Finland may be about to become the first country in the world to start dishing out preventative bird flu vaccines to some citizens. Its being reported that the first shipments of vaccine secured by the European Union (EU) will be heading there, so that those most at risk of exposure to the virus can be offered some protection.
Reuters reports that the EU is due to sign a contract with vaccine manufacturer CSL Seqirus to secure 665,000 doses of a preventative avian influenza vaccine on behalf of 15 nations within the EU and European Economic Area (EEA). Similar efforts are underway in the US, Canada, and UK, but with the EUs deal slated for completion on June 11, 2024, its looking likely the first nation to begin its vaccination efforts will be Finland.
The Zoonotic Influenza Vaccine Seqirus, which was authorized for use by the European Medicines Agency (EMA) in October 2023, was developed against a strain of bird flu in the H5N8 classification.
This is slightly different from the bird flu thats recently been hitting the headlines with outbreaks on dairy farms in several US states thats an H5N1 virus. However, since the vaccines main target is the hemagglutinin surface protein on the virus the H part, which is common to both H5N8 and H5N1 its hoped that it will still offer some protection against H5N1.
So far, three farm workers in the US are known to have contracted the virus after exposure to infected cows, and theres no evidence of transmission between people. While the risk is generally considered low, those whose occupations bring them into close contact with animals will be the proverbial canaries in the coal mine if this virus starts to make more frequent jumps to humans.
The US Centers for Disease Control and Prevention (CDC) is recommending that anyone spending time around dairy cows or raw milk practice good hand hygiene and wear personal protective equipment, including gloves, respirators, and safety goggles. Its hoped a vaccine, even against a slightly different avian flu virus, will offer another layer of protection.
No EU/EEA countries have yet reported a human case of H5N1. The risk of zoonotic influenza transmission to the general public in EU/EEA countries is considered to be low, said the European Centre for Disease Prevention and Control in its weekly report for June 1-7.
That said, Finland saw a number of outbreaks of highly pathogenic H5N1 in 2023, in wild birds and among mammals on a number of the countrys over 500 fur farms, which resulted in large-scale culling.
Animals that are farmed for fur, like mink, are known to be susceptible to avian flu, but outbreaks on fur farms, as well as the ongoing situation with dairy cows in the US, are particularly concerning to epidemiologists as they raise the specter of sustained transmission between mammals, which itself increases the chance of a virus making the jump to humans.
Last year the situation looked very alarming, said Hanna Nohynek, chief physician with the Infectious Diseases Control and Vaccines Unit at the Finnish Institute for Health and Welfare, according to Euractiv. This year has been more calm, but we know from the US that the virus is still around, so we want to protect those who are working with animals that might be affected.
To that end, STAT News reports that Finnish authorities are planning to start delivering doses to poultry farmers, fur farm workers, vets, and scientists studying the virus as soon as the vaccines are in the country.
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PIERRE, S.D.(MITCHELLNOW)The United States and Europe are taking steps to acquire or manufacture H5N1 bird flu vaccines that could be used to protect at-risk poultry and dairy workers, veterinarians, and lab technicians, which influenza experts say could curb the threat of a pandemic.
U.S officials announced they were moving bulk vaccine from CSL Seqirus that closely matches the current virus into finished shots that could provide 4.8 million doses of vaccine. Dawn OConnell of the U.S. Administration for Strategic Preparedness and Response said the government is looking closely at the possibility of vaccinating farm workers and others in close contact with the virus. The U.S. has contracts with CSL and GSK to test pre-pandemic vaccines that more closely match the circulating virus than older H5N1 vaccines in the stockpile. The U.S. is moving forward with the CSL vaccine, a Department of Health and Human Services official confirmed. Only 40 people nationwide have been tested for the virus
In addition to the three human cases reported in the United States, since 2022, bird flu in the United States has infected over 90 million chickens, more than 9,000 wild birds and 81 dairy herds.
US News
By Emily Crane
Published June 6, 2024, 7:27 a.m. ET
COVID vaccines could have contributed to excess deaths in the US and other Western countries in the three years since the pandemic took hold, according to a new study that argues that world leaders and policymakers need to thoroughly investigate the aftermath of the contagion.
Analyzing mortality data from 47 Western countries, scientists from the Netherlands Vrije Universiteit found that excess mortality has remained high since 2020 despite the widespread rollout of COVID vaccines and various containment measures.
