Category: Covid-19

Both 6 feet of social distancing and quarantining may be things of the past as the Centers for Disease Control and Prevention is expected to hand down new COVID-19 recommendations in the coming days. The new recommendations are expected as soon as next week, according to CNN Health, citing sources familiar with the CDC's plan.One large and ongoing recommendation under discussion for adjustments is the 6-foot social distancing guidance. Instead, the CDC may ease the distancing. The CDC is also expected to de-escalate COVID-19 screening tests in schools as a part of the "Test To Stay" strategy, which was originally implemented for unvaccinated students who were exposed to the virus. Test To Stay encouraged daily testing in place of quarantining at home and missing classroom time.Instead, the CDC may shift testing to areas they deem as a more useful strategy, such as in prisons and nursing homes.Quarantine requirements may also change. The current recommendation is to stay home for five days after exposure. The new guidance may simply be wearing a mask while in public for five days, and testing on the fifth day post-exposure.The changes to the guidelines are expected in the coming week.At this time, official guidance has not yet changed.Vaccination sites across Sacramento can be found here.

Both 6 feet of social distancing and quarantining may be things of the past as the Centers for Disease Control and Prevention is expected to hand down new COVID-19 recommendations in the coming days.

The new recommendations are expected as soon as next week, according to CNN Health, citing sources familiar with the CDC's plan.

One large and ongoing recommendation under discussion for adjustments is the 6-foot social distancing guidance. Instead, the CDC may ease the distancing.

The CDC is also expected to de-escalate COVID-19 screening tests in schools as a part of the "Test To Stay" strategy, which was originally implemented for unvaccinated students who were exposed to the virus. Test To Stay encouraged daily testing in place of quarantining at home and missing classroom time.

Instead, the CDC may shift testing to areas they deem as a more useful strategy, such as in prisons and nursing homes.

Quarantine requirements may also change. The current recommendation is to stay home for five days after exposure. The new guidance may simply be wearing a mask while in public for five days, and testing on the fifth day post-exposure.

The changes to the guidelines are expected in the coming week.

At this time, official guidance has not yet changed.

Vaccination sites across Sacramento can be found here.

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CDC expected to make adjustments to COVID-19 recommendations as school starts - KCRA Sacramento

Overview

The pandemic has emphasized the high risk of avoidable harm to patients, health workers, and the general public, and has identified a range of safety gaps across all core components of health systems at all levels.

The rapid review Implications of the COVID-19 pandemic for patient safety explores impacts that the COVID-19 pandemic did have on patient safety in terms of risks and avoidable harm, specifically in terms of diagnostic, treatment and care management related issues as well as highlights the main patterns of these implications within the broader health system context.

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Implications of the COVID-19 pandemic for patient safety: a rapid review - World Health Organization

A screenshot of a map showing case counts of COVID-19 reported in different animal species, part of an interactive COVID data tracking dashboard rendered by Complexity Science Hub Vienna. The drawings represent the type of animal, including both domestic and wild; the size of the bubbles reflects the number of cases in each locale. Complexity Science Hub Vienna/Screenshot by NPR hide caption

A screenshot of a map showing case counts of COVID-19 reported in different animal species, part of an interactive COVID data tracking dashboard rendered by Complexity Science Hub Vienna. The drawings represent the type of animal, including both domestic and wild; the size of the bubbles reflects the number of cases in each locale.

Mink get it. Hamsters get it. Cats and dogs get it.

They're a few of the many animal species to have contracted COVID-19.

But how many species have been affected? And how many cases have there been in the animal kingdom?

Those are difficult questions to answer just as it's hard to come up with an accurate total for human cases, since many people don't report a positive test to health authorities. Yet it's an important task, say researchers, because of the possibility that the virus could mutate into a perhaps more transmissible or virulent strain in animals and then pass back to humans.

Now there's a first effort at compiling a global database of animal counts. Amlie Desvars-Larrive, professor at the University of Veterinary Medicine Vienna, and her team of Austrian researchers combed the internet for data from official sources. On July 23, her team in collaboration with the Wildlife Conservation society published the first COVID data tracking dashboard for cases in animals in Scientific Data.

The interactive visualization lets users explore which animals have gotten COVID, how many cases were reported for each species and the source of the data. It also covers what happened to the animals, ranging from mild symptoms like a runny nose to more severe symptoms like myocarditis or even sudden death.

