Jeanette Contreras portrait

Low-income essential workers lack adequate COVID-19 testing

By NCL Director of Health Policy Jeanette Contreras

As the United States enters the third wave of COVID-19, low-income and minority communities hit hardest by the virus continue to disproportionately lack access to testing. The pandemic is shining a spotlight on the underlying health disparities that have long persisted within these medically underserved communities. Racial and ethnic minorities experience more severe COVID-related illness requiring hospitalization and are at higher risk for death from COVID-19. This is due largely to the prevalence of chronic conditions such as diabetes, asthma, heart disease, and chronic obstructive pulmonary disease (COPD).

In addition, racial and ethnic minorities make up a significant portion of the low-wage essential workers on farms, in grocery stores and warehouses, and in truck shipping. The essential workforce is composed of  64 percent women and 41.2 percent people of color. This translates to a higher risk of exposure to the virus among minorities because their employment involves interacting with the general public or co-workers in an unsafe environment. According to an August 2020 report from the U.S. Department of Health and Human Services (HHS), Hispanic/Latino persons were the largest demographic living in counties identified as coronavirus hotspots (3.5 million persons), followed by Black/African American persons (2 million).

HHS released a comprehensive strategy to address the lack of access to COVID-19 testing in vulnerable communities, which included expanded testing at federally qualified health centers (FQHCs) and partnerships with retail pharmacies. However, the very social determinants of health that these communities face, such as lack of transportation, child care, and paid sick leave, create significant barriers to getting to a community health clinic or a drive-through testing site. Despite higher demand in minority communities, there are fewer testing sites available to them when compared to access in predominantly white, more affluent areas. Researchers of the COVID Tracking Project found that zip codes with white populations of 75 percent had significantly more testing sites per capita than zip codes that were 75 percent minority.

Though adequate testing is only one of the prongs in confronting the pandemic, followed by contact tracing and isolation, it provides critical data needed to provide resources in the communities hardest hit by this pandemic. The World Health Organization (WHO) recommends conducting around 10–30 tests per confirmed case as a general benchmark–less than 5 percent positivity rate suggests the pandemic is under control. The U.S. currently has a positivity rate of 6 percent, and many states are not testing at a rate needed to contain the spread. Further adding to the disproportionate burden, there is no federal guidance for routine testing of essential workers. To provide adequate testing in low-income and minority communities, we need to address the underlying social determinants of health that place them at greater risk.

Equitable allocation of a COVID-19 vaccine

Nissa Shaffi

By Nissa Shaffi, NCL Associate Director of Health Policy

As the world waits with bated breath for the release of a safe and effective COVID-19 vaccine, one concern that is paramount is the proper distribution of the vaccine. According to leaders of Operation Warp Speed (OWS)—a coordinated partnership between the Department of Health and Human Services (HHS) and the Department of Defense (DoD)—detailed planning is ongoing to realize OWS’s lofty goal of delivering 300 million doses of a COVID-19 vaccine, with the initial doses available by January 2021.

Implementing a vaccine program of this magnitude is contingent upon precise coordination that traverses federal, state, local, tribal, and territorial governments. The prodigious task ahead is determining who would get the first initial doses of the vaccine upon release. The pandemic has further illustrated that communities most vulnerable to COVID-19 are often rife with systemic racism and socioeconomic factors conducive to higher infection rates. An initial limited supply of a vaccine will only intensify these inequities.

Multiple analyses conducted on the federal, state, and local levels confirm that people of color have experienced a disproportionate burden of COVID-19 cases and deaths. Hispanic or Latinx, and American Indian and Alaskan Native (AI/AN) communities have experienced three times the rate of infection, and Black communities two times the rate of infection, compared to White populations. The CDC warns that this imbalance in morbidity and mortality is begotten by deep-seated disparities that stem from generations of racism and unaddressed social determinants of health.

To mitigate these inequities, the National Academies of Science, Engineering, and Medicine (NASEM) have formed a committee to establish an overarching framework addressing key considerations for the equitable allocation of a COVID-19 vaccine, including at-risk communities, priority populations, geographic distribution, scalable measures, and vaccine hesitancy.

