Category: Corona Virus

Illinois Department of Veterans Affairs Director Terry Prince (third from left) testifies before the Illinois Legislative Audit Commission at the Capitol in March 2024. He was testifying regarding an audit of a deadly COVID-19 outbreak at the LaSalle Veterans Home that killed 36 residents in 2020. (Andrew Campbell / Capitol News Illinois)

SPRINGFIELD Illinois veterans affairs director told a legislative panel this week that while state-run veterans homes have better policies in place following a COVID-19 outbreak that killed 36 residents at the LaSalle Veterans Home in 2020, understaffing remains a challenge.

The need for long-term care will explode over the next 20 years, Illinois Department of Veterans Affairs Director Terry Prince told the Legislative Audit Commission. He predicted long-term care populations would grow by 200 to 500% in that span.

He said while IDVA has employees who are dedicated and devoted and willing to work overtime, the department has also let its census decrease at state-run veterans homes to keep staff-to-patient ratios sustainable.

It could be easy to say yeah, were gonna fill the Quincy Veterans Home and fill it all the way up to 400 people, but you have to have the staff to do so, he said.

He said staffing remains difficult even though Illinois fantastic benefits package for staff at veterans homes is nearly $40,000 higher than the civilian equivalent.

As for responding to COVID-19 outbreaks, Prince said the department is in a much better place than it was in 2020. Beginning in late October that year, the LaSalle home experienced a COVID-19 outbreak that sickened nearly 200 people a whopping 85% of residents and 35% of staff tested positive for the virus, which eventually killed three dozen residents.

The deadly outbreak led to legislative hearings and scrutiny of Gov. JB Pritzkers administrations response. The General Assembly called for an audit, which was published in 2022. The 12-member Legislative Audit Commission held its hearing to review it on Wednesday.

The audit made three major recommendations, including mandating testing of staff and residents during COVID outbreaks defined as two or more cases and delineating responsibilities between IDVA and IDPH. Additionally, the audit recommended the governors office increase oversight of administrative staff and create a senior home administrator position within IDVA.

I want to make sure that its recognized that this agency threw everything at this situation as they did during the COVID crisis, Prince said.

IDVA Assistant Director Anthony Vaughn told the panel that when he arrived at LaSalle toward the end of the outbreak in December 2020 as the homes newly appointed interim administrator, he found a dedicated staff looking to do the right thing.

But he also compared the scene to a Marine Corps unit thats just been through a big battle.

And theyre still recovering, and theyre still hurting, but they want the leadership to be able to move on, he said.

While a 2021 report from the Illinois Department of Human Services inspector general found fault with IDVAs response, the auditor generals report was more critical of the states public health department. The auditor generals office described the previous IDHS inspector general report as flawed for its reliance on interviews rather than documentation.

On Wednesday, Scott Wahlbrink of the auditor generals office told lawmakers that the Illinois Department of Public Health was not responsive to the crisis even though officials there were repeatedly made aware on almost a daily basis from their counterparts at the Illinois Department of Veterans Affairs.

IDPH did not identify and respond to the seriousness of the outbreak, Wahlbrink said. It was the IDVA chief of staff who ultimately had to request assistance.

That chief of staff, Tony Kolbeck, was among those fired after the IDHS report on the outbreak. IDVA Director Linda Chapa LaVia was fired as well.

Pritzker, in response to the audit in 2021, said IDPH was following U.S. Centers for Disease Control and Prevention guidance not to visit a congregate facility and risk disease spread when a phone call would suffice.

Prince said one of his major changes has been improving communication.

I have a direct line to Gov. Pritzker, if I need to call the governor for something, he said. I have regular conversations with the IDPH director.

Since the outbreak, Prince said the Illinois Department of Veterans Affairs has made changes to prevent future outbreaks and keep residents and staff safe. Angela Simmons, IDVA senior home administrator, said that IDVA has weekly infection control meetings to review daily tests that are reported to IDPH.

In addition to increased reporting, Simmons said the department has begun including staff from the states five veterans homes to develop policies for how to respond to situations ranging disease outbreaks to daily incidents.

Our policy process right now is stronger than it ever has been, Simmons said. We get input from the homes.

Since the outbreak there have also been major staff changes in IDPH and IDVA. Prince was appointed in April 2021, and IDVA hired a senior home administrator and an agencywide infection specialist. It is also looking to hire a medical director this year.

