Category: Covid-19

Mike Stucka USA TODAY NETWORK| Green Bay Press-Gazette

New coronavirus cases leaped in Wisconsin in the week ending Sunday, rising 10.2% as 8,635 cases were reported. The previous week had 7,835 new cases of the virus that causes COVID-19.

Wisconsin ranked 15th among the states where coronavirus was spreading the fastest on a per-person basis, a USA TODAY Network analysis of Johns Hopkins University data shows. In the latest week coronavirus cases in the United States decreased 7.7% from the week before, with 436,694 cases reported. With 1.75% of the country's population, Wisconsin had 1.98% of the country's cases in the last week. Across the country, 24 states had more cases in the latest week than they did in the week before.

Brown County reported 491 cases and two deaths in the latest week. A week earlier, it had reported 466 cases and one death. Throughout the pandemic it has reported 96,165 cases and 586 deaths.

Door County reported 30 cases and zero deaths in the latest week. A week earlier, it had reported 19 cases and one death. Throughout the pandemic it has reported 8,067 cases and 78 deaths.

Kewaunee County reported 16 cases and zero deaths in the latest week. A week earlier, it had reported 31 cases and zero deaths. Throughout the pandemic it has reported 6,410 cases and 61 deaths.

Oconto County reported 37 cases and one death in the latest week. A week earlier, it had reported 48 cases and zero deaths. Throughout the pandemic it has reported 12,558 cases and 126 deaths.

Shawano County reported 79 cases and one death in the latest week. A week earlier, it had reported 91 cases and zero deaths. Throughout the pandemic it has reported 13,177 cases and 157 deaths.

Marinette County reported 93 cases and zero deaths in the latest week. A week earlier, it had reported 121 cases and one death. Throughout the pandemic it has reported 13,244 cases and 135 deaths.

Within Wisconsin, the worst weekly outbreaks on a per-person basis were in Menominee County with 702 cases per 100,000 per week; Florence County with 256; and Marinette County with 230. The Centers for Disease Control says high levels of community transmission begin at 100 cases per 100,000 per week.

Adding the most new cases overall were Milwaukee County, with 1,528 cases; Dane County, with 1,194 cases; and Brown County, with 491. Weekly case counts rose in 45 counties from the previous week. The worst increases from the prior week's pace were in Dane, Milwaukee and Marathon counties.

>> See how your community has fared with recent coronavirus cases

Across Wisconsin, cases fell in 26 counties, with the best declines in Fond du Lac County, with 136 cases from 196 a week earlier; in Racine County, with 286 cases from 325; and in Jackson County, with 47 cases from 81.

In Wisconsin, 70 people were reported dead of COVID-19 in the week ending Sunday. In the week before that, 29 people were reported dead.

A total of 1,851,886 people in Wisconsin have tested positive for the coronavirus since the pandemic began, and 15,190 people have died from the disease, Johns Hopkins University data shows. In the United States 95,658,236 people have tested positive and 1,053,419 people have died.

>> Track coronavirus cases across the United States

USA TODAY analyzed federal hospital data as of Sunday, Sept. 18. Likely COVID patients admitted in the state:

Likely COVID patients admitted in the nation:

Hospitals in 15 states reported more COVID-19 patients than a week earlier, while hospitals in 14 states had more COVID-19 patients in intensive-care beds. Hospitals in 22 states admitted more COVID-19 patients in the latest week than a week prior, the USA TODAY analysis of U.S. Health and Human Services data shows.

The USA TODAY Network is publishing localized versions of this story on its news sites across the country, generated with data from Johns Hopkins University and the Centers for Disease Control. If you have questions about the data or the story, contact Mike Stucka at mstucka@gannett.com.

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Brown County reported 491 additional COVID-19 cases this week - Green Bay Press Gazette

New coronavirus cases leaped in Michigan in the week ending Sunday, rising 15.9% as 18,375 cases were reported. The previous week had 15,854 new cases of the virus that causes COVID-19.

Michigan ranked fifth among the states where coronavirus was spreading the fastest on a per-person basis, a USA TODAY Network analysis of Johns Hopkins University data shows. In the latest week coronavirus cases in the United States decreased 7.7% from the week before, with 436,694 cases reported. With 3% of the country's population, Michigan had 4.21% of the country's cases in the last week. Across the country, 24 states had more cases in the latest week than they did in the week before.

Wayne County reported 3,427 cases and 38 deaths in the latest week. A week earlier, it had reported 2,710 cases and 20 deaths. Throughout the pandemic it has reported 480,854 cases and 8,373 deaths.

Oakland County reported 2,485 cases and 22 deaths in the latest week. A week earlier, it had reported 1,947 cases and eight deaths. Throughout the pandemic it has reported 348,751 cases and 4,104 deaths.

Within Michigan, the worst weekly outbreaks on a per-person basis were in Clinton County with 407 cases per 100,000 per week; Dickinson County with 404; and Schoolcraft County with 358. The Centers for Disease Control says high levels of community transmission begin at 100 cases per 100,000 per week.

Adding the most new cases overall were Wayne County, with 3,427 cases; Oakland County, with 2,485 cases; and Macomb County, with 1,785. Weekly case counts rose in 55 counties from the previous week. The worst increases from the prior week's pace were in Wayne, Oakland and Macomb counties.

>> See how your community has fared with recent coronavirus cases

Across Michigan, cases fell in 27 counties, with the best declines in Huron County, with 27 cases from 90 a week earlier; in Muskegon County, with 211 cases from 248; and in Tuscola County, with 78 cases from 111.

In Michigan, 196 people were reported dead of COVID-19 in the week ending Sunday. In the week before that, 83 people were reported dead.

A total of 2,804,588 people in Michigan have tested positive for the coronavirus since the pandemic began, and 38,317 people have died from the disease, Johns Hopkins University data shows. In the United States 95,658,236 people have tested positive and 1,053,419 people have died.

Note: In the Johns Hopkins University coronavirus data, cases and deaths for the Michigan Department of Corrections and the Federal Correctional Institution separately from Michigan counties.

>> Track coronavirus cases across the United States

USA TODAY analyzed federal hospital data as of Sunday, Sept. 18. Likely COVID patients admitted in the state:

Likely COVID patients admitted in the nation:

Hospitals in 15 states reported more COVID-19 patients than a week earlier, while hospitals in 14 states had more COVID-19 patients in intensive-care beds. Hospitals in 22 states admitted more COVID-19 patients in the latest week than a week prior, the USA TODAY analysis of U.S. Health and Human Services data shows.

