Category: Covid-19

A recentNature Machine Intelligencestudy investigated the efficacy of audio-based artificial intelligence (AI) classifiers in predicting severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection status. SARS-CoV-2 is the causal organism of the coronavirus disease 2019 (COVID-19) pandemic.

Study: Audio-based AI classifiers show no evidence of improved COVID-19 screening over simple symptoms checkers. Image Credit:Aliaksandra Post/ Shutterstock

Since SARS-CoV-2 infection could cause both symptomatic and asymptomatic manifestations, it is important to develop accurate tests to avoid general population quarantine. Previous studies have revealed that AI-based classifiers trained with respiratory audio data could identify SARS-CoV-2 status.

Although these studies indicated the effectiveness of AI-based classifiers, many challenges surfaced while applying them in real-world settings. Some factors that withheld AI-based classifier applications were sampling biases, unvalidated data on participants' COVID-19 status, and delay between infection and audio recording. It is imperative to determine whether the audio biomarkers of COVID-19 are unique to SARS-CoV-2 infection or are inappropriate confounding signals.

The current study focussed on determining whether audio-based classifiers can be accurately used for COVID-19 screening. A large-scale polymerase chain reaction (PCR) dataset linked to audio-based COVID-19 screening (ABCS) was used. For this study, participants of the Real-time Assessment of Community Transmission (REACT) program and the National Health Service (NHS) Test-and-Trace (T+T) service were invited. All relevant demographic data was extracted from T+T/REACT records.

Participants were asked to complete survey questions and record four audio clips. For audio recordings, they were asked to read a specific sentence, followed by three successive exhalations, making a "ha" sound. Furthermore, the participants were asked to record forced coughs once and three times in succession. All recordings were documented in .wav format. The quality of the audio recordings was assessed, and 5,157 records were removed for quality-related issues.

Human figures represent study participants and their corresponding COVID-19 infection status, with the different colours portraying different demographic or symptomatic features. When participants are randomly split into training and test sets, the randomized split models perform well at COVID-19 detection, achieving AUCs in excess of 0.8; however, matched test set performance is seen to drop to estimated AUC between 0.60 and 0.65, with an AUC of 0.5 representing random classification. Inflated classification performance is also seen in engineered out of distribution test sets such as: the designed test set, in which a select set of demographic groups appear solely in the testing set, and the longitudinal test set, in which there is no overlap in the time of submission between train and test instances. The 95% confidence intervals calculated via the normal approximation method are shown, along with the correspondingnnumbers of the train and test sets.

In this study, a respiratory acoustic dataset of 67,842 individuals was collected. Among them, 23,514 individuals tested positive for COVID-19. All data were linked with PCR test results. It must be noted that the most significant number of COVID-19-negative participants were recruited from six REACT rounds compared to the T+T channel.

The dataset considered in this study exhibited promising coverage across England. No significant association between geographical location and COVID-19 status was noted. The highest level of COVID-19 imbalance was found in Cornwall. A previous study indicated recruitment bias in ABCS, particularly linked with age, language, and gender, in both training data and test sets. Despite this bias, the training dataset was balanced in accordance with age and gender across COVID-positive and COVID-negative subgroups.

Consistent with previous studies, the unadjusted analysis conducted in this study exhibited that AI classifiers can predict COVID-19 status with high accuracy. However, when measured confounders were matched, a weak performance of AI classifiers in detecting SARS-CoV-2 status was observed.

Based on the findings, the current study proposed some guidelines to rectify recruitment bias's effect for future studies. Some of the recommendations are listed below:

The current study has come with limitations that include the possibility of potential unmeasured confounders across REACT and T+T recruitment channels. For instance, PCR testing for COVID-19 was performed several days after self-screening of symptoms. In contrast, PCR tests in REACT were conducted on a pre-determined date, irrespective of the onset of symptoms. Although the majority of confounders were matched, there is a possibility of the presence of residual predictive variation.

Despite the limitations, this study highlighted the need to develop accurate machine-learning evaluation procedures to obtain unbiased outputs. Furthermore, it revealed that confounding factors are hard to detect and control across many AI applications.

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AI's ability to detect COVID-19 from coughs faces real-world challenges - News-Medical.Net

An 8-week online rehabilitation program helped long-COVID patients improve their quality of life, according to a new study published in The BMJ.

Compared to standard care, UK patients who completed online group sessions as part of the REGAIN program saw less fatigue, pain, and depression, in one of the first trials to measure outcomes of a long-COVID rehab program. The trial took place between January 2021 and July 2022.

The trial participants included 585 adults (average age 56 years) who had been hospitalized for COVID-19 at least 3 months earlier and reported substantial lasting symptoms. Overall, 88% of participants were overweight or obese, and 34% had been admitted to the intensive care unit (ICU) for COVID.

Baseline health-related quality of life was low, and 43% of participants had a mental health disorder, the authors said.

