Category: Covid-19

The World Health Organization declared the COVID-19 outbreak a pandemic on March 11, 2020. Now, more than two years later, society is at a crossroads, according to AMA member Stephen Parodi, MD.

The U.S. has a chance to move COVID-19 from being a pandemic to an endemic, which means that the disease is still around but that it's at a level that is not causing significant disruption in our daily lives, said Dr. Parodi, an infectious diseases physician.

Endemic diseases can be at high levels. They can be at lower levels. So, where I think we're at a crossroads is that we have an opportunity to actually get that to a lower level, manageable level, where we're not getting impacted in our hospitals, not having to close down schools, close down businesses, he added. That really is through a combination of a concerted effort around testing, vaccination, isolation, quarantining, that looks a lot more normalized than what we've had to do over the last two years.

Dr. Parodi is an associate executive director at The Permanente Medical Group, anAMA Health System Program member. He is also part of the AMA Integrated Physician Practices Section.

He spoke about COVID-19s becoming endemic in a recent episode of AMA Moving Medicine.

How to know when COVID-19 is endemic

There is not a set threshold that dictates when a pandemic becomes endemic, Dr. Parodi said.

While the Omicron variant of SARS-CoV-2led to an enormous surge in positive cases across the U.S., Dr. Parodi said there were encouraging signs connected to endemicity. For the most part, people who were vaccinated and then tested positive had mild symptoms or were asymptomatic. The more people who are vaccinated, the better.

We can move this in a way that the disease is milder, he said. At least so far, vaccine-based immunity appears to provide very broad-based immunity against multiples of variants.

Find out what doctors wish patients knew about vaccine boosters.

The Centers for Disease Control and Prevention (CDC) recently updated its guidelines to track COVID-19 risk in communities, which is another shift toward endemicity, Dr. Parodi said.

Rather than focus on the percent of test positivity and COVID-19 cases per 100,000 people, the new guidelines calculate the number of hospital admissions related to COVID-19 in the previous week, the percentage of staffed hospital beds occupied by COVID-19 patients, and the number of new COVID-19 cases per 100,000 people the previous week. Those calculations will determine whether the areas risk level is judged low, medium or high by the CDC.

The difference is that instead of focusing on preventing transmission of the virus, the CDC guidelines aim to minimize severe illness and prevent overwhelming health care systems.

This shift to looking at it from a severity of disease standpoint is important, Dr. Parodi said. A measure of endemicity really is going to look at how many people are developing severe disease at a given time. If we're seeing increases in that, we've got to take action. If we're not, that's a different set of actions, and that's similar to what we do for influenza year over year.

Endemicity will require a mindset shift

One of the big learnings coming out of this whole experience is that we need to be better prepared, Dr. Parodi said. We've got experience in this. We prepared before all of this for our annual flu season. Now we've got to be prepared for potential COVID ups and downs that are not tied to a season.

Get the latest news on the COVID-19 pandemic, vaccines and variants, and more reliable information directly from experts and physician leaders with the AMA COVID-19 Update.You can catch every episode by subscribing to the AMAs YouTube channel or the audio-only podcast version.

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How we will know when COVID-19 has become endemic - American Medical Association

A healthcare worker administers a Covid-19 test in San Francisco, California, on Monday, Jan. 10, 2022.

David Paul Morris | Bloomberg | Getty Images

People infected with Covid-19 face a higher risk of myocarditis and other inflammatory heart conditions than those vaccinated against the disease, according a large study published by the Centers for Disease Control and Prevention on Friday.

The CDC found the risk of myocarditis, pericarditis and multisystem inflammatory syndrome was higher after Covid infection than after Pfizer or Moderna vaccination in males and females ages 5 and older. However, these cardiac conditions are rare after infection and vaccination alike, according to the CDC.

Myocarditis is an inflammation of the heart muscle and pericarditis is an inflammation of the outer heart lining. Multisystem inflammatory is a condition associated with Covid infection that affects multiple organ systems.

