Category: Covid-19

Health worker treats COVID-19 patient in an emergency COVID-19 care centre.

Health authorities in the UK have identified anxiety and sleeping trouble as new symptoms of the latest COVID-19 sub-variant JN.1, according to a report.

JN.1, from the lineage of Omicron, was first detected in August and is currently present in over 40 countries.

It has been classified as a variant of interest (VOI) by the World Health Organisation (WHO), due to its rapid spread.

JN.1 is a descendant lineage of BA.2.86. In comparison with BA.2.86, JN.1 has the additional L455S mutation in the spike protein, making it more transmissible. However, no signs of new or unusual symptoms caused by the virus have been reported yet.

So far, the symptoms reported are mostly restricted to upper respiratory tract infections such as fever, cough, sore throat, body aches, and runny nose.

However, recent data from December 2023 by the UK's Office for National Statistics (ONS) spotted two new symptoms: trouble sleeping and anxiety.

Over 10 per cent of people with COVID-19 in the UK consistently reported anxiety or excess worrying since early November, revealed the winter COVID-19 report from the ONS.

The most common COVID-19-19 symptoms are runny nose (31.1 per cent), cough (22.9 per cent), headache (20.1 per cent), fatigue (19.6 per cent), muscle pain (15.8 per cent), sore throat (13.2 per cent), trouble sleeping (10.8 per cent), and anxiety (10.5 per cent), the data showed.

Interestingly, the once-common loss of taste and smell is currently reported in only 2-3 per cent of UK cases.

But whether a person will experience some or all of these symptoms, including those that have not previously been commonly reported, largely depends on each individuals health and immunity to the virus.

The findings come at a time when there is a fresh global rise in COVID-19 infections. As per the WHO, the global number of new COVID-19 cases has increased by 52 per cent during the last one month.

The UN health body also reported an increase in hospital, ICU admissions as well as deaths globally.

Meanwhile, India recorded 573 fresh cases of COVID-19 and two deaths in the last 24 hours, the Union Ministry of Health and Family Welfare said on Tuesday.

The total number of active cases stands at 4,565. The country reportedly also has a total of 312 cases of the JN.1 from 11 states, Kerala, Goa, Gujarat, Odisha, Karnataka, Maharashtra, Rajasthan, Tamil Nadu, Telangana, Odisha, and Delhi.

"Overall cases are mild and severity is seen in only less than 10 per cent of the cases, and only when people are having previous comorbidities, involving lungs and old age," Dr Kirti Sabnis, Infectious Disease Specialist, Fortis Hospital Mulund told IANS.

"Generally, the fatality rate is less than 2 per cent, deaths are occurring very sparingly and is not a common feature," she added.

The doctor said there are also no severe illnesses seen among patients and "not many people are requiring hospitalisation, because of JN.1. Majority of the patients are getting better at home".

The doctor advised using masks, maintaining hand hygiene and to avoid public gatherings if one is sick.

**

The above article has been published from a wire agency with minimal modifications to the headline and text.

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Authorities Identify Anxiety and Sleep Trouble as Symptoms of JN.1 COVID-19 Variant | Weather.com - The Weather Channel

India reports 573 fresh cases of Covid. Out of this, 263 were infected with Covid-19 sub-variant JN.1. Kerala reported half of the JN.1 infected cases. India also reported 2 deaths in 24 hours- one each in Karnataka and Haryana. The number of active cases has increased to 4,565. However, experts believe that the actual number of Covid-19 cases is likely to be much higher.

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Covid cases in India latest news: 573 fresh cases reported in 24 hours; Kerala reported half of the JN.1 infected cases - Times of India

In a recent study published in JAMA Network Open, researchers assessed whether psychiatric, neurological, and cognitive complications among patients hospitalized for coronavirus disease 2019 (COVID-19) differ from those with other medical conditions of similar severity.

COVID-19s long-term effects are associated with over 200 symptoms. Besides respiratory symptoms, brain health-related symptoms are the most common, including mental and cognitive symptoms. Nevertheless, long-term neuropsychiatric and cognitive sequelae also appear after myocardial infarction, pneumonia, and other non-COVID-19 illnesses.

Studies on post-COVID-19 brain health impairment compared to that after other diseases are mainly based on surveys or health records and often focus on self-reported symptoms rather than objective clinical investigations. Therefore, longitudinal prospective studies are necessary to discern the extent, nature, and trajectories of COVID-19-specific brain health complications.

In the present study, researchers investigated whether long-term psychiatric, neurological, or cognitive complications differ between patients hospitalized for COVID-19 and those with other medical conditions. Patients hospitalized for COVID-19 between March 2020 and March 2021 were enrolled. Control patients were hospitalized for myocardial infarction, pneumonia, or other non-COVID-19 illness requiring intensive care between March 2020 and June 2021.

Additionally, healthy controls aged 18 with no history of hospitalization in the past two years were recruited. The Montreal Cognitive Assessment (MoCA) and the Screen for Cognitive Impairment in Psychiatry (SCIP) were used to assess cognition. Trial-making tests A and B were used to evaluate executive function.

The Hamilton anxiety (HAM-A) and depression (HAM-D) rating scales were used to assess anxiety and depression. Semi-structured interviews were conducted for subjective neuropsychiatric and cognitive symptoms. Further, cerebellar and sensorimotor functions and cranial nerves were evaluated. The neurological evaluation scale was used to quantify neurological signs. Physical and mental fatigue was examined using the fatigue assessment scale.

