Category: Covid-19

Experts are split on whether the waning delta surge will be the last major COVID-19 wave to strike the U.S., as Americans grow eager for the pandemic to end after 19 months.

The vaccination rate and decreasing cases in most states have provided a ray of hope that the pandemic could be winding down after its final large wave, some experts say.

But other public health experts caution the unpredictability of the virus suggests another surge could still happen as the country braces for winter which led to skyrocketing cases, deaths and hospitalizations last year.

Nicholas Reich, a professor of biostatistics at the University of Massachusetts Amherst, said declaring there wont be another major wave after delta feels like a premature and bold statement.

Is there a chance? Sure, but I feel like if there's one thing we've learned from this, it's that there's a lot more sort of uncertainty and randomness in COVID then we've given it credit for so far, he said.

Some experts, including Reich, pointed out that factors such as the potential development of variants and the unknown endurance of immunity after infection and vaccination could spark larger-scale rises in COVID-19 cases after the country has seen a national decline.

The downturn in cases comes after the delta strain fueled a spike, reaching a seven-day average of more than 175,000 daily cases in mid-September. But on Thursday, that average dropped below 100,000 for the first time since Aug. 4, according to data from The New York Times.

Overall, 39 states have seen their seven-day averages of COVID-19 cases fall within the past two weeks. Despite these drops in cases, COVID-19 is not eliminated and many hundreds of thousands of people are still gonna get infected as the pandemic continues, Reich said.

While COVID-19 numbers are moving in the right direction, some areas of the country, including Alaska and West Virginia, are still very much in the midst of the delta wave, said Leana Wen, an emergency physician and public health professor at George Washington University.

I'm very concerned about people becoming complacent because they think that the delta wave is passing us, she said. We have seen this happen before, where there is a rise in the number of cases, then a decline, and then people let down their guard. And as a result, we plateau at a very high level of cases. That's unacceptable.

The approaching winter season also makes it difficult to forecast future COVID-19 trends, as coronaviruses can more easily spread in colder weather and in indoor spaces. Last winter, the U.S. saw its highest surge of cases, hospitalizations and deaths amid holiday gatherings held before vaccines became widely available.

Christopher Murray, the director of the Institute for Health Metrics and Evaluation at the University of Washington, said he expects cases to increase in the winter after bottoming out in October, but that it is likely to be lower than the delta surge.

I think some people will be surprised that it doesn't just keep going away, and that doesn't seem very likely, he said.

Wen of George Washington University said having just 56.2 percent of the total U.S. population fully vaccinated andfewer restrictions than last year leaves it uncertain that the delta wave could be the U.S.s final major COVID-19 surge.

I don't know how we could possibly say that considering we don't know what's going to come our way, Wen said.

I'm not sure how we can know for certain that the level of protection we have nailed through vaccination is sufficient, she said, adding shes hopeful the end is on the horizon with childrens vaccines, oral treatment and more testing.

Others, including former Food and Drug Administration (FDA) commissioner Scott Gottlieb, took a more optimistic stance, anticipating that cases wont rise to the summer delta levels again.

Barring something unexpected, Im of the opinion that this is the last major wave of infection, Gottlieb told The New York Times this week.

Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security, told MSNBC on Friday that any rise in winter cases will likely be more decoupled from hospitalizations and deaths due to the increased immunity due to vaccines and infections.

Many more people have been vaccinated, so many more people have natural immunity from this big delta wave and unfortunately so many people have died that we probably wont see peaks that are anything like we saw in the past, especially when it comes to what matters which is hospitalization, serious disease and death, he said.

I think delta was hopefully the worst that this virus can throw at us, he added.

David Dowdy, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, said he thinks its unlikely that the U.S. will endure another COVID-19 wave to the level of the summer delta and previous winter surges.

With the vaccination level rising and a fair amount of the unvaccinated getting infected, Americans immunity is higher now than its ever been, he said.

The emergence of a new variant could potentially threaten that immunity if the strain evades the vaccines. But Dowdy said he doesnt expect that in the short-term, as delta has reigned as the dominant variant worldwide for months without another strain usurping it.

