Category: Corona Virus

In the early days of the COVID-19 outbreak, the medical communitys collective wisdom was that everyone should quarantine for 14 days if theyd been exposed to SARS-CoV-2, the coronavirus that causes COVID-19.

Now, however, 2 years of medical data and several vaccines later, we know a bit more about COVID-19, vaccinations, and quarantines.

In fact, the Centers for Disease Control and Prevention (CDC) has recently changed its recommended quarantine and isolation times for people who are vaccinated against COVID-19.

Keep reading to find out more about the latest quarantine recommendations.

Its important to understand some definitions of phrases and words commonly used to discuss COVID-19 and quarantine.

The first two phrases relate to vaccination status:

There are also two terms to keep in mind when it comes to quarantining or distancing yourself from others after COVID-19 exposure:

It may also be helpful to understand the terms that are used to discuss exposure:

According to the CDC, if youre vaccinated and exposed to COVID-19, you do not need to quarantine.

However, its recommended that you:

For clarity, the first day you were exposed is day 0. Day 1 is considered the first full day after you were in contact with a person who has tested positive for COVID-19.

If you arent up to date on your vaccines, or youre not vaccinated at all, the CDC recommends that you:

Below is a summary of the quarantine recommendations if youve been exposed to someone who has COVID-19:

All people who have a positive COVID-19 test should isolate for 5 days, regardless of their vaccination status, according to the CDC. This is true even if you dont have symptoms.

If your symptoms resolve and you are fever-free without the use of fever-reducing medications for 24 hours, you can end isolation.

However, you should wear a well-fitting mask for another 5 days when around people to minimize the chance of transmitting the coronavirus to others.

If you have a fever, remain in quarantine until the fever resolves.

If you never had symptoms, you can end isolation after 5 days, but wear a mask for 5 days after isolation.

If you had severe symptoms of COVID-19, its recommended that you isolate for at least 10 days. Consult a doctor before ending isolation.

Day 0 is your first day of symptoms, or the day you get a positive test. Day 1 is the first full day after you develop symptoms of COVID-19, or the day after your testing specimen is collected.

Everyone, regardless of vaccination status, should follow the 5-day isolation period with mask wearing until day 10. You should also avoid travel, and avoid contact with high-risk individuals.

Below is a summary of the quarantine recommendations if you test positive for COVID-19:

A vaccine is not a guarantee that you wont develop COVID-19 if you are exposed to the coronavirus. Instead, a vaccine aims to reduce the risk of:

However, even the most protective vaccines are not 100 percent effective, and its possible to develop a breakthrough infection.

But vaccinated people who develop COVID-19 are less likely to experience severe illness or require hospitalization. They are also less likely to die as a result of the infection.

According to the CDC, vaccine effectiveness against hospitalization in healthy people who have had two doses of an mRNA vaccine (like Pfizer or Moderna) is approximately 82 percent. Those whove had a vaccine booster restore the vaccines effectiveness against hospitalization to 97 percent.

For those who are immunocompromised, mRNA vaccine effectiveness against hospitalization is 69 percent with two doses. A booster increases it to 88 percent.

As coronavirus variants develop and spread globally, vaccination is an important tool in slowing the spread and reducing the risk of a variant being resistant to the current vaccines.

Vaccinated people who test positive for COVID-19 will likely experience milder symptoms. Its also likely that the duration of symptoms will be much shorter.

One 2022 study found that fully vaccinated people saw benefits during both the Delta variantpredominant period and the Omicron variant surge. Full vaccination protected against infection and death during Delta, and against infection during Omicron. This was especially true among people ages 50 to 64 and people over 65.

These milder symptoms may include:

If you test positive for COVID-19, the best course of treatment depends on your symptoms. Most people can treat their symptoms at home and will not have further issues. Typical self-care steps for COVID-19 include:

For some people, the antiviral remdesivir (Veklury) or an intravenous monoclonal antibody therapy may be recommended. These are typically reserved for people at high risk of complications from COVID-19.

Vaccinated people are less likely to develop severe disease. However, if you do test positive, keep an eye out for signs of a worsening infection. These symptoms include:

As medical professionals better understand COVID-19 and how vaccines affect how easily the virus is spread, advice on quarantine and isolation is changing. Today, the CDC has less strict quarantine requirements for people who have been vaccinated.

