Category: Covid-19

Coronavirus deaths reach 600,000 in the United States, a stark reminder of the pandemics enduring toll even as states edge toward normalcy. USA TODAY

In Minnesota, the HealthPartners system has seen a precipitous decline in COVID-19 hospitalizations, says Dr. Mark Sannes, an infectious disease physician and senior medical director for the system, which operates ninehospitals and more than 55 clinics. But now, nearly every admitted patient he does see is unvaccinated.

Less than 1% of our hospitalized COVID patients are vaccinated,"he said.

In Ohio, at University Hospitals Cleveland Medical Center, only 2% of the COVID-19 patients admitted in the last month were vaccinated, said Dr. Robert Salata, the hospital's physician-in-chief.

And at Sanford Health, which runs 44 medical centers and more than 200 clinics across the Dakotas, Minnesota and Iowa, less than 5% of the 1,456 patientsadmitted with COVID-19 so far this yearwere fully vaccinated, said spokesperson Angela Dejene.

Falling rates of COVID-19 across the United States mask a harsh reality the overwhelming majority of those getting sick and being hospitalized today are unvaccinated, while vaccinated patients are becomingrare.

Hospitals in states with the lowest vaccination rates tend to have more COVID-19 patients in intensive care units, according to hospitaldatacollected in the past week by the Department of Health and Human Services and vaccination rates published by the Centers for Disease Control and Prevention.

Wyoming, Missouri, Arkansas and Idaho currently have the highest percentage of COVID-19patients on average in their ICUs; those states all have vaccinated less than 40% of their population.

Medical centers say there'salso an obvious change in the age of their sickest patients, asolderpeople are much more likely to be vaccinated thanyounger.

"We're all seeing the same thing when someone does get sick and comes to the hospital, they're much more likely to be young and unvaccinated," said Dr. Robert Wachter,professor and chair of the Department of Medicine at the University of California, San Francisco.

Cathy Bennett, president and CEO of the New Jersey Hospital Association, said the picture is the same in her state.

"As COVID vaccinations rolled out across New Jersey, theres been a major shift in the ages of patients admitted to the hospital," said Bennett. "Unlike last spring, when those 65 and older accounted for the majority of hospitalizations, were now seeing more young people hospitalized with COVID."

In Ohio, Salata said the shift should be reassuring, showingthe vaccines work.

"It sends a very strong message to the hesitancy people out there because the data speaks for itself," he said.

Doctors say there are multiple reasons people aren'tyet vaccinated. There are the hesitant, who still have questions and sometimes fall prey to misinformation, andthe opposed, who often harbor anti-government or anti-science sentiments.

"We've had a little success when we've spoken to them on a one-to-one basis. We can give them the information that they need to make their decision,"saidDr. Gerald Maloney, chief medical officer for hospital services at Geisinger health network, which runs ninehospitals inPennsylvania.

Some still can't easily access vaccine, either because it's not available nearbyor because they can't get time off work.

And while the U.S. government paid for all vaccines and vaccinationsso no one should be charged, others remain fearful they will be on the financial hook for a shot, Maloney said.

Eleanor Leisenring speaks with Cheryl McHale, RN, after receiving the COVID-19 vaccine at a Geisinger community vaccine center in Danville, Pa.(Photo: Geisinger)

Last week, Health and Human Services secretarySecretary Xavier Becerra clarified in a letter that providers may not bill patients for COVID-19 vaccines.

There's still a lot of work to be done to create the trust necessary for these groups to embrace vaccination, Maloney said.

"The people who say, 'It's my body, my choice?' Well, it's not all about you," he said."It's also about the people that you're around."

At this point, every vaccination is a win,one more person who can't pass the virus along. That's especially true in families where children can't be vaccinated and are still at risk.

At Akron Childrens Hospital in Ohio, we have not seen any kiddos who have been admitted to the hospital who have been vaccinated, said Dr. Michael Bigham, a pediatric intensivist in the critical care unit.

Among children 11 and younger, who cant yet get the vaccine, having vaccinated family members is keeping them out of the hospital, and protecting them against MIS-C, the multisystem inflammatory syndromethat can be a rare but dangerous aftereffect of a COVID-19 infection in children.

Most of the kids were seeing in the hospital with COVID or MIS-C had COVID in their household, maybe a parent or a grandparent, and most of those individuals had not been vaccinated, he said.

The message from health care workers is unanimous: They just aren't seeing many vaccinated people get sick.

In New Jersey, the percentage of COVID-19 hospitalizations among those ages 18 to 29 has increased 58%since the beginning of the year. By comparison, the percentage of COVID-19 hospitalizations among the 65 and older age group with a statewide vaccination rate of more than 80% declined by 31.2%.