The framework proposes four phases of vaccine distribution and their corresponding priority populations, as follows:

[Source: NASEM]

The above proposal will inform CDC’s Advisory Committee on Immunization Practices’ (ACIP) recommendations in advance of a COVID-19 vaccine release; and it was developed through careful consideration of CDC’s Social Vulnerability Index (CDC SVI), and the apropos, COVID-19 Community Vulnerability Index (CCVI). To elucidate, these phases were designed with people of color in mind, as they experience heightened risk of exposure working in essential roles in society, and therefore succumb to higher rates of infection.

Another key component of the vaccine plan is addressing vaccine hesitancy. People of Color are significantly underrepresented in clinical trials and undertreated in medical settings. This phenomenon, compounded by a general mistrust of medical establishments by minorities, will prove to be a challenge when encouraging vaccine uptake. Community engagement will be essential in building trust among the vaccine hesitant and messaging should be delivered by community leaders, or healthcare providers that resemble the population they treat. Culturally competent care has proven to have favorable effects on health outcomes and it is critical in encouraging vaccine confidence.

Once a vaccine becomes available, health officials across the country will need to deploy resources and personnel to ensure access to the vaccine among our most vulnerable. As affirmed by U.S. Army Lt. Gen. Paul Ostrowski (OWS), “We have to be able to go beyond the pharmacies, the hospitals and so forth to get after nursing homes; to get after meatpacking facilities; to get after those that are sheltered [at home]. We have to get this out to all four corners of this nation.” Getting to a vaccine is a challenge in itself, but once its released, it’s all hands-on deck.

Protecting Nevadans from COVID-19 Scams: A Virtual Panel Event with NV Attorney General Aaron D. Ford and Fraud Experts

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC – This Thursday, October 22, the National Consumers League (NCL), America’s pioneering consumer and worker advocacy organization, will host a virtual fireside chat with Nevada Attorney General Aaron D. Ford and a panel of consumer protection experts on the growing threat of scams linked to the COVID-19 pandemic. The consumer watchdog organization aims to raise awareness in Nevada about the risk of COVID-19 related fraud and arm consumers with information they can use to spot and avoid these scams.

Since the pandemic began, NCL, which operates the website Fraud.org, has seen an uptick in complaints about a variety of scams preying on increasingly vulnerable, financially strapped, and fearful consumers. Scammers running phishing schemes, stimulus check fraud, unemployment benefits scams, and immigration scams have all been working overtime to use the COVID-19 pandemic as a way to defraud consumers. The experts at NCL have watched these scams emerge, forecast they will continue to increase, and are eager to work with AG Ford to get the word out about how Nevadans can protect themselves.

WHAT

Virtual “fireside chat” featuring Nevada AG Aaron D. Ford and NCL, followed by a panel discussion on resources and tips to avoid COVID-19 fraud and scams.

WHEN

Thursday, October 22, 2020
2:00 PM – 3:00 PM Pacific Daylight Time

WHO

Nevada Attorney General Aaron D. Ford
John Breyault, Vice President, National Consumers League

State Senator Dallas Harris, Consumer Rights Attorney, Legal Aid Center of Southern Nevada
Maria Moore, State Director, AARP Nevada
Assemblyman Edgar Flores, Immigration, Family, and Personal Injury, Gonzalez & Flores Law

HOW TO WATCH

YouTube Live link will be provided following registration via Eventbrite.

*** Members of the media are welcome to attend but must RSVP to Carol McKay, National Consumers League, carolm@nclnet.org. If you are unable to attend, a recording of the interview and panel can be provided upon request after the event concludes ***

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About the National Consumers League (NCL)

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

COVID-19 increasing health concerns about obesity

COVID-19 increasing health concerns about obesity
By Nailah John, Program Associate

The pandemic has brought many countries to a standstill, restricting movement, necessitating social distancing, and impeding economic activities across a broad spectrum of nonessential occupations. It’s also resulted in many people changing their habits, including changes in food consumption, physical activity, and an increase in people working from home, which may exacerbate current levels of obesity.

Obesity is a major concern here in the United States and worldwide. The World Health Organization defines obesity as “abnormal or excessive fat accumulation that may impair health.” In 2016, the World Health Organization released data that showed 650 million adults were obese, and in 2019, an estimated 38.2 million children under the age of 5 were overweight and obese. In the United States, the Center for Disease Control and Prevention indicates that, in 2019, the obesity rate surpassed the 40 percent mark and reached 42.4 percent.

