Coronavirus Files: New school guidelines are coming, and Feds take on long COVID

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Amber Dance | Courtesy Photo

THE CORONAVIRUS FILES

By Amber Dance

Disparities in booster access continue 

As the country prepares for yet another round of COVID-19 boosters this fall, Black and Hispanic populations may be left behind.

A new study in Health Affairs finds that while Black and white people had lower rates of uptake for the first dose of a COVID vaccine, Black and Hispanic people were least likely to get a booster shot. It’s not clear why Hispanic people seem to be getting fewer boosters after strong uptake of the initial vaccines. 

That drop-off could have important health consequences because immunity wanes with time and the latest omicron variants undermine the level of protection offered by two shots alone.

One factor in the racial disparities seems to be lower access to vaccination sites in counties with high Black populations and in rural areas, reports Lindsey Mulrooney at Pharmacy Times

“People may choose not to get vaccinated or may be willing to get vaccinated but face barriers including transportation and language, as well as the inability to take time off work,” write the Health Affairs authors from the RAND Corporation. “These disparities suggest that additional resources may be needed to mitigate inequities for the Black community and that booster-specific outreach may benefit Hispanic communities.”

The RAND authors suggest that vaccine equity efforts are particularly challenging in the U.S., because federal and state agencies must coordinate efforts, compared to other countries like the U.K. where there is a single vaccine delivery system. 

State-level emergency orders end as cases remain high

Most states have now let their COVID-19 public health emergency declarations drop, reports Adeel Hassan at The New York Times.

By late August, the emergency declarations will have expired in all but a handful of states, according to data from the National Academy for State Health Policy

“Earlier in the pandemic, there were broad statewide actions; now they are more targeted,” Hemi Tewarson, executive director of the Academy, told The Times. “If you think how emergency orders are used, it makes sense if you see where we are into the arc of the pandemic.” 

The federal emergency declaration, renewed in July, will now run until at least October. This grants a host of benefits, such as expanded access to Medicaid for low-income Americans.

The dwindling emergency orders reflect growing attempts by state officials to return to normalcy even as the nation is stuck in a “horrible plateau,” says USA Today, with more than 100,000 new cases and more than 400 deaths every day, particularly among the elderly. “It’s been this way for the past couple of months, and we’re getting used to it,” Dr. Daniel Griffin of Pro Health Care in New York told the outlet’s Adrianna Rodriguez.

The COVID death rate is similar to the rate of influenza deaths at the peak of flu season — but that season only lasts a few months. With COVID, “many experts don’t foresee much change anytime soon,” writes Andrew Joseph at STAT.

The state emergencies, declared in March 2020, had a range of effects such as expanding telehealth access and making it easier for the National Guard to travel state highways.

In response to pandemic restrictions, some state legislatures have now made it harder to declare a public health emergency or extend one, Hassan reports. For example, starting in 2023, the Arizona governor will require legislative approval to declare a public health emergency.

Other states have enacted laws so that an emergency is no longer required for certain health measures. For example, Virginia will now allow out-of-state health workers to enter the state to care for patients without any emergency status. 

Meanwhile, viral threats continue: The Biden administration declared monkeypox a public health emergency on Thursday. The U.S. has the world’s biggest outbreak of this virus, reports Karen Weintraub at USA Today, and appears to be repeating many of the mistakes made with COVID, notes anthropologist and pandemic expert Wendy Orent in an LA Times op-ed.

CDC to issue new school guidance

A preview of new CDC community guidelines obtained by CNN reveals less emphasis on regular testing in schools and relaxed quarantine and social distancing recommendations, report Brenda Goodman and Elizabeth Cohen. 

The draft guidelines, circulated among educators and public health officials, are not yet final.

It’s likely the CDC will no longer recommend kids exposed to COVID undergo testing to stay in the classroom. Such “test to stay” programs were costly for schools. 

The new guidance will likely also suggest that people who are exposed to COVID and not up to date on vaccines do not need to quarantine but rather just wear a mask around others and test after 5 days.

The agency intends to emphasize good ventilation in buildings rather than maintaining 6 feet of personal space. Most schools have not upgraded their ventilation systems recently, and Al Tompkins at Poynter suggests journalists should quiz schools about the topic.

The recommendation for people who do have COVID to remain in isolation is expected to stay in place.

“Sources say the tweaks reflect both shifting public sentiment toward the pandemic — many Americans have stopped wearing masks or social distancing — and a high level of underlying immunity in the population,” write CNN’s Goodman and Cohen.

Many schools, despite struggling with outbreaks and staff shortages during the pandemic, are making few policy changes for the new year, report Sharon Lurye and Collin Binkley at AP News.

Most schools across the country will be mask-optional going into the new school year, reports Jacqueline Howard at CNN.

Los Angeles Unified School District, which has held to aggressive COVID-19 safety protocols throughout much of the pandemic, will be mask-optional and drop its practice of weekly COVID testing, reports Howard Blume at the Los Angeles Times. It is also deferring a vaccination mandate originally scheduled to go into effect this autumn.

Washington, D.C.’s district will be an outlier in requiring vaccination for students 12 and older, report Lauran Lumpkin and Perry Stein at The Washington Post. But this could disproportionately exclude students of color from the classroom; Black teens have a 60% vaccination rate compared to 85% of all students. 

Ongoing disruptions in school schedules could make it harder for students, particularly at low-income schools, to catch up on learning time lost during the pandemic, Harvard education policy expert Thomas Kane told AP.

“If we don’t get active in trying to close those gaps,” Kane said, “they’re going to become permanent and there will be huge consequences for kids.”

Critics assail government response to long COVID

The Biden administration just released two reports on long COVID, and plans to establish an office devoted to the nebulous but debilitating condition. But patients and physicians say the plans don’t go far enough to meet the current needs of millions of Americans suffering from lingering symptoms.

“Advocacy groups say that while the reports are a good start, they are woefully inadequate in addressing the very questions patients and their physicians have had for more than two years,” writes Erika Edwards at NBC News

Between 7.7 million and 23 million Americans have long COVID — it’s difficult to pin down a number — and 1 to 4 million may be unable to work due to ongoing symptoms.

One new report focuses on services to help people with long COVID and health care providers treating them. The new government office would coordinate activities between the government, patients, and physicians, but it’s not clear there are funds to support it, Edwards notes.

A separate report called the National Research Action Plan on Long COVID emphasizes the need to accelerate research and improve patient care, with an eye to health equity and partnerships with public and private organizations.

More than a year ago, Congress gave the National Institutes of Health $1.15 billion dollars to study long COVID, but progress has been sluggish, writes Rachel Cohrs at STAT.

In fact, Cohrs notes, the money was temporarily borrowed from NIH to help house unaccompanied children at the Mexico border. 

The NIH has launched a 40,000-person study to track long COVID, but as of March, it had enrolled just 1,366 people. Neurology professor and former long COVID patient Lauren Stiles called the study “a slow-moving glacier.” 

And many advocates would prefer to see more focus on testing potential treatments.

“Their goals do not match the goals of people who are suffering,” said Diana Berrent, founder of Survivor Corps, a long COVID patient group.

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