Category: Covid-19

An isolation facility for Covid-19 patients being built in Hong Kong, next to a bridge linking the city with Shenzhen in mainland China, on Friday.Credit...Kin Cheung/Associated Press

Hong Kong is struggling to get a handle on its worst coronavirus outbreak since the start of the pandemic, warning that it doesnt have the testing capacity to carry out the strict strategy handed down by Beijing.

In Shenzhen and Shanghai, in mainland China, officials imposed restrictions on millions of people within days of local outbreaks in order to test every single resident. But Hong Kongs chief executive, Carrie Lam, noted on Monday that her city doesnt have the same ability.

Hong Kong is very different from many mainland cities and therefore we cannot have any comparison, Mrs. Lam told reporters at a news conference.

The difference amounts to resources and systems of governance, Mrs. Lam said. Shenzhen and Shanghai can test millions of people a day; Hong Kongs health officials can only test between 200,000 and 300,000 people a day.

Hong Kong, one of the last places in the world that is still trying to get rid of the virus instead of living with it, has reported more than 700,000 cases and 4,066 deaths since late January. Over the past week, Hong Kong is averaging more than 280 deaths and 21,000 new cases per day, according to the Center for Systems Science and Engineering at Johns Hopkins University.

Source: Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. The daily average is calculated with data that was reported in the last seven days.

It is a strategy that has been dictated by Beijing but one that appears increasingly out of reach for Hong Kong, which continues to hold freedoms that dont exist in the mainland.

In the Chinese cities of Wuhan and Xian, officials halted daily life and confined residents to their homes for weeks until there were no more local cases. In Tianjin, they began testing every single resident after just 20 cases of coronavirus were reported.

Further separating Hong Kong from the mainlands approach, Mrs. Lam said she would not consider tightening social-distancing measures because she had to take into how residents felt about them.

I have to consider whether the public would accept further measures, so we would not just casually roll out further distancing measures, Mrs. Lam said.

The outbreak and Mrs. Lams ability to get it under control has been seen as a test of her leadership, though not one determined by ordinary Hong Kong people. The election of the citys next leader will take place on May 8 and will be decided by an election committee of more than 1,400 people who are loyal to Chinas Communist Party.

Mrs. Lam has been under pressure from the public to commit to a timeline for mass testing since she first raised the possibility in mid-February.

Fears of a Wuhan or Xian type of lockdown have prompted residents to empty supermarket shelves and hoard medicine. It has also led to an exodus of the citys expatriate community, many of whom have grown tired of two years of strict pandemic measures and uncertainty about how and when the citys restrictions will end.

If you want us to follow what Shenzhen is doing, that is to introduce compulsory universal testing within three days, Im afraid we are not up to it, Mrs. Lam said. This is a reality we have to face up to.

On Monday, officials for Hong Kongs international airport announced that mainland airline passengers will no longer be able to take a ferry from Shenzens Shekou Port to Hong Kongs international airport, suspending the service, beginning Tuesday.

Adeel Hassan contributed reporting.

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Covid-19 Live Updates: Cases, Restrictions and More - The New York Times

The connection between a higher level of estrogen and a lower risk of mortality from COVID-19 continues to be of interest to the scientific community.

A recent study takes a fresh look at the connection between the hormone and COVID-19 outcomes. Their findings appear in the journal BMJ Open.

The studys senior author, Dr. Anne-Marie Fors Connolly, a clinical research fellow at Ume University, told Medical News Today:

The results of this particular study showed that postmenopausal women taking estrogen had a lower risk of death from COVID-19 than those who were not taking supplemental estrogen. Its an intriguing result that definitely warrants further study. For example, earlier research investigating possible treatments for COVID-19 also cited estrogen as a potential therapeutic agent.

A previous study found that females have a lower risk of severe SARS-CoV-2 infection. The team also found that older females who were taking or had taken hormone therapy were less likely to have the infection than age-matched females who had never taken hormone therapy.

These and similar findings have led some scientists to ask whether estrogen could play a role in future treatment options.

Estrogen is a hormone associated with the female reproductive system. As menopause begins, the ovaries produce less estrogen.

The new study analyzed national data from the Swedish Public Health Agency, Statistics Sweden, and the National Board of Health and Welfare. The researchers collected the data from February 4 through September 14, 2020.

The data came from 49,853 women who had received a COVID-19 diagnosis during this time frame. Of those, 16,693 were aged 5080 years.

The researchers focused on a group of 14,685 women with at least one positive SARS-CoV-2 test. Among this group, 227 women were taking estrogen blocker drugs to prevent cancer recurrence, and 2,535 were taking hormone replacement therapy to reinforce estrogen levels. The remaining 11,923 women were taking no treatments to influence hormone levels and acted as a control group.

After adjusting for risk factors, including age, income, and medical history, women receiving estrogen had 53% lower odds of dying from COVID-19, compared with women who did not receive the hormonal treatment.

Participants taking estrogen blockers were twice as likely to die from COVID-19 in the initial analysis. However, after the team adjusted the data for other factors, this difference was not statistically significant.

As expected, the researchers also found that age represented an important factor in COVID-19 survival: Mortality odds increased by 15% with every year of age. Similarly, each additional medical condition increased the mortality odds by 13%.

The results also showed that individuals with a higher income had an advantage. Women from the lowest income households were three times more likely to die from COVID-19 than those from the highest income households.

From a clinical perspective, these findings could shed light on future opportunities for treatment. Dr. Amy Roskin, chief medical officer at The Pill Club, told MNT:

The results of this particular study showed that postmenopausal women taking estrogen had a lower risk of death from COVID-19 than those who were not taking supplemental estrogen. Its an intriguing result that definitely warrants further study. As a clinician, Im interested in more validation of these results, especially from a prospective, randomized study.

The specific mechanisms behind the findings are not yet clear. One theory is that estrogen has a protective role for COVID-19 in women. The authors thought there might be a direct effect on viral reproduction, or estrogen might modulate, downregulate, gene expression to reduce mortality, said Dr. Roskin.

Although the study did not include data about dosages of hormone replacement therapy or estrogen blocker drugs, the researchers conclude that increasing estrogen levels may help alleviate COVID-19 severity in postmenopausal women.

Dr. Fors Connolly concluded: Our study is an observational study, therefore currently there should not be any clinical implications, as of now. A clinical trial is needed to determine there is an effect.

Interestingly, she added, there is an ongoing clinical trial, and our study supports the potential beneficial effect of estrogen supplementation against severe COVID-19. It will be very interesting to see what this trial finds.

