Category: Covid-19

First Edition

Good morning. Today were headed to the Covid inquiry, which is increasingly revealing staggering and foulmouthed (youve been warned) insights into how Boris Johnson and his advisers handled the outbreak of the pandemic.

Those who were once closest to the former prime minister have revealed Johnson was referred to as the trolley by pretty much everyone due to the inconsistency of his decision making and that he described coronavirus as just natures way of dealing with old people.

Johnson said in October 2020 that he no longer buy[s] all this NHS overwhelmed stuff, and fought back against scientists calling for a lockdown. He argued instead that we should let the old people get it and protect others from the economic effects of another lockdown.

In one WhatsApp message eventually released to the inquiry being held in Dorland House, west London, Johnson wrote: I must say I have been rocked by some of the data on Covid fatalities. The median age is 82 81 for men, 85 for women. That is above life expectancy. So get Covid and live longer.

His closest adviser, Dominic Cummings, didnt appear to have much faith in Johnson, and even less in his cabinet. At the moment the [Westminster] bubble thinks youve taken your eye off [the] ball, youre happy to have useless fuckpigs in charge he said in reference to other members of the cabinet in a message to the PM in summer 2020.

When asked to explain those messages to the inquiry yesterday, Cummings said: My appalling language is obviously my own but my judgment of a lot of senior people was widespread I would say, if anything, it understated the position.

Theres a lot more, after the headlines.

Israel-Hamas war | Israeli airstrikes destroyed apartment blocks and killed dozens of people at a refugee camp in northern Gaza, according to the Hamas regime, as the UN said the conflict had become a graveyard for children.

Transport | Plans to close railway station ticket offices in England have been scrapped in a government U-turn. The transport secretary, Mark Harper, said the government had asked train operators to withdraw their proposals after a huge public backlash.

AI | The Guardian has accused Microsoft of damaging its journalistic reputation by publishing an AI-generated poll speculating on the cause of a womans death next to a Guardian article. The automated poll appeared next to a story about the death of Lilie James, a 21-year-old water polo coach who was found dead with serious head injuries at a school in Sydney last week. It asked: What do you think is the reason behind the womans death? Readers were then asked to choose from three options: murder, accident or suicide.

Finance | Odey Asset Management is closing down, five months after allegations of sexual misconduct made by junior female members of staff against its founder Crispin Odey threw the hedge fund into turmoil.

Weather | Forecasters have said Storm Ciarn poses a potential threat to life in southern England later this week, bringing gusts of wind likely to hit 80mph.

Cast your mind back to 14 March 2020 when thousands had already died of the virus (including the first deaths in the UK), and Italy had already imposed a national lockdown. The UK governments scientific advisers and Johnsons own top team had recommended that a full UK national lockdown was the only way to try to prevent the spread of the virus.

But Johnson still didnt think it was a big deal and ignored their advice for nine days, according to Lee Cain, the PMs former head of communications.

He doesnt think anything can be done and his focus is elsewhere, he thinks itll be like swine flu and he thinks his main danger is talking economy into a slump, Cain said in a WhatsApp to Cummings.

The diary of a former private secretary recording a meeting with Johnson appears to back this up. Were killing the patient to tackle the tumour. Large ppl [taken to mean large numbers of people] who will die, why are we destroying [the] economy for people who will die anyway soon, the diary of Imran Shafi said.

Cain said Johnson met his most senior advisers on 14 March, and the collective agreement in the room was that a full lockdown was the only strategy that could suppress the spread of Covid-19, save the NHS from collapse and ultimately buy the government more time. Johnson went on to announce the UKs first nationwide lockdown on 23 March.

Cain was clear with the inquiry: Johnson should have done more and that Covid was the wrong crisis for this prime ministers skillset.

I dont think there was any clarity of purpose, any really serious outline, plan to deal with Covid at that particular point, he said. Cain described Johnson as a challenging character to work with because he would oscillate between lockdowns and other policy options.

Cummings did not appear to have a nice word to say about anyone. But he had plenty of nasty ones. He described the Cabinet Office as a dumpster fire, ministers as feral, the cabinet secretary Mark Sedwill as babbling, and spoke of dodging stilettos from that cunt when referring to the deputy cabinet secretary Helen MacNamara. When challenged on the language he denied claims that it was mysogynistic because he was much ruder about men.

***

Frustration at Johnson changed his strategic direction every day

Cummings and Cain werent the only ones struggling to deal with Johnson during the crisis. The UKs most senior civil servant, Simon Case, told Cummings in a message that he was at end of my tether with Johnson changing his strategic direction every day.

He [Johnson] cannot lead and we cannot support him in leading with this approach. He changes strategic direction every day (Monday we were all about fear of virus returning as per Europe, March etc today were in let it rip mode cos the UK is pathetic, needs a cold shower etc).

Martin Reynolds, the head of the private office of the prime minister, said the plans put in place in March 2020 were grossly deficient and admitted that Johnson did blow hot and cold on some issues including the most difficult choices the country was facing.

[Johnson] oscillated in terms of what should be done, he wondered whether he should be regarded as the mayor in the Jaws film shutting the beaches, he said. Then, within hours or days, he would take a contrary position.

***

Party Marty and the disappearing messages

Reynolds was also challenged about why he switched on the disappearing message function in a WhatsApp group of senior No 10 staff. He claimed he couldnt recall why he had switched it on but it might have been because I was worried of someone screenshotting or using some of the exchanges and leaking them.

Reynolds was nicknamed Party Marty after it emerged he had invited more than 100 Downing Street staff to a bring your own booze party during the first lockdown. During the inquiry he apologised for arranging the party and for all the distress caused.

Brenda Doherty, whose mother, Ruth Burke, was the first woman to die in Northern Ireland with Covid, said listening to the evidence at the inquiry felt like being punched in the stomach.

While Covid-19 was ripping through the country and I was doing everything I could to protect my mum, [Johnson] was unable to take decisions, and left the country at the mercy of the virus he was supposed to be protecting them from.

Johnson is due to give evidence to the inquiry before Christmas. Brenda will be listening.

