Category: Covid-19

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COVID-19 Has Left Millions Of Students Behind. Now What? – FiveThirtyEight

March 4, 2022

If a kid isnt keeping up with peers academically, summer school seems like a no-brainer. Instead of forgetting what they learned during the school year while theyre on vacation for two months, theyre catching up and getting ahead. Which is why it was a surprise when a Rand Corporation study of summer school programs in five urban school districts found that this common-sense solution didnt really solve the problem.

Rands study found that summer school offered modest, short-term improvements in math scores at best, but those improvements faded by the fall. Other metrics performance in language arts, student attendance and overall grades showed no meaningful link to summer school. The effects were pretty underwhelming, said Megan Kuhfeld, a senior research scientist with NWEA, a nonprofit educational testing and research organization.

Overall, summer school programs didnt deliver on their promises. But some subgroups did benefit: the students who regularly attended the programs that were better at navigating hurdles like student retention.

Its perhaps never been so urgent to make educational interventions like summer school work for kids. Two years into the pandemic, children across the nation are behind where they would have been academically if the pandemic hadnt happened. To help bridge the gap, educational theories will have to adapt to the unique realities of actual kids lives and families needs. If they dont, even the best ideas, with tons of evidence behind them, wont work in the real world.

Kids learned plenty during the pandemic, Kuhfeld told me. The problem, she said, is that they arent learning as much or as quickly as they were each year before the pandemic. Nationally, third-graders in fall 2021 were, on average, testing significantly below where third-graders were testing in fall 2019 in reading and math. The NWEA assessments showed these declines extended across third-graders through eighth-graders, too.

Most of the experts I spoke to said the popular term learning loss is a misnomer its not that kids have lost ground, theyre just not progressing as fast. But the slower progression is real, and there are patterns to it. The effects were particularly pronounced among Black, Hispanic and American Indian and Alaska Native students.

In the NWEA data, the median percentile ranks for Black third-graders went down 10 points in reading and 14 points in math. For white third-graders, the median percentile ranks declined by exactly half of that (5 points in reading and 7 in math), while the median percentile ranks for Asian American third-graders fell by 3 points in both subjects.

In addition, theres evidence of declines in attendance and high school graduation rates, something that could signal a broad sense of emotional disconnection from school. Which, in turn, could help explain slowed learning or exacerbate it, said Dan Goldhaber, director of the National Center for Analysis of Longitudinal Data in Education Research.

Slowed learning during the pandemic doesnt necessarily mean kids are doomed, however. In fact, other researchers like Torrey Trust, a professor of learning technology at the University of Massachusetts Amherst, said kids actually learned a lot of things during the pandemic that they might not have learned otherwise. For many, virtual classes meant more time with family, more skills with technology, and for some, even better educational experiences, free from bullying.

The other good news: Research shows that the slower progress documented by these test scores should be able to be fixed with small-group tutoring. Its not rocket science, said Thurston Domina, a professor of educational policy and organizational leadership at the University of North Carolina at Chapel Hill. You get the kids in small groups and you can really give them customized instruction and focus on them. When Matthew Kraft, a professor of education and economics at Brown University, reviewed several meta-analyses of the effectiveness of various educational interventions in 2021, he found that tutoring in small groups had a significantly greater effect on student test scores than changes in class size, longer school days or summer-school-type programs.

But while its relatively simple for researchers to run studies on classrooms or schools and figure out which interventions produce the best results, its hard for educators to take those findings and put them to work across America. The evidence doesnt produce a solution it just shows you how hard its going to be to craft a wide-reaching solution.

Case in point: those summer school studies. One of the biggest factors affecting the overall failure of summer school programs in the Rand analysis was that only around half the kids who attended one year didnt come back for the next and some kids didnt even attend each day the first year. The kids who attended summer school habitually, for both years, did improve their math and language skills in ways that lasted all school year. But that group represented only about 35 percent of all the kids involved in the study.

So summer school works just fine if you can get kids to actually go. And that sets up a whole other set of logistical complications that have to be studied and analyzed and implemented. It takes hiring the right teachers who have the motivation and specific interest in teaching summer school, Kuhfeld said. It also takes long-term dedicated recruitment of kids into the programs. Unlike with regular school, students dont have to attend summer school, so getting them and their families to choose the programs means you have to build both interest and trust neither of which is a given. And all of this takes money. Theres a big gap between what should work in theory and what works in practice, Kuhfeld said.

