Category: Covid-19

Philadelphia became the first major U.S. city to reinstate its indoor mask mandate on Monday after reporting a sharp increase in coronavirus infections, with the city's top health official saying she wanted to forestall a potential new wave driven by an omicron subvariant.Confirmed COVID-19 cases have risen more than 50% in 10 days, the threshold at which the citys guidelines call for people to wear masks indoors, said Dr. Cheryl Bettigole, the health commissioner. Health officials believe the recent spike is being driven by the highly transmissible BA.2 subvariant of omicron, which has spread rapidly throughout Europe and Asia, and has become dominant in the U.S. in recent weeks.If we fail to act now, knowing that every previous wave of infections has been followed by a wave of hospitalizations, and then a wave of deaths, it will be too late for many of our residents, said Bettigole, noting about 750 Philadelphia residents died in the wintertime omicron outbreak. This is our chance to get ahead of the pandemic, to put our masks on until we have more information about the severity of this new variant.Health inspectors will begin enforcing the mask mandate at city businesses on April 18.Most states and cities dropped their masking requirements in February and early March following new guidelines from the U.S. Centers for Disease Control and Prevention that put less focus on case counts and more on hospital capacity. The CDC said at that time that with the virus in retreat, most Americans could safely take off their masks.Philadelphia ended its indoor mask mandate March 2, and Bettigole acknowledged it was wonderful to feel that sense of normalcy again.Confirmed cases have since risen to more than 140 per day still a fraction of what Philadelphia saw at the height of the omicron surge while only 46 patients are in the hospital with COVID-19. The CDC says community spread in Philadelphia remains low, a level at which the agency says that masking can be optional.The restaurant industry pushed back against the city's reimposed mask mandate, saying workers will bear the brunt of customer anger over the new rules.This announcement is a major blow to thousands of small businesses and other operators in the city who were hoping this spring would be the start of recovery, said Ben Fileccia, senior director of operations at the Pennsylvania Restaurant & Lodging Association.PolicyLab at Childrens Hospital of Philadelphia said Friday that while it expects some increased transmission in the northern U.S. over the next several weeks, hospital admissions have remained low and our team advises against required masking given that hospital capacity is good.Bettigole said requiring people to mask up will help restaurants and other businesses stay open, while a huge new wave of COVID-19 would keep customers at home. She said hospital capacity was just one factor that went into her decision to reinstate the mandate.I sincerely wish we didnt have to do this again, Bettigole said. But I am very worried about our vulnerable neighbors and loved ones. In New York City, Mayor Eric Adams has paused his push to unwind many of the citys virus rules as cases have risen, opting for now to keep a mask mandate for 2 to 4-year-olds in city schools and preschools. But Adams, a Democrat who has said New Yorkers should not let the pandemic run their lives, has already lifted most other mask mandates and rules requiring proof of vaccination to dine in restaurants, work out at gyms or attend shows.Adams was asked at a virtual news conference Monday afternoon if he was considering reimposing the New York City mask mandate in light of Philadelphias decision. The mayor said he would listen to his team of medical doctors for their advice on whether to bring back any restrictions. Adams himself tested positive for COVID-19 on Sunday.New York City is now averaging around 1,800 new cases per day, about three times higher than in early March when New York began easing rules. That does not include the many home tests that go unreported to health officials.The latest outbreak has struck many high-profile officials in Washington, including Cabinet members and House Speaker Nancy Pelosi, and the governors of New Jersey and Connecticut. Some universities have reinstated mask mandates.D.C. health officials say they have no immediate plans to change virus protocols, but they reserve the right to change course down the road.___Rubinkam reported from northeastern Pennsylvania. Associated Press reporter Michelle L. Price in New York contributed to this story.

Philadelphia became the first major U.S. city to reinstate its indoor mask mandate on Monday after reporting a sharp increase in coronavirus infections, with the city's top health official saying she wanted to forestall a potential new wave driven by an omicron subvariant.

Confirmed COVID-19 cases have risen more than 50% in 10 days, the threshold at which the citys guidelines call for people to wear masks indoors, said Dr. Cheryl Bettigole, the health commissioner. Health officials believe the recent spike is being driven by the highly transmissible BA.2 subvariant of omicron, which has spread rapidly throughout Europe and Asia, and has become dominant in the U.S. in recent weeks.

If we fail to act now, knowing that every previous wave of infections has been followed by a wave of hospitalizations, and then a wave of deaths, it will be too late for many of our residents, said Bettigole, noting about 750 Philadelphia residents died in the wintertime omicron outbreak. This is our chance to get ahead of the pandemic, to put our masks on until we have more information about the severity of this new variant.

Health inspectors will begin enforcing the mask mandate at city businesses on April 18.

Most states and cities dropped their masking requirements in February and early March following new guidelines from the U.S. Centers for Disease Control and Prevention that put less focus on case counts and more on hospital capacity. The CDC said at that time that with the virus in retreat, most Americans could safely take off their masks.

Philadelphia ended its indoor mask mandate March 2, and Bettigole acknowledged it was wonderful to feel that sense of normalcy again.

Confirmed cases have since risen to more than 140 per day still a fraction of what Philadelphia saw at the height of the omicron surge while only 46 patients are in the hospital with COVID-19. The CDC says community spread in Philadelphia remains low, a level at which the agency says that masking can be optional.

The restaurant industry pushed back against the city's reimposed mask mandate, saying workers will bear the brunt of customer anger over the new rules.

This announcement is a major blow to thousands of small businesses and other operators in the city who were hoping this spring would be the start of recovery, said Ben Fileccia, senior director of operations at the Pennsylvania Restaurant & Lodging Association.

PolicyLab at Childrens Hospital of Philadelphia said Friday that while it expects some increased transmission in the northern U.S. over the next several weeks, hospital admissions have remained low and our team advises against required masking given that hospital capacity is good.

Bettigole said requiring people to mask up will help restaurants and other businesses stay open, while a huge new wave of COVID-19 would keep customers at home. She said hospital capacity was just one factor that went into her decision to reinstate the mandate.

I sincerely wish we didnt have to do this again, Bettigole said. But I am very worried about our vulnerable neighbors and loved ones.

