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Q. What is the role of school nurse?A."Professional responsibilities have not changed overall," said Carolyn Duff, president of the National Association of School Nurses. "What has changed is the increasing number of students with chronic health conditions, including asthma, diabetes and severe allergies. All of these conditions have the potential for life-threatening emergencies. What this means for school nurses is an increasing need to train and maintain a competent team of unlicensed school personnel to prevent, recognize and respond to emergencies.”School nurses' duties expand with changing timesMaria SonnenbergBeyond sniffles and sneezes, they must manage complex conditions and chronic illnesses.(Photo: Tim Shortt, Florida Today)STORY HIGHLIGHTSSome nurses are assigned to several schools during a workweekNational Association of School Nurses recommends a 1-to-750 ratio of nurses to well studentsSchool nurses also go beyond the traditional boundaries of kindergarten to high school students to provide Head Start screenings and physicalsThe Boy Scout motto of "be prepared" equally applies to today's school nurses, who not only deal with the typical bruises and tummy aches that have always been part of school life, but must now contend with a student population that is increasingly more medically fragile.As school systems face budget cuts, nurses must also adapt to a "migrant" lifestyle as they are assigned to several schools during a workweek."There have been a lot of changes in the last 20 years," said Pamelia Hamilton, community health nurse consultant and school health coordinator for the Brevard Department of Health, which supervises the 160 nurses and health technicians who serve public schools in Brevard County.According to the National Association of School Nurses, a third of all school districts reduced nursing staff in the past year because of the recession, and a quarter of all school districts in the nation don't have nurses. In these districts, medical emergencies are typically handled by a school's front office staff, the way they were in Brevard until the late 1980s, when nurses were first introduced to local schools.Brevard's ratio of nurse to students — about 1 per 450 — is exemplary, when considering that Florida, with a nurse-to-student ratio of 1 to 2,537, is at the bottom of the list in the number of nurses in schools. Only Utah, North Dakota and Michigan are worse off in numbers. Vermont, on the other hand, has a ratio of 1 nurse per 396 students.The National Association of School Nurses recommends a 1-to-750 ratio for well students and 1 to 125 in student populations with complex health care needs."People who live here think our nursing program is the norm everywhere, but when they move out, they are in for a shock," Hamilton said."What we do is so extraordinary that we've been recognized with several awards."The health department hires, trains and pays the school district's nurses. In turn, the district reimburses the health department for most costs incurred in running the program.New responsibilitiesThe foremost duty of a school nurse is to keep kids learning as long as possible. These days, that can take the form of fixing an accidentally stapled finger or a nasty cold, as it did years ago, but it can also entail helping a pregnant teen stay in school and teaching them to become a good mother. Brevard's Teen Parent Program, for example, assists about 250 pregnant girls at Palm Bay, Eau Gallie, Titusville and Cocoa high schools.Nursing supervisor Travia Williams Torey McGhee in the Head Start classroom in Cocoa High School in Brevard County, Fla. (Photo: Tim Shortt, Florida Today)"We explain to them what is happening to their bodies and train them to care for their babies," Hamilton said.School nurses today also go beyond the traditional boundaries of kindergarten to high school students. Nurse Travia Williams and her team of technicians travel through the county's Head Start program sites to provide the screening, physicals and related services necessary for the little ones to be better prepared when their school days start.Other nurses are devoted to one-on-one care with medically needy students who otherwise would not be able to attend school.School nurses are also tasked with managing children's increasingly complex medical conditions and chronic illnesses. A child may have a tracheotomy or require nasal gastric tube feeds by an experienced nurse. Nurses may be required to monitor students' insulin pumps and keep track of inhalers and EpiPens. In some instances, Medicaid pays for a private duty nurse to be with the student one-on-one throughout the school day."Professional responsibilities have not changed overall," said Carolyn Duff, president of the National Association of School Nurses. "What has changed is the increasing number of students with chronic health conditions, including asthma, diabetes and severe allergies. All of these conditions have the potential for life-threatening emergencies. What this means for school nurses is an increasing need to train and maintain a competent team of unlicensed school personnel to prevent, recognize and respond to emergencies."Another change is a welcome change," Duff said. "There is now a greater emphasis on prevention and wellness in health care.""School nurses are identifying students at risk for both health and learning problems at an early age and are able to initiate early referrals for intervention and treatment."The National Association of School Nurses lists data that underscores why school nurses' duties are so varied these days. Among students ages 12 to 19, pre-diabetes and diabetes has increased from 9 percent in 1999 to 23 percent in 2008, and 32 percent of children ages 2 to 19 are obese. More than 10 million children suffer from asthma. The prevalence of food allergies among children younger than 18 increased 19 percent from 1997 to 2007.Mental health issues among students are on the rise. School nurses estimate they spent about a third of their time providing mental health services.Overall, 15 percent to 18 percent of children and adolescents have a chronic health condition, nearly half of whom could be considered disabling.ACA's impactThe enactment of the Affordable Care Act could provide an opportunity to strengthen a nurse program that serves the nation's 52 million school-age children. For many of these students, the school nurse is the sole provider of access to health care.Health care reform's emphasis on wellness dovetails with the goals of school nurses, who provide continuity of care and promote healthy lifestyles for students during their most critical developmental years. They perform early intervention services such as periodic assessments for vision, hearing and dental problems with the goal of removing barriers to learning.States are testing different health care models for high value rather than high cost and high volume. School nurses are included in the plan."Health care reform will lead to greater opportunity for school nurses to successfully connect students from low-income families to medical homes, because more students will be insured," Duff said."More widespread access to medical homes will provide greater opportunity for school health services to focus on prevention and wellness and tighter management of students with chronic disease."National Association of School NursesThe Roles & Responsibilities of School Health Nursingby Beth GreenwoodWhen the first school nurse was hired in New York City in 1902, her primary goal, according to the National Association of School Nurses, was to reduce student absences from communicable diseases. In the years since Lina Rogers first implemented the practice of school nursing, the role has expanded, but the goal has not changed. School nurses continue to perform valuable services to schools, individual students and the community.Children's Health NeedsThe rationale for placing nurses in school is based on the concept that a child with unmet health needs will have difficulty learning. School nurses are ideally placed to assess physical, emotional, mental and social health needs of the school children for whom they care. Chronic medical conditions such as asthma, epilepsy, Type I diabetes and mental health problems can increase absenteeism and affect learning. The school nurse can help manage the medical care of students who have chronic diseases, and promote education from the primary to the high school level.Health Education and ManagementThe National Association of School Nurses sees the school nurse as taking a lead role in the school community to oversee school health policies and programs. In addition to providing direct services, the school nurse is ideally placed to promote health education and to integrate health-care solutions into the school setting. As the number of children with increasingly complex medical problems has risen, school nurses have taken the primary role in issues such as the management of medical equipment and complicated treatments while the child is at school.Screening and ReferralsA school nurse may perform a wide variety of direct care tasks such as screening students for scoliosis, vision or hearing problems. When a problem is identified, the nurse will make referrals to the appropriate specialist or work with the primary care doctor to assure the child’s needs are met. The school nurse collaborates with parents or other family members and serves as the liaison between school personnel, family, health-care providers and the community at large.Emergency and Public Health FunctionsAs a nursing professional, prepared at the baccalaureate level, the school nurse often practices independently. In addition to routine care such as medication management and screenings, she may act as the first responder in health emergencies for both students and school staffers. School nurses also perform public health functions such as disease surveillance, to increase the opportunity to recognize a communicable disease outbreak and intervene early. A school nurse also helps to assure immunization compliance and promotes overall student health.Performance ExpectationsThe National Association of School Nurses has a number of expectations for school nurse performance. These include such responsibilities as facilitating normal development, providing leadership in the promotion of health and safety, acting as a case manager and intervening in both actual and potential health problems. The school nurse is an essential component of school educational teams such as committees for special education or individual educational plan teams, which must take health issues into account in their decision-making processes.

