Coronavirus Files: Reports outline long COVID’s deadly toll, and millions saved by vaccines

The Coronavirus Files wishes everyone a safe and healthy holiday season! We’ll return on Jan. 9.

U.S. returns to pre-pandemic immigration policies.

Thousands of people are waiting in Mexican border cities for the anticipated Dec. 21 expiration of a Trump-era restriction on U.S. entry during the pandemic.

Hundreds have already crossed the Rio Grande, reports Lauren Villagran of the El Paso Times.

The Title 42 rule allowed officials to quickly expel migrants at the border, including many of those seeking asylum. It has been applied more than 2.4 million times, reports José Ignacio Castañeda Perez at USA Today.

The policy and arguments over its legality have been tied up in the courts for months. The Biden administration attempted to rescind the policy in May, but was blocked by the courts at
that time.

The rule is now coming to an end in response to a Nov. 15 court ruling that found the “arbitrary and capricious” policy was unlawful and did not protect the U.S. from the coronavirus. The Biden administration has appealed the November ruling, aiming to preserve the CDC’s right to institute similar rules in the future.

A set of Republican-led states has also filed an appeal to keep the policy in place, arguing its termination “will cause an enormous disaster at the border,” reports Suzanne Monyak at Roll
Call. The Border Patrol is reportedly unprepared to handle the anticipated surge of migrants. Immigration advocates, who have documented expelled migrants suffering violence in Mexico,
will be glad to see the policy end, USA Today reports.

Legal immigration, meanwhile, has rebounded after a pandemic-induced lull in visa approvals, reports Camilo Montoya-Galvez at CBS News. The State Department issued nearly half a million visas to overseas applicants in 2022, a number comparable to totals from 2018 and 2019. “The rebound, an enormous part of it, is the easing of pandemic restrictions and the reopening of consulates,” said Julia Gellat, an analyst with the nonpartisan Migration Policy Institute. “But I also think the Biden administration is really concentrating on this.”

CDC documents thousands of long COVID deaths

Long COVID has led to not only debilitating symptoms, but death for thousands of Americans, according to a new CDC report. 

Researchers scoured death certificates from 2020 through mid-2022 for a medical code referring to COVID-19 and key words related to long COVID, identifying 3,544 such deaths. Long COVID was not necessarily the main cause of death, but could be listed as a contributing factor.

“The results added to growing recognition of how serious long-term post-COVID medical problems can be,” writes Pam Belluck at The New York Times. “The study appeared to be primarily capturing deaths of people who experienced serious initial infection with the coronavirus and who survived that phase but went on to have organ damage and other severe complications.”

Long COVID can exacerbate chronic conditions or boost the risk of heart or vascular disease, reports MuckRock in its own analysis of long COVID deaths in several U.S. regions. (Journalists can analyze the data on their own here.) For example, a COVID infection can create blood clots that can kill well after the virus is gone.

In the CDC’s study, out of more than 1 million death certificates with the COVID-19 code, 0.3% included long COVID terminology.

The count is almost certainly an underestimate, reports Elizabeth Cooney at STAT: “That tiny fraction of records only hints at the whole story, two experts told STAT, while another has doubts about drawing any conclusions from it at all.”

Dr. Eric Topol of the Scripps Research Translational Institute told Cooney that death certificate data are unreliable for tracking any cause of death. They are a particularly problematic source with something like long COVID, a chronic condition that can contribute to death in myriad complex ways.

Long COVID deaths reflected the pandemic’s broader racial and ethnic disparities. The long COVID death rate was highest among American Indian and Alaska Native people, a disparity the CDC study authors attribute to less access to health care in these groups.

But Black and Hispanic people, despite higher death rates from acute COVID infections, did not have higher long COVID death rates. That may be because there were fewer survivors left to
experience long COVID in those populations, the authors suggest.

In both the MuckRock and CDC studies, long COVID deaths were prevalent among older people. Muckrock’s team also found that many people who died of long COVID lacked college degrees and worked blue-collar, frontline or essential jobs.

