Category: Covid-19

The New York Yankees have had eight members of their traveling party test positive for COVID-19, the team announced. Third base coach Phil Nevin, first base coach Reggie Willits, pitching coach Matt Blake, and four support staffers were among the positives earlier this week. On Thursday, the team announced infielder Gleyber Torres has tested positive as well.

As with the other seven positive cases, Torres had been fully vaccinated, and in fact he had previously contracted COVID-19 this past December. Here is the team's statement:

"The Yankees can today confirm that INF Gleyber Torres has received a positive COVID-19 diagnosis. He was fully vaccinated and previously had COVID-19 during the most recent baseball offseason ... Torres is the eighth Yankees player, coach or traveling staff member to test positive this week. All of the positives are breakthrough positives, occurring with individuals who were fully vaccinated.

Major League Baseball, its medical experts and the New York State Department of Health are currently advising and assisting the Yankees, who continue to undergo additional testing and contact tracing."

Nevin reportedly showed mild symptoms and the other seven were asymptomatic. Torres was held out of Wednesday's lineup as MLB's joint committee reviewed his testing results. The positive tests come after the Yankees achieved the 85 percent vaccination threshold for relaxed health and safety protocols.

"The one positive for us is that today was the first day with no new cases," manager Aaron Boone told reporters, including ESPN's Marly Rivera, on Thursday. "That is the first time that has happened since we had the first case. So hopefully that is good news."

The high rate of breakthrough positives -- the official term for positive tests after being vaccinated -- has led to the Centers or Disease Control and Prevention looking into the Yankees' situation. Here's what CDC Director Rochelle Walensky told ABC 7:

"With regard to the Yankees, we obviously need to learn more about that situation," she said. "My understanding is that six of the seven reports, six of the seven infections were indeed asymptomatic infections. And we will look to more data from that report to understand what happened there. All of the real world data we've seen that's been in the published literature, large studies, in many different settings, have demonstrated that those vaccines are effective, have a high effectiveness against disease."

The Yankees received the single-shot Johnson & Johnson vaccination last month. Because they met the 85 percent threshold, vaccinated individuals were no longer required to have to quarantine if they are identified as a close contact to someone who tests positive, unless they have symptoms. Those protocols are being reviewed amid the outbreak, however.

David Samson broke down the Yankees' COVID issues on Nothing Personal with David Samson. Listen below:

Part of the incentive from Major League Baseball for achieving at least 85 percent vaccinated for a team's "Tier 1" individuals include the relaxing of the COVID-19 restriction; individuals will not have to wear masks in the dugout or bullpen, will no longer be required to wear the league's COVID-19 tracing program's tracking devices and are allowed to gather for activities in the clubhouse, team bus/plane. "Tier 1" includes the team's traveling party, or players, coaches, trainers, and other assorted staff. For teams that reach the 85-percent vaccinated mark, they also are given the option to be exempt from the league's twice weekly testing.

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Yankees' Gleyber Torres tests positive for COVID-19; team up to eight cases and CDC will look into outbreak - CBS Sports

Bars, gyms and restaurants. Those were just a few settings health experts warned could become hotbeds for COVID-19 spread as states began reopening in the spring and summer of 2020 following the first and second waves of the coronavirus pandemic in the United States.

Yet, public data analyzed by ABC News appears to tell a different story. The data from states across the country suggests specific outbreak settings (including bars, gyms, restaurants, nail salons, barbershops and stores -- for the full list, see graphic below in story) only accounted for a small percentage, if any, of new outbreaks after the pandemic's inital wave in 2020.

While experts believe that mitigation measures such as reduced capacity, gradual reopening and mask wearing contributed to keeping outbreak numbers low, they say more could have been done to push those numbers down further and make testing and tracing more robust.

The data is limited -- only a handful of states have released COVID-19 tracking information by setting or business sector upon reopening. And the traced cases only account for a tiny fraction of total cases in each state.

Based on ABC News analysis of public data of all coronavirus cases in four states and D.C., the outbreak settings accounted for less than 5% of all COVID-19 cases in those states.

Experts who spoke with ABC News said contact tracing efforts around the country were very limited, representing only a fraction of reported new cases, as was testing at specific businesses and locations. This meant that smaller businesses and industries, particularly retail shops, couldn't identify all of the cases that spread at that one location, according to Dr. Jason Andrews, an associate professor in the Division of Infectious Diseases and Geographic Medicine at Stanford University's School of Medicine.