More here:

Estrogen and COVID-19: Is there a link? - Medical News Today

Using administrative and RHIS data from ten countries, we assessed the effect of the COVID-19 pandemic on a spectrum of health services. We estimated the immediate effect after the declaration of the pandemic on 11 March 2020 and assessed whether services had returned to pre-pandemic levels by the last quarter of 2020. We found declines of varying magnitude and duration in every country. Effects were heterogeneous across countries, and we found no clear patterns in disruptions by country income group or according to the severity of COVID-19 epidemics. The health systems most affected included those in Chile, Haiti, Mexico, Nepal and South Africa. By contrast, Ethiopia and South Korea, which represent the poorest and richest countries, respectively, in our analysis, were among the least affected by health service disruptions.

The magnitude of health service disruptions at national levels also did not appear to be directly driven by COVID-19 severity. Of the ten countries included, six reported fewer than 2,000 cumulative cases per million in 2020 and even fewer deaths (Supplementary Table 3). Only 41 total cases were reported in Laos in 2020. Chile, Mexico, Nepal and South Africa faced higher COVID-19 caseloads, with peaks in June or July (or late October in Nepal). However, health service disruptions were largest in April and May 2020 in all countries, suggesting that they were not caused by overburdened health systems but rather by a combination of policy responses and demand-side factors. Several reasons for reduced healthcare use appeared common across countries: fear of contagion, inability to pay for healthcare due to loss of employment or remuneration, intentional suspension of routine care to leave room for patients with COVID-19, the redeployment of health workers or hospitals to COVID-19 care and prevention and the barriers imposed by COVID-19 lockdowns. Whether the type of COVID-19 response (for example, elimination versus steady-state strategies) or the stringency and length of COVID-19-related lockdowns were associated with the magnitude of disruptions remains unclear and should be investigated further.

On the other hand, we found patterns in disruptions according to the type of health service. Outpatient visits and hospital-based services (including emergency room visits, inpatient admissions, trauma care, accidents and surgeries) declined in every country reporting them, and these disruptions often persisted throughout the period analyzed. Other studies also reported declining inpatient admissions during the COVID-19 pandemic16,24. These declines may be explained, in part, by a reduction in need. For example, decreased mobility and bans on alcohol sale in some places have led to fewer accidents and a lower need for trauma care22,25,26. Social distancing and mask wearing might have also contributed to reduced spread of infectious diseases. However, the reduction in need is unlikely to account for the entire magnitude of decline. Much of the disruption in tertiary care might reflect that many hospitals were converted into COVID-19 treatment centers and suspended or postponed other services. The prioritization of COVID-19 care also disrupted the availability of intensive care beds, medical supplies and technology for services other than COVID-19. Hospitals also tend to be in urban areas that appear to have been more affected by service disruptions than rural areas (Supplementary Table 4). Declines in emergency room visits may also result from people delaying or foregoing urgent care. For example, studies from France and England suggest that people with chest pains and other symptoms of a myocardial infarction have been reluctant to go to hospitals during the pandemic, leading to a reduction in patients admitted with ST-segment elevation myocardial infarction and an increase in out-of-hospital deaths27,28. Persistent disruptions in hospital services could have important consequences, including exacerbating the already high unmet need for surgical care in LMICs29,30.

Overall, preventive care, such as routine childhood immunizations, screenings and testing, were among the most affected services. Although some of these services can potentially be delayed for a short time, our estimates indicate that many were not fully restored by the end of 2020. After the declaration of the pandemic, there were declines in child vaccinations of more than 10% in Chile, Haiti, Laos, Mexico, Nepal and South Africa (out of eight countries reporting these data). Several of these countries, in particular Laos and Nepal, were able to resume most vaccinations by the end of the year (Fig. 4). However, our estimates for the number of vaccinations missed from April to December 2020 show that not all vaccinations initially delayed were ultimately given (Fig. 5 and Supplementary Table 2). Observed effects were different across vaccine types. This is likely due to differences in vaccine schedules and delivery modes. For example, BCG is delivered at birth and generally followed the same declines as facility-based childbirth. We reported on five common vaccines (BCG, pentavalent, measles, pneumococcal and rotavirus). Other immunizations with different schedules or distribution modes might have been differently affected, including vaccines against the human papilloma virus, which was likely affected by school closures. Globally, DTP3 and MCV1 vaccination coverage is estimated to have fallen by more than 7% in 2020 compared to expected coverage in the absence of the pandemic31. A total of 66 countries also reported postponing at least one vaccination campaign in early 2020, and only 25 reinstated them by the end of the year32. These disruptions are expected to lead to future outbreaks of measles and other vaccine-preventable diseases and to an increase in child deaths8.

We also found large and persisting declines in breast and cervical cancer screening. Declines in cancer screenings and routine diagnostic work have been reported globally33,34,35,36. In England, breast cancer diagnostic delays are projected to increase 5-year mortality by 810%35. Chile and Mexico risk facing similar increases in breast cancer mortality over the next 5 years.

TB case detection declined by 2866% in Ghana, Nepal and South Africa and remained lower than pre-COVID-19 by the end of 2020. With symptoms similar to COVID-19, such as a cough, fever and breathing difficulties, many people with TB symptoms might have opted to stay home or could have been mistakenly diagnosed with COVID-19 (ref. 37). The Global Fund to fight AIDS, TB and Malaria estimates that TB and HIV testing declined by 1822% in countries supported by the fund. We found even larger declines in HIV testing in Nepal. An increase in untreated TB or HIV could have far-reaching consequences10,38. It is unclear whether social distancing may have contributed to reduced TB or HIV transmission. More time spent indoors in crowded households could increase TB transmission.

In contrast, across four countries, we found that the number of people on ART was virtually unaffected during the pandemic. Our findings are consistent with evidence that ART provision was generally maintained during the South African lockdown, whereas HIV testing and ART initiations declined12,39,40. Differentiated service delivery (DSD) programs for HIV, where drugs are distributed in decentralized locations, might explain the resilience of ART provision during the pandemic. Unlike traditional care models where visits are frequent and exclusively at the health facility, DSD models entail modifying the location for care (for example, to venues in the community), the frequency of visits (for example, biannually) and the cadre providing the services41.

Visits for malaria declined by 9% and 10% in Ghana and Thailand, respectively, but returned to pre-pandemic levels by the end of 2020. These short-term disruptions could still have led to an increase in malaria deaths, particularly if prevention activities (such as bed nets and insecticide spraying) were also disrupted42,43.

We found declines in diabetes or hypertension visits of more than 20% in Chile, Haiti, Mexico, Nepal, South Africa and Thailand. Similar disruptions have been reported elsewhere16,44,45,46. Some countries, including Chile, Mexico, South Africa and Thailand, reported implementing strategies to maintain drug adherence during the pandemic for people with these two conditions, such as online refills, community drug delivery or external pick-up points44,47. However, it is unclear whether they have been successful in maintaining drug adherence, as our data cover only the number of in-person visits conducted. Hypertension and diabetes management has been a particular challenge for LMIC health systems where the burden of uncontrolled diseases is high48,49,50. The pandemic could prompt policymakers to rethink the frequency of visits required and consider adopting principles of DSD to meet the needs of people living with these conditions51. South Africa has adopted such a strategy through the Central Chronic Medicines Dispensing and Distribution program52.

