Justice Gorsuch goes into beast mode over COVID restrictions

Justice Gorsuch wrote an opinion on Thursday in Arizona, et al. v. Mayorkas (2023), and we touched on it yesterday for the purpose of talking about how Ian Milhouse Millhiser was dragged for a comment and how his dumb comment allowed people to point out how many times Democrats had violated our civil liberties. And pointing at laughing at Millhiser is a good thing.

Still, Justice Gorsuch’s opinion deserves a lot more attention. The essential Professor Eugene Volokh devotes an entire post quoting extensively from it, and we wouldn’t cut a word from that passage:

Since March 2020, we may have experienced the greatest intrusions on civil liberties in the peacetime history of this country. Executive officials across the country issued emergency decrees on a breathtaking scale. Governors and local leaders imposed lockdown orders forcing people to remain in their homes. They shuttered businesses and schools, public and private. They closed churches even as they allowed casinos and other favored businesses to carry on. They threatened violators not just with civil penalties but with criminal sanctions too.

They surveilled church parking lots, recorded license plates, and issued notices warning that attendance at even outdoor services satisfying all state social-distancing and hygiene requirements could amount to criminal conduct. They divided cities and neighborhoods into color-coded zones, forced individuals to fight for their freedoms in court on emergency timetables, and then changed their color-coded schemes when defeat in court seemed imminent.

Federal executive officials entered the act too. Not just with emergency immigration decrees. They deployed a public-health agency to regulate landlord-tenant relations nationwide. They used a workplace-safety agency to issue a vaccination mandate for most working Americans. They threatened to fire noncompliant employees, and warned that service members who refused to vaccinate might face dishonorable discharge and confinement. Along the way, it seems federal officials may have pressured social-media companies to suppress information about pandemic policies with which they disagreed.

While executive officials issued new emergency decrees at a furious pace, state legislatures and Congress—the bodies normally responsible for adopting our laws—too often fell silent. Courts bound to protect our liberties addressed a few—but hardly all—of the intrusions upon them. In some cases, like this one, courts even allowed themselves to be used to perpetuate emergency public-health decrees for collateral purposes, itself a form of emergency-lawmaking-by-litigation.

Doubtless, many lessons can be learned from this chapter in our history, and hopefully serious efforts will be made to study it. One lesson might be this: Fear and the desire for safety are powerful forces. They can lead to a clamor for action—almost any action—as long as someone does something to address a perceived threat. A leader or an expert who claims he can fix everything, if only we do exactly as he says, can prove an irresistible force.

We do not need to confront a bayonet, we need only a nudge, before we willingly abandon the nicety of requiring laws to be adopted by our legislative representatives and accept rule by decree. Along the way, we will accede to the loss of many cherished civil liberties—the right to worship freely, to debate public policy without censorship, to gather with friends and family, or simply to leave our homes. We may even cheer on those who ask us to disregard our normal lawmaking processes and forfeit our personal freedoms. Of course, this is no new story. Even the ancients warned that democracies can degenerate toward autocracy in the face of fear [citing Aristotle’s Politics].

But maybe we have learned another lesson too. The concentration of power in the hands of so few may be efficient and sometimes popular. But it does not tend toward sound government. However wise one person or his advisors may be, that is no substitute for the wisdom of the whole of the American people that can be tapped in the legislative process.

Decisions produced by those who indulge no criticism are rarely as good as those produced after robust and uncensored debate. Decisions announced on the fly are rarely as wise as those that come after careful deliberation. Decisions made by a few often yield unintended consequences that may be avoided when more are consulted. Autocracies have always suffered these defects. Maybe, hopefully, we have relearned these lessons too.

In the 1970s, Congress studied the use of emergency decrees. It observed that they can allow executive authorities to tap into extraordinary powers. Congress also observed that emergency decrees have a habit of long outliving the crises that generate them; some federal emergency proclamations, Congress noted, had remained in effect for years or decades after the emergency in question had passed.

At the same time, Congress recognized that quick unilateral executive action is sometimes necessary and permitted in our constitutional order. In an effort to balance these considerations and ensure a more normal operation of our laws and a firmer protection of our liberties, Congress adopted a number of new guardrails in the National Emergencies Act.

Despite that law, the number of declared emergencies has only grown in the ensuing years. And it is hard not to wonder whether, after nearly a half century and in light of our Nation’s recent experience, another look is warranted. It is hard not to wonder, too, whether state legislatures might profitably reexamine the proper scope of emergency executive powers at the state level.

At the very least, one can hope that the Judiciary will not soon again allow itself to be part of the problem by permitting litigants to manipulate our docket to perpetuate a decree designed for one emergency to address another. Make no mistake—decisive executive action is sometimes necessary and appropriate. But if emergency decrees promise to solve some problems, they threaten to generate others. And rule by indefinite emergency edict risks leaving all of us with a shell of a democracy and civil liberties just as hollow.

So, what was the case about? Well, we tend to agree with this guy:

The issues of the case were purely procedural, but tangentially related to the official end of the COVID emergency. Beyond that, we doubt it is terribly interesting outside of the legal community. What is more interesting is that searing indictment.

In any case, there was great rejoicing at Gorsuch’s opinion:

It’s amazing how much more sensible you get when you change ‘Ian Millhiser’ to ‘Ian Miller.’ Apparently, the extra ‘h-i-s’ in the name is the problem.

And, of course, there were some people who don’t want to admit the COVID madness was all a mistake that we needed to learn from.

We are always amazed when someone actually uses that word. Do they actually use it in conversations? Do they also clutch pearls and/or drop monocles? Do they say ‘well, I never!’ in a huff? Inquiring minds and all that.

Except that’s not a thing that happens in American law. If the baby is dead, it is not an abortion to remove it.

As for the people taking issue with Gorsuch’s statement that ‘Since March 2020, we may have experienced the greatest intrusions on civil liberties in the peacetime history of this country’ pointing to slavery or Jim Crow or other abuses, a few things to note.

First, he didn’t say it absolutely was the worst, only that it ‘may’ have been among the worst.

Second, let’s not forget what restrictions like the lockdowns were. Telling people that they are not allowed to leave their homes except to work, get food or other necessities? That’s almost exactly the same as what is colloquially called ‘house arrest’—a punishment often meted out to people convicted of a criminal offense. Oh, except under house arrest, you were still allowed to go to church and very often under COVID restrictions you weren’t.

