Category: Covid-19

Illnesses like the common cold and the flu have become endemic in human populations; everyone gets them every now and then, but for most people, they arent especially harmful. COVID-19 will eventually transition to endemic status at some point but when?

Possibly within two years, according to a new Yale study published July 5 in the journal PNAS Nexus.

To develop a better understanding of when and how COVID-19 might become endemic, Yale researchers turned to rats, which, like us, are also susceptible to coronaviruses. By collecting data on coronaviral reinfection rates among rats, they were able to model the potential trajectory of COVID-19.

There are many different types of coronaviruses, including SARS-CoV-2 the virus behind COVID-19 and several that cause the common cold. Animals like pigs and chickens live with endemic coronaviruses, too, and a key factor identified in the spread of animal and human coronaviruses alike is their tendency to evoke whats known as non-sterilizing immunity.

It means that initially there is fairly good immunity, but relatively quickly that wanes, said Caroline Zeiss, a professor of comparative medicine at Yale School of Medicine and senior author of the study. And so even if an animal or a person has been vaccinated or infected, they will likely become susceptible again.

Over the past two years, scientists have come to see that SARS-CoV-2 yields non-sterilizing immunity; people who have been infected or vaccinated are still at risk of reinfection. So experts expect that the virus wont go away any time soon.

To better understand what SARS-CoV-2 might do over time, scientists have used mathematical models. And given the strong similarities between animal and human coronaviruses, collecting relevant data from animals presents an opportunity to better understand SARS-CoV-2, says Zeiss.

There are many lessons to be learned from animal coronaviruses, she said.

In this study, Zeiss and her colleagues observed how a coronavirus similar to one that causes the common cold in humans was transmitted through rat populations. The team modeled the exposure scenario to resemble human exposures in the United States, where a portion of the population is vaccinated against COVID-19 and where people continue to face natural exposure to SARS-CoV-2. They also reproduced the different types of exposure experienced by people in the U.S., with some animals exposed through close contact with an infected rat (high risk of infection) and others exposed by being placed in a cage once inhabited by an infected rat (low risk of infection).

Infected animals contracted an upper respiratory tract infection and then recovered. After three to four months, the rats were then reorganized and re-exposed to the virus. The rates of reinfection showed that natural exposure yielded a mix of immunity levels, with those exposed to more virus through close contact having stronger immunity, and those placed in a contaminated cage (and therefore exposed to lower amounts of the virus) having higher rates of reinfection.

The takeaway, Zeiss says, is that with natural infection, some individuals will develop better immunity than others. People also need vaccination, which is offered through a set dose and generates predictable immunity. But with both vaccination and natural exposure, the population accumulates broad immunity that pushes the virus toward endemic stability, the study showed.

She and her team then used this data to inform mathematical models, finding that the median time it could take for SARS-CoV-2 to become endemic in the United States is 1,437 days, or just under four years from the start of the pandemic in March 2020.

In this scenario, according to the model, 15.4% of the population would be susceptible to infection at any given time after it reaches endemic phrase.

The virus is constantly going to be circulating, said Zeiss. So it will be important to keep more vulnerable groups in mind. We cant assume that once we reach the endemic state that everybody is safe.

Four years is the median time predicted by the model, she said, so it could take even longer to reach the endemic stage. And this doesnt take into account mutations that could make SARS-CoV-2 more harmful.

Coronaviruses are very unpredictable, so there could be a mutation that makes it more pathogenic, said Zeiss. The more likely scenario, though, is that we see an increase in transmissibility and probable decrease in pathogenicity. That means the virus would be easily transmitted between people but less likely to cause severe illness, much like the common cold.

There is precedent for this trajectory. In the late 1800s, what was known as the Russian flu killed approximately one million people around the world. Researchers now think the virus behind that pandemic was a coronavirus that originated in cattle and eventually evolved into one of the common cold viruses still in circulation. Reduced pathogenicity associated with the transition from epidemic to endemic status has also been observed in pig coronaviruses. And almost all commercial chicken flocks across the globe are vaccinated for an endemic respiratory coronavirus that has been present since the 1930s.

Longstanding experience with coronaviral infections in other animals can help us navigate a pathway to living with SARS-CoV-2.

However, endemic stability in the United States also depends on what happens to the virus elsewhere.

We are one global community, Zeiss said. We dont know where else these mutations are going to arise. Until we reach endemic stability around the entire globe, we are vulnerable here to having our U.S. endemic stability disrupted by introduction of a new variant.

But I think overall the pictures hopeful. I think we will be in endemic stability within the next year or two.

The study was funded by the National Science Foundation.

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For COVID-19, endemic stage could be two years away - Yale News

Covering COVID-19 is a daily Poynter briefing of story ideas about the coronavirus and other timely topics for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.