This graphic, part of an interactive COVID data tracking dashboard rendered by Complexity Science Hub Vienna, shows reported clinical signs of SARS-CoV-2 infection or exposure in animals. Note: "subclinical" means no detectable symptoms. Complexity Science Hub Vienna/Screenshot by NPR hide caption

The number of cases reported are undercounts, since there's no systematic gathering of information across countries, among other reasons. But scientists say it is a welcome addition to the body of COVID data.

"[COVID surveillance in animals] has been through either activities at a governmental level or through independent research," says Meghan Davis, professor of environmental health at Johns Hopkins, who was not involved in the study. "What these authors did very well was identifying some of the most likely sources of data and then pulling this information together into a graphical interface.

"This dashboard is incredibly useful at communicating information and bringing together data from multiple sources. People who make public health decisions or are interested in this topic can now interact with the data without needing to go to all of these different sources," says Davis.

"What was new to me was to see [how the number of COVID infections] in the different species compared," says Wim van der Poel, veterinarian and professor of zoonotic viruses at Wageningen University in the Netherlands. Van der Poel was acknowledged in the paper but not involved in the study.

And the limitations of the tracker might help highlight where better reporting or testing initiatives on COVID in animals are needed. "[The dashboard] shows us where we may need to increase our activities," says Davis. "It's really showed me where we have surveillance gaps or lack of reporting."

The study authors acknowledge the gaps.

For example, comparing case counts from country to country isn't useful for understanding which countries have the most cases in animals because "low- and middle-income countries cannot search for COVID in animals as they need to target resources for testing to humans," says Desvars-Larrive.

The statistics about death rates are likely overestimates due to the high number of unreported asymptomatic cases. "The reported cases are only the tip of the iceberg and the symptomatic ones are the tip of the tip of the iceberg," says Desvars-Larrive. "The data don't show the true mortality rate. I think the case fatality rate in animal is low, actually."

The dashboard has so far collected 704 cases of COVID in animals from the Program for Monitoring Emerging Diseases and the World Animal Health Information System. There are 27 different species cited from 39 different countries. Those cases are typically confirmed through a PCR test.

The most confirmed cases are in mink, with 187 cases, followed closely by cats and dogs with 177 and 160 confirmed cases respectively. More often than not, the CDC theorizes that those cats and dogs got COVID from their owners, even though there hasn't been a large study confirming that theory.

In late 2020, an outbreak of COVID among mink on fur farms led Denmark to cull 17 million animals. The photo was taken at the farm run by Stig Srensen in Bording on Nov. 7, 2020. Ole Jensen/Getty Images hide caption

In late 2020, an outbreak of COVID among mink on fur farms led Denmark to cull 17 million animals. The photo was taken at the farm run by Stig Srensen in Bording on Nov. 7, 2020.

The question that looms over this enterprise: Can animals pass COVID back to humans?

In late 2020, an outbreak of COVID in mink fur farms resulted in some of the caretakers contracting the virus and ultimately led Denmark to cull 17 million of the animals. And late last year COVID infections transmitted from hamsters to people sparked an outbreak in Hong Kong.

Staff members of Hong Kong's Health Department collect samples at a pet store in January. Authorities linked at least 3 cases of COVID to infected hamsters. Li Zhihua/China News Service via Getty Images hide caption

Staff members of Hong Kong's Health Department collect samples at a pet store in January. Authorities linked at least 3 cases of COVID to infected hamsters.

The cases of COVID transmission from minks and hamsters both happened in situations where people were caretakers for a large number of animals. But just last month, the first evidence of COVID being passed from a cat to a person was reported. According to a study published last month in Emerging Infectious Diseases, the cat sneezed in the face of a veterinary surgeon who was testing the animal for COVID. Three days later the vet tested positive for COVID, but none of the vet's close contacts did, suggesting the vet got the virus from the infected cat.

There's also a concern that wildlife infected with COVID like a population of deer in Pennsylvania and other parts of North America could become reservoirs for the virus, meaning the virus can circulate in them, perhaps even mutate into more transmissible or virulent strains and get passed back to humans. "That could mean that there is a continuing risk from those animals for public health," says van der Poel. "But we have not seen [evidence of a wildlife animal reservoir] yet."

Scientists still don't know how those deer got COVID. It's unlikely the deer caught it from direct contact with humans, though transmission from contaminated wastewater or other infected animals, like feral cats, are possibilities.

As for the risk of pets and other animals transmitting the virus to humans? "I don't think that there is that is that is a major risk," says van der Poel. The CDC agrees that the risk of catching COVID from an animal is very low. Says van der Poel: "The risk to contract COVID from other people is far higher than from an animal."