State Rep. Amy Elik, R-Godfrey, asked Prince if the states veterans homes had seen outbreaks of other infectious diseases since IDVA overhauled some of its procedures that have served as sort of a test.

Prince said the veterans homes have seen other outbreaks with better outcomes.

I believe in my heart of hearts that the vaccine has been one of the biggest things that has made this a much different story than back in 2020, he said. We are much better positioned.

Jerry Nowicki contributed to this report.

Capitol News Illinois is a nonprofit, nonpartisan news service covering state government. It is distributed to hundreds of newspapers, radio and TV stations statewide. It is funded primarily by the Illinois Press Foundation and the Robert R. McCormick Foundation, along with major contributions from the Illinois Broadcasters Foundation and Southern Illinois Editorial Association.

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Officials Say Illinois Veterans Homes Have Reformed Since Deadly 2020 COVID-19 Outbreak, But Staffing Challenges ... - WTTW News

EL PASO, Texas (KFOX14/CBS4)

After two years, the city of El Paso may finally be moving forward with how to spend the remainder of Coronavirus State and Local Fiscal Recovery Funds.

Back in 2022, the Department of Community and Human Development was awarded $12,000,000 to which $9,000,000 was appropriated and approved by the Council.

In December, half of the $350B state and local recovery funds remained unspent.

If approved at todays meeting, City Council plans to use the unspent money on an emergency shelter for homeless individuals and rapid re- housing to provide rental assistance for homeless individuals; homeless prevention; street outreach; resource navigation for assistance programs available within the community and an equity auditor to ensure services from the city's community and human development department are used in an equitable and diverse way.

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El Paso uses leftover COVID-19 funds for homeless aid and equity - KFOX El Paso

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The CDC Issues New COVID-Related Guidance: What This Means for Employers - The National Law Review