"At the beginning of the epidemic of February and March last year, several people would be called in and you had really good contact tracing, but during really big outbreaks, states just don't have the resources to track every case," he told ABC News.

Workers wearing protective masks and food processing clothing perform quality checks at an Amy's Kitchen facility in Santa Rosa Calif., June 24, 2020.

The COVID outbreak in the U.S. quickly ballooned from a handful of cases with international travel contacts of known origin to uncontrolled community spread. Complicating matters were delays and limits on testing.

One expert who spoke with ABC News called states' attempts to collect data on where new COVID cases were happening upon reopening as "half measures" and that more robust data collection may have helped bring the number of new cases down further than they currently are, even amid mass vaccinations.

Better reporting, the experts said, could also have helped state health departments tweak policies and assist smaller businesses with tracking outbreaks.

States that publicly released data about outbreaks since reopening included Arkansas, California, Colorado, Delaware, Illinois, Kansas, Louisiana, Michigan, North Carolina and the District of Columbia. Their data helped provide some insight into where COVID-19 did and didn't spread during the initial reopening of 2020.

For instance, in California and North Carolina, outbreaks were noted in a variety of settings including in bars, gyms, restaurants, manufacturing, retail and health care facilities since each state began some form of reopening -- January 2021 for California and late May 2020 for North Carolina, based on the data collected.

The data may provide insight into the public health response to the early part of the pandemic, pinpoint where the virus did and did not spread, and may serve as a guide for the future, health experts argue.

Here is what they say can be learned from the data just a few states collected about where new COVID outbreaks happened as they strived to reopen and regain a semblance of normalcy.

Where outbreaks were reported

ABC News pulled public data on reported outbreaks from the health departments of California, Illinois, North Carolina, Michigan and the District of Columbia, which were able to provide data on specific outbreak locations. The data set included dates following the states' reopening their businesses, schools and other services after the first COVID-19 wave in the spring of 2020.

Each location saw different results when it came to its case numbers following those reopenings.

Since wider reopening beginning May 22, 2020, North Carolina had a 981% increase in the average number of new cases since the beginning of the pandemic.

In Illinois, the average number of new cases jumped by 345% compared to the beginning of the pandemic, beginning July 1, 2020, the health data showed.

Following its wide reopening, July 21, 2020, D.C. had a 60% uptake in the average number of new cases since the beginning of the pandemic.

Michigan had a 349% increase in the average number of new cases since the beginning of the pandemic starting in Aug 27, 2020.

When looking at the specifics of the data, some health departments reported a higher load of cases in more settings than others.

Health care and "social assistance" settings -- including doctor offices, dentists, rehab facilities and shelters to assist homeless people -- made up over 2% of California's new COVID-19 cases since reopening as of January 2021, according to the state's data.

And in North Carolina, religious gatherings accounted for 2,406 cases, the highest number of new COVID-19 cases by reported outbreak setting since it reopened as of May 2020.

Factory, animal food processing workers particularly at risk

Manufacturing and food processing centers appeared to have been among locations with some of the biggest outbreak numbers since states reopened, the data showed.

People eat indoors at a restaurant in New York City, N.Y., March 24, 2021.

In Washington state, 286 COVID-19 cases were linked to manufacturing settings and 349 cases were linked to food manufacturing plants, between July 7, 2020 and the end of March 2021, the data showed.

North Carolina recorded 4,803 cases related to meat and poultry factories between May 22, 2020 and the end of March 2021, according to the data.

Samuel Scarpino, an assistant professor at the Network Science Institute at Northeastern University, has been tracking the public health data throughout the pandemic. He told ABC News that the outbreaks in the factories align with reports that workers were not provided with proper personal protective equipment or allowed to socially distance and denied other protections.

"What happened here is we label people as essential but don't give them the resources that they need," Scarpino told ABC News.

When it came to nonessential businesses, the data from the states' health departments showed far lower outbreaks, following reopening. Michigan was the only state to record over 1,000 cases related to a bar or restaurant, with 1,100 incidents recorded after Aug. 27.

After Washington reopened its economy in July, it reported 311 COVID-19 cases related to restaurants and bars, according to health data. In North Carolina, 327 cases were linked to eateries and bars after the state reopened on May 22, the health data showed.

Nuanced numbers

While health experts say the data indicates that calculated restrictions on businesses helped prevent wider spread of the disease and the numbers may not show a complete story, Andrews, the professor at Stanford Medical, said the outbreak data tracks with what researchers know about the state of testing.

Sectors reporting the most outbreaks, including factories and schools, had more robust testing practices for their members and were able to accurately show where cases originated and spread.