The researchers said the trend raised serious concerns as they urged government leaders to thoroughly investigate the underlying causes of persistent excess mortality, according to the study published in BMJ Public Health.
Although COVID-19 vaccines were provided to guard civilians from suffering morbidity and mortality by the COVID-19 virus, suspected adverse events have been documented as well, the researchers wrote.
Both medical professionals and citizens have reported serious injuries and deaths following vaccination to various official databases in the Western World, they continued.
The study found there had been more than 3 million excess deaths across the US, Europe and Australia since 2020.
Of those excess deaths, more than 1 million occurred in 2020 at the height of the pandemic, according to the study.
Those figures, however, remained high in the following years, with 1.2 million in 2021 and 800,000 in 2022, researchers added.
The death toll figures include fatalities directly linked to the virus, as well as indirect effects of the health strategies to address the virus spread and infection. The researchers added that serious side effects of the vaccines had been documented, including ischemic strokes, acute coronary syndromes and brain hemorrhages.
While the study does not establish a link between COVID vaccinations and excess mortality, it argues that more research is needed in order to help better dictate future health policy.
Consensus is also lacking in the medical community regarding concerns that mRNA vaccines might cause more harm than initially forecasted Despite these concerns, clinical trial data required to further investigate these associations are not shared with the public. Autopsies to confirm actual death causes are seldom done, it noted.
Governments may be unable to release their death data with detailed stratification by cause, although this information could help indicate whether COVID-19 infection, indirect effects of containment measures, COVID-19 vaccines or other overlooked factors play an underpinning role, it added.
Meanwhile, various studies have shown that COVID-19 vaccinations saved millions of lives throughout the pandemic.
The shots are estimated to have saved 14 million lives worldwide within their first year alone, according to Science Feedback.
There are many possible explanations for the remaining excess deaths that were not directly caused by COVID-19; however, the evidence is clear that the vaccines saved millions of lives and they are not associated with excess deaths, the non-profit organization said of the study, noting that the researchers didnt analyze the impact of vaccination, nor did it examine the relationship between mortality and vaccination status.
Jeffrey S Morris, Professor of Public Health and Preventative Medicine at the University of Pennsylvania, questioned the study on X.
[T]his study does not accurately represent the existing understanding about sources of excess deaths, downplaying the COVID-19 deaths that are clearly the driving factor throughout 2020-2022, Morris wrote.
I am not sure why this article is classified as original research and not a narrative review or commentary. There is no primary data collection or original data analysis in this paper, he added.
More than 1.1 million Americans have died from COVID since the pandemic broke out, according to the US Centers for Disease Control and Prevention.
During the pandemic, it was emphasized by politicians and the media on a daily basis that every Covid-19 death mattered and every life deserved protection through containment measures and Covid-19 vaccines. In the aftermath of the pandemic, the same moral should apply, the Vrije Universiteit researchers wrote in the study.
Vrije Universiteit ranks 150th out of more than 20,000 universities globally, according to the Center for World University Rankings.
Editors Note: An earlier version of this article did not reflect that the study did not analyze the impact of vaccination nor establish a link between mortality and vaccination status.
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Moderna plans to file for regulatory approval for its combination jab this summer in the U.S. and hopes it can enter the market in 2025, the company's CEO Stephane Bancel said in an interview.
Moderna, Pfizer and Novavax have said that combination shots will simplify how people can protect themselves against respiratory viruses that typically surge around the same time of the year. The added convenience is critical as fewer Americans roll up their sleeves to get vaccinated against Covid.
Bancel added that combination shots could reduce the burden of respiratory viruses on pharmacists and the broader U.S. health-care system, which has been grappling with a labor shortage that has many workers stretched thin.
Moderna's messenger RNA combination shot, called mRNA-1083, is made up of both the company's vaccine candidate for seasonal influenza and a newer, "next-generation" version of its Covid shot. Both of those experimental vaccines mRNA-1010 and mRNA-1283 have shown positive results in separate phase three trials.
The ongoing late-stage trial on mRNA-1083 examined the combination shot in 8,000 patients.
The study compared the combination shot with an enhanced flu vaccine called Fluzone HD and Moderna's currently licensed Covid shot, Spikevax, in one group of patients ages 65 and above. The trial also compared Moderna's combination jab with a standard flu shot called Fluarix and Spikevax in another group of participants between the ages of 50 and 64.
