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Amazon health-care menace? Teladoc CEO says it is ‘overrated’

Amazon health-care threat? Teladoc CEO says it's ‘overrated'

The Amazon Pharmacy home screen on a smartphone arranged in the Brooklyn Borough of New York, U.S., on Tuesday, Nov. 17, 2020.

Gabby Jones | Bloomberg | Getty Images

Ask a sports star before a game whether their team is going to win and they’re likely to say yes with confidence. And then cue the headlines that will sensationalize the hubris. But would you expect an athlete to say — would you want them to think — they’re about to lose?

The heads of companies sometimes talk about the competition in a similar way, and they shouldn’t be in the CEO hot seat without confidence in their company’s ability to win.

Take Teladoc Health CEO Jason Gorevic, recently asked at the CNBC Healthy Returns Summit about the threat Amazon poses in health care.

“Based on the fact that it has one enterprise client of 385 employees, it is overrated,” Gorevic said, answering a question about Amazon Care, the retail and tech giant’s app-based primary care entry in Teladoc’s market, which signed up its first client, Peloton-owned fitness equipment company Precor, in May.

Should the Teladoc CEO be more worried? Even after Amazon’s deal with Berkshire Hathaway and J.P. Morgan to take on the status quo with its health care joint effort, Haven, fell apart, the merchandising giant still has a big market to exploit.

Amazon Care is expected to expand to its own employees in all 50 states this summer. It has been adding workers faster than any company in history, more than 500,000 in 2020. It also has had a deal with employer health provider Crossover Health for in-person employee health clinics that continues to expand across states with a goal of putting these clinics within a few miles of all Amazon employees, especially in light of the attention its workplace injury rates have received.

J.P. Morgan is moving on and deeper into health care after Haven, recently announcing it will move ahead with its own effort to invest in new health-care ideas, to be offered among its 165,000 employees and families.

Virtual health here to stay

As society has moved rapidly from the awareness phase of virtual care to the expectation phase, those expectations have increased, and Teladoc has added services like mental health treatment as part of what Gorevic tells CNBC is the future “unified experience” with patients.

“Virtual care is not a stay at home phenomenon,” Gorevic said. “The utilization we are seeing across multiple conditions all indicate it is here to stay.”

He cited first quarter 2021 results during which visit volume was up 69% year over year in spite of the fact that seasonal flu-related visits were down 90%.

Nevertheless, Teladoc shares have cratered, down from a peak earlier this year above $290 to roughly half that level, ending trading last week slightly above $146. But Gorevic says investors are missing the bigger picture, and overlooking improving numbers. The biggest quarterly number he cites: revenue per member, per month, which in Q1 2021 was $2.25, versus 87 cents a year ago.

Others cite the rapid M&A taking place in Teladoc’s market as reason to worry.

Walmart acquired MeMD in May; two other telemedicine competitors, Doctor on Demand and Grand Rounds, recently merged.

“Everyone feels like they have to have a press release that says something about telehealth to be relevant,” Gorevic told CNBC Healthy Returns. “I’m not surprised by any of these moves.”

“This pandemic has thrown the whole market into motion. As we looked at the market, we said we needed to be bold, and we see where it’s going,” the Teladoc CEO said, citing its $18 billion acquisition of chronic disease management company Livongo, which is focused on diabetes, and its expanding mental health services.

Gorevic says health-care consumers are overwhelmed by health-care websites and apps and want a unified experience, and the company is seeing that in multi-product bookings, which in 2020 represented two-thirds of bookings.

Amazon and the fear of disruption

Amazon’s ability to upend, or at least send waves of terror, through the health care industry has already been seen in the launch of its online pharmacy, which led to shares of Goodrx dropping from over $52 to roughly $33 after the announcement last October.

Wall Street analysts who cover Teladoc see Amazon’s presence as significant, yet not all agree it is an acute threat to Teladoc currently.

“Leery of Amazon’s initiatives here,” wrote Sean Wieland, managing director and a senior research analyst focusing on health-care information technology and health-care services at Piper Sandler, in response to an email.

“Even Amazon would have to get the enterprise market on board one employer at a time, as it’s a highly fragmented market and that would take years. Also, it’s a significant lift to go from offering urgent care visits on demand to whole person health care.”

More from CNBC’s Healthy Returns

Charles Rhyee, managing director and senior research analyst covering health-care technology and distribution at Cowen & Co., said Goodrx is a good example of how Amazon can disrupt health care, and it would be a mistake to ignore Amazon’s potential. But he thinks the threat in pharmacy is more direct than in telehealth.

“It’s is a mature market. There are tons of pharmacies out there and it is not a growth sector. In the truest sense, more of zero sum game,” Rhyee said, and that is something Amazon can afford to win at the expense of CVS or Goodrx.

Telehealth visits still a fraction of the market

Telehealth is still a nascent field and that may play to Teladoc’s favor in the years ahead.

“We are all talking about it because of Covid forcing everyone to seek virtual care, but if you think about how many visits Teladoc will do this year, it’s 12 million to 13 million visits,” Rhyee said.

That compares to a U.S. market in which there are one billion visits or more, annually, including mental health care.

Whether a Teladoc or American Well is growing in the telemedicine market, Rhyee says that amounts to about 2% to 3% of visits, a small fraction of what can be virtualized and an indicator that the market is going to expand.

“I’m not concerned,” Rhyee said. “Where Teladoc sits is not what Amazon is doing. It’s not just basic video visits to speak to a doctor for a minor thing. It is increasingly in multiple specialities and second opinions and Livongo. You can argue right now very few, if any, have that broad capabilities, and that’s why Doctor on Demand is merging with Grand Rounds.”

He looks at Amazon in basic care and pharmacy in a similar way to his analysis of Walmart’s health care after its acquisition of MeMD. “They want to provide some basic connectivity and prescriptions that can be dispensed at Walmart.”  

Why Teladoc shares have been volatile

Stocks move up and down in discrete periods of time, and that doesn’t always correspond to the longer-term trend. That’s part of the challenge for investors with Teladoc right now, trying to figure out what its growth looks like post-Covid.

Membership growth guidance for this year may not be as strong as some investors wanted coming out of Covid, and app tracking firms have shown slowing momentum in daily usage. Yet people using Teladoc less now than April of last year does not mean they are using it less than they were in 2019. And last year was unusual.

“We don’t know what virtual will look like in the end,” Rhyee said. 

