Category: Covid-19

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Collections in a Post-COVID-19 World | Ruder Ware – JDSupra – JD Supra

October 25, 2023

As a collection and banking attorney, I am often asked whether (or when) I think collections will restart now that we are somewhat beyond COVID-19, although not fully. In my own practice I have seen an increase in demand letters to businesses and consumers for past due accounts or debts. Banks and businesses need to start collecting past due accounts and my sense is a slew of consumer and commercial collections are forthcoming in 2024, though it wont be anything like the financial crisis of 2008.

During COVID-19, and thereafter, federal and/or state/local exemptions and protections were implemented by the government for debtors, borrowers, and consumers. Some protections, like the federal moratorium on residential evictions, ended on or before August 26, 2021 (and in 2021). There were also the PPP loan monies allocated to certain businesses, much of which was forgiven (or otherwise went uncollected). Nearly two years later, there are no longer any protections in place, except for the COVID-19 student loan forbearance (pause), which ends on September 1, 2023. On September 1, 2023, interest resumes and payments will be due beginning in October 2023.

As a short case study, I analyzed a few clients who are either residential/commercial landlords or otherwise what I could call in the business of collections (ex: banks, businesses, etc.). Looking into one of our residential landlord clients, there were nearly 20 evictions filed after the end of the eviction moratorium date and prior to the end of 2021. In 2022, 38 evictions were filed for the same client, and to date, there have been 17 residential evictions filed in 2023. It appears that they are starting to trickle in for both residential and commercial clients but leading with commercial clients and properties.

With regard to commercial and consumer collections, there was definitely a halt during COVID-19 in 2020 and continuing into 2021, especially against consumers. One of my collection clients filed only twelve lawsuits against consumers during the year 2021. In 2022, there were approximately twenty-five general consumer and/or commercial collections lawsuits filed by a client who does commercial and consumer collections. Generally speaking, I would assert that most of these collection lawsuits were commercial collections against businesses (instead of consumer collections for loans, credit accounts, or other consumer collection actions). Many of the lawsuits were for notes, mortgages, and enforcement of security agreements against businesses that had failed or were failing.

Delaying a collection or calling a debt due has its disadvantages. Most notes and contracts are written to protect lenders from waiving any rights to collection or enforcement of their notes, even if they postpone collection actions or calling a default. A common defense to a collection action that seems delayed is laches. Merriam-Webster defines laches as, negligence in the observance of duty or opportunity specifically: undue delay in asserting a legal right or privilege. Commonly referred to as No Waiver by Lender in documents, this section in the contract allows lenders and creditors to not waive their rights to collection or enforcement of documents, even if there is some sort of delay (intentional or unintentional) in the commencement of a collection or enforcement action. Taking special note of the term undue delay, a court will also evaluate whether the debtor is prejudiced by said delay in its decision if laches applies as a defense or proven cause of action against a lender. Based on what Im seeing in my practice, I would even go so far as recommending starting the process of collecting, as laches is a real defense to delays in collections and has even been seen more recently asserted as a cause of action.

As collection attorneys, we are continually trying to predict when debts will start being collected in this post-COVID-19 era. I do note that based on my personal and professional experiences, commercial collections have required far more demand letters than consumer collections. However, is it because commercial collections are somewhat more straightforward and not governed by the Fair Debt Collection Practices Act (FDCPA) or the Wisconsin Consumer Act? Or is it because the entities collecting consumer protections are still holding back enforcement of loan documents to give consumers more time? Whatever the reason, lets hope that all collection and lending attorneys are aware that there is at least one potential consequence to sitting on the past-due debts of consumers and entities.

2023 The Business News. Northcentral and Westcentral editions. Reprinted with permission.

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Collections in a Post-COVID-19 World | Ruder Ware - JDSupra - JD Supra

Six indicted by grand jury in $240K Covid-19 fraud conspiracy case in Kansas City – KMBC Kansas City

October 25, 2023

Six indicted by grand jury in $240K Covid-19 fraud conspiracy case in Kansas City