In both age groups, a single dose of Moderna's combination vaccine produced "statistically significantly higher" immune responses against three strains of influenza and the Covid omicron variant XBB.1.5.
Moderna said the safety of the combination shot, along with how well patients could tolerate it, was acceptable. The most common side effects were injection site pain, fatigue, muscle pain and headache. The majority of those effects were mild to moderate in severity.
Moderna is also developing a combination shot targeting the flu and RSV, and another vaccine targeting all three respiratory viruses: Covid, flu and RSV.
Meanwhile, Pfizer and BioNTech also are studying a vaccine that targets both Covid and the flu in a late-stage trial. Novavax is developing a combination for those viruses as well, but its Covid shot uses protein-based technology.
Visivasnc / iStock
A new study today in JAMA Network Open shows that pediatric hospitalizations for respiratory syncytial virus (RSV) doubled during the 2022-2023 season compared to the prior year.
The population-based cohort study of children aged 5 years and younger in Ontario, Canada, looked at hospitalization and intensive care unit (ICU) admissions for RSV from July 1, 2017, through March 31, 2023.
On average, 700,000 children per study year were included. Though the 2021-2022 season peaked a bit earlier than prepandemic seasons, the number of hospitalizations was similar, at 289.1 per 100,000 children in 2021-2022, compared to 281.4 to 334.6 per 100,000 in 2017 through 2020.
In 2022-2023, however, RSV season peaked a month earlier and resulted in more than twice as many hospitalizations (770.0 per 100000).
The RSV hospitalizations also led to more ICU admissions.
The proportion of children admitted to an ICU in 2022-2023 (13.9%) was slightly higher than prepandemic (9.6%-11.4%); however, the population-based rate was triple the prepandemic levels (106.9 vs 27.6-36.6 per 100000 children in Ontario)," the authors said.
The rate of mechanical ventilation use was also two- to three-fold higher in 2022-2023 compared with prepandemic years, the authors said.
During 2020 and 2021, cases of RSV dropped as COVID-19 mitigation measures, including masking and school closures, halted transmission of RSV. In Ontario, only 11 RSV hospitalizations and seven ICU admissions occurred during the 2020-2021 season. But in 2022-2023, a resurgence was seen as RSV, flu, and COVID-19 all co-circulated with most mitigation efforts removed.
The unexpected and widespread influences on seasonal respiratory viruses that followed the COVID-19 pandemic underscore the need for ongoing research.
"The unexpected and widespread influences on seasonal respiratory viruses that followed the COVID-19 pandemic underscore the need for ongoing research to understand the impact of pandemic mitigation measures and the unique factors of transmission for common pathogens to ensure societies are better prepared to respond to future pandemics," the authors concluded.
Former New York governor Andrew Cuomo testifies on COVID-19 nursing home policy
by Megan Coleman | CNY Central
New York Governor Andrew Cuomo gives his press briefing about the coronavirus crisis on April 17, 2020 in Albany, New York. (Photo by Matthew Cavanaugh/Getty Images)
WASHINGTON, D.C.
Former governor Andrew Cuomo spent Tuesday on Capitol Hill, testifying about his handling of the COVID-19 pandemic. He is accused of misrepresenting the number of deaths reported inside state nursing homes during the pandemic.
Cuomo was peppered with questions from reporters as he walked into the closed interview with the Oversight Select Subcommittee on the coronavirus pandemic. Cuomo maintains New York committed no wrongdoing following investigations by the Department of Justice.
"The Department of Justice investigation, three of them, found no wrongdoing. Investigations found that New York followed the federal guidance that was established."
Cuomo was the face of New York's response to the pandemic at its height in the spring of 2020 as the virus ravaged the country and hit New York particularly hard. On Tuesday, Congressional Republicans grilled Cuomo about the March 2020 advisory which barred New York nursing homes from rejecting patients who tested positive for COVID-19. Some people say they lost family members because of the policy.
Cuomo is aiming to defend himself from accusations that the nursing home directive led to the needless death of nursing home patients. The former governor insists the state followed directives issued by the Trump administration and the CDC, "CMS (Centers for Medicare and Medicaid Services) and CDC (Centers for Disease Control and Prevention) did very extensive instructive guidance and the investigations say New York followed the federal guidance."