“We dance round in a ring and suppose, but the secret sits in the middle and knows.”ROBERT FROST 1945“In Florida today, theaters are open, concerts are happening, and the iconic theme parks are accepting visitors (if on a somewhat restricted basis).”The strict lockdown in the UK also arrested the virus in Sweden - oops without a lockdown???Contrast Between New York And Florida — Manhattan ContrarianNEW LANCET RESEARCH: “Covid 19 is not a PANDEMIC.”“The most important consequence of seeing COVID-19 as a syndemic is to underline its social origins. The vulnerability of older citizens; Black, Asian, and minority ethnic communities; and key workers who are commonly poorly paid with fewer welfare protections points to a truth so far barely acknowledged—namely, that no matter how effective a treatment or protective a vaccine, the pursuit of a purely biomedical solution to COVID-19 will fail.” LANCETNOT A PANDEMIC BUT A SYNDEMIC“Coronavirus is no 1918 ‘Spanish’ Influenza that struck down a global population in its prime: this virus is overwhelmingly targeting people who would already be vulnerable to disease. From the available data, then, there is cause to suggest that this is not a pandemic, but a syndemic.”Pandemic … or syndemic? Re‐framing COVID‐19 disease burden and ‘underlying health conditions’“Many seriously ill COVID-19 patients had multiple comorbidities (26); for instance, 96.2% of those who died in hospitals in Italy had comorbidities..If We Just Treat COVID-19 as a Pandemic, We’re ScrewedWe’re in a syndemic, when an illness and our broken society combine to bring terrible things. Here’s how we need to respond.Crawford Kilian 30 Sep 2020 | The Tyee | Home80% CANADA’S COVID 19 DEATHS WERE IN LONG TERM CARE HOMES“Approaching COVID-19 as a syndemic will invite a larger vision, one encompassing education, employment, housing, food and environment. Viewing COVID-19 only as a pandemic excludes such a broader but necessary prospectus.” Richard HortonIf We Just Treat COVID-19 as a Pandemic, We’re Screwed | The TyeeCOMORBIDITY IS EVERYTHING WITH THIS VIRUS.“Many seriously ill COVID-19 patients had multiple comorbidities (26); for instance, 96.2% of those who died in hospitals in Italy had comorbidities..The prevalence of comorbidities is higher among COVID-19 patients compared to the general population who are not infected with coronavirus; for instance, 86% of the COVID-19 patients in India and 72% of the COVID-19 patients in China had comorbidities (28). ““NEW RESEARCH WITH FOCUS ON THE SYNDEMIC ISSUEThe global coronavirus disease (COVID-19) pandemic has greatly affected the lives of people living with non-communicable diseases (PLWNCDs). The health of PLWNCDs worsens when synergistic epidemics or “syndemics” occur due to the interaction between socioecological and biological factors, resulting in adverse outcomes. These interactions can affect the physical, emotional, and social well-being of PLWNCDs. In this paper, we discuss the effects of the COVID-19 syndemic on PLWNCDs, particularly how it has exposed them to NCD risk factors and disrupted essential public health services. We conclude by reflecting on strategies and policies that deal with the COVID-19 syndemic among PLWNCDs in low- and middle-income countries.ConclusionCOVID-19 and NCDs have a reciprocal effect on each other; NCDs increase vulnerability to COVID-19, and COVID-19 increases NCD-related risk factors. The COVID-19 pandemic may not be the last to threaten the global community. Therefore, there is a need to understand the drivers of the syndemic and design safety nets. The health system must address not just one or some medical problems but ensure holistic care for those that need it, particularly PLWNCDs. Care for PLWNCDs, who are at most risk of COVID-19, must be included in national response frameworks and plans so that the government can protect citizens' health and well-being during the current COVID-19 pandemic and for similar crises in the future, otherwise, the interaction of COVID-19 and NCDs will result in disastrous effects that could be difficult to handle given the preexisting stress on healthcare delivery systems and impede progress in achieving the Sustainable Development Goals.”A Syndemic Perspective on the Management of Non-communicable Diseases Amid the COVID-19 Pandemic in Low- and Middle-Income CountriesCDC: “only 6% of deaths are solely from COVID 19” THIS IS A SYNDEMIC. We must broaden are concern and address hypertension, obesity, diabetes, cardiovascular and chronic respiratory diseases, and cancer,” to stop the spread. LANCETDr. Fauci weighs in on 6M US coronavirus cases, deaths and comorbidityThe top health official speaks to "GMA" about the CDC's adjusted numbers that listed 6% of deaths solely caused by COVID-19 and what it means for those with underlying conditions.September 1, 2020“On Sept. 1, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), debunked the claim on ABC’s Good Morning America ( here ).Asked to explain “why the president would retweet a theory that suggests only 9,000 people have died of COVID-19,” Fauci said, “The point that the CDC was trying to make was that a certain percentage of (Americans who have died of COVID-19) had nothing else but just COVID. That does not mean that someone who has hypertension or diabetes who dies of COVID didn’t die of COVID-19. They did.”“A small number of people have COVID ascribed as the sole cause of death. It may be they had no comorbidities or they were just not noted,” Myron Cohen, director of the Institute for Global Health and Infectious Diseases at the University of North Carolina at Chapel Hill, tells PolitiFact. “However, it is also clear that advanced age and several other underlying diseases lead to bad outcomes with COVID infections. The people dying were not going to die but for the acquisition of COVID.”Mark Halstead, a sports team physician at Washington University, described a hypothetical scenario in a Facebook post on August 30. Someone coming to the hospital with COVID-19 would certainly have the virus listed as a primary diagnosis, but if they then required a ventilator, respiratory failure would also be listed as a cause of death. If a person were to decline to such an extent that they went into cardiac arrest and died, that too would be listed on a death certificate. “The COVID infection started the process but that led to the heart and lungs failing, which killed that person,” Halstead says.No, the CDC Has Not “Quietly Updated” COVID-19 Death EstimatesBut that’s not what the CDC information says.In weekly updates provided on the CDC’s website, the agency includes information on additional conditions present in patients who died with COVID-19. These other illnesses or conditions found to be present in a patient are called comorbidities. The agency also includes a chart detailing the number of patients with each additional condition.For the week referenced in the claim, the CDC explained that the chart “shows the types of health conditions and contributing causes mentioned in conjunction with deaths involving coronavirus disease 2019 (COVID-19). For 6% of the deaths, COVID-19 was the only cause mentioned.”That means that 6% of those who died with COVID-19 through Aug. 15 didn’t have any other reported conditions.CDC Did Not 'Admit Only 6%' of Recorded Deaths from COVID-19AGE AND PRE-EXISTING CONDITIONS IS THE WHOLE SHOW FOR COVID 19FOLLOW THE NCD NON COMMUNICABLE DISEASESI submit If you revise your view of Covid as a syndemic rather than a pandemic you will better understand the variability in countries and people world wide. It is not just who followed the guidelines best but who has the most vulnerable underlying health issues that has the worst outcomes with hypertension and diabetes at the top.”From the beginning the impacts of Covid 19 have been uneven hitting some countries, the elderly and disadvantage far harder than others.China’s new research published in the JOURNAL OF ERS shows “hypertension and diabetes” are the major comorbidities for Covid 19 - See ABSTRACT below.“However, comorbidities do not seem to be the prerequisite for symptomatic and severe COVID-19 infection, except hypertension.Prevalence of Comorbidities in COVID-19 Patients: A Systematic Review and Meta-AnalysisSee ABSTRACT below.Most common comorbidities in COVID-19 deceased patients in Italy 2020Published by Statista Research Department, Aug 18, 2020An in depth study on patients admitted to hospital and later deceased with the coronavirus (COVID-19) infection revealed that the majority of cases showed one or more comorbidities. As the chart shows, hypertension was the most common pre-existing health condition, detected in 66 percent of patients who died after contracting the virus. Type 2-diabetes, chronic renal failure, and ischemic hearth disease were also among the most common comorbidities in COVID-19 patients who lost their lives.Italy’s First WaveThe most plausible explanation for this discrepancy is a short-term decrease in mortality after the first phase of the pandemic, which affected mainly older adults and those with underlying chronic conditions, 4, 5 a phenomenon known as the harvesting effect. In fact, the median age at death of patients who died and tested positive for SARS-CoV-2 infection was 82 years; 95% of them had at least one comorbidity, and 60% had at least three comorbidities before being infected. This phenomenon was less evident in Lombardy, where the number of cases, although remarkably reduced in the second half of May, 2020, continued to be non-negligible. More importantly, a large number of patients who had tested positive for SARS-CoV-2 might have died in May of other causes, although their deaths were attributed to COVID-19.”LANCETItaly's first wave of the COVID-19 pandemic has ended: no excess mortality in May, 2020WHY? THE ANSWER IS THAT COVID IS NOT A PANDEMIC. IT IS A SYNDEMIC.The full weight of public attention has been too narrow with too much concern about testing for Covid and too little concern about underlying disease that compromise our immune systems.Coronavirus World Map: Tracking The Spread Of The Outbreak | WAMUTotal casesDeathsPer capitaHOT SPOTS“The most important consequence of seeing COVID-19 as a syndemic is to underline its social origins. The vulnerability of older citizens; Black, Asian, and minority ethnic communities; and key workers who are commonly poorly paid with fewer welfare protections points to a truth so far barely acknowledged—namely, that no matter how effective a treatment or protective a vaccine, pursuit of a purely biomedical solution to COVID-19 will fail.Why context matters when there is comorbidity in play. The world has flunked the Covid crisis by ignoring the syndemic reality which means for example that almost all victims of the virus are also victims for example of diabetes, morbid obesity and hearth disease.”Offline: COVID-19 is not a pandemicAuthor links open overlay panelRichardHortonhttps://doi.org/10.1016/S0140-6736(20)32000-6Get rights and content“As the world approaches 1 million deaths from COVID-19, we must confront the fact that we are taking a far too narrow approach to managing this outbreak of a new coronavirus. We have viewed the cause of this crisis as an infectious disease. All of our interventions have focused on cutting lines of viral transmission, thereby controlling the spread of the pathogen. The “science” that has guided governments has been driven mostly by epidemic modellers and infectious disease specialists, who understandably frame the present health emergency in centuries-old terms of plague. But what we have learned so far tells us that the story of COVID-19 is not so simple. Two categories of disease are interacting within specific populations—infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and an array of non-communicable diseases (NCDs). These conditions are clustering within social groups according to patterns of inequality deeply embedded in our societies. The aggregation of these diseases on a