"The most common pre-existing medical conditions related to chest or breathing (444/585; 76%) and musculoskeletal conditions (275/585; 47%), and more than one third of participants were unable to work owing to post-covid-19 condition (222/585; 38%)," the authors wrote.

Half of the participants (287) were randomized to receive standard care (a single online session of advice) and 298 to the REGAIN intervention (eightweekly home-based, group exercise and psychological support sessions delivered online).

Participant outcomes were assessed at 3, 6, and 12 months.

At 3 months, 17% (39) of the intervention group reported that their overall health was "much better now" compared with 8% (20) in the usual-care group. One serious adverse event of fainting and vomiting after exercise was deemed possibly related to the intervention, and two adverse events (knee pain with exercise, and severe anxiety before exercise) were deemed definitely related, the authors said.

There were no improvements at the 6-month mark, but by 12 months participants in the REGAIN group showed significant improvements.

Overall participants in the REGAIN intervention group had higher odds (odds ratio 1.66; 95% confidence interval, 1.14 to 2.41) of being more physically active compared with participants in the usual care group.

Importantly, the magnitude of improvement in the REGAIN intervention group for post-traumatic stress disorder was twofold greater than in the control group.

"This is an important finding given the high levels of post-traumatic stress disorder witnessed in this population, and the known impact of this on health related quality of life and social and economic productivity," the authors said.

In an editorial on the study, professors of exercise science from two universities in Australia emphasized there were no cases of myalgic encephalomyelitis/chronic fatigue syndrome reported in the REGAIN group.

Regular monitoring in the REGAIN trial did not identify any episodes of post-exertional exacerbations of symptoms.

"Regular monitoring in the REGAIN trial did not identify any episodes of post-exertional exacerbations of symptoms, providing reassurance that individualised exercise at home in online groups supervised by a trained physiotherapist or exercise physiologist is safe," the authors wrote.

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Long-COVID patients see improvement with online program - University of Minnesota Twin Cities

A new study led by the Boston University School of Public Health (BUSPH) challenges prevailing narratives about the causes of excess mortality during the COVID-19 pandemic.

The research has produced compelling evidence that many deaths previously attributed to natural causes were, in fact, uncounted fatalities from COVID-19.

Official COVID-19 mortality statistics have not fully captured deaths attributable to SARS-CoV-2 infection in the United States, wrote the researchers.

While some excess deaths were likely related to pandemic health care interruptions and socioeconomic disruptions, temporal correlations between reported COVID-19 deaths and excess deaths reported to non-COVID-19 natural causes suggest that many of those excess deaths were unrecognized COVID-19 deaths.

The investigation represents a significant stride in understanding the true toll of the pandemic.

Kristin Urquiza co-founded Marked By COVID, a justice and remembrance movement, after losing her father to COVID. This study documents the deadliness of COVID-19 and the effectiveness of public health interventions, said Urquiza. The least we can do to honor those who died is to accurately account for what happened.

The official count of COVID-19 deaths in the United States stands at nearly 1.17 million, according to federal data. However, this figure is believed to be an underestimation, as suggested by multiple excess mortality studies.

Excess mortality refers to the number of deaths during a given time period that surpasses the number expected under normal circumstances.

Until now, the challenge has been to determine whether these additional deaths were directly due to COVID-19 or resulted from indirect consequences of the pandemic, such as healthcare disruptions or socioeconomic factors.

In collaboration with researchers at the University of Pennsylvania, the BUSPH team provides the first definitive evidence linking a significant portion of excess deaths during the pandemic directly to COVID-19, rather than to non-COVID natural causes like chronic illnesses.

By analyzing monthly data on natural-cause deaths and reported COVID-19 fatalities across 3,127 U.S. counties from March 2020 to August 2022, the team discovered that spikes in non-COVID natural cause deaths coincided with or preceded surges in COVID-19 deaths in most regions. This pattern suggests that many deaths were misclassified and should have been attributed to COVID-19.

Our findings show that many COVID-19 deaths went uncounted during the pandemic. Surprisingly, these undercounts persisted well beyond the initial phase of the pandemic, said study co-author Dr. Andrew Stokes, who has led numerous studies analyzing excess mortality patterns and drivers during the pandemic.

According to Dr. Stokes, the temporal correlation between reported COVID-19 deaths and excess deaths reported to non-COVID-19 natural causes offers insight into the causes of these deaths.

We observed peaks in non-COVID-19 excess deaths in the same or prior month as COVID-19 deaths, a pattern consistent with these being unrecognized COVID-19 deaths that were missed due to low community awareness and a lack of COVID-19 testing.

Study lead author Eugenio Paglino, a PhD student at UPenn, noted that if the primary explanation for these deaths were healthcare interruptions and delays in care, the non-COVID excess deaths would likely occur after a peak in reported COVID-19 deaths and subsequent interruptions in care. However, this pattern was not observed nationally or in any of the geographic subregions we assessed, said Paglino.

The study also disproves any claims that mortality during the pandemic can be attributed to COVID-19 vaccinations or shelter-in-place policies.

