Coronavirus Files: Children of color face added risk; Biden pitches pandemic 'mission control'

coronavirus files
September 13, 2021

Since April 2020, the Center for Health Journalism has been publishing a special newsletter geared to journalists as they report on one of the biggest and most complex stories of our times. Each Monday, while the pandemic runs its course, The Coronavirus Files will provide tips and resources and highlight exemplary work to help you with your coverage. This week, The Center for Health Journalism’s Coronavirus Files Monday newsletter is curated and reported by science writer Amber Dance, PhD. Have a suggestion or a request? Write us at editor@centerforhealthjournalism.org.

Students of color experience educational challenges

While there’s a risk of COVID-19 infection for all kids — youths currently make up more than a quarter of cases — it’s especially concerning for children of color, reports Nada Hassanein at USA Today. There are ongoing disparities in health care access, obesity and other COVID risk factors, and children of color are about three times more likely than white children to be hospitalized, according to the CDC. These gaps are unlikely to close in the months ahead. As long as children under 12 remain ineligible for vaccination, the most important thing adults around them can do is get the vaccine themselves, said Dr. Judith Flores, a pediatrician in New York City.
 
Black and Hispanic students are also more likely to need help catching up in school, reports Kiara Alfonseca at ABC News. Not only did families of color disproportionately struggle with virtual schooling due to lack of computer or internet access, but their kids were also more likely to have friends and loved ones who contracted COVID and died. “Children, they take all of this in,” said Amalia Chamoorro, director of education policy for the civil rights organization UnidosUS. “It’s going to be important for school systems to provide wraparound supports to not only help students get on track with unfinished learning but also to provide assistance and support along the way.” That help can take many forms, writes Alfonseca: outreach services, tutoring and counseling, as well as extra support from teachers.
 
Biden's latest salvo against delta
 
The President announced a sweeping “Path Out of the Pandemic” last Thursday, though some measures — such as crisis-response teams for surging areas and booster shots starting as early as Sept. 20 — are already in motion. One of the most notable new measures is to take the question of employee vaccination requirements out of bosses’ hands. The Occupational Safety and Health Administration is expected to issue a rule requiring employers with at least 100 staffers to ensure those workers are vaccinated or tested on a weekly basis. Those employers will also have to offer paid time off for people to get the shots and recover from any side effects. Health care workers in settings that receive Medicare or Medicaid funds will also have to be vaccinated.
 
Many news outlets latched onto the frustration apparent in Biden’s words and tone, notes Jon Allsop at the Columbia Journalism Review. “Biden will turn this car around,” as the Politico Pulse newsletter put it last week. Other coverage focused on Biden’s relative inability to persuade unvaccinated Americans with his message. His speech drew a typical mix of “praise, skepticism and outrage,” writes Lauren McCarthy in The New York Times. Some called the vaccine mandates warranted, while others warned that anti-vaccine Americans might respond negatively or even leave their jobs. Legal challenges to the mandate, writes McCarthy, are “all but certain.”
 
While those measures take the form of top-down rules, Biden is left to issuing requests in cases where federal mandates don’t apply. He asked governors to “step up” and require teachers and other school staff to be vaccinated, while urging schools to set up regular testing based on CDC guidelines. The administration also aims to expand testing by making at-home tests available for free from food banks and community health centers, and at-cost from Walmart, Amazon and Kroger. 
 
Biden was decidedly less optimistic than he was at the start of the summer — the “summer of freedom,” since ruined by delta — but said these measures would gradually make a difference. “We have the tools,” he said. “Now we just have to finish the job … get vaccinated.”
 
Delta wave, vaccines and boosters fuel ethical quagmires
 
Daniel Wilkinson of Bellville, Texas, had an entirely treatable case of pancreatitis, CBS News recently reported in a harrowing story. He died anyway, after his doctors scrambled for hours in search of an ICU bed amid a crush of severely ill COVID-19 patients. “We are playing musical chairs,” said his doctor, Hasan Kakli, “with 100 people and 10 chairs.”
 
It’s starting to look like that tragedy won’t be an isolated incident, with several states now hospitalizing more people than at any other point in the pandemic, reports Will Stone at NPR. That poises hospitals to enact last-resort rationing known as “crisis standards of care.” Such standards, Stone explains, “give hospitals flexibility about whom to prioritize and provides legal protection for doctors. For example, certain patients deemed less likely to survive may not get a bed in the intensive care unit.” It could also mean additional patients for nurses and early discharge for patients. “We’re in a very dangerous place,” said Dr. Bruce Siegel, president of the trade group America’s Essential Hospitals. In some ways, hospitals are worse off than before because there are fewer medical staff, the key limiting resource, than earlier in the pandemic. Arizona hit a crisis state in July; parts of Idaho are there now. “This is a decision I was fervently hoping to avoid,” said Dave Jeppesen, director of the Idaho Department of Health and Welfare.
 
