Category: Corona Virus

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Coronavirus response: Austrian and Italian scientists join forces to strengthen health and safety in workplaces – NATO HQ

May 27, 2021

Today (27 May 2021) marks the launch of a joint project by two Italian and Austrian universities aimed at enhancing health and safety on the workplace, in response to new challenges posed by the COVID-19 global pandemic.

This multi-year initiative supported by the NATO Science for Peace and Security (SPS) Programme involves researchers from the Sapienza University of Rome (Italy) and Graz University of Technology (Austria). Their collaboration caters to the need to develop new detection tools in the context of the ongoing health emergency, but will also contribute to the identification of potential contamination from other toxic bio-agents. Specifically, this project will combine expertise in biophysics, materials science and spectroscopy to propose an innovative monitoring platform based on nanotechnology. The techniques employed by this project are expected to provide a cost-effective, selective and efficient solution to monitor the presence of the coronavirus and other pathogens.

During the launch of the project, H.E. Ambassador Elisabeth Kornfeind, Ambassador of Austria to NATO and to the Kingdom of Belgium, said: The ongoing pandemic has clearly shown that we have to work and cooperate on resilience in a multitude of fields this project clearly fits into this aim. H.E. Ambassador Francesco Maria Tal, Permanent Representative of Italy to NATO, remarked: The complexity of the challenges of the XXI century, such as those resulting from the coronavirus, demonstrates the importance of the link among science, security and safety. The Science for Peace and Security Programme represents a precious resource for the whole Alliance, he added. Since the start of the pandemic, the SPS Programme has been contributing to the Alliances initiatives to build resilience and promote recovery from COVID-19, David van Weel, NATOs Assistant Secretary General for Emerging Security Challenges pointed out.

SPS has been an integral component of NATOs response to COVID-19, and has tapped into its broad network of scientists and research institutions in NATO and partner countries to foster collaborative solutions against the coronavirus. In doing this, it adapted ongoing activities and launched new initiatives to contribute to strengthening diagnosis capacity, enhancing crisis management, and facilitating coordination among first responders.

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Coronavirus response: Austrian and Italian scientists join forces to strengthen health and safety in workplaces - NATO HQ

COVID-19 Has Pushed India’s Junior Doctors To Their Limits – NPR

May 27, 2021

Dr. Shiv Joshi (third from left) with colleagues at the fever clinic where he is a junior doctor in Sevagram, India. Junior doctors are the equivalent of medical residents in the U.S. health system. Dr. Shiv Joshi hide caption

Dr. Shiv Joshi (third from left) with colleagues at the fever clinic where he is a junior doctor in Sevagram, India. Junior doctors are the equivalent of medical residents in the U.S. health system.

MUMBAI Three years ago, when Shiv Joshi was studying to become a doctor at the Mahatma Gandhi Institute of Medical Sciences in central India, he had to choose a specialty. He'd been reading about the Black Death and the Spanish flu, and he wanted to learn how to track infectious diseases through triage, testing and contact tracing. So he decided to specialize in community medicine.

This was in 2018 a century after the 1918 flu pandemic he was reading about, and two years before the coronavirus would become a full-blown pandemic in India.

"Community medicine is about preventing disease in the first place, and then also reacting to it. One of my first assignments was to investigate an epidemic of dengue fever, where an entire village had it," Joshi, 27, recalls. "But I never thought I would find myself in the middle of an actual global pandemic."

When he did, he and his fellow junior doctors the equivalent of medical residents in the U.S. health system were all reassigned to COVID-19 wards. Instead of shadowing more senior specialists, they often found themselves running emergency rooms and clinics and making life-or-death decisions on their own.

"All of a sudden, a lot of additional tasks and responsibilities got shifted to us," he recalls. "I lost two friends who were also doctors, and I'm routinely seeing people dying. Definitely it has been stressful."

Medical attendant Gurmesh Kumawat prepares to administer supplemental oxygen to a coronavirus patient in the emergency ward at the BDM Government Hospital in mid-May in Kotputli, India. Rebecca Conway/Getty Images hide caption

Medical attendant Gurmesh Kumawat prepares to administer supplemental oxygen to a coronavirus patient in the emergency ward at the BDM Government Hospital in mid-May in Kotputli, India.

As India battles the world's biggest and deadliest COVID-19 outbreak, its junior doctors and in some cases, even medical students have been staffing the front lines for more than a year. They're doing the same work as more senior physicians, while those doctors oversee overflowing intensive care units and battle bureaucracy to try to fix supply chains and get deliveries of medical oxygen.

With medical board exams canceled, many junior doctors have been pressed into emergency medicine and critical care, regardless of what they studied. Working 24-hour shifts, they're often the ones who deliver bad news to grieving families and bear the brunt of anger directed at medical professionals due to shortages of oxygen and drugs.

Many have seen more death, suffering and grief in the past year than they expected in an entire career. Indian hospitals rarely provide counseling to their staff. So experts warn these junior doctors may suffer from post-traumatic stress disorder for years to come.

"What this is going to generate is a generation of doctors who are traumatized," says Devika Khanna, a psychiatrist who runs online support groups from her base in London. "That means you're reducing the capacity of medical provision for the future."

"I felt absolutely helpless"

After graduation, Joshi was assigned to a fever clinic in the same town as his medical school Sevagram, a village of about 8,000 people. It's in an impoverished rural area, where illiteracy runs high and medical care is scant. It's also home to one of Mahatma Gandhi's ashrams.

"When the first COVID-19 case arrived in my hospital, I started realizing this problem was going to be huge," Joshi says.

Joshi, 27, in an undated selfie after a long day of work at the fever clinic in Sevagram, a town in a rural area of central India. Dr. Shiv Joshi hide caption

He recalls one of the first times he was left in charge of the clinic. An ambulance pulled up, and the patient's family members piled out, screaming. The patient was a woman who looked extremely unwell.

"I tried to locate her heartbeat, but she was already cold she was in shock. I had to inform my superiors. I didn't think she had a lot of time," Joshi says.

Do something, the patient's relatives pleaded, staring at him.

"But we did not have beds," he says. "Not a single bed was vacant. I mean, that was the time when I felt absolutely helpless."

He called his supervisor, but the supervisor couldn't come. All the higher-ups were too busy with other patients.

"You feel sometimes so stranded. You cannot just say that the patient is not going to survive, to their relatives, because you cannot take their hope away," he says. "Whatever the science we study, the books we read, they do not prepare us for such situations."

Joshi's patient died a half-hour later. He mustered all his strength to deliver the news to her anguished family. It would be the first of dozens of times over the year that he'd have to do so.

Threats of violence in the ER

Rimy Dey, another junior doctor, has faced similar pressures.