And that is one form of restriction. Go and read his opinion and take a walk down memory lane on all the stuff they forced us to do and forbade us to do—except, of course, the people in power refused to live by their own rules.

So, while slavery was unquestionably worse for each person enslaved, these COVID restrictions were done to almost everyone at a time when the American population dwarfed the total number of people kept as slaves since the founding of the republic. We think comparisons of human misery is a bit like arguing about how many angels can dance on the head of a pin—basically it’s a profound waste of time—but there is a non-laughable argument that COVID restrictions were greater not in the amount of misery each person felt, but in the sheer number of people who felt that misery.

But we also suspect that the point of quibbling with that one line is about exactly that: Wasting everyone’s time, so no one actually goes and reads Gorsuch’s barn burner of an opinion.

For our part, we are reminded of Justice Robert Jackson’s brilliant dissent in Korematsu v. United States, 323 U.S. 214 (1944). That case involved one of those times when racist Democrats trampled on the civil liberties of Americans, this time the involving the internment of Japanese Americans during World War II. Horrified by a majority opinion that pretended there was nothing unconstitutional in locking up Americans for no other reason than their race or ethnicity, Jackson wrote this:

Much is said of the danger to liberty from the Army program for deporting and detaining these citizens of Japanese extraction. But a judicial construction of the due process clause that will sustain this order is a far more subtle blow to liberty than the promulgation of the order itself. A military order, however unconstitutional, is not apt to last longer than the military emergency. Even during that period a succeeding commander may revoke it all. But once a judicial opinion rationalizes such an order to show that it conforms to the Constitution, or rather rationalizes the Constitution to show that the Constitution sanctions such an order, the Court for all time has validated the principle of racial discrimination in criminal procedure and of transplanting American citizens. The principle then lies about like a loaded weapon ready for the hand of any authority that can bring forward a plausible claim of an urgent need. Every repetition imbeds that principle more deeply in our law and thinking and expands it to new purposes.

Fortunately, in the case of Korematsu, the decision became what we call an anti-precedent: A case influential in the sense that courts are repulsed by it, and are wary of doing something similar, again. Finally, in Trump v. Hawaii, 138 S. Ct. 2392 (2018), the Supreme Court took a moment to declare that Korematsu was overturned in an opinion by Chief Justice Roberts:

The dissent’s reference to Korematsu, however, affords this Court the opportunity to make express what is already obvious: Korematsu was gravely wrong the day it was decided, has been overruled in the court of history, and—to be clear— ‘has no place in law under the Constitution.’

Which would be much more meaningful if Roberts didn’t forget the lessons of Jackson’s dissent in Korematsu two years later during the pandemic.

(Special thanks to @SimonTemplarPV for helping us create the preview picture.)

***

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Fox News Had A ‘Great Replacement’ White Supremacy Contest And Laura Ingraham Won!

We are not saying that all the hosts at Fox News had a meeting where they got real excited that somebody might finally notice THEM doing the Great Replacement theory — you know, the white supremacist conspiracy theory that inspires all those mass shooters! — now that Tucker Carlson, king of spreading the Great Replacement theory, is gone.

We are fully willing to accept the notion that many of the people who work at Fox News are fucking white nationalist scumbags, and enjoy spreading the white supremacist Great Replacement theory for their own reasons. And maybe, just maybe, they’ve been doing it this whole time but we just couldn’t hear them, because Tucker is just a total fucking scene-hogging diva with his racism.

In the past few days, at least three on-air Fox News hosts have done it. It could be more, but Media Matters watches Fox News all day, and these are the ones they highlighted. It’s related to the Biden administration finally ending Donald Trump/Stephen Miller’s racist Title 42immigration policy, wherein the Trump administration used coronavirus as an excuse to to pretty much immediately kick out anybody coming to the border to ask for asylum. (It was pretty much the only time they were VRY SRS about COVID being a real threat.)


SEAN! (AND VICTOR!)

There was Sean Hannity’s show on Tuesday night, with his weird racist guest Victor Davis Hanson, who said many goofy-ass racist argle-bargles about the Biden administration bringing in SEVEN MILLION ILLEGAL IMMIGRANTS. They were doing this to “flood the zone,” said Hanson, because “they don’t have confidence in their agenda.” Therefore they have to bring in this “new constituency” (A GREAT REPLACEMENT) to vote for them, because they are just so dang unpopular with the rest of the US Americans.

Here’s the video and the full quote:

VICTOR DAVIS HANSON: You can see that in Joe Biden’s approval ratings, so they feel that they can have a new constituency and turn states like California and Nevada, New Mexico, Colorado, maybe Texas, one day, and Arizona blue from red, and they can get a constituency that needs a larger government, then that’s in their favor, and the only thing they’re worried about right now is the public relations and the optics because they feel it’s so egregious that they have no public support and it’s going to alienate them. That’s all they’re worried about. But, privately, they think, “Wow, we pulled it off. We got 7 million people here illegally before they knew what was going on.” That’s all they care about.

This led Hannity to ask some real strange questions about whether Joe Biden is planning to sell US citizenship to the migrants. Victor Davis Hanson was just like nah, they are just so embarrassed about how unpopular they are, but they are secretly excited because they just succeeded in greatly replacing everybody.

Quick, how many times have Republicans won the popular vote in fucking anything in the last 40 years? But sure, whitey. Keep up your bitchin’. You’re definitely winning new voters for your racist side.

JESSE!

Jesse Watters shot his wad with it on Wednesday.

JUDGE BOXWINE: Tomorrow, when 42 is lifted, I mean, how much worse can it get — 5 million in a year, in two years? I’m sorry.

JESSE WATTERS: Yeah, and then imagine a generation from now. That’s what they want to do here. They want to make Texas a Democrat state. And you’ll never see another Republican in the White House after that.

So dang subtle.

They’re lifting Trump’s white supremacist immigration policy as part of their plan to make Texas a “Democrat state.” (Texas is probably already a “Democrat state” if you take away the racist voter suppression policies of Greg Abbott et al.)

Then Jesse whined out a story about how he was stuck behind a bus of “illegal immigrant families” for 20 minutes on his way to work that day. He asked Greg Abbott to please start sending immigrants to “Chicago or Philly, somewhere I don’t live.” He had to “get out of my Town Car and confront the bus driver.” “You can’t have this in Midtown Manhattan. We’re full.”

