Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, listens as President Joe Biden speaks during an event to commemorate the 50 millionth COVID-19 shot.Evan Vucci/AP

On Sunday, Dr. Anthony Fauci, chief medical adviser to President Joe Biden, echoed a warning that rolling back public health restrictions on mask-wearing and mass gatherings too quickly could lead to a spike in COVID cases as the nation races to vaccinate millions of people each day and a more contagious and potentially dangerous COVID variant spreads throughout the United States.

As of Sunday, the United States reported, on average, 60,000 new COVID cases and 2,000 deaths per day. Although the numbers have declined in recent weeks, the decline seems to be leveling off too early. “Historically if you look at the different surges, plateauing at a level of 60,000 to 70,000 cases per day is not an acceptable level,” Fauci said. He pointed to a disturbing trend in Europe, where cases have increased 9 percent in the last week after a plateau.

Another infection spike? A fourth wave? Dr. Anthony Fauci reiterates his concern that COVID-19 cases have declined and plateaued around 60k or 70k cases — he says that's “unacceptable.” pic.twitter.com/bzbcEh0AJ3

— Face The Nation (@FaceTheNation) March 7, 2021

Decisions this week from states such as Texas and Mississippi to end mask mandates and reopen businesses risk increasing the rate of spread. A British variant of the virus, known as B.1.1.7, is reportedly doubling its share of new US cases every 10 days. Researchers predicted that B.1.1.7 could become the predominant strain of the virus in March. “We do want to come back carefully and slowly about pulling back on mitigation methods, but don’t turn the switch on and off,” Fauci said on Face the Nation on Sunday. “It would be risky to have yet another surge.”

As U.S. coronavirus cases remain at a low not seen since October, a more contagious variant first reported in the United Kingdom has likely grown to account for more than 20% of new U.S. cases as of this week. https://t.co/nUfPxtXFZ7

— NYT Graphics (@nytgraphics) March 6, 2021

The Centers for Disease Control and Prevention is expected to release guidelines for how vaccinated people are supposed to interact with others “within the next couple of days,” Fauci noted. Currently, the United States has so far administered nearly 88 million vaccines, at a rate of 2 million people per day. “You have more and more protection of individuals but also communities. We need to hang in there a bit longer,” Fauci said. “It’s not going to be like this indefinitely.”

Although vaccinations are taking place at a rapid clip, the rollout has proven as uneven as COVID’s impact on communities of color. Black, Latino, and Native Americans have been dying of COVID-19 at twice the rate of white Americans. The disparities are even worse for younger people. A New York Times analysis found that Black and Latino people have been vaccinated at no more than half the rate of white people. Fauci noted that doses would dramatically increase in the coming months, and Biden said on Saturday that the nation would have enough for every adult by mid-May, pushing up his previous timeline. 

A Tyson Foods employee received the Johnson & Johnson vaccine in Iowa.Tyson Foods/Zuma

Local governments are doing what public health officials had feared: turning down the Johnson & Johnson vaccine under the false assumption that the single-dose, relatively shelf-stable shot isn’t the “best.”

Mayor Mike Duggan of Detroit declined 6,200 J&J shots that would have added to the city’s arsenal of Pfizer and Moderna vaccines, according to the Detroit Free Press and Crain’s Detroit. “Johnson & Johnson is a very good vaccine,” Duggan said at a Thursday briefing. “Moderna and Pfizer are the best. And I am going to do everything I can to make sure the residents of the city of Detroit get the best.”

This isn’t a good way of thinking about the coronavirus vaccines. Public health officials are purposely shying away from describing one vaccine as any better or worse than another, because they are all highly effective at preventing severe illness and death. As former FDA chief scientists Dr. Jesse Goodman told me earlier this week, all the vaccines work.

“All three vaccines that are currently available under emergency use in the US are very effective in preventing against severe disease, and that’s the main thing individuals need to worry about,” Goodman told me. “What we really want to do is prevent people from getting really sick, and getting hospitalized or dying, and the J&J vaccine appears to do a perfectly fine job with that.”

Plus, the vaccines can’t be compared head to head because each was tested in its own clinical trial. And, as public health officials have pointed out, the J&J vaccine was tested in countries where more contagious variants of the virus were spreading—variants against which the mRNA vaccines may also be somewhat less effective.

Re: J&J 72% vs Pfizer/Moderna 95% – it's sorta like comparing scores of golfers who teed off during a calm morning to those who teed off at 1pm when winds were howling. While it's hard to make precise adjustment, it's clear that equally good play will result in different scores.

— Bob Wachter (@Bob_Wachter) March 5, 2021

Dr. Anthony Fauci explained at a White House press briefing earlier this week that despite their different mechanisms, the mRNA and the J&J vaccines share the same “ultimate end game.” “Both the vaccines ultimately result in a spike protein in the right conformation that gives the body the opportunity to feel that this is the actual virus that it’s seeing when it’s not—it’s the protein,” he said.

So, now is not the time to base public health decisions on which vaccine politicians think is “best.”

A Houston, Texas, Bartender talks with customers shortly after Governor Greg Abbott lifted the state's mask mandate. AP

Earlier this week, Texas and Mississippi became the first states in recent months to lift mask mandates, reopen indoor dining, and do away with a host of other statewide coronavirus restrictions. Connecticut also loosened some restrictions. “With this executive order, we are ensuring that all businesses and families in Texas have the freedom to determine their own destiny,” Texas Gov. Greg Abbott tweeted triumphantly. Some people cheered this move as a long overdue return to pre-pandemic life. After all, why not get back to normal since coronavirus cases and deaths are down since the winter surge, and, at the same time, we’re making great strides on getting highly effective vaccines into more American arms. Right?

Well, not exactly. All that progress is great news. But these actions have spurred public health experts to warn that returning to normal now is a very bad idea. Like, really bad. The governors are “potentially infecting other people in ways that could kill them,” said Sarah Cobey, a computational biologist who studies infectious disease at the University of Chicago. “I’m not a lawyer, but I think it’s a form of battery.”

There are many reasons that reopening now is dangerous. As my colleague Jackie Mogensen recently reported, lifting restrictions is exactly what the virus wants us to do—as we’re seeing the world over, more community spread creates the perfect conditions for the virus to accumulate mutations that can lead to more transmissible and potentially more lethal strains.

But there’s another reason that may be more scientifically complex yet is just as urgent. It has to do with that concept known as herd immunity, which happens when enough people in a population gain immunity—through prior infection or vaccination—so that the virus can no longer run rampant. In order for us to reach herd immunity, vaccines need to work in concert with social distancing strategies. Here’s one important reason why. 

From the vaccine trials, we learned that Pfizer and Moderna both offered protection of greater than 90 percent against the virus, compared to placebo shots, while Johnson & Johnson offers protection of 66 percent. Those figures reflect what’s called relative risk—which is when you’re comparing an intervention to no intervention at all.

That’s different from absolute risk. In this case, absolute risk means how effective the shots would be in a world without any virus restrictions in place, a circumstance that would have been impossible when vaccines were being developed. The trials happened in the real world of 2020, where some level of social distancing requirements—mask mandates, for instance, or limits on gatherings, and restaurant restrictions—existed in some form or another almost everywhere. If, all of a sudden, we lift all those restrictions and repeated the trial, the relative efficacy of the shots—the figures above 90 percent for Pfizer and Moderna and 66 percent for Johnson and Johnson—would likely remain the same. But the absolute risk of becoming infected—for both the placebo and vaccine recipients—would almost certainly increase, meaning more cases for both groups.

Last week, Isreali infectious disease epidemiologist Eran Segal noted this problem in a tweet. “Remember that vaccine efficacy was measured under conditions of masks and social distancing,” he said. “Efficacy is the sum of biological protection of the vaccine and protection resulting from public behavior. If behavior changes, efficacy will likely decline, perhaps even significantly.”

Segal didn’t respond to my request for comment, but the experts I talked to agreed that lifting restrictions could influence even vaccinated people’s absolute risk of contracting COVID-19. Ashleigh Tuite, an infectious disease epidemiologist at the University of Toronto, said that she didn’t believe that lifting restrictions would change anything about the shot’s ability to prevent severe cases of COVID-19, but she was convinced that it would almost certainly increase the overall number of severe infections. “If you have more infections overall, you’re more likely to see people who are vaccinated having severe outcomes—not because the vaccine isn’t working, but because the vaccines are not perfect,” said Tuite.

Cobey added that she worries that people may assume they have near perfect protection from infection once they’re vaccinated. But in places with high levels of community spread, that may not necessarily hold up. “A couple months ago, I was thinking that once enough people got vaccinated that they could be socializing more with other people who are vaccinated,” she told me. But she said she was still concerned that “the absolute risk” would be high for everyone in a community where there is a high level of transmission. 

