Frequently Asked Questions about COVID-19 — September 8, 2021

  “Shared expectations lead to predictability.”

356. Average hospital cost for a Covid-19 hospitalized patient exceeds $20,000.

         Q:  Does the federal government pay for a Covid-19 patient’s hospital cost? 

         A:   No. Only tests and vaccines are paid for directly with federal funds.  All the rest of the costs including the staffing and program costs for administering these tests and vaccines are not free.  A person’s health insurance covers those costs.  But if a patient now has to be admitted to a hospital, their costs have to be covered by their health insurance if they have such insurance.  Last week, the Hartford Courant published an article based on information shared by the Connecticut Hospital Association.  It was estimated that the unvaccinated patients were by far the largest portion of those admitted to a hospital with Covid-19.  The cost for this group of preventable infections in Connecticut during 2 months for hospital care was estimated to be over $9.2M.  Sarah Kliff, of the New York Times, predicts that in the future, the cost for care will likely cost Americans significantly more.  Earlier, most major health insurers voluntarily waived the costs for Covid-19 treatments.  But with the advent of a significant number of people unwilling to be vaccinated, this is view is changing.  For those with insurance, the expenditures add up, causing the insurers to increase future premium rates for everyone.  Taxpayers have to pay more for Medicare and Medicaid coverage.  For those without insurance, the costs, which can be as much as $20,000 per admission, adds to the family debt requiring long-term financial woes.  If one is unvaccinated and doesn’t have health insurance, getting free shot(s) is a lot less expensive than not being able to afford a reliable used car in the years ahead!

357. The political battle over mandates appears to be growing.

         Q: Why is there such diversity of opinion over how well masks reduce infections?

         A:  Science consistently has proven that masks help reduce airborne infectious diseases,  Whet Moser, a writer/editor for the New York Times, succinctly states that “The fight over masks and vaccines is heating up – especially between president Biden and the governors who hope to defeat him in 2024.”   He goes on the state, “The actions of Republican governors reflect how the views of the party’s base have hardened when it comes to curbing Covid.  Ever-rising death tolls are seen as less politically damaging than imposing coronavirus rules of almost any stripe.”  “Many Republicans are out on an island by themselves,” says Whit Ayres, a veteran G.O.P. pollster.  “It may be a safe political decision for some primary electorates at the moment. But you have to win a general election.”  That’s one view on the political side of the debate.  Science v. politics.  This divide is manifest in many areas.  Climate change.  Abortion rights.  Income disparity.  Voting rights.  Unshared expectations and an unpredictable future.  Take a deep breath!

358. And science continues to bring reason to the foreground – for those listening.

         Q:  So, I hear that masks in school actually increase infections.  Why is this wrong?

         A:  A detailed study completed in May was recently published by the CDC.  It received little public notice at the time.  The study covered more than 90,000 elementary-school students in 169 schools in Georgia between November 16 to December 11 comparing the incidence of Covid-19 cases between schools with certain mitigation measures and those without these measures.  In the findings, the study found “that required mask use among teachers and staff members was 39% in schools that reported one or more strategies to improve classroom ventilation.”  Later, “the CDC recommends …until vaccines are available for students under age 12, universal and correct mask use is a critical prevention strategy.”  This universal use is recommended for teachers, staff, and students.  The press published a series of articles that spoke to the science of this CDC study.  Initially, the comments were based on the lack of a separate analysis on each of the mitigation strategies used in the study.  How relative were ventilation systems different from social distancing different from mask-wearing?  Pure science would indicate that one of these might have a lesser influence and that the reduction of incidence might be due to another.  This quickly expanded by opponents of mandated measures to, “The Science of Masking Kids at School Remains Uncertain,” (New York Magazine, the Intelligencer, article by David Zweig).  Now the debate is turning into proof that mandates just don’t work.

A relevant report has been published that found an unvaccinated elementary teacher in Marin County, California, spread the coronavirus to half of her 24-student class in May and June when in violation of her school district’s rules, she lowered her mask to read aloud.  Twelve of her students, all of whom were wearing masks but under the age of12 and who could not be vaccinated, subsequently contracted the disease.  The Delta variant eventually spread to at least 26 people.  Lisa Santora, MD, deputy health officer at the Marin Health and Human Services studied and filed this report.  “I thought I respected its contagiousness,” she reported of the Delta variant.  But the efficiency of this virus in overtaking the classroom actually “surprised and humbled” her.

359. Questions are raised about “waning immunity” and the value of booster shots.

         Q:  Will getting a third “booster shot” help prevent my getting COVID-9?

         A:  We might remember weeks ago when Pfizer announced it was working to get approval for a third dose of its vaccine to increase its efficiency at preventing serious disease.  At the time, there were no studies indicating the initial vaccines were losing their potency over time.  But then late in July, researchers in Israel reported that many who were vaccinated earlier were now contracting the disease while more recently vaccinated people were not becoming infected.  But in science, “correlation does not prove causation.”

However, that Israeli study lit up headlines worldwide about waning immunity.  In the U.S., these headlines sparked a wide-spread discussion and anxiety about an apparent but not proven increase in outbreak infections.  In turn, this prompted president Biden to announce that Americans should get a booster shot after 8 months delay from receiving their last shot.  But the actual research on immunity decreasing over time is much murkier than the Israeli information implied.  Many scientists feel that a third shot may not be of any value for the expense and time spent to administer these in great numbers.  Initially, the two vaccinated groups compared in Israel – the early group and later group of initial vaccinations, were different in several ways.  The early group was more affluent, did more international travel, and had greater exposure to the Delta variant in foreign countries.  In the U.S., many early vaccinations led to an early feeling of protection before Delta appeared, taking more risks than those who were vaccinated later.  This means that many in this group may be more subject to breakout infections than the more cautious later vaccinees.  Again, the risks of exposure weigh heavier than the length of time the vaccines had been taken.

The following are cited for caution about immediately demanding booster shots:

  • Immunity probably does wane over time, but research is needed to determine to what degree. Those most vulnerable will probably benefit most at first.
  • Currently, booster shots may do little good for most people.
  • A national policy of frequent booster shots has significant financial and other costs.
  • While Americans are focusing on booster shots, other policies could do more to eradicate Covid.
  • As always, we should be open to changing our minds as we get more evidence.

And in spite of president Biden’s enthusiasm, the FDA has not yet authorized any booster shots, and when it does, it may be only for immunocompromised people (people with donated organs, cancer patients, and others who need a more potent dose to reach the immunity levels most of us achieve with the usual one or two doses.)

360. Covid-19 survivors are 35% more likely to have kidney damage than others.

         Q:  Has there been any new findings on long-term problems after surviving Covid-19?

         AA large new research study was conducted by Ziyad Al-Aly, MD, chief of the research and development service at the VA St. Louis Health Care System.  Researchers found a correlation between the severity of early coronavirus infections and lingering kidney damage.  Overall, it was found that as many as 35% of Covid-19 patients were likely to have long-term kidney pathology.  The causative connection between the two is still being studied.   It is assumed that kidneys that regulate and clean the blood, might be especially sensitive to surges in inflammation or immune system activation.  Some suspect that blood-clotting problems often seen in Covid patients might disturb kidney function.  Either way, this large number of Covid-19 patients could lead to a high percentage of patients with lasting kidney problems, which could have a profound impact on our health care system.