Category: Corona Virus Vaccine

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Changes in public health: Highlighting the positive aspects of the … – Open Access Government

November 9, 2023

The effects of the coronavirus (COVID-19) pandemic were evident across every single aspect of healthcare, from hospital services to public health decisions and surveillance capacities to the research and development of vaccines. As such, the pandemic transformed into a reality check for many aspects of healthcare systems, especially regarding their overall readiness and ability to adapt to change and absorb and manage sudden and persistent pressures on their workload, especially in patient care settings.

Even though contingency plans were often in place, healthcare systems seemed unable at certain times to cope with the sudden, intense surge in demand. While much of the published literature has focused on the challenges faced during the pandemic, this article highlights the examples that led to effective change and adaptation to those challenges.

In France, a decision was made during the pandemic at the national level to prioritize continued treatment for cancer. In addition, some private non-profit cancer centres as well as some specialized services such as paediatric oncology did not manage COVID patients and could, therefore, function relatively as normal, even during the first wave, albeit with human resource and protective material shortages.

At the same time as the introduction and implementation of guidelines, the role of local actors those working at the individual service or hospital level and the adaptations and innovations they put in place also played an important part in helping healthcare institutions continue to care for their patients. For example, one such sustainable innovation to come out of the crisis was the creation and/or consolidation of inter-disciplinary, online epistemic communities, which can be defined as networks of knowledge-based experts that enabled professionals to continue to seek advice from colleagues.

Another one was that the crisis helped test the possibilities and limits of telehealth services and has had lasting effects on how patient care is organized to the present day.

The speed by which SARS-CoV-2 spread globally highlighted the need for robust genomic sequencing, as well as reliable and representative surveillance systems, to support pandemic prediction. An operational model emerged (or was further strengthened in many cases) with large centralized clinical laboratories performing high-throughput sequencing on one central platform and one or several distal laboratories dealing locally only with urgent analyses.

This led to a harmonization in the quality of genomic sequencing produced while maintaining high-throughput capacities. One of the innovations was the routine use of big data and artificial intelligence approaches to model the pandemic development and to identify and understand the weaknesses of existing systems (close to real-time). Furthermore, the experiences and innovations on digital health were quickly consolidated within a global framework of public health priorities, as articulated in the G20 Riyadh declaration in 2020.

One of the greatest challenges facing healthcare systems was the need to leverage the laboratories capacity in diagnostic testing and to increase the number of people being tested quickly. Several countries, for example, South Korea and Saudi Arabia, were able to conduct successful COVID-19 countermeasures through adequate laboratory diagnostic testing provision.

South Korea is an example of a country that rapidly adapted its COVID-19 testing response, maintaining around 600 screening and testing centres through close collaboration with the private sector, with its testing capacity reaching 110,000 tests as early as November 2020. The laboratory scale-up was successfully achieved in middle-income countries such as Indonesia. In the latter case, the COVID-19 referral laboratory network grew rapidly from a single Ministry of Health NIHRD laboratory in the capital of Jakarta to 685 laboratories across 34 provinces within 12 months since the first Indonesian case was discovered.

This rapid scale-up was the result of successful, cross-sectoral collaboration among previously siloed national and sub-national government institutions, international development agencies, and private sector stakeholders- all brought under one digital umbrella for the functions relating to COVID-19. (4) It is anticipated that this innovative approach within Indonesia will now be expanded and used in other sectors, e.g., the infectious disease surveillance networks.

The COVID-19 outbreak serves as a transformation catalyst for global health, accelerating the implementation and adoption of changes in public health interventions and patient care. It also serves as a reminder that proactive planning for healthcare emergencies and an intensified commitment to global public health preparedness remains necessary. It is hoped that the positive lessons learned, as highlighted in this article, will continue to be considered, enabling the transformation of future healthcare.

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Changes in public health: Highlighting the positive aspects of the ... - Open Access Government

Novavax posts higher-than-expected revenue, says prepared to … – Reuters

November 9, 2023

A vial labelled "Novavax V COVID-19 Vaccine" is seen in this illustration taken January 16, 2022. REUTERS/Dado Ruvic/Illustration Acquire Licensing Rights

Nov 9 (Reuters) - COVID-19 vaccine maker Novavax (NVAX.O) on Thursday beat market estimates for quarterly revenue, boosted by U.S. government grants to help cover the expense of clinical trials, and said it was prepared to further cut costs next year.