The rental market is on its knees and tenants are paying the price. Gaby Hinsliff asks why the government continues to drag its feet as millions of people continue to live in dire and unstable conditions. Nimo

Caroline Kimeu writes here about the talent of female photographers in Africa and delves into how they are using their photography to empower and change the world view about previous stereotypes regarding African women. Some of the works include a photo series on albinism and ballet dancers in a Nairobi slum. Nyima Jobe, newsletters team

Artificial intelligence has changed the way students learn. Johana Bhuiyan spoke to teachers about how they are dealing with these news tools in their classrooms and whether a total ban is actually the right way forward. Nimo

Another Halloween has come and gone and Im sure everyone placed their costumes in pole position, but are Halloween costumes of today really scary? Emma Beddington takes us through when Halloween costumes actually caused a fright with the pictures to prove it. Nyima

The war in Israel and Gaza has stoked up a lot of fear and distress around the world. With emotions running high, people often turn to social media to express themselves. For New York magazine, Angelina Chapin spoke to people who had experienced professional blowback and even dismissal after they publicly posted their views, examining the employment laws that leave many unprotected. Nimo

Football | Saudi Arabia was confirmed on Tuesday as the sole bidder to host the 2034 mens World Cup, raising concerns over Fifas ability to deliver on its human rights commitments.

Cricket | Former champions Pakistan beat Bangladesh by seven wickets, keeping alive their slender chances of making the semi-finals of the World Cup.

Football | Sarina Wiegmans Lionesses depart Belgium bruised in more ways than one, a bad head injury to Alex Greenwood marring the match and a crushing 3-2 defeat taking progression from their Nations League group and Olympic qualification out of their hands.

The Guardian leads with Graveyard for children: airstrikes kill dozens at Gaza refugee camp. Other titles play pick your villian with the Covid inquiry and there are two main choices. Boris: the old should accept their fate, says the Daily Mirror, but in the Daily Mail, where Johnson has a column, its Now Cummings feels the heat, making it one-all so far. Johnson: let elderly accept fate, says the Times while the Daily Telegraph goes with Cummings fed toxic, misogynist culture in No10 and we remain tied at 2-2. Revealed: orgy of narcissism at heart of Covid failings a point scored for Johnson in the Daily Express, which explains the then-PM admonished aides for behaving selfishly instead of solving the crisis. But another point against him in the i UKs old people should accept their fate from Covid Boris Johnsons private stance revealed. So we end in a dead heat. Elsewhere: Rail ticket queue-turn thats the Metro which says hundreds of station offices will stay open after civil servants and ministers relented. The Sun has How dare you after police took down posters of Israeli child hostages of Hamas this comes after them going soft at hate demos, the paper says. And the Financial Times has Odey Asset Management to close five months after women accuse founder.

Is the AI safety summit already too late?

Rishi Sunak has convened a global summit of world leaders and tech executives to discuss how the power of artificial intelligence can be safely harnessed. Dan Milmo reports

A bit of good news to remind you that the worlds not all bad

In the midst of chaos and uncertainty, children in Gaza still manage to smile with the help of street dancing collective Camp Breakerz Crew.

The crew, who have been at the forefront of the hip-hop scene in Gaza since 2004, hold workshops in Nuseirat UN refugee camp, a shelter for mothers and children displaced by the airstrikes.

The aim of the workshops are to remind the children of something positive and remind them they are just children and deserve to feel happy even if its for a short period of time. Ahmed Alghariz, the co-founder of the group, says I feel happy that we make the children forget about the attacks for a while, I feel happy to see some smiles.

Sign up here for a weekly roundup of The Upside, sent to you every Sunday

And finally, the Guardians puzzles are here to keep you entertained throughout the day with plenty more on the Guardians Puzzles app for iOS and Android. Until tomorrow.

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Wednesday briefing: What Boris Johnsons closest advisers had to say for themselves at the Covid inquiry - The Guardian

Two closely related variants, EG.5 and HV.1, now comprise roughly half of the Covid-19 cases in the United States.

EG.5 became the dominant variant nationwide in August. At that time, the World Health Organization classified it as a variant of interest, meaning it has genetic changes that give it an advantage and its prevalence was growing. Since then, the variant appears to have plateaued, holding steady at about 20 to 25 percent of cases in September and October.

HV.1 emerged in the United States at the end of the summer and has progressively made up a larger proportion of the circulating virus. According to the Centers for Disease Control and Prevention, it overtook EG.5 as the dominant variant last week, and now accounts for one in four Covid cases.

Experts have also been watching two other variants, BA.2.86 and JN.1, that make up only a tiny fraction of cases but scientists say carry an alarming number of mutations.

How worried should people be about these variants?

While severe illness in older adults and people with underlying conditions is always a concern, as is long Covid in anyone who gets infected, experts say EG.5 and HV.1 do not pose a substantial threat or at least no more of one than any of the other major variants that have circulated this year.

The EG.5 variant was identified in China in February 2023 and was first detected in the United States in April. It is a descendant of the Omicron variant XBB.1.9.2 and has one notable mutation that helps it to evade antibodies developed by the immune system in response to earlier variants and vaccines.

That mutation may mean that more people are susceptible because the virus can escape a little bit more of that immunity, said Andrew Pekosz, a professor of molecular microbiology and immunology at Johns Hopkins University Bloomberg School of Public Health.

But EG.5, which has also been called Eris, does not appear to have any new capacities when it comes to its contagiousness, its symptoms or its likelihood of causing severe illness. Diagnostic tests and treatments such as Paxlovid continue to be effective against it. Perhaps more important, the new vaccines, which target a related XBB variant, appear to produce a sufficient number of antibodies that work against EG.5.

HV.1 is descended from EG.5 and is highly similar to it. There isnt data yet on how well the new vaccines perform against HV.1, but Dr. Dan Barouch, the head of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston, said he doesnt anticipate it will be substantially different from their efficacy against EG.5.

Given the variants similarity, its unclear exactly how HV.1 has overtaken EG.5, but one of the few additional mutations in HV.1 has likely given it an edge over its predecessor. Whenever a new variant dominates, then by definition it has an advantage, Dr. Barouch said. And the advantage is either increased transmissibility or increased immune escape.

Another variant that scientists were watching closely earlier this fall was BA.2.86, nicknamed Pirola. Experts were initially worried about this variant because of the number of mutations it carries in the spike protein, which is what the virus uses to infect human cells and what our immune systems use to identify it. According to Jesse Bloom, a professor at the Fred Hutchinson Cancer Center who specializes in virus evolution, the mutations in BA.2.86 represent an evolutionary jump similar in size to the changes in the first Omicron variant compared to the original coronavirus strain.

Adding to the concern, early data indicated that the new vaccines may not be very effective against BA.2.86. However, evidence has since emerged that antibody levels produced in response to BA.2.86 are on par with those developed in response to EG.5, suggesting that the vaccines will be sufficiently protective against it. Another study found that BA.2.86 may not be as transmissible as other forms of the virus.

