Category: Covid-19

Kitsap County has committed roughly 90% of theCOVID-19 relief funding itreceived as part of the American Rescue PlanAct (ARPA) of 2021.

To date, Kitsap County has directed the spending of $47.6 millionout of $52.7 million it received from the federal government. The money will goto a varietyofprojects that relate to public health,homelessness, childcare, small business assistance, hospitality and tourism, and infrastructure like broadband expansion.

The spending is focusedon assisting communities disproportionately impacted by COVID-19, those who are homeless or at risk of it, those who are low-income, andsmall businesses,said Eric Baker, Kitsap County deputy county administrator.

Homelessness in Kitsap: South Kitsap's project for tiny home village gains traction again

An August report that details spending shows the amount of money invested in each category:$23.3millionforpublic health;$10 million for "lost revenue recovery";$9.9 million to address "negative economic impacts"; $8.9 million for infrastructure; and $650,000 for administration.

"Our money is largely being focused on going out into the public or addressing internal issues in the county that are affecting the public," Baker said.

Some projects that helphomelessnessinclude $3.4 million for the renovation ofthe former Olympic Fitness Club into a homeless shelter of over 75 bedson Mile Hill Drive and $272,000 for the Housing Solutions Center to create additional homelessness intervention teams.Another$250,000 will go to theDispute Resolution Center of Kitsap Countyto help rentersaddress potential eviction issueswithout involving the court system.

Some of themost expensive projects on the list: $7.2millionto improve the ventilation system for the Kitsap CountyJail and$6.6 million for Kitsap Public Utilities District'sbroadband node expansion project. In that project,up to 30 broadband nodes willbe built inunderserved areas to givepeoplegreater access to in-home reliable high-speed internet.

KPUD also secureda $470,512 budgetfor itsfree Wi-Fiexpansion project, in which24 Wi-Fihotspots will be constructed at Kitsap Transitparkand ride lots and other public facilities, according to county documents.

As for tourism and hospitality businesses,$60,000 has been dedicated toVisit Kitsap Peninsula for a project tocollaborate with the Port of Seattle andVisit Seattleand Olympic Peninsula to bring journalists and writers to the county to promote tourism, county documents said.

Kitsap Public Health Districtis slated to get $748,000 foritsnurse family partnership, which is anexpansion of in-home health assistance to expectant mothers and new families to improve birth outcomes, child development, kindergarten readiness and parenting practices.

YMCA of Pierce and Kitsap County's childcare programs are slated to get $519,000 forsubsidiesfor daytime and before- or after-school childcare for low-income families; $243,000will go to the organization'syouth andsenior programs.

Related: Kitsap tribes use COVID-19 relief funds to build housing, improve infrastructure

The county is working with stakeholdersto hammer out some contract-based projects andis making a goodprocessof spendingthe money, Baker said.

"We do have a number of contracts that have gone out. And then we have a number of projects that are internal, that are not necessarily contract-based, but we're making good progress towardspending the money," Baker said.

The spendingdeadline for the ARPA fund isthe end of2024.The countyis usingthe money in a way that ensures recovery needs beyond those identified in 2021can be covered, according to Baker.

"If we issued all our money last year,a lot of the stuff we know we need today, we wouldn't have money for it," Baker said. "The board is kind of moving methodicallywith this money, making sure that we're getting as much out there as we can, yet also ensuring that we have a certain amount to handle emergent issues that we didn't think of previously."

The countyplanstocommittherest of the $5 millionin 2023, Baker said.

This story has been changed since it was first published to correct the agency that runs the nurse family partnership.

Reach breaking news reporter Peiyu Lin at pei-yu.lin@kitsapsun.comor on Twitter@peiyulintw.

Support local journalism.Subscribe to kitsapsun.comtoday.

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Kitsap County has $53 million in COVID-19 relief funds. Here's how they will get spent - Kitsap Sun

The West Virginia Department of Health and Human Resources (DHHR) reports as of August 15, 2022, there are currently 2,891 active COVID-19 cases statewide. There have been three deaths reported since the last report, with a total of 7,206 deaths attributed to COVID-19.

DHHR has confirmed the deaths of a 63-year old male from Putnam County, a 79-year old female from Cabell County, and a 62-year old female from Morgan County.

Every loss brings grief to family and friends, said Bill J. Crouch, DHHR Cabinet Secretary. "We must do our best to stop this deadly virus by choosing to be vaccinated and boosted against COVID-19.