Shares rose nearly 4% in early trading as the company projected more than $2 billion in cash through end of 2025 from already secured revenues.

Still, the Maryland-based biotech, which has been banking on cost cuts and commercial sales of its retooled COVID shot to help it stay afloat, reiterated its "going concern warning".

Novavax said it had reduced liabilities by $128 million in the third quarter and was prepared to cut costs by an additional $300 million in 2024 to better align itself with the smaller-than-expected COVID-19 vaccine market.

"We are going to drive for higher efficiencies to support this leaner, focused company," finance chief Jim Kelly said on a call, adding that the 2024 savings efforts would include reduction of idle capacity and overhead support at facilities.

Third-quarter revenue of $187 million was down from $734.58 million a year earlier, but above expectations of $158.5 million, according to LSEG data.

"We've really optimized that U.S. grant opportunity, which was something that was uncertain at the beginning of the year," CEO John Jacobs said in an interview.

The company expects the 2023-2024 U.S. market for COVID shots to be between 30 million and 50 million doses.

"We and many others thought there would be 80 to 100 million doses in the U.S. market this year and it turned out to be significantly smaller than that," said Jacobs.

Over 15 million people in the United States, around 4.5% of the population, had received the updated COVID-19 shots by Oct. 27, according to a Department of Health and Human Services spokesperson, lagging behind last year's vaccinations.

Novavax said it had $666 million in cash as of Sept. 30, up from $518 million at the end of June.

The company's updated COVID shot, using a more traditional technology than the mRNA-based vaccines of rivals Pfizer (PFE.N) and Moderna (MRNA.O), was authorized in the U.S. in October.

Novavax missed out on the COVID vaccine windfall that benefited rivals due to manufacturing issues that delayed its filing for approval when the pandemic was raging.

Its stock plunged 93% last year and is down about 34% this year.

Reporting by Bhanvi Satija in Bengaluru and Patrick Wingrove in New York; Editing by Sriraj Kalluvila and Bill Berkrot

Our Standards: The Thomson Reuters Trust Principles.

Bhanvi Satija reports on pharmaceutical companies and the healthcare industry in the United States. She has a postgraduate degree in International Journalism from City, University of London.

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Novavax posts higher-than-expected revenue, says prepared to ... - Reuters

Protect your family with flu, COVID-19, and RSV vaccines – American Military News

November 9, 2023

FALLS CHURCH, Va. Are you preparing to spend time with friends and family this holiday season? Now is a good time to make sure you and your loved ones are up to date with COVID-19, flu, and RSV vaccines. TRICARE covers these vaccines based on Centers for Disease Control and Prevention (CDC) recommendations.

Vaccination against flu, COVID-19, and RSV offers the best protection from serious illness caused by these diseases, said Capt. John Iskander, MD, MPH, chief, Immunization Healthcare Division, Defense Health Agency. People ages 6 months and older should get the seasonal flu vaccine and updated COVID-19 vaccine. Certain people, including older adults, pregnant people, and infants, can get vaccinated against RSV.

Read on to learn about the vaccines recommended for you and where to get them.

Flu and COVID-19 Vaccines

Flu and COVID-19 are contagious diseases that affect millions of Americans each year. These diseases can cause severe illness, hospitalization, and even death. The seasonal flu vaccine and the updated COVID-19 vaccine can help reduce these risks. The updated COVID-19 vaccine can also reduce your risk of developing Long COVID.

The CDC recommends that everyone ages 6 months and older get vaccinated against flu and COVID-19. This years flu vaccine is available as a flu shot or nasal spray. COVID-19 vaccines from Moderna, Pfizer-BioNTech, and Novavax have all been updated for the 2023-2024 season. The types of flu and COVID-19 vaccines you can get are based on your age and other factors. Your health care provider can help you decide which options are best for you.

RSV Vaccines

RSV is a common respiratory virus that usually causes mild, cold-like symptoms. However, infants and older adults are more likely to develop severe RSV. This can lead to hospitalization.

