Britain made a mistake in focusing too much on preparations for a flu pandemic rather than considering other types of pandemic in the years before the COVID-19 outbreak, former Prime Minister David Cameron told a public inquiry Monday.
Cameron, who led Britain’s Conservative government from 2010 to 2016, was the first politician to be questioned by the wide-ranging inquiry into the U.K.’s preparedness for the coronavirus pandemic, how the government responded and what lessons can be learned for the future.
The U.K. had one of the highest COVID-19 death tolls in Europe, with the virus recorded as a cause of death for almost 227,000 people.
Giving evidence under oath, Cameron said that during his time in office, officials were too narrowly focused on the dangers of an influenza pandemic. Not enough questions were asked about the possibility of an outbreak of other highly infectious respiratory diseases, he said.
“So much time was spent on a pandemic influenza and that was seen as the greatest danger,” Cameron said.
He said his government did look at other pandemics, including MERS and SARS. But he added: “I think the failing was not to ask more questions about asymptomatic transmission, highly infectious … what turned out to be the pandemic we had.”
He said many countries were “in the same boat of not knowing what was coming,” but he argued that the U.K. did better than many to “scan the horizon, to try and plan” for a pandemic.
Cameron also rejected accusations that austerity measures under his leadership that cut government spending on public services left the U.K.’s National Health Service much more vulnerable to the pandemic.
Earlier, the British Medical Association, the doctors’ union, argued that Cameron’s austerity policies led to years of damage to public health care and a “failure to prioritize the nation’s health.”
“The U.K. was severely on the back foot when COVID took hold, and this proved disastrous,” said Philip Banfield, chair of council at the union.
The official inquiry, led by a retired judge, is set to take three years to complete. Former Prime Minister Boris Johnson, who led the U.K. during the pandemic, agreed in late 2021 to hold the probe after heavy pressure from bereaved families.
Many other senior politicians are expected to be called to face questions. On Wednesday Jeremy Hunt, the current Treasury chief and former health secretary, and deputy prime minister Oliver Dowden are due to testify.
The pandemic and how Britain’s government handled it is a topic that is again dominating headlines after lawmakers issued a scathing report last week concluding that Johnson deliberately misled Parliament over lockdown-flouting staff parties at his office.
More than 1 million people have been dropped from Medicaid in the past couple months as some states moved swiftly to halt health care coverage following the end of the coronavirus pandemic.
“Pushing through things and rushing it will lead to eligible people — kids and families — losing coverage for some period of time,” Daniel Tsai, a top federal Medicaid official recently told reporters.
Already, about 1.5 million people have been removed from Medicaid in more than two dozen states that started the process in April or May, according to publicly available reports and data obtained by The Associated Press.
Florida has dropped several hundred thousand people, by far the most among states. The drop rate also has been particularly high in other states. For people whose cases were decided in May, around half or more got dropped in Arkansas, Idaho, Kansas, Nevada, New Hampshire, Oklahoma, South Dakota, Utah and West Virginia.
By its own count, Arkansas has dropped more than 140,000 people from Medicaid.
The eligibility redeterminations have created headaches for Jennifer Mojica, 28, who was told in April that she no longer qualified for Medicaid because Arkansas had incorrectly determined her income was above the limit.
She got that resolved, but was then told her 5-year-old son was being dropped from Medicaid because she had requested his cancellation — something that never happened, she said. Her son’s coverage has been restored, but now Mojica says she’s been told her husband no longer qualifies. The uncertainty has been frustrating, she said.
“It was like fixing one thing and then another problem came up, and they fixed it and then something else came up,” Mojica said.
Arkansas officials said they have tried to renew coverage automatically for as many people as possible and placed a special emphasis on reaching families with children. But a 2021 state law requires the post-pandemic eligibility redeterminations to be completed in six months, and the state will continue “to swiftly disenroll individuals who are no longer eligible,” the Department of Human Services said in statement.
Arkansas Gov. Sarah Huckabee Sanders has dismissed criticism of the state’s process.
“Those who do not qualify for Medicaid are taking resources from those who need them,” Sanders said on Twitter last month. “But the pandemic is over — and we are leading the way back to normalcy.”
More than 93 million people nationwide were enrolled in Medicaid as of the most recent available data in February — up nearly one-third from the pre-pandemic total in January 2020. The rolls swelled because federal law prohibited states from removing people from Medicaid during the health emergency in exchange for providing states with increased funding.