We also found large declines in in-person mental health services in Chile and Mexico. Only three countries reported on mental healthcare: Chile, Mexico and South Korea. In Mexico, the indicator was for mental healthcare after an attempted suicide, whereas Chile and South Korea reported on routine mental health consultations. In May 2020, the government of Chile established a digital mental healthcare platform (Saludable mente) to address the rise in mental health disorders during the pandemic. Other countries also integrated mental health interventions, such as telephone hotlines to support frontline health workers and the general population, to their COVID-19 response, including Mexico and South Africa. These programs may have helped mitigate the impact of reduced in-person care, but there is little evidence to date on their effectiveness53. The increase in depressive and anxiety disorders reported globally during the pandemic calls for the urgent need to strengthen mental health systems54.

Reproductive and maternal healthcare was generally more resilient compared to other services. Only two health systems Chile and Mexicos public sectorshad large declines in contraceptive provision (52% and 87%, respectively). Although some public sector users may have switched to the private sector or to pharmacies for contraceptives, the unmet need for contraception appears to have increased across Latin America and the Caribbean during the COVID-19 pandemic55. Frequent contraceptive shortages were also reported. By contrast, family planning visits declined by only 4% and 14% in Nepal and Haiti, respectively, despite large disruptions in other services. This finding is consistent with other studies from low- and lower-middle-income countries (including from household surveys) that found relatively small changes in use of family planning services during the pandemic11,13,15,16. Economic uncertainties during the pandemic may also have led to an increased demand for contraception15.

The number of facility-based deliveries declined substantially in Haiti, Nepal, Mexico and South Africa but were relatively stable in the other six countries reporting. Other studies also found mixed results for the effect of the pandemic on facility-based deliveries11,13,14,16,24,56. Reasons for this likely vary by country. At the Mexican IMSS, many hospitals were converted into COVID-19 treatment centers, and many pregnant women were redirected to the private sector for childbirth (sometimes at their own cost)44. In South Africa, the dataset contained information from all public and private hospitals (in the KwaZulu-Natal province only). Thus, the 11% decline in facility-based deliveries likely reflects an increase in home births. Ethiopia, one of the countries with the lowest rate of facility deliveries, had a 3% decline in facility deliveries (not statistically significant). However, this estimate likely hides sub-national disruptions. One study using household survey data found a decline in hospital births in urban areas only57. Similarly in Haiti and Nepal, more women might have opted to give birth at home or with traditional attendants58. This could be associated with an increase in maternal and perinatal mortality and morbidity9,59. Poorer antenatal care follow-up could also lead to a higher number of pre-term births and stillbirths60,61.

Visits for children younger than 5 years of age with diarrhea and pneumonia declined in all countries reporting, which was also reported by others13,16. Part of these declines may be explained by a reduced incidence of diarrhea and pneumonia from social distancing, school and daycare closures, mask wearing and improved handwashing practices62. Some caregivers may have also opted to seek treatment from pharmacies, shops or the informal sector for their childrens illness rather than visit health facilities, which would not be reflected in our data.

Health system design and organization before the pandemic may be associated with health service resilience. For example, in Chile, maternal health services are provided exclusively by midwives who were not redeployed to COVID-19 care and were able to maintain regular service provision63. In South Korea, the number of hospital beds per capita is about three times higher than the Organization of Economic Cooperation and Development average64. Thus, the country may have been able to reallocate a large share of this capacity to COVID-19 care without substantial negative effects on other services. South Korea also benefited from prior investments and a stronger public health response system, given its experience handling the SARS outbreak of 2003, the novel influenza outbreak of 2009 and the MERS-CoV epidemic of 2015 (ref. 27). The private sector in Mexico is large and expanding, and private facilities were able to provide maternity care for a high percentage of public sector users while public hospitals were repurposed to COVID-19 care44.

Our analysis has several strengths. We estimated the effect of the COVID-19 pandemic on 31 health services using administrative and RHIS data that represented the complete, or nearly complete, census of all health facilities in the country (or province in the case of Kwa-Zulu Natal in South Africa). Unlike costly population health surveys, administrative and RHIS data can provide near real-time data on the performance of health systems. Our study also included countries from all income groups, which provides a more comprehensive picture of the effects of the pandemic. Nonetheless, our study has limitations. First, although we included a range of countries, our results cannot be generalized to their regions or to other parts of the world. Second, the number and type of indicators available in each country varied, including slight variations in definitions (Supplementary Table 1). Thus, cross-country comparisons should be made with care. Third, the exclusion of private providers in some countries in this analysis limits our ability to quantify the extent to which patients switched from the public sector to the private sector for healthcare during the pandemic. Similarly, the routine data systems generally did not include telemedicine consultations that were made during the pandemic. Fourth, disruptions were assessed only at the national level, and our estimates could hide disruptions that occurred in specific sub-national regions, cities, types of health facilities or population groups within a country. Fifth, it is possible that the pandemic affected the quality of reporting in administrative sources and RHIS. However, we used thorough data-cleaning procedures and only used data from facilities that continuously reported throughout the study period in the six countries with disaggregated data (Chile, Ethiopia, Haiti, Laos, Nepal and South Africa). Sixth, our main analysis covers only the first 9 months of the pandemic. However, data for the first 6 months of 2021 in a subset of countries reveal that service disruptions continued in many countries in 2021.

Our findings have implications for current health system planning and for the management of future pandemics. Despite the many efforts deployed to maintain the continuity of health services, we found considerable declines in healthcare use. Part of these declines may be linked to decreased healthcare needs during the pandemic from reductions in non-COVID-19 infectious illnesses and fewer injuries. Nonetheless, a larger share of these declines likely reflects a failure of health system resilience. Health systems must urgently resume essential care and plan to compensate for missed needed services. This includes catching up on missed preventive care (such as health screenings and immunizations) and identifying and addressing any adverse health consequences of missed services, such as trauma care, surgery, C-sections and chronic disease management. These can include physical sequelae (for example, obstetric fistulae), chronic disease complications and health-related suffering. Higher rates of uncontrolled hypertension and diabetes, for example, could lead to an increase in cardiac events and in complications of diabetes, such as blindness, kidney failure and lower limb amputations2. In Chile and Mexico, the decline in family planning could result in higher rates of unplanned pregnancies. Finally, the pandemics negative effects on mental health, combined with declines in in-person care, will lead to greater unmet needs for mental healthcare and a potential increase in suicides53. Increased investments in health systems are needed to address these consequences and the surge in pent-up demand as well as to prepare the health systems for more agile function in the future. Given limited resources in some countries that will be further strained by the global economic downturn due to the COVID-19 pandemic, priority should be given to health interventions that will have the greatest benefits on health65.