The former governor calls it all purely political, saying only blue states were investigated and not red states, which issued the same directives.
On the eve of his testimony, New York representative Claudia Tenney (R, NY-24) took to social media as did Rep. Elise Stefanik (R, NY-21).
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Stuart Malcolm, MD, a primary care physician who practices in Oregon and northern California, started seeing patients with long COVID early in the pandemic. Back then, he was frustrated by the obstacles and lack of standard diagnostic tests and treatments. Four years later, well, he still is.
"Something I learned the last few years is the logistics to get people care is really, really hard," he said. "There's a lot of frustration. It's mostly frustration."
For long COVID doctors and patients, there has been little to no progress addressing the challenges, leaving many discouraged. Researchers and clinicians now have a greater understanding of what health agencies formally call post-COVID condition, but the wide spectrum of symptoms, slow progress in launching pharmacologic clinical trials, and the research toward understanding the underlying causes mean standardized diagnostic tests and definitive treatments remain elusive.
"The frustration is that we aren't able to help everyone with our current knowledge base. And I think the frustration lies not just with us physicians but also with patients because they're at the point where if they tried everything, literally everything and haven't gotten better," said Zijian Chen, MD, director of the Mount Sinai Center for Post-COVID Care in New York City.
Between 10% and 20%of the estimated hundreds of millions of people infected worldwide with SARS-CoV-2 in the first 2 years went on to develop long-term symptoms. While many recover over time, doctors who have treated long COVID since 2020 said they see some patients still wrestling with the condition after 4 years.
The latest Centers for Disease Control and Prevention Household Pulse Survey, taken between March 5 and April 1, 2024, estimated that nearly 7% of the adult population more than 18 million people currently have long COVID. Data from other countries also suggest that millions have been living with long COVID for years now, and hundreds of thousands have seen their day-to-day activities significantly affected.
There is an urgent need for more funding, long COVID clinicians, multidisciplinary clinics, and education for nonlong COVID physicians and specialists, doctors said. Instead, funding remains limited, clinics are closing, wait times are "horrendously long," patients are left in limbo, and physicians are burning out.
"What's changed in some ways is that there's even less access to COVID rehab, which sounds crazy because there was very little to begin with," said Alexandra Rendely, MD, a physical medicine and rehabilitation physician with the interdisciplinary Toronto Rehab, a part of the University Health Network of teaching hospitals in Toronto, Ontario, Canada.
"Patients are still being diagnosed every day, yet the resources available are becoming less and less."
COVID-19 money earmarked during the pandemic was mostly limited to temporary emergency measures. As those funds dwindled, governments and institutions have decreased financial support. The Long COVID Moonshot campaign, organized by patients with long COVID, is pushing Congress to support $1 billion in annual research funding to close the financial chasm.
While long COVID clinics have come a long way in helping patients, gaps remain. Doctors may be unwilling to prescribe off-label treatments without proper clinical trials due to the potential risks and liabilities involved or due to the controversial or unconventional nature of the therapies, said Malcolm, who left his primary care practice more than 2 years ago to focus on long COVID.
In the absence of standard treatments, Malcolm and other doctors said they must take a trial-and-error approach in treating patients with long COVID that centers on addressing symptoms and not the underlying condition.
"There are actually a lot of treatments and a lot of them are not curative, but they can help people," he said.
Malcolm, who is a medical director at Real Time Health Monitoring, a private clinic in the San Francisco Bay Area that specializes in long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), said it was important for him to be with a clinical team that understood and was supportive of his treatment decisions and was able to offer clinical support for those treatments if needed.
For physicians looking for clinical data before prescribing certain medications, the wait may be long. More than $1.5 billion in US federal funding has been earmarked to study long COVID, but the National Institutes of Health (NIH) has faced criticism from patients and scientists alike for its slow progress and emphasis on observational studies instead of research that could unravel the biological roots of long COVID. Among the clinical trials announced by the NIH's RECOVER initiative, only a handful involve studying pharmaceutical treatments.
A 2023 editorial published in The Lancet called out the "dismal state of clinical research relative to the substantial burden of [long COVID]" and said, "we are clearly lacking tested pharmacological interventions that treat the underlying pathophysiology." At the time of publication, it noted that of the 386 long COVID trials listed on ClinicalTrials.gov, only 12 were actually testing pharmacologic interventions.
