Consider This from NPR - COVID Risk May Be Falling, But It's Still Claiming Hundreds Of Lives A Day

Episode Date: September 15, 2022

It's a strange moment in the pandemic. Mask mandates and other restrictions have all but disappeared. For most vaccinated people, the risk of severe illness has gone way down.But hundreds of people are dying of COVID-19 every day. For their loved ones, grieving a terrible loss as the country is moving back to normal can be jarring.Everyday Americans are weighing the threat the coronavirus poses to them. Scientists, too, are debating how dangerous the virus is right now.NPR's Rob Stein reports on the debate about whether COVID is more or less dangerous than the seasonal flu.And Susan Reinhard with the AARP's Public Policy Institute argues that more still needs to be done to protect nursing home residents.In participating regions, you'll also hear a local news segment to help you make sense of what's going on in your community. Email us at [e-mail] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Support for NPR and the following message come from the Kauffman Foundation, providing access to opportunities that help people achieve financial stability, upward mobility, and economic prosperity, regardless of race, gender, or geography. Kauffman.org Carolyn and Bill Robinson had a daily ritual in their later years. After my dad retired, they loved their morning biscuit, and that was something they both looked forward to. Their daughter, Sondra Robinson, says most mornings you could find them at a Hardee's near their North Carolina home before they headed out to look for antiques

or bluegrass music. Neither of those things are very hard to find in Haywood County. Bill died in 2015, and Carolyn lived on her own in an independent living facility. She had her own apartment and was quite active there. They had a wonderful activities director, and she was always playing bingo, going out to eat, making crafts, because she had always loved to work with her hands. Sandra said the facility did a great job keeping her mother safe when the pandemic hit, and Carolyn got her vaccine and both booster doses when she was eligible. Then, this June, she got sick. She went to the ER where she tested positive for COVID.

She went into the hospital and received remdesivir and oxygen. Carolyn spent eight days in the hospital. Her condition improved, and she was discharged to a skilled nursing facility for physical, occupational, and speech therapy. But she started losing weight, refused food, and her health declined. And on August 27th, she died at 89 years old.

If you had asked me in, like, March or April, do you think your mom will make it to 90? I would have said, yeah. Sandra said the doctor told her COVID wouldn't be listed as the primary cause of death. But she feels her mother would still be alive if she'd never had it. You can hear her frustration in the obituary she wrote. Ultimately, Carolyn died of ignorance, not her own, but that of the millions of U.S. citizens who refuse to take the virus seriously, refuse to get vaccinated. It's a strange moment in the pandemic. Mask mandates and other restrictions have all but disappeared.

For most vaccinated people, the risk of severe illness has gone way down, but hundreds of people are dying of the disease every day. And for people like Sandra Robinson, dealing with a terrible loss as the country is moving back to normal, it can be jarring. Dr. Daniel Griffin, an infectious disease specialist at Columbia University, sees it in some of the patients he treats. There really is this disconnect, this idea that Omicron is mild, that it's just an upper respiratory infection. The people that are dying of COVID, this is in their lungs. They're suffocating. And he's worried about the fall.

It's just too much to believe that we've now gotten comfortable with 400 to 500 people dying a day. And every opportunity where the numbers start to go down, we remove some mitigation strategy and we keep it at this horrible plateau. Consider this. COVID deaths have gone from surges to a high plateau. Infectious disease experts are divided on what sorts of precautions make sense to prevent those deaths.