Further research is needed to understand the full indirect health effects of the pandemic and the factors responsible for service disruptions. For example, our analysis did not assess changes in the quality of healthcare, which was likely affected during the pandemic (including from poorer processes of care and shortages of medicines or supplies), resulting in poorer health outcomes even among those who received care7. Similarly, future research should monitor trends in mortality from non-COVID-19 conditions and assess whether certain population subgroups (such as ethnic minorities, teenagers or the poorest) were differentially impacted by health service disruptions. Finally, it is important to disentangle the factors responsible for disruptions in health services.

In 2021, nearly all countries included in this analysis experienced larger waves of SARS-CoV-2 infections and often re-implemented periodic lockdowns, including to prevent further spread of the Delta variant4. Given the widespread disruptions in health services demonstrated in this paper, many of which were unrelated to COVID-19 severity, our results call for rethinking pandemic preparedness and health system response. The unintended consequences of COVID-19 responses may have outweighed the loss of life from COVID-19 itself, particularly in LMICs66. Health system resilience must become a central component of national health plans. Given the likelihood of future pandemics and other major shocks, there is an urgent need to design more resilient health systems capable of addressing a crisis while maintaining essential functions.

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COVID-19 and resilience of healthcare systems in ten countries - Nature.com

WASHINGTON (AP) Eight-year-old Brooklynn Chiles fidgets on the hospital bed as she waits for the nurse at Childrens National Hospital. The white paper beneath her crinkles as she shifts to look at the medical objects in the room. Shes had the coronavirus three times, and no one can figure out why.

Brooklynns lucky, sort of. Each time she has tested positive, she has suffered no obvious symptoms. But her dad, Rodney, caught the virus possibly from her when she was positive back in September, and he died from it.

WATCH: The world marks 2 years since COVID-19 was officially declared a pandemic

Her mom, Danielle, is dreading a next bout, fearing her daughter could become gravely ill even though shes been vaccinated.

Every time, I think: Am I going to go through this with her, too? she said, sitting on a plastic chair wedged in the corner. Is this the moment where I lose everyone?Among the puzzling outcomes of the coronavirus, which has killed more than 6 million people worldwide since it first emerged in 2019, are the symptoms suffered by children.

More than 12.7 million children in the U.S. alone have tested positive for COVID-19 since the pandemic began, according to the American Academy of Pediatrics.

Generally, the virus doesnt hit kids as severely as adults.

But, as with some adults, there are still bizarre outcomes. Some youngsters suffer unexplained symptoms long after the virus is gone, whats often called long COVID.

Others get reinfected. Some seem to recover fine, only to be struck later by a mysterious condition that causes severe organ inflammation.

And all that can come on top of grieving for loved ones killed by the virus and other interruptions to a normal childhood.

Doctors at Childrens National and multiple other hospitals getting money from the National Institutes of Health are studying the long-term effects of COVID-19 on children.

The ultimate goal is to evaluate the impact on childrens overall health and development, both physically and mentally and tease out how their still-developing immune systems respond to the virus to learn why some fare well and others dont.

Childrens has about 200 kids up to age 21 enrolled in the study for three years, and it takes on about two new patients each week. The study involves children who have tested positive and those who have not, such as siblings of sick kids. The subjects range from having no symptoms to requiring life support in intensive care. On their first visit, participants get a full day of testing, including an ultrasound of their heart, blood work and lung function testing.

Dr. Roberta DeBiasi, who runs the study, said its main purpose is to define the myriad complications that children might get after COVID-19 and how common those complications are.

Brooklynn is one study subject. So is Alyssa Carpenter, who has had COVID-19 twice and gets strange fevers that break out unexpectedly, and other unusual symptoms.

Alyssa was just 2 years old when she started the study and has since turned 3. Her feet sometimes turn bright red and sting with pain. Or shell lie down and point her little fingers to her chest and say, It hurts.

Her parents, Tara and Tyson Carpenter, have two other daughters, 5-year-old Audrey and 9-year-old Hailey, who is on the autism spectrum. As for many parents, the pandemic has been a nightmare of missed school, unproductive work, restrictions and confusion. But on top of all the anxiety so many parents feel lies the concern for their toddler. They dont know how to help her.

It was just super frustrating, says Tara Carpenter, who is quick to add that no ones to blame. Were trying to find out answers for our kid and nobody could give us any. And it just was really frustrating.

Alyssa would wail in pain from her red burning feet or whimper quietly. Shed come down with a fever, but suffer no other symptoms and be sent home from school for days, ruining Carpenters work week. But then in ballet class, with her pink tights and tutu, shed seem totally normal.

In the past few months, symptoms have started to subside and its giving the family some relief.

After the fact, what do we do about this? asks Tara Carpenter. We dont know. We literally dont know.

For some families in the study, the child suffering from long COVID is the easy one during the hospital visits.

One recent day, another family finds that its the older sister Charlie who dissolves into tears because she doesnt want blood drawn while younger sister Lexie, used to being prodded by nurses and doctors, hops up on the table. The family dynamics of COVID-19 are tough: The sibling with the illness may get more attention, which can create problems for the others. Exhausted parents struggle with how to help all their children.

In their work-ups, the children receive full medical check-ins. They also receive a full psychological assessment, run by Dr. Linda Herbert.

Herbert asks the kids about fatigue, sleep, pain, anxiety, depression and peer relationships. Do they have memory concerns? Are they having a hard time keeping things in their brains?

Theres this constellation of symptoms, she said. Some kids are incredibly anxious about getting COVID again.

She said psychological symptoms are among the most common, and its not just the kids with COVID-19, its their siblings and parents, too.

Danielle Mitchell feels the stress. Shes a single mother working full time, grieving the loss of her partner and trying not to seem too depressed in front of her daughter. The decision to enroll her daughter Brooklynn in the study was motivated by wanting to draw attention to the need for vaccines, particularly in the Black community.

My baby keeps getting it, she said. Cant the people around us try to protect her?

Brooklynn whimpers when she hears she has to get blood drawn: Do you have to?

Yes, baby, the nurse says. Its so we can figure all this out.

If her daddy was here, hed take her to Dave & Busters after this, Mitchell says, before lowering her voice so her daughter cant hear what shes going to say. Her longtime partner, Rodney Chiles, wasnt vaccinated.

He had qualms, like many do, about the vaccine and was waiting to get it. Shortly after Brooklynn tested positive during the run of the delta variant, he started feeling sick and went downhill fast. Chiles had pre-existing conditions, too, which accelerated his death. He was 42.

And then he called us on a Sunday. He was like, They are about to intubate me because I cant keep my oxygen up. And I love yall and, Brooklynn, forgive me,' she said. It was the last time he talked to them before he died.

Ill tell you what, Mitchell says. The only reason Im still here is because I have a child.