There are also diagnostic and insurance barriers. The specialized tests that can detect long COVID anomalies are neither commonly known by primary care practitioners nor easily requested at the local lab, can be expensive, and are typically not covered by insurance, Malcolm explained.
Patients with long COVID also have the added barrier of being unable to advocate as easily because of their energy limitations, doctors said. Patients may appear outwardly fine, but fatigue and brain fog are among the many problems that cannot be measured in appearances. The condition has upended lives, some losing jobs, even homes, and the mental toll is why there is a "not insignificant" suicide rate.
Charlie McCone, 34, used to be a tennis player and an active musician. But he's spent the past 4 years mostly housebound, grappling with the aftermath of a SARS-CoV-2 infection he contracted in March 2020. He went from biking daily to work 10 miles and back to having at most 2 hours of energy per day.
In the first year alone, McCone saw more than two dozen doctors and specialists. The conditions now associated with long COVID, like ME/CFS, mast cell activation syndrome (a condition in which a patient experiences episodes of allergic symptoms such as hives, swelling, low blood pressure, and difficulty breathing), or dysautonomia (conditions that affect the autonomic nervous system, which controls automatic processes in the body) were not on physicians' radars.
Then in 2021, he became bedbound for more than half a year after a Delta variant reinfection. He developed neurologic symptoms, including incapacitating fatigue, post-exertional malaise (where symptoms worsened after minimal physical or mental activity), left-sided weakness, and cognitive impairment. He stopped working altogether. But the worst was the shortness of breath he felt 24/7, even at rest. A battery of lab tests revealed nothing abnormal. He tried numerous drugs and the classic respiratory treatments.
McCone eventually connected with Malcolm over X and developed what he describes as an effective patient-doctor collaboration. When studies came out suggesting microclots were a common issue with patients with long COVID and positive outcomes were reported from anticoagulant therapy, they knew it could be one of the answers.
"After 3 weeks on [the antiplatelet drug], I was like, oh my god, my lungs are finally opening up," said McCone. He has taken the medication for more than a year and a half, and some days he doesn't even think about his respiratory symptoms.
"That trial-and-error process is just really long and hard and costly," said Malcolm.
Today, fatigue and cognitive stamina are McCone's main challenges, and he is far from recovered.
"[I had a] very fulfilling, happy life and now, it's hard to think about. I've come a long way with my mental health and all this, but I've lost 4 years," McCone said. "The prospect of me being here when I'm 40 seems very realso it's pretty devastating."
Despite the daunting obstacle, doctors said the science has come a long way for a new disease. We now know long COVID is likely caused by a combination of triggers, including viral reservoir in the tissue, inflammation, autoimmunity, and microclots; severity of infection is not necessarily an accurate risk factor predictor long COVID can strike even those who had a mild infection; upward of 200 symptoms have been identified; and we know more about potential biomarkers that could lead to better diagnostic tools.
Unlike many other diseases and conditions with standard treatment protocols, long COVID treatments are typically aimed at addressing individual symptoms.
"It is very detailed and individualized to the patient's specific symptoms and to the patient's specific needs," Rendely said. Symptoms can also fluctuate, relapse, or wax and wane, for example, so what ails a patient at their first doctor's appointment could be completely different at the next appointment 2 months later.
Doctors are still hopeful the RECOVER research, which includes trials that look at autonomic and cognitive dysfunctions, will pave the way for more effective long COVID therapies. In Canada, Rendely is also eying the RECLAIM trial that is currently testing the effectiveness of pentoxifylline, which helps blood flow, and ibudilast, an anti-inflammatory drug.
Doctors are also hopeful when they see patients who have made "tremendous gains" or even full recoveries through their clinics. "It's a new diagnosis, so I always tell my patients to think of this as a journey because I'm learning along with you," said Jai Marathe, MD, an infectious disease physician at Boston Medical Center and an assistant professor of infectious diseases at Boston University Chobanian & Avedisian School of Medicine.
"Now we have 4 years of experience, but at the same time, no two long COVID patients are alike."
Long COVID has also changed the way physicians view healthcare and how they practice medicine.