But the recommendations for isolation following a positive COVID-19 test remain the same, regardless of vaccine status.

Its important that everyone understand and follow the best practices for isolation and quarantine. This will help reduce the spread of the virus and potentially save hospitalizations and even deaths.

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Do You Have to Quarantine If You've Been Vaccinated for COVID-19? - Healthline

WELLINGTON, New Zealand

Samoa has reported scores of new coronavirus cases daily since detecting its first-ever case of community transmission last week.

The South Pacific island nation of 200,000 people has been in lockdown since Saturday as it deals with its first outbreak since a worldwide pandemic was declared two years ago.

The outbreak was discovered after a woman who was about to travel tested positive for the coronavirus Thursday. The cascade of positive tests since indicates that the virus likely had been spreading undetected for days or even weeks.

Samoa reported 95 new cases Saturday and 85 more on Sunday.

Only 15 of the 196 active cases were imported from overseas, according to the latest government statement available Monday. More than 2,200 tests have been performed since Friday, the statement said.

Samoa and several neighboring Pacific island nations were among the last places in the world to avoid coronavirus outbreaks. But the more transmissible Omicron variant has changed the equation, and one by one the island nations have been hit by outbreaks.

Since the start of the year, Kiribati, Tonga, the Solomon Islands, the Cook Islands and American Samoa have all experienced their first big outbreaks.

All Samoan schools are closed, public gatherings are banned and all stores and other services are shut down, except those considered essential. The lockdown is scheduled to last until Tuesday, but many expect it will be extended.

About 65% of all Samoans have had at least two doses of a COVID-19 vaccine, according to Our World in Data.

Samoa has had previous coronavirus scares and lockdowns after returning plane passengers tested positive while isolating, but the country had managed to avoid any community outbreaks until now.

Micronesia, the Marshall Islands and Nauru are among the few remaining Pacific island nations to have avoided Omicron-fueled outbreaks.

Originally posted here:

Scores of cases found in Samoa's 1st-ever coronavirus outbreak - Los Angeles Times

Chris Newman, a wildlife biologist at the University of Oxford and a co-author of one of the studies, said that his Chinese colleagues saw a number of wild mammals for sale at the Huanan market in late 2019. Any of them might have been responsible for the pandemic, Dr. Holmes said.

You cant prove raccoon dogs yet, but theyre certainly a suspect, he said.

Some critics have questioned how sure Dr. Holmes and his colleagues can be that a Huanan animal was to blame. Although many of the earliest Covid cases were linked to the market, its possible that other cases of pneumonia have not yet been recognized as early Covid cases.

We still know far too little about the earliest cases and there are likely additional cases we dont know about to draw final conclusions, said Filippa Lentzos, an expert on biosecurity at Kings College London. I remain open to both natural spillover and research-related origins.

Another problem: If infected animals indeed started the pandemic, theyll never be found. In January 2020, when researchers from the Chinese C.D.C. arrived at the market to investigate, all the animals were gone.

But Dr. Holmes argues that theres more than enough evidence that animal markets could spark another pandemic. Last month, he and Chinese colleagues published a study of 18 animal species often sold at markets, obtaining them either in the wild or on breeding farms.

They were absolutely full of virus, Dr. Holmes said.

Over 100 vertebrate-infecting viruses came to light, including a number of potential human pathogens. And some of these viruses had recently jumped the species barrier bird flu infecting badgers, dog coronaviruses infecting raccoon dogs. Some of the animals were sick with human viruses, too.

The simplest way to reduce the odds of future pandemics, Dr. Holmes has argued, is to carry out studies like this one at the interface between humans and wildlife. His own experience discovering new viruses has convinced him that it doesnt make sense to try to catalog every potential threat in wildlife.

You could never possibly sample every virus out there and then work out which one of those can infect humans, Dr. Holmes said. I dont think thats viable.