Dr. Rimy Dey (left) treats COVID-19 patients in the emergency room of a private hospital in Gurugram, a suburb of New Delhi. Dr. Rimy Dey hide caption

"The physical and mental stress is immense. In a 24-hour shift before the pandemic, we used to see 40 or 50 patients. Right now, we are seeing up to 200 all COVID patients, all critical," Dey says. "And because of the lack of doctors, they've started assigning COVID duties to even medical students third- or fourth-year students who have not even completed their basic medical education!"

Last month, in the wee hours of the morning, a man in his 20s stormed into Dey's emergency room at the hospital where she works in Gurugram, a suburb of India's capital, New Delhi. "Please do something, doctor! Just save my father!" the man shouted.

At the time, hospitals across the capital region were running out of medical oxygen. Hundreds of patients who might have survived COVID-19 were dying because of problems in India's medical supply chains.

The man's father was in the back of a car or an ambulance Dey can't remember which and was hooked up to an oxygen cylinder. But it was running low.

Her hospital had run out of beds, and there was no room for new patients.

"I had to tell him, 'Sir, this cylinder is going to run out of oxygen. We're having a severe crisis,' " Dey recounts. She gave him contacts so he could try other nearby hospitals.

"And that's when the patient's son started telling us, 'If my father dies, you will be responsible for his death! We are going to break this emergency room down.' "

Patients in their beds stared at Dey from behind their oxygen masks wide-eyed, blinking, terrified.

"I was thinking, I did not become a doctor for this to be scared to death while attending to patients," she says.

Dey, 28, in an undated selfie at work at her hospital in a suburb of India's capital. Dr. Rimy Dey hide caption

With help from the hospital's security guards, she was able to defuse the situation. She squeezed the man's father into her emergency room, stabilized him and eventually convinced his son to take him to another hospital with more space.

She doesn't know what happened after that. She has so many patients, she can't follow up on each one.

Afterward, Dey thought about that case for a long time. It troubled her, because the son was right: She had been responsible for his father's care in a health system that was collapsing.

And it often feels like it's collapsing on her shoulders: "I'm checking a patient, declaring a patient dead and then going back [home] and crying for hours," she says.

Lack of support for young doctors

Dey says she often feels angry at India's government for leaving junior doctors overworked and lacking in support. Even before the pandemic, India invested less in public health just above 1% of its gross domestic product than most other countries. (The U.S. spends nearly 18% of its GDP on health, though most of that is private, not public, investment.)

India's government was blindsided by COVID-19's second wave. In January and February, daily caseloads hit record lows. By early March, the country's health minister declared that India was in the "endgame" of the pandemic. Extra wards were disassembled, and lockdown restrictions eased.

Health workers wearing protective gear place a defunct ventilator machine in the corridor of a hospital in mid-May in Amritsar, India. Narinder Nanu/AFP via Getty Images hide caption

Health workers wearing protective gear place a defunct ventilator machine in the corridor of a hospital in mid-May in Amritsar, India.

But new virus variants were circulating even as Prime Minister Narendra Modi presided over huge political rallies and failed to curb a massive Hindu pilgrimage that drew millions of devotees to the banks of the Ganges River.

In April and May, India broke records for the most coronavirus cases and deaths in the world, straining its already understaffed and underfunded health system.

NPR asked Dey and Joshi if their facilities Dey's urban and private, Joshi's rural and public offer them counseling or mental health support. Both say they are unaware of any such resource. In any case, both say, they have no time to devote to therapy.

"Most of the time, it falls on us junior doctors to support one another," Joshi says.

He and his fellow junior doctors try to allay one another's fears. They've been learning on the job while watching their own families and friends fall ill and worrying about their own health.

He and his colleagues belong to a WhatsApp group where they send each other words of encouragement. But the group is also a place where they share grim news stories about fellow junior doctors who've taken their own lives. It seems there are stories like this every month, Dey says.

More than 500 doctors have died in India's second COVID-19 wave, according to the Indian Medical Association, which does not specify how many of those were suicides.

Experts warn the stress these junior doctors describe may have a lasting impact.

Khanna, the London-based psychiatrist, says post-traumatic stress disorder is often compounded by the sense the junior doctors share that government action could have prevented the worst and India's second COVID-19 wave didn't have to be this bad.

"When there's a natural disaster, then trauma is obviously huge. But the PTSD from a man-made disaster is much greater, because there's that sense that people weren't looked after," Khanna says. "If God or the universe did it to you, it's different to if human beings did it to you. It feels so much more personal."

"I have grown ahead of my years"

After more than a year of treating COVID-19 in the rural fever clinic, Joshi recently tested positive for coronavirus antibodies. It means he probably had the virus at some point and didn't realize it. Knowing he's already survived the virus is a relief, he says. He'd spent a year wondering whether he would be able to get a bed in his own hospital if he fell gravely ill.

"That saddens me the most," he says. "How can you work in a hospital, in a pandemic, at your fullest, knowing that if you get infected, there might be nothing available to you?"

Dey's father and brother, back in her home state of Assam, got sick with COVID-19 this winter, and she wasn't able to travel to see them. They've since recovered. But sometimes it feels like only her fellow junior doctors can really understand what she's going through.

A doctor is seen at a facility for COVID-19 patients in April when a New Delhi banquet hall was converted into an isolation center to handle rising cases of infection. Anindito Mukherjee/Getty Images hide caption

A doctor is seen at a facility for COVID-19 patients in April when a New Delhi banquet hall was converted into an isolation center to handle rising cases of infection.

"We've seen a lot more than we should have at our age. When I see old friends from school, they're actually enjoying the lockdown! They're enjoying being at home," she says with a laugh. "And here I am, seeing a lot of death every day and coming back to my room and crying. I think I have grown ahead of my years."

She says her hair is already turning gray. She's 28. But she has no plans to leave medicine.

NPR producer Sushmita Pathak contributed to this report from Hyderabad, India.

Originally posted here:

COVID-19 Has Pushed India's Junior Doctors To Their Limits - NPR

Three Rivers Festival returns after being canceled last year due to coronavirus pandemic – WBOY.com

May 27, 2021

FAIRMONT, W.Va. The Three Rivers Festival is back.

The 42ndannual festival has carnival rides, pageants, educational events, among other things,all scheduledthis year.The weekend has some rain in theforecast,butorganizerssaid they will try their best to put on as many events as planned.

I think that people are going to be happy and ready to get out, as long as we continue to be cautious and safe,John Dodds, member of theThree Rivers Festival Board of Directors,said.

Most of thefestivalseventswerecanceledlast year due tocoronavirus,butorganizershave adapted the event this year for social distancing and cleanliness.