The numbers are no coincidence, Bennett said.

"Vaccination," she said, "works in preventing severe COVID illness."

Nurses struggling to take vital signs. Anguished faces on iPad screens. A chaplain praying with a patient. These are the scenes playing out daily inside of a COVID-19 ICU. USA TODAY

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People hospitalized with COVID-19 now have one overwhelming thing in common. They're not vaccinated. - USA TODAY

In early January 2021, travelers returning to Tokyo, Japan, from Amazonas, Brazil, were screened for COVID-19 at the airport. A few days later, the National Institute of Infectious Disease of Japan announced that the travelers had returned with a new variant of the SARS-CoV-2 virus.

That variant, known as gamma, or P.1, led to a deadly surge in COVID-19 cases in Brazil this spring, and has now spread across the world. More than 200 cases have been detected in Wisconsin. Whether current vaccines are as effective against the gamma variant remains unknown.

In a new study using variant virus recovered from one of the original travelers, researchers in the U.S. and Japan have found that vaccination with an mRNA vaccine induces antibody responses that would protect humans from infection with the gamma/P.1 variant. Hamsters previously infected with the virus strains first circulating in early 2020 were also protected from infection with the gamma variant nine months later.

The findings, the researchers say, suggest that previous SARS-CoV-2 infection and vaccines that are based on earlier strains of the virus still provide protection against infection with gamma. The study published in the Proceedings of the National Academy of Sciences on June 17, 2021.

The animals were quite protected, says study lead Yoshihiro Kawaoka, a professor of virology at the University of WisconsinMadison School of Veterinary Medicine and the University of Tokyo. There may be people who get infected with this variant even though they are vaccinated or were previously infected, but they shouldnt get severe disease.

However, he says, that is not consistent with what has been happening in Brazil, where there have been reports of people reinfected with the gamma variant after recovering from infection with an earlier strain. Its possible, Kawaoka says, that COVID-19 immunity lasts longer in hamsters than in humans, or that cases documented as reinfections are actually first infections.

Kawaokas research team established the Syrian hamster model for COVID-19 last year, after demonstrating that hamsters are highly susceptible to the SARS-CoV-2 virus and develop disease similar to humans, like ground glass opacity in their lungs. They also develop lasting antibodies that protect against reinfection.

Animal models are great because (they allow us to) test vaccines, test drugs, test monoclonal antibodies and even do pathogenesis (studies), says Kawaoka.

In fact, his team studied the gamma variant in hamsters because, while previous studies suggested P.1 might bind better to cells and resist antibodies created by previous infections or vaccination, little is known about the variants ability to replicate in the body, how much illness or pathogenesis it causes, or how well immune responses react to the virus.

The researchers infected hamsters with either the P.1/gamma variant isolated from the traveler, or with one of two earlier strains of the virus from human samples one isolated from a patient in February 2020, and the other from a patient with a non-variant globally predominant strain. Each of the strains replicated similarly in the nose and lungs of hamsters and caused similar illness affecting the lungs.

Next, Kawaokas team looked at whether antibodies in convalescent sera from 35 recovered COVID-19 patients or from people whod received the Pfizer-BioNTech mRNA vaccine could neutralize each of the three viral strains.

Following a natural infection or vaccination, the body produces antibodies that learn to recognize the spike protein of the SARS-CoV-2 virus, which is responsible for binding to cells. Should people encounter the virus again, antibodies recognize the spike protein and subsequently fight off or limit the extent of infection.

Earlier studies have shown that a spike protein mutation E484K, found in gamma variants can change the spike proteins identity just enough that the variant can slip past these defenses. However, antibodies in the blood of vaccinated individuals reacted to all three strains, including gamma.

Antibodies in the blood of recovered COVID-19 patients were also effective at neutralizing each of the strains. However, of the 35 patients, one had been infected with gamma and the antibodies from this individual were less reactive to the non-variant strains.

The researchers say these findings suggest there are some important differences in the spike protein of gamma that might influence immunity, warranting further monitoring. Additionally, Kawaokas group found that gamma, but not other strains of SARS-CoV-2, can infect and replicate in mice, suggesting that the spike protein interacts differently with cells than earlier strains.

The researchers also found that hamsters that had recovered from infection with either of the earlier strains of SARS-CoV-2 were protected against viral replication in their lungs if reinfected with either the same strain or the gamma variant, three weeks and nine months later.

However, gamma was recovered in the nasal passages of reinfected animals in both groups. The amount of virus in the nasal passages of reinfected animals was 1,000-fold lower than animals infected for the first time.