In New York City, Mayor Eric Adams has paused his push to unwind many of the citys virus rules as cases have risen, opting for now to keep a mask mandate for 2 to 4-year-olds in city schools and preschools. But Adams, a Democrat who has said New Yorkers should not let the pandemic run their lives, has already lifted most other mask mandates and rules requiring proof of vaccination to dine in restaurants, work out at gyms or attend shows.

Adams was asked at a virtual news conference Monday afternoon if he was considering reimposing the New York City mask mandate in light of Philadelphias decision. The mayor said he would listen to his team of medical doctors for their advice on whether to bring back any restrictions. Adams himself tested positive for COVID-19 on Sunday.

New York City is now averaging around 1,800 new cases per day, about three times higher than in early March when New York began easing rules. That does not include the many home tests that go unreported to health officials.

The latest outbreak has struck many high-profile officials in Washington, including Cabinet members and House Speaker Nancy Pelosi, and the governors of New Jersey and Connecticut. Some universities have reinstated mask mandates.

D.C. health officials say they have no immediate plans to change virus protocols, but they reserve the right to change course down the road.

___

Rubinkam reported from northeastern Pennsylvania. Associated Press reporter Michelle L. Price in New York contributed to this story.

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This major city is reinstating its indoor mask mandate as COVID-19 cases rise across the US - KCRA Sacramento

Acute COVID-19 illness complications include stroke, encephalopathies, neuropsychiatric and inflammatory syndromes, whereas non-severe cases may suffer from longitudinal brain structure and cognition changes.

In a preprint version of a study posted to SSRN*, researchers investigated the potential of therapeutic drugs, remdesivir and dexamethasone, when used alone or in combination on neurological complications that arise incoronavirus disease 2019 (COVID-19) affected individuals.

The current prospective, observational, non-blinded study involved 89,297 adult COVID-19 patients admitted to hospital screened from 184,986 patients. Of these 89,297 patients, 64,088 were grouped into severe COVID-19 and the remaining 25,209 into non-hypoxic COVID-19.

Inclusion criteria included participants aged 18 and above (median age 71) admitted to the hospital between January 31st, 2020, and June 29th 2021, with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Exclusion criteria defined COVID-19 vaccinated individuals and participants who tested positive for COVID-19 in hospitals. Fifty-six percent were male, whereas 71 % were of white ethnicity. Neurological complications occurred in 4.8% (4,245) of the cohort and consisted of seizures (925), meningitis/encephalitis (194), stroke (1,259), and others (not defined) (2,227)

Covariates involved age, sex, ethnicity, Dalhousie University Clinical Frailty score, smoking status, time from symptom onset to hospital admission, the severity of pulmonary infection, and eligibility for remdesivir.

Treatment groups included under both severe COVID-19 and non-hypoxic were no treatment, dexamethasone alone, remdesivir on day 1, remdesivir at any time, combined treatment on day 1, and combined treatment at any time.

Participants were treated with either remdesivir or dexamethasone or both. Treatment comparison groups included remdesivir alone vs. standard of care, dexamethasone alone vs. standard of care, and combined treatment vs. standard of care. Analysis was done separately for severe (supplemental oxygen required) or non-hypoxic (no supplemental oxygen required) patients. The case duration was considered from admission to the day of discharge, death, or continued admission.

The researchers studied the effects of treatment groups on mortality in severely infected patients. Dexamethasone treatment reduced mortality, while it was found that remdesivir failed in reducing mortality. However, the combined treatment led to a significant reduction in mortality.

Intensive care unit (ICU) admissions were also reduced with the dexamethasone, whereas they increased when treated with remdesivir. This increase in ICU admission probably reflected the increased likelihood of its prescription to the sickest patients requiring higher levels of care. Both the treatments were not associated with worse self-care at discharge. With both the treatment strategies, either with dexamethasone or remdesivir, the incidence of neurological complications with increased mortality, ICU admission, worse self-care at discharge, and increased recovery time was reduced. Combined treatment showed a larger reduction in complications.

In non-hospitalized patients (50% male, 72% white), the treatment reduced ICU admission (0.9%), mortality (9.2%) worse self-care at discharge (13%), length of inpatient stay (5 days). Neurological complications were associated with increased mortality, ICU admission, worse self-care on discharge, and recovery time. This may be attributed to the possibility that patients with non-hypoxic COVID-19 had severe disease affecting organs outside the respiratory system. Treatment with dexamethasone reduced neurological complications. However, the combined treatment led to higher reductions.

The results demonstrated were consistent with the previous pivotal randomized controlled trials and ISARIC cohort studies.

This study suggests that remdesivir and dexamethasone can reduce neurological complications in patients suffering from severe COVID-19. Moreover, their synergistic effect was significantly greater than dexamethasone alone.

Despite having strengths such as a large study with real-life data and the use of the same control population for comparisons, the study has several limitations. The data was not collected on the onset of neurological complications or dexamethasone treatment, and the final diagnosis of these complications was not made. Furthermore, the time of the pandemic's start was not included in the propensity score, compromising the correct confounding effect.

SSRN publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

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Study finds dexamethasone and remdesivir treatment in hospitalized COVID-19 patients is associated with reduced neurological complications -...

Auckland, New Zealand-based in vitro diagnostics company Pictor is partnering with Mobility Health, a laboratory service provider based in Mason, Ohio, to distribute Pictors Covid-19 antibody test that assesses if a patient has Covid-19 antibodies, and if they do, if the antibodies are from vaccination or from having contracted Covid-19. This partnership comes at the same time as a $6.1 million investment led by Marko Bogievski and K One W One Ltd. for Pictor.

Pictors PictArrayTM SARS-CoV-2 assay can identify if a patient has antibodies for Covid-19 as well as determine if those antibodies can be attributed to a previous Covid-19 infection or if they are from vaccination alone. The test does so by identifying if a person has nucleocapsid protein (NP) antibodies as well as spike protein (SP) antibodies present or if the person only has SP antibodies. If only SP antibodies are identified, the person has not contracted Covid-19 and the antibodies present can be attributed to vaccination.

The test has an additional useful application: determining if at risk patients do not have an adequate antibody response even if they have previously been vaccinated or infected.

Pictor sees this test as an opportunity to inform if those patients should then receive additional boosters, explained Howard Moore, CEO of Pictor, in an interview. On the flip side, if someone has a very high antibody count, then the test could indicate that person should perhaps not receive a booster yet. For example, if patients have too high of antibody levels, they may benefit from delaying additional boosting, according to Moore.

