Category: Corona Virus

India recorded the highest number of deaths (1,260) globally from September 25-October 22, 2023,primarily due to retrospective adjustment, shows WHO data

After a lull for many months, COVID-19 now considered an endemic respiratory illness, has registered a small uptick in cases across the country. On November 9 and November 10, 2023, the Union Ministry of Health and Family Welfare recorded nine and 14 new cases, respectively.

As of November 10, the number of active cases stood at 152. Uttar Pradesh, Kerala and West Bengal have the highest active cases with 62, 33 and 23 cases, respectively.

The number of active cases in other states are Gujarat (7), Maharashtra (7), Tamil Nadu (6), Telangana (4), Delhi (2) and Odisha (2).

Just one active was reported each in Punjab, Rajasthan, Sikkim, Haryana Goa, Jammu and Nagaland.

Indias case fatality rate was at 1.19 per cent with 533,295 deaths and a 98.81 per cent survival rate with 44,467,986 cases discharged. The total vaccination stood at 22,06775,965.

Among countries globally, India recorded the highest number of new fatalities (1,260) for the period from September 25-October 22, 2023, primarily due to retrospective adjustment, according to the World Health Organizations latest COVID-19 epidemiological update on October 27, 2023.

Other countries that recorded high deaths include Italy (560 new deaths; +36 per cent), the Russian Federation (172 new deaths; +237 per cent), Sweden (138 new deaths; +28 per cent) and Australia (120 new deaths; -22 per cent).

Over the same period, the Southeast Asia Region reported over 3,400 new cases, a 14 per cent increase as compared to the previous 28-day period. Among the countries for which data was available, India reported 2,527 new cases.

The highest numbers of new cases were reported from India (2,527 new cases; <1 new case per 100,000 people; Thailand (636 new cases; <1 new case per 100,000 people) and Bangladesh (221 new cases; <1 new case per 100,000 people), the WHO update added.

Rajeev Jayadevan, co-chairman of the National Indian Medical Association COVID Task Force, told Down to Earth, The few new reported cases do not necessarily reflect a large caseload in the country. Unlike some other nations, India has been enjoying a period of low tide for months, so justifying the high cost of testing and getting people to comply is not easy. To know accurate caseloads, data from tertiary referral hospitals, airport surveillance and research centres have to be collected. Wastewater surveillance can also provide a prior warning about ten days in advance, as of now there is no signal.

Nonetheless, we must keep a tab on the cases so that people are aware the disease is still lurking, Jayadevan added, expressing concern for vulnerable segments of the population.

Experts had feared that a new version of Omicron called BA 2.86, armed with numerous new mutations, could increase infections. As the virus relentlessly tweaks and changes its genomic sequence, it could spread widely in the coming months.

"However, currently, descendants of XBB (an earlier recombinant version of Omicron) are constituting about 97 per cent of the variants globally. They have been present for over a year and have not been outcompeted or displaced by BA.2.86 descendants like JN.1, Jayadevan said

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COVID-19: India reports 14 new cases and 152 active cases on November 10 - Down To Earth Magazine

What GAO Found

The Department of Justice (DOJ) has brought federal fraud-related charges against at least 2,191 individuals or entities in cases involving federal COVID-19 relief programs, consumer scams, and other types of fraud as of June 30, 2023. Based on GAO's analysis of the cases announced in DOJ press releases, at least 1,525 individuals or entities facing fraud-related charges were found guilty or liable. Courts have ordered individuals to pay restitution ranging up to over $60 million and serve prison terms up to 10 years or more. GAO's analysis of fraud schemes highlights the resulting financial losses and impacts on taxpayers, agency reputation, federal program goals, and health and safety. Agencies can use information about schemes to improve their fraud risk management efforts.

Examples of Fraud Schemes Involving Federal COVID-19 Relief Programs or Consumer Scams

Key mechanism

Fraud scheme description

Conspiracy

A group allegedly conspired to obtain more than $240 million from a federal child nutrition program in a complex fraud scheme. Individuals colluded to open shell companies acting as program sites to claim they were serving thousands of meals a day to underserved children during the pandemic. Instead, these funds were diverted for self-enrichment. Four individuals pleaded guilty but have not been sentenced. Over 40 others are awaiting trial.

Misrepresentation

Two company owners attempted to obtain a total of $5 million by applying for 14 Paycheck Protection Program loans and 12 COVID-19 Economic Injury Disaster Loans. They submitted fabricated tax and other documents inflating the companies' number of employees and payroll. The owners received almost $650,000 in funds they used for personal items, such as a luxury car. Both pleaded guilty, were ordered to pay more than $800,000 in restitution, and were sentenced to 2 to 3 years in prison.

Mislabeling

A company owner sold and mailed pesticide marketed as an air purifier to kill airborne viruses such as COVID-19. The product contained sodium chlorite, a substance declared unmailable under U.S. postal regulations because of its propensity to cause a fire or explosion. The owner was sentenced to 8 months in prison and ordered to pay a total penalty of $556,443 through restitution, fines, and forfeiture.