With vaccines readily available, physicians are questioning what level of treatment the unvaccinated deserve. Some doctors have refused to treat unvaccinated patients in their practices. More than two-thirds of physicians think it’s ethical to limit unvaccinated patients to telehealth, according to a survey by MedPage Today. In response, bioethicist Dr. Jacob M. Appel of the Mount Sinai Health System in New York opined that the motivation for refusing care matters. He suggested doctors may employ a policy of telehealth-only visits for unvaccinated patients to protect staffers and other patients from infection, but not as a lever to pressure people to get vaccinated.
 
 With crisis standards of care looming, “The question now is whether someone who refuses to get a lifesaving vaccine approved by the Food and Drug Administration has the same claim to scarce health-care resources as those who were vaccinated,” writes Nancy Gibbs, director of Harvard’s Shorenstein Center on Media, Politics and Public Policy, in an opinion piece for The Washington Post. While Gibbs acknowledges the appeal of policies that would prioritize vaccinated individuals, she concludes that doctors should exact “medical, not moral, judgment,” just as they would treating a smoker with lung cancer or a gang member with a gunshot wound.
 
The prospect of booster shots is also fueling ethical debates, given that much of the world’s population hasn’t been able to access even a single inoculation. Mike Ryan, the director of the World Health Organization’s Health Emergencies Programme, compared third shots for healthy adults to giving “extra life jackets to people who already have life jackets,” and the WHO Director-General Tedros Adhanom Ghebreyesus said last week that countries flush with vaccines should not give out boosters until 2022.
 
But the solution is not so simple as handing off extra vaccines to other nations, writes Ryan Kost at the San Francisco Chronicle. “The question is, are our life jackets adequate to keep us afloat?” asked bioethics professor Dr. Jodi Halpern of the University of California, Berkeley. “We just don’t fully know.” Ultimately, the question is best left to governments rather than individuals, suggested Dr. David Magnus, a professor of biomedical ethics at Stanford University. If health officials recommend another shot, he said, getting it will be a way people can protect their community.
 
White House calls for pandemic 'mission control' in budget bill
 
The $3.5 trillion budget resolution moving through Congress contains the start-up funds for a new moon shot: a “mission control” for future pandemic preparations, writes Jon Cohen at Science. It would create a “center to coordinate the many branches of government already involved with pandemic preparedness.” The White House is seeking just over $65 billion for the entire program, starting with $15 billion in the current legislation. Sixty percent of the funding would go towards vaccines and treatments. That $15 billion is half the amount the Biden administration originally wanted, and won’t be enough, said Michael Osterholm, an epidemiologist at the University of Minnesota. “It’s a good down payment,” he told Cohen, “but it hardly will provide enough resources for a real plan.”
 
From the Center for Health Journalism
 
Deadline Today for 2021 Data Fellowship
The 2021 Center for Health Journalism Data Fellowship (Oct. 25–29) is designed for skilled journalists who want to learn how to mine data sources to reveal key insights essential to high-impact journalism. Fellows receive five days of intensive training on data acquisition, cleaning, analysis and visualization, as well as an introduction to important data sets that can serve as the basis for groundbreaking journalism. The program also includes a $2,000 grant plus six months of guidance from our expert data journalism mentors. Learn more here.
 
What we're reading
  • “As pandemic aid ends, these women feel left behind at a crucial time: ‘The recovery hasn’t happened’,” by Anne Branigin, The Lily
  • “The pandemic continues to strain nursing homes. What happens if a lot of them close?” by Mariel Padilla, The 19th
  • “Why some U.S. Blacks and Latinos remain COVID-19 ‘vaccine deliberate,’” by Hyeyoon (Alyssa) Choi, ABC News
  • “New studies find evidence of ‘superhuman’ immunity to COVID-19 in some individuals,” by Michaeleen Doucleff, NPR
  • “Kids and COVID: why young immune systems are still on top,” by Smriti Mallapaty, Nature
  • “How the origins of epidemiology are linked to the transatlantic slave trade,” by Jim Downs, Time
  • “How did smallpox anti-vaxxers compare to those today?” by Sara Novak, Discover

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