The primary outcome of the study was overall cognition. Secondary outcomes included trail-making test scores, neurological evaluation scale scores, and HAM-D and HAM-A scores. Further, exploratory outcomes were symptom frequency, number of subjective symptoms, fatigue, psychiatric diagnoses, neurological examination results, and changes in MoCA score over time.

Overall, 345 participants were examined, including 120 COVID-19 patients, 125 control patients, and 100 healthy controls. Among control patients, 50 were hospitalized for pneumonia, 50 for acute myocardial infarction, and 25 for other non-COVID-19 illnesses requiring intensive care. COVID-19 patients had a higher body mass index (BMI) than the control cohorts.

Healthy controls had fewer comorbidities and higher education levels than COVID-19 patients. The estimated SCIP scores at 18-month follow-up were 59, 61.6, and 68.8 among COVID-19 patients, hospitalized controls, and healthy controls, whereas the estimated MoCA scores were 26.5, 27.2, and 28.2, respectively.

Among COVID-19 patients, the mean HAM-A score was higher than healthy controls, but it was not significantly different compared to hospitalized controls. Further, HAM-D scores were higher among COVID-19 patients than among healthy controls but were not significantly different than hospitalized controls.

The average neurological evaluation scale score was higher among COVID-19 patients than healthy controls, indicating worse performance, but it was not significantly higher than hospitalized controls. COVID-19 patients were slower to complete both trail-making tests. They also reported a higher frequency of neurological and psychiatric symptoms than hospitalized controls.

However, only anosmia was significantly more frequent at 18 months after multiple testing. Likewise, only olfactory impairment was less frequent among healthy controls compared to COVID-19 patients after multiple testing. COVID-19 patients also had a higher incidence of new psychiatric diagnoses and scored higher on the fatigue assessment scale than healthy controls.

COVID-19 patients performed poorly on all tests 18 months post-hospitalization compared to healthy controls. COVID-19 patients more often had fatigue, impaired olfaction, and new psychiatric diagnoses than healthy controls. Nonetheless, they had similar outcomes as hospitalized controls, except for olfactory impairment and executive function.

Furthermore, depression and anxiety were more frequent in the COVID-19 group than among healthy controls but no more frequent than in hospitalized controls. Taken together, the findings suggest that patients hospitalized for COVID-19 had worse neurological, psychiatric, and cognitive outcomes at 18 months after hospitalization than healthy controls. However, there were no significant differences compared to hospitalized controls.

The team concluded that multimorbidity has a role in hospitalization and lasting associations with brain health, given that healthy controls had fewer comorbidities than hospitalized participants. Overall, post-COVID-19 brain health was comparable to the brain health after other severe diseases, albeit additional studies are required to corroborate these findings.

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Do hospitalized COVID-19 patients have long-term cognitive, psychiatric, or neurological complications? - News-Medical.Net

European Center for Disease Control (ECDC) chief Andrea Ammon spoke candidly about how her organisation is preparing itself to help the EU be prepared for the next pandemic.

Ammon has been heading up the ECDC since 2017. Trained as a medical doctor, and specialised in public health, she is an alumni of the first cohort of the field epidemiology programme (EPIET) offered by the ECDC. She joined the organisation in 2005, building the European surveillance system, and slowly making her way to the top job.

The ECDC was thrust into the spotlight during the Covid-19 pandemic, and since then has seen its mandate expand through new regulations.

Our conversation ended up revolving around communication, and what both the ECDC and the media could do better in hopefully not anytime soon the next pandemic.

EUobserver: I'd like to briefly talk about new regulations and changes to the ECDC mandate. Can you run me through some of the policy changes we've seen since the pandemic?

Andrea Ammon: The serious cross-border health threat regulation aims at regulating all the different elements connected to health emergencies. That starts with the surveillance, the laboratories, but then also the response to emergencies. So that's really the risk assessment and risk management package. Now, our regulation is really tailored for the ECDC, and it has a lot of cross-references to the serious cross-border health regulation.

So a lot of what is in the serious cross-border health regulation actually refers to us to our work. In principle, our mandate stayed the same as it was before, in terms of that we are dealing with infectious diseases. But some of the tasks have been specified. We have new aspects of our tasks. And then there are a few new elements in, for instance, of the EU reference laboratories that EU Health Task Force, the foresight and modelling, we look at determinants prevention and health system indicators. So there are a few new elements that have been added, as lessons learned from the pandemic.

What were some key lessons learned from the pandemic?

We must enhance our surveillance, and improve preparedness and risk communication. The particular emphasis now, which has been evolving in the past year, is the emphasis on the workforce. Every country has experienced the same scene that the health workforce has massive issues. There are people leaving the service due to burnout, and we have the looming crisis of people going to retire in the next five to 10 years, without sufficient supply in the pipeline.

That is verging on labour communication, or maybe workforce policy, rather than infectious diseases.

Exactly. That is where our mandate and our influence is limited. Of course, we can advocate, and it's what I'm also doing. But in the end, the real turning of the tide can only be done with policy changes in the countries that we cannot do ourselves. Although we can of course provide training for people that would like to be specialised in public health. But we cannot change the salary structure, the career perspective, or the working conditions, that is something that has to happen in the international system.

That must be frustrating to see.

Well, when you come to work for an agency like this, you know where the remits of the mandate lie. And then you have to work within these remits and see how you can advocate for anything that you find important for the mandate.

That's really interesting. The pandemic has shown that the remit of the ECDC expands quite a bit beyond the gathering of relevant data and the coordinating and communication of responses to that data. So for example, on infectious diseases, into the realm of communication the more 'soft' science of bringing across a certain scientific message or a way to evaluate risk for both public health officials but also for citizens. Has that changed the organisation a lot?

