This week marked four years since the World Health Organization declared COVID-19 a pandemic. In that time, the SARS-CoV-2 virus has wreaked devastation across the globe.

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Worldwide, the death toll from the historic public health crisis officially stands at around 7 million, though the actual number is estimated to be significantly higher with an upper bound near 30 million. In the U.S. alone, roughly 1.2 million Americans have died according to the official numbers. Once again, the actual  number is likely higher.

So many deaths have caused a drop in global–and American–life expectancy

The SARS-CoV-2 virus has been linked to serious health complications like heart attacks and strokes and has been shown to leave some patients suffering with lingering symptoms. Long COVID, as the condition is commonly called, can range from frustrating but manageable to utterly debilitating. According to one estimate, more than 144 million people worldwide had developed long COVID between 2020 and 2021. A report from the National Institutes of Health found that as many as 23 million Americans were afflicted.

The National Institutes of Health has acknowledged that the best way to protect against long COVID is by not getting infected in the first place. But the U.S. policies do not reflect best practices like improving indoor air quality and ventilation, staying home when sick, and seeking treatment when necessary.

The country has not implemented indoor air quality rules for workplaces, schools, and public-facing buildings. It has not systematically upgraded ventilation in public buildings. There remains no federally guaranteed paid leave. Nor is there national, free healthcare for all Americans.

Meanwhile, the safety net expansions implemented early on in the pandemic–expanded unemployment assistance, the eviction moratorium, the student debt repayment freeze, and stimulus checks–has expired or ended.

Americans today are left largely to the mercy of their employers and are forced to bear unnecessary risk of a potentially deadly, debilitating disease simply to participate in society. The virus is still killing hundreds of Americans every week.

As Julia Doubleday noted in a new article in The Gauntlet, for the vulnerable–the elderly, the immunocompromised, the disabled–this new American normal that treats infection and re-infection as inevitable facts of life, raises questions about accessibility.

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Fundamentally, COVID is a problem that requires government solutions. But with the presidential election coming up, the White House, having allowed the public health emergency declaration to end, has been telling Americans that the country is in a better place and they can live their lives based on their own individual risk assessments. Of course, there has also been little public warning on the subject of the persistent risk of long COVID and health complications following infection.

With the administration pushing normalcy, public health authorities have retreated from best practices. This month, for example, came the surprise announcement by the Centers for Disease Control and Prevention that the agency was dropping its five-day COVID-19 isolation guidance, which had initially been slated for April with a public comment period.

The news drew criticism from public health and medical experts. Washington, D.C.-based internist Dr. Ida Bergstrom, who has treated both COVID and long COVID patients, told OptOut that the CDC's decision was "totally insane."

Dr. Peter Hotez, director of the Center for Vaccine Development at Texas Children's Hospital and a former Nobel Prize nominee for his development of a low-cost COVID vaccine for use in poor nations, was also critical. Hotez noted that COVID is more dangerous than other respiratory viruses and suggested the CDC ought to focus its efforts instead on increasing vaccination and testing.

"I understand CDC’s desire to harmonize COVID isolation guidelines with other respiratory pathogens but it’s helpful to remember that COVID is different because of its ability to cause thromboembolic events including stroke and heart attacks."

Offering up a scathing rebuke of the agency's move was Dr. Lucky Tran, a molecular biologist and science communicator at Columbia University. Tran posted on Threads that the CDC's decision "goes against the science, encourages disease spread, and prioritizes corporate interests, making it easier for bosses to exploit workers."

A spokesperson for the CDC would not say whether or not industry groups had been consulted prior to making the change. In the past, when asked about other decisions scaling back public health guidance amid corporate lobbying efforts, the agency has said it welcomes input from all "stakeholders" including industry.

Faced with a Biden administration that seems determined to put COVID in the rearview with minimal government action, some public health advocates are done trying to play nice.

A group called the Long COVID Action Project (LCAP), which represents long COVID sufferers, has been waging a pressure campaign in Washington, D.C. to get research funding, recognition, and treatments for the condition. Members of the group have been emailing and calling politicians' offices in the hopes of forcing the issue. In January, the group disrupted a hearing of the Senate Health, Education, Labor, and Pensions Committee about long COVID.

Today, LCAP is one of a number of groups rallying in Washington, D.C. for what they have dubbed the second International Long COVID Awareness Day. The theme of the day: "Confront Long COVID."

The groups, which also include International Long COVID Awareness, Long COVID Washington D.C., the Long COVID Foundation, and Long COVID Kids, laid out a list of demands in a press release including recognition of March 15 as Long COVID Awareness Day and Month by the United Nations, as well as a host of policies for governments to implement to address the ongoing COVID pandemic such as mandating N95 masks in healthcare settings and proving reliable data to track spread.

"Furthermore, governments can implement clean indoor air initiatives such as the Clean Air in Buildings Challenge (United States), as well as fund research and clinical trials for Long Covid treatments, especially novel antivirals targeting SARS-CoV-2," the statement read. "Assisting those in need of social assistance is crucial, as trends indicate a rise in evictions and homelessness as individual costs increase. Global leaders should promote medical programs that assist doctors to provide appropriate guidance and care to patients, especially in Long Covid clinics where some doctors lack knowledge on which tests to run or how to best help patients."

The groups also urge the CDC "to maintain the 5-day COVID-19 isolation guidelines and reject attempts to decrease the isolation period. In fact, the science is clear the original 2-week isolation period would be far better at reducing the spread of the virus and its dangerous health outcomes."

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But wait, there's more!

OptOut co-founder and editorial director Walker Bragman interviewed molecular biologist Philipp Markolin about COVID's origins for IMPORTANT CONTEXT. In this free, hour-long discussion, the pair discuss the scientific evidence and why it it points to natural orgins.

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Did you know OptOut is working on an investigative podcast about how and why the U.S. was hit so hard by COVID-19? The limited series will contain original reporting and cover how systemic holes, special interests, and political cowardice helped undermine the science, fuel the rise of misinformation, and thwart necessary government action.

Please consider donating $20, $100, $1,000, or whatever you can here to make this project a reality!

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