[Durham INC] Share for high-risk & folks who care about them re: differing guidelines metrics, better survival outcomes -- where & why (data from med/scientists)

Wed Mar 16 21:59:24 EDT 2022

A share just for those interested in the other data & discussions re:
earlier & current guidelines for Covid prevention (either serious outcomes,
community transmission, or both) and how different approaches have led to
different results for death/serious illness numbers here vs. elsewhere,
from a qualified medical doctor/epidemiologist, with evidence/data/research
& public health references.

It can be helpful for community members to see some additional figures &
information on protective science especially if they are caring neighbors
of, family/friends/cohabitating with, or themselves in a high-risk category
for Covid. Or in a profession/situation involving any congregate care
environment. Because many mitigation measures are being discontinued in
communities, it makes it potentially worthwhile knowing more context about
the state of things with the SARS Co-V-2 pathogen presently and in the
coming months, from the science, and scientist's perspective (and given
massive outbreaks just emerging in other places (China, parts of the EU and
elsewhere) right now).

Two sets of details follow, and there are further newsletters beyond, for
those who are interested to subscribe to separately from this message if
they choose. Feel free to share/cross post as wished, or simply
ignore/delete if not interested. --DH
-----------------------------------
https://yourlocalepidemiologist.substack.com/p/new-cdc-mask-guidance-my-two-cents?utm_source=url&fbclid=IwAR2JziTkA5mr2JWFGZyL6lUxEw2Av2F2JrszjS8yH-07TQnJteSEDwsmhNY&s=r

I wouldn’t be a scientist without critiques. I think these critiques are
pretty big, too:

   -

   *Case level definition:* It’s not clear to me how they arrived at their
   new case metric: 200 cases per 100K in the past week. (Before today
   masks were needed at 50 cases per 100K in the past week). No scientific
   justification was provided. And I’m shocked the CDC is comfortable with
   this high level of transmission given long COVID19 implications, given that
   not everyone has access to the vaccine, and given high excess death to high
   risk individuals (like we’re seeing in Denmark
   <https://yourlocalepidemiologist.substack.com/p/two-week-recap-denmark-ba2-and-boosters?utm_source=url>with
   high levels of transmission. Vaccines are great but not perfect).

   To demonstrate, this morning the CDC’s old guidance said that 3,074
   counties should wear a mask indoors. This afternoon their new guidance says
   only 1,200 counties need to mask. This is a big difference. And, honestly,
   I’m a bit uncomfortable with this high level of transmission in the
   community.

<https://cdn.substack.com/image/fetch/f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F150b86a4-e030-4cde-96d7-88bd88ef01f2_2269x1057.png>

--- A key thing to consider also (stated in article, on NYT & WaPo articles
& podcasts with public health folks and others: the growing level of
asymptomatic & mild sympto people who aren't testing to add to the figures
the CDC advisory is based upon, and the growing number who lie about a
positive test result (or just avoid a test) because people who call to work
sick or with test results are getting fired, or they can't afford missed
work, or to have a sick child/family member at home and miss work to care
for them (or protect others) with similar unwanted outcomes. Many medical
folk make it clear that the CDC specifically ending the effort to reduce
transmission means we won't know in enough advance to prevent flow on
effects on hospital surges, more thousands of unnecessary deaths, and
breakdown of healthcare systems that affect non-Covid patients and their
health outcomes. It's a head-scratching approach, poor on data collection
and continuation, to be basing decision making upon. The CDC has struggled
to lead in this global crisis....other decision makers should use
information to be better at leading communities than what the agency's been
able to do so far. (We need them, but we need better effort).
<https://email.mg2.substack.com/c/eJx1kktv4jAUhX8N2RH5kQdZZDEiQwUt0FERDLOJHPuSGBI74ziE9NfXKatZjGT7yvY5utL9DmcWSm3GtNWd9aYjt2MLqYKhq8FaMF7fgcmlSMOEREkUBZ5IA4EX4cKTXX4xAA2TdWpND17bF7XkzEqtJgdZYIITr0oBo4QX4YLhWCBMGBWCoyIQSYgCGsTxszHrhQTFIYU7mFEr8Oq0srbtZvTHjKzcGnVvas1ZDa0U0Ehd61J21u_6orOM33yuGydrp83UpODz1kDLDAgFXTfv5jdtgM3vEqxizYyurL6BmtEMxg3m5Dj-JvVtfdV4f1iT_eFMdstBstMKubfH7vqL7rLtsMvOj7flpuV0K_dyM4jT2m6v5WN7_Rmu5SA5PUqnl_wl-RRLPP45ra7ipb4XcpP4Bc2WcLKv53b7Pkb7LKoul7_nUx2_Qvb--XGsDh_3Si-DN-wGnBJECKI4wpjSAPvEX3AU0gvEJKIIgHA_xAwl1ohZgJqS_DMKz6SiYsNNqi5xfoydppxofX86WLmrTa-kHXNQrKhBPDnaZxy-yeYlKDAuJiJnNsVREAcUBRFBGD-xTdFwF5Iksee6C-1cKv0Pqi_SoNRn>

*Si quiere leer la versión en español, pulse aquí
<https://email.mg2.substack.com/c/eJxVkE2OhCAQhU_TLA2UiLBgMZu5hkEobdIKhp_pePvBdjOTFEUI9erle9YUXGM69RFzIVebynmgDvjOG5aCidSMafJODwqEEoITp7ljcpDE52lJiLvxmy6pIjnqvHlrio_hUoBkwBR5aiEXM8hFICAoKd1ouJRSiIXOEuyAt7GpzmOwqPEH0xkDkk0_Sznyo_96wHerXPHwDncft7i2Y83W5TrnYuyrs3FvI8RroAC0Z4Kxvuesg05aOvQLjiB6igi2G5ihqiT34HRf4d8KkrR7mvfLh6yanrE2s16En88GOLV7r8GXc8Jg5g3dzV7uCD9pTCsGTC1aN5mimeAj7ykXQBm7Ua842wOUGklzd7Gpgj5jTR-oP5Q-l19frI3W>.*
------------------------------
Pandemic Preparedness: S. Korea, Vietnam, and…the U.S?
<https://email.mg2.substack.com/c/eJx1ks1y2yAUhZ_G2tkjkCybBYs0iVM6tVwlGk_cjQbDlU0sgQpIjvz0RfGqi87wM8A53JnzXcE9nIwdaWecj6al8mMHVMPVNeA92Kh3YCsl6ZLgjGRZGkmaSrReriPlqtoCtFw11Nseoq4_Nkpwr4yeHHiNMCLRmWK0kphnnEtxFAnKkhRhqNdAEoLqIyb3wryXCrQACgPY0WiIGnr2vnOz5GGGN2GMpreNEbyBTklolWnMSTm_cP3ReS4uC2HaIOumyfWkEPPOQsctSA3Ozd38Yizw-aDAa97Oko03F9Cz5AnGH0jg_fiOmwv7MGhXMrwrDzh_vCrxQm5yQ7rfjyzLy4fPbcmWu1I41jZnGe625SHOb8Vt-1Tg7dtV8ff8Fv5Q4vte_SxZGvSfuzfmmM7RQbGM6W-DSAov2v35kLx2R5yqulj8ifN0-TkcWDN4w56f69PuI7_5vZtnBRs2xQug4ZX8Wme5iRTFMcZxyBKhJMS5wIu1iJdJDSucJTEAFosl4jHxVs7SuD3hf0KKLJVnfr0o7UjwIxQ0p4nj12PAWIW97bXyYwWaHxuQd8L-3ihfzKsTaLChgWTFPUVZukqTOM1wjNAd6NQ04YAJWUWhujTBpel_IP4FpfrclA>