Updated: 4:33 PM CDT Oct 24, 2023

Six people were indicted Tuesday in a conspiracy to defraud the Paycheck Protection Program. Those indicted include four Missouri residents: Renetta Golden-Larimore, 54, - Kansas City, MissouriTajona Manning, 31, - Kansas City, MissouriTashawn Mayfield, 24, - Kansas City, MissouriCamonte Henderson, 25, - Raytown, Mo.Quinniece Smith, 33, - Dallas, TexasDannisha Taylor, 32, - New Orleans, LouisianaAccording to court documents, the conspiracy spanned from March 2021 to January 2022 where the defendants allegedly submitted counterfeit PPP loan applications totaling $240,000. The indictment claims that Golden-Larimore prepared and submitted the fraudulent applications on behalf of the co-conspirators. Documents claim she received between $2,000 to $7,000 as payment from the loan proceeds. She's accused of creating fake IRS forms for fake businesses and exaggerated the income of existing businesses.The indictment states that Manning, Mayfield, Henderson, Smith, and Taylor received a PPP loan amounting to $20,832. Golden-Larimore also faces charges from an April 26, 2023, federal indictment related to a similar conspiracy that led to nearly $250,000 in deceptive PPP loans being awarded to a dozen individuals in the Kansas City area.

Six people were indicted Tuesday in a conspiracy to defraud the Paycheck Protection Program.

Those indicted include four Missouri residents:

According to court documents, the conspiracy spanned from March 2021 to January 2022 where the defendants allegedly submitted counterfeit PPP loan applications totaling $240,000.

The indictment claims that Golden-Larimore prepared and submitted the fraudulent applications on behalf of the co-conspirators.

Documents claim she received between $2,000 to $7,000 as payment from the loan proceeds.

She's accused of creating fake IRS forms for fake businesses and exaggerated the income of existing businesses.

The indictment states that Manning, Mayfield, Henderson, Smith, and Taylor received a PPP loan amounting to $20,832.

Golden-Larimore also faces charges from an April 26, 2023, federal indictment related to a similar conspiracy that led to nearly $250,000 in deceptive PPP loans being awarded to a dozen individuals in the Kansas City area.

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Six indicted by grand jury in $240K Covid-19 fraud conspiracy case in Kansas City - KMBC Kansas City

UN expert warns of debt crisis as world emerges from Covid-19 … – OHCHR

October 25, 2023

NEW YORK (23 October 2023) As the world emerges from the Covid-19 crisis, life has got harder for people as living standards fall, debt payments cannot be made and debt bonds and currencies are being devalued, a UN expert said today.

When the COVID-19 pandemic spread across the world, the achievement of the Sustainable Development Goals was already behind schedule and the pandemic then crippled these efforts, said Attiya Waris, UN Independent Expert on foreign debt, in areportto the UN General Assembly. We are now emerging from this crisis, and yet standards of living continue to drop, debt interest is not being paid, countries debt bonds are being declared as having junk status, currencies are being devalued, and life has become harder for people across the world, she said.

In a world of multiple crises, the Independent Experts report addresses interventions already in place that need to be strengthened and other, newer ones, that need to be urgently implemented to prevent adverse impacts on human rights across countries.

Waris highlighted that global poverty had increased for the first time in 20 years. The fiscal implications of COVID-19 included the loss of millions of jobs which disproportionately affect those in situations of vulnerability.

Climate change, pollution and loss of biodiversity have adverse impacts on human rights. The impact of weather-related disasters on acute food insecurity has intensified. Seven hundred million people could be displaced by severe water scarcity by 2030, the expert said.

People uprooted from their homes are among the most vulnerable to acute food security and malnutrition. Out of around 21 million refugees and 4 million asylum seekers globally in 2021, over 60 percent were hosted in food-crisis countries/territories, Waris said.

As a matter of priority, the UN expert recommended that States and the international community prevent the creation of artificial crises and adopt a rights-based approach to the economy, a progressive tax system to increase fiscal revenues for State, systemic sustainability and financing of equal access to public services, particularly in the areas of health, education, and pensions. She also called on multilateral organisations to increase concessional lending capacity, revise financing conditions, and extend repayment terms.

She stressed the need for an international approach to fiscal matters, foreign debt and international financial obligations. The establishment of a global fiscal authority, with an international tax cooperation framework through a multilateral instrument is essential for States to respond to polycrises, Waris said.

