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	Dying in a Leadership Vacuum by AMA, The Lancet, agencies USA   Sep. 2021   Uncoupling vaccination from politics: a call to action. (The Lancet)   Political polarisation in the USA is impeding vaccination of the population against SARS-CoV-2. Today, the lowest COVID-19 vaccination rates in the USA are overwhelmingly in Republican-leaning states and counties.   At a time when the delta variant is spreading, these are also the areas experiencing surges in admissions to hospital and intensive care.   If political divides on COVID-19 vaccination become ingrained, the consequences could include greater resistance to all vaccination and outbreaks of other vaccine-preventable diseases.   Understanding and countering this trend are urgent public health priorities.   Historically, anti-vaccine rhetoric has had minimal policy impact because bipartisan political leadership strongly endorsed the safety and effectiveness of vaccines.   However, in recent years, anti-vaccine activism has received support from some state-level Republican officials during legislative debates over bills to improve vaccine uptake.   Today, anti-vaccination groups have successfully married their cause to opposing other COVID-19 mitigation measures, including masking and physical distancing.   Misinformation is spreading through right-leaning media programmes and platforms, and on social media. Republican elected officials in multiple states have accepted the framing of vaccination as a matter of personal liberty, with several states passing laws prohibiting private businesses from requiring COVID-19 vaccination.   Once a public health issue becomes politicised, walking back the partisanship becomes difficult, while addressing the challenge head on risks exacerbating the problem. Public and private sector leaders may fail to speak out, afraid of alienating a sceptical base.   This is a moment to prioritise health over short-term political calculations. SARS-CoV-2 is agnostic in whom it infects, and COVID-19 vaccines protect liberals and conservatives alike. Leaders across sectors of every ideological stripe should work together to promote vaccination.   We recommend five short-term steps. First, diversify messengers. Public officials should recognise that when promoting vaccination, the messenger is as important as the message. Promotion efforts will be most effective when communicated from an array of trusted speakers and perspectives, especially outside of government.   Encouraging and supporting Republican leaders to amplify pro-vaccine messages are important priorities.   Second, draw on broad expertise. As COVID-19 vaccine hesitancy is not just a public health problem, public officials need to convene experts from the social, behavioural, and communication sciences to create comprehensive response strategies. Routine public health messaging alone will be insufficient.   Third, invest in research. Recognising that the politicisation of vaccines is now a problem of unprecedented scope and the dominant driver keeping down vaccination rates, public and private funders should invest in social and behavioural research to systematically monitor the phenomenon and develop solutions.   Fourth, counter purveyors of misinformation. Policy makers and professional organisations should examine available legal, regulatory, and private sector options to reduce the impact of well-financed organisations spreading misinformation.   The US Government should solicit the expertise of agencies outside the health sector, including the Departments of Homeland Security, Commerce, Justice, and State.   Fifth, stop the misinformation. Conservative media outlets must stop amplifying falsehoods about COVID-19 vaccines. Advertisers should pull funding from programmes and websites that promote misinformation, as they put the lives of Americans and the health of our economy at risk. Social media platforms should enhance efforts to track, disclose, and stop the spread of misinformation.   http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02099-7/fulltext http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02010-9/fulltext http://www.theguardian.com/us-news/2021/dec/15/a-terrible-tragedy-us-tops-800000-covid-deaths-highest-in-the-world http://www.dailyposter.com/how-the-koch-network-hijacked-the-war-on-covid/ http://coronavirus.jhu.edu/map.html   Oct. 2020   Dying in a Leadership Vacuum, by the Editors of The New England Journal of Medicine.   Covid-19 has created a crisis throughout the world. This crisis has produced a test of leadership. With no good options to combat a novel pathogen, countries were forced to make hard choices about how to respond. Here in the United States, our leaders have failed that test. They have taken a crisis and turned it into a tragedy.   The magnitude of this failure is astonishing. According to the Johns Hopkins Center for Systems Science and Engineering, the United States leads the world in Covid-19 cases and in deaths due to the disease, far exceeding the numbers in much larger countries, such as China. The death rate in this country is more than double that of Canada, exceeds that of Japan, a country with a vulnerable and elderly population, by a factor of almost 50, and even dwarfs the rates in lower-middle-income countries, such as Vietnam, by a factor of almost 2000.   