You know how Jesse Watters speaks for the average voter in Midtown Manhattan.

LAURA!

And then last night there was Laura Ingraham. Her shit was long and drawn-out and convoluted, but it was greatly replace-y!

Importantly, she said you are GONNA DIE because of all the immigration. Or at least her viewers will. “Untold numbers.” You betcha.

Just gonna give you the whole quote, because holy shit, this is so deranged:

LAURA INGRAHAM: Now, understand this, and understand it well. The scenes you’re watching tonight are not happening because of Biden administration incompetence. They’re happening because this is exactly what the Democrats want.

Now, let me explain this. Liberals and business elites have been working toward this for decades, and now they’re celebrating what is ultimately — if they really get their way — the destruction of America’s middle class. Sounds inflammatory, hyperbolic? Stay with me.

We’re trying.

INGRAHAM: Now, why do they want to destroy the middle class? Well, the far Left hates all those traditions that the middle class clings to, especially the flag-waving, guns, religion — you get the score.

When she says “middle class” she means only white Christian conservative Republicans.

INGRAHAM: And big business, they dislike the middle class because it’s an obstacle to keeping wages as low as possible. Remember, under Trump, the middle class was better off. Their median income was rising and we had minimal inflation. But a limitless supply of low-wage workers, that’s what makes business happiest and keeps America’s middle class the poorest.

Hooray, populism. This is 100 percent Tucker territory. Sadly, there are progressives in America who think you can separate the white supremacist fascism from the populist rhetoric, as if it’s not the precise trick of white supremacist fascists to lean into populism. That’s why there were articles after Tucker’s firing like “No, You Absolutely Do Not Have To Hand It To Tucker Carlson.” Anyway, remember all those window signs from all the mom and pop restaurants about BOO EVERYONE IS LAZY NOBODY WILL WORK FOR US, because the Boomers are all retiring and immigration’s been artificially low, but all those mad restaurant owners are probably “BIG BUSINESS” to the woman on Fox. Also, the BIG BUSINESS that is “hiring nurses to come help your mom.” There are not enough nurses either, it is a total thing! BIG BUSINESS!

INGRAHAM: The open borders radicals think every migrant sleeping on the ground tonight waiting for processing is a future Democrat voter. That’s how they see them. The wealthy donors see the migrants as a much-needed cheap labor. Now, it’s as simple as that.

White supremacist Great Replacement conspiracy theory + fake populism = still just white supremacist Great Replacement conspiracy theory.

INGRAHAM: If those two groups didn’t want this to happen, Biden wouldn’t have done it. Because of what they’ve done, an untold number of Americans will not just lose jobs, but lose their lives.

THEIR LIVES.

INGRAHAM: For these globalists, though, it’s all collateral damage. They don’t care as long as they get to hold onto power and get rich.

(((Globalists.))) We know they mean when they say (((globalists))) are trying to (((hold onto power))) and (((get rich))).

It shows up in the mass shooter manifestos too.

Anyway, damn! We think Laura Ingraham won this white supremacy contest. And with Jesse Watters in the running and everything!

We don’t know how Fox News rewards its employees for these things.

Maybe Laura Ingraham will get to keep the official jar of Tucker’s old farts in her office for a whole week or something.

[Media Matters / Media Matters / Media Matters]

Follow Evan Hurst on Twitter right here.

I would like a BlueSky invite.

I’m also giving things a go at the Mastodon (@[email protected]) and at Post!

Have you heard that Wonkette DOES NOT EXIST without your donations? Please hear it now, and if you have ever enjoyed a Wonkette article, throw us some bucks, or better yet, SUBSCRIBE!

Do your Amazon shopping through this link, because reasons.



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#TuckerTwitterFiles: Tucker Carlson censored for complaining about big tech censorship

About a year ago, Tucker Carlson wrote an opinion piece on the Fox News website complaining about big tech censorship:

To quote from his piece:

[T]he WHO’s latest finding — that the vaccine is not safe for children — threatens everything that reckless creeps like Zeke Emanuel and the pharmaceutical industry have been working for….

Facebook has just censored a woman called Michelle Coriaty-Herbst for sharing the WHO’s bulletin on vaccines word-for-word. She just posted it. Facebook deleted it. ‘Your comment goes against our community standards on spam,’ Facebook wrote. So, this is Silicon Valley’s new policy: everything about vaccines is good. Period. You are not allowed to suggest otherwise. No matter what data you might have. No matter what data you might have, no matter what a health organization might tell you.

You got that? The WHO cast doubt on vaccines for children but if someone dares to quote them … Facebook was deleting the post.

And if, like Mr. Carlson, you quote the WHO, while complaining about how big tech censored a person just for quoting the WHO, well … that is double plus ungood. For that, Tucker was put on double-secret probation by Twitter, as Paul D. Thacker just revealed:

He understates this. Not only was the WHO website stealth edited, but according to the substack linked at the end of this thread, it was immediately stealth-edited after Mr. Carlson cited them in his piece, which might have contributed to calls to suppress his column. After all, by citing what the WHO had said the day before, they were contradicting what the WHO was saying the day after. From the substack post:

When Tucker’s June 2021 report on the WHO’s vaccine recommendations hit Twitter, the WHO stealth edited their COVID vaccine page to remove language Tucker cited in his op-ed. The following day, Twitter officials began discussing Tucker’s essay and how to limit its impact without calling attention to Tucker and creating ‘political risks’ for Twitter by directly censoring Fox News.

Back to Mr. Thacker’s thread:

To review, a platform (Twitter) with an advertising deal with a vaccine manufacturer, did their best to suppress a story that, if enough people were persuaded by it, would reduce the sales of vaccines. But they also did their best to keep Mr. Carlson from finding out what they were doing, to prevent them from being called out for this corrupt behavior.

In the long arc of history, the people who try to silence critics are almost never the good guys.

Mr. Carlson, for his part, does not seem to be down about his dismissal from Fox News. Here he is laughing at someone in the media for filming him and his wife:

When he gets back ‘on the air’—and he might have a non-compete agreement that prevents him from doing that for a while—we suspect he will say some very interesting things. It might not be that he has been deplatformed, so much as unleashed.