Halfway through 2022, is the United States national plan to just give up and accept that everyone will get infected with COVID-19 over and over?

I know more people who have COVID-19 infections now than I did at the height of the pandemic a year or two ago. None, fortunately, are deathly ill, thanks to vaccines. Virtually every newsroom I talk with lately has some COVID-19 cases.

The map below shows how we start the week, with virtually the entire county in red on the Centers for Disease Control and Preventions transmission map. It shows 87% of U.S. counties are at a high level and 95% of U.S. counties are at a substantial or higher level of COVID-19 transmission.

(CDC)

And yet news coverage is thin, and we seem determined to keep the pandemic running for another year. If we get a new vaccine targeted toward omicron variants, there is no assurance it will be effective against a quickly changing virus. And new studies just published in Lancet question whether booster after booster will offer the protection you would expect, especially for people who are considered high risk.

Know this: BA.5, which is moving across the globe as the new predominant variant, is severe. In Italy, for example, hospitals report they are increasingly having to use ventilators again to save patients. So far, in the U.S., where cases are rising, severe illness and hospitalizations are stable and well below the worst days of the pandemic with pockets of rising cases.

Intelligencer, part of New York Magazine, put it this way:

The newest wave of COVID infections and reinfections, fueled by more transmissible subvariants of the Omicron strain including BA.4 and BA.5, continues to grow across the U.S. As countless Americans gather(ed) over the July 4 holiday weekend, its entirely possible that there are more new daily infections happening in the country than at any other point in the pandemic other than the Omicron wave. And as the worrisome BA.5 subvariant rapidly rises to what will likely be global dominance, the U.S. isnt the only country experiencing a surge.

Last week, the U.S. test positivity rate which is now a more reliable indicator of case surges than official case counts reached a seven-day average of over 15 percent for the first time since February 3.

Dr. Bob Wachter, chair of the Department of Medicine at the University of California, San Francisco, tweeted this weekend:

(Screenshot/Twitter)

The danger of transmission is not just that people will get sick. Every new infection is an opportunity for the virus to evolve. COVID-19 needs a host to live in and find new ways to survive. Even if the host does not get deathly ill, they keep giving the virus a fighting chance to keep infecting. Intelligencer explains:

Against these new subvariants, vaccines and prior infection are proving less and less effective at preventing infections and reinfections. They also appear to be at least somewhat less effective at preventing hospitalizations as the coronavirus evolves particularly among the many un- and under-boosted seniors. A big wave of cases will be at best disruptive, will increase the risk of a lot more people developing long COVID, and will give SARS-CoV-2 many more opportunities to evolve. The impact of multiple COVID reinfections, which many Americans already have or soon will experience, remains unclear. Most importantly, BA.5 may be the worst COVID variant yet.

Its unique mutations make it the best equipped major variant to date at avoiding antibodies, which means it can likely reinfect people who recently had other Omicron subvariants. There is still a lot that scientists dont know about the strain, and the threat of other even worse variants emerging remains very real. (BA.2.75, an Omicron subvariant recently detected in India, is the newest one to rapidly attract scientists attention.)

Los Angeles County Director of Public Health Barbara Ferrer warns, All of the information to date points to the need for us to prepare for the likelihood of significant transmission in the upcoming weeks. In Los Angeles County, new case numbers are rising day after day.

Deadline reports:

The elevated daily test positivity rate likely represents the higher rate of transmission thats associated with the highly-infectious Covid sub variants and also the decline in routine testing at schools, which was much more comprehensive than in the community-at-large and so included many who wouldnt normally be tested.

The 7-day average number of new Covid-related hospitalizations is now 109 per day. Ferrer called that a stunning increase from the 84 new cases per day reported last week. Todays new hospitalizations average is also 78% higher than what it was just a month ago.

There is now concern again about increasing stress on the healthcare system.

The raw number of Covid-related new cases at area hospitals has risen to whats effectively a four-month high (since February 3) at 808.

Virtually all of the West Coast looks like Florida, listed as high risk.

(CDC)

Investigative Reporters and Editors sent out a note to all of us who attended the conference a week and a half ago in Denver to say:

We have had about 48 people report testing positive, most of them after the conference ended Sunday. That is a low number considering we had more than 1,400 people attending the conference in person and other conferences were going on at the same time as ours at the Gaylord Rockies.

I can tell you that most people did not wear masks, and there was a lot of close contact socializing and seating at the conference. But who knows whether the cases came from the conference as opposed to airports, Ubers, restaurants and bars, where they were loudly cheering the Stanley Cup playoff games.

Some news organizations accused U.S. Supreme Court Justice Clarence Thomas of endorsing a misunderstood claim about fetal cells being used to develop COVID-19 vaccines. The claim was part of Thomas dissent in an opinion involving religious objections to the vaccines.