background of social and economic disparity exacerbates the adverse effects of each separate disease. COVID-19 is not a pandemic. It is a syndemic. The syndemic nature of the threat we face means that a more nuanced approach is needed if we are to protect the health of our communities.The notion of a syndemic was first conceived by Merrill Singer, an American medical anthropologist, in the 1990s. Writing in The Lancet in 2017, together with Emily Mendenhall and colleagues, Singer argued that a syndemic approach reveals biological and social interactions that are important for prognosis, treatment, and health policy. Limiting the harm caused by SARS-CoV-2 will demand far greater attention to NCDs and socioeconomic inequality than has hitherto been admitted. A syndemic is not merely a comorbidity. Syndemics are characterised by biological and social interactions between conditions and states, interactions that increase a person's susceptibility to harm or worsen their health outcomes. In the case of COVID-19, attacking NCDs will be a prerequisite for successful containment. As our recently published NCD Countdown 2030 showed, although premature mortality from NCDs is falling, the pace of change is too slow. The total number of people living with chronic diseases is growing. Addressing COVID-19 means addressing hypertension, obesity, diabetes, cardiovascular and chronic respiratory diseases, and cancer. Paying greater attention to NCDs is not an agenda only for richer nations. NCDs are a neglected cause of ill-health in poorer countries too. In their Lancet Commission, published last week, Gene Bukhman and Ana Mocumbi described an entity they called NCDI Poverty, adding injuries to a range of NCDs—conditions such as snake bites, epilepsy, renal disease, and sickle cell disease. For the poorest billion people in the world today, NCDIs make up over a third of their burden of disease. The Commission described how the availability of affordable, cost-effective interventions over the next decade could avert almost 5 million deaths among the world's poorest people. And that is without considering the reduced risks of dying from COVID-19.The most important consequence of seeing COVID-19 as a syndemic is to underline its social origins. The vulnerability of older citizens; Black, Asian, and minority ethnic communities; and key workers who are commonly poorly paid with fewer welfare protections points to a truth so far barely acknowledged—namely, that no matter how effective a treatment or protective a vaccine, the pursuit of a purely biomedical solution to COVID-19 will fail. Unless governments devise policies and programmes to reverse profound disparities, our societies will never be truly COVID-19 secure. As Singer and colleagues wrote in 2017, “A syndemic approach provides a very different orientation to clinical medicine and public health by showing how an integrated approach to understanding and treating diseases can be far more successful than simply controlling epidemic disease or treating individual patients.” I would add one further advantage. Our societies need hope. The economic crisis that is advancing towards us will not be solved by a drug or a vaccine. Nothing less than national revival is needed. Approaching COVID-19 as a syndemic will invite a larger vision, one encompassing education, employment, housing, food, and environment. Viewing COVID-19 only as a pandemic excludes such a broader but necessary prospectus.Covid-19 is really a syndemic — and that shows us how to fight itCoronavirus does not act alone but with co-morbidities such as obesity and diabetes Please use the sharing tools found via the share button at the top or side of articles. Copying articles to share with others is a breach of Financial Times T&Cs and Copyright Policy. Email [email protected] to buy additional rights. Subscribers may share up to 10 or 20 articles per month using the gift article service. More information can be found at Take a tour - Hints and tips on getting more from your subscription - FT.com.This messy tangle of interacting epidemics is why we should consider Covid-19 a syndemic, according to Richard Horton, editor of the Lancet medical journal, who argues against a narrow “plague” narrative in a recent editorial.“Focusing on the virus alone is a mistake,” he told me, of the single-minded pursuit of Covid-19 treatments and vaccines. The deadly impact of the pandemic “is not caused by the virus acting alone but interacting with chronic diseases like diabetes, obesity, heart disease and high blood pressure — all against a background of inequality and poverty. We can’t fully control the infection without addressing those factors.”Effects of pandemic will widen inequality, report findsDoesn’t expanding the coronavirus pandemic into a syndemic widen the problem and induce a greater sense of hopelessness? Mr Horton claims the opposite as “it gives you a whole range of measures to implement right now to protect people while we wait for a vaccine”. His basic prescription is to tackle those familiar epidemics: cut obesity, improve the treatment of diabetes, heart disease and cancer, among other illnesses. That means paying attention to keeping health systems afloat for other conditions.Obesity was a risk factor for both UK prime minister Boris Johnson and US president Donald Trump in their illnesses. The UK government unveiled a new obesity strategy in July, with promises to stop multi-buy offers on unhealthy foods and clamp down on junk-food advertising. But that feels like nibbling at the edges of a meatier problem that Mr Horton and, most notably, epidemiologist Michael Marmot have identified: the influence of poverty and inequality on health.”Volume 396, Issue 10255, 26 September–2 October 2020, Page 874https://www.sciencedirect.com/science/article/pii/S0140673620320006A non-communicable disease (NCD) is a disease that is not transmissible directly from one person to another. NCDs include Parkinson's disease, autoimmune diseases, strokes, most heart diseases, most cancers, diabetes, chronic kidney disease, osteoarthritis, osteoporosis, Alzheimer's disease, cataracts, and others.Includes Diseases: DiabetesNon-communicable disease - WikipediaHe then confirmed that the recorded 180,000 American deaths “are real deaths from COVID-19.”The double burden of nutrition: When malnutrition and obesity overlap18-Dec-2019 By Danielle MastersonThe Lancet recently published a warning report calling attention to the “new nutrition reality” facing low and middle-income countries that is driven by the modern food system.HTTPS://WWW.NUTRAINGREDIENTS-USA.COM/ARTICLE/2019/12/18/THE-DOUBLE-BURDEN-OF-NUTRITION-WHEN-MALNUTRITION-AND-OBESITY-OVERLAPWuhan Virus Archives - The FederalistBiden says it’s not political, but “this deadly virus has been the greatest political gift to the Democratic Party since the Great Depression,” Hemingway said.https://thefederalist.com/category/wuhanvirus/Study: Majority Of Americans Grossly Overestimated COVID HospitalizationA new study revealed a majority of voters on both sides of the political aisle believed exaggerated claims about COVID-19 and its effects.https://thefederalist.com/2021/03/22/study-majority-of-americans-grossly-overestimated-covid-19-hospitalization-rates/MARCH 22, 2021 By Jordan DavidsonA new study revealed a majority of voters on both sides of the political aisle believed exaggerated claims about COVID-19 and the effects it would have on people including children.While the survey of 35,000 from Gallup and Franklin Templeton showed that Democrats were more likely to overestimate the severity of COVID-19, such as the risk of death the virus posed to children and teens, and Republicans were more likely to underestimate the virus’s toll, a majority of voters on the left, right, and middle of the political aisle all overstated the effect coronavirus had on multiple factors including hospitalization rates.The current hospitalization rate for COVID-related illness in the United States hovers between 1 and 5 percent, but 41 percent of Democrats, 28 percent of Republicans, and 35 percent of independents or members of other political parties said there is a 50-plus percent chance that someone with the Wuhan virus will need to be treated at a hospital.This incorrect yet general consensus, the New York Times noted, was often reinforced with widespread policy decisions by partisan actors, such as Democratic politicians in blue states and cities keeping schools closed despite scientific evidence pointing to reopening while red states started to transition back to in-person models as early as August.“I think in many ways it’s based on the fact that these voters are misinformed about the risks to young people and they’re misinformed about the risks generally,” Gallup’s principal economist Jonathan Rothwell said.Corporate media was quick to pick up the panic narrative about COVID-19, condemning Republican governors for refusing to lock down, despite the scientific data suggesting that prolonged lockdowns would take a large metal and physical toll on people. Journalists also often misconstrued scientific data to fit a fearmongering narrative and employed the censorship efforts of eager Big Tech companies to obscure scientific studies and testimonies about the effects and potential treatment of the virus.Jordan Davidson is a staff writer at The Federalist. She graduated from Baylor University where she majored in political science and minored in journalism.Photo Pexels/PhotoPhoto U.S. Air Force photo/Senior Airman Nicholas Dutton3C epiphanyThe Japanese authorities understood covid-19 better than mostThat has helped keep Japan’s outbreak relatively smallAsiaDec 12th 2020 editionECONOMIST PHOTO AND STORYDec 12th 2020TOKYO“When the Diamond Princess, a cruise ship suffering from an outbreak of covid-19, arrived in Japan in February, it seemed like a stroke of bad luck. A small floating petri dish threatened to turn the Japanese archipelago into a big one. In retrospect, however, the early exposure taught the authorities lessons that have helped make Japan’s epidemic the mildest among the world’s big economies, despite a recent surge in infections. In total 2,487 people have died of the coronavirus in Japan, just over half the number in China and fewer people than on a single day in America several times over the past week. Japan has suffered just 18 deaths per million people, a higher rate than in China, but by far the lowest in the g 7, a club of big, industrialised democracies. (Germany comes in second, at 239.) Most strikingly, Japan has achieved this success without strict lockdowns or mass testing—the main weapons in the battle against covid-19 elsewhere.