***

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Dr. Fauci admits masks didn’t actually do very much good

As we noted earlier today, Dr. Anthony Fauci sat down for an interview with the New York Times and denied any responsibility for the COVID lockdowns. We also covered Alyssa Farah Griffin’s attempt to back him up. That attempt to rewrite history is galling enough. However, Ian Miles Cheong found something else objectionable in that interview:

Now he says it.

Now he says it after people were censored on social media for questioning his claim that masks were some kind of miracle preventative.

Now he says it after lip-reading deaf people had their lives ruined.

Yes, she won a court case but only after losing her job.

Now he says they didn’t work very well after Shannon Heroux was reduced to tears:

Now he says it after this child abuse occurred:

Now he says it after this parent told us how it harmed her children’s health:

Now he tells us.

And he knew masks weren’t important. His behavior told you that he knew:

They all knew:

They all knew, but they imposed these mandates anyway. We are not saying no one benefits from masking. Some people are more vulnerable to COVID than others. But there was never proof that the benefit of a mask mandate outweighed the harms. We should have defaulted to freedom and individual choice.

Listen to these children when they are told they were no longer going to be forced to wear a mask. Listen to their joy:

Their joy is an indictment on every politician who forced them to wear masks—especially if they couldn’t live under the rules they imposed on us.

Naturally, there were some reactions:

That would be sarcasm set to 11.

It’s okay to laugh, folks. But also don’t ever forget the lessons we learned.



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‘We’re Struggling’: Long COVID Mystery Has Doctors in the Dark

March 23, 2023 — This month, I took care of a patient who recently contracted COVID-19 and was complaining of chest pain. After ruling out the possibility of a heart attack, pulmonary embolism, or pneumonia, I concluded that this was a residual symptom of COVID. 

Chest pain is a common lingering symptom of COVID. However, because of the scarcity of knowledge regarding these post-acute symptoms, I was unable to counsel my patient on how long this symptom would last, why he was experiencing it, or what its actual cause was. 

Such is the state of knowledge on long COVID. That informational vacuum is why we’re struggling and doctors are in a tough spot when it comes to diagnosing and treating patients with the condition.

Almost daily, new studies are published about long COVID (technically known as post-acute sequelae of COVID-19 [PASC]) and its societal impacts. These studies often calculate various statistics regarding the prevalence of this condition, its duration, and its scope. 

However, many of these studies do not provide the complete picture — and they certainly do not when they are interpreted by t

he lay press and turned into clickbait. 

Long COVID is real, but there is a lot of context that is omitted in many of the discussions that surround it. Unpacking this condition and situating it in the larger context is an important means of gaining traction on this condition. 

And that’s critical for doctors who are seeing patients with symptoms.

Long COVID: What Is It?   

The CDC considers long COVID to be an umbrella term for “health consequences” that are present at least 4 weeks after an acute infection. This condition can be considered “a lack of return to the usual state of health following COVID,” according to the CDC.

Common symptoms include fatigue, shortness of breath, exercise intolerance, “brain fog,” chest pain, cough, and loss of taste/smell. Note that it’s not a requirement that that symptoms be severe enough that they interfere with activities of daily living, just that they are present.

There is no diagnostic test or criteria that confirms this diagnosis. Therefore, the symptoms and definitions above are vague and make it difficult to gauge prevalence of the disease. Hence, the varying estimates that range from 5% to 30%, depending on the study. 

Indeed, when one does routine blood work or imaging on these patients, it is unlikely that any abnormality is found. Some individuals, however, have met diagnostic criteria and have been diagnosed with postural orthostatic tachycardia syndrome (POTS). POTS is a disorder commonly found in long COVID patients that causes problems in how the autonomic nervous system regulates heart rate when moving from sitting to standing, during which blood pressure changes occur. 

How to Distinguish Long COVID From Other Conditions

There are important conditions that should be ruled out in the evaluation of someone with long COVID. First, any undiagnosed condition or change in an underlying condition that could explain the symptoms should be considered and ruled out. 

Secondly, it is critical to recognize that those who were in the intensive care unit or even hospitalized with COVID should not really be grouped together with those who had uncomplicated COVID that did not require medical attention. 

One reason for this is a condition known as post-ICU syndrome or PICS. PICS can occur in anyone who is admitted to the ICU for any reason and is likely the result of many factors common to ICU patients. They include immobility, severe disruption of sleep/wake cycles, exposure to sedatives and paralytics, and critical illness. 

Those individuals are not expected to recover quickly and may have residual health problems that persist for years, depending on the nature of their illness. They even have heightened mortality

The same is true, to a lesser extent, to those hospitalized whose “post-hospital” syndrome places them at higher risk for experiencing ongoing symptoms. 

To be clear, this is not to say that long COVID does not occur in the more severely ill patients, just that it must be distinguished from these conditions. In the early stages of trying to define the condition, it is more difficult if these categories are all grouped together. The CDC definition and many studies do not draw this important distinction and may confuse long COVID with PICS and post-hospital syndrome.

Control Groups in Studies Are Key

Another important means to understand this condition is to conduct studies with control groups, directly comparing those who had COVID with those that did not. 

Such a study design allows researchers to isolate the impact of COVID and separate it from other factors that could be playing a role in the symptoms. When researchers conduct studies with control arms, the prevalence of the condition is always lower than without. 

In fact, one notable study demonstrated comparable prevalence of long COVID symptoms in those who had COVID versus those that believe they had COVID. 

Identifying Risk Factors

Several studies have suggested certain individuals may be overrepresented among long COVID patients. These risk factors for long COVID include women, those who are older, those with preexisting psychiatric illness (depression/anxiety), and those who are obese. 

Additionally, other factors associated with long COVID include reactivation of Epstein-Barr virus (EBV), abnormal cortisol levels, and high viral loads of the coronavirus during acute infection. 

None of these factors has been shown to play a causal role, but they are clues for an underlying cause. However, it is not clear that long COVID is monolithic — there may be subtypes or more than one condition underlying the symptoms. 

Lastly, long COVID also appears to be only associated with infection by the non-Omicron variants of COVID.

Role of Antivirals and Vaccines 

The use of vaccines has been shown to lower, but not entirely eliminate, the risk of long COVID. This is a reason why low-risk individuals benefit from COVID vaccination. Some have also reported a therapeutic benefit of vaccination on long COVID patients. 

