Coronavirus Files: Flipping the fight on mask mandates, and Biden faces booster backlash

coronavirus files
September 7, 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.

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Do vaccines need a boost? We’ll discuss the latest science and how to report responsibly. Thursday, Sept. 9, 2021, 10–11 a.m. PT. More details below; register here.

Social safety net dwindles

While some people have speculated the delta wave may be peaking, COVID-19 cases are still rising, even as pandemic protections are being phased out. The Supreme Court struck down the Biden administration’s eviction ban — which was always on shaky legal ground — putting millions of people who are behind on rent at risk of losing housing. The White House has, again, begged state and local authorities to take action, writes Joey Garrison at USA Today, but most states have declined to do so, notes Giles Bruce. While several states and the District of Columbia have enacted their own protections, some of those measures are set to expire this month. Congress could act to put a national, legal moratorium in place, but White House press secretary Jen Psaki said this is unlikely. Housing experts told The Atlantic’s Joe Pinsker the fallout will be “really concerning,” “quite bad,” and “a huge problem.” Black women are particularly at risk, and eviction can disrupt health, relationships, employment and education.
 
Labor Day marked the end of another safety net, the extra $300 in federal unemployment benefits offered during the pandemic, “and there’s virtually no political appetite in Washington to extend them,” writes Emily Stewart at Vox. Unemployment checks for gig workers, self-employed individuals, and long-term unemployed people are also at an end. Again, the administration’s hope seems to be that states will fill the gaps with their remaining federal stimulus funds, but it doesn’t look likely, writes Alicia Adamczyk at CNBC’s “Make It” financial channel: “The coronavirus unemployment benefits are as good as gone.” Indeed, many states had already cut off the extra benefits, without much of a boost in employment rates, and U.S. hiring fell sharply in August compared to earlier this summer.
 
Some Americans may be in for another financial hit as insurance companies stop waiving deductibles and copays for COVID testing and treatment. “Insurers are now treating COVID more like any other disease,” Sarah Kliff reports at The New York Times. Those who require hospitalization will see the biggest bills, which average $3,800 for the patient’s share.
 
School mask mandates become civil rights issue
 
The balance between individual rights and public health measures has been in contention since the start of the pandemic. But the dynamic has recently flipped, writes Wendy E. Parmet, director of the Center for Health Policy and Law at Northeastern University, in The Atlantic. Courts initially heard from people and institutions suing to stay unmasked or gather in person. Now, parents of children with disabilities are asking the courts to allow school mask mandates to protect their kids. They argue that children who are at high risk for coronavirus complications have a right to the same education as everyone else, but that’s not possible if the classroom is unsafe while online school is unavailable or subpar. “We’re asking for reasonable accommodations,” mom Suzanne Talleur, whose son has Down syndrome, told Alia Wong at USA Today. One judge in Florida has already ruled in the families’ favor.
 
Now the Biden administration has waded into the fray. The Department of Education sent a warning to five states last week, announcing it would investigate whether their bans violate the civil rights of students at high risk for COVID-19. The move “throws down this gauntlet” at Republican governors that have tried to block public safety measures, write columnists Greg Sargent and Paul Waldman in The Washington Post. 
 
The American Civil Liberties Union, which filed a South Carolina lawsuit on behalf of parents of disabled children and disability rights groups, has also come out in support of vaccine mandates. “We see no civil liberties problem with requiring COVID-19 vaccines in most circumstances,” write A.C.L.U. National Legal Director David Cole and Daniel Mach, director of the union’s program on freedom of religion and belief, in The New York Times. “Vaccine mandates actually further civil liberties,” the pair write, because they protect vulnerable groups including people with disabilities and communities of color.
 
Biden faces booster battle
 
The White House is planning to make COVID-19 booster shots available to all who got the Pfizer and Moderna mRNA vaccines, starting the week of Sept. 20 — but scientists aren’t so pleased that the administration is moving forward before experts have signed off on the idea. Last Thursday, acting FDA commissioner Dr. Janet Woodcock and CDC director Dr. Rochelle  Walensky told the White House they may not have the data yet to support the full plan, report Sharon La Franiere and Noah Weiland at The New York Times.
 
Normally, the FDA would have the first say in such a move. Agency employees are reportedly frustrated as they rush to find data to back up the boosters. “The agency is facing a potential mutiny,” writes Sarah Owermohle at Politico. Two high-ranking officials in the FDA’s vaccine department resigned last week, a move some have attributed to the booster battle. 
 
