Category: Corona Virus

Hardware tools are important to such work. Software is also crucial. During the first year of the Covid-19 pandemic, a young graduate student named ine OToole, along with other members of Andrew Rambauts lab at the University of Edinburgh, developed a tool called PANGOLIN (Phylogenetic Assignment of Named Global Outbreak Lineages). It became one of the go-to systems for placing new genomes on the SARS-CoV-2 family tree, assigning them rational if unmemorable labels (such as B.1.1.7), and contextualizing new variants of the virus when they emerged.

It was Dr. Rambaut, Dr. OToole and their lab colleagues who helped spot and track the first major variant, now called Alpha, when it appeared in southeastern England, moving toward London, in autumn of 2020. One year later, scientists in South Africa and Botswana, sequencing samples from travelers, detected another rising variant, named Omicron.

Such quick detection of variants is enormously valuable, but only if the data are transformed promptly into clear, actionable guidance. We still have the important gaps in getting it into the clinic, Dr. Peacock said. These gaps include making it easy for public health and medical personnel not trained in sequencing to use the data and the willingness of health care providers like hospitals to finance such work. At the moment, the majority of sequencing beyond Covid-19 is funded by public health agencies and research funding, she said.

That hasnt changed since 2014, when Pardis Sabeti, a computational geneticist at Harvard University, led a team of genomic scientists responding to the horrific Ebola virus outbreak in West Africa. They sequenced 99 genomes of the virus, sampled from patients at a hospital in Sierra Leone. Comparing sequences revealed that all those cases most likely resulted from human-to-human transmission, rather than from spillovers from a wildlife host.

The West Africa outbreak ended after more than 28,000 Ebola cases and 11,000 deaths, by which point genomic epidemiology had proved its value by revealing how the virus was spreading. With Covid-19, there have been 589 million known cases and more than six million deaths so far. The new discipline is scarcely able to keep up, let alone get ahead of the virus. Sarah Cobey, an evolutionary biologist at the University of Chicago who works at the juncture of immunology, viral evolution and epidemiology, sees gaping holes in the genetic surveillance of Covid-19.

Even though we do have lots and lots of sequences, they are disproportionally from a few locations, Dr. Cobey told me. During the first year of the pandemic, Britain, New Zealand, Australia and Iceland were among the countries that sequenced a high share of cases. The Netherlands and the Democratic Republic of Congo were also notable for prompt sequencing. As the pandemic progressed, scientists in South Africa mounted an important sequencing effort (as reflected in the detection first of the Beta variant, then of the Omicron), and coverage improved also in Canada and Scandinavia. Other parts of the world remain blind spots, Dr. Cobey said.

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Opinion | We Are Still in a Race Against the Coronavirus - The New York Times

Stacey Abrams, the Democratic nominee for governor of Georgia, tested positive for the coronavirus on Wednesday, taking her off the campaign trail temporarily in her race against Gov. Brian Kemp.

Ms. Abrams, 48, confirmed her diagnosis on Twitter, writing that she took daily tests and had received a positive result Wednesday morning. Im experiencing mild symptoms, and Im grateful to have been vaccinated and boosted, she wrote.

She said she planned to hold meetings by Zoom and phone for the next few days, and added that she had tested negative before delivering a speech Tuesday evening in Atlanta.

A spokeswoman, Jaylen Black, said Ms. Abrams would still make a scheduled appearance on the Pod Save America podcast on Saturday, by phone, if she feels up to it. Before her diagnosis, she was also scheduled to attend the March for Our Lives Atlanta rally for gun violence prevention on Saturday, and Ms. Black said it was undetermined at the moment if she will be able to participate.

Consistent with C.D.C. guidelines, she will isolate at home and looks forward to traveling across the state to meet Georgians as soon as possible, Ms. Black said, adding that the campaign would send surrogates to some events in Ms. Abramss absence and that she would not do any in-person events during the C.D.C.-recommended isolation period.

Guidelines from the Centers for Disease Control and Prevention instruct people with the virus to isolate for at least five days though many people remain positive on rapid tests, and potentially contagious, for longer than that and to continue to wear a mask around others through Day 10.

Ms. Black confirmed that Ms. Abrams had tested negative on a rapid antigen test before her speech on Tuesday, and on a P.C.R. test on Monday.

The race between Ms. Abrams and Mr. Kemp is a rematch of a 2018 contest that Ms. Abrams narrowly lost, falling short by about 1.5 percentage points. Election forecasters rate this years race as lean Republican, meaning it is competitive but Mr. Kemp is favored; recent independent polls have found him leading by low to mid-single digits.

Ms. Abrams is known for her voting rights advocacy, but her campaign this year has focused heavily on Georgia-specific policy issues as well as abortion rights. Mr. Kemp has been emphasizing economic issues, including inflation and taxes.

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Stacey Abrams temporarily steps off the campaign trail after contracting the coronavirus. - The New York Times

Oregon reported the fourth consecutive week of declining new coronavirus cases Wednesday, with a daily average dropping below 1,000 identified cases for the first time in about three months.

Identified cases fell about 17% this week compare to the previous week, almost the same percentage drop as Oregon reported in the total number of COVID-19 test results. But reported cases represent an undercount of all infections because many people use at-home tests.

A more reliable indicator of the viruss impact on Oregon, COVID-19 hospitalizations, also fell, with 371 patients occupying hospital beds, down from the current surges July 17 peak of 464 occupied beds.

The declining case and hospitalization numbers are in line with a recent Oregon Health & Science University forecast, which as of Aug. 5 predicts a continuing decline in cases and hospitalizations that would bottom out in September. Both would then start climbing again because of an anticipated fall bump, with hospitalizations returning to current levels by around the end of the year.

About half of the people hospitalized with COVID-19 are expected to seek care for other reasons and test positive upon admission.

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Since it began: Oregon has reported 863,045 confirmed or presumed infections and 8,252 deaths.