Finally, the researchers studied whether convalescent plasma from three patients infected with SARS-CoV-2 in early 2020 could protect against viral replication in the nose and lungs of hamsters. They found that convalescent plasma, but not plasma from patients who did not have COVID-19, limited virus replication in the lungs of hamsters infected with the prevailing non-variant strain and with gamma/P.1. Virus was found in their nasal passages.

Vaccination, Kawaoka says, is the best way to seek protection from SARS-CoV-2 and emerging variants, including the delta variant, also known as B.1.617.2. The Centers for Disease Control and Prevention recently designated the delta version as a variant of concern due to evidence that it transmits more readily.

Peter Halfmann, research associate professor at UWMadison and co-leader of the study, added that the gamma and delta variants are circulating in Madison and other parts of the U.S., highlighting the importance of vaccination.

The difference between the original strain and (delta) and the original strain and (gamma) is similar, Kawaoka adds, noting: The (delta) variant may become prevalent but it shouldnt be extremely concerning as long as you are vaccinated.

With SARS-CoV-2 changing as it spreads, some versions of the virus will disappear as new variants emerge, as happened with a European variant in early 2020 that quickly eclipsed the original virus first found in China.

At least in the vast majority of the population, we dont have good immunity to SARS-CoV-2, so the selective pressure on the virus at the moment is transmissibility, Kawaoka says, explaining why new variants that successfully spread tend to be more transmissible than those that came before. But it will change. We should expect to see the selective pressure become immunity.

This is why vaccines will likely need to be modified in the coming years, he explains, in order to protect against a virus that will evolve to evade the protections we devise so long as spread of the virus remains high, or if our immune systems dont maintain defenses for long enough to prevent reinfections.

We dont know which one is going to be the case its too early to say how long immunity to this virus lasts, he says. Hamsters look different from humans, anyway. Its difficult to predict.

Peter Halfmann, a research associate professor at UWMadison, and Masaki Imai in the Division of Virology at the University of Tokyo, co-led the study.

It was supported by a Research Program on Emerging andRe-emerging Infectious Diseases (JP19fk0108113, JP19fk0108166, JP20fk0108412, and JP21fk0108104;, a Project Promoting Support for Drug Discovery (JP20nk0101612, JP20nk0101614, and JP20nk0101603); the Japan Initiative for Global Research Network on Infectious Diseases (J-GRID) (JP19fm0108006); the Japan Program for Infectious Diseases Research and Infrastructure (JP20wm0125002 and 20fk0108272) from the Japan Agency for Medical Research and Development (AMED); the National Institutes of Allergy and Infectious Diseases funded Center for Research on Influenza Pathogenesis (CRIP; HHSN272201400008C); the Wisconsin National Primate Research Center (P51OD011106), and the Collaborative Influenza Vaccine Innovation Center (CIVIC; 75N93019C00051).

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Vaccination, previous infection, protect against COVID-19 gamma/P.1 variant in animal model - University of Wisconsin-Madison

The West Virginia Department of Health and Human Resources (DHHR) reports as of June 17, 2021, there have been 2,960,825 total confirmatory laboratory results received for COVID-19, with 163,382 total cases and 2,863 deaths.

DHHR has confirmed the deaths of a 56-year old male from Barbour County and a 68-year old female from Raleigh County.

Each life lost to this disease is a tragedy, said Bill J. Crouch, DHHR Cabinet Secretary. We send our thoughts and sympathies to the families and encourage all West Virginians ages 12 and older to schedule a COVID-19 vaccine.

CASES PER COUNTY: Barbour (1,513), Berkeley (12,802), Boone (2,172), Braxton (1,001), Brooke (2,246), Cabell (8,864), Calhoun (381), Clay (542), Doddridge (638), Fayette (3,544), Gilmer (881), Grant (1,307), Greenbrier (2,883), Hampshire (1,920), Hancock (2,839), Hardy (1,568), Harrison (6,147), Jackson (2,226), Jefferson (4,777), Kanawha (15,459), Lewis (1,279), Lincoln (1,592), Logan (3,274), Marion (4,627), Marshall (3,536), Mason (2,048), McDowell (1,612), Mercer (5,124), Mineral (2,971), Mingo (2,732), Monongalia (9,391), Monroe (1,207), Morgan (1,223), Nicholas (1,892), Ohio (4,303), Pendleton (724), Pleasants (958), Pocahontas (681), Preston (2,954), Putnam (5,316), Raleigh (7,062), Randolph (2,842), Ritchie (756), Roane (659), Summers (861), Taylor (1,272), Tucker (546), Tyler (740), Upshur (1,959), Wayne (3,181), Webster (543), Wetzel (1,385), Wirt (456), Wood (7,925), Wyoming (2,041).

Free pop-up COVID-19 testing is available today in Barbour, Berkeley, Calhoun, Hampshire, Jefferson, Lincoln, Mingo, and Morgan counties.