But if you closely read what Thomas wrote, you could argue that he is not agreeing that there is a legitimate link between aborted cells and the vaccines, but that the people involved in the case the court was considering believe there is an objectionable connection. Thomas wrote:

Petitioners are 16 healthcare workers who served New York communities throughout the COVID19 pandemic. They object on religious grounds to all available COVID19 vaccines because they were developed using cell lines derived from aborted children.

The justice does not say if he agrees with the claim, but he does not refute it either, before going on to say he thinks the court should consider whether state laws should be allowed to require vaccinations for health care workers without offering a religious exemption.

Axios wrote, Clarence Thomas suggests COVID vaccines are created with cells from aborted children.

USA Today columnist Michael Stern tweeted:

Others were factually correct but still do not point out that the citation repeated the claim from the plaintiffs.

NBC reported, Justice Thomas cites debunked claim that Covid vaccines are made with cells from aborted children.'

Politico reported, Clarence Thomas cites claim that Covid vaccines are developed using cell lines derived from aborted children

Now, about those fetal cells. I have mentioned this before but it has been a while but since both abortions and COVID-19 are involved in this matter, it is worth exploring again. It is true that human cells are used in research for drugs of all sorts. But those cells were obtained decades ago from a 1985 voluntary abortion. As PolitiFact explained, while six Catholic bishops (out of 434) raised concerns over the vaccines origins, the U.S. Catholic Bishops said the vaccines links to abortion are very remote:

The vaccine is made using a modified cold virus called an adenovirus, which trains the bodys immune system to recognize the coronavirus. These adenoviruses are grown in a cell line called PER.C6, which was originally derived from an 18-week-old fetus aborted in 1985. To create the cell line, scientists isolated a cell from the fetus and cloned it to produce cells of the same genetic makeup. After the adenovirus grows in the cells, the cells themselves are purified away, essentially removed, to create the vaccine.

To some Catholics, the vaccines link to abortion, however distant, raises strong moral objections.

Pfizer and Moderna use mRNA technology, which gives the body instructions to identify the virus. The companies also made use of human fetal cells to test the safety and efficacy of their vaccines. This makes their use more acceptable U.S. Catholic bishops, who said in December that the connection is very remote from the initial evil of the abortion.

I believe that morally everyone must take (a) vaccine, Pope Francis said in a Jan. 10 interview for an Italian news program. It is the moral choice because it is about your life but also the lives of others.

Here is something to reflect on post-July 4. Gallup found:

While the current 38% expressing extreme pride is the historical low by four percentage points, the combined 65% reading for those who are extremely or very proud was two points lower in 2020 than it is today. The current readings are well below the trend averages of 55% extremely proud and 80% extremely or very proud.

Before 2015, no less than 55% of U.S. adults said they were extremely proud. The highest readings followed the 9/11 terrorist attacks, when patriotism surged in the U.S.

However, extreme national pride in the U.S. has been trending downward since 2015, falling below the majority level in 2018; it is nearly 20 points lower now than it was a decade ago.

(Gallup)

As you read this chart, it is useful to know when the data was collected. Gallup explains:

These data are from a June 1-20 poll that was conducted after mass shootings in Buffalo, New York, and Uvalde, Texas, claimed 31 lives, including 19 children. Bipartisan gun legislation in response to the shootings was passed shortly after the poll ended. The polling also preceded the U.S. Supreme Courts highly anticipated and controversial ruling overturning Roe v. Wade.

Maybe this would be a good time to point you to an essay that The Atlantic just published written by Republican Sen. Mitt Romney. Here is an excerpt:

Bolstering our natural inclination toward wishful thinking are the carefully constructed, prejudice-confirming arguments from the usual gang of sophists, grifters, and truth-deniers. Watching angry commentators on cable news, Im reminded of H. L. Menckens observation: For every complex problem, there is a solution that is clear, simple, and wrong.

When entire countries fail to confront serious challenges, it doesnt end well. During the past half century, we Americans have lived in a very forgiving time, and seeing the world through rose-colored glasses had limited consequences. The climate was stable, our economy dwarfed the competition, democracy was on the rise, and our military strength made the U.S. the sole global hyperpower. Today, every one of those things has changed. If we continue to ignore the real threats we face, America will inevitably suffer serious consequences.

In the last few weeks, I have done a lot of teaching for journalists from Brazil, China, Russia, Georgia and beyond. Those conversations help me to contextualize Americas current struggles and give me deep gratitude for our press freedoms. I do not know if I call what I feel pride as much as I call it gratitude for our freedom to report good and bad news, and gratitude for centuries of people who fought for that freedom and defended it.

