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Ferguson: Omicron Sounds The Death Knell For Globalization 2.0

Ferguson: Omicron Sounds The Death Knell For Globalization 2.0

Authored by Niall Ferguson, op-ed via Bloomberg.com,

On top of an intensifying cold war between the U.S. and China and other seismic changes, the rapid spread of Covid-19’s…

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Ferguson: Omicron Sounds The Death Knell For Globalization 2.0

Authored by Niall Ferguson, op-ed via Bloomberg.com,

On top of an intensifying cold war between the U.S. and China and other seismic changes, the rapid spread of Covid-19’s newest variant could finish off our most recent phase of global integration.

“Somewhere out there,” I wrote here two weeks ago, “may lurk what I grimly call the ‘omega variant’ of SARS-CoV-2: vaccine-evading, even more contagious than delta, equally or more deadly. According to the medical scientists I read and talk to … the probability of this nightmare scenario is very low, but it is not zero.”

Indeed. Little did I know, but even as I wrote those words something that appears to fit this description was spreading rapidly in South Africa’s Gauteng province: not the omega variant, but the omicron variant.

As I write today, major uncertainties remain, but what we know so far is not good. People are emotionally predisposed to look on the bright side — we are all sick of this pandemic and want it to be over — so it pains me to write this. Nevertheless, I’ll stick to my policy of applying history to the best available data, even if it means telling you what you really don’t want to hear.

First the data: South African cases were up 39% on Friday, to 16,055. The test positivity rate rose from 22.4% to 24.3%, suggesting that the true case number is rising even faster. A Lancet paper suggests that Omicron is likely by far the most transmissible variant yet. There are three possible explanations for this:

  1. A higher intrinsic reproduction number (R0),

  2. An advantage in “immune escape” to reinfect recovered people or evade vaccines, or

  3. Both of the above.

An important preprint published on Dec. 2 pointed to immune escape. South Africa’s National Institute for Communicable Diseases has individualized data on all its 2.7 million confirmed cases of Covid-19 in the pandemic. From these, it identified 35,670 suspected reinfections. (Reinfection is defined as an individual testing positive for Covid-19 twice, at least 90 days apart.) Since mid-November, the daily number of reinfections in South Africa has jumped far faster than in any previous wave. In November, the hazard ratio was 2.39 for reinfection versus primary infection, meaning that recovered individuals were getting Covid at more than twice the rate of people who had never had Covid before. And this was when omicron made up less than a quarter of confirmed cases. By contrast, the same study found no statistically significant evidence that the beta and delta variants were capable of reinfection. And, crucially, at least some of these new infections are leading to serious illness. On Thursday, the number of Gauteng patients in intensive care for Covid almost doubled from 63 to 106.

Data from a private hospital network in South Africa that has over 240 patients hospitalized with Covid indicate that 32% of the hospitalized patients were fully vaccinated. Note that around three-quarters of the vaccinated in South Africa received the Pfizer Inc.-BioNTech SE vaccine. The rest got the Johnson & Johnson vaccine.

Yet these are not the data that worried me the most last week. Those had to do with children. Between Nov. 14 and 28, 455 people were admitted to hospital with Covid-19 in Tshwane metro area, one of the largest hospital systems in Gauteng. Seventy (15%) of those hospitalized were under the age of five; 117 (25%) were under 20. And this is not just a story of precautionary hospitalizations. Twenty of the 70 hospitalized toddlers progressed to “severe” Covid. Up until Oct. 23, before experts estimate omicron began circulating, under-fives represented only 1.8% of cumulative Covid hospital admissions in South Africa. As of Nov. 29, 10% of those now hospitalized in Tshwane were under the age of two.

If this trend holds as omicron spreads to advanced economies — and it is spreading very fast, confirming omicron’s high transmissibility — the market impact could be much bigger than is currently priced in. Unlike with the delta wave, many schools would return to hybrid instruction, parents would withdraw from the labor force to provide childcare and consumption patterns would again shift away from retail, hospitality and face-to-face services. Hospital systems would also face shortages of pediatric intensive care beds, which have not been much needed in prior Covid waves.