Which brings me to the second reason that lifting restrictions now would be a bad idea. In order to determine the level of COVID-19 in a particular community, epidemiologists rely on seroprevalence surveys—a process involving the recruitment of volunteers in order to test their blood for COVID-19 antibodies. This kind of study, says Cobey, suffers from a well-known methodological flaw called enrollment or participation bias: The kind of people who volunteer to participate in a survey like this do not tend to behave in the same way that the general population does. In this case, seroprevalence survey volunteers are likely to be the kind of people who follow virus news closely, and therefore are making personal choices to protect themselves in ways that others in their community may not—like by voluntarily wearing masks and choosing not to dine indoors. “Any of the seroprevalence studies where they’re inviting people to enroll will disproportionately be enrolling people who are at lower risk of infection,” says Cobey.

In communities with restrictions in place, survey participants will likely behave more similarly to everyone else—because rules like mask mandates ensure that everyone is taking at least some precautions. But the differences between the survey participants and the general population are likely to be greater in communities where restrictions are lifted—we must assume that once these rules no longer exist, many people will no longer voluntarily take precautions on their own. So in Texas and Mississippi, with the virus restrictions no longer in place, seroprevalence surveys may suggest a low level of community spread—when actually it’s much higher because of the lack of restrictions. 

The difference between relative and absolute risk and the problem of enrollment bias are not typically things that regular people think about—rather, they’re finer points of epidemiological methodology. That’s why leaders have public health experts on their staff—to make sure pandemic decisions are based on sound epidemiology. Individual citizens determining “their own destiny,” on the other hand, don’t have the benefit of a staff of public health experts to help make informed decisions about whether to wear a mask or eat at a restaurant. Which brings us back to why, says Cobey, the lifting of requirements in Texas and Mississippi is so foolish. “It’s completely ridiculous to reduce responsibility to the individual,” she says. “It’s deeply unfair.”  

A patient at the Lebanon VA Medical Center receives a COVID-19 vaccine.Doug Wagner/Veterans Administrat/Planet Pix/ZUMA

This is a week of good news and not-so-good news as we approach the one year anniversary of the coronavirus pandemic in the US. The good news is that a new one-dose coronavirus vaccine from Johnson & Johnson has recently been approved, and President Joe Biden says there’ll be enough vaccine for every American adult by the end of May. But what’s concerning is that a new coronavirus variant in New York City has been identified—and is spreading—with no clarity about how effective vaccines might be against this variant. Also, new data shows significant structural and racial disparities in who is receiving the vaccine, and who is still waiting in line.

On this week’s episode of the Mother Jones Podcast, Kiera Butler and Edwin Rios, two reporters who have been on the pandemic beat for the past year, join host Jamilah King to provide much-needed context about what this all means.

Butler, a senior editor and public health reporter, explains that while the Johnson & Johnson vaccine has lower efficacy rates than the Pfizer or Moderna vaccines, it is still highly effective at fending off the worst outcomes of coronavirus infections. “It prevents hospitalization and death 100 percent of the time,” she tells Jamilah King on the podcast.

While millions of vaccine dosages have been shipped out this week, and vaccination rates are on the rise, there are concerning reports of low vaccination rates among communities of color—the very the same communities that have been disproportionately affected by the coronavirus pandemic itself. Black, Latino, and Native Americans have been dying of COVID-19 at twice the rate of white Americans. Those disparities widen in younger age groups. Despite the fact that Black Americans account for 16 percent of COVID deaths, they have received just six percent of the first dose rollout. “The pandemic exacerbates preexisting inequities,” Rios says. “It’s not as if those barriers to access go away when the vaccine rollout starts.”

One such major barrier for some trying to schedule their vaccine appointments is as simple as internet access. In Butler’s reporting on a rural town in Georgia, she found that lack of reliable access to the internet was an impediment for many who were trying to make vaccine appointments online. These difficulties were even more serious for older adults who are less comfortable with the online booking process. “Elderly folks with younger people in their lives who have the time and wherewithal to constantly refresh websites and try to make appointments, they are getting the vaccine,” says Butler. “Whereas folks who don’t have that are having a much harder time.”

Finding ways around the social and economic inequities in vaccine distribution will require some ingenuity, and Biden has already announced it as a priority for his administration. He is granting millions of dollars to groups that aim to counter vaccine hesitancy in Black, Hispanic, Asian, and Native American communities. Rios says the key will be making sure that those groups actually reach trusted messengers with clear, consistent, and multi-lingual information. “Go where the people are at. If they’re at churches, go to churches,” he tells Jamilah King on the podcast. “What you want to do is eliminate the barriers that have been put in place before.”

Michael Rieger/Zuma

On Sunday, the Food and Drug Administration authorized a third coronavirus vaccine, produced by Johnson & Johnson, for emergency use. This one’s a little different: It’s more shelf-stable than the mRNA vaccines already in distribution, and requires just one dose. Sounds great, right?

Yet questions abound about the new vaccine—and the old ones, too. To clear up existing doubts about how these vaccines trigger an immune response and protect against the coronavirus, we consulted an expert—Dr. Jesse Goodman—who is the director of the Center on Medical Product Access, Safety and Stewardship at Georgetown University and a former chief scientist at the FDA. 

Mother Jones: Public health experts, including Dr. Anthony Fauci, have said the best vaccine is whichever one you can get. Why is that?

Jesse Goodman: The needs and the demand for vaccine are far above what’s available. The virus is circulating at high levels, and vaccination is the best way people can protect themselves. All three vaccines that are currently available under emergency use in the US are very effective in preventing against severe disease, and that’s the main thing individuals need to worry about.

MJ: How does the technology of the Johnson and Johnson vaccine differ from that of the Pfizer or the Moderna vaccines?

JG: The Pfizer and Moderna vaccines use mRNA, which is the message the virus uses to make a protein. The vaccine mixes the RNA with little globules of fat, and when the mixture is injected into a cell, the cell produces the same spike protein that is normally present on the surface of the virus. The body’s immune system then makes antibodies and T cells that can kill the virus that has that same protein on its surface when it comes along.

Instead of using this naked RNA mixed in fat, the Johnson & Johnson vaccine uses DNA that carries the same genetic code for the spike protein inserted into the DNA of a kind of cold virus, an adenovirus, that has been engineered so it can’t replicate in a person. After vaccination, this adenovirus enters your cells, which use the DNA to make mRNA for the spike protein. The cell then uses that mRNA to produce the protein itself, and your body makes antibodies and T cells that, as with the mRNA vaccines, can then react to the spike protein and kill the virus when it tries to infect you.

RNA is very fragile, which is part of the reason that the Moderna and Pfizer vaccines require frozen storage and have limited shelf life once they’re thawed. Because the Johnson & Johnson vaccine doesn’t have that naked RNA, it’s much hardier. It can be frozen under normal conditions and then refrigerated for about three months. That provides advantages in transportation and handling in clinics and healthcare setting where freezing is not as practical. The other thing is that the Johnson & Johnson adenovirus vaccine produces a strong immune response after one dose.

MJ: Because the J&J vaccine is easier to ship and store, it’s likely to be deployed in harder-to-reach communities. How would you respond to the suggestion that this creates a two-tiered system in which marginalized people get the short end of the stick in terms of vaccine effectiveness?

JG: What we really want to do is prevent people from getting really sick, and getting hospitalized or dying, and the J&J vaccine appears to do a perfectly fine job with that. I’ve already been vaccinated, but if J&J had been available when I was vaccinated, I would have gladly taken it.

MJ: How does the Johnson & Johnson version stack up in terms of efficacy?

JG: The vaccines were not compared head to head; these were different studies done in different places at different times. But it does appear that in preventing all infections, the J&J vaccine in the one-dose regimen may not be as effective as the two-dose regimen of the RNA vaccine. In the part of the clinical study that took place in the United States, the J&J vaccine was about 72 percent effective in reducing overall infection, as opposed to 94 or 95 percent with the RNA vaccines. However, they all appear very highly effective in preventing severe manifestations that might require hospitalization or [cause] death.

MJ: Would taking two doses of the J&J vaccine boost its overall efficacy?

JG: We don’t know yet. J&J has a study going on now that looks at two doses. Still, there’s a tremendous advantage to getting vaccinated, if you can get any of these vaccines, because all three seem to really prevent the serious infections and complications that both make people sick and stress our health care system.

MJ: How effective are the mRNA vaccines if just one shot is administered?

JG: Information about that is limited, because virtually everyone in the clinical trials got a second shot. Between the first and second shot, depending on the vaccine and on how we look at the data, there was protection against infection on the order of somewhere from 50 to maybe 80 percent. So even after one dose, within a couple of weeks, there is some protection. What we don’t know is how long would that last without the second dose.

There is also some concern that incomplete immunity could worsen the problem by selecting for variant viruses. In other words, variant viruses might have an advantage over non-variant viruses in overcoming that low-level antibody that’s present after just one dose. It’s not proven, but it’s a reasonable concern.

MJ: How does the efficacy of a vaccine in a clinical trial relate to its effectiveness in the real world?