Well be back tomorrow with a new edition of Covering COVID-19. Are you subscribed? Sign up hereto get it delivered right to your inbox.

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What exactly is the current national COVID-19 response plan? - Poynter

Media Advisory

Tuesday, July 5, 2022

COVID-19 was the third leading cause of death in the United States between March 2020 and October 2021, according to an analysis of national death certificate data by researchers at the National Cancer Institute, part of the National Institutes of Health. The study appears July 5 in JAMA Internal Medicine.

During the 20-month period studied, COVID-19 accounted for 1 in 8 deaths (or 350,000 deaths) in the United States. Heart disease was the number one cause of death, followed by cancer, with these two causes of death accounting for a total of 1.29 million deaths. Accidents and stroke were the fourth and fifth leading causes of death. In every age group 15 years and older, COVID-19 was one of the top five causes of death during this period.

When the authors analyzed deaths in 2020 (MarchDecember) and in 2021 (JanuaryOctober) separately, they found that in 2020, COVID-19 was the fourth and fifth leading cause of death among people ages 4554 and 3544, respectively. But in 2021, COVID-19 became the first and second leading cause of death in these age groups. Among those 85 and older, COVID-19 was the second leading cause of death in 2020, but dropped to third in 2021, likely because of targeted vaccination efforts in this age group.

The pandemic has also had an indirect effect on other causes of death in the United States. Past data have shown that deaths from other causes, including heart disease, accidents, stroke, Alzheimers disease, and diabetes increased from 2019 to 2020, possibly because people were reluctant to seek medical care for fear of catching COVID-19. Additional impacts of the pandemic on other causes of death may emerge in the years to come, the researchers said. For example, the pandemic prevented many people from getting regular cancer screening, which may result in future increases in cancer deaths.

Meredith S. Shiels, Ph.D., Division of Cancer Epidemiology and Genetics, National Cancer Institute

Leading Causes of Death in the United States during the COVID-19 Pandemic, March 2020 to October 2021 appears July 5 in JAMA Internal Medicine.

About the National Cancer Institute (NCI): NCI leads the National Cancer Program and NIHs efforts to dramatically reduce the prevalence of cancer and improve the lives of people with cancer. NCI supports a wide range of cancer research and training extramurally through grants and contracts. NCIs intramural research program conducts innovative, transdisciplinary basic, translational, clinical, and epidemiological research on the causes of cancer, avenues for prevention, risk prediction, early detection, and treatment, including research at the NIH Clinical Centerthe worlds largest research hospital. Learn more about NCIs intramural research from the Center for Cancer Research and the Division of Cancer Epidemiology and Genetics. For more information about cancer, please visit the NCI website at cancer.gov or call NCIs contact center at 1-800-4-CANCER (1-800-422-6237).

About the National Institutes of Health (NIH):NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

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COVID-19 was third leading cause of death in the United States in both 2020 and 2021 - National Institutes of Health (.gov)

TUESDAY 7/5/2022 1:53 p.m.

The Wisconsin Department of Health Services has reported 1,525,180 total positive coronavirus test results in the state and 13,150 total COVID-19 deaths.

The number of known cases per variant is no longer tracked as The Wisconsin Department of Health Services has updated its website, deleting that section.

Unable to view the tables below?Click here.

The DHS announced an attempt to verify and ensure statistics are accurate, some numbers may be subject to change. The DHS is combing through current and past data to ensure accuracy.

Wisconsins hospitals are reporting, that the 7-day moving average of COVID-19 patients hospitalized was 422 patients. Of those,49 are in an ICU. ICU patients made up 11.6%of hospitalized COVID-19 patients.

The Wisconsin Department of Health Services reports that 9,578,270 vaccine doses and 2,064,092 booster doses have been administered in Wisconsin as of July 5.

Unable to view the tables below?Click here.

The Wisconsin Department of Health Services is using a new module to measure COVID-19 activity levels. They are now using the Center for Disease Control and Preventions (CDC) COVID-19 Community Levels. The map is measured by the impact of COVID-19 illness on health and health care systems in the communities.

The Center for Disease Control and Prevention (CDC) reports that two counties in Wisconsin are experiencing high COVID-19 community levels. None of them are located in northeast Wisconsin.

18 counties in Wisconsin are experiencing medium COVID-19 community levels. Three of them are located in northeast Wisconsin: Forest, Langlade, and Oneida County.

Every other county in Wisconsin is experiencing low COVID-19 community levels.

For more information on how the data is collected, visit theCDCs COVID-19 Community Levels data page.

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Wisconsin adds under 750 new cases of COVID-19 - WeAreGreenBay.com

Covid-19 reinfections can bring some new risks of serious medical problems, hospitalization and death, a new study has found.