Continued here:

First global tracker of animals who caught COVID has gaps but is still helpful : Goats and Soda - NPR

Both Pfizer and Moderna are working on bivalent booster vaccines made up of both the old formula and a new one that targets the Omicron BA.4 and BA.5 subvariants of the coronavirus. (Frederic J. Brown / AFP / Getty Images)

(CNN) This fall, Americans could get boosted with a mRNA COVID-19 vaccine unlike any thats come before.

Both Pfizer and Moderna are working on bivalent boosters: vaccines made up of both the old formula and a new one that targets the Omicron BA.4 and BA.5 subvariants of the coronavirus.

If the shots meet US Food and Drug Administration standards, they will probably be available as early as September, the FDA says.

But cases are high now. There are about 124,000 new cases reported each day far from the levels reported during the omicron surge, but nearing peak case rates from the delta wave and cases are more undercounted than ever.

Some experts wonder whether the omicron-specific boosters will come in time to make a difference and if they will actually offer more protection than the current shots.

A prediction game

The current shots are based on the original strain of the virus and offered nearly full protection, even from infection, early on. With new variants in circulation, the vaccines still are good at keeping people out of the hospital, but most scientists think people need a vaccine that offers more protection.

Dr. Michael Chang, a pediatric infectious disease specialist at Memorial Hermann Health System in Houston, thinks vaccines with an omicron component will be helpful within limits.

I just wish that the timing had been sooner so that we could actually be dealing with the kind of BA.5 surge that we have right now, he said.

With the highly contagious BA.5 subvariant now dominant, the goal of minimizing the number of infections is kind of lost, but the new vaccines should help keep hospitalizations and deaths down, Chang said.

I do think, anytime you can introduce additional strains or variants into a vaccine, the human bodys immune response tends to be a little bit broader and more durable and potentially longer-lasting, he said.

But its impossible to know at this point what variant will be dominant a couple months from now, how different it will be from the currently circulating variants or even how many cases there will be, because its hard to predict how humans will behave when cases rise and cases will most likely rise. Much like with the flu, scientists think the coronavirus transmits more efficiently in colder weather. It also spreads more easily as people spend more time indoors.

Dr. Edward Michelson, chair of the Department of Emergency Medicine at Texas Tech University Health Sciences Center in El Paso, is seeing many patients again, even those who had Omicron earlier in the year.

Omicron is not protecting people even a few months after they got sick with it. These subvariants are getting them again, much to my surprise, Michelson said. The good news is, most of the patients dont need hospitalization.

Still, 375 people are dying of Covid-related causes on average every day in the US, according to the CDC.

A new vaccine could really pay dividends

The Covid-19 Scenario Modeling Hub, a group of scientists across the country who create projections for the coming year, predicts an upswing in hospitalizations through early fall. But the model suggests that a booster campaign will make a dent in these numbers, according to Justin Lessler, a University of North Carolina epidemiologist who works with the group.

While scientists are still trying to determine exactly how well the new vaccines will protect people, Lessler said, the model assumes that the reformulated vaccine would have about 80% efficacy against infection with the currently circulating strains. But that depends on how many people actually get an updated booster.

Absent any real new variants, that kind of efficacy would be enough to really tamp down the current circulation if we have a broad uptake of the vaccines, Lessler said. A new vaccine could really pay dividends, particularly if we can get it to a broad swath of the population.

Ideally, public health campaigns could be built to encourage people to get a flu vaccine and a Covid-19 vaccine at the same time, he said.

Lessler presented an earlier version of the model to the FDAs independent vaccine advisers, who voted in June to recommend that the vaccine makers include BA.4 and BA.5 in the fall booster. They said that including an omicron element would offer more protection.

While its impossible for anyone to predict which variants will be circulating at the time, the goal as I see it is to add the subvariants that are most likely to give us that broad spectrum of antibodies that will hopefully prevent serious disease, which is really what were trying to do, said Dr. Archana Chatterjee, dean of the Chicago Medical School at Rosalind Franklin University of Medicine and Science and a member of the FDAs Vaccines and Related Biological Products Advisory Committee.

Europes approach

Some countries may go with vaccines based on the BA.1 Omicron subvariant this fall. Its not fully understood to what extent the sublineages of Omicron influence vaccine effectiveness, but some scientists who advise the World Health Organization argued that BA.1-based shots would be "more distinct" than other subvariants.

Moderna said its developing a booster for the European Union, the UK and Australia that uses the original strain and BA.1. The subvariant is largely extinct, but the company said its studies have shown that this booster candidate still drew significantly higher neutralizing antibody responses against BA.4 and BA.5 compared with the currently authorized booster.

