Category: Corona Virus

CNN

There are signs that the United Kingdom could be heading into a fall Covid-19 wave, and experts say the United States may not be far behind.

A recent increase in Covid-19 cases in England doesnt seem to be driven by a new coronavirus variant, at least for now, although several are gaining strength in the US and across the pond.

Generally, what happens in the UK is reflected about a month later in the US. I think this is what Ive sort of been seeing, said Dr. Tim Spector, professor of genetic epidemiology at Kings College London.

Spector runs the Zoe Health Study, which uses an app to let people in the UK and US report their daily symptoms. If they start to feel bad, they take a home Covid-19 test and record those results. He says that about 500,000 people are currently logging their symptoms every day to help track trends in the pandemic.

Spector says the study, which has been running since the days of the first lockdown in England in 2020, has accurately captured the start of each wave, and its numbers run about one to two weeks ahead of official government statistics.

After seeing a downward trend for the past few weeks, the Zoe study saw a 30% increase in reported Covid-19 cases within the past week.

Our current data is definitely showing this is the beginning of the next wave, Spector said.

On Friday, that increase was reflected in official UK government data too, although it was not as large as the increases reported by Zoe loggers.

Data from the National Health Service showed that after falling for nearly two months, the seven-day average of new cases in England and Wales rose 13% for the week ending September 17 over the week before. The seven-day average of hospitalizations was up 17% in the week ending September 19 compared with the week prior.

The data aligns with what models have predicted would happen in both the UK and the US.

They predicted that wed get a June to July peak and then thered be a month where nothing happened in August and then it would flatten in in August and September and then start again in October. So its exactly matching what the modelers have have been predicting, Spector said.

In the US, some models have predicted that Covid-19 cases will begin to rise again in October and continue to increase into the winter. Experts are hopeful that because most of the population now has some underlying immunity to the coronavirus, this wave would be less deadly than weve seen in previous winters.

Its not clear whats driving the increase in the UK or whether it will be sustained.

These trends may continue for more than a week or two, or they may not, said Kevin McConway, emeritus professor of applied statistics at the Open University in Milton Keynes, England.

Broken down by age, he says, there are clear increases among adolescents who are around middle school age and younger adults, those 25 through 34.

It wouldnt be surprising if there were some increase in infection as people come back from summer holidays and as the schools reopen, McConway said in a statement to the nonprofit Science Media Centre. Even if it is, theres certainly no clear indication yet that it will continue.

Hes not the only one who needs to see more data before calling this the start of a new wave.

Question one is, how significant is that rise? Is it, for instance, the beginning of something, a new wave, or is this a temporary blip because of all of the getting together around the Queens funeral and other events that have been going on? said Dr. Peter Hotez, who co-directs the Center for Vaccine Development at Texas Childrens Hospital in Houston.

A second important question will be whether the increase is being driven by a new variant.

Thats the worst possible situation. Because historically, when that situation occurs in the UK, its reflected within a matter of weeks in the United States, Hotez said. That was true of the Alpha wave; that was true of the Delta wave; that was true of Omicron and its subvariants.

Thats where the US may catch a break this time around.

Instead of new variants, Christina Pagel, a professor of operational research at University College London, thinks cases are going up in the UK because of a combination of waning immunity and behavioral changes.

Many people in the UK are several months past their last Covid-19 booster or infection, and government statistics show that just 8% of adults 50 and older have gotten an Omicron-specific vaccine since the government started its fall vaccination campaign in September. School and work have fully resumed after the summer holidays, and people are spending more time indoors as the temperature drops.

Immunity is also waning in the United States, and Americans have also been slow to get boosted. Just 35% of those for whom a booster is recommended have had one, according to CDC data.

The updated boosters in the US are slightly different from the ones in the UK. The UK is using vaccines that have been updated to fight the original version of Omicron, which is not circulating anymore. US boosters have been updated to fight the BA.4 and BA.5 subvariants, which are currently causing infections both here and abroad. Its not clear whether the strain differences will have an effect on cases or disease severity.

There are a mix of new variants offshoots of BA.4 and BA.5 that are waiting in the wings. They represent just a small proportion of total cases, but several are growing against BA.5, which is still dominating transmission.

It is very likely that these will accelerate current increases and cause a substantial wave in October in the UK, Pagel said in an email to CNN.

Other experts agree with that assessment.

There is talk about a bunch of lineages with concerning mutations, including BA.2.75, BQ.1.1, etc, but none of these are of high enough frequency in the UK right now to be driving the change in cases, Nathan Grubaugh, who studies the epidemiology of microbial diseases at the Yale School of Public Health, said in an email to CNN.

He says the mix of variants in the UK seems to be much the same as it is in the US, at least for now.

We are seeing the increase in many respiratory viruses right now in the US, so its not a stretch to think that a new COVID wave (or ripple) will be coming soon, he wrote.

Originally posted here:

Rising Covid-19 cases in the UK may be a warning for the US - CNN

For the past few years, COVID-19 has dominated public discourse. At first, countless conflicting reports led to confusion that it was just like the flu, and that it didnt have the same impact on children as it did on adolescents and adults.

As we head into our third year of research on COVID-19, more is known about how the novel coronavirus and COVID-19 affect various people in our communities. We now know that pediatric infection rates are similar to that of adults, though many children may not have any symptoms.

In fact, researchers in one 2022 pediatric study examined antibody tests. They found evidence that up to 77% of children have already had COVID-19. We now know that children can, in fact, contract the coronavirus that causes COVID-19.

For parents and caregivers, this can cause anxiety is that cough and runny nose just a cold thats circulating through day care, or something more serious?

This article sheds light on the most common symptoms of COVID-19 in children, and what to do if you suspect your child has it.

Experts note that COVID-19 symptoms in children are similar to those documented in adults. However, the symptoms in children are usually not as severe.

In many cases, children may be asymptomatic. This means that no symptoms may be present even though they test positive.

Common symptoms of COVID-19 include:

Its important to keep in mind that as new coronavirus variants emerge, new symptoms may arise. Others can shift in severity.

For example, when COVID-19 first appeared globally in 2019, a loss of smell and taste was one of the hallmark signs that a person might have contracted the virus.

But with later variants, such as many of the Omicron variants, a loss of taste and smell is less frequently reported as a primary symptom, whereas a sore throat is often more common.

When in doubt, its always best to reference the latest information shared by reliable health organizations, such as the Centers for Disease Control and Prevention (CDC) or the National Institutes of Health (NIH).

Also note that many common COVID-19 symptoms are similar to those of the common cold, flu, stomach flu, and other upper respiratory infections.

Before jumping to conclusions, get your child tested to confirm they have COVID-19.

Even though children tend to have a less severe reaction to COVID-19 than older populations, one serious risk COVID-19 poses to children is the potential to develop multisystem inflammatory syndrome in children (MIS-C).