TRICARE covers RSV vaccines for certain people, based on CDC recommendations:

Where Can I Get Vaccinated?

There are three ways you can get these vaccines at no cost:

You can get the flu, COVID-19, and RSV vaccines recommended for you at the same time.

Talk to your provider if you have questions about vaccines. For more info on vaccine coverage, check out Immunizations.

Would you like the latest TRICARE news sent to you by email? Visit TRICARE Subscriptions, and create your personalized profile to get benefit updates, news, and more.

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Protect your family with flu, COVID-19, and RSV vaccines - American Military News

Equitable COVID-19 vaccine distribution could have saved 670,000 … – The Brown Daily Herald

November 9, 2023

The global COVID-19 vaccine campaign saved 2.4 million lives between January and August 2021, but distributing vaccines more equitably could have saved another 670,000 lives, according to an October working paper from researchers at Browns School of Public Health and the University of Southern California.

The study, titled The Impact of the Global COVID-19 Vaccination Campaign on All-Cause Mortality, is the first, to the researchers knowledge, to examine the effect of the vaccine campaign on death in multiple countries, according to the working paper. In the United States, the vaccine campaign saved 429,486 lives, the researchers estimated.

According to study co-author Chris Whaley, associate professor and associate director of health services, policy and practice at the SPH, the paper finds huge benefits to the vaccine program, both in terms of deaths averted and economic benefits.

We know the global COVID-19 vaccination campaign is one of the (if not the) biggest public health initiatives that we can remember, Whaley wrote in an email to The Herald. Our paper is an initial attempt to evaluate this program.

Neeraj Sood, professor of public policy, director of the USC Schaeffer Centers COVID-19 initiative and co-author of the study, said the vaccines were much more effective than non-pharmaceutical interventions such as lockdowns and mask mandates in an Oct. 30 University press release.

The study, which was limited to 141 countries with a total population of 5.25 billion, further considered an equitable scenario where vaccination in each country (was) proportional to its population. Under such conditions, the authors estimated that 670,000 additional lives would have been saved if the vaccine was distributed equitably.

In reality, the authors wrote, vaccine distribution was inequitable, with higher-income countries gaining access to vaccines much faster than lower-income countries.

Neil Mehta is a University News section editor and design chief at The Herald. They study public health and statistics at Brown. Outside the office, you can find Neil baking and playing Tetris.

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Equitable COVID-19 vaccine distribution could have saved 670,000 ... - The Brown Daily Herald

COVID-19 update 11-06-23 – Suffolk County Government (.gov)

November 9, 2023

Suffolk County reported the following information related to COVID-19 on November 5, 2023

According to CDC, hospital admission rates and the percentage of COVID-19 deaths among all deaths are now the primary surveillance metrics.

COVID-19 Hospitalizations for the week ending October 28, 2023

Daily Hospitalization Summary for Suffolk County From November 3, 2023

NOTE: HOSPITALS ARE NO LONGER REPORTING DATA TO NYSDOH ON WEEKENDS OR HOLIDAYS.

Fatalities 11/3/23

COVID-19 Case Tracker November 3, 2023

Note: As of May 11, 2023, COVID-19 Community Levels (CCLs) and COVID-19 Community Transmission Levels are no longer calculatable, according to the Centers for Disease Control and Prevention.

* As of 4/4/22, HHS no longer requires entities conducting COVID testing to report negative or indeterminate antigen test results. This may impact the number and interpretation of total test results reported to the state and also impacts calculation of test percent positivity. Because of this, as of 4/5/22, test percent positivity is calculated using PCR tests only. Reporting of total new daily cases (positive results) and cases per 100k will continue to include PCR and antigen tests.

COVID-19 Vaccination Information

Last updated 5/12/23

Vaccination Clinics

As of September 12, 2023, the Suffolk County Department of Health Services is not authorized to offer COVID-19 vaccines to ALL Suffolk County residents.

The department will offer the updated vaccine to only uninsured and underinsured patients through New York State's Vaccines for Children program and Vaccines for Adults program, also known as the Bridge Access Program.

Those with insurance that covers the COVID-19 vaccine are encouraged to receive their vaccines at their local pharmacies, health care providers offices, or local federally qualified health centers.

The department has ordered the updated COVID-19 vaccine and will announce when the vaccine becomes available.

