Category: Covid-19

The pandemic and its attendant anxiety, boredom, and loneliness have not been good for people who struggle with alcohol use. According to a new study published in JAMA Network Open, alcohol-related deaths among U.S adults ages 25 and up increased 25% in 2020, and 22% in 2021, compared to average annual deaths from 2012 to 2019.

Led by Dr. Yee Hui Yeo, an internal medicine physician at Cedars-Sinai Medical Center in Los Angeles, the study relied on a massive database maintained by the U.S. Centers for Disease and Control and Prevention (CDC) that registers nearly all deaths in the U.S. and their causes. From 2012 to 2019, about 11 to 15 annual U.S. deaths per 100,000, among adults who were at least 25 years old, were caused by alcohol-use disorder (AUD). But during 2020, that number rose to an average of 19 deaths per 100,000; in 2021, it was 20.

Not all groups were affected equally. Men and women were similar in alcohol-related mortality, with both showing a 25% increase in 2020. Age was a much more significant factor. Far and away, the hardest-hit age group was the youngest measured25 to 44 year oldsamong whom deaths rose by 40% in 2020 and 33% in 2021. In the 45-64 year old age group, deaths increased 22% and 17%, respectively; for those 65 and older, the increased mortality rates were 17% and 22%.

Isolation, stress, and the accompanying urge to self-medicate with alcohol were not the only reasons the researchers believe the death rates climbed. Across the nation, visits to doctors fell during lockdowns, exacerbating health problems for people suffering from all manner of conditions, including AUD. Therapy groups to help treat substance dependence were unavailable (or less available) during COVID-19 lockdowns, although some did move online.

Alcoholics Anonymous and rehab centers, in which it is common to have shared rooms, were closed down during the pandemic, said Yeo in an email to TIME. Even when they reopened, the capacity was reduced. Additionally, individuals with AUD may have avoided going to detoxification centers due to the fear of contracting COVID-19.

The actual numbers may be worse than what the study shows, since AUD is often overlooked as a contributing factor when there is a more-immediate cause of death like heart attack or stroke. We know that alcohol use disorder is often under-reported, Yeo said in a statement that accompanied the release of the study, so actual mortality rates related to alcohol may be even higher.

Going forward, Yeo expects that these numbers will decline. COVID-19 vaccinations, the pandemic-era expansion of Medicaid benefits, and the reopening of societyincluding homeless shelters, rehab centers, and social support groupsshould all help to ease the number of alcohol-related deaths, he says. But lagging indicators of alcohol abuse may still keep death rates above average for a while.

There may, Yeo told TIME, be a rising tide of AUD-related complications such as liver disease, mental health issues and cardiovascular disease during the post-pandemic era.

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Write to Jeffrey Kluger at jeffrey.kluger@time.com.

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Alcohol-Related Deaths Have Soared During the Pandemic - TIME

How risky is being indoors with our 10-year-old granddaughter without masks? We have plans to have birthday tea together. Are we safe?

That question, from a woman named Debby in California, is just one of hundreds Ive received from concerned people who are worried about COVID-19. Im an epidemiologist and one of the women behind Dear Pandemic, a science communication project that has delivered practical pandemic advice on social media since the beginning of the pandemic.

How risky is swim team? How risky is it to go to my orthodontist appointment? How risky is going to the grocery store with a mask on if no one else is wearing one and my father is an organ transplant recipient? How risky is it to have a wedding with 200 people, indoors, and the reception hall has a vaulted ceiling? And on and on.

These questions are hard to answer, and even when we try, the answers are unsatisfying.

So in early April 2022, when Anthony Fauci, the presidents chief medical advisor, told Americans that from here on out, each of us is going to have to do our own personal risk assessment, I put my head down on my desk.

Individualized risk assessment is not a reasonable ask, even for someone who does risk assessment for a living, let alone for the rest of us. Its impossible to evaluate our own risk for any given situation, and the impossibility of the task can make us feel like giving up entirely. So instead of doing that, I suggest focusing on risk reduction. Reframing in this way brings us back to the realm of what we can control and to the tried and true evidence-based strategies: wearing masks, getting vaccinated and boosted, avoiding indoor crowds and improving ventilation.

