Health

There is no solution to the GOP's vaccine refusal

In the past six months, we've all witnessed the near-miraculous effectiveness of the vaccines against COVID-19 and President Joe Biden's success at turning the joke of Donald Trump's vaccine plan into a well-oiled machine. Anyone who wants the shot in the U.S. can get it. Yet, despite an initial surge of interest in vaccines in the mid-spring, there's been a drastic drop-off in vaccination rates just ahead of Biden's Independence Day goal for a return to summer grilling.

"The United States is averaging fewer than 1 million shots per day, a decline of more than two-thirds from the peak of 3.4 million in April," the Washington Post reports, noting that "[s]mall armies of health workers and volunteers often outnumber the people showing up to get shots at clinics" in more conservative areas like Utah, North Carolina and Tennessee.

"Experts are concerned that states across the South, where vaccination rates are lagging, could face a surge in coronavirus cases over the summer," the New York Times further reports. While many states in the Northeast have reached Biden's 70% benchmark, the Times notes that only "about half of adults or fewer have received a dose" in 15 red states.

As vaccine rates have been lagging, a number of reasons for what tends to be called "vaccine hesitancy" have been documented through polls and other research. Issues include a lack of access, skepticism that COVID-19 is particularly dangerous, a lack of trust in the vaccines, a belief in conspiracy theories and fear of side effects.

No doubt all these aspects are true to one extent or another, and there's certainly evidence that some working-class people simply are struggling to find the time to get the shots and recover from them. But the glaring geographical differences give away the one deeply uncomfortable reality about what is driving much, if not most, of the discrepancies in vaccination rates: Republicans are refusing to get vaccinated out of pure spite.

Both Trump and Fox News made it clear in the early days of the pandemic that taking COVID-19 seriously is something only hated liberals would do. To show their right-wing bona fides, it was important for Republican voters to refuse to do anything that would suggest they are concerned about getting sick, which would be seen as disloyalty not only to Trump but to the right-wing cause. This is even though Trump himself got very sick from COVID-19 and then, as soon as it was available, got the vaccine. And it clearly persists, even though the political usefulness of COVID-19 denialism ended when Trump's presidency did.

As Politico's health care reporters Dan Goldberg and Alice Miranda Ollstein wrote on Saturday, the "partisan divide in Covid-19 vaccinations is becoming starker," as evidenced by the fact that all "but one of the 39 congressional districts where at least 60 percent of residents have received a coronavirus shot are represented by Democrats" and "Republicans represent all but two of the 30 districts where fewer than one-third of residents have received a shot."

Another giveaway is how Republican politicians have downplayed the role tribal loyalty and COVID-19 denialism are playing in the vaccine slowdown.

On Sunday morning, Mississippi's Gov. Tate Reeves, in full gaslighting mode to Jake Tapper of CNN, insisted that he believes "all Americans should go get vaccinated because I think it's safe," that that "individuals can make their own decision, Jake, as to how to protect themselves and families."

This is, of course, full-blown nonsense. People aren't carefully researching how best to protect themselves and their families. If that was the case, they'd be lining up for shots because — outside of a few rare cases where people are immunocompromised — the single best and safest way to protect yourself and your family is to get vaccinated.

No, what's actually happening in these red states is that people are putting themselves and their families at risk, deliberately. And they're doing it because Trump spent months downplaying the threat of COVID-19 and making it a loyalty test for his people to do the same. It's also clear that a lot of the fears of vaccine safety being offered to researchers as reasons for vaccine hesitancy are, in fact, just a cover story for the mindless tribalism of the right.

Part of the problem is Trump's ability to convince people to give up their own safety and security in order to prove their loyalty to him. Recall how cronies like Michael Cohen and Rudy Giuliani ended up in deep but predictable legal trouble after sticking their neck out for Trump? Hundreds of Capitol rioters are now facing fines or jail time because they stormed the Capitol for an ungrateful Trump. As hard as it is for those of us who see this comically dressed, half-literate sociopathic narcissist for who he is, there can be no doubt of the hold he has over some people.

Still, the widespread nature of vaccine refusal in the red states suggests this is actually about much more than Trump the cult leader, especially as he himself has gotten the shot. In fact, the whole situation illustrates how certain lies take on a life of their own on the right, becoming identity markers that far outlast their political expediency. In other words, getting the vaccine would be an admission for conservatives that they were wrong about COVID-19 in the first place, and that liberals were right. And for much of red-state America, that's apparently a far worse fate than death.

Of course, adding to the problem is that right-wing media has not abandoned the idea that there's something "liberal" and therefore evil about admitting that medical scientists know stuff. Right-wing media figures keep bashing Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, with increasingly convoluted conspiracy theories involving his emails that no one, right or left, can follow. Such conspiracy theories are incoherent by design. They aren't meant to be understood, so much as to create an air of suspicion around Dr. Fauci and public health officials generally, and to reaffirm that being a true member of the conservative tribe means hating such people.

On Fox News, the message to the audience is quite clear: Real conservatives prove themselves by rejecting the vaccine. Most recently, Tucker Carlson was on air ranting about how it's "medical Jim Crow" to expect people to get vaccinated to protect others. Besides being language designed to minimize the seriousness of actual racism, this kind of rhetoric is also about falsely telling conservative Americans they are akin to a marginalized ethnic group. Refusing vaccination is a way to show off your tribal membership, like wearing a MAGA hat or deliberately getting an ugly haircut, except deadlier.

Outside of mandates or raising the penalties by barring the unvaccinated from public spaces, there's not much to be done now to change Trumper minds on vaccines. They know being unvaccinated is irrational. Being irrational is the appeal. They know how much irrationality annoys liberals. This is one of those situations where, the more that people outside of the Trump tribe push, the more the Trumpers will dig in their heels, ready to stick it to the rest of the country by acting like stubborn asses.

The only solution may be reverse psychology.

People who want the pandemic to end need to, paradoxically, release the desire to see conservatives get vaccinated. The more zen that liberals (or people perceived to be liberals) are about vaccination rates, the less fun it is to try to piss liberals off by refusing to get the shot. Well-intentioned goals, like Biden's 70% by July 4 deadline, end up backfiring. If Biden wants it, then conservatives will, like bratty children, refuse to do it just to stick it to him.