Protection provided by vaccines and prior infection has greatly improved Covid outcomes since the pandemics early days, and reinfections are typically less severe than initial ones. Yet each new infection carries a risk of medical problems, including hospitalization, death and long Covid, according to preliminary data from a study of patients in the Veterans Affairs health system.

Read more from the original source:

The Health Risks of Getting Covid-19 a Second (or Third) Time - The Wall Street Journal

Editor's Note Sign up for Unlocking the World, CNN Travel's weekly newsletter. Get news about destinations opening and closing, inspiration for future adventures, plus the latest in aviation, food and drink, where to stay and other travel developments.

(CNN) The US Centers for Disease Control and Prevention has put a Nordic travel favorite on its "high" risk list for Covid-19 along with two other places.

Representing three continents, the three destinations added to the list on Tuesday are:

Guatemala Morocco Sweden

Level 3, or "high," is now the top rung in terms of risk level and applies to places that have had more than 100 cases per 100,000 residents in the past 28 days. Level 2 and Level 1 are considered "moderate" and "low" risk, respectively.

All three new entries to Level 3 on Tuesday had previously been at Level 2.

There were almost 115 destinations at Level 3 on July 5. Level 3 locations account for almost half of the roughly 235 places monitored by the CDC.

Level 4, previously the highest risk category, is now reserved only for special circumstances, such as extremely high case counts, emergence of a new variant of concern or health care infrastructure collapse. Under the new system, no destinations have been placed at Level 4 so far.

More on Level 3

The village of Oia on Santorini island is a favorite tourist spot in Greece, which remains at the CDC's Level 3.

Francesco Riccardo Iacomino/Moment RF/Getty Images

Much of Europe has been stubbornly lodged at Level 3 for months with the summer travel season in full swing. As of July 5, the following popular European destinations were among those remaining at Level 3:

France Germany Greece Ireland Italy The Netherlands Norway Portugal Spain United Kingdom

Those aren't the only high-profile spots that find themselves at Level 3. Numerous other destinations around the world are among those in the "high" risk category, including the following:

Brazil Canada Costa Rica Malaysia Mexico South Korea Thailand Turkey

Level 2

Baalbek is a UNESCO World Heritage Site in Lebanon, which has moved up to the CDC's "moderate" risk category.

Luis Dafos/Moment RF/Getty Images

Destinations carrying the "Level 2: Covid-19 Moderate" designation reported 50 to 100 Covid-19 cases per 100,000 residents in the past 28 days. The CDC moved three places to this level on Tuesday:

Jordan Lebanon North Macedonia

The move was not good news for the Middle East's Jordan and Lebanon, which had been at Level 1. For North Macedonia in Europe's Balkans, the move was in a positive direction, having previously been at Level 3.

There are 20 places in the "moderate" risk category this week.

Level 1

To be listed as "Level 1: Covid-19 Low," a destination must have had 49 or fewer new cases per 100,000 residents over the past 28 days. Just two little island destinations were added to the category on July 5:

Saba Saint Pierre and Miquelon

Saba, in the Caribbean, had been at Level 2. Saint Pierre and Miquelon, a French archipelago south of Newfoundland, Canada, had been at Level 3.

A few of the more popular places in the "low" risk category this week include Indonesia, India and the Philippines.

Unknown

The Hungarian Parliament is seen through the arches of Fisherman's Bastion in Budapest. The CDC warns against travel to places where the Covid-19 risk is "unknown."

Alexander Spatari/Moment RF/Getty Images

Finally, there are the destinations the CDC has deemed to be of "unknown" risk because of a lack of information. Usually, but not always, these are small, remote places or places with ongoing warfare or unrest. Four places were added to this category this week:

Haiti Hungary Iran Mozambique

Haiti, Iran and Mozambique had all been at Level 1 last week. Hungary, a favorite stop on the Eastern European travel circuit, had been at Level 3.

The CDC advises against travel to these places precisely because the risks are unknown. Other destinations in this category that typically draw more tourist attention include French Polynesia, Macau and the Maldives.

A medical expert weighs in on risk levels

Transmission rates are just "one guidepost" for travelers' personal risk calculations, according to CNN Medical Analyst Dr. Leana Wen.

We've moved into "a phase in the pandemic where people need to make their own decisions based on their medical circumstances as well as their risk tolerance when it comes to contracting Covid-19," said Wen, who is an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health.

There are other factors to weigh in addition to transmission rates, according to Wen.

"Another is what precautions are required and followed in the place that you're going and then the third is what are you planning to do once you're there," she said.

"Are you planning to visit a lot of attractions and go to indoor bars? That's very different from you're going somewhere where you're planning to lie on the beach all day and not interact with anyone else. That's very different. Those are very different levels of risk."

