Category: Corona Virus

People who have had COVID-19 have a significantly higher risk of suffering chronic fatigue than those who havent had the disease, a new study published Wednesday shows.

Our data indicate that COVID-19 is associated with a significant increase in new fatigue diagnoses, according to the study, published by the Centers for Disease Control and Prevention in the journal Emerging Infectious Diseases.

Physicians should be aware that fatigue might occur or be newly recognized [more than a year] after acute COVID-19, the report said.

Specifically, the study looked at electronic health records of more than 4,500 patients in Washington state who had COVID-19 in 2020 and 2021 and compared them to patients who hadnt had COVID. The study found the risk for chronic fatigue in those who had COVID was about four times the risk compared to people who hadnt contracted COVID.

Scientists also looked at a more broad definition of fatigue, which includes chronic fatigue as well as diagnoses of weakness and malaise. The study found that the risk of fatigue among COVID-19 patients was 68% higher among people whod had COVID than those who hadnt.

Among the 4,589 COVID-19 patients in the study, scientists identified 434 as incident fatigue cases, in which the person was diagnosed with fatigue after recovering from COVID-19. Of those, 81 were also identified as having chronic fatigue, which is a subset of general fatigue.

The risk of chronic fatigue after COVID-19 was more common among women, older people and those who had other medical conditions, the study said.

The report illustrates the continuing burden of long COVID long after the emergency phase of the pandemic has ended. CDC survey data from last year said that up to 15% of U.S. adults had ever experienced long COVID and up to 6% of were currently experiencing long COVID.

Among those who have suffered long COVID regardless of whether the person was hospitalized fatigue is often a symptom.

Researchers for this study decided to focus on fatigue among COVID-19 patients because the symptom plays such a central role among those suffering from long COVID.

People who developed fatigue after COVID-19 had far worse clinical outcomes, the report said. Among more than 400 patients who dealt with post-COVID fatigue, 25.6% were hospitalized at some point following an acute bout of COVID-19 during the studys time frame. By contrast, only 13.6% of more than 4,000 patients who didnt develop post-COVID fatigue were later hospitalized.

Patients who had post-COVID fatigue were also at a higher risk of dying than those who did not develop fatigue, the report said.

The report also cautioned that doctors be alert for COVID patients who have a history of mood disorders; such patients are also at increased risk for post-COVID-19 fatigue, it said.

Doctors say the risk of long COVID is further reason to take prudent steps to avoid a coronavirus infection, including avoiding sick people, taking a test to verify a COVID-19 diagnosis and staying home if you are ill but asymptomatic. Masking up in crowded indoor settings, staying up to date on vaccinations and taking antiviral drugs like Paxlovid when experiencing COVID-19 symptoms may also help reduce the risk of long COVID.

People can get infected with coronavirus multiple times, the CDC said, and each time a person is infected or reinfected ... they have a risk of developing long COVID.

Originally posted here:

Risk for chronic fatigue soars among those who had COVID-19, study says - Los Angeles Times

Since 2021, people with COVID-19 have been told to isolate themselves for at least five days to avoid spreading the disease. But that practice may soon join most mask mandates as relics of the peak pandemic era.

The U.S. Centers for Disease Control and Prevention (CDC) is said to be weighing a new, symptom-based approach to isolation for the general public, the Washington Post reported on Feb. 13. Under that potential approach, which may be rolled out for public feedback this spring, people could leave home when their symptoms are mild and improving and theyve been fever-free for at least 24 hours without medication, according to the Post.

That possible shift, which echoes similar moves in California and Oregon, would bring the CDCs recommendations for COVID-19 in closer step with its guidance on the flu. When people are sick with the flu, the CDC recommends they stay home until at least 24 hours after their fever has broken naturally, or until other symptoms clearwhich the agency says can take up to five days.

A CDC representative did not confirm or deny the Posts report when asked by TIME. The agency has no updates to COVID guidelines to announce at this time, the representative wrote in an email. We will continue to make decisions based on the best evidence and science to keep communities healthy and safe.

While the shift is not yet official, experts have previously predicted that 2024 will bring a further relaxation of COVID-19 policy. The guidance becomes lighter and lighter over time, and that actually makes sense as people build up more immunity, Dr. Ashish Jha, dean of the Brown University School of Public Health and the Biden Administrations former COVID-19 response coordinator, said in a January interview with TIME. I do expect that some of those guidances will dissipate.

Read More: Were In a Major COVID-19 Surge. Its Our New Normal

The virus itself has not evolved to become less contagious. But peoples tolerance for public-health precautions has plummeted. Many people in the U.S. havent paid attention to COVID-19 guidance in a long time, says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. You have to face reality, he says.

Meeting people where they are may encourage them to take at least some precautions, he says. Some people who are unwilling or unable to isolate for five full days might be open to staying home for a shorter period of time when theyre acutely ill, for example.

Not all experts are as optimistic. Lucky Tran, a science communicator at Columbia University, called the potential end of five-day isolation periods a reckless anti-public-health policy that goes against science, encourages disease spread, and puts everyone at risk. The bare minimum we should have learned from this devastating pandemic that has killed and disabled millions is that we should stay home when sick. The rumored adjustment would completely ignore the continued suffering of people who are immunocompromised, chronically ill, disabled, or otherwise at heightened risk of severe COVID-19, Tran adds.

