POST 141. March 11, 2021. CORONAVIRUS. Today is the first anniversary of the WHO declaration that the novel coronavirus was a Public Health Emergency of International Concern… “To truly prepare itself against the next pandemic, the U.S. has to reimagine what preparedness looks like.”

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“At the time there were fewer than 100 cases of the disease we now call Covid-19 and no deaths outside China,” WHO Director-General Tedros Adhanom Ghebreyesus said Friday. “This week we reached one hundred million reported cases. More cases have been reported in the past two weeks than during the first six months of the pandemic. A year ago, I said the world had a window of opportunity to prevent widespread transmission of this new virus. Some countries heeded that call, some did not.”

The rare emergency declaration, also known as a PHEIC, is the highest level of alarm under international law. Only six have ever been declared in history.

It’s supposed to notify the world that urgent action is needed, but experts say the reason “some countries heeded that call, some did not” is because the declaration has no teeth.

The declaration gives the WHO “few surge powers and no funding,” according to Lawrence Gostin, a professor of public health law at Georgetown University and the director of the World Health Organization Collaborating Center on Public Health Law & Human Rights.

“The only power a declared emergency provides is to make ‘recommendations’ to governments. But most governments, especially in the US and Europe, almost universally failed to adhere to (WHO) recommendations,” Gostin said.

The WHO has been evaluating how it can improve the system, and changes could happen during the World Health Assembly in May.

In this second year of the declaration, Gostin and other legal scholars argue that there needs to be urgent reform to give the WHO much stronger authority and more ample funding, if such a declaration is ever to work more effectively in a global health crisis.” (A)

“At the time the WHO declared the virus a pandemic, there had been 118,000 confirmed coronavirus cases reported in 114 countries, resulting in 4,291 deaths, many of those in the Wuhan region of China.

According to Johns Hopkins University’s global coronavirus tracker, more than 117 million cases of the coronavirus have been reported, killing more than 2.6 million people.

In the United States alone 29 million COVID-19 cases have been confirmed, resulting in more than 528,000 coronavirus deaths. At the time, 31 coronavirus deaths were reported in the US with just over 1,000 confirmed cases. But testing was scarce at the time, meaning many cases likely went undetected at the time…

Following the WHO’s announcement, a number of major universities decided to suspend in-person classes, the NCAA announced that its March Madness men’s and women’s basketball tournaments would be held without fans, and governors began limiting access to the nation’s nursing homes.

Later in the evening, a contest between the Utah Jazz and Oklahoma City Thunder was suspended right at tip-off when the Jazz had a player test positive for the virus. The NBA then announced that it was suspending its season.

“It’s, ‘Oh my God.’ The NBA is such an ingrained part of American culture that it almost is sacrosanct. To be able to suspend that means something really, really serious is going on,” Fauci said in a 30 for 30 podcast about the events of March 11.

President Donald Trump announced that most non-essential travel between most of Europe and the US would be suspended.

Then actors Tom Hanks and Rita Wilson both announced they had contracted the virus.

While groceries store had been depleted of hand sanitizer and paper towels for days, the series of announcements on March 11, 2020, was a shocking notice to Americans of the severity of the coronavirus.

In the coming days, states closed schools, non-essential businesses and even places of worship and parks. Hospitals began suspending non-essential procedures. Nearly all sports leagues suspended play, and would not resume for months. Some leagues, such as minor league baseball, have yet to resume since the start of the pandemic.” (B)

“Reflecting on the past year in a new interview with Savannah Guthrie for the Today show on Thursday morning, Dr. Anthony Fauci expressed cautious optimism about what lies ahead for the rest of 2021 while also noting the litany of failures that helped fuel the virus’ spread here in the U.S.

While the virus is “still very much circulating,” Dr. Fauci said there is indeed “light at the end of the tunnel” as the vaccine rollout continues…

Later, Dr. Fauci was asked what his reaction would have been if he had been told one year ago today that the U.S. would ultimately see more than half a million deaths due to the pandemic.