The USA TODAY Network is publishing localized versions of this story on its news sites across the country, generated with data from Johns Hopkins University and the Centers for Disease Control. If you have questions about the data or the story, contact Mike Stucka at mstucka@gannett.com.

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Wayne, Oakland counties reported 25% COVID-19 cases increase this week - Hometown Life

In a recent study published in Vaccine, researchers assessed the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines on human fertility.

Claims that the coronavirus disease 2019 (COVID-19) vaccines could cause irreparable harm to the population and may increase the risk of female infertility were made in response to the emergency licensing of the vaccines. The cross-reactivity with syncytin-1 and its potential similarity to the spike protein was proposed as the potential mechanism that purportedly associated vaccinations with decreased fertility in women of reproductive age.

Syncytin-1 is crucial for implantation, and its dysfunction could lead to early pregnancy loss, failed implantation, or later issues from aberrant placentation, such as preeclampsia. In males, it was hypothesized that the vaccine could influence spermatogenesis and sperm parameters, noting that the SARS-CoV-2 virus has been linked to male reproductive impairment.

In the present study, researchers summarized and assessed the available information related to the potential effect of COVID-19 vaccines on female and male fertility.

The study included studies that explored the impact of COVID-19 vaccines on fertility in females and males. The systematic review involved only studies that reported primary data. The team obtained data such as the first author, country, year, population, study design, age, gender, vaccine type, time vaccination-recruitment, number of vaccine doses, indicator employed to assess fertility, and main results corresponding to each study. Additionally, the researchers performed a descriptive analysis based on information including population, age, gender, indicator employed to assess fertility, and vaccine type.

When appropriate, the team performed random-effect meta-analyses for the same outcome concerning fertility indicators reported in two or more studies. The effect measure utilized for most fertility indicators comprised mean concentrations or rates. The first meta-analysis was conducted for any vaccine type used, followed by the analysis of the subgroup based on the specific vaccine administered.

The included studies were assessed with respect to the methodological quality of the study design. The cohort studies were assessed with the Newcastle-Ottawa scale that evaluated quality parameters, including study group selection, comparability of the groups, and ascertainment of the results. The pre-post studies were assessed with the Before and After Quality Assessment scale to evaluate parameters such as clarity of study objective, enrollment of participants, description of eligibility criteria, sample size, and outcome.

The search for relevant studies resulted in a total of 1,489 records after excluding duplicate records. The screening process produced 39 articles that were deemed pertinent for the study. Eventually, 29 articles were included in the systematic review, while 20 were part of the meta-analysis. The 29 articles included ten performed in Israel, seven in the USA, six in Russia, three in China, one in Italy, one in North America, and one in Turkey.

In 16 of the studies conducted in Israel and the USA and one in Turkey, the COVID-19 vaccines assessed were two messenger ribonucleic acid (mRNA) vaccines, namely mRNA-1273 and BNT162b2. Additionally, six studies performed in Russia explored the adenovirus-vector vaccine Gam-COVID-Vac, three from China studied the inactivated vaccines, while three studies from Italy, the USA, and North America assessed vaccines including mRNA and viral vector-based.

Furthermore, 51.7% of the total studies were performed on females, 37.9% on males, and 10.3% on both populations. Approximately 52% of the studies included in vitro fertilization (IVF)/IVG patients, including 11 studies on females and two on males. Two studies performed in Russia, one in Turkey, and one in Israel involved healthy women subjects.

Additionally, seven studies were conducted on healthy males, one on two comparative cohorts of unhealthy and healthy men, two on men undergoing IVG or assisted reproduction technology (ART), and one on men belonging to a big database. With respect to the study design, 14 articles were pre-post studies, and 15 were cohort studies.

Quality assessment of cohort studies using the Newcastle-Ottawa scale showed that 13.3% of the studies were of good quality, 33.3% were of moderate quality, and 53.3% were of poor quality. Furthermore, the meta-analysis of five pre-post studies included 298 males who did not display a remarkable difference with respect to progressive motility prior to post-vaccination with any COVID-19 vaccine type. Notably, there was no significant difference in the subgroup analysis conducted based on the vaccine type used.

Sperm concentration post-COVID-19 vaccination with any type of vaccine did not remarkably vary in the meta-analysis of eight pre-post studies that included 451 males. The meta-analysis of six studies that included 346 males did not exhibit any significant variation in the sperm volume prior to or after vaccination with any vaccine type.

Furthermore, the biochemical pregnancy rate and clinical pregnancy rate did not differ significantly among the vaccinated and the unvaccinated cohorts. Also, estradiol levels did not show any significant difference between the vaccinated and unvaccinated women.

Overall, the study findings showed no association between COVID-19 vaccination and fertility impairment in women and men.

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Is there any impact of COVID-19 vaccines on the fertility of men and women of reproductive age? - News-Medical.Net

In the COVID-19 pandemic, there was no marked path out of the darkness, no experts with a proven playbook and no trucks packed with antidotes to the deadly virus. In March of 2020, the coronavirus leapt from a minor news event in faraway places to a plague at our front doors, and none of us was prepared, least of all schools suddenly asked to produce not only virtual instruction, but also meals, and, in many places in Georgia, internet access.

COVID-19 is better compared to a war than a natural disaster when you look at the death toll of those on the front lines. The World Health Organization estimates that 115,500 health care workers around the world died of COVID-19 between January 2020 and May 2021. The virus overwhelmed and depleted supplies and staff at Georgia hospitals with desperate health care workers reusing masks, gloves and gowns.

Today, at a safe distance secured by new vaccines, we can pick apart what schools should have done better during the pandemic, but we cant assert that they should have known better.

No one knew, as shown by the deaths of more than 6.5 million people around the world. The Centers for Disease Control and Prevention estimates 10.5 million children globally lost a parent or caregiver to COVID-19. In the United States, the current estimate is that 225,600 children experienced the death of a parent or a custodial grandparent from the virus.

Yet, a national narrative is taking shape that school districts ignored the will of parents and remained virtual largely due to politics. Parents in Georgia districts that were remote the longest, including Clayton, Atlanta, Decatur and DeKalb, voiced many reservations about their children returning to classrooms. Most of these districts serve largely Black families, who had a higher proportion of family members or neighbors sickened and killed by the virus.