With the arrival of spring, the United States is easing out of respiratory virus season, a familiar pattern that has been challenged by COVID-19 for the past four years.Related video above: CDC announces change to COVID-19 guidelinesThe addition of a novel germ has complicated and expanded respiratory virus season, which was already notoriously difficult to predict. This season had its own unique set of circumstances as public health balanced a significant transition out of the public health emergency with efforts to find a sustainable way forward.Experts say that focused planning and forecasting efforts helped avoid some of the worst-case scenarios. But there was still a significant number of severe outcomes, and there are still key areas of improvement especially around vaccination.I am grateful that were not still in the height of the pandemic, but we saw some really strong, severe respiratory disease season increases, and some groups were incredibly impacted by it, said Janet Hamilton, executive director of the Council of State and Territorial Epidemiologists.Significant burden persistsThere have been at least 29 million illnesses, 320,000 hospitalizations and 20,000 deaths from flu this season, according to U.S. Centers for Disease Control and Prevention estimates. And the burden from COVID-19 has been about twice as large.At least 42,000 people have died from COVID-19 since the beginning of September, according to provisional data from the CDC, reaching a peak of more than 2,500 deaths during the week ending Jan. 13. COVID-19 hospitalizations also peaked in early January, with more than 35,000 new admissions during the week ending Jan. 6 and more than 570,000 total hospitalizations since September.With flu, respiratory syncytial virus (RSV) and with the addition of a third virus (COVID-19) that can cause severe disease, even an average respiratory season can place significant strain on our healthcare system, the CDCs Center for Forecasting Analytics wrote when it released its first outlook for the season in September. It predicted that this respiratory disease season would be similar to the year before which saw hospitals more full than at any other point in the pandemic and worse than pre-pandemic years once again.In developing the seasonal outlook, the Center for Forecasting Analytics identified a number of key variables that could have shifted the seasons outlook for the worse, including a new coronavirus variant, a more severe flu season or overlapping peaks for multiple viruses.The forecasts have held relatively steady throughout the season, in large part because the viruses spared us from these more severe scenarios. But the U.S. still lagged on one key factor that was fully within human control: vaccination rates.A variable within our controlOnly about 23% of U.S. adults and 14% of children have gotten the latest COVID-19 vaccine, according to data from the CDC. And just about half of the population got their flu shot this year, a tick down from recent years.The COVID vaccine is a really safe and effective vaccine thats kind of a miraculous scientific advancement. Its discouraging to me that so many people seem to be ambivalent or unwilling to get it, and we really need to work on that, said Dr. Marcus Plescia, chief medical officer for the Association of State and Territorial Health Officials. This should be a real asset for our society, and people should be taking better advantage of it.A complicated set of reasons may have contributed to low vaccination rates this year, experts say especially for the COVID-19 and RSV vaccines.The timing for the COVID-19 vaccine was a bit off this season, Plescia said. The latest shot was approved by the U.S. Food and Drug Administration in mid-September, when COVID-19 hospitalizations had already been on the rise for months.One of the problems with the COVID vaccine is that it came out kind of late in the process, he said. If we had the vaccine approved and available earlier maybe in the summer that gives people a little bit longer to become familiar with and take advantage of the recommendations. That might make a difference.Shifting perceptions on where people can get vaccinated and emphasizing the important role that physicians can play in promoting vaccination at doctors visits, in particular could also really lift vaccination rates, Plescia said.Its great that pharmacies are such an easy and efficient and convenient way for people to get vaccinated, but that only works for people who specifically want and seek the vaccine, he said. Early in the pandemic, everybody wanted to get vaccinated, so we really leaned heavily on pharmacies. But I think thats where weve lost some ground.But there were challenges in accessing vaccines this season, especially at pediatrician offices. People also had trouble finding vaccines at pharmacies early on, running into roadblocks that didnt exist before the government commercialized the COVID-19 vaccines last year.I think we need to shift back to really work with the medical care community on addressing whatever the issues are that may be making it difficult for them to stock the vaccines, Plescia said. We need to really make sure that when people are going to see their doctors, particularly people who are vulnerable, that theyre getting these recommendations, theyre having the chance to talk through it with their clinician and work through any concerns or issues.The sense of urgency around vaccination also faded as attention on respiratory viruses waned, said Kathleen Hall Jamieson, a professor of communication and director of the University of Pennsylvanias Annenberg Public Policy Center. Her work has focused on health and science communication, including research on vaccine confidence.When people become attentive, they become pretty good at seeking out knowledge, and theyre pretty effective at aligning their behaviors with that knowledge, she said. The problem is that most of the time, were inattentive to most of these things, and as a result, it takes a lot more effort to get the attention that is required to get the messaging in place and the messaging tied to a behavior.Habits have built up around flu vaccination for much of the population in a way that hasnt developed for COVID-19 vaccines, she said, which is probably why COVID-19 vaccination rates fell so much further.Flu vaccination is a habitual behavior. We dont have that same kind of habitual behavior associated with the Covid vaccine. And when you stop hearing on a regular basis that Covid is a severe problem, it fades to the background in a way that flu does not, Jamieson said.Its not vaccination hesitancy that youre measuring. Its whether or not you incentivize people or prime people by making the risk of the virus season salient enough for them decide if they need a vaccine.Minimizing unpredictability, maximizing preparednessFor vaccines and otherwise, focused and effective communication is at the heart of a successful public health response, experts say, especially in a time as unique as this.In all the chatter that was going on about the season, we really focused on what mattered the most and what would change the risk profile the most, said Dylan George, director of the CDCs Center for Forecasting and Outbreak Analytics.Ongoing and vigilant tracking of these factors helped the forecasts stay spot-on in terms of helping people know what level of hospitalizations to expect from the big three: COVID, RSV and influenza, George said.They gave more specificity to what it meant to be ready, which served as a helpful communication tool with state epidemiologists, state health officials and health care systems, he said.Although flu is known to be seasonal, theres a lot of variation in the timing and severity each year. And COVID-19 is still revealing its patterns, too.The CDC launched the Center for Forecasting Analytics about two years ago, and the groups respiratory virus season outlooks mark a subtle but powerful shift in the ways public health can think about the respiratory virus season, George said.For infectious diseases that are changing very quickly, we need to be more prospective, he said. The outlook was a good addition to help the institution of public health and CDC start looking more forward in how were trying to anticipate risks as they are coming at us instead of just getting hit with something and then trying to understand what were hit with.Coordination and collaborationDespite elevated levels of disease, hospitals generally avoided large-scale spikes in admissions from respiratory viruses this season.Even before the pandemic, hospitals would plan for respiratory virus season and the variability that comes with it, and COVID-19 added a few more factors to that equation, said Akin Demehin, senior director of quality and safety policy with the American Hospital Association.Theres an ongoing process of assessment, reassessment, planning, flexing up or down depending on what the needs are on the ground, he said. Going into this season, I think hospitals and health systems knew there would be some unknowns around the amount of strain that COVID-19 was going to put on the health care system, and certainly rates of vaccination are one of those contributing factors to that uncertainty.Still, better vaccination rates could have eased some of that unpredictability and helped keep hospital capacity levels even more stable this season, experts say.I think what the COVID-19 pandemic really underscored for everybody in the health care system is just how much the situation on the ground can change and how rapidly it can change, Demehin said. We know that are incredibly effective tools in keeping people healthy, keeping them out of the hospital and, ultimately, on taking some pressure off of the health care delivery system when we do experience these annual spikes in respiratory viruses.Data collection ramped up significantly during the COVID-19 pandemic, much of which has scaled back since the public health emergency ended about a year ago, in May 2023. The federal government still requires hospitals to report various data points related to COVID-19, but that will end next month.Experts emphasize that this is just the fourth data point we have to understand the new trajectory of respiratory virus seasons in the U.S.We are one step closer to understanding more about what respiratory season is going to be looking like, generally, but were not there yet, Hamilton said.