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He Goes Where the Fire Is: A Virus Hunter in the Wuhan Market - The New York Times

With uncertainty swirling around the possible impact of the highly contagious Omicron subvariant BA.2 in the United States, vaccine makers Pfizer and Moderna have both asked the US Food and Drug Administration to authorize second boosters - or fourth shots - of their vaccines.

Here is a quick briefing, compiled from Globe wire and major media reports, on whether and when people might get additional jabs:

- The government is pondering what to do. The US Food and Drug Administration said Monday its Vaccines and Related Biological Products Advisory Committee would meet April 6 to discuss more booster shots. The committee of outside experts is expected to hold an open, transparent discussion to help the agency decide who should get boosters, when they should get them, and if the vaccines should be updated to address specific variants.

Now is the time to discuss the need for future boosters as we aim to move forward safely, with COVID-19 becoming a virus like others such as influenza that we prepare for, protect against, and treat, Dr. Peter Marks, director of the FDAs Center for Biologics Evaluation and Research, said in a statement.

The meeting, however, wont address product-specific applications, the agency said.

- Two applications are on the table. Pfizer last week asked the FDA for emergency use authorization of its vaccine for people 65 and older who have already received one booster. Moderna followed a couple of days later with a broader request, asking the FDA to authorize its vaccine for a second booster for all adults. Moderna said it wanted to give the US Centers for Disease Control and Prevention and health care providers flexibility in deciding who should get boosters and when they should get them.

The New York Times reported last week that the Pfizer application might see a speedy approval, but the prospects of the Moderna application werent as clear. The next step after FDA approval would be for CDC advisers and the CDC director to weigh in.

- The second boosters are intended to shore up waning immunity. A study released by the CDC last month showed protection waning after a booster shot of either the Pfizer or Moderna vaccine. The companies have also cited encouraging results from Israel, where second boosters have been administered to older people and health care workers.

The CDC has already recommended that many Americans with immune deficiencies get three shots as part of their initial series, followed by a fourth shot.

- Some are calling for the additional booster shots to be given now. Im a strong proponent of giving a second booster now, Dr. Peter J. Hotez, a vaccine expert at the Baylor College of Medicine in Houston, told the Times. Others are being more cautious. I think youd want to have really convincing evidence that a second booster was needed and beneficial and we just dont have that, Dr. Jesse Goodman, a former chief FDA scientist, told National Public Radio. I dont think we know that a booster will not ultimately be required, but were just not there yet.

- Debate over the need for more boosters comes against a backdrop of worry about the next chapter of the pandemic. In a number of Western European countries, COVID-19 cases are on the rise as the BA.2 variant takes hold, worrying some scientists who see the possibility of a similar resurgence here. Dr. Anthony Fauci, the nations top infectious disease expert and an adviser to President Biden, struck a reassuring note Sunday, saying the country would likely see an uptick in cases, but he didnt think it would turn into a surge.

- One possibility floated by some experts is that people could end up getting yearly boosters every fall. Given how safe the vaccines are and how effective they are, I think it probably does make sense for people to get a booster, and the most convenient would be once a year, Dr. Otto Yang, an infectious disease specialist at UCLA, told Kaiser Health News. If COVID-19 turns out to be seasonal, peaking in the winter, shots given in the fall would provide decent protection, he said.

Material from Globe wire services was used in this report.

Martin Finucane can be reached at martin.finucane@globe.com.

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Is there another coronavirus booster shot in your future? - The Boston Globe

A look at some of the top headlines trending online today including the latest updates on Russias invasion of Ukraine, weather and inflation news, the coronavirus and much more.

Ukraine retakes key Kyiv suburb; battle for Mariupol rages (AP)

AP journalists detail harrowing escape from Mariupol (Axios)

Biden warns of evolving Russian cyber threat to U.S. (CBS)

EU split on Russia oil sanctions, mulls other steps (Reuters)

Powell says inflation is much too high and the Fed will take necessary steps to address (CNBC)

A marathon day is ahead for Supreme Court nominee Ketanji Brown Jackson (NPR)

4 takeaways from Ketanji Brown Jacksons confirmation hearing (Washington Post)

US flying blind to potential COVID-19 resurgence, experts say, as states scale back on testing, data reporting (ABC)

Doctors finding hurdles to using pills to treat COVID-19 (AP)