Dr. Nahid Bhadelia, founding director of the Boston University Center for Emerging Infectious Diseases Policy and Research, said that the research is important because our ability to detect and correctly assign deaths during an epidemic goes to the heart of our understanding of the disease and how we organize our response.

The study is published in the journal Proceedings of the National Academy of Sciences.

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The government continued to dedicate enormous resources to investigating and prosecuting fraud against COVID-19 pandemic relief programs[1] in 2023. While we observed some civil False Claims Act settlements, criminal enforcement continued to dominate COVID-19 enforcement headlines, with some attention-grabbing stories involving politicians, government employees, and those with connections to gangs and transnational crime networks.

The wave of civil pandemic fraud enforcement that we anticipate coming has not yet publicly materialized, but a few pandemic-related False Claims Act (FCA) cases emerged in 2023. A large medical institution agreed to pay more than $2 million to resolve fraud claims, including an allegation that it double-billed for COVID-19 testing. Specifically, a whistleblower alleged that the institution submitted claims to the Health Resources and Services Administration (HRSA) for reimbursement in connection with COVID-related care; however, the institution had already received reimbursement for the services by the State of Texas or City of Houston.

Two civil FCA cases involved allegedly medically unnecessary respiratory pathogen panel (RPP) testing added on to COVID-19 testing. Previously, DOJ pursued criminal penalties in matters involving similar conduct.

One civil FCA matter resolved in 2023 involved a Maryland-based billing company for diagnostic laboratories that agreed to pay roughly $300,000 to resolve allegations that it caused the submission of false claims to Medicare for medically unnecessary RPP testing run on seniors who received COVID-19 tests. The billing company received cooperation credit for performing and disclosing results of an internal investigation, providing information regarding other actors potential misconduct, and admitting liability.

DOJ similarly filed a complaint against an individual and multiple laboratory companies owned by the individual for offering COVID-19 tests to nursing homes as a way to bill Medicare for a wide array of medically unnecessary RPP tests. In that matter, DOJ alleged that the companies had submitted false claims to Medicare for RPP testing not ordered by providers, not medically necessary, and sometimes never performed, including testing ordered for over 300 deceased beneficiaries.

In a PPP-related case, an automotive group agreed to pay $9 million to resolve allegations that it violated the FCA by certifying that it was a small business in connection with a PPP loan obtained and later forgiven when, in fact, the company was under common operational control with dozens of dealerships across the country and had more than 3,000 employees.

Qui tam FCA lawsuits are filed under seal while DOJ investigates the allegations, which can sometimes take years depending on the complexity and scope of the alleged underlying fraud. For this reason, we expect more FCA lawsuits involving COVID-19 relief to become public in 2024 and beyond as the governments investigations progress.

We also expect additional enforcement involving the Provider Relief Fund (PRF) in 2024, similar to the Civil Monetary Penalties Law settlements this year involving PRF payment recipients who were ineligible to receive or retain those payments.[2] The PRF, which was authorized by the Coronavirus Aid, Relief, and Economic Security (CARES) Act, was a major pandemic relief program that allocated $178 billion to hospitals, health systems, and all other health care providers that billed Medicare. The HRSA administered the program in four phases of payments, plus hot spot and targeted payments to providers. In June 2023, as part of the debt ceiling resolution, Congress rescinded all unobligated PRF funds in the amount of $27 billion. HRSAs administrative recovery efforts, as well as DOJs civil enforcement activities, are now turning federal attention to recovery of funds that may have been obtained inappropriately.

A sign of this trend is a qui tam action unsealed in June 2023, and filed in November 2021, against several New Jersey hospitals, management services organizations, and the hospitals chief executive officer and chief financial officer for allegedly refusing to return PRF funds for which the defendants knew they were not eligible, and for allegedly using PRF money for impermissible purposes. The relator, the former system chief medical officer and chief hospital executive for one of the defendant hospitals, alleged that the defendant hospitals received over $50 million in hot spot distributions to which the hospitals were not entitled. The relator alleged that he repeatedly insisted that the hospitals self-report the overpayment and return the funds. PRF funds were administered on an emergency basis, often with little guidance or controls, which could make FCA enforcement difficult, and which could have led to DOJs declination in this qui tam action. But we expect further cases like this one to emerge, likely driven by relators.

Administratively, there have been Government Accountability Office and Health and Human Services Office of Inspector General (HHS-OIG) reports and audits on PRF disbursements. An HHS-OIG report published in October 2023 revealed that while HHSs oversight was generally effective in ensuring that most of the approximately $39.3 billion in automatic PRF payments were properly calculated and disbursed to eligible providers, HHS did not ensure that approximately 5.5% of the disbursements were properly calculated, nor did HHS prevent less than 1% of disbursements from flowing to ineligible providers. To date, ~$2.6 billion in payments to noncompliant providers, overpayments, and unused payments have been identified for recovery by HRSA, but nearly $1.4 billion has yet to be recovered. There is much ground to cover in recouping improper PRF disbursements in 2024.