ENDS

Ms Attiya Waris(Kenya) is theIndependent Expert on the effects of foreign debt and other related international financial obligations of States on the full enjoyment of all human rights, particularly economic, social and cultural rights

The Independent Experts are part of what is known as theSpecial Proceduresof the Human Rights Council. Comprising the largest body of independent experts in the UN Human Rights system, Special Procedures is the general name of the Council's independent fact-finding and monitoring mechanisms that address either specific country situations or thematic issues in all parts of the world. Special Procedures experts work on a voluntary basis; they are not UN staff and do not receive a salary for their work. They are independent from any government or organization and serve in their individual capacity.

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UN expert warns of debt crisis as world emerges from Covid-19 ... - OHCHR

Incidence rate of abortions reduced during COVID-19 pandemic, according to study – Medical Xpress

October 25, 2023

The incidence rate of abortions decreased during the COVID-19 pandemic, mainly driven by procedural abortions, according to a study published online Oct. 24 in the Annals of Internal Medicine.

Catherine S. Hwang, M.D., from Brigham and Women's Hospital and Harvard Medical School in Boston, and colleagues estimated changes in the incidence rate of induced medical and procedural abortions in a cross-sectional study involving reproductive-aged commercially insured women in the United States. The monthly age-adjusted incidence rates were measured among women aged 15 to 44 years from January 2018 to June 2022.

The researchers found that the estimated age-adjusted monthly incidence rate of abortions was 151 per million women in January 2018, with equal rates of medical and procedural abortions. An immediate 14% decrease was seen in the monthly incidence rate of abortions after March 2020 (21 per million women), driven by a 31% decline in procedural abortions (22 per million women). Of the medical abortions, fewer than 4% each month were administered by telehealth.

"Our findings suggest that expanded commercial insurance coverage for telehealth abortions could provide an important opportunity to expand access to abortion care, particularly as some states restrict the delivery of abortion services," the authors write.

More information: Catherine S. Hwang et al, Changes in Induced Medical and Procedural Abortion Rates in a Commercially Insured Population, 2018 to 2022, Annals of Internal Medicine (2023). DOI: 10.7326/M23-1609

Jennifer L. Michener et al, Abortion Trends Amid Restrictions in a Commercially Insured U.S. Population: An Opportunity for Internal Medicine Physicians, Annals of Internal Medicine (2023). DOI: 10.7326/M23-2582

Journal information: Annals of Internal Medicine

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Incidence rate of abortions reduced during COVID-19 pandemic, according to study - Medical Xpress

Norway’s 86-year-old king tests positive for COVID-19 and has mild symptoms – The Associated Press

October 23, 2023

HELSINKI (AP) Norways 86-year-old King Harald V, who has been in frail health in the past few years, has tested positive for the coronavirus and has mild symptoms, royal officials said on Sunday.

His Majesty the King has been diagnosed with corona and is on sick leave until he is symptom-free. The king has cold symptoms and stays at home, the royal household said in a brief statement.

The Norwegian monarch had also tested positive in March 2022 with mild symptoms. Officials have earlier said Harald had received three COVID-19 vaccine shots but its not known whether he had received booster shots.

Prime Minister Jonas Gahr Stre wished the king a speedy recovery in a comment to the Norwegian news agency NTB, which said Haralds son and heir to the throne, Crown Prince Haakon, would take over his duties for now.

The aging monarch, who has been seen using crutches in various occasions, has been hospitalized several times in recent years.

In August 2022, he spent three days with a fever at a hospital, and in December the same year, he was again admitted for an infection that required intravenous antibiotics.

In October 2020, the king underwent surgery to replace a heart valve after being hospitalized with breathing difficulties.

Despite health problems, he has been attending major public events in Norway and its Nordic neighbors. In September, Harald attended celebrations in Stockholm marking the 50th anniversary of Swedens King Carl XVI Gustafs accession to the throne.

In May, the monarch, who was released from a hospital just days earlier, appeared on the royal castles balcony in Oslo to salute the thousands of children marching by as the country celebrated its Constitution Day.

The king is Norways head of state but holds no political power, so his duties are ceremonial. Harald ascended to the throne following the death of his father, King Olav, in 1991.

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Norway's 86-year-old king tests positive for COVID-19 and has mild symptoms - The Associated Press

The Invisible Scars of COVID-19 Severe Infection Could Cause Long-Term Innate Immune System Changes – SciTechDaily

October 23, 2023

Severe COVID-19 can lead to lasting changes in the innate immune system, potentially explaining why it can affect numerous organs and cause prolonged inflammation in some individuals, according to a recent study. The research found changes in blood-forming stem cells in individuals recovering from COVID-19 that increase the production of inflammatory cytokines. One such cytokine, IL-6, might be a key driver behind these changes, and its early intervention could lessen its effects.