JG: Vaccines and drugs frequently look better in their clinical trials than they do when they’re out in the broader population because patients in clinical trials are often healthier. But so far, it looks like the very high levels of efficacy that were present in the clinical trials are being maintained as it’s brought out in the broader population. Part of the reason is that these trials were done with an emphasis on trying to incorporate people of all ages, including older people who often don’t respond as well to vaccines.

MJ: Does getting vaccinated lower the risk of having an asymptomatic infection and spreading the virus to others? 

JG: We don’t have data yet on transmission. Our sense is that the vaccines will decrease transmission in the community and contribute to the health of both individuals and the public. Whether vaccines with higher efficacy will do a better job of that, we’ll hopefully know more in the future.

MJ: How long does immunity last?

JG: We don’t know. It could be that it differs among the vaccines, but right now there’s not a lot of strong information that there should be a strong preference for one or the other.

MJ: Are these vaccines safe and effective for pregnant women?

JG: Animal studies show no evidence of reproductive risk to mother or fetuses. There are no studies performed yet in pregnant women. However, a number of pregnant women have been vaccinated, and to date there is no evidence of adverse effects on the mother or fetus from the vaccines.

Pregnant women are at higher than average risk for getting bad outcomes from COVID-19 infection, and the CDC and the American College of Obstetricians and Gynecologists recommend that pregnant women get vaccinated if they otherwise meet eligibility criteria.

MJ: What about teenagers?

JG: Studies are underway, but there’s no data yet—with the exception of the Pfizer vaccine, which is authorized for people 16 and up.

MJ: When might we expect to see a vaccine approved for use in children?

JG: Those studies will probably not be available until late in the year.

MJ: Is there any fear that a variant could emerge that’s more dangerous for kids?

JG: The virus has kept throwing new things at us, and we still do not understand the multi-system inflammatory syndrome that COVID causes—fortunately, rarely—in children, so this question will need continuous monitoring.

MJ: How do these vaccines hold up against the more contagious variants of the virus?

JG: Some of the genetic variants somewhat lower the effectiveness of the vaccine. The J&J vaccine trials included people in South Africa and Brazil, where some of these variants seem to have originated. While effectiveness was reduced somewhat in those countries, maybe by about 10 percent, the good news is that the vaccines were still effective in preventing hospitalizations and deaths.

MJ: Suppose a vaccine-resistant variant were to emerge. Could we easily just tweak the existing vaccines?

JG: Studies are underway now at most of the major companies using vaccine variants to tweak the vaccines in case it’s needed. It wouldn’t be a completely new vaccine; it would be more like what we do for flu vaccines every year. If the virus changes, we make adjustments, and that can be done quite quickly, particularly for RNA vaccines.

MJ: How big of a threat is vaccine hesitancy to achieving herd immunity?

JG: That’s a real hurdle. There still are people who are concerned, and there needs to be an effective strategy of communication to those people if vaccines are really gonna have impact they can have. Being sure that people understand the ways in which vaccines may or may not be different, understand their benefits, understand their safety profile, those things are really important.

The pandemic seems to have these ups and downs that nobody fully understands. I worry that we could get to a place where events are not as dramatic as they were a month or two ago or back in the spring, and people could feel less urgency about getting vaccinated.

We really need to help people understand that there will be likely upticks again, there is the threat of these variants globally, and that being immunized is smart both to protect yourself, and your loved ones and your community.

picture alliance/Getty

For months, we’ve known that the coronavirus spreads via airborne droplets, invisible molecules or globules of liquid that fall or hang suspended in the air whenever we exhale, talk, or sneeze. As more schools and businesses prepare to safely reopen, they’re looking for ways to purify indoor air—and the market has answered with a dizzying array of devices that go far beyond traditional HVAC (heating, ventilation, and air conditioning) systems and HEPA (high-efficiency particulate air) filters. Sellers of devices like bipolar ionizers, hydroxyl generators, and disinfectant foggers have claimed they can safely destroy the coronavirus or pathogens like it.

Across the country, schools are snapping up these purportedly air-cleaning products. The school district in Chilton County, Alabama, used funds from the CARES Act to buy their custodians agricultural backpack foggers that fill classrooms with chemicals. In Ocean City, New Jersey, schools put hydroxyl generators in nurses’ offices. Four school districts in the Lehigh Valley, Pennsylvania, have collectively spent more than $1.3 million to install bipolar ionizers in their HVAC systems.

But how many of these technologies are really snake oil, and are any them potentially dangerous? To find out, I spoke with Delphine Farmer, an atmospheric chemist at Colorado State University, and the coauthor of a forthcoming study on bipolar ionization. Lately, Farmer has been taking calls from school districts looking for advice on whether these new technologies can effectively keep students and teachers safe. “There’s a definite feeling that if all these other organizations are buying into this technology, then it must be okay,” Farmer says. “I’m like, “Nope, there’s no guarantee.'” 

When we’re thinking about cleaning indoor air, what options do we have?

Think about if you’re cooking, and you’re making soup. If you have too much salt in your soup, then you can add more water, or you can add another flavor that kind of counterbalances the salt. You have these different techniques, the exact same way we have indoors. You can dilute the air—that’s where we pull in cleaner, outdoor air, opening windows and increasing ventilation. That’s just like adding more water to your salty soup. Another approach is to think about removing the salt—like finding a way to remove those particles and just filtering it out. For that we use HEPA filters.

And then you get to the other ways of doing this. And that’s where you start to get into what I would politely call “creative solutions” that take advantage of chemistry and developing new technology. But this is also where there’s a lot of potential unintended consequences, and unintended chemistry that can play a role.

What are these “creative solutions” that are on the market today?

So there are supposedly cleaning systems, which use ozone, or they use hydroxyl radicals—that’s another new one. What they’re trying to do is add chemistry that oxidizes organic molecules and the virus and destroys them. At the end of the day, it’s going to make molecules fall apart, or take on extra oxygen atoms, and then they change form. Eventually, if you make organic molecules react with the oxidant long enough, they’ll end up making carbon monoxide or carbon dioxide—which is safer than, say, coronaviruses.

But it’s hard to oxidize organic molecules all the way. Those are all the steps of chemical reactions that create smog in urban environments. There’s a lot of toxic byproducts. Take a big organic molecule like limonene—the molecule that makes anything citrus scented. It’s all over personal care products, and when you cook. It’s very prevalent in the indoor environment. You interact it with one of these ozone or [hydroxyl radical]generators, and you’re going to make formaldehyde.

Also, the oxidants themselves are quite toxic. Ozone is a well-known air pollutant in outdoor air, very well established to be dangerous. And then hydroxyl radicals are something that you would not want reacting with the tissues of your lungs.

Because they can damage the lungs?

They’re going to chemically react with your lung tissue, and certainly cause damage.

Is there any situation in which those are an appropriate way to clean indoor air?

In general, I can think of no situations where one would want an ozone generator in a house, or in a place where people are present. Same thing with these other oxidant generators. They’re either dangerous, or they’re operated in such a way that they’re not going to be effective.

What other devices are in this universe?

We’ve got another class of air cleaning devices that are foggers, or misters, or sprayers. There’s this thing called List N on the EPA webpage. It will tell you, if you take this commercial product, or you take this bleach mixture, it has this active ingredient, at this concentration. If you follow this set of instructions, and you mix it with water at this concentration, and you put it on a surface for this amount of time, it will destroy SARS-CoV-2. 

Now what’s happened is a lot of companies are taking advantage of the fact that these types of chemicals will kill SARS-CoV-2. They then go and put them into sprayers or foggers. These are little devices that will release the chemical straight into the air, either as gases, or more frequently as little tiny droplets, little aerosol particles. The idea is that if you put enough of these, you spray them into a room, then you would kill any SARS-CoV-2 that’s in the air, in exhaled aerosol particles. And they would hit all the surfaces in the room and also destroy SARS-CoV-2.

It sounds like not a bad idea until you start thinking about it. First off, there’s a problem as to whether or not these work at all—because [according to] that EPA List N, you had to have a certain concentration and for a certain amount of contact time. Any of these airborne sprayers are certainly not meeting that concentration or contact time. So we don’t know that they work at all. Then there’s the problem that if you have people in the room, they are now going to be inhaling these droplets of these disinfectants—and some of them are quite toxic in and of themselves. Then you have that third issue—that these chemicals can actually do chemical reactions in the air, and on the surfaces of your building, and in your room. They can actually make really toxic compounds. This is very definitely the case for hypochlorous acid, which is basically a version of bleach. But this has become really popular in dentist offices.

This to me sounds like President Trump saying, Well, why don’t we just inject disinfectant.

Exactly. It’s “I hear that bleach kills SARS-CoV-2—so let’s drink it and put it everywhere and inject it.” It’s that level of logic. The thing that is scary to me is that this is a level of logic that has turned into products that are being very aggressively marketed.

Okay, so there are ozone and hydroxyl radical generators. Foggers, misters, sprayers that put disinfectants out into the room. What else?