Barbour County

9:00 AM 11:00 AM, Barbour County Health Department, 109 Wabash Avenue, Philippi, WV

3:00 PM 7:00 PM, Junior Volunteer Fire Department, 331 Row Avenue, Junior, WV

Berkeley County

10:00 AM 5:00 PM, 891 Auto Parts Place, Martinsburg, WV

10:00 AM 5:00 PM, Ambrose Park, 25404 Mall Drive, Martinsburg, WV

Calhoun County

10:00 AM 4:00 PM, Calhoun Middle/High School, 50 Underwood Circle, Mt. Zion, WV

Hampshire County

10:00 AM 5:00 PM, Hampshire County Health Department, 16189 Northwestern Turnpike, Augusta, WV

Jefferson County

10:00 AM 6:00 PM, Hollywood Casino, 750 Hollywood Drive, Charles Town, WV

12:00 PM 5:00 PM, Shepherd University Wellness Center Parking Lot, 164 University Drive, Shepherdstown, WV

Lincoln County

Mingo County

10:00 AM 2:00 PM, Delbarton Fire Department, County Highway 65/12, Delbarton, WV

Morgan County

11:00 AM 4:00 PM, Valley Health War Memorial Hospital, 1 Health Way, Berkeley Springs, WV

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COVID-19 Daily Update 6-17-2021 - West Virginia Department of Health and Human Resources

Pupils attend a class as schools reopen after lockdown due to the coronavirus disease (COVID-19) outbreak at Tved School in Svendborg, on the island of Funen, Denmark February 8, 2021. Ritzau Scanpix/Tim Kildeborg Jensen via REUTERS /File Photo

COPENHAGEN, June 17 (Reuters) - Denmark will offer COVID-19 vaccines for children aged 12-15 after the adult population has been inoculated to boost its overall immunity against the virus ahead of the winter, health authorities said on Thursday.

Initially, Denmark will only offer Pfizer-BioNTech's (PFE.N), (22UAy.DE) COVID-19 vaccine for 12-15 year-olds, as it is the only vaccine approved by the EU's drug regulator for use in adolescents, the Danish Health Authority said in a statement. [nL2N2NF1IP]

The EU regulator expects to announce a decision on the use of Moderna's (MRNA.O) shot in adolescents sometime next month. read more

"An expansion of the target group to the 12-15-year-olds is necessary to ensure even greater immunity in the population, and thus ensure control of the epidemic in Denmark," the head of the Danish Health Authority, Soren Brostrom, said.

Vaccination of adolescents would begin after the last adults have been fully vaccinated in mid-September, Brostrom told a press briefing.

"We need the immunity of the population, especially before a winter season," he said.

In an optimal scenario, Brostrom estimated around 75% of Denmark's population will be immune against the virus after all adults have been inoculated. Vaccinating the adolescents would add another 4% to that number, he said.

Danish health authorities would continually review new data on the vaccine's safety, Brostrom said, and would keep a special eye on data from the United States, where he said over 3 million adolescents had already received a jab with the vaccine. read more

Denmark made waves when it announced in April and May it would cease to administer vaccines developed by AstraZeneca (AZN.L) and Johnson & Johnson (JNJ.N) to adults over a potential link to a rare but serious form of blood clot.

The Nordic country's government has since asked health authorities to reconsider the exclusion of those vaccines since new data on their effects and side-effects has been reported. read more

Almost half of Denmark's population have received a first vaccine shot while more than a quarter are completely inoculated.

Reporting by Nikolaj Skydsgaard;Editing by Alison Williams

Reuters Breakingviews is the world's leading source of agenda-setting financial insight. As the Reuters brand for financial commentary, we dissect the big business and economic stories as they break around the world every day. A global team of about 30 correspondents in New York, London, Hong Kong and other major cities provides expert analysis in real time.

Sign up for a free trial of our full service at https://www.breakingviews.com/trial and follow us on Twitter @Breakingviews and at http://www.breakingviews.com. All opinions expressed are those of the authors.

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Denmark to immunize 12-15 year-olds against COVID-19 ahead of winter - Reuters

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Alaska on Wednesday reported 42 new coronavirus infections identified over two days, and no new deaths, according to the state Department of Health and Social Services. The health department now updates its coronavirus dashboard on Mondays, Wednesdays and Fridays.

Alaskas average daily case counts have been trending down significantly statewide, and the states current statewide alert level is low.

By Wednesday, roughly 54% of the states population age 12 and older had received at least their first dose of the vaccine, while 49% of residents 12 and older were considered fully vaccinated.