Similarly, there are indications that antivirals may also diminish the risk for long COVID, presumably by influencing viral load kinetics. It will be important, as newer antivirals are developed, to think about the role of antivirals not just in the prevention of severe disease but also as a mechanism to lower the risk of developing persistent symptoms. 

There may also be a role for other anti-inflammatory medications and other drugs such as metformin.

 Long COVID and Other Infectious Diseases 

The recognition of long COVID has prompted many to wonder if it occurs with other infectious diseases. Those in my field of infectious disease have routinely been referred patients with persistent symptoms after treatment for Lyme disease or after recovery from the infectious mononucleosis. 

Individuals with influenza may cough for weeks post-recovery, and even patients with Ebola may have persistent symptoms (though the severity of most Ebola causes makes it difficult to include). 

Some experts suspect an individual human’s immune response may influence the development of post-acute symptoms. The fact that so many people were sickened with COVID at once allowed a rare phenomenon that always existed with many types of infections to become more visible.

Where to Go From Here: A Research Agenda

Before anything can be definitely said about long COVID, fundamental scientific questions must be answered. 

Without an understanding of the biological basis of this condition, it becomes impossible to diagnose patients, development treatment regimens, or to prognosticate (though symptoms seem to dissipate over time). 

It was recently said that unraveling the intricacies of this condition will lead to many new insights about how the immune system works — an exciting prospect in and of itself that will advance science and human health.

Armed with that information, the next time clinicians see a patient such as the one I did, we will be in a much better position to explain to a patient why they are experiencing such symptoms, provide treatment recommendations, and offer prognosis. 

Amesh A. Adalja, MD, is an infectious disease, critical care, and emergency medicine specialist in Pittsburgh, and senior scholar with the Johns Hopkins Center for Health Security.

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Matt Taibbi’s #TwitterFiles Part 19 takes deep, disturbing look at ‘The Great Covid-19 Lie Machine’

Earlier this month, Democratic Rep. Debbie Wasserman Schultz accused independent journalist Matt Taibbi of profiting off the “Twitter Files.”

Taibbi and journalists like Michael Shellenberger and Bari Weiss have been instrumental in bringing government and media corruption to light through their work on the “Twitter Files,” despite the Democratic Party and liberal media’s coordinated campaigns to kneecap and smear them. So we’re pleased to see that Taibbi hasn’t let the likes of Debbie Wasserman Schultz deter him from lifting heavy boulders and exposing corruption.

And that brings us to the “Twitter Files,” part 19. Taibbi dropped it today, and this particular thread focuses on “The Great Covid-19 Lie Machine, Stanford, the Virality Project, and the Censorship of ‘True Stories.’”

Get comfortable — but not too comfortable. You’re in for quite a ride:

There’s been enough corruption to fill 19 of these things! And we expect that there’s still a lot more where all that came from.

So stay tuned.

***

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Q&A: The Future of COVID-19

Senior writer Kara Grant co-authored this report.

March 15, 2023 – As we approach the third anniversary of the COVID-19 pandemic, experts and everyday Americans wonder if we are finally at the end of what has been a painful and exhausting ordeal that’s lasted 3 years. With vaccine and booster fatigue, COVID-19 cases leveling out, and a growing body of research that has helped us understand the virus more clearly, many are still asking: How concerned should I be?

 In February, the Biden administration announced that it was the end of the road for the COVID-19 emergency orders, which had been in place since January 2020. That came after a year still fraught with ups and downs, with the U.S. surpassing 1 million COVID-19 deaths and variants continuing to evolve.

 We asked experts their thoughts on the future of COVID-19 and how their perspectives have shifted over the years.

Where Are We Now With COVID-19?

While the Omicron variant is still lingering, we’re in a period of lower rates of COVID-19 transmission.

Vaccinations and boosters have helped. That, along with antiviral treatments and high rates of collective immunity, have kept COVID-19 at bay, but it’s important to remember that this virus isn’t going anywhere, says Ashwin Vasan, MD, the commissioner of the New York City Department of Health and Mental Hygiene.  

“The federal emergency will expire in May, and compared to where we’ve been, we’re not in an emergency today,” he says. “But we will have to use the tools and strategies to really manage whatever COVID-19 throws at us going forward – if it were to change or if it ends up being more of a seasonal virus, like other coronaviruses.”

One thing is for certain: Health care will never be the same, says Jennifer Gil, a registered nurse and a member of the American Nurses Association Board of Directors.

“While cases in our area are steadily declining, patients and health care workers continue to experience the long-lasting effects of the pandemic,” she says. “I witness it every day when I see the long-term impact it has had on patients, access to care, and health care workers’ mental and emotional well-being.”

Is This the End of the Pandemic? 

First, it’s important to understand the difference between a pandemic and an epidemic, Vasan says. An epidemic is the spreading of a disease that outpaces what would be expected within a certain time and location. A pandemic is an epidemic that spreads across various continents and regions of the world.

COVID-19 is a new virus, which makes things tricky. “Before 2020, our baseline was zero because COVID-19 didn’t exist,” says Vasan. “So, the question we can’t really answer from an epidemiologic standpoint is – ‘is it still a pandemic?’ Well, is it circulating beyond what’s to be expected? I think we’re going to have to figure out what those expectations are at baseline.”

Jim Versalovic, MD, pathologist-in-chief at Texas Children’s Hospital, deems this a “post-pandemic” period, since the virus isn’t impacting us as dramatically as it did in 2020 and 2021. This is thanks to the successful efforts “to diagnose, treat, and prevent COVID-19,” along with collective immunity after many being exposed and infected with the virus, he says.

Some experts believe that declaring the pandemic “over” is a long shot. Rather, it’s likely that we are changing to more of an endemic status, according to Natascha Tuznik, DO, an infectious disease specialist at the University of California, Davis. It’s best to view COVID-19 as a “permanently established infection” in both humans and animals, she says. So we should treat it like the seasonal flu and continue to be careful to update vaccinations. 

“Vaccine uptake, overall, is still insufficient,” says Tuznik, “It’s important to not let our guard down and believe the problem no longer exists.”

The impact the pandemic has had on communities of color, frontline workers, and the health care system more broadly is also not to be forgotten, says Gil. “While the number of COVID-19 cases is subsiding, the invisible impact of the pandemic will continue to emerge in the coming years,” she says. 

What Worries You Now About COVID-19? 

