WHAT YOU NEED TO KNOW

​Everyone is waiting for a vaccine for COVID-19, and it seems like everyone’s working on making one. According to the World Health Organization, more than 130 vaccines are currently in development, and experts are optimistic that a viable one will be available as soon as early 2021—an incredibly fast turnaround, considering that most vaccines spend up to 10 years in development. What does racing toward a vaccine mean for its safety and effectiveness? The Guardian interviewed two public health experts, who explain how vaccines are made and how they work to protect you from getting sick, and who caution that even if the first vaccines aren’t “perfect” (i.e., they may not confer total immunity to COVID-19), they will still be helpful because they will decrease the severity of illness if you contract the virus. And even when a vaccine is ready for primetime, there will be other hurdles to overcome, including producing enough of it quickly to meet the demand and distributing it—as well as convincing people to vaccinate.

 

The opioid epidemic rages on, as doctors, dentists, and other healthcare providers continue to overprescribe the highly addictive pain medications—putting tens of millions of patients at risk for addiction, overdose, and death. According to the Centers for Disease Control and Prevention (CDC), in 2018, 1 in 5 Americans filled an opioid prescription, and 40 Americans died each day from prescription opioids. Yet recent public data shows that despite the known dangers of opioids and efforts to raise awareness, opioids are still routinely prescribed for mild conditions, such as back pain and headaches, that could be treated better and more safely with over-the- counter drugs, or even a simple ice pack. The continued overuse of opioids is having a devastating impact on people, families, and communities around the United States; CDC data indicates that some parts of the country have an opioid prescription rate two to six times the national average. To prevent patients from developing opioid use disorder, physicians and dentists will have to break some bad habits of their own, and stop prescribing opioid pills so aggressively.

Service workers are struggling to deal with customers who refuse to wear masks in restaurants, coffee shops, and retail stores, and the verbal (and sometimes physical) abuse they receive is having a negative impact on their mental health. It turns out that the employees who are trying to do their jobs—protecting themselves and other customers—and the so-called anti-maskers are sharing virtual spaces as well. However, sites like TikTok, a video-sharing social network, and the ubiquitous Facebook, offer each group something different. Service workers increasingly are finding online support groups like Retail Life, where they can vent their frustrations with other people in the same position and share videos and stories about their clashes with customers who refuse to wear a mask, while anti-mask activists are using the same platforms to organize and share tips on getting around mask mandates. For example, barista Morgan Eckroth made a video about how she and a co-worker were attacked with bear mace by an angry customer—a video which has received more than 1.3 million views and a slew of sympathetic comments. On the other side of the debate, the Facebook group Bare Face is Legal encourages its members to avoid wearing a mask on a plane by eating during the entire flight. The result is that these local confrontations are playing out on an international stage, and the war of ideologies is being waged on the internet for all to see, adding more fuel to the fiery debate.

With all the questions we still have about COVID-19, we do know one thing: Seniors are at high risk for a severe illness if they contract the virus, and they may never re- cover to their previous competence if they survive. Older people also may have under- lying conditions—such as diabetes and heart disease—that put them at even greater risk for hospitalization. So what’s the best way for them to avoid getting sick? Staying home is obviously the safest option, but without consistent guidance from the Cen- ters for Disease Control and Prevention, and with changing recommendations and requirements from state and local governments, most seniors are left to do the math and make their own decisions on what chances they are willing to take. And while lockdown might be the best option, it is hardly the most appealing, so their calcula- tions must also take into account the loved ones they want to see, the vacations and activities they’ve been planning for retirement, and even a much-needed haircut. The decision isn’t easy, but it’s important for seniors to consider their own health and medical history and pay attention to what’s happening with COVID-19 in their com- munities. It all comes down to an individual choice about what you’re comfortable with, but whatever you decide, stick with what all the experts agree works and take the basic precautions of wearing masks, social distancing, choosing outdoor activities over indoor ones, washing your hands—and keeping up with your vaccinations.

Residents of long-term care facilities are among the most vulnerable to COVID-19, and once the virus is introduced it can spread quickly, infecting both residents and staff. In Ohio as of July 16, 70% of COVID-19 deaths were nursing home residents— more than 2,100 people. Keeping them safe is the utmost priority, and JAG Healthcare in Burbank, Ohio, has been doing just that. So far, they haven’t had a single case of COVID-19. But how did they manage that? They say that the secret to their success was acting quickly when the pandemic began, and they’ve gone to extreme lengths to protect everyone in their facility. It takes diligence from staff both at work and in the outside world: They enter through one door, where they are questioned for symptoms and have their temperature checked. They have had an adequate supply of personal protective equipment (PPE). They enforce social distancing among residents while activities continue. And like most long-term care facilities, they have a strict no-visi- tor policy indoors, although families can still see their loved ones through a window or closed door. While they know that an outbreak can happen in any facility at any time, no matter what precautions they take, they continue to do their best to mitigate that risk—and it’s working.

Only 70 years ago, operating on a beating heart was unthinkable, but thanks to trail- blazing surgeons, open cardiac surgery is now a reality, and generally successful. BBC Future shares some stories of these pioneers, including John Lewis, who in 1952 was the first to induce hypothermia to slow a 5-year-old girl’s heart—buying him just six minutes to locate a hole in her heart, sew it up, and close the wound. Two years later, Lewis’ assistant Walton Lillehei revolutionized heart surgery with another procedure called cross-circulation, in which blood is pumped from the surgical patient into a donor with the same blood type for oxygenation. This would isolate the heart but double the risk, potentially killing two people if something went wrong. Fortunately nothing went wrong in his first attempt, on a one-year-old boy whose father served as a donor, and the next surgery was successful as well. Lillehei later helped develop the heart-lung machine (originated by John Gibbon in 1953, with mixed results), which provides a less risky way of keeping cardiac patients alive during an operation, as well as the earliest pacemakers. The groundbreaking work of people like these still serve as the foundation for surgeries today.

 

Being pregnant in a world with COVID-19 probably sounds less than ideal, even if it offers some the unexpected benefit of getting to work from home. Expecting moms are struggling with the additional stresses of pandemic restrictions, for example need- ing to go to doctor’s appointments alone and limiting family interactions. Then there’s the fear of getting COVID-19 and how it can affect the pregnancy. And pregnancy does add some risks. A study from the Centers for Disease Control and Prevention suggests that pregnant women may be more likely to suffer severe symptoms than other wom- en, and French physicians recently shared a case in which a newborn seems to have contracted COVID-19 from his mother in utero. But data from these early studies of the novel virus are still scant and there is much we don’t know about COVID-19 and its impact on pregnancy, so caution and healthy habits are still recommended: stay home as much as possible, wear a mask, wash your hands. But balance this with other necessities for you and your baby. Get regular fresh air and exercise, continue your prenatal visits, and live your life—and plan for the future—as joyfully and hopefully as you can.