It has brought some changes, yes, especially in the way we do our work, not so much in the substance that we are dealing with. There is an article on communication that has actually not changed.

However, there are other elements in the regulation, which influenced the communication. For instance, our mission statement has been expanded not only that we identify, analyse and communicate threats to human health from infectious diseases, but we also make reports thereof available and easily accessible.

This 'accessible' doesn't mean that we put it free of charge on the website, but that it's also formulated in a language that politicians and policymakers understand. So here we have to change our communication.

We are a scientific organisation, and we have our scientific reports, but we have to now add a summary with key messages for public health decision-makers so that they can be used to actually implement and apply in public policy and practice.

Right. So messages like, for example, like 'flattening the curve', were successful, but I think maybe the communication around masking was slightly less successful.

Well, I think we have positive and negative examples, in abundance over the three years. I think it's not about slogans only. It's really about explaining. And that is why, when you have seen our lessons learned document, one of these four lessons that we put forward is Risk Communication and Community Engagement.

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And I think this community engagement was something that really did not work very well in most places. People at one point during the pandemic had not understood why they still had to wear masks, stay at home, keep that distance, get tested, and so forth.

That is what I think our messaging should help. It should help local politicians explain this to the general population, but also then to specific populations, like young people, for instance.

What do you base best practices on? Is there actually a lot of science around effective communication during public health crises and community engagement? Is there something that you can fall back on?

Yes, there is. And that's the interesting part, that the fact that it hasn't been used to its full potential is not because there is no science behind it there is science. But these scientists were not necessarily part of the crisis groups. More and more countries have recognised that scientists, risk communicators, ethicists and behavioural insight specialists should be part of the crisis team. And we have also now assembled a small team here at ECDC that deals specifically with that.

Risk communication is a very difficult thing to do I can imagine. Risk is dependent on a lot of variables, and bringing across a complex message is very challenging for the general public to understand. So for example, I didn't know the risks for someone over eighty when vaccinated are vastly different from those for a person over 60 who is also vaccinated. I think that tailoring specific messages like that must be very complicated.

Yeah, and I think that the risk communication has to evolve during the course of such a crisis, but it's important that it starts at the beginning with clarifications that everybody can understand.

At the beginning of the pandemic, these differentiations weren't even possible, because we didn't know about all these different risks to different people.

And that, I think, has to be very clearly said at the beginning. What is known, what is not known, where there is evidence and where there are decisions based on analogy with similar infections. I think people can understand that there is an evolving situation, so that the fact that one day, they hear one message, and the next day something else, is not necessarily interpreted as 'they don't know what they're doing.'

That touches on something else as well, because up to now, we're talking about proactive communication based on evidence. But another phenomenon that the pandemic showed was that the importance of reactive communication to counter explicit misinformation is also a huge part of public health communication.

That is true, part of this risk communication is also health education, in which the basics are explained to the population. In general, if we could increase the health literacy of the public, then misinformation would have a bit of a harder time getting through. But that is of course, not something that you can do in a crisis, that is something that needs to be built into the preparedness.

My background was in science journalism. And if I know one thing, it's that it's very hard to interest people in something that is not going on at that moment, but that might have importance later. Is raising the bar for public health knowledge among the citizens part of the next pandemic preparedness plan?

In my view, it should be a chapter in the pandemic preparedness plans that are now being looked at and reviewed. And in terms of people not being interested, we have to learn a bit from advertising, because in the end, it concerns them as persons. Moreover, we have health issues ongoing with mosquitoes, with climate change, with West Nile virus, with influenza, with measles. These diseases are there, and we could use each of these as opportunities to take aspects of health to help people become more in-depth informed.

Right. What role could the media play or what could they do better?

It's not just the media who could do better, but it's also from the scientist's side. Some initiatives have to go out in media briefings, so that it's not just a sensational story to report, but also to help inform the media so that they know where certain pieces of information fall into.

I think this is something that we probably will not succeed at one hundred percent. But you have to try your best and see what could reasonably be done to put out trustworthy information. Even when there is weak evidence there, so that people know that we are not fabricating things. And that is a reputation that you have to build in non-crisis time, so that you can count on this in times of crisis.

Continued here:

ECDC chief Andrea Ammon: 'It's not just about slogans' - EUobserver

Design Sample and recruitment

Data were drawn from the Smoking and Alcohol Toolkit Study (STS/ATS), a monthly repeated cross-sectional survey of a representative sample of adults (aged 18+) in England.The study population consisted of adults aged 18 and over living in households in England surveyed monthly between March 2014 and June 2022. All statistical analysis was restricted to people who smoked in the past year or who used alcohol at increasing and higher risk levels as indicated by scoring 38 in the Alcohol Use Disorders Identification Test (AUDIT) [23].

The STS/ATS uses a hybrid of random location and quota sampling to select a new sample of approximately 1,800 adults (aged18years) each month in England [24]. Sample weighting uses the rim (marginal) weighting technique, an iterative sequence of weighting adjustments whereby separate nationally representative targets are set, and the process repeated until all relevant variables match the English sociodemographic population profile relevant at the time each monthly survey was collected.

Respondents with characteristics that are under-represented receive a larger weight, while those who are over-represented receive a smaller weight. Data were collected monthly through face-to-face computer assisted interviews. However, due to the COVID-19 pandemic, from April 2020 data were collected via telephone only. A series of diagnostic analyses suggested it is reasonable to compare data from before and after the lockdown, despite the change in data collection method [25, 26].

