Category: Covid-19

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‘Summer is not a good time’ | Heat is up and COVID numbers are rising – KHOU.com

June 14, 2022

According to wastewater, Houston's 14-day average COVID-19 positivity rate is up to 21.1%. Last week, the rate was 17.4%.

HOUSTON When it comes to COVID-19 cases, the numbers aren't good, in fact, they're going in the wrong direction yet again, according to Harris County health officials.

"Summer is not a good time for us here in Texas and in the southern United States," said Dr. Peter Hotez with Baylor College of Medicine.

As temperatures rise and people look for ways to cool off, health officials are worried about a different kind of wave.

"Summer of 2020, that's when we had our first big wave," Hotez said. "And then we got hit again in 2021 and that was pretty devastating."

Houston's 14-day average COVID-19 positivity rate is up to 21.1%, according to our wastewater. Last week, the rate was 17.4%.

"Numbers are starting to go up again, but we have some problems in that so many people are doing home testing that we don't know what the real numbers are," Hotez said.

Dr. Esmaeil Porsa, President and CEO of Harris Health System, said testing wastewater is a good indicator.

"It has actually been proven to be very effective because you don't have to get tested," Porsa said.

The Houston Health Department wastewater virus load is 502%, which is up from 281% last week. Porsa said that while the latest variant (omicron) is extremely contagious, symptoms are mild.

"I think everybody is letting their guard down," Porsa said.

Clyde Riggenbach is relying on his faith.

"We have to have hope and faith for all things," Riggenbach said. "It's a safe country as long as people are living like they're supposed to."

Hotez shares the same sentiment but hopes we'll learn from past mistakes.

"I think we're going to be in this pandemic for most of this year and the hope is that when we head into 2023, we do better," Hotez said.

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'Summer is not a good time' | Heat is up and COVID numbers are rising - KHOU.com

COVID-19 threats increased as the pandemic raged – Salt Lake Tribune

June 14, 2022

The disgruntled patient walked into the University of Utah urgent care facility without a mask, and when staff gave him one to wear, he left it dangling against his chest.

A security member told the patient that the face covering was important for protecting him, staff and other patients. The man pulled the mask up but left his nose jutting out over the top of it.

A report on the standoff over face coverings describes the ensuing escalation, as the man continued to argue with nurses and other staff members. He lunged toward a medical assistant with his arms raised as if he was going to hit the health care worker, the report states. The patient hurled misogynistic profanities at the assistant, threatened to sue and spat in the security officers direction as he was leaving the building.

The clash appears among more than 200 pages of incident reports from the University of Utah Health, documenting the harassment and abuse suffered by workers at one of the states largest health systems during the pandemic.

The documents echo many of the stories Utah medical providers have been sharing about patients and families pushing back against masking and or lashing out at them in conspiracy-fueled rants about COVID-19.

I had several health care workers contact me that said they were the victims of this type of aggression, said Utah Rep. Robert Spendlove, who sponsored legislation this year to protect hospital and clinic staff. One of the things that really struck me was they said theres not only the physical harm but theres mental harm from having to withstand this kind of abuse.

The incident reports, obtained by The Salt Lake Tribune through a public information request, show that these conflicts ranged from some minor grousing to physical aggression or threats of violence. Health care workers were accused of being foot soldiers for a political agenda; struggled to calm belligerent visitors; and faced heightened exposure to disease when people with COVID-19 refused to cover their faces.

The increase in workplace violence showed up across the states health care systems during the pandemic, not just at the University of Utah Health, according to data collected by the Utah Hospital Association.

Within the states four largest health care systems, reported instances of threats or verbal abuse went up 13% from 2019 to 2021, the association found. And the number of times police had to get involved jumped even more dramatically, increasing by 18% between the two years.

Representatives of the University of Utah Health say these conflicts are not the norm within their workplaces but dont dismiss the impact that aggression and harassment can have on their employees.

Our staff are a cornerstone of our success as a health system, said Dustin Banks, director of support services for U of U Health. If we dont give the tools for our staff members to be safe, they will leave the workforce. That is not something that we want.

(Charlie Ehlert | University of Utah Health) Health care workers attend to patients in the intensive care unit at University Hospital in Salt Lake City, Wednesday, March 9, 2022.

The incident reports describe several conflicts that flared up between hospital staff and visitors of COVID-19 patients or sick people who were resisting the medical care they needed.

One patient hit a nurse on her arm while she was trying to perform a COVID-19 test. Other people argued with their health care team about what treatment they would receive.

A man who was in the hospital with coronavirus became confused and demanded to leave, even though his care team had determined it wouldnt be safe. The patient shoved an aide and cursed at one of the nurses who was giving him a low dose of sedatives.

The records show there were conflicts over oxygen masks, with one coronavirus patient complaining that the supplemental oxygen made his belly blow up like a balloon.

Another time, the daughter of a patient with COVID-19 rushed into a critical care unit without permission and was going from room to room looking for her father. When staff members tried to stop her, she hit one of them and screamed: You people gave my father COVID. Im going to kick your asses.