You have to be somewhat careful in administering vaccination. We believe you should be careful about administering vaccines to those people who have been infected. Their antibodies level may be reasonably high, said Moore.

Though not proven, a correlation could exist between high antibody levels and autoimmune diseases, according to Moore. As a result, Pictors test could prove useful in this regard since it can determine the antibody levels in addition to their origin.

Patients will have access to the test via doctor or hospitals ordering it on their behalf, Moore explained in an email forwarded by a representative.

The $6.1 million investment will fund Pictors marketing for the test as well as its other diagnostics. This funding will go towards US, EU, and ANZ market development; it will also help fund research and development efforts, Moore said. To date, Pictor has raised $17 million.

Current tests that assess antibody levels can determine if a person has had Covid-19 and if the antibodies present are from that infection. However, a person has to take an entirely separate test to see if antibodies present are due to vaccination.

The PictArra SARS-CoV-2 Antibody Test is a high performance, all-in-one, NP/SP COVID-19 antibody test with serological differentiation. This is the only test that separately measures antibodies from vaccines and SARS-CoV-2 infection in one test, said Tadd Lazarus, chief medical officer of Pictor, in a news release. The separate detection of SP and NP enables more precise clinical intervention.

Additionally, Pictors two-in-one test costs roughly the same as one of the competitors tests, allowing Pictors test to potentially cut down the total cost of testing by 50%, according to Moore. Further, money can be saved by paying a lab technician to administer only one test instead of two.

They [our competitors] could do what we do, but they [would] have to sell two tests to do it, Moore added. The lab technician only has to administer one test. These are the advantages that we have. We intend to leverage them as we proceed with our U.S. launch in particular.

Photo: peterschreiber.media, Getty Images

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Diagnostic test determines if Covid-19 antibodies are from vaccination or infection - MedCity News

Editors Note: Rob Relyea is an engineer and an advocate for the immunocompromised. He created a digital tracker to locate available doses of Evusheld and other Covid-19 therapies. He is currently on personal leave from Microsoft. The views expressed here are his own. Read more opinion on CNN.

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My wifes lymphoma diagnosis and 50th birthday came on the same day in March 2021. Rebecca had been aggressively chasing the cause of the small lump she found in her abdomen. With access to a world-class cancer center and support of family and friends, her chemoimmunotherapy regime was deemed a success after a six-month fight. Remission!

This was right around the time that Covid-19 vaccines became widely available. Rebeccas oncologist encouraged her to get her shot ASAP. She participated in a Leukemia & Lymphoma Society study which found that many blood cancer patients immune systems had a markedly worse antibody response to the vaccine, compared to healthy individuals.

Another recent study published in the journal Nature Cancer found that a third shot of vaccine improves immune responses, unless the recipient of that shot is on a specific drug which happened to be a key part of my wifes treatment regime. We were left feeling hopeless; Rebeccas test results showed that her condition and her treatment had conspired to prevent her body from mounting a full immune system response to the vaccine.

Rebecca had won the first round against lymphoma, but our fear of her heightened danger from Covid-19 only grew. We lived with two anxieties: Would her cancer return, and could she stay safe from Covid-19?

Throughout this time, family and friends did all we could do to protect her. I followed developments and grew my understanding of how to keep her and myself healthy. Vaccines and boosters were required for anybody with whom she would spend time.

We were early adopters of N95 and KN94 masks. I did all the shopping. Carryout meals were OK, but no indoor dining in public. Non-household members visited us outside in the backyard. Paid medical leave (thanks to my employer and the state of Washington) allowed me to support her fully. Eventually, we added rapid testing of close family visiting her at home as a key part of her protection.

Then, on December 8, the US Food and Drug Administration announced emergency use authorization for Evusheld, a two-dose cocktail of two different monoclonal antibodies, for moderately to severely immunocompromised people. A randomized clinical trial had shown that the drug could provide 77% reduced risk of Covid-19 for recipients compared to those who received a placebo.

Protection can last six months in the body, to fill the void of antibodies against Covid-19 in immunocompromised people. Evusheld seemed like the pandemic gamechanger that immunocompromised people had been waiting for.

But almost four months in, our health system has failed to execute its campaign to protect the vulnerable. The supply of Evusheld is short, patient outreach is poor and goals to protect the immunocompromised are not being set, measured or reached. On top of that, we are not effectively using the supply already in the pipeline, with thousands of boxes sitting around unused. (In a statement to CNN, a spokesperson for the Department of Health and Human Services said that the government is committed to helping protect immunocompromised Americans and other vulnerable populations from COVID-19, noting that while the national supply of Evusheld is great enough to meet the requests of every state, finding and accessing doses has been challenging for some.)

The government initially ordered 700,000 doses of Evusheld, and 1 million more between January and February. But, as Matthew Cortland, a senior fellow at progressive think tank Data For Progress, pointed out, this presents a major math problem: 1.7 million doses would only provide one year of protection for 850,000 of the at least 7 million Americans who are immunocompromised. How can we think that is good enough?

On February 24, the FDA announced the recommended dose needed doubling due to continued analysis of Evushelds effectiveness against certain Omicron subvariants. This move effectively meant that we had half the supply we thought we had a day earlier now only enough for one year protection for 425,000 of the 7 million people. And now, due to shifting variant prevalence, the FDA can no longer recommend a timing for repeat dosing.

We dont know what the new dosing guidelines will be, or when the FDA feels confident issuing them. But we know there wont be enough doses to go around.

Based on my conversations with other immunocompromised people, most are not learning about this drug from their doctors. And equity is hard to maintain when word of mouth is how news about key health initiatives is spread.

The brand new covid.gov website needs to provide information on Evusheld for the immunocompromised in addition to vaccines, masking and testing.

Beyond that, health organizations need to fix this lack of information. Use patient medical records as a starting point in the effort to find people who would benefit from Evusheld. Contact them. Help them get in line. Provide transparency. People lacking great health care access must be identified and routed to available doses.

Despite capturing data from Evusheld providers, the US Department of Health and Human Services doesnt share the quantity of the drug that has been administered to patients. It also hasnt publicly shared goals for getting doses to patients.

Without goals and measurements, how can we rally our health system to protect the immunocompromised?