Eleanor Murray, an assistant professor of epidemiology at the Boston University School of Public Health, says it would be really strange for the CDC to relax its current guidance, given that even a five-day isolation period isnt always long enough to stop the spread. Studies have shown that a significant portion of people who catch COVID-19 test positive, and thus potentially remain contagious, for longer than five days. (The CDC currently recommends that people with COVID-19 wear a high-quality mask, such as an N95 or KN95, around others for at least 10 days after getting sick; its not clear whether that suggestion would remain in place if the guidelines change this spring.)

The absence of symptoms also isnt a guarantee that someone is no longer infectious, Murray says. Research has long suggested that pre-symptomatic or asymptomatic people can spread the virus, although they may not be as contagious as people who are sicker. At-home tests arent a perfect measure either, although they can provide some information about potential contagiousness.

Even still, Dr. Tara Bouton, an assistant professor at the Boston University Chobanian and Avedisian School of Medicine who has researched COVID-19 isolation periods, feels it's reasonable to loosen isolation guidance at this stage of the pandemic, when fewer people who get infected die or become hospitalized. That's in large part because lengthy isolation periods disproportionately penalize people whose income depends on working in person, Bouton says. The ability to isolate is a privilege, Bouton says, and public-health policy needs to balance the costs and benefits of asking people to do it.

Murray, however, fears that relaxing isolation guidance will make it easier for businesses to deny their employees time off to recover. If the CDC removes its current guidancewhich, Murray notes, is a recommendation rather than a mandateit would be providing information that is not evidence-based and is not going to help people make informed decisions, but will probably be used to limit paid leave.

So what would the experts do if they got sick with COVID-19?

Even though Bouton feels that a blanket five-day isolation recommendation is no longer necessary, she says she would stay home around that long because shes able toand because working as an infectious-disease doctor puts her in contact with lots of immunocompromised patients, who remain at increased risk of severe disease if they get infected.

Murray says she would stay home until her symptoms cleared up and wait until shed gotten two consecutive negative test results, spaced out by at least a day, before exiting isolation. (Often, that approach requires more than five days of isolation, since people can test positive on at-home rapid tests for more than a week.)

Tran says hed go even further: hed stay home for 10 days, self-test multiple times before ending isolation, and wear a maskas he usually does anywayupon returning to public spaces.

Osterholm, too, says hed stay home for five days and continue to wear an N95 in the immediate aftermath of his illness. Efforts like those are important, he saysbut theyre also not everything. Hed like the public-health community to devote more attention to encouraging vaccination among vulnerable older adults, many of whom have not gotten the latest shot, and streamlining Paxlovid access for high-risk patients.

Those efforts, Osterholm says, could save lives at a time when most COVID-19 deaths occur among people who are elderly or otherwise at high riskand at a time when Americans are moving on from COVID-19, whether official guidance tells them to or not.

Read more:

How Long Should You Isolate With COVID-19? Experts Are Split | TIME - TIME

image:

Cross-section of the brainstem: Neurons (blue-gray) are in close contact with immune cells (purple). The threadlike blue structures are extensions of the neurons, which can reach all the way into distant organs in the form of nerve fibers. According to the study, the immune cells and neurons in the brainstem can be activated directly via the nerve fibers as a result of inflammation in the lungs. Charit | Jenny Meinhardt

Credit: Charit | Jenny Meinhardt

Scientists still are not sure how neurological symptoms arise inCOVID-19. Is it becauseSARS-CoV-2infects the brain? Or are these symptoms the result of inflammation in the rest of the body? A study by Charit Universittsmedizin Berlinhas now produced evidence to support the latter theory. It was published today in the journalNature Neuroscience.*

Headaches, memory problems, and fatigue are just some of the neurological impacts that arise during coronavirus infection and can last well beyond the acute period. Even early on in the pandemic, researchers surmised that direct infection of the brain could be the cause. We took that as our hypothesis at the start, too. But so far, there has been no clear evidence that the coronavirus can persist in the brain, let alone proliferate, explains Dr. Helena Radbruch, head of the Chronic Neuroinflammation working group at the Department of Neuropathology at Charit. For that, we would have needed to find evidence of intact virus particles in the brain, for example. Instead, the indications that the coronavirus could infect the brain come from indirect testing methods, so they arent entirely conclusive.

According to a second hypothesis, the neurological symptoms would instead be a kind of side effect of the strong immune response the body deploys to defend against the virus. Past studies had produced indications that this might be the case. The current Charit study now bolsters this theory with detailed molecular biology and anatomical results from autopsies.

No signs of direct infection of the brain

For the study, the team of researchers analyzed various areas of the brain in 21 people who died in hospital settings, typically in an ICU, due to severe coronavirus infection. For comparison, the researchers studied nine patients who died of other causes after treatment in intensive care. First, they looked to see whether the tissue showed any visible changes and hunted for any indication of coronavirus. Then they conducted a detailed analysis of genes and proteins to identify the specific processes that had taken place inside individual cells.

Like other teams of researchers before them, the Charit scientists found coronavirus genetic material in the brain in some cases. But we didnt find neurons infected withSARS-CoV-2, Radbruch notes. We assume that immune cells absorbed the virus in the body and then traveled to the brain. Theyre still carrying the virus, but it doesnt infect cells of the brain. So coronavirus has invaded other cells in the body, but not the brain itself.