Because so many of our families were front line, they were not willing for our students to come back overall, Clayton County Superintendent Morcease Beasley told The Atlanta Journal-Constitution. As a community, we basically made a decision that safety would be prioritized over everything else, which meant that students learned virtually.

It was a vocal parent base of CDC researchers, physicians and university employees that influenced the City Schools of Decatur to offer extended hybrid instruction. That influence also contributed to Decaturs decision to impose a COVID-19 vaccine mandate and later a booster requirement on its school staff, which earned the high-performing district a rebuke from Gov. Brian Kemp.

Decatur, Clayton and other metro districts didnt discount parents in their COVID-19 policies; they deferred to them in many instances.

Its an easy finger to point in hindsight while conveniently forgetting the 95 million COVID cases and 1 million-plus deaths in the U.S. 1 dead out of every 330 people, said University of Georgia professor emeritus of education Peter Smagorinsky. As if the best plan would be to just keep sending people into death traps, which presumably puts children first in the grave. Maybe, they think we shouldnt evacuate for raging fires and floods, either, because its the evacuation thats so disruptive.

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Opinion: Parents shaped COVID-19 policies more than politics - The Atlanta Journal Constitution

The Tompkins County Health Department says there have now been 24,124 total positive cases in Tompkins County, 54 more than on Friday, and a total of 1,939,307 tests conducted. The Health Department is also now reporting positive self-test results that have been submitted through their online portal. They say there are 14 new positive self-test results for a total of 3,741 submitted.

Related: TCHD: If you test positive on an at-home test

As of Monday at 8:30am, the Health Department says 238 tests were conducted in the previous day. The Tompkins County Health Department publishes NYS vaccine tracking info, showing 88,192 Tompkins County residents have a first dose and 79,873 have completed vaccination (which could be one or two doses, depending on vaccine).

Related: Many are eligible for second booster or additional doses, says Health Department

The Health Department says six people are currently hospitalized for COVID-19, one fewer than in Fridays update. As of a shift in data last winter, TCHD is reporting only active cases who are hospitalized, rather than including patients recovered from COVID who remain hospitalized for other reasons.

Of the recent uptick in hospitalizations, a vast majority have been of vaccinated individuals, Tompkins County Public Health Director Frank Kruppa tells us, but of the individuals who are vaccinated and have been hospitalized for COVID-19 related reasons, the trend holds that they are largely older adults, age 65+. This data points to the importance of boosters and 2nd boosters for those age 65+.

Related: CDC and FDA have authorized vaccines for 6 months and up, says Health Department

There have been 67 deaths from COVID-19 recorded among Tompkins County residents, including the death of an area resident reported in mid September.

On September 11, Cornell University reported 144 active student cases and 46 active faculty and staff cases. Cornell has switched to weekly updates, and the timing of their updates doesnt allow a direct comparison to the countys statistics.

As of September 18, Ithaca College reported 7 active student cases, with 143 recovered, and 5 active employee cases and 29 recovered employees. (Ithaca College reset its recovered count to zero on August 1 to reflect the new academic year.)

The Health Department says the public needs to prevent the spread of COVID-19 not just to protect themselves, but others in our community who are most vulnerable to getting very sick older adults, those who are immune-compromised, and those with underlying chronic health conditions.

TCHDs Frank Kruppa says, There is a very high vaccination rate for our community, especially with the successes that have been reported by our local colleges. In addition to the arrival and surveillance testing, many of our new cases are arising from sustained close contact with a positive individual, meaning more than 10 minutes within six feet of a positive case. These close contacts are occurring more frequently in large indoor gatherings that mix different groups of people.

Over the past few weeks, our efforts have focused on vaccinating our young people and providing booster doses to those who are eligible, Kruppa says. We are distributing self-tests and masks throughout the county as we receive shipments and thank our community partners for assisting in this effort.

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September 19 update from Health Department on COVID-19 cases - 14850

The COVID-19 pandemic has sparked widespread concern about the need for mental health services. But depression was already becoming increasingly prevalent in the U.S. in the years leading up to the pandemic, particularly among young people between the ages of 12 and 25, according to a study published Monday in the American Journal of Preventive Medicine.

By 2020, depression affected nearly one in 10 Americans over the age of 12 but the number was nearly one in five among those between the ages of 12 and 25, the study found. This new research arrives at a time when advocates in New York are already urging city and state officials to invest more in behavioral health services for young people and address a shortage of childrens mental health professionals.

I think weve always conceptualized mental health as a clinically treated problem where the prevalence is low, said the study's lead author Dr. Renee Goodwin, a clinical psychologist and epidemiologist who teaches at Columbia University and CUNY. But more is needed in terms of a public health approach at this point, because its become so common.

The study was based on the National Survey on Drug Use and Health, an annual survey run by the Substance Abuse and Mental Health Services Administration. The data involved comes from more than 55,000 respondents per year between 2015 and 2020. The survey asked participants about whether they had experienced symptoms of a depressive episode over the past year, such as feeling sad consistently over a two-week period, or not being interested in activities that typically brought joy, Goodwin explained.

From 2015 to 2020, there was a significant gap between the number of participants experiencing depression and those accessing treatment.

In 2020, 9.2% of Americans over 12 had experienced symptoms of depression over the past year, Goodwins study found. That was up from 8.6% in 2019 and 7.3% in 2015.

But the jump primarily took place among young people, with no increase observed among those over 35. In 2019, about 16% of adolescents reported symptoms of depression, up from about 13% in 2015. By 2020 the figure was about 17% for that age group.

An even sharper increase was observed among those aged 18 to 25: The share with depression grew from a little over 10% in 2015 to about 17% in 2020. That year, only about half of the respondents with depression in that age group said they had spoken to a professional about it, a modest improvement from 2015.

The likelihood of getting help was lower for adolescents in that age group only about 40% said they had spoken with a professional.