On school days, Mitchell picks up Brooklynn from Rocketship Rise Academy Public Charter School in Southeast Washington. They walk hand-in-hand to the car for a short ride before she resumes working for a nonprofit organization.

One recent day after school, as Mitchell had a Zoom meeting in her bedroom office, Brooklynn munched popcorn and talked about how she and her dad bought a pair of tennis shoes and balloons for her mom last year on Mothers Day. They forgot her moms shoe size and they had to come back home and check the size. She giggles as she tells it.

In her room, theres a big photo of her dad and her, though she usually sleeps in bed with her mom now.

Even though kids arent as sick, they are losing, Mitchell said. Theyre losing parents, social lives, entire years. Yes, kids are resilient, but they cant go on like this. No one is this resilient.

AP Medical Writer Lauran Neergaard contributed to this report.

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For kids with COVID-19, everyday life can be a struggle - PBS NewsHour

Its now been two years since the United States shut down due to the rising amount of COVID-19 cases across the country. And experts are still unsure how the pandemic will come to a close.

Driving the news: Pandemics dont all end the same. Each pandemic throughout history has a different endgame, mostly due to the science and medication available at the time.

What they said: Erica Charters of the University of Oxford, who studies pandemic history, told The Associated Press that pandemics dont end quickly.

Pandemics often have three types of endings:

State of play: The World Health Organizationpreviously cautioned the world against assuming the COVID-19 pandemic is over since there are still cases spiking across the world.

What to expect: Dr. Scott Gottlieb, the former commissioner of the Food and Drug Administration, said at the beginning of February that the pandemic may soon end and normality will return in the spring, as I wrote for the Deseret News.

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How will COVID end? Why the COVID pandemic might have 3 endings - Deseret News

As the U.S. moves from responding to the introduction of a new human pathogen to living with ongoing SARS-CoV-2 infections, we must accept the fact that it is no longer March 2020.

In March 2020 the new virus spread like wildfire, wreaking havoc and death in vulnerable populations, in particular the elderly. Now in March 2022, we have highly effectivevaccinesthat prevent severe disease and death, asurveillancesystem that can detect increases in new reported positive tests across the country and within populations by age, sex, and heritage, inexpensive and accuraterapid testsfor home use, safe, availabletreatmentsthat can greatly reduce the risk of hospitalization and very highpopulation immunitydue to the combination of previous infection or vaccination.

There is no going back in time to 2020 when those interventions did not exist.

We can certainly do better in some areas and continue to make sure unvaccinated individuals at risk for severe disease due to the immunosuppressing nature of age, treatments or disease get vaccinated and probably more importantly, that the same groupreceives timely treatment.

In the recentGetting to and Sustaining the Next Normal: A Roadmap for Living With COVID-19 authored by a collaborative of 53 scholars including members of President BidenJoe BidenGas prices hit new record of .43 per gallon, up 79 cents in two weeks Five key developments in Russia's invasion of Ukraine Biden's CIA head leads the charge against Putin's information war MOREs COVID-19 Advisory Board, there was at least one glowing omission: how to assure that those who need timely treatment will get it. Unfortunately, the American Medical Association, not exactly known for its focus on equity or accessible healthcare,does not support access to treatmentoutside of a physicians office. But during an epidemic, which by definition impacts public health and not solely individual health, that is exactly where treatment must exist.

We need to set up systems whereby reported SARS-CoV-2 positive test results are not only collected and analyzed for trends but result in an active process to follow-up with high-risk cases and assure timely treatment.

As a former director of a large and highly effective disease control program in San Francisco, we put in place policies to never let the sun set on a curable case of reportable disease. Public health workers were authorized to work 24/7 to assure cases were contacted and treatment was made available, even if it meant a public health workerpersonally delivered medicationto that persons house or chosen meeting place.

I am not certain why the authors of theRoadmapdid not include the many practical local public health activities that have been used in the past and could be used in the future. Another example might be the use of grading systems to identify the indoor building air quality as we do in many cities forrestaurant food safetywith highly visible grades of A, B, or C.

We need to make sure that future COVID-19 and pandemic preparedness policy is informed by local public health practitioners with the necessary experience. As we used to say in the Centers for Disease Control and Preventions Epidemic Intelligence Service program, local public health is where the rubber meets the road.

Rebuilding our national, state and local public health infrastructure will take time and substantial investment. TheCDC was foundedin the immediate post-World War II era in 1946 primarily as a domestic malaria control program. Within five years in 1951, as a response to the emerging Cold War, it added the Epidemic Intelligence Service to train young physicians in epidemiology and the practice of public health, preparing the country for potential bioterrorism events.

More than 75 years later, its scope and mission have changed, but unfortunately, not much of its authority or ability to serve as a responsive public health agency has. While well-known for its careful investigations, identification of public health hazards and evaluations of public health responses, it was never capacitated to respond in real-time to a large public health crisis like COVID-19. While one cannot hold the agency accountable foractivities it was never supposed to do, we must recognize and accept its failure and move on.

To move forward, we might need to raze the CDC and rebuild an agency for health security, one empowered with information access, a leader with demonstrated experience and success in the practice of public health, trained professionals in communication and decision science and with the necessary authority to implement interventions at the state and local level.

JeffreyKlausner, MD, MPH, is a clinical professor of Medicine, Population and Public Health Sciences at the Keck School of Medicine of the University of Southern California and a former CDC medical officer. Twitter: @DrKlausner.

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The next phase of COVID-19 pandemic response: Revamping the CDC | TheHill - The Hill

The novel coronavirus continues to circulate around the country, infecting thousands of people even as restrictions have ended across multiple states.

What to know: Getting infected with COVID-19 is still possible in the United States, despite high levels of natural immunity and protection from COVID-19 vaccines.

Symptoms: Dr. Allison Arwady, Chicago Department of Public Health commissioner, said back in January that there was one common COVID-19 symptom people experienced early on during their infection sore throat.

What to do: Experts maintain getting the COVID-19 vaccine and the COVID-19 booster shot is the best way to ward off any severe COVID-19 symptoms and keep yourself safe from the virus.

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COVID-19 symptoms: This COVID symptom is an early sign of infection - Deseret News

Schoolchildren attend class after the majority of schools were reopened following their closure due to the coronavirus disease (COVID-19) pandemic, in Mumbai, India, February 24, 2022. REUTERS/Francis Mascarenhas

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BENGALURU, March 14 (Reuters) - India will start administering COVID-19 vaccinations to 12- to 14-year-olds from March 16, the country's health ministry said on Monday, as schools reopen across the country with standard restrictions amid a significant fall in cases.

The government also decided to remove the condition of co-morbidity for people above 60 years to receive a booster shot, the ministry said in a statement.

India has so far been vaccinating children aged 15 and above. According to government figures, more than 90 million children aged between 15 and 17 have been inoculated, mainly using Bharat Biotech's homegrown shot Covaxin.