A cascade of unknowable variables

In my experience, nonscientists and epidemiologists use the word risk to mean different things. To most people, risk means a quality something like danger or vulnerability.

When epidemiologists and other scientists use the word risk, though, were talking about a math problem. Risk is the probability of a particular outcome, in a particular population at a particular time. To give a simple example, the chances that a coin flip will be heads is 1 in 2.

As public health researchers, we often offer risk information in this format: The probability that an unvaccinated person will die of COVID-19 if they catch it is about 1 in 200. As many as 1 in 8 people with COVID-19 will have symptoms persisting for weeks or months after recovering.

To embark on your personal risk assessment, as Fauci casually suggested, you first have to decide what outcome youre talking about. People often arent very specific when they consider risk in a qualitative sense; they tend to lump a lot of different risks together. But risk is not a general concept. Its always the risk of a specific outcome.

Lets think about Debby. First, theres the risk that she will be exposed to COVID-19 during tea; this depends on her granddaughter. Where does she live? How many kids at her school have COVID-19 this week? Will she take a rapid test before she comes over? These factors all influence the granddaughters risk of exposing Debby to COVID-19, but I dont know any of them and likely neither does Debby. Given the lack of systematic testing, I have no idea how many people in my own community have COVID-19 right now. At this point, our best guess at community rates is literally in the toilet monitoring sewage for the coronavirus.

If I assume that Debbys granddaughter does have COVID-19 on the appointed day, I can start thinking about Debbys downstream risks: whether shell get COVID-19 from her granddaughter; the chances that shell be hospitalized and that shell die; and the probability that shell have long COVID. I can also consider the risk that Debby will catch COVID-19 and then give it to others, perpetuating an outbreak. If she gets sick, the whole hierarchy of risks comes into play for everyone Debby sees after she is infected.

Finally, there are competing risks. If Debby decides to skip the party, there may be risks to her own or her granddaughters mental health or their relationship. Many skipped celebrations in many families could negatively affect the economy. People could lose business; they could lose their jobs.

Each of these probabilities is influenced by a cascade of fickle conditions. Some of the factors that shape risks are in your control. For example, I decided to get vaccinated and boosted. Therefore, Im less likely to end up in the hospital and to die if I get COVID-19. But some risks are not in your control age, other health conditions, gender, race and the behavior of the people all around you. And many, many of the risk factors are simply unknowns. Well never be able to accurately evaluate the whole volatile landscape of risk for a particular situation and come up with a number.

Taking charge of what you can

There will never be a situation where I can say to Debby: The risk is 1 in 20. And even if I could, Im not sure it would be helpful. Most people have a very hard time understanding probabilities they encounter every day, such as the chance that it will rain.

The statistical risk of a particular outcome doesnt address Debbys underlying question: Are we safe?

Nothing is entirely safe. If you want my professional opinion on whether its safe to walk down the sidewalk, I will have to say no. Bad things happen. I know someone who tore a tendon in her hand while putting a fitted sheet on a bed last week.

Its much more practical to ask: What can I do to reduce the risk?

Focusing on actions that reduce risk frees us from obsessing over unanswerable questions with useless answers so we can focus on what is within our control. I will never know precisely how risky Debbys tea is, but I do know how to make the risks smaller.

I suspect the question folks are really asking is: How can I manage the risks? I like this question better because it has an answer: You should do what you can. If its reasonable to wear a mask, wear one. Yes, even if it isnt required. If its reasonable to do an at-home antigen test before you see your vulnerable grandparents, do that. Get vaccinated and boosted. Tell your friends and family that you did, and why. Choose outdoor gatherings. Open a window.

Constantly assessing and reassessing risks has given many people decision fatigue. I feel that too. But you dont need to recalibrate risks of everything, every day, for every variant, because the strategies to reduce risk remain the same. Reducing risk even if its just a little bit is better than doing nothing.