The good news is that, as painful as it is for Democrats to admit, there seems to be a growing acceptance that it's unwise to let Republican anti-vaxxers hold the rest of us hostage. Lockdowns and mask mandates are relaxing, even in blue areas, despite not meeting vaccination goals. While this is less than ideal, it's better than the alternative: keeping those measures in place and trying to incentivize conservatives, who are motivated purely by spite and will thus continue to refuse the shot.

They aren't getting shots in order to troll the liberals. Time to stop feeding the trolls and let them get sick if they really want to play.

Beyond 'back to normal' – 5 research-based tips for emerging from pandemic life

by Bethany Teachman, University of Virginia

You've been waiting… and waiting… and waiting for this amazing, magical day when you could return to “normal life."

For many people in the U.S., it feels like that dim light at the end of the pandemic tunnel is becoming brighter. My 12- and 14-year-old daughters now have their first shot, with the second one soon to follow. I was euphoric when the kids received their vaccinations, choking up under my mask at the relief that my family was now unlikely to get sick or pass the coronavirus on to others more vulnerable than we are. Finally our family could start returning to so-called normal life.

But what should those of us fortunate enough to be vaccinated return to? I didn't exactly feel euphoric each day in my normal life pre-COVID-19. How should you choose what to rebuild, what to leave behind and what new paths to try for the first time? Clinical psychological science provides some helpful clues for how to chart your course out of pandemic life.

1. Set realistic expectations

You are less likely to be disappointed if you set reasonable expectations.

For instance, you'll likely feel some anxiety as you try to figure out what's OK to do and what's still risky. Even as the risk level has declined in many places, there is still uncertainty and unpredictability tied to the current coronavirus risks, and it's natural to feel anxious or ambivalent when letting go of an established habit, like wearing masks. So, be ready for some anxiety and realize it doesn't mean something is wrong – it's a natural reaction to a very unnatural situation.

It's also likely that many social interactions will feel a little awkward at first. Most Americans are out of practice socializing, and repeated practice is what helps us feel comfortable.

Even if your social skills were at their peak, the current moment serves up a lot to navigate interpersonally. Chances are you won't always agree with the people in your life on where to draw the lines about what's safe and what's not. There are going to be some complicated July Fourth parties to navigate given many families have some members vaccinated and some not. That will be frustrating after waiting so long to finally get together.

And you won't automatically have warm, fuzzy feelings about all your colleagues, family, friends and neighbors. Many of those little annoyances that cropped up in your interactions before you ever heard of COVID-19 will still be there.

So, expect some awkwardness, frustration and annoyance – everyone's creating new patterns and adjusting to changed relationships. This should all get easier with time and practice, but having realistic expectations can make the transition smoother.

2. Live your values

To help plan which activities and relationships to put time into, think about your priorities.

Living in ways that are consistent with your values can promote well-being and reduce anxiety and depression. Many therapeutic exercises are designed to help reduce the discrepancy between your stated values and the choices you make day to day.

Imagine you are asked to carve a pie to illustrate your different roles and how important each is to the way you feel about yourself and the values you prioritize. You might value your roles as a mother, a spouse and a friend most highly, assigning them the biggest pieces of your pie.

Now, what if you were asked to carve that pie in a way that reflects how you actually allocate your time and energy, or how you actually tend to evaluate yourself. Is the time you spend with friends much lower than its value to you? Is the tendency to judge yourself based on rigid work demands much higher?

Of course, time is not the only meaningful metric, and all of us have periods when certain parts of our lives need to dominate – think about life as a parent of a newborn, or a student during final exams. But this process of considering your values and trying to align what you value and how you live can help guide your choices during this complex time.

3. Keep track

Clinical psychologists recommend engaging in activities that feel rewarding in some way to stave off negative moods. Doing things that are pleasurable, that provide a sense of accomplishment or help you meet your goals can all feel rewarding, so this isn't just about having fun.

For most people, some balance of fun, productive, social, active and relaxing activities in life is key to feeling like your different needs are being met. So, try keeping track of your activities and mood for a week. See when you feel more or less happy and when you feel like you're meeting your goals, and adjust accordingly. It will take some trial and error to find the balance of activities that provides that sense of reward.

4. Is this a time of growth or preservation?

There is fascinating research showing that the perception of time can influence your goals and motivation. If you feel time is waning – as often occurs for older adults or those experiencing a serious illness – you are likely to seek deeper connections with a smaller number of people. Alternatively, those who feel time is open-ended and expansive tend to seek new relationships and experiences.

As restrictions loosen, are you desperate to visit a close friend in the town you grew up in? Or more excited to travel to an exotic location and make new friends? There isn't a right answer, but this research can help you consider your current priorities and plan that next reunion or trip accordingly.

5. Recognize your privilege and pay it forward

If you are vaccinated and healthy and can return to more normal activities, then you are in a fortunate group after a year of such devastating losses. As you plan how to use this time, consider the research showing that your emotional health improves when you do things to benefit others.

Being intentional about helping others is a win-win. Many people and communities are in need right now, so think about how you can contribute – be it time, money, resources, skills or a listening ear. Asking what your community needs to recover and thrive and how you can help address those needs, as well as considering what you and your household need, can boost everyone's well-being.

As the return to so-called normal life becomes more of a reality, don't idealize post-pandemic life or you are bound to be disappointed. Instead, be grateful and intentional about what you choose to do with this gift of a reboot. With a little thought, you can do better than “normal."

[Research into coronavirus and other news from science Subscribe to The Conversation's new science newsletter.]The Conversation

Bethany Teachman, Professor of Psychology, University of Virginia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How Trump and his allies are trying to use a 'fringe' COVID-19 conspiracy as a 'culture war' weapon

In 2020, then-President Donald Trump went from bragging about his ability to make deals with Chinese government officials to pushing the conspiracy theory that the COVID-19 coronavirus was invented in a lab in Wuhan, China and leaked out. Never Trump conservative David Frum, in an Atlantic article published by The Atlantic on May 18, lays out some ways in which Trump and his sycophants are still trying to use that conspiracy theory as a political weapon in the United States.