Since the pandemic began, there have been dozens of studies reported that many patients who become sick with COVID-19 are obese. In an article in the journal Obesity Reviews, an international team of researchers compiled data from scores of peer-reviewed papers capturing 399,000 patients. The findings indicated that individuals with obesity suffer from metabolic dysfunction and low-grade inflammation, which are considerable factors in the manifestation of severe lung diseases. The primary cause of COVID-19 mortality is susceptibility to acute respiratory distress syndrome (ARDS) which is more likely in obese individuals. The review goes on further to state that “being an individual with obesity independently increases the risk of influenza morbidity and mortality, most likely through impairments in innate and adaptive immune responses. Potentially the vaccines developed to address COVID-19 will be less effective for individuals with obesity due to a weakened immune response.”

The Wiley Public Health Emergency Collection found that obesity increases vulnerability to infections and is a risk factor to COVID-19-related mortality. Body mass index (BMI) was significantly higher in patients with a severe form of Covid-19 infections. Being obese increases the odds of COVID-19 patients being hospitalized. The Wiley Public Health Emergency Collection highlighted that COVID-19 patients with obesity were hospitalized more than those without obesity. According to a report that looked at 5,700 COVID-19 patients with obesity in New York City, whereas 22 percent of the population is obese, they make up 41.7 percent of hospitalized patients.

Prevalence of obesity in the United States is increasing yearly, and there is a dire need for this health issue to be curbed. It will take efforts at the federal, state, and local level. Therefore, it is paramount that each individual engages in healthy eating habits, eats the right portion sizes, engages in physical activity, and encourages others.

Hispanic Heritage Month: Focus on the importance of participating in research through clinical trials

Hispanic Heritage Month: Focus on the importance of participating in research through clinical trials
by Elena Rios, MD, MSPH, FACP
President & CEO, National Hispanic Medical Association

The COVID-19 pandemic has impacted the world and the United States with a double threat: decreasing health and function of many, especially older patients with underlying diseases (obesity, asthma, diabetes, hypertension, etc.) that decrease the body’s immune response to fight off the virus; and millions left jobless as businesses downsize or close. In the healthcare arena, scientists and physicians are learning about the disease and how to treat it: We now know to limit ventilators to avoid high air pressures that can hurt damaged lungs; to place infected patients on their stomachs to allow lungs to expand; to use dexamethasone to decrease inflammation; and to use new antiviral therapies like Remdesivir and monoclonal antibodies. While there is no vaccine to prevent COVID-19, vaccine developers, researchers, and manufacturers are expediting the development of one.

The National Institutes of Health (NIH) and several pharmaceutical companies are conducting research through clinical trials that have found potential vaccines to be safe. This summer they started to enroll people and closely follow them for any adverse effects. Historically, Hispanics, Blacks, and Native Americans have been underrepresented in clinical trial research for a variety of factors, chief among them, a distrust of research and the concept of fatalism (leaving life’s challenges in God’s hands). But it is crucially important to have diversity in clinical trials to have information on the vaccine impact for Hispanics, for example. I encourage all persons over the age of 18 to enroll in the important COVID-19 clinical trials — and recommend websites for two ongoing clinical trials: the CoronaVirusPreventionNetwork.org from the NIH and Moderna, and the CovidVaccineStudy1.com

from Pfizer Inc. Each site provides consumers with information on the locations and how to enroll.

The National Hispanic Medical Association (NHMA) was established in 1994 to represent trusted Hispanic physicians and to improve the health of Hispanics and underserved populations. Given that, by 2042, one out of four people living in our nation will be Latino, NHMA has joined as a partner to encourage the Latino community to join the NIH All of Us Research Program. In May 2018, the NIH opened national enrollment for the All of Us Research Program—a momentous effort to advance individualized prevention, treatment, and care for people of all backgrounds—in collaboration with NHMA and other national partners. People ages 18 and older who reside in the United States, regardless of health status, are eligible to enroll. The overall aim is to enroll 1 million or more volunteers and to oversample communities that have historically been underrepresented in research to make the program the largest, most diverse resource of its kind. Our participation will provide information on how to better develop health care prevention and treatment programs for generations to come.