“From the beginning we did not aim at containment,” says Oshitani Hitoshi, a virologist who sits on an expert panel advising the government. That would require identifying all possible cases, which is not feasible in a country of Japan’s size when the majority of infections produce mild or no symptoms, argues Mr Oshitani: “Even if you test everyone once per week, you’ll still miss some.”The Japanese authorities understood covid-19 better than mostThis Overlooked Variable Is the Key to the PandemicIt’s not R.ZEYNEP TUFEKCISEPTEMBER 30, 2020“Perhaps one of the most interesting cases has been Japan, a country with middling luck that got hit early on and followed what appeared to be an unconventional model, not deploying mass testing and never fully shutting down. By the end of March, influential economists were publishing reports with dire warnings, predicting overloads in the hospital system and huge spikes in deaths. The predicted catastrophe never came to be, however, and although the country faced some future waves, there was never a large spike in deaths despite its aging population, uninterrupted use of mass transportation, dense cities, and lack of a formal lockdown.It’s not that Japan was better situated than the United States in the beginning. Similar to the U.S. and Europe, Oshitani told me, Japan did not initially have the PCR capacity to do widespread testing. Nor could it impose a full lockdown or strict stay-at-home orders; even if that had been desirable, it would not have been legally possible in Japan.Oshitani told me that in Japan, they had noticed the overdispersion characteristics of COVID-19 as early as February, and thus created a strategy focusing mostly on cluster-busting, which tries to prevent one cluster from igniting another. Oshitani said he believes that “the chain of transmission cannot be sustained without a chain of clusters or a megacluster.” Japan thus carried out a cluster-busting approach, including undertaking aggressive backward tracing to uncover clusters. Japan also focused on ventilation, counseling its population to avoid places where the three C’s come together—crowds in closed spaces in close contact, especially if there’s talking or singing—bringing together the science of overdispersion with the recognition of airborne aerosol transmission, as well as presymptomatic and asymptomatic transmission.Oshitani contrasts the Japanese strategy, nailing almost every important feature of the pandemic early on, with the Western response, trying to eliminate the disease “one by one” when that’s not necessarily the main way it spreads. Indeed, Japan got its cases down, but kept up its vigilance: When the government started noticing an uptick in community cases, it initiated a state of emergency in April and tried hard to incentivize the kinds of businesses that could lead to super-spreading events, such as theaters, music venues, and sports stadiums, to close down temporarily. Now schools are back in session in person, and even stadiums are open—but without chanting.It’s not always the restrictiveness of the rules, but whether they target the right dangers. As Morris put it, “Japan’s commitment to ‘cluster-busting’ allowed it to achieve impressive mitigation with judiciously chosen restrictions. Countries that have ignored super-spreading have risked getting the worst of both worlds: burdensome restrictions that fail to achieve substantial mitigation. The U.K.’s recent decision to limit outdoor gatherings to six people while allowing pubs and bars to remain open is just one of many such examples.”Could we get back to a much more normal life by focusing on limiting the conditions for super-spreading events, aggressively engaging in cluster-busting, and deploying cheap, rapid mass tests—that is, once we get our case numbers down to low enough numbers to carry out such a strategy? (Many places with low community transmission could start immediately.) Once we look for and see the forest, it becomes easier to find our way out.”* This article originally stated that, in April, coronavirus deaths spiked in Quito, Ecuador. In fact, they spiked in Guayaquil, Ecuador.ZEYNEP TUFEKCI is a contributing writer at The Atlantic and an associate professor at the University of North Carolina. She studies the interaction between digital technology, artificial intelligence, and society.This Overlooked Variable Is the Key to the PandemicBUT BUT BUT ???SHARE18 hours agoJapan Declares State of Emergency in Tokyo Region to Counter Virus SurgeBy Alastair GalePeople wearing face masks cross an intersection in the Shinjuku neighborhood of Tokyo on Thursday.HIRO KOMAE/ASSOCIATED PRESSTOKYO—Japan’s prime minister declared a state of emergency in Tokyo and surrounding areas in an attempt to reverse an acceleration of Covid-19 infections.Yoshihide Suga said that people in the region should stay home after 8 p.m. and restaurants and bars should close by then from Friday for at least a month. New infections in Tokyo rose to 2,447 on Thursday, up sharply from the previous high of 1,591 a day earlier.“We’re in a situation that could have a very severe impact on people’s lives and the economy,” Mr. Suga said in nationally televised remarks.Japan has avoided hard lockdowns in its attempts to control the spread of the virus, and the emergency declaration isn’t backed by fines or other legal penalties. Virus cases declined during a similar emergency period last spring.Unlike during the previous emergency, schools won’t be required to close and events such as sports will be allowed to continue with some spectators. Mr. Suga has been cautious about imposing stricter controls because of the damage to the economy.Japan has focused its efforts on trying to reduce the spread of the virus among those socializing in the evening. Restaurants that cooperate with the new guidelines will receive around $580 per day in support from the government.The governors of Tokyo and surrounding areas called on Mr. Suga to declare the emergency as hospitals in the region struggle to cope with the new wave of infections.Mr. Suga said the emergency period would run until Feb. 7. However, some members of a panel of experts that advises the government on handling the pandemic say the state of emergency may need to stay in place for several months.Japan Declares State of Emergency in Tokyo Region to Counter Virus Surge - WSJ.comMISINFORMATION FROM MISUSE OF STATISTICSChris Martz@ChrisMartzWXCOVID-19 case numbers couldn’t be a more meaningless statistic, yet it’s the center of policy and drives fear. The only way to determine if cases are increasing is to compare the number of tests. When done so, nothing alarming. It’s time to end this sh*tshow and return to normal.1:28 PM · Dec 27, 2020Twitter for iPhoneDoctors urge local approach, not sweeping lockdown, in letter to Ford“The doctors argue against a wholesale return to a lockdown as a way to deal with rising COVID-19 cases.Special to Toronto SunOctober 1, 2020A stethoscope around a doctor's neck. STOCK PHOTO / GETTY IMAGESThe following letter, signed by 20 doctors and professors of medicine from faculties at the University of Toronto, McMaster University, University of Ottawa and from hospitals such as Sick Kids, was sent to Premier Doug Ford on Sept. 27. The doctors argue against a wholesale return to a lockdown as a way to deal with rising COVID-19 cases.Dear Premier Ford,We are writing this letter in support of the government’s plan to use a tactical localized approach, rather than sweeping new lockdown measures, to deal with the increasing COVID case numbers in Ontario.Lockdowns have been shown not to eliminate the virus. While they slow the spread of the virus, this only lasts as long as the lockdown lasts. This creates a situation where there is no way to end the lockdown, and society cannot move forward in vitally important ways including in the health sector, the economy and other critically important instrumental goods including education, recreation, and healthy human social interactions.In Ontario, the increase in cases at this time are in people under 60 years of age who are unlikely to become very ill. At the peak of the pandemic in Ontario in mid-April, 56% of cases were in those over age 60. Now in September, only 14% of cases are in over 60 year olds.In Ontario and other parts of the world, such as the European Union, increasing case loads are not necessarily translating into unmanageable levels of hospitalizations and ICU admissions. This is not a result of a lag in reporting of severe and fatal cases. While we understand the concerns that these cases could spill into vulnerable communities, we also need to balance the actual risk.As the virus circulates at manageable levels within the community, we need to continue the gains we have made in the protection of the vulnerable in long-term care and retirement institutions, and continue to educate other people about their individual risk, so that they can observe appropriate protective measures.Lockdowns have costs that have, to this point, not been included in the consideration of further measures. A full accounting of the implications on health and well-being must be included in the models, and be brought forward for public debate. Hard data now exist showing the significant negative health effects shutting down society has caused. Overdoses have risen 40% in some jurisdictions. Extensive morbidity has been experienced by those whose surgery has been cancelled, and the ramifications for cancer patients whose diagnostic testing was delayed has yet to be determined.A huge concern is the implication of closure of schools, and the ongoing reluctance we have seen in the large urban centres of sending children back to the classroom due to safety concerns. Global data clearly now show that children have an extremely low risk of serious illness, but they are disproportionately harmed by precautions. Children’s rights to societal care, mental health support and education must be protected. This cannot be achieved with ongoing or rotating lockdown.The invitation and involvement of other health experts to advise the government’s response beside individuals in Public Health and Infectious Diseases in addition to leaders in the business, securities and arts communities is essential. We also call for increased open debate, in the public forum, that hears voices from outside the medical and public health communities, in order to consider all points of view from society.This is a fundamental principle upon which democratic societies are built. All stakeholders should have an equal right to participation in public discourse when it comes to setting such fundamental and sweeping societal interventions.All have the right to feel their voices have been heard, and moreover to ensure factual credible data is openly debated, in contrast to the personal and political slants that have had apparent significant impacts on the management of the virus to date.Our society has borne enormous pain over the past six months. It’s time to do something different.Sincerely,Jane Batt MD, PhD, FRCPC. Respirologist, Associate Professor, Department of Medicine, University of TorontoJames Bain MD, MSc, FRCSC. Plastic Surgeon, Professor of Surgery, McMaster UniversityMahin Baqi MD, FRCPC. Infection Prevention and Control and Infectious Diseases PhysicianMarcus Bernardini MD, FRCPC. Gynecologic Oncologist, Associate Professor, University of TorontoSergio Borgia MD, MSc, FRCPC. Infection Prevention and Control and Infectious Diseases Physician, Assistant Clinical Professor, McMaster UniversityPeter Cox, MBChB, FRCPC, DCH(SA), FFARCS. Critical Care Physician, Professor, Department of Anaesthesia, University of TorontoJames D. Douketis, MD, FRCPC, FCAHS. Haematologist, Professor of Medicine, McMaster UniversityPhilippe El-Helou, MD, FRCPC. Infectious Diseases Physician, Associate Professor, Department of Medicine, McMaster UniversityMartha Fulford MD, FRCPC. Infectious Diseases Physician, Associate Professor, Department of Medicine, McMaster UniversityShariq Haider MD, FRCPC. Infectious