India's third wave of COVID-19 cases driven by the Omicron variant has receded, with the country reporting 2,503 infections on Monday compared to more than 300,000 in late January.

The health ministry said children in the age group of 12 to 14 years would be inoculated using vaccine maker Biological E. Ltd's Corbevax, which received an emergency use approval in February for 12- to 18-year-olds. read more

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Reporting by Anuron Kumar Mitra in Bengaluru; Editing by Subhranshu Sahu

Our Standards: The Thomson Reuters Trust Principles.

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India to start vaccinating 12- to 14-year-olds against COVID-19 - Reuters

The vaccine deployment in December 2020 signaled a turning point in the COVID-19 pandemic. By the end of May 2021, 40% of the U.S. population was fully vaccinated. But as vaccination rates lagged over the summer, new surges of COVID-19 came, including Delta in the summer of 2021, and now the Omicron variant, which comprises the majority of cases in the U.S.

Researchers around the world have reported that Omicron is more transmissible than Delta, making breakthrough and repeat infections more likely. Early research suggests this strain may cause less severe illness than Delta and the original virus, however, health officials have warned an Omicron-driven surge could still increase hospitalization and death ratesespecially in areas with less vaccinated populations.

The United States as of March 10 reached 964,448 COVID-19-related deaths and 79.4 million COVID-19 cases, according to Johns Hopkins University. Currently, 65.2% of the population is fully vaccinated, and 44.1% have received booster doses.

Stacker compiled a list of the counties with highest COVID-19 infection rates in California using data from the U.S. Department of Health & Human Services and vaccination data from Covid Act Now. Counties are ranked by the highest infection rate per 100,000 residents within the week leading up to March 9, 2021. Cumulative cases per 100,000 served as a tiebreaker.

Keep reading to see whether your county ranks among the highest COVID-19 infection rates in your state.

New cases per 100k in the past week: 56 (145 new cases, -45% change from previous week) Cumulative cases per 100k: 13,560 (35,097 total cases) 40.5% less cases per 100k residents than California Cumulative deaths per 100k: 105 (272 total deaths) 51.6% less deaths per 100k residents than California Population that is fully vaccinated: 86.7% (224,292 fully vaccinated)

New cases per 100k in the past week: 57 (5 new cases, -77% change from previous week) Cumulative cases per 100k: 11,073 (979 total cases) 51.4% less cases per 100k residents than California Cumulative deaths per 100k: 79 (7 total deaths) 63.6% less deaths per 100k residents than California Population that is fully vaccinated: 41.5% (3,673 fully vaccinated)

New cases per 100k in the past week: 57 (954 new cases, -79% change from previous week) Cumulative cases per 100k: 15,926 (266,180 total cases) 30.1% less cases per 100k residents than California Cumulative deaths per 100k: 106 (1,766 total deaths) 51.2% less deaths per 100k residents than California Population that is fully vaccinated: 80.8% (1,349,877 fully vaccinated)

New cases per 100k in the past week: 59 (27 new cases, -54% change from previous week) Cumulative cases per 100k: 16,547 (7,596 total cases) 27.4% less cases per 100k residents than California Cumulative deaths per 100k: 253 (116 total deaths) 16.6% more deaths per 100k residents than California Population that is fully vaccinated: 52.7% (24,195 fully vaccinated)

New cases per 100k in the past week: 73 (328 new cases, -39% change from previous week) Cumulative cases per 100k: 20,187 (90,135 total cases) 11.4% less cases per 100k residents than California Cumulative deaths per 100k: 148 (659 total deaths) 31.8% less deaths per 100k residents than California Population that is fully vaccinated: 68.4% (305,237 fully vaccinated)

New cases per 100k in the past week: 73 (46 new cases, -36% change from previous week) Cumulative cases per 100k: 21,258 (13,352 total cases) 6.7% less cases per 100k residents than California Cumulative deaths per 100k: 150 (94 total deaths) 30.9% less deaths per 100k residents than California Population that is fully vaccinated: 71.3% (44,770 fully vaccinated)

New cases per 100k in the past week: 74 (293 new cases, -23% change from previous week) Cumulative cases per 100k: 17,446 (69,493 total cases) 23.4% less cases per 100k residents than California Cumulative deaths per 100k: 148 (591 total deaths) 31.8% less deaths per 100k residents than California Population that is fully vaccinated: 66.4% (264,339 fully vaccinated)

New cases per 100k in the past week: 76 (1,187 new cases, -38% change from previous week) Cumulative cases per 100k: 19,379 (300,773 total cases) 14.9% less cases per 100k residents than California Cumulative deaths per 100k: 185 (2,869 total deaths) 14.7% less deaths per 100k residents than California Population that is fully vaccinated: 66.6% (1,034,337 fully vaccinated)

New cases per 100k in the past week: 77 (50 new cases, -46% change from previous week) Cumulative cases per 100k: 22,353 (14,548 total cases) 1.9% less cases per 100k residents than California Cumulative deaths per 100k: 243 (158 total deaths) 12.0% more deaths per 100k residents than California Population that is fully vaccinated: 42.5% (27,637 fully vaccinated)

New cases per 100k in the past week: 78 (593 new cases, -35% change from previous week) Cumulative cases per 100k: 22,879 (174,375 total cases) 0.4% more cases per 100k residents than California Cumulative deaths per 100k: 274 (2,091 total deaths) 26.3% more deaths per 100k residents than California Population that is fully vaccinated: 60.2% (459,064 fully vaccinated)

New cases per 100k in the past week: 78 (1,915 new cases, -31% change from previous week) Cumulative cases per 100k: 24,911 (615,445 total cases) 9.3% more cases per 100k residents than California Cumulative deaths per 100k: 254 (6,279 total deaths) 17.1% more deaths per 100k residents than California Population that is fully vaccinated: 57.7% (1,424,607 fully vaccinated)

New cases per 100k in the past week: 81 (938 new cases, -48% change from previous week) Cumulative cases per 100k: 17,249 (198,967 total cases) 24.3% less cases per 100k residents than California Cumulative deaths per 100k: 109 (1,256 total deaths) 49.8% less deaths per 100k residents than California Population that is fully vaccinated: 81.5% (940,024 fully vaccinated)

New cases per 100k in the past week: 81 (362 new cases, -58% change from previous week) Cumulative cases per 100k: 19,282 (86,313 total cases) 15.4% less cases per 100k residents than California Cumulative deaths per 100k: 97 (435 total deaths) 55.3% less deaths per 100k residents than California Population that is fully vaccinated: 66.0% (295,549 fully vaccinated)

New cases per 100k in the past week: 83 (1,600 new cases, -28% change from previous week) Cumulative cases per 100k: 16,636 (320,714 total cases) 27.0% less cases per 100k residents than California Cumulative deaths per 100k: 114 (2,202 total deaths) 47.5% less deaths per 100k residents than California Population that is fully vaccinated: 84.9% (1,635,937 fully vaccinated)