<https://email.mg2.substack.com/c/eJxNUMuOwyAM_Jpya4QNeR047GV_I6LgpGwJREC2yt8vaS4rWX7IHo1njC60xHSoLebCzjSVYyMV6J09lUKJ7ZnS5KxqR-zGrpPMKmlhaAfm8jQnolU7r0raiW37wzuji4vhROAACCN7Kpj5qFHDgK2UXABJqWcLZjCtAI3iIta7dRQMKfqldMRAzKtnKVu-ia8bftfI-yMXbV6NiWsdtxRn56l22CP2nOP9VfX4I9x_qFYXNHMKOWLl7ACEkNBgMxjeipl67AQnQtO0oPlYkr1Jvi7Y_GdhSdmnfr9cyGPFA9Sb5RT8WVa9U63rHlw5Jgr64cleVpTL0Y8500KBUv3MTroo6GQvBZcdcoBL-eluHXAce1bZbayooI64Jx-N9rQ5S6uLPi4ulz_4DpEI>
Katelyn Jetelina
<https://email.mg2.substack.com/c/eJxNUMuOwyAM_Jpya4QNeR047GV_I6LgpGwJREC2yt8vaS4rWX7IHo1njC60xHSoLebCzjSVYyMV6J09lUKJ7ZnS5KxqR-zGrpPMKmlhaAfm8jQnolU7r0raiW37wzuji4vhROAACCN7Kpj5qFHDgK2UXABJqWcLZjCtAI3iIta7dRQMKfqldMRAzKtnKVu-ia8bftfI-yMXbV6NiWsdtxRn56l22CP2nOP9VfX4I9x_qFYXNHMKOWLl7ACEkNBgMxjeipl67AQnQtO0oPlYkr1Jvi7Y_GdhSdmnfr9cyGPFA9Sb5RT8WVa9U63rHlw5Jgr64cleVpTL0Y8500KBUv3MTroo6GQvBZcdcoBL-eluHXAce1bZbayooI64Jx-N9rQ5S6uLPi4ulz_4DpEI>
Mar 16
<https://email.mg2.substack.com/c/eJx1UkuPmzAQ_jXhVoRtngcO22SzJV1AW6GkyQUZe0Kc8LCMWUJ_fU3SHnqoZM1oxvPN82NUQ92rOZb9oK1FlHqWEHcwDQ1oDcoaB1Cl4LEXYT_yfdfisctR6IWWGMqzAmipaGKtRrDkWDWCUS36bkHgEGEUWZc48jyfhQFHzA1D98wrQkl0ZsgLQgoVdZ6F6cgFdAxi-AQ19x1YTXzRWg4r8rLCW_PmflRNz2gDUnBoRd_0tRi0PYzVoCm72axvTRiVwshPZMSS2KhHj18UULb0tiJb3d_A6A3MO8Twfv6Jm1ty7VFeJDgvjjhbT4K9Rb_4NpKndeJnxcs9LRIvL9iQdLvmeMgceohGgxGuxLdETIIeto6x79n1g2SbdMo2x_v7eicZSUUudhM_JDq91vf0-uot8YzsxYJn7f5yJD9khV1x_rC9EUm1zk9HUp0uwfD18H0fnt4zsa6aPJVdcH0jb-xb8erVbIX9UbflYNbCwEzzdw9__C1wMbbLlMv4loixg7FDkI8QIS6ysR0yxyNnCLBPHADMbA9RJ9KKr1ynrfE_i7VUzC90uoluiAweIRNTL4kfn-b0pdHt2Ak9l9DRqgH-ZIV-kuvRRFlDB8qQjpdUx8h3A5c4ro8dhJ4kWIhmDBxFgWWq896guvg_h_8NoRvuOQ>
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<https://email.mg2.substack.com/c/eJx1UsFy2yAQ_RrrZg0gGVsHHdIkTunUcp1oPHEvGgxrm1gCFZBs-euL4vbQQ2eAGZb3dpe3T3APR2OHvDXOR-NR-aGFXMPF1eA92KhzYCsl81lGaEZpGsk8lXgxW0TKVQcL0HBV5952ELXdvlaCe2X0yCALTHAWnXJEAM0TipP5Yg8p5SjjhCSHFDjiMhXze2HeSQVaQA492MFoiOr85H3rJsnDhCzDGkxnayN4Da2S0ChTm6NyPnbd3nkuzrEwTYC14-Z6RIhpa6HlFqQG56ZuejYW-LRX4DUfsYHRgPahxtKbM-hJ8gTDNyzIdngn9Zl9GLwuGVmXO1I8XpR4yW5ymbU_HxktyofrqmSzdSkca-qTDLFVuUPFbXNbPW3I6u2i-HtxCzmU-LpV30uWBvx1_cYc0wXeKUaZ_tKLZONFsz3tktd2T1J12MS_UJHOrv2O1b037Pn5cFx_FDe_dVO6Yf1y8wK4f81-LGhhJoR2vqlckEZA6P6vFn_iDUjVNeOvxjFFKieIEJRginGSpDgm8UKgWXKAOaEJAiAinuEwIG_lJEXNkfwjbmRzeeKXs9IuC3yMA-Y4Jv58DOOvRj07rfxQgeb7GuTdGf5usM8mqiNosMF4suI-xzSdpwlKKUEY340wmi1cSJbNo1BdmsDS-X-G_xvcL_Bj>
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<https://email.mg2.substack.com/c/eJx1UsGO2jAQ_RpyI4rtEOJDDhUpK9gFtloEpZfI2BNiSOzUdoDs19eBVmoPlWxL8_xmRvPmcebgpE2ftdq6YHgK17eQKbjZGpwDE3QWTCFFNqE4oUkSByKLBUonaSBtURqAhsk6c6aDoO2OteTMSa2GDJwijGhQZVBSOKZTjBIRC0ijEqdASQlTmhJKcPlszDohQXHI4Aqm1wqCOquca-2IfBnhuT-97kytOauhlQIaqWt9ktaFtjtax_gl5LrxtHa4TA0MPm4NtMyAUGDt2I4v2gAbXyU4xZoRmXeuKawvy2FE8j91RjgZ8AaE7Dwpf4z4G-RaOVBuYFe-rkcZHwb-C3D6AkMM_RJxvOu_4_qyOGu02S7wZnvA69lNsv088th9ff5G1vnqts4P97fZsuVkJTdyeRP7hVudT_fV-etkIW-Sk530fMlf6KeYof7Hfn4WL_X1KJc0PJJ8Bnv3emhX732yyZOqLH8e9vX0FfL3z49dtf24VnoWvyG_tAxHGEcEJQgREqMQhymPJsM2cEIiAMzDCWIRdUaM4qg54X_kDUwmKna7SGWpz0fIc06DPI9PbwAvUNN0Srq-AMWONYinN9zTYg8pixMoMN56omAuQ0k8jUkUJzhC6GmFwW4-wJROA99daJ-lsv-s_xc4KfKp>

The U.S. is at a pivotal moment. We can learn from our mistakes to prepare
for future mutations and new public health threats. Or we can continue a
“deadly cycle of panic and neglect”.