FOR HEALTHCARE PROVIDERS

New York State Links

CDC COVID Data Tracker Rates of laboratory-confirmed COVID-19 hospitalizations by vaccination status

For additional information or explanation of data, click on the links provided in throughout this page.

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COVID-19 update 11-06-23 - Suffolk County Government (.gov)

New Testing Proves AURA Ion Bar Highly Effective in Combating … – Yahoo Finance

November 9, 2023

Rigorous lab studies result in scores of 99.98% elimination of viruses and bacteria from entering spaces, exceeding expectations and raising the standard for indoor air quality.

CHAPEL HILL, N.C., November 09, 2023--(BUSINESS WIRE)--AURA Technologies today announced that AURA Ion Bar, the only system in the world that creates a germ-destroying barrier across any two spaces safely using Negative Air Ions (NAIs), is now backed by comprehensive testing that demonstrates its unparalleled effectiveness in combatting the spread of COVID-19.

Designed to create a protective sheet of air enriched with a high concentration of NAIs, Ion Bar acts as an invisible barrier by blocking contaminants before they enter a space. The NAIs inactivate contaminants by causing them to clump and fall out of the air, removing them from the breathing zone and completely deactivating them to ensure indoor spaces remain virus-free.

In a market flooded with safety products lacking adequate testing, AURA was determined to guarantee that the Ion Bar performed as advertised. The test results provide irrefutable evidence of the devices ability to kill up to 99.98% of viruses and bacteria in the air and on surfaces, reducing airborne transmission of diseases like COVID-19.

A six-week study conducted in a controlled laboratory environment tested the efficacy of the Ion Bar against aerosolized SARS-CoV-2, the virus responsible for COVID-19. The testing chamber, measuring 20 ft x 8 ft x 8 ft, maintained precise environmental conditions, offering more realistic and reliable results than smaller testing rooms used by other indoor air quality products.

To further create a unique testing environment, a simulated wall with a doorway frame was constructed inside the chamber. This division allowed for the release of the COVID virus in a manner mirroring its natural spread. Surface testing involved inoculating glass slides with SARS-CoV-2, while aerosol testing saw the virus nebulized and sprayed into the chamber to simulate airborne transmission.

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The results of the testing were nothing short of remarkable. Surface testing showed that after 10 minutes, only 1/6th of the virus remained active. After 20 minutes, a mere 1/3,500th of the virus was still viable, and at the 30-minute mark, there was no trace of the active virus, or less than 1/50,000th of its initial concentration.

In aerosol testing, the spraying of the aerosol took place 5 ft above the floor and 1.5 ft away from the doorway while air samples were collected from the clean side for 2 minutes. Ion Bar acted as an impenetrable forcefield, blocking an astounding 99.98% (3.69 log) of active SARS-CoV-2 from entering during device operation.

"The testing clearly shows that AURA Ion Bar represents a fundamental paradigm shift in the way we should be thinking about air quality: real-time prevention rather than long-term treatment," said Dr. Alex Blate, Chief Innovator at AURA. "Instead of cleaning the air over time as an air purifier would, Ion Bar prevents the air from becoming contaminated in the first place."

AURA Co-CEO, Anna Bennett, expressed the companys commitment to fighting COVID-19 and improving indoor air quality. "After three years of dedicated development and lab studies, the astonishing test results surpassed all expectations," said Bennett. "Were now ready to share this technology and continue the fight against indoor air pathogens. Beyond its potential to revolutionize indoor air quality, Ion Bar represents a revolutionary approach to battle against airborne diseases, restoring a sense of safety and normalcy to shared spaces."

Additional in-vitro studies were conducted to evaluate the effectiveness of Ion Bar against other pathogens. The results of these tests further demonstrate the devices ability to provide a robust defense against a range of pathogens:

Aspergillus Fumigatus: This in-vitro study consisted of aerosol testing to determine the efficacy of the AURA Ion Bar Mark IV against Aspergillus Fumigatus.

Respiratory Syncytial Virus (RSV): This in-vitro study consisted of aerosol and surface testing to determine the efficacy of the AURA Ion Bar Mark IV against Respiratory Syncytial Virus (RSV).