South Africa’s top medical advisor Waasila Jassat noted on Dec. 3 that hospitalizations on average are less severe than in previous waves and hospital stays are shorter. But she also noted a “sharp” increase in hospital admissions of under-fives. Children under 10 represent 11% of all hospital admissions reported since Dec. 1.

Here’s what we don’t know yet. We do not know how far prior infection and vaccination will protect against severe disease and death in northern hemisphere countries, where adult vaccination rates are much higher than in South Africa (just 24%). And we do not know if omicron will prove as aggressive toward children in those countries, especially the very young children we have not previously contemplated vaccinating. (Because South Africa has limited testing capacity, we do not know the total number of under-fives infected with omicron in Gauteng, so we do not know what percentage of children are falling sick.) We may not know these things for another week, possibly longer. So panic is not yet warranted. Nor, however, is wishful thinking. It may prove a huge wave of mild illness, signaling the final phase of the transition from pandemic to endemic. But we don’t know that yet.

Now the history.

First, it makes all the difference in the world whether or not children fall gravely ill in a pandemic. Covid has so far spared the very young to an extent rarely seen in the recorded history of respiratory disease pandemics. (The exception seems to be the 1889-90 “Russian flu,” which modern researchers suspect was in fact a coronavirus pandemic.) The great influenza pandemics of 1918-19 and 1957-58 killed the very young as well as the very old. The former also carried off young adults in the prime of life. The latter caused significant excess mortality among teenagers. Up until this point, Covid was the social Darwinist disease: It disproportionately killed the old, the sick and the gullible (the vulnerable people who allowed themselves to be persuaded that the vaccine was more dangerous than the virus).

A hundred years ago, many experts would have hailed such a disease for the same reasons they promoted eugenics. We think differently now. However, emotionally and rationally, we still dread the deaths of children much more than the old, the sick and the foolish. The moment children become seriously ill — as has already happened in Gauteng — the nature of the pandemic fundamentally alters. Risk aversion will be far higher in the Ferguson family, for example, if its youngest members are vulnerable for the first time.

The second historical point is that this may be how our age of globalization ends — in a very different way from its first incarnation just over a century ago. The first age of globalization, from the 1860s until 1914, ended with a bang, not a whimper, with the outbreak of World War I. Within a remarkably short space of time, that conflict halted trade, capital flows and migration between the combatant empires. Moreover, the war and its economic aftershocks strengthened and ultimately empowered new political movements, notably Bolshevism and fascism, that fundamentally repudiated free trade and free capital movements in favor of state control of the economy and autarky. By 1933, the outlook for liberal economic policies seemed so utterly hopeless that, in a lecture he gave in Dublin, even John Maynard Keynes threw in the towel and embraced economic self-sufficiency.

Now, there is an argument (made by my Bloomberg colleague and occasional editor James Gibney) that the pandemic will not kill globalization. I am not so sure. Defined too broadly, to include any kind cross-border interaction, the word loses its usefulness. Yes, there were all kinds of “transnational networks in science, health, entertainment,” as well as increasingly ambitious international agencies between the wars. But the fact that (for example) the Pan European movement was founded by Richard von Coudenhove-Kalergi in the 1920s does not mean that the subsequent decades were a triumph of European integration. There was a great deal of international cooperation and cross-border activity between 1939 and 1945, too. That does not mean that the 1940s were a time of globalization. For the word to be meaningful, globalization must refer to relatively higher volumes of trade, capital flows, migration flows and perhaps also cultural integration on a global scale.  

On that basis, globalization peaked — or maybe “maxed out” would be more accurate — in around 2007. Calculate it how you like: Whether the ratio of global exports to GDP, the ratio of gross foreign assets to GDP, global or national migrant flows in relation to total population, they all tell the same story of a sustained rise of globalization hitting a peak around 14 years ago.