This kind of effect is depressingly common. When the George W. Bush administration set up a program to compile evidence-based educational resources in 2002, education specialists told me theyd hoped this program the What Works Clearinghouse would bridge the gap between academia and classrooms. They envisioned it as a way for teachers to get a better handle on how to use evidence-based interventions in the classroom. We thought we would punch in third-grade math and get an answer, said Rachael Gabriel, a professor of literacy education at the University of Connecticut.

But it never worked out to be that simple.

In many cases, researchers I spoke to found that teachers the people tasked with educating students and bringing those test scores up didnt have much control over which interventions they could use and how. Those decisions were made higher up in the chain of administration. A teacher might want to try something and not be allowed. Or they might be excited to try something that was allowed but not be given the funding or staff or bus transport to make it happen effectively.

Making things work in a classroom is different from making things work in a whole district or a whole state or the whole country. Thats something Domina learned when Californias State Board of Education tried to mandate all eighth-graders to take and be tested on algebra. The idea was very much based on evidence, he said. Studies showed that separating some kids into elite math and others into remedial math served to widen inequality and narrow kids futures. Giving kids higher expectations leads them to do better. So expanding access to algebra for all should have reduced test-score gaps between rich and poor, white and Black.

But it didnt. In fact, the opposite happened. Domina sees problems of scale particularly staffing issues at the heart of that failure. Offering algebra to everyone meant that schools needed a lot more algebra teachers, and quickly. But there were only so many fully qualified, highly skilled algebra teachers. A lot of kids, particularly the ones in lower-income schools, ended up with teachers who didnt have as much experience and werent as effective at teaching the material, he said.

That story is particularly poignant now. Small-group tutoring can help students catch up on what they didnt get a chance to learn during the pandemic. But small-group tutoring takes staff and schools are one of many industries suffering from staffing shortages. Experts like Kraft are concerned that schools might create failing tutoring programs by using irregular volunteers or older students in place of dedicated staff.

Much like students, schools themselves arent necessarily functioning at a neutral, pre-pandemic state, either. The biggest trend Ive seen in the last 6-12 months is that schools are struggling to get the basics down. Staying open is hard, said Chase Nordengren, the principal research lead for Effective Instructional Strategies at NWEA. Hes seen many cases where federal funds, which otherwise may have been spent on staffing tutoring programs to mitigate learning loss, were spent instead on things like better ventilation, personal protective equipment and substitute teachers.

I think tutoring is a really promising initiative, Goldhaber said. But we have never tried to do tutoring at the scale that we are trying it today. Because of that, he said, parents should be advocating for real-time evaluation and course-correction to go along with these learning-loss interventions. There should be tools in place to help teachers know when something isnt working for their specific school and allow them to make the kind of personalized adjustments we know are necessary to make any intervention effective. But that, again, takes resources.

In the end, its not kids pandemic test scores that really make researchers feel gloomy about the future of education. Instead, its the way educational systems have been set up to fail those kids. Schools have been running with limited resources and little wiggle room for change for at least the past decade, Domina said. And now weve hit a crisis. And theyre not resilient.

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COVID-19 Has Left Millions Of Students Behind. Now What? - FiveThirtyEight

Universal Studios Hollywood to lift its COVID-19 mask rules – Los Angeles Times

March 4, 2022

Ahead of an expected order by county officials easing pandemic health protocols, Universal Studios Hollywood announced it will no longer require guests visiting the theme park to wear masks or show proof of vaccinations or a negative COVID-19 test starting Friday.

The announcement aligns with an order likely to be announced Thursday by Los Angeles County Public Health Director Barbara Ferrer that masks are no longer required in public places such as bars, stores, offices, restaurants, gyms and movie theaters. She is also expected to lift vaccine verification requirements at outdoor mega-events in the county such as at SoFi and Dodger stadiums, L.A. Memorial Coliseum and the Hollywood Bowl.

The theme park, known for its Hollywood backstage tour and Harry Potter-themed land, has required visitors to show proof of being fully vaccinated or a negative COVID-19 test. Inside the park, masks are currently required for guests who are not fully vaccinated. Starting Friday, those guests can go mask-free, just like fully vaccinated visitors.

With COVID-19 cases dropping and health officials relaxing masking mandates, Disneyland announced last month that masks were optional outdoors and vaccinated visitors were no longer required to wear face coverings in many indoor settings at the Anaheim park. Masks are still required for unvaccinated guests ages 2 and older in all indoor areas, including restaurants, stores and attractions. In certain enclosed settings, such as Disney shuttles, face coverings are required for all visitors, regardless of vaccination status.