Pfizer and Moderna's vaccines have been associated with an elevated risk of myocarditis and pericarditis after the second dose, particularly among boys ages 12- to 17-years-old. However, even in this group the risk of myocarditis and pericarditis was higher after Covid infection than after vaccination, according to the CDC.

Among teenage boys, the rate of myocarditis or pericarditis after infection was at least 50 cases per 100,000 people, compared to at least 22 cases per 100,000 after the second vaccine dose. The overall risk of heart conditions after Covid infection was up to 5.6 times higher compared to the second vaccine dose. The risk was up to 69 times higher after infection compared to the first shot.

The CDC examined the electronic health records of more than 15 million people ages 5 and older across 40 health-care systems from Jan. 2021 through Jan. 2022. Scientists studied the risk of developing a cardiac condition after a Covid infection compared to the first and second doses of Pfizer and Moderna's vaccines. The study excluded booster doses from the comparison.

Read CNBC's latest global coverage of the Covid pandemic:

Overall, the risk of a heart issue after Covid infection was anywhere from 2 to 115 times higher compared to vaccination depending on age, gender and the dose administered.

In February, the CDC said males age 12- to 39-years-old should consider waiting eight weeks between the first and second dose of the Pfizer or Moderna vaccines to reduce the risk of myocarditis. Canadian public health authorities had found that the rate of myocarditis after Pfizer or Moderna vaccination was higher when the time between the first and second dose was fewer than 30 days.

Moderna's second dose appears associated with a higher risk of myocarditis than Pfizer's, according to data presented to the CDC's committee of vaccine experts in February. Public health authorities in Ontario, Canada have found that the rate of myocarditis was 5 times higher for males ages 18-24 following a second dose of Moderna compared to Pfizer.

However, the overwhelming majority of people who developed myocarditis after vaccination recovered fully and most of them did not report any effect on their quality of life, according to a CDC survey of health-care providers presented at the February meeting.

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Myocarditis risk higher after Covid infection than Pfizer or Moderna vaccination, CDC finds - CNBC

Philadelphia CNN

As Covid-19 infection rates and restrictions are waning in some places and a variant is surging in others, its difficult to understand where we are in the pandemic.

But two years ago, the situation was clear: for many people, coronavirus had brought the world to a stop. Thats when pediatric surgeon Dr. Ala Stanford sprang into action, bringing Covid-19 testing to Black and Brown communities in Philadelphia that were hard hit by the virus.

In the months that followed, Stanford brought testing and vaccines to more than 75,000 people through her nonprofit Black Doctors Covid-19 Consortium. And as she worked to help underresourced communities weather the pandemic, she diagnosed an even greater problem.

We were seeing folks that hadnt seen a doctor in a decade, said Stanford, who was honored as a Top 10 CNN Hero last year. We were just literally putting a Band-Aid to a much bigger problem with health inequities and health disparities.

Its well-documented that Black and Brown communities have suffered greater hospitalizations and deaths from Covid-19 for a host of reasons, including higher risk factors for exposure and a higher risk of severe disease.

But lack of accessible and affordable health care is a key factor that leads to worse health outcomes for people of color. In particular, lack of outpatient care, like annual checkups and doctors visits, can play a critical role in preventing health issues.

This larger, systemic issue is what Stanford is trying to remedy.

In November, she began seeing patients at the Dr. Ala Stanford Center for Health Equity, her new facility in north Philadelphia. This multi-disciplinary clinic offers services ranging from primary care and mental health, diagnostic testing like EKGs and mammograms and, of course, Covid testing and vaccinations.

We take care of newborns through grandma and grandpa, she said. And that is the next step wanting to not just save lives, but really impact an entire lifetime with people.

Located on the grounds of Deliverance Evangelistic Church, in an area that once housed a day care center, the space underwent a massive renovation. The center now includes exam rooms, consultation areas, a childrens play space, even a fish tank. Most importantly, it provides care to everyone, regardless of their ability to pay.

If you have insurance, we run it, Stanford said. If you dont have insurance, we help you get (it). And if you dont have anything, youre not going to be turned away.

