Frequently Asked Questions about COVID-19 — March 23, 2022

“Shared expectations lead to predictability.”

501.  Accepting the new CDC guidelines differs if people are liberal or conservative.

         QWhy is acceptance of the new CDC guidelines supported by so many?

         A:  David Leonhardt, a reporter for the New York Times, published an article last week that identified the attitude toward returning to normal more rapidly was influenced by their ideology of liberalism vs. conservativism.  It had been previously thought that Republicans were more apt to fight vaccinations and masks while Democrats were more likely to want them continued.  But each party has been showing a division within its ranks, and a recent poll reinforces that the liberal to conservative views of people is a stronger indicator of seeing the threat of Covid now as being at different levels of risk.  Views that spread from eagerly getting shots while others delay and refuse; between those who believe Covid precautions should continue and those who favor rapid moves to normalcy.

In this poll of 2,200 adults conducted earlier in March 2022, each person self-identified their views as being one of seven categories: Very liberal, Liberal, Slightly liberal, Moderate, Slightly conservative, Conservative or Very conservative.   The responses to several questions were then recorded.  The results show that 45% of those who were “very liberal” felt that “Covid poses a great risk to their health and well-being,” while 21% of those identified as “very conservative” felt this way.  More than 60 percent of very liberal Americans believe that mask mandates “should continue for the foreseeable future.” Most moderates and conservatives see mandates as a “temporary strategy that should end this year.”

502.  Public health for Covid-19 is moving from protection to personal preference.

         Q:  Why does political ideology so strongly shape Covid beliefs?

         ADonald Trump certainly plays a role. As president, he repeatedly made false statements downplaying Covid. Many Republican voters adopted his view, while many liberal Democrats went in the other direction. But Trump isn’t the only explanation. Every group of Democrats disdains him, yet some Democrats disagree about Covid. Apart from Trump, the pandemic seems to be tapping into different views of risk perception.  In recent years, these progressives have tended to adopt a cautious approach to personal safety.  It is especially notable in child-rearing. Parents seek out the healthiest food, sturdiest car seats and safest playgrounds. They do not let their children play tackle football, and they worry about soccer concussions. A cautious approach to personal safety has big benefits. It has helped popularize bicycle helmets, for example. In the case of Covid, very liberal Americans have been eloquent advocates for protecting the elderly and immunocompromised and for showing empathy toward the unvaccinated.  Yet the approach also has downsides. David Leonhardt states in his recent New York Times article, “It can lead people to obsess over small, salient risks while ignoring bigger ones. A regimented childhood, with scheduled lessons replacing unstructured neighborhood playtime, may lead to fewer broken bones, but it does not necessarily maximize creativity, independence or happiness.  When it comes to Covid, there is abundant evidence that the most liberal Americans are exaggerating the risks to the vaccinated and to children.  Consider that many liberals (including Sonia Sotomayor) feel deep anxiety about Covid’s effects on children — even though the flu kills more children in a typical year and car crashes kill about five times as many.  Long Covid, similarly, appears to be rare in both children and vaccinated people.”

This, of course, doesn’t address the science that indicates immunity from vaccinations and boosters wane over time, and this has been identified as an actual increasing risk.

503.  A variant already here may cause a new surge – but nobody can be sure of it.

         Q: When could we find a new variant that could make us go back to lockdowns?

         A:  There are an increasing number of articles appearing lately about several countries that are now experiencing surges of Covid-19 cases caused by a subvariant referred to as BA.2.  For example, it was recently reported that New York City has found that 30% of its reported cases were caused by the BA,2 subvariant that is more infectious than the original Omicrom variant.  On March 17, Rachel Gutman published an article in The Atlantic that attempted to present a balanced view.  But the title of the article, “Another COVID Wave Is Looming – How Bad Will It Be?” reveals the concern that is rising.  She writes, “About three weeks ago, COVID case rates in the United Kingdom made an abrupt about-face, spurred on by a more transmissible Omicron subvariant called BA.2.  Case rates are rising, too in Switzerland and Greece and Monaco and Italy and France. Given that BA.2 is already present in the United States, The Washington Post reports that epidemiologists and public-health leaders suspect that North America will be next. After all, the paper said, “in the past two years, a widespread outbreak like the one in Europe has been followed by a similar surge in the United States some weeks later.”

Rachel goes on to say that not all surges in Europe have been followed by rising cases in the U.S.  She cites that different vaccines used here, but not in Europe, may have different effects.  Also different have been the earlier more strict steps taken in this country than many European countries have imposed.  “There are a number of things which tug the U.S. experience away from the European one,” Bill Hanage, an epidemiologist at Harvard, said in a recent press call.  Rachel concludes. “The fact that Europe has, at times, been two steps ahead of us might come down to chance.”

Predicting the future of disease behavior faces difficulty in accounting for how policy and Americans’ behavior would change, says Lauren Ancel Meyers, who directs the COVID-19 Modeling Consortium at the University of Texas at Austin. He stated he is not yet sure about the BA.2 variant,  “We’ll know… only after it’s over and case rates climb up again.” Meyers said he expects to have better predictions in a week or so.  In other words, no one can predict now if we are about to see another surge in cases.

504. 35 companies sign on to produce generic versions of Pfizer’s Covid pill.

         Q:  Have any COVID therapeutics been authorized to be made generically?

         A:  Thirty-five manufacturers around the world have signed agreements to produce generic versions of Pfizer’s Paxlovid Covid pills and sell them inexpensively in 95 lower-income countries that together are home to more than half the world’s people.  The United Nations-backed organization responsible for encouraging pharmaceutical companies to release their patent rights and allow generic copies to be produced made the announcement last week.  Paxlovid is for treating Covid, not preventing it.  Because it is made in pill form and can be taken at home, Paxlovid is much easier to distribute than treatments like monoclonal antibodies that are typically given intravenously.

A course of Paxlovid involves taking two drugs in concert, in a total of 30 pills over five days. Twenty of the pills contain the principal drug, nirmatrelvir, which was developed by Pfizer.  The other 10 pills in the treatment contain a low dose of ritonavir, a generic H.I.V. drug that slows the breakdown of nirmatrelvir so that it remains active in the body longer.

The UN organization reached a similar deal with Merck for its Covid pill, molnupiravir, to be made by other manufacturers and sold inexpensively in 105 lower-income countries. Twenty-seven generic drug makers in 11 countries have signed on to produce molnupiravir for that effort.

505. Moderna and Pfizer ask FDA for authorization for a second booster for adults.

         Q:  When can I get a second booster?  I got the first one last October.

         A:   Last week Tuesday, Pfizer and Moderna asked for emergency authorization for a second booster for those 65 and older. Federal health officials have said they are concerned about the waning potency of the booster shot that was authorized last fall.  About 48 percent of eligible American adults, or 93 million people, have gotten booster shots, according to the C.D.C. More than two-thirds of those 65 or older who are eligible have gotten them.

Peter J. Hotez, MD, a vaccine expert at the Baylor College of Medicine in Houston, said, “I’m a strong proponent of giving a second booster now.”  He said the first booster shot had “made a huge difference” in bolstering protection against hospitalization and even infection from the Omicron variant.  “It’s also clear that protection is waning now pretty quickly a few months after your third dose,” he said. “So it’s short-lived. The hope is that a second booster would restore it.”  Some scientists oppose the move right now, stating that studies have yet to determine if serious disease is associated with waning immunity. Given the anxiety over the new CDC guidelines, for many whose boosters were given many months ago, approval may easily provide some relief.