Hospitalizations: 371 people with confirmed coronavirus infections are hospitalized, down 27 since Wednesday, Aug. 3. That includes 48 people in intensive care, down three since Aug. 3.

Vaccinations: As of Aug. 8, the state has reported fully vaccinating 2,946,721 people (69% of the population), partially vaccinating 299,936 people (7%) and boosting 1,725,022 (40.4%).

New deaths: Since Aug. 3, the Oregon Health Authority has reported 78 additional deaths connected to COVID-19.

Fedor Zarkhin

Where to buy a COVID-19 test online: How to find BinaxNow, iHealth, more at-home kits for sale with fast shipping

Restock your N95 or KN95 face masks, respirators as COVID-19 omicron BA2 variants persist: Best deals with fast shipping

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Coronavirus in Oregon: Cases and hospitalizations continue to fall, but could start climbing again next month - OregonLive

WASHINGTON President Biden finally tested negative for the coronavirus on Saturday, a week after his rebound case emerged, but the White House physician said the president would remain in isolation in an abundance of caution until a second negative test.

In an expression of optimism, the White House separately announced on Saturday night that the president would leave Sunday morning for Rehoboth Beach in Delaware, finally escaping for a summer break after two weeks stuck at the White House with his dog Commander. The trip depends on a negative test on Sunday morning before he departs.

Mr. Biden has been staying away from the Oval Office since he tested positive again on July 30, though he has tried to maintain a public presence through appearances by video from the White House residence. The recurrence of the virus has kept him off the road for political events and delayed summer vacation plans as well.

The president has experienced few symptoms during his rebound case, according to Dr. Kevin C. OConnor, the White House physician, and he appeared in relatively good health in his video events over the last few days. The president continues to feel very well, Dr. OConnor said in a memo released to reporters on Saturday.

Through the presidents initial bout with Covid-19 and during his rebound case, Dr. OConnor has never appeared before reporters to answer questions, unlike previous White House doctors under other presidents. The White House has never offered a clear explanation about why. Dr. OConnors daily memos have provided no theories about where and how the president was infected. White House officials have said that those deemed to have been in close contact with Mr. Biden all tested negative.

The president was treated with Paxlovid early in his bout with Covid, and while the drug has been credited with great success in suppressing the virus and preventing severe cases and hospitalizations, a number of patients who have taken it have nonetheless tested positive again a few days after the last dose of the five-day regimen.

Initial clinical studies found that only about 1 percent to 2 percent of those treated with Paxlovid, which is made by Pfizer, experienced symptoms again. Subsequent studies of patients have found higher rates, though still in the single digits.

But some doctors and patients have speculated that the rebound rate could be even higher because of anecdotal experiences and because of the characteristics of the highly contagious Omicron subvariants in circulation this summer. Among those who have had a rebound case after taking Paxlovid is Dr. Anthony S. Fauci, the presidents chief medical adviser and a leading figure in the response to the pandemic.

Mr. Biden has been described by aides as eager to get out of isolation and back on the road as the midterm congressional campaign begins to heat up. As a result of his infection, he has had to cancel a number of planned trips and has limited his contact with aides, advisers and others at a time when he has scored some important victories that he would like to promote.

I wish I were with you in person, quite frankly, he told Vice President Kamala Harris and several cabinet members over a video feed during an event on Wednesday describing his plans to take action to protect abortion rights. But Im getting there.

Anticipating the end of Mr. Bidens time in isolation, the White House has already scheduled several appearances for the president in the coming days.

After his trip to Rehoboth Beach, Mr. Biden and the first lady are slated to travel to Kentucky on Monday to meet with victims of the flooding there. On Tuesday and Wednesday, the White House is planning to hold ceremonies for the president to sign legislation investing in the domestic semiconductor industry and expanding medical care for veterans exposed to toxic substances from burning trash pits on military bases.

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Biden Tests Negative for Coronavirus but Remains in Isolation - The New York Times

Good evening. Im Karen Kaplan, and its Tuesday, Aug 9. Heres the latest on whats happening with the coronavirus in California and beyond.

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There are so many things we still dont understand about COVID-19, and one of the most perplexing is knowing when its safe to stop isolating after a positive coronavirus test.

The guidelines from the Centers for Disease Control and Prevention are clear. In most cases, you can rejoin the world after five full days as long as you satisfy two key criteria you have to be fever-free for at least 24 hours without the aid of medicine, and your symptoms have to have improved since your initial diagnosis. (If you are immunocompromised or you became severely ill, the CDC advises you to isolate for 10 days.)

If you exit isolation after Day 5, you should continue to wear a mask when youre around other people through the end of Day 10. But what you wont have to do, according to the CDC, is test negative for a coronavirus infection.

The state of California disagrees. According to the Department of Public Health, the soonest you can end your isolation is the end of the fifth full day. But officials in Sacramento want you to have a negative test as well. If you dont, youll need to remain in isolation until you do.

Which policy is right? The answer depends on whether youd rather make people spend several extra days holed up in a room even if chances are good that theyre no longer contagious, or if youre willing to take the chance that some seemingly recovered patients who rejoin the world might still be infectious (though, if theyre following state and federal guidelines, theyll be wearing a well-fitting mask).

The problem is that scientists dont know how much to trust a coronavirus test under these circumstances.

A gloved hand holds a rapid antigen test that indicates a coronavirus infection.

(Jakub Porzycki / NurPhoto via Associated Press)

A study of 729 people who took a BinaxNow antigen test at least five days after becoming infected found that 54% of them tested positive, even though, by the CDCs standards, enough time had passed that their isolation could end. People who had developed COVID-19 symptoms were more likely to test positive during this time, but even 21% of those who had asymptomatic infections continued to see two pink lines on their BinaxNow cards.

Overall, the odds of testing positive fell with time 55% of people did so on Day 6, compared with 39% on Day 9.