Covid-19 is an overwhelming challenge, and many factors contribute to its severity. But the one we can control is how we behave. And in the United States we have consistently behaved poorly.   We know that we could have done better. China, faced with the first outbreak, chose strict quarantine and isolation after an initial delay. These measures were severe but effective, essentially eliminating transmission at the point where the outbreak began and reducing the death rate to a reported 3 per million, as compared with more than 500 per million in the United States. Countries that had far more exchange with China, such as Singapore and South Korea, began intensive testing early, along with aggressive contact tracing and appropriate isolation, and have had relatively small outbreaks.   And New Zealand has used these same measures, together with its geographic advantages, to come close to eliminating the disease, something that has allowed that country to limit the time of closure and to largely reopen society to a prepandemic level.   In general, not only have many democracies done better than the United States, but they have also outperformed us by orders of magnitude.   Why has the United States handled this pandemic so badly? We have failed at almost every step. We had ample warning, but when the disease first arrived, we were incapable of testing effectively and couldn’t provide even the most basic personal protective equipment to health care workers and the general public. And we continue to be way behind the curve in testing.   While the absolute numbers of tests have increased substantially, the more useful metric is the number of tests performed per infected person, a rate that puts us far down the international list, below such places as Kazakhstan, Zimbabwe, and Ethiopia, countries that cannot boast the biomedical infrastructure or the manufacturing capacity that we have.   Moreover, a lack of emphasis on developing capacity has meant that U.S. test results are often long delayed, rendering the results useless for disease control.   Although we tend to focus on technology, most of the interventions that have large effects are not complicated. The United States instituted quarantine and isolation measures late and inconsistently, often without any effort to enforce them, after the disease had spread substantially in many communities.   Our rules on social distancing have in many places been lackadaisical at best, with loosening of restrictions long before adequate disease control had been achieved. And in much of the country, people simply don’t wear masks, largely because our leaders have stated outright that masks are political tools rather than effective infection control measures.   The government has appropriately invested heavily in vaccine development, but its rhetoric has politicized the development process and led to growing public distrust.   The United States came into this crisis with enormous advantages. Along with tremendous manufacturing capacity, we have a biomedical research system that is the envy of the world.   We have enormous expertise in public health, health policy, and basic biology and have consistently been able to turn that expertise into new therapies and preventive measures. And much of that national expertise resides in government institutions. Yet our leaders have largely chosen to ignore and even denigrate experts.   The response of our nation’s leaders has been consistently inadequate. The federal government has largely abandoned disease control to the states. Governors have varied in their responses, not so much by party as by competence.   But whatever their competence, governors do not have the tools that Washington controls. Instead of using those tools, the federal government has undermined them.   The Centers for Disease Control and Prevention, which was the world’s leading disease response organization, has been eviscerated and has suffered dramatic testing and policy failures.   The National Institutes of Health have played a key role in vaccine development but have been excluded from much crucial government decision making. And the Food and Drug Administration has been shamefully politicized, appearing to respond to pressure from the administration rather than scientific evidence.   Our current leaders have undercut trust in science and in government, causing damage that will certainly outlast them. Instead of relying on expertise, the administration has turned to uninformed “opinion leaders” and charlatans who obscure the truth and facilitate the promulgation of outright lies.   Let’s be clear about the cost of not taking even simple measures. An outbreak that has disproportionately affected communities of color has exacerbated the tensions associated with inequality. Many of our children are missing school at critical times in their social and intellectual development. The hard work of health care professionals, who have put their lives on the line, has not been used wisely.   Our current leadership takes pride in the economy, but while most of the world has opened up to some extent, the United States still suffers from disease rates that have prevented many businesses from reopening, with a resultant loss of hundreds of billions of dollars and millions of jobs. And more than 200,000 Americans have died.   