The primary outcome measure was defined using responses to the following questions:

For smoking:

Has your GP spoken to you about smoking in the past year (i.e. last 12 months)?

Yes, heshe suggested that I go to a specialist stop smoking advisor or group

Yes, heshe suggested that I see a nurse in the practice

Yes, heshe offered me a prescription for Champix, Zyban, a nicotine patch, nicotine gum or another nicotine product

Yes, heshe suggested that I use an e-cigarette

Yes, heshe advised me to stop but did not offer anything

Yes, heshe asked me about my smoking but did not advise me to stop smoking

No, I have seen my GP in the last year but heshe has not spoken to me about smoking

No, I have not seen my GP in the last year

Dont know

Respondents who answered with any of responses a-e for smoking were classified as having received a BI. Responses of h were excluded under the sensitivity analyses which cover only those who have visited their GP.

For drinking:

In the last 12 months, has a doctor or other health worker within your GP surgery discussed your drinking?

No

Yes, a doctor or other health worker within my GP surgery asked about my drinking

Yes, a doctor or other health worker within my GP surgery offered advice about cutting down on my drinking

Yes, a doctor or other health worker within my GP surgery offered help or support within the surgery to help me cut down

Yes, a doctor or other health worker within my GP surgery referred me to an alcohol service or advised me to seek specialist help.

Dont know

Refused

Respondents who answered with any of c-e, were classified as having received a brief intervention from their GP for drinking.

For the analyses including only those who visited their GP, we excluded responses of a) in response to the question below:

You said a doctor or other health worker within your GP surgery has not discussed your drinking with you in the last 12months.

a) I have not seen a doctor or health worker within my GP surgery in last 12months.

b) I have seen a doctor or health worker within my GP surgery in the last 12months but did not discuss my drinking.

As a measure of socio-economic position, we used the National Readership Surveys classification of social grade based on occupation (ABC1: higher and intermediate managerial, administrative, and professional, supervisory, clerical and junior managerial, administrative and professional; C2DE: skilled manual workers, semi-skilled and unskilled manual workers and state pensioners, casual and lowest-grade workers, unemployed with state benefits.) [27].

Respondents were classified as having a history of a mental health condition if they reported being diagnosed by a doctor or health professional.

Respondents were asked:

Since the age of 16, which of the following, if any, has a doctor or health professional ever told you that you had?

Depression

Anxiety

Obsessive Compulsive disorder

Panic disorder or a phobia

Post-traumatic stress disorder (PTSD)

Psychosis or schizophrenia

Personality disorder

Attention Deficit Hyperactivity Disorder (ADHD)

An eating disorder

Alcohol misuse or dependence

Drug use or dependence

Problem gambling

Autism or Autism Spectrum Disorder

Bipolar disorder (previously known as manic depression)

None of these

Dont know

Prefer not to say

Responses excluding the final three options above were presented in a randomised order. For our analyses, individual responses of any of the above diagnoses were dummy coded into a composite measure of History of a mental health condition. Those who selected alcohol misuse or dependence were excluded from the alcohol BI analysis given that it is likely a confounder influencing the receipt of a BI for alcohol.

Age was treated as a continuous variable in models, but categorical to summarise the sample characteristics. Other sociodemographic covariates included identified sex (Women vs other (Men and In another way/refused)), the presence of children in the household (Yes vs No), and region of England (North, Midlands and South).

In the analyses of BIs for smoking, data were collected from March 2014 to June 2022. In the analyses of BIs for alcohol, data were collected from March 2014 to March 2022 because from April 2022 the brief intervention variable was collected every other month, and only questions related to AUDIT items one to three were collected (preventing the selection of individuals according to full 10-item AUDIT score).

For all primary analyses on BIs for smoking, and BIs for alcohol, the pre-pandemic period refers to the months up to and including February 2020, and the post-pandemic period from April 2020 onwards (no data were collected in March 2020 due to the pandemic). Characteristics of the sample for the pre- and post-pandemic periods are described in Table S1.

Regarding the analyses involving mental health data, the pre-pandemic period refers to the years 2016 and 2017, and the period from October 2020 onwards as the pandemic onset period, as these were the only periods where data on the included mental health measures were collected. Moreover, for 2016/2017 mental health was only assessed in past-year smokers, so this sample did not include any people who used alcohol at increasing and higher-risk levels but did not smoke.

The analyses were conducted in R version 4.2.1 [28] using the packages survey [29] and mgcv [30]. This analysis plan was pre-registered on the Open Science Framework https://doi.org/10.17605/OSF.IO/65FRC. The STROBE reporting guidelines were used in the design and reporting of this study. Respondents with missing data on any of the covariates of interest were excluded from the analyses (less than 5% of responses). Characteristics of the sample and descriptive statistics are presented using weighted descriptive statistics for the overall sample, and for the pre-pandemic and post-pandemic periods, respectively.

A segmented regression design was used to assess the effect of the COVID-19 pandemic on receipt of BIs for smoking and alcohol, respectively. Data was analysed at the individual-level with segmented regression using generalised additive models (GAM) [31, 32]. These allow the fitting of seasonal smoothing terms and thus seasonality to be considered (which are particularly relevant in the context of delivery of interventions for smoking and alcohol use [33]). A log link function was used so that relative risks can be reported.

Each GAM modelled the trend in the overall receipt of BIs (dependent variable) for smoking and alcohol, respectively in the pre-pandemic period, and any change in the trends in the post-pandemic period. Trend is a variable coded 1n (n being the total number of time-points to the end of the series) reflecting the time trend over time. The slope variable was defined as 0 before April 2020 of the pre-pandemic period and each month from April 2020, by increments of 1 up to m where m is the number of waves from April 2020.