And even when the disagreements werent directly about coronavirus, the disease made arguments more dangerous, the records show.

One report describes an interaction between security staff and an irate woman who was walking from car to car at a hospital, yelling that she needed a ride. Because she wouldnt stop screaming, the security officers began walking her off the property while she mocked and threatened to cough on them.

They later learned shed recently been diagnosed with COVID-19.

(Francisco Kjolseth | The Salt Lake Tribune) A sign encourages people to continue wearing masks on the University of Utah campus on Tuesday, Nov. 30, 2021.

Mandatory masks were among the most common sources of pandemic-related friction between health care workers and patients or visitors, the University of Utah Health records suggest.

For instance, a woman at an eye center refused to wear a face covering, telling the staff that masks were all an experiment. Others blew off the rules and argued they didnt have to don a mask because theyd already been vaccinated or because they believed it would cause health problems.

One man declared that he was exempt from masking and would get a stroke if he covered his face. When he finally relented, he warned that if he had a health complication because of the mask, the hospital would hear from his attorney.

Hospital workers told security about a patient who angry that she had to wear a surgical mask rather than a mesh one ripped through a provided package of face coverings and contaminated all of them. She then threw the box at an employees head.

In one document, a pair of visitors wouldnt comply with the hospitals masks even though one was unvaccinated and the other had tested positive for COVID-19 just a few days before.

Several of the conflicts described in the records escalated to aggression or threats of violence.

The husband of a cancer patient who was getting an MRI exploded at medical staff who asked him to put on a mask and began yelling and swearing at the workers and another patient in the waiting room.

The man made everyone feel in danger and unsafe when he stood up and got in the face of the hospital workers, according to the report.

Security officers were so alarmed by the mans aggressive behavior that university police led him off the property. They decided he could drop his wife off at the hospital in the future, but he wasnt allowed to enter the building for her subsequent treatments.

Another time, a man wearing a gaiter mask became enraged when hospital workers told him that it wasnt an approved face covering but told him he could contact the university offices to ask for an exemption. A security officer told the man that if he wouldnt comply and wasnt at the medical center for an appointment or emergency, he needed to leave.

Id like to see you try, the man mumbled, according to the report.

As he was leaving the building, the man apologized to one of the officers for getting angry. But he continued to criticize the centers customer service manager, pointing to a pocket knife on his cargo shorts and suggesting he might have used it if the security officers hadnt arrived.

Health care workers nationwide are five times more likely to be injured because of an on-the-job attack than people in other industries, and theyve been experiencing growing levels of aggression over the last decade, according to federal labor data.

Banks said the University of Utah Health has been proactive in tamping down these incidents, launching a program to send multidisciplinary behavioral response teams into potentially volatile situations. The teams typically include a security staff member, nurses and a social worker and focus on non-violent responses when a patient or family member begins acting aggressively, he said.

The team receives a briefing before heading into the situation and chooses one point person to do all the talking during the encounter, with the other members standing by for support.

We have found that is incredibly successful, Banks said.

To head off these flare-ups, the universitys security officers also make rounds through the hospitals every day to check in with the nurses and help prevent patients from becoming agitated in the first place.

But the pandemic has exacerbated hostilities, with the rancorous fights over public health measures such as vaccines and masks, says David Gessel, executive vice president of the Utah Hospital Association.

That became a proxy for a lot of people in feeling like with the pandemic, that they had no control in their lives or they didnt like where things were going or were just fed up, he said.

Urged by state health care leaders to help stem this rise in violence, Utah lawmakers earlier this year passed a bill that would stiffen penalties for assaulting medical providers or hospital staff.

Previously, state law only enhanced criminal penalties for attacks against health care workers if they were performing emergency or life saving duties at the time of the assault. But with the changes brought forward by Spendlove, someone could face increased repercussions for harming nurses, doctors and other hospital staff whenever theyre at work, regardless of the care theyre providing.

A handful of lawmakers raised concerns about offering special protections to a particular profession, and Spendlove said hes generally against these types of carveouts. But health care workers are essential employees, he notes, and theyre also legally prohibited from turning away people who need help.

So these workers are essentially forced to care for these people that may be abusive or aggressive, the Sandy Republican said. I think they definitely merit and deserve an extra layer of protection.

As he prepared his bill, Spendlove says he heard alarming stories about attacks in health care settings, including a nurse who suffered a concussion after being assaulted in the workplace.

Gessel said even with the jump in workplace violence, attacks are still relatively uncommon in the states hospitals and health clinics. And he recognizes that hospitals are often reluctant to speak out about harassment and abuse toward employees, not wanting to make people feel uncomfortable or fearful walking through their doors.

We want the public to feel like they can come, and its a place of healing and hope and health and safety, he said.

Hes also optimistic that as the pandemic recedes, so will some of the anger and aggression toward medical providers.

Spendloves bill, which took effect in May, contains a five-year sunset provision meaning it will go away at that point unless legislators extend it. Gessel hopes by that time, the state wont need it anymore.