The economic historian Alan M. Taylor has long argued that we should measure globalization by looking at current account imbalances, which tell us when a lot of trade and lending are happening. On that basis, too, globalization peaked in 2007.

Even Before Covid, Trade and Lending Were Trending Down

Source: Our World in Data from Maurice Obstfeld and Alan M. Taylor, "Global Capital Markets: Integration, Crisis, and Growth," Japan–US Center UFJ Bank Monographs on International Financial Markets; and International Monetary Fund, World Economic Outlook Database.

Note: The data shown is the average absolute current account balance (as a percentage of GDP) for 15 countries in five-year blocks. The countries in the sample are Argentina, Australia, Canada, Denmark, Finland, France, Germany, Italy, Japan, Netherlands, Norway, Spain, Sweden, U.K., U.S..

Since the financial crisis of 2008-9, however, the volume of world trade has flatlined relative to the volume of industrial production. The U.S. current account deficit peaked in the third quarter of 2006 at -6.3% of GDP. The latest read? -3.3%.

The same story emerges when one turns to migration. The foreign-born share of the U.S. population rose rapidly from its nadir in 1970 (4.7%) to a peak of 13.7% in 2019. But the rate of growth clearly slowed after 2012. It remains below its historic peak of 14.7%, back in 1890. Data for net migration similarly point to peaks prior to the financial crisis. Net emigration from South Asia peaked in 2007, for example. So did net immigration to the United Kingdom.

Not-So-Open Borders

Source: United Nations Population Division

What about cultural globalization? My guess is that peaked in 2012, which was the last year that imported films earned more at the Chinese box office than domestic productions. The highest-grossing movie in the history of the People’s Republic is this year’s “Battle of Lake Changjin,” a Korean War drama in which heroic Chinese troops take on the might of the U.S. Army—and win. (Watch the trailer. Then tell me globalization is going to be fine.)

What has caused globalization to recede? Let me offer a six-part answer.

First, global economic convergence. This may come as a surprise. An influential story over the past two decades was Branco Milanovic’s thesis that globalization had increased inequality. In particular, Milanovic argued in 2016 that “large real income gains [had] been made by people around the median of the global income distribution and by those in the global top 1%. However, there [had] been an absence of real income growth for people around the 80-85th percentiles of the global distribution.” He illustrated this argument with a famous “elephant chart” of cumulative income growth between 1988 and 2008 at each percentile of the global income distribution.

On closer inspection, the elephant was a statistical artifact. Strip out the data for Japan, the former Soviet Union and China, and the elephant vanishes. The story Milanovic’s chart told was of the decline of ex-Soviet and Japanese middle-class incomes following the collapse of the USSR and the bursting of Tokyo’s bubble in 1989-90, and the surge of Chinese middle-class incomes, especially after China’s entry into the World Trade Organization in 2001.

The real story of globalization turns out to be a sustained reduction in global inequality as Chinese incomes caught up rapidly with those in the rest of the world, combined with big increases in national inequality as the “one percent” in some (not all) countries got a whole lot richer. At the heart of globalization was what Moritz Schularick and I called “Chimerica”—the symbiosis between the Chinese and American economies that allowed American capital to take advantage of low-cost Chinese labor (offshoring or outsourcing), American borrowers to take advantage of abundant Chinese savings, and American consumers to take advantage of cheap Chinese manufactures.

It could not last. In 2003 Chinese unit labor costs were around a third of those in the U.S. By 2018 the two were essentially on a par. In that sense, the glory days of globalization were bound to be numbered. For as Chinese incomes rose, the rationale for relocating production to China was bound to become weaker.

Secondly, and at the same time, new technologies — robotics, three-dimensional printing, artificial intelligence — were rapidly reducing the importance of human labor in manufacturing. With the surge of online commerce and digital services, globalization entered a new phase in which data rather than goods and people crossed borders, even if the Great Firewall of China partly cordoned off China’s internet from the rest of the world’s.