Covid-19 Doubles Risk Of Pregnancy Complications (Forbes)

Is there another coronavirus booster shot in your future? (Boston Globe)

Severe storms and tornado risk threaten the South today after powerful system tears through Texas (CNN)

Disney employees are walking out, demanding more LGBTQ support (USA Today)

Boeing jets under surveillance after China crash (BBC)

Miami Beach declares emergency, curfew after spring break violence (UPI)

West Side Story Star Rachel Zegler Speaks Out After Not Being Invited To The Oscars (Elle)

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Whats trending today: Ukraine, weather, coronavirus & more - cleveland.com

Several European countries lifted their coronavirus restrictions too soon, the World Health Organization (WHO) has said, and as a result are now witnessing sharp rises in infections probably linked to the new, more transmissible BA2 subvariant.

Hans Kluge, director of the WHOs Europe region, said countries including Germany, France, Italy and Britain had lifted their Covid curbs brutally from too much to too few. Infections are rising in 18 out of the regions 53 countries, he said.

Kluge told journalists in Moldova on Tuesday that more than 5.1 million new cases often linked to the BA2 variant, which experts say is about 30% more contagious and 12,496 deaths have been reported in the region over the past seven days.

The countries where we see a particular increase are the United Kingdom, Ireland, Greece, Cyprus, France, Italy and Germany, he said, adding that he nonetheless remained optimistic but vigilant about the pandemics progress in Europe.

Health experts have said the surge is probably due to a range of factors including the reduced immunity offered by vaccines over time, the relatively high transmission rate of Omicron and its BA2 subvariant, and the relaxing of curbs such as mask wearing and vaccine passes for access to many indoor public places.

WHO data shows the number of new Covid cases in Europe fell sharply from a peak at the end of January, but has been rising again since early March. In some countries, infection numbers are reaching new records even as most curbs are being lifted.

Most pandemic controls were lifted in Germanys Freedom Day on Sunday despite the seven-day rolling average of new daily cases per million hitting 2,619 on Saturday, the highest since the start of the pandemic more than two years ago. The situation is much worse than the mood, the health minister, Karl Lauterbach, warned.

Austria last week reimposed the use of FFP2 masks indoors from Wednesday with its seven-day average per million standing at a record 4,985. The countrys health minister, Johannes Rauch, admitted the country had eased most restrictions too early, on 5 March.

A decline in the current figures is not expected until after the next few weeks, the ministry said, regretting that that the tense situation would therefore be likely to last much longer than previously expected.

Controls in France including the requirement to wear masks in most indoor settings and a vaccine pass to access cafes, cinemas and restaurants were lifted early last week, but its daily average per million has surged to 1,331 from 774 on 5 March.

French authorities have said that for the time being the situation in the countrys hospitals was manageable, while the number of patients in intensive care and the number of daily coronavirus fatalities were going down.

For the past few days the number of people being admitted to hospital each day has stopped falling, Frances health minister, Olivier Vran, acknowledged, adding that he expected to see the number of new infections continue to rise until about the end of March, before falling back again in April.

Vran said there no alarming signals had so far been observed in intensive care wards in France. The greatest risk is for people with underlying conditions and those who have not been fully vaccinated, he said. We are strongly advising them to continue wearing masks and to get their booster shot as soon as possible.

Italy announced last week that people would no longer have to show proof of vaccination or a negative test to enter indoor public spaces from 1 May, with outdoor venues exempt after 1 April and masks no longer required indoors from 30 April.

The countrys seven-day average of new cases has, however, almost doubled since early March to 1,156 per million inhabitants. The equivalent figure in the UK has risen even more dramatically, from 398 at the end of February to 1,189 this weekend.

Despite the rise in new infections, Kluge said Europe was in a relatively good position to cope with the virus. There is a very large capital of immunity either thanks to the vaccination or due to the infection, he said, while the end of winter meant people would be less likely to gather in small, crowded places.

Moreover, Omicron and its subvariant are known to cause milder symptoms in people who are fully vaccinated and have had a booster shot, he added although he warned that in countries with a low vaccination rate, this is still a disease that kills.