With the arrival of spring, the United States is easing out of respiratory virus season, a familiar pattern that has been challenged by COVID-19 for the past four years.

Related video above: CDC announces change to COVID-19 guidelines

The addition of a novel germ has complicated and expanded respiratory virus season, which was already notoriously difficult to predict. This season had its own unique set of circumstances as public health balanced a significant transition out of the public health emergency with efforts to find a sustainable way forward.

Experts say that focused planning and forecasting efforts helped avoid some of the worst-case scenarios. But there was still a significant number of severe outcomes, and there are still key areas of improvement especially around vaccination.

I am grateful that were not still in the height of the pandemic, but we saw some really strong, severe respiratory disease season increases, and some groups were incredibly impacted by it, said Janet Hamilton, executive director of the Council of State and Territorial Epidemiologists.

There have been at least 29 million illnesses, 320,000 hospitalizations and 20,000 deaths from flu this season, according to U.S. Centers for Disease Control and Prevention estimates. And the burden from COVID-19 has been about twice as large.

At least 42,000 people have died from COVID-19 since the beginning of September, according to provisional data from the CDC, reaching a peak of more than 2,500 deaths during the week ending Jan. 13. COVID-19 hospitalizations also peaked in early January, with more than 35,000 new admissions during the week ending Jan. 6 and more than 570,000 total hospitalizations since September.

With flu, respiratory syncytial virus (RSV) and with the addition of a third virus (COVID-19) that can cause severe disease, even an average respiratory season can place significant strain on our healthcare system, the CDCs Center for Forecasting Analytics wrote when it released its first outlook for the season in September. It predicted that this respiratory disease season would be similar to the year before which saw hospitals more full than at any other point in the pandemic and worse than pre-pandemic years once again.

In developing the seasonal outlook, the Center for Forecasting Analytics identified a number of key variables that could have shifted the seasons outlook for the worse, including a new coronavirus variant, a more severe flu season or overlapping peaks for multiple viruses.

The forecasts have held relatively steady throughout the season, in large part because the viruses spared us from these more severe scenarios. But the U.S. still lagged on one key factor that was fully within human control: vaccination rates.

Only about 23% of U.S. adults and 14% of children have gotten the latest COVID-19 vaccine, according to data from the CDC. And just about half of the population got their flu shot this year, a tick down from recent years.

The COVID vaccine is a really safe and effective vaccine thats kind of a miraculous scientific advancement. Its discouraging to me that so many people seem to be ambivalent or unwilling to get it, and we really need to work on that, said Dr. Marcus Plescia, chief medical officer for the Association of State and Territorial Health Officials. This should be a real asset for our society, and people should be taking better advantage of it.

A complicated set of reasons may have contributed to low vaccination rates this year, experts say especially for the COVID-19 and RSV vaccines.

The timing for the COVID-19 vaccine was a bit off this season, Plescia said. The latest shot was approved by the U.S. Food and Drug Administration in mid-September, when COVID-19 hospitalizations had already been on the rise for months.

One of the problems with the COVID vaccine is that it came out kind of late in the process, he said. If we had the vaccine approved and available earlier maybe in the summer that gives people a little bit longer to become familiar with and take advantage of the recommendations. That might make a difference.