Pfizer has said it too will make a vaccine that fits Europes needs, as well as the needs in the US.

"Our program continues to focus on all variants of concern and we remain committed to the public health needs as defined by regulators, Europe and elsewhere," a spokesperson for Pfizer told CNN in an email.

Pfizer submitted its bivalent BA.1-specific vaccine to the European Medicines Agency in mid-July and told CNN it will be ready to distribute this fall, pending authorization.

In the United States, a vaccine updated for BA.4/5 got the go-ahead for fall.

Dr. Larry Corey, a vaccine development expert and professor of medicine and infectious disease division at Fred Hutchinson Cancer Research Center in Seattle, said the data makes a strong case for the addition. Research on infections shows that the BA.4 and BA.5 subvariants seem to induce stronger immune response than BA.1 and BA.2.

We dont have the data yet. Certainly, we will know by the end of August, Corey said.

As with so much during the pandemic, scientists are making educated guesses and figuring things out as they go.

Well start sleeping better in a month, see whether it does well in animals, and well feel we made the right decision when we boost a bunch of people with the BA.4/BA.5 variants, Corey said.

A virus that breaks all the rules

Even as the virus changes, there is only so much vaccine makers can do, says University of Michigan epidemiologist Arnold Monto, who has served as acting chair of the FDAs vaccine advisory panel.

Basically, we can only use those viruses that we know about, Monto said.

Omicron was a big change from previous variants, he said, and most evolutionary virologists dont think there will be such a big leap again. Rather, the changes will probably be along the Omicron lines.

But then again, this has been a tricky virus. It has broken all the rules.

Regardless, Monto is confident that adding the BA.4/BA.5 element to the new vaccines will help.

While we know that the latest viruses that we are encountering that will go into the vaccine probably are not going to the be the viruses in the coming fall and winter, the answer is not to chase them but to try and catch up and broaden them, he said.

In other words, vaccine makers will want to have a wide a distribution of immunity in the population. Thats why theyll continue to include the original strain as well as Omicron.

It seems possible that well be facing different variants in the fall, but Dr. Eric Rubin, an adjunct professor of immunology and infectious disease at Harvard T.H. Chan School of Public Health, said there is a very reasonable argument that having some diversity in the immune response is still a good thing.

For me, the most important thing we can measure right now is the breadth of immunity and not try to guess which strain is going to be there. Thats probably more important than trying to guess what comes up in the fall, said Rubin, who is also on the FDAs vaccine advisory committee but was not a part of the Omicron booster discussion.

Evolution is trying to find its own path, however, and the virus will do whatever works for it as opposed to us. Down the line, he hopes well have even better vaccines that will prevent not just severe disease but infections as well.

I dont think a perpetual game of catchup is going to work forever. We need to think about new approaches, Rubin said.

But he emphasized that more people should get vaccinated and boosted in order to keep cases, hospitalizations and deaths down.

Some people should still get boosted now

The FDA is still encouraging adults 50 and older and those with compromised immune systems to get a second booster now, with the current formula. That would leave enough of an interval for them to get an updated booster in the fall.

The Biden administration has ended its conversations with the FDA about allowing adults under 50 to get a second booster with the current formula this summer.

Once boosters are updated for the fall, the FDA said, people who get boosted now may consider getting one. Scientists say it will be important to get this updated version.

The current vaccines do a pretty great job at keeping people out of hospitals," Rubin said. I dont really want to dismiss what weve got there. Of course, we always want better.

More here:

Updated COVID-19 Boosters Expected in September. Is That Too Late? - WTTW News

The total number of new cases of COVID-19 in Evanston was 163 for the week ending Aug. 3, compared to 185 for the week ending July 28, a decrease of 12%. The seven-day average of new cases in the state also decreased by 12%; hospitalizations declined by 4%.

Cook County, including Chicago, remained in the high community risk level. City officials say Evanston is in the medium risk level.

The number of new cases being reported is significantly lower than the actual number of new cases being contracted because many new cases are not reported. [1] Some researchers estimate the actual number of new cases is between six and 10 times higher than the number being reported.

Illinois: On Aug. 4, the number of new cases in the state was 4,149.

The seven-day average of new cases in Illinois on Aug. 4 was 4,345, down from 4,962 on July 28, a12.4% decrease. The chart below shows the trend.

Evanston: Evanston reported there were 28 new COVID-19 cases of Evanston residents on Aug. 3. (Evanston is reporting COVID-19 data with a one-day delay.)

