Carlo, chief executive officer of the clinic, which runs three locations in Dallas, offers free PrEP to roughly 250 patients, he said, thanks to an assistance program run by Gilead Sciences. The drugmaker currently manufactures two PrEP medications.
The program also helps Carlo generate money to cover the care people on the medication need, like regular doctor visits and lab tests.
Without Gilead’s help, Carlo said, “none of these people would be in care with us.”
Nationwide, safety-net clinics like Prism Health North Texas rely on Gilead’s Advancing Access Patient Assistance/Medication Assistance Program to fund services that keep patients in need HIV-negative.
In April, Gilead announced it will change how much it reimburses through that assistance program. For pharmacies that contract with certain safety-net clinics, like Prism Health, the change means less reimbursement cash to pass along to the clinics.
The domino-like impact of the company’s move means Prism Health may lose between $2 million and $3 million annually, Carlo estimated.
The Advancing Access program offers free medicine to the uninsured. In the simplest terms, pharmacies dispense Gilead’s drugs at no charge to qualifying patients. The pharmacies then file claims with Gilead, which reimburses them.
Shannon Stephenson, who runs a network of safety-net clinics called Cempa Community Care in Chattanooga, Tennessee, said the new policy means she will have to work with a tighter budget and find another way to afford the nearly $2,000 in yearly medical services alone each patient on PrEP needs.
“It could really cause a shift in what HIV looks like in the future,” Stephenson said. “This is not the time to be creating any more barriers to getting people into care.”
Coy Stout, Gilead’s vice president of U.S. commercial access and reimbursement, said that before it changed its policy the company did not know safety-net clinics relied on this money to fund critical services.
Gilead announced the change after discovering it was reimbursing pharmacies at a higher price than what most of them were spending to replace the drugs.
The company declined to tell how much money it will save, but Stout said the move will help keep the aid program sustainable.
In 2020, according to a Gilead , the company earned $24.4 billion in product sales.
“This is a program to provide free medication,” Stout said, “not free medication and other services.”
Currently, the drug company reimburses pharmacies the retail price of the drugs. For HIV prevention medications, the cost is substantial. Gilead’s PrEP medicines, Truvada and Descovy, cost more than $1,800 for a 30-day supply, said Sean Dickson, director of health policy at the West Health Policy Center.
In 2022, Gilead will give pharmacies “” for each bottle of medicine. Certain safety-net clinics will be harmed by the change because they participate in a separate program called 340B.
The federal program requires pharmaceutical companies to sell their medications to safety-net providers at a discount. Although the size of the discounts the drugmakers offer is confidential, the government range from 25% to 50%.
In short, that means clinics that participate in the 340B program will be reimbursed for the discounted price of the drug, which will cut how much they can pocket from the Advancing Access program.
Dickson said the amount clinics keep from Gilead’s aid program is a critical source of revenue to pay for services and medicines for patients in need who can’t get them otherwise.
“These really are needy populations that are being served by them,” Dickson said.
Clinics that participate in the 340B program play a crucial role in treating patients at risk of contracting HIV, said Tim Horn, director of health care access for NASTAD, the National Alliance of State and Territorial AIDS Directors.
He’s particularly concerned about providers in the South, where rates of HIV and the uninsured are among the nation’s highest. The region accounted for over half of all HIV diagnoses in 2018, the Centers for Disease Control and Prevention .
Small, grassroots clinics in the South are “gonna live or die by the 340B savings,” said Horn.
The financial upheaval of Gilead’s change in reimbursement adds fodder to larger questions about the 340B program as a viable source of funding for PrEP services.
Several drugmakers have recently released generic PrEP medicines priced significantly lower than Gilead’s brand-name offerings. Dickson said lower drug prices are a positive development for patients because it makes health care more affordable for everyone.
However, he added, transitioning to generic PrEP would prevent 340B clinics from generating money off the drug company’s aid.
That said, relying on high drug pricing to fund the nation’s safety net “is not a sustainable path forward,” said Dickson. “We actually need to pay for things that work rather than paying too much for prescription drugs.”
KHN senior correspondent Sarah Jane Tribble contributed to this report.
ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .This <a target="_blank" href="/health-care-costs/change-to-gilead-assistance-program-threatens-prep-access-hiv-advocates-say/">article</a> first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150" style="width:1em;height:1em;margin-left:10px;">
<img id="republication-tracker-tool-source" src="/?republication-pixel=true&post=1318517&ga4=G-J74WWTKFM0" style="width:1px;height:1px;">]]>The swelling population of seniors will far outpace growth in other age groups. That acceleration — and the slower growth in other age groups — could leave many older Americans with less family to rely on for help in their later years. Meanwhile, federal officials estimate that more than half of people turning 65 will need long-term care services at some point. That care is expensive and can be hard to find.
Spending for paid long-term care already runs about $409 billion a year. Yet that staggering number doesn’t begin to reflect the real cost. Experts estimate that 1 in 6 Americans provide billions of dollars’ worth of unpaid care to a relative or friend age 50 or older in their home.
As the country weighs Biden’s plan, here’s a quick look at how long-term care works currently and what might lie ahead.
ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .
This <a target="_blank" href="/aging/caring-for-an-aging-nation/">article</a> first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150" style="width:1em;height:1em;margin-left:10px;">
<img id="republication-tracker-tool-source" src="/?republication-pixel=true&post=1275036&ga4=G-J74WWTKFM0" style="width:1px;height:1px;">]]>Extending the emergency use of the Pfizer-BioNTech vaccine to preteens and young adolescents adds nearly 17 million more Americans to the pool of those eligible to be immunized against covid-19, helping to build a vaccinated population closer to herd immunity. Moderna and Johnson & Johnson are also testing the efficacy of their vaccines in teens and children.
Although children appear to catch covid less often and develop milder symptoms than adults, they can develop a rare, severe inflammatory response or “” symptoms. It also remains to be seen what, if any, long-term effects these younger patients may experience from covid.
The share of covid cases in children and teens is increasing — nearly a quarter of the new weekly covid cases were found in this age group, May 6 by the American Academy of Pediatrics and the Children’s Hospital Association.
And, though kids have been less likely to develop severe illness, they still can pose a risk to vulnerable people around them because they may not even know they are carrying the virus, by the Centers for Disease Control and Prevention.