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Depression was on the rise among young people before COVID-19 pandemic, Columbia study finds - Gothamist

Terry Hsieh,1 Bradley S Gundlach,2 Sahar Ashrafzadeh,2 David Sarraf,3,4 Irena Tsui3,5,6

1Stein Eye Institute, University of California, Los Angeles, CA, USA; 2David Geffen School of Medicine, University of California, Los Angeles, CA, USA; 3Ophthalmology Department, West Los Angeles Veterans Health Administration, Los Angeles, CA, USA; 4Retinal Disorders and Ophthalmic Genetics - Stein Eye Institute, University of California, Los Angeles, CA, USA; 5Retina Division - Stein Eye Institute, University of California, Los Angeles, CA, USA; 6Doheny Eye Institute, University of California, Los Angeles, CA, USA

Correspondence: Irena Tsui, Ophthalmology Department, West Los Angeles Veterans Health Administration, Los Angeles, CA, USA, Tel +1 310 825 7290, Fax +1 310 825 9946, Email [emailprotected]

Purpose: To examine the return of patients to intravitreal injection clinic after the COVID-19 lockdown.Patients and Methods: The electronic medical records of all patients who received intravitreal injections at a tertiary care Veterans Health Administration (VHA) clinic 14 weeks post-lockdown (5/9/20-8/13/20) in Los Angeles County were reviewed. Reference groups included injection patients during the 7-week COVID-19 lockdown (3/19/20-5/8/20) and a 7-week pre-pandemic period in 2019 (3/19/19-5/8/19). Clinic volume was compared using a one-way ANOVA. Demographic data, medical and psychiatric co-morbidities, injection diagnoses, visual acuities, and clinic volumes were compared between the 3 periods using a generalized estimating equation multivariate analysis.Results: The post-lockdown period group averaged 25.1 visits per week, compared with 12.3/week during lockdown and 25.4/week pre-COVID in intravitreal injection clinic. In the post-lockdown period, the VHA injection clinic returned closer to the pre-lockdown volume compared to the VHA comprehensive clinic (98.9% vs 57.4%, p Conclusion: Injection volume returned to pre-pandemic levels immediately after lockdown ended. However, patients with high-risk comorbidities did not return to intravitreal injection clinic post-lockdown. These results can inform medical organizations, which groups may need increased safety measures and targeted outreach to address their ophthalmic needs.

Keywords: age-related macular degeneration, anti-vascular endothelial growth factor, coronavirus, co-morbidities, diabetic retinopathy, retina

The COVID-19 pandemic required physicians and patients to make difficult decisions about the urgency of ophthalmology care. Los Angeles County enforced a stay-at-home order (referred to as lockdown) early during the pandemic to minimize the spread of COVID-19.1 Clinics quickly adopted symptom screening algorithms, mask enforcement policies, and disinfection protocols.2,3 Many specialties pivoted into telemedicine visits to continue providing care; however, ophthalmology often requires in-person visits with an exam in close proximity.4,5 Intravitreal injection clinics add to that exposure risk as both the injection and the necessary retinal imaging, such as optical coherence tomography (OCT), must be performed within the recommended safe social distancing.6,7

Intravitreal injections are one of the most commonly performed ophthalmological procedure.8 Anti-vascular endothelial growth factor (anti-VEGF) injections are effective treatments for neovascular age-related macular degeneration (nvAMD) and diabetic macular edema (DME), two of the most common indications for injections. These conditions demand regular visits and often require consistent injection intervals to prevent permanent visual impairment.9,10 The high-risk medical comorbidities defined by the Centers for Disease Control and Prevention (CDC) for SARS CoV-2 infection overlap heavily with the patient population receiving intravitreal injections.11 During the lockdown, physicians were forced to triage vision-threatening conditions and allocate treatment based on the risk of permanent functional vision loss.12 On the other hand, patients also faced a difficult choice between losing vision versus risking serious COVID infection. COVID infections have also been linked to a broad range of ocular pathology, including posterior segment pathology. This wide array of uveal and retinal pathology has been reported to range from cotton wool spots and hemorrhages to optic neuritis, retinitis, panuveitis, and even vascular occlusions.13

We previously investigated both ophthalmic and non-ophthalmic factors during the COVID-19 lockdown period in Los Angeles County and found a decrease in patient volume by 50% along with an increased proportion of Hispanic patients, systemically healthier patients, and patients with a diagnosis of AMD compared with the year prior.14 In this current study, we sought to study similar factors in the intravitreal injection clinic in the period immediately after lockdown to identify ophthalmic trends in the post-lockdown era.

This retrospective cohort study was approved by the Institutional Review Board of the Greater Los Angeles Veterans Health Administration (VHA). The veteran population is considered a vulnerable population due to increasing minority composition.15 Given the retrospective nature of this study, patient consent to review medical records was waived by the IRB. The IRB approval number is 2020000187. Confidentiality of patient data was maintained, and this study was compliant with the Declaration of Helsinki.

Patient charts were reviewed using the VHA Computerized Patient Record System (CPRS). Data was collected from intravitreal injection clinic, comprehensive clinic, and retina clinic from the pre-lockdown (March 19th, 2019 to May 8th, 2019), lockdown (March 19th, 2020 to May 8th, 2020), and post-lockdown (May 9th, 2020 to August 13th, 2020) periods. Patient demographic information (eg age, gender, self-reported race, residential zip code, homeless status), ophthalmic status (eg visual acuity, diagnosis, indication for injection), and both medical and psychiatric co-morbidities [eg body mass index (BMI), hypertension, high-risk COVID-19 co-morbidities, mental health diagnoses] were collected. The medical conditions considered high-risk co-morbidities for COVID-19 disease by the Center for Disease Control and Prevention (CDC) were identified including cancer, chronic kidney disease, chronic obstructive pulmonary disease, heart conditions (defined as heart failure, coronary artery disease, cardiomyopathies, arrhythmias, or valvular insufficiencies), BMI (kg/m2), and type 2 diabetes.11 Associated psychiatric conditions, which have a higher prevalence among veterans than in the general population,16 including depression, anxiety, schizophrenia, schizoaffective disorder, post-traumatic stress disorder, psychosis, and others, were also recorded.

During the seven-week lockdown period of March 19th, 2020 to May 8th, 2020, patients were called one week in advance of their clinic appointments. Patients with decreased vision, any new vision complaints, or with a diagnosis of nvAMD or functional monocular status were encouraged to keep their appointments and come in for evaluation. Those with stable vision or other diagnoses [eg diabetic macular edema (DME), diabetic retinopathy (DR), retinal vein occlusion (RVO), or central serous retinopathy (CSR)] were encouraged to reschedule. Non-ophthalmic co-morbidities did not influence providers recommendations. Appointments were not canceled if the patient wanted to come in, regardless of diagnosis or vision. Patients in the same seven-week period from March 19th, 2019 to May 8th, 2019 served as a pre-pandemic control group. The 14-week period immediately following the lifting of the lockdown order from May 9th, 2020 to August 13th, 2020 served as the post-lockdown group.

