Coronavirus Files: Three years in, data show pandemic hurt Black children, pregnant women

Looking back, and forward, after three pandemic years

The World Health Organization declared the coronavirus a pandemic in March 2020, and several news outlets noted the anniversary last week. 

Laurel Wamsley at NPR recalled how Dr. Anthony Fauci told an unmasked Congress that things would get worse. The bull stock market plummeted into bear territory. Then-President Donald Trump banned travel from Europe, and actor Tom Hanks and basketball player Rudy Gobert tested positive, leading the former to isolate in Australia and the NBA to cancel a game, then the entire season.

If some — or much — of that sounds unfamiliar, you’re not alone. 

“Over time, many details will probably fade because of the quirks and limitations of how much our brains can remember,” writes Richard Sima at The Washington Post. “It was difficult for our brains to encode the overload of information we had to sift through — masks, social distancing, superspreaders, more cases, more deaths, new waves and new variants such as omicron and delta, and who even remembers all the subvariants?”

Yet such collective forgetting means society risks not preparing for future pandemics. 

“Many aspects of how to best respond to a novel virus remain unsettled or fiercely debated,” writes The New York Times, introducing a series of opinion essays arguing the merits of closing schools, banning international travel, and mandating masks or vaccines.

In a recent YouGov poll, conducted in January 2023, about two-thirds of Americans said they remain concerned about the threat of future pandemics, and most would like the U.S. government to invest more in pandemic preparedness.

Part of that preparedness should involve a bipartisan “post-mortem” analysis of the U.S. pandemic response, to identify where mistakes were made and learn from them, argue veterinarian Leslie Bienen and infectious disease expert Margery Smelkinson in Time. 

The pandemic also did long-term damage to the health care system that requires urgent action, writes Dr. Atul Gawande, a global health administrator at the U.S. Agency for International Development, in The New York Times. 

Scientists have learned a lot in the past three years, writes Stephanie Pappas at Scientific American. New mRNA-based vaccines, face masks, ventilation, viral genomic surveillance and wastewater tracking all proved useful weapons against COVID-19.

Yet plenty of questions remain. “There are so many things that I — you know, my team would love to know about COVID, particularly how a person might develop long COVID and how we can prevent that,” Yale immunologist Akiko Iwasaki told Sacha Pfeiffer at NPR’s Morning Edition. 

It’s not even clear how to define long COVID, what causes it, and how many people have it, notes Dylan Scott at Vox. 

Then there’s the $64,000 question: Is the pandemic over? The U.S. winter wave was much smaller than in the preceding two years, notes Mary Kekatos at ABC News. 

“A combination of more immunity, better treatments, less severe infections and more people following mitigation measures likely played a role,” Kekatos writes.

Yet COVID is still killing more than 300 people per day in the U.S.

And a new variant or outbreak could easily worsen the situation, Kekatos warns.

There’s no one organization that calls the end of a pandemic, writes Jennifer Alsever at Fast Company. Scientific, social, and political factors are all at play.

Americans are nearly evenly split on whether COVID has passed the pandemic stage, according to a March Gallup poll. 

“It’s over when people decide it’s over and return to normal patterns of living,” said John M. Barry, author of a book about the 1918 influenza pandemic. “Which we seem to have done.”

New analysis points to animal origin for COVID

Coronavirus genetic material was closely associated with that from raccoon dogs being sold at the Wuhan wet market in 2019, scientists asserted last week, providing the “strongest evidence yet” that the virus emerged from the illegal wildlife trade, Katherine J. Wu was the first to report at The Atlantic.

 The evidence comes from swabs taken in the market in January 2020, after the outbreak began and the animals were removed.

The sequencing data from these samples, briefly posted to an international database and noticed by scientists before they were taken down again, do not confirm that raccoon dogs were infected, nor prove they passed the virus to people. 

But researchers said the finding “was consistent with a scenario in which the virus had spilled into humans from a wild animal,” writes Benjamin Mueller at The New York Times. 

Wu explains, “Think of it as finding the DNA of an investigation’s main suspect at the scene of the crime.”

Last week, the House of Representatives voted unanimously to declassify intelligence about the origins of the coronavirus, including information related to activities and any illnesses at the Wuhan Institute of Virology. The legislation was already approved by the Senate, but President Joe Biden has not yet decided if he’ll sign it, reports Lisa Mascaro at AP News.

Black children and babies bore brunt of COVID

A new study highlights racial inequities among children during the pandemic, when Black children were hospitalized and died at more than twice the rate of white children.

“Children with COVID-19 in communities of color were sicker, hospitalized and died at higher rates than white children,” said Sandra Harris-Hooker of the Morehouse School of Medicine, one of the historically Black organizations that participated in the study commissioned by the Black Coalition Against COVID.