The Cowen analyst has a $240 price target on the stock and says at $140 it is trading at roughly 8 times forward revenue, which is up from where it traded before Covid, but that was when “people didn’t believe it was a real business.”

Rhyee says he will worry more about Amazon if it starts stringing together acquisitions in health care, including in the chronic condition management space. “That would tell me they are much more serious about it,” he said.

As long as Amazon Care is one enterprise client and its own employees, the Teladoc outlook will be based elsewhere.

The idea of competition between Teladoc and Amazon may be missing the real threat Amazon poses in health care, according to David Grossman, research manager director at Stifel. That includes disrupting the legacy providers in insurance and pharmacy benefits managers.

Teladoc is disrupting traditional providers by creating a virtual 24/7 network on demand that can offer a potentially lower-cost alternative. Those traditional providers now forced to offer telemedicine are more of a near-term threat to Teladoc, in Grossman’s view, as they evolve from starting telehealth “literally overnight” to incorporating virtual care as a permanent feature of their care delivery models.

“Virtual care is now table stakes for providers, while 15 months ago it was barely on the radar screen,” he said.

Setting up appointments online and having telehealth as an option may be one of the features Amazon offers, but that is a shortsighted way to view what Amazon is after in the health care system.

Amazon is saying we take over everything. It’s not lets go after Teladoc. That’s incidental.

David Gross, Stifel analyst

Grossman, who is concerned about Teladoc’s ability to grow revenue and margins, says Gorevic is a smart guy building a reasonable model. Now they can pitch health plans on using a provider network they have created at lower cost for employers, if employees agree to access services virtually as a first stop. That disintermediates the traditional provider network, but he does not see Amazon stopping there or even thinking in those terms specifically.

“Amazon is saying we take over everything,” Grossman said, looking at traditional health care market that is flawed in delivery and pricing and adds little value. “It’s not lets go after Teladoc. That’s incidental.”

Taking cost out of the system is what Amazon already has proven to be great at, squeezing out players that don’t offer value and shouldn’t be there. “I’m rooting for them in that sense,” the Stifel analyst said.

But whether it is Amazon’s or Walmart’s efforts that are emerging in health care, the models to watch do not exclude Teladoc. “There is no indication we should write it off,” Grossman said.

Teladoc shares are down for a lot of reasons, starting with the market rotation out of growth names and the market acknowledging that traditional providers are ramping up their own telemedicine products.

“Everyone points to Amazon, and let’s be fair, it was a high multiple stock and the market is getting out of the stay at home trade and pricing how high can utilization translate into pricing” Grossman said. He added that Teladoc has struggled to convince the street of its pricing power. “They have been opaque.”

The company is growing monthly revenue per member, as Gorevic noted, but the Stifel analyst was quick to point out the recent Q1 growth relied on the acquisition of Livongo. Livongo is the largest provider of virtual chronic care and that is top of mind for employers, but Teladoc has a lot of work left to do to prove demand for it is a secular driver of its business growth.

Behavioral health, meanwhile, is the fastest- growing incremental service but there is only so much that can be delivered on an automated basis, so it becomes a staffing platform to match supply and demand and help sole mental health practice proprietors fill their book of business like an Uber or Lyft.

While the 8 times revenue the company is trading at might seem less than rich, double-digit revenue multiple companies tend to be in sectors like software, where scalability comes fast and at high margins. Teladoc’s subscription-heavy sales model means a majority of revenue is fixed while the costs remain variable.

“Their claim all along has been as utilization goes up it’s good for them, but there is no pricing algorithm around that. We don’t know how to calculate that,” Grossman said.

Companies like Teladoc and American Well can grow members, and grow utilization among members, but how either of those growth measures factor into pricing power remains unpredictable. Utilization can go up, but revenue not match it. And that contributes to investor concerns about its scalability.

“It is factually correct they can get more per member with more services and there are lots of opportunities, but lots of competition for each module and booking,” Grossman said. The company’s scale and visibility give it an advantage, “but lots remains uncertain,” he said.

Gorevic told CNBC this is not a pandemic story. “Something else is going on here. People are reaching out for other things.”

Mental health, dermatology, and chronic conditions including diabetes, and health issues linked to it such as weight loss. “Not one and done things, and that’s why I am convinced,” the Teladoc CEO said.

Building the virtual primary care model and convincing payers and employers that it is most cost-effective to choose this option, and agree to have members enter the health system virtually as the first step, is the bigger opportunity to drive higher revenue per member, Grossman said, and longer-term it is the more sustainable way to disrupt the traditional provider network.

In that sense, Teladoc is taking market share just like Amazon would, and they can grow for a longer period of time. That may be a discrete disruption in health care that becomes permanent. The biggest disruption in health care, though, is not about telemedicine.

“All roads lead into the payers,” Grossman said. “That’s where the level of satisfaction is low and the control they have is high.”

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Health

New York Turns to Good Thermometers for Illness Detection in Faculties

New York Turns to Smart Thermometers for Disease Detection in Schools

And then of course there are the inevitable privacy concerns. Kinsa emphasizes that all data made available to the city is aggregated and anonymized. “None of the individual data goes to anyone other than that person,” said Mr Singh. “You have the data, and we’re really persistent with it.”

While digital privacy experts say these are important safeguards, they also point out that information about children and health is particularly sensitive. “It’s really important to weigh the benefits and needs of public health against the social or societal risks,” said Rachele Hendricks-Sturrup, health policy advisor at the Future of Privacy Forum, a think tank focused on privacy.

For example, even anonymized data can sometimes be re-identified. “Even if it turns out to be ‘A fourth grader at this school in this neighborhood,’ that might narrow it down,” said Hayley Tsukayama, a legislative activist at the Electronic Frontier Foundation, a digital privacy group. “It doesn’t take a lot of data points to identify something new.”

The data, aggregated by zip code, will also feed into disease signals that Kinsa makes available on its public HealthWeather map. The company sometimes shares this information at the postal code level with pharmacies, vaccine distributors, and other companies. For example, Clorox used Kinsa’s data to determine where to target its ads. (Lysol won’t have special access to the data, says Kinsa.)

Both Kinsa and the city need to be transparent to families about how the data is used, stored and shared, and how long it is retained, experts said. City officials “are essentially putting their stamp on,” said Amelia Vance, director of youth and education privacy at the Future of Privacy Forum. “They need to make sure they are living up to parents’ trust that this program has been fully reviewed and is safe for their children and families.”