All patients who attended intravitreal injection clinic during the time periods listed above were included for statistical analysis. One-way Analysis of Variance (ANOVA) with Dunnett correction for multiple comparisons was performed to analyze the proportion of visits per week compared to pre-lockdown. A p-value <0.05 was considered to be statistically significant. Generalized Estimating Equations (GEE) routine was used for analysis to allow for inter-eye correlation and repeat measurements during each follow-up period. The GEE routine used a linear model to analyze the main effects between parameters using a robust estimator covariance matrix with an independent correlation structure. Parameter estimates () were used to calculate odds ratios (OR) with corresponding 95% confidence intervals (CI) and p-values. This routine was used to calculate ORs between two time periods, analyzing the rates of follow-up for each independent variable (demographic information, medical/psychiatric history, ophthalmic history) in a univariable model. This was repeated twice to calculate ORs for each combination of time periods. Bonferroni correction was applied to both analyses for two multiple comparisons: (1) pre- versus post-lockdown and (2) during versus post-lockdown. Thus, a p-value <0.025 was considered statistically significant due to multiple comparisons. A Pearson chi-square test between groups was used to compare the number of patients in each time period whose BMI > 30 or BMI > 40. Study data were managed using Research Electronic Data Capture (REDCap, Vanderbilt University, Nashville, TN). Matlab 2020a (Natick, MA, USA) was used for data handling and processing, and SPSS 27.0 (IBM Corp., Armonk, NY, USA) was used for statistical analysis.17,18

The study sample included a total of 625 visits of 292 patients across all time periods. In the intravitreal injection clinic, the pre-, during, and post-lockdown period groups averaged 25.4, 12.3, and 25.1 visits per week, respectively. Table 1 shows the mean visits per week in the pre-, during, and post-lockdown periods for various clinics as well as percentage of volume in the post-lockdown period compared to the pre-lockdown period. The comprehensive clinic averaged 57.4% (95% CI 0.4280.719), retina clinic 77.2% (95% CI 0.6020.941), and injection clinic 98.8% (95% CI 0.8571.12) of their normal volume in the post-lockdown period. In comparison to the injection clinic, the comprehensive clinic post-lockdown volume was significantly lower (p = 0.0003), while the retina clinic volume only trended towards significance (p = 0.0597). The mean ages of patients in the intravitreal injection clinic for the pre-, during, and post-lockdown periods were 74.3, 72.0, and 74.6 years, respectively. Demographic data for each time period are presented in Supplemental Table 1. No significant difference was found in the gender of the patients between the groups. The proportion of Hispanic patients trended toward more in the lockdown period than in post-lockdown (OR 1.13, p = 0.027). No other significant differences were found between groups for the proportion of those self-identified as White, Black, Asian, or Pacific Islander between each of the time periods (Figure 1).

Table 1 Clinic Volume

Figure 1 Odds ratios of demographic variables. No significant differences were found in demographics when comparing periods against the post-lockdown period (A). Demographic variables of pre- vs post-lockdown time periods (B). Demographic variables of during vs post-lockdown time periods. Significance set at p<0.025 to account for multiple comparisons.

Medical and psychiatric co-morbidities of patients in each time period are provided in Supplemental Table 2. There was no significant difference in the mean BMI (Supplemental Table 2), presence of diabetes, or presence of chronic kidney disease in patients in each of the time periods (Figure 2). As the risk for COVID-19-related morbidity increases with BMI, a chi-square analysis was performed to compare the number of patients in each time period with obesity (BMI > 30) or severe obesity (BMI > 40). This analysis demonstrated no difference in the number of patients between each period (Supplemental Tables 3 and 4).11 Post-lockdown, COPD patients and organ transplant patients were less likely to receive injections compared to 2019 (OR post vs pre-lockdown 0.76 p = 0.008, OR 0.62 p < 0.0001, respectively) (Figure 2). In the pre-pandemic period, 11.2% of patients had a history of organ transplant, but during the lockdown period, zero patients with organ transplant history presented to clinic; after the lockdown, those patients comprised only 4.2% of the patient volume. Patients with cancer diagnoses comprised a lower proportion of pre-pandemic patients compared to post-lockdown patients (OR 0.77, p = 0.007).

Figure 2 Odds ratios of medical and psychiatric co-morbidities. In the pre-lockdown period compared to the post-lockdown period, significantly more patients with COPD or organ transplants received intravitreal injections. Comparison of during vs post-lockdown periods showed significantly decreased patients with solid organ transplants. Patients with cancer were significantly increased in the post-lockdown period in comparison to pre-lockdown. No significant differences were found in the proportion of patients with psychiatric co-morbidities in either of the time period comparisons. (A) Medical co-morbidities of pre- vs post-lockdown time periods (B). Medical co-morbidities of during vs post-lockdown time periods (C). Psychiatric co-morbidities of pre- vs post-lockdown time periods (D). Psychiatric co-morbidities of during vs post-lockdown time periods. Significance set at p<0.025 to account for multiple comparisons. **p < 0.01. ****p < 0.0001.

Our data showed no significant differences in the proportion of patients with psychiatric co-morbidities between the time periods, except for psychosis and schizoaffective disorder though there were very few patients in each group (n 3). The proportion of patients with depression trended toward a decrease from 20.2% in 2019 to 16.3% during lockdown to 14.1% in the post-lockdown period, but these differences were not significant. Similarly, patients with anxiety decreased from 7.3% to 5.8% to 4.2%, but these differences were not statistically significant.

Figure 3 and Supplemental Table 5 contain the proportion by indication for which patients received intravitreal injections during each time period. This analysis demonstrated no significant differences in patients receiving injections for nvAMD when comparing the pre- and post-lockdown periods or the during and post-lockdown periods (OR 0.98 and 0.91, respectively). After lockdown, the proportion of patients receiving injections for diabetic macular edema (DME) increased in the post-lockdown versus the lockdown period (OR for during vs post-lockdown 0.90 with reciprocal OR 1.11, p = 0.01) and was not significantly different from the pre-pandemic period (OR 0.95, p = 0.58). There were no other significant differences found among other indications for injections (eg RVO, CSR or pachychoroid, and other) between the time periods.

Figure 3 Odds ratios of indications for intravitreal injections. Comparison of during vs post-lockdown period showed a significant decrease in the proportion of patients receiving intravitreal injections for diabetic indications during lockdown. There were no significant differences found in the indications for intravitreal injections between pre- and post-lockdown time periods (A). Indications for injections of pre- vs post-lockdown time periods (B). Indications for injections of during vs post-lockdown time periods. Significance set at p<0.025 to account for multiple comparisons. *p < 0.025.