Other countries, like South Korea and Vietnam, have had very effective
responses to SARS-CoV-2. This was because of the lessons they learned from
previous flawed responses, like MERS and SARS. By preparing, they were able
to save hundreds of thousands of lives during this pandemic.
<https://email.mg2.substack.com/c/eJxVUt2upCAMfprxTgMFFC64ONlkX8MgVIeMggfwzLpPvzhebUL6y9evaWtNwSWmU-8xl-YSYzl31AHfecVSMDVHxjR6p4WCXvU9b5zmjkohG5_HOSFuxq-6pAOb_ZhWb03xMVwIkBSoap565hMCpQBAmOn5NANyOSBwBXaQ1t3E5nAeg0WNP5jOGLBZ9bOUPT_Y1wN-12dd6PIx5WLsq7NxqyG_mQWrnrHY56VrmRIf8Ov7NtjXEqOr_ryOe4pLwpz9D9Z4Loh7RdwUIC4ScdFUMR32hTWfWiRimqzk7WQMazkbsFWCyta4icGEw6Ak7zLrzGb-xmDe-e6r1riH8TE_TeaPSTgiKCPaGaRouSR9WyfSt4pzJd0wG0vlSKngfxSHbg9L4zWQa3C0p5QxTjvopCWCzThAz0gtZztBDVEluQcn2wL_zahJ2j3N--VDVhVPaf2zXCv7JGuTY9XbEXw5RwxmWtHdyyz3TXzWOy4YMNVbcaMpmvZ84IzwHgil9-6u-6gOKDU0ld3Figr6jEdaozUr7t7h5uMaF5_LPztCy6w>
*South Korea’s lesson*

In 2015, South Korea was hit with Middle East respiratory syndrome
coronavirus (MERSCoV) from a traveler returning from the Middle East. The
South Korea outbreak involved 186
<https://email.mg2.substack.com/c/eJwlkMGKxCAMhp9mPIpGa9uDh2Vhbwv7BsVqpiNjtaid0rdfOwMSTWL483_WVFxSPvWWSiVXmOq5oY54lIC1YiZ7wTx5p7sR1KiUJE5Lx4duIL5M94y4Gh90zTuSbZ-Dt6b6FK8JGDjwkTz0zPq7YZ0Y-kEo5kC5kQuQBriQXLj5I2x25zFa1PjCfKaIJOhHrVu5ia8b_LRzHAeNdvY0hpVG_6BLerXyttoWTa7eBizt-ff73Q2SKSZbQrwGBsAEV5yLJkiBDrZtc8celGCIYGnHDRtrdjfJ1gVo2edSjX1Sm1aStXuY4-ljaVsLztuf5fL8bjbLU7vXPfp6ThjNHNB9aNQP1DefacGIucF2k6maK9lLwaQCxvnH_AW4JTCOPWnqLrWpqM-055CsCbh5h6tPIS2-1H87uZBn>
confirmed
cases, 16,752 suspected cases, and 38 fatalities. All of which could be
explained through 5 superspreader events and/or patient exposures across 16
hospitals. South Korea’s MERS epidemic was the second highest outside of
the Arabian Peninsula. While the epidemic only lasted for 2 months, close
to 17,000 people were quarantined, many South Koreans lived in fear, and
the economic loss was high: ~9.3 trillion
<https://email.mg2.substack.com/c/eJwlUMuOwyAM_JpyRGAIIQcOe9nfiAi4KVoCEZBW-fsljWT5IXtszzjbcM3lNHuujVxubueOJuGnRmwNCzkqljl4M0ygJqUk8UZ6rgdNQp2fBXGzIZpWDiT7scTgbAs5XQjQHPhEXmZ5DhycZ0yMapKo5YjaaeXBDc4Kre7D9vABk0ODbyxnTkiiebW214f4ecBvt75_Q0-TWwJNcaMpvOia370DoxRCaN1TEgwwACa44lwIySlQ7dggnjiCEgwRHB24ZVMr_iHZtgKtx1KbdX_U5Y0U41_28xdSnTqe8z6zXhy_zf7C3ON2pNDOGZNdIvqbfbtF_Ooxr5iwdHH9bJvhSvb_mFTAOL_JXoL2AqZpJP26zx2VzJmPErOzEffgcQs55jXU9g__zIu2>
Korean
won (~8.5 billion U.S. dollars).
<https://email.mg2.substack.com/c/eJxVUsuupCAQ_Zpmp-GpsGBxM8n8huFR2qQVvIC3x_n6wXY1CaknVeekqpypsKR86j2Vii4x1XMHHeFdVqgVMjoK5Cl4LRQd1DBw5DX3RAqJQpnmDLCZsOqaD0D7YdfgTA0pXhVUEkoUemo_KyH95UksjLDcWmcwYAZecmzdDWwOHyA60PAD-UwR0Kqfte7lwb4e9Hd7zse-HLZU4169S1sLhc0s0PQM1T0v3drU9KC_vm-DfS0p-ebP67TntGQoJfxAi5cKsLeKG4KKC0RcME3Yw72g5XMHWDSyknfWGNZxNkKnBJGd8ZZRC-OoJO8L681m_qZo3uXm1Xrcw_iYH5LlYxou3CA97pjHc8cVJ50R3HaeYoX5YBmjfiJ05H_aqPs9LihoiinFjAyEMMZJT3vpsGAzjHRgGIC6XhCDVc3-wfG20P9mhLL2T_N-hVhUqyek_VmulX2SjeTU9HbEUM8JorEr-HuZ9b6Jz3qnBSLkdit-MlWTgY-cNbYUE3Lv7rqP5lClRtTQfWpVUZ_pyGtyZoU9eNhCWtMSSv0HXObMQw>
Confirmed
global cases of Middle East respiratory syndrome coronavirus reported to
World Health Organization (WHO) as of November 17, 2017 (n = 2,103). Source
Here
<https://email.mg2.substack.com/c/eJwlkEtuwyAQhk8TdkG8jRcsqkrdVeoNLAxThwaDBTiWb1-SSKN5_5rR52yDJZfTbLk29HRTOzcwCY4aoTUoaK9QpuCNHJkalRLIG-GplhqFOv0WgNWGaFrZAW37HIOzLeT0VDBNGR3RzehBkJnN4JQgXnGppSJS6lFKPw_Ck_dhu_sAyYGBB5QzJ0DR3Frb6oV_XNhXt-M4cHJzwCmuOIUbXvKjt7fVdW9LCy5C7enP96fUgigiXjo-6-v9L6xXRqi-Ek5RMIww1jNFKeeCYoa1I5L_wsAUJwDMYUktGVvxF0HWheG6z7VZd8cur6gYf7PHPaQ6dj2lfWd5YngNO4Wpx3VPoZ0TJDtH8G9A7c35hWxaIEHp_P1km6FKDIITofqP9M3jybwXbBwH1K_73FXJnHkvMTsbYQse1pBjXkJt__5nlTY>