Complacency can be an issue with any viral infection, says Versalovic, and it’s critical to continue to treat COVID-19 with extreme caution. For example, the U.S. will always need to track COVID-19 trends.

“It has become one of our major respiratory viruses affecting mankind around the globe,” he says. “Certainly, in the medical profession, we’re going to have to do our best to communicate and emphasize to everyone that these viruses aren’t going to disappear, and we need to continue to be aware and vigilant.”

Don’t forget that people still die from this virus every day, says Tuznik. “COVID-19 has killed over 1 million Americans and over 6.8 million people globally,” she says. “While the rates of death have declined, they have not stopped.”

Vasan poses another critical question: “What pieces are in place to ensure that we have a strong health system prepared to respond to COVID-19 changes or if another epidemic or pandemic illness arrives?” 

Examples could include ensuring tests, vaccines, and treatments are deployed in a quick, strategic manner, and building a public health system that can make that happen, without failing to support health care workers, he says.

Challenges like staffing shortages and hazardous work conditions have resulted in mental health-related issues and burnout among health care workers, Gil says. Many have reported skyrocketing rates of PTSDanxietydepression, and stress. Some have chosen to leave the health care workforce entirely.

“Investing in our health care workforce by providing mental health and wellness resources is essential,” says Gil. “We must also equally address the underlying issues by enforcing safe staffing standards and investing in long-term solutions that aim to improve the work environment.”

Has the Pandemic Changed Your Relationship to Medicine? 

The COVID-19 crisis has altered the health care world, likely for posterity. For many, like Vasan, the last 3 years have been a shining example of how fragile our health care system is. 

“We continually spend on things that don’t deliver on health,” he says, referring specifically to the $4 trillion spent on health care, with only a small fraction of that dedicated to disease prevention efforts. “Had we spent more on prevention, fewer would have died from COVID. We need to have a reckoning in this country about whether we are willing not to design for health care and medicine, but to design for health.” 

And while COVID-19 certainly brought to light the major – and minor – flaws in the health care system, the knowledge we’ve learned along the way is a silver lining for many doctors. Versalovic says that the chaos and anxiety forced those in medicine to rapidly refine their approaches to diagnostics, from in-hospital testing to drive-thru and at-home testing. Along the way, he says, there has also been a renewed gratitude for treatments like monoclonal antibodies and the preventive powers of RNA vaccines. 

But for Tuznik, the pandemic has given her an entirely newfound appreciation for her career path. 

“The infectious diseases community really came together as a tour de force during the pandemic, and it was humbling to be a part of such a mass effort and collaboration,” she says. 

What Have the Last 3 Years Taught You?

COVID-19 has forced us all to learn new and often difficult lessons about ourselves, our relationships, and how we each fit into the world. 

It’s a line we’ve heard over and over again: These are unprecedented times. A large part of that has been the extreme politicization of science and the growing divisiveness across the country. But despite what feels like unyielding friction in the medical community and beyond, people were still able to come together and tackle the pandemic’s challenges. 

Vasan says that our ability to work together on life-saving treatments and prevention strategies is “a testament to human endeavor, ingenuity, collaboration, in the face of an existential threat.”

For nurses, the pandemic brought about pervasive burnout and fatigue. But that’s not the end of the story. 

“Personally, it has driven me to go back to school to gain the research and analytical skills necessary to develop evidence-based policies and programs that aim to improve health care delivery,” says Gil. “Now, more than ever, nurses are key stakeholders at the policy and decision-making table.”

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COVID at 3 Years: Where Are We Headed?

March 15, 2023 – Three years after COVID-19 rocked the world, the pandemic has evolved into a steady state of commonplace infections, less frequent hospitalization and death, and continued anxiety and isolation for older people and those with weakened immune systems.

After about 2½ years of requiring masks in health care settings,  the CDC lifted its recommendation for universal, mandatory masking in hospitals in September 2022.

Some statistics tell the story of how far we have come. COVID-19 weekly cases dropped to nearly 171,000 on March 8, a huge dip from the 5.6 million weekly cases reported in January 2022. COVID-19 deaths, which peaked in January 2021 at more than 23,000 a week, stood at 1,862 per week on March 8.

Where We Are Now

Since Omicron is so infectious, “we believe that most people have been infected with Omicron in the world,” says Christopher J.L. Murray, MD, a professor and chair of health metrics sciences at the University of Washington and director of the Institute for Health Metrics and Evaluation in Seattle. Sero-prevalence surveys — or the percentage of people in a population who have antibodies for an infectious disease, or the Omicron variant in this case — support this rationale, he says.

“Vaccination was higher in the developed world but we see in the data that Omicron infected most individuals in low income countries,” says Murray. For now, he says, the pandemic has entered a “steady state.”

At New York University Langone Health System, clinical testing is all trending downward, and hospitalizations are low, says Michael S. Phillips, MD, an infectious disease doctor and chief epidemiologist at the health system. 

In New York City, there has been a shift from pandemic to “respiratory viral season/surge,” he says. 

The shift is also away from universal source control – where every patient encounter in the system involves masking, distancing, and more – to a focus on the most vulnerable patients “to ensure they’re well-protected,” Phillips says. 

Johns Hopkins Hospital in Baltimore has seen a “marked reduction” of the number of people coming to the intensive care unit because of COVID, says Brian Thomas Garibaldi, MD, a critical care doctor and director of the Johns Hopkins Biocontainment Unit.

“That is a testament to the amazing power of vaccines,” he says. 

The respiratory failures that marked many critical cases of COVID in 2020 and 2021 are much rarer now, a shift that Garibaldi calls “refreshing.”

“In the past 4 or 5 weeks, I’ve only seen a handful of COVID patients. In March and April of 2020, our entire intensive care unit – in fact, six intensive care units – were filled with COVID patients.”

Garibaldi sees his own risk differently now as well. 

“I am not now personally worried about getting COVID, getting seriously ill, and dying from it. But if I have an ICU shift coming up next week, I am worried about getting sick, potentially having to miss work, and put that burden on my colleagues. Everyone is really tired now,” says Garibaldi, who is also an associate professor of medicine and physiology in the Division of Pulmonary and Critical Care Medicine at Johns Hopkins University School of Medicine. 

What Keeps Experts Up at Night?

The potential for a stronger SARS-CoV-2 variant to emerge concerns some experts.  