City officials will be closely monitoring how well the program is performing over the coming months, said Dr. Varma. How do families feel about the program? Is there enough intake to produce useful data? Can they actually spot outbreaks earlier – and slow the spread of disease?

“Our goal is to see if it really has the effect we hope in the real world,” said Dr. Varma. “It is also possible that the system does not detect anything conspicuous or unusual, but still proves successful because it provides people with useful information and increases their confidence that they have their children in school.”

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Biden Covid group holds briefing as U.S. doubles down on vaccine efforts

Fauci says AstraZeneca will likely issue modified statement

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President Joe Biden’s Covid-19 Response Team holds a press conference Thursday on the country’s response to the coronavirus pandemic that infected more than 33.3 million Americans and killed at least 595,849 people.

On Wednesday, Biden said the government had redoubled efforts to get more Americans vaccinated against Covid-19 by July 4th

In early May, Biden announced his administration’s new goals in the fight against this virus: 70% of adults in the US should receive at least one dose of a vaccine and 160 million adults should be fully vaccinated by Independence Day.

In a White House speech on Wednesday, Biden announced June as “national month of action” to vaccinate more Americans. He urged unvaccinated Americans to get the shots and said they were still at risk of getting seriously ill, dying, and passing the disease on to others, especially as autumn approaches.

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Why A.I. Ought to Be Afraid of Us

Why A.I. Should Be Afraid of Us

Artificial intelligence is gradually catching up with ours. AI algorithms can now consistently beat us in chess, poker and multiplayer video games, create images of human faces indistinguishable from real ones, write news articles (not this one!) And even write love stories and drive cars better than most teenagers .

But AI isn’t perfect when Woebot is an indicator. Woebot, as Karen Brown wrote in the Science Times this week, is an AI-powered smartphone app that aims to offer low-cost advice and dialogue through the basic techniques of cognitive behavioral therapy. However, many psychologists question whether an AI algorithm can ever express the kind of empathy required for interpersonal therapy to work.

“These apps really cut down on the essential ingredient that much evidence shows that helps in therapy, which is the therapeutic relationship,” said Linda Michaels, a Chicago-based therapist and co-chair of the Psychotherapy Action Network, a professional group, said the Times.

Empathy is of course not a one-way street, and we humans don’t show much more of it for bots than bots for us. Numerous studies have shown that people placed in a situation where they can collaborate with a benevolent AI are less likely to do so than if the bot were a real person.

“Something seems to be missing from reciprocity,” said Ophelia Deroy, philosopher at the Ludwig Maximilians University in Munich. “In principle, we would treat a complete stranger better than AI”

In a recent study, Dr. Deroy and her neuroscientific colleagues try to understand why this is so. The researchers paired human subjects with invisible partners, sometimes humans and sometimes AI; Each couple then played a series of classic business games – trust, prisoner’s dilemma, chicken and deer hunting, and a game they developed called reciprocity – designed to measure and reward cooperation.

It is widely believed that our lack of reciprocity towards AI reflects a lack of trust. It is, after all, hyper-rational and callous, certainly only to itself, barely cooperating, so why should we? Dr. Deroy and her colleagues came to a different and perhaps less reassuring conclusion. Their study found that people were less likely to cooperate with a bot, even if the bot is interested in cooperating. It’s not that we don’t trust the bot, but we do: the bot is guaranteed benevolent, a capital S sucker, so we’re taking advantage of it.

This conclusion was confirmed by the subsequent discussions with the study participants. “Not only did they tend not to reciprocate the cooperative intentions of the artificial agents,” said Dr. Deroy, “but if they were basically abusing the bot’s trust, they were not reporting guilt while they were doing it on humans.” She added, “You can just ignore the bot and don’t feel like you’ve broken a mutual obligation.”

This could have an impact on the real world. When we think of AI, we often think of Alexas and Siris of our future world with whom we may have some kind of intimate relationship. But most of our interactions will be one-off, often wordless, encounters. Imagine you are driving on the motorway and a car tries to pull in in front of you. If you notice the car is driverless, you are much less likely to get in. And if the AI ​​doesn’t take your bad behavior into account, an accident could ensue.

“What supports cooperation in society on any scale is the establishment of certain standards,” said Dr. Deroy. “The social function of guilt is precisely to get people to follow social norms that lead them to compromise, to work with others. And we didn’t evolve to have social or moral norms for non-sentient creatures and bots. “

That is, of course, half the premise of “Westworld”. (To my surprise, Dr. Deroy had never heard of the HBO series.) But a guilt-free landscape could have ramifications, she noted, “We’re creatures of habit. So what guarantees that the behavior that is repetitive and where you show less courtesy, less moral obligation, less cooperation does not color and pollute the rest of your behavior when you interact with another person? “

There are similar consequences for AI. “When people treat them badly, they are programmed to learn from what they experience,” she said. “An AI that has been put on the street and programmed to be benevolent should start not being so friendly to people, otherwise it will get stuck in traffic forever.” (That is basically the other half of the premise of ” Westworld “.)

There we have it: The real Turing test is Road Rage. When a self-driving car starts honking wildly from behind because you cut it off, you know that humanity has reached the peak of achievement. By then, hopefully AI therapy will be mature enough to help driverless cars solve their anger management problems.

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Day by day U.S. knowledge on June 3

Daily U.S. data on June 3

A man receives a test for coronavirus disease (COVID-19) in a mobile test car in Brooklyn, New York on June 2, 2021.

Brendan McDermid | Reuters

Average daily Covid cases remained below 20,000 for the third day in a row on Wednesday, according to data compiled by Johns Hopkins University.

At the same time, federal data shows the pace of daily reported vaccinations has fallen to a seven-day average of 1.1 million, the lowest level in months. White House Covid data director Cyrus Shahpar wrote in a tweet on Wednesday that Memorial Day holiday is responsible for lower vaccine administration and a delay in reporting.

According to the Centers for Disease Control and Prevention, approximately 51% of the total US population and 63% of American adults have had one or more vaccinations.

Covid cases in the USA

According to Hopkins data, the US reports an average of about 16,300 infections per day over the past week. Many states did not report any data on Memorial Day and may still be in the process of cleaning up their residues.

Covid deaths in the US

The seven-day average of daily Covid deaths in the US is 537, Hopkins data shows. This number could also be affected by lack of coverage on Memorial Day weekend and is made more complicated by data reviews by state health officials.

For example, on Tuesday, Kentucky Governor Andy Beshear announced that an audit found 260 new Covid deaths, according to the Associated Press. All of these are currently attributed to June 1 in the Hopkins data, although they occurred earlier in the pandemic.