I think anyone who says that they can predict the future of this pandemic is probably lying to you, Dowdy said. But I think we have a lot of reasons to be optimistic that we will not see another massive wave the way that we have seen so far.

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Are COVID-19's big waves over? Experts are split | TheHill - The Hill

A look at major COVID-19 developments over the past week   The Atlanta Journal Constitution

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A look at major COVID-19 developments over the past week - The Atlanta Journal Constitution

MONTGOMERY, Ala. (AP) Alabama Gov. Kay Ivey has extended through the end of the month a COVID-19 state of emergency that relaxes some health care regulations.

The order was scheduled to expire Tuesday.

Ivey first ordered the limited, narrowly-focused state of emergency on Aug. 12, when a surge caused by the delta variant of the coronavirus and by Alabamas low vaccination rate was rising. The order was aimed at helping hospitals adjust to the caseload from the virus, al.comreported.

Alabamas case numbers and hospitalizations began to decline a few weeks later. The total number of patients in Alabama hospitals with COVID-19 fell under 1,000 on Friday, the first time its been that low since July. The number of newly reported cases per day in Alabama has dropped more than 70% since early September, the governors office said.

Despite that, the governors proclamation Friday said the pandemic persists and continues to present a serious threat to public health, taxing Alabama hospitals, many of which were already struggling to staff their facilities.

The proclamation relaxes some regulations to help allow expanded capacity in healthcare facilities, additional liability protections, increased authority for frontline health care personnel, and easier shipment of emergency equipment and supplies, the governors office said. It also allows out-of-state doctors, nurses, and pharmacists to practice in Alabama under expedited licenses or temporary permits.

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Ivey extends limited COVID-19 health emergency to Oct. 31 - WIAT - CBS42.com

The Inland Northwest saw more than 1,200 new COVID-19 cases in the past week as virus continues to spread in the area.

In Spokane County, case numbers remain high, despite a dip in cases statewide. In the last week, the county has had 767 new COVID-19 cases. On Friday, the Spokane Regional Health District reported 215 new cases and two additional deaths. There have been 862 deaths in Spokane due to the virus.

There are 175 people currently hospitalized in Spokane.

After hitting record highs for COVID-19 hospitalizations, Kootenai Health numbers dipped slightly toward the end of the week. At its peak Wednesday, the hospital had 150 COVID-19 cases. As of Friday morning, that number was down to 139 patients, with 42 patients requiring critical care. There were no pediatric patients. A week ago, there were 127 patients hospitalized.

The Panhandle Health District reported 79 new cases on Friday. There have been 512 deaths in the Panhandle Health District due to the virus.

In the past week, the districts numbers have also remained high, with 942 new cases reported in the last seven days.

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COVID-19 case rates remain high in Inland Northwest - The Spokesman Review

U.S. Sen Ron Johnson told those who gathered for a town hall meeting in northern Wisconsin Friday that vaccines against COVID-19 "are not as safe ... and effective as we all hoped and prayed they would be," and said overwhelmed hospitals weren't a sign of a health crisis.

The comments come two weeks after Wisconsin surpassed 8,000 deaths from the pandemic disease and just days after the U.S. Department of Health and Human Services released a report suggesting the use of vaccines prevented 700 deaths in Wisconsin in the first five months of 2021 alone.

Johnson, who had an asymptomatic case of COVID-19 in 2020, said he hasn't received the vaccine. He has spent months amplifying conspiracy theories and calling attention to rare cases of adverse reactions to it, as well as blasting medical authorities who say there's no scientific evidence supporting the use of the drug Ivermectin as a prophylactic or early treatment for the disease.

Johnson's town hall Friday afternoon in far northern Boulder Junction included brief discussions of immigration, gerrymandering and climate change. But Johnson spent by far the most time at and after the event expressing his skepticism of the vaccine and his strong opposition to employer and government policies mandating it. He dismissed accusations that his actions are undermining public confidence in the vaccine.

"'Anti-vax' is now a pejorative," Johnson said in a brief exchange with reporters after the town hall. "It's hurled at people falsely all the time. It's like the worst thing you could possibly be. I've had every vaccine (except COVID-19)."

But Johnson in the town hall made numerous false or misleading claims about the drug, including implying that a federal database that records all health events experienced by the hundreds of millions of people who have been vaccinated shows that thousands died as a direct result of the vaccine.