Universal Studios Hollywood, Disneyland, Knotts Berry Farm in Buena Park and Six Flags Magic Mountain in Valencia were all forced to close for more than a year due to the pandemic and reopened last year under health protocols that have been amended and revised in response to COVID-19 case numbers and orders from county health officials.

Despite the mask mandates and health protocols, the parks have moved forward with many of their most popular events, including Universal Studios Hollywoods Halloween Horror Nights and Disneylands Christmas Fantasy Parade.

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Universal Studios Hollywood to lift its COVID-19 mask rules - Los Angeles Times

Pittsylvania-Danville Health District to Distribute Free COVID-19 Test Kits this Weekend – Newsroom – Virginia Department of Health

March 4, 2022

March 3, 2022

Media Contact:Linda Scarborough,linda.scarborough@vdh.virginia.gov

Pittsylvania-Danville Health District to Distribute Free COVID-19 Test Kits this Weekend

DANVILLE, Va. The Virginia Department of Healths Pittsylvania-Danville Health District will return to the local farmers market this weekend to distribute at-home COVID-19 test kits free of charge. A limit of two test kits per person will be available to adults 18 and older on a first-come, first-served basis while supplies last. The free rapid at-home test kits will be distributed Saturday, March 5 from 9 a.m. to 1 p.m. at Danville Farmers Market, 629 Craghead St.

VDH recommends that following people perform a test for COVID-19:

Testing is a critical component for slowing the transmission of COVID-19 and should be administered when you have symptoms, have been exposed to someone with the coronavirus, or before you travel or gather in large groups. It is proven to be an effective method to help decrease spread through preventing further infections.

To anonymously report a positive result or to download COVIDWISE, the free exposure notifications app, visithttp://www.vdh.virginia.gov/covidwise. Forquestionsabout COVID-19 testing or a list of testinglocations, visit the VDHwebsiteor call 877-VAX-IN-VA (877-829-4682), Monday through Friday, 8 a.m. to 6 p.m.

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Pittsylvania-Danville Health District to Distribute Free COVID-19 Test Kits this Weekend - Newsroom - Virginia Department of Health

Return to normal-ish: Is Michigan entering the endemic phase of COVID-19? – WXYZ 7 Action News Detroit

March 4, 2022

DETROIT (WXYZ) At the popular Cantoro Italian Market & Trattoria in Plymouth, curbside pickup and cross-trained employees have become seamless parts of operating thanks to the pandemic.

Family and friends are able to sit comfortably on the restaurant side, but General Manager Alex Bazzy said things still aren't quite back to normal.

"I do think that the volume is up," he adds. "People are ready to get out, ready to dine out. The restaurant no longer has the spacing issues. Were back to normal in terms of our floor plan."

Restaurants and churches may be some of the best examples of how comfortable people are when it comes to learning to live with COVID-19 and the precautions they take.

"For the most part, it's a no-touch zone," said Bishop Charles Ellis III of Greater Grace Temple in Detroit.

Before the pandemic, churchgoers would greet others with a hug and a handshake.

When case numbers were high, church was held outside on Greater Grace's large campus in Detroit. People could sit in their vehicles and tune to a radio station to hear the sermon.

"It was like a family reunion," said Ellis who plans to incorporate some outdoor sermons during the summer.

So has COVID-19 moved from being a pandemic to being endemic - something that we will just learn to live with? Not yet, according to Dr. Matthew Sims, Director of Infectious Disease Research at Beaumont Health.

But he adds that COVID-19 is still spreading.

"We have way less people in the hospital, but it's still out there," he said.

While restrictions are easing, Dr. Natasha Bagdasarian, Michigan's Chief Medical Executive, said it's likely that we will still see concerning variants so we can't think of the pandemic as a straight line to the finish.

"We're going to continue to see times where things are relatively higher risk with COVID and then relatively lower risk with COVID," she continues. "And we just need to be able to communicate that with the public that this is a time of relatively lower risk."

Dr. Bagdasarian says, "don't throw all of your mitigation strategies out of the window. You still may want to keep some of those mitigation strategies, depending on your individual risk profile. And then we'll communicate again when things get a little bit more risky, and when we want people to dial up those mitigation strategies."