Nevertheless, the daily reported death rates are far below the increased values ​​of last spring and last winter.

US vaccine shots given

The US reports an average of 1.1 million daily vaccinations over the past week, CDC data shows.

President Joe Biden on Wednesday redoubled his administration’s efforts to get more Americans vaccinated against Covid-19 by July 4th. Biden’s goal is to get 70% of American adults to get at least one vaccination by then.

US percentage of vaccinated population population

Approximately 51% of Americans have had one or more vaccinations, and 41% are fully vaccinated.

63% of those over the age of 18 are at least partially vaccinated.

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Blinded by Brighter Headlights? It’s Not Your Creativeness.

Blinded by Brighter Headlights? It’s Not Your Imagination.

Lights have gotten smaller over time, and “any given intensity appears brighter if it’s emitted by a smaller apparent surface versus a larger one,” said Daniel Stern, chief editor of Driving Vision News, a technical journal that covers the automotive lighting industry.

“Tall pickups and S.U.V.s and short, small cars are simultaneously popular,” he added. “The eyes in the low car are going to get zapped hard by the lamps mounted up high on the S.U.V. or truck every time.” (Almost half of the 280 million registered passenger vehicles in the United States are S.U.V.s or pickup trucks.)

LED and high-intensity discharge headlights can appear more blue in their output spectrum than halogens, and they often provoke “significantly stronger discomfort reactions” than warm white or yellowish lights, Mr. Stern said.

“Blue light is difficult for the human visual system to process because blue wavelengths tend to focus just ahead of the retina rather than on it,” he said.

Mark Baker, the founder of an activist group called Softlights, said that, while the blue LEDs might be among the best for nighttime driving, that did not mean they were good for everyone.

“It’s true that blue will allow you to illuminate farther,” he said. “If you choose to say, ‘I’m going to make the biggest, baddest light I can,’ you’re not paying attention to the receptors of another driver coming at you.”

“Brightness” is not a term generally recognized by scientists and researchers, who refer instead to lumens, or the output of a light. Halogen lights put out 1,000 to 1,500 lumens, while high-intensity discharge lights and LEDs can measure 3,000 to 4,000 lumens.

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Fauci’s 2,000 emails a day present how little U.S. officers knew within the early days of the Covid pandemic

Fauci's 2,000 emails a day show how little U.S. officials knew in the early days of the Covid pandemic

Dr. Anthony Fauci, Direktor am National Institute of Allergy and Infectious Diseases, nimmt an einer Anhörung des Gesundheits-, Bildungs-, Arbeits- und Rentenausschusses des US-Senats teil, um die COVID-19-Reaktion zu untersuchen, wobei der Schwerpunkt auf einem Update von Bundesbeamten auf dem Capitol Hill in Washington liegt , 18. März 2021.

Anna Geldmacherin | Schwimmbecken | Reuters

Am 12. April 2020 schickte ein Beamter der National Institutes of Health eine E-Mail an Dr. Anthony Fauci, den führenden Experten für Infektionskrankheiten des Landes, und den damaligen CDC-Direktor Dr. Robert Redfield, der sich über die zunehmenden Feindseligkeiten zwischen den USA und der Weltgesundheitsorganisation wegen des Coronavirus Sorgen machte Pandemie.

Dann drohte Präsident Donald Trump, der internationalen Gesundheitsorganisation die Finanzierung zu entziehen, weil sie „jeden Aspekt“ des Ausbruchs falsch gemacht hatte

„Ich bin besorgt über den jüngsten Kampf zwischen den USA und der WHO, weil er die aktuellen weltweiten Bemühungen zur Kontrolle der Ausbreitung von COVID-19 beeinträchtigen könnte“, heißt es in der E-Mail, die auch Fragen zur Genauigkeit des chinesischen Covid-19-Falls aufwirft und Daten zum Todesfall.

Fauci antwortete: „Diese Pandemie war für viele Länder auf der ganzen Welt, einschließlich China und den USA, eine extreme Herausforderung. Ich kann nur sagen, dass ich (und ich bin mir sicher, dass Bob Redfield genauso denkt) lieber nach vorne blicke und keine Schuld zuschreibe.“ oder Schuld.”

“Es liegen genug Probleme vor uns, die wir gemeinsam bewältigen müssen”, fügte er hinzu.

Notfallmediziner (EMT) heben einen Patienten, bei dem eine Coronavirus-Krankheit (COVID-19) festgestellt wurde, in einen Krankenwagen, während er Schutzkleidung trägt, während der Ausbruch der Coronavirus-Krankheit (COVID-19) in New York City, New York, andauert. USA, 26. März 2020.

Stefan Jeremiah | Reuters

E-Mails veröffentlicht

Die Nachricht des NIH-Beamten, dessen Name geschwärzt ist, wurde als Teil einer Sammlung von Tausenden von Faucis E-Mails aus der ersten Hälfte des Jahres 2020 veröffentlicht, die BuzzFeed News und andere Medien über das Informationsfreiheitsgesetz erhalten hatten. Als Direktor des Nationalen Instituts für Allergien und Infektionskrankheiten innerhalb der NIH stand Fauci im Mittelpunkt des Sturms.

Die ängstliche Note und Faucis ominöse Antwort veranschaulichen das Chaos des Augenblicks.

Covid-Fälle und Todesfälle in den USA hatten erschreckende neue Höchststände erreicht, seit Trump einen Monat zuvor die Pandemie zum nationalen Notstand erklärt hatte. Staatsoberhäupter hatten drakonische Sperrbefehle erlassen, die Millionen von Menschenleben auf den Kopf gestellt und einen wirtschaftlichen freien Fall ausgelöst haben. Tests, soziale Distanzierung und Kontaktverfolgung steckten in den Kinderschuhen, Krankenhäuser waren überfordert, wichtige Schutzausrüstungen wurden knapp und Impfstoffe mussten noch entwickelt werden.

US-Präsident Donald Trump erklärt die Coronavirus-Pandemie zu einem nationalen Notfall, während Vizepräsident Mike Pence und Gesundheitsminister Alex Azar während einer Pressekonferenz im Rosengarten des Weißen Hauses in Washington am 13. März 2020 zuhören.

Jonathan Ernst | Reuters

Der Präsident, der im Januar und Februar Chinas Reaktion auf den Ausbruch des neu auftretenden Virus gelobt hatte, hatte seinen Ton scharf geändert, die WHO und Peking kritisiert und beide für die Krise verantwortlich gemacht.