This fall, as the coronavirus seemed to recede into the background, Stanford was excited to switch gears to focus on this broader health mission. But the Omicron variant of the virus changed her plans.

After Christmas, there were so many people sick, literally wrapped around this building to get Covid tested. The positivity rate was 45% she said. So, we had to stop primary care and just focus on testing and vaccination.

Yet, she and her team still figured out a way to provide brief wellness checks with each vaccination.

You come in for a shot and you see your vital signs are out of whack you might say Did you know you have high blood pressure? or Did you take your medication today? Stanford said.

And in early January, when Stanford realized that Covid rates were rising in children and young people, she added another approach.

In a public health crisis, you go to the people. And the kids are primarily in school, so thats what I pushed for, she said.

Since then, Stanfords team has worked with FEMA to hold nearly 20 vaccination clinics at schools in and around Philadelphia. She says in some of them, they have doubled the vaccination rates among students. Her group also still offers vaccinations and testing throughout the community at police departments and mass transit SEPTA stations.

Two years later, Stanfords surgical practice is still on hold. While she admits to missing the operating room at times, she knows that the work she is doing now is making a difference on a much larger scale.

What weve done has touched over 100,000 lives. And that refuels me, she said. The need here right now is so great. I feel that this is where Im supposed to be.

Want to get involved? Check out the Black Doctors Covid-19 Consortium website and see how to help.

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After vaccinating thousands against Covid-19, this CNN Hero is fighting inequity in the medical system - CNN

Syracuse, N.Y. With rising Covid-19 infection rates, Onondaga County will be handing out home tests and KN95 masks on Monday at the New York State Fairgrounds.

The drive-thru giveaway will begin at 9:30 a.m. in the Orange Lot, county executive Ryan McMahon announced Friday in a news release.

Each car will receive four tests and the masks will be handed out as quantities allow, he said.

The tests will be given out until noon and residents are asked not to arrive before the start time.

On Friday, McMahon said the county received 449 positive test results, including 144 at-home tests reported by residents. That was the highest total of new cases since Jan. 30 when there were 518 new cases.

The number of Covid-19 patients in the hospital ticked up to 54 Friday, the highest in 10 days. There were no new deaths, McMahon said.

Onondaga County is one of three counties in Central New York that the U.S. Centers for Disease Control and Prevention is recommending wear masks. The other two counties at high risk were Oswego and Cayuga counties.

Broome, Cortland, Tompkins and Tioga counties are at medium risk, according to the CDC.

Covid-19 community levels were low enough three weeks ago that masks werent recommended in any county in the state, but cases and hospitalizations have increased in Central New York due to the rise of the highly contagious BA.2 variant, the end of widespread mask-wearing, and the waning of vaccines.

As we focus on our recovery, we must still remain vigilant against COVID-19, McMahon said Friday in the release. This means making sure you are vaccinated and boosted, staying home when sick and also taking advantage of the widespread availability of testing. Onondaga County is committed to distributing tests and masks as quickly as we receive them and this drive-thru distribution is the latest part of that effort.

Staff writer James McClendon covers breaking news, crime and public safety. Have a tip, a story idea, a question or a comment? Reach him at 914-204-2815 or jmcclendon@syracuse.com.

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Onondaga County to hold drive-thru Covid-19 test and mask giveaway at NYS Fairgrounds - syracuse.com

New Jersey Gov. Phil Murphy (D) tested positive for COVID-19 in a breakthrough case of the virus, a spokesperson confirmed on Thursday.

This afternoon, as part of a regularly-scheduled testing regime, @GovMurphy took a rapid antigen test that came back positive for COVID-19. He subsequently took a PCR test, which also came back positive. He is currently asymptomatic and feeling well, Mahen Gunaratna, a Murphy spokesperson, said in a statement on Twitter.

Gunaratna said that Murphy was fully vaccinated and boosted and that they were notifying those who may have come in contact with him. He added that the governor would be isolating over the next five days and canceling in-person events.