There was a total of 163 new COVID-19 cases of Evanston residents in the week ending Aug. 3, compared to 185 new cases in the week ending July 28, a decrease of 12%.

The chart below shows the trend.

No Evanstonians died due to COVID-19 during the week ending July 28. The total number of Evanston deaths due to COVID-19 remains at 155.

Northwestern University. The latest data reported on NUs website shows that between July 22 and July 28, there were 65 new COVID-19 cases of faculty, staff or students. Cases of Evanston residents are included in Evanstons data for the relevant period, Ike Ogbo, Director of Evanstons Department of Health and Human Services, told the RoundTable. NU will update its data tomorrow.

The weekly number of new cases per 100,000 people in Illinois is 239 in the seven days ending Aug. 4.

As of Aug. 3, the weekly number of new cases per 100,000 people in Evanston was 220. As of Aug. 4, the number was 211 for Chicago, and 226 for Suburban Cook County. An accompanying chart shows the trend.

There were 1,416 hospitalizations in Illinois due to COVID-19 on Aug. 3, compared to 1,476 one week ago.

The chart below, prepared by the City of Evanston, shows the trends in hospitalizations due to COVID-19 at the closest two hospitals serving Evanston residents.

The U.S. Centers for Disease Control and Prevention and Illinois Department of Public Health look at the combination of three metrics to determine whether a community level of risk for COVID-19 is low, medium, or high. They are the total number of new COVID-19 cases per 100,000 people in the last seven days; the new COVID-19 hospital admissions per 100,000 in the last seven days; and the percent of staffed inpatient hospital beds occupied by COVID-19 patients. [2]

The City of Evanston reported this evening, Aug. 4, that Evanston is in the mediumrisk category. IDPH reported today that Cook County, including Chicago, is in the high risk category. Lake, DuPage, Will, Kane, and McHenry Counties are also in the high risk category.

While Evanston has more than 200 new cases per 100,000 people, the city reported this evening that Evanston has a seven-day total of 5.12 new hospital admissions per 100,000 people, and that it has 2.61% staffed inpatient hospital beds that are occupied by COVID patients (using a seven-day average).

The city has not said which hospitals or how many hospitals it is considering in making its analysis of community risk.

The CDC and IDPH recommend that people in a community with a high transmission rate should take the following precautions:

FOOTNOTES

1/The City of Evanston says the state, the county and the city do not have a mechanism to report, verify or track at home test results. Because a positive at home test is regarded as highly accurate, most people who test positive in an at home test do not get a second test outside the home that is reported to government officials. The number of new COVID-19 cases reported by IDPH and the City thus significantly understates the actual number of new cases that are contracted. Some studies estimate the cases are underestimated by 600% or more.

2/ CDC recommends the use of three indicators to measure COVID-19 Community Levels: 1) new COVID-19 cases per 100,000 population in the last 7 days; 2) new COVID-19 hospital admissions per 100,000 population in the last 7 days; and 3) the percent of staffed inpatient beds occupied by patients with confirmed COVID-19 (7-day average).

The chart below illustrates how these indicators are combined to determine whether COVID-19 Community Levels are low, medium, or high. The CDC provides many recommendations depending on whether the COVID-19 Community Level is low, medium, or high.

Read more:

COVID-19 update as of Aug. 4: Cook County stays in high community risk level, Evanston in the medium risk level - Evanston RoundTable

CNN

Theres no test for long Covid. Theres no specific drug to take or exercises to do to ease its symptoms. There isnt a consensus on what long Covid symptoms are, and some doctors even doubt that its real. Yet with vast numbers of people having had Covid-19, and estimates ranging from 7.7 million to 23 million long Covid patients in the US alone, researchers say it has the potential to be the next public health disaster in the making.

The Biden administration released two reports this week to initiate a whole-government effort to prevent, detect and treat long Covid. Two new studies also try to gather some of the small pieces of the puzzle that is long Covid.

President Joe Biden said in April that long Covid was a priority for his administration and ordered two reports: one that lays out a research agenda for the country and one that sketches out the federally funded services and support available for people in the US with long Covid. A total of 14 government departments and agencies worked together to create these new long Covid plans.

A national, US government-wide coordinated, action-oriented approach is urgently needed, the report says.

The plan proposes a new long Covid office within the Department of Health and Human Services, but it does not offer specifics on how to fund or staff the office.

The plan also calls for further federal investment and asks the private sector to do more. It builds on existing government research with a goal to accelerate and expand it.

These initial reports are an important step as HHS continues to accelerate research and programmatic support to address the consequences of the pandemic and work across sectors to ensure no one is left behind as we continue to build a healthier future, HHS says.