“Well, I have to tell you quite honestly, Savannah, it would have shocked me completely,” he said. “I mean, I knew we were in for trouble … I said it then, ‘we better be really careful.’ In fact, that day at a congressional hearing, I made the statement ‘things are gonna get much worse before they get better’ and that was at a congressional hearing a year ago today.”

Dr. Fauci, however, never imagined that “much worse” would come to mean so many deaths.

Asked what went wrong, particularly earlier in the pandemic, Dr. Fauci explained that “a lot of things” contributed to the dire situation in the U.S. and the full extent of their damage will be studied historically for years to come.

“One of the things I keep harkening back to that you can’t run away from is that we had such divisiveness in our country that even simple, common-sense public health measures took on a political connotation … It wasn’t a pure public health approach,” he said. “It was really very much influenced by the divisiveness that we had in this country.” (C)

“The past year has seen nearly 86 million cases of COVID-19 and more than 1.8 million deaths. In the immediate aftermath of the virus’ global spread, economies around the world were sent reeling, with the World Bank estimating that the global economy would shrink by 5.2 percent by the end of 2020. More than 20 million people lost their jobs in the United States alone, where unemployment reached 14.7 percent in April—the highest level of unemployment since the Great Depression. Just last month, the United Nations warned that the loss of jobs and income threatens to push a billion people—nearly one-eighth of the world’s population—into extreme poverty, erasing decades of progress on poverty reduction in an instant. Reports of discrimination and xenophobia, against people of Asian descent, refugees and other groups inaccurately perceived as being more likely to spread COVID-19, are on the rise and hampering disease control efforts, according to the United Nations. The pandemic has also strained governments at all levels and impaired the work of international organizations. (D)

“Even though pandemic preparedness and biodefense have had ardent and clarion supporters, namely Bill Gates and the first Secretary for Homeland Security Tom Ridge, COVID-19 proved how ill-prepared we were to combat a 100-year pandemic. It is not too early to draw lessons from this lack of preparation and global coordination. Not only will doing so aid current recovery efforts, but it would also increase readiness for the next communicable or vector-borne disease to threaten the world. Below are seven areas of opportunity to learn from our COVID-19 response and improve readiness for future pandemic shocks…

There is an adage in management circles that if you do not measure something, you cannot manage it. In fighting the spread of COVID-19, data and science should be the most critical elements of decision making. Unfortunately, the void of reliable real-time information has been a global challenge during the COVID-19 crisis. This has been particularly true in the U.S., where different states have each pursued varying degrees of transparency, accuracy, accountability, and, critically, methodologies, with regards to reporting infection and casualty rates. In some instances, low-levels of technological processes like the limits of Excel spreadsheets or the specter of keystroke errors, have created misreporting and miscalculation on the number of confirmed cases, as well as the prevalence of community spread.” (F)

“The pandemic will end not with a declaration, but with a long, protracted exhalation. Even if everything goes according to plan, which is a significant if, the horrors of 2020 will leave lasting legacies. A pummeled health-care system will be reeling, short-staffed, and facing new surges of people with long-haul symptoms or mental-health problems. Social gaps that were widened will be further torn apart. Grief will turn into trauma. And a nation that has begun to return to normal will have to decide whether to remember that normal led to this. “We’re trying to get through this with a vaccine without truly exploring our soul,” said Mike Osterholm, an epidemiologist at the University of Minnesota….

After the post-9/11 anthrax attacks in 2001, fears of bioterrorism encroached on American attitudes toward naturally emerging diseases. Preparedness was framed with the rhetoric of national security. Health experts developed surveillance systems for disease, simulated epidemics in war games, and focused on fighting outbreaks in other countries. “This came at the expense of investment in public health, equity, and housing—boringly crucial sectors that actually support human wellness,” Lincoln said. “One cannot prevent a pandemic by preparing for a war, but that is exactly what the U.S. has been doing.”