Some deaths from Covid-19 were unavoidable. But, although it is impossible to project the precise number of additional American lives lost because of weak and inappropriate government policies, it is at least in the tens of thousands in a pandemic that has already killed more Americans than any conflict since World War II.   Anyone else who recklessly squandered lives and money in this way would be suffering legal consequences. Our leaders have largely claimed immunity for their actions. But this election gives us the power to render judgment.   Reasonable people will certainly disagree about the many political positions taken by candidates. But truth is neither liberal nor conservative. When it comes to the response to the largest public health crisis of our time, our current political leaders have demonstrated that they are dangerously incompetent. We should not abet them and enable the deaths of thousands more Americans by allowing them to keep their jobs.   http://www.nejm.org/doi/full/10.1056/NEJMe2029812   * May 2022: The United States has recorded over one million Covid deaths: http://www.pbs.org/newshour/show/how-misinformation-and-the-partisan-divide-drove-a-surge-in-u-s-covid-deaths http://www.pbs.org/newshour/show/dr-fauci-on-the-state-of-the-pandemic-as-the-u-s-approaches-1-million-covid-19-deaths http://www.poorpeoplescampaign.org/pandemic-report/   22 Sep. 2020   Today, the American Medical Association (AMA), American Hospital Association (AHA), and American Nurses Association (ANA) released a joint statement on the amount of deaths caused by the coronavirus in the United States.   'Today we mark a somber milestone as more than 200,000 people in the United States have died of COVID-19 over the course of the pandemic. Those lost include mothers and fathers, grandparents, children, teachers, and frontline workers. The steps required to stop the spread of this virus should be well-known by now, but with more than 6 million COVID-positive Americans, we say again: wear your mask, wash your hands, and practice physical distancing.   By scale and raw numbers, COVID-19 has had a devastating impact on our country, affecting Americans at a rate that represents a nearly worst-case scenario.   As autumn begins and as we continue working to minimize the suffering and death of this pandemic, we urge all Americans to get their flu shot early. With no end to COVID-19 in sight, a bad flu season has potential to cause additional strain on our health system that is still battling the pandemic. America’s physicians, nurses, and hospitals and health systems thank you for doing your part.   http://www.ama-assn.org/about/leadership/marking-tragic-milestone-200000-covid-19-deaths   July 2020   ‘Let’s stop this nonsense,’ top infectious-disease expert Anthony Fauci says of federal coronavirus response as he comes under fire from White House.   Sidelined by the White House and harshly criticized in an extraordinary op-ed from a top adviser to the Trump administration, Anthony Fauci — the nation’s top infectious-disease expert — said in an interview with the Atlantic that the country needs to focus on a surging virus “rather than these games people are playing.”   “We’ve got to almost reset this and say, ‘Okay, let’s stop this nonsense,' ” he said after being asked to state “the truth about the federal response to the pandemic” in the United States. “We’ve got to figure out, How can we get our control over this now, and, looking forward, how can we make sure that next month, we don’t have another example of California, Texas, Florida, and Arizona?”   Here are some significant developments:   The total number of coronavirus infections reported in the United States is approaching 3.5 million, according to data tracked by The Washington Post, including at least 137,000 deaths.   The greater Washington, D.C., region recorded its highest daily coronavirus caseload in weeks as the District lost more ground in its fight to quell the pandemic. Hospital capacity in several hard-hit states is running low as officials scramble to keep their expanding outbreaks from spinning even further out of control.   Health experts and hospital officials warn that an abrupt change in how the Trump administration requires them to report coronavirus data will increase the burden on facilities already strained by the pandemic.   Support for mask mandates continued to grow a day after another of the country’s top health officials said universal face-covering could bring covid-19 “under control” in the United States. Alabama and the city of Tulsa mandated masks on Wednesday, while Walmart announced it would require all shoppers to wear masks.   http://www.cbpp.org/research/poverty-and-inequality/tracking-the-covid-19-recessions-effects-on-food-housing-and http://www.cbpp.org/ http://frac.org/hunger-poverty-america Visit the related web page