Shifting perceptions on where people can get vaccinated and emphasizing the important role that physicians can play in promoting vaccination at doctors visits, in particular could also really lift vaccination rates, Plescia said.

Its great that pharmacies are such an easy and efficient and convenient way for people to get vaccinated, but that only works for people who specifically want and seek the vaccine, he said. Early in the pandemic, everybody wanted to get vaccinated, so we really leaned heavily on pharmacies. But I think thats where weve lost some ground.

But there were challenges in accessing vaccines this season, especially at pediatrician offices. People also had trouble finding vaccines at pharmacies early on, running into roadblocks that didnt exist before the government commercialized the COVID-19 vaccines last year.

I think we need to shift back to really work with the medical care community on addressing whatever the issues are that may be making it difficult for them to stock the vaccines, Plescia said. We need to really make sure that when people are going to see their doctors, particularly people who are vulnerable, that theyre getting these recommendations, theyre having the chance to talk through it with their clinician and work through any concerns or issues.

The sense of urgency around vaccination also faded as attention on respiratory viruses waned, said Kathleen Hall Jamieson, a professor of communication and director of the University of Pennsylvanias Annenberg Public Policy Center. Her work has focused on health and science communication, including research on vaccine confidence.

When people become attentive, they become pretty good at seeking out knowledge, and theyre pretty effective at aligning their behaviors with that knowledge, she said. The problem is that most of the time, were inattentive to most of these things, and as a result, it takes a lot more effort to get the attention that is required to get the messaging in place and the messaging tied to a behavior.

Habits have built up around flu vaccination for much of the population in a way that hasnt developed for COVID-19 vaccines, she said, which is probably why COVID-19 vaccination rates fell so much further.

Flu vaccination is a habitual behavior. We dont have that same kind of habitual behavior associated with the Covid vaccine. And when you stop hearing on a regular basis that Covid is a severe problem, it fades to the background in a way that flu does not, Jamieson said.

Its not vaccination hesitancy that youre measuring. Its whether or not you incentivize people or prime people by making the risk of the virus season salient enough for them decide if they need a vaccine.

For vaccines and otherwise, focused and effective communication is at the heart of a successful public health response, experts say, especially in a time as unique as this.

In all the chatter that was going on about the season, we really focused on what mattered the most and what would change the risk profile the most, said Dylan George, director of the CDCs Center for Forecasting and Outbreak Analytics.

Ongoing and vigilant tracking of these factors helped the forecasts stay spot-on in terms of helping people know what level of hospitalizations to expect from the big three: COVID, RSV and influenza, George said.

They gave more specificity to what it meant to be ready, which served as a helpful communication tool with state epidemiologists, state health officials and health care systems, he said.

Although flu is known to be seasonal, theres a lot of variation in the timing and severity each year. And COVID-19 is still revealing its patterns, too.

The CDC launched the Center for Forecasting Analytics about two years ago, and the groups respiratory virus season outlooks mark a subtle but powerful shift in the ways public health can think about the respiratory virus season, George said.

For infectious diseases that are changing very quickly, we need to be more prospective, he said. The outlook was a good addition to help the institution of public health and CDC start looking more forward in how were trying to anticipate risks as they are coming at us instead of just getting hit with something and then trying to understand what were hit with.

Despite elevated levels of disease, hospitals generally avoided large-scale spikes in admissions from respiratory viruses this season.

Even before the pandemic, hospitals would plan for respiratory virus season and the variability that comes with it, and COVID-19 added a few more factors to that equation, said Akin Demehin, senior director of quality and safety policy with the American Hospital Association.

Theres an ongoing process of assessment, reassessment, planning, flexing up or down depending on what the needs are on the ground, he said. Going into this season, I think hospitals and health systems knew there would be some unknowns around the amount of strain that COVID-19 was going to put on the health care system, and certainly rates of vaccination are one of those contributing factors to that uncertainty.

Still, better vaccination rates could have eased some of that unpredictability and helped keep hospital capacity levels even more stable this season, experts say.

I think what the COVID-19 pandemic really underscored for everybody in the health care system is just how much the situation on the ground can change and how rapidly it can change, Demehin said. We know that [vaccines] are incredibly effective tools in keeping people healthy, keeping them out of the hospital and, ultimately, on taking some pressure off of the health care delivery system when we do experience these annual spikes in respiratory viruses.