Brain reacts to inflammation in the body

Still, the researchers did note striking changes in molecular processes in some cells of the brain in those infected withCOVID-19: For example, the cells ramped up the interferon signaling pathway, which is typically activated in the course of a viral infection. Some neurons evidently react to the inflammation in the rest of the body, says Prof. Christian Conrad, head of the Intelligent Imaging working group at the Berlin Institute of Health at Charit (BIH) and one of the principal investigators in the study, along with Radbruch. This molecular reaction could be a good explanation for the neurological symptoms we see inCOVID-19patients. For example, neurotransmitters emitted by these cells in the brainstem could cause fatigue. Thats because the brainstem is home to groups of cells that control drive, motivation, and mood.

The reactive nerve cells were found primarily in what are known as the nuclei of the vagus nerve. These are nerve cells located in the brainstem that extend all the way to organs such as the lungs, intestine, and heart. In simplified terms, our interpretation of our data is that the vagus nerve senses the inflammatory response in different organs of the body and reacts to it in the brainstem without there being any actual infection of brain tissue, Radbruch explains. Through this mechanism, the inflammation does spread from the body to the brain in a way, which can disrupt brain function.

Limited-time reaction

The neurons reaction to the inflammation is temporary, as shown by a comparison of people who died during an acute coronavirus infection with those who died at least two weeks afterward. The molecular changes are most evident during the acute infection phase, but they do normalize again afterward at least in the vast majority of cases.

We think its possible that if the inflammation becomes chronic, that could be what causes the neurological symptoms often observed in long COVID in some people, Conrad says. To follow up on this suspicion, the team of researchers is now planning to study the molecular signatures in the cerebral fluid of long COVID patients in greater detail.

*Radke J et al. Proteomic and transcriptomic profiling of brainstem, cerebellum, and olfactory tissues in early- and late-phaseCOVID-19. Nat Neurosci 2024 Feb 16. doi: 10.1038/s41593-024-01573-y

About the study The study was made possible by the explicit consent of patients and/or their family members, for which the research group is grateful. The work was performed within the framework of the National Autopsy Network (NATON), a research infrastructure that is part of Netzwerk Universittsmedizin (NUM), the university medicine research network, which is funded by the German Federal Ministry of Education and Research (BMBF). NUM was initiated and is coordinated by Charit. It pools the strengths of the 36 university medical centers in Germany.

Related links:

Original publication

Chronic Neuroinflammation working group (Radbruch)

Intelligent Imaging working group (Conrad)

Nature Neuroscience

People

Proteomic and transcriptomic profiling of brainstem, cerebellum and olfactory tissues in early- and late-phase COVID-19

16-Feb-2024

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

The rest is here:

How COVID-19 affects the brain - EurekAlert

The Health and Human Services Departments lack of cooperation with a congressional committee investigating the Covid-19 pandemic is unacceptable and could prompt the committee to force people to testify, the panels chairman said in a letter to the agency Friday.

The letter, shared exclusively with STAT, comes roughly two weeks after a top HHS official testified before the House Select Subcommittee on the Coronavirus Pandemic. Republicans including Chairman Rep. Brad Wenstrup (R-Ohio) were vocally frustrated with HHS Assistant Secretary for Legislation Melanie Egorins responses to questions about Covid-19s origins, shutdown policies, and federal messaging about vaccines.

While HHS has shared thousands of pages of documents pertaining to the coronavirus response with the panel, Republicans argue they are heavily redacted and offer no clear answers on these policies or the virus origin. They also accused HHS officials of dragging their feet on responding to at least a dozen inquiries.

We know, for a fact, that the Department is currently withholding critical documents. The Departments failure to provide the requested documents is unacceptable, Wenstrup wrote Friday.

Egorin said repeatedly during the hearing that the agency has produced documents that have been ongoing and responsive to your request.

If this next round of questions does not satisfy GOP committee leaders, Wenstrup warned that they will evaluate the use of the compulsory process to obtain the testimony of Department employees who know the answers to these questions.

The chairman then listed 12 separate times the committee asked for more information from HHS, spanning from February to November last year. For each, he requested more details about how HHS handled relevant staff interviews and email and document searches before handing over the redacted content to the committee.

HHS did not immediately respond to a request for comment.

Besides Egorins testimony, the committee has heard from nearly a dozen current and former health officials including retired infectious disease official Anthony Fauci and former National Institutes of Health Director Francis Collins, both of whom voluntarily testified in lengthy closed-door sessions.

Democrats have lamented that these briefings have not produced new information about the virus or shutdown policies, and instead are further politicizing the pandemic amid national divides over public health information.

The committees most recent hearing focused on the safety of Covid-19 vaccines and the governments messaging about their benefits.

Conspiratorial accusations manufacture distrust; fear mongering manufactures distrust. And with increased distrust, you increase vaccine hesitancy, said ranking member Rep. Raul Ruiz (D-Calif.) on Thursday. How does this help us prevent or better prepare for the next pandemic? It doesnt, it makes it worse, puts peoples lives at risk, and actually harms the American people.