A positive antigen test result does not necessarily mean that a person is infectious, wrote the authors of the study, which was published in February in the CDCs Morbidity and Mortality Weekly Report. Similarly, a negative test result does not necessarily mean that a person is not infectious.

A second study attempted to evaluate whether rapid antigen tests actually determine infectiousness.

Researchers recruited 17 people who had coronavirus infections and collected specimens from them six days after they first tested positive. The specimens were taken to a lab and cultured to see if the coronavirus was still present. Six of those tests came back positive. All six of those patients also tested positive on rapid antigen tests on the same day. However, another six patients tested positive on rapid tests but got negative results on their culture tests.

In other words, if you just finished your five-day isolation period and then tested positive on a rapid antigen test, there was only a 50-50 chance that you actually harbored coronaviruses that could grow in a lab the kind of test the researchers called the best proxy for determining whether a person was still infectious, according to their report last week in the journal JAMA Network Open.

(The other five people who tested negative on the rapid antigen tests had negative culture results as well.)

The 17 volunteers were among a group of 40 people who tested themselves daily once they were eligible to end their isolation. Only 10 of those 40 got a negative result on a rapid antigen test on Day 6. In fact, it took an average of eight days for those with asymptomatic infections to test negative, and nine days for those who had any COVID-19 symptoms to do so. Of the 90 tests administered to study volunteers on days when they had no COVID-19 symptoms, 68% came back positive.

The upshot, the researchers wrote, is that requiring a negative antigen test to rejoin the world would unnecessarily extend the isolation periods of many people who arent contagious. However, they added, if you test negative on a rapid test, you can feel reassured about ending your isolation without putting others in jeopardy.

It took President Biden a full week to test negative after he experienced a rebound infection. Dr. Kevin OConnor, the presidents physician, said the president would continue following strict isolation measures until he racked up two consecutive negative tests. The second of those tests came in Sunday, clearing the way for him to resume his public engagement and presidential travel, OConnor said.

California cases and deaths as of 5:15 p.m. on Tuesday:

Track Californias coronavirus spread and vaccination efforts including the latest numbers and how they break down with our graphics.

Dominic Green was in graduate school at Loma Linda University near San Bernardino when the arrival of the coronavirus forced the state into lockdown. His public health courses went online, so he moved back to his parents home in southern Michigan and logged in from his bedroom there.

As the pandemic dragged on, several rites of passage in Greens life were dealt with remotely. Instead of graduating in a formal ceremony, he received his masters degree last year in a drive-through event. When he interviewed for jobs, he used videoconferencing software to impress his prospective employers. And after he landed a job as a contract epidemiologist with the Los Angeles County Department of Public Health, he moved into his own one-bedroom apartment in Koreatown and set up a remote workstation there.

He never met his new work colleagues in person, but some of them came to know one another virtually. Not only was he a terrific epidemiologist with a strong work ethic but also cooperative and kind, they said.

Dominic Greens work ID badge.

(Green family photo)

About 4 in 10 white-collar workers are still doing their jobs from home. Theyre less likely to be exposed to the coronavirus this way, but theyre also less likely to bond with other people.

That was particularly true in Greens case. He was a natural introvert and knew only a few people in L.A. when he moved here. Because of the pandemic, he wasnt going to the kinds of places where hed normally make new friends. In fact, he hardly left his apartment unless it was to pick up dinner. (In those cases, a long drive was a welcome respite.)

So when he didnt report for work on Jan. 13, there was no one in his circle who was concerned enough to check in on him. And when he skipped his online check-in on Jan. 14, the result was the same.

It was only after the entire Martin Luther King Jr. holiday weekend passed without Green sending a single text that his parents realized something was amiss, my colleague Kiera Feldman reports.

Greens father, Joseph, a recently retired lieutenant colonel in the Air Force, checked the records for the familys cellular plan and saw that his son hadnt made or received a call for five days. Greens mother, Jeannine, a former registered nurse, likewise saw no activity on their joint bank account.

Joseph saw that someone with a Los Angeles phone number had sent his son two text messages. He called the texter and found himself talking to Lisa Smith, a supervisor at the county health department. Smith told the elder Green that she hadnt heard from his son since Wednesday, and she was concerned.

Joseph and Jeannine wondered why they werent notified when their punctual son missed two days of work with no warning. They were listed as his emergency contacts, and when his bosses were looking for him, they could have helped.

Greens parents were also dismayed that his supervisors didnt go to his apartment.

Why didnt you check on him? Joseph asked one of them. The supervisor responded that he was in charge of 100 people, and he didnt want Green to get in any trouble by drawing attention to his unexplained absence.

His intentions might have been good, but Joseph and Jeannine told Feldman that more should have been done. In their view, employers have a moral responsibility to check on workers who suddenly and inexplicably go missing.

Greens parents asked the police to conduct a wellness check on their son on the night of Martin Luther King Jr. Day. They also asked a family friend in the Los Angeles area to meet the officers at their sons apartment.

When the friend arrived, he peered into a window and saw Greens lifeless body lying on his bed.

Joseph and Jeannine flew to L.A. but couldnt get many answers. They found a leftover Chipotle burrito in the fridge and a freshly unboxed video game controller near his Xbox. They were comforted to see that their son had spent his final hours with some of his favorite things.

They waited four months to get the autopsy results. In all likelihood, Green went to bed that Wednesday night and never woke up. The cause of death was cardiomyopathy, a heart condition that can cause sudden death even in people who seem healthy.

Joseph Green poses with his sons photo and casket.

(Green family photo)

The pandemic wasnt directly responsible, but it does explain why it took five days for anyone to realize Green had died. By then, his body was unrecognizable; officials had to use his few remaining fingerprints to verify his identity.

How many people out there may be single and dont have somebody else at home to see that theyre OK? Joseph asked.

See the latest on Californias vaccination progress with our tracker.

