Category: COVID-19

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-Top News COVID-19 USA

Covid marks sixth leading cause of death in US in Jan

Pedestrians pass a sign advertising a COVID-19 testing site in New York, the United States, on May 12, 2022. (Photo by Michael Nagle/Xinhua/IANS)

XBB.1.5 is growing in proportion in all regions nationwide, according to the CDC. BQ.1.1 remains the second most prevalent strain at 9.4 per cent…reports Asian Lite News

The highly transmissible Omicron subvariant XBB.1.5 now accounts for 85 per cent of all Covid-19 cases reported in the US this week, according to the latest estimates of the Centers for Disease Control and Prevention (CDC).

The prevalence of XBB.1.5 kept increasing since late last year — up from 79.2 per cent last week and 71.9 per cent two weeks prior, Xinhua news agency reported citing the estimates as saying.

XBB.1.5 is growing in proportion in all regions nationwide, according to the CDC. BQ.1.1 remains the second most prevalent strain at 9.4 per cent.

The CDC first started tracking XBB.1.5 in November last year, when it accounted for less than 1 per cent of cases nationwide.

Since then, the strain is spreading quickly in the US. Early study suggests XBB.1.5 has a couple of concerning mutations that suggest it is even more contagious than other strains, possibly the most transmissible one so far.

While XBB.1.5 is spreading easier, scientists said it does not seem to cause more severe disease. The US still remains the worst-ht country in the world with the highest number of Covid-19 cases and deaths.

As of Saturday morning, the country’s overall number of cases and fatalities stood at 105,169,945 and 1,144,441, respectively.

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-Top News China COVID-19

‘No new Covid variants emerged during China’s recent outbreak’

Workers line up for nucleic acid testing at the construction site of a residential area in Jiangdong New Area of Haikou, south China's Hainan Province, Sept. 2, 2022.(Xinhua/Yang Guanyu/IANS)

Imported cases during the same period mostly involved different variants to those dominant in Beijing….reports Asian Lite News

No new Covid-19 variants have emerged in China during the recent surge in infections since the country ended its zero-Covid policy, according to an analysis of cases in Beijing published in The Lancet.

The study suggests two existing Omicron sub-variants, BA.5.2 and BF.7, among the most dominant variants in Beijing during 2022, accounted for more than 90 per cent of local infections between November 14 and December 20, 2022.

Imported cases during the same period mostly involved different variants to those dominant in Beijing.

Genome analysis of 413 new Covid-19 infections in Beijing spanning the time period when China lifted its most strict pandemic control policies suggests that all were caused by existing strains.

“Our analysis suggests two known Omicron sub-variants – rather than any new variants – have chiefly been responsible for the current surge in Beijing, and likely China as a whole. However, with ongoing large-scale circulation of Covid-19 in China, it is important we continue to monitor the situation closely so that any new variants that might emerge are found as early as possible,” said Professor George Gao of the Institute of Microbiology at the Chinese Academy of Sciences.

The results represent a snapshot of the pandemic in China, due to the characteristics of Beijing’s population and the circulation of highly transmissible Covid-19 strains there.

In the three years since Covid-19 was declared a global pandemic, the emergence of variants such as Alpha, Beta, Gamma, Delta, and Omicron has caused multiple waves of cases around the world.

In the latest study, the authors analysed Covid-19 samples detected in Beijing in 2022. Genome sequences were generated using rapid, large-scale sequencing technology, and their evolutionary history and population dynamics analysed using existing high-quality Covid-19 sequences.

Analysis of the 413 new sequences revealed they all belong to existing, known COVID-19 strains.

The dominant strain in Beijing after November 14 2022 was BF.7, which accounted for 75.7 per cent of local infections. Another Omicron sub-variant, BA5.2, was responsible for 16.3 per cent of local cases.

Professor Wolfgang Preiser and Dr Tongai Maponga of the University of Stellenbosch, South Africa, who were not involved in the study, said: “It is welcome to see this much-needed data from China. It is certainly reassuring that this study yielded no evidence for novel variants but not a surprise: the surge is amply explained by the abrupt cessation of effective control measures.”

However, they urge caution in drawing conclusions about China as a whole based on data from Beijing, saying that “the SARS-CoV-2 molecular epidemiological profile in one region of a vast and densely populated country cannot be extrapolated to the entire country”.