, a pediatrician and the division director of adolescent medicine at MetroHealth Medical Center in Cleveland, said she has had to explain to her young patients that getting immunized would help their community curb the spread, cut the risk of variants and help society reopen.
“I talk about them doing their part,” Stager said. “That this is all part of them contributing to the greater good.”
The Fine Print
The CDC this week use of the Pfizer vaccine for children ages 12 to 15 after the Food and Drug Administration its emergency use authorization to include these preteens and young adolescents. That means this age group now can receive the same shots in the same time frame — 21 days apart — as adults do.
In a reversal of its previous guidance, teens and adults do not need to wait 14 days before or after getting the covid shot to receive a vaccine for another condition. This could be a boon for health care providers who have child patients lagging on other, routine vaccines, which has been a persistent problem during the pandemic.
“It’s a tremendous opportunity to play catch-up,” said Stager.
CDC officials noted in the May 12 Advisory Committee on Immunization Practices’ recommendation that they do not have data specifically looking at potential side effects in patients immunized against covid and other illnesses at the same time. However, the agency made the decision given the strong safety data of the Pfizer-BioNTech shot and previous experience with other immunizations.
This question will become more important as covid vaccines are studied . Trials are planned to test the vaccine in children as young as 6 months old.
As in adults, the question of how long the immunity lasts in children remains unknown, said , an associate professor of infectious diseases at the University of Minnesota. However, she said, it’s likely that any waning immunity detected in adults will also be seen among the young.
“Whatever we learn in adults,” Wurtz said, “kids will be not far behind.”
Whether this approval will prompt schools to require vaccination against covid for K-12 students returning to the classroom this fall is a pending question, said Stager. whether federal law allows state authorities to mandate a vaccine that has not yet been fully approved. That said, the government’s approval will also likely play into parents’ decisions about sending their children to summer camp.
What Did the Trial Find?
Pfizer tested the vaccine in 2,260 preteens and young adolescents living in the United States. Researchers followed participants for two months or more, the FDA said. Pfizer’s clinical protocol says the company will continue to follow participants for two years after the second dose.
Results show the vaccine is safe to use in this age group, causing side effects similar to those seen in young adult populations for whom it had already been cleared, according to the FDA in a . Those vaccinated also produced a strong immune response — the level of antibodies recorded in this age group was than what was seen in 16- to 25-year-olds.
The vaccinated group also had no covid cases when tested seven days after their second dose. Sixteen participants out of 978 who did not get the shot but were followed as part of the study as a control group tested positive for the virus. In short, the vaccine was 100% effective in preventing covid, according to the FDA.
Why So Few Kids?
One data point that may give parents pause is the trial’s number of participants. The relatively low number — especially when compared with the tens of thousands enrolled in adult trials — is a reflection of what the researchers were trying to accomplish, said , an assistant professor of international health at Johns Hopkins University School of Public Health.
Gauging whether the shot was safe for children and if it generated a strong immune response did not require a large study group, she said. Statisticians can calculate how many people a trial needs to generate meaningful results without unnecessarily exposing people to dangerous pathogens like the coronavirus.
In addition, the findings pertaining to the younger age group built on what has already been learned in earlier studies.
“It’s just not practical to do 30,000-person trials over and over with the same vaccine,” Talaat said. Large trials are expensive, she added. Including minors also poses extra challenges, said Stager, such as getting parental consent.
Jerica Pitts, a Pfizer spokesperson, said in an email the company is using a “careful, stepwise approach” to including minors in clinical trials.
Stager said physiological similarities among 12- to 15-year-olds in response to vaccines have previously been documented. Studies related to a vaccine for the human papillomavirus have shown kids at this age generated similar, strong immune responses, too.
Administering the vaccine to preteens and young adolescents in large numbers may reveal additional effects that weren’t detected in the clinical trials, said A. Oveta Fuller, associate professor of microbiology and immunology at the University of Michigan Medical School.
That said, when weighing the threat of the virus versus the vaccine’s proven safety, she said, the choice is clear.
“The thing is the danger is really not so much the vaccines as it is what it protects against,” Fuller said, “and that’s covid disease.”
ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .This <a target="_blank" href="/public-health/what-does-approval-of-the-pfizer-vaccine-for-teens-and-preteens-mean-for-my-child/">article</a> first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150" style="width:1em;height:1em;margin-left:10px;">
<img id="republication-tracker-tool-source" src="/?republication-pixel=true&post=1310215&ga4=G-J74WWTKFM0" style="width:1px;height:1px;">]]>But what about all the people — a number , though estimated to be in the millions — who now possess some degree of immunity because they recovered from covid-19?
The agency recommends that everyone — vaccinated, recovered or otherwise — wear a mask
There is no mention of whether people who have recovered can congregate without face coverings like those who are fully vaccinated.
And, through it all, the need for masks continues to be a contentious issue. As the federal government doubles down on their importance, some states have thrown caution — and face coverings — to the wind. We decided to dig into the science and motives behind the masking recommendation.
I Beat Covid! Isn’t This Behind Me?
People who recover from the virus enjoy some immunity. The CDC says the protection lasts at after testing positive for the virus. During that time, they do not need to quarantine or retest if they’re exposed again.
Cases of reinfection . While those infected can continue shedding the virus for months after they recover, the CDC said, the amount is that it is unlikely to infect others.
Given that, some have questioned whether people who have recovered still need to abide by mask mandates. Linsey Marr, an engineering professor at Virginia Tech University who studies airborne transmission, told us there’s no strong scientific rationale for face coverings among people who have had the virus.
However, important questions remain unanswered about the level of post-infection immunity that make it advisable to continue wearing a mask, experts said. For instance, scientists have yet to determine whether people who experienced mild or no symptoms generated enough of an immune response to meaningfully shield them from getting the virus again.
Additionally, no one knows how long immunity lasts. A person could get reinfected and start spreading the virus without knowing it, said A. Oveta Fuller, associate professor of microbiology and immunology at University of Michigan Medical School.
“You don’t want to be putting virus into the environment,” she said.
What Makes Vaccines More Protective?
The covid vaccines available in the United States provide a high degree of protection from illness, hospitalization and death.