Now that eligibility reviews have resumed, states have begun plowing through a backlog of cases to determine whether people’s income or life circumstances have changed. States have a year to complete the process. But tracking down responses from everyone has proved difficult, because some people have moved, changed contact information or disregarded mailings about the renewal process.
Before dropping people from Medicaid, the Florida Department of Children and Families said it makes between five and 13 contact attempts, including texts, emails and phone calls. Yet the department said 152,600 people have been non-responsive.
Their coverage could be restored retroactively, if people submit information showing their eligibility up to 90 days after their deadline.
Unlike some states, Idaho continued to evaluate people’s Medicaid eligibility during the pandemic even though it didn’t remove anyone. When the enrollment freeze ended in April, Idaho started processing those cases — dropping nearly 67,000 of the 92,000 people whose cases have been decided so far.
“I think there’s still a lot of confusion among families on what’s happening,” said Hillarie Hagen, a health policy associate at the nonprofit Idaho Voices for Children.
She added, “We’re likely to see people showing up at a doctor’s office in the coming months not knowing they’ve lost Medicaid.”
Advocates fear that many households losing coverage may include children who are actually still eligible, because Medicaid covers children at higher income levels than their parents or guardians. A report last year by the U.S. Department of Health and Human Services forecast that children would be disproportionately impacted, with more than half of those disenrolled still actually eligible.
That’s difficult to confirm, however, because the federal Centers for Medicare & Medicaid Services doesn’t require states to report a demographic breakdown of those dropped. In fact, CMS has yet to release any state-by-state data. The AP obtained data directly from states and from other groups that have been collecting it.
Medicaid recipients in numerous states have described the eligibility redetermination process as frustrating.
Julie Talamo, of Port Richey, Florida, said she called state officials every day for weeks, spending hours on hold, when she was trying to ensure her 19-year-old special-needs son, Thomas, was going to stay on Medicaid.
She knew her own coverage would end but was shocked to hear Thomas’ coverage would be whittled down to a different program that could force her family to pay $2,000 per month. Eventually, an activist put Talamo in contact with a senior state healthcare official who confirmed her son would stay on Medicaid.
“This system was designed to fail people,” Talamo said of the haphazard process.
Some states haven’t been able to complete all the eligibility determinations that are due each month. Pennsylvania reported more than 100,000 incomplete cases in both April and May. Tens of thousands of cases also remained incomplete in April or May in Arizona, Arkansas, Indiana, Iowa, New Mexico and Ohio.
“If states are already behind in processing renewals, that’s going to snowball over time,” said Tricia Brooks, a research professor at the Georgetown University Center for Children and Families. “Once they get piles of stuff that haven’t been processed, I don’t see how they catch up easily.”
Among those still hanging in the balance is Gary Rush, 67, who said he was notified in April that he would lose Medicaid coverage. The Pittsburgh resident said he was told that his retirement accounts make him ineligible, even though he said he doesn’t draw from them. Rush appealed with the help of an advocacy group and, at a hearing this past week, was told he has until July to get rid of about $60,000 in savings.
Still, Rush said he doesn’t know what he will do if he loses coverage for his diabetes medication, which costs about $700 a month. Rush said he gets $1,100 a month from Social Security.
In Indiana, Samantha Richards, 35, said she has been on Medicaid her whole life and currently works two part-time jobs as a custodian. Richards recalled receiving a letter earlier this year indicating that the pandemic-era Medicaid protection was ending. She said a local advocacy group helped her navigate the renewal process. But she remains uneasy.
“Medicaid can be a little unpredictable,” Richards said. “There is still that concern that just out of nowhere, I will either get a letter saying that we have to reapply because we missed some paperwork, or I missed a deadline, or I’m going to show up at the doctor’s office or the pharmacy and they’re going to say, ‘Your insurance didn’t go through.’”
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Lieb reported from Jefferson City, Missouri, and DeMillo from Little Rock, Arkansas. Also contributing were AP reporters Anthony Izaguirre in Tallahassee, Florida; Marc Levy in Harrisburg, Pennsylvania; and Arleigh Rodgers in Bloomington, Indiana. Rodgers is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.
The next round of COVID-19 vaccines will target one of the latest versions of the coronavirus, the Food and Drug Administration said Friday.
FDA’s decision came one day after an agency panel of outside advisers supported the recipe change. The agency told vaccine makers to provide protection against just one omicron strain, known as XBB.1.5.