The COVID-19 lockdown, an unprecedented event, was unsustainable, as businesses and healthcare institutions suffered remarkable financial losses and in some cases, operational insolvency.19,20 Despite the lockdown ending in May of 2020, COVID-19 was still a palpable threat without the availability of a vaccine at that time. Physicians and patients had little guidance on how to proceed in the post-lockdown era while still needing to maintain precautionary measures. This study showed that immediately after lockdown, the VHA intravitreal injection clinic returned to its pre-COVID-19 volume but was comprised of systemically healthier patients seeking treatment. Furthermore, there was a rebound in the number and proportion of diabetic patients who had delayed injections during lockdown.

Interestingly, our previous study demonstrated a significant rise in the Latino/Hispanic proportion of patients in injection clinic during the lockdown, which was not true after restrictions were lifted.14 Our previous theory was that Hispanic patients tend to live in multigenerational housing and have a higher proportion of essential workers, which would increase the exposure risk to COVID-19. Though we cannot exactly determine why there was such a difference, we speculate that much higher COVID-19 infection and death rates in the Latino/Hispanic population during March and April21 may have caused this vulnerable population to take more precautions and stay at home in May and June even after the lockdown was lifted.

Our data demonstrate that although overall injection clinic volume returned to baseline after lockdown, even faster than other ophthalmology clinics, patients with COPD and solid organ transplants, both high-risk co-morbidities, were less likely to return to clinic post-lockdown. It makes sense that these groups chose to limit their exposure given the significantly increased mortality and hospitalization risk if infected with COVID-19. It is important for ophthalmologists to be aware of this trend to identify patients with high-risk systemic co-morbidities and accommodate their safe return to intravitreal injection clinic for continued vision care.22 Our data contained a significant proportion of diabetic patients in the intravitreal injection clinic during each period. As diabetes causes widespread microangiopathy, other studies have demonstrated that diabetic retinopathy and nephropathy can be frequently associated and correlate in severity.2326 Attendance in injection clinic by diabetics and patients with chronic kidney disease was not significantly different between periods in our study. Since our data suggest that these patients are likely to continue physician visits even during lockdown measures, it is important that these patients be referred for multifactorial diabetes management to reduce their cardiovascular and overall mortality, especially with emerging data demonstrating long-term elevated cardiovascular risk.25,27

Veterans have a higher incidence of psychiatric co-morbidities and that the pandemic may represent a factor destabilizing mental health, we hypothesized that these patients would be most affected during the pandemic.16 Other studies have shown that the pandemic increased anxiety and depression, as well as creating difficulties in accessing mental health care.28,29 There were statistical differences in those diagnosed with psychosis or schizoaffective, but we caution limited extrapolation given the very small number of patients. Our data showed that there were no significant differences in intravitreal clinic visits among those with a diagnosis of depression or anxiety. This may reflect the accessibility and high quality of mental healthcare within the Veteran healthcare system.

Injection and clinic volumes fell both nationally and worldwide as lockdown measures were enforced.3034 While the VHA injection clinic returned to pre-pandemic volumes in the post-lockdown period, comprehensive and retina clinics at the same site continued to have a decreased volume of about 50%. Our facility opened the standard scheduling grids for these clinics in the post-lockdown period. This demonstrates the priority that both physicians and patients placed on continuing intravitreal injections as a delay in injections can lead to permanent vision loss. Other studies have demonstrated that pandemic-induced delays in care are associated with worse visual outcomes in patients who need injections for treatment across all types of diagnoses.3538 Furthermore, one center reported a significant rise in large submacular hemorrhages as a result of the lockdown.39 Therefore, we are encouraged that injection clinic was able to rebound back to pre-lockdown volumes so quickly.

As with many other groups, we prioritized those with nvAMD over RVO and diabetic indications for injection during the lockdown period.12,33,40 Our results support that nvAMD patients are continuing their treatments during and after the lockdown. Previous randomized trials of patients with DME show that treatment can be delayed in eyes with good visual acuity.41 Telemedicine has been shown to be efficacious in the diagnosis and management of diabetic retinopathy.26,42 Spurred on by the pandemic, telemedicine could offer increased access to care and decentralized monitoring of diabetic retinopathy or macular edema patients via physician review of images instead of face-to-face visits during lockdown times.43 However, post-pandemic studies have demonstrated delays in care resulted in worse short-term visual outcomes for diabetic retinopathy.37,44 Therefore, we view it favorably that immediately after we stopped the triage process post-lockdown, there was a rebound increase in patients receiving injections for diabetic indications, and we expect more to have returned in the post-vaccine area.

This study examined a racially diverse and often underserved, urban population with a high prevalence of medical and psychiatric co-morbidities from a composite EMR. Other studies have examined the visual acuity outcomes, clinic volumes, or indications for injection during the pandemic period, but to our knowledge, this study is the first to analyze and report on the co-morbidities of the patients in the post-lockdown era. A major limitation of this study may be related to ascertainment bias due to the retrospective nature of the study. The cohort studied was predominantly male, as this was a VHA-based study, which may not be representative of the general population. While this was a single-institution study, the West Los Angeles Veterans Affairs ophthalmology clinic is a tertiary care center providing intravitreal injections for a large catchment area and multiple satellite clinics across Southern California.

This study can be expanded into the post-vaccine era along with COVID variant-induced spikes to see whether repeated COVID surges continue to affect patient and physician decision-making on intravitreal injection clinics. Furthermore, during future pandemics, this study and its framework can be used as a starting point to identify at-risk patients when access to ophthalmological care becomes limited.

Intravitreal injection clinic volume rebounded to pre-pandemic levels immediately following the state-mandated COVID-19 lockdown period in the spring of 2020, while other clinics continued at half of their pre-COVID-19 volume. However, patients with high-risk medical co-morbidities were less likely to return to the post-lockdown injection clinic, increasing their risk of permanent vision loss. These results can be used to appropriately allocate clinic resources towards injection clinic and determine which groups may need increased safety measures and targeted outreach to address their fears about returning to clinic and their ophthalmic needs.

Dr David Sarraf reports grants, personal fees from Amgen, personal fees from Bayer, grants from Boehringer, grants from Genentech, non-financial support from Heidelberg, personal fees from Iveric Bio, personal fees from Novartis, grants, personal fees, non-financial support from Optovue, grants from Regeneron, non-financial support from Topcon, outside the submitted work. The authors report no other conflicts of interest in this work.