The last major set of air cleaning devices are ion generators—these ionizers that are being incredibly aggressively marketed, especially toward schools. The idea behind them sounds great. If you pass air through one of these devices, it will ionize an array of molecules. What that really means is you’re either knocking out an electron, or you’re adding on a proton. You’re giving these little molecules a charge. These ions now will have a tendency to go towards anything that is grounded. I think of them as being quite sticky. They’ll hit surfaces, and they’ll just stick there. Or the particles might attract get attracted to other particles, and then they’ll stick together and become larger and larger and larger, until they fall out of the air.

That’s the theory. The practice is a little bit different. It’s actually quite hard to push enough volume through to actually make this system work to remove particles. There are not a lot of tests that have been done independently, that have shown that the system actually works to remove aerosol particles from the air.

The other problem is that you do chemistry when you have ions in air. Ions will react with other molecules in the air in a series of reactions, and, again, they’ll generate some oxidized organic compounds. Some of those are potentially more toxic than what you had in the first place. The problem with those ionizers is that we just don’t understand the chemistry of them. We don’t understand whether they make air toxic in concentrations we should be worried about, or if they don’t.

As an environmental chemist, I think about the precautionary principle, where you say, “Well, if this might do harm, and you don’t need to do it, then you just shouldn’t use it.” You have to prove that something is benign—that it’s not going to hurt the environment, and it’s not going to hurt people before you use it. And I think this rush to market these air cleaning devices is very concerning. I think we’re creating devices that might—not guaranteed—but they might create some some dangerous byproducts. And they certainly haven’t been proven to be effective.

I’ve seen lots of references to ultraviolet light, which seems to be maybe more recommended than these other techniques. Is that true?

Ultraviolet is pretty established. It’s expensive, but there’s some useful guidelines out there. The idea is that ultraviolet light is really strong, [it] breaks down DNA, and it will tear apart the COVID particles. It’s very effective as a germicide and quite well understood. If it is installed carefully and properly can be very effective. What you want to really be careful of is improperly installed UV, or anything that would expose you as an individual to it.

Dr Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, speaks during a White House press briefing, at the White House on January 21, 2021 in Washington, DC. Alex Wong/Getty Images

Dr. Anthony Fauci, President Joe Biden’s chief medical adviser, encouraged Americans not to hesitate to receive the Johnson & Johnson coronavirus vaccine that the FDA authorized for use on Saturday. Johnson & Johnson’s one-shot vaccine prevented severe illness and hospitalization in trials, but its overall efficacy was 72 percent in the United States, whereas the clinical trials for the Pfizer and Moderna vaccines showed higher efficacy rates. This raises concerns of vaccine hesitancy for the newest vaccine, which will be rolled out over the coming months with initial shipments expected as early as next week.

“The message that needs to prevail, Dana, is that these are three highly efficacious vaccines,” Fauci told CNN’s Dana Bash on State of the Union Sunday. Fauci said that if he weren’t already vaccinated, “and I had a choice of getting a J&J vaccine now or waiting for another vaccine, I would take whatever vaccine would be available to me as quickly as possible.”

Dr. Fauci addresses the concerns about the Johnson & Johnson Covid-19 vaccine and how effective it is compared to the other vaccines available: “The message that needs to prevail, Dana, is that these are three highly efficacious vaccines.” #CNNSOTU pic.twitter.com/FMuH8b0whf

— State of the Union (@CNNSotu) February 28, 2021

Fauci took the same message to other Sunday shows, urging Americans to take the Johnson & Johnson vaccine and speed up vaccination rates overall, rather than trying to hold out for a different vaccine. He further emphasized that it’s hard to compare efficacy rates across different studies, because they were conducted under different circumstances.

He cautioned that states beginning to ease lockdown restrictions are doing so prematurely, and he fears that infection rates will begin to tick up yet again. Premature reopening, he said, was “really risky” and would put us “right back on the road to rebounding.”

As governors across the country begin to ease some coronavirus restrictions, Dr. Anthony Fauci says he thinks the efforts are premature: “It is really risky to say, ‘It’s over. We’re on our way out. Let’s pull back.’” #CNNSOTU pic.twitter.com/rKLzd6ft54

— State of the Union (@CNNSotu) February 28, 2021

On Feb. 27, 2020, Donald Trump hosted a Black History Month event where he talked about the COVID-19 pandemic.Tia Dufour/White House/Planet Pix/Zuma

It’s the one-year anniversary of former President Donald Trump’s fateful remarks dismissing the COVID-19 pandemic. At a Black History Month event on February 27, 2020, Trump predicted:

And you know what?  If we were doing a bad job, we should also be criticized.  But we have done an incredible job.  We’re going to continue.  It’s going to disappear.  One day—it’s like a miracle—it will disappear.  And from our shores, we—you know, it could get worse before it gets better.  It could maybe go away.  We’ll see what happens.  Nobody really knows.

The fact is, the greatest experts—I’ve spoken to them all.  Nobody really knows. 

Two days after Trump’s comments, health officials in Washington State announced the first known coronavirus death in the United States (though later on the first known death was revised to February 6). Now, at the one-year mark of Trump’s denial, the United States has had more than 500,000 people die from COVID-19, roughly equal to the population of a major city like Atlanta. The toll has been worse for people of color, disproportionately taking Black, Latino, and Native American lives.

It also wasn’t true that nobody really knew what would happen. While CDC Director Dr. Robert Redfield testified that same day before Congress that his agency “believes that the immediate risk of this new virus to the American public is low,” the Trump administration received warnings from top scientists and national security experts on the threat of a pandemic as early as January. Despite these warnings, the Trump administration failed to take needed steps to ensure the supply of medical supplies, issue mask mandates, and urge Americans away from large gatherings. 

Read Mother Jones‘ comprehensive timeline for more on Trump’s deadly denial.

Paul Christian Gordon/Zuma

Johnson & Johnson’s one-shot coronavirus vaccine is highly effective at preventing severe disease and death from COVID-19, the Food and Drug Administration found in analyses published today.

An international study found the vaccine’s efficacy rate to be 72 percent in the United States and 64 percent in South Africa, where a more contagious variant is spreading. While these figures are lower than Pfizer’s and Moderna’s efficacy rates, the vaccine greatly reduces the risk of hospitalization and death from COVID-19 and could play a key role in keeping the pandemic at bay. In a clinical trial of 40,000 people, no one who took the vaccine was hospitalized or died of COVID-19 after the vaccine took effect.

Plus, the vaccine requires only one shot and does not need special refrigeration—good news at a time when demand for vaccines greatly outstrips supply.

The FDA could authorize the vaccine for emergency use as early as Saturday, with 20 million doses available by the end of March and a total of 100 million doses delivered by the end of June.

Artist Suzanne Brennan Firstenberg walks among thousands of white flags planted in remembrance of Americans who have died of COVID-19 in October 2020.Patrick Semansky/AP

The United States’ COVID-19 death toll has surpassed 500,000, a staggering milestone.

“People decades from now are gonna be talking about this as a terribly historic milestone in the history of this country, to have these many people to have died from a respiratory-borne infection,” Dr. Anthony Fauci said in a CNN interview Monday morning. “It really is a terrible situation that we’ve been through, and that we’re still going through.”

It’s nearly impossible to conceive of the loss of half a million Americans. The virus has killed one in 670 people across the country. In places like New York City, the number is closer to one in 295. President Biden will hold a memorial ceremony this evening and will order flags on federal property to fly at half staff for five days.

COVID-19 infection rates in the US have fallen dramatically since their January peak, and more than 13 percent of the country’s population has received at least one vaccine dose. Still, public health officials are urging the public not to let their guard down. At a White House COVID-19 response team press briefing this afternoon, Fauci reiterated that people should continue wearing masks because of the possibility that people who have been vaccinated could still be infected and spread the disease asymptomatically.

“There will be things that you will not be able to do because the burden of virus in society will be very high,” he said. “We are still at an unacceptably high baseline level with the seven-day average being quite high.”

It was a little less than a year ago that then-President Trump declared that the coronavirus was “going to disappear.” Lockdowns in New York City, one of the initial epicenters, began in mid-March 2020. Since then, the world as we knew it has disappeared.

Dr. Jonathan Poon (right) next to his father, Dr. Glenn Poon (left), outside the Medical Center of Elberton in Elberton, GeorgiaMother Jones illustration

Update, February 19, 2021: After this piece was published, Dr. Poon reported that the Georgia Department of Health restored vaccines access to the Medical Center of Elberton. The clinic will be able to order shots starting March 8 and resume vaccinations March 15. 