The Governor has diligently taken precautions to limit the spread of COVID-19 and encourages everyone eligible to get vaccinated and boosted, as he has done, to protect themselves and their loved ones from the virus, Gunaratna said.

More than two years since the World Health Organization declared the coronavirus a pandemic, case numbers in the United States have declined following a spike driven by the omicron variant, as have deaths and hospitalizations. Amid that decline, states and cities around the country dropped COVID-19 restrictions such as indoor masking requirements.

However, the Centers for Disease Control and Prevention has now said that the latest variant the omicron subvariant BA.2 is the most dominant strain in the U.S.

The variant is believed to be more transmissible than the original omicron strain, though it remains unclear what kind of impact it could have on the U.S., including what kind of increase in cases could be expected.

The Hill has removed its comment section, as there are many other forums for readers to participate in the conversation. We invite you to join the discussion on Facebook and Twitter.

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NJ Gov tests positive for COVID-19 - The Hill

Officials are calling this next stage of the pandemic response Steady State.

(Chris Samuels | The Salt Lake Tribune) Cars wait in line for COVID-19 testing in Herriman, Monday, Jan. 03, 2022. State sponsored COVID-19 testing sites closed March 31, 2022, as the state has wound down its coronavirus response.

| April 1, 2022, 12:00 p.m.

Editors note: The Salt Lake Tribune is providing free access to critical stories about the coronavirus. Sign up for our Top Stories newsletter, sent to your inbox every morning. To support journalism like this, please donate or become a subscriber.

As Utahs coronavirus metrics remain consistently low, the state is winding down its coronavirus response.

That means Utah will no longer provide daily reports on case counts, hospitalizations, deaths and more information thats been provided each day since the pandemic began two years ago.

Its a response thats involved tracking the approximately 928,000 coronavirus infections documented in Utah to date, and spending millions on free testing sites and vaccine centers. Many of those state-sponsored testing sites closed Thursday, with others being transferred to private companies.

Heres what you need to know about keeping tabs on Utahs coronavirus metrics in the latest phase of the states pandemic response, which officials are calling Steady State.

The Utah Department of Health will still update its coronavirus dashboard, but those updates will come weekly now, launching every Thursday. Officials likened it to how they treat other diseases, like the flu.

Because the state expects more people to use at-home COVID-19 tests when they feel ill, officials will instead focus on monitoring longer-term trends using wastewater analyses and the number of hospitalizations and deaths.

The Salt Lake County Health Department will still update its own county dashboard, which also will focus on longer-term metrics including hospitalizations, deaths, vaccination rates and outbreaks, spokesperson Nicholas Rupp said. That dashboard will update on Mondays.

Utah County will discontinue its dashboard and refer people to the states website. It will share summaries of its COVID-19 data Mondays on social media, including Twitter, Facebook and Instagram, officials said.

Sewage data will be updated at wastewatervirus.utah.gov.

Most people seeking a COVID-19 test will now need to either find a private business or healthcare provider and pay for one, or use an at-home test.

The health department will keep some test kits on-hand in case there is another surge, or help people who dont have insurance and otherwise cant afford testing.

For information on available testing sites visit coronavirus.utah.gov/utah-covid-19-testing-locations. To order free, at-home COVID-19 tests, visit covid.gov/tests.

Those who need tests for travel can find information at coronavirus.utah.gov/travel. Such tests typically cost between $75 and $250.

The state will continue monitoring metrics that may indicate a severe disease.

State epidemiologist Dr. Leisha Nolen acknowledged there will likely be future waves of COVID-19, but that alone wont trigger a reversal. If there is a future outbreak, she said she hopes peoples vaccine immunity or immunity from previously contracting the virus would prevent them from getting seriously ill.

But if severely sick people begin to overwhelm hospital systems, Nolen said, Thats where well need to consider whether or not we need to restart some of these additional protections.

Officials did not identify a specific threshold for returning to daily updates or reopening free testing centers.