The Moderna and Pfizer-BioNTech vaccines are over 94% effective after two doses. The percentage is lower for the Johnson & Johnson vaccine — 72% in the U.S. These vaccines can’t be compared exactly for a variety of reasons. (Tuesday, the FDA recommended a pause in use of the J&J vaccine as reports of a rare side effect are investigated.)
So far, the Moderna and Pfizer-BioNTech injections shield people for at least six months, but research is ongoing. This data is not yet available for the J&J shot.
Scientific evidence also appears to show vaccine-induced immunity is stronger than what the body generates after an infection, Fuller said. And vaccines appear to offer some protection against the variant discovered in the United Kingdom, now widely circulating in the U.S. Whether natural immunity can combat this strain or other variants is unknown, CDC spokesperson Jade Fulce said.
What could account for these differences? Visualize the virus as a hand, Fuller said. A natural infection triggers the body to attack any part of the pathogen, including dispensable bits like the tip of a fingernail. But the vaccines are engineered to create fighters that react to the virus’s “thumb,” the spike protein that binds it to the human cell.
“We know the thumb is critical for infection,” Fuller said, “so any immunity you make against that will be more protective against infection than immunity from natural infection.”
suggests the vaccines could also prevent or limit how much the virus replicates in the respiratory system, an effect that could further cut down transmission.
That said, vaccine-induced immunity comes with its share of unknowns. Vaccines have a high efficacy rate, but they are still not 100% protective against the virus. Scientists are still figuring out whether immunity from vaccines or an infection will fade over time.
Depending on how this protection dissipates, people with vaccine-induced immunity could become vulnerable to the virus again and get infected without knowing it, said Fuller. Infected people can start shedding the virus up to two days before they show symptoms, and an never show signs of illness.
“We’ve learned a lot” in the year since covid emerged, Fuller said. “But there’s so, so much more to know.”
A Mask Protects You, Your Neighbor and the World
When a person infected with SARS-COV-2 breathes out, they release droplets into the air that contain moisture, saliva and possibly bits of virus.
Masks work by blocking those droplets from landing in or on another person. Tightly woven fabrics can trap smaller droplets than those made with looser weaves, said Richard Sachleben, a retired chemist. Some versions also help the wearer .
Droplets of different sizes come with different risks, said Sachleben. Larger ones are pulled to the ground by gravity, he said, but they’re more dangerous because they carry more virus than smaller ones that linger in the air. Luckily, they’re also easier to block with a face covering.
“That’s why a crappy mask is better than no mask,” Sachleben said.
Face coverings also help stop more variants from forming, he continued, because the fewer particles are in the air, the fewer opportunities the virus has to mutate into a form that’s more resilient against humanity’s defenses.
That said, not even the best masks are 100% effective at catching and blocking every piece of virus, said Dr. Donald Milton, professor of environmental health at the University of Maryland School of Public Health. But, when combined with other public health measures, they can meaningfully reduce viral spread.
“If you combine a mask that does a little bit on me with a mask that does a little bit on you with being outside or having good ventilation inside,” he said, “these things then add up.”
Wearing a mask also sends a message about what people need to do “to break the back of this pandemic,” said Fuller. Because face coverings protect the public from the wearer’s germs, it also communicates that the wearer cares about the community, said Sachleben.
“When you wear a mask, that means you care,” said Sachleben. “When I wear a mask, that means I care about you.”
ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .This <a target="_blank" href="/public-health/ask-khn-politifact-ive-recovered-from-covid-why-do-i-still-have-to-mask-up/">article</a> first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150" style="width:1em;height:1em;margin-left:10px;">
<img id="republication-tracker-tool-source" src="/?republication-pixel=true&post=1293007&ga4=G-J74WWTKFM0" style="width:1px;height:1px;">]]>But the research underpinning these vaccines isn’t that new at all, vaccine experts say. Some of it is decades old. This foundation, combined with technical expertise, urgency and financial resources, enabled scientists to pull off the medical marvel.
“The reason it was so fast is money and work,” said Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia.
Leveraging mRNA: A Technique as Old as Millennials
Covid mRNA vaccines use the human body’s natural immune response to its advantage. The shot contains the recipe for making the molecule known as the spike protein, which the covid virus uses to bind to cells. Once the cell receives these instructions, it creates the protein and displays it on its surface. The immune system then spots the unknown protein and makes antibodies to fight it.
The vaccines made by the companies Pfizer-BioNTech and Moderna use this technology, which stems from research that began in the early ’90s, said Dr. Drew Weissman, a professor of medicine at the University of Pennsylvania. It has been tested against other viruses Scientists learned from previous clinical trials and have since worked to perfect the use of mRNA, he said. Previous work on related coronaviruses like helped speed the process.
Weissman and his colleague , a senior vice president of , are credited with the that enabled these vaccines to be safe and highly effective.
“This isn’t new technology,” Weissman said.
Viral Vector Vaccines: A Health Emergency Veteran
The third vaccine being distributed in the United States to protect against severe covid-19 uses viral vector technology to generate an immune response. It contains a weakened form of a different virus that carries instructions for cells to make the spike protein found on SARS-CoV-2, the virus that causes covid. The protein appears on the cell’s surface, and the immune system creates antibodies against it.
Like the mRNA vaccines, this technology carries the code for making the spike protein to the cell, said Dr. Ruth Karron, director of the Center for Immunization Research at Johns Hopkins University.
“The truck is different,” she said, “but what’s being delivered is very similar.”
Viral vector technology has been studied . These vaccines have been approved for use to immunize people against Japanese encephalitis. Johnson & Johnson, which uses this platform for its covid shot, also created a viral vector vaccine for Ebola after a in 2019 in the Democratic Republic of the Congo.
Are They Safe?
In addition to existing research, generous resources were allocated to quickly create the covid vaccines, experts said. As of Dec. 2020, the federal government spent $12.4 billion alone on to hasten vaccine development. Drug companies partnered with the National Institutes of Health to tap into its expertise and quickly enroll trial participants.
Perhaps most important, the final clinical trials for the covid vaccines enrolled between 30,000 and nearly 45,000 participants.
“These studies are so much bigger than the studies we do for many licensed vaccines,” Karron said. Some trials for previously approved vaccines have included as few as 3,000 participants, she added.
Dr. Scott Ratzan, who runs a covid-19 vaccine communications initiative called at the City University of New York, said pushing certain information has helped assuage fears among the vaccine hesitant. These include highlighting the reality of the virus, comparing the shot’s side effects to other vaccines and showing the vaccines’ effectiveness in millions of people.