After the epidemic, the South Korean government made 48 reforms
<https://email.mg2.substack.com/c/eJxVUcmO3CAU_BpzRGzG9oHDaBYph0xmspwRhtdu0jZYgMfy3wd3nyKhelRB6UlV1hSYYjrUGnNBJ-hyrKAC7HmGUiChLUPS3ql2YHKQUiCnhKN92yOf9SUBLMbPqqQN0LqNs7em-BhOB-spowO6ql50QlycrYNK0ZJeACWisyMZW8vI8FhsNuchWFDwBemIAdCsrqWsueFPDXurZ993vMTrjqeIb6kKEKaKYb8DoYR-7fhvXhv-9vH0U39_ff-jv700_IUS0jVM_i8QWqXVTHDyen3-8f5b_3r9rJQzSSRBXjHCGOFUUsq5oJjh3pKWX6BjkhMAZnFLDRlKco0gy8Rw3sZcjL1hGxeUlLua_eZDHqqf0vpnOtO6P9awdJ3LFnw5NAQzzuAeOZZHHfdk9QQBUq3JaVNUja8TnAjJCKWP2M5qKmHD0KG63cXqCuqIW5qjNTOs3sHi4xwnn8s_fJiemw>
to
boost public health preparedness and response. You can read them here
<https://email.mg2.substack.com/c/eJxVUcmO3CAU_BpzRGzG9oHDaBYph0xmspwRhtdu0jZYgMfy3wd3nyKhelRB6UlV1hSYYjrUGnNBJ-hyrKAC7HmGUiChLUPS3ql2YHKQUiCnhKN92yOf9SUBLMbPqqQN0LqNs7em-BhOB-spowO6ql50QlycrYNK0ZJeACWisyMZW8vI8FhsNuchWFDwBemIAdCsrqWsueFPDXurZ993vMTrjqeIb6kKEKaKYb8DoYR-7fhvXhv-9vH0U39_ff-jv700_IUS0jVM_i8QWqXVTHDyen3-8f5b_3r9rJQzSSRBXjHCGOFUUsq5oJjh3pKWX6BjkhMAZnFLDRlKco0gy8Rw3sZcjL1hGxeUlLua_eZDHqqf0vpnOtO6P9awdJ3LFnw5NAQzzuAeOZZHHfdk9QQBUq3JaVNUja8TnAjJCKWP2M5qKmHD0KG63cXqCuqIW5qjNTOs3sHi4xwnn8s_fJiemw>,
as they were extensive, but briefly, the changes can be grouped into four
categories:

   1.

   *Detection*. Initial response systems, like a 24/7 Emergency Operations
   Center and an Immediate Response Team, to stop the outbreak of emerging
   infectious diseases, and to make sure that, if any type of infectious
   diseases break out, the spread can be prevented at the initial stage.
   2.

   *Treatment*. A specialized diagnosis and treatment system, including
   quarantine facilities; increasing the capacity of testing laboratories; and
   funding for the development of vaccines and remedies. All of these would
   promptly detect and prevent the outbreak of emerging infectious diseases.
   3.

   *Healthcare*. Improvement of healthcare facilities to reduce spread
   within hospitals, like more negative-pressure isolation rooms and
   "infection control rooms,” which involved building capacity for more beds
   and hiring more infection specialists.
   4.

   *Infrastructure*. Community-based collaboration between medical centers
   and local governments. This included restructuring the Korean CDC.

South Korea also already had a strong backbone for these changes, with a
fantastic national health insurance system and ample human resources and
infrastructure.

So, when SARS-CoV-2 hit, South Korea was more than prepared. Their first
case was in January 2020. They were quickly able to detect, contain, and
treat all COVID19 cases. They leveraged a combination of technology and
strict quarantine guidelines, but also support. For example, those in
quarantine had case officers
<https://email.mg2.substack.com/c/eJwlkNGOhCAMRb9meBtDUVEeeNiX_Q1ToTpkEAzgTPz7xTVp2jS3Nzc9BgutMZ16j7mwq03l3EkH-mZPpVBiR6Y0Oat7JaSSsmNWdxbGfmQuT0si2tB5XdJBbD9m7wwWF8PlECMIUOylObSICyjAfun4MI4DDqOUZEdC3tNwB-NhHQVDmj6UzhiIef0qZc-P9uchfmuZ-HEWVIPJoQ3kcc5NTGtVVh9n9E9PmIILa37meJTX8x0TYZWZ04ILwVuQAG3bQSOa0fC-XWgQsuVEwjQ9IFcl2UfHt1U0-ZhzQfNuTNxY0vaF37cLWVU_QL1Zr7__xfr2VOd2BFfOiQLOnuxNpNxg_xlNKwVKFbidsGiQ3dC1vJOCA9wALsh1EUoNrKbbWF1Bn_FIPhr0tDtLm4s-ri6XP6JulQI>
who
provided food delivery, toiletries, psychological counseling if needed, and
video-streaming services to keep busy. On May 6, 2020, mandates were
relaxed and, by May 20, 2020 schools were back in session.

There have been small outbreaks since, but they’ve been contained.
Concurrently they were also vaccinating, and today, 88%
<https://email.mg2.substack.com/c/eJwlkEuOwyAQRE8TdmPxM4EFi9nMNSwCbQcFgwXtRL794FhCjfpTKr3yDmEp9bBbaUjOMuGxgc3waQkQoZK9QZ1isKPhyiglSbAyMD1qEts0V4DVxWSx7kC2_ZGidxhLPhVcM84MeVomQbuZGphFGJ3yEsydBU21ktooP1_Gbg8RsgcLb6hHyUCSfSJu7SZ-b_yvv7LXT6kpxBwcuqHUpQ99ecfw83bex_y1biRaTjmnginGhJBs4IP2dBQz3LkSFID7YWSOGqzhJum68KHtj4bOvwZfVlJteLrPK-Zmup6xfrOclN9lh5z6v-454jFBdo8E4eLHK8ZvItMCGWqPN0wOLVPyLgWVilPGLtwz0t5wY-6ku4fSVdkenTEV7xJsMcAaSypLbPgPGQqPtw>of
the population is vaccinated.