Vaccination is the most significant safety factor for travel, since unvaccinated travelers are more likely to become ill and transmit Covid-19 to others, Wen said.

And it's also important to consider what you would do if you end up testing positive away from home.

Top image: The island of Tjorn off the west coast of Sweden. (Peter Adams/Stone RF/Getty Images)

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CDC puts Nordic favorite and 2 other places on 'high' risk list for Covid-19 - CNN

News Release

Tuesday, July 5, 2022

Findings could give insight into long-term neurological symptoms of COVID-19.

A study from the National Institutes of Health describes the immune response triggered by COVID-19 infection that damages the brains blood vessels and may lead to short- and long-term neurological symptoms. In a study published in Brain, researchers from the National Institute of Neurological Disorders and Stroke (NINDS) examined brain changes in nine people who died suddenly after contracting the virus.

The scientists found evidence that antibodiesproteins produced by the immune system in response to viruses and other invadersare involved in an attack on the cells lining the brains blood vessels, leading to inflammation and damage. Consistent with an earlier study from the group, SARS-CoV-2 was not detected in the patients brains, suggesting the virus was not infecting the brain directly.

Understanding how SARS-CoV-2 can trigger brain damage may help inform development of therapies for COVID-19 patients who have lingering neurological symptoms.

Patients often develop neurological complications with COVID-19, but the underlying pathophysiological process is not well understood, said Avindra Nath, M.D., clinical director at NINDS and the senior author of the study. We had previously shown blood vessel damage and inflammation in patients brains at autopsy, but we didnt understand the cause of the damage. I think in this paper weve gained important insight into the cascade of events.

Dr. Nath and his team found that antibodies produced in response to COVID-19 may mistakenly target cells crucial to the blood-brain barrier. Tightly packed endothelial cells help form the blood-brain barrier, which keeps harmful substances from reaching the brain while allowing necessary substances to pass through. Damage to endothelial cells in blood vessels in the brain can lead to leakage of proteins from the blood. This causes bleeds and clots in some COVID-19 patients and can increase the risk of stroke.

For the first time, researchers observed deposits of immune complexesmolecules formed when antibodies bind antigens (foreign substances)on the surface of endothelial cells in the brains of COVID-19 patients. Such immune complexes can damage tissue by triggering inflammation.

The study builds on their previous research, which found evidence of brain damage caused by thinning and leaky blood vessels. They suspected that the damage may have been due to the bodys natural inflammatory response to the virus.

To further explore this immune response, Dr. Nath and his team examined brain tissue from a subset of patients in the previous study. The nine individuals, age 24 to 73, were chosen because they showed signs of blood vessel damage in the brain based on structural brain scans. The samples were compared to those from 10 controls. The team looked at neuroinflammation and immune responses using immunohistochemistry, a technique that uses antibodies to identify specific marker proteins in the tissues.

As in their earlier study, researchers found signs of leaky blood vessels, based on the presence of blood proteins that normally do not cross the blood brain barrier. This suggests that the tight junctions between the endothelial cells in the blood brain barrier are damaged.

Dr. Nath and his colleagues found evidence that damage to endothelial cells was likely due to an immune responsediscovering deposits of immune complexes on the surface of the cells.

These observations suggest an antibody-mediated attack that activates endothelial cells. When endothelial cells are activated, they express proteins called adhesion molecules that cause platelets to stick together. High levels of adhesion molecules were found in endothelial cells in the samples of brain tissue.

Activation of the endothelial cells brings platelets that stick to the blood vessel walls, causing clots to form and leakage to occur. At the same time the tight junctions between the endothelial cells get disrupted causing them to leak, Dr. Nath explained. Once leakage occurs, immune cells such as macrophages may come to repair the damage, setting up inflammation. This, in turn, causes damage to neurons.

Researchers found that in areas with damage to the endothelial cells, more than 300 genes showed decreased expression, while six genes were increased. These genes were associated with oxidative stress, DNA damage, and metabolic dysregulation. This may provide clues to the molecular basis of neurological symptoms related to COVID-19 and offer potential therapeutic targets.

Together, these findings give insight into the immune response damaging the brain after COVID-19 infection. But it remains unclear what antigen the immune response is targeting, as the virus itself was not detected in the brain. It is possible that antibodies against the SARS-CoV-2 spike protein could bind to the ACE2 receptor used by the virus to enter cells. More research is needed to explore this hypothesis.

The study may also have implications for understanding and treating long-term neurological symptoms after COVID-19, which include headache, fatigue, loss of taste and smell, sleep problems, and brain fog. Had the patients in the study survived, the researchers believe they would likely have developed Long COVID.

It is quite possible that this same immune response persists in Long COVID patients resulting in neuronal injury, said Dr. Nath. There could be a small indolent immune response that is continuing, which means that immune-modulating therapies might help these patients. So these findings have very important therapeutic implications.

