillance testing may never return.
Thats the reality we find ourselves in, said Kristian Andersen, a virologist at the Scripps Research Institute in San Diego. We dont really have eyes on the pandemic like we used to.
To track BA.2, as well as future variants, officials will need to pull whatever insights they can from an array of existing indicators, including hospitalization rates and wastewater data. But truly keeping tabs on the virus will require more creative thinking and investment, scientists said.
For now, some scientists said, people can gauge their risk by deploying a lower-tech tool: paying attention to whether people they know are catching the virus.
If youre hearing your friends and your co-workers get sick, that means your risk is up and that means you probably need to be testing and masking, said Samuel Scarpino, the vice president of pathogen surveillance at the Rockefeller Foundations Pandemic Prevention Institute.
Tracking the virus has been a challenge since the earliest days of the pandemic, when testing was severely constrained. Even when testing improved, many people did not have the time or resources to seek it out or had asymptomatic infections that never made themselves known.
By the time Omicron hit, a new challenge was presenting itself: At-home tests had finally become more widely available, and many Americans relied on them to get through the winter holidays. Many of those results were never reported.
We havent done the groundwork to systematically capture those cases on a national level, said Katelyn Jetelina, an epidemiologist at the University of Texas Health Science Center at Houston.
Some jurisdictions and test manufacturers have developed digital tools that allow people to report their test results. But one recent study suggests that it may take work to get people to use them. Residents of six communities across the country were invited to use an app or an online platform to order free tests, log their results and then, if they chose, send that data to their state health departments.
Nearly 180,000 households used the digital assistant to order the tests, but just 8 percent of them logged any results on the platform, researchers found, and only three-quarters of those reports were sent on to health officials.
General Covid fatigue, as well as the protection that vaccination provides against severe symptoms, may also prompt fewer people to seek testing, experts said. And citing a lack of funds, the federal government recently announced that it would stop reimbursing health care providers for the cost of testing uninsured patients, prompting some providers to stop offering those tests for free. That could make uninsured Americans especially reluctant to test, Dr. Jetelina said.
The poorest neighborhoods will have even more depressed case numbers than high-income neighborhoods, she noted.
Monitoring case trends remains important, experts said. If we see an increase in cases, its an indicator that something is changing and quite possibly that something is changing because of a larger shock to the system, like a new variant, said Alyssa Bilinski, a public health policy expert at the Brown University School of Public Health.
But more modest increases in transmission may not be reflected in the case tally, which means that it could take officials longer to detect new surges, experts said. The problem could be exacerbated by the fact that some jurisdictions have begun updating their case data less frequently.
Dr. Nash and his colleagues have been exploring ways to overcome some of these challenges. To estimate how many New Yorkers may have been infected during the winter Omicron surge, they surveyed a diverse sample of 1,030 adults about their testing behaviors and results, as well as potential Covid-19 exposures and symptoms.
People who reported testing positive for the virus on tests administered by health care or testing providers were counted as cases that would have been caught by standard surveillance systems. Those who tested positive only on at-home tests were counted as hidden cases, as were those who had probable unreported infections a group that included people who had both Covid-19-like symptoms and known exposures to the virus.
The researchers used the responses to calculate how many infections might have escaped detection, weighting the data to match the demographics of the citys adult population.
The study has limitations. It relies on self-reported data and excludes children, as well as adults living in institutional settings, including nursing homes. But health departments could use the same approach to try to fill in some of their surveillance blind spots, especially during surges, Dr. Nash said.
You could do these surveys on a daily or weekly basis and quickly correct prevalence estimates in real time, he said.
Another approach would be to replicate what Britain has done, regularly testing a random selection of hundreds of thousands of residents. Thats really the Cadillac of surveillance methods, said Natalie Dean, a biostatistician at Emory University.
The method is expensive, however, and Britain has recently started scaling back its efforts. Its something that should be part of our arsenal in the future, Dr. Dean said. Its sort of unclear what people have the appetite for.
The spread of Omicron, which easily infects even vaccinated people and generally causes milder disease than the earlier Delta variant, has prompted some officials to put more emphasis on hospitalization rates.
If our goal is to track serious illness from the virus, I think thats a good way to do it, said Jason Salemi, an epidemiologist at the University of South Florida.
But hospitalization rates are lagging indicators and may not capture the true toll of the virus, which can cause serious disruptions and long Covid without sending people to the hospital, Dr. Salemi said.
Indeed, different metrics can create very different portraits of risk. In February, the Centers for Disease Control and Prevention began using local hospitalization rates and measures of hospital capacity, in addition to case counts, to calculate its new Covid-19 community levels, which are designed to help people decide whether to wear masks or take other precautions. More than 95 percent of U.S. counties currently have low community Covid-19 levels, according to this measure.
But the C.D.C.s community transmission map, which is based solely on local case and test positivity rates, suggests that just 29 percent of U.S. counties currently have low levels of viral transmission.
Hospitalization data may be reported differently from one place to another. Because Omicron is so transmissible, some localities are trying to distinguish between patients who were hospitalized specifically for Covid-19 and those who picked up the virus incidentally.
We felt like, because of the intrinsic factors of the virus itself that were seeing circulating in our region now, that we needed to update our metrics, said Dr. Jonathan Ballard, the chief medical officer at the New Hampshire Department of Health and Human Services.
Until late last month, New Hampshires Covid-19 online dashboard displayed all inpatients with active coronavirus infections. Now, it instead displays the number of hospitalized Covid-19 patients taking remdesivir or dexamethasone, two frontline treatments. (Data on all confirmed infections in hospitalized patients remains available through the New Hampshire Hospital Association, Dr. Ballard noted.)
Another solution is to use approaches, such as wastewater surveillance, that dont rely on testing or health care access at all. People with coronavirus infections shed the virus in their stool; monitoring the levels of the virus in wastewater provides an indicator of how widespread it is in a community.
And then you combine that with sequencing, so you get a sense of what variants are circulating, said Dr. Andersen, who is working with colleagues to track the virus in San Diegos wastewater.
The C.D.C. recently added wastewater data from hundreds of sampling sites to its Covid-19 dashboard, but coverage is highly uneven, with some states reporting no current data at all. If wastewater surveillance is going to fill in the testing gaps, it needs to be expanded, and the data needs to be released in near real time, scientists said.
Wastewater is a no-brainer to me, Dr. Andersen said. It gives us a really good, important passive surveillance system that can be scaled. But only if we realize that thats what we have to do.
Dr. Scarpino, of the Pandemic Prevention Institute, said that there were other data sources that officials could leverage, including information on school closings, flight cancellations and geographic mobility.
One of the things were not doing a good enough job of doing is pulling those together in a thoughtful, coordinated way, Dr. Scarpino said.