In fact, a new analysis by the Rural Policy Research Institute found death rates from COVID-19 in rural counties are now roughly double the rates in urban areas due to lagging vaccination rates in rural America.

The room of around 150 people was overwhelmingly supportive of the senator, offering applause breaks and questions that teed up favorite topics. The northern region of Wisconsin voted overwhelmingly for former Republican President Donald Trump in 2020, and he won Vilas County by a 60-38 margin.

As Wisconsin experienced a spike in new infections in August and September, some hospital systems were overwhelmed by COVID-19 patients. As recently as this week, central Wisconsin's Marshfield Clinic was full to capacity.

Johnson said that is normal.

"A bad flu season will put stress, sometimes overwhelm hospitals for certain regions. That happens all the time," he said. "Just because it happens with COVID doesn't mean theres some massive crisis in terms of our health care system."

Two questioners during the town hall said they had children who were facing being fired due to employers' vaccine mandates. That included one who said his son was a military physician being "threatened with dishonorable discharge (and) pulling his medical license" because he is declining to give or receive COVID-19 vaccines. On Thursday, the website Military.com reported that 92 percent of active service members had received at least one dose of the vaccine.

"They are threatening to ruin him if he does not comply," the questioner said. "Yes or no, will you help him if they do that?"

"Yes," Johnson said.

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Johnson: Hospitals overwhelmed by COVID-19 patients 'doesn't mean there's some massive crisis' - Wisconsin Public Radio News

Onondaga County and Kinney Drugs to host COVID-19 booster clinic Thursday, October 14  CNYcentral.com

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Onondaga County and Kinney Drugs to host COVID-19 booster clinic Thursday, October 14 - CNYcentral.com

Massachusetts public schools have found and reported almost 15 times as many cases of COVID-19 among students and staff as they had at this point last year.

After four weeks of classes, the state tallies 8,502 total cases 7,388 among students and 1,114 among staff compared to just 578 in the same period of the2020-21 school year.

While increases in the number of students learning in-person and in school-based testingaccount for part of that disparity, some public health experts and local officials take it as a sign that the state cant yet let its guard down when it comes to controlling the viruss spread.

Changes to state regulations mean that nearly all students are in school buildings this October, compared to about half as many by this point last fall. But Julia Raifman, an assistant professor at the Boston University School of Public Health, says the virus has changed, too.

[The delta variant] is very transmissible, and it's clear that it's transmitting among children, Raifman says. And while children are lower-risk than adults, weve seen record-high hospitalizations and deaths of children across the country with the variant.

Though the hospitalization and death of children from COVID-19 are still quite rare, CDC data do suggest that, nationally, this Septemberwas the worst yet for children ages 0-17, with 81 deaths from the virus. But in Massachusetts, the same data shows no known deaths of COVID-19.

But Raifman adds that childrens health outcomes are not the only potential ramification of high case counts in schools.

She notes, for example, the unusually high numbers of deaths among people of parenting age, from 25 to 44. Theres also the concern of what happens to everybody when children have to miss school, when parents have to miss out on work to take care of their kids, or if they become sick, she added.

State officials say this falls numbers may be further inflated by the reopening of large districts for in-person learning and the expansion of a pooled-testing program to include 2,200 schools twice as many as participated last year.

In a statement accompanying the latest reports, they note that pooled testing data in this report show low positivity rates, less than 1 percent, and instances of in-school transmission are rare.

School-based reports reached their peak in the second week of classes, and have decreased in each of the last two weeks.

Nevertheless, Raifman who oversees a Boston University database of state COVID-19 policies hopes that both parents and policymakers will exercise caution in the weeks ahead. She supports the use of a mask mandate in schools, but adds that parents and communities should adopt data-driven masking policies like theone used in Nevada, which is enforced and loosened depending on local rates of spread.

Children ages five to 11 will soon be eligible for vaccines, Raifman says, so any deaths or severe disease that we prevent in the next few months until they can begin receiving vaccines may be prevented forever. Its certainly worth really leaning in to prevent illness in children now.

Comparatively hard-hit districts like Worcester are hoping to do just that, according to school committee member Tracy OConnell Novick.