Consequently, BA.2.86 has not taken hold like scientists worried it might; currently, there are no cases of it reported on the C.D.C. variant tracker. Dr. Bloom said that it is not uncommon for new variants to fizzle out instead of spreading widely.

Just like EG.5 evolved to produce HV.1, JN.1 has recently emerged from BA.2.86. According to data released Oct. 18 on X (formerly Twitter) by scientists in China, JN.1 carries a mutation that gives it extra immune-evading capabilities, but it doesnt appear to bind to human cells as well. Time will tell if JN.1 gains traction or follows the path of BA.2.86.

More than the risk conferred by any individual variant, it is the rapid rate of virus evolution that is most concerning to Trevor Bedford, a professor in the vaccine and infectious disease division at the Fred Hutchinson Cancer Center. No single variant has been that impactful, he said, but the overall accumulation of these mutations is having significant impact.

Read more:

New Covid Variants: What to Know About HV.1 and EG.5 - The New York Times

OK, hands up who has a stockpile of COVID rapid antigen tests in the cupboard?

There is a wide variation in the accuracy of COVID rapid antigen tests

Experts say we still need RATs to stop the spread of COVID and ensure timely treatment

There's a lot you can do to maximise the accuracy of RATs

As COVID continues to do the rounds you mayfind yourself reaching for one of those tests. But your RAT test could give you a bum steer on whether you are infected with Sars-CoV-2 or not if it has passed its expiry date.

Even if the test is still current and has been stored at the right temperature the result may still not be accurate.

While some of the blame for this lies with us not using RATscorrectly,a new study suggests manufacturers have also overstated the accuracy of their tests.

So what's the story, and what can be done to increase test accuracy?

In 2022, a Cochrane review found enormous variation in the 'sensitivity' theability to accurately pick up a positive case of COVID between different brands of RATs.

"When tests were used according to manufacturer instructions, average sensitivity by brand ranged from around 34 per cent to 93 per cent," said Emily MacLean, an epidemiologist at the University of Sydney.

She said RAT accuracy was generally confirmed in the studies by using PCR.

Yet, the World Health Organization recommends RATs have a minimum sensitivity of 80 per cent which means they pick up at least 80 of 100 positive cases, missing 20.

"So some of those RATs [studied by Cochrane] certainly did not meet WHO's target sensitivity," Dr MacLean said.

Dr MacLean and colleagues decided to compare the estimates of accuracy from the Cochrane reviewwith theclaims made by manufacturerson the little slips of paper the'instructions for use' found inside test kits.

To minimise the impact of 'user error', they only included research in which people using the tests stated they followed the manufacturers' instructions.

The new study of 22 tests, published in Lancet Microbe, found that manufacturers claims over-estimated accuracy, on average, by 12 per cent, meaning an extra 12 positive cases per 100 infected would be missed.

"Not every test is overstating sensitivity but more of them do than don't," Dr MacLean said.

While RATs are evaluated before they are sold, the 2022 Cochrane review was looking at how the tests actually worked when they were deployed, Dr MacLean said.

And this is when many factors can affect accuracy.

For example, RATs are known to have lower accuracy in people with few symptoms and in people who test too early after they've been infected.

And, as mentioned, failing to follow test instructions can be a problem.

For example, if you eat, smoke, brush your teeth or chew gum before doing a spit test that can throw the accuracy out.

Touching the swab or forgetting to blow your nose before a nasal test can also cause problems.

"Some tests are more robust to user error than others," Dr MacLean said.

Paul Griffin, director of infectious diseases at Mater Health Services in Brisbane said it was important to understand the limitations of RATs.

"The biggest limitation is the sensitivity. There is a relatively high rate of false negatives, meaning it can fairly easily miss COVID, particularly if it's done early or incorrectly."

Dr Griffin said given that the accuracy of tests is generally assessed in "ideal conditions" it's not surprising that they have lower accuracy in the real world.

However experts suggest medical professionals and people who do tests regularly are more likely to get an accurate result.

While most states don't collect RAT results anymore, Dr Griffin said the tests still play an important role in controlling the spread of COVID, and ensuring effective treatment is given early enough to work well.

"We still have around 200 outbreaks of COVID in aged care facilities around the country at present," he said.

"It's still really important we find people with COVID, particularly those at high risk."

Dr Griffin said access to oral antivirals was dependent on a positive test, and since PCR tests were now much more difficult to get, this placed more importance on rapid antigen tests.

"While it's talked about very little publicly these days, COVID is still around and will continue to be for the foreseeable future," he said, adding everyone should consider using RATs.

"It's the right thing to do to isolate if you have COVID."

His advice for maximising the accuracy of your RAT is to use the Therapeutic Goods Administration list of approved COVID-19 rapid antigen tests to find a test with the highest sensitivity possible, and then be careful how you do the test.

"There are subtle differences in how they all work so you do have to make sure you are following the included manufacturer's instructions," Dr Griffin said.

He also says it's worth purchasing a "combination test" that picks up RSVs and types of influenza.

Jon Deeks, a professor of biostatistics at the University of Birmingham, who led the Cochrane review on RAT accuracy, and was co-author on the new study with Dr MacLean, argues for a big-picture change when it comes to test evaluation.

He says there isa lack of transparency in evaluations done by manufacturers and a relatively low level of evidenceis used to evaluate tests, compared to drugs.

"We're about 30 years back in terms of the strength of evidence we can get," Professor Deeks said.

A spokesperson for the Therapeutic Goods Administration, however, stated the TGA's expectations for manufacturers aligned with requirements of the World Health Organization (WHO) and the European Commission, and no change was being proposed.

The TGA carries out ongoing independent verification of approved RATs to ensure compliance with requirements.

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Rapid antigen tests should still be used for COVID-19, but some brands are better than others - ABC News

Photo: 123rf.com / Composite Image - RNZ

There have been 3934 new cases of Covid-19 reported in New Zealand over the past week, and 29 further deaths attributed to the virus. There were 573 probable cases.

Of the new cases, 2036 were reinfections.

At midnight on Sunday 29 October, 225 cases were in hospital and three in intensive care.

The seven-day rolling average of new cases was 585 per day, up from 574 last week.

Last week, Te Whatu Ora reported 4018 new cases and 23 further deaths.

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Covid-19 update: 3934 new cases, 29 deaths attributed to virus - RNZ

Avery Travis and David Barer

19 hours ago

AUSTIN (KXAN) With pandemic emergency rules declared over by federal authorities in May, state and local health officials have halted their ongoing collection and public display of detailed nursing home COVID-19 case data. The change could make it tougher for residents and their families to find up-to-date, facility-level information.