As of last week, more than 14 million children in the US have tested positive for Covid-19, according to the American Academy of Pediatrics. But its unclear how many have had long Covid.

One study published in July estimated that fewer kids have it than adults: 5% to 10% of children who have had Covid. Other researchers believe the number is much higher: around 26% of kids who have had Covid.

Children typically have some of the same symptoms of long Covid as adults do including breathing problems, changes in taste and smell, brain fog, anxiety, depression, fatigue and sleep disorders but they can also have serious problems that involve their organs.

A new report from the US Centers for Disease Control and Prevention says kids with long Covid have a much higher chance of serious lung, heart, kidney and pancreatic problems than kids who did not catch the virus.

For the sake of their study, the CDC researchers define long Covid as involving symptoms four or more weeks after a Covid-19 diagnosis.

They used a large medical claims database to look for 15 long Covid conditions among 781,419 children and adolescents who had a confirmed case of Covid-19.

The study, published Thursday, found that children with long Covid had higher rates of an acute pulmonary embolism or a blockage in the lung that can cause a sudden shortness of breath, anxiety, chest pain, palpitations and dizziness.

They also had a higher rate of potentially serious heart conditions like myocarditis, inflammation of the heart muscle that can cause a rapid or irregular heartbeat, chest pain, shortness of breath, fatigue and body aches. They had a higher rate of cardiomyopathy, a condition that makes it difficult for the heart muscle to deliver blood to the body and, in extreme cases, can lead to heart failure.

Children with long Covid also had a higher chance of kidney failure and were more likely to develop type 1 diabetes.

All of these conditions are rare or uncommon in this age group, the CDC says.

Early in the pandemic, people believed that Covid-19 wasnt as serious for children. Unlike with other respiratory viruses, children often have less severe symptoms than adults do, some studies show, but that is not always the case.

Dr. Amy Edwards, associate medical director of pediatric infection control at UH Rainbow Babies and Childrens Hospital in Cleveland, said she has seen children with more severe symptoms like myocarditis and cardiomyopathy, as well as some problems with blood clotting.

Its nice to see proof here that children experience long Covid symptoms, said Edwards, who was not involved in the study.

Edwards would have liked the researchers to distinguish between long Covid and MIS-C, a rare but serious condition that can also follow a case of Covid-19 and causes similar symptoms in the same window of time. But any study that raises awareness about long Covid can help, she said.

Several patients have come to her after other doctors dismissed the seriousness of their symptoms, she said. And she worries about the kids whose caregivers dont know to get their children the extra help from a doctor or Covid clinic that they may need to get better.

Those are the kids that keep me up at night. I worry about those kids, Edwards said.

The CDC researchers say they hope their study will encourage caregivers to get children vaccinated and to watch for these serious symptoms and conditions among kids who get Covid-19.

Covid-19 prevention strategies, including vaccination for all eligible children and adolescents, are critical to prevent SARS-CoV-2 infection and subsequent illness, including post-Covid symptoms and conditions, the study said.

Another new long Covid study finds that 1 in 8 adults with Covid-19 may have symptoms months beyond the initial infection.

The study, published Thursday in the journal The Lancet, found that 12.7% of people with Covid-19 had new or severely increased symptoms at least three months after their initial diagnosis, a smaller percentage than some other research has suggested.

The researchers surveyed 4,231 people who had Covid and 8,462 who didnt. They checked in on the participants 24 times between March 2020 and August 2021 and compared the two groups.

The researchers asked about 23 symptoms, and fatigue and shortness of breath were most common. Many people also reported chest pain.

The studys limitations include that it was done in the Netherlands and does not include an ethnically diverse population. Most of the data was collected before vaccines were available, and some studies suggest that vaccination can help protect against long Covid.

The research was also conducted before the dominance of the Omicron coronavirus variant, so its unclear whether the results would be the same in people infected with later strains.

The researchers say scientists must do more to determine what long Covid is and how many people get it, as well as how to treat or even prevent it.

Research has been hampered by an absence of a consensus on the prevalence and nature of the post-Covid-19 condition, the study says.

There is an urgent need for empirical data informing on the scale and scope of the problem to support the development of an adequate health-care response.