Chimerica, as Schularick and I argued back in 2007, was in many ways a chimera — a monstrous creature with the potential to precipitate a crisis, not least by artificially depressing U.S. interest rates and inflating a real estate bubble. When that crisis struck in 2008-9, it was the third blow to globalization. For those who suffered the heaviest losses in the United States and elsewhere, it was not illogical to blame free trade and immigration. A 2015 study by the McKinsey Global Institute showed clearly that people in the U.S., U.K. and France who saw themselves as “not advancing and not hopeful about the future” were much more likely than more optimistic groups to blame “legal immigrants,” “the influx of foreign goods and services,” and “cheaper foreign labor” for, respectively, “ruining the culture and cohesiveness in our society,” “leading to domestic job losses” and “creating unfair competition to domestic businesses.”

The only surprising thing was that these feelings took as long as seven years to manifest themselves as an organized political backlash against globalization, in the form of Britain’s vote to exit the European Union and America’s vote for Donald Trump. Dani Rodrik’s famous trilemma — which postulated that you could have any two of globalization, democracy and sovereignty — was emphatically answered in 2016: Voters chose democracy and sovereignty over globalization. This was the fourth strike against “the globalists,” a term invented by the populists to give globalization a more easily hateable human face.

The financial crisis and the populist backlash didn’t sound the death knell for globalization. They merely dialed it back — hence the plateau in trade relative to manufacturing and the modest decline (not collapse) of international capital flows and migration. The fifth blow was the outbreak of Cold War II, which should probably be dated from Vice President Mike Pence’s October 2018 Hudson Institute speech, the first time the Trump administration had taken its anti-Chinese policy beyond the confines of the president’s quixotic trade war (which only modestly reduced the bilateral U.S.-Chinese trade deficit).

Not everyone has come to terms with this new cold war. Joseph Nye (and the administration of President Joe Biden) would still like to believe that the U.S. and China are frenemies engaged in “coopetition.” But Hal Brands and John Lewis GaddisJohn Mearsheimer and Matt Turpin have all come round to my view that this is a cold war — not identical to the last one, but as similar to it as World War II was to World War I. The only question worth debating is whether or not, as in 1950, cold war turns hot. There is no Thucydidean law that says this is inevitable, as Graham Allison has shown. But I agree with Mearsheimer: The risk of a hot war in Cold War II may actually be higher than in Cold War I. Nothing would kill globalization faster than the outbreak of a superpower war over Taiwan. (And “The Battle of Lake Changjin” is blatantly psyching Chinese cinemagoers up for such a conflict.)

The decoupling of the U.S. and Chinese economies would almost certainly have continued even if the sixth blow — the Covid pandemic — had not struck. It has been astounding how little the Biden administration has changed of its predecessor’s China strategy. However, the pandemic has delivered the coup de grace — “a brutal end to the second age of globalization,” as Nicholas Eberstadt put it last year.

True, the volume of merchandise trade has recovered even more rapidly in 2021 than the World Trade Organization anticipated back in March. But the emergence of a new, contagious and lethal coronavirus has caused a collapse of international travel and tourism. The number of passengers carried by the global airline industry plunged by 60% in 2020. It will be not much better than 50% of its pre-pandemic level this year. International tourist arrivals are down by even more this year than last year — close to 80% below their 2019 level. In Asia, international tourism has all but ceased to exist this year.

Meanwhile, both the U.S. and the Chinese governments keep devising new ways to discourage their nationals from investing in the rival superpower. Didi Global Inc., the Chinese Uber, just announced it is delisting its shares from the New York Stock Exchange. And the pressure mounts on Wall Street financiers — as Bridgewater Associates founder Ray Dalio discovered last week — to wind up their “long China” trade and stop turning a blind eye to genocide in Xinjiang and other human rights abuses. Next up: the campaign to boycott the 2022 Winter Olympics in Beijing.