Waiting for others to get the shot first was “a fair thing” when they first rolled out, Offit said. However, after nearly in the United States have received at least one vaccine dose with no sign of safety issues, he said, the skepticism should be fading away.
“You have your proof in terms of efficacy and safety,” Offit said. If you are still refusing, “then that’s because you’re not a skeptic anymore. You’re a cynic.”
ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .This <a target="_blank" href="/public-health/ask-khn-politifact-how-can-covid-vaccines-be-safe-when-they-were-developed-so-fast/">article</a> first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150" style="width:1em;height:1em;margin-left:10px;">
<img id="republication-tracker-tool-source" src="/?republication-pixel=true&post=1282307&ga4=G-J74WWTKFM0" style="width:1px;height:1px;">]]>Doctors at Children’s Hospital Colorado and Seattle Children’s Hospital will use scents like these to treat children who lost their sense of smell to covid-19. Parents will attend clinics and go home with a set of essential oils for their child to sniff twice a day for three months. Clinicians will check their progress monthly.
The Smell Disturbance Clinic at Children’s Hospital Colorado was approved to open March 10. So far, five children have been screened and one enrolled. Seattle Children’s expects to open its program this spring.
The treatment, known as “smell training,” is clinically proven to be effective in adults. However, clinicians said, there’s virtually no data on whether the method will work in children.
Although children are much less likely to develop covid or suffer its consequences than adults, the number of pediatric patients has steadily grown. More cases means more kids are demonstrating lingering symptoms known as “long covid.” Among these complaints is loss of smell.
The link between coronavirus infections and smell disturbances in adults is well documented in both patients with short-term disease and so-called long haulers. However, scientists are still unsure how many people develop this complication or how the virus triggers it. Different research teams have found clues that could explain the phenomenon, including and that support the cells responsible for olfactory function.
But scant research has focused on smell disturbances in children, said Dr. John McClay, a pediatric ear, nose and throat surgeon in Frisco, Texas — let alone those caused by covid. That’s because children seldom develop these issues, he said, and the novel coronavirus has been just that — novel.
“Everything’s so new,” said McClay, who is also the chair of the American Academy of Pediatrics education committee on otolaryngology. “You can’t really hang your hat on anything.”
It Works for Adults. Will It Work for Kids?
One intervention for adults who lose their sense of smell — whether as a result of a neurological disorder like Alzheimer’s, a tumor blocking nasal airflow or any number of viruses, including covid — has been olfactory training.
It generally works like this: Doctors a patient’s sense of smell to establish a baseline. Then, adults are given a set of essential oils with certain scents and instructions on how to train their nose at home. Patients usually sniff each oil twice a day for several weeks to months. At the end of the training, doctors retest them to gauge whether they improved.
Dr. Yolanda Holler-Managan, a pediatric neurologist and assistant professor of pediatrics at Northwestern University Feinberg School of Medicine, said she doesn’t see why this method wouldn’t work for children, too. In both age groups, the olfactory nerve can regenerate every six to eight weeks. As the nerve heals, training can help strengthen the sense of smell.
“It’s like helping a muscle get stronger again,” she said.
Late last spring, when doctors started discovering smell and taste issues in adults with covid, Dr. Kenny Chan, the pediatric ear, nose and throat specialist overseeing the new clinic in Colorado, realized this could be an issue with kids, too.
Dr. Kathleen Sie, chief of Otolaryngology Head and Neck Surgery at Seattle Children’s Hospital, became aware of the problem when she received an email from someone at a local urgent care center. After reading the message, Sie called Chan to talk about it. The conversation snowballed into her spearheading a smell-training clinic at her facility.
Both clinicians must contend with the challenges “smell training” may pose to children. For starters, some young patients may not know how to identify certain scents used in adult tests — spices such as cloves, for instance — because they’re too young to have a frame of reference, said McClay.
As a workaround, Chan substituted some scents for odors that might be more recognizable.
Finding children who are experiencing smell disturbances is also tricky. Many with covid are asymptomatic, and others may be too young to verbalize what they are experiencing or recognize what they are missing.
Nonetheless, McClay said, the potential benefit of the simple treatment outweighs the cost and challenges of setting it up for children. Adult smell-training kits sell for less than $50.
“There is zero data out there that says that this does anything,” said Chan. “But if no one cares to look at this question, then this question is not going to be solved.”
This <a target="_blank" href="/public-health/pediatric-covid-patients-loss-of-smell-scent-training/">article</a> first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150" style="width:1em;height:1em;margin-left:10px;">
<img id="republication-tracker-tool-source" src="/?republication-pixel=true&post=1278165&ga4=G-J74WWTKFM0" style="width:1px;height:1px;">]]>A recent analysis by the Wall Street research firm fueled this idea, suggesting as many as nine states were already reaching the coveted “herd immunity” status as of March 7, signaling that a return to normal was close at hand.
“Presumed ‘herd immunity’ is ‘the combined value of infections + vaccinations as % population > 60%,’” noted a by a CNBC anchor based on a more complete analysis by the firm. That got us thinking: Does this calculation hold up?
First, do public health experts generally consider herd immunity to kick in at 60%? In addition, does current scientific thinking equate protection from the antibodies generated by past covid infections with the same degree of protection as a vaccination?
We decided to find out.
First, a review of herd immunity. Also known as community or population immunity, the term is used to describe the point at which enough people are sufficiently resistant — or have an immune response — to an infectious agent that it has difficulty spreading to others.
In this explainer, we noted that people generally gain immunity either from vaccination or infection. For contagious diseases that have marked modern history — smallpox, polio, diphtheria or rubella — vaccines have been the mechanism through which herd immunity was achieved.
While the United States is getting closer to this point, most health experts caution, it still has ground to cover. Fundstrat’s analysis offered a rosier take. Although the site is located behind a paywall, the chart generated buzz on and in news outlets like the .
Fundstrat relied on a variety of sources — particularly, a data scientist and pandemic modeler named — to determine what level of immunity a state needs to stamp out covid, said , the firm’s head of data science research. From there, analysts created a chart intended to track the level of covid immunity in each state. They calculated the number by adding the percentage of people estimated to have been infected with the virus to the percentage of people who had received the vaccine.