From NPR, I'm Juana Summers. It's Thursday, September 15th. This message comes from WISE, the app for doing things in other currencies. Send, spend, or receive money internationally, and always get the real-time mid-market exchange rate with no hidden fees. Download the WISE app today or visit WISE.com. T's and C's apply. It's Consider This from NPR. It can be tricky to figure out what's safe in this in-between stage of the pandemic, thinking about your health risks and deciding whether it's okay to go back to a movie theater or to take a long-planned vacation. Carla and Frank Scazzarella of Saugus, Massachusetts, had put off their European vacation since 2020. But the summer, they were both double boosted. It felt safe, so they went. Spain, Portugal, Morocco, London. And we had a wonderful,

wonderful three weeks. I'm grateful for that time and that my husband enjoyed everything we did. And I have lots of great memories and good pictures from that. But, you know, we're home for four days and he's in the emergency room. Frank went to the hospital on August 6th, and he quickly got worse. Kind of unbelievable how quickly it established itself in him. And, you know, within a week he had small blood clots in both lungs from the COVID. You know, it was terrible. Frank was on a daily steroid to manage his rheumatoid arthritis,

and that put him at higher risk for a severe case. And he died just last week on Labor Day. He was 64 years old. Now, Carla is adjusting to life without the man who coached their son's hockey and Little League teams, who was getting ready to welcome their second grandchild, the man who she'd been with since they were 17 years old. I've been thinking a lot about what we still wanted to do. And now I got to figure out, you know, how to be by myself without him.

It's been a long time. Carla says she wants people to know that COVID is not a joke. For the people who can't fight it off, it's not just a cold. But she also understands that people want to live their lives. You can't say it's gone. And I know everybody, you know, we don't have to necessarily wear masks. We don't have to stay six feet apart. You have to live your life. And that's the way we looked at it when we planned to go on our trip this summer, that we felt safe and we have to live our lives still. But you just you can't totally let your guard down yet.

Even among scientists, there is debate about how risky COVID is right now and what precautions most people should be taking. And the way this question is often framed is as a comparison. At this point, is COVID more or less dangerous than the seasonal flu? The flu, after all, is a disease we're familiar with and a risk that most of us are comfortable dealing with each fall and winter. NPR Health correspondent Rob Stein has been digging into this debate. Hey, Rob. Hi, Juana. All right. So we have spent years now living in fear of COVID because it was seen as so much more dangerous than the flu.

So how could COVID have become no more menacing than the flu? That's the big debate right now. Many experts say it's way too soon to declare COVID a threat on par with the flu, but some infectious disease experts are ready to go that far, like Dr. Monica Gandhi at the University of California, San Francisco. We have all been questioning, when does COVID look like influenza in terms of deaths? And yes, we are there. We are essentially at a low case fatality rate where COVID has reached influenza. So live your life

in a way that you used to live with endemic seasonal flu. Gandhi says that's because people have built up strong immunity from getting vaccinated or infected or both. And because Omicron doesn't appear to have made people as sick as earlier versions of the virus. So she says, unless some nastier variant suddenly emerges, COVID's menace has diminished considerably. Okay, but that is a controversial perspective, right? Yeah, absolutely. Absolutely. Others argue that we may hopefully be heading in that direction, but we're not there yet. Not even close. I talked about this with White House advisor, Dr. Anthony Fauci. I'm sorry, I just disagree.

COVID is a much more serious public health issue than is influenza. The severity of one compared to the other is really quite stark. And the potential to kill of one versus the other is really quite stark. Never, ever, ever would flu kill 1,031,000 people in two and a half years. Making COVID the third leading cause of death in the U.S. And Dr. Fauci points out that COVID is still killing hundreds of people every day, which would translate into more than 125,000 deaths a year. A very bad flu season kills, you know, maybe 50,000 people. Okay, that is a pretty large difference, Rob. So what do people who say that the COVID risk has waned say about that?

You know, they agree that Omicron is so contagious that it's still making lots of people sick, some really sick. So, you know, lots of people are still getting seriously ill and even dying. But it's become rare for most young, otherwise healthy people to get so sick they end up in a hospital or die, especially if they're vaccinated and boosted. And Dr. Shira Duran at Tufts University argues that many hospitalizations being blamed on COVID are really people hospitalized with COVID, not because of COVID. We are now seeing consistently more than 70% of our COVID hospitalizations are in that category. If you're counting them all as hospitalizations, and then those people die, and you count them all as COVID deaths, you are pretty dramatically overcounting. Which she says means the daily death count is probably really much closer to what happens during a typical flu season.