Alaskas most-vaccinated region as of Wednesday was Juneau, with 70% of its eligible population vaccinated as of Wednesday. The states least-vaccinated region was the Mat-Su, where just a third of its 12-and-up population had received a dose.

On Wednesday, there were 15 people with confirmed or suspected cases of COVID-19 hospitalized around the state, including five who were on ventilators.

No new deaths were reported Wednesday. In total, 366 Alaskans and seven nonresidents with COVID-19 have died since the pandemic reached the state last spring. Alaskas death rate per capita remains among the lowest in the country, though the states size, health care system and other factors complicate national comparisons.

Over the last two days, there were 40 new cases reported among Alaska residents, including 18 in Anchorage, four in Fairbanks, three in Hooper Bay, two in Craig, two in North Pole, two in Palmer, two in Wasilla, and one each in Eagle River, Homer, Juneau and Wrangell. Three were reported in a smaller community or communities in the Copper River Census Area.

Two new nonresident cases were also identified in Fairbanks and Anchorage.

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Tracking COVID-19 in Alaska: 42 new infections and no deaths reported Wednesday - Anchorage Daily News

Regenerons antibodies were studied in a clinical trial in outpatients in Arizona in 2020. Now, the Recoverystudy has found the therapy reduces mortality in some hospitalized patients with severe disease.

By Kai KupferschmidtJun. 16, 2021 , 1:00 AM

Sciences COVID-19 reporting is supported by the Heising-Simons Foundation.

The worlds largest trial of COVID-19 therapeutics has for the first time produced convincing evidence that a therapy that directly attacks the virus can save hospitalized patients from death. A combination of antibodies called casirivimab and imdevimab, produced by Regeneron, did not lower mortality when all patients in the study were taken together, investigators of the United Kingdoms Recovery trial announced todaybut it reduced deaths by one-fifth among those who did not produce antibodies themselves. A paper with the results will be made available on the medRxiv preprint server later today, the researchers say.

Here you have really the first direct SARS-CoV-2 drug, says Eric Topol, director of the Scripps Research Translational Institute. Two drugs previously shown to reduce mortality from COVID-19 were developed for other diseases and work by dampening an overactive immune response, which is kind of an indirect strategy, Topol says.

But Regenerons antibodies, which attach to the receptor-binding domain of the spike protein and prevent the virus from entering cells, are expensive and not widely available, and quickly identifying patients that benefit from it may be a challenge.

Researchers have developed several monoclonal antibodies against SARS-CoV-2, with mixed results. Some, including Regenerons, have shown some positive effects on disease progression in outpatients, but none was demonstrated to save the lives of severely ill patients in the hospital. The Recovery trial started to evaluate Regenerons cocktail in mid-September 2020. By late May, 9785 patients had been randomly allocated to receive either the usual care in the United Kingdom or the usual care plus a one-time infusion of the two antibodies, a procedure that takes roughly 1 hour.

About one-third of the patients were seronegative when they entered the trial, meaning they did not produce antibodies themselves. That includes people with underlying health conditions that weaken their immune system, but also people who, for unclear reasons, are unable to produce antibodies early on. In this group, 30% of patients given standard care died, versus 24% of those who received the antibody cocktail. That translates to six lives saved for every 100 such patients treated with the drug.

The Regeneron cocktail received a lot of attention when former U.S. President Donald Trump received it during his bout with COVID-19 in October 2020. Although its not clear whether Trumps immune system produced antibodies, the new results suggest the treatment may have helped save his life, Topol says: Who knows what might have happened at his age, with his morbid obesity and all the other risk factors that he had.

Although itreceived an emergency use authorizationfrom the U.S. Food and Drug Administration in November 2020and theU.S. government bought 1.5 million doses Regenerons therapy has not been widely used in the United States, Topol says. This is just sitting on shelves, he says. I think [the Recovery trial] is going to wake people up as to the benefit.

But doctors will have to determine which patients fail to produce antibodies. I think this isnt a complicated test to run, it just needs to be done, says Martin Landray of the University of Oxford, one of Recoverys principal investigators.

A bigger challenge may be cost. We anticipate, but we dont know this, that they may be around 1000 or 2000 per treatment, Recovery co-investigator Peter Horby said at a press conference on Tuesday. That might put the therapy and many similar ones in the pipeline out of reach for most people living in developing countries, which also have far fewer COVID-19 vaccine doses than rich countries. Access to antibody drugs in general has been particularly unequal across the globe, says Lindsay Keir, a pediatrician who co-authoreda Wellcome Trust report on global access to such treatmentsreleased last year. Antibodies that we have benefited from in high-income countries for 20, 30 years, still arent available in many countries, Keir says.

The inequity is a scandal, Horby says. There really must be an initiative to make these drugs accessible, and that requires two things: They have to be available, which means we have to scale up manufacturing, and they have to be affordable, which means we have to reduce the prices.