Students throughout Los Angeles will return to classrooms on Monday, and their upcoming school year will feature much fewer swabs poked into their nostrils.

Under new Supt. Alberto Carvalho, L.A. Unified will continue to defer its COVID-19 vaccination mandate and allow mask use to remain voluntary. But what kids will notice most is the end of the weekly coronavirus testing program that screened for infections among the districts 400,000-plus students. Baseline testing wont be required before kids step into their classrooms either.

Instead, the nations second-largest school district will shift to a response testing program. That means tests will be required only for students who are sick and for their close contacts. Tests will also be deployed when theyre needed to help squelch an outbreak, officials said.

If a student or teacher or staff member does test positive, they will need to isolate for at least five days. But quarantines are no longer required for close contacts as long as they are healthy and test negative for an infection.

Most of the 80 school systems in Los Angeles County are following a similar course, according to Public Health Director Barbara Ferrer. But a few are mulling over a more aggressive approach to testing. Culver City Unified, for instance, will give students rapid tests to take at home before school starts next Thursday. Weekly testing on campus will begin during Week 2.

Some LAUSD parents would like to see their district test more aggressively too. More than 6,000 of them have sent letters to the district demanding a better COVID plan to protect in-person learning one that also includes improved air quality through updated HVAC systems, high-grade HEPA filters and low-cost DIY filters, among other things.

Parents arent entirely at the mercy of their school system. State health officials reminded them that if they want to maximize their kids protection, they can make sure theyre up to date on their COVID-19 vaccinations.

Not only do vaccinations provide individual-level protection, but high vaccination coverage reduces the burden of disease in schools and communities and may help protect individuals who are not vaccinated or those who may not develop a strong immune response from vaccination, the state Department of Public Health wrote in its latest guidance for schools.

According to The Times vaccination tracker, 67% of California adolescents ages 12 to 17 are fully vaccinated. But among those ages 5 to 11, just 36% have had their initial COVID-19 shots.

Im predicting that after the kids come back to school ... we probably will have another wave in early fall, Dr. Clayton Chau, director of the Orange County Health Care Agency, said last week. In O.C., 34% of 5- to 11-year-olds and 66% of 12- to 17-year-olds are fully vaccinated, according to our tracker.

Serious cases of COVID-19 are far less common in children than adults, but they can happen. On Friday, L.A. County announced that an adolescent patient had died of the disease, the 12th pediatric death in the county.

In other news, the final version of an independent report on L.A.'s emergency response to COVID-19 concluded that the lack of formal discussions about who was in charge of emergency operations led to a breakdown in coordination and communication among city departments. On the other hand, it praised Mayor Eric Garcetti for acting quickly and decisively on many fronts, often with innovative initiatives to help protect the city and its people.

The 220-page report by CPARS Consulting Inc. also softened or removed several criticisms of the mayor that were present in an earlier draft. For instance, gone is a reference to how several department leaders said Garcettis weekly cabinet meetings often felt more like dictations rather than discussions. Also excised were complaints from staffers at the Emergency Management Department that their work tasks were politically driven.

But the report did note that the EMD said Garcetti was less involved in emergency preparedness than his predecessors had been. The mayors office disputed this view.

At the federal level, the U.S. immigration system has nearly ground to a halt as it struggles to deal with the immense backlog stemming from pandemic closures. Millions of visas, work permits, green cards, naturalization petitions and cases in immigration courts are facing unprecedented delays.

Nearly 410,000 immigrant visa applicants have finished all their paperwork and are just waiting for an interview, according to figures from the State Department. In 2019, before the pandemic, the typical figure was 61,000.

The human cost of those delays can be profound. One analysis by the Cato Institute estimates that 1.6 million people who have been sponsored for a green card will die before they are able to enter the country legally.

Experts say it will be impossible for the government to catch up unless significant reforms are made. That doesnt seem likely its been more than 30 years since Congress approved a major overhaul of the U.S. immigration system.

Todays question comes from readers who want to know: Does COVID-19 still affect men more than women?

The answer depends on what you mean by affect.

According to the CDC, boys and men account for 46.5% of official coronavirus cases to date. Thats a little low considering that they make up 49.25% of the U.S. population. (Girls and women have experienced 53.5% of recorded cases, a figure thats higher than their 50.75% share of the population.) However, among Americans 65 and older, men account for a little more than their fair share of cases.

The gender disparity is more pronounced when it comes to COVID-19 deaths and that one doesnt work in mens favor.

Overall, 55.1% of the nations COVID-19 victims have been boys and men, the CDC says. Thats not only well above their share of the population, its significantly higher than the percentage of COVID-19 deaths involving women and girls (44.9%).

Whats more, it doesnt take until age 65 for men to be affected more than women. COVID-19 deaths are disproportionately high for men starting at ages and 16 and 17 and remain that way right up through the 85+ cohort, as you can see in the chart below.

We want to hear from you. Email us your coronavirus questions, and well do our best to answer them. Wondering if your questions already been answered? Check out our archive here.

The deck in the photo above is attached to a villa on the outskirts of Tivat, a coastal town in Montenegro. The villa was rented by Richard Ayvazyan and Marietta Terabelian, a couple from the San Fernando Valley who took drastic steps to evade the law enforcement officers trying to send them to prison.

Ayvazyan and Terabelian were convicted last year of various crimes for their role in a family fraud ring that pocketed $18 million worth of pandemic relief loans for fake businesses. Rather than go to prison, the couple used forged Mexican passports to escape to the Balkans with their family pet. Their three teenage children were left behind in Tarzana.

While I am writing this our tears are dripping on our breakfast table, Ayvazyan wrote in a goodbye note. Without saying too much, we both love you more than anything in this world.

Did the couples daring escape succeed? Find out in this thrilling story by my colleague Michael Finnegan.

Resources

Need a vaccine? Heres where to go: City of Los Angeles | Los Angeles County | Kern County | Orange County | Riverside County | San Bernardino County | San Diego County | San Luis Obispo County | Santa Barbara County | Ventura County

Practice social distancing using these tips, and wear a mask or two.