Kluge said the world would have to live with Covid for quite a time, but that does not mean that we cannot get rid of the pandemic. To be able to do so, he said, countries must protect vulnerable people, strengthen surveillance and sequencing, and make sure they had access to new antiviral medicines.

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WHO blames rising Covid cases in Europe on curbs lifted too soon - The Guardian

When my friend texted me last week to say that she had a fever, I nearly discounted the possibility that she might have contracted Covid-19. The case numbers are so low in California right now, I thought.

But, it turns out, she did have Covid. And, as I found out the next day, so did I.

Over the past 10 days, Ive heard about more friends and acquaintances infected with the coronavirus in Los Angeles, where I live, than at any time other than the earliest days of the Omicron surge.

Of course, this might be my own bias, given my recent positive diagnosis. But outside of my Covid-19 bubble, too, there are growing concerns that the United States is headed for another Covid wave.

Pandemic restrictions are being lifted, a more contagious Omicron subvariant is taking root nationwide, and infections are climbing in Western Europe, often a harbinger of whats to come in the United States.

The big question seems to be not if cases will rise here, but how seriously we will need to take that increase.

The bottom line is, we will likely see an uptick in cases, Dr. Anthony S. Fauci, the nations top pandemic adviser, said Sunday in a TV interview. Hopefully, we wont see a surge. I dont think we will.

Currently, coronavirus testing numbers nationwide are far lower than they were during the Omicron wave. But in California and other states, infections are no longer falling as precipitously as they once were.

This may be because people are socializing more as restrictions lift. The wave in Europe is believed to be at least partly fueled by a loosening of precautions.

And then theres the proliferation of BA.2, a more contagious subvariant of Omicron. The subvariant is estimated to be 30 to 50 percent more transmissible than the previous version of Omicron, BA.1, which drove the winter wave.

Nationwide, BA.2 made up 23 percent of new coronavirus cases in mid-March, up from 2 percent a month before, according to the Centers for Disease Control and Prevention. The latest data from Los Angeles County shows that BA.2 accounts for less than 10 percent of new cases locally.

Theres no way to know for sure whether the spread of BA.2 will make infections rise overall. But early signs suggest that the coronavirus is already picking up across the United States.

Nationwide, roughly 40 percent of wastewater sites tracking coronavirus levels have reported increases in the virus over the past 15 days, according to the C.D.C.

In California, some of the biggest jumps have been detected at treatment plants in San Diego, San Benito and Fresno. A site that collects sewage from Monterey and Santa Cruz Counties reported a 26-fold increase in coronavirus levels in the past 15 days, federal data shows.

Today we have a much lower case count, but thats today, and that doesnt mean we have a handle on whats coming, Anne Rimoin, an epidemiologist at the University of California, Los Angeles, told me. Were in the calm before the storm.

Other experts predicted that the next wave will most likely have less severe consequences than previous ones.

Obviously, the dangers of contracting Covid vary from person to person, and many who are immunocompromised remain at high-risk. But on average, the risks of becoming seriously ill have fallen because of immunity from past infections, vaccines, boosters and improved treatments.

To use myself as an example: Im fully vaccinated and boosted, which probably helped prevent my infection from advancing beyond fever and fatigue. (Im mostly recovered after many days spent resting.)

And if I had been high-risk, I could have taken one of the new antiviral treatments that reduce the risk of hospitalization and death by as much as 89 percent. So while many people may catch the coronavirus this year, far fewer are likely to become dangerously sick.

Jeffrey Klausner, a public health professor at the University of Southern California, summed it up this way: A rise in Covid cases in 2022 should be entirely different from one in 2020.

Theres some likelihood that there will be additional infections, and maybe some additional waves, but were much better able to effectively respond to those and mitigate the severity and the risk of severe disease, Klausner told me. Were kind of more in the realm right now of what a typical influenza season might look like.

For more:

Grocery store strike: Thousands of workers at Ralphs, Albertsons, Vons and Pavilions are voting on whether to authorize a strike, The Associated Press reports.

Covid-19: Once hard to find, at-home test kits have become more readily available for now.

D.M.V. tests: California is allowing the written portion of its drivers test to be taken online, The Los Angeles Times reports.