Models were first fit assuming a linear underlying and post-implementation trend, followed by fits using non-linear trends to explore changes in the level of BI delivery and potential rebounding in the delivery of BIs over time. Specifically, the outcome of BI delivery refers to receipt of a BI in the previous 12months. It is therefore possible that an immediate step change in delivery would not be detected in April 2020 or in the months immediately afterwards but would be reflected by changes in the trend in the longer term. In addition, after an initial drop during heightened restrictions 2020 and 2021, rates of BI delivery may have rebounded with some GP delivery returning to normal practice. Therefore, we fit further GAMs with the independent variables for slope and trend wrapped in a smooth function (model fit using the restricted maximum likelihood method with nine basis functions specified for the underlying trend and change in slope). Models accounted for seasonality in the receipt of BIs by using a smoothing term with cyclic cubic regression splines (11 knots, one for each month in the year) and were adjusted for sociodemographic characteristics (age, sex, children in the household, and region).

Interactions were tested between social grade and the post-intervention change in slope, and results reported stratified by social grade to explore whether the post-intervention slope depends on social grade. The model fit of the linear and non-linear GAMs were compared using the Akaike Information Criterion (AIC; lower values indicating better model fit) and a likelihood ratio test.

BI delivery may have declined during the pandemic due to reduced GP contact overall, rather than reduced delivery rates among those who visited their GP. To understand whether BI delivery also declined among those still visiting their GP, all analyses were repeated with the sample of only those who smoked in the past-year and those who used alcohol at increasing and higher risk levels, respectively, who reported visiting their GP in the past year (Table S2).

Models were checked for full convergence, and for randomly distributed residuals using the gam.check() function in the mgcv package [30] in R.

We constructed logistic regression models to explore whether changes in the of receipt of BIs for smoking and alcohol, respectively, from December 2016 to January 2017 and October 2020 to June (or March in the case of BIs for alcohol) 2022, depended on history of a mental health condition. Associations were reported as odds ratios (ORs) with 95% confidence intervals. Models adjusted for sociodemographic characteristics. The inclusion of the time period*mental health interaction allowed us to explore potentially differential changes in receipt of interventions over between the two time periods according to whether an individual had a history of a mental health condition.

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Brief interventions for smoking and alcohol associated with the COVID-19 pandemic: a population survey in England ... - BMC Public Health

Californias hospitals are getting busier with more COVID-19 and flu patients, some of whom are suffering from both viruses at the same time.

The simultaneous sickness is another wrinkle in an already hectic respiratory virus season. Although hospitals are not nearly as crowded as during the emergency phase of the pandemic, they are becoming increasingly so with Los Angeles County recently entering the medium COVID-19 hospitalization category outlined by the U.S. Centers for Disease Control and Prevention for the first time this winter.

Some of these patients are testing positive for more than one virus influenza definitely likes to travel with COVID. [And] were seeing an outbreak of RSV, said Dr. Daisy Dodd, an infectious disease specialist with Kaiser Permanente Southern California.

The viral cocktail could also include coronavirus or flu with RSV, or respiratory syncytial virus, simultaneously. Sometimes a common cold virus, like rhinovirus, is in the mix.

And its not just the very young and the very old who are getting hit with a double whammy of disease younger and middle-aged adults have also been afflicted. Dodd said shes seen some patients reporting fevers lasting more than a week.

Now it seems like everyone has this hacking cough that doesnt want to go away, she said. Its making them fairly sick and ... its not very gentle.

For many of the patients who need medical attention, theyre miserable. No doubt about it.

Its hard to say why doctors are seeing a number of viral co-infections this winter, experts say.

Is it that one lowers the immunity and allows them to catch the other one easily? Dont know the answer, Dodd said. But were seeing a lot of double whammies going around.

L.A. Countys entry into the medium COVID-19 hospitalization category has prompted local public health officials to order hospitals, nursing homes and any other inpatient facility to require healthcare employees mask up while in patient-care areas. Visitors to those facilities are also required to mask up in the same areas.

When a county enters the medium COVID-19 hospitalization level, those at high risk of getting very sick should wear a high-quality mask such as a KF94, KN95, or N95 mask when indoors in public, the CDC says.

The agency also says that those who live with, or have social contact with, someone at high risk should consider getting a rapid COVID test before meeting with them, and consider wearing a mask when meeting with them indoors.

A negative rapid COVID test result helps reduce, though does not entirely eliminate, the risk of passing along a coronavirus infection. There is a chance that a single rapid test may not detect an infection in its initial stages.

Multiple tests over a time period, such as over two or three days, can be helpful, especially when the people using the tests dont have COVID-19 symptoms, according to the U.S. Food and Drug Administration.

More infected people are being admitted into Californias hospitals. For the week that ended Dec. 23, 3,279 coronavirus-positive patients were newly admitted statewide, up 14% from the prior week and the highest weekly tally in 10 months.

New hospitalizations remain considerably lower than last winters peak, however. And a number of hospitals are not seeing signs of a COVID-19 surge in their intensive care units.

Our ICUs are busy, but theyre not overwhelmed with COVID, said Dr. Tevan Ovsepyan, medical director of the hospitalist program at Providence Holy Cross Medical Center in Mission Hills.

Still, the sickness season continues apace. Californias level of flu-like activity which includes nonflu illnesses such as COVID-19 recently rose to very high, one of the worst levels as defined by the CDC, for the first time this winter.