In March 2023, President Biden introduced a $1.6 billion pandemic anti-fraud proposal focused in part on ensuring resources for investigations and prosecutions of major or systemic pandemic fraud. In furtherance of this goal, President Biden expressed a desire to triple the COVID-19 anti-fraud strike forces pursuing pandemic fraudsters.

Following President Bidens remarks, the Department of Justice (DOJ) announced in August the creation of two additional COVID-19 Fraud Enforcement Strike Forces: one in the US Attorneys Office for the District of Colorado and the other in the US Attorneys Office for the District of New Jersey. There are now five COVID-19 strike forces, including those launched in September 2022 in the Eastern and Central Districts of California, the Southern District of Florida, and the District of Maryland. The strike forces are intended to strengthen the efforts and increase the reach of the COVID-19 Fraud Task Force established by the Attorney General in May 2021. The strike forces focus on large-scale, multistate COVID-19 relief fraud perpetrated by criminal organizations and transnational actors using prosecutor-led and data analyst-driven teams. The expansion of pandemic fraud strike forces signals the Biden administrations investment in investigating and prosecuting major or systemic pandemic fraud.

The fraud task forces demonstrated their value with two high-profile, nationwide takedowns in April and August 2023. These takedowns show the breadth of DOJs enforcement efforts and move the DOJ closer towards fulfilling its strategic goal of seeking restitution in at least 90% of applicable criminal cases concerning COVID-19 related fraud and increasing the percentage of COVID-19 related fraud cases resolved favorably to 90%.

In April, DOJ announced the first nationwide takedown of 2023. It included criminal charges against 18 defendants in nine federal districts across the country involving $490 million in COVID-19 related fraud the largest ever coordinated law enforcement action in the United States targeting health care fraud schemes that exploited the COVID-19 pandemic. The April takedown showed the power of data analytics in rooting out pandemic fraud. A single doctor allegedly defrauded HRSAs COVID-19 Uninsured Program (UP) by $230 million. This doctor was the second-highest biller to the UP in the country. The physician operated a small midwife practice, which transformed into one of the busiest vaccination sites in New York State, seemingly outpacing larger, state-run vaccination sites. The medical professionals who worked at this small midwife practice were charged with allegedly distributing nearly 2,700 forged COVID-19 vaccination record cards to unvaccinated individuals and destroying vials of COVID-19 vaccines intended to be used to inoculate patients.

DOJ expanded its COVID-19 enforcement success with another coordinated, nationwide action, announced in August 2023. This second takedown yielded charges against 371 defendants for offenses related to over $836 million in alleged COVID fraud affecting numerous federal programs, including the PPP, EIDL, and ERAP. Some 119 defendants arrested in the sweep pleaded guilty or were convicted at trial, and the cases resulted in restitution orders of over $57 million. The defendants arrested in the takedown included gang members who allegedly used pandemic funds to pay for murder for hire, and those with connections to transnational criminal networks.

As of August 2023, DOJ had seized over $1.4 billion in COVID relief funds and charged over 3,000 defendants with crimes in federal districts across the country.

In addition to coordinated takedowns, 2023 saw a broad range of individuals sentenced to jail and ordered to pay restitution for COVID-19 related fraud. A former Missouri state representative sought government reimbursement for COVID-19 testing allegedly performed at her nonprofit clinic when, in fact, the testing had been performed at her for-profit clinic and paid for by the clients at the for-profit clinic. A former Florida lawmaker pleaded guilty to wire fraud, money laundering, and making false statements in connection with obtaining COVID-19 relief. A former IRS employee pleaded guilty in connection with a scheme to defraud the EIDL program by submitting a false application and using the loan proceeds for unauthorized purposes. And a Florida corrections officer was charged with wire fraud in connection with a PPP loan obtained for an allegedly non-existent business. We anticipate additional high-profile cases in 2024.

With over $4.6 trillion in pandemic relief funding authorized since March 2020 and estimates of over $300 billion in fraud on pandemic relief programs thus far, we expect continued criminal enforcement into the foreseeable future as the government works to root out and prosecute the most nefarious and egregious fraud. The government cannot prosecute all pandemic reliefrelated fraud cases, but it seems to be focused on the cases likely to result in large monetary recoveries or cases that will generate substantial media coverage (which will, in turn, at least theoretically deter others from engaging in similar conduct). That said, given the governments continued investment in resources to investigate and prosecute pandemic relief fraud, and the sheer breadth of estimated fraud on pandemic relief programs, we anticipate criminal and civil actions will continue in 2024 and beyond.

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EnforceMintz COVID-19 Fraud Enforcement Unlikely to Slow Down in 2024 - Mintz

New research adds to the mounting evidence supporting the safety of Covid-19 mRNA vaccines for pregnant women, with potential benefits for their newborn babies.

The population-based cohort study, published February 6th in JAMA, found that exposure to mRNA COVID-19 vaccination during pregnancy did not increase the risk of adverse events in newborn infants. The study found that babies born to vaccinated mothers were less likely to experience serious complications, including death.