While they are currently experiencing a massive case wave, cumulative
deaths in South Korea are clearly differentiated from the U.S. Their
preparation, swift response, and vaccination coverage has and will continue
to save many, many lives in South Korea.
*Vietnam’s lesson*

Vietnam is another interesting case example. During the epidemic of Severe
Acute Respiratory Syndrome (SARS), Vietnam was the second country, after
China, to face SARS and one of the top four countries hit hardest. Over the
course of 100 days, they had 63 cases and a case fatality rate of 8%
<https://email.mg2.substack.com/c/eJxNUcuupSAQ_JrDDsPDo7JgcTfzGwahVebyMNBe498P3rOZhKZT6a4UVFmDsOVy6yNXJM81432ATnDVAIhQyFmhzN7ptxKDGoaeON07Pr0n4uu8FoBofNBYTiDHuQRvDfqcHoaYuOCK7HrqnZFyBAvjOggF68gNgOKLMKpnxn6Ezek8JAsafqDcOQEJekc86kt-vcSfdq7r6q49dz5hQ_-p1QZjK4_wtHrGaMpN80qPkhezBKDVlEqtqVDp5XGnjQT4bPgQEtRK15Ij5TTlH4gLFCoYExQzlZz-PcP9YEm8FkwIJvnAuZQ970Q3WfaWK4xikAxA2O7NDVNY3KtncRNdPZeKxn53NkdStNvN9e1TVY3PedvZHv9-h-1Dc-vxTB7vGdLzbvdxFj8B_Xo9b5CgtODcbFDzoR97yfpBMM4_Rj5hNSCUGklTd7mxkr7zWUK2JsDhHUSfQ958xX_zpq4x>
.
[image: FIGURE 1. Epidemic curves (numbers of cases by date of symptom
onset) for severe acute respiratory syndrome (SARS) outbreaks in a) Hong
Kong, b) Vietnam, c) Singapore, and d) Canada and the corresponding
effective reproduction numbers (R) (numbers of secondary infections
generated per case, by date of symptom onset) for e) Hong Kong, f) Vietnam,
g) Singapore, and h) Canada, 2003. Markers (white spaces) show mean values;
accompanying vertical lines show 95% confidence intervals. The vertical
dashed line indicates the issuance of the first global alert against SARS
on March 12, 2003; the horizontal solid line indicates the threshold value
R = 1, above which an epidemic will spread and below which the epidemic is
controlled. Days are counted from January 1, 2003, onwards.]
<https://email.mg2.substack.com/c/eJxVUsuu3CAM_ZrJLhEYSMKCxVWl_kbEw8nQSSAFcqfp15dMVpWQnxwfy7bVBZeYTrXHXJpLTOXcUQV85xVLwdQcGdPknRISetn3vHGKOzqKsfF5mhPipv2qSjqw2Q-zequLj-FCwEiByuapDPQMZ0ON0ZwITmfKGPKRWcYJyMHdxPpwHoNFhd-YzhiwWdWzlD0_2NcDftZnXejyYXLR9tXZuNWQ3_SCVc9Y7PPStUyJD_jx-zbY1xKjq_68TnuKS8Kc_TfWeC6Ie0XcFCAuEnHRVGEO-8KaTy0SYYwdeWu0Zi1nA7ZS0LHVzjAwOAxy5F1mnd703xj0O9991Rr3MD7mp8n8MckwcIDetOgkttwybMerMnMwoJCDJXScBJA_wPru145L4xUQAMJoT-vYOO2gGy0RbMahjpUggu0E1USW5B6cbAv8N6MmKffU75cPWVY8pfXPcq3sk6xNTlVvR_DlnDBos6K7l1num_isd1owYKq34iZdFO35wBnhPRBK791d91EdkHJoKruLFRXUGY-0RqtX3L3Dzcc1Lj6Xf51BzBo>
Epidemic
curves (numbers of cases by date of symptom onset) for severe acute
respiratory syndrome (SARS) outbreaks in *a*) Hong Kong, *b*) Vietnam, *c*)
Singapore, and *d*) Canada and the corresponding effective reproduction
numbers (*R*) (numbers of secondary infections generated per case, by date
of symptom onset). Wallinga at al. American Journal of Epidemiology. Source
Here
<https://email.mg2.substack.com/c/eJwlkEluxCAURE_TLC0mY1iwyCbXsDD8dpNgsBjS8u0DbQmKsVSqZ02FPeVLn6lUNGSt1wk6wrsEqBUyagXy6p2eFRVKCI6c5o7IWSJf1mcGOIwPuuYG6Gxb8NZUn-JwUEkoUeiliZqllGIz2CixAGViEYrLDWMQRlBzB5vmPEQLGv4gXykCCvpV61ke7OtBv_sw1jg4vJ1SOyebjnH1A0Nz9TaMHRG4q-hzxqrrovhCkdcUU4oZEYQwxslEJ2nxzJ6wUMEwALXTTAxWNbsHx8dOp9K2Uo39HTkoa_cy718fi-p-QvqffdT-PPbWa1-PFn29VohmC-BuIPXm-kG07hAhd95uNVUTwRfOMBcUE3L3H4z7gSq1oJ7uUndFfaWWQ7ImwOlH-RTS7kv9B63wj_Y>

After the epidemic, Vietnam stepped up its public health game to prepare
for the next threat. Specifically, Vietnam increased public health
expenditures per capita 9%
<https://email.mg2.substack.com/c/eJwlkEGOhCAQRU_TLA0FiLJgMZu5hkGoVtIIBnCMtx9sE6AgxefznzUVl5QvvadSyb1M9dpRRzxLwFoxk6NgnrzTvWJSSSmI08LB2I_El-mdETfjg675QLIfc_DWVJ_irWAjMFBk1UICaxMFzgOfDeXA5_YcigHsDEY9xuZwHqNFjX-YrxSRBL3WupcX_3mx3zbSjvET0xnQLdidKQc3m_jpUl5adzXRBWwboGqUrXIG40C8ZpSx5ikBOBfQsW60tOdvHJjkFJHZrgdDVc3uJei2sK4cc6nGfjqbNpK1W8358bGopgdod5Y78rfZEk-tbkf09Zowmrn97YFRH6ZfPNOCEXNj7SZTNUgxCE6FZBTgyX7zbQem1ECau0tNFfWVjhySNQF373DzKaTFl_oPvrqRDw>
per
year. With this spending, they improved their public health infrastructure,
developed an emergency operations center and improved national disease
surveillance. One thing they developed was a centralized, real-time data
system
<https://email.mg2.substack.com/c/eJwlkN2KxCAMhZ9mvBT_au2FF8vC3i3sGxSraUfGalE7pW-_dgohMTGHcD5rKiwpn3pLpaIrjfXcQEc4SoBaIaO9QB69093A5CClQE4LR1WnkC_jnAFW44OueQe07VPw1lSf4qVgijI6oKfujXTzQDhTagJDBGfMKcoFnzjnszX3YbM7D9GChjfkM0VAQT9r3cqDfz3YT4vjOHC0k8cxrDj6J17Su4231bZscvU2QGnPv9_vrqeUE9Ua5DUjjBFOZRtxQTHDypKOz9AzyQkAs7ijhgw1u4cg68Jw2adSjX1hm1aUtXua4-VjGZqe0razXJ4_n83y2Oq6R1_PEaKZAribRr2hfviMC0TIDbYbTdVUil5wIiQjlN7mL8CtYcPQo3bdpaaK-kx7DsmaAJt3sPoU0uJL_Qfy55D6>
in
which all hospitals were required to report any infectious diseases for
timely epidemiological surveillance.