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

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It's Impossible to Determine Your Personal COVID-19 Risks and Frustrating to Try but You Can Still Take Action - GovExec.com

The latest Covid-19 case surge is expanding beyond the Northeast, with places from the Midwest to Florida and California under rising pressure.

Fueled by highly contagious versions of the Omicron variant, the tide is posing a test of how much new infections matter in a changing pandemic. Though built-up immunity in the population has kept more people out of hospitals, federal health officials on Wednesday urged people in hot spots to take precautions, from booster shots to pre-gathering tests and masks, to limit the virus spread.

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Latest Covid-19 Wave Expands to More of U.S. - The Wall Street Journal

Covid-19 vaccines have rapidly altered our relationship with SARS-CoV-2, turning a dangerous infection into something akin to the common cold for many vaccinated people who contract it. But while these vaccines are great at protecting against severe illness and death, they cannot stop vaccinated people from contracting the virus and experiencing mild symptoms.

If we want to prevent mild Covid infections, were going to need vaccines that protect us where infections start: in the mucus membranes of the nose, mouth, and throat. And for that, were likely going to need intranasal vaccines.

A number of research groups and companies are working on Covid-19 vaccines that would be delivered intranasally, but the development process is tricky. Watch the explainer above to learn more.

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Why isn't there a nasal vaccine for Covid-19 yet? - STAT

Fox News medical contributor Dr. Marty Makary says the coronavirus has reached the endemic phase.

While face masks arent mandatory on public transportation or in related transportation hubs, the Centers for Disease Control and Prevention (CDC) recommends COVID-19 testing before travel.

The national health agency suggests people "consider" getting a viral test laboratory, rapid point-of-care or self-tests done "as close to the time of departure as possible," so travelers will know if they have a "current" coronavirus infection before they depart.

These tests, if completed by a concerned party, should be done no more than three days before travel, according to the CDC.

Although pre-travel testing isnt mandated on most forms of domestic transportation, the CDCs guidance has been updated at a time when coronavirus infections are on the rise in the U.S.

CDC 'COVID-19 BY COUNTY' TOOL HELPS YOU LOOK UP GUIDELINES BY LOCAL AREAS

Johns Hopkins Universitys COVID-19 Dashboard reported more than 100,000 coronavirus cases in the U.S. on Wednesday, May 18.

People can get tested for COVID-19 with viral laboratory and rapid point-of-care tests at health care centers or with self-tests that can be done at home or on-the-go. (istock)

Infections had been on a decline since the end of March but are now increasing steadily.

"Given the the spread of infections thats happening across the country, we know [the] use of rapid tests is a very effective way of keeping infections down," said Dr. Ashish Jha, coordinator of the White Houses COVID-19 Task Force, at Wednesday's press briefing.

"You can test yourself before you go to a large gathering, before you go visit someone vulnerable," Jha continued. "Theres very good evidence that the use of rapid tests can reduce the amount of infections thats happening out there. So this is one of the tools we have, one of the capabilities we have."

SHOULD YOU STILL WEAR A MASK TODAY? WHAT ALL OF US SHOULD KNOW NOW

Outside of testing, another pre-travel tip officials at the CDC offer travelers during the lingering pandemic include checking their intended destinations infection risks with the CDCs online COVID-19 Community Level tool, which identifies infection risks weekly by county.

The CDC also recommends checking mandates about mask wear, vaccination, testing and quarantining from local governments and airlines. Travelers with medical conditions or who have prescribed medications that weaken immune systems are advised to consult their doctors before they make their journeys.

Travel is not recommended by the CDCs standards if a person shows COVID-19 symptoms (regardless of vaccination status) or receives a positive viral test.

If a positive COVID-19 test is received, the CDC says self-quarantining should be done for "a full 10 days." Travel can usually be resumed after this point.

COVID-19 FACE MASKS GIVEN RISE OF OMICRON SUBVARIANTS: WHAT TO KNOW

People who have been in close contact with someone who received a positive COVID-19 test are advised to quarantine for five days and practice coronavirus safety precautions if travel is necessary after six to 10 days of exposure, which could include viral testing and mask wear.