Ovsepyan said that at his hospital, there was an uptick in coronavirus-positive patients about a week and a half ago that has tapered off as of Friday. But, he said, I dont know what the future will hold, because ... we have New Years ... and people are getting together. So Im sure well probably see a little uptick.

For the week that ended Dec. 23, California had a very high level of flu-like activity, which includes nonflu illnesses such as COVID-19, according to the U.S. Centers for Disease Control and Prevention.

(U.S. Centers for Disease Control and Prevention)

Other areas in California that are in the CDCs medium COVID-19 hospitalization category include the four-county area around the state capital Sacramento, Placer, Yolo and El Dorado counties and several counties in the rural north: Butte, Tehama and Glenn.

The rate at which lab specimens are coming back positive for the coronavirus and flu is continuing to rise in L.A. County. For the week that ended Dec. 23, the most recent available, 23% of specimens tested at surveillance labs came back positive for flu, a jump from the prior rate of 18%. As for COVID-19, 12% of specimens are coming back positive for the coronavirus, an increase from the prior weeks 11%.

RSV, which can cause severe illness and death, especially among babies and older people, has plateaued at a high rate countywide, with 10% of specimens coming back positive over the most recent week. The positive test rate has stayed within 10% and 15% in recent weeks, a relatively high rate compared with the prior six years, but still below last years terrible RSV season, when the positive test rate exceeded 20%.

For the week that ended Dec. 4, L.A. County averaged five COVID-19 deaths a day, up from an average of two in mid-November, though still below last years numbers.

In terms of severe illness and deaths, hospitals are in a better place than the terrible first winter of the pandemic and the initial Omicron wave the year after.

Omicron was just horrible. It was a terrible time, because we were just overwhelmed with COVID-positive then, and people were sick, said Ovsepyan, who is also chair of the hospital medicine department at Facey Medical Group, which has outpatient clinics in the San Fernando, Santa Clarita and Simi valleys.

Ovsepyan urged people to be responsible and stay home if sick.

And if you must leave the house and go anywhere theres a crowd and have symptoms such as sniffles, wear a mask, Ovsepyan said.

With time, people have had this COVID fatigue, and the fatigue of masks. Thats all reasonable, Ovsepyan said. But its still a virus. It still causes illness. Itll be harmful for our frail patients, our elderly or people with co-morbid diagnosis ... those are the people who end up getting hospitalized.

People might initially shrug off a little sniffle or a tiny sore throat. But that can be the beginning of a full-fledged viral illness, and it would be fabulous if those who feel that start wearing a mask as soon as possible to protect others around them, Dodd said.

Probably 95%, if not more, of respiratory infections, you feel it in your throat to begin with, she said.

Its likely a combination of factors that has led COVID-19 to be less deadly than it used to be, including protection provided by vaccinations and lingering immunity from infection, as well as the development of anti-COVID drugs that can be taken after infection.

But health officials worry about the lackluster utilization of those drugs, as well as lagging uptake of the latest COVID vaccines. The CDC urges virtually everyone age 6 months and older to get a fresh COVID-19 vaccination this winter, as well as the seasonal flu shot.

RSV immunizations are also available for babies, those who are pregnant and people age 60 or older.

Officials urge more widespread use of antiviral drugs such as Paxlovid that can reduce symptom severity and the risk of hospitalization and death. Theyre best taken early on, but many people arent doing so, or their healthcare providers arent prescribing them.

There is an ample supply of COVID-19 therapeutic agents, but they have been underused, the California Department of Public Health said in a health advisory. Lack of familiarity with new medications ... and the misperception of drug scarcity have contributed to low treatment rates, including reports of eligible patients ultimately being denied treatment.

California still offers a free telehealth service through Sesame Care, where sick people can talk to a healthcare provider by phone or online and get a prescription, if eligible. (A copay might be needed to pick up the prescription.) That service is available to Californians age 12 and up, regardless of insurance status, until February, by calling (833) 686-5051 or visiting sesamecare.com/covidca.

L.A. County residents can do the same by contacting the countys Public Health Call Center at (833) 540-0473, which is open seven days a week from 8 a.m. to 8 p.m. The county says free and low-cost treatment is available for eligible patients, including those who are uninsured or on Medi-Cal.

A program funded by the National Institutes of Health, featured at test2treat.org, gives adults who test positive for COVID-19 or flu free access to telehealth care and treatment. That program is expected to run through the early summer. Adults who arent positive can still enroll to get free tests shipped to them if they are uninsured or underinsured; on Medicare or Medi-Cal; or in the healthcare system of the Department of Veterans Affairs or the Indian Health Service.

The U.S. government is also allowing residents to order free at-home COVID tests through COVIDtests.org. People are able to order four free at-home tests per household. And if they didnt already place an order between Sept. 25 and Nov. 19, theyre eligible for two separate orders of four tests.