Today’s shots include the original coronavirus and an earlier version of omicron. They do still help prevent severe disease and death even as XBB variants have taken over. But protection gradually wanes over time and was short-lived against milder infection even before the virus, inevitably, evolved again.
The three U.S. companies that make COVID-19 shots said this week they had geared up to make the formula change, in anticipation of making many millions of doses available for the fall. One company, Pfizer, said it could have at least some doses ready as early as next month.
The Centers for Disease Control and Prevention will eventually decide whether to recommend the shot for nearly all Americans or just for certain high-risk groups.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
The COVID-19 vaccines are on track for a big recipe change this fall.
Today’s vaccines still contain the original coronavirus strain, the one that started the pandemic — even though that was long ago supplanted by mutated versions as the virus rapidly evolves.
Thursday, the Food and Drug Administration’s scientific advisers reviewed whether the next round of shots in the U.S. should only include protection against the newest variants that are now dominant worldwide — a branch of the omicron family tree named XBB.
While infections have declined, the virus could be a real concern next winter, FDA’s vaccine chief Dr. Peter Marks said as the daylong meeting began.
“We’re concerned that we may have another wave of COVID-19 during a time when the virus has further evolved, immunity of the population has waned further, and we move indoors for wintertime,” he said.
Here are some things to know:
WHY ANOTHER ROUND OF SHOTS?
The FDA told Americans to expect an updated fall vaccine against COVID-19, just like they get a new flu shot every fall. Even though most of the population has either been infected or had at least one round of vaccinations, the coronavirus keeps churning out new varieties.
What’s in use in the U.S. now are combination shots from Pfizer and Moderna that mix the original strain with protection against last year’s most common omicron variants, called BA.4 and BA.5. But just 17% of Americans rolled up their sleeves for a combo booster.
And while the FDA did allow seniors and others at high risk to get an extra booster dose this spring, most people will be many months beyond their last shot by fall.
Those currently available shots do still help prevent severe disease and death even as XBB variants have taken over. But protection gradually wanes over time and was short-lived against milder infection even before the virus, inevitably, evolved again.
SHARPENING PROTECTION
Last year when regulators were struggling to decide how to update the vaccine, a combo shot seemed like the safest bet. Omicron was pretty new, and there was no way to know how long it would stick around or if the next big coronavirus change would more resemble the original strain.
Now, “there’s no reason really to keep the original strain in there,” said Dr. Rachel Presti, an infectious disease specialist at Washington University in St. Louis. She is not on the FDA panel.
Doing so actually has a downside called “imprinting.” After repeated exposure to the original strain, people’s immune systems tended to recognize and respond more strongly to it than to the half of the new booster dose that was brand new.
So the FDA is leaning toward dropping the original strain and picking a fall shot recipe that targets just XBB. The hope is that the XBB variants are different enough to spark the immune system to make more diverse, cross-protective virus-fighting antibodies.
The World Health Organization’s vaccine advisers and European regulators recently made similar recommendations.
PREDICTING WHAT WILL HIT THIS WINTER
Another challenge: Deciding which XBB variant to target — since what’s spreading now likely will have mutated again by winter.
Regulators will be making their best guess, just like they do every year in setting the recipe for the fall flu vaccine.
The FDA has identified three XBB subtypes as the top strain choices. Vaccine makers already have been developing XBB-targeted formulas, and FDA’s outside advisers on Thursday will review new data on how well those choices rev up the immune system.
HOW MANY MORE SHOTS?
The FDA’s advisers will debate that, too. Older adults and others at high risk because of seriously weak immune systems continue to have the highest rates of hospitalization from COVID-19 even as cases have declined. One question is whether they’ll be urged to get a single fall shot or be eligible for more than one.
Another is how many doses the youngest children who’ve never been vaccinated would need.
Ultimately, the Centers for Disease Control and Prevention will make the final recommendations.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
The homicide rate for older U.S. teenagers rose to its highest point in nearly 25 years during the COVID-19 pandemic, and the suicide rate for adults in their early 20s was the worst in more than 50 years, government researchers said Thursday.
The Centers for Disease Control and Prevention report examined the homicide and suicide rates among 10- to 24-year-olds from 2001 to 2021.
The increase is alarming and “reflects a mental health crisis among young people and a need for a number of policy changes,” said Dr. Steven Woolf, a Virginia Commonwealth University researcher who studies U.S. death trends and wasn’t involved in the CDC report.
Experts cited several possible reasons for the increases, including higher rates of depression, limited availability of mental health services and the number of guns in U.S. homes.