Editors note This story is available to Salt Lake Tribune subscribers only. Thank you for supporting local journalism.

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COVID-19 threats increased as the pandemic raged - Salt Lake Tribune

Study Finds Ivermectin Not Effective at Treating COVID-19 – Democracy Now!

June 14, 2022

The original content of this program is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License. Please attribute legal copies of this work to democracynow.org. Some of the work(s) that this program incorporates, however, may be separately licensed. For further information or additional permissions, contact us.

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Study Finds Ivermectin Not Effective at Treating COVID-19 - Democracy Now!

Daywatch: About one in every dozen CPS students contracted COVID-19 this school year – Chicago Tribune

June 14, 2022

Good morning, Chicago.

Tornado sirens in downtown Chicago signaled an evening of wild weather last night that will usher in temperatures in the upper 90s today.

Damage reports were being tallied Monday evening after heavy rains and high winds hit the Chicago area, forecasters said. Castro said there were reports of 84 mph wind gusts at OHare International Airport and a structural collapse in Bellwood.

Heat indexes are expected to top 105 degrees for two consecutive days on Tuesday and Wednesday, a benchmark that triggered a National Weather Service heat advisory.

And at Wrigley Field, Tribune photographer Brian Cassella captured some striking images of Monday nights storm.

Here are the top stories you need to know to start your day.

COVID-19 tracker | More newsletters | Puzzles & Games | Daily horoscope | Ask Amy | Todays eNewspaper edition

Chicago Public School Kenwood Academy High School students return to school, Jan. 12, 2022, after five days off for COVID-19 protocol discussions between CPS and CTU. (Antonio Perez / Chicago Tribune)

About one in every dozen Chicago Public Schools students contracted COVID-19 this school year, the districts first year of full-time, in-person learning since the pandemic began. With CPS closing out the school year Tuesday, the district is reporting nearly 22,500 cases among 272,000 students from the first week of school in August through last week.

Each case represents an individual report of COVID-19, so a student reinfected with the virus would count as two cases. The data doesnt include CPS charter, contract and alternative learning students, of which there are 58,000.

This was supposed to be a recovery year for CPS, but thats not the way it unfolded.

Carmen Navarro Gercone, a longtime official in the sheriff's office pictured in February, has lost her bid to stay on the June 28 primary ballot for Cook County sheriff. (John J. Kim / Chicago Tribune)

The Democratic primary for Cook County sheriff will officially be a two-man contest this month after challenger Carmen Navarro Gercones last hope for getting back on the ballot was dashed.

The Illinois Supreme Court declined Monday to hear Navarro Gercones appeal in a case that started with incumbent Sheriff Tom Dart challenging her candidacy under a controversial new state law that requires all sheriff contenders to be certified law enforcement officers.

It was the final twist in a high-profile saga that saw Navarro Gercone, a former top aide to Dart who now works for the Circuit Court clerks office, get tossed from the ballot, reinstated and then removed once more.

Mayor Richard M. Daley chats with Ald. Ricardo Munoz in 2002. (NANCY STONE / CHICAGO TRIBUNE)

Former Chicago Mayor Richard M. Daley has been released from the hospital and is now at a rehabilitation center after experiencing what his doctor called a neurological event.

Daley, 80, spent five nights at Northwestern Memorial Hospital after falling ill. His physician, Dr. Eric Terman, said in a news release Daley experienced a neurological event and is expected to recover fully.

Meta employees celebrate the 15th anniversary of the social media company in Chicago during an event at their new Loop offices, June 8, 2022. (E. Jason Wambsgans / Chicago Tribune)

When Meta, the social media giant formerly known as Facebook, hosted the grand opening for its Fulton Market headquarters last week, it was a celebration delayed more than two years by the pandemic. Despite welcoming hundreds of cheering employees, the celebration, which also marked Metas 15th anniversary in Chicago, was muted by a hybrid return to office that could make the expansive new workplace a monument to the past.

Companies across Chicago are beginning to herd employees back into the office, but after two years of remote working and the lingering COVID-19 pandemic, it is a tentative process at best. Employees used to the flexibility of remote working are balking at a mandatory return, while hybrid work schedules turn the once busy office into a fortress of solitude.

The team behind Kasama walks the red carpet while attending the James Beard Foundation Awards at the Lyric Opera House, June 13, 2022 in Chicago. (Armando L. Sanchez / Chicago Tribune)

The James Beard Foundation Awards returned to Chicago on Monday after a two-year hiatus, celebrating the best and brightest of the culinary world on a national scale. Prominent chefs and restaurateurs from across the country gathered at Lyrics Civic Opera Building for the award ceremony, which began just as sirens began to blare in downtown Chicago for a tornado warning.

Of the nine Chicago chefs, restaurants and bars up for six awards during the ceremony, only Virtue chef-owner Erick Williams took home an award, for the regional Best Chef: Great Lakes category, which pitted him against chefs in Illinois, Indiana, Ohio and Michigan.