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Return to normal-ish: Is Michigan entering the endemic phase of COVID-19? - WXYZ 7 Action News Detroit

COVID-19 takes a heavy toll on women’s health – WHO | Regional Office for Africa

March 4, 2022

Brazzaville, 3 March 2022 Disruptions to essential health services due to the COVID-19 pandemic are being felt broadly. As the world marks International Womens Day, a new World Health Organization (WHO) analysis finds that womens health services are far from being fully restored, with 40% of African countries reporting disruptions to sexual, reproductive, maternal, newborn, child and adolescent health services.

The WHO Global Pulse Survey on Continuity of Essential Health Services during the COVID-19 pandemic carried out between November and December 2021 shows that the majority of the 36 African countries that provided full data reported up to 25% disruption of services. The extent of the disruption remained largely unchanged from the first quarter of 2021.

Another WHO survey in 11 African countries found that maternal deaths in health facilities in six of the 11 countries rose by 16% on average between February and May 2020 compared with the same period in 2019. The figure dropped slightly in 2021 to 11%. However, the estimate is likely to be far higher as maternal deaths tend to occur mostly at home rather than in health facilities. Data show that facility-based births reduced in 45% of countries between November and December 2021 compared with the pre-pandemic period.

Two years on, the COVID-19 burden still weighs heavily on women. Africas mothers and daughters are struggling to access the health care they need. The pandemics disruptive force will be felt by women for many years to come, said Dr Matshidiso Moeti, WHO Regional Director for Africa. Countries must look beyond short-term measures to restore services to pre-pandemic levels and make major investments for stronger systems capable of withstanding health emergencies while ensuring continuity of key services.

During the pandemic, women and girls are facing a rising risk of sexual violence due to lockdowns, economic uncertainties, decrease in access to key support and health services, and increase in stress in households. Globally, from the latest analysis done in 2021, WHO estimates that 245 million women and girls aged 15 years and above are subjected annually to sexual and/or physical violence perpetrated by an intimate partner. Unfortunately, in Africa, due to the pandemic, services to women who have experienced sexual violence declined in 56% of countries between November and December 2021 compared with the period before the pandemic.

The disruptions also affected the uptake of essential reproductive health supplies. Between June and September 2021 contraceptive use fell in 48% of countries, according to a rapid WHO survey in 21 African countries. Teenage pregnancies also rose in some countries. A 2021 report by the British Medical Journal found that adolescent secondary school girls who were out of school for six months due to the COVID-19 lockdown in Kenya were twice as likely to become pregnant and three times as likely to drop out of school compared with those graduating just prior to the pandemic. In South Africa, a study by the Medical Research Council in five provinces showed that teenage pregnancies have increased by 60% since the start of the pandemic.

Beyond the health impacts, COVID-19 is also inflicting deep economic damage on women and girls. The pandemic is poised to push more women and girls into extreme poverty. Poverty rates rose from 11.7% in 2019 to 12.5% in 2021 and it may take until 2030 to revert to pre-pandemic levels, according to a report by the International Monetary Fund, the UN Development Programme and the UN Women.

Globally in 2021, 247 million women aged 15 and above were projected to live on less than US$ 1.90 per day due the economic impact of COVID-19, with an estimated 53% (132milion) of them from sub-Saharan Africa.

The pandemic has also worsened existing gender inequities in key spheres of life and development. Even though women constitute 70% of the health and social workers in Africa and are on the frontlines of COVID-19 response, few of them are in top pandemic management positions, according to the UN Development Programme and the UN Women Global Gender Response Tracker. In the African region, 85% of national COVID-19 task forces are led by men and only 15% by women, and the overall participation by women is only 30%.

Dr Moeti spoke during a virtual press conference today. She was joined by Dr Francine Ntoumi, President and Director-General, Congolese Foundation for Medical Research, and Dr Eleanor Nwadinobi, President, Medical Womens International Association.

Also on hand from the WHO Regional Office for Africa to respond to questions were Dr Adelheid Onyango, Director Universal Health Coverage/Healthier Populations, Dr Richard Mihigo, Coordinator, Immunization and Vaccines Development Programme, Dr Thierno Balde, Regional COVID-19 Incident Manager, Dr Leopold Ouedraogo, Regional Adviser for Sexual and Reproductive Health.

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COVID-19 takes a heavy toll on women's health - WHO | Regional Office for Africa

DHHR reports another drop in active COVID-19 cases, hospitalizations on Thursday – West Virginia MetroNews

March 4, 2022

CHARLESTON, W.Va. COVID-19 hospitalizations and active cases continue to go down in West Virginia, according to the latest report from the state Department of Health and Human Resources (DHHR).