After my advocacy for several months, my wife has secured her dose of Evusheld, but there are so many more who need protection. Im working closely with other advocates to call for needed improvements to the Evusheld campaign.

As a software engineer, Ive been able to understand governmental data about Evusheld inventory, and Im sharing it in useful ways with a mapping tool that is easy to use and shows the inventory history of Evusheld at hospitals across the nation.

It has enabled many eligible people to help their doctors locate doses for them. This information can fill existing gaps in distribution, enabling people to advocate for themselves or loved ones. But people shouldnt be forced into what Ive previously called a Hunger Games hunt.

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Opinion: There's a drug to protect the most vulnerable from Covid-19. Why is it so hard to get? - CNN

For Kaia Brooke, little has changed this spring, even as others declare that California and the country are finally getting back to normal.

She has not gone out to dine inside a restaurant or sat down in a movie theater. She avoids going out much, save for outdoor walks and drives, and is still wearing her KN95 mask when she ventures out of her Monrovia home.

We cant move on like everyone else has been doing, said the 24-year-old autistic woman, who has chronic illnesses, including a metabolic disorder that requires iron infusions. Her eyes, over the top of her maroon mask, are the color of the sea.

At times, she said, its hard to shake the feeling of our lives feeling disposable.

As government agencies have loosened pandemic protections, advocates for immunocompromised and disabled people have raised concerns. Were doing all the things that dont protect people with disabilities, said Bethany Lilly, senior director of income policy at the Arc, which advocates for people with intellectual and developmental disabilities.

Mask mandates have been rolled back, but crucial medications to prevent COVID-19 in immunocompromised people can still be hard to get. Federal money for testing and treating uninsured people has been drying up, just as a coronavirus subvariant that has driven spikes in Europe is on the rise.

Health officials have started focusing more heavily on hospitalizations than COVID-19 cases to gauge risk levels in communities a measure that focuses more on strain to the health system, but fails to reassure immunocompromised people who face danger from high levels of coronavirus transmission. And although the White House recently announced a new push to clean indoor air, some critics say the government should have acted much sooner to ensure public spaces are safe.

If we actually cared about chronically ill, disabled and immunocompromised Americans including children every state in the country would be doing proactive wastewater monitoring, said Matthew Cortland, senior fellow on healthcare and disability at Data for Progress, a progressive think tank. As for air purifiers, they should be so plentiful, we should be tripping over them.

For Emily Brooke Holth, the situation has been maddening.

Kaia Brooke, 24, reads to her twin brother, Ry, who has Down syndrome. Both twins are autistic and immunocompromised, and Kaia has a chronic illness and metabolic disorder that requires iron infusions. Their mom, Emily Brooke Holth, background, is their caregiver.

(Gina Ferazzi / Los Angeles Times)

Holth is mother to Kaia and her twin brother, Ry Brooke, who is also disabled and immunocompromised. Ry, who speaks a few words and phrases, is autistic, has Down syndrome and uses a feeding tube. As their caregiver, Holth is constantly assessing risks when she heads outside. If the Trader Joes looks too full, she turns away to find another store or pays for grocery delivery.

As masking and other measures have been dropped, it puts the burden on the individual, Holth said.

Most of the pandemic has passed the same way for the family. Kaia rests in bed, reads, plays video games and messages friends. When she feels up to it, they go for a drive or head for a walk. Their mother feeds Ry every three hours through his tube, helps him bathe, and makes phone calls to schedule appointments for both twins with a gaggle of specialists.

Most of the time, they saw friends only through the glass door of their townhouse, waving to them from inside as they spoke on the phone. During surges, they would sometimes go on walks at a nearby cemetery. Holtz remembers her unease and then dawning anguish when it suddenly became crowded that first winter, as mourners gathered around a rash of new graves.

After they had all gotten vaccinated, the family had been tiptoeing back into the world. Holth got married last June and invited seven vaccinated people into their home to celebrate, sharing hugs and wedding cake at their Monrovia townhouse. She had begun to plan for Ry to return to a day program for people with developmental disabilities.

Instead, the Delta variant began to drive up cases, and they retreated. When the Omicron wave arrived this winter, we went back to the strictest stay-at-home, as if it were the beginning of the pandemic, Holth said. We were like that for two and a half months.

As that wave receded, they were beginning to think about venturing out again. Maybe a masked trip to a museum, Holth thought, eyeing the Hayao Miyazaki exhibit at the Academy Museum of Motion Pictures. She was grateful that Los Angeles County had been stricter than other parts of California when it came to masking and other pandemic rules.

But when those rules were stripped away, she decided against it. It has felt like were a little raft off in the middle of the ocean.

I would love to take him to Disneyland, Holth said of Ry, who she remembers being delighted on the Alice in Wonderland ride. His room features a framed photo of him and his family plunging on the Splash Mountain ride.

I dont think its going to be anytime soon, Holth said wistfully.

We talk to all of their specialists ... and theyre like, Dont go. Its not safe.

Emily Brooke Holth and her son, Ky, and daughter, Kaia, watch a movie. Holth had planned for the family to start venturing outside their home, but then the Delta and Omicron waves sent them back inside.

(Gina Ferazzi / Los Angeles Times)

The latest phase of the pandemic comes on the heels of a pair of grueling years for disabled and immunocompromised people.

Disabled advocates say that the threat has not only been the virus, but the biases of the health system itself. Early in the pandemic, they complained that guidelines put forward by many states on how to allocate scarce resources such as ventilators were discriminatory against people with disabilities.

In January, the head of the Centers for Disease Control and Prevention outraged disability groups by publicly declaring that it was encouraging that a study had found that the bulk of vaccinated people who died of COVID-19 had at least four co-morbidities, calling them unwell to begin with.

Dozens of groups reacted with a letter complaining that the public health response to COVID-19 has treated people with disabilities as disposable. The CDC chief apologized, calling her remarks hurtful but unintentional. Months later, she angered many disabled activists again by likening masks to a scarlet letter that was annoying and inconvenient.

Saying the quiet part out loud is what has happened with the pandemic, said Christine Mitchell, a public health researcher and advocate with the Public Health Justice Collective in the Bay Area. Mitchell herself has a connective tissue disorder.