Health care fraud

A licensed medical practitioner pleaded guilty to selling homeopathic immunizations, falsely claiming they provided immunity to COVID-19. She received over $74,000 for fabricated COVID-19 vaccination and immunization records, knowing this would mislead school officials enforcing the state's vaccination laws. She was sentenced to almost 3 years in prison.

Source: GAO Antifraud Resource and analysis of court documentation (information); Icons-Studio/stock.adobe.com (icons). | GAO-24-106353

Various interagency task forces and the Pandemic Response Accountability Committee (PRAC) were established to combat COVID-19 fraud. For example, the COVID-19 Fraud Enforcement Task Force conducted an enforcement sweep and reported taking law enforcement actions against fraudsters responsible for approximately $836 million in fraud. Similarly, the PRAC estimated its information and resource sharing with investigative agencies supported hundreds of criminal convictions and the recovery of more than $1 billion.

Since March 2020, Congress provided over $4.6 trillion to help the nation respond to and recover from the COVID-19 pandemic. The public health crisis, economic instability, and increased flow of federal funds associated with the pandemic increased pressures on federal agency operations and presented opportunities for individuals to commit fraud. The COVID-19 pandemic saw an increase in the number of fraud-related charges, including schemes by individuals and large complex syndicates.

The CARES Act of 2020 includes a provision for GAO to report regularly on the federal response to the pandemic.

This report describes: (1) the status of federal COVID-19 fraud-related cases announced by DOJ, including examples of fraud schemes and (2) examples of federal efforts that have been taken to combat COVID-19 fraud.

GAO reviewed public statements from DOJ from March 2020 through June 2023 to identify federal fraud-related cases. Specifically, GAO identified cases involving COVID-19 relief program fraud; consumer scams; and other types of fraud. GAO then analyzed court documents for details on fraud schemes. GAO also reviewed federal agency documentation and rules, proposed legislation, and proposed antifraud efforts.

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COVID-19: Insights from Fraud Schemes and Federal Response Efforts - Government Accountability Office

A coronavirus uses protein "spikes" to grab and infect cells. Despite their name, those spikes aren't stiff and pointy. They're shaped like chicken drumsticks with the meaty part facing out, and the meaty part can tilt every which way on its slender stalk. That ability to tilt, it turns out, affects how successfully the spike can infect a cell.

Now researchers from the Department of Energy's SLAC National Accelerator Laboratory and Stanford University, along with collaborators at three more universities, have obtained high-resolution images of intact coronavirus spikes on the surfaces of virus particles; identified a tiny hinge surrounded by sugar molecules that allows the spike's glob-like "crown" to bend on its stalk; and measured how far it can tilt in any direction.

While the study was carried out on a much less dangerous cousin of SARS-CoV-2, the coronavirus that causes COVID-19, it has implications for COVID-19, too, since both viruses bind to the same receptor on a cell's surface to initiate infection, said Jing Jin, a biologist at Vitalant Research Institute and adjunct assistant professor at the University of California, San Francisco who performed virology experiments for the study.

The results, she said, suggest that disabling the spike's hinges could be a good way to prevent or treat a wide range of coronavirus infections.

The team also discovered that each coronavirus particle is unique, both in its underlying shape and its display of spikes. Some are spherical, some are not; some bristle with spikes while others are nearly bald.

"The spikes are floppy and move around, and we used a combination of tools to explore all their possible angles and orientations," said Greg Pintilie, a Stanford scientist who developed detailed 3D models of the virus and its spikes. Seen up close, he said, each spike is different from all the rest, mainly in its direction and degree of tilting.

The research team reported its findings in Nature Communications.

"Since the pandemic started, most studies have looked at the structures of coronavirus spike proteins that were not attached to the virus itself," said Wah Chiu, a professor at SLAC and Stanford and co-director of the Stanford-SLAC Cryo-EM facilities where the imaging was done. "These are the first images made of the spikes of this strain of coronavirus while they're still attached to the virus particles."

SARS-CoV-2's more benign cousin

The study has roots in the early days of the pandemic, when research at SLAC shut down except for work aimed at understanding, preventing and treating COVID-19 infections.

Because experiments with the actual SARS-CoV-2 virus can only take place in high-level (BSL3) biosafety labs, many scientists chose to work with more benign members of the coronavirus family. Chiu and his colleagues selected human coronavirus NL63 as their subject. It causes up to 10% of human respiratory infections, mainly in children and immunocompromised people, with symptoms ranging from mild coughs and sniffles to bronchitis and croup.

In 2020, Chiu said, the team used cryogenic electron microscopy (cryo-EM) and computational analysis to image the crowns of NL63 spikes with near-atomic resolution.

But because a spike's stalk is much thinner than its crown, they were not able to get clear, high-resolution images of both at once.

Zooming in on spikes

This study combined information gleaned from a series of experiments to get a much more complete picture.

First, Stanford graduate student David Chmielewski used cryogenic electron tomography (cryo-ET) to combine cryo-EM images of viruses that were taken from different angles into high-resolution 3-D images of more than a hundred NL63 particles.