Streptococcus Pneumoniae: This in-vitro study consisted of aerosol and surface testing to determine the efficacy of the AURA Ion Bar Mark IV against Streptococcus Pneumoniae.

To learn more about the AURA Ion Bar and its capabilities, please visit here.

About AURA Technologies

At AURA Technologies, we bring a new way of thinking to advanced technology R&D. Using the highest caliber talent and the latest advancements in computer science, we are actively innovating to make the world a better place through the use of Artificial Intelligence, Advanced Science, Physics, and Engineering combined with the latest emerging technologies. From our cutting-edge solutions created for the Department of Defense to our revolutionary products designed in response to COVID, we develop real innovations for health, safety, security, and national defense.

View source version on businesswire.com: https://www.businesswire.com/news/home/20231109273486/en/

Contacts

Ricca Silverio or Andrea Courtney FINN Partners for AURA Technologies AURATechnologies@FinnPartners.com

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New Testing Proves AURA Ion Bar Highly Effective in Combating ... - Yahoo Finance

Winter’s Triple Threat: Covid-19, Influenza, and RSV Vaccines … – The Bloomingtonian

November 9, 2023

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Winter's Triple Threat: Covid-19, Influenza, and RSV Vaccines ... - The Bloomingtonian

Virtual Urgent Care Initiative Did Little to Divert Patients From … – Drug Topics

November 9, 2023

A recent study published in the Canadian Medical Association Journal revealed that virtual urgent care (VUC) had minimal impact on emergency department visits or hospital admissions in Ontario, Canada, during the COVID-19 pandemic.1 However, a significant number of study participants who initially sought virtual urgent care eventually attended an emergency department in person.

Virtual urgent cares purpose is to assist in redirecting folks with minor health concerns away from in-person emergency department visits to decrease high volumes of patients that dont necessarily need to be there.

The COVID-19 pandemic significantly impacted the Canadian healthcare system, especially early on when social distancing posed challenges for arranging non-urgent, in-person visits. This period witnessed an almost 80% decline in in-person primary care visits and a 50% decrease in emergency department visits, which led to a surge in the adoption of virtual care tools.

For a better understanding of healthcare use and the outcomes of VUC, researchers of the study observed both variables in comparison to similar patients who opted for an in-person emergency department visit.

Researchers used patient-level encounter data from 14 pilot programs in Ontario where individuals used VUC services. Researchers then collected the data and connected it to administrative databases, which helped them figure out how people used healthcare services and what happened in the 30 days after.

Results revealed that out of the 19,595 patients who used VUC, researchers matched 2,129 patients who were quickly referred to the emergency department by a VUC provider with those who physically went to the emergency department.

The rates of hospital admissions during the first visit (9.4% vs. 8.7%), 30-day emergency department visits (17.0% vs. 17.5%) and hospital admissions (12.9% vs. 11.0%) were similar between these two groups.

Of the 14,179 patients seen by a VUC provider without a documented referral to the emergency department, those who used VUC were more likely to have in-person emergency department visits within 72 hours (13.7% vs. 7.0%), 7 days (16.5% vs. 10.3%), and 30 days (21.9% vs. 17.9%).

However, hospital admissions were similar within 72 hours (1.1% vs. 1.3%) and higher within 30 days for patients discharged home from the emergency department (2.6% vs. 3.4%).

Authors of the study suggest that the increased use of healthcare services following virtual follow-up visits might be due to virtual clinicians facing limitations in physically examining patients.

This limitation could lead clinicians to refer patients back to the emergency department for an in-person evaluation more readily if they have persistent symptoms, they said.

Its recommended that future research efforts should focus on identifying quality-of-care and virtual care practices care to foster a culture of continuous improvement.

Researchers suggest future investigations should highlight and examine the root causes of low healthcare use after a VUC visit as it will help determine necessary changes and improvements that will help improve these trials.

This article originally appeared in Managed Healthcare Executive.

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Virtual Urgent Care Initiative Did Little to Divert Patients From ... - Drug Topics

Longitudinal study of disease severity and external factors in … – Nature.com

November 9, 2023

Study design and setting

This longitudinal study utilized a cohort of Indonesian post-COVID-19 patients recruited since September 2021 and extracted in January 2023. Participants with a history of COVID-19 were followed up for residual symptoms. We assessed cognitive function 6months after diagnosis and their first symptoms through an online submission system, and this platform was disseminated to the entire country through social media, health care providers, and survivor groups.