I get it. People are tired. People are annoyed. People dont want to wear masks, Mitchell said. But my life and the lives of disabled people and immunocompromised people and all the people who are at high risk is worth more than someones convenience.

Few expect broad mandates to return, short of a massive surge in hospitalizations.

Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases, said that the practical reality now for immunocompromised people is that all of those folks are going to have to look to themselves for protection by masking, gauging the risk of events and activities, and staying up to date on vaccines.

Mask mandates have become a nonstarter, he said, so the initiative will have to remain with the individuals who are affected and those closest around them. Society has moved on.

Matan Koch, vice president for workforce and faith programs at the nonprofit RespectAbility, said that easing pandemic restrictions doesnt mean that we all need to go back to, Screw it, youre all on your own.

His hope is that governments and employers will take steps to protect and include vulnerable people, including guaranteeing paid leave so that sick workers do not come in to infect others, retaining the flexibility of remote work, and streaming live events.

During the pandemic, all of a sudden the impossible was possible, Koch said. I really hope the artificial limitations will go away.

Holth, sitting with Ry and Kaia outside their home in Monrovia on a sunny weekday, wanted to make clear that they do not feel sorry for themselves. Their life lived at home is a good one, filled with music and videos and Christmas decorations that stay up long after Christmas because Ry loves the holiday so dearly.

But if people really want to protect the immunocompromised, acknowledging us would be a good start, Kaia said.

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For this family, the COVID-19 threat hasn't gone away - Los Angeles Times

Nothing has shaped Gov. Kate Browns reputation and legacy more than her administrations response to the COVID-19 pandemic. Under Brown, Oregon schools and businesses faced prolonged restrictions; teachers received vaccine priority over seniors; and Oregon was among the last states in the country to lift an indoor mask mandate. Yet the state also recorded a significantly lower death rate than other states. Through it all, Browns administrations decisions, strategy and execution have been lauded, decried and second-guessed.

For the upcoming primary, The Oregonian/OregonLive Editorial Board sent endorsement questionnaires to Democratic and Republican candidates seeking to succeed Brown. (Former State Sen. Betsy Johnson, who is running as an unaffiliated candidate and wont compete in a primary, was not sent a questionnaire). We asked them to share in 200 words or less what stood out in Oregons COVID response and how they would govern as the pandemic continues its uncertain path. Below are responses from eight of the candidates, listed alphabetically.

What principles will guide you in navigating Oregon through whatever comes next in the COVID-19 pandemic? What has Oregon gotten right or wrong (e.g. closing schools, mask mandates, vaccine priority) in addressing COVID?

Julian Bell, Democrat: Kate Brown and the state of Oregon both did an excellent job of navigating the challenges of COVID-19, and I am grateful to the state agencies and their staff for their work in very difficult circumstances. I took care of a lot of COVID-19 patients in the hospital. It was a bizarre time. Without question, the vaccines, the use of masks and state recommendations saved peoples lives. While the governor is responsible for the health of the people of the state, they are also responsible for the economy. Even so, you might be able to limp an economy along and then rebuild it, but you cant bring back the dead. The principles that would guide me in the future, should we see another resurgence of the virus, would be the best epidemiology available.

Christine Drazan, Republican: I will lead with facts, not fear. I will respect Oregonians and their right to determine the best approach for themselves and their family when it comes to responding to the virus and in making personal medical decisions. I will engage in a transparent and open dialogue with Oregonians about where we are at, why their state government is responding in a certain way and reject heavy-handed mandates.

Gov. Brown made the wrong call when she went all in for vaccine mandates, for mask mandates, and in her fear-based rhetoric, which did more to erode public trust in the states response than it helped. Her administration was also too rigid, inconsistent in responding to the latest science, and sloppy and overly bureaucratic in the rollout of testing and vaccines.

I will give Gov. Brown credit for resisting the urge to establish an essential business/non-essential business list early in the pandemic, a move many other states made, that would have shut down many vital industries and been disastrous for Oregon. At the time, I urged Gov. Brown to reject this approach and believe she ultimately made the correct decision.

Jessica Gomez, Republican: They say that hindsight is 20/20. I dont believe that statement is true anymore, as each person looks back at the COVID pandemic through their own partisan lens. In the early stages of the pandemic, we lacked reliable information on transmission pathways, disease severity and fatalities. Oregon responded cautiously and appropriately. As time went on, it was apparent that our leaders and state agencies were struggling. Oregons rollout of the vaccine was not adequately planned and resourced, and vulnerable communities were not prioritized. Some feel they were misled about the efficacy of the vaccine, as it is more of a pre-emptive therapeutic rather than a traditional vaccine. The vaccine has been shown to reduce the severity of infection but often fails to prevent future infection or transmission.

As governor, whether it be for COVID, or other challenges, I will always be mindful of individual freedom, government transparency and accountability. I would not have extended business or school closures beyond what was absolutely necessary. For our state to have a unified front against the next challenge, it will be imperative that we avoid politicization and work hard to build trust between the governors office, state agencies, and the people of Oregon.

Tina Kotek, Democrat: There are a lot of Oregonians walking around today, alive and well, because Oregonians followed the science, wore a mask and got vaccinated. There was no playbook for how to respond to this crisis, no one had perfect information, and while a lot of the public health measures werent easy, we should be proud that Oregon fared better than most of the country.

But our state agencies certainly fell short in some areas - the failure to handle unemployment payments at a time when so many Oregonians lost their jobs was unacceptable.

We are going to need to manage life with this virus for some time to come. So, we need to make a plan to keep our communities safe and prevent our hospitals from being overextended. As governor, I will consult with experts, read the data, be consistent and be clear, especially if we are faced with new variants and potential surges, and weigh the physical health, emotional well-being, and economic impacts of every decision thoughtfully.

Bud Pierce, Republican: Current Oregon leadership spent money on endless ineffective advertising with scare tactics and guilt-inducing messaging. Businesses were threatened and fined if they tried to stay open. Vaccine priority should have been to those at greatest risk; the aged and chronically ill. While we did not know everything at the beginning of the pandemic, I believe we will soon determine that closing schools caused greater harm to children and their families than keeping them open. Children were at very low risk for severe illness from the virus. As a result of school and business closures, depression, suicide, learning setbacks and financial pressure on families increased. The administrations obsession with wearing masks long after they were needed (punishing businesses and threatening individuals) only caused unnecessary push-back that only widened the rift between government and its citizens.