SLAC senior scientist Michael Schmid plugged those images into a 3D visualization tool and discovered that each of a particle's spikes was bent in a unique way. Another SLAC scientist, Muyuan Chen, used advanced image reconstruction to create maps showing the average density of the spikes' crowns and stalks.

Zooming in on one of those spikes, biological chemist Lance Wells at the University of Georgia used a technique called mass spectrometry to pinpoint the site-specific chemical compositions of the 39 sugar chains attached to each of the spike's three identical proteins.

Finally, Abhishek Singharoy, a computational biophysicist at Arizona State University, and his student, Eric Wilson, integrated all those measurements into atomic models of the spikes' crowns and stalks at different bending angles, and carried out further simulations to see how far and how freely a spike can bend.

"It turns out that no matter what, the spikes have a preferred bending angle of about 50 degrees," Chiu said, "and they can tilt up to 80 degrees in any direction in the simulation, which matches well with our cryo-ET experimental observations."

The bending occurred at a place on the stalk, just below the crown, where a particular cluster of sugar molecules clung to the protein, forming a hinge. Computer simulations suggested that changes in the structure of this hinge would affect its ability to bend, and lab experiments went one step further: They showed that mutations in the protein part of the hinge made the spike much less infectious. This suggests that targeting the hinge could provide an avenue to fight the virus.

"People working on the more dangerous coronaviruses, including MERS-CoV and SARS-CoV-2, have identified a region equivalent to this one and discovered antibodies targeting this region," Jin said. "That tells us it's a critical region that is highly conserved, meaning that it has stayed much the same over the course of evolution. So maybe by targeting this region in all coronaviruses, we can come up with a universal therapy or vaccine."

This work was supported by the National Virtual Biotechnology Laboratory, a group of Department of Energy national laboratories that was focused on responding to the COVID-19 pandemic with funding provided by the Coronavirus CARES Act; the National Science Foundation; and the National Institutes of Health.

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How tiny hinges bend the infection-spreading spikes of a coronavirus - Science Daily

When the next pandemic strikes, policymakers will face tough decisions about how best to protect the publics health. Mask-wearing is a straightforward intervention that could be recommended alongside other measures, assuming the pathogen spreads through respiratory droplets as COVID-19 and influenza do.

Yet ongoing disagreement over the effectiveness of masks could undermine policymakers ability to take decisive action when new threats appear, researchers warn.

A new study by former US Centers for Disease Control and Prevention (CDC) Director Dr Tom Frieden and colleagues tries to cut through the misinformation and summarise what the COVID-19 pandemic has taught us about masks and their ability to prevent disease transmission.

Randomised clinical trials (RCTs) are often regarded as the gold standard for evaluating the effectiveness of interventions or treatments. They involve randomly assigning people to either receive the intervention of interest or a control intervention, like no treatment or a placebo, and then following what happens to them.

Yet, while a well-designed RCT can supply valuable information in many areas of public health and medical practice from speed limits on highways to seatbelt and motorcycle helmet laws they are difficult to conduct, Frieden and colleagues said.

Similarly, during a pandemic caused by a lethal respiratory virus, it is difficult to find a setting in which it is ethical and workable to randomise people to masking vs. no masking. The time and funding needed to properly design and implement such trials further limits their feasibility. Also, different types of masks and contexts in which people might be recommended to wear them, with no guarantee that participants will do so correctly, may all affect study results.

Just two RCTs on community mask use have been published in the context of COVID-19. The first study randomised 3,030 people in Denmark to either receive surgical masks and a recommendation to wear them outside the home, or no recommendation. The results were inconclusive: although COVID-19 infections were 20% lower in the mask group, the study was too small to be sure this wasnt down to chance.

The second study involved more than more than 340,000 people living in 6 villages in Bangladesh, randomised to receive cloth or surgical masks, plus information promoting their use, or no such intervention. Mask use was three times more common (42% vs. 13%) in villages assigned to receive masks particularly when people visited mosques. Overall, mask use was associated with a 9% reduction in symptomatic COVID-19 infections, and a 35% reduction among people aged 60 years or older.

Another type of study that is sometimes used to probe areas of medical uncertainty is meta-analysis. These do not create new data, but statistically combine the results from existing RCTs to draw conclusions based on a larger set of data. However, if the studies differ in their methods, populations, contexts or measurements, their results and conclusions may be unreliable.

Frieden and colleagues pointed to a recent Cochrane review on interventions to reduce the spread of respiratory viruses as an example of this. It pooled the results of 78 RCTs examining the impact of various physical interventions, including hand hygiene and masks, for preventing respiratory illnesses mostly influenza during non-epidemic flu seasons when viral circulation and transmission was lower than during the COVID-19 pandemic.

The results did not show a clear reduction in respiratory viral infection associated with mask wearing, which some people have seized upon as evidence that masks dont work. However, the authors clearly said that the high risk of bias in the trials, variation in outcome measurements and relatively low adherence to the interventions meant that they couldnt be certain as to whether wearing masks helps slow respiratory virus spread. They called for large, well-designed RCTs to address the effectiveness of these interventions in multiple settings and populations.