Smaller businesses did not have the capability or time to have that detailed of a report on their cases, according to Andrews.

"Restaurants pose a greater challenge for tracking outbreaks. You're there for a short period of time and you don't know who is coming or going," he said. "It poses a greater challenge for contact association."

A worker receives the Pfizer vaccine as part of a city program to vaccinate essential food processing workers performing essential jobs in high-density work environments such as large-scale food processing, cold storage and food warehousing facilities in Vernon, Calif., March 17, 2021.

In fact, Andrews and other experts noted that the public health data on outbreaks represents a fraction of the cases throughout the states because of tracking challenges.

Outbreaks in tracked settings accounted for 4.2% of new cases since reopening in California; 0.62% in D.C.; 0.11% in Illinois; .8% in Michigan and 2.39% in North Carolina.

Reopening Outbreak: Location Specifications

Dr. John Brownstein, an epidemiologist at Boston Children's Hospital and an ABC News contributor, said most COVID-19 cases took place during the first and second waves outside of workplaces and indoor businesses, making it hard to quantify their origins.

For example, a Centers for Disease Control and Prevention report found that COVID-19 cases involving a school in Illinois were tracked back to a bar opening.

"You have transmission in these settings that then gets back into the community," Scarpino said.

Nonetheless, Scarpino said the limited data that has been collected is beneficial for planning how to address the next phase of the pandemic and future health crises.

Where policies went right and went wrong

Even with limited data and tracking, health experts said the controlled reopening of indoor businesses was effective at slowing cases following the first wave.

Decreased capacity and extra distance at gyms, schools and restaurants helped mitigate the spread of the virus outside of households, according to Scarpino.

"There are plenty of examples of employees wearing masks, it keeps them safe, it keeps clients safe. The things we did had an impact," he said.

Workers sew personal protective equipment (PPE) at an outdoor furniture manufacturer in Alsip, Ill., March 30, 2020.

Scarpino said that some of the policies could have been fine-tuned to decrease numbers even more. For instance, over 1,000 cases were reported in K-12 schools in Kansas, Michigan and North Carolina, after the states reopened in the end of May 2020, according to the public health data.

North Carolina had 3,639 cases in college settings after its reopening, the state data showed.

"It's also possible that if schools were opened back in the summer we may not have had as many cases," Scarpino said. "The indoor setting really increased transmission during the fall and winter."

He also reiterated that health protocols should have been stricter in the factories, manufacturing plants and other indoor businesses.

"It's clear the measures did help, but we were stuck at these half measures that have kept us at this misery," he said.

How the data can shape future public health decisions

Andrews said that outbreak data can give officials a more strategic battle plan on vaccination efforts and keep cases down.

In particular, increasing vaccine administration in the locations that have seen outbreaks could help prevent future COVID-19 spread, he said.

Vaccinations among people who work in factories is crucial as is vaccinating inmates and staff at jails and prisons, Andrews said.

"Those locations are going to continue to be high risk until you increase the number of vaccinations," he said.

In this undated file photo, three boys play games on a smart phone at school.

From the state data pulled by ABC News, correctional facilities accounted for nearly 0% of new cases since reopening. Those states seem to have grasped the importance of preventative measures and vaccinations among inmates and corrections staff early on in the pandemic.

But for other settings, Scarpino recommended the U.S. enact a similar response to Israel, which brought the vaccines directly to people at several locations.

"Let's literally go to the bars, go to the boardwalks and get people vaccinated," he said.

In the meantime, the government needs to take a hard look at their public health offices and boost resources needed to collect more detailed data on disease outbreaks, Scarpino said.

While Scarpino said some states' health agencies took extra steps to track and trace cases to specific locations, overall, agencies were undermanned and underfunded to get accurate counts.

That tracked data is the first step to containing any future coronavirus outbreak or future contagion, he said.

"We need that investment and to be prepared," Scarpino said. "Something like this will happen again in our lifetimes. We now have the power to put the systems into place to prevent the spillover to become a pandemic."

ABC News' Mark Nichols, Luis Yordan and Martin Karlin, a former economist for the U.S. Department of Labor, contributed to this report.

See the article here:

Where COVID-19 has and hasn't spread since states reopened: Analysis - ABC News

Florida's Governor on Thursday said he would grant pardons to any residents of his state facing penalties for violating local COVID-19 curbs, saying the rules should have been recommendations rather than mandates.

Ron DeSantis, a Republican, has opposed local COVID-19 health restrictions at nearly every turn and has led the charge nationally in reopening his state, to criticism from health experts.