Texas Health and Human Services Commission used to update its COVID-19 case counts and vaccination rates for nursing homes and assisted living facilities on its website. Online display of COVID-19 vaccine data ended in May 2023, and case and death rate data stopped being posted online in March 2023, according to the agencys website.

With the expiration of emergency rules that required this data to be reported, HHSC is no longer collecting detailed COVID-19 data from nursing or assisted living facilities, according to HHSC. The agency said it has no plans to resume posting the data online.

Long-term care facilities have been home to one of the most vulnerable populations to COVID-19. The virus wreaked havoc on senior homes at the height of the pandemic, causing thousands of deaths.

Early in the pandemic, the disaster prompted a fight for transparency and public display of case information for nursing homes. Local and state health authorities initially cited federal health privacy laws and blocked that information from being released to KXAN, other media organizations and the Freedom of Information Foundation of Texas.

FOIFT called for state and local officials to identify nursing facilities where COVID-19 cases had been discovered. After an Office of Attorney General ruling, HHSC and local health authorities like Austin Public Health began publicly displaying detailed information about the number of cases and deaths in individual nursing homes.

Lawmakers also got involved in 2021. State Sen. Judith Zaffirini, D-Laredo, passed Senate Bill 930, permitting the public disclosure of the number of residents diagnosed with a communicable disease like COVID-19 and the name or location of the facility.

State and local COVID-19 reporting hasnt stopped completely for nursing homes. Facilities continue to report COVID-19 outbreaks to HHSC. The agency uses those reports to determine whether to investigate or conduct an infection survey, according to an HHSC spokesperson. An outbreak is classified as one or more cases, HHSC said.

KXAN has requested those outbreak numbers, and we will report on that information when it becomes available.

KXAN checked back on COVID-19 case reporting after a viewer submitted a tip about an outbreak at an Austin nursing facility. Texas saw a recent spike in COVID-19 cases in senior facilities in September, when 860 cases were reported in one week a significant increase compared to late June, when there were fewer than 100, according to federal data.

APH also ended its public presentation of facility-level COVID-19 data and launched a trimmed-down version of its COVID-19 dashboard in June that shows aggregate cases citywide for long-term care facilities.

Instead of focusing on case counts, public health officials believe there is more value in tracking hospitalizations, deaths and other indicators such as wastewater, APH said in a statement.

See Austin Public Healths COVID-19 dashboard data and long-term care facility data.

Long-term care facilities are still required to report COVID-19 information to the Centers for Disease Control and Prevention weekly. The Centers for Medicare and Medicaid Services provides public datasets that show COVID-19 case counts, numbers of deaths, as well as vaccine rates for residents and staff for individual locations. Assisted living facility data is not available through CMS.

You can find the CMS nursing home data here. In addition to cases and deaths, the dataset also shows vaccination percentages. When vaccines were first made available, Texas nursing home residents and staff were prioritized.

According to CMS latest data, more than half of Texas nursing facilities had just 10%, or fewer, healthcare staff with up-to-date COVID vaccinations, as of Sept. 24.

Read more here:

Texas nursing home COVID-19 data becoming harder to find - KXAN.com

Although a majority of Canadians have already received or intend to get a COVID-19 booster shot or flu vaccine this year, 40 per cent of the population does not plan on rolling up their sleeves for the updated shot this fall, according to a new Ipsos poll done exclusively for Global News.

The poll, released Wednesday, found of that group, 45 per cent said they did not feel it was worth getting one. An additional 23 per cent of this group expressed concerns regarding the shots safety, while seven per cent were outright opposed to the COVID-19 vaccine.

The narrative around COVID boosters is shifting, explained Sean Simpson, vice-president of Ipsos Public Affairs. When the vaccine first came out most people supported mandatory vaccinations. Most people got their vaccines. Now were further removed.

I think one of the reasons support was so high originally was because it was seen as a civic duty. And were not really talking about that anymore and its more about a personal choice.

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4:52 Health Canada approves updated COVID-19 vaccine

Health Canada approvedModernas updated COVID-19 vaccineon Sept. 12. A few weeks later, it thengave the green light to Pfizers updated vaccine. Approval for the updated Novavax vaccine is still under review and has not been announced.

The updated mRNA vaccines are tailored to the XBB.1.5 Omicron subvariant that is circulating in the country. They are recommended for anyone over six months old who either last had a COVID-19 infection or a shot more than six months ago.

The boosters as well as the annual flu shots started rolling out across Canada in October, with the latest landing in Ontario. On Monday the province announced that public health units and primary health providers around Ontario will all offer new COVID-19 boosters along with annual flu shots.

Forty per cent of respondents may not want to get the updated shot, but 60 per cent said they have already received the recent booster or plan to get it soon, Simpson said.

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And that 60 per cent is the same when it comes to flu shots, he said. So if youre going to get one, youre going to get the other.

When it came to the polls results, Simpson said the division in attitudes toward vaccines was strongly influenced by age.

If youre over 55, youre much more likely to say you youve either received or will receive the flu shot, the COVID-19 vaccine booster vaccine, youre much more likely to be actively following the news about COVID-19, he said.

For example, when it comes to following the news about COVID-19, four in 10 respondents believe the virus is no longer a concern for them. But this sentiment is higher among those aged 18 to 34 (52 per cent) compared to 30 per cent among those aged 55 plus.

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More than half (53 per cent) of Canadians said they have stopped following the news for information about COVID-19 and government recommendations, the poll found.

Sixty per cent of Canadians aged 18 to 34 agreed with this, while only 40 per cent of those 55 and older agreed.

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Canadians aged 18 to 34 were more likely to have said they already received the COVID-19 booster vaccine (31 per cent) compared to those aged 35 to 54 (18 per cent) or age 55-plus (19 per cent), the poll found.

However, Simpson believes there may be confusion when it comes to younger people and boosters.

When we look at younger people in this poll, theyre more likely to say that theyve received a recent booster, but they may not appreciate what recent means, he said.

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Because we know that younger people are less likely to get the COVID-19 vaccine boosters than older people. And they admit that theyre less likely to follow those recommendations than older people who follow them more or more diligently, he said.

5:44 Halloween health check with Dr. Isaac Bogoch

In September, Global News interviewed health experts who raised concerns about the guidance coming from public health officials regarding COVID-19 booster shots.

Kerry Bowman, a professor of bioethics and global health at the University of Toronto, told Global News on Sept.1, that he believed information related to COVID-19 boosters was truly confusing and pointed out a lack of clarity in the messaging from public health officials.