The CDC’s vaccine committee is also supposed to weigh in on these kinds of decisions, and it did so last week, but said the evidence on boosters remains mixed, reports Nathaniel Weixel at The Hill. On one hand, Israel is experiencing a huge surge that started exactly six months after it hit the 50% vaccinated mark, corroborating other evidence suggesting antibodies wane in that timeframe, notes University of Texas epidemiologist Katelyn Jetelina on her blog. And some experts don’t think a third shot even counts as a “booster” or bonus, but as the final dose in a primary series of shots to cement immunity, writes Helen Branswell at STAT. 
 
But while it’s true that antibody levels dwindle over time, the ones that stick around are the most powerful versions, and they’re capable of calling in reinforcements when needed, explains Michaeleen Doucleff for NPR’s All Things Considered. Immune memory cells, patrolling the body, can also jump into action if they detect the coronavirus. That’s why breakthrough infections are usually mild. The CDC committee indicated it would prioritize high-risk people, such as health workers, rather than everyone at once for the extra shot.
 
Learn more about the science behind booster shots and breakthrough infections at our upcoming webinar on Sept. 9 (details below).
 
Long COVID mysteries abound
 
Not only do vaccines prevent or lessen the severity of COVID-19, they also cut the risk for long COVID, Andrew Joseph reports at STAT. A new study, conducted in the U.K. where all vaccines are on two-dose schedules, found that in people who had breakthrough cases the second dose lowered the risk of long-term symptoms by 50%, compared to just the first dose. But another report, the largest long-term study yet with 1,276 people who were hospitalized with COVID-19 in Wuhan last year, paints a less rosy outlook for those who already have long COVID, reports Alice Park at Time. Six months after first falling ill, 68% of those who required hospitalization had at least one ongoing symptom; that fraction dropped to 49% after a year. While other researchers recently documented 203 different possible long COVID symptoms, the most common to linger in the Wuhan cohort were fatigue and muscle weakness. Another study, in Italy, found the complex pain condition fibromyalgia in one-third of people who had long COVID, writes Nancy Walsh at MedPage Today. “I would not say this is a glass-half-full story,” David Putrino, who oversees the long COVID rehab program at Mount Sinai Health Systems, told Park. Normally, he’d expect people to recover from a hospital stay much faster. 
 
Long COVID risk remains “one of the pandemic’s biggest and least-addressed unknowns,” writes Ed Yong for The Atlantic. And the long COVID sufferers themselves are frustrated with slow progress by researchers who don’t always fully appreciate what life is like for those with the widely variable condition. Several studies are ongoing, writes Sruthi S. Balakrishnan at The Scientist, and while there are no answers on what causes the condition yet, there are theories: Perhaps blood clots damage organs, causing long COVID. Or maybe the immune system gets stuck in a heightened state, leading to ongoing inflammation. Or it could be something else altogether. “The main challenge at this point is to nail (it) down at a phenomenological level,” neuroscientist Ryan Low of the Sainsbury Wellcome Center told Balakrishnan. “Just what are the relevant systems it involves? ... What organs are affected?” 
 
Reporters can help the situation by acknowledging these unanswered questions and eschewing generalizations, as well as telling diverse patient stories, notes journalist and long-hauler Fiona Lowenstein,who has penned a guide to Long COVID coverage
 
From the Center for Health Journalism
 
Covering Coronavirus: Do vaccines need a boost?
The delta surge has ushered in a growing number of breakthrough infections, while new studies have fueled fresh worries about waning vaccine effectiveness. In our next webinar, an expert panel will address the latest understanding of COVID-19 immunity, what role booster shots are likely to play, and how reporters can responsibly report this complex and fast-moving story. Sign up here! Sept. 9, 10–11 a.m. PT
 
2021 Data Fellowship Application Deadline Extended to Sept. 13
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. Application deadline: Sept. 13.
 
What we're reading
  • “'A pandemic tinderbox': In Hurricane Ida’s aftermath, experts worry COVID-19 outbreak in Louisiana will worsen,” by Nada Hassanein, USA Today
  •  “Women of color and LGBTQ+ people are taking on the invisible work of the vaccination effort,” by Chabeli Carrazana, The 19th
  •  “This is the moment the anti-vaccine movement has been waiting for,” by Tara Haelle, The New York Times
  • “Inside Pfizer’s labs, 'variant hunters' race to stay ahead of the pandemic’s next twist,” by Olivia Goldhill, STAT
  •  “How this after-school program achieved a high vaccination rate in a Black neighborhood where most young adults are unvaccinated,” by Perry Stein, The Washington Post
  • “Why the COVID-19 origin report came up inconclusive,” by Reid Wilson, The Hill
  • “Americans are losing sight of the pandemic endgame,” by Céline R. Gounder,