Werevery excited to have an unmodified festival this year, of coursesafetyis a precaution, andeveryonessafetyis our greatest concern, so weveconsulted with the health department on virtually all aspects of the festival,from the parade to the music, the events, the carnival, Doddssaid. We still encourage people toparticipateinwhateverlevels that theyseemto be comfortable with. Weve reduced theamountof commercial vendorsat thecarnival area, to get moredistancingspace, so things are not as crowded. But, Im excited to get out in the community, see the community members and get back to a new sense of normal.

Dodds has been helping with the Three Rivers Festival for two years. In his first year, he was a volunteer, but this year he is serving on the boardof directors. Doddssaid that most of the people who help with thefestival are unpaidvolunteers.

The full list of events can be found here.

The rest is here:

Three Rivers Festival returns after being canceled last year due to coronavirus pandemic - WBOY.com

Effects of Coronavirus Disease Pandemic on Tuberculosis Notifications, Malawi – CDC

May 27, 2021

Disclaimer: Early release articles are not considered as final versions. Any changes will be reflected in the online version in the month the article is officially released.

Author affiliations: Malawi Liverpool Wellcome Clinical Research Programme, Blantyre, Malawi (R. Nzawa Soko, R.M. Burke, H.R.A. Feasey, W. Sibande, M. Nliwasa, M.Y.R. Henrion, M. Khundi, A.T. Choko, T.H. Divala, E.L. Corbett, P. MacPherson); London School of Hygiene and Tropical Medicine, London, UK (R. Nzawa Soko, R.M. Burke, H.R.A. Feasey, M. Khundi, T.H. Divala, E.L. Corbett, P. MacPherson); University of Malawi College of Medicine, Blantyre (M. Nliwasa); Liverpool School of Tropical Medicine, Liverpool, UK (M.Y.R. Henrion, P. MacPherson); University of Sheffield, Sheffield, UK (P.J. Dodd, C.C. Ku); District Health Office, Blantyre (G. Kawalazira)

Tuberculosis (TB) is a major killer, causing 1.4 million deaths worldwide annually (1), making it second only to coronavirus disease (COVID-19) as the biggest cause of infectious disease deaths in 2020 (2). In addition to the direct health effects of COVID-19, the secondary effects of the COVID-19 pandemic, including lockdowns, economic turmoil, healthcare worker illness and attrition, overwhelmed health facilities, and fear of healthcare facilities, might affect delivery of health services (3). Concerns have been raised that COVID-19 could adversely affect TB disease diagnosis, treatment, and prevention, reversing recent progress in improving TB case detection and reducing deaths, although protective measures used for COVID-19 also could reduce TB transmission (1,3,4). Initial modeling published in May 2020 suggested that healthcare service disruption worldwide could lead to 6.3 million additional TB cases and 1.4 million additional TB deaths from 2020 through 2025 because of TB underdiagnosis and interruptions in TB treatment (5). Empirical data from settings with high TB burdens are urgently needed to examine the effects of COVID-19 on TB and to determine mitigation strategies (4).

According to the World Health Organization, Malawi is 1 of 30 countries that have high TB and HIV burdens (1). In Blantyre, in the southern region of Malawi, a citywide electronic TB register has been maintained in partnership by the Malawi Liverpool Wellcome Trust, Malawi National Tuberculosis Control Programme, and Blantyre District Health Office (6). We used these data to investigate the effects of COVID-19 on citywide TB case notifications. We hypothesized that the direct and indirect effects of the COVID-19 epidemic in Malawi would reduce TB case notifications and that effects might have been experienced disproportionately at different health system levels and by certain population groups, including persons living with HIV. Our primary objective was to estimate the number of missed TB case notifications. Our secondary objective was to determine whether missed notifications were affected by sex, health facility, or HIV status. Finally, to investigate and explain the underlying causes of under notification of TB, we performed a qualitative study with TB officers, the cadre of healthcare workers who provide most TB services in Malawi.

To estimate population denominators for Blantyre District, we obtained age- and sex-specific background mortality rates and fertility rates from 20082020 World Population Prospect data (7). We used the cohort-component method to combine these data into local estimates from the 2008 and 2018 Malawi national population censuses.

In Blantyre, TB officers working at all primary health centers and the citys main hospital, Queen Elizabeth Central Hospital (QECH), record demographic and clinical characteristics of all TB patients who register for treatment by using an electronic case record form. Data collected includes date and clinic of registration, age, sex, HIV status, residential address, and TB characteristics, such as pulmonary versus extra-pulmonary TB and microbiological classification. Records are reconciled with the Ministry of Health National Tuberculosis Control Programme treatment registers every quarter. Each month, a randomly selected 5% sample of registered TB cases undergo home tracing for data validation purposes.

To investigate the effects of COVID-19 on TB case notification in Blantyre, we conducted an interrupted time series analysis (8). The Malawi government declared a state of emergency due to COVID-19 on the March 23, 2020, and the first COVID-19 cases were diagnosed on April 2, 2020. We assumed that COVID-19 restrictions and the government and public response to the emerging epidemic would cause both an immediate step change in TB case notifications and a slope change leading to different month-by-month trends than those seen before COVID-19 (8). Using a negative binomial distribution to account for overdispersion, we modeled monthly counts of TB cases as a function of month, COVID-19, and month-given-COVID-19, with an offset term to account for underlying population (Appendix). We used TB notification data from June 2016, when the country began a universal test-and-treat program to provide antiretroviral therapy for persons with HIV and started using the Xpert MTB/RIF assay (9), which rapidly diagnoses Mycobacterium tuberculosis, the bacterium that causes TB disease, and rifampin resistance in <2 hours (10).

We estimated trends in TB case notification rates (CNRs) by using estimated Blantyre census population denominators to convert model-fitted monthly numbers of notified cases to annualized equivalent cases per 100,000 population. We used the model to predict TB CNRs from April 2020 on under a counterfactual situation in which COVID-19 had not occurred and background trends from April 2016 and March 2020 continued linearly. We defined numbers of missed TB cases as the difference between the observed numbers of notified cases and numbers expected under the counterfactual noCOVID-19 situation, acknowledging that some of the missed cases might be diagnosed later and thus be delayed rather than entirely missed. We estimated the 95% CI for the total number of missed TB cases through 1,000 parametric bootstrap replications. We took observed cases as-is and predicted cases under the counterfactual scenario from a normal distribution on the link scale with the mean equal to model prediction for given month under the counterfactual and SD equal to model SE for predictions for the given month under the counterfactual scenario.

For the secondary objective, we modeled the differential effect of COVID-19 on TB case notifications by sex, HIV status, and whether TB was diagnosed at the QECH or primary care level (Appendix). Because a small amount of data were missing for HIV status and sex, we performed multiple imputations using chained equations with predictive mean matching by using the mice package in R software (11).