Watch for symptoms such as fever, cough, shortness of breath, chills, shaking with chills, muscle pain, headache, sore throat and loss of taste or smell. Heres what to look for and when.

Need to get a test? Testing in California is free, and you can find a site online or call (833) 422-4255.

Americans are hurting in various ways. We have advice for helping kids cope, as well as resources for people experiencing domestic abuse.

Weve answered hundreds of readers questions. Explore them in our archive here.

For our most up-to-date coverage, visit our homepage and our Health section, get our breaking news alerts, and follow us on Twitter and Instagram.

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Coronavirus Today: The isolation conundrum - Los Angeles Times

Antigen tests that are ready in 15 minutes and can be stored and used at home have been crucial for many who are trying to mitigate risk of contracting the coronavirus. But now some people with COVID-19 related symptoms are reporting that they are repeatedly testing negative on at-home rapid tests. This has brought up the question of whether these tests are working for newer omicron variants.

This might also happen if the SARS-CoV-2 virus changes enough so that the part that binds to the rapid antigen tests isnt as good of a match. As mutation occurs, it may somehow change the structure of these different proteins, which may result in a decrease in detection by the antigen testing, said Esther Babady, who is chief of the clinical microbiology service at Memorial Sloan Kettering Cancer Center in New York, to CNBC. It can also be that earlier in the infection by BA.4 and BA.5, you dont produce enough of the SARS-CoV-2 protein.

With the current variants, it seems that the antigen tests still work, although the timing of when you take the test may matter more or the sensitivity of the test to pick up an infection may be less than with previous variants.

Early data suggests that antigen tests do detect the omicron variant but may have reduced sensitivity, the Food and Drug Administration (FDA) state on their website. It is important to note that these laboratory data are not a replacement for clinical study evaluations using patient samples with live virus, which are ongoing.

The FDA are consistently testing the various brands of rapid antigen tests and maintain an updated list of authorized tests.

The FDA would know if there are performance concerns because they continue to monitor all authorized tests and scientific evidence over a period of time in the event that they need to make changes, Mark Fischer, who is the Regional Medical Director at International SOS, said in an email to CNET.

If in doubt, people can turn to PCR tests. If someone is testing negative with antigen tests but is suspected to have COVID-19, following up with a PCR test is important for determining if it is a coronavirus infection, according to the FDAs recommendations. Although PCR testing may be less accessible than previously during the pandemic, it is still the most surefire way to find out if someone is infected.

If someone has a high suspicion of having BA.5 and their antigen test is negative, a PCR test will really rule it out, says Babady.

Published on Aug. 10, 2022

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Are COVID-19 rapid tests working against new omicron variants? - The Hill

August 10, 2022 Scientists from the University of California, Davis, School of Veterinary Medicine have launched new clinical trials focused on improving treatments for feline infectious peritonitis, or FIP, and are currently enrolling patients at the UC Davis veterinary hospital.

FIP is a serious disease caused by a feline coronavirus variant, though not the one that causes COVID-19. The virus will spread through a cats body causing systemic inflammation. Up to 95% of cats diagnosed with FIP die without treatment. Cats can develop FIP at any age, but it is usually diagnosed in cats between 6 months and 2 years of age. It is one of the most common causes of death in young cats with infectious diseases. Currently there is no successful treatment approved for veterinarians in the United States.

Previous research conducted by UC Davis Professor Emeritus Niels Pedersen uncovered several promising treatments for this disease, including an antiviral drug that is not available to veterinarians in the U.S. Associate Professor Amir Kol, Professor Brian Murphy and Assistant Professor Krystle Reagan with the School of Veterinary Medicine are expanding on Pedersens research to further improve FIP treatment. They are seeking cats in the early to mid-stage of FIP disease for inclusion in clinical trials.

Trials will examine antiviral drugs, stem cell therapy

One trial will compare whether cats improve when treated with one of two closely related antiviral drugs. The first drug, remdesivir, is an antiviral drug with emergency use authorization from the FDA to treat COVID-19. If fully licensed, veterinarians could prescribe it to affected cats in the future. The second drug, GS-441524 is closely related to remdesivir. Pedersen found it safe and effective in treating cats with FIP. Currently veterinarians cannot prescribe it in the U.S. In this study, cats will receive either oral GS-441524 or oral remdesivir for comparison. Cats eligible for the study must be diagnosed with the wet form of FIP, in which obvious fluid build-up is present within the abdomen and chest.

The other trial, funded by the National Institute of Child Health and Development, will examine if antiviral drugs combined with a new stem cell therapy using mesenchymal stem cells, or MSCs, improve response to treatment for FIP. The goal of the study is to see if cell therapy can direct a more effective antiviral immune response and help regenerate the cats compromised immune system post-infection. For this study, one group will receive antiviral drugs along with infusions of MSCs, and the other will receive an antiviral drug and placebo infusions.

FIP, as many other chronic viral infections, is characterized by a dysfunctional immune system that is unable to clear the virus, said Kol, associate professor in the schools Department of Pathology, Microbiology and Immunology. Our study explores a novel cellular therapy that may help cats with FIP to better fight infection, clear the virus, and regenerate their injured immune systems. Results from our study will be highly impactful with immediate translatable potential.

Potential to help children

The trial could help humans as well. It is part of a larger study looking into new treatments for multisystem inflammatory syndrome in children, or MIS-C, a condition that causes organs and other body parts to become inflamed. FIP is similar to MIS-C and provides a clinically relevant model to investigate this novel, multipronged therapeutic approach. While the exact causes of MIS-C remain unclear, it is known that children diagnosed with it had the virus that causes COVID-19 or had been in contact with someone who was COVID-19 positive.