"I am a completely different person than I used to be because of this illness, and I don't even have it. That is how profoundly it has affected how I view the universe," said Malcolm. "I've been doing this for 4 years, and I'm very hopeful. But I don't think about this in terms of months anymore. I think about this in terms of years."
A sweeping new definition of long COVID could help affected people get recognition of their condition and improve diagnosis and treatment.
The U.S. National Academies of Sciences, Engineering and Medicine announced the definition for long COVID June 11.
Previous definitions of long COVID have been all over the map, each with its own set of accepted symptoms, timelines and requirements for proof of infection (SN: 7/29/22).
That lack of standardization left many patients in the lurch without clear ability to be recognized for the condition that they had, with difficulty explaining to family and even to their caregivers, says Harvey Fineberg, a public health expert who chaired the committee that drafted the definition. We heard from literally hundreds of people experiencing long COVID about the challenges that they had in being heard, in gaining access to care and obtaining the care they needed.
More than 1,300 people contributed to the definition. The committee decided to adopt the patients own term long COVID instead of more medical terms such as post-acute sequelae of COVID-19 that have also been used to describe the long-term condition.
Adoption of the name the patients advocated for gives validation to everyone with the condition who has been struggling, sometimes for years, to have their experience acknowledged, says Daria Oller, a physical therapist in New Jersey who developed long COVID in 2020. Now, people are trying to not use the term long COVID, and all of us, patients from the first wave, are fighting. We were ignored. Thats ours. We named it.
The committee chose to go with the name because its simple, familiar and easy to communicate, Fineberg said during a webinar introducing the definition.
No one knows exactly how many people have long COVID, but a recent survey found that more than 17 percent of adults in the United States have experienced the condition. While the National Academies dont have regulatory or legal power to enforce adoption of the definition, the respected body of scientific experts recommendations are often used in making regulatory decisions, determining medical and scientific policies and crafting laws.
Heres what to know about the long COVID definition.
Its a medical condition that belongs to a family of chronic conditions that kick in after infections with viruses, bacteria, fungi or parasites. That includes chronic health problems such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Lyme-associated chronic illnesses.
According to the National Academies definition, long COVID is a medical condition that persists for at least three months after an infection with SARS-CoV-2, the coronavirus that causes COVID-19. Long COVID can affect any organ or system in the body. People may have any of more than 200 symptoms, which may include difficulty breathing, brain fog, blood clots, dizziness, extreme fatigue after exercising, loss of taste or smell, fast heart rate, diarrhea, constipation, diabetes and autoimmune diseases such as lupus (SN: 2/2/22; SN: 8/21/23; SN: 1/4/22). Those symptoms can appear alone or in multiple combinations, can be continuous, get progressively worse or have bouts in which the patient gets better and then worse again.
Chronic symptoms can affect people who originally had mild to severe COVID and can even strike people who didnt have any symptoms at all from their original infection. For that reason, the committee that crafted the Academies definition says that people dont need to have had a positive COVID test to be diagnosed with long COVID.
The condition can strike adults and children and can start weeks or months after seeming recovery from the initial infection. The committee didnt put an upper limit on how long after getting the original illness that long COVID could start.
There are no blood tests or biomarkers that doctors can use to reliably diagnose long COVID right now. The report calls for continued research to find such diagnostic tools.
This definition follows a June 5 report that the Social Security Administration asked the National Academies to prepare. That report similarly found that long COVID can have debilitating symptoms that can affect peoples physical function, quality of life and their ability to work or perform in school for years.
The definition is intentionally inclusive, the committee says.
We wanted to be sure that long COVID was not regarded as a diagnosis of exclusion, says Fineberg, who is president of the Gordon and Betty Moore Foundation, based in Palo Alto, Calif. Everyone with lingering effects from a coronavirus infection should fall under the broad umbrella erected by the new definition. That means some people who have long-term health problems caused by a different infectious disease or other cause might be mistakenly diagnosed with long COVID, Fineberg admits.
That big-tent approach is essential for health equity, says committee member Monica Verduzco-Gutierrez, a physical medicine and rehabilitation physician at the University of Texas Health Science Center at San Antonio. The committee wanted to make sure that people who dont have access to testing because tests werent available early on and free testing has ended now or who got a false negative test or had asymptomatic infections could still be included in the definition.