Diseases Physician, Professor, Department of Medicine, McMaster UniversityStephen Kravcik MD, FRCPC. General Internist, Associate Professor, Department of Medicine, University of OttawaNicole Le Saux MD, FRCPC. Infectious Diseases Physician, Professor, Department of Pediatrics, University of OttawaPaul MacPherson PhD, MD, FRCPC. Infectious Diseases Physician, Associate Professor, Department of Medicine, University of OttawaNeil Rau MD, FRCPC. Infectious Diseases Physician and Medical Microbiologist, Assistant Professor, Department of Medicine, University of TorontoSusan Richardson MD, FRCPC. Medical Microbiologist and Infectious Disease Physician, Professor Emerita, Department of Laboratory Medicine and Pathobiology, University of TorontoRob Sargeant MD, PhD, FRCPC. General Internist, Associate Professor, Department of Medicine, University of TorontoNick Vozoris MD, MHSc, FRCPC. Respirologist, Assistant Professor, Department of Medicine, University of TorontoThomas Warren MD, FRCPC. Infectious Diseases Physician and Medical Microbiologist, Assistant Clinical Professor (Adjunct), Department of Medicine, McMaster UniversityYvonne Yau, MD FRCPC. Medical Microbiologist, Assistant Professor, Department of Laboratory Medicine and Pathobiology, University of TorontoGeorge Yousef MD, PhD, FRCPC. Anatomic Pathologist, Professor, Department of Laboratory Medicine and Pathobiology, University of TorontoDr. Susan Richardson joined Anthony Furey on National Post Radio to explain why her and her colleagues believe Ontario shouldn’t go into a second lockdown and the best ways to tackle COVID-19: “Doctors urge local approach, not sweeping lockdown, in letter to FordCoronavirus and the homeless: Washington risks 'people dying in communal shelters'People without a home to self-quarantine in and without regular access to sanitation are likelier to contract the coronavirus. As cases hit New York City shelters, advocates in D.C. are warning about the city’s homeless.We have all heard what to do to minimize the risk of getting coronavirus: Wash your hands regularly, stay at home if possible, stay away from large crowds and keep a safe distance. But what if your home is a tent without running water? Or if you can only get a warm meal and a roof over your head in a shelter where the beds are packed together in cramped quarters? This is the difficult reality facing homeless people.In 2019, the Washington, D.C. metropolitan area had roughly 9,800 homeless residents, according to a study by the Metropolitan Washington Council of Governments. The number fluctuates greatly and cannot be pinned down exactly. One thing is certain, however: a large number of people without a roof over their heads are facing even greater challenges since the coronavirus outbreak.The US organization National Alliance to End Homelessness states on their website that "individuals experiencing homelessness include many older adults, often with compounding disabilities, who reside in large congregate facilities or in unsheltered locations with poor access to sanitation." The coronavirus entry continues: "Their age, poor health, disability, and living conditions make them highly vulnerable to illness."Coronavirus and the homeless: Washington risks 'people dying in communal shelters' | DW | 21.03.2020A closer look at U.S. deaths due to COVID-19By YANNI GU | November 22, 2020COURTESY OF GENEVIEVE BRIANDAfter retrieving data on the CDC website, Briand compiled a graph representing percentages of total deaths per age category from early February to early September.According to new data, the U.S. currently ranks first in total COVID-19 cases, new cases per day and deaths. Genevieve Briand, assistant program director of the Applied Economics master’s degree program at Hopkins, critically analyzed the effect of COVID-19 on U.S. deaths using data from the Centers for Disease Control and Prevention (CDC) in her webinar titled “COVID-19 Deaths: A Look at U.S. Data.”From mid-March to mid-September, U.S. total deaths have reached 1.7 million, of which 200,000, or 12% of total deaths, are COVID-19-related. Instead of looking directly at COVID-19 deaths, Briand focused on total deaths per age group and per cause of death in the U.S. and used this information to shed light on the effects of COVID-19.She explained that the significance of COVID-19 on U.S. deaths can be fully understood only through comparison to the number of total deaths in the United States.After retrieving data on the CDC website, Briand compiled a graph representing percentages of total deaths per age category from early February to early September, which includes the period from before COVID-19 was detected in the U.S. to after infection rates soared.Surprisingly, the deaths of older people stayed the same before and after COVID-19. Since COVID-19 mainly affects the elderly, experts expected an increase in the percentage of deaths in older age groups. However, this increase is not seen from the CDC data. In fact, the percentages of deaths among all age groups remain relatively the same.“The reason we have a higher number of reported COVID-19 deaths among older individuals than younger individuals is simply because every day in the U.S. older individuals die in higher numbers than younger individuals,” Briand said.Briand also noted that 50,000 to 70,000 deaths are seen both before and after COVID-19, indicating that this number of deaths was normal long before COVID-19 emerged. Therefore, according to Briand, not only has COVID-19 had no effect on the percentage of deaths of older people, but it has also not increased the total number of deaths.These data analyses suggest that in contrast to most people’s assumptions, the number of deaths by COVID-19 is not alarming. In fact, it has relatively no effect on deaths in the United States.This comes as a shock to many people. How is it that the data lie so far from our perception?To answer that question, Briand shifted her focus to the deaths per causes ranging from 2014 to 2020. There is a sudden increase in deaths in 2020 due to COVID-19. This is no surprise because COVID-19 emerged in the U.S. in early 2020, and thus COVID-19-related deaths increased drastically afterward.Analysis of deaths per cause in 2018 revealed that the pattern of seasonal increase in the total number of deaths is a result of the rise in deaths by all causes, with the top three being heart disease, respiratory diseases, influenza and pneumonia.“This is true every year. Every year in the U.S. when we observe the seasonal ups and downs, we have an increase of deaths due to all causes,” Briand pointed out.When Briand looked at the 2020 data during that seasonal period, COVID-19-related deaths exceeded deaths from heart diseases. This was highly unusual since heart disease has always prevailed as the leading cause of deaths. However, when taking a closer look at the death numbers, she noted something strange. As Briand compared the number of deaths per cause during that period in 2020 to 2018, she noticed that instead of the expected drastic increase across all causes, there was a significant decrease in deaths due to heart disease. Even more surprising, as seen in the graph below, this sudden decline in deaths is observed for all other causes.COURTESY OF GENEVIEVE BRIANDGraph depicts the number of deaths per cause during that period in 2020 to 2018.This trend is completely contrary to the pattern observed in all previous years. Interestingly, as depicted in the table below, the total decrease in deaths by other causes almost exactly equals the increase in deaths by COVID-19. This suggests, according to Briand, that the COVID-19 death toll is misleading. Briand believes that deaths due to heart diseases, respiratory diseases, influenza and pneumonia may instead be recategorized as being due to COVID-19.COURTESY OF GENEVIEVE BRIANDGraph depicts the total decrease in deaths by various causes, including COVID-19.The CDC classified all deaths that are related to COVID-19 simply as COVID-19 deaths. Even patients dying from other underlying diseases but are infected with COVID-19 count as COVID-19 deaths. This is likely the main explanation as to why COVID-19 deaths drastically increased while deaths by all other diseases experienced a significant decrease.“All of this points to no evidence that COVID-19 created any excess deaths. Total death numbers are not above normal death numbers. We found no evidence to the contrary,” Briand concluded.In an interview with The News-Letter, Briand addressed the question of whether COVID-19 deaths can be called misleading since the infection might have exacerbated and even led to deaths by other underlying diseases.“If [the COVID-19 death toll] was not misleading at all, what we should have observed is an increased number of heart attacks and increased COVID-19 numbers. But a decreased number of heart attacks and all the other death causes doesn’t give us a choice but to point to some misclassification,” Briand replied.In other words, the effect of COVID-19 on deaths in the U.S. is considered problematic only when it increases the total number of deaths or the true death burden by a significant amount in addition to the expected deaths by other causes. Since the crude number of total deaths by all causes before and after COVID-19 has stayed the same, one can hardly say, in Briand’s view, that COVID-19 deaths are concerning.Briand also mentioned that more research and data are needed to truly decipher the effect of COVID-19 on deaths in the United States.Throughout the talk, Briand constantly emphasized that although COVID-19 is a serious national and global problem, she also stressed that society should never lose focus of the bigger picture — death in general.The death of a loved one, from COVID-19 or from other causes, is always tragic, Briand explained. Each life is equally important and we should be reminded that even during a global pandemic we should not forget about the tragic loss of lives from other causes.According to Briand, the over-exaggeration of the COVID-19 death number may be due to the constant emphasis on COVID-19-related deaths and the habitual overlooking of deaths by other natural causes in society.During an interview with The News-Letter after the event, Poorna Dharmasena, a master’s candidate in Applied Economics, expressed his opinion about Briand’s concluding remarks.