All decisions about the expected effect model (i.e., a step and slope change), the date of change (i.e., April 2020), and the covariates in model 2 (i.e., age, sex, and primary care vs. QECH) were made a priori on the basis of knowledge about likely effects of COVID-19 and covariates known to differentially affect access to TB healthcare (12). To assess the statistical significance of the change in TB notifications concurrent with COVID-19 epidemic in Malawi, we extracted residuals from a regression that did not model changes due to COVID-19. We compared the sum of the residuals for the 9 months during the COVID-19 epidemic in Malawi, AprilDecember 2020, with the distribution of this statistic from 1 million randomly permuted residuals. We also computed this statistic for all 9-month windows, excluding COVID-19 within the data.

TB exhibits seasonality related to climate and weather conditions (13). Therefore, we performed a sensitivity analysis by adding seasonal effects to the interrupted time series model by using a harmonic term with 2 peaks every 12 months.

During October 21December 14, 2020, we conducted in-depth interviews with 12 TB officers from healthcare facilities in Blantyre, 2 from QECH and 10 from primary healthcare centers, to ascertain the main reasons for changes in TB case notifications during the COVID-19 pandemic. A local social scientist with experience of qualitative interviewing conducted interviews in Chichewa, the local language. Data were recorded and simultaneously transcribed and translated to English. We developed a thematic framework from the initial 4 interviews, which we applied across all subsequent interviews. Coding and data analysis were done using NVIVO (QSR International, https://www.qsrinternational.com). Interviews were continued until saturation of themes was reached. We did not interview persons attending clinics to receive healthcare.

Participants provided oral consent for their data to be recorded in the enhanced surveillance dataset. A waiver of requirement for written consent was approved by London School of Hygiene and Tropical Medicine and College of Medicine, University of Malawi, both of which provided ethical approval for the Blantyre enhanced TB surveillance system and qualitative interviews. TB officer participants in the in-depth interviews provided informed written consent.

During June 2016December 2020, a total of 10,274 TB cases were notified in Blantyre. During June 2016March 2020 (i.e., before COVID-19), annualized Blantyre TB CNRs fell by 1% per month, reaching a peak of 405 cases/100,000 persons in November 2016 and declining to 137 cases/100,000 persons in October 2019. A total of 9,199 TB cases were notified in Blantyre during the preCOVID-19 period (June 2016 to December 2020), 3,561 among women and girls and 5,611 in men and boys; 27 cases were missing data on sex. Persons living with HIV represented 5,820 (63.3%) TB notifications and 3,279 (35.6%) HIV-negative persons were among notified TB cases; 100 TB cases had missing data or unknown HIV status. TB notifications were split almost evenly between QECH (4,889 notifications; 53.1%) and primary health facilities (4,310 notifications; 46.9%). Children <14 years of age comprised 920 (10%) notifications. The median age among adults with diagnosed TB was 35 (interquartile range [IQR] 2844) years for women and 37 (IQR 3045) years for men.

Figure 1

Figure 1. Effects of coronavirus disease (COVID-19) pandemic on monthly TB case notification rates in Blantyre, Malawi. Circles represent the observed number of cases each month. Solid blue linerepresents the fitted model...

The declaration of a national COVID-19 disaster led to an abrupt 35.9% (95% CI 22.1%47.3%) decline in TB notifications in April 2020 (Figure 1). However, subsequent TB notifications increased at a rate of 4.40% (95% CI 0.59%8.36%) per month. The effect of the initial decline at the start of the COVID-19 pandemic was that observed Blantyre TB annualized CNRs preCOVID-19, in March 2020, were 240 cases/100,000 persons and rates after the COVID-19 disaster declaration were 152 cases/100,000 persons in April 2020. By comparison, the predicted April CNR in the counterfactual scenario without COVID-19 was 230 cases/100,000 person-years. However, by November 2020, observed Blantyre TB CNRs were 205 cases/100,000 person-years and December 2020 rates were 156 cases/100,000 person-years, compared with a predicted CNR of 213 cases/100,000 person-years in November and 211 cases/100,000 person-years in December in the counterfactual scenario.

During AprilDecember 2020, a total of 1,075 TB cases were notified in Blantyre, equivalent to 196 cases/100,000 person-years (Table 1). Under the counterfactual situation of no COVID-19 epidemic, we would expect 1,408 (95% CI 1,3661,451) TB cases would have been notified, equivalent to annualized case notification rate of 221 cases/100,000 person-years. Therefore, we estimate that the COVID-19 epidemic directly and indirectly led to 333 (95% CI 291376) fewer TB notifications, a 23.7% (95% CI 21.4%26.0%) reduction in TB notifications.

Figure 2

Figure 2. Effects of coronavirus disease (COVID-19) on monthly TB case notifications in Blantyre, Malawi, by HIV status, registration site, and sex. A) TB notifications at primary healthcare centers. B) TB notifications...

As a secondary objective, we modeled which population groups were most affected by disruption to TB services (Figure 2). This model incorporated sex, HIV status, and healthcare facility (QECH vs. primary care clinics) and estimated that 352 (95% CI 319385) TB cases were missed during AprilDecember 2020. Men and boys accounted for a slightly larger number of missed TB diagnoses with 183 (95% CI 158209) missed cases compared with 170 (95% CI 151188) missed cases among women and girls. However, women and girls had a larger proportional decline, 30.7% (95% CI 28.4%33.0%) than did men and boys, 20.9% (95% CI 18.5%23.3%). Notifications at primary healthcare centers also were disproportionately reduced compared with hospital notifications, as were notifications for HIV-negative persons compared with those living with HIV (Table 2). The nonoverlapping confidence intervals for these groups indicated statistically significant differences in effects of COVID-19 by gender, HIV status, and healthcare setting.

The drop in TB notifications during AprilDecember 2020 was greater than that for any other 9-month period observed, and the sum of the residuals during this period was more negative than expected by random chance (p = 0.004). The sum of residuals in other 9-month periods was significantly more negative than anticipated from random resampling (p<0.05), indicating a unique statistically significant drop in cases during AprilDecember 2020. Sensitivity analysis around seasonality of TB did not materially affect the conclusions.

Of the 12 in-depth interviews with healthcare providers, 9 participants were female and 3 were male; ages were 3453 years. Most (10/12) participants had secondary-level education. Themes that emerged from the in-depth interviews related to both an overall reduction in persons attending health facilities and to TB-specific issues.

In addition to reduced attendance at healthcare facilities among the general public from fear of being infected with COVID-19, participants mentioned that several healthcare workers tested positive for COVID-19 during the epidemic (Table 2). The facility-based COVID-19 outbreaks led to temporary closures for disinfection. Facility closures not only affected the number of persons attending the health facilities on the days of closure but also led to greater fear of infection at healthcare facilities and, in 1 instance, rumors that the clinic was closed for a longer period than it was (Table 2). Finally, health facility worker strikes and sit-ins over risk allowance payments and lack of personal protective equipment (PPE) also resulted in temporary closures of facilities (Table 2).