Some travelers who have been in close contact with someone who has COVID-19 can skip testing and isolation if they tested positive for the virus within the past 90 days, but the CDC still recommends mask wear when in public or optional viral tests if symptoms start to show up.

As of April 18, 2022, masks are no longer required on public transportation conveyances and transportation hubs in the U.S., which includes airports and planes. (iStock)

The CDC reiterates that it recommends "well-fitting" masks or respirators for people over the age of two "in indoor areas of public transportation (such as airplanes, trains, buses, ferries) and transportation hubs (such as airports, stations, and seaports), especially in locations that are crowded or poorly ventilated such as airport jetways."

The agency also urges the public to be "up to date" with COVID-19 vaccines before traveling.

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On Tuesday, May 10, the TSA announced that its preparing for a "busy summer travel season."

The security agency explained that daily passenger volumes have increased at checkpoints nationwide, and it anticipates this volume could match or "occasionally exceed those of 2019 for the first time since the pandemic began."

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CDC recommends pre-travel COVID-19 tests: 'Close to the time of departure' - Fox Business

Those in need of COVID-19 treatments can now find them at The Giant Companys in-store pharmacies.

The Carlisle chain announced May 19 its Giant and Martins stores have Molnupiravir and Paxlovid in stock. The antiviral medications are used to treat COVID-19 and must be prescribed by a customers healthcare provider.

Paxlovid, a five-day course of pills from Pfizer, has become the go-to option against COVID-19 because of its at-home convenience and impressive results in heading off severe disease. Paxlovid has been proven to be nearly 90% effective at cutting the risks of getting hospitalized or dying because of COVID.

Molnupiravir, developed by Ridgeback Biotherapeutics in partnership with Merck, is a series of capsules taken over five days.

The treatments are free for everyone regardless of insurance status or coverage. Customers will be asked for their insurance card to cover the dispensing fee, but those without insurance will be given the product free of charge.

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Giant store pharmacies carrying COVID-19 therapeutics including Paxlovid - PennLive

MultiCare is committed to supporting your health and safety as we navigate the continued presence of COVID-19 in our communities. Consider this your hub for up-to-date information about our COVID-19 policies and services, including testing and vaccination.

COVID-19 is a disease caused by a contagious respiratory virus. Common symptoms may include fever, cough, congestion, sore throat, headache, fatigue or shortness of breath, among others. Symptoms of COVID-19 can be similar to symptoms of other illnesses like the flu and common cold.

Most people recover from COVID-19 without hospitalization. Yet some people are at high risk of developing serious health complications, including:

There is no way to predict with certainty who will have mild symptoms and who will get very sick. One of the best ways to protect yourself and your loved ones from COVID-19 is to get vaccinated.

Learn more

By now, many people have received the primary series of a COVID-19 vaccine, but is your vaccine status up to date? According to the Centers for Disease Control and Prevention (CDC), being up to date means you have gotten all doses of a COVID-19 vaccine you are eligible to receive, including booster shots.

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If you have COVID-19 symptoms or were recently exposed to the virus, you can visit one of our Indigo Online Urgent care locations in person or start a virtual visit with one of our Indigo providers.

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If youve been diagnosed with COVID-19, follow your providers guidance for treatment and recovery and let them know if your symptoms worsen. Call 911 or go to the emergency department right away if your symptoms are life-threatening. Find your doctor.

So youve got COVID-19 symptoms or maybe you just found out youve been exposed to someone who has the virus. Its time for a test, but what kind should you get? Will it detect omicron? What should you do if you test positive?

Read the Article

Everyone is required to wear a mask at MultiCare facilities even those who are vaccinated against COVID-19. Masking helps ensure the safety of our patients, staff and visitors and is in alignment with Washington state law. Read our visitor policy.

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COVID-19 Care & Services - MultiCare

CNN

More than one million people have now died of Covid-19 in the US since the pandemics start, according to Tuesday data from Johns Hopkins University a reminder the pandemic is not over even as much of the country pushes to move away from Covid-19 measures.

And experts believe the true toll of the disease is higher.