Observational studies can help researchers to investigate relationships that cant be tested in RCTs and understand what happens in real life situations. They involve following groups of people without trying to change who is or isnt exposed to the intervention of interest. Frieden and colleagues reviewed a number of observational studies conducted during the COVID-19 pandemic and said that high quality data showed the effectiveness of masks to prevent COVID-19 transmission on airplanes, in schools and among household and community contacts of infected people.

An outbreak on the USS Theodore Roosevelt aircraft carrier which occurred early in the pandemic when few people would have had immunity to SARS-CoV-2 was particularly instructive, they said. In this high-risk environment, more than 80% of people who reported not masking were infected, while the odds of infection were 30% lower for those who wore masks.

Friedens team also reviewed data from other types of study including laboratory studies that showed masks reduced the spread of infectious respiratory particles, and that N95 respirators offered better protection than surgical or cotton masks.

Frieden and colleagues stressed that whether masks work is a different question from whether mask mandates work. If adherence is low, mandates are unlikely to have an impact. They also acknowledged that it can be difficult for young children to wear well-fitting masks, and that it was possible masking may impede cognitive and social development, meaning the risks and benefits should be carefully weighed up.

However, they concluded that, taken together, the available evidence strongly suggests that masks can reduce the spread of COVID-19, and that high-quality masks should play an important role in future respiratory pandemics.

As with any intervention, they are just one of several measures that are needed but masks are an important tool to prevent infections, protect healthcare workers and the public, and save lives, Frieden told VaccinesWork.

He also stressed that the protection they supply isnt perfect, and is more important for certain people, in certain places and at certain times. People who are elderly, immunosuppressed, or concerned about reducing their risk of infection, can wear a mask, particularly an N95 or KN95 mask, indoors, particularly in crowded spaces during times when COVID-19 is spreading widely, to reduce risk, he said. For people who are ill or who have been exposed to COVID-19 and may have asymptomatic infections, wearing a mask protects others.

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Facemasks catch viruses so why is the evidence on their effectiveness so confusing? - Gavi, the Vaccine Alliance

By now, after a few years of COVID-19 disease and virus management, many people in the United States have some sort of protection or immunity against the virus. This is due to mass vaccination, encountering previous infection, or both. The availability of tests and treatment options for these patients has also helped many diagnose the virus faster and be able to act before the illness can become more severe. Such actions have also helped reduce hospitalizations and deaths because of COVID-19.1

Even with the current available treatment options, it is important to recognize the importance of masking, particularly for those with immunocompromised conditions and lowered immunity due to other comorbidities. Higher risk factors could also include age, lack of access to vaccination, and serious previous infections.

Image credit: Thaut Images | stock.adobe.com

Weekly new hospital admissions rates due to COVID-19 went from about 150,000 in January 2022 to about 15,722 in October 2023. The numbers may still be high, especially going into the flu and winter season, but there has been a huge reduction and improvement in reducing the hospitalizations since 2022. Weekly deaths because of COVID-19 have been reduced from 24,845 in January 2021 to about 1369 September 2023.2

COVID-19 Treatment Options

There are now a number of treatment options available in the United States. Some of these options include the use of the antiviral nirmatrelvir/ritonavir (Paxlovid; Pfizer), which can be used for adults and children ages 12 years and older. This oral medication is taken at home. Another at-home, oral option is molnupiravir (Lagevrio; Merck), an antiviral agent that can be used in adults when initiated within 5 days of symptom onset. Remdesivir (Veklury; Gilead) is an inpatient treatment option used in adults and children and recommended to start within 7 days of symptoms onset. This medication is given intravenously as infusion at a health care facility for 3 consecutive days or more, if needed.3

Other authorized treatments for COVID-19 include tocilizumab (Actemra; Genentech) for hospitalized patients and baricitinib (Olumiant; Lilly), approved for hospitalized adults, especially needing oxygen.

Immune modulators have also been used to activate and suppress the immune function for patients impacted by COVID-19. These include anakinra (Kineret; Sobi) for hospitalized pediatric ages 2 to less than 18 years of age who are receiving systemic corticosteroids and may require oxygen and mechanical ventilation. The investigational drug vilobelimab (Gohibic; Ementals), used for hospitalized patients, is another option to be initiated within 48 hours of receiving invasive mechanical ventilation.

Some of these treatment options may have adverse effects or drug-drug interactions, just like other medications, and patients should be educated about potential symptoms or concerns.

Vaccines

There are currently a few options available to all patients in the United States. Depending on the location of the clinics and pharmacies, 1 or more of these vaccines may be available. Approved or authorized COVID-19 vaccines include Spikevax (Moderna), Comirnaty (Pfizer), Jcovden (Janssen), and COVID-19 Vaccine, Adjuvanted from Novavax.

There are many other COVID-19 vaccines in clinical trials at this time. Patients should be encouraged to stay up-to-date on vaccinations, particularly those at higher risk of developing severe COVID-19.