CURRENT ACTIVE CASES PER COUNTY: Barbour (11), Berkeley (205), Boone (37), Braxton (17), Brooke (30), Cabell (154), Calhoun (4), Clay (13), Doddridge (11), Fayette (61), Gilmer (7), Grant (25), Greenbrier (74), Hampshire (33), Hancock (37), Hardy (37), Harrison (114), Jackson (23), Jefferson (55), Kanawha (291), Lewis (17), Lincoln (44), Logan (83), Marion (109), Marshall (54), Mason (56), McDowell (34), Mercer (164), Mineral (62), Mingo (47), Monongalia (101), Monroe (29), Morgan (14), Nicholas (50), Ohio (55), Pendleton (9), Pleasants (6), Pocahontas (14), Preston (20), Putnam (82), Raleigh (155), Randolph (21), Ritchie (18), Roane (28), Summers (23), Taylor (13), Tucker (5), Tyler (8), Upshur (38), Wayne (42), Webster (19), Wetzel (20), Wirt (6), Wood (161), Wyoming (45). To find the cumulative cases per county, please visit coronavirus.wv.gov and look on the Cumulative Summary tab which is sortable by county.

West Virginians ages 6 months and older are recommended to get vaccinated against the virus that causes COVID-19. Those 5 years and older should receive a booster shot when due. Second booster shots for those age 50 and over who are 4 months or greater from their first booster are recommended, as well as for younger individuals over 12 years old with serious and chronic health conditions that lead to being considered moderately to severely immunocompromised.

Visit the WV COVID-19 Vaccination Due Date Calculator, a free, online tool that helps individuals figure out when they may be due for a COVID-19 shot, making it easier to stay up-to-date on COVID-19 vaccination. To learn more about COVID-19 vaccines, or to find a vaccine site near you, visit vaccinate.wv.gov or call 1-833-734-0965.

To locate COVID-19 testing near you, please visit https://dhhr.wv.gov/COVID-19/pages/testing.aspx.

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COVID-19 Daily Update 8-15-2022 - West Virginia Department of Health and Human Resources

Defense Secretary Lloyd Austin has tested positive for COVID-19 for a second time, according to a statement released Monday.

Austin first contracted COVID early this year, though both cases have presented only mild symptoms.

Now, as in January, my doctor told me that my fully vaccinated status, including two booster shots, is why my symptoms are less severe than would otherwise be the case. I will continue to consult closely with my doctor in the coming days, he wrote.

Austin will be working from home, with all necessary authorities to maintain command of the Defense Department.

Austins positive test comes two days after VA Secretary Denis McDonough announced he had contracted the virus. Austin said his last in-person contact with President Joe Biden, who tested positive for COVID-10 on July 21, was on July 29.

Meghann Myers is the Pentagon bureau chief at Military Times. She covers operations, policy, personnel, leadership and other issues affecting service members.

Original post:

Austin quarantining with second bout of COVID-19 - Military Times

Britain has become the first country in the world to approve Moderna's bivalent Covid-19 vaccine, which targets both the original strain of the virus and the newer Omicron variant.

Long Visual Press | Universal Images Group | Getty Images

LONDON Britain on Monday became the first country in the world to approve a dual Covid-19 vaccine, which tackles both the original virus and the newer omicron variant.

The updated Moderna vaccine known as a bivalent because it targets two variants is expected to be available to adults as a booster jab from the fall after receiving the go-ahead from the U.K.'s Medicines and Healthcare products Regulatory Agency on Monday.

It also received endorsement from the British government's independent scientific advisory body, the Commission on Human Medicines.

The MHRA said that while existing vaccines which were designed to combat the original strain of Covid continue to provide good protection, the augmented version would provide better defense as the virus evolves.

"The first generation of Covid-19 vaccines being used in the UK continue to provide important protection against the disease and save lives. What this bivalent vaccine gives us is a sharpened tool in our armory to help protect us against this disease as the virus continues to evolve," Dr. June Raine, chief executive of MHRA, said.

The Commission on Human Medicines added that the approval marks a step forward for vaccine development, particularly for viruses with high levels of mutation.

"The virus, SARS-CoV-2, is continually evolving in order to evade the immunity provided by vaccines. This novel bivalent vaccine represents the next step in the development of vaccines to combat the virus, with its ability to lead to a broader immune response than the original vaccine."

The approval follows clinical trials, in which a booster with Moderna's bivalent vaccine was shown to trigger a strong immune response against both the original 2020 strain as well as omicron BA.1, which emerged in the U.K. last winter.

This bivalent vaccine has an important role to play in protecting people in the U.K. from Covid-19 as we enter the winter months.

Stephane Bancel

CEO, Moderna

It was also found to generate a good immune response against omicron sub-variants BA.4 and BA.5, currently the dominant strains in the country.

Following the release of its findings in June, Moderna Chief Executive Stephane Bancel said he was hopeful that the new iteration would become its "lead candidate for a Fall 2022 booster."

"This bivalent vaccine has an important role to play in protecting people in the U.K. from Covid-19 as we enter the winter months," Bancel added in a statement Monday.

The U.K. government has not yet announced exactly who will receive the vaccine, however all over-50s and people in high-risk groups in the U.K. will be offered some form of booster from next month.