The current guidelines provided by the National Advisory Committee on Immunization (NACI), say beginning in the fall of 2023, it recommends a dose of the XBB.1.5-containing formulation of COVID-19 vaccine for individuals in the authorized age group if it has been at least six months from the previous shot or known SARS-CoV-2 infection (whichever is later).

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These are some of the findings of an Ipsos poll conducted between October 20 and 23, 2023, on behalf of Global News. For this survey, a sample of 1,000 Canadians aged 18+ was interviewed. Quotas and weighting were employed to ensure that the samples composition reflects that of the Canadian population according to census parameters. The precision of Ipsos online polls is measured using a credibility interval. In this case, the poll is accurate to within 3.5 percentage points, 19 times out of 20, had all Canadians aged 18+ been polled. The credibility interval will be wider among subsets of the population. All sample surveys and polls may be subject to other sources of error, including, but not limited to coverage error, and measurement error.

2023 Global News, a division of Corus Entertainment Inc.

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40% of Canadians don't plan on getting updated COVID booster, flu shot: poll - National | Globalnews.ca - Global News

Although virtual studying by school pupils and working from a distance by employees were initially thought during the COVID-19 pandemic to be a blessing, they quickly turned off people of all ages who regarded them as a bore. The same thing occurred during the beginning of the Gaza War when schools and workplaces closed.

New research from Finland suggests that sleepiness during virtual meetings is caused by mental underload and boredom.

Earlier studies suggested that fatigue from virtual meetings stems from mental overload, but new research from Aalto University shows that sleepiness during virtual meetings might actually be a result of mental underload and boredom.

I expected to find that people get stressed in remote meetings. But the result was the opposite especially those who were not engaged in their work quickly became drowsy during remote meetings, said Prof. Niina Nurmi, an expert in organizational psychology and organizational behavior who led the study.

The researchers measured heart rate variability during virtual meetings and face-to-face meetings, examining different types of fatigue experiences among 44 knowledge workers across nearly 400 meetings. The team published in the Journal of Occupational Health Psychology under the title Virtual Meeting Fatigue: Exploring the Impact of Virtual Meetings on Cognitive Performance and Active Versus Passive Fatigue.

We combined physiological methods with ethnographic research, following each participant for two workdays, recording all events with time stamps to find out the sources of human physiological responses, Nurmi explained. They used subjective and heart-rate variability to investigate the relationships between virtual versus face-to-face meetings and active (exhaustion) and passive types (drowsiness) of tiredness. The study also included a questionnaire to identify peoples general attitudes and work engagement.

A meetings format had little effect on people who were highly engaged and enthusiastic about their work. They were able to stay active even during virtual meetings. On the other hand, workers whose work engagement was low and who were not very enthusiastic about their work found virtual meetings very tiring.

"Its easier to maintain focus in face-to-face meetings than in virtual ones, as the latter have limited cognitive cues and sensory input. Especially when cameras are off, the participant is left under-stimulated and may start to compensate by multitasking," she continued. Although an appropriate level of stimulation is generally beneficial for the brain, multitasking during virtual meetings is problematic. Only highly automated tasks, such as walking, can be properly carried out during a virtual meeting.

She suggested that walking and other automated activities can boost your energy levels and help you concentrate on the meeting.

"But if youre trying to focus simultaneously on two things that require cognitive attention, you cant hear if something important is happening in the meeting. Alternatively, you have to constantly switch between tasks. Its really taxing for the brain.

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Virtual meetings tire people out because they're doing them wrong - The Jerusalem Post

Key Points

Question During the COVID-19 pandemic, what has been learned about whether face mask use is associated with lower transmission of SARS-CoV-2 in community settings, and how has it been learned?

Findings Literature review revealed many high-quality observational studies demonstrating the association of face mask use in the community and of mask mandates with reduced spread of SARS-CoV-2. Randomized clinical trials conducted during the pandemic provide limited information.

Meaning Robust available data support the use of face masks in community settings to reduce transmission of SARS-CoV-2 and should inform future responses to epidemics and pandemics caused by respiratory viruses.

Importance As demonstrated by the influenza virus and SARS-CoV-2, viruses spread by the respiratory route can cause deadly pandemics, and face masks can reduce the spread of these pathogens. The effectiveness of responses to future epidemics and pandemics will depend at least in part on whether evidence on masks, including from the COVID-19 pandemic, is utilized.

Observations Well-designed observational studies have demonstrated the association of mask use with reduced transmission of SARS-CoV-2 in community settings, and rigorous evaluations of mask mandates have found substantial protection. Disagreement about whether face masks reduce the spread of SARS-CoV-2 has been exacerbated by a focus on randomized trials, which are limited in number, scope, and statistical power. Many effective public health policies have never been assessed in randomized clinical trials; such trials are not the gold standard of evidence for the efficacy of all interventions. Masking in the community to reduce the spread of SARS-CoV-2 is supported by robust evidence from diverse settings and populations. Data on the epidemiologic, environmental, and mask design parameters that influence the effectiveness of masking provide insights on when and how masks should be used to prevent transmission.

Conclusions and Relevance During the next epidemic or pandemic caused by a respiratory pathogen, decision-makers will need to rely on existing evidence as they implement interventions. High-quality studies have shown that use of face masks in the community is associated with reduced transmission of SARS-CoV-2 and is likely to be an important component of an effective response to a future respiratory threat.

More than 3 years after the COVID-19 pandemic began, the use of face masks in the community remains controversial. Vaccination, treatment, population immunity, and other developments have enabled a return to a semblance of prepandemic life, but disagreement about what the evidence shows about masksand the implications for their usepersists. SARS-CoV-2 is still a disruptive and deadly presence, and future epidemics or pandemics caused by pathogens spread by the respiratory route are a near certainty.1 Failure to understand the evidence on the role of masks in preventing the spread of SARS-CoV-2 could undermine our ability to respond to epidemics and pandemics caused by respiratory pathogens.

Evidence on Community Masking at the Advent of the COVID-19 Pandemic

In early 2020, when SARS-CoV-2 was spreading globally and the World Health Organization declared a Public Health Emergency of International Concern, there were neither vaccines against nor treatments for COVID-19. Furthermore, we lacked understanding of the viruss routes of transmission, extent of presymptomatic and asymptomatic spread, and degree of transmissibility. As a result, prevention and control strategies were based on what was known about transmission of other respiratory pathogens, especially influenza viruses and previously characterized human betacoronaviruses, such as those that cause severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and the common cold.2-4 Public health officials needed to consider that available evidence came from studies on specific types of masks (particularly N95 respirators vs surgical masks), that there was variation in the aims of masking interventions (ie, wearer protection vs source control), and that epidemiologic and behavioral differences between study settings (especially in health care settings vs the community) might influence apparent mask effectiveness.