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-Top News COVID-19 USA

US govt announces plan to end Covid-19 emergency declarations

It comes as lawmakers have already ended elements of the emergencies that kept millions of Americans insured during the pandemic….reports Asian Lite News

President Joe Biden informed Congress on Monday that he will end the twin national emergencies for addressing COVID-19 on May 11, as most of the world has returned closer to normalcy nearly three years after they were first declared.

The move to end the national emergency and public health emergency declarations would formally restructure the federal coronavirus response to treat the virus as an endemic threat to public health that can be managed through agencies’ normal authorities.

It comes as lawmakers have already ended elements of the emergencies that kept millions of Americans insured during the pandemic. Combined with the drawdown of most federal COVID-19 relief money, it would also shift the development of vaccines and treatments away from the direct management of the federal government.

Biden’s announcement comes in a statement opposing resolutions being brought to the floor this week by House Republicans to bring the emergency to an immediate end. House Republicans are also gearing up to launch investigations on the federal government’s response to COVID-19.

Then-President Donald Trump’s Health and Human Services Secretary Alex Azar first declared a public health emergency on Jan. 31, 2020, and Trump later declared the COVID-19 pandemic a national emergenc y that March. The emergencies have been repeatedly extended by Biden since he took office in January 2021, and are set to expire in the coming months. The White House said Biden plans to extend them both briefly to end on May 11.

“An abrupt end to the emergency declarations would create wide-ranging chaos and uncertainty throughout the health care system — for states, for hospitals and doctors’ offices, and, most importantly, for tens of millions of Americans,” the Office of Management and Budget wrote in a Statement of Administration Policy.

More than 1.1 million people in the U.S. have died from COVID-19 since 2020, according to the Centers for Disease Control and Prevention, including about 3,700 last week.

Congress has already blunted the reach of the public health emergency that had the most direct impact on Americans, as political calls to end the declaration intensified. Lawmakers have refused for months to fulfill the Biden administration’s request for billions more dollars to extend free COVID vaccines and testing. And the $1.7 trillion spending package passed last year and signed into law by Biden put an end to a rule that barred states from kicking people off Medicaid, a move that is expected to see millions of people lose their coverage after April 1.

“In some respects, the Biden administration is catching up to what a lot of people in the country have been experiencing,” said Larry Levitt, the executive vice president for health policy at Kaiser Family Foundation. “That said, hundreds of people a day are still dying from COVID.”

Still, some things will change for Americans once the emergency expires, Levitt pointed out.

The costs of COVID-19 vaccines are also expected to skyrocket once the government stops buying them, with Pfizer saying it will charge as much as $130 per dose. Only 15% of Americans have received the recommended, updated booster that has been offered since last fall.

People with private insurance could have some out-of-pocket costs for vaccines, especially if they go to an out-of-network provider, Levitt said. Free at-home COVID tests will also come to an end. And hospitals will not get extra payments for treating COVID patients.

Legislators did extend for another two years telehealth flexibilities that were introduced as COVID-19 hit, leading health care systems around the country to regularly deliver care by smartphone or computer.

The Biden administration had previously considered ending the emergency last year, but held off amid concerns about a potential “winter surge” in cases and to provide adequate time for providers, insurers and patients to prepare for its end.

Officials said the administration would use the next three months to transition the response to conventional methods, warning that an immediate end to the emergency authorities “would sow confusion and chaos into this critical wind-down.”

ALSO READ: US’ bid to win back influence in Africa

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COVID-19 Health India News

India launches first intranasal Covid vaccine

Expressing his elation at the event, Mandaviya said that over 65 per cent of vaccines supplied in the world are from India…reports Asian Lite News

Union Health Minister Mansukh Mandaviya on Thursday unveiled the Covid-19 vaccine, iNNCOVACC in the presence of Union Minister of State (IC) for Science and Technology, Jitendra Singh.

iNNCOVACC is the world’s first intranasal Covid-19 vaccine to receive approval for the primary 2-dose schedule, and as a heterologous booster dose. It is developed by Bharat Biotech International Limited (BBIL) in collaboration with Biotechnology Industry Research Assistance Council (BIRAC), a PSU under the Department of Biotechnology, Ministry of Science and Technology.

Expressing his elation at the event, Mandaviya said that over 65 per cent of vaccines supplied in the world are from India.