The government lowered the age threshold for those eligible for an autumn booster in July, following the continue spread of the virus.

Vaccines are considered one of the most effective ways of reducing the spread and the severity of the virus. Research in the medical journal The Lancet estimated in June that Covid-19 vaccines prevented almost 20 million deaths in their first year of use.

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UK becomes the first country to approve a dual Covid vaccine targeting omicron - CNBC

GETTY

For two years, the Covid-19 pandemic rattled financial markets, dominated news coverage and disrupted daily life in ways most Americans would never have predicted.

But now, in year three, the coronavirus has been downgraded to a persistent yet manageable threaton par with the flu. Thanks to some familiar medical solutions (vaccines, antiviral meds and public safety measures), three-quarters of Americans say the worst of Covid-19 is behind us.

Now, a new disaster looms. American healthcare stands in direct path of the perfect storm.

Doomsday predictions often prove wrong or overinflated. But, in 2004, a team of hurricane experts at Louisiana State University predicted a catastrophe [is] right on the horizon. They were right. Less than a year later, New Orleans was eleven feet under water. Hurricane Katrina killed 1,833 people and left thousands more homeless.

How did the researchers know Katrina was coming? Using data-based computer simulations, they observed a confluence of potentially deadly forcesrising heat, weak levies, high wind speeds, transportation issues and morethat, when combined, would bring about certain destruction.

A similar situation is unfolding in American healthcare.

Decades of price escalation combined with eroding quality and misused technologies have made U.S. healthcare the most expensive and least effective system in the developed world. By themselves, these protracted healthcare issues are manageable and might have been tackled over time, using familiar fixes.

However, that was before a trio of mega forces arrived that now threaten to create healthcares version of the perfect storm. Without urgent and radical solutions, these forces will combine to produce a massive medical disasterone that will prove far more destructive and costly than Covid-19.

In my 2021 book Uncaring, I predicted federal Covid-19 relief efforts, totaling in the trillions, would cause inflation to rise rapidly. However, I failed to anticipate that a series of global eventsthe war in Ukraine, an international oil shortage and a persistent supply-chain squeezewould enter the picture and, together, drive U.S. inflation to a 40-year high.

Without these added pressures, our country may have had five to 10 years to fix healthcares thorniest problems. Instead, the United States no longer has the luxury of tinkering with payment models or carrying out the long-term transformation of medical practice.

Most public health officials and patients dont realize that healthcare prices are about to explode. They mistakenly compare todays soaring consumer prices with the relatively tame rate of healthcare inflation.

But unlike gas, grocery and housing prices, healthcare prices dont adjust in real time. Instead, the cost of everything from nursing salaries to bandages to Rx medications is set one to two years in advance and holds firm for 12 to 24 months.

A when these contracts come up for renewal this fall, the piper will have to be paid.

Labor in healthcare is essential and increasingly expensive. So are raw materials and supply-chain expenses. The same factors that have driven consumer prices up 8% to 9% are likely to drive up the price of healthcare to unaffordable levels for decades to come.

Starting next year, the majority of U.S. health insurers plan to increase employer premiums 10 to 15% with American families likely to pay an even higher percentage for their share of healthcare costs.

Last Friday, my frienda surgeoncalled at 4 p.m. to cancel dinner plans. He told me one of his patients scheduled for surgery that morning was still waiting for his procedure. Since the patient wasnt allowed to eat or drink anything since the night before, the doctor didnt want to cancel the procedure and have to reschedule it.

Surgical delays and cancellations are becoming increasingly common. A driving factor is a growing shortage of nurses.

According to multiple studies, one-third of RNs plan to leave their current roles while many intend to exit the workforce entirely. More than 1 in 4 baby boomer RNs intend to retire within the year.

This dwindling headcount poses a huge problem for patients. Hospitals literally cant function without enough nurses. State regulators set minimal requirements for RN staffing on medical floors and in critical care units. The nursing shortage is especially pronounced in operating rooms, where experienced nursing is essential for optimal patient care. When hospitals cant meet these numbers, care gets delayed and patients must be turned away.

You might assume an easily solution would be to expand nursing-school enrollments and increase class sizes. But training nurses is expensive and time-consumingit takes at least five years to get nursing students ready to deliver bedside care and even longer to train them for the operating room. Further complicating the issue is that it takes a skilled RN to teach nursing students the hands-on techniques of bedside patient care.

And in the context of a nursing shortage, hospital administrations are loath to assign experienced RNs to educational roles rather than care delivery roleseven if the former is the best long-term choice.

With the dual threats of inflation and nursing shortages, hospital administrators feel trapped in lose-lose situations. They know that aggressively raising wages to recruit and retain nurses will drive costs through the roof whereas holding salaries down to address ever higher costs will lead to more nurses quitting.

Without immediate solutions, surgical backlogs will grow and even fully insured patients will find their surgeries delayed or postponed. The result will be progressively poorer outcomes, avoidable complications and even death.

