Covering COVID-19 is a daily Poynter briefing of story ideas about the coronavirus and other timely topics for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.
The American Society of Nephrology’s COVID-19 Response Team reported that as many as half of the patients with severe COVID-19 that go into intensive care experience kidney failure that requires some form of dialysis.
The numbers that doctors in New York were seeing months ago are playing out nationwide now. And the result is a staggering demand for kidney disease treatment that will last long after the pandemic passes.
46% of patients that were admitted to the hospital with COVID-19 since the beginning of the pandemic had some form of acute kidney injury; of those, 17% required urgent dialysis.
Surprisingly, 82% of patients that got an acute kidney injury had no history of kidney issues; 18% did. More than a third of patients that survived did not recover the same kidney function they had before contracting the virus.
This finding alone points us to what will likely become a new urgent health need.
Pre-pandemic, the U.S. was spending about $100 billion annually to treat the nearly 40 million Americans suffering from chronic kidney disease who need dialysis and organ transplants. It was the ninth-leading cause of death in the nation due to the rise in obesity and Type 2 diabetes, according to the Centers for Disease Control and Prevention.
“The next epidemic will be chronic kidney disease in the U.S. among those who recovered from the coronavirus,” says Dr. Steven Coca, associate professor of nephrology at Mount Sinai Health System and co-founder of RenalytixAI. “Since the start of the coronavirus pandemic we have seen the highest rate of kidney failure in our lifetimes. It’s a long-term health burden for patients, the medical community — and the U.S. economy.”
To add to the concerns, as if you needed to add to them, new studies are showing an alarming fatality rate among dialysis patients who get COVID-19. The National Kidney Foundation said polling shows an urgent need for the public to understand this threat.
The National Kidney Foundation-Harris Poll Survey on COVID-19 and Kidney Health shows fewer than 1 in 5 Americans know that COVID-19 can cause renal damage. Just 17% are aware of the potential effects of the virus on the kidneys, while more than half (58%) know about the possibility of acute respiratory failure, pneumonia (54%), and acute respiratory distress syndrome (52%).
According to the results, public awareness of what COVID-19 can do to the kidneys is on par with what the virus can do to the liver, as 15% of the respondents knew it can cause acute liver injury; 16% knew it could cause septic shock.
Closing public restrooms in a pandemic
Takeout only restaurants have closed their restrooms. So have office buildings and other businesses. The New York Times pointed out:
The lack of restrooms has become an issue for delivery workers, taxi and ride-hailing drivers and others who make their living outside of a fixed office building. For the city’s homeless, it’s part of an ongoing problem that preceded COVID-19.
“It’s gone from bad to worse,” said Eric, who lives in an encampment near Interstate 5. (Eric asked to be identified by only his first name.) “It’s definitely much, much harder.”
A nearby pet supply store used to let homeless people use the restroom, but that changed during the pandemic. Conditions improved markedly when the city placed a portable restroom and handwashing station near the camp, but Eric said many more parts of town still lack similar amenities.
Some thoughtful cities have added more public toilets to ease the shortage.
The Times included this insightful passage:
Private companies might require guests to buy something before using the restroom, advocates said, creating a barrier for homeless or otherwise marginalized people. In places where public urination laws are enforced, those who can’t pay may face repercussions.
“You’re criminalizing having a bladder,” said Taunya Lovell Banks, a professor at the University of Maryland School of Law who recently wrote a law review article about the lack of public toilets. “If you’re caught by the police and ticketed, you have to register as a sex offender. It’s beyond the pale.”
Banks noted that businesses may be less likely to allow homeless people to use their facilities, and people of color also are less assured of gaining access. For female-bodied people, urinating discreetly in the absence of restrooms is not always possible.
“It’s a class issue, it’s a race issue, it’s a gender issue,” she said. “(During the pandemic,) middle-class white people who normally have greater access to toilets in public spaces are all of a sudden being denied access. Now they’re woke to it.”
Are public restrooms really a COVID-19 danger? It is a legit question, especially since we learned about something called “toilet plumes,” in which flushing a toilet may shoot the virus into the room. Serious research found, “Toilets are a daily necessity but also become dangerous if used improperly, especially against the current scenario of a global pandemic.”
The best advice is to avoid public toilets, and when you can’t, to close the lid when you flush. But, in lots of public facilities, there is no lid.
A bit of context, however: Researchers believe that the virus passed around by toilet flushing or on sink counters is not as infectious as the virus that people cough out.
More clothing stores file for bankruptcy
It is a lousy time to be a clothing store chain with everyone working at home and not wearing fancy clothes. Men’s Wearhouse and Jos. A. Bank were already having financial trouble before the pandemic. But it pushed them over the financial cliff, as it has done for other big names like J. Crew and Brooks Brothers. Then there is Lord & Taylor, in a class by itself as the oldest department store chain in America, which also filed for bankruptcy. Lord & Taylor invented ornate department store window displays.
Back-to-school clothing sales usually provide a spike for retailers. But with so much uncertainty about school plans, even that sector has been lethargic.
A survey by the National Retail Federation released in July showed that more than half of consumers who hadn’t made back-to-school purchases had put off shopping because they did not yet know what they would need.