Congratulating the BBIL team and the Department of Biotech for bringing about the world’s first nasal vaccine, he stated that “being the world’s first intra-nasal Covid-19 vaccine, this marks a glorious tribute to the call for Atmanirbhar Bharat.”

The Union Health Minister added that India’s vaccine manufacturing and innovation capability is appreciated all over the world as it has made a mark in producing quality and affordable medicines.

Congratulating BBIL for innovating another vaccine in collaboration with BIRAC, Jitendra Singh said that “India has taken a lead in developing vaccines and medicines for diseases common in the developing world.”



He also stated that ZyCoV-D, the world’s first and India’s indigenously developed DNA based vaccine for Covid-19 to be administered in humans including children and adults 12 years and above, was also developed in partnership with the Department of Biotechnology in the Ministry of Science & Technology under ‘Mission Covid Suraksha’ through BIRAC.

iNCOVACC is a cost effective Covid-19 vaccine which does not require syringes, needles, alcohol wipes, bandage, etc, saving costs related to procurement, distribution, storage, and biomedical waste disposal, that is routinely required for injectable vaccines.

It utilises a vector-based platform, which can be easily updated with emerging variants leading to large scale production, within a few months. These rapid response timelines combined with the ability of cost effective and easy intranasal delivery, makes it an ideal vaccine to address future infectious diseases.

A rollout of iNCOVACC is expected to begin in private hospitals that have placed advance orders. Initial manufacturing capacity of several million doses per annum has been established, this can be scaled up to a billion doses as required. iNCOVACC is priced at Rs 325 per dose for large volume procurement by State Governments and Government of India.

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Business COVID-19 India News

First Covid, now layoffs: Tech professionals undergo tremendous stress

About 3,000 tech professionals are losing their jobs on an average daily in the month of January, including thousands in India…reports Asian Lite News

Amid the growing layoffs, there has been a surge in the number of patients coming from various companies — both office-goers and those working from home — with panic anxiety attacks and depression as they fear losing control over their immediate future plans, mental health experts said on Monday.

About 3,000 tech professionals are losing their jobs on an average daily in the month of January, including thousands in India.

According to health experts, the last 2-3 years of Covid lockdowns, deaths, and fear of re-infection, and now massive layoffs, have resulted in extreme stress for Indian professionals.

Dr Saumya Mudgal, Senior Consultant, Psychiatry, Max Hospital in Gurugram, told IANS that there has been a drastic increase in the number of patients coming from MNCs.

“These patients are usually presented with the issues of panic anxiety and panic disorder with agoraphobia and there is quite an increase in such patients. Some of them are already taking medications and the requirement of medication has gone up and the severity of symptoms has gone up,” Dr Mudgal told IANS.

According to her, there are a lot of people coming with fresh or recent onset symptoms of anxiety and adjustment issues pertaining to anxiety or mixed anxiety.

Layoffs and loss of employment are very stressful experiences for most people. It is a time filled with uncertainties, economic challenges and loss of control over your future.

According to Dr Rishi Gautam, Assistant Professor of Psychiatry, The GW School of Medicine and Health Sciences in Washington, DC, this can lead to significant impact on a professional’s mental health and cause anxiety, depressed mood, shock and grief.

“It affects sleep and appetite, increases risk of unhealthy consumption of drugs and alcohol, causes worsened irritability, loss of self-esteem, family discord etc,” Dr Gautam told IANS.

Dr Arti Anand, a senior clinical psychologist at Sir Ganga Ram Hospital in Delhi, said that the pandemic and massive layoffs both knocked out the working class without any warning.

“This leads to fear and stress. The way to deal with it is to be able to use your available resources, not to panic and stop thinking negatively about the future,” she advised.

Health experts said that to cope in these uncertain times is by maintaining supportive relationships with friends and family, exercising regularly and practicing mindfulness.

Keep a positive attitude and outlook. Stay away from generalising negative thoughts like “I will never have a job again or I will never enjoy my work again etc,” said Dr Gautam.

Divya Mohindroo, Founder, Embrace Imperfections and a counselling psychologist, told IANS that those impacted in the current layoffs need to deal with it practically, rather than emotionally.

“Start making a list of potential employers, research about available opportunities and companies, look for avenues to upskill and even diversify into other sectors, if required,” she advised.

“Approach employers while being mentally prepared to describe their situation while pitching their candidature. It is also important to network – with friends, ex-bosses and colleagues,” she said.