The study involved nearly 200,000 newborns from Sweden and Norway, making it the largest study on this topic to date.

Getting vaccinated can reduce the chances of severe or critical COVID-19 in pregnant individuals. Still, vaccination rates remain lower in pregnant individuals compared to the general population.

COVID-19 is still present in society and is probably something we will have to deal with for a long time, Mikael Norman, M.D., Ph.D., lead researcher of the study and professor of pediatrics and neonatal medicine at the Karolinska University Hospital in Stockholm Sweden, stated in an email to MHE.

It is therefore very important for all women who become pregnant every year to know that vaccination with mRNA-vaccines against COVID-19 is safe for their babies, he stated.

Using national registers in both countries, the study included 98% of all newborns from women who became pregnant after the Covid-19 vaccines became available. The data collection spanned from June 2021 to January 2023, with all babies followed up for at least one month or as long as they were admitted to a neonatal unit.

The results found no increased risks for newborn infants whose mothers were vaccinated against Covid-19 during pregnancy. Vaccination during pregnancy was associated with lower odds of neonatal intracranial hemorrhage, cerebral ischemia, hypoxic-ischemic encephalopathy, and death. The mortality rate among infants born to vaccinated mothers was only half as high compared to babies whose mothers were not vaccinated.

The study's findings have important implications for healthcare professionals, public health authorities, and expectant parents.

Despite the fact that the pandemic is over, the study and the results are of great importance for healthcare professionals offering counseling, authorities issuing recommendations, and above all, for anyone who will become pregnant in the future, Norman stated.

The research was primarily funded by Region Stockholm and the Karolinska Institutet, along with other organizations. The researchers disclosed no conflicts of interest.

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Largest Study to Date Confirms Safety of COVID-19 Vaccines in Pregnant Women - Managed Healthcare Executive

Before she caught the coronavirus, Rut Mulero was a globetrotter. She worked with the Peace Corp in Ukraine, volunteered with HIV-infected orphans in West Africa, and earned her masters from Johns Hopkins University.

But in the three years since she was first diagnosed, Mulero has been exhausted. Shes had to take disability leave from her job as a remote nurse, and dreams of hiking Machu Pichu in Peru are on hold. Even talking to friends on the phone is too much energy some days, she says.

Mulero is one of a large, but largely unknown, number of New Jersey residents who have been living with prolonged COVID-19 symptoms after their initial illness, usually called long COVID or post-acute COVID.

While New Jerseys Department of Health doesnt collect data on long COVID, a study conducted by the National Center for Health Statistics and the national Census Bureau suggests that up to 14% of all adults in New Jersey will meet the criteria for long COVID after an initial infection.

Thats at least 1 million people in New Jersey.

That is an underestimate, Lauren Stiles, the founder and president of Dysautonomia International, a non-profit advocacy group for people living with conditions of the autonomic nervous system, including long COVID.

There are a lot of people who have long COVID who never knew they had COVID when they actually had it because they were asymptomatic, or they just had a little mild thing, Stiles said. So its very hard for those people to relate their new onset chronic symptoms to COVID.

The symptoms of long COVID can be nebulous and theres no definitive diagnostic test.

Symptoms can include shortness of breath, brain fog, joint pain, prolonged loss of smell and taste, and fatigue, according to Dr. Sabiha Hussain, the director of the Long COVID Program at Robert Wood Johnson University Health and Rutgers Health.

That is absolutely the most difficult part of this, is that it is because the symptoms are so sort of, one, varied and, two, so common with other disease entities that people are having a hard time figuring it out, Hussain said.

When Mulero first developed COVID symptoms in January 2021, itstarted off like a bad flu - muscle aches, fever, headache. Initially, things seemed to get better, but weeks later, the post-COVID symptoms began. The headaches devolved into intractable migraines, and the aches seeped into her bones.

I woke up one time thinking I had broken my hips because I was in so much pain in my hips and I could barely move, Mulero said. I really thought I broke my hips while I was sleeping.

She developed visual hallucinations, her sense of taste became distorted, and fatigue became so bad she could barely stay awake.

It was worse than malaria, and malaria was pretty bad, Mulero said.

She started taking hormonal birth control pills to see that would ease the post-COVID symptoms, and for a few months it seemed like that did the trick. But in December 2021, less than a year after her initial infection, Mulero caught COVID a second time.

She hasnt been symptom-free since.

Her post-COVID symptoms are different now, Mulero said, presenting like myalgic encephalomyelitis / chronic fatigue syndrome, a debilitating condition that causes extreme fatigue.

I wake up fatigued, so my battery is already depleted versus everybody else, she said. I can only do so many not so many, so little things, during the day.

Ryan Thomas first contracted COVID in May 2022 on a work trip, and never saw an improvement.

Fatigue is just one of the symptoms that has derailed his life. Adrenaline surges cause what felt like eight hour long panic attacks, which turned into intense memory and concentration issues, he said.