This investment prepared Vietnam for the arrival of SARS-CoV-2, which was
first reported on January 23, 2020. Home to 100 million people and a 1,400
km border with China, Vietnam was thought to be highly vulnerable to
SARS-CoV-2. But they leveraged their well invested public health system to
do four things
<https://email.mg2.substack.com/c/eJwlkE2OwyAMhU9Tdo3AISQsWMxmrhERcFNUAhE47eT2Q1vJsuWfJ-t9zhKuuZxmz5XYO8107mgSvmpEIizsqFjm4M2gQWmlJPNGejENEwt1vhXEzYZoqBzI9mOJwVkKOb0VMAkQmt0NjGqZcBzA3yS3k9KLllpyzW9yAaXG72N7-IDJocEnljMnZNHcifZ66X8u8NsiH-WVS_QheUu2y2VtQ5efwV_xD7c92nJ9BqRkNxYMcADeCyVE30vRQTc5PvQ3HEH1HBFcNwjLNRV_kXxboavHUsm6R-fyxorxd_t6hFR10wvRbta308-yGZ1b3Y4U6Jwx2SWi_zKgL8oPlXnFhKUh9rMlI5QcZc-lAi7E1_Iba2tA65G17z43VTJn8xmzsxH34HELOeY1VPoHkkCQcQ>:
early action, like lockdowns; contact tracing and testing; quarantining;
and clear communication. Together, more than 90%
<https://email.mg2.substack.com/c/eJwlUctuxCAM_JrNLRGPhIQDh176G5EDbhaVAAKyVf6-zq6EbAwexsxYaLincpmcauvusLYro4n4VwO2hqU7K5bVOzNpobRSY-fM6PgyLZ2v609BPMAH08qJXT634C00n-KNEAsXXHdPY9UCTKHetFbzJhU6OTmunAQQgBY-xHA6j9GiwReWK0Xsgnm2lutDfj3EN62WHFzDlc49vQabjvdR9rbSxkcaNr65IVANpXkbsPYFcyrtbhFMMEpMUuAzhYzFYr4hPb1I8ANj658QXfBx7216edfTD7whqGCSK86lHPkghsWySf7gLJRkiMIOEwemW3GPkR27GOq51Qb29x6zK8Y94e_Xx6oJzzn17Ldq70sSbaV8nNG3a8UIW0D30bN9bHkrvO4YsZBdboVmuBrnUbJRCcb5R77bIiqE1nNH7C4RKhoSq4RkIWD2Dg-fQtp9bf_Pr6q7>
of
Vietnamese people reported that their government responded “very” or
“somewhat” well. And, again, many lives continue to be saved because of it.
*United States’ lesson…?*

For decades, the U.S. has neglected public health, which left us a
fragmented, outdated, and significantly understaffed infrastructure to
adequately fight SARS-CoV-2. This coupled with poor communication, health
disparities, poor healthcare coverage, and a highly politicized environment
led to losing 1,000,000 Americans in two years. *What are we doing to
prepare for the future?*

In the short-term, federal COVID19 funds will run out soon, as a $22.5
billion spending bill was denied last week. (There should be another stand
alone COVID funding bill coming, but as NPR reported
<https://email.mg2.substack.com/c/eJwlUUuOhSAQPM1jh-GjCAsWs5lrGIR-SkbBQDvG2w_OS0h1KnSl0lXeISy53PbIFckDE94H2ARX3QARCjkrlCkGOxihjFI9CbYPXA-axDq9C8Du4maxnECOc96idxhzehRCc8ENWW0vnGdOmDArI8fABqN7PXozz8CNduxj7M4QIXmw8AvlzgnIZlfEo77k10t8t3ddV5eO0uWyNCaYEG0w2YAPDzCt1CC11I3gCvRaIwJdczuBVndXGrHScqYU00LziTS_6d6MboqZ-txsH4yBItS26VKgv877mKCSaB8_JrniXMqed6LTng3yDaNQkgEI3w3cMYMlvHq2L6Kr51zR-Z_O550UG1Z3_cRUTdNz3naWJ7n_zxbc1OZ-poj3BMnNG4RPpvip5j_laYEEpVUWJoeWq37sJeuVYJx_InxqakQYM5LmHnJTJXvns2zZuw2OGGCPectLrPgHakGpZA>,
isn’t expected to pass the Senate). This means the government can’t buy
more antivirals; preventative treatments for immunocompromised need to be
scaled back; funding for monoclonal antibodies will end; and next
generation vaccines will be curbed. Congress must act now so we get
ourselves out of this reactive public health response and move to a
proactive one.