When my friend called me the next day, he said his patient finally underwent surgery at 2 a.m. Fortunately, the case went well. When I asked how the family reacted, he replied, Theyre still irate.

Even before the pandemic, doctors were reporting burnout rates of 44% or more. Now, after two years of intensifying workplace demands and an endless parade of patient deaths, the emotional trauma on healthcare professionals has reached a boiling point.

The shortage of nurses and support staff, combined with cost-cutting efforts from insurers and hospital administrators have only fueled the discontent.

Doctors, who increasingly reject the word burnout, label the problem moral injury, a pain that comes from being unable to provide excellent medical care. Physicians say hospital administrators and insurance company executives are more concerned with profits than patients. Furthermore, doctors feel they dont get the respect and appreciation they deserve for all their hard work.

As a result, dissatisfied physicians are turning to private equity firms for better compensation and greater control over their day-to-day. Private equity leaders recognize this as a great financial opportunity.

The PE approach is to first sign up as many community specialists as possible (with a particular eye on the kinds of doctors that hospitals need to stay in business: anesthesiologists, ER physicians, orthopedists, urologists and cardiologists). Then, having gained market control through consolidation, the PE firms demand significantly higher physician reimbursements from insurers and hospitals (25% or more).

Between 2010 and 2019, private equitys annual healthcare investments soared from $42 billion to $120 billion. Naturally, the last thing these companies want is to reduce reimbursement. And as burnout continues to intensify, more and more doctors will pursue this route, thus worsening healthcares cost crisis.

As happened with Katrina, this vicious combination of forces, all hitting medical practice at once, will inflict massive damage. Double-digit inflation, a major nursing shortage and monopolistic control of physician specialists through private equityon top of the ongoing healthcare problems that predate Covid-19will produce a mega disaster unless we take urgent and bold action.

The old solutions (i.e., financial incentives and assigning doctors and nurses ever-larger patient loads) simply wont work. Try raising nursing salaries or acquiescing to private equity demands and well exacerbate healthcare inflation. Try squeezing compensation or reducing headcount, and well worsen nurse and doctor dissatisfaction and compromise access.

Addressing all three mega forces together will require a radically different approach than in the past. The details of that solution will be the focus of my next article. To receive that story in your inbox, click the FOLLOW button at the top of this article.

Full coverage and live updates on the Coronavirus

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These 3 Healthcare Threats Will Do More Damage Than Covid-19 - Forbes

In the months after COVID-19 infection, some patients may experience post-acute sequelae of COVID-19 (PASC), commonly referred to as long COVID. The continuation of COVID-19 symptoms inevitably leads patients to continue seeking health care after acute infection.

The impact of post-COVID conditions (PCC) on health care uptake has not been extensively described. A recent study, published in JAMA, examined whether COVID-19 infection is associated with health care utilization 6 months after acute illness.

The investigators sought to estimate the excess COVID-19-related health care usage, as well as the most troublesome long COVID symptoms pushing patients to seek medical help.

The matched, retrospective, cohort study included patients from 8 large integrated health systems from across the United States. Patients of all ages completed a COVID-19 diagnostic test between March 1-November 1, 2020.

The final study included 127859 patients with a positive COVID-19 test; they were matched by age, sex, race, ethnicity, and date of COVID-19 test to 127859 patients who tested negative for COVID-19. Data were analyzed from March 18, 2021-June 8, 2022.

The average age of the cohort was 41.2 years, 53.7% were female, 51.8% were Hispanic, 7.1% were non-Hispanic Asian, 6.2% were non-Hispanic Black, and 26.9% were non-Hispanic White.

Using Poisson regression models and difference-in-difference analysis, the investigators calculated ratios of rate ratios (RRRs) for COVID-19-associated health care utilization. Overall RRRs were estimated, and estimates were then broken down by health care setting, select population characteristics, and by 44 post-COVID conditions. Excess COVID-19-associated health care utilization was estimated by health care setting.

The investigators found that health care utilization was higher in the patients who had contracted COVID-19 6 months prior. Overall, COVID-19 infection was associated with a 4% increase in health care utilization over 6 months. Health care visits were predominantly virtual.

COVID-19associated utilization for 18 post-COVID conditions remained elevated even 6 months after acute illness, with the largest increase observed for infectious disease sequelae (86%), COVID-19 (19.47%), alopecia (2.52%), bronchitis (1.85%), pulmonary embolism or deep vein thrombosis (1.74%), and dyspnea (1.73%).

COVID-19-associated excess health care utilization accounted for an estimated 27217 additional medical encounters over 6 months.

The study authors concluded their findings suggest health systems should plan for long-term strategic resource allocation to adequately respond to the elevated health care needs of long COVID patients.