Xuan, who was quick to note that he is not a public health expert, said he and his team followed Gu’s predictions and arrived at 60%, a figure he acknowledges is an assumption.
“The idea would be we don’t know if 60% is true,” he said. However, if states that have reached this threshold see steep declines in covid cases, “then it’s the number to watch.”
What About the 60% Marker?
Throughout the pandemic, health experts have tended to set the magic number for herd immunity between 50% and 70% — with most, including Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, leaning toward the higher end of the spectrum.
“I would say 75 to 85% would have to get vaccinated if you want to have that blanket of herd immunity,” he told in December.
The experts we consulted were skeptical of the 60% figure, saying the mechanics of the Fundstrat analysis were relatively sound but oversimplified.
Ali Mokdad, chief strategy officer for population health at the University of Washington, said the level of immunity needed to reach this goal can vary due to several factors. “Nobody knows what is herd immunity for covid-19 because it’s a new virus,” he said.
That said, Mokdad described using 60% as “totally wrong.” Data from other communities around the world show covid outbreaks happening at or near that level of immunity, he said. Indeed, the city of Manaus in Brazil saw cases drop for several months, then despite three-fourths of their residents already having had the virus.
Josh Michaud, associate director for global health policy at KFF, described the 60% assumption as “off-base.”
And some said it wasn’t even the main point.
Dr. Jeff Engel, senior adviser for covid at the Council of State and Territorial Epidemiologists, said the question of herd immunity may not even be relevant because, regarding covid, we may never reach it. The novel virus may become endemic, he said, which means it will continue circulating like influenza or the common cold. For him, lowering deaths and hospitalizations is more important.
“The concept of herd immunity means that once we reach the threshold, it’s going to go away,” Engel said. “That’s not the case. That’s a false notion.”
Natural and Vaccine Immunity — Should They Be Lumped Together?
When asked why the Fundstrat analysis treated the two types of immunity as equivalent, Xuan said it was an assumption.
Here’s what current science supports.
Those who receive any of the in the United States enjoy a high level of protection against getting seriously sick and dying from covid — even after one dose of a two-shot series.
In addition, people who were infected and recovered from the virus appear to retain some protection for at least after testing positive. Immunity may be lower and decline faster among people who developed few to no symptoms.
Practically speaking, two experts said, natural and vaccine-induced immunity work the same way in the body. This lends credibility to Fundstrat’s approach.
However, some health experts consider vaccine-induced immunity to be better than the protection generated by the infection because it may be more robust, said Michaud. Researchers are still figuring out whether people who were infected with the virus but experienced mild or no symptoms generated an immune response as strong as those who developed more severe disease.
In fact, the Centers for Disease Control and Prevention cites the unknowns surrounding natural immunity and the risk of getting sick again with covid as reasons for those who had the virus a vaccine.
“They haven’t been studied well at all yet,” said Engel, in reference to asymptomatic people. “And maybe we’re going to discover that a large group of them didn’t develop really robust immunity.”
Both types of viral protection leave room for potential breakthrough infections, Michaud said. Neither offers “perfect immunity,” he said. And wild cards remain. How long do both types of immunity last? How do different people’s systems respond? How protected will people be from emerging coronavirus variants?
“It’s a witches’ brew of different factors to consider when you’re trying to estimate herd immunity at this point,” said Michaud.
ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .This <a target="_blank" href="/public-health/can-vaccination-and-infection-rates-add-up-to-reach-covid-herd-immunity/">article</a> first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150" style="width:1em;height:1em;margin-left:10px;">
<img id="republication-tracker-tool-source" src="/?republication-pixel=true&post=1276597&ga4=G-J74WWTKFM0" style="width:1px;height:1px;">]]>The teen from Fort Walton Beach, Florida, tested positive for covid-19 about a week later, said her mother, Sara, leaving her bedridden with flu-like symptoms. However, her expected recovery never came.
Delaney — who used to train 20 hours a week for competitive dance and had no diagnosed underlying conditions — now struggles to get through two classes in a row, she said. If she overexerts herself, she becomes bedridden with extreme fatigue. And shortness of breath overcomes her in random places like the grocery store.
Doctors ultimately diagnosed Delaney with COPD — a chronic lung inflammation that affects a person’s ability to breathe — said Sara, 47. No one has been able to pinpoint the cause of her daughter’s decline.
“There’s just no research there,” she said. “Kids are not supposed to have this kind of condition.”
While statistics indicate that children have largely been spared from the worst effects of covid, little is known about what causes a small percentage of them to develop serious illness. Doctors are now reporting the emergence of downstream complications that mimic what’s seen in adult “long haulers.”
In response, pediatric hospitals are creating clinics to provide a one-stop shop for care and to catch any anomalies that could otherwise go unnoticed. However, the treatment offered by these centers could come at a steep price tag to patients, health finance experts warned, especially given that so much about the condition is unknown.
Nonetheless, the increasing number of patients like Delaney is leading to a more structured follow-up plan for kids recovering from covid, said Dr. Uzma Hasan, division chief of pediatric infectious diseases at St. Barnabas Medical Center in New Jersey.
“The cost of missing these children means a horrible event,” she said.
Unanswered Questions
More than 3 million children and young adults had tested positive for covid in the United States as of Feb. 18, the American Academy of Pediatrics and the Children’s Hospital Association . Most of these kids experience mild, if any, symptoms.
Over the course of the pandemic, though, it has become apparent that some children develop serious and potentially long-term problems.
The most well-known of these complications is called “multisystem inflammatory syndrome in children,” or MIS-C. — which include high fever, a skin rash and stomach pain — can appear up to a month after getting covid. Around have been identified in the United States. Black and Hispanic children make up a disproportionate share: 69%.
But clinicians also said they’re increasingly hearing of children seeking help for different complications, such as fatigue, shortness of breath and loss of smell, that don’t go away.
Clinics for Child Long Haulers
At Norton Children’s Hospital in Louisville, Kentucky, clinicians in October after receiving calls from area pediatricians who had patients with long-haul symptoms.
No one knows how often children develop these symptoms, how many already have the illness or even what to name it, said Dr. Kris Bryant, president of the Pediatric Infectious Diseases Society, who works at the hospital.
The children see an infectious diseases doctor who then refers them or orders tests as necessary.