Subjects with previous COVID-19 infection (at least thirty days from the onset or diagnosis) were diagnosed using either Indonesian Food and Drug Administration-approved antigen test for the anterior nasal sample (sensitivity over 80%)11 or real-time polymerase chain reaction (RT-PCR) of the nasopharyngeal, nasal, or pooled samples12. These procedures were performed by trained staff, as the self-administered antigen test was not recognized during the study period. This study covered all types of patients, from asymptomatic to hospitalized. After the provision of consent given by the participants, a follow-up cognitive assessment was made, and those without responses of expected outcomes were omitted. Aside from having self-reported mental illness and stroke, there is no other exclusion or limit for those with specific morbidities, age, and digital literacy. Moreover, the snowball sampling approach recruited more individuals to this cohort.

Demographic characteristics, health behaviour, chronic diseases, and other comorbidities were the baseline information covered in the questionnaire. Additionally, this study recorded the latest COVID-19 episode, including date and diagnostic methods, duration of symptoms, type of medication, vaccination status, type of vaccine, and time between doses. Investigators also identified the date from vaccination to infection and the type of care received (home isolation, hospitalization, or both). These variables may interact with each other and affect the relationship between COVID-19 and cognitive failure.

This study cited the definition of cognitive failure as a cognitive mistake made while performing a task that a person would typically complete successfully in daily life. Problems with memory, perception, and focus are signs of cognitive failure13.

This study measured the cognitive failure 6months after the COVID-19 infection. Investigators implemented the assessment using a questionnaire that is in proximity to clinical cognitive assessment, the Cognitive Failures Questionnaire (CFQ)(14), consisting of 25 5-Likert scale questions. The responses range from 0 to 4, where a higher number indicates frequent cognitive failure events. The Indonesian version of this questionnaire was derived from a study with a Cronbach alpha value of 0.94214. Furthermore, one study disclosed three domains in the questionnaire which are forgetfulness (related to something known or planned), distractibility (alteration of attention and focus), and false triggering15.

Investigators assessed other residual COVID-19 symptoms and neuropsychiatry conditions to identify the possible contribution of these symptoms to cognitive failure. Investigators evaluated any presence of residual symptoms after the first onset or diagnosis using a set of measurement tools such as the Fatigue Severity Scale (FSS)16 over the past 6months, Generalised-Anxiety Disorder (GAD-7) to screen for recent anxiety and a 10-Likert scale question to identify its incidence over the past two weeks.

Investigators admit that the quality of baseline data was heavily affected by recall bias. Therefore, participants were required to provide the answers based on the observation chart, written source (such as medical records summary), and through the PeduliLindungi application (for data related to testing, vaccinations, and individual information).

Participants might experience reinfection. Hence, only the last episode of COVID-19 should be provided as the response. By applying this approach, the investigators could not examine in detail the previous infection and, possibly, its latent impact on cognitive function.

Investigators knew that robust cognitive assessments such as Cambridge Neuropsychological Test Automated Battery (CANTAB) could provide objective cognitive results. However, the investigators considered the survey exhaustion and other factors affecting the response, such as internet connection and adaptation to the measurement tools. The questionnaire was deemed sufficient to represent the domains tested by these standardized clinical tests.

There is limited information on long-term cognitive situations after COVID-19. However, a study of CFQ application to neurosarcoidosis (a subset of sarcoidosis, a multi-inflammatory systemic disorder) shows a mean score of 45.620.713. Therefore, investigators assumed that the variance of cognitive failure values of COVID-19 survivors is approximately 20.7. Using the equivalence formula from the assumed score, with 5% type 1 error, 90% power of the study, the absolute mean difference between the assumpted mean and sample means of 1, a 5% equivalence limit, and 10% listwise deletion of incomplete response, a total of 5653 participants should be drawn from the cohort.