The state, Salt Lake County and Utah County health departments do not anticipate a return to daily COVID-19 reporting, but officials at all three agencies said they have discussed that possibility in the event of a surge.

Nolen added that the current coronavirus strain dominating U.S. case counts the omicron subvariant BA.2 has been in Utah since at least January and hasnt had a significant impact. But officials will continue monitoring its spread.

Nolen said people who are fully vaccinated against the coronavirus and have received a COVID-19 booster shot should feel safe.

Department of Health analyses continue to show that people whove been fully vaccinated and have received a booster face a significantly lower risk of being hospitalized and dying from COVID-19. Vaccines remain free and are available for everyone 5 and older.

To find information on where to get vaccinated, visit coronavirus.utah.gov/vaccine-distribution.

People who are immunocompromised, she said, do face more risk. She noted that there are now treatments available including Evusheld, a long-acting antibody treatment, that can help reduce the chances of infection.

I do encourage them to seek out whatever protection is most appropriate for them, Nolen said, and I really hope people can get back to feeling secure and safe in their lives.

For more information on the states COVID-19 response visit coronavirus.utah.gov/steady-state.

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Utah stopped its daily COVID-19 updates. Here's how to keep tabs on metrics. - Salt Lake Tribune

The majority of funds given to the city of West Haven through the COVID-19 Relief Funds (CRF) program were misused, according to a report released from the Office of Policy and Management.

The audit, done by CohnReznick, shows that approximately 80% of the $1.15 million in pandemic relief funding provided to the city was not used properly.

The CRF program was passed by Congress at the start of the pandemic in 2020 to help municipalities across the county.

According to the report, federal officials laid out rules and requirements to properly use this funding.

Auditors said that approximately $892,887 spent didn't meet the criteria.

The report states that the purchasing process within city departments are inconsistent and individual city departments were performing their own purchasing functions. This is because the purchasing manager role has been vacant for a long time. City officials said purchasing can't be centralized until the position is filled.

Auditors concluded that the city shouldn't have allowed the majority of funds that were ultimately approved.

These expenditures were the result of either ineligible expenses or a lack of sufficient justification and documentation. Additionally, auditors uncovered significant deficiencies in internal controls, policies and procedures that were not related to the CRF program, the report said.

Auditors said that the CRF funds weren't separated from the city's general operating bank account, according to the report. CohnReznick suggested that the city establish segregated bank accounts for all future grant or program funds received to avoid any crossover.

The audit findings are outrageous and a betrayal of the publics trust. They require further analysis and investigation. The MARB has considerable work to complete in order assist West Haven with its finances and accounting practices. The legislature established the MARB process to improve municipal transparency and accountability and that process should continue for the benefit of the residents of West Haven and the State of Connecticut," Max Reiss, spokesperson for Gov. Lamont said.

According to the report, there are several instances where the Municipal Accountability Review Board previously identified and required the city to take corrective action.

West Haven's former finance director Frank Cieplinski told auditors that city invoices are often times submitted once it's due to be paid. The report found that this process has resulted in many accounting irregularities.

Back in October of 2021, West Haven Mayor Nancy Rossi said in a YouTube video posted on the citys website that she has reviewed many of the citys federal CARES Act expenditures and came across several large expenditures that concerned her.

The review board plans to meet in the coming weeks to figure out next steps. Officials said a corrective action plan will be considered at the next meeting.

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Majority of COVID-19 Relief Funds Were Misused in West Haven: Report - NBC Connecticut

Because SARS-CoV-2 can be detected in wastewater systems, a commentary published March 30 in Nature suggests that smart toilets may be a good public health strategy for detecting and tracking COVID-19 cases.

Gastrointestinal symptoms are a primary indication of COVID-19 infection, and the virus can be detected through fecal testing. Smart toilets would leverage this through their integrated stool collection and analysis kits that could inform users of a positive result within minutes.

Alongside helping track and monitor COVID-19 cases, the toilets could also aid in research about how COVID-19 rates and infection time correlate with stool samples.