All professionals should share their work responsibilities with colleagues at work and family members at home, which will help them not only be accountable but also feel light about their life and tasks in hand,” Mohindroo noted.

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COVID-19 USA

Mandatory Covid testing for visitors from China

Travelers wearing face masks are seen at Ronald Reagan Washington National Airport in Arlington, Virginia, the United States, Feb. 2, 2021. (Photo by Ting Shen/Xinhua/IANS)

Under the new rules, travelers to the US from China, Hong Kong and Macau, will be required to take a Covid-19 test no more than two days before travel and provide a negative test before boarding their flight…reports Asian Lite News

The US announced new Covid-19 testing requirements Wednesday for all travelers from China, joining other nations imposing restrictions because of a surge of infections.

The increase in cases across China follows the rollback of the nation’s strict anti-virus controls. China’s “zero Covid” policies had kept the country’s infection rate low but fueled public frustration and crushed economic growth.

The new US requirements, which start Jan. 5, apply to travelers regardless of their nationality and vaccination status.

In a statement explaining the testing, the US Centers for Disease Control and Prevention cited the surge in infections and what it said was a lack of adequate and transparent information from China, including genomic sequencing on the viral strains circulating in the country.

“These data are critical to monitor the case surge effectively and decrease the chance for entry of a novel variant of concern,” the CDC said.

Some scientists are worried the COVID-19 surge in China could unleash a new coronavirus variant on the world that may or may not be similar to the ones circulating now. That’s because every infection is another chance for the virus to mutate.

“What we want to avoid is having a variant enter into the US and spread like we saw with delta or omicron,” said Matthew Binnicker, director of clinical virology at Mayo Clinic in Rochester, Minnesota.

But the CDC’s action may be less about stopping a new variant from crossing US borders and more about increasing pressure on China to share more information, said Dr. David Dowdy, an infectious disease epidemiologist at Johns Hopkins Bloomberg School of Public Health, adding he hopes the restrictions “aren’t kept in place longer than they need to be.”

“I don’t think it’s going to have a major impact in slowing the spread of COVID-19,” Dowdy said. “We have a whole lot of transmission of COVID-19 here within our borders already.”

Dr. Stuart Campbell Ray, an infectious disease expert at Johns Hopkins University, agreed China isn’t sharing enough genomic sequencing information. But he also said the US has become a little complacent about sequencing and needs to redouble its own efforts. The CDC also announced the expansion of an early warning program that tests volunteers at select airports for new and rare variants of the coronavirus. That program will expand to airports in Seattle and Los Angeles.

Under the new rules, travelers to the US from China, Hong Kong and Macau, will be required to take a COVID-19 test no more than two days before travel and provide a negative test before boarding their flight. The testing applies to anyone 2 years and older, including US citizens.

It will apply to people traveling from China via a third country and to people connecting through the US as they go on to other destinations. Anyone testing positive more than 10 days before the flight can provide documentation showing they’ve recovered from COVID-19 instead of a negative test result.

It will be up to the airlines to confirm negative tests and documentation of recovery before passengers board.

Other countries have taken similar steps in an effort to keep infections from spreading beyond China’s borders. Japan will require a negative COVID-19 test upon arrival for travelers from China, and Malaysia announced new tracking and surveillance measures. India, Italy, South Korea and Taiwan are requiring virus tests for visitors from China.

Lunar New Year, which begins Jan. 22, is usually China’s busiest travel season, and China announced Tuesday it will resume issuing passports for tourism for the first time since the start of the pandemic in 2020.

“We look forward to welcoming Chinese travelers back to the United States,” US Travel Association President and CEO Geoff Freeman said in a statement. He called the US approach to testing inbound travelers “reasonable and appreciated.”

The US action is a return to testing requirements for some international travelers. The Biden administration lifted the last of such mandates in June. At that time, the CDC continued to recommend that people boarding flights to the U.S. get tested close to departure time and not travel if they are sick.

Early in the pandemic, the US barred entry to foreigners traveling from China, weeks after the virus first emerged there three years ago, and dozens of other countries were added to the list. The country started lifting travel bans late last year, but required travelers to the US to be vaccinated and tested.