Although Frum's article is critical of Trump, it is also critical of the Chinese government's initial response to COVID-19. The novel coronavirus was first reported in Wuhan, China in December 2019 and spread rapidly in January 2020, when Chinese officials downplayed its severity — which is the same thing Trump subsequently did when COVID-19 spread rapidly in the United States. But Frum rejects the conspiracy theory that COVID-19 originated in a lab in Wuhan.

"Early on, it became clear that Chinese authorities were lying about the disease's human toll," Frum explains. "Nick Paton of CNN, in December 2020, reported on 117 pages of internal Chinese government documents suggesting that the local authorities in Wuhan had massively underreported COVID-19 infections in the early weeks of the outbreak. In January 2021, HBO aired a documentary by the director Nanfu Wang minutely detailing the Chinese undercount. From the beginning, though, many have suspected the Chinese authorities of concealing an even darker secret about the outbreak than China's count of the sick and the dead. Those doubters suspected that the Chinese were also lying about how the outbreak started. They suspected that the official story of a spread from bats to humans was an excuse to conceal the fact that the virus had originated in a Chinese lab."

Frum adds that on January 29, 2020, the Washington Post published an article headlined "Experts Debunk Fringe Theory Linking China's Coronavirus to Weapons Research." And on February 17, 2020, the New York Times published an article headlined "Senator Tom Cotton Repeats Fringe Theory of Coronavirus Origins." Cotton, an Arkansas Republican, has been a devoted Trump supporter.

"Over time, the suspicious modulated their accusation a little," Frum notes. "In the spring of 2020, Trumpworld was also arguing that the virus was no big deal, no reason to shut down the U.S. economy. The president and his supporters wanted to argue that masking was stupid and that public-health officials were hysterical. You couldn't argue both that the virus was absurdly exaggerated and that it had begun its existence as a Chinese superweapon. By the time Secretary of State Mike Pompeo endorsed a lab-origin theory of the virus in May 2020, the suspicion about the virus' origin had been downgraded from 'superweapon' to 'medical experiment gone wrong.' Despite this softening, the scientific community, for the most part, continued to emphatically reject the lab-origin theory."

Scientists, Frum points out, are unsure exactly how COVID-19 started — adding that Trump supporters are happy to toss science aside if it is politically advantageous.

"If there is any group of people more disliked by Trump supporters than Chinese Communists," Frum observes, "it is the U.S. scientific community. For months, scientists had irritated Trump supporters by not falling in line with the pro-Trump argument that the coronavirus was much exaggerated and no big deal."

Frum adds, "Anthony Fauci in particular has become a hate figure to the pro-Trump world and the Fox News network. It's weird, it's hard to explain, but it is an organizing fact of American politics: More than Biden, more than Vice President Kamala Harris, more than any Democrat in Congress other than Alexandria Ocasio-Cortez, Fauci has become the emblem and totem of everything that Trumpists resent."

The Never Trump conservative stresses that although COVID-19-releated "misconduct" on the part of Chinese officials needs to be called out, that shouldn't include pushing bogus conspiracy theories.

"Pro-Trumpers want to use Chinese misconduct — real and imagined — as a weapon in a culture war here at home," Frum warns. "They are not interested in weighing the evidence. They want payback for the political and cultural injuries inflicted on them by the scientists. They want Fauci to have time in the barrel. What the rest of us should want is the truth…. By actively seeking the truth, the Biden Administration will deny the Trump dead-enders the culture-war weapon they want."

'You lie': Katie Porter wields 'whiteboard of justice' while grilling pharma CEO on price hikes

U.S. lawmakers on Tuesday took the CEO of the maker of the world's bestselling drug to task for high product prices, with Rep. Katie Porter using her famed "Whiteboard of Justice" to demonstrate what she called "the Big Pharma fairy tale" that pharmaceutical research and development costs justify perpetual price hikes.

Members of the House Oversight Committee grilled AbbVie CEO Richard Gonzalez—whose total compensation topped $24 million last year (pdf)—about the reasons for increasing the price of its top-selling drug Humira to $77,000 for a year's supply.

Humira (adalimumab) is an immunosuppressant used to treat a wide range of inflammatory conditions including arthritis, Crohn's disease, psoriasis, and ulcerative colitis. Last year, Humira sales neared $20 billion, making it by far the world's bestselling pharmaceutical drug.

In January, Fortune reported AbbVie would raise the price of Humira by 7.4%. Why the increase? Drugmakers often claim higher prices are needed to fund research and development. AbbVie spent a total of $2.45 billion on R&D from 2013 to 2018.

Porter (D-Calif.) pointed out that the company spends nearly double that—$4.7 billion—annually on advertising.


When Porter asked Gonzalez how much the company compensates its executives, the CEO said, "About $60 million a year."

"Try $334 [million] on for size," Porter shot back.

Noting that AbbVie spent around $50 billion on cumulative stock buybacks and dividends from 2013 to 2018, Porter then told Gonzalez: "You're spending all this money to make sure you make money rather than spending money to invest in [and] develop drugs and help patients with affordable, lifesaving drugs."

"You lie to patients when you charge them twice as much for an unimproved drug, and then you lie to policymakers when you tell us that R&D justifies those price increases," Porter asserted.

"The Big Pharma fairy tale is one of groundbreaking R&D that justifies astronomical prices," she said. "But the pharma reality is that you spend most of your company's money making money for yourself and your shareholders."

"The fact [is] that you're not honest about that with patients and policymakers—that you're feeding us lies that we must pay astronomical prices to get 'innovative' treatments," added Porter. "The American people, the patients, deserve so much better."

How Modi’s privatization agenda fueled the COVID disaster in India

While the incompetence of the Indian government is starkly visible in its handling of the second wave of the COVID-19 crisis, its performance has been far worse on the vaccine front. The BJP-led government of Prime Minister Narendra Modi, which seems to believe in the ideology of free-market capitalism, thinks that the market will magically produce the number of vaccines the country needs. This would explain why it has starved seven public sector vaccine manufacturing units—according to an April 17 article in Down to Earth—of any support instead of ramping up much-needed vaccine production.