Several data were presented as discrete variables, including the duration of symptoms and administration of drugs. Moreover, to assume the possible variant, the investigators matched the date of diagnosis with the variant surveillance reports issued by the Ministry of Health according to surveillance week and region. Other continuous data were kept at their original values. Each type of vaccine possesses different efficacy17. Hence an ordinal level of this variable was made, where a higher ordinal level of vaccination means worse vaccination status (unvaccinated) (Supplementary Data 1).

The analysis involved participants with complete responses; hence no imputation and other missing data analysis were undertaken. Descriptive statistics and bivariate analysis of variables were conducted before the final analysis. We performed the structural equation model. First, the whole model was built (Fig.1) and simplified by the trimming approach. The structure of the model consists of exogenous variables, latent variables, and CFQ score as endogenous factors. The assumption was that vaccination, medication, virus variant, and comorbidity might affect the severity of COVID-19 and, eventually, cognitive failure. Aside from COVID-19, demography, chronic fatigue over the past 6months, recent headaches, and anxiety may affect the cognitive situation. The investigators constructed latent variables with confirmatory factor analysis. The selection of the explanatory factors was based on bivariate analysis and model fitting assessed using the Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), Standardized Root Mean Square Residual (SRMR), and Root Square Mean Error of Approximation (RMSEA). The Lavaan library in R performed the analysis and produced the final plot.

Proposed Model of Cognitive Failure post-COVID-19. This model comprises four exogenous latent variables (circle variables), and one variable acts as both an exogenous and endogenous latent variable (severity). The final endogenous factor is cognitive failure. Factor loadings of the latent variable are presented with diverging arrows from the latent variable (Recent Headache with six elements. Demography with three factors. Vaccination with two factors. Severity with three factors, and comorbidities with four factors). Converging arrows indicate the impact of the exogenous variable on the endogenous factor.

This study was authorized by the Hasanuddin University Research Ethics Review Committee for Research Involving Human Research Participants (full-board review number 758/UN4.6.4.5.31/PP36/2021). We confirm that all procedures, particularly the clinical data collection, were performed following relevant guidelines and regulations. Informed consent was obtained from all participants when they provided information to the cohort. We appropriately de-identified, stored, and used the data while respecting confidentiality. Any circumstances that needed immediate action were directed to a professional. This research is a subset of a clinical trial with the identifier NCT05060562 on clinicaltrials.gov.

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Longitudinal study of disease severity and external factors in ... - Nature.com

CDC’s HICPAC Update: Impact on COVID-19, Pathogen Control … – Infection Control Today

November 9, 2023

Picture of computer with CDC on the screen.

(Adobe Stock, unknown)

The CDCs HICPAC (Healthcare Infection Control Practices Advisory Committee Committee) on November 3 and 4, 2023, advanced changes in their infection control guidance, which will impact the control of SARS-CoV-2, the virus that causes COVID-19, and other airborne pathogens.

A letter to the CDC1 was submitted on Oct 24, 2023, supporting the safety of immunocompromised individuals in health care settings. This concern was further underscored by the findings of the INFORM2 and EPOCH3 research initiatives. The EPOCH study concluded:

Immunocompromised populations appear to be at substantial risk of severe COVID-19 outcomes, leading to increased costs and HCRU. Effective prophylactic options are still needed for these high-risk populations as the COVID-19 landscape evolves.3

The action letter was signed by 11 prominent patient advocacy and professional organizations and 21 patient advocates. This letter stresses that our healthcare system frequently encounters and treats airborne pathogens, including seasonal influenza, respiratory syncytial virus (RSV), and SARS-CoV-2.

Another group is concerned with HICPACs charter. The World Health Network has filed a complaint with the Office of the Inspector General charging Xavier Bacerra, secretary of the Department of Health and Human Services, Dr. Mandy Cohen, director of the CDC, and Dr. Alexander Kallen, the lead for HICPAC, with gross misconduct, according to Forbes.

Kevin Bell, a retired lawyer and member of the World Health Network, explained that the HICPAC committee violates its charter, which requires 14 members; it only has 9. Also, theFederal Advisory Committee Actrequires that committee memberships be fairly balanced in terms of the points of view representedand the functions to be performed. The Act adds, 'In balancing committee memberships, agencies are expected to consider a cross-section of those directly affected, interested, and qualified.'