ALSO READ-‘Country may see spike in Covid cases mid-January’

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COVID-19 India News

‘Country may see spike in Covid cases mid-January’

Complications in kids hospitalised with Covid: Lancet.(photo:pixabay.coM)

Union Health Minister Mansukh Mandaviya went to the Safdarjung Hospital to observe the Mock drill on Tuesday…reports Asian Lite News

The next 40 days will be crucial as India may see a surge of COVID cases in mid of January, said Union Health Ministry sources on Wednesday.

The sources said the assessment had been made after analysing the previous trends of the COVID surge the country experienced. As there have been reports of a surge in COVID cases in some countries, the operational readiness of health facilities is being reviewed in all States and Union Territories in case of another wave.

Notably, two passengers coming from Dubai tested positive for the COVID infection at Chennai airport on Wednesday.

“Two passengers who arrived from Dubai tested positive at the Chennai airport today. Both of them hailed from the Alangudi district of Tamil Nadu’s Pudukkottai. Their test samples have been sent to State Public Health Laboratory,” said Tamil Nadu Health Department said.

At least 39 international travellers have tested positive for COVID infection between December 24-26 as the random testing of international passengers arriving at the airports is being done

“The total number of international flights screened in the last three days ie December 24, December 25 and December 26 is 498. The number of samples collected for COVID-19 testing is 1,780. The cumulative number of samples collected is 3,994. The cumulative number of samples testing positive is 39 and the cumulative number of samples sent for whole genome sequencing is 39,” sources told ANI on Tuesday.

In light of the surge in COVID in some countries, hospitals across India conducted a Mock drill for COVID. The purpose of the mock drill was to evaluate COVID preparedness in terms of resources, protocol and personnel.

Union Health Minister Mansukh Mandaviya went to the Safdarjung Hospital to observe the Mock drill on Tuesday.

“To make sure there is not a COVID surge in the country, Prime Minister Narendra Modi has asked us to be careful. The government is also preparing if the Covid cases increase. Today mock drills are conducted across Covid hospitals in the country to make sure people get proper treatment,” the Union Health Minister said at Safdarjung hospital.

This came after four international travellers from Myanmar tested positive for COVID infection at the Delhi airport.

Meanwhile, India recorded 188 new COVID-19 infections in the last 24 hours, informed the Ministry of Health and Family Welfare on Wednesday.

India’s active caseload currently stands at 3,468 which accounts for 0.01 per cent of the total cases. The recovery rate currently is at 98.8 per cent. As many as 141 recoveries were made in the last 24 hours, thereby taking the total recoveries to 4,41,43,483

The daily positivity rate stood at 0.14 per cent, while the weekly positivity rate is at 0.18 per cent.

A total of 90,529 COVID-19 vaccine doses were administered in the last 24 hours.

On the COVID-19 vaccination front, the government data informed that over 220.07 crore vaccine doses had been administered so far under the nationwide COVID-19 vaccination drive. (ANI)

ALSO READ-US mulls new Covid curbs on Chinese arrivals

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COVID-19

Researchers use new tech to test blood proteins in Covid patients

The researchers discovered that Covid-19 patients had changes in immunosuppression pathways, which normally keep the immune system in balance, the study revealed…reports Asian Lite News

A team of researchers are combining new technologies to discover unique patterns of blood plasma proteins in critically ill patients that may help develop a more personalised approach to treating severe Covid-19, a new study has shown.

According to the study published in the Journal of Cellular and Molecular Medicine, the proteins being studied, called the “plasma proteome”, are released by cells that often play a key role in the body’s immune response to viruses.

To conduct the study, blood samples were taken from 30 subjects in three patient groups at London Health Sciences Centre (LHSC).

One group had patients with Covid-19, another group had patients with severe infection but were negative for Covid-19, and the third was a healthy control group.

“We collected plasma from these patients and measured well over a thousand proteins with great accuracy using new technology that combines immunology and genomics,” said Dr Douglas Fraser, Lawson Scientist, Critical Care Physician at Children’s Hospital at LHSC.

“With the use of this advanced technology, we were able to better analyse the protein patterns and better understand what is happening with Covid-19, especially in critically ill patients,” he added.

The researchers discovered that Covid-19 patients had changes in immunosuppression pathways, which normally keep the immune system in balance, the study revealed.

The changes were heightened in critically ill patients.

The plasma proteome analysis assisted researchers in determining which cells in the body are active during the disease state and which signalling pathways were activated.