The results suggest that treatments designed to prevent the development of the immune complexes observed in the study could be potential therapies for post-COVID neurological symptoms.

This study was supported bythe NINDS Division of Intramural Research (NS003130) and K23NS109284, Roy J. Carver Foundation, and the Iowa Neuroscience Institute.

NINDSis the nations leading funder of research on the brain and nervous system.The mission ofNINDSis to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease.

About the National Institutes of Health (NIH):NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

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Small NIH study reveals how immune response triggered by COVID-19 may damage the brain - National Institutes of Health (.gov)

Federal workplace safety officials just announced an extension of its COVID-19 National Emphasis Program (NEP) that focuses its inspection targeting efforts on hospital and skilled nursing care facilities that treat or handle COVID-19 patients while also signaling that a broader and permanent rule for the healthcare industry is on the horizon. The June 30 announcement from the Occupational Safety and Health Administration (OSHA) reemphasized the agencys promise to devote 15% of its inspections per region to four healthcare-related NAICS classifications for the foreseeable future, extending the focus past the original July 7 expiration date. This will continue to enable OSHA to police those facilities COVID-19 protocols and documentation while the agency endeavors to fast-track a permanent COVID-19-related healthcare rule.

What Should Healthcare Employers Do?

We have previously highlighted the steps healthcare employers should take to prepare themselves for the increased scrutiny of an OSHA inspection under the NEP, specifically those falling under the following NAICS classifications:

We suggest you follow the guidance provided in these two Insights:

Hospitals, Skilled Nursing Facilities Targeted for COVID-19 Scrutiny 5 Steps to Help Ensure You are Ready for Federal Initiatives (March 9, 2022)

4-Step Plan for Healthcare Employers as OSHA Increases Scrutiny (June 23, 2022)

Whats On the Horizon?

In speaking about the announcement of the extension, Doug Parker, the agencys head, noted OSHA is attempting to finalize the permanent standard by the fall a nine-month turnaround for a process that typically takes seven years. Parker also indicated that, once the COVID-19 rule was in place, OSHA would turn its focus to a permanent infectious disease standard directed at the healthcare industry along with other high-risk industries beyond healthcare something Fisher Phillips will be monitoring closely.

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OSHA Extends COVID-19 Emphasis Program for Healthcare Industry While Plotting Permanent Rule - JD Supra

Novavax Inc. is billing its long-awaited COVID-19 shot as an appealing option for vaccine skeptics who skipped out on shots that used new messenger RNA technology but new Morning Consult data indicates it isnt likely to move the needle.

The Maryland biotechs protein-based vaccine is in use around the world, but after a federal advisory group cleared the shot last month, 77% of unvaccinated U.S. adults said they wouldnt get a traditional protein-based COVID-19 shot if one were available. The vast majority cited concerns over potential side effects, mirroring qualms theyve had with COVID-19 shots overall throughout the vaccination campaign.

The unwillingness was reported across ages, racial groups and political leanings. And it suggests Novavaxs biggest market may not be with the unvaccinated, but among those who are due for booster shots, health care providers and public health communicators said.

Few Unvaccinated Adults Are Interested in Traditional Protein-Based COVID-19 Shots

Survey conducted June 18-23, 2022, among a representative sample of 1,788 unvaccinated U.S. adults, with an unweighted margin of error of +/-2 percentage points.

Could we persuade some of those individuals who refuse to take mRNA to take Novavax? Yeah, I think we should try, said Dr. Peter Hotez, co-director of the Center for Vaccine Development at Texas Childrens Hospital and dean of the National School of Tropical Medicine at Baylor College of Medicine. But officials should also try to understand what the reasons are that theyre not going to do it.

In the survey, some unvaccinated groups were less staunchly against traditional shots than others. Democrats, those in urban areas, adults under 35 and Black and Hispanic adults were all less likely than the average unvaccinated American to say they would skip a traditional protein-based shot.

Among the fully unvaccinated, Novavaxs shot may primarily appeal to those who were wary of Moderna Inc.s and Pfizer Inc.-BioNTech SEs mRNA vaccines, said Stefanie Friedhoff, an associate professor at the Brown University School of Public Health who works with the nonprofit Rockefeller Foundation on its COVID-19 vaccine equity initiative.

The vaccination decision plays out very differently for Americans based on all kinds of factors, and different communities have different questions, Friedhoff said. The narrative of, some people will never change, in terms of who will take the vaccine, its beyond unuseful. Its harming our vaccination efforts, because these decisions are made on a continuum and changing factors might change our take.