The US Centers for Disease Control and Prevention estimates that the number of Covid-19 deaths in the US was about 32% higher than reported between February 2020 and September 2021. Provisional data from the CDC also shows the US surpassed the death milestone during the week ending on May 14, and a CNN analysis of data released by the agency shows that severe outcomes disproportionately affected older Americans and minority populations.

About three-quarters of all Covid-19 deaths have been among seniors, including more than a quarter among people 85 and older, according to CDC data. And while racial and ethnic disparities have lessened over the course of the pandemic, the risk of dying from Covid-19 has been about two times higher for Blacks, Hispanics and American Indians compared to Whites in the US.

Last week, President Joe Biden issued a proclamation marking a million deaths and ordered the American flag to fly half-staff, writing that the nation must not grow numb to such sorrow.

To heal, we must remember, the President said in a statement. We must remain vigilant against this pandemic and do everything we can to save as many lives as possible.

And it all comes as Covid-19 cases are rising again across the country, with reported infections more than doubling over the past month in the US overall. New York City reached the high Covid-19 alert level, indicating high community spread and substantial pressure on the health care system, officials said, and encouraged people to wear high-quality masks in all public indoor settings and crowded outdoor spaces, regardless of whether vaccination status is known.

Across the world, there have been more than 524 million cases reported of the virus since the pandemics start more than 82 million of which have been in the US.

The World Health Organization declared Covid-19 a pandemic on March 11, 2020.

Overall, death rates have been higher in the Northeast region of the country and lowest in the West, according to JHU data.

But at the state level, death rates have been highest in Mississippi, Arizona and Oklahoma each with more than 400 total Covid-19 deaths for every 100,000 people compared with Vermont and Hawaii, which have had about 100 deaths for every 100,000 people.

Globally, there have been more than 6.2 million reported Covid-19 deaths, according to Johns Hopkins data.

What we can learn from the WHO Covid mortality numbers

Vaccinations for the virus have saved millions of lives, but about half of all Covid-19 deaths in the US have happened over the past year when vaccines were already widely available for everyone age 5 and older.

And though the government has not shared an official estimate of how many vaccinated people have died of Covid-19, a CNN analysis of CDC data shows that deaths in recent months have been much more evenly split between vaccinated and unvaccinated people as highly transmissible variants take hold, vaccine protection wanes and booster uptake stagnates.

But the risk of dying from Covid-19 is still about five times higher for unvaccinated people than it is for vaccinated people, according to the CDC.

And evidence continues to build around the critical importance of booster shots.

Of those vaccinated people who died from a breakthrough case of Covid-19 in January and February, less than a third had gotten a booster shot, according to a CNN analysis of data from the CDC. The remaining two-thirds had only received their primary series.

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More than 1 million people have died of Covid-19 in the US - CNN

Severe acute respiratory syndrome coronavirus 2 (SARSCoV2) infection is reported to cause pulmonary vascular dysfunction with immunothrombosis, pulmonary embolism, endotheliitis, and neoangiogenesis of larger vessels in patients. These further lead to increased pulmonary vascular resistance, dead space and shunt, as well as right ventricular (RV) dysfunction, which can be improved by therapies that modulate endothelial function.

Inhalation of nitric oxide (NO) has been identified to have anti-inflammatory, pulmonary vasodilating, along with potential antiviral properties. Previous studies have reported sildenafil which is a phosphodiesterase type 5 inhibitor to increase endogenous NO and is also tolerated by patients with lung fibrosis. However, it can worsen shunt in acute respiratory distress syndrome (ARDS). Sildenafil (Viagra) is a medication used to treat erectile dysfunction and pulmonary arterial hypertension.

A new study published in the British Journal of Anaesthesia aimed to determine whether sildenafil could improve gaseous exchange in patients with COVID-19 ARDS with pulmonary hypertension, RV dysfunction, or both.

Study:Use of sildenafil in patients with severe COVID-19 pneumonitis. Image Credit:Angelo DAmico / Shutterstock

Sildenafil was administered to 25 patients with COVID-19 pneumonitis and moderate to severe ARDS. Oxygenation and carbon dioxide (CO2) clearance were assessed in the patients immediately prior, 24 h, 48 h, and 5 days after sildenafil administration for the calculation of the P: F ratio (PaO2:FiO2), ventilatory ratio, dead space fraction, and oxygenation index.