Excerpt from:

Health Care Utilization in the Months After COVID-19 Infection - Contagionlive.com

CDC relaxing its COVID-19 guidelines

The nation's top public health agency relaxed its COVID-19 guidelines Thursday, dropping the recommendation that Americans quarantine themselves if they come into close contact with an infected person. (Aug. 12)

AP

New data show COVID-19 infections are declining in Ventura County after rising much of the summer.

California Department of Public Health metrics posted Friday show an average of about 26infections a day per 100,000 county residents, compared to a daily rate of nearly 32a week ago. The percentage of PCR tests coming up positive fell to 13.1%, down from 15% two weeks earlier.

The data doesn't prove the surge of infections has ended, cautionedRigoberto Vargas, director of the Ventura County Public Health Department.Transmission is still being driven by highly contagious subvariants but the trend may be finally headed downhill.

"I dont want tosay were out of the woods," Vargas said. "Its still high even though were trending in the right direction."

The county remains in the highest of three tiers for COVID-19 risks in a weekly ranking by the U.S. Centers for Disease and Control Prevention. But the region barely missed moving down a notch and could make that jump within a week depending on COVID-19 hospitalization levels, Vargas said.

Admissions continue to hover on a relatively low plateau, rising orfalling slightly each day. On Friday, 64 people with COVID were being cared for in hospitals countywide, compared to 70 patients a day earlier. The levels are far less than peaks hit in January in an omicron surge that subsided and then was reborn, this time driven by subvariants.

The local metrics mirror a statewide trend that suggeststhe current surge is diminishing, said George Rutherford, epidemiologist at UC San Francisco.

"The smart money says its going to stay down for about three months or so, and well get a kick with the winter," he said.

The virus will likely continue to ride a rollercoaster of surges and lullsthough it may also cause less severe illness and fewer deaths, Rutherford said.

Schools are reopening across Ventura County but the activities triggerno special COVID concerns regardless of whether students and staff wear face coverings, Vargas said. Masking indoors on campuses is no longer being urged by public health with decisions left up to individuals.

"I think schools are much safer than a year or two ago," he said.

Federal COVID-19 guidelines have also been loosened, including downplaying the emphasis on social distancing. New recommendations call it "just one" component ofprotection.

Quarantine guidance is also changing. TheCDC previously said if people who are not current on their COVID-19 vaccinations come into close contact with a person who tests positive, they should stay home for at least five days.

The agency now saysquarantining at home is not necessary, but it urges those people to wear a high-quality mask for 10 days and get tested after five.

Vargas praised the new recommendations.

"We're entering a different chapterof COVID, more into the endemic stage," he said. "Were going to learn how to adaptand co-exist."

The Associated Press contributed to this report.

Tom Kisken covers health care and other news for the Ventura County Star.Reach him at tom.kisken@vcstar.com or 805-437-0255.

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COVID-19 infections appear to be headed downhill in Ventura County after months-long climb - VC Star

Paul Bibeau/WHRO

Steve Neskis is a self-described 67-year-old surf dog.

It just clears the mind, like meditation, he said. When you drop into a wave, you're no longer thinking about anything . [The] energy and the pulse that it gives you is something that is just so sacred.

As COVID-19 locked down the world many discovered the benefits Neskis touted as they headed for the ocean.

Surfing booms swept places like Australia, China and India.An Old Dominion University study found a possible reason for the trend: Surfing seemed to enable people to cope with the stress of the pandemic and meet up with each other in safe, socially distanced ways.

Surfing really allowed people to just let it all go and not have to think about the pandemic for a little while, said Lindsay Usher, an associate professor of park, recreation and tourism studies at ODU, who authored the study.

She added surfers in the water had experience staying socially distanced to avoid collisions, while sharing a sense of community.

In some places, though, COVID-19 restrictions stopped folks from surfing. People told Usher they felt restless, depressed and bored.

She said Virginia Beach benefitted from relatively relaxed restrictions on surfing.

We were pretty lucky that our region kind of handled it middle of the road, said WRV President L.G. Shaw. And they encouraged people to get outside and get fresh air [and] just to stay away from each other.

Shaw said when lockdown started in spring 2020, skateboards were the hot item at his store. Parents would buy multiple boards for their kids, because mom was going to lose it.

But as the waters warmed, he saw new customers try surfing. And he agreed with Ushers findings about why.

During COVID, it was one of the only times you could be you weren't getting inundated with the the crazy news, he said. You're outside getting fresh air, getting your endorphins going and enjoying yourself, and the whole world kind of fades away.

Shaw said 2020 saw a confluence of events that boosted the sport. People were already becoming more interested in surfing, because it was scheduled to debut at the Olympics in Tokyo that summer, though authorities delayed the games for a year and held them in 2021.

But then the pressures of the strange and challenging pandemic years drove whole families to buy boards and paddle out to sea.

It was a pretty significant impact that it made, for sure, Shaw said.

Read the original story at the WHRO website.