Precision medicine is an emerging approach to disease treatment and prevention that considers differences in people’s lifestyles, environments and biological makeup, including genes. By partnering with 1 million diverse people who share information about themselves over a 10-year period, the All of Us Research Program will enable research to more precisely prevent and treat a variety of health conditions.

Participants can access their own health information, including genetics information, summary data about the entire participant community, and information about studies and findings, that come from All of Us. Participants are asked to share different types of health and lifestyle information, through online surveys and electronic health records (EHRs), which will continue to be collected over the course of the program. At different times over the coming months and years, some participants will be asked to visit a local partner site to provide blood and urine samples and to have basic physical measurements taken, such as height and weight, to ensure that the program gathers information fromall types of people. This program is especially focused on those who have been underrepresented in research, but not everyone will be asked to give physical measures and samples. In the future, participants may be invited to share data through wearable devices and to join follow-up research studies, including clinical trials.

In addition, data from the program will be broadly accessible for research purposes. Ultimately, the All of Us Research program will be a rich and open data resource for traditional academic researchers as well as citizen scientists—and everyone in between. To learn more about the program and how to join, please visit https://www.JoinAllofUs.org.

About NHMA

NHMA is a nonprofit association representing the interests of 50,000 Hispanic physicians with the mission to improve the health of Hispanics in the U.S. For more information, please visit www.NHMAmd.org

Mail-in and absentee voting during COVID-19

By NCL Executive Assistant Adrienne Archer

The National Consumers League (NCL) wants consumers to know that voting by mail or absentee ballot during the COVID-19 pandemic is safe. Due to conflicting information being shared by the media, and federal, state and local governments, it can be difficult to determine how best to vote. During the COVID-19 pandemic, a voter should always focus on keeping themselves and their family safe and healthy. Whether voting by mail-in or absentee ballot, it’s important to have a plan. However, due to the variety of challenges posed by the pandemic, it might be difficult to keep up with the changes or updates to a state’s voting guidelines. Voters should contact their local elections office.

Many states and the District of Columbia have made it easier to vote early by mail or by absentee ballot. In the past, voters needed a reason why they couldn’t vote in person. National Conference of State Legislators (NCSL) has resources for on state laws governing voting across the U.S. To know exactly when to vote in your state, contact your local elections office. USA.gov also offers information on the time frames for early or absentee voting.

All states will offer a form of mail-in voting and some states will make it more accessible to vote than others. Some states are still crafting legislation to make it easier for people to vote by mail or absentee ballot. The New York state legislature passed three bills allowing voters to request an absentee ballot or mail-in ballot because of COVID-19 fears. One of the bills allows for absentee ballots to be postmarked as late as election day and still be counted.

Government officials have noted possible instances of voter fraud. Some states have voiced concerns that mail-in ballots can easily be stolen, altered, or forged. Voters worry that they will not receive their ballot in time to vote. Congress is worried that the increase in mail will overwhelm the United States Postal Service (USPS) and delay the delivery of ballots. To add to the problems, the U.S. Postmaster General has made budget cuts to the USPS, dismantled machines, collected mailboxes, and reduced mail services causing consumers to worry that the USPS will not be able to process the increase in mail. Disability advocates want to ensure that mail-in voting will not be more difficult for voters with disabilities to exercise their right to vote.

Voting by mail is a safe option: it increases the overall voter response in the election. Even with these challenges to voting, military members and older Americans have been always encouraged to vote absentee. The Centers for Disease Control and Prevention (CDC) has provided recommendations for people to handle mail-in ballots safely when they are received. In response to consumer requests, the USPS has created a website to help voters ensure that they can receive and return their ballot safely. Also, voters should remember that the main goal of voting during this pandemic is to safely cast their votes.

Americans voting from abroad, or in the military should be aware of the following: potential delays with sending and receiving mail, possible embassy closures due to COVID-19, and ensuring that their personal address is updated with his or her state. Americans abroad should request a ballot immediately from the Federal Voting Assistance Program’s website and check with their local U.S. polling place for instructions on receiving and returning the ballot. Most states permit Americans abroad to request a ballot via email with the caveat that a completed ballot should be returned by well before the November 3rd deadline via postal mail. Under Federal law, ballots should be requested by overseas military voters by September 19th (at least 45 days before the election). The Military Postal Agency has a list of recommended mailing dates. After individuals have returned their ballot, they should be sure to contact their local elections office to ensure that their ballot was received or if they have any questions.