A recent study supported by the National Institute of Allergy and Infectious Diseases, a branch of the National Institutes of Health, suggests that severe cases of COVID-19 might lead to persistent changes in the innate immune system, our bodys initial barrier against disease-causing agents. This could shed light on the reasons behind the widespread organ damage observed in the illness and the elevated inflammation levels in individuals experiencing long COVID. The research was recently published in the journal Cell.

Researchers led by Steven Z. Josefowicz, Ph.D., of Weill Cornell Medicine in New York City examined immune cells and molecules in blood samples from 38 people recovering from severe COVID-19 and other severe illnesses, as well as from 19 healthy people. Notably, the researchers established a new technique for collecting, concentrating, and characterizing very rare blood-forming stem cells that circulate in the blood, eliminating the need to extract such cells from bone marrow.

In these rare stem cellsthe parents of immune-system cellstaken from people recovering from COVID-19, the scientists identified changes in the instructions for which genes got turned on or off. These changes were passed down to daughter cells, leading them to boost the production of immune cells called monocytes.

Colorized scanning electron micrograph of a macrophage, one of the innate immune cells derived from monocytes. Credit: NIAID

In the monocytes of people recovering from severe COVID-19, the changes in gene expression led the cells to pump out greater amounts of molecules called inflammatory cytokines than monocytes of people who were healthy or had non-COVID-19 illnesses. The researchers observed these changes as much as a year after the participants came down with COVID-19. Due to the small number of study participants, the scientists could not establish a direct association between cellular and molecular changes and health outcomes.

The investigators suspected that an inflammatory cytokine called IL-6 might play a role in establishing the changes in gene expression instructions. They tested their hypothesis both in mice with COVID-19-like disease and in people with COVID-19. In these experiments, some of the subjects received antibodies at the early stage of illness that prevented IL-6 from binding to cells. During recovery, these mice and people had lower levels of altered stem cell gene-expression instructions, monocyte production, and inflammatory cytokine production than subjects that didnt receive the antibody. In addition, the lungs and brains of mice that received the antibodies had fewer monocyte-derived cells and less organ damage.

These findings suggest that SARS-CoV-2 can cause changes in gene expression that ultimately boost the production of inflammatory cytokines, and one type of those cytokines perpetuates the process by inducing these changes in stem cells even after the illness is over. Additionally, the findings suggest that early-acting IL-6 is likely a major driver of long-term inflammation in people with severe COVID-19.

These findings shed light on the pathogenesis of SARS-CoV-2 infection and may provide new leads for therapies. The results also underscore the importance of staying up to date with recommended COVID-19 vaccines, which are proven to protect against serious illness, hospitalization, and death.

Reference: Epigenetic memory of coronavirus infection in innate immune cells and their progenitors by Jin-Gyu Cheong, Arjun Ravishankar, Siddhartha Sharma, Christopher N. Parkhurst, Simon A. Grassmann, Claire K. Wingert, Paoline Laurent, Sai Ma, Lucinda Paddock, Isabella C. Miranda, Emin Onur Karakaslar, Djamel Nehar-Belaid, Asa Thibodeau, Michael J. Bale, Vinay K. Kartha, Jim K. Yee, Minh Y. Mays, Chenyang Jiang, Andrew W. Daman, Alexia Martinez de Paz, Dughan Ahimovic, Victor Ramos, Alexander Lercher, Erik Nielsen, Sergio Alvarez-Mulett, Ling Zheng, Andrew Earl, Alisha Yallowitz, Lexi Robbins, Elyse LaFond, Karissa L. Weidman, Sabrina Racine-Brzostek, He S. Yang, David R. Price, Louise Leyre, Andr F. Rendeiro, Hiranmayi Ravichandran, Junbum Kim, Alain C. Borczuk, Charles M. Rice, R. Brad Jones, Edward J. Schenck, Robert J. Kaner, Amy Chadburn, Zhen Zhao, Virginia Pascual, Olivier Elemento, Robert E. Schwartz, Jason D. Buenrostro, Rachel E. Niec, Franck J. Barrat, Lindsay Lief, Joseph C. Sun, Duygu Ucar and Steven Z. Josefowicz, 18 August 2023,Cell. DOI: 10.1016/j.cell.2023.07.019

The study was funded by the National Institute of Allergy and Infectious Diseases.