New cases per 100k in the past week: 91 (1,984 new cases, -8% change from previous week) Cumulative cases per 100k: 26,707 (582,245 total cases) 17.2% more cases per 100k residents than California Cumulative deaths per 100k: 307 (6,703 total deaths) 41.5% more deaths per 100k residents than California Population that is fully vaccinated: 56.0% (1,221,724 fully vaccinated)

New cases per 100k in the past week: 94 (127 new cases, -50% change from previous week) Cumulative cases per 100k: 14,559 (19,736 total cases) 36.1% less cases per 100k residents than California Cumulative deaths per 100k: 101 (137 total deaths) 53.5% less deaths per 100k residents than California Population that is fully vaccinated: 65.4% (88,613 fully vaccinated)

New cases per 100k in the past week: 95 (171 new cases, -44% change from previous week) Cumulative cases per 100k: 20,256 (36,477 total cases) 11.1% less cases per 100k residents than California Cumulative deaths per 100k: 274 (493 total deaths) 26.3% more deaths per 100k residents than California Population that is fully vaccinated: 46.0% (82,779 fully vaccinated)

New cases per 100k in the past week: 95 (27 new cases, -37% change from previous week) Cumulative cases per 100k: 22,808 (6,476 total cases) 0.1% more cases per 100k residents than California Cumulative deaths per 100k: 151 (43 total deaths) 30.4% less deaths per 100k residents than California Population that is fully vaccinated: 54.4% (15,442 fully vaccinated)

New cases per 100k in the past week: 99 (17 new cases, -51% change from previous week) Cumulative cases per 100k: 14,910 (2,565 total cases) 34.6% less cases per 100k residents than California Cumulative deaths per 100k: 35 (6 total deaths) 83.9% less deaths per 100k residents than California Population that is fully vaccinated: 43.9% (7,551 fully vaccinated)

New cases per 100k in the past week: 99 (9,907 new cases, 0% change from previous week) Cumulative cases per 100k: 27,863 (2,797,184 total cases) 22.3% more cases per 100k residents than California Cumulative deaths per 100k: 306 (30,759 total deaths) 41.0% more deaths per 100k residents than California Population that is fully vaccinated: 72.3% (7,262,335 fully vaccinated)

New cases per 100k in the past week: 101 (44 new cases, -51% change from previous week) Cumulative cases per 100k: 16,346 (7,117 total cases) 28.3% less cases per 100k residents than California Cumulative deaths per 100k: 170 (74 total deaths) 21.7% less deaths per 100k residents than California Population that is fully vaccinated: 47.9% (20,863 fully vaccinated)

New cases per 100k in the past week: 103 (790 new cases, -27% change from previous week) Cumulative cases per 100k: 16,431 (125,957 total cases) 27.9% less cases per 100k residents than California Cumulative deaths per 100k: 82 (630 total deaths) 62.2% less deaths per 100k residents than California Population that is fully vaccinated: 83.7% (641,460 fully vaccinated)

New cases per 100k in the past week: 103 (227 new cases, -18% change from previous week) Cumulative cases per 100k: 17,707 (39,043 total cases) 22.3% less cases per 100k residents than California Cumulative deaths per 100k: 139 (306 total deaths) 35.9% less deaths per 100k residents than California Population that is fully vaccinated: 69.6% (153,488 fully vaccinated)

New cases per 100k in the past week: 103 (225 new cases, -13% change from previous week) Cumulative cases per 100k: 17,935 (39,310 total cases) 21.3% less cases per 100k residents than California Cumulative deaths per 100k: 172 (378 total deaths) 20.7% less deaths per 100k residents than California Population that is fully vaccinated: 52.7% (115,417 fully vaccinated)

New cases per 100k in the past week: 103 (445 new cases, -41% change from previous week) Cumulative cases per 100k: 21,007 (91,184 total cases) 7.8% less cases per 100k residents than California Cumulative deaths per 100k: 163 (706 total deaths) 24.9% less deaths per 100k residents than California Population that is fully vaccinated: 71.5% (310,186 fully vaccinated)

New cases per 100k in the past week: 106 (13 new cases, -52% change from previous week) Cumulative cases per 100k: 11,925 (1,465 total cases) 47.7% less cases per 100k residents than California Cumulative deaths per 100k: 163 (20 total deaths) 24.9% less deaths per 100k residents than California Population that is fully vaccinated: 48.4% (5,943 fully vaccinated)

New cases per 100k in the past week: 106 (294 new cases, -41% change from previous week) Cumulative cases per 100k: 25,243 (70,095 total cases) 10.8% more cases per 100k residents than California Cumulative deaths per 100k: 285 (791 total deaths) 31.3% more deaths per 100k residents than California Population that is fully vaccinated: 50.6% (140,570 fully vaccinated)

New cases per 100k in the past week: 108 (85 new cases, -17% change from previous week) Cumulative cases per 100k: 21,452 (16,876 total cases) 5.8% less cases per 100k residents than California Cumulative deaths per 100k: 146 (115 total deaths) 32.7% less deaths per 100k residents than California Population that is fully vaccinated: 48.3% (37,966 fully vaccinated)

New cases per 100k in the past week: 120 (340 new cases, -20% change from previous week) Cumulative cases per 100k: 19,618 (55,541 total cases) 13.9% less cases per 100k residents than California Cumulative deaths per 100k: 158 (448 total deaths) 27.2% less deaths per 100k residents than California Population that is fully vaccinated: 63.5% (179,665 fully vaccinated)

New cases per 100k in the past week: 121 (26 new cases, -13% change from previous week) Cumulative cases per 100k: 20,940 (4,512 total cases) 8.1% less cases per 100k residents than California Cumulative deaths per 100k: 97 (21 total deaths) 55.3% less deaths per 100k residents than California Population that is fully vaccinated: 59.7% (12,870 fully vaccinated)

New cases per 100k in the past week: 122 (192 new cases, -43% change from previous week) Cumulative cases per 100k: 27,420 (43,139 total cases) 20.4% more cases per 100k residents than California Cumulative deaths per 100k: 225 (354 total deaths) 3.7% more deaths per 100k residents than California Population that is fully vaccinated: 53.5% (84,126 fully vaccinated)

New cases per 100k in the past week: 125 (616 new cases, -15% change from previous week) Cumulative cases per 100k: 17,113 (84,597 total cases) 24.9% less cases per 100k residents than California Cumulative deaths per 100k: 96 (473 total deaths) 55.8% less deaths per 100k residents than California Population that is fully vaccinated: 77.6% (383,487 fully vaccinated)

New cases per 100k in the past week: 138 (26 new cases, -33% change from previous week) Cumulative cases per 100k: 16,244 (3,055 total cases) 28.7% less cases per 100k residents than California Cumulative deaths per 100k: 69 (13 total deaths) 68.2% less deaths per 100k residents than California Population that is fully vaccinated: 54.4% (10,236 fully vaccinated)