Voting by mail has always been a good way to ensure access to those with disabilities. The American Civil Liberties Union has guidelines to improve accessibility to persons with disabilities. They suggest voters with a disability should receive ballots electronically so they can vote from the safety of their homes. Voters could indicate their candidate on the ballot by using accessibility features on his or her device. Then the ballot should be printed and mailed to his or her local polling place. Some states require witnesses or notarization on the ballot envelope. The American Civil Liberties Union (ACLU) wants to dispense with this requirement. Election poll workers should receive training on accessible voting options and how to respectfully interact with voters with a disability. Lastly, every state should raise awareness about accessible voting options.

In summary, to effectively vote by mail or absentee ballot during the COVID-19 pandemic, the National Consumers League suggests these steps:

  1. Create a plan for voting by mail or via absentee ballot.
  2. Check your local polling office to ensure that it has your correct mailing address and you are eligible to vote in the upcoming election.
  3. Request your absentee or mail-in ballot NOW, well before the deadline of October 3rd (45 days before the election) from your local polling office.
  4. If voting from abroad or in the military, allow for extra time to request and receive your ballot.
  5. If you have a disability, every state has in place accommodations so you may vote safely and effectively. If you have questions, please contact your local polling place early so they may be resolved.
  6. When you get your ballot, review the instructions for completing and returning it. If you have questions, contact your local polling office for guidance.
  7. Mail-in your ballot immediately, in advance of your state’s deadline, allowing for time for it to be reviewed and counted.

Above all, vote, vote, vote!

Jeanette Contreras portrait

FDA Emergency Use Authorizations and public trust for COVID-19 treatments

By NCL Director of Health Policy Jeanette Contreras

There has never been a more critical time for consumers to have confidence in the Food and Drug Administration (FDA). The FDA is charged with ensuring the safety, efficacy, and security of the drugs, biologic products, and medical devices needed to treat and prevent the spread of COVID-19. The agency has undergone scrutiny from the scientific community for issuing Emergency Use Authorization (EUA) for COVID-19 treatments and diagnostics that appeared to be politically motivated.

On August 23, the FDA issued an EUA for the use of an investigational convalescent plasma to treat patients with COVID-19, touting it as yet another achievement in the Administration’s fight against the pandemic. After just two days of backlash from the scientific community, FDA Commissioner Dr. Stephen Hahn, took to Twitter to concede his mistake, admitting that the criticism was justified. Commissioner Hahn stated that the EUA is not the final FDA approval and that the agency would revoke authorization if needed. Criticism included former FDA Commissioners who stand by randomized clinical trial as the gold standard for evidence-based medicine.

This renowned round of criticism has come not long after the FDA provided EUA for hydroxychloroquine in March which it revoked in July after further review proved that it lacked efficacy.

The Federal Food, Drug, and Cosmetic Act provides the FDA Commissioner with the authority to issue EUAs for unapproved medical products or unapproved uses of medical products in response to a public health emergency, such as the current pandemic. An EUA can be revoked when new evidence emerges and the risk no longer outweighs the benefit of the unapproved use of a drug or product, yet the Trump Administration claimed that it was revoked due to political reasons.

Since February, when the Department of Health and Human Services (HHS) declared the pandemic a public health emergency, the FDA has exercised its authority to issue hundreds of EUAs for diagnostic tests, personal protective equipment, ventilators, and other medical devices to combat COVID-19. In August alone, the FDA revoked EUAs for over 100 diagnostic tests, including antibody and rapid tests. The FDA recognizes that EUA is not intended to replace randomized clinical trials and that clinical trials are critically important for the definitive demonstration of safety and efficacy of a drug, treatment, or product.

Throughout the pandemic, consumers have received conflicting information from the Administration on various COVID-19 treatments, testing products, and safety recommendations. After witnessing the media controversy over EUAs for hydroxychloroquine and convalescent plasma, we are concerned that consumers may believe that the FDA is hastily approving investigational tests and drugs for political gain. The FDA, now more than ever, needs to reestablish public trust as it proceeds to fast track the approval of a COVID-19 vaccine.