An ambitious effort by the World Health Organization to calculate the global death toll from the coronavirus pandemic has found that vastly more people died than previously believed a total of about 15 million by the end of 2021, more than double the official total of six million reported by countries individually.
But the release of the staggering estimate the result of more than a year of research and analysis by experts around the world and the most comprehensive look at the lethality of the pandemic to date has been delayed for months because of objections from India, which disputes the calculation of how many of its citizens died and has tried to keep it from becoming public.
More than a third of the additional nine million deaths are estimated to have occurred in India, where the government of Prime Minister Narendra Modi has stood by its own count of about 520,000. The W.H.O. will show the countrys toll is at least four million, according to people familiar with the numbers who were not authorized to disclose them, which would give India the highest tally in the world, they said. The Times was unable to learn the estimates for other countries.
The W.H.O. calculation combined national data on reported deaths with new information from localities and household surveys, and with statistical models that aim to account for deaths that were missed. Most of the difference in the new global estimate represents previously uncounted deaths, the bulk of which were directly from Covid; the new number also includes indirect deaths, like those of people unable to access care for other ailments because of the pandemic.
The delay in releasing the figures is significant because the global data is essential for understanding how the pandemic has played out and what steps could mitigate a similar crisis in the future. It has created turmoil in the normally staid world of health statistics a feud cloaked in anodyne language is playing out at the United Nations Statistical Commission, the world body that gathers health data, spurred by Indias refusal to cooperate.
Its important for global accounting and the moral obligation to those who have died, but also important very practically. If there are subsequent waves, then really understanding the death total is key to knowing if vaccination campaigns are working, said Dr. Prabhat Jha, director of the Centre for Global Health Research in Toronto and a member of the expert working group supporting the W.H.O.s excess death calculation. And its important for accountability.
To try to take the true measure of the pandemics impact, the W.H.O. assembled a collection of specialists including demographers, public health experts, statisticians and data scientists. The Technical Advisory Group, as it is known, has been collaborating across countries to try to piece together the most complete accounting of the pandemic dead.
The Times spoke with more than 10 people familiar with the data. The W.H.O. had planned to make the numbers public in January but the release has continually been pushed back.
Recently, a few members of the group warned the W.H.O. that if the organization did not release the figures, the experts would do so themselves, three people familiar with the matter said.
A W.H.O. spokeswoman, Amna Smailbegovic, told The Times, We aim to publish in April.
Dr. Samira Asma, the W.H.O.s assistant director general for data, analytics and delivery for impact, who is helping to lead the calculation, said the release of the data has been slightly delayed but said it was because we wanted to make sure everyone is consulted.
India insists that the W.H.O.s methodology is flawed. India feels that the process was neither collaborative nor adequately representative, the government said in a statement to the United Nations Statistical Commission in February. It also argued that the process did not hold scientific rigor and rational scrutiny as expected from an organization of the stature of the World Health Organization.
The Ministry of Health in New Delhi did not respond to requests for comment.
India is not alone in undercounting pandemic deaths: The new W.H.O. numbers also reflect undercounting in other populous countries such as Indonesia and Egypt.
Dr. Asma noted that many countries have struggled to accurately calculate the pandemics impact. Even in the most advanced countries, she said, I think when you look under the hood, it is challenging. At the start of the pandemic there were significant disparities in how quickly different U.S. states were reporting deaths, she said, and some were still collecting the data via fax.
India brought a large team to review the W.H.O. data analysis, she said, and the agency was glad to have them do it, because it wanted the model to be as transparent as possible.
Indias work on vaccination has won praise from experts globally, but its public health response to Covid has been criticized for overconfidence. Mr. Modi boasted in January 2021 that India had saved humanity from a big disaster. A couple of months later, his health minister declared that the country was in the endgame of Covid-19. Complacency set in, leading to missteps and attempts by officials to silence critical voices within elite institutions.
Science in India has been increasingly politicized over the course of the pandemic. In February, Indias junior health minister criticized a study published in the journal Science that estimated the countrys Covid death toll to be six to seven times greater than the official number. In March, the government questioned the methodology of a study published in The Lancet that estimated Indias deaths at four million.
Personally, I have always felt that science has to be responded with science, said Bhramar Mukherjee, a professor of biostatistics at the University of Michigan School of Public Health who has been working with the W.H.O. to review the data. If you have an alternative estimate, which is through rigorous science, you should just produce it. You cannot just say, I am not going to accept it.
India has not submitted its total mortality data to the W.H.O. for the past two years, but the organizations researchers have used numbers gathered from at least 12 states, including Andhra Pradesh, Chhattisgarh and Karnataka, which experts say show at least four to five times more deaths as a result of Covid-19.
Jon Wakefield, a professor of statistics and biostatistics at the University of Washington who played a key role in building the model used for the estimates, said an initial presentation of the W.H.O. global data was ready in December.
But then India was unhappy with the estimates. So then weve subsequently done all sorts of sensitivity analyses, the papers actually a lot better because of this wait, because weve gone overboard in terms of model checks and doing as much as we possibly can given the data thats available, Dr. Wakefield said. And were ready to go.
The numbers represent what statisticians and researchers call excess mortality the difference between all deaths that occurred and those that would have been expected to occur under normal circumstances. The W.H.O.s calculations include those deaths directly from Covid, deaths of people because of conditions complicated by Covid, and deaths of those who did not have Covid but needed treatment they could not get because of the pandemic. The calculations also take into account expected deaths that did not occur because of Covid restrictions, such as those from traffic accidents.
Calculating excess deaths globally is a complex task. Some countries have closely tracked mortality data and supplied it promptly to the W.H.O. Others have supplied only partial data, and the agency has had to use modeling to round out the picture. And then there is a large number of countries, including nearly all of those in sub-Saharan Africa, that do not collect death data and for which the statisticians have had to rely entirely on modeling.
Dr. Asma of the W.H.O. noted that nine out of 10 deaths in Africa, and six out of 10 globally, are not registered, and more than half the countries in the world do not collect accurate causes of death. That means that even the starting point for this kind of analysis is a guesstimate, she said. We have to be humble about it, and say we dont know what we dont know.
To produce mortality estimates for countries with partial or no death data, the experts in the advisory group used statistical models and made predictions based on country-specific information such as containment measures, historical rates of disease, temperature and demographics to assemble national figures and, from there, regional and global estimates.
Besides India, there are other large countries where the data is also uncertain.
Russias ministry of health had reported 300,000 Covid deaths by the end of 2021, and that was the number the government gave the W.H.O. But the Russian national statistics agency that is fairly independent of the government found excess mortality of more than one million people a figure that is reportedly close to the one in the W.H.O. draft. Russia has objected to that number, but it has made no effort to stall the release of the data, members of the group said.
China, where the pandemic began, does not publicly release mortality data, and some experts have raised questions about underreporting of deaths, especially at the beginning of the outbreak. China has officially reported fewer than 5,000 deaths from the virus.