To truly prepare itself against the next pandemic, the U.S. has to reimagine what preparedness looks like. Every epidemic is different, as new pathogens with unique characteristics emerge from different regions. But those pathogens eventually test the same health systems and expose the same historical inequities. Think of epidemics as a million rivers that must all flow through the same lake. The U.S. has been trying to dam the rivers. It has to focus on the lake…

In The Past Is a Foreign Country, the historian David Lowenthal wrote, “The art of forgetting is a high and delicate enterprise … It can be a process of social catharsis and healing or one that sanitises and eschews the past.” The choice between those options is now before us, as the coronavirus pandemic enters its second full year. As Americans get vaccinated, they must decide whether to remember the people who sacrificed to keep stores open and hospitals afloat, the president who lied to them throughout 2020 and consigned them to disaster, the families still grieving, the long-haulers still suffering, the weaknesses of the old normal, and the costs of reaching the new one. They must decide whether to resist the decay of memory and the elision of history—whether to forget, or to join the many who will never be able to.” (G)

“Seeking to comfort Americans bound together by a year of suffering but also by “hope and the possibilities,” President Biden set out concrete steps to build on the progress so far, starting with a requirement that states act by May 1 to make all adults eligible to be vaccinated. The administration had already announced last week that it would have enough doses to begin inoculating every adult by the end of May. Mr. Biden said that Americans should expect to get in line for a vaccine by May 1, but not to expect to have been vaccinated.

He said the federal government would also create a website that would allow Americans to search for available vaccines, make the vaccine available at more pharmacies, double the number of mass vaccination sites and certify more people — including dentists, paramedics, veterinarians and physician assistants — to deliver shots into arms.” (H)

(A)On the anniversary of Covid-19 becoming an official public health emergency, experts say it’s time for a change, By Jen Christensen, https://www.cnn.com/2021/01/30/health/covid-19-public-health-emergency-first-anniversary/index.html

(B) March 11, 2020: After the WHO declared COVID-19 a pandemic, the world came to a screeching halt, by Justin Boggs, https://www.thedenverchannel.com/news/national/coronavirus/march-11-2020-after-the-who-declared-covid-19-a-pandemic-the-world-came-to-a-screeching-halt

(C) Dr. Fauci Reflects on One-Year Anniversary of COVID-19 Being Declared Pandemic, by Trace William Cowen, https://www.complex.com/life/dr-fauci-reflects-on-one-year-anniversary-of-covid-19-being-declared-pandemic

(D)Three Public Health Lessons From Year One of COVID-19, by Jeremy Youde, https://www.worldpoliticsreview.com/articles/29327/what-the-coronavirus-has-taught-us-about-fighting-pandemic-disease

(E) A Timeline of COVID-19 Developments in 2020, by AJMC Staff, https://www.ajmc.com/view/a-timeline-of-covid19-developments-in-2020

(F) Preparing for the next pandemic: Early lessons from COVID-19, by Dante Disparte, https://www.brookings.edu/research/preparing-for-the-next-pandemic-early-lessons-from-covid-19/

(G) Where Year Two of the Pandemic Will Take Us, by Ed Yong, https://www.theatlantic.com/health/archive/2020/12/pandemic-year-two/617528/

(H) Biden Tells Nation There Is Hope After a Devastating Year, By Katie Rogers, https://www.nytimes.com/2021/03/11/us/politics/biden-coronavirus.html?referringSource=articleShare

This is an updated look at how the pandemic progressed throughout 2020.

January 9 — WHO Announces Mysterious Coronavirus-Related Pneumonia in Wuhan, China

January 20 — CDC Says 3 US Airports Will Begin Screening for Coronavirus

January 21 — CDC Confirms First US Coronavirus Case

January 21 — Chinese Scientist Confirms COVID-19 Human Transmission

January 23 — Wuhan Now Under Quarantine

January 31 — WHO Issues Global Health Emergency

February 2 — Global Air Travel Is Restricted

February 3 — US Declares Public Health Emergency

February 10 — China’s COVID-19 Deaths Exceed Those of SARS Crisis

February 25 — CDC Says COVID-19 Is Heading Toward Pandemic Status

March 6 — 21 Passengers on California Cruise Ship Test Positive

March 11 — WHO Declares COVID-19 a Pandemic

March 13 — Trump Declares COVID-19 a National Emergency

March 13 — Travel Ban on Non-US Citizens Traveling From Europe Goes Into Effect

March 17 — University of Minnesota Begins Testing Hydroxychloroquine

March 17 — CMS Temporarily Expands Use of Telehealth

March 17 — Administration Asks Congress to Send Americans Direct Financial Relief