Be wary of bad hand sanitizers

By NCL Executive Assistant Adrienne Archer

Hand sanitizers help protect and prevent the spread of COVID-19 when soap and water are not readily available. When the coronavirus first emerged, demand for hand sanitizers soared. Stores were unable to maintain ample inventory, resulting in rampant hoarding and price gouging. Essential workers that desperately needed hand sanitizer couldn’t get them, prompting some companies to start making sanitizers that originally did not produce them (i.e. distilleries, cosmetic companies, etc.)

Guidelines from the Centers for Disease Control and Prevention (CDC) require hand sanitizer to have at least 60 percent ethanol (ethyl alcohol) in order for it to be effective. The CDC does not encourage members of the public to make hand sanitizer for individual use.

The Food and Drug Administration (FDA) has observed a sharp increase in those that, in addition to ethanol, also contain methanol—an ingredient that can be toxic when absorbed through the skin and can be fatal when ingested. Children and adults ingesting certain sanitizers led to blindness, hospitalizations, and even death.

Extended exposure to methanol can cause nausea, vomiting, seizures, permanent blindness, or death. The FDA has also found sanitizers with 1-propanol are also harmful. Accidental ingestions can cause central nervous system depression or death. Consumers that may have been exposed to hand sanitizers containing methanol or 1-propanol should seek medical attention immediately.

The FDA recently updated its guidelines on temporary policies about testing hand sanitizers to determine methanol levels. As companies produce hand sanitizers, they should frequently test to ensure that methanol is not created as a byproduct of either ethanol or isopropyl alcohol. The testing should be performed by an FDA inspected lab to ensure that it has met current good manufacturing practice (CGMP) standards. CGMP ensures the proper design, monitoring, and control of manufacturing processes and facilities. If alcohol (ethanol) has been found to contain more than 630 parts per million of methanol, it is contaminated and should be disposed of in hazardous waste containers. This guidance serves to help state-licensed pharmacies and outsourcing facilities report any incidents. The FDA has guidelines for an additional deterrent formula of alcohol to prevent children from ingesting them.

Consumers should also be cautious of false claims that hand sanitizers provide prolonged protection against COVID-19. Carefully inspect any purchased hand sanitizers to see if methanol or 1-propanol is listed.

FDA maintains a current list of hand sanitizers that are not recommended. As consumers review the list, they should compare the manufacturer name, product name, and National Drug Code (NDC) # on the hand sanitizer. If you find a product on the list, dispose of it immediately in a hazardous waste container and NOT down the drain.

The FDA encourages health professionals, consumers, and patients to report adverse effects and problems to the FDA’s MedWatch Adverse Event Reporting Program. Questions can be emailed to COVID-19-HandSanitizers@FHA.nns.gov. The FDA has also created a quiz to test consumer’s knowledge about hand sanitizers and a Q&A section on hand sanitizers and COVID-19 to keep consumers informed.

‘Should I stay or should I go?’ How the pandemic has affected higher education

By NCL Health Policy intern Talia Zitner

Every morning, I wake up with a new decision to make. Am I going back to campus? Or am I spending the Fall semester taking online classes from the comfort of my childhood bedroom? I’m a rising sophomore at Wesleyan University, and to add insult to injury, I’m also an incoming transfer student. My internal debate about going back to school is near-constant, and despite weighing the pros and cons of each, I still can’t seem to come to a comfortable conclusion.

Around the country, colleges and students are faced with this same, nearly impossible challenge. If schools can’t or won’t open in the fall, they risk closing forever without tuition money. If they do allow students to come back to campus, and an outbreak occurs, they put students, professors, faculty, staff, their families, and the greater community at risk. Students rely on colleges to be their home away from home, a place where they can work and learn in a structured, safe, and healthy environment, not to mention the social benefits.

Consequently, coming back to campus poses a serious financial and ethical question. Like anything else, college and higher education is a business. Consumers want to get the most for their money, and the colleges and universities need consumers to engage to have a sustainable business model. The pandemic has shifted the conversation in many areas of life, higher education included.