Data collection ramped up significantly during the COVID-19 pandemic, much of which has scaled back since the public health emergency ended about a year ago, in May 2023. The federal government still requires hospitals to report various data points related to COVID-19, but that will end next month.

Experts emphasize that this is just the fourth data point we have to understand the new trajectory of respiratory virus seasons in the U.S.

We are one step closer to understanding more about what respiratory season is going to be looking like, generally, but were not there yet, Hamilton said.

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After four years with COVID-19, the US is settling into a new approach to respiratory virus season - WVTM13 Birmingham

HONOLULU (KHON2) When it was launched in September 2020, the COVID-19 dashboard was the central data source for tracking the virus across the state.

Check out whats going on around the nation on our National News page

It also showed the virus impact on the hospitals and even the number of personal protection equipment available.

Currently, the website is used to keep count of the reported cases of COVID-19 and is updated weekly.

We track these statistics on a daily basis, and it helps us allocate resources, we share this information with the leadership within our entire healthcare delivery system, not only hospitals, long-term care, home care, hospitals, said Hilton Raethel, Health Care Association of Hawaii, President and CEO.

The Hawaii State Department of Health is aligning its health avisements with the CDC guidelines but still plans to continue to use the dashboard with more than just COVID-19 data.

Our decisions are informed by what we put in those dashboards and what were seeing happening locally, explained State Epidemiologist Dr. Sarah Kemble.

So, I do think its really important that we continue to provide updated information to the public about whats happening COVID but also other respiratory diseases like not just COVID but RSV respiratory syncytial virus, influenza.

Federal money was used to create the site and the health department plans to continue using federal funding for the next two years to maintain the dashboard but develop an additional dashboard to keep track of overall respiratory disease activity in Hawaii.

Were really looking at how can we make updates to those dashboards to give that kind of broader information to people can make informed choices about how to protect themselves, said Kemble.

Raethel agreed stating that having more visibility into that is very helpful from a public health perspective and also from a treatment perspective.

The Department of Health hopes to publish the updated site next month.

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COVID-19 Dashboard could soon be tracking more - KHON2

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The Impact of the Novel Coronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pandemic on ... - Cureus

Prescribing PrEP: Its Easy as 1, 2, 3 KFF PrEP, prescribing PrEP, motivation, PrEP follow-up, no prior training, infectious disease doctor, HIV doctor In this video, Dr. Demetre Daskalakis explains to providers that if they are able to prescribe any medicine, they can prescribe PrEP. No pri

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Talk with Your Patients About PrEP | Covid-19 | news-journal.com - Longview News-Journal

Prescribing PrEP: Its Easy as 1, 2, 3 KFF PrEP, prescribing PrEP, motivation, PrEP follow-up, no prior training, infectious disease doctor, HIV doctor In this video, Dr. Demetre Daskalakis explains to providers that if they are able to prescribe any medicine, they can prescribe PrEP. No pri

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Prescribing PrEP: It's Easy as 1, 2, 3 | Covid-19 | news-journal.com - Longview News-Journal

Millions of Americans are still experiencing long COVID more than four years since the global COVID-19 outbreak was declared a pandemic.

According to the most recent federal Household Pulse Survey, between Jan. 9, and Feb. 5, 6.8% of U.S. adults currently have long COVID and 17.6% have had long COVID.

Using 2020 U.S. Census Bureau estimates, this means 17.5 million adults currently have long COVID and 45.4 million people have ever had long COVID.

Since the early days of the pandemic, scientists have learned a great deal about what puts someone at risk for long COVID, but researchers say we are still "scratching the surface" when it comes to our understanding of what causes the condition or how to treat it.

"We know much more today than we did four years ago; that's a fact," Dr. Alba Azola, an assistant professor of physical medicine and Rehabilitation at Johns Hopkins Medicine, told ABC News. "But we do not have clarity on the exact pathophysiology or that mechanism that's driving those symptoms."

"We're just scratching the surface, we're just beginning to understand what makes those people that develop long COVID different than those people that have COVID and completely recover after," she added.

Long COVID occurs when patients still have symptoms at least four weeks after they have cleared the infection. In some cases, symptoms can be experienced for months or years.

Symptoms vary and can include fatigue, difficulty breathing, headaches, brain fog, joint and muscle pain and continued loss of taste and smell, according to the Centers for Disease Control and Prevention (CDC).