The rights to produce the public sector vaccine, Covaxin, which has been developed by the Indian Council of Medical Research (ICMR) and National Institute of Virology (NIV), in collaboration with Bharat Biotech, have been given to the private company partner on an exclusive basis. The Indian government also believed that Serum Institute of India, another private sector company and the world's largest vaccine manufacturer, which has tied up with AstraZeneca for producing Covishield, would make vaccines according to the country's requirements without any prior orders or capital support. The government did not even see the necessity to intervene and prevent India's new Quad ally, the U.S., from stopping sending India supplies of the required raw materials needed by India for manufacturing vaccines.

The sheer negligence by the government is further highlighted by the fact that even though India has about 20 licensed manufacturing facilities for vaccines and 30 biologic manufacturers, all of which could have been harnessed for vaccine manufacturing, only two companies are presently producing vaccines. That too is at a pace completely inadequate for India's needs.

India has a long history of vaccine development, which can be traced back to the Haffkine Institute for Training, Research and Testing, in Mumbai, in the 1920s. With the Patents Act, 1970 and the reverse engineering of drugs by the Council of Scientific and Industrial Research (CSIR) laboratories, the country also broke the monopoly of global multinationals. It is this change, fought for by the Left, that led to India emerging as the largest generic supplier of drugs and vaccines in the world and becoming the global pharmacy of the poor.

Bill Gates recently spoke to Sky News in the UK regarding India and South Africa's proposal to the World Trade Organization on the need to lift intellectual property (IP) protection for COVID-19 vaccines and medicines during the pandemic. Gates claimed that IP is not the issue and that "moving a vaccine… into a factory in India… It's only because of our grants and our expertise that can happen at all." In other words, without the white man coming in to tell India and other middle-income countries how to make vaccines and provide them with his money, these countries would not be able to make vaccines on their own.

This is a rehash of the AIDS debate, where the Western governments and Big Pharma argued that developing generic AIDS drugs would lead to the manufacturing of poor-quality drugs and theft of Western intellectual property. Bill Gates, who built his fortune on Microsoft's IP, is the leading defender of IP in the world. With his newfound halo as a great philanthropist, he is leading Big Pharma's charge against the weakening of patents on the global stage. The role of the Bill and Melinda Gates Foundation, a major funder of the World Health Organization, is also to dilute any move by the WHO to share patents and knowledge during the pandemic.

Indian companies are the largest manufacturers of existing vaccines by volume in the world, according to the WHO's Global Vaccine Market Report 2020. When it comes to measuring vaccine manufacturing by value, however, the global share held by multinational corporations or Big Pharma is much bigger than that of India. For example, as per the WHO report, GlaxoSmithKline (GSK), with 11 percent of the global market by volume, generates 40 percent of the market by value, while Serum Institute with 28 percent of the market by volume has only 3 percent of the market by value. This shows that the patent-protected vaccines with monopoly pricing get much higher prices. This is the model that Bill Gates and his ilk are selling. Let Big Pharma make the big bucks even if it bankrupts the poorer countries. The Western philanthropic money of Gates and Warren Buffett will 'help' the poor Third World to get some vaccines, albeit slowly. As long as they get to call the shots.

The Modi government's approach to vaccines is based on the central pillar of Rashtriya Swayamsevak Sangh ideology—which serves as the ideological parent of the ruling BJP—that the task of the state is only to help big capital. Anything else including planning is seen by the right wing as socialism. In the case of vaccines, it means not to make any attempt to get the companies, both in the public and private sectors, to make necessary preparations for a quick vaccination program: to put in the money and provide the necessary supply chain. Instead, the government believed that India's private pharmaceutical industry would do all of this on its own.

It forgot that the Indian pharmaceutical industry was the product of public domain science—the CSIR institutions—the public sector and nationalist companies like Cipla. They all came out of the national movement and built India's pharmaceutical industry. It is institutions like the Haffkine Institute under Sahib Sokhey's leadership and the Center for Cellular and Molecular Biology (CCMB) built under the leadership of Dr. Pushpa Bhargava that led to India's vaccine and biologics capacity. It is on this base that India's vaccine manufacturing capacity rests.

It is not niji (private) companies that built the vaccine capacity in India, as Prime Minister Narendra Modi claims. The private sector companies rode on the back of public sector science and technology that was built in the country between the 1950s and the 1990s.

The Indian government recently opened up vaccinations for all adults in the country on May 1. To vaccinate all the eligible population—above 18 years of age—India would require about 2 billion doses of the vaccine in order to give the required two shots per person. To plan for the production of an order of this size, apart from technology and capital support, India also needs to plan for the complex supply chain that is required for production. This includes raw materials and intermediate supplies such as filters and special bags. There are at least 37 "critical items" that are currently embargoed by the U.S. from exports under the Defense Production Act, 1950, a relic of the U.S.'s Korean War.

On April 16, Adar Poonawalla, head of the Serum Institute of India, had taken to Twitter to ask U.S. President Joe Biden "to lift the embargo of raw material exports out of the U.S. so that vaccine production can ramp up."

If India puts together the production capacity of the Serum Institute, Bharat Biotech, Biological E, and Haffkine Bio-Pharmaceutical Corporation Limited, and the five other companies that have signed up to manufacture Sputnik V, developed by the Gamaleya National Center of Epidemiology, India could have planned for an annual production capacity of more than 3 billion doses. If it also included the public sector units idling under the Modi government, India could have easily boosted its vaccine manufacturing capacity to 4 billion doses and produced the necessary 2 billion doses and more in 2021. It would then have made it possible for India to completely vaccinate its target population and yet have enough left to meet its export commitments including for the WHO's Access to COVID-19 Tools (ACT)-Accelerator program and its vaccines pillar of COVAX. What is missing is a planning commission that could plan this exercise and create the political will to carry it forward. Not a vacuous Niti Ayog—the public policy think tank of the Indian government—and an incompetent government.

Instead, the Modi government did not even bother to place an order with the Serum Institute until January 11, and that too for a measly 11 million doses. The next order of 120 million Covishield and Covaxin doses was placed only in the third week of March when the number of cases had reached a daily caseload of nearly 40,000, and India was well into its deadly second wave. The government seemed to bank on its belief in the magic of the capitalist market, which it thought would solve all its problems, without any real effort on the center's part.