“At the end of the day, it’s still a deadly virus. And over-exaggeration or not, to a certain degree, is irrelevant,” Dharmasena said.When asked whether the public should be informed about this exaggeration in death numbers, Dharmasena stated that people have a right to know the truth. However, COVID-19 should still continuously be treated as a deadly disease to safeguard the vulnerable population.A closer look at U.S. deaths due to COVID-19The coronavirus doesn’t exist in isolation — it feeds on other diseases, crisesMay 25, 2020 11.04am EDTAuthor“1. We may be in self-isolation, but the COVID-19 pandemic is clearly not.It isn’t isolated from other social, environmental and health crises — like food insecurity, the opioid crisis and the mental health crisis — nor is it separate from other epidemics like HIV, malaria, dengue fever and Zika virus.When two or more epidemics co-exist and compound one another to worsen health, they are said to be syndemic, or “synergistic epidemics.”What is a syndemic?The concept of syndemics arose in the 1990s to describe how substance abuse, violence and AIDS (known as the SAVA syndemic) overlapped and negatively reinforced health among inner-city populations in the United States.The concept has been cited increasingly over the past 25 years to call attention to the way various diseases like HIV and tuberculosis, along with mental illness, diabetes and infectious diseases cluster together, particularly in disadvantaged populations.While the term syndemic has traditionally been used to describe disease clusters at the individual level, a 2019 Lancet Commission study expanded on the concept to include climate change.The commission called the clustering of climate change and malnutrition (including both obesity and undernutrition) the Global Syndemic. This is because they share common underlying societal causes, such as modern industrial food systems, and affect people in all corners of the world.Dr. Horacio Arruda, Québec’s, director of health, reminds people to keep their distance as he arrives for a visit to a day centre for the homeless on May 8, 2020 in Montréal. THE CANADIAN PRESS/Ryan RemiorzA key feature of a syndemic is the way overlapping diseases and health conditions amplify one another biologically within the human body. For example, a disease can weaken the immune system and promote the progression of another disease.Interactions between overlapping diseases and other health conditions can complicate medical treatments, lead to higher health-care costs and worsen health outcomes. In the case of COVID-19, people with pre-existing and underlying conditions, including obesity, high blood pressure and diabetes, appear to be at higher risk for complications from the disease.But diseases don’t just interact biologically, they also interact with social factors. Poverty, housing, education and social stigma, for example, are all powerful determinants of health.Individuals with lower incomes and less education are several times more likely to develop diabetes than more socially advantaged individuals. These same relationships play a part in other risk factors for COVID-19, like high blood pressure and obesity.And it’s precisely these interactions — between both biological and social factors — that sets syndemics apart from other epidemic events.COVID-19 and marginalized communitiesThe coronavirus has been particularly dangerous for marginalized and vulnerable populations.A major outbreak of COVID-19 in the Navajo Nation is one example. Many Navajo people have underlying health conditions and lack basic needs, including access to running water.A Navajo mother and daughter sit on their family’s compound in Tuba City, Ariz., on April 20, 2020. The Navajo reservation has some of the highest rates of coronavirus in the United States. (AP Photo/Carolyn Kaster)By regarding COVID-19 as a syndemic and taking biological and social interactions directly into account, health practitioners could become more effective in their clinical practices and community-based interventions — in the United States, Canada and around the world.Addressing a syndemic demands not only the management of each affliction, but efforts to address the underlying forces that unite them — social inequality chief among them.In Canada, we have seen some semblance of this approach in COVID-19 emergency response strategies directed towards supporting people experiencing homelessness and violence and food banks and local food organizations.Yet these responses don’t go far enough. A basic income, not just expanded food charity, is needed to address food insecurity.Read more: More than food banks are needed to feed the hungry during the coronavirus pandemicWithout strong national frameworks to protect fundamental human rights (like access to food and housing), the ability of Canadians to meet their most basic needs, including health care, is vulnerable to the vagaries of government funding decisions and political will.In 2018, for example, a pilot project in Ontario to implement basic income in Ontario was cut by the incoming government.‘Slow-motion disaster’Most of the social and health issues now at the forefront of the COVID-19 pandemic were already major public health concerns prior to the outbreak of the pandemic.But these issues were often long term in nature. For example, rates of non-communicable disease — those not transmissible directly from one person to another, like type 2 diabetes and cardiovascular disease — have been surging for decades into what the World Health Organization (WHO) has called a “slow-motion disaster.” Yet immediate emergencies are dealt with first, while long-term problems wait.And as they tended to disproportionately impact socially, economically and politically marginalized groups, funding and responses have been inadequate. A lack of funding, for example, is responsible for the stalled progress on the eradication of tuberculosis in Inuit communities.Living conditions in Indigenous communities have long been inadequate, but the lack of access to clean water and a housing crisis persist.So why are governments only responding now? Could these issues not have been responded to sooner? Far more money, in fact, is spent responding to health crises than preparing and preventing them.Leaving no one behindThe WHO suggests an all-hazards approach to preparedness, from infectious disease outbreaks to extreme weather events and climate change. Epidemics, in fact, were only one of 13 urgent global health challenges identified for the next decade by the WHO in January.What the COVID-19 pandemic makes clear is that we need an “all people approach” that leaves no one behind, wherein the social factors and health conditions that cluster around the most vulnerable are not ignored until they’re cast to the foreground of a global pandemic.A man rides his ATV in the northern Ontario First Nations reserve in Attawapiskat, Ont., in April 2016. THE CANADIAN PRESS/Nathan DenetteThinking about COVID-19 through a syndemics lens helps bring attention to the fact that these crises haven’t waned, and they aren’t background noise.Instead, they’re compounded to forge a challenging landscape within which the COVID-19 pandemic has now taken centre stage. The health and social issues that concentrate in disadvantaged populations, and/or that are chronic and long-term in nature, simply can’t wait any longer.”https://theconversation.com/the-coronavirus-doesnt-exist-in-isolation-it-feeds-on-other-diseases-crises-135664The syndemic rewards countries like Canada with better health from fewer NCD or non communicable diseases like obesity and diabetes.Does Canada’s obesity data being lower than the USA matter?“Obesity has been described as a global epidemic. It has been linked to diabetes, hypertension, cardiovascular disease and some forms of cancer. Accurate surveillance of obesity trends is an important step in developing effective strategies to reduce its impact on public health. In the United States, the National Health and Nutrition Examination Survey (NHANES) has been gathering measured height and weight data for years. In 2007, the Canadian Health Measures Survey (CHMS), the most comprehensive health measures survey in Canada, began collecting direct measurements of height, weight, body mass index (BMI), skinfolds and waist circumference from a nationally representative sample of the population. The complementary nature of these surveys has created an opportunity to compare rates of obesity among adults in Canada and the United States.In 2007 to 2009, the prevalence of obesity in Canada was 24.1%, over 10 percentage points lower than in the United States (34.4%).Among men, the prevalence of obesity was over 8 percentage points lower in Canada than in the United States (24.3% compared with 32.6%) and among women, more than 12 percentage points lower (23.9% compared with 36.2%) (Chart 1).”Chart 1Prevalence of obesity in adults aged 20 to 79, by sex: Canada, 2007 to 2009 and United States, 2007 to 2008DescriptionBecause Sweden now has Europe’s lowest death rate herd immunity is seen as one explanation although not very convincing. It seems rather than Sweden treated the virus as syndemic where the focus was on the comorbidity not testing and masks etc. Sweden did put strong protections for the elderly and vulnerable pollutions who would well be the most likely to have NCDs but allowed the younger populations to go about their business. See this CNN video below-WUHAN VIRUSNEWSArticlesDR. ROGER HODKINSON ON COVID: “THIS IS THE BIGGEST HOAX EVER PERPETRATED ON AN UNSUSPECTING PUBLIC”NOVEMBER 18, 2020 CAP ALLON“Dr. Roger Hodkinson is the former Chairman of the Royal College of Physicians and Surgeons committee in Ottawa, he was once CEO of a large private medical laboratory in Edmonton, Alberta, and for the past 20 years has held the position as Chairman of a Medical Biotechnology company based in North Carolina currently tasked with selling a COVID-19 test. He is a medical specialist in pathology, which includes virology, who trained at Cambridge University in the UK — he is perfectly positioned to speak on this topic.In a recent Edmonton City Council Community and Public Services Committee meeting (the audio from which is currently gaining traction on YouTube), Dr. Hodkinson says: “The bottom line is there is utterly unfounded public hysteria driven by the media and politicians. It’s outrageous. This is the greatest hoax ever perpetrated on an unsuspecting public.“[COVID-19] is nothing more than a bad flu season. This is not Ebola. It’s not SARS. It’s politics playing medicine, and that’s a very dangerous game.”Hodkinson goes on to stress that no action of any kind is needed, other than what happened during last year’s flu season: “If we felt ill, we stayed home, we took chicken noodle soup, we didn’t visit granny, we decided when we would return to work; we didn’t need anyone to tell us.”“MASK ARE UTTERLY USELESS”“There is no evidence base for their effectiveness whatsoever.“[Masks] are simply virtue signalling.“Seeing these people walking around like lemmings obeying, without any knowledge base, to put the mask on their face.”“SOCIAL DISTANCING IS ALSO USELESS”“COVID is spread by aerosols, which travel 30 meters-or-so before landing.”“CLOSURES OF SCHOOLS AND BUSINESSES HAVE HAD SUCH TERRIBLE CONSEQUENCES”“Everywhere should be open tomorrow, as was stated in the Great Barrington Declaration (linked below).“POSITIVE TEST RESULTS DO NOT MEAN A CLINICAL INFECTION”“All testing should stop, unless you’re presenting to hospital with some respiratory problem … it’s driving public hysteria, and all testing should stop.“All that should be done is to protect the vulnerable.“And I would remind you all that using the provinces [Alberta’s] own statistics, the risk of death under 65 is 1 in 300,000. You’ve got to get a grip on this. The scale of the response … with no evidence for it, is utterly ridiculous.