The agency confirmed 2,049 active cases of the coronavirus Thursday, down from 2,143 reported Wednesday. That level of active cases in the state is the lowest since July 28 of last year when the number was under 2,000.

There are 444 patients in the hospital due to the coronavirus with 108 in the ICU and 60 patients on a vent. All three of those numbers are down from Wednesdays report. Its the lowest level of hospitalizations in West Virginia due to COVID-19 since mid-August of last year.

Due to technical issues, the DHHRs dashboard had not been updated Thursday morning.

The DHHR confirmed 46 additional deaths on Thursday including a 60-year old female from Kanawha County, a 78-year old male from Doddridge County, an 82-year old male from Greenbrier County, a 97-year old male from Kanawha County, an 81-year old female from Marion County, a 73-year old female from Kanawha County, a 39-year old male from Greenbrier County, a 71-year old male from Jackson County, an 80-year old male from Mason County, a 73-year old female from Harrison County, and a 64-year old male from Taylor County.

Included in the total deaths reported on the dashboard as a result of the Bureau for Public Healths continuing data reconciliation with the official death certificate are a 69-year old female from Wyoming County, a 68-year old male from Monongalia County, a 70-year old female from Cabell County, a 77-year old male from Ohio County, a 77-year old male from Boone County, an 82-year old female from Harrison County, an 84-year old male from Monongalia County, a 68-year old female from Raleigh County, an 83-year old male from Wayne County, a 61-year old male from Brooke County, an 80-year old female from Wayne County, an 82-year old female from Jefferson County, a 60-year old male from Boone County, a 59-year old male from Wetzel County, a 76-year old female from Marshall County, a 74-year old female from Morgan County, a 65-year old female from Fayette County, an 86-year old male from Jefferson County, a 66-year old female from Kanawha County, an 83-year old female from Mercer County, an 83-year old male from Randolph County, a 93-year old female from Harrison County, a 79-year old female from Marion County, an 89-year old male from Greenbrier County, a 69-year old female from Greenbrier County, a 95-year old male from Raleigh County, a 77-year old male from Wayne County, a 73-year old female from Summers County, a 48-year old female from Wayne County, a 42-year old male from Mingo County, a 70-year old female from Kanawha County, a 72-year old male from Lincoln County, a 78-year old female from Putnam County, a 74-year old male from Wyoming County, and an 85-year old male from Hancock County.

These deaths range from December 2021 through February 2022, with one death occurring in December 2020.

The COVID-19 death total in West Virginia is 6,427.

As we remember and honor each life lost to COVID-19, I urge every West Virginian to be vaccinated and boosted against this deadly virus, said Bill J. Crouch, DHHR Cabinet Secretary in a release.

Current active COVID-19 cases per county: Barbour (25), Berkeley (78), Boone (21), Braxton (21), Brooke (25), Cabell (92), Calhoun (15), Clay (9), Doddridge (9), Fayette (69), Gilmer (2), Grant (7), Greenbrier (49), Hampshire (26), Hancock (10), Hardy (12), Harrison (121), Jackson (20), Jefferson (37), Kanawha (153), Lewis (12), Lincoln (20), Logan (48), Marion (95), Marshall (20), Mason (39), McDowell (44), Mercer (105), Mineral (16), Mingo (40), Monongalia (103), Monroe (19), Morgan (7), Nicholas (71), Ohio (20), Pendleton (1), Pleasants (10), Pocahontas (6), Preston (53), Putnam (43), Raleigh (94), Randolph (28), Ritchie (16), Roane (12), Summers (14), Taylor (37), Tucker (10), Tyler (6), Upshur (50), Wayne (40), Webster (18), Wetzel (20), Wirt (5), Wood (81), Wyoming (45). To find the cumulative cases per county, please visit http://www.coronavirus.wv.gov and look on the Cumulative Summary tab which is sortable by county.

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DHHR reports another drop in active COVID-19 cases, hospitalizations on Thursday - West Virginia MetroNews

Companies Bet Youre Ready to Test at Home for More Than Covid-19 – The Wall Street Journal

March 4, 2022

The Covid-19 pandemic has hastened consumers willingness to test for more medical conditions at home, test makers said, expanding the market for self-diagnostic products.