It was a gloriously sunny Wednesday in early February, but Dennis Fowler was worried. The 77-year-old retired transit worker sat in the waiting room at his doctor’s office at the Medical Center of Elberton, a bustling clinic in rural Elbert County, Georgia. He was there for a routine appointment, but he had also come to ask his doctor about his COVID-19 vaccine. Weeks earlier, as soon as they’d heard they were eligible, Fowler and his wife called to make appointments to get their shots. The prospect of an immunization was a big relief: Dennis’ wife had kidney failure, and the two had spent the last 11 months under strict quarantine to protect her. But a few days earlier, the Fowlers’ doctor had called to tell them the bad news. They may not get a vaccine after all and would likely have to start the process all over again. “We’re concerned that we’ll get the virus before we get our shot,” Fowler said. 

The Fowlers are not the only ones in this Georgia community whose vaccinations were canceled. In late December, the county had finished vaccinating health care professionals and first responders, so the Elberton Medical Center opened up appointments to what they’d thought was the next tier: people over age 65 along with essential workers, including teachers. Most people in town cheered this development. The schools had been open since August, since remote learning was impossible for the community’s many children who lacked internet access. But the doctors at the medical center didn’t realize that the Georgia Department of Health had changed the guidelines in January, and teachers were not eligible after all. When the Georgia DPH found out that the Medical Center of Elberton had vaccinated 177 school workers with Pfizer and Moderna vaccines, state health officials meted out a harsh punishment. They suspended all vaccine shipments until July and seized most of the remaining doses in the clinic’s freezer, leaving only enough for those who had already gotten their first dose to receive a second.

The state’s seizure of the clinic’s vaccine supply comes at a critical time. At the urging of the Centers for Disease Control and Prevention, many states have opened vaccine appointments to broader swaths of the community to speed the process and prevent wasted doses. Yet some local leaders are cracking down hard on anyone who doesn’t rigidly adhere to guidelines. The New York Times recently reported that a physician in Houston was fired this month for giving away vaccine doses that otherwise would have gone to waste. Many public health experts question the logic of disciplining providers. “I think it’s really important that we stop punishing groups or individuals for vaccinating those outside state or [national] COVID-19 vaccination guidelines,” Peter Hotez, a vaccinologist and dean of the National School of Tropical Medicine at Baylor College of Medicine, told me for a previous story. The guidelines, he said, “mostly serve as a barrier or hindrance to vaccinations rather than their intended purpose.”

I visited the Medical Center of Elberton last week and chatted with Dr. Jonathan Poon, a physician who practices at the clinic, which is the largest in town and the main supplier of COVID-19 vaccines. He planned to distribute vaccines to the more than 3,000 patients the clinic sees every month. Now, like the Fowlers, most will struggle to get immunized elsewhere. About 70 percent lack private insurance, and many don’t have internet access they’d need to book appointments at other locations. “We’re in a very precarious situation,” he said. 

Elbert County is in the far northeastern corner of Georgia, close to the South Carolina border. Many of its 20,000 residents are employed making tombstones and memorial statues out of stone—a mural downtown in Elberton, the county seat, boasts the town is “the monument capital of the world.” Trucks bearing slabs of granite rumble through the modest downtown, a square of municipal buildings and a few storefronts still open for business: Stan’s Music World, say, and Tena’s Fine Jewelry & Gifts. On Friday nights, people go to see the the Blue Devils football team from the high school play at the Granite Bowl stadium, which is carved out of 100,000 tons of blue granite. The people here live modestly: In 2018, the median household income was about $44,000, and nearly 20 percent lived below the poverty line.

On the day that I visited, I watched as residents stopped to greet each other around town. The older ladies had names like Sarabelle and Shelly Anne. “How’s your mama?” They asked neighbors at the pharmacy. “She managing okay?” 

Almost everyone in this county knows Dr. Poon because he’s lived here almost his whole life. His family, originally from Hong Kong, moved to Elberton when Poon was 3 months old so his father could practice family medicine. Poon decided to follow in his father’s footsteps, and after medical school and residency, he moved back home to practice family medicine. Today, he sees patients down the hall from his father.

Poon, who has an unflappable air about him and speaks in a slow Southern drawl, isn’t used to being in the spotlight. He spends his days at the clinic, seeing local patients at all phases of life: children with sore throats, pregnant women, elderly people who need medication for diabetes. But in the last few weeks, Poon has appeared on TV news shows, talking about how much the people of Elbert County need the vaccines that the state took away. As he and I walked from the parking lot of the medical center to the pharmacy, neighbors greeted him like a conquering hero. “Thank you so much for what you’re doing for our town,” a man in a pickup truck said through his window. “I really mean it.”

When Poon and his colleagues heard in November that vaccines would be available by the end of the year, their planning went into overdrive. The clinic purchased a special freezer for $7,000, and a trailer to use as a vaccination clinic for $90,000. They wanted to make it as easy as possible for their patients to get vaccines, and they aimed to get the process started quickly. They saw how their community was suffering.

COVID-19 ripped through Elbert County this winter. So intense was the spread of disease that the small local hospital had to send patients to ICUs as far away as Jacksonville, Florida. The county EMS team has been stretched thin, transferring patients while also trying to provide regular emergency services to the county. In the three local nursing homes, the COVID-19 mortality rate was 30 percent. Poon estimates that 30 or 40 people died of the virus. 

The county’s plight did not move the state public health department to reverse its decision despite Poon’s efforts. When I contacted the Georgia DPH for a previous story, spokesperson Nancy Nydam responded, “It is critical that DPH maintains the highest standards for vaccine accountability to ensure all federal and state requirements are adhered to by all parties, and vaccine is administered efficiently and equitably.” In other words, there was little hope for recourse. 

When the state seized the medical center’s vaccines, the pharmacy next door, Madden’s, attempted to pick up some of the slack, applying to receive more vaccine doses from the state, a process that took several weeks. The gregarious head pharmacist, Don Piela, has been working hard to book appointments every day. As he stood behind the prescriptions counter, he told me he had to bring in help to cope with the demand for vaccine. His wife, who usually works as a pharmacist in another town, came into assist with booking appointments and performing vaccinations. The pharmacists also had to contend with unscrupulous line jumpers. An Atlanta couple in their 50s, for instance, drove two hours from the suburbs for a vaccine, claiming they were caregivers for the woman’s elderly mother, who lived in Tennessee. The pharmacists had to turn them away.

Piela told me he’s grateful that his pharmacy was able to help with vaccines, but he’s worried that the state’s decision to punish the medical center could have consequences beyond the pandemic. “If the state is coming in and suspending vaccines to a medical facility, there’s part of your population says, ‘Well, they must have been doing something wrong,’” he says. “If you damage the reputation of anybody, that’s damaging. But especially somebody that’s in health care, that’s really even more damaging.”

Poon and his colleagues are working hard to try to convince state officials to restore their vaccine supply. They’ve been meeting regularly with county leaders, who have appealed the state’s decision twice, with no luck. State public health representatives responded with a letter stating that the decision to withhold vaccines will stand. Poon is worried that all the delays are wasting valuable time. Every day that Elbert County residents don’t get vaccinated is another day they could contract the virus. Meanwhile, more contagious variants are spreading quickly; the one that originated in Africa already has been identified in neighboring South Carolina.  

Fowler, the 77-year-old whose vaccine appointment was canceled, is frustrated about being stuck in the house indefinitely, always worried about the fragility of his wife—and himself. If the state doesn’t restore vaccine shipments, he’ll make an appointment at Madden’s, but he doesn’t know how long he’ll have to wait—it could be weeks. He misses seeing his neighbors and going for a date with his wife to the Outback Steakhouse. He’s eager to get back to church. “I’m hoping something will come through,” he said, “and we will be able to get our shots.”

Standing in front of the clinic, Poon looked at the vaccine trailer his practice had purchased and shook his head. He intends to keep trying to impress upon the state that his patients deserve vaccines, and that he and his colleagues never meant to flout any rules. “There’s nothing we’re doing for personal gain,” he said. “We’re just trying to do the right thing.”

This piece has been updated. 

Louise Pomeroy

COVID-19 doesn’t discriminate, but the havoc wrought by the virus—the deaths, economic devastation, and intergenerational trauma—has disproportionately affected Black, Latino, and Native American communities. The Trump administration’s feckless response didn’t help, yet even proactive steps have reinforced preexisting inequities: Stay-at-home orders protected people with the privilege to work remotely while frontline workers, disproportionately Black and Latino, took on greater risk of exposure. People of color have also experienced more unemployment and financial insecurity. As Mary Bassett, director of Harvard’s François-Xavier Bagnoud Center for Health and Human Rights, explains, none of this is caused by the virus itself: “It’s because of the social consequences of race in our society, which has been reinforced by decades, centuries of bad practices and policies.”

Illustrations by Louise Pomeroy

 

The COVID death rate for Black Americans ages 30 to 49 is four times that of white Americans.

Black Americans make up 12% of all 50- to 64-year-olds yet 22% of all COVID deaths in this age group.

 

 

The COVID death rate for Native Americans ages 18 to 29 is 12 times that of white Americans.

 

 

White Americans make up 68% of all 50- to 64-year-olds yet only 39% of all COVID deaths in this age group.