Strikingly, a growing number of Western sports stars and organizations such as the Women’s Tennis Association are already willing to defy Beijing — in the case of the WTA by suspending tournaments in China in response to the disappearance of the tennis star Peng Shuai, who accused a senior Communist Party official of sexually assaulting her. China’s leaders should be even more worried by a recent Chicago Council of World Affairs poll, which showed that just over half of Americans (52%) favor using U.S. troops to defend Taiwan if China invades the island — the highest share ever recorded in surveys dating back to 1982.

Last month I asked a leading American lawmaker how he explained the marked growth in public hostility toward the Chinese government. His answer was simple: “People blame China for Covid.” And not without reason, as Matt Ridley’s new book “Viral” makes clear.

For the avoidance of doubt, I do not foresee as complete a collapse of globalization as happened after 1914. Globalization 2.0 seems to be going out with a whimper — or perhaps a persistent cough — rather than with a bang. Income convergence and technological change were bound to reduce its utility. Having overshot by 2007, globalization settled at a lower level after the financial crisis and was less damaged by populist policies like tariffs than might have been anticipated. But the advent of Cold War II and Covid-19 struck two severe blows. How far globalization is rolled back depends on how far the two phenomena persist or worsen.

Maybe — let us pray — the alarming data from Gauteng will not imply a major new wave of illness and death in the wider world. Maybe the omicron variant will not, after all, be that nightmare variant I have feared: more infectious, more lethal, vaccine-evading, not ageist.

But omicron is only the 15th letter in the Greek alphabet. In all of Africa only 7.3% of the population are fully vaccinated and there are countless immunocompromised individuals with HIV. Even if omicron turns out to be, like delta, a variant we can live with, there is still some non-zero chance that at some point we get my “omega variant.” In that scenario, the pandemic does not oblige us, weary as we are of it, by ending, but recurs in a succession of waves extending for years. One begins to wonder if China will ever lift its stringent restrictions on foreign visitors. Under such circumstances, I see little chance of Cold War II reaching the détente phase earlier than Cold War I.  

In addition to applying history, I have come to believe that we should also apply science fiction, on the principle that its authors are professionally incentivized to envision plausibly the impact of social, technological and other changes on the future. (Fact: an Italian sci-film called “Omicron,” in which an alien takes over a human body, was released in 1963.) No living author is better at this kind of thing than Neal Stephenson, whose “Snow Crash” coined the word “metaverse,” and whom I got to know — appropriately via Zoom — through my friends at the Santa Fe Institute.

When Stephenson and I met for a late-night Scotch at a bar in Seattle a few weeks back, we swiftly found common ground. Never have I seen a longer list of wines and spirits: We could have scrolled down on the iPad the server handed us for an hour and still not reached the end. Eventually, we found the malt whisky. And immediately we agreed: Laphroaig — the standard 10-year-old version.

Stephenson’s latest novel is “Termination Shock.” Buy it. You will be catapulted into a future Texas of intolerable heat, man-eating hogs, and other nightmares, the effect of which will be to make your present circumstances seem quite tolerable. Part of Stephenson’s genius is his use of the throwaway detail.

“RVs,” he writes, were “already at a premium because of Covid-19, Covid-23 and Covid-27.”

It’s not really part of the plot, but it stopped my eyeballs in their tracks. And remember: He predicted the metaverse. In 1992.

Tyler Durden Mon, 12/06/2021 - 05:00

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About 35% of People Who Received Placebo in Vaccine Trials Report Side Effects and More COVID-19 News

According to a recent study conducted by researchers at Harvard Medical School and Beth Israel Deaconess Medical Center, 76 percent of the adverse side effects (such as fatigue or headache) that people experienced after receiving their first COVID-19…

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About 35% of People Who Received Placebo in Vaccine Trials Report Side Effects and More COVID-19 News

The placebo effect is where a person who received a placebo instead of a drug or vaccine shows clinical signs, positive or negative, associated with the actual treatment. Much has been made about the side effects of the COVID-19 vaccines, but a new study found a startlingly high number of adverse events associated with people who received placebos in clinical trials. For that and more COVID-19 news, continue reading.