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Monoclonal antibodies cut risk of dying from COVID-19but only in some patients - Science Magazine

MISSOURI The state of Missouri is seeing a dramatic rise of COVID-19 cases in the month of June.

Last week Missouri saw a 101% rise in cases, which led the country.

Health experts believe that the new Delta variant is a cause of the recent increase in cases.

"I think it's here," CoxHealth President and CEO Steve Edwards said. "We have a lot of admissions, our admissions have grown dramatically."

A Wednesday news release from the Department of Health and Human Services says Missouri is "experiencing a rise in individuals contracting the Delta variant. The variant was just reclassified as a "variant of concern" by the CDC on Tuesday.

CDC data says the variant accounts for 6.8% of cases of Missouri, which is the highest percentage of the variant in the nation.

Edwards said CoxHealth hospitals, which is based out of Springfield, went from 16 COVID patients three weeks ago to 61 patients Wednesday.

Counties in south Missouri are being hit the hardest by the recent surge of cases.

"We're seeing fast growth in Taney County as well, which is where Branson is," Edwards said.

The overall state positivity rate has gone from 3.9% to 5.9% in the last month.

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DHSS Acting Director Robert Knodell says the greatest concern across Missouri is in areas with lower vaccine uptake.

With this variant being easier to spread and possibly causing more severe illnesses among unvaccinated people of all ages, vaccinations are the best way to stop this virus in its tracks," Knodell said in a news release.

Edwards also attributes the surge to people who continue to not get vaccinated.

"It's as safe as a vaccine I think we've created," Edwards said. "If you choose not to get vaccinated you're putting yourself at risk."

Hospitals throughout Missouri are filling up and having staff issues due to the increase of cases.

According to Edwards, CoxHealth hospitals are experiencing similar issues to the ones they faced in 2020.

"Even though the COVID numbers aren't as high as they were, our overall volume is as high," Edwards said.

CoxHealth hospitals are also enduring extended ER wait times, pent up demand for people with deferred care and strains on staffing.

To combat staffing issues, CoxHealth hospitals are bringing in agency nurses for additional help.

"Every area that has low vaccination rates is at risk, which includes the majority of the South, and lots of the Midwest," Edwards said.

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Missouri sees surge in COVID-19 cases, with nearly 7% classified as the Delta variant - KOMU 8

Of the more than 600,000 Americans who have died of COVID-19, a disproportionate number are Black. Growing research suggests that a key to understanding why lies in examining where many of them spent their final days: in the hospital.

A new study published on Thursday, and believed to be the largest of its kind so far, finds that for Black patients hospitalized with the coronavirus, the quality of the hospitals they are admitted to may play an outsize role in determining whether they survive. Hospitals mattered more than any other individual traits like age, income, or other medical conditions.

The study, published in JAMA Network Open, comes after a brutal year in which the coronavirus pandemic and a reinvigorated civil rights movement collided to highlight racial and economic disparities in healthcare. While the virus killed fewer people in white, wealthy enclaves, it crushed communities of color with low incomes and the chronically underfunded, effectively segregated hospitals that served them. Black people account for about one-third of COVID-19 deaths in the US, even though they make up only about 13% of the population.

Its not surprising that Black patients may live [near] and therefore go to hospitals that have fewer financial resources and therefore have a harder time providing optimal care, David Asch, a University of Pennsylvania professor of medicine who led the study, told BuzzFeed News. There are a variety of elements of our historical past that have tended to create white neighborhoods and Black neighborhoods, rich neighborhoods and poor neighborhoods. This is the legacy of our nations racial history.

Aschs team looked at Medicare Advantage data for more than 44,000 patients who were admitted with COVID-19 to a total of nearly 1,200 hospitals across the US from January through September of last year. And they looked at the number of people who died, measured by either dying at the hospital or being sent to hospice for end-of-life care within a month of hospital admission.

In their analysis, the researchers accounted for differences in other traits like age, gender, income, and non-COVID-19 medical conditions between the groups of Black and white patients who died. Even when the other factors were equivalent, Black patients were more likely to die.

Their increased odds of dying didnt seem to be rooted in health differences, such as the chronic conditions like diabetes and heart disease seen in high numbers among Black patients. Instead of individual factors, the most direct link to who ended up dying was where they were hospitalized. Black patients were on average more likely to be admitted to hospitals where patients of all races died at higher rates, the analysis found. In contrast, white patients tended to check into hospitals where survival rates were higher overall.

Black and white survival rates might basically level out, the researchers calculated, if Black patients received care in the same hospitals and in the same distribution as white patients.