Manufacturers are developing new types of at-home tests, including for flu and strep throat, aimed at consumers who are increasingly monitoring and managing their own health through fitness apps and smartwatches.

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Companies Bet Youre Ready to Test at Home for More Than Covid-19 - The Wall Street Journal

K-12 COVID-19 Testing Reporting Requirements and Allocation Update | Texas Education Agency – Texas Education Agency

March 4, 2022

The purpose of this communication is to update superintendents, school system administrators, and school system testing coordinator about COVID-19 test reporting requirements and reallocations occurring within the Department of State Health Services (DSHS) and the Texas Education Agencys (TEA)K-12 COVID Testing Program.

School systems that opted into the K-12 Testing Program agreed to adhere to the following reporting requirements:

LEAs must submit a Tests and Services Received Report within 48 hours (2 business days) after the last day of engagement with the vendor.

To adhere to the requirements of the federally funded CDC grant, the DSHS and TEA will require that all school systems ensure that the following conditions are met byMarch 31, 2022:

After March 31, school systems will be expected to continue to meet the above reporting requirements and thresholds. Failure to adhere to these requirements may delay access to the allocation or cause removal from the K-12 COVID-19 Testing Program.

School systems across the state utilize the K-12 COVID Testing Program in various ways to keep their students and staff safe and to provide the school system with information on COVID-19 positivity rates in their school systems. In order to support all school systems in the state, DSHS and TEA have reallocated funds from schools that have not utilized their testing allocation so that schools that have implemented effective screening practices or schools in areas of high transmission can continue to test.

As of today, March 3, 2022, school systems that have not utilized any of their allocation will have their allocation reduced by 90%. If school systems decide they need to utilize their testing allocation and need more than the updated allocation amount, they will need to emailCOVIDCaseReport@tea.texas.gov

School systems that have been effectively utilizing the K-12 COVID-19 Testing Program and have met the above reporting requirements may request an increase in allocation once they have reported 80% use of their allocation. Schools systems that would like to request an increase in allocation should complete theSY 21-22 COVID-19 Stop Gap and Allocation Increase Form.

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K-12 COVID-19 Testing Reporting Requirements and Allocation Update | Texas Education Agency - Texas Education Agency

For millions of vulnerable people, COVID-19 is far from over – National Geographic

March 2, 2022

Janet Handal was feeling optimistic when she booked her flight to Texas in early 2021. The 71-year-old New York City resident had just scheduled her first COVID-19 vaccine appointment amid news that the mRNA vaccines available in the U.S. were highly effective. She carefully counted the days until she would be safe to travel, eager to see family for the first time in over 18 months.

But that optimism was short-lived.

A blood sample taken a month after her second shot revealed that Handal had developed nearly no antibodies against COVID-19. The two vaccine doses being recommended for mRNA shots didnt confer the same robust immunity as they had for tens of thousands of vaccine trial participants. Thats because she has been on immune-suppressing drugs due to a kidney transplant she received in 2010.

It was really a punch to the gut, she says. I never imagined that I was not going to be protected [in the same way].

Handal is among the estimated 10 million people in the U.S. with a compromised immune system. Unlike everyone else, they mount a much weaker immune response to several vaccines. But when pharmaceutical companies first began testing COVID-19 vaccines in 2020 and 2021, the clinical trials excluded immunocompromised individuals and issued the same vaccination recommendations for them without conducting separate trials.

When a new vaccine comes out, the recommendation for an immunocompromised patient is the same as that for everyone else, says Deepali Kumar, a transplant infectious diseases physician at the University of Toronto. It isnt until later that those recommendations are adjusted, in part because the burden of providing data for immunocompromised individuals falls on the shoulders of independent scientists, not the vaccine makers, and it can take months to years to conduct the studies. Its a long-standing issue, she says.

Even now it remains unclear whether more vaccine doses will help protect the severely immunocompromised. The U.S. Food and Drug Administration authorized a third dose in August 2021 for certain immunocompromised people. Some transplant recipients have since been vaccinated with a fourth shot and a smaller subset have secured a fifth dose. But Kumar says more may not always be better, and additional studies are needed to prove that further doses are effective.

The irony is that the third dose may not have been authorized if not for people like Handal taking matters into their own hands.

Without robust protection from two shots, Handal knew her weak immune system meant greater chances of severe disease or death from exposure to the SARS-CoV-2 virus. So she and some others like her got a third COVID-19 shotwell before the FDA authorized its use. But not all immunocompromised people did, making things tricky in May 2021 as the Centers for Disease Control and Prevention was saying no masks for the fully vaccinated.