While China has indeed kept caseloads at much lower levels than most countries, it has done so in part through some of the worlds strictest lockdowns which have had their own impact on public health. One of the few studies to examine Chinas excess mortality using internal data, conducted by a group of government researchers, showed that deaths from heart disease and diabetes spiked in Wuhan during that citys two-month lockdown. The researchers said the increase was most likely owing to inability or reluctance to seek help at hospitals. They concluded that the overall death rate in Wuhan was about 50 percent higher than expected in the first quarter of 2020.
Indias effort to stall the reports release makes clear that pandemic data is a sensitive issue for the Modi government. It is an unusual step, said Anand Krishnan, a professor of community medicine at the All India Institute of Medical Sciences in New Delhi who has also been working with the W.H.O. to review the data. I dont remember a time when it has done so in the past.
Ariel Karlinsky, an Israeli economist who built and maintains the World Mortality Dataset and who has been working with the W.H.O. on the figures, said they are challenging for governments when they show high excess deaths. I think its very sensible for the people in power to fear these consequences.
Vivian Wang contributed reporting.
First detected on January 19 2022, the Omicron XE variant, which some have called the "Frankenstein" ... [+] variant has been spreading in the United Kingdom. (Photo by TOLGA AKMEN/AFP via Getty Images)
The name Frankenstein may conjure up some frightening images. For example, telling your significant other, hey, your face has that Frankenstein look today could end up being quite scary for you. So now that some have dubbed the relatively new Omicron XE Covid-19 coronavirus variant the Frankenstein variant, should you be particularly worried?
Well, first of all, the XE is not going to turn you into Frankensteins monster. You wont suddenly wake up one day with bolts in your neck and a head thats flat enough to carry a plate of hot dog franks. Something like that will not occur, assuming that you arent using ecstasy. XE may sound like a new version of Microsoft Windows. But before you download in your pants, dont let the monstrous moniker mislead you. While Frankensteins monster may have been created by Dr. Victor Frankenstein, theres no evidence that the XE variant was produced in a laboratory.
Instead, the XE is something that was totally expected to arise naturally, especially with so many people abandoning Covid-19 precautions as if they were leaving a theater showing the movie Morbius. With the BA.1 and BA.2 Omicron variants circulating so widely, it was only a matter of time before they found themselves in the same human and started knocking spikes together, so to speak. When two different versions of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infect the same cell, they can swap their genetic material so that their progeny end up with a new combination. Scientists call the XE a recombinant because it is the result of the BA.1 and BA.2 swapping right with each other and recombining their genetic material. The XE contains BA.1 mutations for NSP1-6 and BA.2 mutations for the rest of its genome. Also present are three mutations that neither the BA.1 nor the BA.2 have: NSP3 V1069I (non-synonymous) and C3241T (synonymous), and NSP12 C14599T (synonymous).
This certainly wasnt the first time that such a thing has occurred. For example, just last month, I described for Forbes another recombination between the Delta GK/AY.4 and Omicron GRA/BA.1 lineages mixed to form the then-dubbed Deltacron recombinant. In fact, theres been a Wheel of Misfortune of Delta and BA.1 recombinants ranging from XD to XF to XS.
The relaxation of Covid-19 precautions such as face mask wearing and social distancing could be ... [+] making it easier for Covid-19 coronavirus variants to emerge and spread. Pictured here is a line into a nightclub in Cardiff, Wales. (Photo by Matthew Horwood/Getty Images)
First detected in England January 19 2022, the XE variant has been spreading in the U.K., primarily in East of England, London, and the South East. According to the U.K. Health Security Agency, from January 15 through the end of March, the amount of XE compared to BA.2 in tested samples in the U.K. grew by an average of 12.6% per week with a 20.9% increase per week over the last three weeks of March. As of April 5, the U.K. had 1,179 documented cases of XE, and England had 1,125 documented XE cases.
The spread of the XE does suggest that it may be more transmissible than the BA.2. A World Health Organization (WHO) report from March 29 stated that early-day estimates indicate a community growth rate advantage of ~10% as compared to BA.2, however this finding requires further confirmation. At this time, the WHO hasnt listed the XE as a separate variant of interest or variant of concern. There just isnt enough information yet, and its not clear how widely the XE has spread so far. The WHO report did add that XE belongs to the Omicron variant until significant differences in transmission and disease characteristics, including severity, may be reported. So more studies are needed to determine whether the XE is indeed more contagious, whether it is more likely to cause more severe Covid-19 outcomes, and how effective immune protection from vaccination or prior infection may be against XE.
One things for sure, new recombinants and new variants in general of the SARS-CoV-2 will continue to emerge like bad reality TV shows. The SARS-CoV-2 has a high mutation rate. Similar to a drunk person trying to make photocopies of his or her butt, the virus can make mistakes whenever it tries to reproduce. The resulting copies of the virus then may have somewhat different genetic material. And new genetic material can give these new copies different properties. Thats why scientists had warned years before 2020 about the possibility of some type of coronavirus jumping from other animals to humans to cause a pandemic.
Now, just because new variants will keep emerging indefinitely doesnt mean that the pandemic and Covid-19 precautions will last forever. The road to the end of the pandemic is maintaining Covid-19 precautions until enough of our immune systems go from virginal to been there, done that when it comes to the SARS-CoV02. This could occur something this year through a combination of people having gotten vaccinated or repeatedly infected with the virus. Of course, the problem with the get infected route right now is the whole potentially dying thing or the months and months of brain fog, fatigue, palpitations, shortness of breath, and other long Covid symptom thing. So encouraging each other to get vaccinated against Covid-19 remains the best way to shorten the duration of the pandemic and the length of time Covid-19 precautions like face mask wearing will be needed or recommended.
At this point, the Frankenstein name is probably not that appropriate for the XE variant. Its not as if theres going to be a Dracula variant, a werewolf variant, a mummy variant, a Tinder swindler variant, a Ponzi scheme variant, a douchebag variant, or any other type of monster variant. The emergence of the XE is a frank reminder that the pandemic is not over yet. And that you should do what you should have been doing all along, maintaining appropriate Covid-19 precautions.
STATEN ISLAND, N.Y. By now, weve all heard about the most common symptoms of coronavirus (COVID-19), but there are several unusual signs of the illness that no one seems to talk about.
While fatigue, sore throat, fever, body aches and cough are the most common symptoms of COVID and its subsequent variants, Dr. Thomas Gut, associate chair of medicine at Staten Island University Hospital, recently revealed to ETNT Health that there are four unusual symptoms that often signal the illness.
Other rare symptoms, such as loss of speech movement, conjunctivitis, discoloration of fingers or toes and rash, have been reported by the Centers for Disease Control and Prevention (CDC).
People experiencing difficulty breathing or chest pain or pressure should seek immediate medical attention, the CDC advises.