Norepinephrine equivalents (NE) and the vasoactive-inotropic score (VIS) were used to calculate the vasoactive drug dose. Initially, sildenafil was administered at 12.5 mg three times a day, increasing to 25 mg if it was well tolerated. Finally, the patients underwent baseline and follow-up CT scanning and detailed echocardiographic assessment.

The results indicated that out of the 25 patients, 10 were on venovenous extracorporeal membrane oxygenation (VV-ECMO) and 11 were prone. Pulmonary hypertension, RV dysfunction, or both were detected at baseline in all patients. One patient was removed from sildenafil before ICU discharge, while 24 continued it for 12.7 days at 25 mg three times a day.

The results reported an increase in NE and VIS 24 hours following initiation of sildenafil therapy. The dose of norepinephrine was increased in 14 patients, decreased in 10 patients, and remained unchanged for one patient. HR and MAP were found to be stable 24 h after sildenafil. Moreover, the P: F ratio was observed to increase in non-ECMO patients 24 h after sildenafil while dead space and ventilatory ratios remained unchanged.

Pulmonary embolism was detected in 17 patients in baseline CT scans, while a reduction in pulmonary artery (PA) volume and the right atrial area was observed in follow-up CT scans. A decrease in brain natriuretic peptide (BNP) and hs-troponin was observed from before sildenafil to a 1 to 2-day time point for troponin or a 1 to 7-day time point for BNP. Additionally, pulmonary vascular resistance was reported to decrease, and LV cardiac output was reported to increase during the follow-up period.

Nine patients (four ECMO recipients) died in the ICU, a 36% mortality rate.. After the last follow-up, 12 out of 13 patients had normal echocardiography, four had mild parenchymal changes, and one was observed to have a persistent perfusion defect.

Therefore, the current study determines that sildenafil is safe in carefully selected COVID-19 ARDS patients. No deterioration in oxygenation, hemodynamics, or dead space was observed. Moreover, sildenafil also did not deteriorate gaseous exchange. However, the role of sildenafil in the longer-term improvement in lung impairment is yet to be seen.

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Patients with COVID-19 pneumonitis and moderate to severe ARDS treated with sildenafil - News-Medical.Net

HARLINGEN, Texas (ValleyCentral) In April, Dr. Anthony Fauci claimed the U.S. was out of the pandemic phase but said caution was still needed. Now local health experts say the possibility of getting the virus is not impossible and are urging the public to be safe.

For the past two years, the pandemic has drastically affected everyones life. Last week the White House marked one million covid deaths in America. Physician Advisor with Valley Baptist, Dr. Christopher Romero says how weve made our way out of the worst but the virus isnt going away any time soon.

We are currently at a low level of covid 19 infection and spread according to the CDC. However, Dr. Romero goes on to say, some organizations have predicted models of what they see the infection spread will look like in the community. Some of these models are forecasting a small spike during this month in May and June and then it is going back down and then another significant wave in the Winter.

Romero along with Dr. Sohail Rao with DHR Health agrees that due to multiple vaccines people are able to fight covid.

More and more data are coming out that suggest that perhaps we will be needing these vaccinations on a yearly or a bi-annual bias, said Dr. Rao.

Although a lot of people in the community are vaccinated the virus will still remain a threat in the future.

Those who are not vaccinated, those who are immunocompromised, or those who have other commonalities are the ones who are going to be more vulnerable, said Dr. Rao.

Dr. Romero says if someone does become infected with COVID-19 they shouldnt ignore it.

Truly speaking with their health care provider, Now we have treatment options that are available at a lot of pharmacies in our area that are proven to keep people out of the hospital, said Dr. Romero.

Both doctors say they dont believe covid 19 cases and mortality rates will be as high as they were at the beginning of the pandemic. However, they both agree the greatest way to make that true is for everyone to get vaccinated.

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The future of COVID-19 is coming into question - KVEO-TV