A new Omicron  subvariant could emerge, or a new variant altogether could arise.  

One of the main concerns is not just a variant with a different name, but one that can escape current immune protections. If that happens, the new variant could infect people with immunity against Omicron. 

If we do return to a more severe variant than Omicron, Murray says, “then suddenly we’re in a very different position. 

Keeping an Eye on COVID-19, Other Viral Illnesses

We have better genomic surveillance for circulating strains of SARS-CoV-2 than earlier in the pandemic, Phillips says. More reliable, day-to-day data also helped recently with the respiratory syncytial virus (RSV) outbreak and for tracking flu cases.

 Wastewater surveillance as an early warning system for COVID-19 or other respiratory virus surges can be helpful, but more research is needed, Garibaldi says. And with more people testing at home, test positivity rates are likely an undercount. So, hospitalization rates for COVID and other respiratory illnesses remain one of the more reliable community-based measures, for now, at least. 

One caveat is that sometimes, it is unclear if COVID-19 is the main reason someone is admitted to the hospital vs. someone who comes in for another reason and happens to test positive upon admission. 

Phillips suggests that using more than one measure might be the best approach, especially to reduce the likelihood of bias associated with any single strategy. “You need to look at a whole variety of tests in order for us to get a good sense of how it’s affecting all communities,” he says. In addition, if a consensus emerges among different measures – wastewater surveillance, hospitalization and test positivity all trending up – “that’s clearly a sign that things are afoot and that we would need to modify our approach accordingly.”

Where We Could Be Heading

Murray predicts a steady pace of infection with “no big changes.” But waning immunity remains a concern. 

That means if you have not had a recent infection – in the last 6 to 10 months – you might want to think about getting a booster, Murray says “The most important thing for people, for themselves, for their families, is to really think about keeping their immunity up.” 

Phillips hopes the improved surveillance systems will help public health officials make more precise recommendations based on community levels of respiratory illness. 

When asked to predict what might happen with COVID moving forward, “I can’t tell you how many times I’ve been wrong answering that question,” Garibaldi says.

 Rather than making a prediction, he prefers to focus on hope. 

“We weathered the winter storm we worried about in terms of RSV, flu, and COVID at the same time. Some places were hit harder than others, especially with pediatric RSV cases, but we haven’t seen anywhere near the level we saw last year and before that,” he says. “So, I hope that continues.”

“We’ve come very far in just 3 years. When I think about where we were in March 2020 taking care of our first round of COVID patients in our first unit called a biocontainment unit,” Garibaldi says. 

Murray addresses whether the term “pandemic” still applies at this point. 

“In my mind, the pandemic is over,” he says, because we are no longer in an emergency response phase. But COVID in some form is likely to be around for a long time, if not forever.  

“So, it depends on how you define pandemic. If you mean an emergency response, I think we’re out of it. If you mean the formal definition you know of an infection that goes all over the place, then we’re going to be in it for a very long time.”

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Self-anointed ‘Vaccine Scientist-Author-Combat Antiscience’ still fighting lab-leak ‘misinformation’

A whole lot of so-called “experts” still have a whole lot of egg on their faces today after the lab-leak conspiracy theory for the origins of the COVID pandemic turned out to not be a conspiracy theory after all. If only someone had tried to convince them that it was a terrible, horrible, no-good, very-bad idea to dismiss the lab-leak hypothesis as unscientific, racist, conspiratorial garbage.

Someone did try to convince of that, in fact. Many people did. GOP Sen. Tom Cotton was one of them, and he was slimed and raked over the coals for it by the FoLLoW tHe SciEnCe™ community.

Sen. Cotton called for transparency. The “experts” fought tooth-and-nail against it. It didn’t work out well for the latter group. And now we’re seeing how they behave when confronted with extremely compelling evidence that they put all their eggs in the wrong basket.

Let’s take a look at “Vaccine Scientist-Author-Combat Antiscience” Peter Hotez MD PhD BBQ PDQ (OK, we added the last two), for example, who, like so many others, isn’t handling the news very well:

Here’s our post about the New York Times piece that Hotez is referring to. It really screwed with the narrative Hotez wanted to perpetuate.

It’s important to note, since Peter did not, that COVID having natural origins does not actually disprove the lab-leak hypothesis. Virology labs often conduct research on viruses that originated in nature. The problem is when one of those viruses that originated in nature somehow gets out of the lab and spreads to places where it wasn’t naturally found, like, say, outside of caves inhabited by infected bats.

Now, now, Peter … just because you got caught trying to whitewash your own COVID misdeeds doesn’t mean that’s what people giving credence to the lab-leak hypothesis are doing. But you already knew that, didn’t you? You just know where your bread was buttered and don’t want to go hungry.

We can actually picture Hotez sneering as he typed that.

Admitting they may have been wrong would be the first step toward redemption in the eyes of a willfully misled public. It would also just be the right thing to do.

And that is why — perhaps with a handful (see what we did there?) of exceptions — they’ll never, ever do it.

***

Related:

Your crow is served: The COVID lab leak theory was dismissed by many – Twitter reminded them today

Jill Filipovic knows who’s to blame for libs/media calling misinfo on any theory blaming China lab for Covid

***

Join us in the fight. Become a Twitchy VIP member today and use promo code SAVEAMERICA to receive a 40% discount on your membership.



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COVID Emergency Orders Ending: What’s Next?

Feb. 1, 2023 – It’s the end of an era. The Biden administration announced Monday that it will be ending the twin COVID-19 emergency declarations, marking a major change in the 3-year-old pandemic.  .

The orders spanned two presidencies. The Trump administration’s Health and Human Services Secretary Alex Azar issued a public health emergency in January 2020. Then-President Donald Trump declared the COVID-19 pandemic a national emergency 2 months later. Both emergency declarations – which remained in effect under President Joe Biden – are set to expire May 11. 

Read on for an overview of how the end of the public health emergency will trigger multiple federal policy changes. 

Changes That Affect Everyone

  • There will be cost-sharing changes for COVID-19 vaccines, testing, and certain treatments. One hundred-percent coverage for COVID testing, including free at-home tests, will expire May 11. 
  • Telemedicine cannot be used to prescribe controlled substances after May 11, 2023.
  • Enhanced federal funding will be phased down through Dec. 31, 2023. This extends the time states must receive federally matched funds for COVID-related services and products, through the Consolidated Appropriations Act of 2023Otherwise, this would have expired June 30, 2023.
  • Emergency use authorizations  for COVID-19 treatments and vaccinations will not be affected and/or end on May 11.