Lastly, besides the treatment options mentioned above, as well as the vaccines available, protection tools such as masks and hand washing are effective tools to combat the spread of COVID-19, as well as other viruses circulating during the colder months. As we continue to combat this virus, with many more treatment options on the horizon, disease control will only become easier and more effective, if everyone participates.

References

1. COVID-19 by County. CDC. Updated May 11, 2023. Accessed November 10, 2023. https://www.cdc.gov/coronavirus/2019-ncov/your-health/covid-by-county.html

2. COVID Data Tracker. CDC. November 10, 2023. https://covid.cdc.gov/covid-data-tracker/#trends_weeklyhospitaladmissions_weeklyhospitaladmissions100k_00

3. COVID-19 Treatments and Medications. CDC. Updated October 4, 2023. Accessed November 10, 2023. https://www.cdc.gov/coronavirus/2019-ncov/your-health/treatments-for-severe-illness.html

4. Coronavirus (COVID-19) Drugs. FDA. Updated May 25, 2023. Accessed November 10, 2023. https://www.fda.gov/drugs/emergency-preparedness-drugs/coronavirus-covid-19-drugs

5. Stay Up to Date with COVID-19 Vaccines. CDC. Updated November 8, 2023. Accessed November 10, 2023. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html

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Clinical Updates On COVID-19 Treatments and Vaccines - Pharmacy Times

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A sweeping ban on COVID-19 vaccine requirements for all private businesses, including hospitals, is the latest blow to medically vulnerable Texans who rely on others immunization to shield themselves from highly transmissible viruses.

Tamer coronavirus variants and a soft vaccine booster rollout have contributed to a lessened sense of urgency around the virus. But the new measure, which Gov. Greg Abbott signed into law on Friday, could risk the health of groups like organ transplant recipients, cancer patients and those with underlying conditions as common as severe asthma.

These risks led to some bipartisan dissent during original Senate discussions of the bill, especially from state Sens. Borris Miles, D-Houston and Kelly Hancock, R-Fort Worth, who both take immunosuppressants for their respective kidney transplants.

I live a pretty normal life and am not fearful, but it does make you think about others, Hancock said. There's just a balance we have to keep in mind just try to always think of others and the positions they may be in.

For one, vaccines are less effective in some of these patients because their conditions prevent their bodies from manufacturing the white blood cells that can recognize and fight off viruses. But even with protection, the virus can exacerbate underlying conditions and lead to long-term symptoms of the virus, known as long COVID.

Scientists and health experts agree that the vaccine is safe and effective for most people with functioning immune systems, in reducing both transmission and severity of the virus.

Everybodys going to be different, so it's not automatic that a compromised individual will end up in the hospital or in the ICU, said Dr. Jimmy Widmer, an internal medicine specialist. But what we do know throughout the past three and a half years of COVID, is that time and time again, study after study has shown that those who are immunocompromised are hospitalized at a higher rate.

In the past, state lawmakers efforts to stymie vaccine mandates have excluded hospitals and other medical facilities partially because under federal emergency rules, the U.S. Centers for Medicare and Medicaid Services required vaccinations among employees.

The regulation was withdrawn over the summer, and since then, many facilities have differed on their rules. A vast majority of them did not even have a blanket mandate at this point, said Carrie Kroll, an advocacy leader for the Texas Hospital Association.

Were very hopeful that the worst of the COVID pandemic is behind us, Kroll said. But we know with infectious disease, what may rule today may not rule in six months, in terms of disease levels and what this disease morphs into.

In the end, lawmakers included a provision that would allow hospitals to require unvaccinated employees to wear personal protective equipment despite advocates fighting for a complete exclusion from the bill.

Alice Barton, a retired infectious disease doctor living in Austin, said it's impossible to imagine this measure will be enforced. Barton, 70, has severe asthma and an autoimmune disease, and said she just received the triple vaccine for the flu, COVID, and RSV.

I'm the only person still who wears a mask to the doctor's office. I'm one of two people in my church who wears a mask, Barton said. One becomes lonely. It's not just being physically isolated from other people. It's that other people aren't thinking about us anymore.

Barton is one of many people worried that state lawmakers will continue further down the warpath against vaccine requirements, onto other immunizations like those for polio or measles.

But, with the law now in place, advocates hope to transform the idea that people have to get the vaccine into an idea that they should to protect their peers.

Chase Bearden, a leader at the Coalition of Texans with Disabilities, said now that theres less external pressure on Texans to make this decision, he hopes they realize its one they can make of their own accord.

What can we all do on a personal level to keep everyone safe, especially those who may not have the great health that the rest of us do? Bearden said. Theres so many family members that are going through cancer treatment or living with a chronic health condition. And yes, you're a healthy person. You don't think you need it. But if you get it, you easily pass that on to the next person who takes it home.

Stephanie Duke, an attorney who helps handle disaster management at Disability Rights Texas, said the state should be doing everything it can to promote public health, and that should include people with disabilities.