So far, the clinic has seen about 25 patients with a wide range of symptoms, said Dr. Daniel Blatt, a pediatric infectious diseases specialist involved with the clinic. Because covid mimics symptoms associated with a variety of other illnesses, he said, part of his job is to rule out any other possible causes.
“Because the virus is so new,” Blatt said, “there’s a presumption that everything is covid.”
Similarly, an ad hoc clinic for other young patients has been set up within the cardiology department at the Children’s Hospital & Medical Center in Omaha, Nebraska. Patients are screened to assess the heart’s structure and how it functions. She said they’ve been seeing six to eight patients per week.
“The question I can never answer for the parents,” said Dr. Jean Ballweg, a pediatric cardiologist at the hospital who also works at the clinic, “is why one child and not another?”
So far, Ballweg said, she’s seen no published literature on the heart health of children who develop these symptoms after recovering from covid. By standardizing how doctors in the clinic collect data and treat patients, Ballweg said, she hopes the information will provide some clues as to how the virus affects a child’s heart. “Hopefully, we can look at the collective experience and recognize patterns and provide better care.”
University Hospitals Rainbow Babies & Children’s Hospital in Cleveland is involved in creating a multidisciplinary clinic that will consolidate care by giving patients access to specialists and integrative medicine like acupuncture.
Clinicians saw a need for the unit after teenagers with post-covid symptoms began arriving at the hospital system’s clinic for adults with long-haul symptoms, said Dr. Amy Edwards, a pediatric infectious diseases specialist at the hospital involved with the project. So far, she said, she’s heard of about eight to 10 children who could need care.
The clinic, yet to open, intends to recruit more children through announcements, said Edwards. Identifying the right patient for the clinic will be complicated, she added. There’s no test to check for post-covid symptoms and there’s no agreed-on definition for the condition. Doctors also don’t know whether some symptoms can be cured, she said, or last a lifetime.
“The question is if we’re going to be able to do anything about it,” Edwards said.
‘I Don’t Know’ Is a Difficult Answer
Even Dr. Abby Siegel, a 51-year-old pediatrician who works in Stamford, Connecticut, couldn’t find answers for her daughter. Siegel tested positive for the virus last March after being exposed at work. She believes she passed on the virus to her husband and their then-17-year-old daughter, Lauren.
The family recovered by early April, but then both Siegel’s daughter and husband took a turn for the worse. Lauren — who played rugby — started feeling fatigued, shortness of breath and a racing heart rate. Siegel took her to multiple specialists — including a friend who is a cardiologist — all of whom doubted her.
Lauren, now 18, receives care at Mount Sinai Hospital’s adult covid care center and is improving. Siegel said the clinic has affirmed her daughter’s experience and helped her get more information about this condition. She wishes the doctors they had visited earlier had been more honest about the unknowns surrounding post-covid health problems.
“It’s amazing how we’re met with the denial rather than the ‘I don’t know,’” she said.
There’s another wrinkle that often comes with the I-don’t-know response.
The uncertainty swirling around these symptoms in children will likely require clinicians to run a battery of tests — procedures that could potentially cost their families a lot of money, said Glenn Melnick, a health economist and professor at USC Sol Price School of Public Policy. Pediatric hospitals usually have little regional competition, he said, allowing them to charge more for their specialized services.
For families without comprehensive health insurance or who face high deductibles, many tests could mean big bills.
Gerard Anderson, a professor of health policy and management at Johns Hopkins University, said these clinics’ potential profitability hinges on several factors. If a clinic serves a large enough area, it could attract enough patients to earn substantial dollars for the affiliated pediatric hospital. A child’s health care coverage plays a role as well — those who are privately insured are more lucrative patients than those covered by public programs like Medicaid, but only as long as the family can shoulder the financial burden.
“If I had a kid who had this problem,” said Anderson, “I’d be very concerned about my out-of-pocket liability.”
ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .This <a target="_blank" href="/health-care-costs/children-covid-long-hauler-clinics-pediatric-hospitals/">article</a> first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150" style="width:1em;height:1em;margin-left:10px;">
<img id="republication-tracker-tool-source" src="/?republication-pixel=true&post=1265327&ga4=G-J74WWTKFM0" style="width:1px;height:1px;">]]>Gov. Ned Lamont pointed to statistics showing the risk of death and hospitalization from covid-19 rises significantly by age.
Yet, shifting to an age-based priority system — after health workers, nursing home patients and people 65 and up have been offered vaccines — has frustrated people with health conditions such as cancer or diabetes who thought they would be next in line. It also could exacerbate the difficulty in getting people in underserved communities and those in minority racial and ethnic groups vaccinated, health experts said.
While it’s reasonable for states to want to vaccinate people in their 50s and 60s ahead of those in their teens and 20s, the experts added, there are no easy answers in deciding who should get vaccines first. Is a 40-year-old with diabetes at higher risk than a 64-year-old without serious health issues? How about an older person who works at home or a younger person whose job puts them at higher risk of infection?
Gini Fischer, 57, a portrait artist in Wilton, Connecticut, has mixed feeling about people her age being in line ahead of those with chronic illnesses. She also teaches water aerobics to seniors at her local YMCA and sees getting vaccinated as a way to protect others. So, she plans to make an appointment for the vaccine.
“I do think people with chronic illnesses are more vulnerable than I am,” said Fischer, a breast cancer survivor. But given her teaching responsibilities, “I certainly don’t want to be a risk to anyone in the class,” she said. “I do believe the more people who get vaccinated the safer it will be for others who have not been vaccinated.”
People 50 to 64 are nine times more likely to die of the virus than adults 30 to 39, from the Centers for Disease Control and Prevention.
“There’s no magic bullet,” said Claire Hannan, executive director of the Association of Immunization Managers, referring to the different priority lists.
Under Connecticut’s , the state on Monday will be the first to start vaccinating everyone age 55 to 64 and up. Later this spring, the state plans to vaccine younger adults. The only exception will be educators and child care providers, who also can also get vaccinated starting Monday.
Last month, Nebraska Gov. Pete Ricketts also indicated the state would adopt a plan to move away from prioritizing vaccinating people with chronic illnesses. But Friday he said Nebraska would issue plans in March to give certain people, such as those on dialysis and those who have compromised immune systems, priority when the state finishes vaccinating those 65 and older.