March 19 — California Issues Statewide Stay-at-Home Order

March 24 — With Clinical Trials on Hold, Innovation Stalls

March 25 — Reports Find Extended Shutdowns Can Delay Second Wave

March 26 — Senate Passes CARES Act

March 27 — Trump Signs CARES Act Into Law

March 30 — FDA Authorizes Use of Hydroxychloroquine

March 31 — COVID-19 Can Be Transmitted Through the Eye

April 8 — Troubles With the COVID-19 Cocktail

April 16 — “Gating Criteria” Emerge as a Way to Reopen the Economy

April 28 — Young, Poor Avoid Care for COVID-19 Symptoms

April 29 — NIH Trial Shows Early Promise for Remdesivir

May 1 — Remdesivir Wins EUA

May 9 — Saliva-Based Diagnostic Test Allowed for At-Home Use

May 12 — Death Toll Likely Underestimated, Fauci Testifies

May 21 — United States and AstraZeneca Form Vaccine Deal

May 28 — US COVID-19 Deaths Pass the 100,000 Mark

June 4 — Lancet, NEJM Retract COVID-19 Studies on Hydroxychloroquine

June 10 — US COVID-19 Cases Reach 2 Million

June 16 — HHS Announces COVID-19 Vaccine Doses Will Be Free for Some

June 18 — WHO Ends Study Into Hydroxychloroquine

June 20 — NIH Halts Trial of Hydroxychloroquine

June 22 — Study Suggests 80% of Cases in March Went Undetected

June 26 — White House Coronavirus Task Force Addresses Rising Cases in the South

June 29 — Gilead Sets Price for Remdesivir at $3120

June 30 — Fauci Warns New COVID-19 Cases Could Hit 100,000 a Day

July 2 — States Reverse Reopening Plans

July 6 — Scientists, Citing Airborne Transmission, Ask WHO to Revise Guidance

July 7 — CMS Plans to Pay More for Home Dialysis Equipment

July 7 — US Surpasses 3 Million Infections, Begins WHO Withdrawal

July 9 — WHO Announces COVID-19 Can Be Airborne

July 14 — States With COVID-19 Spikes Report Greatest Health Insurance Coverage Losses

July 14 — Early Moderna Data Point to Vaccine Candidate’s Efficacy

July 15 — New Hospital Data Reporting Protocol Prompts Concern

July 16 — US Reports New Record of Daily COVID-19 Cases

July 20 — Diagnostic Delays From COVID-19 May Increase Cancer-Related Deaths

July 21 — Vaccines From AstraZeneca, CanSino Biologics Show Promising Results

July 22 — HHS, DOD Announce Vaccine Distribution Agreement With Pfizer and BioNTech

July 23 — Antibody Levels Drop After First 3 Months of COVID-19 Infection

July 23 — Antibody Cocktail May Treat, Prevent COVID-19

July 27 — Moderna Vaccine Begins Phase 3 Trial, Receives $472M From Trump Administration

July 27 — Senate Introduces HEALS Act

July 29 — FDA Grants Truvian EUA for Rapid Antibody Test

August 3 — New US Pandemic Phase; US to Pay Sanofi, GlaxoSmithKline $2B for Vaccine

August 4 — Rural Hotspots Face Lack of Intensive Care Unit Beds

August 7 — Talks Stall on Second Relief Package

August 11 — Trump Administration Reaches Deal With Moderna

August 12 — Severe Obesity Increases Mortality Risk From COVID-19

August 13 — Biden Calls for 3-Month Mask Mandate

August 15 — FDA Approves Saliva Test

August 17 — COVID-19 Now the Third-Leading Cause of Death in the US

August 23 — Convalescent Plasma Is Cleared for Use by FDA

August 24 — Remdesivir’s Clinical Benefits Questioned

August 25 — CDC Changes Testing Guidance, but Later Reverses Itself

August 26 — FDA Grants EUA to Abbott’s Rapid Test

August 28 — First Known Case of COVID-19 Reinfection Reported in the US

September 1 — US Rejects WHO Global COVID-19 Vaccine Effort

September 3 — Steroids Reduce Mortality in Severe Cases; Sanofi, GSK Begin Human Vaccine Trials