 

 

Latinos make up 20% of all 30- to 49-year-olds yet 45% of all COVID deaths in this age group.

After California reopened last summer, the rate of excess deaths among Latinos in the state tripled.

 

 

Asian Americans make up 6% of the population and 4% of all COVID deaths.

 

 

The jobless rate for Latinas in December was nearly three times higher than it was a year earlier.

Due to COVID, Americans’ life expectancy has dropped 1.2 years. For Black Americans, it’s down 2.1 years; for Latinos, 3 years.

 

 

More than 40% of the 12 million jobs lost by women last spring have not come back.

 

 

Black men had the nation’s highest unemployment rate in December—10.4%—their highest level since 2015.

As of mid-January, the vaccination rate for Black Americans in 11 states was less than half that for white Americans.

 

Sources: Death rates: Calculations based on data from the Centers for Disease Control and Prevention (data as of February 3, 2021) and Census Bureau; household surveys: Census Bureau (data as of January 6, 2021); California excess deaths: JAMA Internal Medicine; Latina unemployment rates: Bureau of Labor Statistics; life expectancy drops: Proceedings of the National Academy of Sciences; women’s job losses: National Women’s Law Center; vaccination rates: Kaiser Health News (data as of January 14, 2021); Black men’s unemployment rates: Bureau of Labor Statistics, St. Louis Fed; concern about local outbreak: Civiqs

Andreas Arnold/AP Images

In mid-January, the Centers for Disease Control and Prevention warned that a coronavirus variant first identified in the United Kingdom was likely going to, as the New York Times put it at the time, “lead to a wrenching surge in cases and deaths that would further burden overwhelmed hospitals.”

A new study, published on Sunday by a team of scientists from labs across the country, including the Scripps Research Institute, ahead of full peer review, confirms that dire prediction. The variant, known as B.1.1.7, is “spreading rapidly in the United States, doubling roughly every 10 days,” the Times reported Sunday, with a transmission rate 30-to-40 percent higher than more common strains. In a matter of weeks, this variant could be the predominant domestic variant, the research suggests.

“There could indeed be a very serious situation developing in a matter of months or weeks,” Nicholas Davies, an epidemiologist at the London School of Hygiene and Tropical Medicine, who was not part of the research team, told the newspaper.

The news comes as communities across the country—and around the world—continue to grapple with spotty vaccine availability and distribution. President Joe Biden has increased his goal for daily vaccinations to 1.5 million (up from 1 million) and overall dosing numbers are increasing. Still, the current pace means that it won’t be until late summer before a sufficient majority of Americans will have been vaccinated, leaving a troubling window for the B.1.1.7 variant, and others, to circulate widely.

“If these data are representative,” Davies told the Times, “there may be a limited time to act.”

Andres "Jay" Molina, Molly Schwartz, and Vincent Pierce talk during a Facebook Live event.Mother Jones Illustration

It’s impossible to consider the full impact of the pandemic without looking at nursing homes. According to data from the COVID tracking project, an astonishing 35 percent of all COVID deaths in the United States have been nursing home deaths. And that’s likely far from the real number. A recent report from the New York Attorney General’s office found that nursing home deaths in the state have been undercounted by up to 50 percent.

This week, I published a story about how the pandemic has prompted residents at Coler Rehabilitation and Nursing Care Center to speak out about what they’ve gone through during the various surges of the contagion. Many Coler residents have been infected by the coronavirus. Many have died. They’ve been on lockdown for months on end, sometimes unable to leave their rooms. They’ve had to fight for protective measures against the virus, like proper PPE, frequent testing, and isolation of COVID patients.

Last night, I got the chance to interview Vincent Pierce and Andrew “Jay” Molina—two residents whose voices have been the strongest in asserting the rights of Coler residents—for a Facebook Live event. Neither of them fit the image of what one would think of as a traditional, elderly, nursing home dweller. Pierce is 34-years-old and paralyzed from the neck down. Molina is 43 and restricted to a wheelchair because of a lung disease. But they share a commitment to spread awareness about disability rights, the impact of the pandemic on nursing home residents’ physical and mental health, and what nursing home administrators could do better. 

Over the summer, during the racial justice protests, Pierce founded the Nursing Home Lives Matter movement as a way to advocate for rights of nursing home residents he believed had been ignored during the spread of the coronavirus. He wanted them to play more of a role in the decision-making that affects their health and well-being. “I was hesitant at first, because I would be afraid of any type of retribution from the administrators,” said Pierce. “But then I realized somebody has to really speak up from inside, and who else but me? No one else is gonna do it, and I felt like it was time.”

Molina is the co-director of an upcoming documentary, Fire Through Dry Grass, about the spread of COVID inside Coler when the New York City was overwhelmed by the pandemic last March and April. He was prompted to start filming after an infected patient was moved into his room at Coler. Despite Molina’s rare lung condition, Coler administrators refused to move the patient out. A COVID patient was also moved into the room of Ray Watson, a fellow resident and Molina’s friend. Watson caught the virus and died.

“When that happened, I said enough is enough,” Molina told me during the event last night. “We have to say something. I am a filmmaker, so that is the way I know how to express myself.”

Pierce and Molina were broadcasting from inside the nursing home where they’ve been on lockdown for the past 10 months. In the background you’ll hear some bleeps from medical machinery and nursing staff talking in the background. (It was my first time doing one of these, so please excuse my inability to speak to the camera. Zoom can be tricky like that.) “I would hope everyone that’s watching that has anyone living inside a nursing home, join the movement and let this be heard across the country,” said Pierce at the end of our conversation. “Nursing home lives matter.”

A woman wearing a mask takes part in a vigil outside Queensboro Correctional Facility on April 23, 2020Johannes Eisele/Getty

A new poll indicates widespread public support for releasing some prisoners early to slow the spread of COVID-19, which has rapidly spread through prisons and jails, killing incarcerated people at twice the rate of people outside.  

The poll, conducted by Data For Progress, a progressive think tank, and The Appeal, a policy research outlet, and published today, was based on an online survey of more than 1,110 likely voters. Most said they supported releasing elderly people, people charged with low-level offenses or with less than six months remaining on their sentences, and people with medical conditions that put them at higher risk of complications from COVID. Nearly two-thirds of respondents, including more than half of Republicans, believe the police should be booking fewer people into jails.

The results line up with those of similar polls from last spring that found widespread support for early releases as a way of controlling the spread of the coronavirus and limiting its impact on people in federal and state custody.

Republicans were far more likely than Democrats to oppose early release for people in prisons and jails. Just 37 percent of Republicans supported releasing prisoners who do not pose a threat to public safety and have medical conditions like cancer or lung disease. 

The poll results point to strong public support for releasing elderly prisoners, who have extremely low recidivism rates. Sixty-three percent of respondents approved of releasing them if they did not pose a serious risk to public safety—including half of Republicans. Governors in several states, including Michigan and Maryland, have taken executive actions to prioritize older prisoners for release.

White people were significantly more likely to oppose releasing people from prison as a public health measure compared to Black and Latino respondents. Nearly 70 percent of Black and Latino voters supported releasing people with low-level offenses, versus 56 percent of white respondents. While 61 percent of Black and Latino voters said people within six months of completing their sentences should be released, 54 percent of white voters answered the same way.

The onset of the pandemic did more to quickly reduce the US prison and jail population than any other development in recent history. Nationally, the prison and jail population fell 14 percent between 2019 and mid-2020—from 2.1 million to 1.8 million incarcerated people, according to a recent report from the Vera Institute of Justice. The decline in prison population appears to be mainly the result of fewer people being sent to prison, rather than early releases, according to an analysis by the Prison Policy Initiative. The dramatic drop in jail populations in the first half of 2020 was the result of releasing pretrial detainees and booking far fewer people in the first place.

According to the poll, measures like issuing tickets and summons rather than arresting and booking people into jail are supported by nearly two-thirds of voters, including a majority of Republicans. 

Since the middle of 2020, jail populations have been rising again—the result of a complicated mix of factors including court delays, a pause on transfers of sentenced people from jails to prisons, and a backlog of people facing felony charges who were not deemed eligible for pretrial release. Some police departments have already abandoned the alternatives to jailing people that they adopted at the beginning of the pandemic. As early as last May, Philadelphia police resumed arresting people for nonviolent property crimes, rolling back a policy of briefly detaining and fingerprinting suspects before releasing them until charges could be filed later.

More than 1.8 million people remain locked up in the United States. More than 570,000 incarcerated people and prison and jail staff have tested positive for COVID-19, by the New York Times’ count. At least 2,500 have been killed by the virus.