COVID symptoms vary from person to person, based on where the virus attacks first, or causes the most inflammation, Gut told ETNT Health, a science and health-related news website headquartered in Brooklyn. This has a large role in why some symptoms are present for some individuals, yet are absent in other cases. Also, the variants of COVID have caused some interesting and relatively unique symptoms to each wave.
People experiencing flu-like symptoms that feel worse than a cold or flu should also seek medical attention, experts advise.
Those who are fully vaccinated and still get COVID should only feel minor symptoms, doctors say. Anything new or alarming should be evaluated by a doctor, Gut told ETNT Health.
Almost exactly 12 months ago, Americas pandemic curve hit a pivot point. Case counts peakedand then dipped, and dipped, and dipped, on a slow but sure grade, until, somewhere around the end of May, the numbers flattened and settled, for several brief, wonderful weeks, into their lowest nadir so far.
I refuse to use the term hot vax summer (oops, just did), but its sentiment isnt exactly wrong. A year ago, the shots were shiny and new, and a great match for the variants du jour; by the start of June, roughly half of the American population had received their first injections, all within the span of a few monthsa remarkable single buildup of immunity, says Virginia Pitzer, an epidemiologist at Yale. The winter surges had run their course; schools were letting out for the season; the warm weather was begging for outdoor gatherings, especially in the countrys northern parts. A confluence of factors came together in a stretch that, for a time, really was great, Katelyn Jetelina, an epidemiologist at the University of Texas Health Science Center at Houston, told me.
Its now the spring of 2022, and at a glance, the stop-SARS-CoV-2 stars would seem to be aligning once more. Like last time, cases have dropped from a horrific winter peak; like last time, people have built up a decent bit of immunity; like last time, rising temperatures are nudging people outside. Already, one of the pandemics best-publicized models is projecting that this summer could look about as stellar as the start of last.
These trends dont guarantee good times. If anything, national case countscurrently a woeful underestimate of realityhave started to creep upward in the past couple of weeks, as an Omicron subvariant called BA.2 continues its hostile takeover. And no one knows when or where this version of the virus will spit us out of its hypothetical surge. I have learned to not predict where this is going, says Theresa Chapple, a Chicago-area epidemiologist.
Read: America is staring down its first so what? wave
In crisis, its easy to focus our attention on wavesthe worst a pandemic can bring. And yet, understanding the troughswhether high, low, or kind of undecidedis just as essential. The past two years have been full of spastic surges; if the virus eventually settles down into something more subdued, more seasonal, and more sustained, these between-bump stretches may portend what COVID looks like at baseline: its true off-season.
At these times of year, when we can reliably expect there to be far less virus bopping around, our relationship to COVID can be different. But lulls are not automatic. They cannot be vacations. Theyre intermissions that we can use to prepare for what the virus serves up next.
Lulls, like waves, are the products of three variableshow fast a virus moves, how hospitable its hosts are to infection, and how often the two parties are forced to collide. Last years respite managed to hit a trifecta: a not-too-speedy virus met fresh vaccines while plenty of people were still on high alert. It was enough to stave off COVIDs worst, and tamp transmission down.
This time around, some of the variables are a bit different. The virus, for one, has changed. In the past year, SARS-CoV-2 has only gotten better at its prime operative of infecting us. High transmissibility nudges the natural set point of the pandemic higher: When the virus moves this fast among us, its simply harder to keep case levels ultralow. We have a lot less breathing room than we used to, says Alyssa Bilinski, a health-policy researcher at Brown University.
The situation arguably looks a bit better on the host side. By some estimates, population immunity in the U.S. could be near its all-time high. At least 140 million Americansperhaps many morehave been infected with SARS-CoV-2 since the pandemics start; some 250 million have dosed up at least once with a vaccine. Swirl those stats together, and its reasonable to estimate that more than 90 to 95 percent of the country has now glimpsed the coronaviruss spike protein in some form or another, many of them quite recently. On top of that, America has added a few tools to its defensive arsenal, including a heftier supply of at-home tests to identify infection early and super-effective oral antivirals to treat it.
But any discussion of immunity has to be tempered with a question: immunity against what? Although defenses against serious illness stick around pretty stubbornly, peoples safeguards against infection and transmission erode in the months after theyve been infected or vaccinatedwhich means that 90 to 95 percent exposed doesnt translate to 90 to 95 percent immune. Compared with last spring, the map of protection is also much patchier, and the range of immunity much wider. Some people have now banked several infections and vaccinations; others are many months out from their most recent exposure, or havent logged any at all. Add to that the trickiness of sustaining immunity in people who are older or immunocompromised, and the mediocrity of Americas booster campaign, and its easy to see how the country still has plenty of vulnerable pockets for the virus to exploit.
Read: Will Omicron leave all of us immune?
Then theres the mess of usour policies and our individual choices. The patterns of viral spread depend a lot on what we as a society do, and how we interact, Yonatan Grad, who studies infectious-disease dynamics at Harvard, told me. A concerted effort to mitigate transmission through masking, for instance, could help counteract the viruss increased contagiousness, and squish case curves back down nice and low. But the zeal for such measures is all but gone. Even amid the rise of actual waves, the willingness to take on interventions has gotten smaller, Yales Pitzer told me. During declines and lulls, people have even less motivation to act.
The more the virus is allowed to mosey about, the more chances it will have to mutate and adapt. Variants are always the wild card, says Ajay Sethi, an epidemiologist at the University of Wisconsin at Madison. Already, America is watching BA.2the speedier sister to the viral morph that clobbered the country this winter (now retconned as BA.1)overtake its sibling and spark outbreaks, especially across the northeast. Perhaps BA.2 will drive only a benign case bump. Maybe a sharp surge will happen, but contract quickly, ushering the country out of spring with even more immunity on its side. Or BA.2s rise will turn dramatic and prolonged, and sour summers start all on its own. Nor is BA.2 the worst-case scenario we could imagine, Sethi told me. Though its faster than BA.1, it doesnt appear to better sidestep the immune shields left behind by infection or vaccines. SARS-CoV-2s relentless mutational churn could still slingshot something far more problematic our way; already, a slew of recombinant variants and other Omicron subvariants are brewing.
I asked Deshira Wallace, a public-health researcher at the University of North Carolina at Chapel Hill, what would make this summer less than rosyor possibly, close to cataclysmic. Continuing as is right now, she told me. The pandemic is indeed still going, and the U.S. is at a point where excessive mingling could prolong the crisis. Tracking rises in cases, and responding to them early, is crucial for keeping a soft upslope from erupting into a full-on surge. And yet, across the nation, weve been seeing every single form of protection revoked, Wallace said. Indoor mask mandates have disappeared. Case-tracking surveillance systems have pulled back or gone dark. Community test and vaccination sites have vanished. Even data out of hospitals have begun to falter and fizz. Federal funds to combat the pandemic have dried up too, imperiling stocks of treatments and care for the uninsured, as the nations leaders continue to play chicken with what it means for coronavirus cases to stay low. And though many of the tools necessary to squelch SARS-CoV-2 exist, their distribution is still not being prioritized to the vulnerable populations who most need them. Spread is now definitively increasing, yet going unmeasured and unchecked.