Guns were used in 54% of suicides and 93% of homicides among the age group in 2021, the most recent year for which statistics were available.
“Picture a teenager sitting in their bedroom feeling desperate and making a decision, impulsively, to take their own life,” Woolf said. If they have access to a gun, “it’s game over.”
Suicide and homicide were the second and third leading causes of death for 10- to 24-year-olds, after a category of accidental deaths that includes motor vehicle crashes, falls, drownings and overdoses. Other researchers have grouped the data by the method of death, and concluded that guns are now the biggest killer of U.S. children.
Earlier this year, Woolf and other researchers looking at CDC data noted dramatic increases in child and adolescent death rates overall at the beginning of the pandemic, and found suicide and homicide were important factors.
The report also found:
—Suicide and homicide death rates remained far higher for older teenagers and young adults than they were for 10- to 14-year-olds.
—In 2021, there were about 2,900 suicides in youths ages 10 to 19, and 4,200 in 20- to 24-year-olds. About 3,000 homicide deaths were reported in the younger group, and nearly 3,900 in the adults in their early 20s.
—The homicide death rate jumped from 8.9 deaths per 100,000 teens aged 15 to 19 in 2019 to 12.3 in 2020. It rose to 12.8 deaths per 100,000 in 2021, the highest since 1997, according to CDC data.
—Homicide deaths became more common than suicide deaths among 15- to 19-year-olds, while suicide was more common in the younger and older age groups.
—While large increases were seen in homicide rates for young Black and Hispanic people in the U.S., there were not significant increases for their white counterparts, other CDC data shows.
—Among 20- to 24-year-olds, the homicide death rate jumped 34% from 2019 to 2020 — from 13.4 per 100,000 population to 18 per 100,000. It held stable in 2021, but the suicide rate rose enough in 2021 — to 19.4 per 100,000 — to surpass the homicide rate.
Suicide death rates in children and teens were rising before COVID-19, but they jumped up at the beginning of the pandemic. Dr. Madhukar Trivedi, a psychiatrist at the University of Texas Southwestern Medical Center, said the reasons may be hard to pinpoint, but that isolation during COVID-19 lockdowns could be a factor.
“There is a misperception that if you talk to young people about depression, they’ll get depressed. A don’t-ask, don’t-tell policy for depression is not effective,” Trivedi said. “The earlier we can identify the ones who need help, the better chance we’ll have at saving lives.”
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
A mammoth three-year public inquiry into the U.K. government’s handling of the response to COVID-19 opened Tuesday by asking whether suffering and death could have been avoided with better planning.
Lawyer Hugo Keith, who is counsel to the inquiry, said the coronavirus pandemic had brought “death and illness on an unprecedented scale” in modern Britain. He said that COVID-19 has been recorded as a cause of death for 226,977 people in the U.K.
“The key issue is whether that impact was inevitable,” Keith said. “Were those terrible consequences inexorable, or were they avoidable or capable of mitigation?”
A group of people who lost relatives to COVID-19 held pictures of their loved one outside the inquiry venue, an anonymous London office building. The first day of public hearings began with a 17-minute video in which people described the devastating impact of the pandemic on them and their loved ones.
Britain’s pandemic death toll is one of the highest in Europe, and the decisions of then Prime Minister Boris Johnson’s government have been endlessly debated. Johnson agreed in late 2021 to hold an inquiry after pressure from bereaved families.
The inquiry, led by retired judge Heather Hallett, is due to hold hearings until 2026. It is due to investigate the U.K.’s preparedness for a pandemic, how the government responded and what lessons can be learned for the future.
Senior scientists and officials including Johnson are expected to appear as witnesses. Hallett, who has the power to summon evidence and question witnesses under oath, is currently in a legal battle with the government over her request to see an unedited trove of notebooks, diaries and WhatsApp messages between Johnson and other officials.
U.K. public inquiries are often thorough, but rarely quick. An inquiry into the 2003 Iraq war and its aftermath began in 2009 and issued its 2.6-million word report in 2016.
Hallett says she will release findings after each section rather than waiting until hearings conclude.
Keith said the first section would look at whether British planning relied too heavily on the mistaken assumption a future pandemic would resemble influenza.
He said that at the start of the pandemic in March 2020, the government had said that “the United Kingdom was well prepared to respond in a way that offered substantial protection to the public.”
“Even at this stage, before hearing the evidence, it is apparent that we might not have been very well prepared at all,” he said.