Government COVID-19 prevention measures that required use of facemasks and social distancing also were reported to have contributed to reduced access to health services. Mandatory use of face masks at health facilities was introduced during the epidemic, but TB officers cited the inability to afford a mask and the feeling that masks suffocate them as reasons patients did not want to wear masks (Table 2). Patients who tried to attend facilities without having a mask were sent away (meaning that they were not seen by a healthcare worker) and often did not return (Table 2). Public transportation in Blantyre also had a limit on vehicle capacity, which led to doubled transport costs and limited clinic access (Table 2).

Because TB and COVID-19 both have symptoms of cough and fever, TB officers reported issues around TB testing. First, persons with fever and cough reportedly were afraid of being tested for COVID-19 if they went to healthcare facilities. TB officers said patients were more afraid of COVID-19 than TB because they knew that TB could be cured and that patients with COVID-19 might need to be placed under facility isolation (Table 2). The similarity of symptoms also led to persons who normally would have been tested for TB being turned away from healthcare facilities and told to go home and call the COVID-19 help line (Table 2).

TB officers also spoke of their own fear of contracting COVID-19 from presumptive TB patients. TB officers reported changing how they interacted with symptomatic persons, including interacting less directly and not supervising sputum collection as closely (Table 2). In addition, many TB officers reported that the lack of PPE in health facilities forced them to temporarily stop conducting TB tests or supervising sputum collection at all. For those patients who did submit sputum, results could be delayed because, as a TB officer reported, laboratory staff were taught that sputum has the highest concentration of COVID-19 (Table 2).

In addition to directly causing millions of deaths, the COVID-19 pandemic has directly and indirectly affected delivery of health services globally (14). In our analysis of the effects of the COVID-19 pandemic on TB notifications in Blantyre, Malawi, we found a substantial immediate decline in TB case notifications concurrent with the start of the COVID-19 epidemic in Malawi. Our findings are consistent with initial reports on COVID-19 effects on HIV and TB diagnosis and care from other settings (1522). However, we show that, after an initial decline, TB CNRs increased and reached near prepandemic levels within 9 months. Overall, we estimate that 333 fewer cases of TB were notified, equivalent to 39 cases/100,0000 persons, during AprilDecember 2020 than would have been expected in the absence of the COVID-19 epidemic. For the affected persons, the missed or delayed diagnoses likely will have severe consequences, and for public health programs the consequences might hinder progress toward TB elimination. The reduction in TB case notifications also could be indicative of more general disruption of a range of primary healthcare services.

To put these results into context, Malawi has high HIV and TB burdens. Estimated prevalence of TB in urban Malawi was 988 cases/100,000 persons at the last national survey in 2013 (4). TB in Malawi is declining in response to concerted efforts from the national and district TB and the HIV programs. In June 2016, Malawi introduced a test-and-treat program for HIV, which involved starting antiretroviral therapy for persons who had positive HIV tests regardless of CD4 cell count. Malawi is coming close to achieving United Nations AIDS/HIV 90-90-90 goals (23). However, TB remains one of the leading causes of death and years of life lost in Malawi (24).

We hypothesize that the major reason for the drop in TB notifications during the COVID-19 pandemic is that persons with true TB disease had their TB diagnosis missed or at least delayed. This hypothesis is consistent with data from our qualitative interviews with TB officers, who noted that, in the immediate period after the Malawi COVID-19 epidemic began, access to health facilities was extremely challenging. Alternative explanations are that persons with diagnosed TB started on treatment, but their cases were not notified to the national program, or that the true incidence of TB declined. However, we consider these explanations unlikely. TB treatment cannot be accessed in Malawi outside of TB registration centers, and our electronic TB surveillance system is cross-referenced with paper ledgers that confirm the same trends in notifications. Reduced incidence of other respiratory pathogens, notably influenza, has resulted from the nonpharmaceutical interventions for COVID-19, which possibly also resulted in a decline in TB transmission. However, the prolonged interval between infection and onset of symptoms for TB makes an immediate effect on notifications in <3 months implausible, particularly because Malawi has had less stringent COVID-19 prevention measures than many other countries.

Our qualitative interviews indicate that, in addition to general restrictions on healthcare access during the COVID-19 epidemic, TB testing and notifications particularly were affected because of the similarity in clinical presentation of TB and COVID-19. The TB officers considered that persons with TB symptoms were less likely to attend facilities for fear of a COVID-19 diagnosis and possible consequences, such as isolation. In addition, TB officers believed that at least some persons with possible TB who went to healthcare facilities were turned away and directed to COVID-19specific services where they would be unlikely to be assessed for TB. In countries with high TB burdens, alignment of COVID-19 and TB diagnosis, prevention, and care will likely lead to improved outcomes for both diseases.

Women and girls had disproportionately higher reductions in case notifications than men and boys, as did HIV-negative compared with HIV-positive patients and notifications from primary care clinics compared with the central hospital. We hypothesize that women and girls faced greater barriers to accessing healthcare during COVID-19 than men and boys because of greater requirements of women to stay home to school children; social gender norms, meaning that men were more likely to disregard COVID-19 public health restrictions; and perhaps economic requirements for men leave the house to work, meaning men could more easily continue to access TB services (25).

Primary healthcare centers were more affected than QECH, both in terms of initial step change (drop in TB cases notified at the start of COVID-19) and with slower recovery in the period after the initial phase of COVID-19 epidemic in Malawi. Reasons for the difference in reporting rates could include QECH being prioritized for PPE, thus remaining more functional than healthcare centers; in addition, patients with TB diagnosed at QECH tend to have more severe illness and potentially were unable to delay seeking healthcare.

TB cases among HIV-negative persons declined more than among persons living with HIV, which also could be associated with site of TB diagnosis. QECH has the largest number of HIV-positive persons registered for antiretroviral therapy in the city, and so persons living with HIV may have accessed TB services through the ART clinic. Alternatively, persons living with HIV can have more severe TB symptoms and be less able to defer healthcare seeking.

Limitations to our study include uncertainty around the counterfactual conditions; during June 2016 March 2020, TB case notifications were declining in Blantyre, and for the counterfactual condition, no COVID-19 scenario we modeled TB notifications as continuing to decline at the same rate. Since December 2020, Malawi has had a second wave of COVID-19. Our electronic enhanced surveillance data are entered in real time, but data are monitored and verified on a quarterly basis, so we do not yet have information on the effects of the second wave of COVID-19 in Malawi. Finally, we only interviewed healthcare workers; we did not directly capture perspectives of patients about their difficulties accessing healthcare.

Malawi is fortunate to have well-functioning TB and HIV programs that are more resilient to COVID-19 than programs in other countries. Malawi did not introduce any substantial restrictions on population movement and gathering due to COVID-19, so no legal restrictions hindered travel to TB clinics. Therefore, our data are not necessarily generalizable to other settings in southern Africa or elsewhere.