	While China and the US squabble, the world’s debt and climate crises worsen by William Nee Business and Human Rights Analyst at Amnesty International   “One of the many great things about our just signed giant Trade Deal with China is that it will bring us closer together in so many other ways. Terrific working with President Xi, a man who truly loves his country. Much more to come!”   President Donald Trump’s upbeat tweet from January 2020 was, alas, not the prelude to a productive year of collaboration between the world’s two largest economies. On the contrary, it preceded a new low in US-China relations that has had catastrophic global consequences.   Trump says he has not spoken to President Xi “in a long time” amid the tensions of a pandemic he routinely refers to as “the Chinese virus”. But while these two superpowers have been trading petty insults, they have dropped the ball on two of the biggest crises facing the world today: debt relief and the climate crisis.   Long-term debt cancellation needed to temper virus devastation   The economic fallout of the COVID-19 pandemic has been particularly crippling for developing countries, who were already indebted and now need urgent support. In April 2020, G20 countries, including the US and China, agreed to suspend principal and interest repayments on loans to 76 of the world’s poorest countries from May to December 2020 in a program known as the debt service suspension initiative (DSSI). But given the ongoing economic and social devastation facing these countries, an eight-month repayment suspension now hardly seems adequate.   To make matters worse, the temporary repayment relief did not apply to commercial loans – private creditors who expect to be repaid. And since Beijing does not transparently disclose the terms, size or recipients of the grants and loans it provides, the true scale or nature of its lending is unclear.   What we do know is that the US and China are the top bilateral lenders to developing countries: $394.6 billion and $354.3 billion, respectively, from 2000 to 2014. They can – and should – do more to alleviate the financial and humanitarian crisis that COVID-19 has inflicted on countries least equipped to deal with it (especially since many of these countries are reluctant to proactively seek debt relief because it can harm their credit ratings).   Yet, deplorably, neither the US nor China has shown any inclination to restart the debt relief process let alone consider concerted action on long-term debt cancellation that is vitally needed now.   Beijing is unlikely to make a public commitment to forgiving the debt upon which the Belt and Road Initiative – its massive influence and infrastructure project – is built. China’s preference is for making, and renegotiating, loan agreements in bilateral conversations behind closed doors.   Meanwhile, the US and the international financial institutions over which it holds great sway, such as the World Bank, are also not incentivized to provide relief that they suspect will be used to repay commercial debts to China.   At the same time, China has questioned the effectiveness of the DSSI without the World Bank’s involvement. Both China and the US-based funding institutions face a conundrum: if the other side fails to meaningfully act, then their side will be at a disadvantage.   But this issue, at this precipitous moment in history, is too important to be derailed by political calculations. It’s time for both sides to set the standard for other government lenders and further leverage their power to influence private creditors.   That’s why Amnesty International is calling on China, the US and all bilateral lenders to cancel all external sovereign debt payments in 2020 and 2021 of all countries requiring such relief to respond or recover from the COVID-19 pandemic. If the US and China lead, others will certainly follow.   Global climate efforts undermined   And they must not stop there. The pandemic has underscored the importance of understanding unconventional threats stemming from human overexploitation of natural resources. That means pursuing a transformative post-COVID-19 recovery plan that puts the climate and human rights at its heart and leaves the fossil fuel economy behind.   And yet, both China and the US – the world’s top two carbon emitters – are irresponsibly backsliding on the Paris Agreement.   At a time when we need to keep the global average temperature rise below 1.5°C to avoid irreversible effects on human rights and the environment, Climate Action Tracker has ranked China’s actions as contributing to a path that will increase global temperatures by between 3°C and 4°C. China is the largest supporter of new carbon emission investments, with over 70% of the world’s new coal-fired power plants backed by Chinese banks.   The Trump administration, which has backed out of the Paris Agreement altogether and denies the climate crisis even exists, is a vocal supporter of fossil fuels and is on a path that could raise global temperatures by more than 4°C.   Meaningful action on climate change will be nearly impossible without strong leadership and concerted action by these two superpowers. With evidence mounting that global temperatures are rising at “worst case scenario” levels, the future of the planet, along with the global economy, hinges on Beijing and Washington working with – rather than against – each other.   While this may sound a fanciful aspiration amid today’s toxic rhetoric, an olive branch was recently extended when Chinese Foreign Minister Wang Yi put forth a framework to get US-China relations back on track. Both sides need to come to the table ahead of the G20 summit in November, regardless of the outcome of that month’s US election, and put debt relief and climate change at the top of their agenda before it’s too late. http://bit.ly/2FCQ6n1   http://www.amnesty.org/en/latest/news/2021/02/amnesty-launches-first-global-emergency-appeal-to-counter-growing-anti-human-rights-agenda-worldwide/ http://www.amnesty.org/en/latest/news/ Visit the related web page
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