In the long-term, it does seems that the U.S. is having a conversation
about pandemic preparedness. A Congressional committee met this week to
discuss the new, bipartisan bill for pandemic preparedness called PREVENT
Pandemics Act, which is a proposed $2 billion over 1-6 years. This comes
after the White House proposed a $65 billion pandemic preparedness plan
<https://email.mg2.substack.com/c/eJwlkctu7CAMhp9m2CUCcpnJgkVVabaniyN1GRFwElQCCJxGefs6MxKyMfi3rc9GIywxnyrFguwyI54JVICjeECEzPYCeXRWdYPsh75vmVWtFY_uwVwZ5wywaecV5h1Y2ifvjEYXw6WQDyHFwFZlJgO8b4XpRN8DzPYOjRFCtNZCI6jkq7HerYNgQMEv5DMGYF6tiKncmo-bfNI5jqM-VoewRpqqXuLv9ZgqEwNCQAr25KO2hW6SS0GOD2Q-Nsg0V6i-dLCwOVN9ZUg6gw1QSvU_61DmmDcXlurfnqtPnfTkvEMHpXq6oH31jLn6hqlOdmZOUXHJaXIhmqYVtawfhnfNDHfZNxxAmroTmg-Y7a3l2yLrsk8FtfmpTdxYVnbVx48LZSC9EJSzXBBfn8RwJL_tweE5QtCTB_vGi-8tvYCPCwTItD07alTE8N42vO0lF-JN89oYBXIY7oy620iqoM64Zx-N9pDcRSL6uLiCf2XnsGk>
over
10 years. As you can see from the figure
<https://email.mg2.substack.com/c/eJwlkEtuxCAQRE8z7Mbi5w8LFtnkGhaGtgcFgwNNRr598FhCoKarVKpnDcKW8qmPVJBc14znATrCuwRAhExqgTx7p3vFBzUMkjgtHZv6ifgyrxlgNz5ozBXIUZfgrUGf4uXgE-NMkZce3SqMYopxO652Wnqgq1rU5CynVjp5B5vqPEQLGv4gnykCCfqFeJSH-Hrw73aOnLYMpXQ-FvRYET6fTR_Rx-15mOhg97Y8M_xW36TPtUbXVk1HvOaUcyrYwJgQknW8myztxQojHwQF4LbrmaEKs3tIum-8K3UpaOxPZ9NOsnYv8_5p2ar5GWua7er-Wbbqc3v3Gj2eM0SzBHA3FbzhfjjNG0TIDbqbDWo2yFEKKgdOGbshXKDbwJUaSUt3qbmiPlPNIVkT4PBXwxTS5gv-AykfmGA>
below,
money in each category was significantly reduced and a lot of things were
completely cut.
<https://email.mg2.substack.com/c/eJxVUsuunDAM_ZphB4rzALLI4qpSfwPlYZh0IKFJuFP69Q3DqlLkZ-xj-djqgktMp9pjLs0lpnLuqAK-84qlYGqOjGnyTglJe9n3vHGKOxjF2Pg8zQlx035VJR3Y7IdZvdXFx3BV0BEoyOap0Blwpue2t8SikE7YgRKrR95TOgpxA-vDeQwWFX5jOmPAZlXPUvb8YF8P-rM-60KXD5OLtq_Oxq2G_KYXrHrGYp-Xrm1KfNAfv2-DfS0xuurP67SnuCTM2X9jjeeCuNeKG4KKC0RcMFWYw76w5lOLRBhjR94arVnL2YCtFDC22hlGDQ6DHHmXWac3_TcG_c73XLXHvYyP-Rkyf0ycOUfnoNUCZMutIFe_6g7CwjxoEIgTED7-gbqa7teOS-MVJZQSBj0AYxw62o2WCDbjQHtGEKntBGgiS3IPTraF_relJin31O-XD1nWeoD6Z7lI-yTrmFPV2xF8OScM2qzobjrLfRUfgqcFA6Z6LW7SRUHPB85IpY8A3OxdF1IdKuXQVHQXa1VQZzzSGq1ecfcONx_XuPhc_gE43M1H>
(Institute
for Progress Source Here
<https://email.mg2.substack.com/c/eJwlkEtuxCAQRE8z7Mbi5w8LFtnkGhaGtgcFgwNNRr598FhCoKarVKpnDcKW8qmPVJBc14znATrCuwRAhExqgTx7p3vFBzUMkjgtHZv6ifgyrxlgNz5ozBXIUZfgrUGf4uXgE-NMkZce3SqMYopxO652Wnqgq1rU5CynVjp5B5vqPEQLGv4gnykCCfqFeJSH-Hrw73aOnLYMpXQ-FvRYET6fTR_Rx-15mOhg97Y8M_xW36TPtUbXVk1HvOaUcyrYwJgQknW8myztxQojHwQF4LbrmaEKs3tIum-8K3UpaOxPZ9NOsnYv8_5p2ar5GWua7er-Wbbqc3v3Gj2eM0SzBHA3FbzhfjjNG0TIDbqbDWo2yFEKKgdOGbshXKDbwJUaSUt3qbmiPlPNIVkT4PBXwxTS5gv-AykfmGA>
)

One thing *added* was improving public health communication and combatting
disinformation (maybe Congress saw my critique
<https://email.mg2.substack.com/c/eJx1kcuOwyAMRb-m7BrxyoMFi5FG_Y2IgpOgJoDAmSp_P6RZzWIk2wjZ11c6tgZhjvnQKRYkZxnxSKADvMsKiJDJXiCP3ulW8U51nSROS8eGdiC-jFMG2IxfNeYdSNqfq7cGfQyngg-MM0UWTTkzUtqWil4pyhwooJOd-ona2mH8Mja78xAsaPiBfMQAZNULYio38XXjjxpH3PMarVkheQebj2ucfcGm7M-Cxr4aG7c6lmq6bAp6ey-Ln_A-xXxPJpwae08ZksngApS6-lHz-0285pRzKljHmBCSNbwZLG3FBD3vBAXgtmmZoQqzu0m6zfyPK8naLeb98qGoqmeszswnmE-zchnru-3B4zFCMM8V3IUML_IfiOMMAXK9iBsNatbJXgoqO04ZuwidV6gfrlRPqruLVRX0P1R-AZWhoeU>last
summer that this was desperately missing). PREVENT Act is also proposing
the creation of an Office of Pandemic Preparedness and Response Policy.
This would bring pandemic preparedness front and center at the Executive
Office of the White House (and perhaps it means they will be able to
request more funding down the line, too.)

Yesterday, PREVENT Act made it out of the Health, Education, Labor, and
Pensions committee with amendments
<https://email.mg2.substack.com/c/eJw1UEGOwyAMfE25bYSBkHDgsJf9RkTASVEJREAa5fdL210J2bKH0XjGmoprypfeU6nkVaZ67agjniVgrZjJUTBP3uleMamkFMRp4WDsR-LLtGTEzfigaz6Q7MccvDXVp_hisBEYKHLXllLOGR17nFEuwCVagX3P1chmLpblI2wO5zFa1PjEfKWIJOh7rXu58e8b-2nvPM_OprhmLKVb07OtZh9CawBDvX_9Y21RMDZrX38wH5QiXjPKGOUgATgX0LFutLTnCw5McorIbNeDoapmdxN0W1lXjrlUYx9NdSNZu7s5Hz4W1fgA7c_68v4Gm_Wp9e2Ivl5TE58Duk8q9RPuO6dpxYi5XeYmUzVIMQhOhWQU4BPCK-g2MKUG0tRdaqyor3TkkKwJuHuHm08hrb7UX639lOA>
and
a 20-2 vote. It will now go to Senate and the House.

But, is a $2 billion enough for the meaningful, long-term change that we
need? As Nikki Teran eloquently said
<https://email.mg2.substack.com/c/eJwlkEtuxCAQRE8z7Mbi5w8LFtnkGhaGtgcFgwNNRr598FhCoKarVKpnDcKW8qmPVJBc14znATrCuwRAhExqgTx7p3vFBzUMkjgtHZv6ifgyrxlgNz5ozBXIUZfgrUGf4uXgE-NMkZce3SqMYopxO652Wnqgq1rU5CynVjp5B5vqPEQLGv4gnykCCfqFeJSH-Hrw73aOnLYMpXQ-FvRYET6fTR_Rx-15mOhg97Y8M_xW36TPtUbXVk1HvOaUcyrYwJgQknW8myztxQojHwQF4LbrmaEKs3tIum-8K3UpaOxPZ9NOsnYv8_5p2ar5GWua7er-Wbbqc3v3Gj2eM0SzBHA3FbzhfjjNG0TIDbqbDWo2yFEKKgdOGbshXKDbwJUaSUt3qbmiPlPNIVkT4PBXwxTS5gv-AykfmGA>
:

