Frequently Asked Questions about Covid-19 — January 19, 2022

  “Shared expectations lead to predictability.”

451. The US Supreme Court has blocked the employer mandate for vaccinations.

         QWill the Supreme Court allow the OSHA workplace mandate to take place??

         A:  No.  Last Thurday the U.S. Supreme court ruled against the Biden administration’s authorizing OSHA to mandate routine Covid testing of unvaccinated workers in companies with over 100 workers.  In a 6-3 vote, the court blocked the enforcement of the rules.

The reason for this was that “Permitting OSHA to regulate the hazards of daily life — simply because most Americans have jobs and face those same risks while on the clock — would significantly expand OSHA’s regulatory authority without clear congressional authorization,” the majority opinion said.

The three dissenting justices asked who decides how much protection American workers need from Covid-19?  “An agency with expertise in workplace health and safety, acting as Congress authorized?  Or a court, lacking any knowledge of how to safeguard workplaces, and insulated from responsibility for any damage it causes?”

This decision clearly focused on the need to satisfy the political needs of big business and the demands of many people who see that mandates for vaccinations violate a person’s “freedom” to choose for themselves what is acceptable.  Following the judicial precedent of this case, one can anticipate future state and federal challenges to eliminate mandatory vaccinations of children entering school.  Ending vaccinations given for such diseases as polio and measles could lead to future widespread outbreaks.

In this ruling, the court allowed a more modest mandate to go forward that requires vaccinations for health care workers at facilities receiving federal money.  This, even though the disease wasn’t created in healthcare facilities and would recognize that CMS (Medicare and Medicaid) has the authority “to regulate the hazards of daily life” for all, not just those protected by Medicare and Medicaid. The vote in the health care case was 5 to 4, with Chief Justice John G. Roberts Jr. and Justice Brett M. Kavanaugh joining the liberal justices to form a majority.

452. Infected, unvaccinated pregnant women are 4 times more likely to lose their child.

         Q: What new has been learned about the effects of Covid-19 during pregnancy?

         A:  Researchers in Scotland report that pregnant women with Covid were more likely to lose their fetuses and babies compared with uninfected women who gave birth during the pandemic.  The risk of losing a baby through stillbirth or during the first month of life was highest among women who delivered their babies within four weeks of the onset of a Covid infection: 22.6 deaths for every 1,000 births. That’s four times the overall rate in Scotland. All the deaths occurred in pregnancies among unvaccinated women, the researchers found.

453. Up to 8 free at-home rapid tests per month available – if they can be found.

         Q:  How do I get the free at-home Covid-19 tests that have been promised?

         AAs of January 15 – last Saturday – new federal rules require private insurers to cover the costs of the rapid at-home Covid antigen tests.  Up to 8 tests per person per month are allowed.  The goal is for insured people to pick up their tests at “preferred” pharmacies and pay no money.  Insurers have complained that they have not had time to establish their systems to do this.  So in the interim, anyone picking up test kits will have to pay for them and get a receipt.  When submitting the receipt to their insurance company a refund will be issued.  Only purchases made on or after January 15, 2022, will be covered.  No more than 8 such purchases per month are eligible for each person covered by the insured person’s plan, and the limit of $12.00 per kit will be allowed regardless of the price paid.

The new process will be hard, the insurers say, because over-the-counter coronavirus tests are different from the doctor’s visits and hospital stays they typically cover.  The tests do not currently have the type of billing codes that insurers use to process claims. Health plans do not process retail receipts.  Instead, they’ve built systems for digital claims with preset formats and long-established billing codes.

Another problem is that more than 30% of the population isn’t covered by health insurance.  The major problem in the short term is the lack of availability of tests.  Both these problems will ultimately be solved by plans to distribute free kits directly to everyone who signs up.  But this will take time, and frustration is expected as the near future is unpredictable and shared expectations will not be met.

454. Calling Omicron “mild” is wishful thinking.

         Q: If the Omicron variant is mild, why not just catch it and get it over with?

         A:  Katherine J. Wu reported electronically last week in the Atlantic that recent characterizations of the Omicron variant have allowed a deceptively reassuring narrative to take root and grow: Omicron is mild.   The word mild itself is ambiguous.  Much of our Omicron problem can be traced back to a false binary – That the variant is less of a danger too often gets misconstrued as the variant is not a danger at all. Severity works in degrees, which is indeed what we’re seeing.  Disease always manifests as an interaction between pathogen and host, which means there are two main reasons that Omicron cases can present with softer symptoms: a more resilient human, or a more docile microbe. In this current surge, we’re likely seeing both effects collide.  The second part of the equation—the inherent potency of the virus itself—unfortunately, gets harder to understand when the world is more immune.  So to simply call the virus “mild” massively undersells the danger it still poses, especially when it finds its way into unvaccinated or vaccinated-but-still-vulnerable hosts.   That’s the trap of mildness: the underlying sense of fatalism it engenders. “People say, it’s inevitable.  it’s mild.  I hope I can catch it and move on,”

455. WHO: half the population of Europe soon to be infected with Omicron Covid-19. 

       Q:  How many people have Covid?

       A:  0:07


The World Health Organization warns that more than half of people in Europe could be infected with the Omicron coronavirus variant in the next six to eight weeks.  “The region saw over seven million cases of Covid-19 in the first week of 2022, more than doubling over a two-week period,” Dr. Hans Kluge, the agency’s regional director for Europe, said at a news conference.  While coronavirus vaccines remain remarkably effective at preventing severe illness and death, the agency cautioned against treating the virus like the seasonal flu, since much remains unknown — particularly regarding the severity of the disease in areas with lower vaccinates rates such as Eastern Europe.

Since Omicron was first detected in late November, it has torn across the planet at a pace unseen during two years of the pandemic. As friends, co-workers, and family members test positive, the reality that the virus is moving quickly and widely has been a defining feature of this wave of infection.

But the steep rise that Dr. Kluge cited, based on forecasts by the Institute for Health Metrics and Evaluation, is a stark paradigm shift. Although the institute’s models have frequently been criticized by experts, it is clear that the virus is spreading quickly. Even if many people avoid severe illness, the virus promises to cause societal disruption across the continent.  While much of the public discussion has revolved around whether this was the moment when governments should shift policies and restrictions to treat the coronavirus as an endemic disease — removing most restrictions and allowing people to manage risk in a way similar to the way they do with influenza — the WHO said it was too early to call this virus endemic.

Catherine Smallwood, a WHO senior emergencies officer, said that one of the key factors in declaring the virus to be endemic was some sense of predictability.  “We are still ways off,” she said. “We still have a huge amount of uncertainty.”  “I am also deeply concerned that as the variant moves east, we have yet to see its full impact in countries where levels of vaccination uptake are lower, and where we will see more severe disease in the unvaccinated,” she said.

“Allow me to reiterate that the currently approved vaccines do continue to provide good protection against severe disease and death, including for Omicron,” Dr Kluge said. “But because of the unprecedented scale of transmission, we are now seeing rising Covid-19 hospitalizations.  It is challenging health systems and service delivery in many countries where Omicron has spread at speed and threatens to overwhelm in many more.”  This is completely unlike the seasonal flu.