Link:

'The next public health disaster in the making': Studies offer new pieces of long Covid puzzle - CNN

August 2nd 2022Jeremy D. Bailoo

It is now over two years since the COVID-19 pandemic was declared and, to date, 6.4 million people have died as a consequence of contracting the disease. In the space of one year, vaccines were developed and their safety and efficacy evaluated and demonstrated. This shorter time frame for vaccine development was a result of over a decade of animal research into other coronaviruses, MERS and SARS, as well as decades of animal research into mRNA. 4.87 billion individuals are now fully vaccinated against COVID-19. Many restrictions related to the reduction of transmission of the virussuch as mask mandates and social distancinghave been removed as more individuals became vaccinated. Why? Because even though it is still possible to catch COVID-19, especially the new BA. 4 and BA. 5 variants, vaccinated individuals on average are spared the severe and often lethal effects of the disease.

It is important to note that there is still a great deal of disagreement among scientists with respect to the current guidance from the Centers of Disease Control. Some, for example, think that based on scientific data and knowledge of virology and immunology, the 5 day minimum quarantine period is insufficient to guard against transmission from the new COVID-19 variants. Others feel that given the lack of enforcement and adherence to strict policies early on with respect to safeguards of transmission against COVID-19, the disease is now a part of our new normal. And yet others think that the virus will be labeled as endemic by 2024. Importantly, endemic does NOT mean that the virus will persist in the population in a less harmful way. To an epidemiologist, endemic simply means that the rate of infection in a population is at some fixed level. In the case of COVID-19, this means that COVID-19 can still be widespread and deadly. It is unsurprising, therefore, that scientists are still hard at work developing new therapeutics, such as novel strategies for the administration of vaccines.

Last week, two such strategies made the news cycle. The first, a needle-free vaccine patchcalled a high-density microarray patch (HD-MAP)was found to be highly effective at neutralizing COVID-19 variants in mice. According to the lead author, Dr. McMillan:

The high-density microarray patch is a vaccine delivery platform that precisely delivers the vaccine into the layers of the skin which are rich in immune cells. We found that vaccination via a patch was approximately 11 times more effective at combating the Omicron variant when compared with the same vaccine administered via a needle. So far, every vaccine type we have tested through the patch, including subunit, DNA, inactivated virus, and conjugate produces superior immune responses compared to traditional needle vaccination methods. [emphases added]

The second strategyagain in miceinvolved a needle-free mucosal COVID-19 vaccine. According to the press release, current vaccines are injected intramuscularly in 2 or more doses and are effective in preventing COVID-19, but they do not induce efficient mucosal immunity or prevent viral transmission. Here, intranasal administration (that is, via the nose) of 2 doses of the phage T4-COVID-19 vaccine 21-days apart induced robust mucosal immunity, in addition to strong systemic humoral (in body fluids such as blood) and cellular immune responses. The intranasal vaccine induced broad virus neutralization.

All these responses were much stronger in intranasally vaccinated mice than that induced by the injected vaccine.

Key to both studies was that both novel methods of vaccination, be it the patch or via the nose, elicited a more robust immune response than the current method of intramuscular injection, particularly against the new variants of COVID-19. In light of the current prediction by leading virologists and epidemiologists that COVID-19 is indeed a part of our immediate and distant future, strategies such as these can serve to further reduce the severity of infection, and thus save lives. And all of this is made possible by animal research. #MPAR

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Animal research and our future with COVID-19 Speaking of Research - Speaking of Research

Republic file photo An exterior view of Columbus Regional Hospitals sign directing patients to the emergency entrance.

Republic file photo An exterior view of Columbus Regional Hospitals sign directing patients to the emergency entrance.

COLUMBUS, Ind. COVID-19 hospitalizations at Columbus Regional Hospital have climbed to their highest level in over five months as Bartholomew County records its first death from the virus in weeks.

On Wednesday, there were 18 people hospitalized with COVID-19 at CRH, up from 11 two weeks ago and the highest daily total since Feb. 22, according to the most recent data from the local coronavirus task force.

The figures include people who are hospitalized due to COVID-19 infections and people who test positive for the virus but are hospitalized for other reasons, the hospital said.

The majority of hospitalizations are because of COVID illness, said CRH spokeswoman Kelsey DeClue. But we also do have the factor of because of such high community spread, we have a few patients that are in the hospital with COVID but not because of it.

The overwhelming majority of people who are hospitalized at CRH due to coronavirus infections never got vaccinated or didnt keep up with their booster shots, DeClue said.

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CRH COVID-19 hospitalizations reach highest level in five months - The Republic

COVID

The Massachusetts Department of Public Health willno longer release daily COVID-19 reports. The following report represents seven days of data beginning Thursday, July 28.