Fauci hatte in den Tagen und Wochen vor der offiziellen Erklärung der WHO am 11. März 2020 E-Mails von Personen erhalten, die besagten, dass eine Pandemie wahrscheinlich sei.

Einige fragten ihn, ob sie große persönliche Veranstaltungen absagen sollten, während andere Ideen für mögliche Behandlungen und Lösungen für den Ausbruch ausspuckten. Einige fragten, ob er der Meinung sei, dass die Amerikaner angemessen vorbereitet seien.

2.000 E-Mails pro Tag

Fauci bewies Geduld, Diplomatie und Fleiß in seinen oft nächtlichen Antworten an hochrangige US-Beamte, berühmte Künstler und normale Menschen. Die E-Mails zeigen auch den enormen physischen und manchmal emotionalen Tribut, den die Pandemie von Fauci forderte, der unter einer manchmal unzusammenhängenden Reaktion unter der Trump-Administration zu einer der vertrauenswürdigsten Informationsquellen zu Covid-19 geworden war.

Am 18. Februar 2020 erhielt Fauci eine E-Mail von einem scheinbar alten Bekannten, der fragte, ob er am Wochenende zu einem möglichen Treffen in der Stadt sei. Fauci entschuldigte sich, schrieb, dass er keine Verbindung herstellen könne und fragte, ob sie sich ein anderes Mal treffen könnten, während er ununterbrochen arbeitete.

„Das Weiße Haus und HHS haben mich rund um die Uhr, einschließlich Samstag und Sonntag, mit der Coronavirus-Krise beschäftigt. Ich habe meine Frau … in den letzten 10 Tagen insgesamt etwa 45 Minuten lang gesehen“, schrieb er. “Ich hoffe, dass du verstehst.”

Anthony Fauci, Direktor des National Institute of Allergy and Infectious Diseases, Center, spricht, während US-Vizepräsident Mike Pence (rechts) und Deborah Birx, Koordinatorin der Coronavirus-Reaktion, während einer Pressekonferenz im Besprechungsraum des Weißen Hauses in Washington zuhören. DC, USA, am Montag, 2. März 2020.

Andrew Harrer | Bloomberg | Getty Images

Bis Ende März, als die USA etwas mehr als 153.000 Covid-Fälle hatten, entschuldigte sich Fauci dafür, dass er so lange gebraucht hatte, um zu einem anderen alten Freund zurückzukehren, und sagte, er erhalte mehr als 2.000 E-Mails pro Tag. In einer separaten E-Mail einige Tage später an Dr. J. Larry Jameson, einen Arztkollegen an der University of Pennsylvania, sagte Fauci, er sei „völlig überfordert“ und bekomme „3 bis 4 Stunden Schlaf pro Nacht“.

Hilfsangebote

Seine E-Mails sind gespickt mit Pitches von Leuten mit sehr unterschiedlichem Fachwissen, die ihre besten Vermutungen zum Umgang mit der anhaltenden Krise abgeben.

Eine Person, die sich Anfang März meldete und sich selbst als „weder Arzt noch Wissenschaftler“ bezeichnete, schlug vor, dass die Regierung US-Erwachsene anderen bekannten und „weniger tödlichen“ Coronaviren aussetzt, um zu versuchen, ein gewisses Maß an Immunität gegen das neue Virus zu entwickeln.

Fauci antwortete um 22.50 Uhr: “Danke für Ihren Hinweis. AS Fauci.”

Quilter Ami Simms hat sich Mitte März gemeldet, um dem NIH ihre Dienste bei der Herstellung eines Musters für Gesichtsmasken anzubieten. Sie sagte, sie habe in der Vergangenheit Quilter für andere Zwecke mobilisiert und es gab “Millionen von Kanalisationen, die sich freuen würden, jetzt zu helfen und zu helfen”. Fauci leitete die E-Mail an Dr. Andrea Lerner, eine Top-Ärztin seiner Agentur, weiter.

Frau mit hausgemachter Gesichtsmaske

Isabel Pavia | Moment | Getty Images

Seine Antworten zeigen, dass die Eingabe, die den Posteingang verstopft, nicht immer willkommen war.

„Bitte lesen Sie dies und finden Sie heraus, worüber er spricht, und handeln Sie nach Ihrem Ermessen“, schrieb Fauci in einer E-Mail vom 7. ” zur Covid-Erkennung.

„Heute Abend sind nur noch 498 E-Mails zu versenden“, fügte Fauci hinzu.

Die vielfältigen Ratschläge und Fragen, die Fauci in diesen ersten Monaten erhielt, zeigten, wie viel führende US-amerikanische und internationale Wissenschaftler, einschließlich Fauci selbst, zu Beginn der Pandemie nicht über Covid wussten.

Unheimliche Frühwarnungen

Die Frage nach Masken kam früh und oft auf, und einige von Faucis Ratschlägen erwiesen sich später als falsch.

In einer E-Mail vom 5. Februar 2020 an die Präsidentin der American University, Sylvia Burwell, die unter dem ehemaligen Präsidenten Barack Obama als HHS-Sekretärin tätig war, riet Fauci ihr davon ab, am Flughafen eine Maske zu tragen. “Die typische Maske, die Sie in der Drogerie kaufen, ist nicht wirklich effektiv, um das Virus fernzuhalten, das klein genug ist, um das Material zu durchdringen”, schrieb er.

Fußgänger, die Schutzmasken tragen, um die Ausbreitung eines tödlichen Virus zu stoppen, das in der chinesischen Stadt Wuhan begann, gehen am 25.

Charly Triballeau | AFP | Getty Images

Der chinesische Immunologe George Gao wandte sich Ende März an Fauci, um sich für die Kritik an der US-Maskenpolitik zu entschuldigen. „Wie konnte ich so ein Wort ‚großer Fehler‘ über andere sagen? Das war die Formulierung des Journalisten. Ich hoffe, Sie verstehen“, schrieb Gao am 28. März.

Die USA würden ihre Maskenrichtlinien erst im Juli ändern.

Einige der E-Mail-Ketten erwiesen sich auch als unheimlich prophetisch.

Der Kolumnist der Washington Post, Michael Gerson, wandte sich am 2. März 2020 an Fauci, als es in den USA 91 bestätigte Fälle gab, und sagte, NIH-Direktor Dr. Francis Collins habe ihm gesagt, dass 5 bis 20 % des Landes mit Covid infiziert sein könnten.