Owners interested in enrolling their cats in these clinical trials must live in Northern California or close by because cats will need several trips to UC Davis. Cats will need to meet the medical criteria. To learn more, visit UC Davis Veterinary Clinical Trials.

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UC Davis Launches Clinical Trials to Treat a Deadly Coronavirus Disease in Cats (Not the One that Causes COVID-19) - YubaNet

The Hawaii Department of Health today reported 3,189 new COVID-19 infections over the past week, lower than reported the previous week, bringing the total number of cases since the start of the pandemic to 332,822.

The states seven-day average of new cases also fell to 452, down from 528 reported on Aug. 3, representing a decline for three weeks in a row. DOHs daily average reflects new cases per day from July 30 to Aug. 5, which is an earlier set of days than the new infections count.

Actual numbers are estimated to be at least five to six times higher since these figures do not include home test kit results.

DOH also reported 14 more deaths, bringing the states coronavirus-related death toll to 1,606.

The states average positivity rate, meanwhile, continued its downward trend to 12.4%, compared to 13.8% reported the previous week, representing tests performed between Aug. 2 to 8.

By island, there were 2,262 new infections reported on Oahu, 369 on Hawaii island, 342 on Maui, 162 on Kauai, and six on Molokai. Another 48 infections were reported for out-of-state Hawaii residents.

There are 142 patients with COVID in Hawaii hospitals today, according to the Healthcare Association of Hawaii, with 11 in intensive care.

For the past week, HAH reported an average of 141 COVID patients hospitalized, and an average of 23 new COVID admissions per day.

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Hawaii Department of Health reports 3,189 new infections, 14 coronavirus-related deaths - Honolulu Star-Advertiser

Introduction

COVID-19 is one of the leading causes of morbidity and mortality globally. It is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and was first identified in Wuhan, China in early December 2019. It can cause fever, headache, shortness of breath, coughing, body weakness, sore throat, pain, and severe respiratory syndrome in human beings and is mainly transmitted by respiratory droplets and close contact with an infected human being.1 On January 30, 2020, the outbreak was declared a public health emergency of international concern by the WHO. According to the WHO daily situation report, currently the transmission is classified as community transmission and the total cases of COVID-19 are increasing worldwide; there were a total of 538,321,874 confirmed cases and 6,320,599 deaths as of June 22, 2022.2

In Ethiopia, the first case of COVID-19 was confirmed on March 13, 2020 and the infection has been spreading to all parts of the country, including Tigray region, wherein this research was conducted. According to the WHO, Ethiopia reported a total of 484,536 confirmed cases and 7524 deaths as of June 22, 2022.2

The infection fatality rates of COVID-19 patients, patient outcomes and related complications reported so far have varied considerably between countries. Previous studies showed that the overall mortality rate of COVID-19 patients is 3.77% 5.4%,35 and 41.1% - 61.5%68 among critical ill and severe patients. To reduce the infection fatality rate, understanding the factors associated with the duration of viral ribonucleic acid (RNA) shedding, the time from infection to viral RNA-negative conversion in COVID-19 patients is urgently needed.9 Moreover, it is also important to evaluate the testing time in order to reduce the infection fatality rate.10

Reports from previous studies indicated that the median duration of viral shedding in COVID-19 patients ranged from 847 days.9,1117 Most of the studies conducted on the duration of SARS-COV-2 shedding among COVID-19 patients are from China and Europe. The recovery time among severely ill patients is limited and different factors might hasten recovery or delay of the disease. Evidences reveal that older age, the time lag from illness onset to hospital admission and underlying comorbidities are associated with prolonged duration of viral RNA shedding in COVID-19 patients.9,1620 However, the epidemic in high income countries seems to be different from that of low and middle income countries in the risk factors, speed of the spread of the virus, and the record of the death toll related to the duration of SARS-COV-2 shedding.

Understanding the average time of recovery and its predictors is crucial for the decision making process at national and international levels in order to formulate preventive measures and optimize treatment options. Different studies have shown that the median time to recovery from COVID-19 patients varies across settings and disease status. The present study aimed to estimate the time to recovery and identify its associated factors among severely ill COVID-19 patients admitted to treatment centers in Tigray, Northern Ethiopia. This study provided useful information to predict the recovery time of severely ill COVID-19 patients through this retrospective cohort study.

A retrospective cohort study was analyzed that involved 139 severely ill COVID-19 patients admitted to isolation and treatment centers in Tigray, northern Ethiopia. Regardless of signs or symptoms development, all individuals with laboratory confirmed SARS-CoV-2 infection were admitted to the isolation and treatment centers within 24 hours. Anyone who has contact with confirmed COVID-19 case was being isolated for 14 days. Persons who failed to develop symptoms within 14 days were discharged from the isolation centers. Cases were confirmed by polymerase chain reaction (PCR) in the treatment centers.

All laboratory-confirmed positive COVID-19 severely ill patients admitted to treatment centers in the region between May 7 and October 28, 2020 with a definite outcome (recovered or dead) were designated as study participants.

The data were collected using a standardized form from electronic medical records. The data set contains demographic characteristics such as age, gender and occupation, clinical information of the patients contains temperature at admission, sign and symptoms status (such as fever, cough, shortness of breath, pain, sore throat, headache, body weakness), and presence of comorbidity (such as cardiovascular disease, diabetes mellitus, renal disease, respiratory disease) and patient outcomes (recovered or died). All severely ill COVID-19 patients admitted to the treatment centers between May 7 and October 28, 2020 were included in this study. Those severely ill patients with incomplete demographic and treatment outcome were excluded from the study.

In this study, the dependent variable was time to recovery from COVID-19 among severely ill patients and recovery is the event of interest. The time was estimated in days and recovery time was defined as the number of days it takes from the day the PCR test was positive until the patient is diagnosed negative for COVID-19 and discharged from treatment centers. The confirmed COVID-19 patients in the treatment centers were retested when symptoms subside and the body temperature remains at the normal range for at least three days and they were considered as recovered only after receiving two consecutive laboratory tests negative.