Newly reported cases:9,646

Total confirmed cases:1,813,037

Newly reported deaths:41

Total confirmed deaths:19,939

Newly reported tests:133,419

Total tests:46,692,520

Percent positivity (seven-day average):7.97%

Hospitalized patients:560

Hospitalized patients who are fully vaccinated:334

Hospitalized patients who are primarily hospitalized for COVID-19 related illness:144

ICU patients:57

Intubated patients:15

View an interactive version of the states dashboardhere.

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Mass. reports 9,646 COVID-19 cases and 41 deaths over 7 days - Boston.com

Viruses that cause respiratory diseases like the flu and COVID-19 can lead to mild to severe symptoms within the first few weeks of infection. These symptoms typically resolve within a few more weeks, sometimes with the help of treatment if severe. However, some people go on to experience persistent symptoms that last several months to years. Why and how respiratory diseases can develop into chronic conditions like long COVID-19 are still unclear.

I am a doctoral student working in the Sun Lab at the University of Virginia. We study how the immune system sometimes goes awry after fighting off viral infections. We also develop ways to target the immune system to prevent further complications without weakening its ability to protect against future infections. Our recently published review of the research in this area found that it is becoming clearer that it might not be an active viral infection causing long COVID-19 and similar conditions, but an overactive immune system.

Keeping your immune system dormant when there isnt an active infection is essential for your lungs to be able to function optimally.

Your respiratory tract is in constant contact with your external environment, sampling around 5 to 8 liters (1.3 to 2 gallons) of air and the toxins and microorganisms in it every minute. Despite continuous exposure to potential pathogens and harmful substances, your body has evolved to keep the immune system dormant in the lungs. In fact, allergies and conditions such as asthma are byproducts of an overactive immune system. These excessive immune responses can cause your airways to constrict and make it difficult to breathe. Some severe cases may require treatment to suppress the immune system.

During an active infection, however, the immune system is absolutely essential. When viruses infect your respiratory tract, immune cells are recruited to your lungs to fight off the infection. Although these cells are crucial to eliminate the virus from your body, their activity often results in collateral damage to your lung tissue. After the virus is removed, your body dampens your immune system to give your lungs a chance to recover.

Over the past decade, researchers have identified a variety of specialized stem cells in the lungs that can help regenerate damaged tissue. These stem cells can turn into almost all the different types of cells in the lungs depending on the signals they receive from their surrounding environment. Recent studies have highlighted the prominent role the immune system plays in providing signals that facilitate lung recovery. But these signals can produce more than one effect. They can not only activate stem cells, but also perpetuate damaging inflammatory processes in the lung. Therefore, your body tightly regulates when, where and how strongly these signals are made in order to prevent further damage.

While the reasons are still unclear, some people are unable to turn off their immune system after infection and continue to produce tissue-damaging molecules long after the virus has been flushed out. This not only further damages the lungs, but also interferes with regeneration via the lungs resident stem cells. This phenomenon can result in chronic disease, as seen in several respiratory viral infections including COVID-19, Middle East Respiratory Syndrome (MERS), respiratory syncytial virus (RSV) and the common cold.

In our review, my colleagues and I found that many different types of immune cells are involved in the development of chronic disease after respiratory viral infections, including long COVID-19.

Scientists so far have identified one particular type of immune cells, killer T cells, as potential contributors to chronic disease. Also known as cytotoxic or CD8+ T cells, they specialize in killing infected cells either by interacting directly with them or by producing damaging molecules called cytokines.

Killer T cells are essential to curbing the virus from spreading in the body during an active infection. But their persistence in the lungs after the infection has resolved is linked to extended reduced respiratory function. Moreover, animal studies have shown that removing killer T cells from the lungs after infection may improve lung function and tissue repair.

Another type of immune cells called monocytes are also involved in fighting respiratory infections, serving among the first responders by producing virus- and tissue-damaging cytokines. Research has found that these cells also continue to accumulate in the lungs of long COVID-19 patients and promote a pro-inflammatory environment that can cause further damage.

Understanding the immunological mechanisms underlying long COVID-19 is the first step to addressing a quickly worsening public health problem. Identifying the subtle differences in how the same immune cells that protect you during an active infection can later become harmful could lead to earlier diagnosis of long COVID-19. Moreover, based on our findings, my team and I believe treatments that target the immune system could be an effective approach to manage long COVID-19 symptoms. We believe that this strategy may turn out to be useful not only for COVID-19, but also for other respiratory viral infections that lead to chronic disease as well.

Harish Narasimhan, PhD Candidate in Immunology, University of Virginia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Long COVID-19 and Other Chronic Respiratory Conditions After Viral Infections May Stem From an Overactive Immune Response in the Lungs - Nextgov