Jesús Hellín/AP

Earlier this week, CNN’s Alisyn Camerota asked epidemiologist Dr. Salim Abdool Karim, the co-chair of the South African Ministerial Advisory Committee on COVID-19, about the “South African variant” of the coronavirus and whether it was any deadlier. He took a deep breath and explained that early evidence doesn’t suggest that the variant causes more serious instances of the disease, but only that this mutation spreads faster than others. He also pointed out that calling the strain the “South African variant” was not appropriate. Even though it was first identified in the country, it might not even have originated there. “It’s better just to call it by its name: 501Y.V2,” Karim said, adding that 501Y.V2 now is present in as many as 31 countries, including the United States. 

Camerota acknowledged that talking about the South African variant—or the Brazilian or the UK variant, for that matter—to refer to the still little-understood but worrying mutations of the virus may be more convenient for the media and the public. “I don’t mean to disparage South Africa, but it’s just a handy shorthand,” she said. But health experts and genetic sequencing researchers have a number of concerns about how geographical associations are not only inaccurate but can potentially stigmatize certain countries and populations. Donald Trump appeared to do so deliberately by constantly referring to the coronavirus as the “Chinese virus,” a description that incited some racist demonstrations.

One researcher recently described the current naming system as a “bloody mess.” 

“It’s too confusing with these variant names,” said Dr. Maria Van Kerkhove, the World Health Organization’s COVID-19 technical lead, according to Politico. “I am on record multiple times to say we need to fix this because it’s too hard to communicate all these numbers.” 

‼️ WHO's Maria Van Kerkhove and Mike Ryan are asking people to stop referring to the Covid variants by the country they were identified in.

It creates a negative stigma when these countries should be celebrated for identifying these concerning mutations.

— Noah Higgins-Dunn (@higginsdunn) February 3, 2021

The WHO’s official guidelines for naming new infectious diseases, which don’t cover variants, discourage the mentions of geographic locations, people’s names, and cultural references. 

Epidemiologists have started adopting unusual “nicknames” for certain mutations. The UK seems to be the place where the “Pooh” mutation was identified but it shares “Nelly” with Brazil and South Africa. 

Now the SARS-CoV-2 variants that were first identified in the UK (B.1.1.7), South Africa (B.1.351), and Brazil (P.1) have been found in the US, a couple of thoughts (i.e., speculation…) on what happens next, as I been getting many questions about transmission and immunity. 🧵👇 pic.twitter.com/2VZzGx19li

— Kristian G. Andersen (@K_G_Andersen) January 31, 2021

Critics of the location-informed nomenclature also argue it could potentially discourage countries conducting genetic sequencing from notifying the broader international public health community of the discovery of a new variant. “The last thing we want to do is dissuade any particular place from reporting they’ve got a new concerning variant—in fact, we want to do the opposite,” Oliver Pybus, an evolutionary biologist at the University of Oxford, told Nature. As a leader in viral sequencing, the UK is naturally more likely to find new variants than other countries, experts say. 

In recent weeks, the detection of variants in Brazil, South Africa, and the UK has led to the imposition of travel bans. Dr. Tulio de Oliveira, the bioinformatician who spearheaded the discovery of the variant in South Africa, said countries are “being sanctioned because they were transparent about the results of their genomic surveillance.” 

You don't find what you don't seek — that's the American situation with #COVID19 mutant viruses in a nutshell. The good folks @GISAID have a variants tracker, and as this table shows the UK mass genomic screening effort has found 36,658 VUIs (Variant Under Investigation)…
MORE pic.twitter.com/pnOBhQhGPg

— Laurie Garrett (@Laurie_Garrett) February 2, 2021

So what are the options to reverse this trend? The WHO is reportedly conferring with other agencies such as the Centers for Disease Control and Prevention and the National Institutes of Health on how to implement a common nomenclature for the variants. The goal is to avoid “geopolitical issues” while also finding a way to simplify the otherwise technical terminology based on genetic sequence.

As a Brazilian, I may be taking this a bit personally. I’m the first to admit that my country, which has struggled to contain soaring infection rates from the start, is in trouble. And there are plenty of candidates who can share the blame. But language matters. In looking at all the alarming headlines about a “Brazilian variant” arriving in Minnesota or the Bay Area, like some sort of terrifying alien invader, I can’t help but think that we Brazilians don’t pose a danger to others any more than we do to ourselves. And let’s face it, we didn’t ask for some new variant either.

Tribal members at the burial of a husband and wife on the Standing Rock Indian Reservation, December 2020. Richard Tsong-Taatarii/Getty

This story was originally published by The Guardian and is reproduced here as part of the Climate Desk collaboration.

Covid is killing Native Americans at a faster rate than any other community in the United States, shocking new figures reveal.

American Indians and Alaskan Natives are dying at almost twice the rate of white Americans, according to analysis by APM Research Lab shared exclusively with the Guardian.

Nationwide one in every 475 Native Americans has died from Covid since the start of the pandemic, compared with one in every 825 white Americans and one in every 645 Black Americans. Native Americans have suffered 211 deaths per 100,000 people, compared with 121 white Americans per 100,000.

The true death toll is undoubtedly significantly higher as multiple states and cities provide patchy or no data on Native Americans lost to Covid. Of those that do, communities in Mississippi, New Mexico, Arizona, Montana, Wyoming and the Dakotas have been the hardest hit.

The findings are part of the Lab’s Color of Coronavirus project, and provide the clearest evidence to date that Indian Country has suffered terribly and disproportionately during the first year of the deadly coronavirus pandemic.

The losses are mounting, and the grief is accumulating.

“Everyone has been impacted. Some families have been decimated. How can we go back to normal when we’ve lost so many after so many layers of trauma? It’s unbearable,” said Amber Kanazbah Crotty, a tribal council delegate in the Navajo Nation.

On Tuesday, the former Navajo president and Arizona state representative Albert Hale died from Covid, bringing the tribe’s death toll to 1,038, the equivalent of losing one in every 160 people on the reservation.

The figures show that even though multiple more infectious variants are yet to take hold in the United States, the situation has already wrought a devastating toll on Native communities and may get worse.

Last month was the deadliest so far in the US, with 958 recorded Native deaths – a 35% increase since December, a bigger rise than for any other group. For white Americans, deaths rose by 10% over the same period.

“Not only do Native people have the highest rate of Covid deaths, the rate is accelerating and the disparities with other groups are widening. This latest data is terrible in every way for indigenous Americans,” said Andi Egbert, senior analyst at APM Research Lab.

There are 574 federally recognized American Indian tribes and Alaska Native Villages in the United States. The Navajo Nation, the second largest by population, has suffered the greatest number of deaths, but smaller tribes are facing insurmountable losses.

In Montana, the Northern Cheyenne tribe has lost about 50 people to Covid so far – which is 1% of the reservation population of 5,000 people.

“Our collective grief is unimaginable. Losing 1% of our people is the equivalent of losing 3 million Americans. Native Americans are used to dying at disproportionate rates and we’re used to scarcity but Covid is different, there’s a growing sense of hopelessness,” said Desi Rodriguez-Lonebear, an assistant professor of sociology and American Indian studies at the University of California.

Rodriguez-Lonebear added: “I fear the long-term impacts on mental health, our children, community resilience and cohesiveness. We’re in the middle of a massive storm and we’re not prepared for the aftermath.”

About a quarter of those who have died were native Cheyenne speakers. The tribal clinic is currently receiving 100 vaccine doses a week, at which rate it will take almost a year to vaccinate everyone.

“Our language, culture and traditions is what makes us Cheyenne, but we’re losing our teachers. How am I going to teach my son when I still have so much to learn? Indigenous communities are facing a cultural crisis that other communities are not.”

n Oklahoma, the Cherokee Nation, the country’s biggest tribe, has suffered a relatively low death count thanks to a well-functioning tribe-led health service and a public health system that has pushed testing, contact tracing and consistent science-led messaging from day one, according to Chief Chuck Hoskin.

“We have one of the best public health systems in the country, which allowed us to be nimble when the worst crisis in modern memory struck … We’re a society, unlike the wider US, which believes in our citizens having access to healthcare at no costs,” said Hoskin.

Still, there have been significant losses. At least 35 of the remaining 2,000 fluent Cherokee speakers have died from Covid, undermining an ambitious program launched in 2019 to stop the language dying out.

As a result, tribal leaders decided to prioritize fluent speakers, alongside frontline workers and elders, and about half have now been vaccinated. Overall, almost one in 10 citizens on the reservation have been vaccinated.

“So far we’ve led this country in getting the vaccine out in an efficient and effective way. The only question now is whether the US can keep up with the Cherokee Nation,” Hoskin added.

Anecdotal evidence from across the country suggests that tribal vaccination programs, which can include mobile clinics, home visits and drive-throughs, appear to be running more efficiently and effectively than in many states, though shortages are widespread.

Amid growing debate and concern about vaccine hesitancy in communities of color, the Urban Indian Health Institute (UIHI) conducted the first ever national survey to better understand Native Americans’ knowledge, attitudes, and beliefs.

About 75% of participants said they would be willing to receive a Covid vaccine – compared with just 56% of the general US population according to one large survey in December 2020. The vast majority view getting the vaccine as a community responsibility, even though three-quarters have safety concerns. The survey included American Indians and Alaska Natives across 46 states – representing 318 different tribal affiliations.