A long continuation of virtual learning also could hurt sales of back-to-school sneakers and athletic shoes for sports, one analyst said. High unemployment, later school start dates and cancellations of fall sports could contribute to lackluster sales, Matt Powell, a senior industry adviser for sports for NPD Group, said in a report.
Sneaker sales were strong in June, due to pent-up demand and promotions after three months of lockdowns. But Powell says those levels are not sustainable.
“Every day, we hear about another school district going virtual this fall,” Powell wrote in the report. “Those students probably don’t need new shoes to take classes virtually (do they need shoes at all?).”
The Sun said parents might spend more on technology for their kids’ virtual learning and spend less on new school clothes this year.
Why are your home electric bills so high?
Maybe you are like me and were a little surprised by how much your summer electric bills have gone up. When you think about why, it should not surprise you. You probably have been home more this summer, maybe like me, working from home a lot.
With people spending more time at home, one-third of U.S. households should see electricity bills climb 10% to 15% higher this summer, according to data from the clean energy technology firm Arcadia.
Households in metro areas will spend the most, between $2 and $37 more on utility bills this summer, Arcadia found.
(Source: Arcadia COVID-19 bill increase estimations; Graphic by George Petras/USA TODAY.)
A bunch more stores just announced they will not be open to Thanksgiving crowds this year and are holding off on announcing Black Friday plans. Retailers are hinting that they will put even more effort into online sales and start offering Black Friday kinds of sales a lot earlier this year. It will be interesting to see what all of these changes mean to holiday advertising since it is so important to all legacy media.
Prioritizing who would get vaccines first
My friend and medical ethicist Art Caplan is always one who makes us think. Some of what he said this weekend won’t be popular. Caplan said:
- When we get a COVID-19 vaccine it will likely be about 50% effective. (Sometimes vaccines do not work as well on older populations. The World Health Organization recommended the 50% rate in April.) In fact, the WHO said Monday that there may never be a silver bullet that vaccinates everyone from COVID-19.
- The first people to get vaccines should be health care workers and people who are “likely to die” which, he said, might put people who are prisoners at the front of the vaccine line since prisons and jails are among the most infectious places in America at the moment.
- Poor communities of color, including Native Americans living on reservations, should be among the first vaccinated, he said.
- What about obese people, since they are more at risk of getting sick?
- If you don’t wear a mask, should you be last in line for a vaccine? Caplan said we should not try to sort out “saints and sinners” when it comes to health care.
- When it comes to “America first,” Caplan said if the vaccine comes from a U.S. company then Americans should get the vaccine before shipping it worldwide. He compared it to putting on an oxygen mask on an airplane. Once the U.S. is vaccinated then we might be more available to help other countries.
He also said there will be some who will push for mandatory vaccinations but, he said, in the end it may be private employers who require workers to show proof of vaccination. We have seen this debate before when some hospitals required all workers to get flu shots.
Any one of these suggestions could produce a story of its own.
Let me clarify some numbers from yesterday
Yesterday I passed along the story and some data from that COVID-19 outbreak at a day camp in Georgia. I said:
And, look at this: 51% of cases were among those aged 6 to 10 years, 44% were among those aged 11 to 17 years, and 33% were among those aged 18 to 21 years.
My thanks to sharp-eyed reader Sam Houff for challenging my figures which, of course, sum up to more than 100%. I should have said:
Researchers have test results for 344 of the 597 people at the camp. Of those tested, 44% tested positive. 51% of campers under age 10 were positive. 44% of campers 11-17 were positive. And 33% of campers ages 18-21 had positive tests.
The outbreak was fairly widely reported in July, but this data is part of a deeper dive in a briefing from the CDC. The new data is important because, “These findings demonstrate that SARS-CoV-2 spread efficiently in a youth-centric overnight setting, resulting in high attack rates among persons in all age groups, despite efforts by camp officials to implement most recommended strategies to prevent transmission.”
Since I am drilling down on the data again, there are a few other noteworthy details.
Attack rates increased with length of time spent at the camp, with staff members having the highest attack rate (56%). It makes me wonder if there is something in that data that might interest educators who will be in close contact with students for hours on end soon.
I have also been interested to see what symptoms younger people are showing when they do test positive. Among 136 cases at the Georgia camp that reported symptom data:
- 36 (26%) patients reported no symptoms.
- Among 100 (74%) who reported symptoms, those most commonly reported were subjective or documented fever (65%), headache (61%) and sore throat (46%).
Fast food breakfasts are down, cereal is up
Market researcher NPD Group said breakfast transactions for U.S. restaurant chains declined by 18%. Before the pandemic, breakfast traffic in fast food establishments had nearly quadrupled in the last five years, while breakfast cereal declined.
Now, NPD said, we are eating a lot more cereal, with sales up 16% in the second quarter of this year. The best guess is that when we are not hustling off to work we don’t see a need to drop by and grab breakfast. We can just eat it at home.
Mac and cheese, ketchup, frozen potatoes and paper towel sales are also strong in the pandemic. Anything having to do with shaving is not so popular right now.
One more thing. The CEO of McDonald’s said that the chain may ditch its playground ball pits. CEO Chris Kempczinski said, “I don’t know if we’ve got ball pits in our future. There’s probably some good public health reasons not for us to be doing a lot of ball pits.”
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Al Tompkins is senior faculty at Poynter. He can be reached at atompkins@poynter.org or on Twitter, @atompkins.