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Daywatch: About one in every dozen CPS students contracted COVID-19 this school year - Chicago Tribune

Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study | Scientific Reports -…

June 14, 2022

Study population

106 patients with laboratory-confirmed COVID-19 who were admitted to the ICU for treatment of ARDS at University Hospital Aachen, Germany, were recruited to this retrospective subcohort study. 59 of these patients were published8,9 previously in respect to a single-centre cohort study, COVAS. Patients in the present study were admitted between February 24, 2020, until May 15, 2021 and fulfilled the following criteria (Fig.1). Inclusion criteria for the subcohort were a positive respiratory SARS-CoV-2 PCR result and admission to the ICU requiring mechanical ventilation due to COVID-19 and ARDS. Exclusion criteria of this study were lack of consent, positive PCR result or age of majority, as well as pregnancy or inability to legally give consent. In order to calculate the variability of FPG levels, we excluded patients who did not have at least 3 days of consecutive glucose measurements during their admission to the ICU.

Flowchart of patient enrolment. The register population represents all patients included in the COVAS cohort. A total of 106 out of 271 patients were enrolled in this subgroup analysis. ARDS acute respiratory distress syndrome; DGV daily glycaemic variability.

Since University Hospital Aachen is designated a tertiary care facility, patients with minor or mild severity were triaged by the emergency services towards other regional hospitals. Thus, the present study includes a significant number of patients with severe clinical course from other regional hospitals, who were either previously screened for ECMO or other high-end treatment methods.

All patients gave their written informed consent before participating in the COVAS study, which complies with the Declaration of Helsinki. Study approval was acquired by the ethics committee at the Faculty of Medicine of RWTH Aachen University (EK080/20). This trial has been retrospectively registered in the German Clinical Trials Register (DRKS00027106).

Based on national guidelines10 and internal standards of operation, all patients with an FPG above 180mg/dl were titrated to a FPG target of 150mg/dl using continuous insulin infusion during ICU admission.

ARDS was defined according to the Berlin definition11. Comorbidities were defined as conditions that were known before hospital admission. Likewise, previous medication included any medication prescribed before admission to our hospital.

Baseline vital parameters are characterized as the first available measurements after ICU admission. Respiratory disease was defined as a composite of bronchial asthma, chronic obstructive pulmonary disease, obstructive sleep apnoea syndrome and pulmonary malignancy. Moreover, composite heart disease is a composite of arterial hypertension, atrial fibrillation, coronary artery disease, heart failure and previous myocardial infarction. History of T2D was specified either by a previously known T2D diagnosis, diabetes medication at time of hospital admission or HbA1c at admission of6.5% (48mmol/mol).

For outcome measures, the primary endpoint was defined as all-cause mortality during ICU admission. As exposures, high and low glycaemic variabilities during ICU admission were defined as daily glycaemic variability (DGV)25.5mg/dl and DGV<25.5mg/dl. To determine this cut-off for DGV, we fitted a regression tree model (25.5mg/dl) and compared it to a cut-off based on a hazard ratio of 1 derived from a Cox-PH model, which was adjusted for age, sex and history of T2D (31mg/dl). The regression tree-based cut-off demonstrated a higher AUC (0.729 vs. 0.689) in 30-day survivalROC curves, therefore we used the cut-off DGV value of 25.5mg/dl in further models and testing rather than the Cox-PH based cut-off of DGV 31mg/dl.

We collected symptoms on admission, co-morbidities and previous medication either per interview/questionnaire in alert patients or per admission/discharge documents from our emergency department and previous hospitals. Vital parameters were acquired immediately on the first day of ICU admission. On subsequent days, we recorded the worst daily value, in the context of shock and/or respiratory failure. All data was manually retrieved from our EHR software, which automatically transfers ventilation parameters at set intervals from the ventilator to the patients electronic health record. In order to reduce confounders in ventilation parameters due to this automated process and initially extreme ventilation parameters, we intentionally omitted the first four hours of ventilation parameters after admission and intubation to allow the staff to properly configure the ventilator according to the patients requirements at the time.

PCR results were acquired by quantitative real-time polymerase-chain-reaction (PCR). Diagnosis of COVID-19 was established by positive respiratory PCR from either a throat swab or tracheal fluid in awake patients and bronchoalveolar lavage (BAL) in intubated patients. Respiratory PCR was repeated on days 7 and 14 of admission. Additionally, BAL, serum, stool and urine samples were tested for bacterial, fungal and viral pathogens, including Legionella pneumophila and Streptococcus pneumoniae antigens as well as SARS-CoV-2. All patients received daily routine laboratory tests including glucose levels between 03:00 05:00 AM.

All statistical analysis was performed in R version 4.1.212 using packages ggplot2 (version 3.3.5)13 for scatter plots, tangram (0.7.1)14 for tables and Rmarkdown for text. The characteristics were described as median (IQR) for continuous and percentages for categorical variables. Categorical parameters were compared by Fishers Exact Test and continuous parameters by KruskalWallis test. Statistical significance was determined as a p-value below 0.05. We opted not to do any parameter imputation for missing values.