I think they got it right in the sense that they didnt leave anybody out, says Ziyad Al-Aly, head of research at the VA Saint Louis Health Care System. Al-Aly was one of the independent experts who reviewed the report.
Yes. The report calls for revision of the definition in no more than three years and possibly sooner if new science warrants it.
Were very mindful that the definition is only good as far as science can take us at this time, Fineberg says.
Having the gravitas of the National Academy of Medicine behind the definition will be seen by patients and patients advocates as legitimizing the illness which they have been complaining about, says Al-Aly. Theres a lot of gaslighting by physicians and by providers, and by the community [and] our society at large.
Some people have dismissed the condition as being a mental health disorder, but plenty of research has established that there are widespread biological changes, Verduzco-Gutierrez says. The definition makes it clear that long COVID is a physical health condition.
Not requiring a positive test to be diagnosed with long COVID is huge for Oller, who has no proof that she was infected with SARS-CoV-2 in early 2020. We couldnt get tested. There were long lines, and you needed symptoms that I didnt have.
Before COVID, Oller was a runner and dancer. After, she had difficulty breathing and pains in her chest, which she now thinks may have been caused by microclots in her lungs. Shes had a battery of health problems that have persisted. Though many symptoms have improved, they havent all gone away, and Oller has accepted that she may be dealing some unwanted aftereffects of COVID-19 for life. Early on, she had no name for what she was experiencing and encountered much skepticism that anything was actually wrong with her, even from other medical professionals.
Oller is a founding member of long COVID Physio, an international peer group of people with long COVID and their allies. She was not involved in the National Academies report but welcomes the broad definition.
It will be something patients can take to their doctors to bolster their claims, Oller says. She understands some of the difficulties clinicians have with diagnosing long COVID. Its hard because it challenges a lot of our biases, she says. Exercise makes us worse, trying harder makes us worse. Its easier to blame the patient and be like, Oh, youre not trying. Youre lazy. You just want to get on disability. Its in your head. Its easier to just send them on that route than to read through all the literature.
Over time, Oller says, the definition may be refined to include subtypes of long COVID, much the way cancer is an overarching definition of runaway cell growth but is divided by where the cancer occurs and the mutations that cause it. But for now, she says, starting out broad will allow people whose symptoms dont fit into a nice little package to have their condition recognized and acknowledged.
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The Future Circular Collider would occupy a 91-kilometre tunnel (artists impression).Credit: PIXELRISE/CERN
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Reference: Moderna press release
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In her new book Systemic, science journalist (and former Nature reporter) Layal Liverpool presents harrowing differences in health outcomes for people of racially and ethnically marginalized groups, amply supported by evidence from a wide range of global sources. For example, a long-standing measure of kidney function was calculated based on the racist assumption that waste-production levels in the kidney differ by race. Liverpool makes available a plethora of resources and advocacy groups that should help everyone to get involved in anti-racism efforts, notes health-services researcher and reviewer Sirry Alang.
Nature | 8 min read
Pick a card, any card or in this case, a worm. Researchers are using magic tricks to reveal how animals such as Eurasian jays (Garrulus glandarius) think. For example, a sleight-of-hand called the fast pass, in which an object is tossed so quickly between two fists that the observer cant see it, revealed that the trick also works on jays giving new insight into their visual system. Magic effects can reveal blind spots in seeing and roadblocks in thinking, says cognitive scientist Nicky Clayton.
Knowable | 11 min read
Reference: Annual Review of Psychology review
Robyn Elman is an entrepreneur and citizen scientist in Queens, New York.Credit: Karine Aigner/naturepl.com
Entrepreneur and community scientist Robyn Elman has raised thousands of monarch butterflies (Danaus plexippus) from eggs that would otherwise be destroyed by lawnmowers cutting down roadside weeds. From July through to September, that still takes me around six hours a day, seven days a week, she explains. Elman tags some of the butterflies with stickers to monitor them on their migration to Mexico. Shes also working with New Yorks Department of Transportation, which is responsible for roadside mowing, to better protect the animals habitats. (Nature | 3 min read)
Last week, rockhopper penguin Leif Penguinson was living up to the name by rock-hopping in Germanys Bavarian Forest National Park. Did you find the penguin? When youre ready, heres the answer.
Thanks for reading,
Flora Graham, senior editor, Nature Briefing
With contributions by Katrina Krmer
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