COVID-19 Vaccine Side Effects: Real or Placebo Effect?

A recent study out of Harvard Medical School and Beth Israel Deaconess Medical Center evaluated 12 COVID-19 vaccine trials with a total of 45,380 participants. The study found that 76% of the adverse side effects reported, such as fatigue or headache, after the first shot were also reported by participants who received a placebo. Mild side effects were more common in people receiving the vaccine, but a third of those given the placebo reported at least one adverse side effect. The statistics from the study showing that 35% of placebo recipients reported adverse side effects is considered unusually high. Several experts suspect that there’s such a high report of adverse events because of the amount of misinformation found on social media about the dangers of the vaccines and the amount of media coverage.

This is not to say that the adverse side effects felt by people who received the vaccines are all in their heads. People do have side effects to vaccines, but this study reports on an unusually high level of the placebo effect. Nocebo is used to describe a negative outcome associated with the placebo.

Source: BioSpace

“Negative information in the media may increase negative expectations towards the vaccines and may therefore enhance nocebo effects,” said Dr. Julia W. Haas, an investigator in the Program in Placebo Studies at Beth Israel Deaconess and the study’s lead author. “Anxiety and negative expectation can worsen the experience of side effects.”

Four Factors for Long COVID

A study published in Nature Communications identified specific antibodies in the blood of people who developed long COVID. Long COVID is not well understood and has a range of up to 50 different symptoms, and it is difficult to diagnose because there is no one test for it. The study, conducted by Dr. Onur Boyman, a researcher in the Department of Immunology at University Hospital Zurich, compared more than 500 COVID-19 patients and found several key differences in patients who went on to present with long COVID. The most obvious was a significant decrease in two immunoglobulins, IgM and IgG3. The study found that a decrease in these two immunoglobulins, which generally rise to fight infections, combined with other factors, such as middle age and a history of asthma, was 75% effective in predicting long COVID.

75% of COVID-19 ICU Survivors Show Symptoms a Year Later

A study out of the Netherlands found that a year after being released from an intensive care unit (ICU) for severe COVID-19, 75% of patients reported lingering physical symptoms, 26% reported mental symptoms, and up to 16% noted cognitive symptoms. The research was published in JAMA. The research evaluated 246 COVID-19 survivors treated in one of 11 ICUs in the Netherlands. The mental symptoms included anxiety (17.9%), depression (18.3%), PTSD (9.8%). The most common new physical symptoms were weakness (38.9%), stiff joints (26.3%), joint pain (25.5%), muscle weakness (24.8%), muscle pain (21.3%) and shortness of breath (20.8%).

Pennsylvania Averaging Most COVID-19 Deaths Per Day in a Year

In general, COVID-19 deaths are dropping across the country. However, in two states, Pennsylvania and New Jersey, the numbers are increasing. Pennsylvania is averaging 156 COVID-19 deaths per day over the past seven days, which is a 17% uptick compared to two weeks ago. The number of deaths per day in Pennsylvania is below what was hit in January 2021, largely due to the availability of vaccines. New Jersey averages 111 deaths from COVID-19 per day, an increase of 61% over the last two weeks and the highest since May 2020. Similarly, New Jersey cases and hospitalizations are declining.