In conclusion, the effects of missed or delayed TB diagnoses likely will be severe for affected persons and households. However, the initial COVID-19related decline in TB case notification was not sustained, and the Malawi National Tuberculosis Control Programme had a relatively quick recovery after the first wave of COVID-19. We observed a shorter period of disruption than earlier modeling of COVID-19 effects on TB assumed (5). COVID-19 or TB diagnosis, treatment, care, and public health measures should not be considered in isolation. Rather, public health and healthcare officials should seek opportunities to combine resources to tackle both COVID-19 and TB. Through improved infection prevention and control at health facilities, strengthened laboratory infrastructure, and community engagement to address stigma and provide sources of information about both diseases, communities can create a setting of universal health coverage.

Dr. Burke is a medical doctor and research fellow at London School of Hygiene and Tropical Medicine and the Malawi Liverpool Wellcome Trust. She researches HIVassociated TB, public health effects of TB diagnostics and reducing deaths among hospitalized adults with HIV in southern Africa. Ms. Nwanza Soko is studying for her masters of science degree at London School of Hygiene and Tropical Medicine and is a data manager at Malawi Liverpool Wellcome Trust. Her research interest is TB epidemiology in Malawi.

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Suggested citation for this article: Nwaza Soko R, Burke RM, Feasey HRA, Sibande W, Nliwasa M, Henrion MYR, et al. Effects of coronavirus disease pandemic on tuberculosis notifications, Malawi. Emerg Infect Dis. 2021 Jul [date cited]. https://doi.org/10.3201/eid2707.210557

The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.

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Effects of Coronavirus Disease Pandemic on Tuberculosis Notifications, Malawi - CDC

Another Mainer has died and 162 more coronavirus cases are reported across the state – Bangor Daily News

May 27, 2021

Another Mainer has died as health officials on Wednesday reported another 162 coronavirus cases across the state.

The number of coronavirus cases diagnosed in the past 14 days statewide is 2,546. This is an estimation of the current number of active cases in the state, as the Maine CDC is no longer tracking recoveries for all patients. Thats down from 2,686 on Tuesday.

That marks a sharp rebound in infections following a dayslong slide when new cases slipped below 100 for the first time in months, reaching lows not seen since last October. Its not yet clear whether the current downward trend represents an overall decline in transmission with more than half the states population fully vaccinated.

But the general decline from the late winter surge has many in the state feeling optimistic about a full economic recovery ahead of the start of Maines summer tourist season this weekend. A former epidemiologist told the Bangor Daily News that another surge is unlikely barring the emergence of a new variant or something really untoward.

A woman in her 70s from Cumberland County has succumbed to the virus, bringing the statewide death toll to 825.

Wednesdays report brings the total number of coronavirus cases in Maine to 67,294, according to the Maine CDC. Thats up from 67,132 on Tuesday.

Of those, 49,298 have been confirmed positive, while 17,996 were classified as probable cases, the Maine CDC reported.

The new case rate statewide Wednesday was 1.21 cases per 10,000 residents, and the total case rate statewide was 502.79.

Maines seven-day average for new coronavirus cases is 142.7, down from 148.7 a day ago, down from 225.6 a week ago and down from 360 a month ago. That average peaked on Jan. 14 at 625.3.

The most cases have been detected in Mainers younger than 20, while Mainers over 80 years old make up the majority of deaths. More cases and deaths have been recorded in women than men. For a complete breakdown of the age and sex demographics of cases, hospitalizations and deaths, use the interactive graphic below.

So far, 1,989 Mainers have been hospitalized at some point with COVID-19, the illness caused by the new coronavirus. Of those, 118 are currently hospitalized with 43 in critical care and 20 on a ventilator. Overall, 78 out of 386 critical care beds and 232 out of 319 ventilators are available. Meanwhile, 473 alternative ventilators are available.

The total statewide hospitalization rate on Wednesday was 14.86 patients per 10,000 residents.

Cases have been reported in Androscoggin (8,207), Aroostook (1,837), Cumberland (17,049), Franklin (1,331), Hancock (1,333), Kennebec (6,422), Knox (1,123), Lincoln (1,048), Oxford (3,543), Penobscot (6,072), Piscataquis (555), Sagadahoc (1,454), Somerset (2,169), Waldo (1,011), Washington (876) and York (13,264) counties.

For a complete breakdown of the county by county data, use the interactive graphic below.

Out of 6,517 COVID-19 tests reported to the Maine CDC in the previous 24 hours, 2.3 percent came back positive. Overall, 2,622,789 tests have been administered and the statewide positivity rate is 2.81 percent.

An additional 2,905 Mainers have been vaccinated against the coronavirus in the previous 24 hours. As of Wednesday, 706,853 Mainers have received a first dose of the vaccine, while 682,978 have received a final dose.

New Hampshire reported 79 new cases on Wednesday and no deaths. Vermont reported nine new cases and no deaths, while Massachusetts reported 228 new cases and 10 deaths.

As of Wednesday morning, the coronavirus had sickened 33,168,275 people in all 50 states, the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands and the U.S. Virgin Islands, as well as caused 591,035 deaths, according to the Johns Hopkins University of Medicine.

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Another Mainer has died and 162 more coronavirus cases are reported across the state - Bangor Daily News

U.S. Covid cases down more than 50% since start of May as the country averages 1.7 million daily vaccine shots – CNBC

May 27, 2021

Average daily Covid case counts in the U.S. are at less than half of the level recorded at the start of May, data compiled by Johns Hopkins University shows.

The country is seeing an average of 23,407 new infections per day over the past week, down from about 49,600 on May 1, a 53% drop.

Federal data shows the U.S. is reporting an average of 1.7 million daily vaccinations, and nearly 50% of the U.S. population has received one dose or more.

The seven-day average of daily U.S. Covid cases is 23,407 as of Wednesday, according to Johns Hopkins data, down 23% from a week ago and 53% from the start of the month.

Case counts have not been this low since June 2020.

Average daily case counts have fallen by 5% or more in 44 states and the District of Columbia over the past week, a CNBC analysis of Johns Hopkins data shows.

Elsewhere, outbreaks are worsening. India is currently the epicenter of the global coronavirus pandemic, but other countries from Argentina in Latin America to Nepal in Asia have also reported record increases in Covid cases in the last few weeks.

The country is reporting an average of 571 daily Covid deaths over the past seven days, according to Johns Hopkins data.

Wednesday's figures include 373 deaths reported for Oklahoma, which the state announced is part of an "ongoing effort to investigate and reconcile backlog of COVID-19 related deaths." In some situations, state health departments will attribute a batch of previously unreported cases or deaths to a single day, even if those may have occurred previously.