"We envision passive toilet-based sampling and testing as a key strategy in advancing precision health-based diagnostics by tapping into the wealth of information contained in urine and stool, which has been too frequently flushed away," writes the Stanford School of Medicine authors, led by T. Jessie Ge, MD.

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Could smart toilets lead the way for COVID-19 tracking? - Becker's Hospital Review

Four women who have combined their emergency management education and experience to serve

Emergency management is transforming. Growing populations, a global pandemic, and intensified natural and human-made disasters are key reasons the field has an evolving scope.

Pictured in above image (from L to R): Katja Miller, Clarissa Grant, Julia Watson, and Torii Sutherland

In Hillsborough County, there is another noteworthy shift. As a mighty team of 17, the County's Office of Emergency Management (OEM) is dominated by women. Torii Sutherland, Katja Miller, Julia Watson, and Clarissa Grant are four of the women changing the face of emergency management.

The tides of change

They are in good company. For the first time in history, the nation's emergency management departments - the Federal Emergency Management Agency (FEMA) and the U.S. Fire Administration -both have women at the helm.

When emergency management was in its infancy, the field naturally attracted individuals working in law enforcement, fire rescue, and the military. Traditionally, those roles were male-driven, therefore, emergency management was as well.

Miller, who focuses on human services and mass care for the County, looks forward to the continued evolution of emergency management with women holding top positions. Grant, an operations coordinator, agrees. She hopes for an increased number of women in the field and more diverse leadership.

Miller and Grant's wishes are coming true on a national scale.

In the early days of emergency management, when staff mostly hailed from law enforcement, fire rescue, and the military, responding to emergencies was the primary focus. Now, response is one pillar of emergency management, and the field has grown to embrace preparedness and recovery in impactful ways.

What once was a field entered into by progression is now entered into as a profession. Academia is driving people into emergency management, driving diversity, and - as proven by Miller, Grant, Sutherland and Watson - when education meets experience, capabilities soar.

Education meets experience

A strong drive to use her skills to help people during times of crisis led Sutherland from satellite communications to the military, and it eventually guided her to Hillsborough County. In her current role as Planning Section Chief, Sutherland is able to expand her knowledge base and use her talents to help Hillsborough residents during critical moments. Sutherland holds a master's degree in biochemistry, and says she is constantly learning in her position.

Similarly, Miller knew that she wanted to serve. Beginning her career as a firefighter at age 18, Miller was hooked. While obtaining her bachelor's degree at USF, a course titled "Planning for Emergencies" opened her eyes to emergency management, and in the midst of COVID-19 and 18-hour workdays, Miller pushed through, earning her master's degree in crisis and emergency management.

Having her mom as a director for BayCare, Watson always knew that she was destined for something in the medical field. She started out as an EMT for Pinellas County but wanted more. Helping people in emergencies was her passion, but Watson sought to help people on a large scale. While working full time, Watson obtained her undergraduate degree in emergency management and homeland security. Like Miller, while on the front lines of COVID-19, Watson completed her master's degree in disaster medicine and management.

Grant chooses this line of work because of the great need. Grant says that she has always had an interest in public health and science. And she has carried that interest through her adult life. Grant has her nursing degree, an undergraduate degree in biology and chemistry, and her master's degree in public health. Emergency management is a big component of public health, and Grant wanted to be able to help communities prepare for and recover from disasters at any moment.

Women play an important role

As Women's History Month closed out, questions specific to the role of women in emergency management were posed to the group.

What do women bring to this line of work? Sutherland, Watson, Miller, and Grant agree that compassion and resiliency are just two of many qualities. And, in emergency situations, these abilities are crucial.

How can the profession increase the number of women in the field? Through education and mentorship.

Finally, why should women be in emergency management? Their resounding answer, "Why not?"

Read Part One

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The Women Behind Hillsborough's COVID-19 Response - Part Two - Hillsborough County

Millions of people could lose health insurance coverage when the COVID-19 emergency ends  USA TODAY

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Millions of people could lose health insurance coverage when the COVID-19 emergency ends - USA TODAY