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Surfers hit the waves to escape COVID-19, according to ODU research - VPM News

Waste water testing is the best and most cost-effective way to understand public health threats from infectious diseases in communities for a wide range of diseases, said David Larsen, an associate professor at Syracuse University who played a key role in establishing New York states waste water surveillance program.

The federal government last week declared the monkeypox outbreak a national health emergency. The US Centers for Disease Control and Prevention says that as of Thursday there were more than 10,000 cases recorded nationwide.

Boehm said that once waste water samples have been collected, testing doesnt have to be limited to the original target, SARS-CoV-2, the virus that causes COVID-19, and can be expanded to include monkeypox and other diseases.

Its pretty straightforward to swap in different assays for different important targets. Its a great way to be prepared for the next pandemic, she said. WastewaterSCAN has also been testing samples for influenza and RSV, two respiratory viruses that spread across the country during the colder months every year.

Newsha Ghaeli, Biobot co-founder and president, said the hope is that the monkeypox testing currently under research and development by the company can really help us better understand this disease.

Biobot, founded in 2017 with an initial focus on testing sewage for opioids to help communities address the opioid epidemic, pivoted swiftly after the pandemic swept the nation to begin testing for the coronavirus. It is now the biggest player in the waste water surveillance testing business, said Ghaeli. It currently does testing for about 500 sites in all 50 US states.

Ghaeli said Massachusetts officials have inquired about Biobots plans for monkeypox testing. State officials say they currently have no plans to test for monkeypox.

Ghaeli said the company is also considering testing for polio in waste water as concern has been rising about the disease making a comeback after being nearly eradicated worldwide. Waste water surveillance for polio has been used in the past in Israel to control outbreaks. In recent days, it has made headlines in the United States after poliovirus was discovered in waste water in New York City and a suburb, prompting officials to urge people to get vaccinated.

Larsen said the same waste water sample can be used to test for tens, if not hundreds of diseases. One caveat, he said, is that the technique wont work very well for a disease that doesnt shed in the waste water, but he added, I havent found an example of that yet.

Waste water surveillance got a big boost from its performance during the COVID-19 pandemic, when it became a key metric to understand the spread of the virus, researchers said.

It definitely supercharged this field, said Boehm. Over the course of the pandemic, we realized waste water could be a really great resource.

The CDC, acknowledging the value of waste water testing for the coronavirus, established the National Wastewater Surveillance System to coordinate and build the nations capacity to track coronavirus levels in waste water around the country.

An editorial last week in the journal Nature Microbiology called for routine waste water monitoring to be deployed around the world to mitigate the spread of pathogens, both old and new.

Sam Scarpino, a vice president at the Pandemic Prevention Institute of the Rockefeller Foundation, said, Multi-pathogen waste water surveillance has the potential to transform global public health in terms of its ability to tell us whats making people sick in real time and in a less biased way than many traditional surveillance systems. ... We absolutely need multi-pathogen surveillance.

CDC officials, too, have said they recognize the value of testing for more diseases. Amy Kirby, team lead for the NWSS, said in a February press briefing that waste water surveillance for COVID-19 was giving us a glimpse into a new frontier of infectious disease surveillance in the US.

One of the strengths of waste water surveillance is that it is very flexible. So once we have built this infrastructure to collect the samples, get them to a laboratory, get the data to CDC, we can add tests for new pathogens fairly quickly. So ... should there be a new pathogen of interest, we could ramp up this system within a few weeks to start gathering community-level data on that new pathogen, she said.

The CDC said in a statement it was exploring the possibility of monitoring for monkeypox virus in waste water but has not released any recommendations on waste water surveillance of this virus.

Ghaeli and the researchers noted there is a major obstacle ahead for a field that they believe could be key to protecting peoples health.

With the testing dependent on government funding, The biggest barrier is money, said Larsen. Public health surveillance, in general, is not well funded.

Ghaeli said that once a sample is collected, it is only a nominal or fractional increase to do other tests on the water.

Weve always believed it should be an integral part of our public health intelligence system, she said. Our vision is that waste water monitoring becomes a permanent infrastructure layer on top of our sewer systems.

Martin Finucane can be reached at martin.finucane@globe.com.

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Experts say waste water testing, crucial for COVID-19, could be useful for monkeypox and the next big disease - The Boston Globe

Aim: Most dental procedures are aerosol-generating and hence highly risky for spreading SARS-CoV-2 (COVID-19) infection. This can lead to sufficient psychological distress, avoidance of risky procedures, and impact on dental practice. We intend to examine the effect of the COVID-19 pandemic on dental practice and psychological distress among dental practitioners.

Methods: An online survey was conducted by an email-based survey link; 1257 registered dental practitioners were contacted across the country.