Read more from the original source:

Congress may force more Covid-19 testimony from HHS - STAT

California and Oregonrecently became the first states to break with the U.S. Centers for Disease Control and Prevention on how long a person infected with COVID-19 should isolate, saying that people who test positive are no longer expected to isolate for at least five days and those without symptoms don't have to isolate at all.The CDC is considering a shift in its COVID-19 isolation guidance to say that people no longer need to isolate once they have been fever-free for 24 hours and their symptoms are mild or improving, according to theWashington Post.In a statement Tuesday, the agency told CNN that there were no changes to announce at this time."We will continue to make decisions based on the best evidence and science to keep communities healthy and safe," spokesperson Dave Daigle said.Wastewater surveillancedatapublished by the CDC suggests that COVID-19 is still circulating at high levels across the U.S., and experts emphasize that until any new recommendations are announced, most people should continue to follow the CDC's current guidance: isolating for at least five days after you test positive for COVID-19 then wearing a mask until at least 10 days after a positive test. If you're not fever-free for 24-hours without taking fever-reducing medications at day five, you should isolate longer.Some states shift isolation guidelinesEven if the CDC changes its guidance,statehealth departments can still implement their own.People who test positive for COVID-19 in California and Oregon are no longer expected to isolate for a set period of time. Those without symptoms don't have to isolate at all, and those with symptoms can return to school or work once their symptoms are improving and they've been fever-free for at least 24 hours, according to the state policies."Most school systems and most places of employment will go along with whatever the state is recommending," said Dr. Peter Hotez, who co-directs the Center for Vaccine Development at Texas Children's Hospital. "You're more or less obligated for to follow that guideline."Health officials in those states say the changes to their isolation guidelines reflect policy that's evolving along with the pandemic. Both California and Oregon still encourage people who test positive to wear a mask around others for at least 10 days.Dr. Carlos del Rio, a professor of medicine in the Division of Infectious Diseases at the Emory University School of Medicine, said the CDC may take a similar step as evidence shows infections becoming milder.The CDC notes that "infections arecausing severe disease less frequentlythan earlier in the pandemic."Changes to CDC's guidance could bring COVID-19 in line with other respiratory viruses, such as flu and RSV."We need to start ending COVID exceptionalism and incorporate COVID into our respiratory viruses," del Rio said. "At the end of the day, there's going to be a similar approach to all these viruses."Some infectious disease experts also believe that a change would better align with how many Americans are already treating the virus."Currently, many of our citizens are no longer testing for COVID-19 and are not actively isolating," said Dr. Clay Marsh, West Virginia's COVID-19 czar. "With the caveat of the risk of long COVID and the potential for mortality in the elderly and immunocompromised, the future guidance by CDC meets the standard we are seeing."West Virginia currently recommends that people who've tested positive for COVID isolate for at least five days, according to the state's Department of Health.Hotez isn't a fan of ending isolation for people who don't have symptoms, particularly because COVID-19 is generally more severe than the flu and because asymptomatic COVID-19 cases are more common.He says he would like to see the CDC recommend using a home test after you have gone 24 hours without a fever."If you have an antigen test and if you're negative, then you can leave isolation," he proposed. If you test positive, you would keep isolating until you got a negative test."Home antigen tests give you an idea of how much virus you're actually shedding," he said. "That's the kind of thing the CDC needs to look at."But in order to make a proper recommendation, Hotez says, the CDC would need to gather data on how many people test positive for COVID-19 after a 24-hour period with no fever.Experts say COVID-19 vaccinations which are helpful in preventing the spread of the virus as well as severe illness or death could also lessen the need for isolation if they were utilized more."You're isolating because you're worried that you're shedding virus," Hotez said. "People forget that vaccinations can have a big effect on reducing the amount of virus shedding."The latest COVID-19 shot was rolled out in September. It's a monovalent vaccine formulated to target newer variants of the virus that are currently circulating.But not enough Americans are getting the updated vaccine, Hotez and del Rio say, exposing older adults and people with weakened immune systems to severe infection."I think we really need to focus on what we can do to prevent cases and what we can do to prevent severe disease," del Rio said.What's the CDC's current guidance?For now, the agency continues torecommendisolating for at least five days after you test positive for COVID-19, while keeping a distance from other people in your household. This means staying home from school and work for about a week.If your symptoms are improving and you are fever-free for 24 hours without taking any fever-reducing medications like acetaminophen, you can end isolation on day five, the CDC says. If your symptoms are not improving by day five, continue to isolate until you feel better, and your fever is gone.After ending isolation, you should continue to wear a high-quality mask around other people until at least 10 days after the positive test, according to the agency. You may stop wearing a mask earlier if you have two negative tests 48 hours apart.If you had shortness of breath or trouble breathing,isolate for at least 10 days, the CDC says. The same applies to people who were hospitalized or who have a weakened immune system; these patients should talk to their doctor before ending isolation.CNN's Jamie Gumbrecht, Brenda Goodman, Deidre McPhillips and Meg Tirrell contributed to this report.

California and Oregonrecently became the first states to break with the U.S. Centers for Disease Control and Prevention on how long a person infected with COVID-19 should isolate, saying that people who test positive are no longer expected to isolate for at least five days and those without symptoms don't have to isolate at all.

The CDC is considering a shift in its COVID-19 isolation guidance to say that people no longer need to isolate once they have been fever-free for 24 hours and their symptoms are mild or improving, according to theWashington Post.

In a statement Tuesday, the agency told CNN that there were no changes to announce at this time.