Americans would have less to worry about if they reversed some of these behavioral trends, Wallace told me. But shes not counting on it. Which puts the onus on immunity, or sheer luck on the variant side, to countervail, which are gambles as well. Say no new variant appears, but immunity inevitably erodes, and no one maskswhat then? Behavior is the variable we hold most sway over, but Americas grip has loosened. Last year, around this time, there were more protections in place, Wallace said. Now it just feels like were in chaos.
Even last summers purported reprieve was a bit of an illusion. That lull felt great because it was the pandemics kindest so far in the United States. But even at its scarcest, the virus was still causing about 200 deaths per day, which translates to about 73,000 deaths per year, Bilinski told me. Thats worse than even what experts tend to consider a very bad flu season, when annual mortality levels hit about 50,000 or 60,000, Harvards Grad told me. (Stats closer to 10,000 or 20,000 deaths in a season are on the low end.) To chart a clearer future with COVID, even during lulls, the United States will have to grapple with a crucial question, says Shruti Mehta, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health: Whats the acceptable level of mortality per day?
Theres a bit of a bind to work through here. With SARS-CoV-2s dominant variants now as fast-spreading as they are, infections will remain tough to stave off, at least in the near term. The U.S. is growing only less equipped to track cases accurately, given the shift to home tests, which are rarely reported; community-level data collection is also in disastrous flux. So in some respects, the success of future COVID off-seasons might be better defined by hospitalizations or deaths, UT Healths Jetelina noted, as many other infectious diseases are. Its the exact shift that the Biden administration and the CDC have been pushing the population toward, and there is at least some logic to it. Thanks in large part to the potency of vaccines, infections have continued to untether from serious illnesses; speedy diagnostics and treatments have made a big dent as well. (Consider, for instance, that COVID hospital admissions have now dipped below last summers lows, even though documented cases have not.)
But merely tracking hospitalizations and deaths as a benchmark of progress doesnt prevent those outcomes; theyve already come to pass. By the time serious illness is on the rise, its too late to halt a surge in transmission that imperils high-risk groups or triggers a rash of long-COVID cases. That makes proactiveness during case lulls key: The virus doesnt have to be actively battering a countrys shields for them to get a shoring up. Its tempting to chill during low-case stretchesignore the virus for a little while, stick our heads in the sand, says Andrea Ciaranello, an infectious-disease physician at Massachusetts General Hospital. But its wiser, she said, to realize that efforts to build capacity at community, state, and federal levels cant rest during off-seasons. Lulls do tend to end. Its best if they dont catch people off guard when they do.
I asked nearly a dozen experts where theyd focus their resources now, to ameliorate the countrys COVID burden in the months and years ahead. Almost all of them pointed to two measures that would require intense investments now, but pay long-term dividendsall without requiring individuals, Chapple told me, to take repeated, daily actions to stay safe: vaccines, to blunt COVIDs severity; and ventilation, to clean indoor air. Other investments could similarly pay off when cases rise again. More widespread wastewater-surveillance efforts, Ciaranello says, could give public-health officials an early glimpse of the virus. Paid-sick-leave policies could offer workers the flexibility to isolate and seek care. If masking requirements stay in place on buses, trains, subways, and planes, they could more seamlessly move into other indoor public places when needed. The more were willing to do thats happening in the background, the more headroom we have, Bilinski told me.
Read: Were entering the control phase of the pandemic
Most essential of all, vaccines, tests, masks, and treatments will need to become and remain available, accessible, and free to all Americans, regardless of location, regardless of insurance. Supply alone is not enough: Leaders would need to identify the communities most in need, and concentrate resources therean approach, experts told me, that the U.S. would ideally apply both domestically and abroad. A truly good summer would be one in which we felt like the risk level was more comparable across populations, across individuals, Mehta told me. America, much less the globe, is nowhere near that benchmark yet.
As grand as last summer might have felt, it was also a time when the U.S. dawdled. Inequities went unaddressed. International aid fell short. Delta gained steam in parts of the American South where vaccination rates were low, and where people were cloistering indoors to beat the heat, then trickled into the east, west, and north. The pandemic simmered; Americans looked away, and let the crisis boil over again. Instead of holding last summer up as our paragon, we would do better to look ahead to the next one, and the nextmoving past wanting things as they were, and instead imagining what they could be.
INDIANAPOLIS (WISH) A decline in coronavirus cases and the easing of many restrictions means more people are getting together or going out. Thats a big change from life over the last two years, and it could cause some people to feel anxious or uneasy.
Dr. Danielle Henderson, a clinical psychologist with IU Health, says some COVID anxiety is possible as things open back up and people start making more plans.
More events and activities are being planned, and maybe, since we didnt get to do them last year or the year before, were feeling like weve got to do it now or we might miss out, Henderson said. That can be anxiety-provoking and overwhelming for people, particularly since were still in COVID.
Its okay to feel nervous or anxious, Henderson says, and its okay to take things slowly.
There are now probably a lot of events on peoples social calendars. Maybe think about, Ive been invited to a lot of things, but do I need to go to all of these things? Maybe I want to prioritize and then slowly build up to more activities.
Feeling worn out after a lot of socializing or after attending an event like dinner with a large group is normal, according to Henderson.
Were kind of trying to relearn those skills, and it can be tiring and hard, Henderson said.
To examine the effect hunters and jostlers may have on vaccinations, we conducted two pre-registered and monetary incentivized survey experimentsa main study and a follow-up study.
Data for the main study were collected on the Prolific platform at a time (March 2224 of 2021) when COVID-19 vaccines were still unavailable to large groups of the adult U.S. population. We recruited a sample of Americans, representative of the population on age, gender and race/ethnicity. The survey experiment was pre-registered in the AEA registry for RCTs as AEARCTR-0007285. Informed consent was obtained from all participants, the experiment was conducted in accordance with relevant guidelines and regulations, and the experimental protocol was approved by the George Mason IRB (#1724890).
Participants were paid $1 for completion, plus any incentives earned as part of the survey. While a total of 1,503 participants answered the survey, we here focus on those (N=1,117) who were randomized into the following treatments: i) a control treatment (participants received information about the existence of COVID-19 vaccines); ii) a hunters treatment (participants were additionally provided brief information that described how vaccine hunters went through great lengths to secure left-over vaccine doses); and iii) a jostlers treatment (providing corresponding information about how some privileged people jumped the vaccine line). The remaining 386 of participants of the total sample (N=1,503) were randomized into a safe treatment. The safe treatment emphasized the safety of COVID-19 vaccines and was included to provide a benchmark for the size of any treatment effects in the hunters and the jostlers treatment. The safe treatment did, however, not impact the enthusiasm about the vaccines (most likely because our sample already have very high trust in the safety of the vaccinesmore than 85% of participants believed vaccines were safe). Details on the safe treatment, its (null-)results, as well as on our participants trust in the vaccines, are provided in the Supplementary Information.
