(2022-03-10) ZviM Covid 3/10/22 We Have A Plan

Zvi Mowshowitz: Covid-19 3/10/22: We Have a Plan. Covid situation continues to improve, although Covid remains a thing. There’s a new executive plan that I did my best to read with incomplete success, that checks off lots of boxes and doesn’t have anything horribly wrong with it.

What’s less great is that Congress passed an omnibus bill that cut out all pandemic funding and most already allocated funds have been spent, so we are failing to pay for our Paxlovid purchases and threaten to run into a wide range of other problems as well if this isn’t addressed, such as us no longer paying for the uninsured to get treatment and running out of monoclonal antibodies. It would be quite the disaster, although scaled to the extent of cases at the time.

We presume that like most such things the snafus with pandemic funding will get sufficiently worked out that it won’t actually cause us to lose access to treatments, although I wouldn’t fully count on it.

Executive Summary
Conditions are safe and one can return to living life.
Congress withholds pandemic funding, endangering treatment if not fixed.
New executive plan for Covid seems fine, so long as they get their funding.

The Numbers

I Read The Plan So You Don’t Have To

I nitpick a bunch throughout here, but mostly I was actually pretty impressed.

I’m not quite as high on it as Scott Gottlieb, but I’m still high.

#1: Protect Against and Treat Covid-19

They have a very long list of checked off things, many of which one could reasonably dispute are ready to be checked off.

The approach to the immunocompromised is to prioritize them for treatment and testing and vaccination, but doesn’t act like this is a good reason to shut things down. Again, good.

The bad news is that they also avoid almost all specifics, so this ‘plan’ isn’t much of a plan in the sense that it would actually tell you what is going to happen, even before we get punched in the mouth.

The only glaring omission is that there’s no mention of air ventilation here, although they do clearly intend to do a lot about it in the context of schools.

#2: Prepare For New Variants

If we can get systematic wastewater data from across the country that’s a really big game. What does it mean to have 700 systems? I don’t know, but it’s more.

They will make it (FDA process) as fast as does not require any compromises or tradeoffs, which is still way way faster than normal for some reason, but no faster.

#3: Prevent Economic and Educational Shutdowns

#4: Continue to Lead Vaccination Efforts

Paxlovid Remains Unpurchased

Paxlovid access likely matters more than all other questions combined at this point.

If you can get access to Paxlovid in time, there is a huge (perhaps 90%+) decline in the downsides of getting Covid-19, thus consigning the whole thing to not be a big deal even with another surge.

The White House on Thursday acknowledged its Covid-19 response money has nearly run out and it needs $22.5 billion more, or it won’t be able to secure treatments, vaccines and tests for the future.

I have no idea whether this ‘transparency’ is indeed a problem, but holding up the funds to pay for Paxlovid, when the total amount asked for is about 0.5% of the money that’s already been spent, is a rather crazy way to make this point.

Congress actively cut all pandemic funding out of the bipartisan omnibus bill, I have no idea why both sides agreed to this but it seems like this was the change that made Republicans in the house sign on to the bill

Physical World Modeling

Mina warns us that Omicron spread with a backdrop of a lot of pre-existing immunity, and we should not be too confident even now that we know exactly how deadly it is relative to past strains

Things are very much quite bad in Hong Kong right now, due to a combination of using Sinovac as their vaccine and having previously suppressed the virus, leaving the population vulnerable.

China continues to face this issue.

Prevention and Prevention Prevention Prevention

Austria suspends its mandatory vaccination law.

Think of the Children

Rochelle Walensky expresses some regret over being over-optimistic about vaccines, in particular in not warning people that effectiveness might wane over time. Yet if it happened again, even if they knew what they know now, would they act differently? I doubt it

The whole myocarditis scare thing has done orders of magnitude more damage than myocarditis, while also increasing children’s net risk of myocarditis

In Other News

Recent rise in UK cases seems to be driven by incidental testing, which doesn’t mean it isn’t a real (although small) rise. It does mean there is little worth worrying about unless the trend continues quite a lot in ways I do not expect

• meaning the rise in hospital admissions/cases is from high % of population having/had COVID, then getting hospitalized for a different reason, then getting tested for COVID while they're there. cf With COVID vs From COVID.