Omicron Surge: Shattering Cases and Hospitalizations, but Less Severe

According to the CDC, although the current Omicron surge is setting records for positive infections and hospitalizations, it’s less severe than other waves by other metrics. Omicron has resulted in more than 1 million cases per day in the U.S. on several occasions, and reported deaths are presently higher than 15,000 per week. However, the ratio of emergency department visits and hospitalizations to case numbers is lower compared to COVID-19 waves for Delta and during the winter of 2020–21. ICU admissions, length of stay, and in-hospital deaths were all lower with Omicron. They cite vaccinations and booster shots as the likely cause. Although the overall result is that Omicron appears less severe, it’s not completely clear if that’s because the viral variant doesn’t infect the lower lung as easily as other variants, or because so much of the population has either been vaccinated or exposed to the virus already. It is clearly far more infectious than other strains, which is placing a real burden on healthcare systems. The number of emergency department visits is 86% higher than during the Delta surge.

J&J Expects Up to $3.5 Billion in COVID-19 Vaccine Sales This Year

Johnson & Johnson projected annual sales of its COVID-19 vaccine for 2022 to range from $3 billion to $3.5 billion. This was noted during the company’s fourth-quarter 2021 report. In December 2021, the U.S. Centers for Disease Control and Prevention recommended the PfizerBioNTech or Moderna shots over J&J’s due to a rare blood condition observed with the J&J shot. By comparison, Pfizer and BioNTech project their vaccine will bring in $29 billion in 2022, after having raked in almost $36 billion in 2021. Moderna expects approximately $18.5 billion this year, with about $3.5 billion from possible additional purchases. Although final figures for Moderna aren’t in yet, they projected 2021 sales between $15 and $18 billion.

BioSpace source:

https://www.biospace.com/article/about-35-percent-of-people-receiving-placebo-in-vaccine-trials-report-side-effects-and-more-covid-19-news

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COVID-19 cases at highest ever in Americas – regional health agency

New cases of COVID-19 in the Americas in the past week were the highest since the pandemic began and the very contagious Omicron variant has clearly become the predominant strain, the Pan American Health Organization said on January 26.

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COVID-19 cases at highest ever in Americas – regional health agency

BRASILIA, Jan 26 (Reuters) – New cases of COVID-19 in the Americas in the past week have been the highest since the pandemic began in 2020 and the very contagious Omicron variant has clearly become the predominant strain, the Pan American Health Organization said on Wednesday.

There were more than 8 million new cases, 32% higher than the previous week, while fatalities throughout the region also increased by 37%, with 18,000 new deaths caused by COVID-19.

The United States continues to have the highest number of new infections, although cases decreased by nearly 1 million over the last week, the regional health agency said.

Mexico’s southern states have seen new infections triple and Brazil has seen new cases surge 193% over the last seven days, PAHO said in weekly briefing.

Medical workers take care of patients in the emergency room of the Nossa Senhora da Conceicao hospital that is overcrowding because of the coronavirus outbreak, in Porto Alegre, Brazil, March 11, 2021. REUTERS/Diego Vara

Children in the Americas are facing the worst educational crisis ever seen in the region, with millions of children yet to return to classes, according to PAHO, which recommended that countries try to get them safely back to school to protect their social, mental and physical wellbeing.

It urged parents to get their children vaccinated.

Many countries have already authorized and are safely administering COVID vaccines to adolescents, PAHO said.

Last week, the WHO’s expert group on immunization authorized the COVID vaccine developed by Pfizer Inc (PFE.N) for children aged 5 to 12 years, offering a roadmap for countries to roll out vaccines for them, the regional agency said.

Reporting by Anthony Boadle; Editing by David Gregorio

Our Standards: The Thomson Reuters Trust Principles.

 

Reuters source:

https://www.reuters.com/world/americas/covid-19-cases-highest-ever-americas-says-regional-health-agency-2022-01-26

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Don’t believe the claim that only 17,371 people have died from COVID in England and Wales

A freedom of information request is only useful if you know how to read the data.

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There is no doubt that the pandemic has led to many deaths; however, in the past week, new claims have emerged that the true number of people who have died from COVID in England and Wales is much lower than previously thought. These claims have been widely shared on social media and even amplified by a senior MP. Can it really be true that new data shows that COVID has killed far fewer people than we previously thought?