India and South Africa have asked the WTO to consider waiving the rules relating to intellectual property during the pandemic, and further sought that knowledge, including patents and know-how, should be shared without restrictions. This proposal has been backed by the WHO and has huge support among most countries in Asia, Africa and Latin America. The holdouts predictably are from the rich countries that want to protect the global vaccine market for their Big Pharma companies. Under pressure from the global community and the bad optics of the U.S. hoarding vaccines, the Biden administration has finally just decided to accept South Africa and India's initiative of a temporary patent waiver, after stonewalling it in the WTO until now. But this waiver is restricted to vaccine patents only and does not extend to other patents or associated intellectual property as South Africa and India's proposal had suggested. This is still a victory for the global public health community, though only a first step.

While India is spearheading the need to share know-how with all companies capable of manufacturing vaccines, it still has explaining to do as to why it has given an exclusive license to Bharat Biotech to manufacture a vaccine developed with public money and in public institutions like ICMR and NIV. Why is it not being shared under a nonexclusive license with both Indian companies and those companies outside India? Instead, ICMR is receiving royalties from Bharat Biotech from sharing its know-how exclusively with Bharat Biotech. Under public pressure, ICMR is now sharing its know-how with the government of the Indian state of Maharashtra's public sector Haffkine Bio-Pharmaceutical Corporation Limited, while giving Bharat Biotech six months' lead time with financial support money from the central government.

Modi had dreamed that India would be the vaccine arm of the Quad. He forgot that in order to compete with China, India needs a vaccine production base that not only takes care of its vaccination needs but also fulfills all its external commitments. China can do this because it has developed at least three vaccines already—from Sinopharm, Sinovac, and CanSino—that have been licensed to others. Their production is now being ramped up, and China is the largest supplier of vaccines to countries in Asia, Africa, and Latin America. And it has also managed to control the spread of the COVID-19 virus, unlike India.

This is where the Modi government has failed and failed badly. An incompetent, vainglorious leadership, combined with the RSS belief in magical capitalism, has led to the disaster that we are now facing.

This article was produced in partnership by Newsclick and Globetrotter. Prabir Purkayastha is the founding editor of Newsclick.in, a digital media platform. He is an activist for science and the free software movement.

Help! My family won't get the vaccine

Dear Pandemic Problems,

There's a growing rift between me and my son-in-law, who says the COVID-19 vaccines are not safe because they have not been "FDA approved." What makes our rift even more difficult? His wife and grown kids with families themselves will also not get the vaccine because of this FDA approval issue. What do I do?

Sincerely,

Ruffled by Rifts

Ruffled by Rifts, it does appear that rifts are all around you — or at the very least, you are in the minority of being willing to get vaccinated in your family. I know it's frustrating, and rest assured that you are not alone. I've answered many questions now from people who find themselves in similar predicaments. Plus, it doesn't help that families being divided on whether or not to get vaccinated is adding fuel to perhaps decades of family drama, and at the very least four years of the Trump era tearing families apart.

I have no idea if your family members are staunch anti-vaxxers, or to what extent political allegiances play a role here. But I do know that undermining their concerns won't help if there is any hope of them getting vaccinated. The best approach is to listen to their concerns, and have empathy, which it sounds like you've done a little bit of already.

So, you say that your son-in-law is saying the COVID-19 vaccines are not "safe" because they have not been approved by the United States Food and Drug Administration (FDA). While partly true, this is a classic example of how misinformation spreads. Technically, the COVID-19 vaccines haven't been "approved" by the FDA. However, all three vaccines available in the U.S. have been granted an emergency use authorization, also known as an EUA.

EUAs, by the way, aren't limited to vaccines — they sometimes are issued for medical devices, in vitro diagnostics, and some therapeutics. When it comes to passing an EUA, there are specific conditions that must be considered; they are likely to be granted in situations when "there are no adequate, approved, and available alternatives."

That is certainly that case with COVID-19. The FDA usually takes years to formally approve a vaccine, but in the coronavirus pandemic, the priority was to get a safe vaccine in as many peoples' arms as quickly as possible — hence the emergency use authorization.

But just because there's a bureaucratic difference between an EUA and approval doesn't mean that there isn't a rigor to attaining an EUA. Specific criteria must be met. For example, clinical trials must be done on tens of thousands of study participants to generate at least two months of sufficient scientific data needed for the FDA to determine a vaccine's safety and efficacy. You can read more about this process here.

In order to apply for full FDA approval, a company needs to show at least six months of data. Since Pfizer now has that, recently submitted an application for full approval. The FDA is expected to take at least a few weeks to review it, according to NBC News.

Now, what do you do? Well, I suggest expressing your concerns about their health and safety, and what the consequences are of not getting vaccinated. You could also note that attaining an emergency use authorization is a very rigorous process. And ask: Once the FDA formally approves the Pfizer vaccine, will you get it? While it's not ideal for your family members to wait, it's better than a straight-out refusal of getting vaccinated. Hopefully if they have more understanding into the EUA process, and perhaps speak with their doctors, they can be persuaded to be vaccinated.

Sincerely,

Pandemic Problems

Dear Pandemic Problems,

My husband is refusing to get the Covid vaccine. I will be fully vaccinated by the end of the week. Am I wrong to not want to be intimate with him for fear he could infect me?

Sincerely,

Hesitant about Intimacy

Dear Hesitant about Intimacy,

Congratulations on being fully vaccinated so soon. As someone who recently joined the fully-vaccinated club, I feel so grateful not having to worry (as much) about getting the coronavirus, potentially dying from it or spreading it to people. It seriously feels so good, and I'm excited for you to feel so good, too.

And yet, you are at a crossroads with your husband not getting vaccinated. I'm curious, why is he refusing the vaccine? The first step to understanding someone's hesitancy is to better understand why they don't want to be vaccinated. It could be due to misinformation they've consumed, a previous trauma or experience.

You ask: "Am I wrong to not want to be intimate with him for fear he could infect me?"

Unfortunately, I cannot answer this question for you. The CDC has not issued guidance on sex between vaccinated and unvaccinated people, and what the risk is. (Hopefully they will soon.) The CDC states that vaccinated people can still possibly get infected and spread the virus to others, but there is still much to be learned from this situation. I'm definitely not a marriage therapist, but here's what I would tell my best friend: do not anything you're uncomfortable with, as that won't be good for your marriage.