The independent variables considered in this study were sex, age, occupation, symptoms, comorbidity and type of comorbidity, temperature, travel history and source of infection.

The COVID-19 cases were all individuals tested positive for SARS-CoV-2 by PCR. Symptomatic cases were defined as any SARS-CoV-2 positive individual by PCR with at least one sign or symptom for COVID-19, including but not limited to: cough, fever, shortness of breath, headache, sore throat, and pain. Cases with comorbidity are COVID-19 patients with at least one known preexisting chronic medical illness. Severely ill COVID-19 patients: These patients with clinical signs of pneumonia and have at least one of the following conditions i) respiratory rate interval > 30 breaths/min; ii) SpO2 (saturation of peripheral oxygen) < 93% at rest; iii) severe respiratory distress, and iv) oxygenation index (artery partial pressure of oxygen/inspired oxygen fraction, PaO2/FiO2) < 300 mmHg.

The data were coded, cleaned, and checked for inconsistencies and completeness. STATA version 16 software was used for data processing and data analysis. Summary measures such as counts, percentages, means, medians and IQRs were calculated. The Log rank test was applied to compare the survival time between different predictors. A cox proportional hazard regression model was used to determine the potential risk factors associated with the duration time to recovery among severely ill COVID-19 patients. Factors associated with outcome at p-value < 0.20 in bivariate Cox regression were selected for multivariable Cox regression analysis. An adjusted hazard ratio (AHR) with 95% confidence interval was computed and statistical significance was declared at p-value < 0.05. Cox proportional hazards assumption was checked using the Schoenfeld residual test.

The ethics committee of Mekelle University, College of Health Sciences approved the current study with the ethical clearance registration number of IBR1826/2021. The study was conducted in accordance with the Declaration of Helsinki. Consent to participate was fully waived as the study participants were not directly involved in the study (ie an already existing data were utilized for analysis in the current study). The confidentiality of data was kept as there were no personal identifiers used and neither the raw data nor the extracted data were passed to a third person.

A total of 139 severely ill COVID-19 patients were included in this study that was reported from May 7, 2020 to October 28, 2020. The median age of the patients was 35 years (IQR, 2760). A total of 55.4% of patients were younger than 40 years, and 25.9% were older than 59 years. The patients in the non-survivor group were much older than those in the survivor group [median = 57 years (IQR, 29.572 years) versus median = 30 years (IQR, 2540 years), p-value < 0.001]. Of the non-survival patients (56 (40.3%) of 139), 48.2% of the patients were older than 59 years. The majority of COVID-19 patients (77.0%) were males and 73.2% of COVID-19 deaths were in men. Majority (60.4%) of the severely ill COVID-19 patients their sources of infection were from the community and 18% were imported. Among the study patients in our study, 20.1% of the patients had travel history and 40.3% were died (Table 1).

Table 1 Background Characteristics of 139 Severely Ill COVID-19 Patients Admitted to Treatment Centers of Tigray, Northern Ethiopia, 2020

Of the total study patients, 61.2% were symptomatic. The most common symptoms at the onset of disease reported were shortness of breath 57.5%, and cough 52.5%. This is followed by body weakness 36.7%, fever 32.4% and pain 28.1%. Among the non-survival patients (56 (40.3%) of 139), 78.6% had shortness of breath and 71.4% had cough symptoms. Moreover, 28.8% patients had one or more coexisting medical conditions alongside COVID-19. The comorbidity rate in the non-survivor group was higher than that of the survivor group (44.6% versus 18.1%, p-value < 0.001). Based on the body temperature on admission, 71.9% of the patients had temperature < 37.3C and 28.1% had elevated temperature 37.3C (Table 2). The most frequent comorbidities were cardiovascular diseases (50%), diabetes mellitus (20%) and respiratory diseases (18%) (Figure 1).

Table 2 Clinical Characteristics of 139 Severely Ill COVID-19 Patients in Tigray, Northern Ethiopia, 2020

Figure 1 Types of underline comorbidity of severely ill COVID-19 patients in Tigray, 2020. *Cardiovascular diseases included hypertension and heart failure. **Other diseases include traumatic injury, HIV, malignancy, hepatitis, cancer, rabies, smoker, peptic ulcer disease.

A total of 139 severely ill COVID-19 patients were followed for a minimum of 1 and a maximum of 37 days with median follow-up of time 18 days (IQR: 1127). Eighty-three patients were recovered with median time of 26 days (95% CI: 2327 days). The overall incidence recovery rate was 3.1 (95% CI: 2.5 3.9) per 100 person-days of observations. The incidence recovery rate among male and female severely ill patients was 3.1 per 100 person-day (95% CI: 2.54.0) and 3.2 per 100 person-day (95% CI: 2.05.1) respectively. In this study, the recovery rate from COVID-19 among severely ill patients with and without comorbidity was found to be 2.1 (95% CI: 1.33.5) and 3.5 (95% CI: 2.84.4) per 100 person-day respectively. Log Rank test was used to compare survival time between categories of different predictors. The survival estimates of severely ill patients varied in relation to age, fever, cough, shortness of breath, headache, body weakness, pain, and underline comorbidity (Tables 1 and 2). The survival status of severely ill COVID-19 patients was also estimated by the KaplanMeier survival curve. The overall graph of KaplanMeier survival function depicted that the curve tends to decrease rapidly in between 18 and 26 days indicating that most severely ill COVID-19 patients recovered within this time (Figure 2). A separate KaplanMeier survivor functions curve was constructed to estimates the survival time based on different covariates to see the existence of difference in recovery rate between categories of individual covariates. There was a significant difference in the time of recovery between patients with and without previous medical conditions or comorbidity, where patients without comorbidity recovered faster (Figure 3). A significant difference in the recovery rate among the two groups is also found by the Log rank test (Table 2). The median recovery times of the patients with and without comorbidity were 32 days and 24 days, respectively.