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7. American Academy of Ophthalmology. Coronavirus (COVID-19) American Academy of Ophthalmology Update. Coronavirus (COVID-19); 2021. Available from: https://eyewiki.aao.org/Coronavirus_(COVID-19)#Non-essential_imaging.2Ftesting_should_be_deferred.2C_and_equipment_use_should_be_kept_at_a_minimum. Accessed May 8, 2022.

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9. Ramakrishnan MS, Yu Y, VanderBeek BL. Visit adherence and visual acuity outcomes in patients with diabetic macular edema: a secondary analysis of DRCRnet Protocol T. Graefes Arch Clin Exp Ophthalmol. 2021;259(6):14191425. doi:10.1007/s00417-020-04944-w

10. Framme C, Eter N, Hamacher T, et al. Aflibercept for patients with neovascular age-related macular degeneration in routine clinical practice in Germany: twelve-month outcomes of PERSEUS. Ophthalmol Retina. 2018;2(6):539549. doi:10.1016/j.oret.2017.09.017

11. Centers for Disease Control and Prevention. People at increased risk: people with certain medical conditions. Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html. Accessed July 17, 2021.

12. Korobelnik JF, Loewenstein A, Eldem B, et al. Anti-VEGF intravitreal injections in the era of COVID-19: responding to different levels of epidemic pressure. Graefes Arch Clin Exp Ophthalmol. 2021;259(3):567574. doi:10.1007/s00417-021-05097-0

13. Sanjay S, Agrawal S, Jayadev C, et al. Posterior segment manifestations and imaging features post-COVID-19. Med Hypthesis Discov Innov Ophthalmol. 2021;10(3):95106. doi:10.51329/mehdiophthal1427

14. Ashrafzadeh S, Gundlach BS, Tsui I. The impact of non-ophthalmic factors on intravitreal injections during the COVID-19 lockdown. Clin Ophthalmol. 2021;15:36613668. doi:10.2147/OPTH.S314840

15. Health Equity. Veterans affairs office of research & development. Available from: https://www.research.va.gov/topics/health_equity.cfm. Accessed July 17, 2021.

16. Hoerster KD, Lehavot K, Simpson T, McFall M, Reiber G, Nelson KM. Health and health behavior differences: u.S. Military, veteran, and civilian men. Am J Prev Med. 2012;43(5):483489. doi:10.1016/j.amepre.2012.07.029

17. MATLAB Mathworks Version R2021a

18. IBM SPSS statistics for Windows. Version 27.0; 2020.

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20. Coibion O, Gorodnichenko Y, Weber M. The cost of the Covid-19 crisis: lockdowns, macroeconomic expectations, and consumer spending. Nat Bur Econ Res. 2020. doi:10.3386/w27141

21. County of Los Angeles Department of Public Health. COVID-19 surveillance dashboard. Available from: http://dashboard.publichealth.lacounty.gov/covid19_surveillance_dashboard/. Accessed August 7, 2021.

22. Centers for Disease Control and Prevention. When youve been fully vaccinated. Available from: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html. Accessed July 17, 2021.

23. Minutolo R, Gabbai FB, Provenzano M, et al. Cardiorenal prognosis by residual proteinuria level in diabetic chronic kidney disease: pooled analysis of four cohort studies. Nephrol Dial Transpl. 2018;33(11):19421949. doi:10.1093/ndt/gfy032

24. Minutolo R, Sasso FC, Chiodini P, et al. Management of cardiovascular risk factors in advanced type 2 diabetic nephropathy: a comparative analysis in nephrology, diabetology and primary care settings. J Hypertens. 2006;24(8):16551661. doi:10.1097/01.hjh.0000239303.93872.31

25. Sasso FC, Chiodini P, Carbonara O, et al. High cardiovascular risk in patients with Type 2 diabetic nephropathy: the predictive role of albuminuria and glomerular filtration rate. The NID-2 Prospective Cohort Study. Nephrol Dial Transplant. 2012;27(6):22692274. doi:10.1093/ndt/gfr644

26. Sasso FC, Pafundi PC, Gelso A, et al. Relationship between albuminuric CKD and diabetic retinopathy in a real-world setting of type 2 diabetes: findings from No blind study. Nutr Metab Cardiovasc Dis. 2019;29(9):923930. doi:10.1016/j.numecd.2019.05.065

27. Xie Y, Xu E, Bowe B, Al-Aly Z. Long-term cardiovascular outcomes of COVID-19. Nat Med. 2022;28(3):583590. doi:10.1038/s41591-022-01689-3

28. Xiong J, Lipsitz O, Nasri F, et al. Impact of COVID-19 pandemic on mental health in the general population: a systematic review. J Affect Disord. 2020;277:5564. doi:10.1016/j.jad.2020.08.001

29. Sarraf D, Sarraf DR, Sadda S. Is virtual existence our new reality? Graefes Arch Clin Exp Ophthalmol. 2020;258(7):13571358. doi:10.1007/s00417-020-04750-4

30. Xu D, Starr MR, Boucher N, et al. Real-world vitreoretinal practice patterns during the 2020 COVID-19 pandemic: a nationwide, aggregated health record analysis. Curr Opin Ophthalmol. 2020;31(5):427434. doi:10.1097/ICU.0000000000000692

31. Leng T, Gallivan MD, Kras A, et al. Ophthalmology and COVID-19: the impact of the pandemic on patient care and outcomesAn IRIS registry study. Ophthalmology. 2021;128:17821784. doi:10.1016/j.ophtha.2021.06.011

32. El Hamichi S, Gold A, Heier J, Kiss S, Murray TG. Impact of the COVID-19 pandemic on essential vitreoretinal care with three epicenters in the United States. Clin Ophthalmol. 2020;14:25932598. doi:10.2147/OPTH.S267950

33. Borrelli E, Grosso D, Vella G, et al. Impact of COVID-19 on outpatient visits and intravitreal treatments in a referral retina unit: lets be ready for a plausible rebound effect.. Graefes Arch Clin Exp Ophthalmol. 2020;258(12):26552660. doi:10.1007/s00417-020-04858-7

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36. Elfalah M, AlRyalat SA, Toro MD, et al. Delayed intravitreal anti-VEGF therapy for patients during the COVID-19 lockdown: an ethical endeavor. OPTH. 2021;15:661669. doi:10.2147/OPTH.S289068

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Effects of COVID-19 on intravitreal injection clinic | OPTH - Dove Medical Press

Native Hawaiians/Pacific Islanders, or NH/PIs, comprising more than 20 ethnic groups hailing from Polynesia, Micronesia, and Melanesia, are understudied despite being the third fastest growing racial group in the United States. Two studies now report that NH/PIs have been deeply affected by the COVID-19 pandemic.