Misinformation and mistrust about COVID safety protocols and vaccines played key roles in the disparities, reports Donovan J. Thomas at The Atlanta Journal-Constitution.

The report also pointed to the effects of social factors such as poverty and housing insecurity that rose for Black and Latino families during the pandemic.

Children of color have also been subject to higher rates of and long-term symptoms, more likely to lose a primary caregiver, and suffered deep learning gaps.

Another new study reports that sudden unexpected infant deaths rose among non-Hispanic Black babies during the first pandemic year, to nearly triple the rate among non-Hispanic white babies in 2020.

The deaths, reported by a CDC team in the journal Pediatrics, included sudden infant death syndrome as well as accidental suffocation and other unknown causes. 

The authors characterized the findings as preliminary, and said they weren’t sure what factors were behind the changes. 

But a commentary in the journal by other physicians pointed to a variety of possible causes, including poverty, lack of access to health care and less education about safe sleep practices and breastfeeding. 

They also noted that during the pandemic, resources such as doctors’ offices and programs that support families cut back on in-person care, which may have limited support to Black families.

“If you don’t have a safe place for your baby to sleep, how are you going to have them sleep safely?” commentary author Dr. Rebecca Carlin, a pediatrician with Columbia University, pointed out to Erika Edwards at NBC News.

Pandemic likely contributed to spike in maternal death rates

Experts blame COVID-19 infections and physician burnout for a 40% rise in maternal mortality in the U.S. in 2021, reports Mike Stobbs at AP News.

More than 1,200 women died during pregnancy or shortly after childbirth in 2021, according to new CDC data. 

Pregnant people infected with COVID have a seven times higher risk of death than uninfected pregnant people, reports Akilah Johnson at The Washington Post. 

“It didn’t help that vaccination rates among pregnant women were disappointingly low in 2021 — particularly among Black women,” Stobbs adds. 

Maternal mortality among Black women was more than double that of white women in 2021.

The CDC did not issue a complete recommendation for pregnant women to get vaccinated until August of that year.

Maternal mortality rates fell in 2022, and while the data aren’t fully in, they are likely to come closer to pre-COVID levels.

FDA supports Paxlovid for adults, booster for young children

An FDA committee voted 16-1 in support of full, non-emergency approval of the antiviral medication Paxlovid on Thursday.

The agency and its advisors agreed the drug’s benefits for adults with mild to moderate COVID, and who are at high risk for severe disease, outweigh the medication’s risks.

The FDA is expected to complete its analysis in May, reports Janelle Chavez at CNN Health.

More than 8 million people in the U.S. have received the drug since its emergency authorization in December 2021.

“Besides oxygen, Paxlovid has probably been the single most important tool in this epidemic,” said Dr. Richard Murphy, a member of the FDA committee.

The FDA, in a report leading up to the committee vote, concluded that Paxlovid does not specifically promote COVID rebound, in which a person tests positive, negative, then positive again. 

People who took placebo medication in clinical trials also experienced rebound, according to the agency. It characterized rebound as part of the natural course of some infections.

The FDA also granted emergency authorization to a fourth dose of Pfizer’s COVID vaccine for children younger than 5, reports Kristina Fiore at MedPage Today. 

Children who received the Pfizer primary series — three shots of the original-formula, monovalent vaccine for ages from 6 months to four years — are now eligible for a booster with the newer, bivalent formula.

The new authorization reflects data on the immune responses of 60 children who received three monovalent shots before a bivalent booster.

Meanwhile, STAT’s Helen Branswell wonders about boosters for adults who haven’t had a COVID shot since fall. 

Some nations, including Canada and the U.K., already have plans to offer spring boosters to people at high risk of severe illness. This would aim to counter waning immunity.

Some experts say people who are older or immunocompromised deserve another booster.

“But in the United States, there’s been radio silence from the Food and Drug Administration,” writes Branswell.

What we’re reading

• “The next stage of COVID is starting now,” by Katherine J. Wu, The Atlantic
• “Do a quarter of all children really get long COVID?” by Michael Schulson, Undark
• “What people with ‘super immunity’ can teach us about COVID and other viruses,” by Erika Edwards, NBC News
• “Fathers gained family time in the pandemic. Many don’t want to give it back.” By Claire Cain Miller, The New York Times
• “How forest loss can unleash the next pandemic,” by Al Shaw, Irena Hwang and Caroline Chen, ProPublica

Events & Resources

• Data on Americans’ attitudes about the coronavirus, covering March 2020 through December 2022, are available from the Axios/Ipsos poll (h/t COVID-19 Data Dispatch).
• Listen to a recent podcast featuring Maryn McKenna discussing her Wired article on avian flu with the Heritage Radio Network.