Researchers still dont fully understand the link between MIS-C and COVID-19. But they do know that since the appearance of the novel coronavirus, many children with MIS-C had either an earlier coronavirus infection or were exposed to someone who had COVID-19.

MIS-C can affect multiple organ systems across the body, including the heart, lungs, kidneys, gastrointestinal system, and brain. If left untreated, MIS-C can be deadly. In most cases, its easily treated.

If your child has symptoms of MIS-C, get them evaluated by a doctor immediately. Symptoms associated with MIS-C include:

Another potential symptom of COVID-19 in young children is croup. Croup is the inflammation of the airways that causes:

If your child has symptoms of croup, its worth getting evaluated and tested for COVID-19 or other possible causes.

Studies are still being conducted to determine how COVID-19 specifically affects babies.

One 2022 study from Poland looked at infections in infant populations (newborns up to 12 months old) during the first year of the COVID-19 pandemic (March through December 2020). Researchers noted the majority of cases in this group were mild.

Of the infant cases reviewed even though 94% were hospitalized 276 cases were mild, six were moderate, 32 were asymptomatic, and none were reported as severe cases.

Similar to adults, the most common symptoms were low and high grade fevers. However, other reported symptoms included:

Researchers noted that one of the most common secondary diagnoses that followed COVID-19 in infants was pneumonia. It was found in 70 of the 300 cases reviewed.

On the whole, the Polish study noted that infant cases of COVID-19 tend to represent only 1% to 2% of all cases, even when looking at general case counts in other countries. But, in countries with more prevalent testing, this percentage could increase to a range of 5% to 13%.

Still, infant cases were generally mild compared with adult cases, which were often more severe.

A 2022 study from Germany suggests that at-home rapid antigen tests tend to be less precise or accurate than the RT-PCR test, which healthcare professionals perform.

Experts have consistently questioned the effectiveness of at-home tests because of known issues regarding low sensitivity to detect the coronavirus across all age groups.

This means theres a higher possibility of false negatives for at-home rapid tests. Coupled with a heightened chance of improper nasal swabbing in younger populations, theres an increased risk of getting incorrect results from an at-home rapid antigen test performed on children.

Parents and caregivers should keep in mind that a rapid test only offers results for a snapshot in time. It can only provide sufficient results if theres enough viral load for the test to pick up.

The coronaviruss incubation period ranges from 2 to 14 days, with the average being 3 to 6 days, depending on the coronavirus variant.

So, a negative rapid test result doesnt necessarily mean youre in the clear if the test is taken fewer than 14 days after a known exposure. It could mean the virus is not yet detectable.

If you suspect that your child may have been exposed to COVID-19, your first step should be to get them tested.

While at-home tests might provide an initial answer, its always best to take your child to a physician or clinic for an RT-PCR test. This test type offers higher accuracy and has a lower false-positive rate.

Plan to keep your child at home from day care or school if COVID-19 is suspected to reduce the risk of transmitting the virus to others.

Currently, theres only one antiviral medication for COVID-19 thats approved by the Food and Drug Administration (FDA) for use in babies and children under the age of 12: remdesivir (Veklury).

Its only administered intravenously at healthcare facilities and used for children with an increased risk of developing severe symptoms.

The CDC currently recommends that if your child tests positive for COVID-19, treat the day you first noticed symptoms as day 0 and the following day as day 1. The organization recommends that children be kept at home for at least 5 days. Ideally, try to isolate them from other members of the household.

Depending on the severity of the disease, isolation may end on different dates. Children with mild symptoms who show improvement with no symptoms on day 5 of isolation can end isolation.

If symptoms persist or worsen, continue isolation until your child is fever-free for 24 hours without the need for fever-reducing medication and until symptoms begin to improve.

If youre not sure when to end isolation, talk with a healthcare professional.

When youre caring for small children, isolating them from yourself or other family members can be a tall order especially if theyre babies and not self-sufficient enough to manage basic tasks without adult supervision.

In this case, youll want to wear a mask when interacting with your child. Wash your hands frequently to avoid transmitting the coronavirus to other surfaces or family members.

Additionally, avoid sharing personal items, like cups, utensils, towels, and bedding. Likewise, be sure to regularly clean and disinfect surfaces throughout shared areas of the home, like the kitchen, living room, and bathrooms.

Anyone can contract the coronavirus and develop COVID-19. But according to health organizations around the world, babies and children consistently tend to contract the virus less frequently and in a milder form than in older populations.

According to the American Academy of Pediatrics, as of early September 2022, there have been a total of 14.7 million cases of COVID-19 reported in children in the United States since the start of the pandemic in March 2020.

Thats out of a total of 79.4 million cases across all age demographics in the country. The child case count represents 18.4% of the total U.S. case count.

With an active case of COVID-19, its important to talk with a doctor to determine what type of treatment is needed.

Depending on your childs age and the severity of their illness, a doctor may recommend different treatments. A very mild case may just need home remedies and rest. Others might be better served by introducing a therapeutic or antiviral medication.

Regardless of which option a doctor recommends, keeping your little one hydrated and trying as best as possible to isolate them from other members of the household is important.

Preventive solutions are often best at minimizing your childs risk of severe COVID-19. This means that if your child is of an approved age to get any of the COVID-19 vaccines, its recommended that they get vaccinated according to the recommended schedule and receive boosters as needed.

Its important to note that COVID-19 vaccines prevent severe infections that could lead to serious illness, hospitalization, or death. However, they do not necessarily prevent contracting the virus itself.

To date, COVID-19 vaccines have been proven safe and effective for babies, children, and adults. Getting vaccinated is one of the best measures to prevent severe COVID-19.

The CDC offers comprehensive information regarding which vaccines are approved in which age groups, and the recommended schedules for receiving them.

COVID-19 continues to be an issue of concern. While babies and children tend to contract the coronavirus less frequently and usually develop a milder case of COVID-19, they are not immune to it.

To date, vaccination is the best preventive method to reduce the chances of hospitalization, getting very sick, or dying from COVID-19. If your baby or child contracts the coronavirus, seeking immediate medical attention can ensure that they receive treatment that can help recovery and reduce symptoms.

When in doubt, follow the guidelines as outlined by authoritative health organizations such as the CDC and NIH. If your child has any COVID-19 symptoms, get them tested.

Read more from the original source:

COVID-19 Symptoms in Kids: What to Know - Healthline

LONDON, Sept 28 (Reuters) - British health officials on Wednesday warned that increased circulation of flu and a resurgence in COVID-19 could lead to a difficult winter that increases pressure on the already stretched National Health Service (NHS).

Warnings over a possible "twindemic" of COVID-19 and flu have been issued each winter since the start of the coronavirus pandemic in early 2020, but COVID restrictions that limited social contact have meant flu levels stayed low.