Andrew Subica at the University of California, Riverside, led research groups that surveyed more than 300 NH/PIs from April-November 2021 in Washington, Utah, Oregon, California, and Arkansas states with large NH/PI populations. Their findings are published in two journals.

Described in the first paper, published in Public Health Reports, the researchers found 30% of the NH/PI participants reported being diagnosed with COVID-19 and approximately 50% of the participants reported having a close family member with COVID-19.

Further, nearly 1 out of 5 NH/PIs reported the death of a close family member due to COVID-19 infection; the overall U.S. COVID-19 mortality rate was 1 death per 400 persons at the end of 2021.

NH/PIs may carry the highest rates of COVID-19 infections and deaths of any U.S. racial/ethnic minority group during the pandemic, said Subica, an associate professor in the School of Medicines Department of Social Medicine, Population, and Public Health. For example, an earlier report found NH/PIs possessed the highest per capita death rate in 90% of states reporting NH/PI COVID-19 deaths.

According to Subica, several factors increase NH/PIs risk for exposure to SARS-CoV-2, the virus that spreads COVID-19. These factors include employment in essential frontline positions, dwelling in dense households and neighborhoods, and traditional sociocultural practices and obligations that result in large in-person group contact.

Our findings call for greater attention and funding of NH/PI research to prevent and reduce NH/PIs glaring health disparities associated with COVID-19, Subica said. Due to their high rates of comorbidities such as obesity, cancer, heart disease, and smoking that increase their risk of severe COVID-19 outcomes, it is crucial that future studies monitor and evaluate long-term COVID-19-related health issues facing NH/PI communities.

The research paper is titled Assessing the Health and Impact of COVID-19 on Native Hawaiians/Pacific Islanders.

In the second paper, published in Drug and Alcohol Review, Subica and his team share their findings after conducting a large-scale investigation of NH/PI substance use, mental health, and treatment need during COVID-19.

The research team found NH/PI communities experienced high levels of alcohol, tobacco, and other drug use, depression, anxiety, and unmet treatment need during COVID-19; 47% and 22% of NH/PI adults reported current alcohol and cigarette use, respectively, while 35% reported lifetime illicit substance use. The national smoking rate during COVID-19 is 13%.

Further, more than 1 in 4 NH/PI adults, or 27%, screened positive for alcohol use disorder, a rate that is more than 2.6 times the national alcohol use disorder rate during the pandemic.

Participants also reported heightened depression, anxiety, and psychological distress during COVID-19 with 27% of NH/PIs screening positive for major depressive disorder and 20% for generalized anxiety disorder, vastly exceeding the general population rates for these disorders.

What our work makes clear is that we need targeted research and treatment services to mitigate COVID-19s negative behavioral health impact on NH/PI communities, Subica said.

The researchers also found that approximately 50% of non-binary NH/PIs in the sample screened positive for probable alcohol use disorder and more than 50% reported needing mental health treatment during COVID-19.

This illuminates the need for further research exploring the behavioral health needs of these at-risk individuals, Subica said. We need to develop and implement culturally responsive prevention, intervention, and recovery programs to reduce NH/PI substance use and mental health disparities during and after the COVID-19 pandemic.

The research paper is titled Native Hawaiian/Pacific Islander alcohol, tobacco, and other drug use, mental health, and treatment need in the United States during COVID-19.

Subica was joined in the first study by Dr. Howard B. Moss of UCR; Nia Aitaoto of Pacific Islander Center of Primary Care Excellence; Quixi Li of Special Services for Groups; Brittany N. Morey of UCI; Li-Tzy Wu of Duke University; Derek K. Iwamoto of the University of Maryland; and Erick G. Guerrero of I-Lead Institute.

Subica, Moss, Guerrero, Aitaoto, Morey, and Wu were joined in the second study by Tammy K. K. Martin and Scott K. Okamoto of Hawaii Pacific University.

Both projects were supported by the National Institute of Drug Abuse and National Institute of Alcohol Abuse and Alcoholism of the National Institutes of Health. None of the content of this news release represents the official views of these institutes.

Header image credit:Solovyova/iStock/Getty Images Plus.

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COVID-19 took serious toll on Native Hawaiian/Pacific Islander mental and physical health - UC Riverside

Sen. Tammy Baldwin (D-WI) tested positive for COVID-19 on Sunday.

"Thankfully, I am vaccinated and boosted and only experiencing minor symptoms," Baldwin tweeted. "I will quarantine while I continue to work remotely."

SENATE PUNTS VOTE ON SAME-SEX MARRIAGE TO AFTER MIDTERM ELECTIONS

This makes Baldwin the fourth Democratic senator to test positive for the virus since the Senate returned from its August recess. Sens. Jacky Rosen(D-NV) and Bob Menendez(D-NJ) also tested positive, while the diagnosis for Sen. John Ossoff (D-GA) is keeping him from a week of voting.

Andrew Harnik/AP

Baldwin, the first lesbian senator, is working on finding 10 GOP senators to support her Respect for Marriage Act, a bill codifying same-sex marriage protections. Baldwin had hoped for a vote next week but now expects to put it to a vote following the midterm elections.

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"Weve asked Leader Schumer for additional time, and we appreciate he has agreed," Baldwin and Sens. Kyrsten Sinema (D-AZ), Susan Collins (R-ME), Rob Portman (R-OH), and Thom Tillis (R-NC) said in a joint statement. "We are confident that when our legislation comes to the Senate floor for a vote, we will have the bipartisan support to pass the bill."

This push from Baldwin to codify same-sex marriage comes in the wake of the Supreme Court overturning Roe v. Wade. Democrats have cited Justice Clarence Thomass concurring opinion, which states that the high court should reconsider it, as a reason to codify certain rights specifically on abortion and contraception access, as well as marriage equality.

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Sen. Tammy Baldwin tests positive for COVID-19 - Washington Examiner

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September 19, 2022National, News from NPR

While cases have decreased dramatically, there are still thousands of cases being reported across the world.

(Image credit: Ted S. Warren/AP)

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