Thomas has struggled to find doctors to take him seriously, and he says an application for disability benefits was denied because he sometimes feels good enough to play video games for a little bit.

Long COVID was added as a qualifying disability under the Americans with Disabilities Act in 2021.

Whenever I see a doctor, or even a specialist, sometimes even post-COVID clinics, there is a 50/50 chance that they are going to believe that what Ive said is true, Thomas said.

There just arent enough doctors to treat all of the patients, said Hussein, the long COVID clinic directo. Even during educational seminars shes run with the Department of Health, doctors would say they did not want to treat post-COVID symptoms, Hussein said.

The major thing was, the complexity of care is just too huge, Hussein said. Primary care doctors cant handle the breadth of a long COVID symptoms in the time allotted for a typical appointment, she said.

Patients who think they might have long COVID, or who have been diagnosed and need a managing physician, can check patient support groups on Facebook for recommendations of knowledgable doctors, Stiles said.

Patients are really, really struggling to find doctors who feel comfortable treating it and who actually know what to do for them, Stiles said. And even if patients can find a good doctor, some of them are not accepting new patients or have months-long weight lists.

Adding to the challenges in diagnosing and treating is the vast spectrum of symptom severity. Not every patient who develops long COVID will become totally disabled, said Dr. David Sousa, the medical director at the Atlantic COVID Recovery Center.

Weve seen people with very severe very debilitating disease, and weve seen people with more mild symptoms, and it sort of varies, he said.

Some people recover from long COVID, but the condition is too new to understand the longterm ramifications.

Hussein compared the impact of long COVID to 9/11-related cancers, saying, We thought that it would likely not result in anything but you know, weve had now we have the World Trade Center program going on for 25 years.

Our experience is that its been an individual scenario, and there are some people who struggle with symptoms for quite some time, and there are some people their symptoms dissipate, Sousa said.

Mulero and Thomas, in separate interviews, both discussed the mental health impact of long COVID and having to come to terms with a new normal.

I cant really say that I have a lot of hope for the future. I would like to be able to say differently, but I cant in good conscience, Thomas said. Its a weird thing to say, but I miss being able to wake up in the morning and I want to do something and just doing it.

Mulero isnt done planning for the future.

Some of her symptoms are getting better with new medications. Shes seeing a doctor at the RWJUH Long COVID Clinic and says shes to the point where Im a bit functional where I can actually have a life of some sort.

Her long-term disability benefits have run out, so shes going to go back to her virtual nursing job soon.

I want to climb Machu Picchu. How am I going to do that now? I dont want to think that I cant do it, she said. But I do have to understand that I do have limitations now that prevents me from doing the things that I would really like to do.

Her days still require meticulous planning to make sure she doesnt over-do it. She cant walk too far, and even just showering and cleaning the bathroom in the same day is too much. She grieves a life that she can no longer live the way she used to but that life isnt over yet.

I have to come up with a different way of how Im going to travel, how Im gonna get to where I want to go, Mulero said.

Editors Note: If youre facing a mental health challenges, youre not alone. Mental health disorders affect people from all areas of life and all ages, but are treatable. Call Mental Health Services Administrations national helpline at 1-800-662-HELP (4357) for treatment referral and information. If you are in crisis, please call the National Suicide Prevention Lifeline at 988 or contact the Crisis Text Line by texting TALK to 741741.

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Katie Kausch may be reached at kkausch@njadvancemedia.com. Follow her on Twitter @KatieKausch.

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Long COVID could affect at least 1 in 7 N.J. adults. The symptoms can be devastating. - NJ.com

EDITOR'S NOTE: This story was originally published Jan. 24, 2024.

RICHMOND, Va. -- John Bolecek's family loves being outdoors.

"I was a huge cyclist, I built my career off of it," Bolecek said. "I mean, I love to be interactive with my kids too. We would ride bikes down to Belle Isle to the kid's mountain bike skills course all the time."

Provided to WTVR

Bolecek, who used to work for the Virginia Department of Transportation as a planner for pedestrian and cyclist projects, moved to Richmond's Oregon Hill neighborhood to be able to ride his bike close to the James River and to his job downtown.

Unfortunately, it's something he doesn't do anymore.

"It was a joy to be able to teach my youngest son how to ride his bike, and it's a tragedy to me that I can't be active with my children right now," he explained.

Provided to WTVR

About two years ago, Bolecek's family was infected with COVID-19. He explained he was vaccinated and boosted at the time, only suffered a mild infection, and expected to eventually get over the infection.

He never did.

"I started waking up feeling like I hadn't gone to sleep at all," he explained. "So I would sleep eight solid hours, and then wake up and I was like, 'I feel horrible right now.' And that feeling has never gone away."

Bolecek said he felt as if he was progressively getting weaker. In April 2022, his symptoms worsened.

"My body just slowly shut down. I got so weak that I could barely walk from my bed to the bathroom. I couldn't sleep, I couldn't think," Bolecek explained. "And that permanently lowered my baseline."