I hope you and your spouse can talk about the implications of him not getting vaccinated, and how that might impact the future of your marriage. My hope is that he will listen, and carefully consider your concerns. If not, there's always couple's therapy. If you can't afford to pay out of pocket, check with your insurance or look for free or low-cost counseling options.

Sincerely,

Pandemic Problems

"Pandemic Problems" is an advice column that answers readers' pandemic questions — often with help from public health data, philosophy professors and therapists — who weigh in on how to "do the right thing." Do you have a pandemic problem? Email Nicole Karlis at nkarlis@salon.com. Peace of mind and collective commiseration awaits.

'Caving to the new authoritarian Republican regime': Governor gets slammed for thwarting the constitution

In 2020, 53% of Missouri voters approved a ballot measure that called for expanding eligibility for the state's Medicaid program, MO HealthNet, and putting that expansion into the state's constitution. The expansion would have gone into effect on July 1, increasing the number of Missouri residents eligible for Medicaid by an estimated 275,000. But on Thursday, Republican Gov. Mike Parson announced that Missouri is "unable to proceed with" the expansion "at this time" — and the Missouri Department of Social Services, according to Kansas City Star reporter Jeanne Kuang, has notified the federal government that the expansion is being dropped.

In an official statement, John Rizzo, Democratic minority leader in the Missouri State Senate, said, "The Constitution says Medicaid Expansion happens on July 1. There is more than enough money in the budget to implement expansion. This is the governor caving to the new authoritarian Republican regime that doesn't respect the outcome of elections. This governor is determined to block people's healthcare while violating his oath to uphold Missouri's constitution."

Crystal Quade, Democratic minority leader in the Missouri House of Representatives, was equally scathing in her official statement. Quade attacked the decision as "dishonorable" and said, "By backtracking on implementation of Medicaid expansion, Gov. Parson is breaking his promise to the people of this state and violating his oath to uphold the Missouri Constitution. Whatever reputation he once had for respecting the law is gone forever, and he is just another politician whose word can't be trusted."

Although Missouri's largest cities, St. Louis and Kansas City, have Democratic mayors, Missouri on the whole is a red state. Parson is a Republican, the GOP controls both houses of the Missouri State Legislature, and both of Missouri's U.S. senators are Republicans: Sen. Roy Blunt and Sen. Josh Hawley. Although President Joe Biden enjoyed a decisive victory over former President Donald Trump in the 2020 presidential election, it wasn't because of Missouri — where Trump won by 15%. Texas, in fact, was better for Biden than Missouri; Biden only lost by 6% in the Lone Star State.

Yet despite Missouri's Republican leanings, its Medicaid expansion ballot initiative was approved in 2020.

According to Kuang, "Parson had been opposed to the expansion but agreed to implement the will of the voters this year, asking for $130 million in state funds to pay for it. That would come with $1.6 billion from the federal government for the bulk of the expansion costs. Under the Affordable Care Act, the federal government picks up 90% of the tab."

But now, Parson is saying that MO HealthNet will run out of money if the Medicaid expansion goes forward.

Kuang observes, "MO HealthNet has one of the nation's strictest eligibility rules. It does not cover most non-disabled adults without children. Parents can qualify if their household income is no more 21% of the federal poverty level…. Expansion would allow Missourians making up to 138% of the federal poverty level — or a little under $18,000 a year — to enroll."

A complex new phase of the pandemic has arrived. Here's what experts say will happen next

When the COVID-19 era is chronicled in the history books, the first phase will be marked as beginning with the outbreak itself and ending with the development of successful vaccines. The last phase, of course, will be the one in which we have contained the pandemic and can resume the normal rhythms of life as they had been pre-2020 (although early research suggests some who were infected may experience long-term health problems).

Yet what about the middle phase, the one we're in right now? We know what the beginning looked like, and what the end will (hopefully) resemble. What should expect as we transition from one to the other?

"We're really just moving between phases," Dr. Sarah Cobey, an associate professor in the department of ecology and evolution at the University of Chicago, told Salon. "It's not going to be some sort of binary switch back to normal. I might describe the phase that we're in now as not just being one where obviously there's a lot of immunity that's being gained through vaccination, but also we have, of course, they're accumulating immunity, especially when we take a step back and look globally."

She noted that we are entering a "complex period" defined by the fact that the SARS-CoV-2 virus (which causes COVID-19) is adapting.

"I think many of us who previously studied viruses like influenza, we were waiting for this," Cobey explained. "We're seeing this fast evolution of the virus, and this evolution is of course relevant to vaccination policy."

Dr. Bernard Lo, professor of medicine at the University of California, San Francisco, expressed a similar view.

"I think our concern is that some of these variants might be less effectively blocked by the current vaccine," Lo explained. "The question is, will further variants emerge that are even more resistant to the antibodies that the vaccine stimulates?"

Lo added that this concern is exacerbated by the large number of people who remain unvaccinated — either by choice or because they are unable to access a vaccine — and are thus at risk of getting infected in a way that helps mutant strains.

It's a worldwide issue as well," Lo pointed out, referring to how many poorer countries do not have access to the vaccines that wealthier nations do. "There are a lot of countries that really don't have access to vaccines, and variants could emerge there." He predicted that there is a "very good chance" we will need regular booster shots to combat emerging strains, similar to what already exists with influenza.

Cobey echoed that view.

"I really think that worst case scenario here is that a variant does arise that really does escape a lot of the vaccine-induced protection and we're slow to recognize it, and slow to distribute vaccines to the populations that need either to get the first dose or a booster," Cobey told Salon.

Another aspect of the vaccine management phase is the growing awareness that vaccine passports — some kind of official proof that recipients have either been vaccinated or tested negatively for the disease — could become prevalent.

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"Vaccine passports will probably be very important and useful as a transition," Lawrence Gostin, a professor at Georgetown Law who specializes in public health law, told Salon. "Once everybody is fully vaccinated and we have herd immunity, there'll be no need for a vaccine passport, but what vaccine passports do is get us back to a state of more normal quicker because it means that you have to show proof that you're vaccinated in order to get into high risk environments."

Gostin pointed to Israel as "probably the best example" of a country which has succeeded with its "green pass" policy. (Israel has aroused controversy for not prioritizing Palestinians in its vaccination process, however.) "Basically life is normal in Israel already," Gostin said.