However, the government ended coronavirus restrictions earlier this year, meaning that social contact rates have returned to near pre-pandemic norms while immunity to flu is relatively low.

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The UK Health Security Agency (UKHSA) said that given the risk it was important those eligible took up vaccines against COVID and flu.

"There are strong indications we could be facing the threat of widely circulating flu, lower levels of natural immunity due to less exposure over the last three winters and an increase in COVID-19 circulating," said Susan Hopkins, Chief Medical Advisor at UKHSA.

After falling over the summer, there are signs that COVID-19 cases and hospitalisations are starting to tick up, and Hopkins said lots of variants currently circulating could evade the immune response to some extent.

Around 33 million people are eligible for a free flu vaccine this year, and 26 million are eligible for a COVID-19 booster. The elderly and clinically vulnerable are eligible for both, and young children can get flu shots.

If concerns about a so-called twindemic materialise, it will heighten pressure on Britain's already stretched hospitals, which are bidding to catch up with procedures delayed during the pandemic and struggling with a staffing crisis.

On Tuesday, Labour Party leader Keir Starmer said he was really worried with how many lives were at risk this winter given the strain on the NHS.

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Reporting by Alistair Smout; editing by William James

Our Standards: The Thomson Reuters Trust Principles.

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British health officials warn of difficult winter with flu and COVID - Reuters UK

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Do COVID-19 vaccines help keep you from going bald? - The Lawton Constitution

Background

Plastic surgery practices have changed drastically during the coronavirus disease 2019 (COVID-19) pandemic, as most non-elective surgeries were deferred owing to the high presumed risk of infection transmission. Therefore, this study aimed to assess the impact of the COVID-19 pandemic on the patterns and characteristics of plastic surgery in an academic medical city.

This retrospective comparative study was conducted at King Saud University Medical City, Riyadh, Saudi Arabia. We reviewed data from patient medical records during the pandemic period(from March 2, 2020, to December 31, 2020)and the corresponding pre-pandemic period, defined as the same timeframe in the preceding year (from March 2, 2019, to December 31, 2019).

The total number of admitted patients in the pre-pandemic period was 479 and in the during-pandemic period was 254, indicating a 46.97% reduction in admission frequency. The median length of hospital stay was significantly shorter in 2020 than in 2019 (1.62 1.74 days versus 2.13 4.18, respectively, p = 0.011). The during-pandemic period was characterized by significantly higher frequencies of urgent procedures (9.8% versus 5.4% in 2020 and 2019, respectively, p = 0.025) and lower frequencies of elective procedures (90.2% vs. 94.4% in 2020 and 2019, respectively, p = 0.035) than the pre-pandemic period.

The number of plastic surgeries performed has decreased since the onset of the pandemic. However, the impact of the pandemic on plastic surgery practices remains unclear. Further studies are needed to determine the effects of this pandemic on patient outcomes.

Coronavirus disease 2019 (COVID-19) is a highly contagious disease that first appeared in Wuhan, China, in December 2019 [1]. In March 2020, COVID-19 was officially declared a global pandemic [1]. This pandemic has since had an extremely detrimental impact on the world. Governments have enforced major lockdowns, travel restrictions, and border shutdowns, which have combined to cause major economic crises [2]. Furthermore, COVID-19 is a significant obstacle to all healthcare systems worldwide. The surgical field is no exception, as surgery has been reported to worsen the disease progression of COVID-19 [3].

Plastic surgery practices have changed drastically during the pandemic, as many non-elective surgeries were deferred owing to the high presumed risk of infection transmission. The International Society of Aesthetic Plastic Surgery recommends minimizing or postponing aesthetic procedures as much as possible [4]. Since the beginning of the pandemic, several studies reporting the impact of COVID-19 on plastic surgery have been published. These studies all showed a significant decline in the number of surgeries in both academic and private practice and, to a greater extent, in private practice [5-8]. As the number of cases began to decline, restrictions on elective surgeries began to decrease. Many institutions, including ours, require preoperative polymerase chain reaction (PCR) test results to ensure the safety of patients and healthcare workers. Although this can minimize the risk of infection transmission, false-negative test results remain a possibility [9]. A survey-based study by Teitelbaum et al. demonstrated that plastic surgeries could be safely conducted even during a significant pandemic surge [10]. Furthermore, Brown et al. investigated 350 elective surgical procedures and indicated a minimal risk of COVID-19 transmission with appropriate screening and safety precautions [11]. This study aimed to assess the impact of the COVID-19 pandemic on the patterns and characteristics of plastic surgery practices in King Saud University Medical City, Riyadh, Saudi Arabia.

This study was a retrospective, comparative study performed at a single center. We enrolled all consecutive plastic surgical patients who underwent surgical intervention from the start of the COVID-19 pandemic in Saudi Arabia.

Patient records during the pandemic period (from March 2, 2020, to December 31, 2020) and the corresponding pre-pandemic period in the same timeframe in the preceding year (from March 2, 2019, to December 31, 2019)were reviewed. This study was approved by the Institutional Review Board and Research Ethics Committee of King Saud University, Riyadh, Saudi Arabia (IRB No. 0092/22). Data were retrospectively collected and uploaded to a Microsoft Excel sheet (Microsoft Corporation, Redmond, WA)from the hospital's electronic medical records and patient charts. We identified the demographics (including age and sex), comorbidities, smoking status, admission and discharge dates, diagnosis, diagnosis category, the surgical procedure performed, type of anesthesia, length of hospital stay, priority category, complications, and mortality of the patients. Patient triaging priority was defined by the use of the following four categories: Category 1 (immediate - within minutes), Category 2 (urgent - within hours), Category 3 (expected - within days), and elective (planned).

To ensure the reliability of the analysis, we compared the frequencies and characteristics of admissions during the pandemic period (from March 2, 2020, to December 31, 2020) and the corresponding pre-pandemic period in the same timeframe in the preceding year (from March 2, 2019, to December 31, 2019). Additionally, we analyzed the percentage change in admissions between the lockdown period (from March 25, 2020, to June 21, 2020) and the same period in 2019. Descriptive data were used to express categorical variables (frequencies and percentages) and numerical variables (means and standard deviations (SD)). Statistical differences between the preand during-pandemic periods were assessed using the Mann-Whitney U test for continuous data (e.g., length of hospital stay) and the chi-squared test for categorical data. A p-value of < 0.05 was considered statistically significant. The collected data were coded, entered, and analyzed using the Statistical Package for the Social Sciences (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, version 26.0. Armonk, NY: IBM Corp). Summary and display of the data were performed using descriptive methods.

The total number of admitted patients was 479 in the pre-pandemic period and 254 in the during-pandemic period, representing a 46.97% reduction in the frequency of admissions. The number of patients admitted for plastic surgery was generally lower during the pandemic period from April to December 2020 than in the same period in 2019 (Figure1).