Changes That Affect People With Private Health Insurance

  • Many will likely see higher costs for COVID-19 tests, as free testing expires and cost-sharing begins in the coming months.
  • COVID-19 vaccinations and boosters will continue to be covered until the federal government’s vaccination supply is depleted. If that happens, you will need an in-network provider.
  • You will still have access to COVID-19 treatments – but that could change when the federal supply dwindles.

Changes That Affect Medicare Recipients

  • Medicare telehealth flexibilities will be extended  through Dec. 31, 2024, regardless of public health emergency status. This means people can access telehealth services from anywhere, not just rural areas; can use a smartphone for telehealth; and can access telehealth in their homes. 
  • Medicare cost-sharing for testing and treatments will expire May 11, except for oral antivirals. 

Changes That Affect Medicaid/CHIP Recipients

  • Medicaid and Children’s Health Insurance Program (CHIP) recipients will continue to receive approved vaccinations free of charge, but testing and treatment without cost-sharing will expire during the third quarter of 2024.
  • The Medicaid continuous enrollment provision will be separated from the public health emergency, and continuous enrollment will end March 31, 2023.

Changes That Affect Uninsured People

  • The uninsured will no longer have access to 100% coverage for these products and services (free COVID-19 treatments, vaccines, and testing). 

Changes That Affect Health Care Providers

  • There will be changes to how much providers get paid for diagnosing people with COVID-19, ending the enhanced Inpatient Prospective Payment System reimbursement rate, as of May 11, 2023.
  • Health Insurance Portability and Accountability Act (HIPAA) potential penalty waivers will end. This allows providers to communicate with patients through telehealth on a smartphone, for example, without violating privacy laws and incurring penalties.

What the Experts Are Saying 

WebMD asked several health experts for their thoughts on ending the emergency health declarations for COVID, and what effects this could have. Many expressed concerns about the timing of the ending, saying that the move could limit access to COVID-related treatments. Others said the move was inevitable but raised concerns about federal guidance related to the decision. 

Q: Do you agree with the timing of the end to the emergency order?

A: Robert Atmar, MD, a professor of infectious diseases at Baylor College of Medicine in Houston: “A lead time to prepare and anticipate these consequences may ease the transition, compared to an abrupt declaration that ends the declaration.” 

A: Georges C. Benjamin, MD, executive director of the American Public Health Association: “I think it’s time to do so. It has to be done in a great, thoughtful, and organized way because we’ve attached so many different things to this public health emergency. It’s going to take time for the system to adapt. CDC data collection most likely will continue. People are used to reporting now. The CDC needs to give guidance to the states so that we’re clear about what we’re reporting, what we’re not. If we did that abruptly, it would just be a mess.”

A: Bruce Farber, MD, chief public health and epidemiology officer at Northwell Health in Manhasset, NY:  “I would have hoped to see it delayed.”

A: Steven Newmark, JD, chief legal officer and director of policy at the Global Healthy Living Foundation: “While we understand that an emergency cannot last forever, we hope that expanded services such as free vaccination, promotion of widespread vaccination, increased use of pharmacists to administer vaccines, telehealth availability and reimbursement, flexibility in work-from-home opportunities, and more continues. Access to equitable health care should never backtrack or be reduced.”

Q: What will the end of free COVID vaccinations and free testing mean? 

A: Farber: “There will likely be a decrease in vaccinations and testing.The vaccination rates are very low to begin with, and this will likely lower it further.”

A: Atmar: “I think it will mean that fewer people will get tested and vaccinated,” which “could lead to increased transmission, although wastewater testing suggests that there is a lot of unrecognized infection already occurring.” 

A: Benjamin: “That is a big concern. It means that for people, particularly for people who are uninsured and underinsured, we’ve got to make sure they have access to those. There’s a lot of discussion and debate about what the cost of those tests and vaccines will be, and it looks like the companies are going to impose very steep, increasing costs.”

Q: How will this affect higher-risk populations, like people with weakened immune systems? 

A: Farber: “Without monoclonals [drugs to treat COVID] and free Paxlovid,” people with weakened immune systems  “may be undertreated.”

A: Atmar: “The implications of ongoing widespread virus transmission are that immunocompromised individuals may be more likely to be exposed and infected and to suffer the consequences of such infection, including severe illness. However, to a certain degree, this may already be happening. We are still seeing about 500 deaths/day, primarily in persons at highest risk of severe disease.”

A: Benjamin: “People who have good insurance, can afford to get immunized, and have good relations with practitioners probably will continue to be covered. But lower-income individuals and people who really can’t afford to get tested or get immunized would likely become under-immunized and more infected. 

“So even though the federal emergency declaration will go away, I’m hoping that the federal government will continue to encourage all of us to emphasize those populations at the highest risk – those with chronic disease and those who are immunocompromised.”

A: Newmark: “People who are immunocompromised by their chronic illness or the medicines they take to treat acute or chronic conditions remain at higher risk for COVID-19 and its serious complications. The administration needs to support continued development of effective treatments and updated vaccines to protect the individual and public health. We’re also concerned that increased health care services – such as vaccination or telehealth – may fall back to pre-pandemic levels while the burden of protection, such as masking, may fall to chronic disease patients, alone, which adds to the burden of living with disease.”

Q: What effect will ending Medicaid expansion money have? 

A: Benjamin: Anywhere from 16 to 20 million people are going to lose in coverage. I’m hoping that states will look at their experience over these last 2 years or so and come to the decision that there were improvements in healthier populations.

Q: Will this have any effect on how the public perceives the pandemic? 

A: Farber: “It is likely to give the impression that COVID is gone, which clearly is not the case.”

A: Benjamin: “It’ll be another argument by some that the pandemic is over. People should think about this as kind of like a hurricane. A hurricane comes through and tragically tears up communities, and we have an emergency during that time. But then we have to go through a period of recovery. I’m hoping people will realize that even though the public health emergencies have gone away, that we still need to go through a period of transition … and that means that they still need to protect themselves, get vaccinated, and wear a mask when appropriate.”

A: Atmar: “There needs to be messaging that while we are transitioning away from emergency management of COVID-19, it is still a significant public health concern.”

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