Although some conservatives have claimed that vaccine passports would violate individual rights, Gostin does not share that view. His position is that from an ethics point of view, vaccine passports are on solid ground.

"They're inherently a good thing because they maximize our health and safety, and I don't think they violate any privacy or autonomy," Gostin explained. "A person doesn't have to show proof of vaccination. It's their choice. But if they don't, they can't get into certain places. Everyone has a right to make decisions about their own health, but they don't have an ethical right to expose other people to a potentially dangerous infectious disease."

His only caveat was the same as Lo's: Vaccines are not being equitably distributed and, therefore, vaccine passports could give the wealthy unfair privileges. As such, vaccine passports are only unethical until "everyone who wants a vaccine can get a vaccine, because we don't want to give privilege to the already privileged, and we don't want to leave the disadvantaged behind."

White House slams Joe Rogan after podcaster tells younger listeners not to get COVID vaccine

In a rare move several Biden White House officials are responding to podcaster Joe Rogan, a popular culture warrior on the right who appeals to a wide audience, in an effort to combat vaccine hesitancy as COVID inoculations drop thanks to conservatives spreading false information and misinformed opinions – which Rogan shared last Friday.

Dr. Anthony Fauci, the director of the U.S. National Institute of Allergy and Infectious Diseases (NIAID) who also serves as President Joe Biden's chief medical advisor blasted Rogan for telling listeners younger Americans should not get the coronavirus vaccine – an opinion not based in science.

"That's incorrect," the usually diplomatic immunologist told "TODAY" show co-host Savannah Guthrie Wednesday, "and the reason why is you're talking about yourself in a vacuum then."

"You're worried about yourself getting infected and the likelihood that you're not gonna get any symptoms," he added. "But you can get infected and will get infected if you put yourself at risk. And even if you don't have any symptoms, you're propagating the outbreak because it is likely that you — even if you have no symptoms — that you may inadvertently and innocently then infect someone else who might infect someone who really could have a problem with a severe outcome."

Rogan on his Spotify podcast (the company paid him $100 million to license his show), said, "you should get vaccinated if you're vulnerable," but added "it's crazy" that it's "controversial" to say "I'm not going to inject my child with the vaccine."

"We are not talking about even the flu, that we just found out killed 20,000 people last year, we're not talking about that right, we're talking about something that is not statistically dangerous for children," Rogan told his millions of listeners, spreading more misinformation that will likely help even more Americans decide to not get vaccinated.

"COVID-19 has killed thousands of young Americans," a January Business Insider article revealed. Countless articles over the past six months, especially in local news outlets, detail deaths of younger Americans, and especially those who are people of color.

"Are you healthy?" Rogan said he would ask a 21-year old. "Are you a healthy person? Like, look, don't do anything stupid, but you should take care of yourself. You should – if you're a healthy person, and you're exercising all the time, and you're young, and you're eating well, like, I don't think you need to worry about this," meaning the coronavirus.


While the death rate for younger Americans is less than that of middle aged and older Americans, children and young adults do contract the disease, and do die from it. They also are more likely to spread the virus to others, given their often asymptomatic status. And death is not the only concern, as millions with "long COVID" can attest.

Fauci is not the only Biden official to criticize Rogan.

"I guess my first question would be, did Joe Rogan become a medical doctor while we weren't looking? I'm not sure that taking scientific and medical advice from Joe Rogan is perhaps the most productive way for people to get their information," White House communications director Kate Bedingfield told CNN on Wednesday (relevant segment begins at 4:16 mark):


'I have to compose myself': Doctor smacks down Orange County Republican who asked if COVID vaccine embeds a tracking device

To be honest, I'm not all that concerned that the COVID vaccine I took last Friday might have a tracking device in it. For one thing, it doesn't, because that would be bonkers. For another, I can't fathom who the hell would want to track me. I can just imagine the folks at the NSA gawking at my 24-hour feed and thinking, "He's going to the cupboard again? How many Little Debbie Fig Bars can one guy eat?"

Also, I have a phone in my pocket that's tracking me pretty much everywhere I go—which is basically nowhere except the aforementioned cupboard. If the government really wants to send in an artillery strike, they can just check the iPhone coordinates. Or look up my address, FFS.

Honestly, Republicans need to come up with better, more plausible horror stories—like that the vaccine contains a cache of self-replicating nanobots that gradually Brundlefly you into a Republican. Now that would give me pause.

Sadly, though, the way this conspiracy theory so effortlessly glides off this doofus' tongue makes me think he represents thousands, if not millions, of his fellow travelers in the International Bizarro World Party.

So for your endless entertainment, here's Don Wagner, a Republican member of the Orange County, California, Board of Supervisors asking Dr. Clayton Chau, director of the county's health care agency, whether his constituents need worry about Joe Biden slipping on his Professor X Cerebro helmet to find out where they hide their freeze-dried bunker snacks:


WAGNER: "Does it … is there any intention of tracking folks?"

CHAU: "Nope."

WAGNER: "Is there any, in the vaccine, we heard about an injection of a tracking device. Is that being done anywhere … in Orange County?"

CHAU: "I'm sorry, I have to compose myself. There's not a vaccine with a tracking device embedded in it that I know of ... exists in the world. Period."

That you know of. As Don Rumsfeld famously noted, absence of evidence is not evidence of absence.

Again, if the government really wants to track me through the vaccine, they're welcome to try. Because if I don't get vaccinated, it'll be really easy to find me. I'll be buried at Evergreen Cemetery next to the other anti-vax dipshits.

Share vaccine recipes with poor during pandemic? One of world's richest men says 'no'

Bill Gates, one of the world's richest men and most powerful philanthropists, was the target of criticism from social justice campaigners on Sunday after arguing that lifting patent protections on Covid-19 vaccine technology and sharing recipes with the world to foster a massive ramp up in manufacturing and distribution—despite a growing international call to do exactly that—is a bad idea.

Directly asked during an interview with Sky News if he thought it "would be helpful" to have vaccine recipes be shared, Gates quickly answered: "No."