These considerations are essential to the interpretation of evidence on mask efficacy and effectiveness. When the COVID-19 pandemic began, there were limited data on masks to prevent community transmission of respiratory pathogens.2 In addition, there were legitimate concerns that studies on prevention of influenza might not be relevant to COVID-19, as the influenza and SARS-CoV-2 viruses differ in their degree of transmissibility, proportion of transmission attributable to asymptomatic shedding, and other factors. Studies on community masking and transmission of SARS-CoV-2 were eagerly awaited and, once available, widely cited. As the pandemic progressed, high-quality data demonstrated the benefits of masking as well as increased protection associated with certain mask types and patterns of use. However, the robustness and nuance of those data have at times been overshadowed by attention to one particular type of study: the randomized clinical trial (RCT).

RCTs on Community Masking During the COVID-19 Pandemic

Two RCTs5,6 on mask use in the community conducted during the COVID-19 pandemic have been published.7 The first, which randomized 3030 people in Denmark to receive surgical masks and a recommendation to mask outside the home vs no intervention, produced inconclusive results.5 The incidence of SARS-CoV-2 infection was 20% lower in the intervention group, but the sample size was insufficient for the difference in infection rates to achieve statistical significance. During the study period, it is possible that other interventions diluted measurable effects of masking or that detected infections were largely transmitted within households. Only 46% of participants in the intervention group reported masking as recommended. Rates of community masking were also low; any effects of the intervention would have been derived primarily from wearer protection alone.8

The second, much larger study6 showed that widespread community masking in Bangladesh was associated with a modest, statistically significant reduction in symptomatic SARS-CoV-2 infections. This was a cluster RCT in which 600 villages with more than 340000 residents were randomized to receive either cloth or surgical masks and promotion of masking in public spaces vs no intervention. Mask use was observed to be 3 times more common (42% vs 13%) in intervention than control villages, with the largest increases in mask use observed in mosques. In villages assigned to the intervention, the incidence of symptomatic SARS-CoV-2 infection was reduced 9.5% overall and 35% among people aged 60 years or older compared with controls. Surgical masks appeared to be more effective than cloth masks.

Why do we not have more RCTs on masks to prevent the spread of SARS-CoV-2? In a pandemic caused by a lethal respiratory virus, it is difficult to find a setting in which it is ethical and feasible to randomize people to masking vs no masking. The time needed for RCTs to be funded, designed, and implemented further limits their feasibility during public health emergencies.9 Other challenges to conducting RCTs of masking during a pandemic include adequately powering a study amid fluctuating community transmission levels and crossover between study groups (ie, inadequate adherence by participants in the intervention group or adoption of the intervention by those in the control group). Perfect adherence with the intervention (ie, wearing a mask correctly at all times of potential exposure) can be impractical, biasing results toward the null. Although imperfect adherence might mimic reality, it can complicate the interpretation of study results. It is not possible to conduct a blinded RCT on mask use vs no mask use, and crossover can be a particular problem if the intervention carries social meaning or if fear of the disease influences adherence with randomization assignment.

In the clinical world, choices between therapeutic regimens to treat various conditions are, whenever possible, guided by the results of carefully planned and executed RCTs. Although the RCT is often referred to as the gold standard, methodological considerations correct the misconception that RCTs are necessarily superior.10 RCTs are not the onlyor even the most importantway to assess the efficacy of health interventions. Although a well-designed RCT can provide valuable and internally valid information on the efficacy of a health intervention, in many areas of public health and medical practice, RCTs are impractical to conduct.11 Furthermore, extrapolation to populations and settings outside the study may be invalid. Many highly effective policies and recommendations that reduce illness and injury have never been assessed in either an individual-level or cluster RCT. Examples include speed limits on highways; seatbelt and motorcycle helmet laws; interventions such as taxation and smoke-free indoor areas to reduce tobacco use; and putting babies to sleep on their backs to reduce the risk of sudden infant death syndrome.11-13 In public health practice, evidence that does not come from RCTs is, appropriately, almost invariably assessed and used in support of policy making.

When RCT data are sparse, creating a summary measure of effect using meta-analysis can seem appealing.14 Meta-analysis was originally developed as a tool for combining results of multiple RCTs that assessed the efficacy of the same therapeutic agent against the same disease outcome, especially when available studies were of limited size and therefore limited statistical power. A meta-analysis does not create new data. Rather, it assesses previously conducted studies, assigning weights based on study size and quality, to improve understanding of an intervention. If the studies available for inclusion in a meta-analysis differed in their methods, populations, contexts, or measurements, combining them for the purposes of conducting a meta-analysis may yield invalid results and conclusions. Meta-analysis can work well for simple interventions expected to have consistent effects across populations (eg, the effect of a particular drug on a specific patient outcome). However, if masking is the intervention under investigation, the effectiveness of the intervention might vary greatly depending on the type of mask, masking behavior in the nonintervention group, force of infection in the community, whether the intervention is designed for individual protection or for source control, uptake of the intervention, and characteristics of the circulating pathogen. If any of these components vary among studies, different interventions are being tested. Lumping studies together because they include a mask can yield invalid conclusions and conceal important findings of individual studies. The results of a Cochrane review of RCTs and cluster RCTs on interventions to reduce the spread of respiratory viruses14 exemplified this pitfall; studies on masking to prevent influenza virus transmission and studies on masking to prevent SARS-CoV-2 virus transmission were analyzed together. When interpreting study findings, decision-makers should strive to understand the conditions under which specific interventions are likely to be useful.

Observational Studies on Community Masking During the COVID-19 Pandemic

Before the emergence of SARS-CoV-2, observational studies of measures to prevent transmission of the related betacoronaviruses that cause SARS and MERS indicated that use of respirators or masks was associated with a large reduction in the risk of infection in health care settings and in the community.2 Since the pandemic began, high-quality case-control, cohort, and ecologic studies support the effectiveness of masks in the community to prevent transmission of SARS-CoV-2 (Table 1).6,7,15-21 Proof of concept that masking can reduce transmission of SARS-CoV-2 comes from laboratory evaluations that have used simulated human respiration and other techniques to show that cloth masks, surgical masks, and N95 respirators reduce the spread of potentially infectious respiratory droplets and aerosols.15,22,23 Masks can offer effective source control and some wearer protection; reduction of droplet and aerosol spread is greatest when both the source and the exposed individual are masked.15,22,24 Studies show that mask type and fit influence efficacy.15,17,22,25,26 The higher filtration efficiency of N95 respirators compared with surgical masks provides further evidence of efficacyessentially, a dose-response association of the intervention with the outcome.