Focusing on the analysis of the lockdown period in 2020 (March 25 to June 21), we reported seven admissions, which was lower than that reported in the same period in 2019 (n=126). This represented a 94.44% reduction in the number of admissions between the two periods.

There was no difference in patients sex distribution between the pre and during-pandemic periods. However, significantly higher proportions of patients aged zero to five years were admitted to our institution during the pandemic period than in the same timeframe in 2019 (15.4% versus 6.9% in 2020 and 2019, respectively, p < 0.0001). Additionally, the frequency of admissions of pediatric patients (aged <18 years) was significantly higher in the during-pandemic period than in the pre-pandemic period (25.2% vs. 16.3%, p = 0.004). Conversely, admissions were significantly lower in 2020 than in 2019 among patients aged 40-60 years (24.4% vs. 34.7%, p = 0.004) and among smokers (3.5% vs. 11.3%, respectively, p < 0.001, Table1).

Regarding comorbid conditions at presentation, there were significant differences in the proportions of patients with diabetes mellitus (61.8% in 2020 compared to 10.3% in 2019, p < 0.0001), hypertension (50.0% vs 6.1%, p < 0.0001), and other comorbid conditions (26.5% vs 97.7%, p < 0.0001, Figure2).

The median length of hospital stay was significantly shorter in 2020 than in 2019 (1.62 1.74 days versus 2.13 4.18, respectively, p = 0.011). The during-pandemic period was characterized by significantly higher frequencies of urgent procedures (9.8% versus 5.4% in 2020 and 2019, respectively, p = 0.025), and lower frequencies of elective procedures (90.2% vs. 94.4% in 2020 and 2019, respectively, p = 0.035). Furthermore, we observed significant differences in the frequencies of distinct surgeries in 2020 compared to 2019, where the proportions of hand and upper extremity surgeries were significantly higher (59.1% vs. 49.3%, p = 0.012), and craniofacial surgeries were significantly lower (7.1% vs. 15.0%, p = 0.002). Regarding the employed anesthesia, the proportions of surgeries requiring general anesthesia were significantly higher in the during-pandemic period than in the pre-pandemic period (68.9%% versus 61.4%%, p = 0.044, Table2).

Carpal tunnel syndrome (CTS) was the most common reason for admission in both the pre-pandemic (9.2%) and during-pandemic (10.2%, Table3) periods.

Excision procedures and CTS release were the most commonly performed surgeries in the pre-pandemic (22.8% and 7.1%, respectively) and during-pandemic periods (16.9% and 9.4%, respectively; Table4).

No mortality was reported in our institution during the study period. The reported complications included pneumonia, acute respiratory distress syndrome, and neuropraxia (n=1 each) in the pre-pandemic period, with no significant differences compared with those in 2020. Additionally, deep venous thrombosis occurred in one patient in the pre-pandemic period and one patient in the during-pandemic period. Lastly, neuropraxia occurred in one patient in the pre-pandemic period.

During the pandemic, a significant reduction in the admission rate was observed. The frequency of admissions to the plastic surgery department was reduced by approximately 47%. The reduction was particularly remarkable during the lockdown period from March 25 to June 21, 2020, with a reduction rate of 94.44%. This finding is consistent with other similar studies conducted in Iran and southern India, where a significant decline in the number of plastic surgeries conducted after the pandemic was reported[8,12]. The reduction in the admission rate is thought to be partly due to the hospital's policy of prioritizing urgent and emergent cases and partly because of patients' fear of contracting COVID-19 infection in the hospital. This reduction is beneficial in terms of increasing the hospital capacity for COVID-19 patients, minimizing the cross-infection of COVID-19, and preserving PPE for health care workers[13]. However, postponing this huge number of surgeries could cause a significant setback in the healthcare system. Indeed, Wiseman et al. previously highlighted the massive impact of COVID-19 on surgical waitlists[14].

Our study found that the number of pediatric patients admitted was significantly higher in the during-pandemic period than in the pre-pandemic period. There was an 8.5% increase in the admission rate for the zero to five years age group and an 8.9% increase in the pediatric age group (aged <18 years). In contrast, there was a 10.3% decrease in the adult age group admission rate (40-60 years) (Table 1). Furthermore, we noticed a significant increase in the admission rates among patients with comorbidities, diabetes, and hypertension by 51.5% and 43.9%, respectively (Figure2). 'Significant Comorbidities' has been a way to define major surgeries preoperatively[15]. This may be a reason for the increase in the number of admissions of patients with significant comorbidities such as diabetes and hypertension. We believe that these changes can be attributed to the restrictions implemented by the hospital in prioritizing urgent and emergent cases admitted for surgery.As for the elective procedures mentioned in this article during the pandemic, most of these patients were electively operated on after the lockdown was lifted. Prior to surgery, all patients had a negative COVID-19 swap.

Moreover, the hospital stay was significantly shortened compared to the pre-pandemic period. This was observed in many centers worldwide, as many centers have been reported to have implemented enhanced recovery programs[13]. Furthermore, early discharge was proven to be both safe and feasible. Sica et al. described that coping with these protocols was facilitated by the high awareness of infectious risk among patients[16]. A significant reduction in the rate of craniofacial surgeries was also observed in this study. This finding is consistent with that of a similar study that reported a 52% reduction in craniofacial surgeries[12]. This might be attributed to the riskiness of the operative area, as infected individuals tend to have the highest viral load in the pharynx and upper aerodigestive tract [17]. Our study reported a higher incidence of urgent procedures after the pandemic. Conversely, a similar study conducted in the US reported fewer emergency cases admitted following plastic surgery than in 2019[18].

In addition, during the study period, no mortality was documented in the plastic surgery department.After surgery in the plastic surgery division, none of the included patients contracted COVID-19. Four patients experienced at least one complication during their hospital stays in the pre-pandemic period (a single case of pneumonia, acute respiratory distress syndrome, neuropraxia, and deep vein thrombosis (DVT)). Regardless of the increase in admission of patients with significant comorbidities, which has been documented as being associated with a higher risk of poor outcomes[19,20], there were no significant postoperative complications documentedduring the pandemic period except for a single reported case of DVT.

The study has several limitations. First, data were collected using a retrospective design and from a single-center experience. Therefore, our results may not be representative of all hospitals. Furthermore, with the ongoing pandemic, the situation is expected to change over time.Additionally, the data did not include the effects of postponing surgeries for patients on the waiting list, which is considered an essential factor in assessing the outcomes of the pandemic.