“Eine Pandemie erscheint jetzt wahrscheinlich”, sagte er. “Abhängig von der Sterblichkeitsrate könnte dies zu Hunderttausenden von Todesfällen führen”, schrieb er. Fauci sagte, er habe Recht. Selbst wenn die Sterblichkeit bei 1% lag und nur 5% der US-Bevölkerung sie bekam, “könnten wir ein paar hunderttausend Tote haben”, antwortete er um 6:11 Uhr

Wuhan Institut für Virologie

Eine E-Mail vom 1. Februar von Faucis stellvertretendem Direktor am Nationalen Institut für Allergien und Infektionskrankheiten, Hugh Auchincloss, zeigt an, dass die Agentur versuchte festzustellen, ob sie an der sogenannten Funktionsgewinnforschung am Wuhan Institute of Virology beteiligt war. Das Labor wurde seitdem ins Rampenlicht der Debatte über die Ursprünge des Virus gerückt, nachdem Medienberichte aufgetaucht waren, dass mindestens drei Forscher dort im November 2019 an einer Covid-ähnlichen Infektion genug erkrankt waren, um sich in ein Krankenhaus zu begeben.

Während des Besuchs des Teams der Weltgesundheitsorganisation (WHO), das mit der Untersuchung der Ursprünge der Coronavirus-Krankheit (COVID-19) beauftragt ist, am 3. Februar 2021 in Wuhan, Provinz Hubei, China, halten Sicherheitspersonal Wache vor dem Wuhan Institute of Virology.

Thomas Peter | Reuters

Fauci hatte Auchincloss eine 2015 in Nature Medicine veröffentlichte Studie mit dem Titel „Ein SARS-ähnlicher Cluster von zirkulierenden Fledermaus-Coronaviren zeigt Potenzial für die Entstehung des Menschen“ geschickt. Die Studie wurde teilweise vom NIAID finanziert und hatte mehrere Autoren, meist von renommierten US-Institutionen. Einer von ihnen war jedoch am Wuhan-Institut ansässig, wo Forscher den umstrittenen Forschungsstil verwendeten, der einen Krankheitserreger aufnimmt und ihn tödlicher oder ansteckender macht, um Wege zu seiner Bekämpfung zu untersuchen.

“In dem Papier, das Sie mir geschickt haben, heißt es, dass die Experimente vor der Verstärkung der Funktionspause durchgeführt wurden, aber seitdem vom NIH überprüft und genehmigt wurden. Ich bin mir nicht sicher, was das bedeutet, da Emily sicher ist, dass keine Coronavirus-Arbeit das P3-Framework durchlaufen hat. Sie wird es versuchen.” um festzustellen, ob wir entfernte Verbindungen zu dieser Arbeit im Ausland haben.”

US-Präsident Joe Biden sagte im vergangenen Monat, er habe den US-Geheimdiensten befohlen, sich eingehend mit den Ursprüngen von Covid zu befassen, und sagte, es sei ebenso wahrscheinlich, dass es aus der Natur hervorgegangen oder aus einem Labor durchgesickert sei.

Fauci der Frauenschwarm

Als angesehener Experte für Infektionskrankheiten in wissenschaftlichen Kreisen, machten Faucis hochkarätige Rolle und sein sachlicher Stil als führende Autorität in der Pandemie ihn zu einem bekannten Namen – und zu einer widerstrebenden Popkultur-Ikone, wie seine E-Mails zeigen.

„Ich hätte mir das nicht einmal ausdenken können“, schrieb Fauci am 10. April über einen Artikel in The Atlantic, in dem er seinen schnellen Aufstieg zum „Herzenschwarm“ -Status inmitten der Pandemie beschrieb.

Brad Pitt als Dr. Anthony Fauci bei den “Fauci Cold Open” bei “Saturday Night Live” am 25. April 2020.

ABC | NBCUniversal | Getty Images

“Unsere Gesellschaft ist wirklich total verrückt”, schrieb Fauci als Reaktion auf einen ähnlichen Artikel, der “Fauci Fever” und die Online-“Sexualisierung” des heute 80-jährigen Virologen dokumentiert.

Sein Gesicht war auf Kleidung, Essen und Getränken eingebrannt, und er wurde ständig sowohl in den Nachrichten- als auch in den Unterhaltungsmedien erwähnt. Fauci reagierte in einer E-Mail vom 31. März auf einen Artikel der Washington Post über seine „Kultgefolgschaft“ und nannte ihn „wirklich surrealistisch“.

“Hoffentlich hört das alles bald auf”, schrieb Fauci. Er fügte in einem Follow-up hinzu: “Es ist überhaupt nicht angenehm, das ist sicher.”

Aber die Aufzeichnungen zeigen, dass Fauci von mindestens einer Darstellung von ihm geschmeichelt wurde: Brad Pitts Version von Saturday Night Live. “Pitt war unglaublich”, schrieb Fauci am 27. April an einen Kollegen. “Ein Rezensent der SNL-Show sagte, dass Pitt ‘genau wie ich’ aussah. Diese Aussage hat mein Jahr gemacht.”

“Jetzt haben Sie auch die Antwort darauf, wer Sie in dem Film spielen würde”, antwortete Tara Schwetz, die stellvertretende Direktorin des NIH. Fauci frönte der Idee: “Du könntest die Rolle meiner Freundin vom Medizinstudium spielen, was dir die Möglichkeit geben würde, mit Brad Pitt zusammenzuarbeiten.”

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Health

Alzheimer’s Drug Poses a Dilemma for the F.D.A.

Alzheimer’s Drug Poses a Dilemma for the F.D.A.

The Food and Drug Administration is on the verge of announcing one of its most contentious decisions in years: the fate of an Alzheimer’s drug that could be the first treatment approved after nearly two decades of failed efforts to find ways to curb the debilitating disease.

On Monday, the agency will rule on the drug, aducanumab, which aims to slow progression of memory and thinking problems early in the disease. If approved, it would be the first new Alzheimer’s medication since 2003 and the first treatment on the market that attacks the disease process rather than just easing symptoms.

It would become a blockbuster drug within several years, analysts predict, costing tens of thousands of dollars annually per patient and bringing a windfall to its manufacturer, Biogen.

Patient groups, desperate for treatments, are pushing for approval. But greenlighting the drug would fly in the face of objections from several prominent Alzheimer’s experts and the F.D.A.’s independent advisory committee.