Stan Pulliam, Republican: The core problem with the COVID response was that our elected officials made stopping the spread of the disease (which we were no better at than other states) the one and only priority. (Editors note: Oregons case rate is the second-lowest in the country, according to figures kept by The New York Times.)

In a society with so many moving parts, its inconceivable that we allowed our economy, our mental health, our small businesses, and our childrens education and socialization to not just be ignored, but to be voluntarily destroyed in the name of trying to stop the inevitable spread of a virus. This was a self-inflicted wound, and history will show how much more damaging the response was to society than the virus itself.

Tobias Read, Democrat: I will be guided by science in any decision we make in the future around the pandemic. I think following the science, especially at the beginning of the pandemic helped make Oregon one of the least impacted states in the country. However, I do think we made a mistake in having bars and restaurants open before kids were back in school. As a parent of two public school students, I saw firsthand the impact that had. Many childrens mental health suffered and test scores and literacy rates dropped significantly. Were going to need to spend years helping children make up for learning loss and supporting our teachers with the resources they need to dig out of this hole. Its clear that there should have been a much greater priority placed on keeping schools open, with proper masking, testing and ventilation to keep everyone safe while continuing our kids education and social and emotional development.

In addition, the state and Legislature could have done a much better job ensuring that agencies like the employment department and the states housing agency were equipped to handle the predictable surge in applications for assistance. We need to restore trust that our government can handle important programs that Oregonians in need rely on.

Bob Tiernan, Republican: My decision-making process balancing harm v. benefit, ability to put together knowledgeable teams, using fact-based approaches, listening to different ideas, considering and exploring unintended consequences of each major decision and making necessary adjustments as the facts or circumstances change.

Oregon should not have closed schools. The harm it caused our children far outweighed the benefits. Government mandates, such as vaccine mandates, should only come in extreme situations, especially when it denies Oregonians some of their most basic rights.

-The Oregonian/OregonLive Editorial Board

Oregonian editorials

Editorials reflect the collective opinion of The Oregonian/OregonLive editorial board, which operates independently of the newsroom. Members of the editorial board are Therese Bottomly, Laura Gunderson, Helen Jung and John Maher.

Members of the board meet regularly to determine our institutional stance on issues of the day. We publish editorials when we believe our unique perspective can lend clarity and influence an upcoming decision of great public interest. Editorials are opinion pieces and therefore different from news articles.

Read the original:

Editorial: COVID-19 takes from Oregon candidates for governor - OregonLive

A sign at the 2022 Bar & Restaurant Expo and World Tea Conference + Expo recommends face mask ... [+] wearing. Yet, few at the Las Vegas Convention Center are seen covering their noses and mouths. (Photo by David Becker/Getty Images for Nightclub & Bar Media Group)

At first glance, the maps on the Centers for Disease Control and Prevention (CDC) Covid-19 Integrated County View web page look great. As of April 7, most of the U.S. was in the green, with green representing low Covid-19 Community Levels in US by County. It almost makes it seem like people dont have to worry about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) any more. After all, when you are told that the risk of anything is low whether its getting a disease, being attacked by lemurs at a restaurant, or falling face first into some quiche, you tend to not take precautions.

However, some health experts have expressed concerns that such maps and measures may be misleading. For example, Eric Topol, MD, founder and director of the Scripps Research Translational Institute, tweeted the following:

As you can see, Topol called a CDC tweet and the accompanying County-level Covid-19 Community Levels map misleading. He added that it will give BA.2 more chance to spread. This is presumably because Americans may take it as false reassurance that Covid-19 is no longer a threat and thus become too lax about Covid-19 precautions. In other words, it could lead to premature relaxation. Premature relaxation of Covid-19 precautions? Gee, when has that ever happened before?

Both Jonathan S. Reiner, MD, a Professor of Medicine at the George Washington School of Medicine and Health Sciences, and Jason L. Salemi, PhD, an Associate Professor of Epidemiology at the University of South Florida College of Public Health, pointed out the differences between the green-appearing Covid-19 Community Levels map and the multi-colored CDC Covid-19 Community Transmission map:

The Community Levels U.S. map may look like a giant green light whereas the Community Transmission one looks more like the background of a Wheres Waldo picture. Speaking of Wheres Waldo, Reiner pointed out that the Community Transmission maps are not so easy to find on the CDC website. Contrast that with the fact that the CDC tweeted out the Community Levels map without providing the Community Transmission maps alongside. Moreover, the Community Levels web site is what comes up first on Google searches.

Focusing on the Community Levels map would be like using a weather map from March to determine what to wear today. Life coaches frequently say, dont live in the past, so why should that be done with Covid-19? A countys Covid-19 level qualifies as low when there has been less than 200 cases per 100,000 people, the number of new Covid-19 admissions per 100,000 people has been less than 10, and the percentage of staffed inpatient beds in use by Covid-19 patients has been less than 10% over the previous 7 days. But Covid-19 isnt like Bieber Fever. You dont get diagnosed as soon as you get infected. It can take up to two weeks before you notice symptoms if you even develop symptoms. It can take even longer to get hospitalized. Therefore, the Community Levels map represents transmission that occurred one to four weeks ago. It wont help you determine when to institute precautions such as face mask wearing to prevent an upcoming Covid-19 upswing.

When it comes to Covid-19 precautions, the Community Transmission maps offer much more relevant info than the Community Levels ones. On these maps, a county is considered low when the number of new cases per 100,000 persons has been less than 10 and the percentage of positive Nucleic Acid Amplification (NAAT) tests has been less than 5% over the past 7 days. The level moves up to moderate if the first measure has gone up to the 10 to 49.99 range or the second measure has moved up to the 5% to 7.99% range. Substantial means that either the first measure has been in the 50 to 99.99 range or the second has been in the 8% to 9.99% range. When the first measure has reached 100 or the second has reached 10%, transmission levels then would qualify as high.

Now even these CDC transmission measures dont give you a fully up-to-date and accurate picture. Many people may never get tested and even if they do, they may take time to get tested and may not even report the results. In fact, without Covid-19 tests being free and readily available to all, there can be substantial differences between who gets tested and who doesnt. It can be yet another difference between the haves and have nots in this country. So Community Transmission maps alone may allow you to be a little more proactive but still not enough so.