The Worcester Public Schools are planning another round of vaccination clinics in secondary schools, paired with information for familiesabout the vaccines and work with the professional unions on mandatory vaccinations or weekly testing, Novick says.

Novick notes with regret thatamong students who already qualify our vaccination rates arent where we need them to be, and we just need to keep working on that.As of last week, the vaccination rate for Massachusetts residents age 12 to 17 was still among the lowest of the state's age groups, at around 72%.

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So far this year, schools report far higher rates of COVID-19 in students, staff - WBUR

With the authorizations for several effective vaccines against Covid-19 and a strong vaccination program in place, concerns about burnout among health care workers who have been at the frontlines of the Covid-19 pandemic for more than 18 months began to recede. Then Delta became a household discussion as vaccination rates have fallen far short of expectation, keeping health care workers in the trenches.

Burnout was a near-daily topic before Covid-19, but after multiple crushing rounds of the pandemic and with infections rising again, this systemic exhaustion has shifted from a concern to a crisis.

For many health care workers, this round feels personal and tragically preventable. Why? Because, as of July, more than 99% of recent Covid-19 deaths are among unvaccinated people.

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If burnout isnt addressed, it can lead to lasting mental health complications. Multiple studies show instances of post-traumatic stress disorder in health care workers following the SARS outbreak in 2002. Equally worrisome, there will also likely be a continued exodus of health care workers from the industry if health care leaders do not take drastic and immediate measures to stem the rapid turnover rate.

Health care workers have shown up day after day, in the most difficult of circumstances, and it is time past time, actually to show up for them. Health care leaders have a responsibility to reinforce resilience and protect mental wellness as health care workers continue to grapple with the complexities of treating Covid-19.

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Although its tempting to push off focused improvement under the guise of Lets just get through this moment before making any changes, delaying the important work of addressing burnout does a disservice to health care workers who need support and relief now. Even as hospitals continue to see influxes of Covid-19 patients, there are steps health care leaders can take right now to advance welcome and much-needed changes.

Know and articulate organizational goals and values and connect these to current initiatives. Health care should not be willing to accept staff injury and caregiver exhaustion as inevitable. Leaders can and must prioritize creating a culture of safety throughout health care, where employees know they will be both safe and supported within the workplace. Many other complex, high-risk industries, such as nuclear power and aviation, have implemented high reliability practices with rigorous processes to protect employees and, by extension, create safer operations. Covid-19 can be the catalyst to finally move toward addressing persistent safety issues in health care in an intentional, systemic way.

Speak out in support of vaccines. Although health care leaders may not be able to scrub in alongside their clinical team members, they can use their influence to speak out in support of Covid-19 vaccines. Misinformation about these vaccines is rampant, and hospital, health system, and medical center leaders and employees can all play roles in increasing confidence about the vaccines within their respective communities. Increasing vaccination rates is an essential element to finding relief for workers caring for Covid-19 patients and to standing alongside staff in a tangible, visible way.

Engage frontline workers early and often. Burnout is driven by workplace conditions, and no one has a better perspective on what works and what doesnt in health care organizations than those working directly with patients. Theyve seen policies and internal practices (that dont always match policies) pushed to the limit over the last 18 months and have invaluable insights. Successful change initiatives are informed by the experiences of employees at every level and in a variety of roles. Its important to engage those on the frontlines to understand their experiences and empower them as agents of change to help drive lasting improvements. It is more critical than ever to listen to learn what employees need now and to address their barriers and challenges.

Health care has countless lessons to learn from Covid-19 and even more opportunities to build back stronger and better on the other side of the pandemic. Health care leaders must take these lessons to heart and drive positive and lasting change. The health care workforce and the people they serve deserve nothing less.

Anne Marie Benedicto is vice president of the Joint Commission Center for Transforming Healthcare.

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Learning the lessons of health care worker burnout from Covid-19- STAT - STAT

Medical workers treat patients suffering from the coronavirus disease (COVID-19) at Batajnica COVID-19 hospital in Belgrade, Serbia, October 4, 2021. REUTERS/Marko Djurica/File Photo

NEW YORK, Oct 7 (Reuters) - The World Health Organization (WHO) this week issued a definition for "long COVID," a term used to describe the persistent health problems that affect some survivors of COVID-19. Scientists are still working to understand the syndrome. Here is what they know so far.