"We will continue to make decisions based on the best evidence and science to keep communities healthy and safe," spokesperson Dave Daigle said.

Wastewater surveillancedatapublished by the CDC suggests that COVID-19 is still circulating at high levels across the U.S., and experts emphasize that until any new recommendations are announced, most people should continue to follow the CDC's current guidance: isolating for at least five days after you test positive for COVID-19 then wearing a mask until at least 10 days after a positive test. If you're not fever-free for 24-hours without taking fever-reducing medications at day five, you should isolate longer.

Even if the CDC changes its guidance,statehealth departments can still implement their own.

People who test positive for COVID-19 in California and Oregon are no longer expected to isolate for a set period of time. Those without symptoms don't have to isolate at all, and those with symptoms can return to school or work once their symptoms are improving and they've been fever-free for at least 24 hours, according to the state policies.

"Most school systems and most places of employment will go along with whatever the state is recommending," said Dr. Peter Hotez, who co-directs the Center for Vaccine Development at Texas Children's Hospital. "You're more or less obligated for to follow that guideline."

Health officials in those states say the changes to their isolation guidelines reflect policy that's evolving along with the pandemic. Both California and Oregon still encourage people who test positive to wear a mask around others for at least 10 days.

Dr. Carlos del Rio, a professor of medicine in the Division of Infectious Diseases at the Emory University School of Medicine, said the CDC may take a similar step as evidence shows infections becoming milder.

The CDC notes that "infections arecausing severe disease less frequentlythan earlier in the pandemic."

Changes to CDC's guidance could bring COVID-19 in line with other respiratory viruses, such as flu and RSV.

"We need to start ending COVID exceptionalism and incorporate COVID into our respiratory viruses," del Rio said. "At the end of the day, there's going to be a similar approach to all these viruses."

Some infectious disease experts also believe that a change would better align with how many Americans are already treating the virus.

"Currently, many of our citizens are no longer testing for COVID-19 and are not actively isolating," said Dr. Clay Marsh, West Virginia's COVID-19 czar. "With the caveat of the risk of long COVID and the potential for mortality in the elderly and immunocompromised, the future guidance by CDC meets the standard we are seeing."

West Virginia currently recommends that people who've tested positive for COVID isolate for at least five days, according to the state's Department of Health.

Hotez isn't a fan of ending isolation for people who don't have symptoms, particularly because COVID-19 is generally more severe than the flu and because asymptomatic COVID-19 cases are more common.

He says he would like to see the CDC recommend using a home test after you have gone 24 hours without a fever.

"If you have an antigen test and if you're negative, then you can leave isolation," he proposed. If you test positive, you would keep isolating until you got a negative test.

"Home antigen tests give you an idea of how much virus you're actually shedding," he said. "That's the kind of thing the CDC needs to look at."

But in order to make a proper recommendation, Hotez says, the CDC would need to gather data on how many people test positive for COVID-19 after a 24-hour period with no fever.

Experts say COVID-19 vaccinations which are helpful in preventing the spread of the virus as well as severe illness or death could also lessen the need for isolation if they were utilized more.

"You're isolating because you're worried that you're shedding virus," Hotez said. "People forget that vaccinations can have a big effect on reducing the amount of virus shedding."

The latest COVID-19 shot was rolled out in September. It's a monovalent vaccine formulated to target newer variants of the virus that are currently circulating.

But not enough Americans are getting the updated vaccine, Hotez and del Rio say, exposing older adults and people with weakened immune systems to severe infection.

"I think we really need to focus on what we can do to prevent cases and what we can do to prevent severe disease," del Rio said.

For now, the agency continues torecommendisolating for at least five days after you test positive for COVID-19, while keeping a distance from other people in your household. This means staying home from school and work for about a week.

If your symptoms are improving and you are fever-free for 24 hours without taking any fever-reducing medications like acetaminophen, you can end isolation on day five, the CDC says. If your symptoms are not improving by day five, continue to isolate until you feel better, and your fever is gone.

After ending isolation, you should continue to wear a high-quality mask around other people until at least 10 days after the positive test, according to the agency. You may stop wearing a mask earlier if you have two negative tests 48 hours apart.

If you had shortness of breath or trouble breathing,isolate for at least 10 days, the CDC says. The same applies to people who were hospitalized or who have a weakened immune system; these patients should talk to their doctor before ending isolation.

CNN's Jamie Gumbrecht, Brenda Goodman, Deidre McPhillips and Meg Tirrell contributed to this report.

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CDC isolation guidelines for COVID-19 haven't changed yet. Here's what you need to know - WBAL TV Baltimore

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What should I do if I have COVID in 2024? Experts on isolation rules. - USA TODAY

Americans who test positive for the coronavirus no longer need to routinely stay home from work and school for five days under new guidance planned by the Centers for Disease Control and Prevention.

The agency is loosening its covid isolation recommendations for the first time since 2021 to align it with guidance on how to avoid transmitting flu and RSV, according to four agency officials and an expert familiar with the discussions.

CDC officials acknowledged in internal discussions and in a briefing last week with state health officials how much the covid-19 landscape has changed since the virus emerged four years ago, killing nearly 1.2 million people in the United States and shuttering businesses and schools. The new reality with most people having developed a level of immunity to the virus because of prior infection or vaccination warrants a shift to a more practical approach, experts and health officials say.