Bell expressed his concern about the need for more balance in the committee. He found it surprising that the committee had only a few voting members who were an expert in aerosol science. He pointed out that the guidelines needed to give more importance to the aerosol transmission of COVID-19, the primary mode of virus transmission.

The complaint by the World Health Network challenges the legality of HICPAC's formal guidance on "Preventing Transmission of Infectious Agents in Healthcare Settings." It questions the legitimacy of this guidance due to a purported violation of the committee's charter membership requirements. Specifically, the World Health Network argues that HICPAC should include a substantial representation of experts in specialized fields like aerosol science, industrial hygiene, UV and HEPA filtration, ventilation engineering, respiratory protection, and occupational health and safety to comply with the Federal Advisory Committee Act. However, the complaint highlights the absence of such members within the Committee. This void in the representation of these critical fields is the core contention within the complaint, aiming to challenge the credibility and legal standing of the guidance provided by HICPAC.

The current CDC draft guidance4 appears to be conflicting and in places in error. For example, some provisions allow for the use of surgical masks when treating patients who have airborne infections (COVID-19 and seasonal influenza). Surgical masks are not designed for or intended to prevent the spread of airborne pathogens.

In a statement to CNN and posted on WSILTV.com, Jane Thomason, the principal industrial hygienist at National Nurses United (NNU), the biggest nursing union in the US, expressed concern that the draft incorrectly classified surgical and medical masks as both personal protective equipment (PPE) and respiratory protection.

A surgical or medical mask does not provide protection against inhalation of infectious aerosols, Thomason wrote in a statement to CNN on HICPACs draft recommendations. NNU urges CDC to fully recognize the science on aerosol transmission of infectious diseases and respiratory protection (including N95s, powered air-purifying respirators, and elastomeric respirators) in creating infection prevention guidance, Thomason wrote.

Patients reactions were similar. During one of the public comment periods, a member of the public said, I am deeply afraid of being in a situation where avoiding health care is not an option, said Seifer Almasy, who spoke as a member of the public. He said he was recently in that situation when he decided he couldnt put off getting his updated COVID-19 and influenza vaccines. He said he made 34 phone calls and was on hold for more than four hours to find a provider that would wear an N95 while giving him his vaccines.

HICPAC must recommend clear, robust, and authoritative precautions against the airborne transmission of pathogens.Anything less is malpractice and will do harm, Almasy said. Negative pressure rooms are not recommended for patients infected with MERS, SARS-CoV-1, SARS-CoV-2, and influenza. United States modern health care facilities often prioritize energy efficiency by sequestering indoor air from the outside air. This sequestration allows deadly pathogens to circulate throughout a facility, placing not just immunocompromised individuals but everyone at risk.

Finally, another disputed CDC strategy involves Enhanced Barrier Precautions (EBP).5,6 This strategy is not supported by the predicated data7 upon which it is based and allows patients colonized with candida auris to walk around a facility. This seems contradictory to attempts to prevent outbreaks of this deadly pathogen.8

CDC interim guidance recommends EBP as a strategy in nursing homes to interrupt the spread of novel or targeted MDROs (eg carbapenem-resistant organisms or C auris).

There is also a lack of provisions for air quality standards, such as ASHRAE Standard 241 for the Control of Infectious Aerosols" and for screening of these pathogens.

The inertia and back peddling of standards is often justified by the imposed burden preventive strategies would place on facilities. However, the burdensome argument has had little, if any, supportive data regarding the actual impact on an institution. The Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, considers an intervention cost-effective if the cost is less than 9.6 million dollars per life saved.9

During the August 22, 2013, CDC HICPAC meeting, a commentator stated, The only COVID-19 risks we are forced to take is when seeking out medical care. As stated in an action letter sent to the CDC, for the immunocompromised the status quo is unacceptable, and weakening current regulations will result in a direct threat (Section 36.208) to their safety and well-being and does not maintain accessible features (Section 36.211) for safe and adequate access to a facility.10 The conclusion of the action letter emphasizes that the CDC be mindful of the provisions of the ADA and the impact recommendations will have regarding vulnerable individuals who both work in health care settings or are experiencing reduced access to healthcare because of unsafe healthcare environments.

References

See more here:

CDC's HICPAC Update: Impact on COVID-19, Pathogen Control ... - Infection Control Today

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