In order to select a suitable metric to evaluate fasting plasma glucose variability, we first compared established parameters: standard deviation (SD), Neumans (root) mean square of successive differences (MSSD and rMSSD), bias corrected coefficient of variation (CoefVar) and median of the absolute difference between successive values (DGV, daily glycaemic variability). In order to compute DGV, we first calculated the absolute differences of FPG (FPG) for consecutive days, where FPGday represents the fasting plasma glucose of the current day and FPGday+1 the fasting plasma glucose of the following day (Eq.1):

$$Delta FP{G}_{day}=left|FP{G}_{day}-FP{G}_{day+1}right|$$

(1)

Then, we calculated DGV as the median of all (FPG) values for each patient.

We calculated MSSD and rMSSD using the psych package (version 2.1.9)15 and CoefVar using the implementation provided by the DescTools package (version 0.99.44)16.

The cut-off DGV was estimated by regression tree analysis using rpart (version 4.1.16)17. Through rms (version 6.2.0)18, smooth hazard ratios and survival analysis were examined in Cox-proportional-hazard (Cox-PH) regression models, which were compared by likelihood ratio (LR) test, Akaike information criterion (AIC) and Concordance Index (C-Index).

All Cox-PH models were tested for the proportional hazard assumption as well as for collinearity utilising the variance inflation factor (vif function rms18 package). While recommendations vary, in accordance with most studies, we defined a VIF<5 as acceptable.

Before analysis and based on clinical judgment we selected the following confounders for adjustment of our final Cox-PH models: age, sex, BMI, history of type 2 diabetes (T2D), dialysis during admission, dexamethasone treatment, median procalcitonin (PCT) and FPG during ICU admission. To reduce overadjustment of the models, we removed BMI and dialysis during admission from the final model. For this model we additionally used Firths penalized maximum likelihood bias reduction method, provided by the coxphf (version 1.13.1)19 package.

To evaluate the accuracy of the outcome-based cut-offs, we compared the AUC in 30-day survival models using the implementation of survivalROC (version 1.0.3)20.

Utilizing survminers (version 0.4.9)21 ggforest function, forest plots were created. Furthermore, KaplanMeier estimator was calculated with the survival (version 3.2.13)22 package and plotted with survminers (version 0.4.9)21 ggsurvplot function, which compared survival curves and computed p-values using the log-rank test.

Study approval was acquired by the ethics committee at the Faculty of Medicine of RWTH Aachen University (EK080/20). The present research complies with the Declaration of Helsinki.

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Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study | Scientific Reports -...

This Covid wave might be the start of our ‘new normal,’ experts sayhere’s what you need to know – CNBC

June 12, 2022

Packed indoor events and fully booked flights where masks are few and far between suggest that the pandemic is a distant, unpleasant memory.

In reality, Covid-19 cases have steadily increased nationwide since the end of March. Hospitalization and death rates remain low, and will likely stay that way. But beyond that, many experts say they're unable to predict the trajectory of the current wave, including how and when it will end.

Given the past two years of pandemic precedent, that's somewhat surprising and one indicator of many that the ongoing rise in cases is noticeably different than previous Covid surges. Some experts say it might even mark the beginning of the country's "new normal."

Here's why, and what that means for the future of the pandemic:

Previous surges were caused by the emergence of new Covid variants. This wave is powered predominantly by waning immunities, says Dr. David Dowdy, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health and a physician with Baltimore Medical Services.

The immunity people gained by recovering from the omicron wave in December and January is fading away, allowing omicron and its subvariants "to make [their] rounds again," Dowdy tells CNBC Make It. And many Americans aren't taking particularly strict Covid precautions anymore, assuming that if they get sick, they'll likely recover without ever being hospitalized.

Taken together, that helps explain the past couple months of rising cases: The country's seven-day rolling average of new daily cases is up to 109,032 as of Wednesday, according to the Centers for Disease Control and Prevention. That large number is likely a significant undercount, with many people now relying on at-home tests and not reporting their results or eschewing Covid tests entirely.

"We're seeing this disconnect between the 'official' number of cases, for example, and percent positivity or other indicators like wastewater surveillance," Dowdy says.

The winter omicron wave had an incredibly steep peak. By contrast, this one is more driven by "lots of mini waves that come and go," says Dr. Howard P. Forman, director of the health care management program at the Yale School of Public Health.

Forman says the virus' geographic circulation is different this time around: When New York is struggling, for example, Florida may be doing just fine, and vice versa. Those regional waves are often driven by different omicron subvariants sometimes multiple at once making the virus additionally difficult to tamp down. Forman says this is likely what Covid will look like for the foreseeable future.

That doesn't mean reinstating lockdowns or mask mandates. Rather, Forman says, people should be prepared to adjust their behavior and take necessary precautions when there's an outbreak in their area using metrics like hospitalization rates instead of new daily cases to gauge local severity.