Azola said not all symptoms are visible in every single patient, but they can experience a wide range of them.

Long COVID most often occurs in people who had severe illness but anyone can develop the condition. People who are not vaccinated against COVID-19 are at higher risk of developing long COVID, according to the CDC.

Scientists are not sure what causes long COVID but have identified risk factors including having underlying conditions or experiencing multi-system inflammatory syndrome due to COVID.

Research has also found that patients with long COVID tend to have lower cortisol levels and lower testosterone levels.

Another theory is that virus particles may become active again, causing people to suffer long-term symptoms.

"What we want, of course, it's just to be able to diagnose, and to treat," Dr. Fernando Carnavali, director of the Mount Sinai Center for Post-COVID Care in New York, told ABC News. "We have people that are really suffering with this, brain fog and other symptoms that are significantly impacting the quality of life. And it feels because of that some of [the research] is not enough. But I think that we are on the way."

Research is also not clear about why some patients recover and others don't.

New York City resident David Speal, 41, contracted COVID-19 in March 2020. He became seriously ill and was hospitalized at Lenox Hill Hospital. After he was discharged from the hospital, he said he experienced a consistently high heart rate.

It was several months later that he was diagnosed with long COVID. It's been a long road to recovery, but Speal has regained most of his health since his initial infection.

However, he said his wife is suffering. Speal said she contracted COVID twice -- the second time resulting in brain fog so severe that she no longer works, but its unclear whether or not she receives disability.

"I'm not 100%. Sometimes, you do a lot, you get really tired, and you can tell like, 'Okay, you know, this is still, it's still a part of me, but not to the point where I can't function,'" he told ABC News. "My biggest question is, well, how did I recover? You know, like, what happened?" We don't truly know what was the turning point for me when everything went normal."

Because those with long COVID can experience a variety of symptoms, there is no single treatment or cure for the condition.

Patients and health care providers often have to work together to create a personal care plan to manage symptoms.

"We need to remind ourselves that without really knowing the pathophysiology of the disease, without knowing biomarkers, it's complex," Carnavali said. "There are certain things that people been trying and some of these treatments do potentially have some benefit."

The National Institutes of Health (NIH) RECOVER Initiative launched several clinical trials of potential treatments for long COVID.

Currently, the only medications or treatments that can be used aim to alleviate some long COVID symptoms, but arent specifically for long COVID. Speal said he was prescribed propranolol, a medication that slows down the heart rate and makes it easier for the heart to pump blood.

Speal said he took an extremely low dose of the medicine for about two years until he got to a point where he no longer needed to take the medication.

Azola said that while she expects that clinical trials will eventually result in effective treatments, she urges patients and the general public to be patient.

"The reality is that the science is moving forward, but it's going to take a long time for that to translate into clinical improvement or treatment," she said. "So, there's a big canyon between science and clinical treatments that are available to us."

Doctors say that one of the most difficult things about treating long COVID patients is not having an answer about why they're feeling the way they feel or how to best treat them.

"I would probably say that's one of the hardest things about being a physician that takes care of this patient population," Azola said. "Because as physicians, we want to help people, we want to get them better, we want to have those answers. But in the case of long COVID, it's quite frustrating. We don't have those answers."

"You really need to kind of get comfortable with not knowing ... but also being curious and partnering with my patients to try to find creative ways that can be beneficial to them or finding creative ways to make their quality of life better," she added.

Azola said she currently helps patients better manage symptoms and pain so that, even if they are not free for long COVID symptoms, they can at least participate in their day-to-day activities.

Speal said it's often hard to describe to other people who have not gone through COVID what he may be experiencing, even his own family and friends.

"People say, 'No, it'll be okay' or 'Try this, do that' but it's like the only way you can truly understand long COVID is if it happens to you, and I wouldn't wish that on anybody," he said. "The reality is it's so hard to explain to people, because every case is totally different."

Azola also cautioned family members and caregivers of long COVID patients to not dismiss them or how they feel.

"At times, by pushing themselves too much, or trying to go beyond their energy envelope, they can actually end up harming themselves and losing function," she said. "So, it is certainly important for families and people that have caregivers to continue to help them because that's the only way they're gonna be able to get better."

Original post:

4 years later, experts are just beginning to 'scratch the surface' of understanding long COVID - ABC News

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Battling the coronavirus infodemic among social media users in Kenya and Nigeria - Nature.com