*“The total cost of the pandemic in the United States is estimated at $16
trillion
<https://email.mg2.substack.com/c/eJwtkEGOwyAMRU9TllFMCJQFi9nMNSICbsqUQATOVLn9kGYkZMuYr89_zhIuuRxmy5XYWSY6NjQJ3zUiERa2VyxT8GbUXGopBfNGeLiPdxbq9CiIqw3RUNmRbfscg7MUcjoV_A4cNHsarsRox1nNMI-Sg_dKKzegdHqGVvxlbHcfMDk0-IvlyAlZNE-ird6Grxv_bufHrjYhvXN5dS6v503eS7Kx_i9be-wx2kLBRWwTVwpU-3MwvOe8H0ACDIOAjnd314_DAxWXQ4_IXTeC7TUVfxP9uvCu7nMl6z5OrBj_tO9XSFU3PUB7s5y5P8sWe2p93VOgY8Jk54j-IkIX2A-jacGEpQH3kyUDUigx9ELyHuACcEJuA9dasebuc1Mlc7SIMTsbcQse15BjXkKlP9hck_M>.
Even if a pandemic of this magnitude only happens once every 100 years, it
would be worth it for the government to spend up to $160 billion every year
towards preventing the next pandemic. For reference, the US spends $175
billion each year
<https://email.mg2.substack.com/c/eJwtkUFu5SAMhk_z2DUCQkiyYFFVmgPMdI8IOHmoBBA4E-X2JX2VkC3b_Lb12RqELZVL5VSR3EbjlUFFOGsARCjkqFC0d2qYuZylFMQp4dg0TMRXvRaA3figsBxA8rEEbw36FG8FnxhnM3kqahy1yzKKlQ90Gi2HaQYhjewFG4eRvQabw3mIFhT8h3KlCCSoJ2Kuj_79wf-0d55nV9HvNcUule3O5DebIkLEFqw-QP31bwbR2OfeKnfq41P_yxCdj5v-CzkV1LTLbiVecco57ZlkrG_rdLybLB36FUYuewrAbTcwQ2cs7iHovvGuHkttvb86m3ZSlHua88vHOjc9Y-3PdgP5KTYeuvn9iB4vDdEsAdwLFb6I_8DTG0Qo7RJOG1RMilH0VEhO2S-Zm34L-DyPpE13qamiutJRQrImQPYOdp9C2nzFb0K0ngs>
on
counterterrorism. Despite having “a 9/11 in deaths every day”
<https://email.mg2.substack.com/c/eJwlUd2OtSAMfJrDHYYfRbngYpMv-xoGoXrIIhjANb79V_ckpKXQybQzzjbYcrnNkWsjT5jbfYBJcNUIrUEhZ4UyB28GLZRWqife9J5Pw0RCndcCsNsQTSsnkONcYnC2hZwehJi44Jq8jWOr0lKuC3ipFdeTt9Ooh17JYeQTwIfYnj5AcmDgF8qdE5Bo3q0d9SW_XuIbz3Vd3ZrLArVzeceHGhpUzCUvUNoBtkSsBBMcE2dPeG7YfNgS0kZd_g2eck1bpppzWpDLxkqv901rprtNN7U7FNwiVYrz0DMlcFAr4uP9jCG_6_sl_3kL0yi1mJj1JBjkFExyxbmUPe9ENzk2yBVGoSQDEK4buGW6Ff_q2b6Jrp5Lbdb9PJuQYvzbXj8hVY14nLln2yPr3yeqOmPezxTaPUOySwT_Ebx9fPuzYN4gQUE__Wyb4aofe8l6JRjnH30fD7EQWo8E2X1GVDJ3PkvMzkY4goc95Ji3UNt_o7-ypQ>
for
much of the pandemic, the federal government has not moved to act in even a
remotely proportionate manner.”*

Another epidemic on American soil will happen sooner than in 100 years,
too. Since the Spanish Flu, we’ve seen new diseases emerge more and more
rapidly due to climate change and globalization.
<https://email.mg2.substack.com/c/eJxVUsuupCAQ_Zp2p-EpsGBxM8n8huFR2qQVvIC3p-frB3U1CaknVadSp5ypsKT80XsqtTvFVD876AjvskKtkLujQJ6C11yRUY0j67xmHksuu1CmOQNsJqy65gO6_bBrcKaGFM8KIjHBqntqx6VwyCqJhRyFF0xybtmMBbVW8NbyAjaHDxAdaPiB_EkRulU_a93Lg349yO_2nI9DOWypxr0Gl7YWCptZoOkZqnueurWp6UF-fd8G_VpS8s2f12nPaclQSviBFi8VYG8VNwThJwg_YZqwh3tBy-ceELfWSdZbY2jPqIBecSx74y0lFoRQkg2FDmYzf1M073LP1Xrcy7jMa8hymVRSyZnBvUES9cx72isnbU8d91YSEOPMJ8nkH4b5sMelC5ogQhDFI8aUMjyQQTrE6QyCjBQBEDdwbJCq2T8Y2hby34q6rP3TvF8hFtXqMW5_lpOxK9lmnJrejhjqZ4Jo7Ar-5rLeJ3GxOy0QIbdT8ZOpGo9MMIrYSBDGN3XneTSHKCW6hu5Tq4r6k468JmdW2IOHLaQ1LaHUf_8Sy2I>
Serious
Viral Outbreaks Over Past 100 Years, Table can be found here
<https://email.mg2.substack.com/c/eJwlkctu7CAMhp9m2CUCcpnJgkVVabaniyN1GRFwElQCCJxGefs6MxKyMfi3rc9GIywxnyrFguwyI54JVICjeECEzPYCeXRWdYPsh75vmVWtFY_uwVwZ5wywaecV5h1Y2ifvjEYXw6WQDyHFwFZlJgO8b4XpRN8DzPYOjRFCtNZCI6jkq7HerYNgQMEv5DMGYF6tiKncmo-bfNI5jqM-VoewRpqqXuLv9ZgqEwNCQAr25KO2hW6SS0GOD2Q-Nsg0V6i-dLCwOVN9ZUg6gw1QSvU_61DmmDcXlurfnqtPnfTkvEMHpXq6oH31jLn6hqlOdmZOUXHJaXIhmqYVtawfhnfNDHfZNxxAmroTmg-Y7a3l2yLrsk8FtfmpTdxYVnbVx48LZSC9EJSzXBBfn8RwJL_tweE5QtCTB_vGi-8tvYCPCwTItD07alTE8N42vO0lF-JN89oYBXIY7oy620iqoM64Zx-N9pDcRSL6uLiCf2XnsGk>
.
*Bottom line*

Forgetting about SARS-CoV-2 without preparing or investing in the future
will be a dire mistake. Not only for the next SARS-CoV-2 wave but for
future viruses and public health emergencies. We prepare by adequately
funding short- and long- term public health responses, transforming our
infrastructures, improving communication, strengthening interdepartmental,
interagency coordination, and developing better surveillance systems.
Hundreds of thousands of lives *can* be saved. We just need to learn from
our mistakes, like other countries have in the past.

Love, YLE
------------------------------

*“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, MPH
PhD—an epidemiologist, biostatistician, professor, researcher, wife, and
mom of two little girls. During the day she has a research lab and teaches
graduate-level courses, but at night she writes this newsletter. Her main
goal is to “translate” the ever-evolving public health science so that
people will be well equipped to make evidence-based decisions. This
newsletter is free thanks to the generous support of fellow YLE community
members. To support the effort, please subscribe here:*

Subscribe now
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