Side Effects Are Top Concern Among Unvaccinated Adults Who Dont Want Protein-Based COVID-19 Shots

Survey conducted June 18-23, 2022, among a representative sample of 877 unvaccinated U.S. adults who said they would not get a traditional protein-based COVID-19 shot, with an unweighted margin of error of +/-3 percentage points.

Some people may be prone to conspiracy theories or believe misinformation about the shots, for example, while others may lack trust in the government or health care systems. And others may have changed their minds over the course of the pandemic or have gotten COVID-19 themselves, lessening their sense of urgency around getting vaccinated.

Should the Food and Drug Administration authorize Novavaxs COVID-19 shot, Friedhoff cautioned that health officials, community leaders and providers should be on the lookout for new misinformation from the anti-vaccine movement, which railed against mRNA.

Those who are passionately advocating for others not to get vaccinated will shift their narratives, Friedhoff said.

The survey picked up on the concern over mRNA technology. Nearly 3 in 10 unvaccinated adults view traditional protein-based vaccines as safe, compared with 17% who said mRNA shots are safe. And theyre far less likely than vaccinated adults to view either type of shot as safe.

Asked how Novavax plans to market its vaccine in the United States, a company spokesperson said the need for additional vaccine options continues and that the biotech is engaged in educational efforts aimed at increasing understanding about our science.

Meanwhile, the Novavax vaccine could be an appealing booster dose for those who have already gotten vaccinated, Hotez said, but only if the biotech can prove that the shot offers strong levels of protection following mRNA vaccination. Last week, Novavax said final clinical trial data is expected in September and that the company is prepared to supply an Omicron-based vaccine this fall as part of the U.S. booster campaign.

The fall booster effort may prove challenging, given the ongoing campaign has lagged. Federal data shows that fewer than half of vaccinated adults have gotten a first booster dose.

There was a terrible mistake made by the Centers for Disease Control and Prevention, in calling people with two doses fully vaccinated, said Hotez, whose lab developed a COVID-19 vaccine that is available in India. That was never really the case, but they still clung to that outdated concept.

Dr. Leana Wen, an emergency physician and professor at George Washington University, said the most eager cohort for Novavaxs shots will likely be those who have kept up to date on their COVID-19 vaccinations.

I dont even think that we will need to spread the message, Wen said. There is a group of people who are so eager to get the best protection possible, they are awaiting any news of anything that they can be taking.

The FDA is reviewing changes to Novavaxs manufacturing process before it authorizes the shot, but even if it gains clearance, it may be some time before the vaccine is widely available. While the company has pledged 110 million doses to the United States and another 1.1 billion for low-income countries, its struggled to ramp up production. Novavaxs spokesperson said the company is working with the U.S. government to finalize our order and has millions of doses ready to ship.

Ultimately, Hotez said Novavax is under pressure to deliver, given it received $1.6 billion in federal funding through the Trump administrations Operation Warp Speed vaccine development program. He has said his own team got $400,000 from the U.S. government to develop its shot.

If it were offered to me, I would take it in a heartbeat, Hotez said of the Novavax vaccines promise as a COVID-19 booster. Right now, the American people are balking at getting an mRNA booster every few months.

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Novavax's Traditional Vaccine for COVID-19 Could Hit the U.S. Soon. Most Unvaccinated Adults Wouldn't Be Swayed - Morning Consult

The COVID-19 pandemic shocked the world affecting organizations and institutions that supported the delivery of nutrition programs at all levels. To timely respond to the needs of the nutrition community, the Agile Core Team for NutritionMonitoring (ACT-NM) group, a collaboration amongst UNICEF, USAID, WHO and USAID Advancing Nutrition, developed an analytical framework for exploring pathways for the impact of COVD-19 pandemic on key nutrition outcomes.

The comprehensive analytical framework encompasses the six maternal, infant and young children nutrition targets endorsed by WHA, the outcomes monitored towards the elimination of malnutrition in all its forms, one of the Sustainable Development Goals(SDGs) targets.

Linking the overarching categories of food, health, social protection, education, water, and sanitation to outcomes and impacts of COVID-19 on nutrition, the Analytical Framework the is an useful tool that allows users to construct context-specific pathwaysto study the impact of COVID-19 and future shocks.

The Analytical Framework Visualizercan be accessed at https://www.who.int/tools/covid19-nutrition-analytical-framework

Health care professionals, community health workers, business owners, and policy makers can all delve into the impacts of a given shock, exploring various contexts that expand into underlying determinants. Policy makers can also click on the visualizersinteractive features to expand, collapse, and build out their own pathways and explore the impacts of specific shocks, such as a lockdown or supply chain disruption. The tool allows for the download a pool of potential data sources for the severalfactors included in the framework, the data mapping tool.

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Launch of the COVID-19 impact on nutrition Analytical Framework - World Health Organization