September 3 — Bioethicists Weigh In on Equitable Vaccine Distribution

September 8 — AstraZeneca Halts Phase 3 Vaccine Trial

September 14 — US Airports Stop Screening International Travelers

September 14 — Pfizer, BioNTech Expand Phase 3 Trial

September 14 — NIH Launches Investigation Into Halted Astrazeneca Trial

September 15 — CDC Reports on Spread of COVID-19 at Restaurants

September 16 — Trump Administration Releases Vaccine Distribution Plan

September 17 — Europe Reports Rising COVID-19 Cases

September 21 — CDC Pulls Guidance Saying COVID-19 Transmission Is Airborne

September 21 — Johnson & Johnson Begins Phase 3 Vaccine Trial

September 23 — A New, More Contagious Strain of COVID-19 Is Discovered

September 25 — Midwest States See Increase in COVID-19 Cases

September 28 — Global COVID-19 Deaths Surpass 1 Million

September 29 — HHS to Distribute 100 Million Rapid Tests to States

September 29 — Regeneron Announces Positive Results for Monoclonal Antibody Treatment

October 2 — Trump, First Lady Test Positive for COVID-19; Trump Enters Hospital

October 5 — Trump Leaves Hospital, Continues Receiving Treatment

October 8 — NEJM Criticizes Trump’s COVID-19 Response; 39 States See Case Spikes

October 8 — More Americans Trust Biden to Lead Health Care System

October 8 — White House COVID-19 Outbreak Grows to 34

October 9 — US Signs Deal With AstraZeneca

October 12 — Johnson & Johnson Halts Vaccine Trial

October 15 — US Cases Spike Again; Studies Connect Blood Type and COVID-19 Risk

October 19 — Global Cases Top 40 Million

October 22 — FDA Approves Remdesivir as First COVID-19 Drug

October 23 — AstraZeneca and Johnson & Johnson Announce Restart of COVID-19 Vaccine Trials

October 28 — CMS Issues Vaccine, Treatment Coverage Rules

November 4 — US Reports Unprecedented 100,000 Cases in 1 Day

November 5 — Study Predicts Difficulties in Nationwide COVID-19 Immunity

November 9 — President-Elect Biden Announces COVID-19 Transition Team; Pfizer Publishes Vaccine Results

November 9 — FDA Issues EUA for Eli Lilly’s Antibody Treatment

November 11 — Indoor Venues Responsible for Much of COVID-19’s Spread

November 16 ­— Moderna Reveals Vaccine Efficacy Results

November 16 — FDA to Move Rapidly on EUAs for Pfizer, Moderna Vaccines

November 17 — Fauci Highlights the Need for Long-term Follow-up of COVID-19 Effects

November 18 — Pfizer, BioNTech Vaccine Is 95% Effective

November 20 — Pfizer, BioNTech Submit EUA Application; CDC Warns Against Holiday Travel

November 23 — AstraZeneca Reports Vaccine Is 90% Effective; FDA Grants EUA for Second Antibody Treatment

December 10 — FDA Advisory Panel Recommends Pfizer, BioNTech COVID-19 Vaccine

December 11 — FDA Agrees to EUA for COVID-19 Vaccine From Pfizer, BioNTech

December 17 — FDA Panel Backs Moderna COVID-19 Vaccine

December 18 — FDA Signs Off on EUA for Moderna’s COVID-19 Vaccine

December 21 — New COVID-19 Variant Circling the UK

December 23 — US Buys More Pfizer Vaccine

December 28 — Novavax Starts Phase 3 Trial of COVID-19 Vaccine

December 29 — First US Case of New COVID-19 Variant Found in Colorado

December 30 — UK Approves Emergency Authorization for the AstraZeneca and Oxford COVID-19 Vaccine

December 31 —US Falls Short of Goal to Give 20 Million Vaccinations by Year End (E)