There are of course many reasons why Black patients often have worse outcomes than white patients. But often one of the reasons is that Black patients, for a variety of reasons, find themselves going to hospitals that have worse outcomes for all, Asch said.

Asch stressed that the study doesnt single-handedly prove that the hospital that a Black patient checks into is the determining factor in whether they live or die. It also left open the possibility that the difference could be driven by circumstances even bigger than the hospitals themselves the states in which people got hospitalized. The study acknowledged that it was unable to disentangle one from the other, since Black patients were distributed differently than white patients across states.

But his teams finding does track with what is already known about the relationship between how segregated hospitals are and the quality of care people of color receive for other conditions, said Amal Trivedi, a professor at Brown University School of Public Health who was not involved in the study, by email.

Its a dynamic that predates the pandemic. Black patients are more likely than white patients to undergo surgery at low-quality hospitals in segregated areas. Theyre more likely to be under-treated for, and to die from, pneumonia at hospitals that primarily serve Black patients, compared to white patients at mainly white-serving hospitals.

The reasons for these differences date back to even earlier in history to the Jim Crow era and its aftermath. When Black families were legally excluded from buying homes in the suburbs and denied conventional mortgage loans, they were unable to build up generational wealth and were effectively forced into racially segregated neighborhoods. And when inner-city neighborhoods grew predominantly Black, their hospitals closed in greater proportions than those in white neighborhoods.

Many of the hospitals that still serve minority communities with low incomes were already hanging by a thread when COVID-19 hit. On Chicagos South Side, where about 1 in 5 residents live below the poverty line, Roseland Community Hospital quickly became maxed out when the virus struck last spring. We are outgunned, outmanned, underfunded, and no one is coming to help us, the head of the hospital told the Chicago Tribune in April 2020. When South Los Angeles erupted into a COVID-19 hot spot over the winter, sick patients flooded the 131-bed Martin Luther King Jr. Community Hospital. The hospital is surrounded by a sea of chronic illness and lack of access to healthcare, the CEO told the Guardian.

In some places in the US, there wasnt even a hospital to turn to. A record 19 rural hospitals shut down in 2020, disproportionately cutting off healthcare access for Black communities in the South and Southeast while COVID-19 cases and deaths surged.

The quality of hospitals also likely affected patient care in the lead-up to the pandemic, setting people up for worse outcomes, said Ruqaiijah Yearby, a law professor who specializes in racial disparities in healthcare at Saint Louis University School of Law. This is probably some place they were going for all of their care, that left them without the proper care, and so they were more vulnerable to dying from COVID-19, she said.

Earlier studies examining racial disparities among COVID-19 deaths in hospitals have been based on smaller data sets from one or a handful of healthcare systems. The largest study until now was based on data from more than 11,000 patients across 92 Catholic hospitals in the Ascension network, a large, private healthcare system. Researchers there reached a similar conclusion to the study published Thursday, though phrased it differently: When they controlled for the hospitals where patients went, Black COVID-19 patients had basically the same chances of survival as their white counterparts.

But experts are still puzzling over which characteristics of a hospital, exactly, might be making the biggest differences. Perhaps its having a certain volume of COVID-19 cases, the number and training of healthcare staff, or access to key equipment like ventilators. Baligh Yehia, a senior vice president at Ascension, said hes attempting to tease out these granular factors in forthcoming research.

What is it about the hospital? is the next question, Yehia said.

The new study also did not examine whether, within hospitals themselves, Black and white COVID-19 patients might be treated differently by staff and if those differences affect their health. For most other health conditions, both of these scenarios matter, noted Karen Joynt Maddox, codirector of the Center for Health Economics and Policy at Washington University in St. Louis. Black patients typically have worse outcomes even within the same hospital, AND Black patients typically receive care at lower-quality hospitals, so worse outcomes are due to BOTH things, she said by email.

Throughout the pandemic, Black patients have raised concerns that they are not taken seriously sometimes with fatal results, as in the case of Susan Moore, a Black doctor who was hospitalized with COVID-19 at an Indiana University hospital late last year. In a viral Facebook video, Moore complained that her white doctors were ignoring her pain and failing to treat her appropriately. After she died, an investigation concluded that while the medical care she received didnt contribute to her death, Moore did suffer at the hands of providers who lacked empathy, compassion and awareness of implicit racial bias. The hospital system has apologized for its failures and pledged to increase its diversity and equity training.

And not everyone who is killed by COVID-19 dies at the hospital. To understand why Black Americans are dying in greater numbers, researchers say there is a need to explore why many Black Americans may not feel comfortable going to a hospital in the first place and may instead be dying, for example, at home.

Its not just about ensuring hospitals in a predominantly Black neighborhood are of high quality, Yearby said. Its about ensuring its a place where those patients want to go, feel comfortable going, and that they receive the highest quality of care in those places.