In November, the committee voted overwhelmingly against recommending approval, saying data failed to demonstrate persuasively that aducanumab slowed cognitive decline. Three advisory committee members later wrote a point-by-point critique of the evidence. Other scientists, and an independent think tank, say aducanumab hadn’t shown convincing benefit to outweigh its safety risks.

“This should not be approved, because substantial evidence of effectiveness hasn’t been shown,” said Dr. Lon Schneider, director of the California Alzheimer’s Disease Center at the University of Southern California and one of many site investigators who helped conduct one of the aducanumab trials. “There’s very little potential that this will address the needs of patients.”

Beyond the status of this particular drug, some experts worry approval could lower standards for future drugs — an especially important question at a time when public trust in science is teetering.

“I simply don’t see a path for approval because of the absence of evidence that’s been shared to date that this product works, and I think it would set a remarkably dangerous precedent — not only for the field of Alzheimer’s research but also for the broader regulation of prescription drugs in our country,” said Dr. G. Caleb Alexander, an F.D.A. advisory committee member and an internist, epidemiologist and drug safety and effectiveness expert at the Johns Hopkins Bloomberg School of Public Health.

About six million people in the United States and roughly 30 million globally have Alzheimer’s, a number expected to double by 2050. Currently, five medications approved in the United States can delay cognitive decline for several months in various Alzheimer’s stages. About two million Americans have mild Alzheimer’s-related impairment, fitting criteria for aducanumab, a monthly intravenous infusion requiring regular imaging to detect potential brain swelling.

Biogen officials declined to comment for this article, but in earnings calls, medical meetings and F.D.A. presentations, they have said the evidence shows cognitive benefit. Several Alzheimer’s experts whose experience includes consulting for Biogen wrote recently that aducanumab “achieves the standard of meaningful efficacy with adequate safety.”

Debate centers on two never fully completed Phase 3 trials that contradicted each other. One suggested that a high dose could slightly slow cognitive decline; the other showed no benefit. Biogen says that given the need for Alzheimer’s medications, the single positive trial, plus results from a small safety trial and aducanumab’s ability to reduce a key protein, should justify approval.

The F.D.A. typically follows advisory committee recommendations and usually requires two convincing studies for approval, but it has made exceptions, especially for severe diseases that lack treatments.

Two other medications now in trials appear more promising than aducanumab, experts say, but it could be three or four years before data would indicate whether they merit approval. Many families say that’s too long to wait.

“There’s lots of issues with the data,” acknowledged Maria Carrillo, chief science officer for the Alzheimer’s Association, a patient advocacy group campaigning vigorously for approval. But she said her organization must “weigh the crushing reality of what people live with today” and support giving patients something to try instead of waiting several years for more conclusive positive results.

The F.D.A. itself seems divided. In advisory committee presentations, a clinical analyst cited “substantial evidence of effectiveness to support approval.” But an F.D.A. statistician wrote that another trial was needed because “there is no compelling, substantial evidence of treatment effect or disease slowing.”

And some experts, like Dr. Ronald Petersen, director of the Mayo Clinic’s Alzheimer’s Disease Research Center in Rochester, Minn., say they’re “on the fence.” He said he’d like to give patients a new option soon but “the data are iffy.”

Aducanumab, a monoclonal antibody, targets a protein, amyloid, that clumps into plaques in the brains of Alzheimer’s patients. Many amyloid-reducing drugs failed to slow symptoms in trials, a history that, some experts say, makes it especially important that aducanumab’s data be convincing. If effective, it would support a long-held, unproven theory that attacking amyloid can help if done early enough.

Excitement about aducanumab grew after a small early trial to evaluate safety showed amyloid reduction and hinted it might slow cognitive decline. The F.D.A., in a move some experts question, allowed Biogen to skip Phase 2 trials and conduct two Phase 3 trials of about 1,640 patients each.

Both trials were stopped early, in March 2019, when an independent data monitoring committee said aducanumab didn’t appear to be working. Consequently, 37 percent of participants never completed the 78-week trials.

But that October, Biogen announced it found benefit in one trial after evaluating data from 318 participants who finished before the trials were stopped but after the cutoff point for results the monitoring committee assessed.

In that trial, Biogen said, the highest dose slowed cognitive decline by 22 percent, or about four months over 18 months. A lower dose in that trial and high and low doses in the other showed no statistically significant benefit over a placebo.

“One study was positive, and one identically performed study was negative,” said Dr. David Knopman, a clinical neurologist at the Mayo Clinic and a site principal investigator for one trial. “I don’t think it takes a Ph.D. in statistics to see that that’s inconclusive.”

Dr. Alexander added that Biogen’s interpretation of data using after-the-fact analyses was “like the Texas sharpshooter fallacy — the idea that the sharpshooter shoots up a barn and then goes and draws a bull’s-eye around the cluster of holes that he likes.”

By contrast, Dr. Stephen Salloway, who has received research and consulting fees from Biogen but wasn’t paid for being an aducanumab trial site principal investigator, called himself a “passionate” supporter of approval. He considers the evidence sufficient because Alzheimer’s is so disabling.

“I understand people’s concerns — the data set has issues, of course,” said Dr. Salloway, director of neurology and the Memory and Aging Program at Butler Hospital in Providence, R.I. “F.D.A. is in a tough spot, obviously.”

But he favors giving patients the option. Of his 17 participants in both the safety trial and Phase 3, he said, 10 had remained relatively cognitively stable for several years, while seven had declined at typical rates.

“It didn’t work for everybody,” he said, but “it just seemed like there were more people that were steady for longer than I’m used to.”

One challenge with assessing impact is that many early-stage patients decline slowly anyway, Dr. Schneider said.

Advocates and many patients say delaying deterioration even slightly is meaningful. But some experts say the single trial’s slowing of 0.39 on an 18-point scale rating memory, problem-solving skills and function may be imperceptible to patients’ experience and doesn’t justify approving a drug that floundered in another trial and carries risk of harm.

“This product, even in the best of circumstances, would be not terribly effective at all, with significant safety risks,” Dr. Alexander said.

The potential harm involves brain swelling or bleeding experienced by about 40 percent of Phase 3 trial participants receiving the high dose. Most were either asymptomatic or had headaches, dizziness or nausea. But such effects prompted 6 percent of high-dose recipients to discontinue. No Phase 3 participants died from the effects, but one safety trial participant did.

Some trial participants’ views reflect the situation’s complexity.