With no face mask wearing or social distancing in sight, college students dance at a South Padre ... [+] Spring Break party at Clayton's Beach Bar in South Padre Island, Texas. (Photo by Brandon Bell/Getty Images)

Reiner wondered whether the public may take the Community Levels maps in the wrong way:

Topol, Reiner, and Salemi certainly havent been the only folks to raise such concerns. Eric Feigl-Ding, PhD, an epidemiologist and Chief of the COVID Risk Task Force at the New England Complex Systems Institute, tweeted that Countless experts are frustrated with the CDC and their risk level maps that mainly use hospitalization metrics. Those are always too late, as you can see here:

Sure, some politicians and businesses may want things to appear as normal as possible as soon as possible. The illusion of complete normality could prompt people to spend more and re-elect current politicians for office. Plus, Covid-19 precautions require some up front spending and investment. All of this could make people want to green and bear it and be reluctant to leave the green, so speak. Remember back in 2020 when some politicians and business leaders kept downplaying the pandemic, claiming that the pandemic was rounding the corner and other overly optimistic scenarios as I covered in 2020 for Forbes? Hmm, whats happened since then?

The rush to return to normal, whatever normal means, and the repeated premature relaxation of Covid-19 precautions has continued to be remarkably short-sighted. The SARS-CoV-2 doesnt really care what politicians and business leaders say. Failing to maintain proper Covid-19 precautions such as face mask use, social distancing, and Covid-19 vaccination could further extend the pandemic and increase the negative impact of the SARS-CoV-2. This is especially true with the more contagious BA.2 Omicron subvariant spreading. The CDC Covid-19 Community Levels map alone may have you seeing green as in low risk, go, go, go, and perhaps even mo money. But that could end up being an off-color conclusion.

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Health Experts Worry That CDC Covid-19 Maps, Measures May Be Misunderstood - Forbes

Let's stop all the fighting. Let's stop letting social media companies monetize our differences. Let us study this fascinating, new phenomenon.

Tom Benzoni| Guest columnist

Omicron study: Longest living variant on skin and plastic

According to researchers' report on bioRxiv.org, the omicron variant's high "environmental stability" might have helped it spread so rapidly.

STAFF VIDEO, USA TODAY

A frequent topic of discussion lately is how the COVID-19 pandemic ends. As is usual when trying to predict the future, the near-term is pretty much anybody's guess. The longer-term view is clearer: COVID-19 will become incorporated into our lifecycle, just like the other four coronaviruses.

Yes, you read that right. There are already four coronaviruses in the human population: 229E, NL63, OC43, HKU1. These are a few of the viruses that cause the common cold.(Im easing back on terminology here: 229E, NL63, OC43, HKU1 = Coronavirus 1-4.Coronavirus 5 = COVID-19. Just easier.) Donald Trump may have spoken clumsily, but he was right when he said that COVID-19 is just a common cold. That is what it eventually will become. The eventually part is the problem.

First lets try to understand a bit about coronaviruses. They have been with humans for centuries. The 1889 flu pandemic, the so called Russian flu, is thought to be OC43 entering the human population. The Wikipedia article on Russian flu describes the waves of infections that swept the globe. It's a worthy read. (Interesting factoid: the 1918 flu pandemic was called influenza because that was the bacterium most frequently recovered from many people who died. Viruses weren't known for another 20 to 30 years. And this was not the Spanish flu, it was the Kansas flu, but that's not nearly as interesting a name. Revising opinions is nothing new!)

So how do coronavirus infections look? Coronaviruses cause that runny, snotty nose that kids bring home from daycare. They can have a cough for a week to 10 days and be "off the feed. Additionally, that child can bring this loving gift home to their parent, giving them a runny, snotty nose for a couple of days. (Thanks, kids!) This is key to understanding coronaviruses and their transmission: essentially everyone alive today got Coronavirus OC43 as a child. The parent (obviously) had this when a child. Then, if the parent had OC43 as a child, why does the parent get sick again? (This is Question #1.) Should the parent not be resistant? Answer #1. This is what the body does with coronavirus do. Infection does not impart absolute lifelong immunity; any immunity is temporary. (This is common; get your tetanus shot updated?) The immune system cannot maintain a permanent defense against all pathogens all the time; you wouldn't have the time or energy to do anything else! Corollary #1. This is likely the reason why COVID immunizations don't give permanent absolute immunity; that simply is what the immune system does with coronavirus.

The parent with a runny snotty nose and cough that they got from their loving child knows better than to visit their elderly sick grandma in the nursing home. They know to wash their hands. They know to cough into their elbow. They know to throw away the used Kleenex. They know not to visit people with poor immunity. We knew all of this before COVID-19. Question #2: Why are we acting all surprised at the recommendations on COVID-19? Didn't we already know this before 2019? Answer #2. Common sense is not that common; cool heads do not always prevail. Theres no money in that! Corollary #2. Pay attention to what your parents taught you. Wash your hands. Don't share your pop cans. Put your used dinnerware in the sink. And don't visit old, sick people in the nursing home when you are sick yourself. (Full disclosure: My dad is 97 and living in a nursing home.)

More: Ag Secretary Vilsack joins Speaker Pelosi, Sen. Collins in testing positive for COVID as outbreak spreads among DC officials

So now that we understand this, what about COVID vs. those other four coronaviruses? They have been with us for well over a century and seem to be nothing more than a common cold; one wonders why all the excitement about COVID-19? It does seem we're getting all excited about a common cold. The answer is combining the first two ideas, COVID-19 and the other four coronaviruses. No one, from a newborn up to my father, had antibodies to COVID-19. That's because it wasn't present when my dad was a child, when I was a child or when you were a child (unless you're too young to be able to read this.)

Thus, when anyone older than a teenager gets COVID-19, their body has noidea how to fight it off. They don't have that wonderful, active, well-controlled immune system of a youngster. This is why children receive all those immunizations; their immune system knows how to handle them. The adult immune system has to be trained and doesnt do as well. It lacks the skills of a child's immune system in properly responding to challenges.