Public health has to be realistic, said Michael T. Osterholm, an infectious-disease expert at the University of Minnesota. In making recommendations to the public today, we have to try to get the most out of what people are willing to do. You can be absolutely right in the science and yet accomplish nothing because no one will listen to you.

The new guidance, which is expected in the spring, would bring covid-19 in line with recommendations for other respiratory viruses. Reporter Lena Sun explains. (Video: Drea Cornejo/The Washington Post)

The CDC plans to recommend that people who test positive for the coronavirus use clinical symptoms to determine when to end isolation. Under the new approach, people would no longer need to stay home if they have been fever-free for at least 24 hours without the aid of medication and their symptoms are mild and improving, according to three agency officials who spoke on the condition of anonymity to share internal discussions.

The federal recommendations follow similar moves by Oregon and California. The White House has yet to sign off on the guidance that the agency is expected to release in April for public feedback, officials said. One agency official said the timing could move around a bit until the guidance is finalized.

Work on revising isolation guidance has been underway since last August but was paused in the fall as covid cases rose. CDC director Mandy Cohen sent staff a memo in January that listed Pan-resp guidance-April as a bullet point for the agencys 2024 priorities.

Officials said they recognized the need to give the public more practical guidelines for covid-19, acknowledging that few people are following isolation guidance that hasnt been updated since December 2021. Back then, health officials cut the recommended isolation period for people with asymptomatic coronavirus from 10 days to five because they worried essential services would be hobbled as the highly transmissible omicron variant sent infections surging. The decision was hailed by business groups and slammed by some union leaders and health experts.

The plan to further loosen isolation guidance when the science around infectiousness has not changed is likely to prompt strong negative reaction from vulnerable groups, including people older than 65, those with weak immune systems and long-covid patients, CDC officials and experts said.

Doing so sweeps this serious illness under the rug, said Lara Jirmanus, a clinical instructor at Harvard Medical School and a member of the Peoples CDC, a coalition of health-care workers, scientists and advocates focused on reducing the harmful effects of covid-19.

Public health officials should treat covid differently from other respiratory viruses, she said, because its deadlier than the flu and increases the risk of developing long-term complications. As many as 7 percent of Americans report having suffered from a slew of lingering covid symptoms, including fatigue, difficulty breathing, brain fog, joint pain and ongoing loss of taste and smell, according to the CDC.

The new isolation recommendations would not apply to hospitals and other health-care settings with more vulnerable populations, CDC officials said.

While the coronavirus continues to cause serious illness, especially among the most vulnerable people, vaccines and effective treatments such as Paxlovid are available. The latest versions of coronavirus vaccines were 54 percent effective at preventing symptomatic infection in adults, according to data released Feb. 1, the first U.S. study to assess how well the shots work against the most recent coronavirus variant. But CDC data shows only 22 percent of adults and 12 percent of children had received the updated vaccine as of Feb. 9, despite data showing the vaccines provide robust protection against serious illness.

Coronavirus levels in wastewater indicate that symptomatic and asymptomatic infections remain high. About 20,000 people are still hospitalized and about 2,300 are dying every week, CDC data show. But the numbers are falling and are much lower than when deaths peaked in January 2021 when almost 26,000 people died of covid each week and about 115,000 were hospitalized.

The lower rates of hospitalizations were among the reasons California shortened its five-day isolation recommendation last month, urging people to stay home until they are fever-free for 24 hours and their symptoms are mild and improving. Oregon made a similar move last May.

Californias state epidemiologist Erica Pan said the societal disruptions that resulted from strict isolation guidelines also helped spur the change. Workers without sick leave and those who cant work from home if they or their children test positive and are required to isolate bore a disproportionate burden. Strict isolation requirements can act as a disincentive to test when testing should be encouraged so people at risk for serious illness can get treatment, she said.

Giving people symptom-based guidance, similar to what is already recommended for flu, is a better way to prioritize those most at risk and balance the potential for disruptive impacts on schools and workplaces, Pan said. After Oregon made its change, the state has not experienced any disproportionate increases in community transmission or severity, according to data shared last month with the national association representing state health officials.

California still recommends people with covid wear masks indoors when they are around others for 10 days after testing positive even if they have no symptoms or becoming sick. You may remove your mask sooner than 10 days if you have two sequential negative tests at least one day apart, the California guidance states.

Its not clear whether the updated CDC guidance will continue to recommend masking for 10 days.

Health officials from other states told the CDC last week that they are already moving toward isolation guidelines that would treat the coronavirus the same as flu and RSV, with additional precautions for people at high risk, said Anne Zink, an emergency room physician and Alaskas chief medical officer.

Many other countries, including the United Kingdom, Denmark, Finland, Norway and Australia, made changes to isolation recommendations in 2022. Of 16 countries whose policies California officials reviewed, only Germany and Ireland still recommend isolation for five days, according to a presentation the California public health department gave health officials from other states in January. The Singapore ministry of health, in updated guidance late last year, said residents could return to normal activities once coronavirus symptoms resolve.

Even before the Biden administration ended the public health emergency last May, much of the public had moved on from covid-19, with many people having long given up testing and masking, much less isolating when they come down with covid symptoms.

Doctors say the best way for sick people to protect their communities is to mask or avoid unnecessary trips outside the home.