Dewayne Nash, 71, of Santa Barbara, Calif., learned after the trial that he had received 18 months of a placebo, during which his cognitive scores improved — partly, he believes, because he lowered his cholesterol. Dr. Nash, a retired family physician, then received seven months of aducanumab, scaling up to the high dose, hoping it would slow decline, but “I didn’t notice any difference.”

Dr. Nash, whose mother and brother died of Alzheimer’s, will resume aducanumab soon through Biogen’s study for previous participants. He said that for his situation, he would like it approved because he expects to decline before other therapies become available and is willing to risk “brain bleeding and stuff.”

But scientifically, “I don’t like it when they rush drugs,” he said.

“They really ought to do the studies that need to be done” before approval, he added. Otherwise, “you’re giving people a drug that may help, but it may not.”

Dr. Salloway said one trial patient whose dementia had remained mild considerably longer than he’d expected was Henry Magendantz, a retired obstetrician-gynecologist in Providence, R.I. Dr. Magendantz, 84, started the safety trial after his wife, Kathy Jellison, noticed him having trouble following steps to assemble furniture.

He received a year of placebo, then a year of lower-dose aducanumab, then two years of the high dose before the 2019 halt. During that time, Ms. Jellison said, he was “slipping a bit,” but she believes aducanumab slowed decline enough to allow him to participate in tasks like choosing an assisted-living facility, where he moved in October 2018.

“It brought us some time,” she said.

Another issue with evaluating treatments is that some assessment scales, including in the aducanumab trials, involve reports from relatives or caregivers, who might miss subtle symptom progression.

“It is squishy stuff,” said Susan Woskie, a professor emeritus in public health at the University of Massachusetts Lowell, whose wife, Debby Rosenkrantz, 68, participated in the trial. “This stuff is really difficult, I think, to compile into metrics that have any validity.”

Ms. Rosenkrantz, a former social worker in Cambridge, Mass., said that while receiving roughly eight months of low-dose aducanumab in the trial, “I was really optimistic that there was a drug, and so for me it was like, yes, it’s working.”

Since restarting infusions in Biogen’s study for previous participants last September, though, “I haven’t noticed any change,” she said.

She experiences short-term memory loss and cannot follow recipes. “It just feels like there’s a blank in places where there shouldn’t be a blank in my brain,” she said.

Dr. Woskie said the couple yearns for treatments but that if the F.D.A. told Biogen, “‘No, we don’t fast-track approve you; come back when you have more data,’ that wouldn’t surprise me, and it might make sense.”

Some doctors who consider aducanumab’s evidence weak, including Dr. Knopman, say that if it is approved, they would tell patients their reservations but would feel ethically compelled to offer it.

Still, Dr. Jason Karlawish, a co-director of the University of Pennsylvania’s Penn Memory Center and a site investigator on Biogen-sponsored studies, said, “Physicians like me, who would be prescribers, are saying, ‘I want an effective drug to prescribe to my patients — but this is not the drug.’”

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Health

Non-public fairness group nears a $30 billion deal to purchase Medline, report says

Private equity group nears a $30 billion deal to buy Medline, report says

A Medline Industries employee collects examination gloves to be included in personal protective equipment (PPE) kits that will be shipped to various healthcare facilities at their warehouse in Mundelein, Ill., On Monday, October 20, 2014. Bloomberg via Getty Images

Bloomberg | Bloomberg | Getty Images

A group of private equity firms, including the Blackstone Group, Carlyle Group and Hellman & Friedman, are on the verge of a deal to buy medical device manufacturer and distributor Medline Industries, the Wall Street Journal reports.

The sale could be worth more than $ 30 billion for Medline, people familiar with the matter told the newspaper.

Medline Industries of Northfield, Illinois, manufactures 550,000 types of medical supplies for specialty medical facilities such as surgical centers, acute care facilities, nursing homes, hospice centers, and hospital laundries, according to the company’s website. Founded in 1910 by AL Mills, the family business now sells in more than 125 countries.

WSJ originally reported Medline’s interest in an April sale.

When CNBC reached them, Blackstone and Hellman spokesmen declined to comment. Carlyle and Medline representatives were not immediately available.

Read the full report in the Wall Street Journal here.

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Health

C.D.C. Says Little one Covid Hospitalizations Are Uncommon, however Extra Frequent Than Flu

C.D.C. Says Child Covid Hospitalizations Are Rare, but More Frequent Than Flu

According to a study published Friday by the Centers for Disease Control and Prevention, the number of Covid-19-related hospitalizations among teenagers in the United States over the past three flu seasons has been about three times higher than influenza-related hospitalizations.

The results contradict claims that influenza is more threatening to children than Covid-19, an argument used to reopen schools and question the value of vaccinating adolescents against the coronavirus.

“Much of this suffering can be prevented,” said CDC director Dr. Rochelle P. Walensky, in a statement. “Vaccination is our way out of this pandemic.”

Children are at a much lower overall risk of Covid-19 compared to adults, but it is believed that their likelihood of infection and serious illness increases with age. Since the beginning of the pandemic, the hospitalization rate for children ages 12-17 has been 12.5 times lower than that of adults. However, according to the new report, the rate was higher than in children ages 5-11.

The researchers counted Covid-19 hospital stays in children aged 12 to 17 from March 1, 2020 to April 24, 2021. The data came from Covid-Net, a population-based surveillance system in 14 states that covers about 10 percent of Americans.

The number of adolescents hospitalized for Covid-19 decreased in January and February of this year, but rose again in March and April. Between January 1, 2021 and March 31, 2021, 204 teenagers were likely hospitalized mainly for Covid-19. Most children had at least one underlying medical condition, such as obesity, asthma, or a neurological disorder.

None of the children died, but about a third were admitted to intensive care and 5 percent required invasive mechanical ventilation. About two-thirds of adolescents admitted to the hospital were Black or Hispanic American, reflecting the greater risk the virus poses to these populations.

The researchers compared the numbers for Covid-19 to hospital admissions for flu in the same age group during the 2017-18, 2018-19, and 2019-20 flu seasons. From October 1, 2020 to April 24, 2021, adolescent hospital admission rates for Covid-19 were 2.5 to 3.0 times higher than for seasonal flu in previous years.

The rate could have increased this spring due to the more contagious variants of the coronavirus floating around, as well as the reopening of schools that brought children together indoors and looser adherence to precautions like wearing masks and social distancing, the researchers said .

The data adds urgency to the drive to get more teenagers vaccinated, said Dr. Walensky, who added that she was “deeply concerned” with the numbers.