Original post:

Sick with COVID and the flu: Double infections hit California hard - Los Angeles Times

It's been almost four years since the start of the pandemic.Since October, Mad River Valley Arts in Waitsfield has been hosting an exhibit that shares what it was like for the Vermont Abenaki tribe during COVID-19.Curator Vera Sheehan has spent multiple years creating the "Beyond The Curve: American Abenaki Covid Experience."Sheehan's mission is to educate others and spark conversation about how people heal differently. Samantha Talbot-Kelly, Mad River Valley Arts executive director, loves showcasing educational displays like this in her gallery for those very reasons, too."Its a wonderful segway to have a conversation around all of our experiences and how were healing from all our different experiences of the pandemic," Talbot-Kelly said.The exhibit is full of crowd-sourced art pieces, crafted face masks, and photographs.More than a decade ago, the Green Mountain State recognized four of its tribes.This display showed how the group chose to cope and heal while the pandemic was at its peak."How they turned to crafts, their traditional makings, and their traditional medicines," Talbot-Kelly said.It also educated people on how they felt about the vaccine."They were hesitant to participate in traditional vaccines that non-indigenous people have access to," Talbot-Kelly said.Another outlet for many to get through the pandemic was through paintings and sculptures."The arts help provide that healing," Talbot-Kelly said. "It helped to generate what was necessary to express that tough time we all experienced."Talbot-Kelly hopes to continue to share stories like this at her gallery."Hopefully, the word gets out more and more to the community that were here," Talbot-Kelly said. "People have been coming in more and more frequently."This exhibit will be up through Saturday. It's free to the public.For more information, click here.

It's been almost four years since the start of the pandemic.

Since October, Mad River Valley Arts in Waitsfield has been hosting an exhibit that shares what it was like for the Vermont Abenaki tribe during COVID-19.

Curator Vera Sheehan has spent multiple years creating the "Beyond The Curve: American Abenaki Covid Experience."

Sheehan's mission is to educate others and spark conversation about how people heal differently.

Samantha Talbot-Kelly, Mad River Valley Arts executive director, loves showcasing educational displays like this in her gallery for those very reasons, too.

"Its a wonderful segway to have a conversation around all of our experiences and how were healing from all our different experiences of the pandemic," Talbot-Kelly said.

The exhibit is full of crowd-sourced art pieces, crafted face masks, and photographs.

More than a decade ago, the Green Mountain State recognized four of its tribes.

This display showed how the group chose to cope and heal while the pandemic was at its peak.

"How they turned to crafts, their traditional makings, and their traditional medicines," Talbot-Kelly said.

It also educated people on how they felt about the vaccine.

"They were hesitant to participate in traditional vaccines that non-indigenous people have access to," Talbot-Kelly said.

Another outlet for many to get through the pandemic was through paintings and sculptures.

"The arts help provide that healing," Talbot-Kelly said. "It helped to generate what was necessary to express that tough time we all experienced."

Talbot-Kelly hopes to continue to share stories like this at her gallery.

"Hopefully, the word gets out more and more to the community that were here," Talbot-Kelly said. "People have been coming in more and more frequently."

This exhibit will be up through Saturday. It's free to the public.

For more information, click here.

Read this article:

Mad River Valley Arts hosts American Abenaki COVID-19 experience exhibit - WPTZ

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Genetic diversity and seroprevalence of Toxoplasma gondii in COVID19 patients; a first case-control study in Iran ... - BMC Infectious Diseases

In a recent preprint* study posted to the medRxiv server, a team of researchers evaluated the impact of hybrid immunity (combining vaccination and recovery from infection) on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody levels in Canadian adults.

Study: Hybrid immunity from SARS-CoV-2 infection and vaccination in Canadian adults: cohort study. Image Credit:Lightspring/ Shutterstock

*Important notice: medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

In late 2021 and early 2022, the Omicron BA.1/1.1 variant of SARS-CoV-2 spread globally. During this period, hybrid immunity significantly reduced coronavirus disease 2019 (COVID-19) morbidity and mortality compared to previous years. Hybrid immunity offers partial protection against reinfection and a more robust defense against severe outcomes. However, most studies focus on hospitalized patients or those tested via polymerase chain reaction (PCR), not reflecting the general population. This gap hinders understanding the longevity and effectiveness of hybrid immunity.

Further research is needed to understand the long-term dynamics and effectiveness of hybrid immunity at a population level, especially considering varying infection and vaccination histories for transitioning from pandemic to endemic management of COVID-19.

The present study, conducted between May 2020 and December 2022, involved serial assessments of SARS-CoV-2 antibodies in a cohort of mostly vaccinated Canadian adults recruited from a national online polling platform. Participants reported their viral testconfirmed infections and sent self-collected dried blood spots to a central laboratory for analysis. The study focused on estimating the cumulative incidence of SARS-CoV-2 before and during the Omicron BA.1/1.1 and BA.2/5 waves, along with changes in antibody levels and age-specific immunity levels.

Highly sensitive and specific antibody assays were used to detect spike and nucleocapsid protein antigens, the latter being indicative of infection. The study evaluated the decay of spike protein antibodies post-vaccination and post-infection, noting that recent vaccination mitigated the decline in spike levels from older infections. The research team also correlated spike antibody and cellular responses in a convenience sample.

By the end of 2022, approximately 35% of adults over 60 had their last vaccine dose more than six months prior, and about 25% had not been infected. The cumulative incidence of infection rose significantly by December 2022, suggesting a role for hybrid immunity in reducing COVID-19 severity and mortality.

In the study, people who previously had SARS-CoV-2 infection showed more spike protein than those who did not, regardless of the number of vaccination doses received. This pattern was consistent among various demographics, including age groups, sex, and ethnicities. Particularly notable was finding out that adults who had received at least three shots from the vaccine and were sick more than half a year earlier had spike levels that went down quickly and kept going lower for nine months after getting vaccinated. On the other hand, adults who got sick in less than six months saw a slower decrease in spike amounts.