“The results show the danger in grouping all people of color together when deciding on public health messaging to overcome Covid vaccine hesitancy,” said Abigail Echo-Hawk, director of the national tribal epidemiology centre based in Seattle.

The findings, published last week, have since been incorporated into a public health campaign called “Be a Good Ancestor”, focusing on community responsibility over individualism.

Joe Biden’s national Covid strategy lays out plans to bolster federal resources to speed up the vaccine rollout in Indian Country, as part of the administration’s efforts to improve equity.

Overall, there is no race data for about 42,000 of America’s Covid deaths, which means we do not know the ethnic background of one in 10 people killed by the virus so far, according to the researchers. Perhaps 700 or more Native Americans are likely to be missing from the data.

“The structural racism in the data collection systems makes us invisible by hiding deaths, which perpetuates inequalities and leads to further deaths in our communities, as this information is used to allocate resources,” said Echo-Hawk. “The maze of missing data is part of the genocide that continues to be perpetrated against our people. Their final stories are being lost.”

The data issues have not been fixed over the past year. Instead, the same gaps are now hampering our understanding about the vaccine rollout: almost half the race and ethnicity data is missing from the vaccine recipients, according to the CDC, thwarting efforts to ensure equitable access and accountability.

In states with patchy or no data, it is extremely hard to know whether states and counties allocated vaccine doses for indigenous residents are using them appropriately.

Tribal leaders and health experts agree that while the excessive death toll is shocking, it’s hardly surprising given the chronic structural, economic and health inequalities – such as overcrowded housing, understaffed hospitals, lack of running water and limited access to healthy affordable food – resulting from the US government’s failure to comply with treaty obligations promising adequate funding for basic services in exchange for vast amounts of tribal land.

After centuries of broken promises, expectations are high given that Native American voters helped Joe Biden win crucial swing states including Arizona, Wisconsin and Nevada to take the White House.

On Wednesday, Biden approved the Navajo Nation’s disaster declaration, which will result in additional federal resources for the tribe as Covid rates again climb.

But longstanding inequalities require transformational changes, and experts are calling on Biden to fully fund the Indian Health Service, for the first time in history, which would enable the yet-to-be-nominated new director to reduce chronic health disparities that have contributed to the high death toll.

“Native people showed up for Biden-Harris. Now it’s time to show up for them,” said Echo-Hawk.

Experts worry new strains could make vaccines less effective.Michael Ciaglo/Getty

The data on COVID-19 hospitalizations and new cases looks better, for a change. After hitting a peak on January 8, the 7-day average case count is down 40 percent, according to the New York Times. Hospitalizations are improving, too, down 24 percent. This isn’t just in a few highly populated states. We’re seeing steep cliffs in new case counts all across the country—half of states have experienced at least a 50 percent drop. 

Our daily update is published. States reported 2M tests, 147k cases, 97,561 people currently hospitalized with COVID-19, and 2,972 deaths. pic.twitter.com/O1eif97YOT

— The COVID Tracking Project (@COVID19Tracking) January 31, 2021

All of this is promising news. Vaccine distribution, bumbling as the rollout has been, seems to be finally doing some good.

But there are two big caveats.

Yes, for the first time since December 1 2020, hospitalizations are below the 100,000 mark, according to the COVID-19 Tracking Project. But that doesn’t mean ICU beds still aren’t nearly full (or, in the case of the hospital closest to me in the Bay Area, entirely full of 81 COVID-19 patients). There is still the possibility of a healthcare system remaining overly taxed. The peak was so high that any declines need to be taken into context of the horrific rise we saw during the first winter months.

And then there are these new strains. As COVID-19 mutates, scientists have scrambled to track new strains of the disease—potentially more infectious—that could harm the case decline researchers predicted following a projected peak in January. “We’re very worried,” Francis Collins, director of the National Institutes of Health, told the Washington Post. There are variants of the coronavirus from California, from England, and from South Africa (a strain just detected in Baltimore). Research suggests the various vaccines will work on the new strains, but the level of effectiveness for each strain, and for each vaccine, remains unclear.

For now, at least, we have some hope: The trend lines are headed in the right direction.

Health care workers operate in an ICU in the "COVID Area" of the Beverly Hospital in Montebello, California.Xinhua/Zeng Hui via Getty Images

Today marks the one-year anniversary of the World Health Organization declaring “a public health emergency of international concern over the outbreak of novel coronavirus.” Since then the virus has killed more than 2.2 million people worldwide. 

At the time WHO Director General Dr. Tedros Adhanom Ghebreyesus made the declaration, there were fewer than 100 cases in the world, and this week we passed 102 million reported cases. More positive cases have been reported in the past two weeks than during the first six months of the pandemic, Tedros said at a press conference Friday.

“A year ago, I said the world had a window of opportunity to prevent widespread transmission of this new virus,” Tedros said. “Some countries heeded that call; some did not.”

The United States is one of the countries that squandered that opportunity under the leadership of a president who denied the severity of the virus, refused to wear a masks or to advise the public to do so, put the economy ahead of public safety, and kept key information from the American public about how the disease spreads.

For much of the last year, the United States has had some of the worst rates of infection in the world. As of Saturday, there have been 25.9 million COVID-19 cases confirmed in the United States, and more than 436,000 people have died, according to data from John Hopkins University.  

President Joe Biden has made the pandemic a top priority for his administration since taking office Jan. 20, signing executive orders that mandate mask-wearing for travel, streamline vaccine distribution, and prioritize those hardest hit by the virus. These are all crucial mitigation measures, but for millions of families—Black and Brown people disproportionately among them—it’s already too late. 

“The pandemic has exposed and exploited the inequalities of our world,” Tedros said. “There is now the real danger that the very tools that could help to end the pandemic—vaccines—may exacerbate those same inequalities.”

Vaccines are giving us another window of opportunity to bring the pandemic under control, so “we must not squander it,” he said. “The world has come to a critical turning point in the pandemic and also a critical turning point in history.” 

Mother Jones illustration; Courtesy of Ashley Bartholomew

A parent without child care, Ashley Bartholomew was preparing to resign from her role in El-Paso as a nurse when cases of COVID-19 spiked. Seeing the influx of patients—in 2020, the urban counties west of the Mississippi River with the highest per-capita COVID-19 death rate were the Texas border counties of Hidalgo and El Paso—she delayed. In the final moments, she met a patient who believed COVID-19 is no worse than the flu.

I didn’t know that the thread would go as viral as it was going to. I had been planning to resign—we’re a military family and with child care and stuff, it wasn’t going to be sustainable for me to continue to work with three little kids we’re moving soon too. So, I needed to resign.

I’m an RN in El Paso and was recently transferred from the OR to COVID ICU.

I resigned from my job last week and I’ve been asked several times, “What was the breaking point?” I don’t know a specific one, but I’ll share this: a thread 🧵1/

— Ashley B., BSN, RN (@TheBlondeRN) November 16, 2020

The day prior, I went into work and the administration came to us at the front desk and said, “We’re closing down the OR. We’re only going to run two rooms for emergencies and everyone else needs to be redeployed to the COVID-19 units.” That’s the day that I went to COVID-19 ICU. And I saw first-hand just how busy and how crazy it was over there. They had a huge influx of patients with a lag of waiting for the travel FEMA nurses to get on board and get running. I was like “Wow, they need all the help they can get.” I actually told my boss and was like, “Hey, I can take three more weeks…just put me in the main COVID-19 ICU for my shifts and I’ll pick up some extra shifts and I’ll stay until November 13.”

It was my last shift, and I went into this patient’s room to check his glucose. He was awake and alert. He was being transferred to a lower level of care; he was doing well enough to where he didn’t need to be in ICU anymore. He was definitely—definitely—the exception to all the other patients I had seen that day. It was lunchtime and the news was on. And he kind of referenced towards the TV like, “Oh, fake news.” I was shocked. I thought to myself wow, we’ve really dropped the ball, or we’ve missed something—a key ingredient here—if this patient is thinking this isn’t any more than a flu and he should’ve just taken his vitamins.

I started to wonder…is this person thinking clearly? Just the power of denial, even as a coping mechanism, was surprising to me. He was thinking clearly, I realized, after a little bit more conversation. That’s when I was just kind of honest with him and said, “This is my last shift and I’ve never seen so much death and so much sickness my entire 10 years of being in healthcare combined.” He was just like “Woah, really?” And I’m like “Yeah, this has been unlike anything I’ve ever seen.”

That’s when he asked how other people were doing and if a lot of people had died, and I said “yeah.” And he said, “Well, that must be really hard.”

When he changed from the pure denial to validating “wow, that must be hard” it made me cry. I think that was kind of the only response that I could have because it was so overwhelming to me in the moment. And then I apologized, I said, “sorry I don’t mean to tear up in front of you.”