This study provides a retrospective comparison of the practices of the plastic surgery department in a university hospital before and after the COVID-19 pandemic. There has been a notable decrease in the number of surgeries performed since the onset of the pandemic in March 2020.As a historical record and for determining the effects of the pandemic on plastic surgery practice, the information presented in this article is crucial. The impact of the pandemic on plastic surgery practices remains unclear. More studies are needed to determine the effect of the COVID-19 situation on patient outcomes, as it is an unprecedented situation in modern history. In addition, the pandemic's financial impact must be considered.

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Impact of the Coronavirus Disease 2019 Pandemic on the Patterns and Characteristics of Plastic Surgery Practice: A Retrospective Comparative Study of...

Leszek Szymaski/PAP

Poland recorded 26,736 confirmed coronavirus cases and 118 deaths between September 22 and 28, 2022, data released by the Health Ministry on Wednesday shows.

In total, 6,285,403 cases have been confirmed and 117,509 people have died since March 4, 2020, when the first SARS-CoV-2 infection was detected in Poland, the country's health ministry reported.

To date, Poland has already distributed 56,661,099 doses of Covid-19 vaccine, with 22,559,689 people having been fully vaccinated, of whom 13,943,840 have also had a booster jab, according to data posted on the official government website, gov.pl.

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Poland reports 26,736 coronavirus cases, 118 deaths between Sept 22-28 The First News - The First News

Another symptom thats more typical with COVID-19 than with the flu or a cold is diarrhea, Shaw says. It may not be as prevalent as some of the other COVID symptoms, but people still get it with a coronavirus infection. Diarrhea is not a common sign of flu in adults (it is in kids, though), nor does it usually accompany a cold.

That said, there are other viral and bacterial illnesses that can give you diarrhea, so that alone doesnt mean it can only be COVID. But if youre trying to differentiate, I would say that those elements, if theyre present, might be helpful, Shaw says.

Finally, disorientation could point to COVID-19, especially in older adults, says Kenneth Koncilja, M.D., a geriatrician at Cleveland Clinic.

Older adults often present atypically. And with these recent BA.4 and BA.5 [variants], Ive seen more of my older adults present with symptoms of confusion [and test positive for COVID-19], where you might think its a urinary tract infection, he says.

So, if you or a friend or family member is experiencing a sudden onset of confusion, dont rule out COVID-19, even if theres no fever (older adults often dont run fevers the same way younger people do, both Shaw and Koncilja note) or any of the other usual symptoms, like cough or fatigue.

Its a little disconcerting, because so many things can cause confusion, Koncilja adds. Thats why its important to talk to your primary care doctor or provider if you experience it.

Sneezing a lot? Thats typically a symptom thats more commonwith a coldthan with flu or COVID-19, the National Institutes of Health says. And chances are if you have a cold, you wont experience the body aches and fever that accompany the other two infections.

A crucial tool this time of year is anat-home COVID-19 test. That way, if you start to feel sick, you can check to see if your symptoms are due to COVID-19 in a matter of minutes.

Most private insurance companies cover the cost of these over-the-counter tests, and Medicare beneficiaries can receiveup to eight a month, free of charge. You can also check in with a nearby health center to see if it offers COVID-19 test kits to members of the community.

Particularly given the nonspecific nature of a lot of COVID symptoms and the fact that there can be a diminished fever response and other kinds of atypical symptoms, I think the safest thing would be to definitely test, Shaw says.

If youre positive for COVID-19, you may beeligible for an antiviral treatmentthat can significantly lessen your chances of severe illness. Two have been authorized by the Food and Drug Administration: Paxlovid, from Pfizer, and molnupiravir, from Merck and Ridgeback.

Its important to start these medicines early in the disease course, though, so talk to your doctor right away if you find out you have COVID-19. Some pharmacists can also prescribe the pills, or you can find them at one-stoptest-to-treat centers.

If you test negative for COVID but symptoms persist, your health care provider may conduct a flu test. As with COVID-19, prescription antiviral treatments taken early on can help you feel better if you have flu.

If its a cold, there is no miracle cure. But the Centers for Disease Control and Prevention (CDC) says lots of rest and plenty of fluids can help you recover, and over-the-counter medicines may help ease symptoms youre experiencing.

One way to lower your likelihood of getting the flu or COVID-19 or both at the same time, becausethats a possibility is to get vaccinated against each disease. Not everyone who gets vaccinated will be able to completely avoid an infection, but the separate shots can blunt the severity of symptoms and help to keep you out of the hospital.

When it comes to COVID-19,health experts recommend that fully vaccinated adults roll up their sleeves this fall for one of thenew omicron boosters. There are two options, one from Moderna (for individuals 18 and older) and one from Pfizer-BioNTech (people 12 and older can opt for this one).

For flu, adults 65 and older should ask for ahigh-dose vaccine this year, new CDC recommendations say. There are three options to choose from, but experts say the differences among them are minimal, so for most people, the best one to get is the one your doctor or pharmacist has available. Theres no need to space out your flu and COVID-19 shots, so if its more convenient to get them at the same visit, the CDC says that can be done.

And while there is no vaccine to help prevent a cold, there are several things you can do to avoid one: Wash your hands often; stay away from people who are sick; and disinfect frequently touched surfaces. These measures can also help you avoid the flu and COVID-19.

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Is It a Cold? The Flu? Or COVID? - AARP

After COVID-19 pandemic protocols were put into place, asthma exacerbations decreased and were lower than during the prior year through May 2021.

It has been anecdotally observed that severe asthma (SA) exacerbations have decreased following the implementation of COVID-19 protocols such as social distancing and exposure avoidance, explains Wendy C. Moore, MD. Since the impact of the COVID-19 pandemic on asthma exacerbations and hospitalizations in adults has not been well-documented, Dr. Moore and colleagues analyzed asthma exacerbation rates in the longitudinal CHRONICLE Study to gather and evaluate observational information on patients with SA before and during the pandemic. The study was published in the Journal of Asthma and Allergy.

Dr. Moore shared her concerns when the pandemic began. As asthma specialists, many of us were quite worried that our patients would have high morbidity and mortality associated with the COVID pandemic, she says. For years, coronaviruses have triggered SA exacerbations in our patients, sometimes requiring ED visits and hospitalizations, so we were very concerned about a new coronavirus.

What Dr. Moore and other specialists observed was that COVID-19 turned out to be quite different from past coronaviruses and did not lead to increased asthma exacerbations. The decrease in asthma exacerbations was likely multifactorialasthma patients staying home as advised and wearing masks because they were afraid of a circulating respiratory virus given their underlying respiratory disease. In general, they reported no (or very few) respiratory illnesses that are typically a trigger for an asthma exacerbation. Many of my patients will opt to continue to mask in public because they didnt get the common cold during the pandemic.

The CHRONICLE Study is a continuing noninterventional observational investigation of 3,100 subspecialist-treated patients with SA. Participants consist of adults who meet one of the following criteria: are taking an FDA-approved monoclonal antibody therapy for SA, use maintenance systemic corticosteroid or other systemic immunosuppressants for at least 6 of the past 12 months, or have persistently uncontrolled asthma while being treated with high-dosage inhaled corticosteroids with additional controllers.