“Suicides, business closures, [cancelled] funerals, weddings, etc., etc. — it’s simply outrageous, it’s just another bad flu, and [people] have got to get their minds around that.”Hodkison concludes with some advice for policy makers in Alberta: “Let people make their own decisions. You should be totally out of the business of medicine. You’re being led down the garden path by the chief medical officer of health in this province. I’m absolutely outraged that this has reached this level. It should all stop tomorrow. Thank you very much.”Dr. Roger Hodkinson on COVID: "This is the Biggest Hoax ever perpetrated on an Unsuspecting Public" - ElectroverseI Am Living in a Covid-Free World Just a Few Hundred Miles From ManhattanWelcome to Nova Scotia, the land that proves that beating back the virus is possible.By Stephanie NolenMs. Nolen is a journalist.Nov. 18, 2020760Credit...Paul Atwood for The New York Times“HALIFAX, Nova Scotia — This morning, my children went to school — school, in an old brick building, where they lined up to go in the scuffed front doors. I went to work out at the gym, the real gym, where I huffed and puffed in a sweaty group class. And a few days ago, my partner and I hosted a dinner party, gathering eight friends around the dining room table for a boisterous night that went too late. Remember those?Where I’m living, we gather without fear. Life is unfolding much as it did a year ago. This magical, virus-free world is just one long day’s drive away from the Empire State Building — in a parallel dimension called Nova Scotia.This is one of the four Atlantic provinces that cling to the coast of Canada, north and east of Maine. In Canada, these are typically known as “have-not provinces,” economically depressed areas dependent on cash transfers from wealthier provinces to the West.In the pandemic era, however, “have not” takes on new meaning.ImageCredit...Paul Atwood for The New York TimesImageOur coronavirus lockdown began swiftly in March and was all-encompassing. The provincial borders were slammed shut. In Nova Scotia, even public hiking trails were closed, a big deal for a population used to the freedom to head into the wilderness at will. But the lockdown worked, and we released our collectively held breath as new case numbers dropped to the single digits. Restrictions eased in May and lifted in June; in early July, the Atlantic provinces “bubbled” together, allowing free travel among them — but maintaining a strict quarantine rule for anyone who came from outside. And the border to the south, the one with the United States, has remained firmly closed.Credit...Paul Atwood for The New York TimesThe horrific pandemic news from south of the border feels like a looming shadow these days. The numbers coming from the United States are almost ungraspable: 120,000, 140,000, 180,000 new cases a day. When I talk to friends there, they are locked up in their houses, trying to work with the kids running through the room, or, increasingly often, sick or recovering from Covid-19. Case counts are also climbing in other parts of Canada. My brother and his family in Montreal are once again in lockdown. The pictures I post in our group chat, of slumber parties and speedskating races, are a surreal contrast to their circumscribed days.The pandemic has changed the way people live, here, too. We stand six feet apart in the line at the grocery store. There is plexiglass around the cashier at Starbucks. I had to keep my dinner party guest list to 10 people in total. Nova Scotia has required everyone to wear a mask in any indoor public space, including upper grade schools, since July. But that seems normal, by now, just one more thing in the morning: got your homework, got your lunch, got your mask? I can go days without the virus really intruding on my life.And word has gotten out: The Halifax real-estate market is frenzied this fall. Our small, pretty city has relatively affordable housing, beaches and wooded parks. But historically a lack of jobs kept ambitious people away. Now that so many of us work from the kitchen table, the pokey economy matters much less — and Torontonians are fleeing the big city, and the virus, for a charmed life in the bubble.”Editors’ PicksWhen It Comes to Living With Uncertainty, Michael J. Fox Is a ProKurt Russell and Goldie Hawn, a.k.a. Mr. and Mrs. ClausThe Thanksgiving Myth Gets a Deeper Look This YearContinue reading the main storyContinue reading the main storyImageCredit...Paul Atwood for The New York TimesGeography and demographics have helped Atlantic Canada establish this alternate universe. The population is small, about 2.5 million people across the region, none of it too densely populated. Newfoundland and Prince Edward Island are, well, islands, which makes border control easier. Only one province in this bubble has a land border with the United States, and only one an active border with Quebec, the hardest-hit province. The Halifax airport is the largest in the region, and it was receiving only about a dozen international flights each day when the pandemic began. There are none now. We’re a very small New Zealand.When I asked Robert Strang, Nova Scotia’s avuncular public health chief, what he thought allowed us to maintain this level of normality, he added another ingredient to my list: Public health officials, not politicians, set the policy here about what opens. And people (mostly) follow the rules on closures and gatherings and masks. “The message has been that we need to do it to keep each other safe,” he told me. “I think there’s something about our culture, our collective ethic, if you will, that means people accept that.”The pandemic has caused real pain in this region: the economy, heavily dependent on tourism, has regained only about 80 percent of the jobs that were lost in April, and won’t fully recover with the borders closed. This morning I saw another small business in my neighborhood with a closing-down notice taped to a shuttered window. Eviction rates are climbing. Residents of long-term care homes can have only limited visitors. If we leave the region, we have to spend two weeks in quarantine when we come back, and that can make a person feel trapped.We argue all the time about what level of isolation and restriction are appropriate; but we have a sense here in Halifax of what has kept us safe and we know that those things are deeply controversial in the United States: public health care; public media; a social safety net. It’s baffling to watch the epidemic in the United States spin wildly out of control, knowing it could easily be different. We know that it could, because we’re living it.At my dinner party last week, my friends and I raised a glass to our good fortune, and to Dr. Strang. Our freedom feels precious and fragile. It has not come cheap. But it’s a steadying thing, the knowledge that we will make hard choices for each other, and that sometimes when we do, the reward is a life we recognize.Stephanie Nolen is a journalist based in Halifax, Nova Scotia.ESPECIALLY RELEVANT TODAY THAT THE NCD COUNTRY % RANKING FOR DIABETES SHOWS US IS MUCH HIGHER THAN CANADA AT 10.8 TO 7.6 WHILE SWEDEN IS ONLY 4.8.Home > Indicators > Health > Risk factorsDiabetes prevalence (% of population ages 20 to 79) - Country Ranking - North AmericaDefinition: Diabetes prevalence refers to the percentage of people ages 20-79 who have type 1 or type 2 diabetes.Source: International Diabetes Federation, Diabetes Atlas.See also: Thematic map, Time series comparisonFind indicator:Rank Country Value Year 20191 Mexico 13.502 United States 10.803 Canada 7.604 Greenland 2.10Why people with diabetes are being hit so hard by Covid-19By ELIZABETH COONEY @cooney_lizOCTOBER 1, 2020There are no easy answers to the coronavirus pandemic, but for people with diabetes, it’s dismayingly difficult to untangle the thicket of biological and socioeconomic factors that make them more likely to suffer severe illness and die should they catch the virus that causes Covid-19. That leaves prevention — controlling blood sugar through diet, exercise, monitoring, and medication — as the leading tactic to protect people, until a successful vaccine proven to work in people with diabetes, too, reaches a population bearing multiple burdens of chronic illness.The numbers are alarming. A Lancet Diabetes & Endocrinology study mining 61 million medical records in the U.K. says 30% of Covid-19 deaths occurred in people with diabetes. After accounting for potentially relevant risk factors such as social deprivation, ethnicity, and other chronic medical conditions, the risk of dying from Covid-19 was still almost three times higher for people with type 1 diabetes and almost twice as high for type 2, versus those without diabetes.Data from the U.S. Centers for Disease Control and Prevention show more than three-quarters of people who died from Covid-19 had at least one preexisting condition. Overall, diabetes was noted as an underlying condition for approximately 4 in 10 patients. Among people younger than 65 who died from the infection, about half had diabetes.Why people with diabetes are being hit so hard by Covid-19Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide AnalysisWei-jie Guan, Wen-hua Liang, Yi Zhao, Heng-rui Liang, Zi-sheng Chen, Yi-min Li, Xiao-qing Liu, Ru-chong Chen, Chun-li Tang, Tao Wang, Chun-quan Ou, Li Li, Ping-yan Chen, Ling Sang, Wei Wang, Jian-fu Li, Cai-chen Li, Li-min Ou, Bo Cheng, Shan Xiong, Zheng-yi Ni, Jie Xiang, Yu Hu, Lei Liu, Hong Shan, Chun-liang Lei, Yi-xiang Peng, Li Wei, Yong Liu, Ya-hua Hu, Peng Peng, Jian-ming Wang, Ji-yang Liu, Zhong Chen, Gang Li, Zhi-jian Zheng, Shao-qin Qiu, Jie Luo, Chang-jiang Ye, Shao-yong Zhu, Lin-ling Cheng, Feng Ye, Shi-yue Li, Jin-ping Zheng, Nuo-fu Zhang, Nan-shan Zhong, Jian-xing He on behalf of China Medical Treatment Expert Group for Covid-19European Respiratory Journal 2020; DOI: 10.1183/13993003.00547-2020ArticleFigures & DataInfo & MetricsPDFAbstractBackground The coronavirus disease 2019 (Covid-19) outbreak is evolving rapidly worldwide.Objective To evaluate the risk of serious adverse outcomes in patients with coronavirus disease 2019 (Covid-19) by stratifying the comorbidity status.Methods We analysed the data from 1590 laboratory-confirmed hospitalised patients 575 hospitals in 31 province/autonomous regions/provincial municipalities across mainland China between December 11th, 2019 and January 31st, 2020. We analyse the composite endpoints, which consisted of admission to intensive care unit, or invasive ventilation, or death. The risk of reaching to the composite endpoints was compared according to the presence and number of comorbidities.Results The mean age was 48.9 years. 686 patients (42.7%) were females. Severe cases accounted for 16.0% of the study population. 131 (8.2%) patients reached to the composite endpoints. 399 (25.1%) reported having at least one comorbidity. The most prevalent comorbidity was hypertension (16.9%), followed by diabetes (8.2%). 