Specifically, participants in the control group were shown information about the existence of COVID-19 vaccines, among other things saying that [t]he COVID-19 vaccines will decrease your risk of getting COVID-19 and of becoming seriously ill or dying []. As the COVID-19 vaccines prevent the coronavirus from spreading and replicating, they will also help in preventing additional mutations of the virus.
In addition to the information given in the control group, participants in the hunters and jostlers treatments saw information that described the respective phenomenon. We took care to ensure that the information contained language similar to that used in news media reporting, e.g., how vaccine supply shortages in the early spring of 2021 fueled the behavior of hunters and jostlers. Participants randomized into the hunters treatment read: Even though the vaccines have been approved, the supply is still too low to meet the demand. This has led to the global rise of so called vaccine hunters []. The vaccine hunters wait for entire days outside for example grocery store pharmacies in hopes of securing left over vaccine doses (that would otherwise be discarded) at the end of the day. Those randomized into the jostlers treatment read: Even though the vaccines have been approved, the supply is still too low to meet the demand. This has led to a situation where, globally, the wealthy are trying to jump the line to get a COVID-19 vaccine []. One example of this is the Canadian billionaire Rod Baker who, together with his wife, chartered a private plane and traveled to a remote region in Yukon to pose as a motel worker in order to feign being eligible for the vaccine. Immediately after the treatment information, participants answered a short question about the main message of the paragraph. This was done to identify participants who might not be paying adequate attention, or misunderstanding the text. Such limited attention/misunderstandings were, however, uncommon: only 2.95% of participants provided an incorrect answer and our results are robust to excluding these.
Four outcome measures were assessed immediately after the treatment. First, we asked participants to state their (1) willingness to get vaccinated immediately [VAXTODAY], and (2) in two months [VAX2MONTHS] on a 110 scale (from definitely not being willing to definitely being willing). If participants had already received at least their first vaccine dose, these measures assessed their willingness to recommend vaccination to friends and family, using the same scale. Thereafter participants were asked whether they (3) wanted (yes/no) to get a link to general vaccine eligibility and sign-up information (for the use to self, or to friends and family) in the post survey confirmation email [VAXINFO].
The last outcome variable, which was only asked of participants who had not yet received at least a first COVID-19 vaccine dose, measured their (4) monetary valuation of a vaccine sign-up service that facilitated access to a COVID-19 vaccine. Specifically, the service provided individualized help with identifying, and signing up for, a COVID-19 vaccine appointment in the participants geographical vicinity once the participant became eligible (at the point of data collection, in March 2021, most adults in the U.S. were still not eligible, and many people were eager to get their vaccines as soon as they became eligible). Additional information about the vaccine sign-up service, and how it was made available to participants, is available in the Supplementary Information.
Willingness to pay for the vaccine sign-up service was elicited using a multiple-price-list, MPL28participants were presented with a list of eight choice pairs. In each choice pair, participants had to decide between either getting access to the vaccine sign-up service, or instead receiving a monetary prize ($2, $5, $10, $25, $50, $75, $100 and $200 in the eight choice pairs, respectively). Participants were informed that 15 survey participants would be randomly selected and that their preferred alternative in a randomly chosen choice pair out of the eight would be implemented (i.e. they would either receive the monetary prize, or access to the vaccine sign-up service, depending on their chosen alternative in a randomly selected choice pair). Choice pairs were ordered from lowest to highest monetary amount, such that we can use the number of times a participant selected the vaccine sign-up service before switching to the monetary prize as a measure of the willingness to pay for the service [VAXHELP]. The last part of the survey assessed participants demographic information.
Of the 15 people randomly selected to receive their preferred alternative in the MPL, 3 participants preferred the vaccine sign-up service in the randomly selected choice pair, and 12 participants were paid a monetary price (which averaged $62).
While the sample is, by design, quota representative of the U.S. population on gender, age and race/ethnicity, it is not necessarily representative in other respects. Notably, close to 60 percent (59.4 percent, SE=1.3) of our sample have completed at least a four year college degree, which is a higher proportion than in the general U.S. population. As education correlates positively with beliefs about vaccines in general being safe1,2,3,4,5,6,7,8,9, this might (at least partly) explain the large share of our participants believing that COVID-19 vaccines are safe.
The willingness to get vaccinated is generally high in our sample. In the control treatment, 82.6, SE=1.9, (84.6, SE=1.8) percent were more willing than unwilling to receive/recommend the vaccine immediately (in two months). This is at least weakly higher than corresponding shares observed in most studies who estimate willingness to get vaccinated against COVID-19 in the U.S.1,2,3. Of participants in the control treatment, 42 percent (SE=2.49) stated that they wanted to receive information about eligibility and sign-up for COVID-19 vaccines. The willingness to pay for the vaccine sign-up service is low, however: the average participant in the control group only choose the vaccine service over the monetary prize in 0.85 (SE=0.11) of the 8 questions, which indicates a mean WTP of less than $2.
We examined the balance of demographic and attitude variables across treatment groups by conducting 36 pairwise t-tests (two-sided) of equality of means. One test was statistically significant (p<0.05): we find that the share of female participants is higher in the hunters than in the control treatment group. While this is not surprising with 36 pairwise tests, we therefore include the variable female as a control variable in our main regression specifications reported in Fig.1 and Table 1 (excluding this control variable does, however, not impact the results reported, or conclusions drawn).
Effect of the hunters and jostlers treatments on the willingness to get vaccinated as soon as the vaccine becomes available [VAXTODAY]. The upper two bars of the hunters and jostlers treatments on all participants (Column (1) in Table 1, panel A) the lower two bars show the effect of the treatments on unvaccinated participants only (Column (1) in Table 1, panel B). Error bars denote robust standard errors.
To better understand the effect on willingness to vaccinate from the hunters and jostlers treatments that we observed in the main study, we next conducted a follow-up study. Data collection took place on May 19, 2021, on Prolific, and participants were 800 Americans, distinct from those who responded to the first survey. They were paid $1 for completion, plus any incentives earned as part of the study. The experimental survey used in the follow-up study elicited participants emotional response to the control and treatment information in the main study, as well as their incentivized predictions about the treatment informations effect on the willingness to get vaccinated. This study was pre-registered in the AEA registry for RCTS as AEARCTR-0007656. Informed consent was obtained from all participants, the experiment was conducted in accordance with relevant guidelines and regulations, and the experimental protocol was approved by the George Mason IRB (#1756922-1).