HOW DOES THE WHO DEFINE LONG COVID?

The WHO defines long COVID as a condition with at least one symptom that usually begins within three months from the onset of confirmed or probable infection with the coronavirus, persists for at least two months, and cannot be explained by another diagnosis. Symptoms may start during the infection or appear for the first time after the patient has recovered from acute illness.

Among the most common persistent symptoms are fatigue, shortness of breath, and cognitive problems. Others include chest pain, problems with smell or taste, muscle weakness and heart palpitations. Long COVID generally has an impact on everyday functioning.

The WHO's definition may change as new evidence emerges and as understanding of the consequences of COVID-19 continues to evolve. A separate definition may be applicable for children, the agency said.

HOW COMMON IS LONG COVID?

The exact number of affected people is not known. A study from Oxford University of more than 270,000 COVID-19 survivors found at least one long-term symptom in 37%, with symptoms more frequent among people who had required hospitalization.

A separate study from Harvard University involving more than 52,000 COVID-19 survivors whose infections had been only mild or asymptomatic suggests that long COVID conditions may more often affect patients under age 65.

More than 236 million infections caused by the coronavirus have been reported so far, according to a Reuters tally.

WHAT ELSE DO STUDIES SHOW ON LONG COVID SYMPTOMS?

In a study published in the Lancet, Chinese researchers reported that 12 months after leaving the hospital, 20% to 30% of patients who had been moderately ill and up to 54% of those who were critically ill were still having lung problems.

The Harvard study also found that new diagnoses of diabetes and neurological disorders are more common among those with a history of COVID-19 than in those without the infection.

DO PEOPLE RECOVER FROM LONG COVID?

Many symptoms of long COVID resolve over time, regardless of the severity of initial COVID-19 disease. The proportion of patients still experiencing at least one symptom fell from 68% at six months to 49% at 12 months, according to the study published in the Lancet.

The WHO said long COVID symptoms can change with time and return after showing initial improvement.

DO COVID-19 VACCINES HELP WITH LONG COVID?

Small studies have suggested that some people with long COVID experienced improvement in their symptoms after being vaccinated. The U.S. Centers for Disease Control and Prevention said more research is needed to determine the effects of vaccination on post-COVID conditions.

Reporting by Manojna Maddipatla; Editing by Nancy Lapid, Caroline Humer and Bill Berkrot

Our Standards: The Thomson Reuters Trust Principles.

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Explainer: What researchers say about the long-term effects of COVID-19 - Reuters

As many companies impose COVID-19 vaccine mandates, employees who refuse to get jabbed are getting the ax. Employers in the health care and aviation industries have already dismissed thousands of workers who declined to get inoculated.

Oakland, California-based Kaiser Permanente, one of the largest nonprofit health systems in the U.S. with more than 200,000 employees, said that as of this week, 2,200 staffers, or 1% of its workforce, have not complied with the company's vaccine mandate and were placed on unpaid leave.

More than 92% of Kaiser Permanente's staff is vaccinated, and the number of holdouts is declining daily, a spokesperson noted. Employees who have not demonstrated proof of vaccination have until December 1 to do so in order to return to work.

"We hope none of our employees will choose to leave their jobs rather than be vaccinated, but we won't know with certainty until then. We will continue to work with this group of employees to allay concerns and educate them about the vaccines, their benefits, and risks," a spokesperson said in a statement to CBS MoneyWatch.

This week, Northwell Health, the largest health care provider in New York, said it fired 1,400 employees, who make up less than 2% of its staff, for failing to get vaccinated against COVID-19. Both the company and the state of New York have vaccine mandates in place. New York requires its more than 650,000 hospital and nursing home workers be fully vaccinated against COVID-19 or else lose their jobs.

After unvaccinated employees were dismissed, Northwell announced a 100% vaccination rate among its roughly 76,000 employees.

Joe Kemp, a spokesperson for Northwell, said that while it regrets losing some employees, it is prioritizing the health and safety of its patients and colleagues.

