Cutting Through COVID-19 Confusion

Q&A: Cutting Through COVID Confusion

More than 900,000 Americans have died from COVID-19, and while new cases have declined in the past week, deaths increased. As the world continues to grapple with COVID-19, questions remain about the future of the virus and what endemic means. Here’s the latest news on common concerns:

Q: When can children under five get vaccinated?
A: Infants as young as six months could be vaccinated in the next few weeks, depending on the Food and Drug Administration’s (FDA) review of Pfizer-BioNTech’s application for authorization of the vaccine for this age group. UPDATE: Pfizer-BioNTech postpones FDA application to wait for data on a three-dose series of the vaccine, which they believe may offer better protection for this age group (2/11/22).

Q: What do we know about the new variant?
A: The emerging BA.2 sub-variant of omicron has replaced the original strain in many countries and is detected in more than half of the states. BA.2 does not appear to cause greater disease severity but a study from Denmark found it to be 33% more likely to infect others compared to BA.1.

Q: How effective are boosters?
A: Fully vaccinated people are 14 times less likely to die from COVID-19 than unvaccinated individuals. People with boosters are 97 times less likely to die of the virus. Yet, 51% of eligible Americans have not received their booster dose. New data from the Centers for Disease Control and Prevention (CDC) shows that booster doses are most beneficial to older adults. UPDATE: A recent study found booster doses lost substantial effectiveness after around four months (2/11/22).

Q: Is omicron really that bad?
A: Even though omicron cases are often milder than earlier variants and there is less risk of being admitted to the intensive care unit than during previous waves, the high volume of hospital admissions is straining the health care system. Additionally, many hospitalized patients come in for other reasons and incidentally test positive for COVID. Omicron is not as mild for people with underlying conditions and may cause 50,000 to 300,000 more deaths by mid-March. Some people are deliberately trying to get omicron but learn the reasons why experts say that is a bad idea.

Q: What have we learned about Long COVID?
A: New research on factors that may increase the risk for Long COVID includes one study that suggests four biological factors, such as type 2 diabetes or certain autoimmune conditions, could be identified early in a person’s COVID-19 infection. Another study hints that a blood test may be able to predict Long COVID.

Q: What’s the latest on COVID-19 treatments?
A: There are several therapeutic options for people who have gotten COVID-19. However, there are not enough of these drugs, and some patients are left untreated. Learn more about the challenges of Remdesivir and the federal contract for Paxlovid.

The Pandemic's Impact on Children

In January, COVID-19 cases among children topped 1 million, nearly five times the rate at the peak of last winter’s surge. Across the U.S., 80% of people over five years old have received at least one vaccine shot. With authorization and recommendation for vaccination of children under five still in progress, new evidence suggests that vaccinating adults may protect children against COVID-19.

• COVID-19 in Children: The latest omicron surge has led to an increase in pediatric hospitalizations and the rise of Multisystem Inflammatory Syndrome in Children (MIS-C), a dangerous disorder that causes inflammation in the body. Recent studies found that one out of every 1,000 pediatric cases will experience MIS-C and one in every ten pediatric cases will experience severe gastrointestinal problems.
• Vaccine Efforts in Children: Vaccination rates in children are stalling and only 30% of parents of children under five want to get their child vaccinated once eligible. Pending FDA approval and CDC recommendation, the White House COVID-19 response team will immediately begin packing and shipping doses for this younger age group to thousands of health care providers around the country.
• COVID-19 and Food Insecurity: Many children lost access to free or reduced school meals as a result of the disruption of in-person learning, exacerbating food insecurity among the school-aged population. Once schools re-opened for in-person learning, many parents were forced to decide between remote learning and school meals.

Resources & Initiatives:

• Blue Cross and Blue Shield of Texas teamed up with Feeding America to mitigate the food insecurity crisis which has been magnified by the COVID-19 pandemic.
• The Biden administration issued standards for school lunches, meant to ease the path for schools to get back to healthier courses, that were previously set by First Lady Michelle Obama.
• The Department of Health and Human Services released an infographic on how to make vaccine shots less stressful for children.
• Learn more about the pandemic’s impact on children from a recent NIHCM infographic.

Behavioral Health and Substance Use Disorders

Substance use disorders (SUD) have increased during the pandemic, as well as alcohol use and overdose deaths. In addition, the pandemic’s disruptions result in elevated and long-term mental health symptoms. A recent study found that addressing mental and behavioral health should be priorities as the COVID-19 pandemic continues.

• Alcohol Use: A national survey of U.S. adults reported that excessive drinking increased by 21% during the pandemic. A one-year increase in consumption is estimated to cause 8,000 additional deaths from alcohol-related liver disease.
• Overdose Deaths: A five-year study found that people between the ages of 10 and 24 lost more than 1.25 million years of life due to unintentional drug overdoses. Even though intentional drug overdose deaths and suicides by an overdose experienced an overall decline in recent years, there is a reported increase in young people aged 15-24, older people aged 75-84, and non-Hispanic Black women.
• Expanding Access to Behavioral Health Services: Colorado state lawmakers are investing $450 million in federal relief money towards improving the behavioral health system. Blue Cross Blue Shield of Michigan recently collaborated with Integrated Health Associates to incorporate behavioral health services into primary care, which promotes accessible and equitable treatments spanning behavioral, mental, and physical health.

Resources & Initiatives:

• A recent study published in JAMA found several factors associated with opioid overdose after initial exposure.
• NIHCM Grantee, Tradeoffs, released a podcast discussing the new, nationwide mental health hotline (988).
• Premera Blue Cross partnered with the Seattle Kraken, Washington’s National Hockey League team, to raise awareness, destigmatize, and encourage people to seek help with issues related to mental health.
• The Florida Blue Foundation announced a $3.8 million investment to enhance mental wellbeing among children, families, and seniors.
• Highmark expanded services to help members with alcohol use disorder by teaming up with Tempest, an evidence-based, digital recovery program.

Health Disparities in Cancer

Cancer is the second leading cause of death in the U.S., with significant disparities in screening, treatment, and outcomes by race and ethnicity. Compared to White individuals, the risk of cancer death is 33% higher for Black Americans and 50% higher for American Indians and Alaska Natives. This month, President Biden reignited the Cancer Moonshot program intending to reduce the cancer mortality rate by at least 50% over the next 25 years, including reducing health disparities in cancer research.

• Screening: Cancer screening is significantly lower among Black, Asian, Hispanic, American Indian, and Alaska Native populations than White Americans. Research suggests that the pandemic has led to further disruptions in cancer screening, worsening disparities.
• Treatment: In addition to delayed screening, there are also racial disparities in diagnostic and treatment delays. Compared to White women, Black and Hispanic women are less likely to receive guideline-recommended breast cancer treatment.
• Outcomes: Discrepancies in care and treatment contribute to higher mortality rates. Black women are more likely to have a later-stage cancer diagnosis, contributing to the almost one and a half times higher mortality rates than White women. Across most cancers, American Indians and Alaska Natives had a worse 5-year survival rate compared to White patients.

Resources & Initiatives:

• While data remains unclear regarding the pandemic’s impact on cancer detection and treatment, the American Cancer Society released its annual report estimating the new cancer cases and deaths in the US.
• The National Cancer Institute has several recommended cancer screening tests that aim to find cancer before symptom onset, when it may be easier to successfully treat.
• Blue Cross Blue Shield of Minnesota recently participated in a panel discussion on diversity, equity, and inclusion in the cancer community, furthering understanding of addressing racial and health disparities in cancer treatment.