I know three people myself who were transplant recipients whove died because they listened to the message of take your masks off, Handal says. Many, many, many, of us just decided we were going to get our [additional] vaccines early because we knew we werent protected.

When our bodies receive a COVID-19 shot, the immune system springs into action. It stimulates the production of antibodieswhich can bind to the virus and prevent it from infecting cells. It also activates specialized immune cells called T cells, as well as memory cells that remember how to respond when a COVID-19 infection occurs.

But those immune responses are blunted in immunocompromised people, including those taking immunosuppressive drugs for autoimmune diseases, organ transplants, cancers, HIV infections, and other conditions.

When a transplant patient receives an organ from another human, their immune system sees it as foreign and immediately tries to reject it. To counter these attacks doctors use immunosuppressants to dial down the activity of the patients immune system and stop it from attacking the new organ. Its always this really careful balance in leaving some of the immune system intact, obviously, and wanting to leave it suppressed enough so it doesnt cause harm, says Dorry Sergev, a transplant surgeon at Johns Hopkins University. But it also reduces the ability to respond to the vaccine.

Several studies have suggested that two shots of an mRNA vaccine were grossly inadequate for several immunocompromised individuals, particularly kidney transplant recipients. One study published in May 2021 found that 46 percent of 658 kidney, lung, liver, and heart transplant individuals in the U.S. had no antibody response after receiving one or two doses of the mRNA vaccines. Compared to everyone else, transplant patients vaccinated with two doses had an 82-fold higher risk of breakthrough infections and 485-fold increased risk of hospitalization or dying.

Following a third shot, one study found that 77 out of 197 people with kidney transplants developed COVID-19-specific antibodies after producing none from two doses. In another study, 26 out of 60 organ transplant recipients who were given the third dose produced antibodies at levels nearly equivalent to those seen in people with healthy immune systems whod gotten two doses.

But for some immunocompromised people, such as those who are older or taking certain immunosuppression drugs or high doses of it, even the third or fourth vaccine dose has proven limited.

I have two patients whove had the fourth dose critically ill with COVID-19 because they didnt mount a sufficient antibody response even with the fourth dose, says Ayelet Grupper, a nephrologist at Israels Tel Aviv Medical Center. And its getting more complicatedIm not sure what level of antibodies are needed to fight against Omicron and new variants that might come.

Sergev has been measuring post-vaccination antibody responses among organ transplant recipients, including Handal, since last year. While her blood work indicated an increase in antibody levels following a third dose in April 2021, the response was still weak compared to that seen in people with healthy immune systems.

So in October 2021six months after her third doseHandal got a fourth. Some of Sergevs patients still didnt mount a robust immune response and needed a fifth shot. In a recent study, he recorded an increase in antibodies at dose five among some patients who didnt have a sufficient response at four. There are people out there who need two doses, there are people out there who need five doses, and there people in between, Sergev says.

But, theoretically, too many doses of the same vaccine could create a problem of tolerance, he says, meaning a potential lukewarm immune response following multiple vaccine doses. Your body can say, I know this vaccine, I dont need to do anything.

Feeling unprotected, several of his patients have lived far more isolated lives during the pandemic than everyone else. Essentially youve been living under house arrest, Handal says. You havent been able to participate in your familys lives or be with your friends. Getting additional shots hasnt been easy either. It created dissonance for almost everyone who chose to do it, Handal says, especially if the shots were not yet officially authorized by the CDC and FDA.

We are building the plane as we fly it, Sergev says, and weve been doing that through the entire pandemic.

Scientists are conducting clinical trials and are exploring alternative strategies to boost the immune response for the immunocompromised.

Sergev, for instance, is leading a randomized clinical trial involving kidney and liver transplant recipients who have failed to produce antibodies after two, three, or four mRNA vaccine doses and giving them an additional dose. In some participants hes also reducing their immunosuppressive medication one week before and two weeks after giving them the additional COVID-19 shot to see if such an adjustment improves the immune response, similar to what researchers have observed in people with autoimmune diseases.

At the University of California, Davis, Transplant Center, Aileen Wang is leading a similar clinical trial specifically with kidney transplant recipients for whom the second or third mRNA vaccine doses werent adequate. Before and after giving an additional shot, she and her colleagues plan to halve the dose of one immunosuppressive drug called mycophenolate, which prevents the recipients body from rejecting a transplant organ.