While this reporting issue makes the latest trend more difficult to interpret, the pace of daily nationwide Covid deaths has been on the decline for weeks.

About 1.7 million vaccine shots have been reported administered each day on average over the past week, CDC data shows, down 5% from one week ago.

Daily vaccinations have been on a mostly downward trend since peaking at 3.4 million shots per day in mid-April, though the average has hovered between 1.7 million and 2 million for nearly two weeks.

Nearly half of the U.S. population has received at least one dose of a vaccine with 40% fully vaccinated, CDC data shows.

On Wednesday, Pennsylvania became the 10th state to report that 70% of its adult population is at least partially vaccinated. The other nine states are Vermont, Hawaii, New Hampshire, Massachusetts, Connecticut, Maine, New Jersey, Rhode Island and New Mexico.

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U.S. Covid cases down more than 50% since start of May as the country averages 1.7 million daily vaccine shots - CNBC

Is Nose Burning a Symptom of Coronavirus? What to Know – Healthline

May 26, 2021

COVID-19 is a highly contagious respiratory disease first discovered in late 2019, caused by the coronavirus (SARS-CoV-2).

The majority of people with COVID-19 develop mild symptoms such as a cough, fever, and fatigue. People over age 65 and people with underlying health conditions like diabetes or obesity are at the highest risk of developing a severe case.

COVID-19 can cause nasal symptoms similar to upper respiratory infections, such as a stuffy or runny nose. Some anecdotal reports and case studies also describe people with COVID-19 developing a nose burning sensation.

Keep reading as we take a deeper look at whether a burning sensation in your nose is a common symptom of COVID-19. Well also take a look at how the symptoms of COVID-19 compare with those of other respiratory infections and allergies.

Burning in your nose can potentially be a symptom of COVID-19, but its not one of the most common symptoms. The only medical studies examining nose burning are isolated case studies. So, at this time, its not clear how frequently people experience it.

A burning sensation in your nose can be caused by inflammation in your sinuses from a sinus infection. Viruses, fungi, and bacteria can cause sinus infections.

One August 2020 study of 1,773 people with COVID-19 found that 4.1 percent developed nasal congestion and 2.1 percent developed a runny nose. These conditions can lead to a blockage of the sinuses that encourages the growth of bacteria or fungi.

Sinus infections dont seem to be common among people with COVID-19, but a few case reports have noted them.

A study published in the Journal of Surgical Case Reports in March 2021 describes a 52-year-old man with COVID-19 who developed a severe sinus infection that led to erosion of bone on the floor of his sinus and complications in his right eye.

It was unclear if COVID-19 was the only cause of or a contributing factor to the infection. However, negative fungal and bacterial cultures suggest that COVID-19 may have played a major role.

A February 2021 study examined three people with COVID-19 requiring intensive care, who developed fungal sinus infections. Fungal sinus infections have a high mortality rate among immunocompromised people. All three people in the study died from other COVID-19 complications.

Again, most people dont appear to get a sinus infection from COVID-19.

According to an April 2020 review, researchers think that COVID-19 enters your cells through an enzyme called angiotensin-converting enzyme 2 (ACE-2). ACE-2 is found in as high a concentration in your nasal cavity as well as any other part of your upper respiratory or digestive tract.

ACE-2 is also found in other parts of your body, such as your gastrointestinal tract, lungs, blood vessels, and heart.

The highest concentration of ACE-2 in your nose is found in mucus-producing goblet cells and ciliated epithelial cells, which are cells that line the tract of your nasal cavity.

Researchers have also found that COVID-19 also needs a protein called TMPRSS2 to optimally enter a cell. TMPRSS2 has also been identified in the cells that line your nose, according to June 2020 research.

Mouse studies have found that reducing levels of this protein in mice led to decreased replication of the COVID-19 virus.

According to a 2021 study published in the American Journal of Otolaryngology, about 33 percent of people with COVID-19 have mild symptoms affecting the nose, such as loss of smell or taste.

Loss or reduction of taste and smell are frequently reported as early symptoms of COVID-19. One July 2020 study found that 73 percent of people reported a loss of smell prior to COVID-19 diagnosis and 26.6 percent of people reported it as the initial symptom.

Other nasal symptoms linked to COVID-19 include:

According to the World Health Organization, the most common symptoms of COVID-19 are:

Less common but still frequently reported symptoms include:

The symptoms of COVID-19 are similar to the symptoms of other upper respiratory infections and allergies.

Heres a look at how the typical symptoms of COVID-19, the flu, colds, and allergies compare.

A few key symptoms may help identify your condition:

Most people with COVID-19 develop mild symptoms. Mild COVID-19 can be treated at home by:

Its important to isolate yourself as much as possible and to avoid public areas.

According to the Centers for Disease Control and Prevention (CDC), most adults can stop isolating 10 days after symptom onset and 24 hours after their fever is gone without the use of medication.

Its important to seek immediate medical attention if you or a loved one have emergency symptoms of COVID-19. Many hospitals have separate wings dedicated to treating COVID-19 and take walk-ins.

The CDCs list of emergency symptoms includes:

People with dark skin may have more difficulty noticing discoloration in their nails, lips, or skin. Discoloration in these areas suggests oxygen deprivation.

A burning sensation in your nose can potentially be a sign of COVID-19, but its not a typical symptom.

Some people with COVID-19 develop a runny or stuffy nose. These conditions can lead to a sinus infection that can cause inflammation and a burning sensation.

The symptoms of COVID-19 are similar to the symptoms of other upper respiratory infections and allergies. A fever isnt a symptom of allergies and might be a sign youre dealing with a viral infection.

If you think you have COVID-19, its important to isolate yourself from other people and seek medical attention if you develop severe symptoms.

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Is Nose Burning a Symptom of Coronavirus? What to Know - Healthline

Half Of All U.S. Adults Are Now Fully Vaccinated Against COVID-19 – NPR

May 26, 2021

Nearly 130 million U.S. adults have completed their vaccine regimens, the CDC says, with another 70 million vaccine doses currently in the distribution pipeline. Here, Maryland National Guard Brig. Gen. Janeen Birckhead greets soldiers last week at a mobile vaccine clinic in Wheaton, Md. Chip Somodevilla/Getty Images hide caption

Nearly 130 million U.S. adults have completed their vaccine regimens, the CDC says, with another 70 million vaccine doses currently in the distribution pipeline. Here, Maryland National Guard Brig. Gen. Janeen Birckhead greets soldiers last week at a mobile vaccine clinic in Wheaton, Md.

The U.S. COVID-19 vaccination program has gone from zero to 50% in less than six months.

As of Tuesday afternoon, the Biden administration said, half of the country's adults are now fully vaccinated against the coronavirus.

"This is a major milestone in our country's vaccination efforts," Andy Slavitt, a White House senior adviser on the COVID-19 response, said during a midday briefing. "The number was 1% when we entered office Jan. 20."