You see a lot of people with symptoms you dont know if they have covid or influenza or RSV but in all three of those cases, they probably shouldnt be at Target, coughing, and looking sick, said Eli Perencevich, an internal medicine professor at the University of Iowa.

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CDC plans to drop five-day covid isolation guidelines - The Washington Post

Overview

SARS-CoV-2 PCR percent positivity, as detected in integrated sentinel surveillance as part of the Global Influenza Surveillance and Response System (GISRS) and reported to FluNet was around 10% as of 4 February 2024.

Globally, the number of new cases decrease by 58% during the 28-day period of 8 January to 4 February 2024 as compared to the previous 28-day period, with over 503 000 new cases reported. The number of new deaths decreased by 31% as compared to the previous 28-day period, with over 10 000 new fatalities reported. As of 4 February 2024, over 774 million confirmed cases and more than seven million deaths have been reported globally.

During the period from 8 January to 4 February 2024, COVID-19 new hospitalizations and admissions to an intensive care unit (ICU) both recorded an overall decrease of 32% and 38% with over 114 000 and more than 1300 admissions, respectively.

Globally, JN.1 is the most reported VOI (now reported by 99 countries), accounting for 88.0% of sequences in week 4 of 2024 compared to 64.5% in week 52 of 2023.

In this edition, we include:

See more here:

COVID-19 epidemiological update 16 February 2024 - World Health Organization (WHO)

As the medical world continues to grapple with the complexities of the ever-changing COVID-19 virus, theres a growing focus on the potential long-term effects of the illness.

Now there's a new comprehensive analysis recently published in the American Academy of Pediatrics' (AAP) publication Pediatrics. They looked at research from previous scientific studies around the world to highlight what is currently known about long COVID and the potential effects it has on children. It is sometimes also called long haul COVID or Postaacute Sequelae of COVID-19 (PASC).

The review found that in some cases, long COVID can lead to neurological, gastrointestinal, cardiovascular, and behavioral issues months after acute infection.

Suchitra Rao, MD, a pediatric infectious disease expert at Childrens Hospital Colorado, and co-author of the review explains that occasionally, a persons immune response to fighting off a virus can be harmful.

It can start attacking its own cells inadvertently, which can lead to autoimmune and other post-infectious conditions, she says. The studies included in the review found those post-COVID conditions included type 1 diabetes, Graves disease, lupus, and Immune thrombocytopenia (ITP) or low platelets.

Long COVID, she cautions, can present in many different ways, affecting virtually any organ system.The review includes a range of studies that look at a variety of factors, such as the patients age, severity of initial infection, and hospitalizations.

Rachel S. Gross, MD, MS, a general pediatrician, clinical research investigator, and an Assistant Professor of Pediatrics at the NYU School of Medicine and Bellevue Hospital Center, is one of the dozens of pediatric clinicians and researchers participating in the National Institutes of Health-funded RECOVER (Researching COVID to Enhance Recovery) Initiative. It aims to improve the diagnosis, treatment, and prevention of long Covid in children.

Dr. Gross says while the research currently indicates that long COVID is more prevalent in adults, its a common misconception that children are not at risk.

According to the Centers for Disease Control and Prevention (CDC), long COVIDin both children and adultsis when a person has symptoms that last weeks, months, or even years after their COVID infection. It can include symptoms they had during the infection that lingers or new symptoms that they didnt have beforeand these symptoms can even come and go.

Sometimes, long COVID can happen to people who had a mild COVID-19 infection or didn't even know they had the virus to begin with. Some may also start to feel better after an initial infection and then begin having symptoms again.

According to RECOVER,there are more than 40 symptoms of long COVID in children and young adults. Children who have long COVID can have any mix of them.

Some of the most common symptoms of long COVID in children include fatigue, brain fogor trouble concentrating on daily tasks, headaches, and sleep issues.It may also affect what a child can do during the day, like how they play or if they can go to school. They may also have trouble walking or standing, including walking up stairs, worsening of symptoms after being active, or needing to rest more.

Dr. Gross says the impact of long COVID on childrens mental health is also well-documented, and these symptoms can include mood changes, feeling sad, anxious, angry, or stressed.

More severe cases can include prolonged cardiac complications like myocarditis (MIS-C) and arrhythmias.Long COVID in those with pre-existing conditions may experience aggravated or worsening of those conditions, particularly those with respiratory issues like asthma, according to the CDC.

Long COVID does not look the same in everyone, with different people experiencing different symptoms. In children, who are still growing, this is especially true, says Dr. Gross. Thats why RECOVER is conducting research to learn why this happens, how to treat it, and ways to prevent it.

Data from the National Health Interview Survey published by the CDC shows the prevalence of long COVID in children in 2022 was about 1.3% while the estimate in adults was closer to 7%.

According to the RECOVER Initiative though, estimates appear higher. The review, which gathered data from the start of the pandemic in 2019, says 10-20% of children who had an initial COVID infection developed long COVID, and that it affected up to 5.8 million children.

Dr. Rao says there is still much to be learned about why some patients experience long COVID symptoms but not others and more clinical trials are needed to evaluate the effectiveness of treatments for the illness in children. She says the current COVID vaccine, along with booster shots, have helped reduce and prevent the risk of long COVID-19.

There are trials underway exploring whether longer courses of antiviral treatments during the acute phase of infection may decrease the risk of long COVID, but it is not recommended at this time, she explains.