Syncope is the medical term for fainting. Its a potential side effect of any vaccine, including those used to prevent COVID-19. Fainting is when you pass out due to a lack of oxygen to your brain. Its most commonly a vaccine side effect among younger adults and teenagers, according to the Finnish Institute for Health and Welfare, but it can affect anybody.
In most cases, the stress and anxiety of getting a vaccine cause fainting, not the vaccine itself. In very rare cases, a severe allergic reaction to one of the ingredients can cause a drop in blood pressure that leads to loss of consciousness.
Read on to learn more about why some people faint after receiving a COVID-19 vaccine and what factors cause people to faint.
According to the Centers for Disease Control and Prevention (CDC), fainting is a reported side effect of almost every vaccine. Its most common after vaccines against:
In most cases, fainting is caused by the stress and anxiety of receiving a vaccine. These emotions can trigger a condition called vasovagal syncope. Vasovagal syncope is the most common cause of fainting in general.
Nerves send messages from your brain to your heart and blood vessels to control your heart rate and blood pressure. Vasovagal syncope occurs when these nerves dont send an appropriate signal, causing a drop in blood pressure and inadequate blood flow to your brain.
Strong emotions, like the fear of receiving a vaccine, and other factors like dehydration or pain can trigger vasovagal syncope.
In a May 2021 report published by the CDC, the reported frequency of fainting from Janssen COVID-19 vaccines and flu shots was 8.2 and 0.05 per 100,000 people, respectively, between 2019 and 2021.
Of the people who fainted, 62 percent were ages 11 to 18. And 25 percent were ages 19 to 49.
Nearly a quarter of people who experienced fainting or other anxiety-related side effects after receiving the Janssen vaccine reported a history of similar anxiety-related events from other vaccines.
In fewer than 1 in 1 million people, vaccination can trigger a severe allergic reaction called anaphylaxis. Anaphylaxis can be fatal if not quickly treated. According to the World Health Organization (WHO), it usually develops 5 to 30 minutes after injections.
Symptoms of anaphylaxis can include:
Fear of medical procedures involving needles is called trypanophobia. Its an extremely common fear. In a 2018 review, researchers estimated the prevalence to be 20 to 50 percent in adolescents and 20 to 30 percent in young adults.
The development of phobias is complex and can be caused by a combination of social, psychological, and physiological causes.
According to the WHO, the development of a vaccine phobia may be explained by physiological factors, like:
Vaccine phobia is also influenced by psychological factors, including:
Social factors also play a role, such as:
In the same May 2021 report published by the CDC, the most reported anxiety-related symptoms were:
More than 98 percent of fainting episodes occur within 30 minutes of injection, according to a 2021 review. After your vaccine, the person who administered the shot will likely tell you to wait around for at least 15 minutes for monitoring.
If youre with a person who faints, lay the person down with their legs in a raised position until the person is feeling better.
If you develop anxiety-related symptoms after vaccination, you can try taking slow, deep breaths to calm your heart rate. Staying hydrated and having a snack available may also help you ease symptoms such as faintness or lightheadedness.
Many people find it helpful to distract themselves with something such as listening to music, playing a game, or talking.
In two 2018 studies, researchers found that short bouts of exercise before vaccination lowered the number of side effects.
The WHO recommends administering vaccines in a calm, planned, and private environment when possible.
If your child is nervous about vaccines, you may be able to lower their stress by:
Its common to experience mild side effects after getting a vaccine. If side effects appear, they usually go away after 1 or 2 days.
According to the CDC, the most common side effects are:
Rarely, some people may experience more serious reactions. These can include:
Many people find getting a vaccine stressful. This stress can lead to anxiety-related side effects such as fainting, dizziness, or nausea. In very rare cases, vaccines can cause a severe allergic reaction that causes fainting.
For the vast majority of people, vaccines cause no or mild side effects. If you have a history of vaccine-related anxiety, talk with your doctor about ways to manage your anxiety before a vaccine to lower your chances of side effects.
Since their introduction in late 2020, COVID-19 vaccines have bolstered the fight against the pandemic, substantially reducing the likelihood of infection and especially severe cases (Amit et al. 2021, Dagan et al. 2021, Polack et al. 2020, Voysey et al. 2021). Given their proven effectiveness as well as the continued social costs of infection and public health measures like lockdowns, the persistent resistance to vaccination poses an urgent policy problem. Correspondingly, understanding the factors shaping decisions to get vaccinated or not constitutes an urgent scientific question.
Scholars have offered some initial findings. For example, exposure to online misinformation is associated with a decline in willingness to get vaccinated against COVID-19 (Loomba et al. 2021, Roozenbeek et al. 2020), and individuals who are opposed to COVID-19 vaccines are less likely to obtain information about the pandemic from traditional and authoritative sources (Murphy et al. 2021). Conservative media consumption is associated with less social distancing (Ash et al. 2020, Gollwitzer et al. 2020, Simonov et al. 2020) and worse COVID-19 health outcomes (Bursztyn et al. 2020).
At the early stages of the vaccination roll-out, news providers varied in their scepticism toward COVID-19 vaccines. Therefore, it seems reasonable to assume that differential exposure to their programmes might have influenced vaccine hesitancy and, consequentially, vaccine uptake. For example, Fox News primetime show Tucker Carlson, one of the most popular shows on the network, took a strong stance against vaccines, misleadingly representing deaths after vaccination as being caused by the vaccination (Barr 2021, Stelter 2021). In addition, the network has generally doubted scientific research and experts (Feldman et al. 2012, Huertas and Kriegsman 2014, Hmielowski et al. 2014).
In order to assess the effects of media misinformation on vaccination rates, we pair data on county-level vaccination rates with data on viewership of the main cable news providers: Fox News Channel, MSNBC, and CNN. The results from the analysis show that, starting May 2021, counties with higher Fox News viewership report lower vaccination rates: watching one additional hour of Fox News per week for the average household reduces the number of vaccinations by 0.35 to 0.76 per 100 people.
In the early months of the vaccination campaign, we do not observe a relationship between cable channel viewership and vaccinations. However, starting in May 2021, Fox News viewership starts reducing vaccine uptake. The relationships for the other cable news networks, MSNBC and CNN, remain without any statistically significant effect.
Figure 1 Effect of network viewership on weekly vaccination rates (2SLS)
Notes: Regressional coefficient plots with 95% CIs of the effect of one standard deviation changes in viewership on weekly vaccinations per 100 people. Our viewership measure is instrumented using the channel line-up positions.
We observe that results are driven by people aged 18 to 65 years, with no significant effect on the group older than 65 years. To strengthen our analysis, we control for the main networks relative channel position and viewership, as well as for geographical confounders including socio-demographic characteristics and political preferences of the counties.