The study found that in April 2020, after pandemic protocols were put into place, asthma exacerbations decreased and were lower than they were during the prior year through May 2021 (Figure). The decrease in asthma exacerbations during the pandemic has led to improved asthma control in many of our most patients with SA, Dr. Moore says. As working remotely and universal masking comes to an end, asthma exacerbations will likely increase again.

Dr. Moore cautions practitioners about the application of this information. When making decisions about therapy including starting biologic therapy, physicians need to understand that the past 2 years will not be predictive of poor asthma outcomes and control going forward, she says. While asthma exacerbations decreased in all the patient groups in our study, patients with SA on biologic therapy had the lowest baseline asthma exacerbation rate and thus, had the lowest exacerbation rate during the pandemic. Lack of asthma exacerbations in the past 2 years should not exclude patients from consideration for biologic therapy if indicated.

More work is needed in this field of study, Dr. Moore notes. This study exemplifies the power of preventing all respiratory illnesses (not merely COVID-19) driven by viruses on asthma exacerbation rates, she says. In this situation, which was accomplished by isolation and universal maskingie, removing the patients from virus exposurewhich is not compatible with regular life.

Research into further vaccines to prevent the portfolio of respiratory viral illnesses is needed. The leap in innovation with RNA-based vaccines has created the possibility of vaccines for other viruses that cause respiratory illnesses in at-risk patients, Dr. Moore says. Patients with SA would benefit immensely from not getting viral infections as seen in our study.

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Decreased Asthma Exacerbations Observed During COVID-19 Pandemic - Physician's Weekly

Introduction

The coronavirus disease 2019 (COVID-19) pandemic is a worldwide threat in many aspects, making developing countries with scarce primary health care and medical services more vulnerable. Evaluation of the relationship between the COVID-19 pandemic, sociodemographic variables, and medical services provides useful information to take countermeasures to stop the infection spread and could mitigate the damage. Therefore, this study investigated the relationship between the spread of COVID-19 and sociodemographic variables, medical services, and the transportation system in Myanmar.

This study was a cross-sectional study and was conducted using data on COVID-19 cases from August 20, 2020 to January 31, 2021 in Myanmar. We evaluated the association between the COVID-19 cases and 13 independent variables that were sociodemographic, medical services, and transportation system factors using simple linear regression analysis and multiple linear regression analysis in three phases (increasing (from August 20th to October 10th), stable (from October 11st to December 4th) and decreasing phases (from December 5th to January 31st)) on the infection timeline.

It was found that the population density wasparallelly associatedwith COVID-19 cases. On the other hand, among the medical services factors, the number of doctors was parallelly associated with COVID-19 cases and the number of nurses was inversely related to COVID-19 cases.

The result indicated that a high population density area was a risk factor for the increase of COVID-19 cases. This supported the worldwide countermeasures to deal with the spread of the infection, such as social distancing, banning largegatherings, working from home, and implementing quarantine procedures for suspected individuals to reduce person-to-person contact. Finally, at least in Myanmar, employing a large number of nurses could reduce the emergence ofnew COVID-19 cases. We believe that our study can make valuable contributions to tackling future epidemics like COVID-19 not only in Myanmar but also in other developing countries.

This article was previously presented as an abstract at the 91stconference of The Japanese Society for Hygiene (JSH ) on March 08, 2021.

The first case of the coronavirus disease 2019 (COVID-19) was reported in Wuhan, the capital city of Hubei Province of China on December 8, 2019[1]. The infection subsequently spread rapidly across the world, turning the epidemic into a pandemic. The World Health Organization (WHO) reported that by July 2022, over 564 million people were infected and suffering and of these nearly 6.4 million people died worldwide, while in Myanmar, the number of cumulative COVID-19 cases was 614,009 and deaths were 19,434 [2]. Coronavirus belongs to theCoronaviridaefamily, which consists of enveloped viruses with positive-sense single-stranded RNA. Primal clinical symptoms are high fever, cough, myalgia, and dyspnea, which could develop into acute respiratory distress syndrome or multiorgan failure[3], finally causing death. COVID-19 spreads from person to person via droplet infection [4]. Since the R naught (R0: basic reproduction number) of COVID-19 has been measured at 3.0 and above[5], it is more contagious than the influenza virus (R0 of Influenza A(H1N1) is 1.4 to 1.6) [6]. The average incubation period of the virus is between three and seven days, and over 80% of the virus may have been transmitted - asymptomatically or symptomatically - with the early onset of symptoms[7,8]. Since the vaccine had not yet been invented, during the early stages of the COVID-19 pandemic, countermeasures such as keeping social distancing, maintaining personal hygiene, wearing masks, and lockdowns of cities[9,10] were implemented.The transmission of the virus and the infection rate was restrainedby various government policies such as mitigation and containment strategies [11].

The COVID-19 pandemic has been associated with several factors like socioeconomic factors, demographic factors, climate, and individual immunity [10,12-14], but the impact of these factors has varied across countries. Therefore, it is important to detect the factors that affected the COVID-19 infection in each area. While there has been a considerable amount of literature on the topic available with regard to developed countries, the literature is scant in developing countries,and there is none pertaining to Myanmar.Medical services are now vulnerable in Myanmar. Therefore, we tried to evaluate the relation between the COVID-19 cases and some independent variables such as sociodemographic factors, medical services, and the transportation system. We believe that our findings are a valuable contribution for formulating government policies and handling further outbreaks.

The first COVID-19 case in Myanmar was reported on March 23, 2020, and the first death was confirmed on March 31, 2020[15]. Since the rise in patients started on August 20, 2020 and converged in February 2021,we used the COVID-19 data from August 20, 2020 to January 31, 2021.

Myanmaris dividedintoseven regions, seven states, and one union territory, and its total population is 51,486,253[16]. Therefore, we set the 15 survey areas as our evaluation fields.

The number of COVID-19 cases from August 20, 2020, to January 31, 2021 was retrieved from the Ministry of Health and Sport (Myanmar)[15]. Our evaluation of independent variables in this study, such as population density; aging rate (population aged 65 years and above); unemployment rate; average monthly income; average annual temperature; number of doctors, nurses, midwives, hospitals and rural health centers; number of cars, buses, and two-wheelers were derived from the Myanmar Population Census[16]and the official government websites of Myanmar (Ministry of Labor, Employment, and Social Security[17], Ministry of Transportation and Communication[18], Ministry of Health and Sports[15], Department of Meteorology and Hydrology[19], and Myanmar Statistical Information Services[20]). The population density, aging rate, and unemployment rate were of 2014[16]; the year 2017 was considered for the average income per month [21]; average annual temperature was based upon the years 2008-2017[20]; medical facility and staff data was from 2021 [15]; and transportation data was from 2020 [18].Since Myanmar is a developing country, its electronic database system is not very advance; therefore, it was very difficult to assemble independent variables data of the same year. However, we have conducted this research with limited datasets without ignoring the fact that there have been some changes in these datasets for several years.