Results: Most dental practitioners continue to practice during the COVID-19 pandemic (81.08%). Postgraduate specialists significantly outnumber undergraduates in performing dental procedures (p=.001). Career-related anxiety was considerably high among postgraduates (61.96%;p=.036) during the initial phase of the SARS-CoV-2 pandemic in India. In contrast, self-efficacy was significantly better among postgraduates than undergraduates (p=.027).

Conclusion: Dentalpractitionerssuffered considerable impact due to the COVID-19 pandemic. It is important toenhance coping and self-efficacy strategies among dental practitioners.

The World Health Organization (WHO) officially declared the SARS-CoV-2 (COVID-19) outbreak a pandemic on March 11, 2020. Several preventive measures and restrictions were imposed to prevent the spread of the SARS-CoV-2 (COVID-19) virus. In India, a nationwide lockdown was declared on March 24, 2020for 21 days [1-3]. The devastating effect of the COVID-19 pandemic was seen across all strata of lives, and the threat was palpable to all categories of health professionals and medical specialties [4].

The COVID-19 pandemic significantly affected dental practice; dental practitioners suffered a great amount of COVID-19-related anxiety and fear since the COVID-19 virus primarily spreads through aerosol, and most dental procedures are aerosol generating [5,6]. It was observed that most dental procedures were either postponed or limited to oral surgeries only during the COVID-19 pandemic [7-9]. Several safety guidelines were released to ensure that dental practitionerscontinued dental care services safely [7].

There are around 117,825 registered dental surgeons in the country; it is pertinent to assess the pattern of dental practices and psychological distress related to dental procedures during the COVID-19 pandemic [10]. We hypothesized that dental practice sustained a significant impact, and dental practitioners were subjected to substantial psychological distress during the COVID-19 pandemic. To validate our hypothesis, we conducted an online survey from August-September 2020, i.e. at the peak of India's first wave of the COVID-19 pandemic.

The institutional ethics committee of the All India Institute of Medical Sciences, Raipur approved the study (AIIMSRPR/IEC/2020/597). The study was conducted using - the SurveyMonkey platform. Participants who were undergraduates or above in dentistry, registered with the Dental Council of India, and currently practicing in India were invited by email.A WhatsApp invitation was sent to those whose email addresses could not be found. Participants whodid not practice dentistry (due to any reason other thanthe COVID-19 pandemic), did not provide consent or did not complete the survey were excluded. The invitation link and IP address were anchored to thecollector link to avoid duplicate responses. A weekend reminder was sent to only those who did not respond to the first invitation. The invitation link remained open from August 27, 2020, 5:00 PM IST to September 15, 2020, 10 AM IST (18 days and 17 hours). After clicking on the invitation link, the participants were directed to the invitation page; the invitation page provided detailed information about the study, followed by the participant's consent.

A questionnaire composed of 32 items was used to collect the sociodemographic details (10 items), factors related to the COVID-19 pandemic, and fear and anxiety associated with COVID-19 (12 items). The questionnaire was distributed to 10 doctors of the same institution, their opinion and suggestions were collected separately, and finally, the questionnaire was used. The self-efficacy scale, a 10 items scale with 1 to 4 scores for eachitem, is used to assess the coping skills of the dental practitioners. A higher score on the self-efficacy scaleindicates lower psychological distress and better general coping skills [11,12].The average time taken by the participants to complete the survey was six minutes.

Continuous variables were reported as means with standard deviation (SD), and categorical variables were reported as a number with the percentage of the total. Chisquare test was used to assess the statistical significance of the distribution pattern of various variables. The analysis was carried out using Statistical Package for the Social Sciences, version 20.0 (SPSS, IBM Corp., Armonk, NY).

A total of 1257 registered dental practitioners were invited to participate by disseminating invitation links through email and weblink in WhatsApp messages; a total of 742 responses, 228 by email, and 514 weblinks, with a response rate of 71% was received. Finally, 518 participants completed the survey and their responses were included in the final analysis.

The mean age of the participants was 33.69 8.95 years; 50.19% were males (50.19%) and 56.76% were married. The graduates of MasterofDental Surgery(MDS) outnumbered (81.08%) the graduates of Bachelor of Dental Surgery (BDS) (32.04%). Most participants were involved in private practice (44.21%) and did not have risk factors like age of more than 60 years, uncontrolled diabetes, hypertension, or current treatment with immunosuppressant drugs (83.88%)(Table 1).

Most practitioners continued their practice (81.08%) with a significantly higher proportion of males and with postgraduate qualifications (=37.21, p=<.001and =10.68, p=.001)during the COVID-19 pandemic, performing all sorts of dental procedures while limiting themselves to the non-aerosol generating procedure(Table 2).

As much as 61.97% expressed concern about getting COVID-19 infection while 50% were concerned about losing their job or shut-down of a privately owned clinic as well as anxiety related to their career. We found a significant difference in career-related anxiety levels between postgraduates and undergraduates ( =8.49, P=.036) (Table 3).