And many experts say so many non-fatal infections aren't being reported because of home testing. It's masking that the risk of dying from COVID has probably dropped to about the same as the flu. And Rob, what do we know about who is still dying from COVID? Yeah, most of those ending up in a hospital or dying are those who are older, especially the age 75 and older, who have other health problems, especially those who aren't vaccinated or boosted. I talked about this with Heather Scobie at the Centers for Disease Control and Prevention. People that are 65 to 74 years have 60 times the risk of dying than people that are 18 to 29. And people that are 85 years and older have 330 times the risk compared to people that are 18 to 29. So it's super important

that they get vaccinated and boosted and get treated quickly if they do get sick. And Rob, we've been talking a lot about deaths from COVID, but something that I know a lot of people are concerned about is long COVID. Right, absolutely. You know, Dr. Fauci and others say that's another way COVID remains a far greater risk than the flu. While people can end up with lingering health problems from the flu and other viral infections, the risk from COVID is estimated to be much greater. But you know, some doctors say the estimated risk for long COVID comes from people who got seriously ill early on in the pandemic. And if you account for that, the risk of long-term health problems may not be much greater from COVID than from other viral infections. But, you know, that too remains a subject of great debate.

NPR's Rob Stein. From the very earliest days of the pandemic, one of the most vulnerable groups has been nursing home residents. That's still true today. We're really not in a good place. Susan Reinhardt leads the AARP's Public Policy Institute and has been tracking COVID in nursing homes throughout the pandemic. They just put out their analysis for the four weeks ending August 21st. Since April, resident deaths have quadrupled. She told me that even as the general public seems to have mentally moved on from COVID, the numbers in nursing homes don't bear out that reality.

As we're heading into the fall and winter, that's when we've seen last year and the year before that cases go up in the population, never mind in nursing homes. So we can't think that this is over, particularly for the most vulnerable. As I understand it, you also track vaccination rates. What did those look like? Well, you know, we did a good job initially with vaccinations. You know, we had a big press on this. Federal assistance, the states all got into it.

And so in terms of the primary vaccination, we did pretty well. About 87% of residents and 89% of staff were fully vaccinated, but we haven't continued with the boosters. So right now, 44% of residents are either not vaccinated or are not up to date on their boosters. That's like half a million people. What strategies are you seeing in place to bring the number of nursing home COVID deaths down? I know that there is evidence that the lockdown policies or the restrictions on visitors in early phases of the pandemic, they took a toll on residents. And a lot of people don't want to see a return to those sorts of measures. Right. We definitely don't want to see a return to those sorts of measures. Right. We definitely don't want to see a return to no visitors. That was so hard. The social isolation was almost as deadly as the

actual disease. So we don't want to see that. We need hand washing. We need masks where appropriate. We need infection control is really what we need. Can you talk more specifically about things you might like to see the federal government or even state governments do as you continue to track cases among this very vulnerable population rising month after month? Well, first of all, I'd like both the federal and state governments to do what they did initially regarding vaccines. There was such a strong push. They've had pharmacists, nurses going into nursing homes.

That isn't happening right now. And I'm not sure that we have to have armies of people going into nursing homes to have these vaccinations occurring, but there should be more help. Do you have personal experience with dealing with nursing homes like the ones that you're talking about

in your research and this reporting? My personal experience with dealing with nursing homes like the ones that you're talking about in your research and this reporting? My personal experience, I used to be Deputy Commissioner of Health in New Jersey. And so I was responsible for oversight of nursing homes. And I am a nurse. So I've also worked in nursing homes with students. I've also had a father that was in nursing homes. So I've been a caregiver, a family caregiver, visiting in nursing homes. He had excellent care, but that's not always the case. So we really do have to work harder to make sure that the attention is given to this. It seems to have faded from the consciousness,

but that's why we keep trying to get the word out, like, don't give up the attention. Please keep the pressure on to take care of these very vulnerable people in nursing homes. Susan Reinhardt, Senior Vice President at AARP. It's Consider This from NPR. I'm Juana Summers.