Nearly 130 million people age 18 and older have completed their vaccine regimens since the first doses were administered to the public in December, the Centers for Disease Control and Prevention said. Another 70 million vaccine doses are currently in the distribution pipeline, according to the agency.

Vaccinations have risen sharply in children 12 years and older, weeks after the Food and Drug Administration said that cohort is eligible to receive the COVID-19 vaccine made by Pfizer-BioNTech. Nearly 5 million adolescents have received at least one dose of the vaccine, according to the CDC's latest data.

The U.S. is pushing to add millions more people to the ranks of the vaccinated. President Biden said this month that his new goal is to administer at least one dose of a COVID-19 vaccine to 70% of U.S. adults by the Fourth of July.

Nine states have given at least one vaccine shot to 70% of their adult population, Slavitt said at Tuesday's briefing. Acknowledging the welcome return to a more normal life taking place around the country, he urged more people to get the vaccine: "Unless you're vaccinated, you're at risk."

An increasing number of states, businesses and organizations are offering incentives for people to get vaccinated, from free doughnuts to free airline flights. One of the best-known programs is in Ohio, where people who get vaccinated are entered into a $1 million lottery called the Ohio Vax-a-Million.

"Gov. Mike DeWine has unlocked a secret," Slavitt said, noting that Ohio's vaccination rate went up 55% among young adults in the days after unveiling the program. Other states have since announced similar plans.

The stunning speed of the vaccines' development and rollout has helped tame COVID-19 in the U.S., which remains the worst-hit country in the world, despite having less than 5% of the world's population. The U.S. has reported more than 33 million COVID-19 cases, and more than 590,000 people have died from the disease.

Vaccination rates vary sharply across the nation. On the state level, more than half of all adults were fully vaccinated in just 25 states, along with the District of Columbia and Guam, as NPR's Laurel Wamsley reported.

The lowest overall vaccination rates in the U.S. remain in the South, where Mississippi, Alabama, Louisiana and Arkansas have administered the fewest doses per 100,000 adults, according to the CDC. The highest rates are in Vermont, Massachusetts, Hawaii and Connecticut.

Pfizer and BioNTech's vaccine is the most prevalent in the U.S., with more than 155 million doses administered, the CDC said. Moderna is next, with nearly 122 million doses. Johnson & Johnson, whose one-dose vaccine was approved after the two messenger RNA vaccines, accounts for more than 10 million doses.

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Half Of All U.S. Adults Are Now Fully Vaccinated Against COVID-19 - NPR

Moderna’s COVID-19 Vaccine Is Safe And Effective For Teens, Company Says – NPR

May 26, 2021

Moderna says clinical trials showed its COVID-19 vaccine is effective for children from age 12 to 17, with mostly mild or moderate side effects. Here, a syringe is filled with a dose of the Moderna coronavirus vaccine in Wheaton, Md. Chip Somodevilla/Getty Images hide caption

Moderna says clinical trials showed its COVID-19 vaccine is effective for children from age 12 to 17, with mostly mild or moderate side effects. Here, a syringe is filled with a dose of the Moderna coronavirus vaccine in Wheaton, Md.

Trials of Moderna's COVID-19 vaccine show that it's safe and effective for teenagers, the company said Tuesday a finding that could boost supply ahead of the new school year's start this fall.

"We will submit these results to the U.S. [Food and Drug Administration] and regulators globally in early June and request authorization" for use in kids from age 12 to 17, Moderna CEO Stphane Bancel said.

The company announced the positive results roughly two weeks after the FDA said children 12 to 15 years old are now eligible to receive the Pfizer-BioNTech vaccine.

At the time, Dr. Janet Woodcock, the acting FDA commissioner, said the expansion of Pfizer's vaccine authorization "brings us closer to returning to a sense of normalcy."

Moderna's clinical trial involved 3,732 adolescents, who were given two shots of either the vaccine or a placebo. No participants who got two doses of the vaccine developed COVID-19, compared to four cases in the placebo group.

For the above results, researchers used the same definitions of a COVID-19 case that they used in adult trials. But because adolescents have a lower incidence rate for the disease than adults, the trial also included a second, more expansive definition set by the CDC. That definition includes milder cases, as it requires only one COVID-19 symptom and also a positive test. When that definition was applied, the vaccine's efficacy rate was still 93% after the first dose.

As for potential side effects, Moderna said, "the majority of adverse events were mild or moderate in severity," listing symptoms such as headache, fatigue, muscle pain and chills.

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Moderna's COVID-19 Vaccine Is Safe And Effective For Teens, Company Says - NPR

Coronavirus cases in 2021 are already higher than 2020 worldwide. These seven charts break down the spread. – USA TODAY

May 26, 2021

The world has already reported more coronavirus cases in 2021 than it had in all of 2020, a USA TODAY analysis of Johns Hopkins University data shows.

Through Sunday, the world reported 83.62 million cases this year, up from 83.56 million cases last year.

The trajectory of the number of global cases in 2020 compared with 2021 is startling.

The early months of 2020 reflect the gradual rise and spread of the virus around the world. But since the fall of 2020, the global pace of infections hasn't abated even with 1.7 billion COVID-19 vaccine doses administered.

Confirmed coronavirus cases in India, the United States andBrazilhave outpaced the rest of the worldin 2020 and 2021, but the U.S, with half of the population at least partially vaccinated, is the only country where the number of cases have fallen this year.

India, which has seen a spike ininfections and deaths in recent weeks, has reported 60% more cases than it did in 2020 and driven a large portion of the worldwide increases. Brazil is approaching 1 million more reported infections than last year.

Of the 10 countries that have reported the most coronavirus infections, four (the U.S., Italy, the United Kingdom and Russia) have reported fewer infections this year.

A lack of widespread testing in some places, and an initial lack of testing early in the pandemic nearly everywhere, mean many infections were never reported. Many cases are asymptomatic, also, so many people would not have been tested.

The biggest increases over last year were in several island countries, southeast Asia and South America.In Southeast Asia, cases were 127 times higher in Timor-Leste than last year, 66 times higher in Cambodia, 43 times higher in Laos and 17 times higher in Thailand.

Double-digitmultiples in these countries are worrisome. But they also put India's dire predicament into perspective. The combined number of confirmed cases during 2021in these 10 countries (512,000)is just one-fifth of India's weekly average of reported cases India in duringMay.

Americans still have suffered the most confirmed coronavirus cases and deaths since the start of the pandemic, but India could surpass U.S. this summer or sooner should infection trends continue.

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Published2:24 pm UTC May. 25, 2021Updated3:28 pm UTC May. 25, 2021

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Coronavirus cases in 2021 are already higher than 2020 worldwide. These seven charts break down the spread. - USA TODAY

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