Provided to WTVR

His doctors told him the symptoms were brought on by his COVID infection.

"It's been very challenging getting medical care," he explained. "There's no specialist for Long COVID. My symptoms exactly match what's called myalgic encephalomyelitis, and there's very, very few specialists for that, in this country."

Bolecek explained the process of through research studies, even traveling out of state to be seen by researchers.

One research study found he had the cardiovascular capacity to take in oxygen at the rate of a 94-year-old.

WTVR

Now, the 40-year-old has to track how far he walks, trying not to overexert himself.

"Some of the most nervous I've been, is a situation where there's nowhere to sit or I have to go somewhere, and I don't know how long it is," he explained.

Bolecek is not alone. Roughly one in eight people who are infected with COVID-19 will likely experience a Long COVID symptom. Over 200 symptoms have been reported and researched, some of the most common including, fatigue, a linger cough, shortness of breath, and loss of taste or smell.

Provided to WTVR

Why are some people getting them? Why are some people recovering quickly? What is about these, this individual, where the symptoms are persisting? Or is it something about a certain population of people? And so were really digging deeply into that question," Dr. Patricia Kinser, the Assistant Dean of Research at VCU's School of Nursing.

VCU is conducting its own studies on Long COVID symptoms, including the RECOVERkids research study focusing on COVID-19's impacts on children.

"It's heartbreaking. A lot of families are at their wit's end about how to get help for these children," Kinser said.

Kinser and Dr. Amy Salisbury, the Associate Dean for Research and a Professor at VCU's School of Nursing, said more participants are needed for research studies, to help not only better understand Long COVID, but other viruses that can impact those infected in a similar manner.

Provided to WTVR

"I think thats what its going to take, is people to keep interested, keep asking these questions, so that the lawmakers and people who are in that position of making decisions know that this is real, and that this is really impacting so many people," Salisbury said.

Bolecek traveled to Washington, D.C. alongside Senator Tim Kaine, who's experienced Long COVID, and others impacted, vouching for permanent funding for national research.

WTVR

Ive been dealing with long COVID symptoms for about 4 years now," Senator Tim Kaine said Wednesday. "I'm going to be battling for it in the appropriations bill, I have a couple pieces of Long COVID legislation that are bi-partisan."

That's why we need treatment is because there's, there's millions of people suffering. And, you know, it's a strain on the economy, it's a strain on families. And the sooner we can get people, you know, treatment that improves their quality of life, you know, the better it will be for everyone," Bolecek said.

Provided to WTVR

I think thats what its going to take, is people to keep interested, keep asking these questions, so that the lawmakers and people who are in that position of making decisions know that this is real, and that this is really impacting so many people," Salisbury said.

People interested in joining VCU's RECOVERkids program can find more information here.

Depend on CBS 6 News and WTVR.com for in-depth coverage of this important local story. Anyone with more information canemail newstips@wtvr.com to send a tip.

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Virginia father with Long COVID has cardiovascular capacity of 94-year-old, study shows - CBS 6 News Richmond WTVR

In your recent article, Far more Maryland students are missing too much school, an important topic isnt addressed: absences due to illness. Focusing on attendance might be harming children who need to rest and recover from seasonal and other infections.

Studies show that schools ranked highest as public sources of COVID-19 exposure, and 1 in 6 children have persistent COVID symptoms for three months after infection. Most infections in children are asymptomatic, but chronic symptoms may still develop in the absence of acute symptoms. We must protect children in school settings.

Clean air, high-quality masks and encouraging staying home when sick can substantially reduce acute and chronic illness. The only way to prevent long COVID is to prevent COVID infection.

Long COVID is an umbrella term describing long-term effects after acute COVID infection. Nearly half of those with long COVID meet the diagnostic criteria for myalgic encephalomyelitis (ME or ME/CFS), a chronic neurologic disease. No approved treatments exist for ME or long COVID.

The Baltimore Banner thanks its sponsors. Become one.

As a child with undiagnosed ME, I pushed through symptoms to meet attendance requirements in school. I continued this pattern in university and work settings until I became permanently disabled. I wish I had received more encouragement to rest and recover and more guidance on managing symptoms.

#MEAction Maryland is advocating for our news publications, elected officials and health department leaders to communicate the risks for long-term effects after infection. We urge you to encourage readers to rest and stay home while sick to limit spread and prevent long-term illness.

Whitney Fox, Windsor Mill

Whitney Fox is the co-chair and co-founder of the #MEAction Maryland State Chapter.

The Baltimore Banner welcomes opinion pieces and letters to the editor. Please send submissions to communityvoices@thebaltimorebanner.com or letters@thebaltimorebanner.com.

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Letters: Absenteeism high due to COVID, other infections - The Baltimore Banner

Difficulty: Summiteer (Lexile 1010-1200)

Hong Kong medical experts expect an increase in Covid-19 cases in the next two months. They are asking people who are considered high-risk to get the latest vaccine jabs before the Lunar New Year begins.