Observational studies have demonstrated the effectiveness of mask use to prevent transmission of SARS-CoV-2 on airplanes,27 in schools,28,29 and among household30 and community17,18,31 contacts of individuals with COVID-19. A COVID-19 outbreak on the USS Theodore Roosevelt aircraft carrier was particularly instructive. Ships are high-risk environments for respiratory disease outbreaks because they bring people together for prolonged periods in often poorly ventilated close quarters. The outbreak on the USS Theodore Roosevelt occurred early in the COVID-19 pandemic, before crew members would have had immunity to SARS-CoV-2. More than 80% of those who reported not masking were infected; the odds of infection were 30% lower among those on the ship who reported masking.32

In many COVID-19 outbreak settings, including the USS Theodore Roosevelt, masking was not the sole implemented public health measure (eg, hand hygiene, isolation of cases, physical distancing). Confounding can be a particular problem in observational studies. Studies demonstrating the effectiveness of masks to prevent COVID-19 have attempted to address this by controlling for factors, such as other interventions7,30,33-35 or demographic characteristics that might influence risk of infection.17,31 Others have used stratified analysis and shown that the impact of masking varies across patterns of use, populations, and settings. For example, masking in the household was protective if performed in the days prior to symptom onset in the index case,30 demonstrating the risk of presymptomatic transmission and the effectiveness of masking to prevent asymptomatic transmission. Masks were associated with a greater reduction in risk of infection among unvaccinated than vaccinated individuals and with reduced risk of infection among those exposed outside their households but not among those exposed within their households31 (possibly because low rates of masking within households precluded sufficient assessment). Several studies have shown increased protection with greater consistency of masking.7,17,18

Other Considerations: Mask Mandates, Risk-Benefit Calculations, and Areas of Uncertainty

Whether masks work is a different question from whether mask mandates work. The effectiveness of mandating an even partially effective intervention depends on many factors, and the impact of the intervention can be challenging to demonstrate. If adherence to a public health mandate is low, a mandate is unlikely to have an impact (seat belts reduce the risk of death, if they are worn). Higher rates of indoor masking in parts of Asia (eg, Hong Kong, Japan, Korea, and Singapore) may account for lower rates of infection and death, especially early in the pandemic.36,37 For a population in which use of the intervention is already common, a statistically significant reduction in infection rates will be more difficult to establish. Furthermore, assessment of the effectiveness of mask mandates requires either cluster randomized studies or ecologic studies in which the unit of observation is the group, not the individual. Such studies have been done: rigorous evaluations of mask mandates in several settings suggested substantial protective benefits. In Germany, an opportunity to generate high-quality data arose when different regions mandated masking at different times during the COVID-19 pandemic. Mask mandates were associated with a 45% reduction in SARS-CoV-2 infections.38 Variation in timing of mask mandates across the United States provided a similar study opportunity, and a matched cohort analysis of more than 400 US counties showed that enactment of a mask mandate was associated with a 25% reduction in COVID-19 incidence 4 weeks later.20 Although it is possible that cases might soon peak without intervention if masking is implemented when incidence is increasing, US communities with mask mandates had less transmission than those without mandates after controlling for potential confounders, including premandate incidence.19,20

The risk-benefit calculations that shape public health recommendations may differ by setting and may change over time (Table 2).15,17-20,22,24-26,28-33,35,39-46 When the COVID-19 pandemic began, scarcity of medical masks and respirators precluded their use outside of health care settings. There was concern that community members wearing masks might self-contaminate with SARS-CoV-2 or might fail to practice other public health measures due to a false sense of security. However, although respiratory viruses can contaminate the outside of masks when masks are worn for hours in high-exposure clinical settings,46 the relevance of this finding to community settings is unclear. There is no compelling evidence that masking is associated with neglect of other public health measures; in fact, studies have suggested the opposite.18

Other concerns raised about masks included possible impacts on respiratory function; although masking can be uncomfortable, especially in warm conditions, there is no compelling evidence of consequential deleterious effects on physiology, including during exercise.47 It can be difficult for young children to wear well-fitting masks, and the possibility that masking may impede cognitive and social development40,41 suggests that this risk should be considered, balancing with possible benefits of masking. There is abundant evidence that school closures are deleterious to childrens health and that masking in schools decreases transmission of SARS-CoV-2 within schools.28,29,39 Using measures including masking to protect high-risk people in the school community and to keep schools open is likely to result in better health and educational outcomes than school closures. Consideration of trade-offs should inform future decisions about masking in schools to prevent the spread of respiratory viruses, and frequent reassessments of the epidemiologic context and available evidence can help maximize benefits and reduce disruption and potential harms.

Although available evidence strongly suggests that masking in the community can reduce the spread of SARS-CoV-2, knowledge gaps persist. It is challenging to disentangle the impacts of masks from those of other interventions on transmission of SARS-CoV-2. The effectiveness of masks may differ between variants of SARS-CoV-2. Until recently, respirators such as N95s were not widely available outside health care settings. We lack precise estimates of the extent to which the community spread of SARS-CoV-2 is reduced at different levels of uptake of different mask types in different contexts. However, there is alignment between findings from laboratory models and limited available effectiveness data: a study on the use of masks or respirators in indoor public settings17 showed that respirators were more protective against SARS-CoV-2 infection than surgical masks, which were more protective than cloth masks.

Effectiveness depends on many factors. No public health intervention, even a highly efficacious vaccine, is 100% effective. Even the best masks will not provide complete protection, and benefits of masking are limited if masks are not worn everywhere transmission occurs (eg, health care workers who consistently wear masks while working with patients but not in break rooms with other health care workers or in the community can be infected in the latter settings). In any pandemic or epidemic, masking will be just one of a series of interventions. The most effective strategies to limit illness and death from SARS-CoV-2 and other respiratory pathogens involve a layered response, including vaccination when available, isolation of infectious people, and protection through risk reductionincluding use of high-quality masks in areas and at times and by vulnerable populations when the pathogen may be spreading. The COVID-19 pandemic and the global mpox outbreak are sobering reminders that we will confront new infectious disease threats in the future. Despite new approaches to developing and manufacturing vaccines (particularly mRNA technology) that can reduce the time between pathogen discovery and vaccine availability, that time frame will still be months at best and, for some pathogens, years or decades. Thus, decision-makers will again need to rely on existing and rapidly generated evidence as they implement interventions to mitigate disease spread. In these circumstances, RCTs and meta-analyses have important limitations and should not form the sole, or even primary, basis of public health decisions. Available evidence strongly suggests that masking in the community can reduce the spread of SARS-CoV-2 and that masking with the highest-quality masks that can be made widely available should play an important role in controlling whatever pandemic caused by a respiratory pathogen awaits us.