To manage cases of COVID-19, sufficient personnel protective equipment was present in their clinical set-up. Female dental practitioners expressed highercareer-related anxiety compared to their male counterparts, as shown by their response to the question -"Are you anxious about your career as a dentist because of the COVID-19 outbreak?" ( =9.26, p=.026) (Table 4).

The overall general coping skills and self-efficacy of the dentists were adequateduring the COVID-19 pandemic (Table 5).

The present cross-sectional study assessed the level of psychological distress, anxiety, and fear of getting infected amongst dental practitioners, while working during the COVID 19 pandemic outbreak in India, and assessed the possible factors associated with it. For this purpose, a questionnaire composed of closed-ended questions was used to gather information about psychological distress, anxiety, and fear of getting infected among dental practitioners while working during the COVID 19 pandemic. The findings confirmed our hypothesis, suggesting that dental practitioners exhibited an elevated risk of developing psychological distress. Similar studies involving dental staff in countries like Israel [13], India [6], Italy [14], Poland [15], and Saudi Arabia [16] also report confirming higher psychological distress rates due to the COVID-19 pandemic.

Since it has been established that the primary route for transmission of coronavirus is through the airborne spread via aerosols formed during dental procedures [17], other possible routes are contact spread, and contaminated surfaces spread [18]. This enhances the likelihood of dental practitioners getting infected and further spreading the virus. The present study found that many dental practitioners feared getting infected by their patients or co-workers. The rapid spread of the coronavirus terrified the rest of the population as they were at risk of getting infected by other individuals in the community [4]. The majority of dental practitioners were fearful of providing treatment to any symptomatic patient. Since the coronavirus rapidly infected such a large number of individuals in a short time in almost every country, the fear of getting infected by a patient has supporting empirical evidence.

In the present study, 61.97% of the dental practitioners expressed much concern about getting COVID-19 infection during practice. In comparison with other countries, it was around 85% of 356 dental practitioners and 71.9% of 1237 participants in Italy [14,19] and Norway [20], respectively. Also, in the present study, around 50% of the participants expressed concern about losing their job or closure of practice due to the COVID-19 pandemic. In contrast, it was comparatively higher, i.e. 67.02%, 89.6%, and 80% in studies from India, Italian, and America [5,14,19,20], where dentists reported more concerns about professional future, practice closure, and economic issues. The possible reasons were earning from other sources or support from other family members both psychologically and economically in our study group. The current study found that females had higher career-related anxiety compared to their male counterparts.

Many dental practitioners in India wanted to shut down their privately owned clinics which may have had significant economic implications and may have reflected in the level of anxiety. During the COVID 19 pandemic, patients suffering from dental pain experienced delays in dental care due to a multi-visit treatment plan and teleconsultations.

The current guidelines on the COVID-19 outbreak have recommended deferring all non-essential and elective dental treatment until the situation is regressing or under control. Only emergency dental treatments have to be done, such as for patients suffering from severe pain, swelling, bleeding, and trauma [7]. Another genuine fear that dentists have was of carrying infections from their dental practices to their families. The prolonged incubation period during the asymptomatic phase and the longevity of coronavirus on various surfaces from a few hours to a few days make it particularly difficult to limit its transmission [18]. The anxiety and fear of getting quarantined due to coronavirus infection also legitimise nervousness. The burden on the healthcare system and the cost incurred during treatment also put one's mind under stress.

In our study, it was found that self-efficacy was adequate and comparable in both postgraduate and undergraduate dental practitioners (Table 5).

Limitations, being an online survey, posed several limits to sample coverage. The study was subject to selection bias and sampling error, as participants were approached using social media, dedicated mailing lists, and forums. Capturing a relatively younger population, perhaps due to the accessibility of smartphones and the internet, affected the sample. Missing out older practitioners, who may be more vulnerable to COVID-19-related stress, could have caused under-reporting psychological distress. The questionnaire used to assess attitude and knowledge was not adequately validated and just validated by a pilot survey among 10 doctors of the same institute.

Strengths of this study include a large sample size; responses were conducted during the peak of the first wave of COVID-19 immediately after a lockdown in India to minimise recall biases and enable the assessment of the actual situation.

It can be concluded that dentalpractitionerssuffered considerable impact due to the COVID-19 pandemic. Although there was a variation in the stressors and psychosocial factors, dental practitioners suffered significant career-related anxiety. Surprisingly,postgraduatedental practitioners continuedtheir dental practicewith their clinical work by performing non-aerosol generating procedures despite significant COVID-19-related anxiety, perhaps due to better self-efficacy skills. Hence, apart from COVID-19 safety guidelines and policies, there is a need to enhance coping and self-efficacy strategy among dental practitioners.

Read more from the original source:

Psychological Distress and Coping Among Dental Practitioners During the COVID-19 Pandemic: A Survey From India - Cureus