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Struggling Hospitals Could Explain Why So Many Black Patients Have Died Of COVID-19 - BuzzFeed News

The NFL and NFL Players Association have agreed to extend their two-tiered COVID-19 protocols into training camp and the preseason, maintaining severe restrictions on unvaccinated players but removing almost all of them for those who are fully vaccinated.

In a memo distributed Wednesday, teams also received details on fan and media access to training camp and preseason games as well as a fine schedule for players who violate specific protocols. But the most pressing issue was how the NFL and NFLPA would treat players and coaches who either decline to be vaccinated or are not fully vaccinated -- with "fully vaccinated" defined as being at least two weeks past their final shot -- when camps open next month.

The NFL decided earlier this year not to make vaccines mandatory for players, and a number of high-profile players have said in recent weeks that they have not yet received a shot. While those players will still be allowed to participate in practices and games, the memo outlines a set of protocols that will essentially create two teams within each organization.

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Per the memo, any player who is not fully vaccinated will continue to be subject to:

Daily testing, mask wearing (including in the team facility) and physical distancing

A quarantine if he has a high-risk exposure to someone with COVID-19

Significant restrictions when traveling, including required isolation in the team hotel and relegation to a separate team plane

A prohibition of meals with teammates

A prohibition on social, media and marketing sponsorship activities

A ban on gathering with more than three other players away from the team facility

A requirement to wear personal protective equipment to visit a nightclub or indoor bar that has more than 10 people in it

A ban on attending indoor concerts or other entertainment events.

A five-day delay between first reporting to training camp and participating fully in activities.

Vaccinated players will face none of those restrictions. They will be required to be tested once every 14 days.

The memo also directed teams to keep fans a minimum of 20 feet from players and key staff members during training camp. That means no autographs or photographs will be allowed. Fully vaccinated media members will have access to physically distanced in-person interviews, but postgame locker room access will be limited to team and NFL media, or NFL Films.

Read more from the original source:

NFL preseason COVID-19 restrictions to remain severe for unvaccinated, nearly all lifted for fully vaccinated - ESPN

Chautauqua County Executive PJ Wendel said Tuesday he was glad to see only two new cases of COVID-19 reported locally. I cant remember when we only had two, he said.

A day later, the numbers were even better.

On Wednesday, the county Health Department announced only one new case part of a prolonged pattern of fewer new cases, active cases, those in the hospital and in quarantine.

To date there have been 9,285 confirmed cases, 9,120 recoveries and 157 virus-related deaths. There are currently eight active cases, two people in the hospital with the virus and 36 in quarantine.

COUNTY SEEKS RESULTS FROM AT-HOME TESTS

COVID-19 testing options have expanded over the past several months, including increased availability of several at-home kits.

The Chautauqua County Health Department is requesting that residents report any positive test results from at-home tests to the department by phone (1-866-604-6789) or email (cchealth@chqgov.com).

When an individual tests positive for COVID-19 in a clinical setting, the result is automatically reported to the local Health Department. The positive result triggers the local Health Department to conduct a disease investigation (interview) and conduct contact tracing. Isolation orders are issued, which can be provided to an employer or other official setting as proof of a prior positive result.

Some at-home COVID-19 tests are supervised by a lab or medical professional, usually via video chat, and results are either mailed to a lab for processing, or processed at home. If the test syncs to an app or is sent out to a lab, these results are automatically reported (e.g. Ellume, Lucira, Cue, Binax Now with NAVICA app).

Other at-home antigen tests, such as the Binax NOW Self Test, are simple and affordable, but do not include a mechanism to report results into the states electronic database.

Proof of a prior COVID-19 infection and recovery within the last 90 days is an acceptable form of proof to grant entry into some public events and other settings (e.g. overnight camps) in lieu of proof of full vaccination status or a negative test within an appropriate timeframe. Additionally, prior positives within 90 days can avoid quarantine when exposed to a confirmed COVID-19 case. However, the positive test showing prior infection must be documented in the New York State Electronic Clinical Laboratory Reporting System in order to count for these purposes.

COVID-19 case numbers are declining fast, but it is very important to maintain surveillance of this disease so that our community can act quickly to prevent further spread of disease.

COVID-19 vaccines are widely available in Chautauqua County. These vaccines are safe and highly effective in preventing severe disease and death due to COVID-19. The Chautauqua County Health Department urges all individuals ages 12 and up to get vaccinated. If you have concerns about the vaccine, contact your primary care provider with your individual needs. Visit chqgov.com/public-health/covid-19-vaccination-clinics to find local vaccination opportunities.

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Only one new case of COVID-19 reported in county - Evening Observer