Accepted for Publication: September 6, 2023.

Published: October 31, 2023. doi:10.1001/jamanetworkopen.2023.39443

Open Access: This is an open access article distributed under the terms of the CC-BY License. 2023 Cash-Goldwasser S et al. JAMA Network Open.

Corresponding Author: Shama Cash-Goldwasser, MD, MPH, Resolve to Save Lives, 85 Broad St, Ste 1626, New York City, NY 10004 (shamacg@gmail.com).

Author Contributions: Dr Cash-Goldwasser had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Cash-Goldwasser, Reingold, Jackson, Frieden.

Acquisition, analysis, or interpretation of data: Cash-Goldwasser, Reingold, Luby, Frieden.

Drafting of the manuscript: Cash-Goldwasser, Reingold, Jackson, Frieden.

Critical review of the manuscript for important intellectual content: Cash-Goldwasser, Reingold, Luby, Frieden.

Administrative, technical, or material support: Cash-Goldwasser, Reingold, Frieden.

Supervision: Reingold, Frieden.

Conflict of Interest Disclosures: Dr Frieden reported that Resolve to Save Lives received funding from Bloomberg Philanthropies, #startsmall, Gates Philanthropy Partners, which is funded with support from the Chan Zuckerberg Foundation, and the Bill & Melinda Gates Foundation. No other disclosures were reported.

Funding/Support: This analysis was conducted with funding from Resolve to Save Lives. Resolve to Save Lives is funded by grants from Bloomberg Philanthropies; the Bill and Melinda Gates Foundation; and the Chan Zuckerberg Initiative DAF, an advised fund of Silicon Valley Community Foundation.

Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Masks During Pandemics Caused by Respiratory PathogensEvidence and Implications for Action | Infectious ... - JAMA Network

How accurately a person recalls the COVID-19 pandemic is affected by motivational factors, including how they feel about their vaccination status. The recollections of vaccinated and unvaccinated people are skewed in opposite directions, leading to different retrospective narratives about the pandemic. This distorted recall influences how individuals evaluate past political action, and will complicate preparation for future crises.

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Personal motivations polarize people's memories of the COVID-19 pandemic - Nature.com

Health

UK study finds cognitive function and working memory in older adults declined even if they were not infected with virus

The pandemic has caused sustained harm to the brain health of people aged 50 or over, rapidly speeding up cognitive decline regardless of whether or not they caught Covid, researchers have discovered.

Almost 780 million people were killed or made ill by the coronavirus, according to the World Health Organization. Health experts are now learning more about the indirect effects of the biggest public health crisis in a century.

A study has found that cognitive function and working memory in older adults declined more quickly during the first year of the pandemic between March 2020 and February 2021, even if they were not infected with the virus. The trend continued into 2021/22, suggesting an impact beyond the initial lockdowns.

The research is the largest of its kind to link the pandemic conditions and the enormous lifestyle shifts triggered by lockdowns and other Covid restrictions to sustained cognitive decline.

The acceleration in cognitive decline has been exacerbated by a number of factors since the arrival of Covid, the researchers said. These included an increase in loneliness and depression, a fall in exercise and higher alcohol consumption, as well as the effects of the disease itself. The study, led by the University of Exeter and Kings College London, was published in the Lancet Healthy Longevity journal.

Anne Corbett, a professor in dementia research and the lead at Exeter for the Protect study, said: Our findings suggest that lockdowns and other restrictions we experienced during the pandemic have had a real lasting impact on brain health in people aged 50 or over, even after the lockdowns ended.

This raises the important question of whether people are at a potentially higher risk of cognitive decline, which can lead to dementia.

It is now more important than ever to make sure we are supporting people with early cognitive decline, especially because there are things they can do to reduce their risk of dementia later on. She advised people concerned about their memory to see their GP.

Our findings also highlight the need for policymakers to consider the wider health impacts of restrictions like lockdowns when planning for a future pandemic response, she added.

The researchers analysed brain function tests from 3,142 people who took part in the Protect study, which launched in 2014 to gain an insight into the brain function of people over 40 during a 25-year period.

The people assessed were all aged between 50 and 90 and based in the UK. Tests analysed participants short-term memory and their ability to complete complex tasks.

The study then looked at all the data collected over the year from March 2019 to February 2020, and compared it with the results from the pandemics first year (March 2020 to February 2021) and second year (March 2021 to February 2022).

Analysis showed the rate of cognitive decline quickened in the first year of the pandemic, and was higher among those who had already shown signs of mild cognitive decline before the outbreak of Covid-19.

Writing in the Lancet Healthy Longevity journal, the researchers said: We found that people aged 50 years and older in the UK had accelerated decline in executive function and working memory during the first year of the Covid-19 pandemic, during which the UK was subjected to three societal lockdowns for a total period of six months.

Notably, however, this worsening in working memory persisted in the second year of the pandemic, after the social restrictions had eased. The scale of change is also of note, with all groups the whole cohort and the individual subgroups showing more than a 50% greater decline in working memory and executive function.

They cautioned that the study was observational so could not prove cause and effect but said the rise in depression, loneliness and alcohol use and fall in exercise during Covid was well known.

As such, there is a clear need to address these changes in lifestyle behaviour as a public health priority, and on the basis of the patterns of associations seen in the current study, we would hypothesise that interventions targeting these behaviours could benefit cognition.

Prof Dag Aarsland, professor of old age psychiatry at Kings, said: This study adds to the knowledge of the longstanding health consequences of Covid-19, in particular for vulnerable people such as older people with mild memory problems.

Dr Dorina Cadar, a senior lecturer in cognitive epidemiology and dementia at Brighton and Sussex Medical School, who was not involved with the study, said it was clear the effects of the pandemic on the general population had been catastrophic.

The new findings from the Protect study indicate domain-specific cognitive changes for individuals with a history of Covid-19 that mirrored similar trajectories for those with mild cognitive impairment but with a slightly lower rate of decline, said Cadar in a linked comment in the Lancet Healthy Longevity journal.

This study also highlights reduced exercise, alcohol use, depression, and loneliness as key risk factors that affected the rates of cognitive decline in the older population during the Covid-19 pandemic.

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Pandemic had lasting impact on brain health of people aged 50 or over - The Guardian