"We owe it to our staff, our patients and the communities we serve to be 100 percent vaccinated against COVID-19," Kemp said in a statement to CBS MoneyWatch.

Novant Health, a North Carolina hospital system with more than 35,000 employees, last week fired 175 unvaccinated workers who failed to comply with its vaccination requirements. Compliance for the company means being fully vaccinated or qualifying for a medical or religious exemption that allows employees to test weekly and wear an N95 mask as well as eye protection while on the job, according to Novant.

By the end of last month, Novant had suspended without pay roughly 375 employees who it determined violated its policy and given them five days to comply or else be terminated. An additional 200 Novant employees subsequently rolled up their sleeves, according to the company.

"We are thrilled [that the] vast majority of team members gave @NovantHealth patients and visitors, as well as our team members, better protection regardless of where they are in our health system," Megan Rivers, the company's director of media relations, said on Twitter.

Novant Health CEO Carl Amato said the company is not concerned about staffing shortages.

"Staffing is no more a concern today than before this event, and we have been steadily adding travelers to meet the needs of our organization throughout the pandemic. Without a vaccine mandate for team members, we faced the strong possibility of having a third of our staff unable to work due to contracting, or exposure to, COVID-19," Amato said in a statement to CBS MoneyWatch.

Other health care organizations are also cracking down on unvaccinated workers who they say put their colleagues and communities at risk of getting COVID-19.

ChristianaCare, which is headquartered in Wilmington, Delaware, and has 1,200 beds across three hospitals, last monthannounced that some 150 of its employees had failed to meet a September 21 deadline to be fully vaccinated. As a result, they were fired. Of these, roughly 50 provided direct patient care, including a dozen nurses.

"As we anticipated, a small number of caregivers chose not to be vaccinated and have left the organization. Separations for non-compliance with our vaccination policy resulted in the loss of approximately 150 employees, the equivalent of fewer than 90 full-time employees," CEO Janice Nevin said in a statement.

ChristianaCare noted that about 200 of its caregivers were exempted from vaccination on religious or medical grounds, as required by Title VII of the Civil Rights Act and by the Americans with Disabilities Act.

Although health care organizations account for most of the firings of unvaccinated workers, other kinds of employers are expected to follow suit when workers start reporting to offices again in earnest.

"I've heard from general counsel and human resources folks that they are gearing up to do it," said Randi May, a labor and employment attorney at Hoguet Newman Regal & Kenney in New York. "The reason we're seeing it in the health care industry first is they are all back to work in person, and companies that can still allow people to work from home are gearing up. They have the luxury of being more protracted about their approach and are starting to engage in the interactive process with employees whose positions are deemed essential to return to the office."

"You'll see terminations in other sectors soon," she added.

One company already lowering the boom: United Airlines. The carrier in August told its 67,000 U.S.-based employees that they would have to be fully vaccinated against COVID-19 by the fall. United said it initially identified nearly 600 employees who were in violation of its policy and who were set to be terminated. But almost half that number have since opted to get vaccinated, according to United.

"Our vaccine policy continues to prove requirements work in less than 48 hours, the number of unvaccinated employees who began the process of being separated from the company has been cut almost in half, dropping from 592 to 320," the company said in a statement to CBS News.

More than 99% of United's eligible U.S. employees have now chosen to get vaccinated, according to the company.

A dilemma for some companies considering vaccine mandates is an acute worker shortage among retailers, restaurants, hotels and other service-sector employers.

"I believe that in certain industries they are afraid that if they fire people they won't have any one to do the work," May said.

In Connecticut, an executive order requires workers to either have been vaccinated by October 4 or take weekly COVID-19 tests. As of Monday, 2,200, or 7% of executive branch state employees were noncompliant, the governor's office said Monday.

The administration said it expects most vaccine holdouts to provide proof of vaccination before they face termination. Gov. Ned Lamont saidhe would consider deploying the National Guard to replace workers who fail to comply in order to avoid worker shortages.

"I continue to remain optimistic that our employees will submit their testing and vaccination information quickly," Lamont said. "But as we have done throughout the pandemic, we will prepare for the worst to prevent impacts to the critical services the state provides."

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COVID-19 vaccine mandates pressure employees to get their ...