"People have to understand that we're still going to have real waves and new concerning variants, and they do need to continue to pay attention and treat this as though it's still a pandemic," Forman says.

The U.S. case load could eventually fall back to its early-March levels. Or, this could be a glimpse of what Covid-19 looks like as an endemic virus in other words, our "new normal."

Either way, instead of trying to live like it's 2019 again, Forman recommends building Covid prevention strategies into your daily routine. Primarily, he says, that means staying up-to-date on your vaccines and getting comfortable with self-testing at home on a semi-regular basis.

Dowdy says you should take an at-home test an hour before heading to any big event or visiting loved ones, because "that's going to be the best indication of your contagiousness level at that time." You should also take an at-home test about five days after any potential exposure to the virus, he adds.

If you test positive, quarantine or isolate yourself appropriately even if that means having to skip something important in your life. Forman says you could also consult your doctor about an antiviral treatment like Paxlovid, which is becoming increasingly available for treating Covid infections.

"Paxlovid works best if used to treat patients early, which means testing is even more important now than it was a few months ago," he says.

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This Covid wave might be the start of our 'new normal,' experts sayhere's what you need to know - CNBC

‘More work’ to be done’: Key takeaways from the WHO report on origins of the Covid-19 pandemic – CNN

June 12, 2022

The 27-member scientific advisory group convened by the World Health Organization said available data suggests the virus jumped from animals to humans but gaps in "key pieces of data" meant a complete understanding of the pandemic's origins could not be established.

The team, called the Scientific Advisory Group for the Origins of Novel Pathogens (SAGO), was formed last year to recommend further areas of study to better understand the pandemic's origins and as well as the emergence of future pathogens.

"Studying origins of any novel pathogen or pandemic is incredibly difficult," said Dr. Maria Van Kerkhove, WHO's Covid-19 technical lead for its Health Emergencies Program. "There is a lot more work that needs to be done, in China and elsewhere."

Here are key takeaways from the report.

Animal origins

Current data suggests a zoonotic origin of SARS-CoV-2 -- which means the virus originated in animals and jumped to humans.

The most closely genetically related viruses were found to be beta coronaviruses identified in bats in China and Laos, according to SAGO.

"However, so far neither the virus progenitors nor the natural/intermediate hosts or spill-over event to humans have been identified," the report said.

The group pointed to published surveys of animals sold at the Huanan Seafood Market in Wuhan, where the virus was first identified.

Between 2017 and 2019, the survey showed that several species known to be susceptible to SARS-CoV-2, such as racoon dogs and red foxes, were present in the market. But those animals were not sampled in the studies presented to the team by invited Chinese scientists.

SAGO said further information about studies into the testing of these animals, as well as tracing back to source farms and serologic investigations into people who farmed and sold or traded the animals have been requested.

The seafood market

Another area the group identified for further study is the Huanan Seafood Market in Wuhan, which investigations suggest "played an important role early in the amplification of the pandemic."

Several of the patients first detected in December 2019 had a link to the market, and environmental samples from the market tested positive for the virus, the report said.

However, once again, big gaps remain.

It is not clear how the source of the virus was introduced to the market and where the initial spill over to humans occurred, the group said, adding that follow-up studies have not been completed.

"There is a need to examine environmental samples collected from specific stalls and drains at the market in January 2020 that tested positive for SARS-CoV-2 in areas known to have sold live animals," SAGO said.

"Other essential studies include detailed mapping of upmarket trade of wild/domestic animals sold in Wuhan City and Hubei Province and clinical history and seroprevalence of SARS-CoV-2 antibodies in humans and animals from the source farms of animals sold at Wuhan markets," the report said.

The lab-leak theory

SAGO's preliminary report said it "remains important to consider all reasonable scientific data" to evaluate the possibility that Covid-19 spilled into the human population through a laboratory incident.

However, the group said there "has not been any new data made available" to evaluate this theory and recommended further investigation "into this and all other possible pathways."

Essentially, because lab leaks have happened in the past and there is no new data available, the group said this theory cannot be ruled out.

Three members from Russia, Brazil and China objected to this recommendation, "due to the fact that from their viewpoint, there is no new scientific evidence to question the conclusion" of a WHO report from March 2021 that describes the lab leak theory as "extremely unlikely."

Nonetheless, experts have roundly condemned the theory of a laboratory origin for the virus, saying that there's no proof of such origins or of a leak.

'We do not yet have the answers'

According to the report, more than 200 samples initially tested positive for the antibodies but when tested again were not found to be positive. SAGO said it has requested further information on the data and methods used to analyze the samples.

Similarly, the group recommended further study of 76,000 Covid patients identified in the months before the initial outbreak in Wuhan in December 2019 and who were later discounted.

SAGO also said it supports further investigations in any part of the world where there is "firm evidence" of coronavirus in humans before the recognized outbreak.

The preliminary report was based on studies reviewed by SAGO, which was only able to assess information that was made available to them through published reports or presentations from invited scientists.