For children who do experience long COVID, getting lots of rest can help in the recovery process and may help symptoms from getting worse.

Doctors also say recovery should include:

Experts say if you notice your child having lingering or new symptoms following a COVID-19 infection, it is important to consult with a health care professional. Parents and caregivers can make an appointment with their childs doctor to talk about their concerns or talk about these issues during their childs regular visits.

It is also recommended to keep a log of the start of symptoms, the severity, and anything that may make their child feel better or worse.

For more information on symptoms of Long COVID, and how parents and caregivers can speak with a pediatrician, please see the RECOVER Pediatric Long COVID Tip Sheet.

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New Report Looks at the Effects of Long COVID in Children - Parents

The latest HILDA survey shows Australias gender gap in employment continuing to close, with progress beginning on the earnings gap.

Remarkably, the progress has continued notwithstanding the disruptions caused by COVID; there are indications they may even have helped.

Funded by the Australian government and managed by the Melbourne Institute, the Household, Income and Labour Dynamics in Australia (HILDA) survey is one of Australias most valuable social research tools.

HILDA examined the lives of 14,000 Australians in 2001 and has kept coming back each year to discover what has changed. By surveying their children as well, and in future surveying their grandchildren, it is building up a long-term picture of how the lives of Australians are changing.

The full span of the surveys through to the results for 2021 released this morning shows shows the proportion of women aged 18 to 64 in paid employment climbed from 64.3% in 2001 to 74.1% in 2019 before dipping during COVID and then bouncing back.

Separate labour force figures collected by the Bureau of Statistics suggest it might be as high as 76% by now, indicating that COVID may have merely dented rather than turned back progress.

For men of that age, the proportion in paid employment has changed little during those two decades, fluctuating between 80% and 84%, allowing the gap in employment between men and women to narrow eight percentage points.

Older women aged 65 to 69 are also much more likely to be employed. Most of the gain has taken place since 2009 when one in ten women of that age were in paid employment, a figure that has since climbed to one in four, not too far off the one in three men of that age employed.

Read more: Older women are doing remarkable things it's time for putdowns to end

Much of the increase would be due to the phased increase in the female pension age between 1995 and 2004 and the further increase in both the male and female pension age between 2017 and 2023. Broader social and economic changes such as the increase in two-earner couples will have also played a role.

While men remain well ahead in full-time employment, that gap is narrowing too. The proportion of women aged 18 to 64 employed full-time has climbed from around 35% to around 40% while the proportion for men has stayed close to 70%.

Previous HILDA reports have shown the arrival of children remains an important driver of divergence in the labour market experiences of men and women.

The arrival of a couples first child sees hours of paid work of the mother plummet and in many cases not recover for more than a decade. It has almost no effect on the paid working time of fathers.

Time spent on housework and child care, by contrast, rises dramatically for mothers and actually falls slightly for fathers.

If the gender gap in employment is to be eliminated, it is clear couples with children will need to share the load more equally.

Male and female earnings have been converging slower than male and female employment, but the pace has picked up.

In 2001, women employed full-time earned on average 79% of what men earned. As recently as 2016, they still earned only 78% of what men earned.

But, since then, their earnings relative to male earnings have shot up, hitting 86% in 2021.

The gap in earnings of all employees full-time and part-time is greater because women are more likely to be employed part-time, but growth in the number of women employed full-time means this gap is closing faster. Average female earnings have climbed from 66% of male earnings in 2001 to 75% in 2021.

While the pandemic seemed to hurt womens employment prospects more than mens, longer term it seems to be improving the relative position of women.

HILDA shows the proportion of employees working from home in 2020 and 2021 has increased substantially.

The proportion working any hours at home climbed from 25.1% in 2019 to 37.3% in 2021. The proportion working only at home climbed from 3.5% to 17.7%.

There has also been a sizeable rise in the proportion of employees reporting an entitlement to work from home, from 35% in 2019 to 45%.

While the increases were greatest in the regions that experienced extensive lockdowns Victoria, NSW and the ACT working from home increased in almost all parts of Australia.

Read more: HILDA finds working from home boosts women's job satisfaction more than men's, and that has a downside

HILDA shows women have been more likely to work from home than men since COVID, even after accounting for differences in the occupations and industries in which they work.

This is probably because of an increase in the number and types of jobs that can be worked at home by mothers with caring responsibilities.

But this latest 2021 HILDA survey also reveals another gender gap in the labour market: women are more likely to work while unwell, including working at the workplace while unwell.

There are health risks from working from home while unwell and also career risks from working at home. Being physically present in the workplace is likely to assist with career advancement.

Out of sight can mean out of mind when it comes to promotions.

Also providing a glimmer of hope for closing the gender gaps in the labour market is that, among parents with children, weve seen an increase in the time men have been spending on household chores and looking after the children.

The improvement accelerated slightly in 2020 and 2021, via both an increase in the hours worked on domestic chores by men and a slight decrease for women.

But there is a long way to go. In 2021, mothers of dependent children were still spending 75% more time on unpaid housework and child care than their male partners.

The mothers spent 53 hours per week. Their male partners spent 30 hours.

Read more: HILDA survey at a glance: 7 charts reveal we're smoking less, taking more drugs and still binge drinking

Originally posted here:

HILDA data show women's job prospects improving relative to men's, and the COVID changes might have helped - The Conversation