Presidential bid: Democratic campaign leaders are quietly encouraging this California congressman to run for president in 2024 if President Biden doesnt seek re-election, Politico reports.

Wells Fargo lawsuit: A Black homeowner from California is suing the bank for racial discrimination.

SOUTHERN CALIFORNIA

L.A. film museum: Following criticism, the Academy Museum of Motion Pictures will open a new permanent exhibition devoted to the contributions of Jewish studio founders.

Anas Nins sanctuary: The erotic writers preserved Los Angeles home is a lasting monument to her life and legacy.

CENTRAL CALIFORNIA

Drought consequences: As Californias ongoing drought forces farmers to leave their land unplanted, Central Valley farms are vanishing and taking entire communities with them, The Washington Post reports.

NORTHERN CALIFORNIA

Chevron strike: More than 500 workers at a Bay Area Chevron refinery went on strike on Monday over salary and safety concerns, The Associated Press reports.

Covid-19 pregnancy risk: A study from Kaiser Permanente found that pregnant people who contract Covid-19 are twice as likely to develop significant complications, Forbes reports.

$1.7 million homes in California.

Todays tip comes from Tammy Sims, who lives in Camarillo:

I love visiting Laguna Beach in Orange County because its close enough for a day trip, and yet feels like Im on a mini vacation in a tropical location like Hawaii. I have never seen water as aqua blue as in Laguna. The wonderful views from above the shore cliffs make it so picturesque for my photography, unlike other SoCal flat beaches. There are so many wonderful restaurants to dine in along Pacific Coast Highway, as well as art galleries and shops. I can get a lot of walking in taking in all of the sights. Its my summer getaway destination without costing a lot of money!

Tell us about your favorite places to visit in California. Email your suggestions to CAtoday@nytimes.com. Well be sharing more in upcoming editions of the newsletter.

Deyonna Hancock didnt have an easy road to her new career in construction.

Despite being vaccinated, she contracted Covid-19 three times, which slowed her training and path to a job.

She also had to break into a field where she is a rarity only 4.5 percent of construction laborers nationwide are women.

But Hancock enjoys the work. One of her instructors told The New York Times that Hancock caught everything everyone else missed. And, as Hancock painted, she hummed.

Read Hancocks powerful story in The Times.

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Whats Next for the Pandemic in California? - The New York Times

(NEXSTAR) With the rise ofthe BA.2 variant of COVID-19, a subvariant of omicron that isalso called stealth omicron, are people who caught the virus in the last wave susceptible again?

Early research indicates its not likely the subvariant will reinfect most people who just caught omicron in this recent wave of cases, but it is possible.

A study of 2 million people in Denmark conducted between November and February found 187 instances of reinfection. Of those 187 cases, 47 were people who had the BA.1 variant, then caught the BA.2 variant.

According to Healthline, the majority of the people in the study who caught both omicron subvariants were young and unvaccinated. They did not have severe cases.

The study has not yet been peer-reviewed.

Eric Feigl-Ding, an epidemiologist and former Harvard researcher, raised a warning flag on Twitter in February, citing other early studies that showedomicrons protectiveness from reinfection doesnt last long.

Our results suggest that Omicron-induced immunity may not be sufficient to prevent infection from another, more pathogenic variant, should it emerge in the future, he tweeted, quoting thestudy.

It may seem counterintuitive, but people who only had a mild case of omicron the first time around may also be more likely to get it again.

If you had a mild infection, didnt get a very good immune response, and you get exposed again with a big dose of the virus, its definitely possible, Dr. Stanley Weiss, professor at the Rutgers New Jersey Medical School, told Yahoo.

However, because there is so much similarity between the two subvariants of omicron, many people infected in the most recent winter surge could be protected in the short term.

I think [reinfection] is unlikely because there is so much shared similarity [between the two types] that the minor differences are probably not enough to allow it to evade immunity to omicron, said Dr. Daniel Kuritzkes, head of Brigham and Womens Hospitals infectious disease division, in an interview withWBTS last month.

As with other variants, any added protection you get from a recent omicron infection also wanes over time. Abouttwo-thirds of those infected with omicronin the U.K. were people who had caught the alpha or delta variant in past COVID waves, a study from Imperial College London found.