On Thursday, WHO Director-General Tedros said it has been two-and-a-half years since Covid-19 was first identified but "we do not yet have the answers as to where it came from or how it entered the human population."

He urged the importance of scientific work being kept separate from politics.

"The only way this scientific work can progress successfully is with full collaboration from all countries, including China, where the first cases of SARS-CoV-2 were reported," he said.

CNN's Katherine Dillinger contributed reporting.

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'More work' to be done': Key takeaways from the WHO report on origins of the Covid-19 pandemic - CNN

You Can Get Covid Again. Heres What to Know About Reinfection. – The New York Times

June 12, 2022

If youre one of the millions of Americans who have already had Covid-19, you may be wondering how long you will have immunity from the coronavirus. Earlier in the pandemic, most people assumed that getting infected had at least one upside: that you would be protected against future encounters with the virus. But as the latest wave heads toward the Western region of the country and the virus shows no signs of easing up, reinfections seem to have become common. Already, many people are reporting second or even third infections with newer variants.

Experts have warned that exposure to the coronavirus through vaccination or infection does not mean that you are completely protected from future infections. Rather, the coronavirus is evolving to behave more like its closely related cousins, which cause common colds and infect people repeatedly throughout their lives.

Ive thought, almost since the beginning of this pandemic, that Covid-19 is eventually going to become an inevitable infection that everybody gets multiple times, because thats just how a new respiratory virus gets established in the human population, said Dr. Amesh Adalja, an infectious-disease specialist at Johns Hopkins University.

However, the coronavirus doesnt yet fit into clear seasonal patterns like the other common cold viruses. It can also cause debilitating symptoms that persist for months or years in some people, and has claimed the lives of millions of others. So what can you do to protect yourself, not only from infection but also reinfection? We asked experts for answers to common questions.

Before Omicron, reinfections were rare. A team of scientists, led by Laith Abu-Raddad at Weill Cornell Medicine-Qatar, estimated that a bout with Delta or an earlier coronavirus strain was roughly 90 percent effective in preventing a reinfection in both vaccinated and unvaccinated people. But Omicron really changed that calculus, said Dr. Abu-Raddad, an infectious disease epidemiologist.

After Omicron emerged, prior infections only provided about 50 percent protection against reinfection, Dr. Abu-Raddads study showed. The coronavirus had acquired so many mutations in its spike protein that newer versions became more transmissible and better able to evade immunity. That means you can catch a version of Omicron after recovering from an older, non-Omicron variant. You can even get sick with one of the newer Omicron subvariants after getting over a different version of it.

Other factors also increase your vulnerability to reinfection, starting with how long it has been since you had Covid. Immune defenses tend to wane after an infection. A study published in October 2021 estimated that reinfection could occur as soon as 3 months after contracting Covid-19. While these findings were based on the genome of the coronavirus and accounted for expected declines in antibodies that could fight off the virus, the study did not account for new variants like Omicron that were radically different from older variants. Because of how different Omicron is, your protection may wane even sooner. In a study published in February that has not yet been peer-reviewed, scientists from Denmark found that some people got reinfected with the BA.2 sublineage of Omicron as soon as 20 days after they got infected with the original Omicron BA.1.

Because the virus is infecting more people now, your chances of being exposed and getting reinfected are also higher, Dr. Abu-Raddad said. And while its unclear if some people are simply more susceptible to Covid-19 reinfection, researchers are beginning to find some clues. People who are older or immunocompromised may make very few or very poor quality antibodies, leaving them more vulnerable to reinfection, Dr. Abu-Raddad said. And early research shows that a small group of people have a genetic flaw that cripples a crucial immune molecule called interferon type I, putting them at higher risk of severe Covid symptoms. Further studies could find that such differences play a role in reinfection as well.

For now, you should treat any new symptoms, including a fever, sore throat, runny nose or change in taste or smell, as a potential case of Covid, and get tested to confirm if you are positive again.

The good news is that your body can call on immune cells, like T cells and B cells, to quash a reinfection if the virus sneaks past your initial antibody defenses. T cells and B cells can take a few days to get activated and start working, but they tend to remember how to battle the virus based on previous encounters.

Your immune system has all kinds of weapons to try and stop the virus even if it gets past the front door, said Shane Crotty, a virologist at the La Jolla Institute for Immunology in California.

Many of these immune cells build up their protections iteratively, Dr. Crotty said. That means that people who are vaccinated and boosted are especially well equipped to duke it out with the coronavirus. Similarly, people who have been infected before are able to keep the virus from replicating at high levels if they get reinfected. And most people who have logged encounters with both the vaccine and the coronavirus build up a hybrid immunity that may offer the best protection.

The result is that second or third infections are likely to be shorter and less severe.

Dr. Abu-Raddad, who has been tracking reinfections among large groups of people in Qatar, has already started seeing this promising pattern in patient records: Of more than 1,300 reinfections that his team identified from the beginning of the pandemic to May 2021, none led to hospitalization in an I.C.U., and none were fatal.