People go in to get health care, and you would expect your health care provider to be doing everything they can to make that safe, Duke said.

Duke said government officials often forget to include disabled people in disaster preparedness, and the global pandemic was no different than a hurricane evacuation. Several policies issued during the height of the public health emergency have hurt those who dont have functioning immune systems or with chronic illnesses.

For instance, when the pandemic began, disabled people werent a specific category included in the demographic data that states began collecting on the virus, she said.

Shit is going to happen. Lights are going to go out, we're going to have viruses again. This is the world that we live in, Duke said. But how we plan for it, is how we give people choices to promote their safety, autonomy and independence after an event and build that resilience.

Neelam Bohra is a 2023-24 New York Times disability reporting fellow, based at The Texas Tribune through a partnership with The New York Times and the National Center on Disability and Journalism, which is based at the Walter Cronkite School of Journalism and Mass Communication at Arizona State University.

Disclosure: Coalition of Texans with Disabilities, Texas Hospital Association and The New York Times have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.

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COVID-19 vaccine mandate ban jeopardizes medically- vulnerable ... - The Texas Tribune

Researchers from the Texas A&M School of Veterinary Medicine & Biomedical Sciences (VMBS) Veterinary Education, Research, & Outreach (VERO) program have joined an international team studying how coronaviruses are spread and whether an individuals microbiome (the collection of microbes living in or on the body) might impact that transmission.

Coronaviruses are a family of viruses that can cause a variety of diseases in many species, from the common cold and severe acute respiratory syndrome (SARS) in people, to diarrhea in calves and respiratory disease in adult cattle.

The research team which includes researchers from the United States, the United Kingdom, and Canada has received $3.5 million from the United States Department of Agriculture National Institute of Food and Agriculture (USDA-NIFA), the National Science Foundation, the National Institutes of Health, and the Biotechnology and Biological Sciences Research Council (BBSRC).

Their work will use cattle as a model for viral transmission during group commingling events when unfamiliar animals or people come together in a defined space and time with intensive and sustained contact.

Commingling is associated with increased disease transmission risk and possible global consequences, as the COVID-19 pandemic has highlighted. Commingling events in humans include large group events, air travel, incarceration, and classroom settings.

Among animals, commingling routinely occurs during livestock production when the body's ability to fight disease may be lowered, while, at the same time, the body is being exposed to more pathogens.

It's more and more the nature of our society that we have these types of commingling events, through travel, socialization, and the general nature of day-to-day interactions, said Dr. Paul Morley, VEROs director of food animal research and one of the projects co-principal investigators. Being able to understand how viruses behave would help us apply preventive measures, including vaccination and antiviral treatment, for both humans and cattle.

The researchers, led by Dr. Noelle Noyes, an associate professor in the University of Minnesota College of Veterinary Medicine, will work to understand why some people and animals get infected and/or develop symptoms during commingling events but others do not.

Photo: Dr. Matthew Scott, an assistant professor of microbial ecology and infectious disease at VERO, is one of several scientists working with an international team in studying how coronaviruses are spread.

At VERO, Morley and Dr. Matthew Scott, an assistant professor of microbial ecology and infectious disease, will work alongside three graduate students to collect samples from local beef and dairy cattle to track how bovine coronavirus, which is not able to infect people, spreads between animals.

The Texas Panhandle is one of the greatest epicenters of cattle production in the United States, Morley said. We're taking advantage of our great contacts in the cattle production industries, both beef and dairy, to look at coronavirus transmission in young calves during natural management circumstances.

Specifically, they will look at how the virus spreads depending on factors like how many cattle are housed together and if they are moved to new locations via livestock trailers. They will also measure the cattle's immune systems and microbiomes to understand if differences have an impact on whether cattle get infected.

We'll be looking at virus shedding before, during, and after commingling events, as well as immune function, genes that get turned on or off, and changes in the microbiomes of the respiratory and gastrointestinal tracts, Morley said.

Using cattle from real livestock operations will ensure that data collected accurately represents real-world transmission factors.

"We hope to uncover the complex multi-level mechanisms that underlie viral transmission during intensive mixing of unfamiliar calves, said Dr. Joseph Neary, principal investigator of the projects U.K. activities. These new insights will better inform calf husbandry practices to reduce infectious disease transmission risk, particularly where newly mixed calves have been sourced from multiple farms."

The study will also expand fundamental scientific understanding of viral behavior.

A unique aspect of this work is the integration of microbiome dynamics into models of virus transmission at the population level, Noyes said. Theres a lot of scientific evidence about the importance of the microbiome in individual health, but we dont have as much understanding of how population-level microbiome dynamics may influence disease transmission, particularly during situations of heightened disease risk, such as commingling.

The project is expected to last through 2026. In addition to Texas A&M University and the University of Minnesota, collaborators on the project include scientists from Mississippi State University, the University of Liverpool, and the University of Saskatchewan.

This project is the idealization of what we're trying to do at VERO, working with people around the world on a big project with big impact, Morley said. The impact on our graduate students is going to be tremendous; theyll get to interact with this internationally renowned, extremely talented group of people. Its a great opportunity for them in their graduate programs.