Rhode Island has also set up an age-based plan, and the it will begin vaccinating people younger than 65 by age group starting in mid-March. But between vaccinating the group of residents who are 60 to 64 years old and those with ages ranging from 50 to 59, Rhode Island also will offer vaccines to people with certain chronic illnesses. The state expects to start vaccinating those in the 16-to-39 age group in June.
In addition, Indiana also has set up a largely age-based vaccine priority system for adults 60-64. It has plans to continue vaccinating by age but also include people with chronic conditions.
Cathy Wilcox, 59, of Stamford, Connecticut, made an appointment for Monday when the new eligibility kicks in. “I am really happy to be able to get it,” she said.
Wilcox, who wears a KN95 mask when working the front desk at an indoor tennis facility, expected she wouldn’t be eligible until April or later but is excited because she has been worried about her risk of getting covid-19. “What worries me about covid is you can have no symptoms but be a carrier and be fine or you can die or everything in between,” she said.
More than 40 states adopted plans to prioritize adults with certain chronic conditions, a strategy that generally uses the “honor system” for people to self-attest they have conditions ranging from a smoking history to asthma, according to KFF. (KHN is an editorially independent program of KFF.)
“There is no obvious right or wrong way to do it,” said Dr. Amesh Adalja, an infectious diseases expert with the Johns Hopkins Center for Health Security in Baltimore. He said the goal of the vaccine program — at least initially — is to protect the most vulnerable so they don’t overwhelm hospital capacity. But it is difficult to determine who is most at risk.
A simpler age-based system could speed vaccination efforts that some say have been complicated in states with covid priority phases with numerous tiers based on job and health status, Adalja said. “There is a clear argument to make it as simple and seamless as possible,” he added.
The big advantage of giving vaccines out by age is it could reduce people from gaming the system (or lying that they have a health condition) since vaccinators can easily check a person’s age identification, said Dr. Richard Zimmerman, a University of Pittsburgh professor who works with its Center for Vaccine Research.
“It may stop some people from skipping the line,” he said.
States and the District of Columbia defend their systems that give early access to people with chronic illnesses, saying they are following CDC recommendations.
After it finishes vaccinating seniors, Maryland will include all adults 16 to 64 who are front-line workers and adults with certain health conditions. A spokesperson for the Maryland Health Department said vaccines should be in large-enough supply in a few months so there won’t be a need to prioritize by age.
Washington, D.C., has a similar strategy. “Age is not a good metric for disease severity nor disease progression,” the city’s health department said in a statement when asked why it plans to eventually give people ages 18 to 64 equal access to the vaccine.
Age also doesn’t not necessarily reflect overall risk, said Dr. Ana Núñez, an internist and vice -dean for diversity, equity and inclusion at the University of Minnesota School of Medicine. Housing, employment and other social determinants can raise a healthy person’s chance of getting the virus.
Indeed, experts said these factors help explain why people from Black, Hispanic and Native American backgrounds are dying at disproportionately high rates.
Distributing by age without targeting the most affected populations also gives preference to white residents, she said, because they outnumber racial and ethnic minority groups in many states.
“If you just do age,” Núñez said, “who are you preferentially immunizing?”
Michelle Cantu, who oversees infectious disease and immunization programs at the National Association of County and City Health Officials, said it’s important for jurisdictions to use data to determine who and how they immunize.
Multiple locations with large minority populations have contacted her in the past month about how an age-based system doesn’t work for them, she said. “I think there are a lot of critical considerations that states and local health departments have to consider,” she said.
Figuring out the best priority order for vaccines will be a short-term issue, as the number of vaccine doses is expected to rise exponentially by late April. But the question of vaccine hesitancy may then become a greater challenge, said. Dr. Sonja Rasmussen, a professor in the departments of pediatrics and epidemiology at the University of Florida.
“I have a concern we will soon get to a point where we have more vaccine than people who want to get it.”
ºÚÁϳԹÏÍø News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .This <a target="_blank" href="/aging/connecticut-covid-vaccine-eligibility-age-priority-under-65-chronic-conditions/">article</a> first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150" style="width:1em;height:1em;margin-left:10px;">
<img id="republication-tracker-tool-source" src="/?republication-pixel=true&post=1267463&ga4=G-J74WWTKFM0" style="width:1px;height:1px;">]]>“We did have tragedies and we did have losses. But we also got through it better than virtually every other state.”South Dakota Gov. Kristi Noem on “The Ingraham Angle,” Fox News, Feb. 2, 2021
Covid-19 has pushed states to adopt unique approaches to protect their residents, but few have garnered as much scrutiny as . Its governor, Kristi Noem, refused to enact a mask mandate or close any businesses. She argued these precautions were a matter of personal choice, even at large gatherings, such as a at Mount Rushmore and the annual motorcycle rally in Sturgis that was connected to in Minnesota and other nearby .
She sees success in the approach.
In a recent television interview, Fox News personality Laura Ingraham asked Noem, a Republican, why she believes news outlets criticize her handling of the pandemic. Her response: While her state sought to protect high-risk populations and keep hospitals from overflowing with patients, she said, it was done in a way that still allowed residents to earn a living.
“That was a unique approach that, for our people, really worked well,” she said in . “We did have tragedies and we did have losses. But we also got through it better than virtually every other state.”
That got us wondering. Are we really “through” the pandemic? And on what measures is this statement based?
We first reached out to Noem’s office to ask these questions.
In an email, communications director Ian Fury didn’t address the first question. On the second, Fury cited South Dakota’s standing in these categories: vaccine distribution, unemployment, the number of people moving to the state and the state’s budget surplus.
Fury dismissed using an “apples-to-apples” comparison between South Dakota and other states on measures such as deaths and case counts, saying such assessments are flawed because the timing of surges and the metrics used can vary by state.
Expanding the Lens on How South Dakota’s Doing
Several measures can offer clues as to how a state is managing the pandemic, experts said.
In the health category, the number of deaths per capita is one way to track the most severe covid cases, said Kumi Smith, assistant professor of epidemiology at the University of Minnesota.
This metric is not a real-time snapshot of how quickly the virus is spreading in a community, given the lag in reporting deaths. But, Smith said, it can provide “a much fuller picture of what’s going on with the pandemic” than case counts alone. That’s because case counts can wax and wane depending on other factors, such as the availability of coronavirus tests and which populations a state prioritizes for testing, she said.