I suspect over time, yes, you probably can get reinfected. But we dont have that data yet because omicron has only been around since October/November, John Hopkins Senior Scholar, Dr. Amesh Adalja, toldKHOU.

Protection from the COVID vaccines is more reliable, the Centers for Disease Control and Prevention says. A fully vaccinated person who had a breakthrough infection isbest protected against future infection, a recent CDC study found.

Vaccinated and boosted people were also far less likely to have severe symptoms associated with an omicron infection.

The BA.2 subvariant makes up about 23% of COVID-19 cases in the U.S., according to the CDCs last estimate. Epidemiologists point out its presence has been doubling about every week.

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Can you catch the omicron COVID-19 variant twice? - WeAreGreenBay.com

The city of Jilin will lock down some 4.5 million people for three days starting Monday to help curb the spread of Chinas biggest coronavirus outbreak.

China has imposed stay-at-home orders on millions more people in the countrys northeast, as it tries to tackle its biggest coronavirus outbreak in two years.

The country has largely kept the virus at bay since it brought to heel its initial outbreak in 2020 using targeted lockdowns, mass testing and travel restrictions.

However, the Omicron strain of COVID-19 has taken hold in multiple cities across China.

Jilin, the second-biggest city in Jilin province, will lock down about 4.5 million inhabitants for three days from Monday night, local authorities announced.

More than 4,000 new infections were reported across China on Sunday, with two-thirds in Jilin province, which borders Russia and North Korea.

Changchun, Jilin provinces capital, said Saturday it would also tighten restrictions for three days.

On Saturday, China reported its first two COVID-19 deaths in more than a year. The deaths, both in Jilin province, bring the countrys coronavirus death toll to 4,638 since the start of the pandemic.

Both fatalities occurred in elderly patients and were the result of their underlying conditions, Jiao Yahui, an official with the National Health Commission, told a news briefing on Saturday.

One of them had not been vaccinated for COVID-19, she said.

Since March 11, Changchuns nine million people have only been allowed out once every two days to buy food.

The new measures mean only medical personnel and other anti-epidemic workers will be authorised to leave their homes.

Meanwhile, restrictions are being eased in the southern tech hub of Shenzhen, which locked down its 17.5 million residents a week ago.

Public transport will resume fully from Monday, alongside some administrative and business activities, local health authorities said on Sunday.

Non-essential businesses will remain closed and the downtown Futian business district is still under strict anti-COVID measures.

Shenzhen is home to some of Chinas biggest tech firms, meaning any curbs on businesses come at a significant economic cost.

Tens of millions of people are currently in lockdown in other regions and authorities are rushing to create hospital beds, fearing the outbreak could put the healthcare system under strain.

East of the capital Beijing, the city of Tangshan banned traffic for 24 hours on Sunday in an effort to slow the virus spread, and will test all its 7.7 million people.

President Xi Jinping earlier this week urged tighter virus controls at ports of entry and stressed the need to swiftly control local clustered outbreaks.

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Millions in Chinas northeast placed under COVID-19 lockdown - Al Jazeera English

In March 2020, just as COVID-19 cases began to surge in Boston, Massachusetts, Esther Freeman noticed something peculiara deluge of people with discoloured toes requesting appointments. Freeman, director of global health dermatology at Massachusetts General Hospital, had seen these kinds of toes before. The itchy red and purple patches are a classic sign of chilblains, a skin condition that typically appears in cold weather. But usually, she would see one or two cases each winter. Suddenly, I was seeing 15, 20 patients a day, she says. Intriguingly, the surgeseen by physicians around the globeseemed to coincide with the rise of the COVID-19 pandemic.

Yet, when physicians examined people with what the media began calling COVID toes, most didnt test positive for a coronavirus SARS-CoV-2 infection. Scientists were stumped, and have been looking for answers ever since.