Vaccines have saved millions of lives

The first COVID-19 vaccines were authorized two years ago, and they’ve saved about 3.2 million lives, according to a new report from The Commonwealth Fund. (The Fund also supports
programs at the Center for Health Journalism.)

Despite that success, vaccine uptake and efficacy are both on the wane. Just over 14% of people have received the latest, updated booster.

And those boosters are already out of date: The BQ strains currently dominating the U.S., as well as the XBB variant on the rise, are “barely susceptible” to the antibodies created by
existing vaccines, according to a new study in the journal Cell.

That reduced efficacy could set the nation up for a surge in breakthrough infections and reinfections, but the shots should hold up against severe disease and hospitalization, reports
Spencer Kimball at CNBC.

Researchers are calling for a new generation of COVID vaccines, reports Aria Bendix at NBC News. Formulas that are given through the nose or mouth might be better at halting transmission, and vaccines that target multiple variants or viral components might reduce the need for ongoing boosters.

“Coming up with a vaccine that’s going to last longer and cover a wider range of the COVID family is a life and death problem,” said Dr. Tom Frieden, former CDC director and president of Resolve to Save Lives, a public health organization.

COVID and flu plague nation

Pediatrician Dr. Christina Lane sums up the fall of 2022: it’s like “a big bomb of viruses went off,” she told Ariana Eunjung Cha at The Washington Post. Cases of both influenza and COVID are on the rise, but RSV may have already peaked. In response, major cities are recommending masking, but a dip in COVID cases in Los Angeles appears to have pulled that county back from the brink of a new mask mandate.

Free tests by mail relaunched

U.S. households can order four more COVID test kits for free by mail this winter as part of the government’s response to the current surge, report Adam Cancryn and David Lim at Politico. The program’s first three rounds of free tests proved popular, but it was put on hold in September to ensure there would be inventory available now. Politico reports that the Biden administration used funds leftover from 2021’s American Rescue Plan to purchase additional tests.

The tests by mail are part of the White House’s latest “Winter Preparedness Plan,” released Thursday. The plan also includes free tests distributed at clinics and community centers, support to deliver vaccines and treatments, and preparations to deploy health care professionals and supplies to areas where they’re needed. The White House has requested more than $9 billion to help fight the ongoing pandemic, but a divided Congress appears unlikely to approve the additional funds.

From the Center for Health Journalism

Apply now for the 2023 California Health Equity Fellowship

Our Fellowship supports reporters in the Golden State pursuing ambitious projects on overlooked health and health equity issues. You’ll received a week of intensive training on the USC campus, a $2,000 reporting grant and five months of mentoring by a veteran journalist. 

Signup deadline: January 13. Learn more here!

What we’re reading

• “Is COVID a common cold yet?” by Katherine J. Wu, The Atlantic
• “Why pandemic fatigue and COVID-19 burnout took over in 2022,” by Tina Hesman Saey, Science News
• “It isn’t just long COVID. Post-viral illnesses are more common than you think,” by Jamie Ducharme, Time
• “How will China fare with COVID? ‘Meaningless’ data clouds the picture.” By Daisuke Wakabayashi and Claire Fu, The New York Times
• “The global plan for COVID-19 vaccine fairness fell short. Will next time be different?” by Gretchen Vogel, Science
• “Addiction treatment got easier during COVID. A new proposal would keep it that way,” by Lev Facher, STAT

Events & Resources

• The House Select Subcommittee on the Coronavirus Crisis has released its final report detailing vulnerabilities and failures that contributed to pandemic suffering, and lessons to prepare for future crises.
• The Oxford COVID-19 Government Response Tracker, winding up data collection this month, has tracked government policy actions since early 2020. The group will continue tracking Chinese provinces into 2023. Data are available on GitHub.
• The Journalist’s Toolbox has recently updated its pages on COVID-19 Data and Research and COVID-19 Vaccines.