In South Dakota, 1,815 lives have been lost to the pandemic, making its per capita death rate 205 deaths for every 100,000 residents as of Wednesday, according to data from the . The state’s death rate ranks among the top 10 in the nation.
Another key metric is positivity rates — or the percentage of people tested who have the virus. It can indicate whether a state is regularly testing enough residents, said Dr. Amesh Adalja, an infectious diseases physician and senior scholar at the Center for Health Security at Johns Hopkins University.
Positivity rates vary . Data from the South Dakota Department of Health and the CDC shows the average weekly positivity rate peaked in the spring. Few tests were being done at the time, which means every positive result would have had a greater impact on the rate. Johns Hopkins’ covid tracker, which uses a different method, shows the state’s rate peaked in November.
High positivity rates can indicate a lack of adequate testing that allowed the virus to spread unchecked, said Adalja. “Their death count may be even higher,” he added, because some of those cases may not have been properly tested and identified as caused by covid.
Last week, the positivity rate hovered slightly under 7%, as reported by the state. Johns Hopkins researchers placed the figure closer to 20% as of Feb. 3. Both are above the 5% maximum rate recommended by the World Health Organization to reopen a community.
Hospitalization data — specifically, the number of intensive care unit beds occupied — can also help gauge how a state is handling the pandemic, public health experts said. By comparing the number of beds occupied in intensive care units during the pandemic with the year before, said Smith, the metric can show whether hospitals could keep up with the demand caused by the virus.
some South Dakota hospitals struggled to keep up with demand in the fall when the state’s outbreak peaked. As of Wednesday, state data shows, about half of adult and pediatric ICU beds in the state were available.
Public health experts noted South Dakota has emerged as in distributing covid vaccines, ranking among the 10 states with the most residents vaccinated per capita. While the vaccines do offer a way out of the pandemic, “I do think that we are still at the very, very beginning of a very long end,” said Smith.
And the Economy?
Most of the metrics Noem’s office highlighted related to South Dakota’s economy. And, indeed, the state has the lowest unemployment rate in the country and ended the budget year with a
How did the state manage to pull that off during a pandemic?
Evert Van der Sluis, a professor of economics at South Dakota State University, said several factors helped. The state experienced less of an economic decline than initially projected at the start of the pandemic because of federal aid, conservative revenue projections and a multibillion-dollar , he said.
South Dakota — where agriculture is the — also benefited from in direct federal government payments to farmers, said Van der Sluis. While some of these payments were connected to the pandemic, others helped offset the financial losses caused by fallout from a U.S. trade dispute with China.
However, Van der Sluis said, these indicators don’t capture the depth of the damage caused by the pandemic.
They also don’t necessarily highlight how a state has done better than others because they don’t take into account that variations in population density, tax revenue and industries all influence how a state manages an outbreak.
“We can talk about economic well-being,” he said, “but some of the enormous harm done by covid is not reflected, at least in the short run, by economic measures.” It may become apparent in long-term measures like health care spending and lost productivity, he added.
While the lack of lockdowns also may have played a role in keeping South Dakota’s economy afloat, said Lucy Dadayan, a senior research associate at the Urban Institute, there are other states that raked in cash while implementing strong public health measures. Case in point: California.
As , California defied expectations of an economic downturn because of tax revenue from its wealthiest residents and their stock market gains. Ultimately, Dadayan said, a state’s ability to stay financially afloat is dependent on a variety of factors — which makes it more difficult to draw comparisons between states and their economic performance during the pandemic.
“It all matters,” she said.
Our Ruling
Both public health measures and fiscal stability represent important pieces to forming a full picture of how the state is handling the pandemic, experts said.
As Van der Sluis noted, these metrics are blunt instruments when measuring the damage done by the death of a loved one.
In addition, comparing states wholesale is difficult, given their differences and the dynamic nature of the pandemic, as various sources noted. And, though South Dakota is experiencing a decline in case counts, with 109,580 cases to date and growing concern nationwide about the virus’s emerging variants, it’s hard to say the state has “come through” the pandemic.
Noem’s statement on South Dakota’s performance cherry-picked the data, emphasizing the state’s economy while giving less weight to the lives lost and the burden of disease its residents suffered. We rate it Mostly False.
Sources
Centers for Disease Control and Prevention, Nov. 20, 2020
South Dakota Department of Agriculture,
U.S. Department of Agriculture, July 25, 2019
CNN, “,” Nov. 21, 2020
CNN, “,” June 30, 2020
NBC News, Sept. 2, 2020
NPR, Aug. 3, 2020
United Van Lines, Jan. 4, 2021
South Dakota State News, July 16, 2020
U.S. Bureau of Labor Statistics, Jan. 26, 2021
Johns Hopkins Coronavirus Resource Center,
Johns Hopkins Coronavirus Resource Center, Feb. 10, 2021
Fox News, Feb. 2, 2021
South Dakota Department of Health, Feb. 8, 2021
White House COVID-19 Team, Joint Coordination Cell, and Data Strategy and Execution Workgroup, Feb. 9, 2021
Johns Hopkins Coronavirus Resource Center, Feb. 10, 2021
NPR, Nov. 14, 2020
Centers for Disease Control and Prevention, Feb. 9, 2021
Argus Leader, Dec. 4, 2020
ABC News, Nov. 7, 2020
Johns Hopkins Coronavirus Resource Center, Feb. 10, 2021
Argus Leader, Sept. 6, 2019
Email statement from Ian Fury, communications director for South Dakota Gov. Kristi Noem, Feb. 3, 2021
Telephone interview with Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security, Feb. 5, 2021
Telephone interview with Kumi Smith, assistant professor of epidemiology at the University of Minnesota, Feb. 4, 2021
Telephone interview with Evert Van der Sluis, professor of economics at South Dakota State University, Feb. 8, 2021
Telephone interview with Dr. Jeffrey Engel, senior adviser for the Council of State and Territorial Epidemiologists, Feb. 8, 2021
Telephone interview with Lucy Dadayan, senior research associate at the Urban Institute, Feb. 5, 2021
This <a target="_blank" href="/public-health/s-d-governor-gives-state-high-marks-in-handling-the-pandemic-are-they-deserved/">article</a> first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150" style="width:1em;height:1em;margin-left:10px;">
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