The Health Divide: Doctors Without Borders Comes to the U.S.

The international aid organization Doctors Without Borders, is best known for its work surrounding natural disasters and violent conflict in poor regions of the world. Now the group has dispatched a team to the Navajo Nation in the U.S., where residents say they’re not getting enough help from the federal government. The government has sent some financial assistance to the Navajo Nation and other reservations around the country. But with one of the highest coronavirus counts per capita, the Navajo Nation is struggling to handle the outbreak with health care and social services systems weakened from years of funding and resource shortages. Limited internet means updating residents on safe practices is a challenge, and the reservation, which relies on the Indian Health Service for health care, has only 12 IHS facilities for an area larger than West Virginia, writes Clarissa-Jan Lim for BuzzFeed.

As part of their COVID-19 pandemic response, Doctors Without Borders has also sent help to Native American communities in New Mexico, and homeless and migrant communities elsewhere. They’re targeting those who “are normally excluded from health care” and “likely to be left behind during a health emergency,” according to an FAQ on the organization’s website.

“In the U.S., there are significant health inequities and a high number of people who suffer from co-morbidities that put them at higher risk of death from COVID-19,” the FAQ explains. “There is a clear need for additional support for the COVID-19 response, especially among vulnerable communities with limited access to health care, shelter, or basic sanitation.”

Cleared Countries See Virus Bounce Back

South Korea, once a “beacon of hope for the world” due to its early success in beating back the spread of coronavirus, has been forced back into battle as new, large outbreaks crop up in Seoul, according to NPR’s Morning Edition. In China, Wuhan, too, has been hit with a new cluster after 35 days free from lockdown, prompting China’s announcement it would test all 11 million residents of the city. The new outbreaks suggest how easily the virus can return when social distancing measures are relaxed. Even so, many parts of the U.S. continue to advance plans to abandon or lessen such restrictions, and smartphone data suggests many Americans are on the move again.

Herd Immunity Won't Save Us

The questions pop up on social media frequently: If we protect people from exposure to the virus, how will we ever build up immunity? Isn’t it possible that we’re making the situation worse down the line by not going out? It’s true that a collective “herd immunity” can stop a virus from spreading further through a population. But experts think that, in the case of this coronavirus, trying to reach herd immunity without a vaccine will be disastrous, possibly leaving more than a million Americans dead.

FiveThirtyEight has built a simple simulator to help us understand why that’s the case. The simulator lets you manipulate the characteristics of a fictional virus — characteristics we haven’t fully pinned down yet for SARS-CoV-2 — to see how many people would die in the course of achieving herd immunity.

Playing around with the simulator, you’ll see that, for a virus that isn’t very contagious and not particularly deadly, hoping for herd immunity might not be a bad idea. But because the coronavirus is so contagious, a very high percentage of the population would have to get it in order to reach herd immunity. And because the virus is so deadly, a lot of people would die as a result.

All that’s assuming getting infected by the coronavirus gives you immunity, which we really, really hope is the case. But we just don’t know for sure yet, which makes this already perilous idea even more dangerous. (Set the “immunity duration” in FiveThirtyEight’s simulator to less than 100 days and things really start to get scary.)

“This disease is too deadly, too contagious and too new to depend on post-infection immunity (as opposed to immunity via vaccination) as a solution,” the FiveThirtyEight team writes. “Naturally acquired herd immunity is not the answer.”

We Don't Have a COVID-19 Vaccine Yet, But Campaigns Against it Have Already Begun

Many of us hope every day for news of a coronavirus vaccine on the horizon. Others, not so much. Members of a powerful vocal minority, who (despite overwhelming evidence to the contrary) consider vaccines unnecessary and dangerous, are already gearing up to fight COVID vaccination, writes Kevin Roose of The New York Times. And they have a good shot at doing some real damage, according to a new paper about how vaccine misinformation has spread via Facebook pages. The paper, which suggests “anti-vaccine pages treated vaccine resistance as a kind of political campaign, and used different messages to reach different types of undecided ‘voters’” ”was widely covered. But Roose went a bit farther than most, arguing that in order to have a chance to stop the pandemic through vaccination (once that option exists), “we need to mobilize a pro-vaccine movement that is as devoted, as internet-savvy and as compelling as the anti-vaccine movement is for its adherents. We need to do it quickly, with all the creativity and urgency of the scientists who are developing the vaccine itself.”

Passing the Test

Testing for COVID-19 has been described as essential for easing restrictions and reopening the country, but the testing effort has been shrouded in confusion since the start. How many people should be tested? How often? And are the tests accurate enough to give us the kind of information we need?

This week we discussed all that and more during the Center for Health Journalism’s “Covering Coronavirus” webinar series with infectious disease epidemiologist Michael Osterholm and New York Times health and science writer Apoorva Mandavilli. They discussed the current state of coronavirus testing in the U.S. and what that means for our public health response. One important point they made is that tests alone are not enough to get us out of this mess. Both Osterholm and Mandavilli agreed that testing in the absence of other steps is not particularly helpful. What happens, for example, if someone tests positive, but they don’t get their results quickly or there’s no system in place to make sure that person can stay away from others? And in crowded quarters like a nursing home, where one case can be a “match in a gas can,” tests can’t protect workers and other residents if that home is not equipped with the appropriate personal protective equipment and protocols, says Osterholm.

It’s not that testing isn’t critical, he says. “But if you can't tie it to all these other actions, I don't know why you're doing it, because you're just documenting the train wreck — you're not preventing one.”

When Coronavirus Hits Children

As it first started to become apparent how serious the COVID-19 outbreak would be in the U.S., one often-cited saving grace was its seemingly minor impact on children. But now health care professionals are raising the alarm about a spate of unusual symptoms in kids and cautioning that we’re far from having the full picture. “New research continues to be published describing the ways that the virus can behave in children, which is not always how it behaves in adults,” writes pediatrician Perri Klass for The New York Times.

The good news is that most children are still far less affected than adults. There have been fewer cases detected in kids and the fatality rate is much lower than in adults. But a small number of children have still turned up pretty sick. Often these cases are kids who already have some sort of underlying medical condition, but that’s not always the case. And doctors have been perplexed by what seems to be a COVID-linked spike in cases of a rare childhood ailment called Kawasaki disease, which leads to high fever, red eyes, swollen hands and feet and rashes, among other symptoms. Researchers are still confirming that the coronavirus is causing this spike in cases — just one of many questions remaining about how the virus affects kids.

Courtesy: The Center for Health Journalism    editor@centerforhealthjournalism.org

The Center for Health Journalism has begun offering a special newsletter geared to journalists as they report on one of the biggest and most complex stories of our times. Each Monday, while the pandemic runs its course, The Coronavirus Files will provide tips and resources and highlight exemplary work to help you with your work. The Center for Health Journalism’s Coronavirus Files Monday newsletter is curated and reported by science writer Lindzi Wessel.