Grupper, who isnt involved in these studies, feels the research will be informative. But she emphasizes the delicate balance between increasing a transplant recipients immune response to the vaccine while still preventing organ rejection. Monitoring clinical trial participants health closely is key, she says.

As this work continues and researchers recruit more participants, transplant recipients may have to wait at least another three months, if not more, to find out if Sergev, Wang, and their colleagues approach is successful.

In the meantime, as COVID-19 continues to be a serious risk for many immunocompromised individuals, theyre also struggling to access Evusheldthe only monoclonal antibody authorized for prevention of COVID-19 in people who cant take the vaccine due to a severe allergy or an immunocompromised condition. The intramuscular injection must be given once every six months while the virus circulates, and supplies are extremely limited. Last week the FDA revised its initial dosing regimen in light of Omicron to a higher dose.

People have driven hours, sometimes eight to 10 hours, to get the injection, Handal says. Alongside finding ways to access additional vaccine doses, were also strategizing about how to get Evusheld.

With several states rolling back masking mandates and pushing for a return to normalcy, Handal and others remain frustrated. We know were not safe, she says, and there isnt adequate treatment if you get sick. Shes planning on getting her fifth dose very soon.

Original post:

For millions of vulnerable people, COVID-19 is far from over - National Geographic

Living in a COVID-19 Pandemic While Immunocompromised – University of Utah Health Care

March 2, 2022

Mar 02, 2022 12:00 AM

Author: University of Utah Health Communications

The virus that causes COVID-19 impacts everyone differently. Most people will experience mild to moderate symptoms, or possibly no symptoms at all. But a large population is more vulnerable than most, and the outcome of infection can be quite devastating.

Older adults, people with chronic illness, people who are immunocompromised, and people with disabilities are most at risk of getting severely sick with COVID-19. They also have a higher risk of becoming hospitalized or dying from the virus. While COVID-19 vaccines help protect the vast majority of people, they may not work as well for these groups.

Immunocompromised patients have some deficit to their immune system, either because they are taking medication that compromises the immune system or because they have an innate condition. These patients are at higher risk of not responding to the vaccine, says Hannah Imlay, MD, an infectious diseases physician who takes care of immunocompromised patients at University of Utah Health. You need an immune system to help with that, and many of these patients have some deficit.

While these groups may not generate a good response to the vaccines or experience a higher rate of breakthrough symptomatic infection, COVID-19 vaccines still offer some protection against the virus. COVID-19 vaccines help decrease disease severity and death. This is why the vaccines are highly recommended for these groups.

Early in the pandemic, it was recognized that immunocompromised patients specifically those with organ transplants, cancer chemotherapy, stem cell transplants, and autoimmune conditionsdid not respond as well to the primary two-dose vaccine series as other people. In order to receive a good level of protection, a third dose is now recommended and part of the initial primary series.

Immunocompromised patients have a higher risk with any vaccine strategy," Imlay says. Whether its two, three, or four doses, we cant change that. What we can do is try and change the vaccine strategy to make immunity as good as possible.

A fourth dose, the booster shot, is also recommended three months following the initial three-dose vaccine series for immunocompromised patients. At this time, anyone age 12 years and older are eligible to receive a booster shot.

Preventive medications for COVID-19 are available for immunocompromised patients. Pre-exposure prophylaxis can help prevent a patient from getting SARS-CoV-2 before theyve been exposed to the virus. Evusheld, a monoclonal antibody therapy, was recently authorized by the FDA and has shown to prevent patients from getting symptomatic COVID-19 infection. Evusheld is really targeted at people who dont get much protection from vaccination, Imlay says.

Other early COVID-19 therapies are available for immunocompromised patients. Pfizers paxlovid antiviral pill and the Sotrovimab antibody infusion are COVID-19 treatments for certain patients whove been infected with the virus.

Getting fully vaccinated is the best and easiest thing you can do to protect vulnerable groups. Wearing a well-fitted face mask will also help stop transmission of any respiratory infections circulating in the community.

These are physicians, students, teachers, children, and people that work in the community just like everybody else, Imlay says. Its a population that needs to be protected and needs to be protected by the rest of our actions.

Its especially important for immunocompromised people to invest in high filtration face masks, such as an N95, especially when out in public or in an indoor setting. According to Imlay, fit, filtration, and comfort are the most important elements to an N95 mask.

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Living in a COVID-19 Pandemic While Immunocompromised - University of Utah Health Care

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