This issue is especially complicated because it can be broken down from multiple perspectives. For example, an economic point of view argues that colleges are only re-opening because they need the money. Like many other businesses, they stay open because they have no other choice. Without the money generated through tuition and other forms of revenue like donation and state funding, it would take years for schools to recover from the impact of COVID. But college is a substantial investment for families. Why should consumers be expected to pay full (or reduced) tuition for an experience that is more like a monastery than college? Will the investment really be worth it if schools are simply shut down again because of an outbreak at a campus party?

On the other hand, if students aren’t in school come fall semester, what else would they be doing? Most students are hard-pressed to find a job or internship that’s worth taking a semester off for in this environment. And time off may push back a student’s graduation time, putting them behind the rest of their peers. For very legitimate reasons, students want to come to campus and keep their college experience intact.

This seems to be where my own expectations fall. I have no idea if the situation will improve between now and the spring semester. To me, the only course of action is to enjoy the experience that I will have, even if it means wearing a mask.

Talia is a Washington, DC native and a rising sophomore at Wesleyan University, where she is studying English. Beyond health policy, Talia’s interests are in journalism, law, and social justice.

Reopening the economy prematurely has dire consequences for states

By NCL Health Policy intern Talia Zitner

The past month has seen a serious surge in reported coronavirus cases in the United States. It seems the virus is going to be with us for a while. Of states where COVID is spiking, the majority are in the South, many of which had ambitious reopening plans that are now being reconsidered.

Three of these states—Texas, Florida, and Arizona—have current surges. All three pushed to reopen their economies early in an attempt to “return to normal.” The current deluge in cases that resulted was due to a lack of continuing stay-at-home order and a failure to require masks.

Texas officially started Phase 1 of its reopening plan on May 1, but—as of June 26—had to retract much of the opening that it had started. In total, Texas was only able to reopen the state for 55 days. As of July 27, Texas has seen an average of 8,089 new cases of the coronavirus over a seven-day period. Compared to cases in April, when there were 814, this is astounding. Texas Governor Greg Abbott (R) has since ordered everyone to start wearing face masks and has limited the size of public gatherings.

It does not appear that Texas will shut down again, however. As the governor said, “we need to refocus on slowing the spread, but this time we want to do it without closing down Texas again.” Although it is an issue of public health, the issuance of a statewide masking policy and the staggered re-opening of the economy has become a matter of contention across party lines. Some residents find the Governor’s actions to be inadequate, and others feel as if the newly implemented precautions impede their personal liberties.

Florida and Arizona are not faring much better. As of April, Florida had 1,027 cases reported. In July, it was 6,563. Florida started its reopening plan on May 4 and entered into Phase 2 on June 5. Clearly, cases have surged.

Earlier this week, Florida reported 8,892 new COVID-19 cases. Like Texas, there seems to be a mixed reaction among Florida representatives to slow the spread of the virus. Senator Rick Scott (R) has been vocal about his intentions for Florida, and it appears the state will not roll back any of its reopening course. As Senator Scott put it a couple of months ago, “wearing a mask is a choice you get to make.”

Like Texas and Florida, Arizona is hurting badly, with only 115 in April surging to 4,753 cases in July. Arizona’s stay-at-home order lasted until May 15, and was replaced by the new Stay Healthy, Return Smarter, Return Stronger Executive Order, on May 16. When Arizona first reopened, Governor Doug Ducey did not require residents to wear face masks, but as the case numbers increased, he allowed local governments to set their own masking policies. As of July 1, officials said that Arizona saw the highest rate of new cases in the entire country.

Many public officials are starting to realize opening too soon was foolhardy and has spread the virus. New revelations by scientists show the virus can actually be airborne, urging those to take indoor transmission more seriously. The virus is also proving to be more of a blood vessel disease than solely a respiratory one, which may lead to long-term impacts that doctors are still learning about.

There’s one takeaway here: following the example of states like Texas, Florida, and Arizona is not recommended. The more seriously states take this crisis the better, and the sooner the entire country will be able to move towards a newer, safer “normal”.

Talia is a Washington, DC native and a rising sophomore at Wesleyan University, where she is studying English. Beyond health policy, Talia’s interests are in journalism, law, and social justice.