130 (8.2%) patients reported having two or more comorbidities. After adjusting for age and smoking status, COPD [hazards ratio (HR) 2.681, 95% confidence interval (95%CI) 1.424–5.048], diabetes (HR 1.59, 95%CI 1.03–2.45), hypertension (HR 1.58, 95%CI 1.07–2.32) and malignancy (HR 3.50, 95%CI 1.60–7.64) were risk factors of reaching to the composite endpoints. The HR was 1.79 (95%CI 1.16–2.77) among patients with at least one comorbidity and 2.59 (95%CI 1.61–4.17) among patients with two or more comorbidities.Conclusion Among laboratory-confirmed cases of Covid-19, patients with any comorbidity yielded poorer clinical outcomes than those without. A greater number of comorbidities also correlated with poorer clinical outcomesComorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide AnalysisAbstractBackground:In this study, we aimed to assess the prevalence of comorbidities in the confirmed COVID-19 patients. This might help showing which comorbidity might pose the patients at risk of more severe symptoms.Methods:We searched all relevant databases on April 7th, 2020 using the keywords (“novel coronavirus” OR COVID-19 OR SARS-CoV-2 OR Coronavirus) AND (comorbidities OR clinical characteristics OR epidemiologic*). We reviewed 33 papers’ full text out of 1053 papers. There were 32 papers from China and 1 from Taiwan. There was no language or study level limit. Prevalence of comorbidities including hypertension, diabetes mellitus, cardiovascular disease, chronic lung disease, chronic kidney disease, malignancies, cerebrovascular diseases, chronic liver disease and smoking were extracted to measure the pooled estimates. We used OpenMeta and used random-effect model to do a single arm meta-analysis.Results:The mean age of the diagnosed patients was 51 years. The male to female ratio was 55 to 45. The most prevalent finding in the confirmed COVID-19 patients was hypertension, which was found in 1/5 of the patients (21%). Other most prevalent finding was diabetes mellitus (DM) in 11%, cerebrovascular disease in 2.4%, cardiovascular disease in 5.8%, chronic kidney disease in 3.6%, chronic liver disease in 2.9%, chronic pulmonary disease in 2.0%, malignancy in 2.7%, and smoking in 8.7% of the patients.Conclusion:COVID-19 infection seems to be affecting every race, sex, age, irrespective of health status. The risk of symptomatic and severe disease might be higher due to the higher age which is usually accompanied with comorbidities. However, comorbidities do not seem to be the prerequisite for symptomatic and severe COVID-19 infection, except hypertension.Prevalence of Comorbidities in COVID-19 Patients: A Systematic Review and Meta-Analysis“Contrast Between New York And Florida”December 22, 2020/ Francis Menton“Of all the states, the one most comparable to New York by demographics is Florida. These two states are close not only in overall population, but also in relative numbers of immigrants and of minority groups. As to population, as recently as 2013, New York had slightly more population than Florida (both around 19.6 million), but since then Florida has been growing rapidly, while New York has been shrinking slowly. Pending release of final 2020 Census numbers, estimates put Florida’s current population at about 21.8 million, and New York’s at about 19.4 million.Despite being, at least for now, relatively close in population and other demographics, New York and Florida could not be more different in their approaches to public policy. In Florida, Republicans have controlled the legislature (both houses) since 1997, and the governorship since 1999. Florida exemplifies the low tax, low spend, low regulation approach to state government. New York is firmly in control of the progressive left, and exemplifies high taxes, high spending, and high regulation.Different policies lead to different results. For today I’ll focus mainly on the policy response to the Covid-19 virus. On this subject, the differences in policy mostly concern regulation, rather than taxing and spending.Yesterday, I had a roundup of the current onerous regulatory response to the virus in New York. By contrast, Florida, led by Republican Governor Ron DeSantis, has been very much at the opposite end of the regulatory response spectrum. As to results, here’s the bottom line: As one would expect, the economic decline caused by intentional government suppression of the economy has been much, much less severe in Florida than New York; but just as important, Florida has also experienced, and continues to experience, superior health results to New York. In other words, Florida stands as a clear demonstration that all of New York’s behavioral mandates (e.g., masks) and intentional destruction of small business have had no measurable effect whatsoever in decreasing spread of the virus or in improving health results.As per my review yesterday, in New York City, restaurant dining has been severely restricted for months under fluctuating directives, and as of last week, by order of the Governor, all indoor restaurant dining has been shut down entirely, with no indication of when it may re-open. Theaters, concerts and performance venues are all shuttered, and it appears they will remain so at least until the Spring. Although not mentioned in yesterday’s post, since April 17 we have had a state-wide mandate for mask-wearing covering “anyone over the age of 2” when “in a public place.”Florida at first imposed some substantial restrictions on restaurants and other indoor businesses, but began loosening them in early June, when, for example, bars and movie theaters were allowed to reopen. On September 28 Governor DeSantis issued an executive order rescinding almost all of the remaining restrictions. At a news briefing that day, DeSantis was quoted as saying “Every business has the right to operate,” and “We’re not closing anything going forward.” WebMD summarized Florida’s provisions going forward from that time:Businesses that have used remote work protocols can return to unrestricted staffing at their offices. Employees can resume non-essential travel. Theme parks can return to normal operations, and gyms can operate at full capacity. Bars and clubs can operate at full capacity but with “limited social distancing protocols.”In Florida today, theaters are open, concerts are happening, and the iconic theme parks are accepting visitors (if on a somewhat restricted basis).As to masks, Florida never imposed a state-wide mandate, but instead left it up to each county to make its own decision. Twenty-two counties imposed mask mandates for at least some period of time, but 45 never did. Townhall on December 21 has a long piece (mostly based on a paywalled study of the data at Rational Ground) giving the results. Those results are totally devastating to any claim of effectiveness of mask mandates. From Town Hall (with internal quote from Rational Ground):If masks did even close to as advertised, one would expect to see the counties that went maskless to be absolute dumpster fires next to the counties that implemented mandates, right? At the very least, the numbers should favor the masked areas by more than a percentage point or two. So, how did it go? Yep, it was the Mask Cult’s worse nightmare: “When counties DID have a mandate in effect, there were 667,239 cases over 3,137 days with an average of 23 cases per 100,000 per day. When counties DID NOT have a countywide order, there were 438,687 cases over 12,139 days with an average of 22 cases per 100,000 per day.”In short, the mask-free counties actually had better health results than the counties with mask mandates.As part of his September 28 directives, Governor DeSantis announced that he would not enforce any fines or penalties for failure to wear masks.So let’s compare health and economic results as between Florida and New York. First, health:Florida. Deaths per million population, pandemic inception to date (figures from Worldometers.info as of December 22): 966. Deaths within last 10 days, most recent first, from Dec 21 back to Dec 12: 106, 86, 69, 108, 102, 112, 89, 137, 81, 71 — total of 961 over that 10 day period.New York. Deaths per million population, pandemic inception to date: 1,886 (almost double Florida’s rate — and Florida has far more elderly people). Deaths within last 10 days, most recent first from Dec 21 to Dec 12: 179, 95, 85, 121, 156, 112, 126, 120, 87, 79 — total of 1160 over the ten days, or more than 20% more than Florida, even though Florida has more than 10% more population.If New York’s elected leaders have anything to show for turning this city into a ghost town, you sure can’t find it in those statistics.Now, as to economic statistics:Florida. Unemployment rate for November (most recent available): 6.4% (versus national rate of 6.7%)New York. Unemployment rate for New York State for November: 8.4%; for New York City, 12.1%. Clearly, New York City is bearing the brunt of the forced closures of the restaurant and entertainment industries.For New York City, that extra almost 6% people unemployed by forced government action, as compared to Florida, represents about 200,000 people, most of them from the lower end of the income distribution. I suppose you could kind of, sort of justify intentionally putting all those people out of work if you could show some kind of health benefit from the decrees. But there is no health benefit to be shown. New York’s health results are demonstrably worse than those of Florida. The virus does its own thing, despite our dictators’ desperate need to show that they are “doing something,” however meaningless the “something” may be.In other comparisons of public policy metrics between the two states, Florida’s annual state government budget is about $92 billion, while New York’s is $177 billion. How could that possibly be, when Florida has 10% more people? New York City spends almost $29,000 per student on K-12 education, while Florida spends less than $10,000 — and Florida gets somewhat better results on the NAEP national tests. And of course, New York has some of the highest income tax rates in the country, and yet has a legislature desperate to raise more revenue by hiking rates even higher; while Florida has no income tax at all and yet seems to have sufficient money to go around.Florida shows us all what basic competent state government looks like. The extreme lack of competence in New York is simply shocking.Contrast Between New York And Florida — Manhattan ContrarianCOMMENTSKevin kilty A day agoThere is a fairly extensive scientific literature going back two decades on the effectiveness of masks, and the bulk of it appears to fail to find any effectiveness that couldn't be ascribed to "chance". Some of this evidence is randomized clinical trials, and some of it actually involves making measurements of particle distributions passing through masks. Home-made cloth masks have zero effectiveness. Respirators made to standards, like N95 and N98, have the effectiveness they were designed for and no more. People who insist on the necessity of mask mandates don't and won't read this literature. An observation about blowing out candles does not qualify as evidence.I have tried to point out to anyone who will listen that the way people have promoted the effectiveness of masks is problematic. It is well known and has been for half a century that people miscalculate, under-estimate especially, risks when they think they are in control of a situation. The endless promotion of masks as the solution for the COVID-19 epidemic may have caused people to become nonchalant about risks. People who under-estimate risks the worst are often young people. It is a situation that could explain why a rise in cases often appears to follow a mask mandate.”Horowitz: Comprehensive analysis of 50 states shows greater spread with mask mandates”Hard to see science that shows masks work when Denmark hit all indoor spaces with mask mandate that failed to arrest the spread?Friends of Science@FriendsOScience“COVID is real, but perhaps the problem is health care and the lack of beds. In 2018 Canadian's had put improved health care at the TOP of their list of priorities, NOT #climatechange youtu.be/DF04nxUbV54 Think of the $$ in subsidies to BIG GREEN. Could have added beds+staff.