Figure1indicates the epidemic curve of COVID-19 casesin Myanmar.The period was divided visually into three phases as shown in Figure 1 - the increasing, the stable, and the decreasing phase - and we evaluated the relationship between the COVID-19 cases and the independent variables for each phase.

Simple linear regression analysis and multiple linear regression analysis were obtained with p < 0.05 being considered statistically significant. We used the variance inflation factor (VIF) index to evaluate the degree including multicollinearity and removed some variables to reduce the VIF index (about 5.0 or less) and to fit the model. High VIF contains much multicollinearity that needs to be corrected generally [22].We evaluated the relation between the number of COVID-19 cases and the independent variables usingmultiple linear regressionanalysis. Excel 2003 (Microsoft Corporation, Redmond, USA) and JMP 16 (SAS Institute, Cary, USA) were used for the analysis.

Figure1shows the epidemic curve of COVID-19 cases in Myanmar. The number of COVID-19 cases for increasing, stable, and decreasing phases are 25668, 71983, and 42059, respectively. Table1summarizes the outline of the number of COVID-19 cases, the sociodemographic variables and other independent variables. Yangon is the biggest city in Myanmarand ranked first in population, population density, average income, number of doctors, and number of cars.

We separately evaluated the correlation between the number of COVID-19 cases(per 10,000 people) and the variables in each of the three phases by using a simple linear regression analysis (Table2) in each phase. The results indicated a parallel relationship between COVID-19 cases and population density, average income, and the number of doctors, cars, and buses.

Additionally, we verified the relationship between the number of COVID-19 casesand the variables using multiple linear regression analysis (Table3, Model 1). Thereafter, we eliminated the number of cars, buses, nurses, midwives, and hospitals from the variables to minimize VIF (about 5.0 or less) for reducing multicollinearity, and re-evaluated the relationship (Table3, Model 2). We detected a statistically significant parallel relationship between the cases and population density. However, this relationship was not observed for the decreasing phase.

After we divided the variables into two categories - the variables excluding medical services and the variables concerning medical services, we also investigated the relationship between the number of COVID-19 cases and the variables (Tables 4, 5 ) while excluding the number of cars, buses, midwives, and hospitals to minimize VIF. The results showed that the population density was statistically significantly associated with increased cases during all three phases (increasing, stable, and decreasing) (Table 4 Model 4). The number of doctors displayed a significant parallel association, while the number of nurses revealed a significant reverse association statistically (Table 5 Model 6).

The COVID-19 pandemic has caused immense suffering and many deaths worldwide. This disease has had a detrimental impact globally and affected both developed and developing countries, including Myanmar. Immunization by vaccination was limited to developed countries, and it took a long time for the vaccine to be available in developing countries. Therefore, it is important to understand the risk factors that can cause the infection to spread, and to put into place effective countermeasures.

Since the coronavirus gets transmitted from person to person through droplet infection, contact with people is a high-risk factor. Living in urban or major cities [10,23] and a crowded public transportation system [24-26]could be assumed risk factors for increasing COVID-19 cases. It was reported that there was a parallel relation between population density and virus contagion and morbidity [27,28]. Moreover, the number of buses was considered a more important factor for rapid contagion than the number of cars[24,26,29,30]. Using public transportation could increase the risk of contagion [24,26,29,30]. Other factors such as high unemployment rate [14], being senior citizens [31], and residing in areas with poor medical facilities [32,33] could be factors causing the rise of COVID-19 cases. Additionally, high income, a developing economy, and high employment rate could induce the rapid spread of emerging infectious diseases due to increased human mobility necessitated by economic activity [14,34]. Therefore, it is important to detect risk factors for the increase of COVID-19 cases, and prevent the infection when effective vaccines are not available. We evaluated the relationship between the COVID-19 cases and the variables such as sociodemographic and other factors (population density, aging rate, unemployment rate, average income per month, average annual temperature, numbers of hospitals, health centers, doctors, nurses, and transportation system (buses, cars and two-wheelers)).

Table2indicates that population density, average income per month, and the number of doctors, cars, and buses had a parallel correlation with the number of COVID-19 cases. Our results aligned with those of other studies [24-28,35,36].

We also re-evaluated the relationship using multiple linear regression analysis to evaluate the influence of the variables individually with reducing multicollinearity. We found that only population density was significantly associated with the increased number of COVID-19 cases (Table3 Model 2). It means that living in urban or major cities could be a potential risk for the infection spread. Therefore, staying at home, keeping social distance, and banning large gatherings could be effective countermeasures to contain the spread of the COVID-19 infection, especially for those living in densely populated areas. During the decreasing phase, the population density was not associated with the increase in COVID-19 cases. Though the reason is unclear, we believe that the preventive countermeasures were already effective in the decreasing phase. We could not evaluate the relation between the COVID-19 cases and the transportation system, such as the number of cars and buses, because of high multicollinearity with other variables.

Some references suggest that medical services were a mitigating factor in containing the spread of COVID-19 [33,37,38]. However, we could not evaluate this due to high multicollinearity with other variables. Therefore, we evaluated the relation between the COVID-19 cases and the variables excluding medical services and the variables concerning medical services (Tables 4, 5). Our finding was that there was a significant parallel correlation between the population density and the number of doctors with the number of COVID-19 cases, while there was an inverse correlation with the number of nurses. Some studies showed that medical services could be an important protective measure for COVID-19 infection [33,37,38]. However, the relation between the number of doctors and the number of COVID-19 cases in our study did not align with the results of other studies [33,39]. A plausible reason is that we detected a high correlation between the population density and the number of doctors. First, there are not many doctors in Myanmar, and they are concentrated in the highly populated areas; moreover, their main role is that of curative care. The infection prevention activities are mainly carried out by nurses. Previous studies have also indicated that nurses played an important role in the successful prevention and control of mosquito-borne outbreaks, such as the zika and dengue viruses [40]. The results of our study did not show a correlation between the number of nurses and the population density. Notably, there is an imbalance between doctors and nurses in Myanmar [41].

Some studies have reported that high incomes and increasing employment rates are factors responsible for the spread of emerging infectious diseases [14,34]. Additionally, elderly people are more prone to infection [31]and could be a risk factor for contagion. However, we could not find any significant association between the COVID-19 cases and the aging rate, unemployment rate, or average income in Myanmar. Though we could not provide sufficient reasons for this, the difference in the unemployment rate, average income and aging rate between areas was small (Table 1) when compared to other reports [42].