To arrive at an answer, we first need to delve into the various ways that COVID deaths are counted in England and Wales. There are two main sources of this data: the first, published by the UK Health Security Agency (UKHSA) and featured prominently on the government’s coronavirus dashboard, is a simple count of all deaths that occur within 28 days of a positive COVID test.

The second, published by the Office for National Statistics (ONS) is based on death certificates that list COVID as a cause of death. Being based on a medical assessment of the circumstances of each individual death, the ONS figures represent the gold standard.

The UKHSA figures will include some deaths that are clearly unrelated to COVID – for example, somebody who has a mild case of COVID and is involved in a car accident three weeks later – and exclude some COVID deaths where someone is in hospital for more than 28 days. The UKHSA data gives us a picture of what is happening now – albeit an imperfect one – while the ONS data takes several weeks to process.

We also need to understand how death certificates work in England and Wales. When somebody passes away, a medical professional completes a death certificate. This includes a field for the “disease or condition directly leading to death” – often called the “underlying cause”. It also includes the option to list one or two diseases or conditions that were not the underlying cause, but which contributed to the death (“contributory causes”).

The data that the ONS publishes shows that, in 2020 and 2021 combined, 157,889 deaths were registered where COVID was mentioned on the death certificate. Of these, 139,839 listed COVID as the underlying cause. In almost 90% of cases where COVID was a factor in somebody’s death, it was considered by medical professionals to be the primary reason they died. So where does the figure of 17,371 COVID deaths come from?

Freedom of information request

This figure originates from a freedom of information request to the Office for National Statistics that asked for the number of deaths where COVID was the only cause of death recorded. This is complicated by the fact that often COVID itself can cause complications, such as severe respiratory difficulties or organ failure, which will then be listed alongside COVID on the death certificate.

To exclude these deaths, the ONS responded by giving the number of deaths where no “pre-existing conditions” were listed on the death certificate. Which comes to 17,371 for the period up to the end of September 2021. But what is a “pre-existing condition”?

Pre-existing conditions and their International Classification of Diseases (ICD) codes

Office for National Statistics

This list is extensive, including high blood pressure, asthma, COPD, diabetes and a wide range of other common conditions. The argument being made by some is that 17,371 is the true number of COVID deaths, because people with these pre-existing conditions, who make up the vast majority of deaths that list COVID on the death certificate, were already sick. But even a cursory glance at the list makes it clear that this will be incorrect for a great many people.

Over a quarter of adults have high blood pressure, 4 million people in England have diabetes and a similar number have asthma. Having one of these conditions is neither a death sentence nor a sign of being in poor health. You almost certainly know several people with one or more of them, or are living with one yourself.

The idea that people with a pre-existing condition are at death’s door is simply untrue. Over half of people aged 50 and over have at least one long-term health condition. But if someone with one of these conditions is unlucky enough to catch COVID and subsequently die, all it takes is for the condition to have some impact for it to end up being listed as a contributory cause on the death certificate.

Let’s take asthma as an example. COVID frequently attacks victims’ lungs, leading them to require ventilation. As a respiratory condition, asthma may well exacerbate these difficulties and will therefore be listed on the death certificate if the person dies. It would be bizarre to claim that the person died of asthma on this basis. Perhaps they would not have died if they didn’t have asthma, but they certainly wouldn’t have died if they hadn’t got COVID.

The vast majority of people who get seriously ill with COVID were living full, independent lives before they were hospitalised. And reasonable estimates suggest that the average number of years of life lost per COVID death is around ten. The idea that people who died from COVID are all extremely ill and would have died soon anyway is not borne out by the facts.

To argue that the deaths from COVID of people with pre-existing conditions don’t count as true COVID deaths is to say that people with pre-existing conditions don’t matter; that their lives are expendable and shouldn’t be considered when assessing the impact of the pandemic. Over 140,000 people with pre-existing conditions have died of COVID in the last two years. We should be mourning this tragic loss of life, not minimising it.

Colin Angus does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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