Professor Ivan Hung Fan-ngai works at the University of Hong Kong (HKU). He said the rise in Covid-19 cases could affect vulnerable groups such as elderly people, children and people whose bodies struggle to fight disease.

He added that everyone should get another jab, but high-risk groups should prioritise it as they are more likely to be hospitalised or die from Covid-19.

Hung encouraged high-risk groups to get the latest vaccine targeting the XBB virus variant soon. This will give their immune systems time to strengthen before the holiday. This XBB-targeting jab is also effective against the JN.1 strain. The scholar said this vaccine offered a much better boosting effect of up to about 20 to 30 times.

Medical experts also recommended people get mixed jabs. For example, people who got the Sinovac jab could get BioNTech or Moderna mRNA booster shots next.

Some studies actually showed that if you have been receiving BioNTech and cross over to receive the Moderna vaccine, the antibody ... is even better, Hung noted.

When do Hong Kong medical experts expect a rise in Covid-19 cases?

Which types of people are considered to be high risk?

Why does Professor Hung recommend that vulnerable groups get the latest vaccine as soon as possible?

According to medical experts, what is the purpose of getting mixed jabs?

Hong Kong medical experts expect a rise in Covid-19 cases over the next two months.

Elderly people, children and people who struggle to fight off infections are considered high risk.

Getting the latest vaccine as soon as possible will help their immune systems to strengthen before the holiday. The latest jab will also protect from the newer virus strains.

Getting a Covid-19 booster made by a different company compared to their initial shots could make the antibody better, meaning it can help us fight off infection.

Link:

Medical experts warn of Covid-19 wave in Hong Kong in the next two months - South China Morning Post

The omicron variant of COVID-19 poses enormous challenges for governments. In America, cases are at three times their previous peak in January 2021, hospitals are as busy as they have ever been and deaths have risen by 40% in two weeks to 1,800 per day. Meanwhile, China has recorded just one death from COVID in the past 12 months and fewer than 17,000 cases.

Xi Jinping, Chinas president, hails its record on COVID-19 as proof of the superiority of the one-party system. But his strategy has necessitated strict border controls and severe lockdowns for cities that suffer an outbreak. The 13m residents of Xian, a city in western China, have been confined to their homes since December 23rd. Another 10m are subject to lockdowns elsewhere in the country.

To determine how life has been upended by COVID-19, The Economist devised a global normalcy index. It tracks day-to-day behaviour relating to eight indicators split into three categories: transport, recreation and commercial activity. The index monitors 50 countries, which together account for 75% of the global population and 90% of GDP. Our overall global index is a population-weighted average of the country scores which are, in turn, an average of the eight indicators, where 100 is equivalent to the pre-pandemic norm.

Our overall index stands at 75 points, up from a nadir of 35 points in April 2020. China scores 66 points, placing it 34th in our table, which is topped by Egypt and Pakistanthe only two countries where normalcy is higher than 100, suggesting that activity is above pre-pandemic levels. Normalcy is lowest in the Netherlands, which shut bars, restaurants and many shops in December to reduce infections. America, despite its high infection rate and the pressure on hospitals, scores 70 points, placing it 26th.

Over the past four weeks normalcy has declined in 42 of the countries we track as they reel from the spread of Omicron. But compared with January last year, when few people were vaccinated, it has improved in 47 of the 50 countries, by an average of 22 points. Vaccines have given governments room to loosen restrictions. Britains government hopes to remove most covid rules in England by the end of March, including mandatory self-isolation for those testing positive.

China is one of three countries where normalcy is lower today than it was a year ago. Vietnam imposed stern restrictions last June in response to a surge in cases and is now normalising again. New Zealand had a zero-covid policy in January 2021, under which life continued largely as normal, albeit with strict border controls. It abandoned that approach in October after it was hit by a wave of Delta infections that it could not suppress, and has now adopted a traffic-light system of restrictions. But although 90% of Chinas adults are double-vaccinated, there is no sign that its government plans to follow the same path. That may be because it does not trust the efficacy of its domestically produced vaccines, particularly when faced with a variant that is at least twice as transmissible as the last.

Omicron is likely to expose any gaps in Chinas defences. Cases, still mostly Delta, have spread slowly around the country in recent weeks. Tianjin, a city 110km from Beijing, has recorded 365 infections over the past fortnight. On January 15th an Omicron case was discovered in Beijing. The citys health authorities blamed it on a contaminated parcel from Canada, echoing the central governments anti-Western propaganda. They will hope it is an isolated incident. Beijing can ill afford restrictions as it prepares to host the Winter Olympic Games, beginning on February 4th.

For a look behind the scenes of our data journalism, sign up to Off the Charts, our weekly newsletter.

2023, The Economist Newspaper Limited. All rights reserved. From The Economist, published under licence. The original content can be found on http://www.economist.com

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China stands alone in its attitude towards the pandemic - Hindustan Times