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The Invisible Scars of COVID-19 Severe Infection Could Cause Long-Term Innate Immune System Changes - SciTechDaily

Canada’s health-care crisis is gendered: How the burden of care falls to women – The Conversation

October 23, 2023

As we enter cold, flu and COVID season, Canada is continuing to experience a health-care crisis. One in six Canadians dont have a family doctor and less than 50 per cent are able to see a primary care provider on the same or next day. Both the B.C. Nurses Union and Hospital Employees Union report over one-third of their members are considering quitting, largely due to burnout.

Because women make up 75 per cent of the health-care workforce and are responsible for the majority of care work in the community and at home women bear the brunt of this crisis, much as they did during the COVID-19 pandemic.

In 2020 and 2021, as co-lead of the Gender and COVID-19 Project based at Simon Fraser University, I spoke with nearly 200 women working on the frontlines of the COVID-19 response.

Their stories, compiled in my book Conscripted to Care, range from well-paid physicians to those making minimum wage cleaning rooms in long-term care (LTC) facilities, with participants identifying along a range of social positions related to factors including race, ethnicity and sexuality. Their combined experiences illustrate the cracks within our health system created by gender inequality.

Not only is the health sector feminized, but women particularly racialized women are more likely to be in positions at the lower end of the pay scale, that also require close and prolonged contact with patients. When space, equipment and staff are scarce, these frontline workers are left to fill intractable gaps.

An LTC care aid described working under conditions so short staffed that some residents had missed several baths in a row:

You feel bad because there are people, and this is their homes and their lives potentially, right. And theyre not getting the care that they need and so how I mean it always ends up coming back on us is we have to eventually just have to stop and find the energy or find the time it eventually just catches up to us. The work just doesnt disappear, we just dont do it for that day.

Such circumstances can lead to moral distress, the experience of being unable to provide ethically required care due to structural constraints. In a recent study we found 57 per cent of LTC workers surveyed were considering leaving their profession due to moral distress.

The care economy is the paid and unpaid labour related to caregiving such as childcare, elder care and domestic chores.

Like health care, the care economy is primarily staffed by women. For example, in Canada, over 96 per cent of early childhood educators (ECEs) are women.

Jobs in the care economy tend to be poorly paid and valued. ECEs felt this distinction during the pandemic, noting they were rarely mentioned in celebrations of essential workers:

You know, theyre clapping for the nurses, theyre clapping for all the essential workers, but they never mention us. Like, were taking care of your children and yet nobodys clapping for us.

The pandemic demonstrated how essential childcare was to a strong health-care workforce. A nurse I spoke to described how lack of access to childcare forced her to reduce her hours by 50 per cent, and a physician described how, due to a nanny having to self-isolate, she was called away from surgery by her childs school when he was ill. Midwives describe leaving the field due to lack of childcare corresponding to shiftwork hours.

Due to gender norms and roles, in Canada, women do 1.5 times more unpaid care work than men. This means that when formal health and care systems fails, the burden is most likely to fall on women.

For example, in 2020, a mother who had recently immigrated to Canada explained how her child suffered from severe anxiety, due to past experiences of violence, but had been receiving support at her daycare.

When the daycare closed due to COVID the childs health deteriorated to the point she was vomiting due to stress. The mother called the nurses line and was told to keep her child home due to fear of COVID infection at the hospital, and so was left to care for her sick and distressed child alone.

A single mother and community health worker explained how she struggled to balance the needs of those she cared for at work and at home during the pandemic.

Im a single mom. This is how I show up in the world, its a huge part of how I identify. Theres a lot of things that have to be done because there is no other choice. I have tiny humans to keep alive and try to keep their mental health OK through a pretty earth-shaking experience. I mean if nobody else is going to show up, you can pretty much count on the mom. She will show up and that is beautiful and wonderful, but also heavily fucking exploited.

While pandemic restrictions exacerbated weaknesses within the health and care system, the knock-on effects continue with the current crisis and are felt most acutely by frontline staff the majority of whom are women. This leads to increased risk of moral distress and burnout, which in turn fuels the crisis.