Top photo: Dr. Paul Morley,VEROs director of food animal research, works in his lab on the campus of West Texas A&M University.

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Texas A&M Researchers Contribute to International Project Studying ... - West Texas A&M University

Every year, millions of consumers across the country elect to use the various OTC cough and cold products to treat the fever, cough, sneezing, sore throat, nasal congestion, muscle aches, and/or headaches associated with the common cold, influenza, COVID-19, or other respiratory viruses.

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During this time of the year, pharmacists are likely to encounter patients seeking guidance on the various OTC products marketed for the relief of mild to moderate symptoms. These include cough expectorants, cough suppressants, antipyretics and analgesics, decongestants and antihistamines, and anesthetic and antiseptic products, which are available as single-entity or multi-ingredient products. These products are also formulated in various dosages and forms, including oral and topical products, to meet the needs of adult and pediatric patient populations.1 A well-known brand, Coricidin HBP (Bayer), is formulated for patients with hypertension, and there are also several sugar-free products for patients with diabetes, such as Diabetic Tussin (Hi-Tech Pharmacal Co, Inc).

Pharmacists will also likely encounter patients seeking guidance on dietary supplements marketed for immune support that may contain one or more of the vitamins A, C, D, and E, along with essential trace elements of zinc and selenium.1 Some also contain echinacea, ginger, elderberry, garlic, other herbal ingredients, prebiotics, and probiotics for immune enhancement. Findings from one study showed that essential nutrients such as vitamins C, D, and E; zinc; selenium; and -3 fatty acids have well-defined immunomodulatory effects, including protective clinical benefits in some infectious diseases.2

Literature indicates that since the start of the COVID-19 pandemic, there has been an augmented interest and use of dietary supplements among the general public. Sales of cold, influenza, and immunity supplements accounted for an estimated $6 billion by the end of 2020, up from $3.4 billion reported in 2019, and immune health supplements represented an estimated 10% of all supplement sales in the United States.3

Pharmacists can be instrumental in counseling patients on the proper use of OTC cough and cold products. They can also ascertain if self-treatment is appropriate and direct patients to seek further care from their primary health care provider when warranted. This is particularly important for pediatric patients, patients with preexisting medical conditions or those taking prescription medications, and patients without a confirmed diagnosis or experiencing severe symptoms. The FDA does not recommend using OTC cough and cold medicines in pediatric patients younger than 2 years due to efficacy and safety concerns.1,4 Manufacturers voluntarily label these cough and cold products to state, Do not use in children under 4 years of age, and have added precautions to products containing antihistamines against their use for sedation purposes.1

NEWS AND RECENT CLINICAL DATA

In September 2023, the FDA held a Nonprescription Drugs Advisory Committee meeting to discuss the effectiveness of oral phenylephrine as an active ingredient in OTC cough and cold products. The FDA press release indicated that current data do not support the use of orally administered phenylephrine as a nasal decongestant. Importantly, however, neither the agency nor the committee raised safety concerns about its use at recommended doses.5 More information is available on the FDA website.

According to recently published data from a scientific review, in Clinical Infection in Practice, researchers concluded that when no contraindications are present, OTC medications utilized for the symptoms of common cold and influenza-like illnesses caused by respiratory viruses are safe and effective treatments for similar symptoms associated with COVID-19 infections.6

In study findings published in Nutrients, the researchers had conducted a systematic review to assess the supposed benefits or possible harms of dietary supplement ingredients commonly marketed to enhance immune system response or promote immune system health. Based on their findings, the authors wrote: There is little evidence to suggest [that] certain ingredients, if taken prior to getting sick, will reduce the severity or duration of any acute respiratory infection, versus not taking a dietary supplement prophylactically or as compared [with] placebo.3

Further, in an article published in Heliyon, data indicated that with regard to immune-boosting supplements, there are only a few clinically proven natural products, vitamins, and minerals. These include vitamin C, vitamin E, and zinc, and these supplements can be considered as an alternate option for protection against certain types of immunologic and inflammatory diseases.7

CONCLUSION

When used as directed and with no contraindications, OTC cough and cold medications marketed for the relief of mild to moderate symptoms are safe and effective. Before recommending these products, pharmacists should always review for potential allergy sensitivities, drug-drug interactions, and possible contraindications. To avoid medication errors, patients should be prompted to read labels before administration, review ingredients to avoid therapeutic duplications, always check the expiration dates, and adhere to the recommended dosages and administration guidelines.

Before administering medications to pediatric patients, parents or caregivers should be reminded to always use calibrated measuring devices provided by the manufacturer for liquid medications and read all labels carefully. When in doubt regarding the appropriateness or dose of the medication, caregivers should always consult their pediatrician or pharmacist. Patients should be encouraged to seek medical attention from their primary health careprovider if symptoms worsen or linger or if they experience high fever or signs of infection.