“In-depth analysis of the human plasma proteome helps us capture tissue proteins that can provide us with information regarding organ integrity during infection,” said Cristiana Iosef, Lawson Research Associate.

“This is important because it will allow us to search for new blood biomarkers that are specific for Covid-19 patients,” she added.

Moreover, Dr Fraser commented that the team can now examine potential new drug therapies with the hopes of improving outcomes for these patients.

ALSO READ-We are keeping a close eye on the Covid situation in China, says Govt

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China COVID-19 India News

We are keeping a close eye on the Covid situation in China, says Govt

While official figures of recent Covid-19 infections and deaths are hard to come by, social media has been flooded with videos and images of overcrowded healthcare facilities as well as crematoriums…reports Asian Lite News

India is keeping a close eye on the Covid-19 situation in China but there is no specific guideline for Indians living there as of now, the Ministry of External Affairs (MEA) said on Thursday.

“We are keeping a close eye on the situation evolving in China. There is no advisory or specific guideline by the MEA for Indians living in China as of now,” MEA Spokesperson Arindam Bagchi said in response to a question at the weekly media briefing.

Indian nationals living in China would be expected to follow guidelines issued by the local health authorities, he added.

Bagchi also pointed out that India had helped other countries as the pharmacy of the world after the Covid-19 outbreak.

The past few days have seen China reporting an alarming surge in Covid-19 cases after it relaxed stringent curbs under its ‘zero-Covid policy’ after huge country-wide protests.

While official figures of recent Covid-19 infections and deaths are hard to come by, social media has been flooded with videos and images of overcrowded healthcare facilities as well as crematoriums.

Reviewing the Covid-19 situation in India amid a sharp spike in cases in China and several other countries, Union Minister of Health and Family Welfare Mansukh Mandaviya had on Wednesday directed officials to stay alert and step up surveillance.

The review came a day after the Ministry of Health and Family Welfare sent a letter to States and Union Territories citing the COVID-19 situation in the USA, Japan, South Korea, Brazil, and China.

Through the letter, Health Secretary Rajesh Bhushan requested all States and Union Territories (UTs) to gear up the genome sequencing of positive case samples to track the variants through the SARS-CoV-2 Genomics Consortium (INSACOG) network.

ALSO READ-US reports severe Covid community transmission

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-Top News COVID-19 World News

Covid will no longer be health emergency next year: WHO chief

The WHO chief said one of the most important lessons from the pandemic is that all countries need to strengthen their public health systems..reports Asian Lite News

The chief of the World Health Organization (WHO) has said that he hopes that Covid-19 will no longer be a global health emergency sometime next year.

Addressing a press briefing in Geneva, WHO Director-General Tedros Adhanom Ghebreyesus said that the WHO Covid-19 Emergency Committee will discuss next month the criteria for declaring an end to the Covid-19 emergency, Xinhua news agency reported.

“We’re hopeful that at some point next year, we will be able to say that Covid-19 is no longer a global health emergency,” he said.

He added, however, that the SARS-CoV-2 virus, the culprit behind the Covid-19 pandemic, will not go away.

People walk past a COVID-19 testing site in New York, the United States, on Dec. 7, 2022. (Photo by Michael Nagle/Xinhua/IANS)

“It’s here to stay, and all countries will need to learn to manage it alongside other respiratory illnesses including influenza and RSV (Respiratory Syncytial Virus), both of which are now circulating intensely in many countries,” he said.

The WHO chief said one of the most important lessons from the pandemic is that all countries need to strengthen their public health systems to prepare for, prevent, detect and respond rapidly to outbreaks, epidemics and pandemics.

Another key lesson is the need for much stronger cooperation in collaboration, rather than competition and confusion that marked the global response to Covid-19.

Meanwhile, Maria Van Kerkhove, technical lead of the WHO’s Health Emergencies Program, warned waves of infection and re-infection would continue around the world, as the number of weekly new deaths reported by countries still hovers between 8,000 to 10,000.

Mike Ryan, executive director of the WHO Health Emergencies Program, warned that the world still does not know how the SARS-CoV-2 virus will evolve in the future, and such uncertainties add to risks.

Before the WHO chief ends the Covid-19 emergency, a balance needs to be stricken between the virus — including its impact and unpredictability — and “whether or not we have dealt with the vulnerabilities and the resilience issues in our health systems,” Ryan said.

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