New cases per 100k in the past week: 140 (193 new cases, -8% change from previous week) Cumulative cases per 100k: 19,210 (26,460 total cases) 15.7% less cases per 100k residents than California Cumulative deaths per 100k: 99 (136 total deaths) 54.4% less deaths per 100k residents than California Population that is fully vaccinated: 78.2% (107,734 fully vaccinated)

New cases per 100k in the past week: 143 (390 new cases, -30% change from previous week) Cumulative cases per 100k: 17,828 (48,708 total cases) 21.7% less cases per 100k residents than California Cumulative deaths per 100k: 93 (254 total deaths) 57.1% less deaths per 100k residents than California Population that is fully vaccinated: 74.5% (203,411 fully vaccinated)

New cases per 100k in the past week: 144 (26 new cases, -13% change from previous week) Cumulative cases per 100k: 25,101 (4,528 total cases) 10.2% more cases per 100k residents than California Cumulative deaths per 100k: 310 (56 total deaths) 42.9% more deaths per 100k residents than California Population that is fully vaccinated: 61.5% (11,086 fully vaccinated)

New cases per 100k in the past week: 147 (267 new cases, -51% change from previous week) Cumulative cases per 100k: 36,231 (65,656 total cases) 59.0% more cases per 100k residents than California Cumulative deaths per 100k: 491 (890 total deaths) 126.3% more deaths per 100k residents than California Population that is fully vaccinated: 91.2% (165,195 fully vaccinated)

New cases per 100k in the past week: 149 (1,488 new cases, -25% change from previous week) Cumulative cases per 100k: 24,982 (249,597 total cases) 9.7% more cases per 100k residents than California Cumulative deaths per 100k: 266 (2,653 total deaths) 22.6% more deaths per 100k residents than California Population that is fully vaccinated: 60.2% (601,348 fully vaccinated)

New cases per 100k in the past week: 151 (97 new cases, -32% change from previous week) Cumulative cases per 100k: 17,748 (11,427 total cases) 22.1% less cases per 100k residents than California Cumulative deaths per 100k: 202 (130 total deaths) 6.9% less deaths per 100k residents than California Population that is fully vaccinated: 54.2% (34,879 fully vaccinated)

New cases per 100k in the past week: 153 (844 new cases, -18% change from previous week) Cumulative cases per 100k: 24,416 (134,449 total cases) 7.2% more cases per 100k residents than California Cumulative deaths per 100k: 279 (1,537 total deaths) 28.6% more deaths per 100k residents than California Population that is fully vaccinated: 56.1% (308,738 fully vaccinated)

New cases per 100k in the past week: 159 (5,292 new cases, -14% change from previous week) Cumulative cases per 100k: 23,705 (791,352 total cases) 4.0% more cases per 100k residents than California Cumulative deaths per 100k: 152 (5,068 total deaths) 30.0% less deaths per 100k residents than California Population that is fully vaccinated: 74.7% (2,492,721 fully vaccinated)

New cases per 100k in the past week: 159 (739 new cases, -34% change from previous week) Cumulative cases per 100k: 28,280 (131,841 total cases) 24.1% more cases per 100k residents than California Cumulative deaths per 100k: 282 (1,316 total deaths) 30.0% more deaths per 100k residents than California Population that is fully vaccinated: 53.5% (249,188 fully vaccinated)

New cases per 100k in the past week: 166 (66 new cases, -8% change from previous week) Cumulative cases per 100k: 22,696 (9,022 total cases) 0.4% less cases per 100k residents than California Cumulative deaths per 100k: 211 (84 total deaths) 2.8% less deaths per 100k residents than California Population that is fully vaccinated: 52.0% (20,666 fully vaccinated)

New cases per 100k in the past week: 193 (187 new cases, +10% change from previous week) Cumulative cases per 100k: 22,997 (22,300 total cases) 0.9% more cases per 100k residents than California Cumulative deaths per 100k: 224 (217 total deaths) 3.2% more deaths per 100k residents than California Population that is fully vaccinated: 59.6% (57,821 fully vaccinated)

New cases per 100k in the past week: 203 (176 new cases, -16% change from previous week) Cumulative cases per 100k: 18,275 (15,853 total cases) 19.8% less cases per 100k residents than California Cumulative deaths per 100k: 135 (117 total deaths) 37.8% less deaths per 100k residents than California Population that is fully vaccinated: 67.9% (58,942 fully vaccinated)

New cases per 100k in the past week: 241 (67 new cases, -40% change from previous week) Cumulative cases per 100k: 21,376 (5,945 total cases) 6.2% less cases per 100k residents than California Cumulative deaths per 100k: 173 (48 total deaths) 20.3% less deaths per 100k residents than California Population that is fully vaccinated: 46.8% (13,028 fully vaccinated)

New cases per 100k in the past week: 299 (458 new cases, -30% change from previous week) Cumulative cases per 100k: 35,728 (54,643 total cases) 56.8% more cases per 100k residents than California Cumulative deaths per 100k: 283 (433 total deaths) 30.4% more deaths per 100k residents than California Population that is fully vaccinated: 44.3% (67,746 fully vaccinated)

New cases per 100k in the past week: 303 (165 new cases, +11% change from previous week) Cumulative cases per 100k: 23,811 (12,972 total cases) 4.5% more cases per 100k residents than California Cumulative deaths per 100k: 329 (179 total deaths) 51.6% more deaths per 100k residents than California Population that is fully vaccinated: 51.7% (28,150 fully vaccinated)

New cases per 100k in the past week: 343 (3,087 new cases, -11% change from previous week) Cumulative cases per 100k: 26,101 (234,963 total cases) 14.6% more cases per 100k residents than California Cumulative deaths per 100k: 239 (2,152 total deaths) 10.1% more deaths per 100k residents than California Population that is fully vaccinated: 52.7% (474,630 fully vaccinated)

New cases per 100k in the past week: 363 (111 new cases, +14% change from previous week) Cumulative cases per 100k: 32,038 (9,795 total cases) 40.6% more cases per 100k residents than California Cumulative deaths per 100k: 203 (62 total deaths) 6.5% less deaths per 100k residents than California Population that is fully vaccinated: 28.6% (8,730 fully vaccinated)

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Counties with highest COVID-19 infection rates in California - FOX 5 San Diego

Just when it seemed global risks might be peaking, a new but all-too-familiar fear is back.

Covid-19 cases are surging again in China. Chinese authorities imposed a lockdown of the southern city of Shenzhen on Sunday and implemented fresh restrictions in Shanghai, the countrys most populous city.

Hong Kongs Hang Seng Index tumbled 5% Monday,...

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Chinas Covid-19 Lockdown Is the Wrong Risk at the Wrong Time - Barron's