Our study is not without limitations. We acknowledge that vaccination is an important countermeasure for infectious diseases. However, since most people were not vaccinated before January 31, 2021, we could not evaluate the influence of vaccination on the spread of the infection. Moreover, Myanmar was faced with a military coup on February 1, 2021, which hindered our efforts to obtain additional detailed information on the COVID-19 contagion and vaccination status.

The formulation of governmental policies with regard to COVID-19 is an important countermeasurefor reducing infection. The countermeasures employed in Myanmar were social distancing, restricting gatherings of more than 15 people, a temporary ban on international commercial flight landings, establishing public health labs, and home quarantining, which isolated infected individuals. However, the Myanmar government was unable to systematically implement these countermeasures, and it was difficult to obtain the data regarding state- and region-wise anti-COVID-19 infection policies. Therefore, we could not evaluate the relation between the number of COVID-19 cases and the policies.

In general, using the latest data that are also of the same year is important for high validity. Myanmar is a developing country, and its electronic database is still not fully developed. Additionally, the political situation in Myanmar is currently unstable. The latest national demographic survey (census) was carried out in 2015, and the largest national survey, Myanmar Living Conditions Survey, was carried out in 2017. It is impossible to obtain the data for the same year as the timeline of COVID-19 outbreak. Therefore, this study had to be carried out with limited valuable data. Additionally, it is essential to identify the difference in the variables mediating the COVID-19 cases between urban and rural areas. However, unfortunately, we could not obtain detailed data on COVID-19 cases and variables area-wise (urban and rural).

Despite the limitations mentioned above, this research was the first report concerning the relationship between COVID-19 cases and variables, such as sociodemographics and other factors. We believe that this report could help to formulate countermeasures in Myanmar if and when confronted with an epidemic in the future.

This study was conducted to evaluate the relationship between the COVID-19 cases and the variables concerning the sociodemographic, medical, and transportation systems. We identified population density to be a contributing factor to the spread of infection and the number of nurses as a protective factor, in Myanmar. However, we could not indicate any correlation between the COVID-19 cases and aging rate, unemployment rate, and average income, unlike other previous studies. This is the first study to investigate the various factors regarding the COVID-19 contagion in Myanmar. It aims to provide useful information to control the spread of infectious diseases like COVID-19and makes valuable contributions for policy-makers to consider in times of future epidemics not only in Myanmar but also in other developing countries.

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Socio-Demographic, Health, and Transport-Related Factors Affecting the COVID-19 Outbreak in Myanmar: A Cross-Sectional Study - Cureus

In a recent study posted to the medRxiv* preprint server, researchers assessed the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in the US.

By August 1st 2022, coronavirus disease 2019 (COVID-19) had been responsible for nearly 90 million SARS-CoV-2 infections and one million fatalities in the US. SARS-CoV-2 vaccinations have been a crucial part of the US pandemic response since December 2020. However, the effects of immunization are difficult to measure.

In the present study, researchers calculated the number of COVID-19 cases, hospitalizations, and fatalities prevented by SARS-CoV-2 vaccination within the first six months after the vaccine became available using a dynamic county-scale metapopulation model.

The team combined a data assimilation technique with a metapopulation model coupled with a Susceptible-Exposed-Infected-Recovered (SEIR) structure. Here, the spread of SARS-CoV-2 throughout and among the 3142 American counties was simulated. The reported case counts for each American county from the time the first COVID-19 cases were discovered there in February 2020 through the date of the first authorized SARS-CoV-2 vaccination on December 14th, 2020, were assessed using the model-inference system.

The team compared the baseline vaccination scenario to three counterfactual no-vaccination scenarios that were simulated over the same period to measure the burden prevented by vaccination. To simulate various levels of non-pharmaceutical intervention (NPI) response in the absence of vaccination, all counterfactual scenarios assumed no vaccinations but had varied transmissibility:

The study assumed that excess cases would have persisted and resulted in hospitalizations and mortalities at the same overall rate as observed in each US state in the summer and fall of 2020 before the vaccine was available. This assumption allowed the estimation of hospitalizations and deaths in the counterfactual scenarios. Each scenario's total number of prevented cases was multiplied by a state-specific pre-vaccine Case Fatality Rate (CFR) and Case Hospitalization Rate (CHR).

The team used data from the US-based Premier Healthcare COVID-19 claims database to multiply the distribution of estimated COVID-19-related hospitalizations prevented by the distribution of expenses per hospitalization episode.

On December 14th, 2020, the beginning of the simulation period, it was predicted that 74.1% of the American population was susceptible, while 0.8% had been exposed, 0.8% had become infectious, and 24.3% had recovered. The proportion of the population that had not yet contracted COVID-19 since the pandemic started, known as the median estimated susceptible fraction, ranged between 58% in North Dakota and 94% in Vermont. In states located in the northwest and northeast, the susceptible fraction was the highest. In Minnesota, the median time-dependent reproductive number was 0.8, while in Tennessee, it was 2.0.

Before immunization, the CFR ranged between 0.5% in Alaska and 2.3% in Rhode Island. The CHR was between 3.8% in Alaska and 20.7% in Kentucky during the same time frame. Despite a slight decrease in CHR at the national level from the pre-vaccination period to the analysis period, the team found no consistent population-level changes in CFR at the national level or in CFR and CHR at the state level.

The baseline model predicted a total of 16.1 million COVID-19 cases, 1.4 million related hospitalizations, and over 246 thousand deaths between December 14th and June 3rd, 2021. Almost 51% of Americans had received a minimum of one COVID-19 vaccine dose by June 4th, 2021. Location-specific vaccination rates varied greatly, from 35% in Mississippi to 74% in Vermont. The number of vaccinations received by individuals each week increased over time, starting at fewer than five million per week and peaking at 14 million in April when vaccination was made available to all adults aged 16 years and older.

The majority of prevented cases were recorded between April and June 2021 in the three counterfactual scenarios. The median estimates of cases prevented for each state ranged from 1000 to 6400 cases per 100,000 people. Hospitalizations prevented ranged from 74 to 752 median cumulatively per 100,000, while deaths prevented ranged from 16 to 128 median cumulatively per 100,000. At the start of the immunization campaign, a greater vaccination rate and population susceptibility were associated with a greater averted case burden.

Overall, the study findings demonstrated that COVID-19 vaccination decreased the disease burden. The COVID-19 vaccination was linked to over 8 million fewer confirmed cases, over 120,000 fewer deaths, and 700,000 fewer hospitalizations within the first six months of the campaign, according to base case statistics. As a result, the COVID-19 vaccines were a vital part of the US's public health response to the COVID-19 epidemic.

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

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COVID-19 cases, hospitalizations, and fatalities prevented by SARS-CoV-2 vaccination within the first 6 months after the vaccine became available -...