Figure 2 Kaplan-Meier survival estimate for time to recovery among severely ill COVID-19 patients in Tigray, Northern Ethiopia.

Figure 3 Kaplan-Meier survival estimate for time to recovery among patients with and without comorbidity.

Predictors that had association at a p-value of <0.20 in bivariate Cox regression were included in multivariable Cox regression. Age, fever, coughing, shortness of breath, sore throat, headache, body weakness, pain, comorbidity, and temperature were statistically significant at a p-value of < 0.20 level of significance. In the multivariable cox regression model only age, shortness of breath, body weakness and comorbidity were found to have statistically significant association with recovery time among the severely ill COVID-19 patients. Severely ill COVID-19 patients who were aged < 40 years had 4.1 times higher rate of recovery as compared to patients who were aged 60 and above years (AHR=4.09, 95% CI: 1.5810.61). In addition, the recovery rate was higher for patients who had no underline comorbidity diseases (AHR = 2.48, 95% CI: 1.185.24), shortness of breath (AHR = 2.07, 95% CI: 1.083.98) and body weakness (AHR = 2.62, 95% CI: 1.205.72) (Table 3). The Schoenfeld residual test results confirmed that the proportional hazard assumption satisfies.

Table 3 Predictors of Time to Recovery Among Severely Ill COVID-19 Patients in Tigray Region, 2020

This study comprised 139 severely ill COVID-19 patients who were admitted to treatment centers in Tigray region. Our study shows that the overall median time to recovery among severely ill COVID-19 patients was 26 days, which is consistent with some previous research study.11,2123 However, the median recovery time was lower in many other previous studies. For instance, a study done in Eka Kotebe General Hospital, Ethiopia (19 days),20 Guangzhou Eighth Peoples Hospital, China (12 days),9 Singapore (12 days),24 University of California San Diego (7 days)25 and Wollega Referral Hospital, Ethiopia (18 days).26 The discrepancy of the findings could be the differences in the composition of study participants, sample size and severity of the disease. In addition, the fact that the recovery time was shorter among patients treated in China, Singapore and the United States of America could be due to the availability of advanced medical technologies and medications and effective COVID-19 patients management approach and conducive hospital setting. The selected study participants in most of these studies were all COVID-19 cases, whereas our study was conducted among severely ill COVID-19 patients admitted to intensive care units. Evidences have shown that severely ill patients stay longer to recover from COVID-19.27 The time at which the first swab is taken and the criteria for considering patient recovered can also influence the recovery time. Moreover, in the current study, a significant number of the patients had previous medical conditions or comorbidity, which might have affected to delay recovery.

This study revealed that cardiovascular diseases and diabetes mellitus were the most common comorbidities, which is consistent with the previously reported research studies.5,2834 Moreover, in this study 61% of the patients had signs and symptoms on admission. The most common symptoms were shortness of breath and cough. This finding is in line with most previous studies.3538 The result of this study showed that there was no difference between males and females in the recovery period in bivariate analysis. This was consistent with some previous studies.39,40 However, other studies have found that male patients had longer duration of viral RNA shedding than female patients with COVID-19.17,41

The multivariable cox proportional hazard regression analysis demonstrated that age, comorbidity, shortness of breath and body weakness were risk factors for time to recovery among severely ill COVID-19 patients. We found that older age was associated with high risk of delayed viral clearance. The younger patients recovery rate is significantly higher than those older than 59 years. This finding was in line with previous studies.9,17,27,4246 This might be attributed to the severity progression of COVID-19 among older age cases compared to the younger cases which in turn leads to either death or delayed duration of viral clearance in elderly patients.42 Moreover, it could be due to the life style of old aged patients in that they might not have a regular physical exercise or could have additional underlying disease conditions like chronic illnesses and may also have the habit of consuming lifesaving and life prolonging drugs.

The current study has demonstrated that patients with comorbidity condition had higher risk of delayed viral clearance from COVID-19 compared to their counterparts. The existing facts are supporting the present study finding that comorbidity conditions majorly cardiovascular diseases attributed to the high risk of delayed viral clearance from COVID-19 cases.17,37,42,47 Moreover, this study revealed that the recovery rate was higher for patients who had no shortness of breath and body weakness. The limitation of the present study is the retrospective study design and finding the whole array of COVID-19 patient information from the electronic medical record was a challenge.

The median of recovery time from severely ill COVID-19 patients was long. The study revealed that older age, having at least one comorbid condition, shortness of breath and body weakness were significant factors related with the time to recovery among the severely ill COVID-19 patients. Therefore, elders and individuals with at least one comorbid condition has to get due attention to prevent infection by the virus. Moreover, attention should be given in the treatment practice for individuals who had shortness of breath and body weakness symptoms.

The findings of this research were extracted from the data gathered and analyzed based on the stated methods and materials. The dataset supporting this finding can be obtained from the corresponding author upon request.

Ethics approval to conduct this study was obtained from the institutional research review committee of College of Health Sciences, Mekelle University with the ethical clearance registration number of IBR1826/2021. The study was conducted in accordance with the Declaration of Helsinki. Consent to participate was fully waived as the study participants were not directly involved in the study (ie, already existing data were utilized for analysis in the current study).

No funding was obtained for this study.

The authors declare no conflicts of interest in relation to this work.

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Time to Recovery of Severely Ill COVID-19 Patients and its Predictors: | JMDH - Dove Medical Press

Patient deaths: 1,034,020

Total vaccine doses distributed: 794,231,535

Patients whove received the first dose: 261,591,428

Patients whove received the second dose: 223,035,566

% of population fully vaccinated (both doses, not including boosters): 67.2%

% tied to Omicron variant: 100%

% tied to Other: 0%

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Coronavirus Omicron variant, vaccine, and case numbers in the United States: Aug. 10, 2022 - Medical Economics