But just because reinfections are less severe, it doesnt mean that they are not terrible. You may still run a fever and experience body aches, brain fog and other symptoms. And theres no way of knowing if your symptoms will linger and become long Covid, Dr. Adalja said.

It is possible that each Covid infection forces you into a game of Russian roulette, though some researchers hypothesize that the risk is highest right after your first infection. One of the risk factors for long Covid is having high levels of virus in your system early in an infection, and you are likely to have such a high viral load the first time you are infected, Dr. Abu-Raddad said. In subsequent infections, your body is better prepared to fight off the coronavirus so you may be able to keep the virus at low levels until it is completely cleared, he said.

Many of the tools and behaviors that help protect against infection can still help you avoid reinfection, Dr. Abu-Raddad said. There is no magical solution against Covid reinfection.

Getting vaccinated and boosted, for example, is a good idea even after youve had Covid. You only need to wait a few weeks after an infection to get a shot. The vaccines will bolster your antibody levels, and research shows that they are effective in preventing severe outcomes if you get sick again. Scientific confidence in vaccine-induced immunity was and is much higher than infection-induced immunity, Dr. Crotty said.

Additional measures, like masking indoors and in crowded spaces, social distancing and improving ventilation where possible, can provide another layer of protection. But because most people and communities have largely dropped these protections, it is up to individuals to decide when to adopt extra precautions based on their risk of getting Covid and how much theyd like to avoid it.

If you had an infection just last week, you probably dont have to mask up, Dr. Adalja said. But as a month or so passes from your infection and new variants start circulating in the U.S., it may make sense for high risk individuals to do that. People who are trying to avoid getting Covid because theyre going on a cruise soon or because they need a negative P.C.R. test for some other reason may consider taking precautions. Covid protections dont have to be one-size-fits-all.

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You Can Get Covid Again. Heres What to Know About Reinfection. - The New York Times

COVID-19 cases on Cape Cod decline for third week in a row May June – Cape Cod Times

June 12, 2022

Novavax aims to bring new COVID shot option to US

Americans may soon get a new COVID-19 vaccine option a more traditional kind of shot known as a protein vaccine. It's late in the pandemic for a new choice, but Novavax is hoping to find a niche with those who are unvaccinated or need boosters. (June 2)

AP

The number of new COVID-19 cases on Cape Cod has declined for the third week in a row, according to a weekly report on cities and towns released by the state Department of Public Health Thursday.

During the last two-week reporting period, from May 22 to June 4, new COVID-19 cases in Barnstable County on Cape Cod declined by about 215 to approximately 910, the DPH said.

State public health officials reported 1,125 new coronavirus cases for the previous two-week reporting period on June 2; 1,380 on May 26; and 1,440 on May 19.

The DPH also said the 14-day testing positivity rate for Cape Cod had declined to 8.64% Thursday from 9.29% June 2.

Daily casenumbers are also down, state public health officials said.

They said Thursday that there were 1,989 newly confirmed cases of COVID-19 in Massachusetts, for a total of 1,736,088 since the pandemic began.

There were also 261 new probable cases for a total of 155,710.

In their daily report Thursday, DPH officials said Barnstable County had 53 new coronavirus cases for a total of 39,572 since the pandemic started.

Hospitalizations also are down.

From the archive: As nation records 1M COVID deaths, Cape Cod remembers those we lost

The DPH said that as of June 8, Massachusetts hospitals had 505 patients with COVID-19, 62% of whom or 313 were fully vaccinated and 33% of whom or 169 were being treated primarily for a COVID-19-related illness.

Cape Cod Hospital in Hyannis had 12 patients with coronavirus, one of whom was in intensive care. Falmouth Hospital had four, none of whom were in the ICU.

The 16 Cape patients representa decline from 23 reported last Thursday.

DPH officials said in their Thursday daily report that there were 17 new fatalities among people with confirmed cases of COVID-19 for a total of 19,531 since the pandemic began.

There were no new deaths of people with probable cases. The number of fatalities from probable cases stands at 1,195 in Massachusetts.

More: Patients are waiting for days in Cape Cod ERs for behavioral health care. Here's why.

Barnstable County had one new coronavirus death, the DPH said Thursday, for a total of 598.

The two-week COVID-19 case count, total case count and 14-day testing positivity rate for Cape Cod towns follows.

Barnstable (214; 10,269; 9.66%); Bourne (72; 3,829; 6.38%); Brewster (36; 1,553; 5.91%); Chatham (22; 881; 8.73%); Dennis (50; 2,448; 7.70%); Eastham (15; 527; 8.38%); Falmouth (151; 4,839; 9.73%); Harwich (39; 2,200; 7.23%); Mashpee (68; 2,699; 8.74%); Orleans (19; 821; 8.76%): Provincetown (less than five; 464; 1.54%); Sandwich (97; 3,761; 9.34%); Truro (less than five; 183; 1.92%); Wellfleet (12; 290; 16.00%; and Yarmouth (111; 4,755; 9.63%).

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COVID-19 cases on Cape Cod decline for third week in a row May June - Cape Cod Times

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