We can show that there is a causal relationship between exposure to Fox News Channel and lower vaccination uptake. Our statistical analysis exploits the fact that networks are exogenously assigned a channel position in the television line-up, with casual viewers being more likely to watch channels with a lower channel number. We therefore use the geographical variation of the networks channel position as an instrument for the networks viewership. This empirical approach has been widely used in economics and political science to study the effects of biased media coverage (Ananyev et al. 2020, Ash et al. 2021, Galletta and Ash 2019, Martin and Yurukoglu 2017, Simonov et al. 2020). The causal estimates are also coherent with the correlational results of the Ordinary Least Squares regressions of viewership on vaccination rates.
Overall, our results support the interpretation that Fox News Channel promulgated a uniquely sceptical narrative about vaccines and that this narrative caught on and reduced uptake among the marginal vaccine recipient. We back this interpretation with the following observations.
First, in areas with higher exposure to Fox News Channel, respondents to a national survey reported higher COVID-19 vaccine hesitancy. This agrees with a behavioural mechanism where Fox News Channels sceptical vaccine narrative affects vaccination rates by changing attitudes and intentions regarding the vaccine, discouraging in particular the population with low health-related risks.
Second, we consider whether the effects that we see might be driven by local healthcare capacity. If the difference in vaccination rates were due to healthcare capacity, we should see similar effects throughout all stages of the vaccination campaign. Yet we find there was no effect on vaccine uptake in the early months, when the vaccines were only available to older/at-risk individuals. Thus, we infer that the effect of cable news is most pronounced for relatively low-risk individuals, such as the younger population, helping to rule out an effect due to local healthcare capacity.
It could also be that the healthcare systems in areas with higher Fox News viewership systematically differ in their capability to handle a COVID-19 outbreak, for example, due to effects on local government funding (Galletta and Ash 2019). Or it could be that these counties suffered more cases and deaths in 2020 or in the period before the vaccinations. We find that Fox News Channel has no effect on measurements of local healthcare capacity, including the number of ICU beds, number of hospitals, and Centers for Disease Control and Preventionestimated risk indexes. We also rule out that the difference in uptake is due to differences in infections or deaths.
Third, as Fox News viewership has been shown to be correlated with voting Republican (Ash et al. 2021, DellaVigna and Kaplan 2007, Martin and Yurukoglu 2017), we check if partisan affiliation or political ideology are driving the Fox News effect. Republicans or conservatives could overall be more sceptical of the COVID-19 vaccine, indicating that the observed effect was driven by Fox News Channel increasing the number of Republicans or conservatives. Our results show that this is unlikely to be the case, as the effect of Fox News Channel on vaccine uptake holds in several tests that control for partisan affiliation and political ideology.
Finally, we consider whether Fox has affected general attitudes towards vaccines, for example through anti-science rhetoric. To check this, we look at the effects on seasonal flu vaccination rates (20172019) and conclude that the network does not contribute to a generic anti-vaccination sentiment and that the effect on COVID-19 vaccines is due to a COVID-specific narrative.
This column provides evidence that the main cable news television providers are affecting vaccination decisions, suggesting that Foxs COVID-19 coverage is at least partially responsible for reducing vaccination rates. Fox News slanted media rhetoric is linked to vaccination hesitancy, producing significant behavioural effects in the under-65 population with low health risks. Future efforts by government agencies and health organisations to encourage vaccine uptake should account for how media narratives may strengthen or weaken those efforts.
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For months, Mayor Lori Lightfoot has been caught between a rock and a hard place as thousands of Chicago Police officers refused to get vaccinated against COVID-19 in defiance of her order, which was upheld by court rulings and a final decision by an arbitrator.
Lightfoot refused to roll back the mandate, even as conservative members of the Chicago City Council ratcheted up the pressure on the mayor by warning she would have blood on her hands if the requirement took cops off Chicagos streets as murders and carjackings soared to record levels.
After the final deadline for members of the Fraternal Order of Police Lodge 7 to be fully vaccinated against COVID-19 passed on Wednesday, data released by the mayors office disclosed that Lightfoot while ramping up her re-election bid agreed to exempt at least 1,439 officers from the COVID-19 vaccine mandate.
The decision to exempt at least 11.5% of the Chicago Police Department from her vaccine mandate will mean Lightfoot will not have to ask Chicagoans for a second term in office while moving to fire thousands of Chicago Police officers at a time when polls repeatedly show public safety is voters biggest concern.
Lightfoots office declined to respond to questions about WTTWs analysis on Thursday, citing staff absences because of the upcoming Passover and Easter holidays.
Despite the massive number of vaccine exemptions granted to members of the Chicago Police Department by Lightfoot, 681 members of the department who have not been vaccinated and have not received an exemption are at risk of being disciplined and ultimately terminated, according to data released by the mayors office. That amounts to more than 5.5% of the department.
However, officials are still weighing 571 exemption requests from Chicago Police officers. If those exemptions are granted, nearly 16% of the Chicago Police Department would not be vaccinated against COVID-19.Exemptions can only be granted for religious or medical reasons under state law.
Officials granted nearly double the number of exemptions to members of the Chicago Police Department than to members of any other city department, according to data provided by the mayors office.
By comparison, officials granted vaccine exemptions to 6.6% of the Chicago Fire Departments employees, to 5.6% of the members of the Department of Streets and Sanitation and 5% of the Department of Water Management.
In all, 21% of the Chicago Police Department has not been vaccinated against COVID-19, eight months after Lightfoot issued the mandate. When an arbitrator ruled in February that members of the Chicago Police Department must get the vaccine, 24% of members had not been vaccinated.
Lightfoot said at the time of that ruling she believed the decision would prompt officers to get vaccinated in large numbers, heading off a confrontation. That hope was in vain, according to the data released by her office.
An additional 3,250 vaccine exemption requests submitted by members of the Chicago Police Department were rejected by city officials, according to data provided by city officials.
In all, more than 5,900 of the citys 30,200 employees requested an exemption from Lightfoots vaccine. Nearly 79% of those requests came from Chicago Police Department members, according to data released by the mayor's office.
Nearly 2,300 vaccine exemptions were granted by city officials more than 63% to members of the Chicago Police Department, according to data released by the mayors office.
Officials declined to tell WTTW News how many exemptions were granted for medical reasons and how many were granted for religious reasons. Cardinal Blase Cupich has instructed pastors in the Archdiocese of Chicago not to grant religious exemptions to the vaccine, saying that is not supported by church teachings or law.
Just 15 members are not being paid because they are defying the vaccine mandate. Lightfoot has been criticized by Fraternal Order of Police President John Catanzara for slow walking the implementation of the vaccine mandate.
Lightfoot has said each employee will be disciplined individually, and said mass firings will not take place.
Chicago Police officers can only be terminated on the recommendation of Chicago Police Supt. David Brown and a vote of the Chicago Police Board.
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