The latest study, published on 25 February, is an immunological deep dive, examining 21 people who developed chilblains during the early months of the pandemic in Connecticut. Although the results dont rule out a direct connection between COVID-19 and chilblains, the authors couldnt find any immunological evidence of a past SARS-CoV-2 infection in 19 of those people. The report adds to the argument by some researchers that COVID toe could have been caused by something unrelated to the virus. For instance, it might have arisen from people in lockdown being at home, not wearing shoes and socks, says Jeff Gehlhausen, a dermatologist and immunologist at Yale School of Medicine in New Haven, Connecticut, and first author of the study.

Still, the results raise some very interesting questions that deserve further study, says Freeman, who was not involved in the research. For instance, the study doesnt exclude the possibility that people exposed to the virus could have fought it off using an innate immune responsea first-line defence that would not prompt the body to produce detectable antibodies and T-cells against SARS-CoV-2. So for now, she adds, the mystery remains.

How chilblains arise isnt entirely clear. We think of it as a cold-weather-related injury, says Patrick McCleskey, a dermatologist and researcher at Kaiser Permanente in Oakland, California. We always see some amount of chilblains in the winter, and then it goes down in the summer. Researchers think that the cold probably leads to a restriction in blood flow, causing some cells to die and kicking off an inflammatory process. The purple or red patches that appear on toes (and sometimes fingers, ears or noses) can be itchy, tender or, in some cases, downright painful.

Most of the people in the latest study developed COVID toes between April and May 2020, when COVID-19 cases surged in Connecticut. About one-third reported having some symptoms of COVID-19 before developing the condition, and one-third reported that they had been in contact with a person confirmed or suspected to have been infected with SARS-CoV-2.

The researchers used a variety of methods to look for antibodies and T-cells specific to the coronavirussigns of the body having whats called an adaptive immune response to a pathogen. These people were months past the onset of their chilblains, so their immune systems would have had plenty of time to respond to SARS-CoV-2 if they had been infected. But the team picked up signs of a past infection only in two people, one of whom had initially tested positive.

Many groups have tested people with chilblains for SARS-CoV-2 antibodies, but nobody had looked really into this hypothesis about the T-cell response, Freeman says. The team did a fantastic, really extraordinary job. But she emphasizes that the study is smalland therefore not necessarily generalizableand that much larger epidemiological studieshave shown a connection between chilblains and SARS-CoV-2.

Dermatologist Thierry Passeron, at Cte dAzur University in Nice, France, still thinks COVID toes are triggered by the virus. His team foundthat people who developed chilblains during the pandemic showed evidence of a strong innate immune response. The researchers posit that many people with pandemic chilblains clear the virus in this way, so very few develop antibodies, he says.

Previous studieshave examined whether people with chilblains had been infected with SARS-CoV-2 by taking tissue biopsies and staining the samples with a dye that identifies parts of the virus. Gehlhausen and colleagues tried the stain and found that it stuck to some of their tissue samples. But they also tested the stain on random tissue samples collected before the pandemic, when the virus was not in circulation, and found that it also marked some of those. Our study suggests that there may be a lack of specificity in that staining, Gehlhausen says.

With the link between COVID-19 and chilblains still in question, some researchers point to the lockdown theorythat people spent more time at home barefoot early in the pandemic and got cold feet, literally. Or perhaps all the media coverage of COVID toes led to more people than usual seeking medical attention for the problem.

For Freeman, the case is not yet closed. On one hand, she has seen patients who developed chilblains, justifiably, after walking in flip flops during a snowstorm. On the other hand, she has seen people who test positive for SARS-CoV-2 and then develop chilblains with no other obvious explanation.

The debate has become strangely polarizing, Gehlhausen says. But the hypotheses are not mutually exclusive. Its possible that all these things are true, he says. I am not on any team.

Its also possible the problem might be fading. Were still seeing patients with new chilblains, but it seems to be kind of back to the old background rate, says Yale dermatologist William Damsky, an author on the paper.

In the end, the issue makes for an intriguing scientific debate, but the answer isnt likely to alter how dermatologists treat patients, McCleskey says. Irrespective of whether a person had COVID-19, chilblains generally go away on their own in two or three weeks.

Honestly, I think maybe we can chill out about chilblains, he says.

This article is reproduced with permission and wasfirst publishedon March 162022.

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Are 'COVID Toes' Actually Caused by the Coronavirus? - Scientific American