Thus, many older people, myself included, are known to have less-than-ideal immune systems. We've known this for 15 to 20 years. People my age (over 65) must get four times the amount of flu shot to get our immune systems just to respond. We know that older folks get sicker and die easier. Thus, when an older person (defined as anybody older than me) gets sick, they tend to get sicker and die more easily from a sickness that would not have so affected a young person. So Question #3: How are people going to get immunity? After all, people are all going to get immunity to this coronavirus, just like the other four. Answer #3: People are going to get immunity to COVID-19 the same way they got immunity to the other coronaviruses: by getting antibodies and T-cell immunity. They're going to get an infection or an injection. Period, end of discussion. This is 100% of the population … that survives. And the ones that don't survive, who die from COVID, do so through the infection route. It will be extremely rare to be damaged via the injection route.

Those who claim they don't have the immunization and yet don't get sick have antibodies they got from somewhere; no magic allowed. They could have had a stealth infection or a stealth injection; both occur. Corollary #3: At the end of this, everybody will have antibodies. If they die of COVID-19, they may not have developed antibodies in time. If they survive COVID-19, they will have antibodies from infection. Infection or injection, everyone will have antibodies to Coronavirus #5, (COVID-19) the same as the Coronaviruses 1 through 4.

More: Here's the thing about that dire climate report: We have the tools we need to fix things

This final stage, when COVID is present everywhere, from childhood through the elderly, is called the endemic stage. It will take several decades to occur; the children will grow up and have children themselves. The young adults will become old adults. The old adults will have either died or had infection or injection which allows them to survive COVID. We will remain, of course, susceptible to all the usual vicissitudes of life. (That's a complicated way of saying that people are going to die anyway, whether they get COVID-19 or are in a car wreck or have a heart attack.)

In the meanwhile, we're all in this together. We are responsible for what happens to our neighbor. If our actions harm our neighbor, we are responsible for that harm. This is what personal responsibility is all about; adults take responsibility for their actions. So let's stop all the fighting. Let's stop letting social media companies monetize our differences. Let us study this fascinating, new phenomenon.

Never before have we been able to track a virus as it makes this way into the human population. The possibilities for new knowledge and research are incredible. I'm going to predict that we will find an answer to such things as chronic fatigue syndrome and fibromyalgia. We're going to find answers to disorders like Kawasaki disease, a cause of heart attacks in children. There's so much interesting research to be done and so many burning questions to be answered! Wasting this opportunity by fighting with each other is a sin of the gravest order.

How does end? Not with a bang, but with a whimper.

And that's my prediction for the future.

I won't be around to see if I'm right.

Thats my opinion; whats yours?

Dr. Tom Benzoni is an emergency physician, practicing locally. He is a spokesperson for the American College of the Emergency Physicians. All opinions expressed are exactly that, his opinion.

Read the original here:

Opinion: How does the COVID-19 pandemic end? History and biology help provide the answer. - Des Moines Register

The stolen money was used on rent, hotels, dog boarding, attorney fees, rideshares, electronics, and a Tesla Model 3. At least $288,000 was converted to cryptocurrency and other funds were wired across 13 bank and brokerage accounts. Some funds were used in over 2,000 transactions utilizing 43 different types of cryptocurrency.

D.C. Department of Justice officials say that Elias Eldabbagh, 30, has pleaded guilty to wire fraud charges after carrying out a scheme with the potential to gain $31 million of CARES Act funding. He successfully stole $2,385,000.

Eldabbagh is said to have stolen the money for a luxury car using a Paycheck Protection Program and Economic Injury Disaster Loan scheme.

During the two years since the CARES Act was passed, IRS-CI special agents have rooted out and continue to pursue these selfish criminals who thought they could get away with stealing from those who truly needed help, IRS-CI Special Agent in Charge Waldon said.

According to a statement, the man used a company Alias Systems, LLC to apply for 25 PPP loans totaling over $30 million from July 2020 through May 2021. He also submitted at least four EIDL applications that totaled $950,000.

Officials say he disguised himself using a stolen identity in order to submit most of the applications. He also used identities, tax returns and financial documents from a consulting company in D.C. and doctored those documents to match his company name.

The stolen money was used on rent, hotels, dog boarding, attorney fees, rideshares, electronics, and a Tesla Model 3. At least $288,000 was converted to cryptocurrency and other funds were wired across 13 bank and brokerage accounts. Some funds were used in over 2,000 transactions utilizing 43 different types of cryptocurrency.

In May of 2021, officials say that Eldabbagh tried to transfer funds seized by IRS-CI to other accounts. He has since agreed to forfeit the Tesla Model 3, the contents of 21 bank accounts and liquidate his cryptocurrency interests.

Eldabbagh is scheduled for sentencing on Aug. 25.

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DC man steals over $2 million in COVID-19 funding - WTOP

WASHINGTON (NEXSTAR) This week, dozens of top government officials and others tested positive for COVID-19 after a high-profile Washington dinner last weekend.

Sen. Susan Collins, R-Maine, and Sen. Raphael Warnock, D-Ga., are the latest victims.

Possibly the highest profile positive case Speaker Nancy Pelosi. She abruptly canceled her weekly press conference after testing positive on Thursday.

Friday, White House Press Secretary Jen Psaki acknowledged President Biden could be vulnerable.

Like anyone, the President may also test positive for COVID-19, said Psaki.

Shortly before testing positive, Speaker Pelosi was spotted hugging and even kissing the president on the cheek.

Thursday, the Vice Presidents communications director also tested positive.

The Vice President and the President have since tested negative.

The Vice President wore a mask inside today, when she was both with the President and with her staff, Psaki said.

She said whats most important is the President is prepared.

He has taken a range of precautions, as we all have, but hes also taken steps like getting his second booster, as he did last week. Psaki said.

Earlier this week, Chief Medical Advisor to the President Doctor Anthony Fauci said the fourth shot is proven to prevent serious illness or death.

According to the Speakers office, Pelosi is fully vaccinated, boosted and only experiencing mild symptoms, as are most others who reported positive cases.

The White House says the President will continue his public schedule.

His doctors are comfortable that he can carry out his duties, said Psaki.

That continued Friday when the President held a rather large gathering on the south lawn of the White House to celebrate the confirmation of justice-to-be, judge Ketanji Brown Jackson. There was some concern that the event could end up being another super-spreader event, as was there not many masks outdoors.

There are no public events for the President today. He is back home in Delaware for the weekend.

More:

Top government officials positive for COVID-19 after Washington dinner - WGN TV Chicago