Cumulative incidence in each stratum of infection and vaccination in the pre-omicron wave, during the omicron BA.1/1.1 wave, and during the BA.2 and BA.5 waves by age group.*Including uninfected and infected cases. The first column in each age group represents the antibody and viral test positivity for the entire period prior to omicron, whereas the second column represents the values during the omicron BA.1/1.1 wave and the third during the BA.2/5 waves. By the last time period studied, the numbers of participants aged 15-59 who were N-positive, viral testpositive, and positive to both were 675 (41%), 37 (2%), and 699 (43%). The comparable numbers for participants aged 60 or more were 763 (44%), 35 (2%), and 500 (29%).

The research also showed that new vaccines helped stop the drop in spike levels from older sicknesses. In some people, the level of spike antibodies was linked to how their cells reacted. By the end of 2022, about 35% of adults over the age of 60 had their last vaccine dosage more than six months ago, and approximately 25% had not been infected.

The cumulative incidence of SARS-CoV-2 infection in the studied population increased dramatically from 13% before the emergence of the Omicron variant to 78% by December 2022, which equated to around 25 million infected adults. Despite this high incidence rate, the COVID-19 weekly death rate during the Omicron BA.2/5 waves was significantly lower than during the BA.1/1.1 wave, suggesting a protective effect of hybrid immunity.

Furthermore, the study found significant increases in infection rates among younger, i.e., 18-59 years, and older i.e., 60+ years adults, most of whom were vaccinated. By December 2022, the cumulative incidence rates in these age groups were approximately 86% and 75%, respectively. However, a significant proportion of older adults, who are most at risk of severe outcomes from COVID-19, either had not been vaccinated in over six months or remained uninfected.

The study highlights the protective nature of hybrid immunity against SARS-CoV-2 at a population level, with a focus on Canadian adults. By December 2022, nearly 80% of Canadian adults were infected, predominantly with Omicron variants, leading to significant morbidity and mortality but also contributing to hybrid immunity. Despite the high infection rate, death rates during Omicron BA.2 and BA.5 were significantly lower than during BA.1/1.1, suggesting hybrid immunity's role in reducing severe disease. Hospitalizations have decreased since summer 2022, especially in intensive care units. The study also found that recent vaccination helped maintain spike protein levels, indicating its importance in sustaining immunity. This research underscores the need for continuous high vaccination coverage, including booster doses for older adults, to maintain this hybrid immunity and manage COVID-19 effectively.

*Important notice: medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Original post:

Hybrid immunity's role in curbing COVID-19: Canadian study sheds light on vaccine-infection synergy - News-Medical.Net

Hospitals across the U.S. are reinstating COVID-19 mask mandates as the JN.1 variant becomes the dominant strain spreading throughout the country.

Hospitals in California, Illinois, Massachusetts, New York and Washington D.C. have all brought back divisive rules meaning masks are mandatory for selected people in medical settings. The Centers for Disease Prevention and Control has recorded a 10.4 percent increase in COVID-19 hospitalizations across America in the week leading up to December 16. There has been an increase of 3.4 percent in deaths related to coronavirus in the same period. Newsweek has contacted the CDC for comment via email.

Mask mandates have long been controversial since they were implemented during the coronavirus pandemic, which reached the U.S. in early 2020. Medical professionals and the CDC have consistently advocated for mask wearing, including outside of doctor's office or hospital. Currently, no state in the country has a mandatory mask policy for any indoor and outdoor setting.

This week, Mass General Brigham, the largest health system in Massachusetts, said that effective January 2, masks will be essential for healthcare staff directly engaging with patients in clinical-care settings until respiratory illnesses fall below a certain percentage. Patients and visitors are also strongly encouraged to wear masks, which will be provided by the hospital, and staff in hallways and common areas are exempt.

Mass General Brigham said that its policy is determined by the percentage of patients with respiratory illness symptoms presenting at emergency departments or outpatient clinics.

The mandatory masking rule is activated when this percentage surpasses 2.85 percent for two consecutive weeks and will be lifted once the rate falls below the same percentage for a week.

The Dana-Farber Cancer Institute in Boston, Massachusetts, also said that it would require masks wearing for patients and staff on December 18. The hospital added that the policy would be in place for the foreseeable future.

The hospital said on its website: "We check a number of different data points, including rates of influenza-like illness, staff absenteeism, and emergency room visits and hospitalizations caused by respiratory viruses. We will lift the mask requirement when these data points remain consistently lower."

Staff at MedStar National Rehabilitation Hospital in Washington D.C. are currently required to wear a mask while at work, according to political website The Hill.

University of Wisconsin Hospitals and Clinics are also asking that people wear masks in its medical buildings, including University Hospital, American Family Children's Hospital and East Madison Hospital.

In New York, NYC Health + Hospitals has said there would now be a mask policy in place at all of its facilities, adding on its website that "COVID-19 and other respiratory infections continue to pose a threat to all New Yorkers."

Hospitals in California are also asking patients, workers and visitors to mask up.

Officials in Yolo County said in a news release that, due to "a rise in respiratory virus activity in the community," individuals should consider wearing masks "in crowded, indoor spaces." Aimee Sisson, Yolo County public health officer, said: "Our wastewater monitoring program is currently detecting high COVID-19 and RSV levels. I recommend that everybody in the community take steps to protect themselves from infection, including wearing a high-quality mask when indoors around others."

Marin County hospitals have had a mask mandate in place since November 1 of this year. In Santa Clara County, masks have been required since April 4, 2023. In San Francisco, masks are required in hospital settings for all workers in medical fields and in prisons.

Newsweek is committed to challenging conventional wisdom and finding connections in the search for common ground.

Newsweek is committed to challenging conventional wisdom and finding connections in the search for common ground.

See the article here:

COVID Mask Mandates Return to Hospitals in Five States - Newsweek