Asked to explain why not, Gates—whose massive fortune as founder of Microsoft relies largely on intellectual property laws that turned his software innovations into tens of billions of dollars in personal wealth—said that: "Well, there's only so many vaccine factories in the world and people are very serious about the safety of vaccines. And so moving something that had never been done—moving a vaccine, say, from a [Johnson & Johnson] factory into a factory in India—it's novel—it's only because of our grants and expertise that that can happen at all."

The reference is to the Serum factory in India, the largest such institute in the country, which has contracts with AstraZeneca to manufacture their Covid-19 vaccine, known internationally as Covishield.

The thing that's holding "things back" in terms of the global vaccine rollout, continued Gates, "is not intellectual property. It's not like there's some idle vaccine factory, with regulatory approval, that makes magically safe vaccines. You know, you've got to do the trial on these things. Every manufacturing process needs to be looked at in a very careful way."

Critical advocates for robust and immediate change to intellectual property protections at the World Trade Organization when it comes to the Covid-19 vaccines, however, issued scathing indictments of Gates' defense of the status quo.


Nick Dearden, executive director of Global Justice Now, one of the lead partner groups in an international coalition calling for WTO patent waivers at a crucial meeting of the world body next month, characterized Gates' remarks—and the ideological framework behind them—as "disgusting."

"Who appointed this billionaire head of global health?" asked Dearden. "Oh yeah, he did."

Journalist Stephen Buryani, who on Saturday wrote an in-depth Guardian column on the urgent need for the patent waivers and technology sharing, offered a similarly negative view of the billionaire's "awful" arguments against sharing the vaccine technology.

Gates, charged Buryani, "acts like an optimist but has a truly dismal vision of the world."

During the Sky News interview, Gates said it was "not completely surprising" that the richest nations like U.S., U.K., and others in Europe vaccinated their populations first. He said that made sense because the pandemic was worse in those countries, but said he believed that "within three or four months the vaccine allocation will be getting to all the countries that have the very severe epidemic."

Watch the full interview:


COVID-19: Bill Gates hopeful world 'completely back to normal' by end of 2022 www.youtube.com

Offering his interpretation of what Gates was actually throughout the interview, Buryani paraphrased it this way: "We can't make more vaccines, we can't compromise profits, we can't trust poor countries with our technology, and they'll get their scraps after we eat."


"The poverty of vision from [Gates] and other 'leaders' has been astounding," added Buryani. "Smallpox, Polio, both had joined-up responses that shared knowledge and technology across the world. We're happy to let the *pharma* market sort out the biggest crisis of our lifetimes. Totally on autopilot."

While public health experts agree that developing nations may not have the current know-how or capacity to produce advanced vaccines at scale, they argue that is also the result of policy choices that governments and others have made. Earlier this month 66 organizations called on the U.S. to initiate a global vaccine manufacturing program that, in tandem with patent waivers and recipe sharing, would pave the way for ramped up capacity.

"The U.S. government has helped produce hundreds of millions of vaccine doses for people living in the U.S., on a relatively short timeline. The same is needed—and within reach—for all countries," said Peter Maybarduk, director of Public Citizen's Access to Medicines program, at the time. "The key missing ingredient is ambitious political leadership, to end the pandemic for everyone, everywhere."

Meanwhile, in a detailed online social media thread earlier this month, journalist and activist Cory Doctor stated that while numerous "people helped create our 'Vaccine Apartheid,' the single individual who did the most to get us here is Bill Gates, through his highly ideological 'philanthropic' foundation, which exists to push his pitiless doctrine of unfettered monopoly."


Doctorow also pointed people to a feature in The New Republic by Alexander Zaitchik earlier this month which details Gates has long used his "hallowed foundation" and position as the "world's de facto public health czar" to defend the intellectual property regime that is now central to the fight between those defending "Vaccine Apartheid" on the one hand and international campaigners fighting for a "People's Vaccine" that would unleash the life-saving inoculations from their corporate masters in the pharmaceutical industry.


According to Zaitchik:

In April [of 2020], Bill Gates launched a bold bid to manage the world's scientific response to the pandemic. Gates's Covid-19 ACT-Accelerator expressed a status quo vision for organizing the research, development, manufacture, and distribution of treatments and vaccines. Like other Gates-funded institutions in the public health arena, the Accelerator was a public-private partnership based on charity and industry enticements. Crucially, and in contrast to the C-TAP, the Accelerator enshrined Gates's long-standing commitment to respecting exclusive intellectual property claims. Its implicit arguments—that intellectual property rights won't present problems for meeting global demand or ensuring equitable access, and that they must be protected, even during a pandemic—carried the enormous weight of Gates's reputation as a wise, beneficent, and prophetic leader.

How he's developed and wielded this influence over two decades is one of the more consequential and underappreciated shapers of the failed global response to the Covid-19 pandemic. Entering year two, this response has been defined by a zero-sum vaccination battle that has left much of the world on the losing side.

Quoted in the piece is James Love, founder and director of Knowledge Ecology International, which studies public policy and intellectual property as it intersects with public health and the drug industry. Love explains just how powerful the influence of Gates and the Bill & Melinda Gates Foundation has been in curtailing the conversation around I.P. and vaccines.

"If you said to an ordinary person, 'We're in a pandemic. Let's figure out everyone who can make vaccines and give them everything they need to get online as fast as possible,' it would be a no-brainer," Love told TNR. "But Gates won't go there. Neither will the people dependent on his funding. He has immense power. He can get you fired from a U.N. job. He knows that if you want to work in global public health, you'd better not make an enemy of the Gates Foundation by questioning its positions on I.P. and monopolies. And there are a lot of advantages to being on his team. It's a sweet, comfortable ride for a lot of people."

Back at the beginning of the pandemic in March of 2020, said Love, "Things could have gone either way, but Gates wanted exclusive rights maintained." That, argues, was crucial in terms of what has happened since.

As Doctorow also suggests in his exploration of the issue, the fix was in from the beginning in terms of intellectual property and the Covid-19 pandemic and nobody should take seriously Gates' argument that there's simply not enough time to make lifting patent protections a priority at this point.

"Having sabotaged the efforts by poor countries to engage in the kind of production ramp-up the rich world saw as vaccines were being developed, it may NOW be too late," tweeted Doctorow. "Because of my bad ideas THEN, it's too late NOW."

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