Implementing preventive measures for potentially decreasing the risk of contracting or preventing transmission of colds, such as routine handwashing and using hand sanitizers when soap and water are unavailable, is also very effective. Pharmacists can also seize this opportunity to encourage eligible patients to obtain the recommended vaccinations if appropriate. They can also advise patients exhibiting signs of influenza and COVID-19 infections to get tested so that therapy with recommended prescription antivirals can be initiated as soon as possible when appropriate to improve clinical outcomes.

ABOUT THE AUTHOR

Yvette C. Terrie, BSPHARM, RPH, is a clinical pharmacist and medical writer based in Northern Virginia.

REFERENCES

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Ensure Proper Use of Nonprescription Medications for Cold ... - Pharmacy Times

Suffolk County reported the following information related to COVID-19 on November 13, 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 November 4, 2023

Daily Hospitalization Summary for Suffolk County From November 13, 2023

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

Fatalities 11/13/23

COVID-19 Case Tracker November 11, 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.

Visit link:

COVID-19 update 11-14-23 - Suffolk County Government (.gov)

As a result of the coronavirus pandemic, travel demand in Victoria has shifted significantly in two ways:

As we recover from the coronavirus pandemic, we expect some people to continue to work from home more and travel patterns to change. We are also looking at how we keep the networks moving as people return to work and school while keeping people safe and confident to use public transport.

Changes to working patterns may mean less pressure on managing peak-hour commuter travel into and out of the CBD and more focus on managing work travel differently across the day, as well as improving connections that support living and working locally.

These shifts in demand are occurring in other cities around the world as well as closer to home.

While we are continually gathering data to help us understand where, when and why people will travel, what we already know is our transport infrastructure projects are a vital part of our recovery from the pandemic, creating thousands of jobs for Victorians and preparing our transport system for generations to come in our state.

While Victorians were staying at home to slow the spread of coronavirus, the Victorian Government has been pushing ahead with critical maintenance and infrastructure projects getting our road and rail network ready for safer and more reliable journeys.

A growing population and increasing urban density are driving the need to maximise the volume of freight moving on high-capacity road and rail links between vital logistics centres. At the same time, we need to manage increasing volumes of deliveries within our growing urban areas.

In response to this growing demand, were investing $80 billion in road and rail projects to help move more people and goods than ever before, and support Victorias place as the economic powerhouse of the nation.

In addition to getting on with the Big Build, we are working to make sure transport will continue to support public health, be adaptable to new travel patterns and community needs, and capitalise on the many opportunities to use transport to innovate and drive economic growth.

Our focus will be on initiatives that meet the changing needs of our community, improve services, and make the most of information and technology to get more from our transport network. This includes, for example, a $340 million package of measures to create more space on our roads by putting extra technology and people in place to keep drivers and freight moving.

Shifting work locations from central Melbourne will also have an effect on regional travel, economies and communities with more opportunities for people to relocate to regional centres.

This may change the demand for regional rail services and road links between regional centres and Melbourne CBD. We will get on with our plans for more trains more often to regional centres, and deliver the upgrades to highways, arterial roads and intersections across regional Victoria, while also strengthening local bus networks and delivering new flexible solutions like on-demand travel.

Through our regional rail upgrades, were connecting communities, reducing congestion on busy roads, delivering better services and supporting thousands of jobs. Were working to upgrade every regional passenger train line in the state through the Regional Rail Revival program(opens in a new window).

Weve delivered more services to regional Victoria through a new timetable, on more comfortable, reliable VLocity trains, delivering country Victorians the transport amenities they deserve.

The freight industry is critical to the success of regional economies. Thats why new approaches may be needed to support supply chain performance and maximise the efficiency of the road network.

Given these significant challenges and uncertainties, and the importance of the transport system in driving Victorias economic and social recovery from coronavirus, there is a need for a strategic framework to underpin the transport response during the recovery period and beyond.

The Department of Transport and Plannings new strategic directions will help us prioritise policies and investments and guide our response to the impacts of the coronavirus pandemic.

We are also getting on with projects already underway, including a predictive crowding indicator, more services and off-peak fares.

We have delivered measures like hand sanitisers at stations and more intensive cleaning to improve hygiene. Weve also invested $22 million to support our commercial passenger vehicle industry and committed $340 million to manage congestion on our roads using better road management and technologies.

We have introduced off-peak fares and added hundreds of new train and tram services each week to spread demand across the day and enable passengers to avoid crowded services.

Passengers can now track their train and see how busy a service or station is ahead of time with RideSpace. The free online tool is available on Google Maps, displaying real-time passenger volumes on trains, on individual platforms and at stations across the entire metropolitan train network. This will help passengers make informed decisions about the best time to travel.

Weve also changed the way buses operate to make boarding quicker and easier by making buses cashless and allowing all-door boarding. This means less time wasted at stops and quicker journeys. Were looking at some of our busiest bus routes to take full advantage of these changes, trialling new buses and road prioritisation to make journeys even quicker.

On the latest version of the PTV app, you can also view the location of your bus service on a map in real-time.

Excerpt from:

Department of Transport and Planning - Responding to coronavirus - Victorian Government