Policy responses can interrupt this vicious cycle through increased investments in the care economy and increasing mental health services for those providing care.

Improved working conditions including flexibility, pay and benefits in feminized health and care sectors would empower those providing care to be able do their best. After all, it is these women we all rely upon.

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Canada's health-care crisis is gendered: How the burden of care falls to women - The Conversation

COVID-19 update 10-19-23 – Suffolk County Government (.gov)

October 23, 2023

Suffolk County reported the following information related to COVID-19 on October 19, 2023

According to CDC, hospital admission rates and the percentage of COVID-19 deaths among all deaths are now the primary surveillance metrics.

COVID-19 Hospitalizations for the week ending October 14, 2023

Daily Hospitalization Summary for Suffolk County From October 19, 2023

NOTE: HOSPITALS ARE NO LONGER REPORTING DATA TO NYSDOH ON WEEKENDS OR HOLIDAYS.

Fatalities occurring in Suffolk County (Data showing fatalities by place of residence is archived as of 10/12/23 and is no longer being updated)

COVID-19 Case Tracker October 17, 2023

Note: As of May 11, 2023, COVID-19 Community Levels (CCLs) and COVID-19 Community Transmission Levels are no longer calculatable, according to the Centers for Disease Control and Prevention.

* As of 4/4/22, HHS no longer requires entities conducting COVID testing to report negative or indeterminate antigen test results. This may impact the number and interpretation of total test results reported to the state and also impacts calculation of test percent positivity. Because of this, as of 4/5/22, test percent positivity is calculated using PCR tests only. Reporting of total new daily cases (positive results) and cases per 100k will continue to include PCR and antigen tests.

COVID-19 Vaccination Information

Last updated 5/12/23

Vaccination Clinics

As of September 12, 2023, the Suffolk County Department of Health Services is not authorized to offer COVID-19 vaccines to ALL Suffolk County residents.

The department will offer the updated vaccine to only uninsured and underinsured patients through New York State's Vaccines for Children program and Vaccines for Adults program, also known as the Bridge Access Program.

Those with insurance that covers the COVID-19 vaccine are encouraged to receive their vaccines at their local pharmacies, health care providers offices, or local federally qualified health centers.

The department has ordered the updated COVID-19 vaccine and will announce when the vaccine becomes available.

FOR HEALTHCARE PROVIDERS

New York State Links

CDC COVID Data Tracker Rates of laboratory-confirmed COVID-19 hospitalizations by vaccination status

For additional information or explanation of data, click on the links provided in throughout this page.

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COVID-19 update 10-19-23 - Suffolk County Government (.gov)

How to tell if it’s a cold, the flu, COVID-19 or RSV – Tahoe Daily Tribune

October 23, 2023

Theres much to look forward to at the start of winter. The holiday season starts winter off with a bang, while outdoor enthusiasts know their chances to hit the slopes and ski and snowboard are just beginning. Sports fans know January marks the return of the National Football League playoffs, while travelers who need a little winter warmth often designate February as a month to soak up some sun in a faraway locale. With so much to do each winter, its especially problematic when you come down with a cold. However, winter tends to be cold and flu season in many areas, as viruses tend to spread more easily when people spend more time indoors. This winter, people may wonder if their sniffles indicate they have a cold, the flu or a sign of something more serious, such as COVID-19 or respiratory syncytial virus (RSV). Anyone unsure of whats behind a cold-like illness is urged to speak with their physician. In addition, the National Foundation for Infectious Diseases notes that the common cold, the flu, COVID-19, and RSV present some similar symptoms, but also some unique ones. Though each illness is complex, the frequency with which some symptoms present may indicate which issue a person is dealing with. Knowledge of those symptoms and their frequency can help people determine if the culprit behind their winter illness is a cold, the flu, COVID-19, or RSV.

Cold

Flu

COVID-19

RSV

Individuals who are concerned by the presence of cold- or flu-like symptoms are urged to speak with their physicians. Though many instances of cold, flu, COVID-19, and RSV will go away without medical intervention, each condition can pose a significant health risk in certain situations.

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How to tell if it's a cold, the flu, COVID-19 or RSV - Tahoe Daily Tribune

Immune Thrombocytopenia Purpura Associated With COVID-19 … – Cureus

October 23, 2023

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