He told Fox News he would sign a reprieve to spare Florida gym owners Mike and Jillian Carnevale from criminal penalties they were facing for not requiring patrons to wear masks at their business.

"When our clemency board meets in the coming weeks, we'll issue pardons not only for Mike and Jillian, but for any Floridian that may have outstanding infractions for things like masks and social distancing," DeSantis said.

"These things with health should be advisory, they should not be punitive."

DeSantis, like some other Republican governors, has criticized what he termed the "government overreach" of some public health ordinances enacted by cities and counties, like mask mandates, and has pushed for voluntary measures that favor personal freedom.

He lifted all capacity restrictions on restaurants and bars in September and this month declared by executive order that all local emergency orders pertaining to the COVID-19 pandemic were suspended.

Our Standards: The Thomson Reuters Trust Principles.

Link:

Florida governor to pardon residents facing penalties for COVID-19 violations - Reuters

UABs Sarah Nafziger, M.D., encourages those who have not received their COVID-19 vaccination to get it now before UABs sites close.

Editor's Note: The information published in this story is accurate at the time of publication. Always refer to uab.edu/uabunited for UAB's current guidelines and recommendations relating to COVID-19.

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Video production: Laura Gasque, Steve Wood, Jeff Myers, Lexi Coon, Ryan Meyer and Andrea Mabry

All four of the University of Alabama at Birminghams community vaccination sites are now open to administer vaccines to ages 12 and up after the Centers for Disease Control and Prevention signed off Wednesday for children ages 12-15 to begin receiving the Pfizer vaccine. Sarah Nafziger, M.D., vice president of Clinical Services at UAB Hospital, encourages everyone who has not received the vaccine to get it now because UABs vaccine sites will be closing soon.

Unfortunately, the demand for the vaccine has fallen off faster than we wanted it to, and its just not feasible for us to continue to operate these locations at our current scale, Nafziger said of UABs efforts, which the organization has funded at $1.4 million a month. We will continue to provide vaccines through a variety of outlets, including pop-up sites. We have delivered almost 200,000 vaccinations to Alabamians living in 62 of our 67 counties, and it has been an honor and a privilege to be welcomed into these communities so we could serve and try to do our part to end this pandemic. That said, this pandemic is not over. And not enough Alabamians have been vaccinated to ensure we can safely return to normal and officially put this pandemic behind us. I hope more will come to our sites while they are open or will usehttp://www.vaccinefinder.orgto find a location close to them to receive a vaccine.

The Parker site will remain open until 1:30 p.m. on Friday, June 18. Photography: Steve WoodShots in arms thats still the way out of this COVID-19 pandemic.

Volume for first-dose vaccinations has dropped 75 percent in total at all of UABs community vaccination locations over the past five weeks.

While UABs community sites will be closing over the next several weeks, those receiving vaccines at one of our locations will be able to get their second dose through UAB at the UAB Hospital-Highlands drive-through. The public will also be able to receive first- and second-dose vaccines at the new UAB Injection Clinic, which opens Monday, May 17. The UAB Injection Clinic will be located at 539 Richard Arrington Jr. Blvd., in the former Regions Bank retail space at the corner of The Kirklin Clinic parking deck.

The vaccination site at the Hoover Met will close at 5 p.m., Tuesday, May 18, so preparations can be made for next weekends Southeastern Conference Baseball Tournament. It will not re-open after the SEC Tournament.

Cathedral of the Cross AOH church in Center Point is currently scheduled to close at 1:30 p.m. Friday, May 28. Parker High School is currently scheduled to close at 1:30 p.m. on Friday, June 18. UAB Hospital-Highlands will remain open for scheduled and unscheduled first- and second-dose vaccinations for now.

UAB will operate several pop-up sites as well over the months of May and June.

On behalf of UAB, I want to thank everyone who has visited one of our locations to receive their vaccine. I also want thank the leadership in these communities for stepping up to provide safe, convenient, centralized locations where vaccines can be safely and efficiently administered, Nafziger said. Our staff and volunteers who have worked these locations in the cold, in the rain, in the heat and the wind also are to be commended. They have been the heartbeat of this operation since we began in January, and this critical work could not have been accomplished without them.

Its also important that I thank our leadership at UAB and the UAB Health System. When we proposed opening these vaccination sites that we believed met a critical need for Alabamians, they did not blink. They supported these efforts from the beginning and realized mobilizing these sites filled a key gap at a crucial time in the pandemic. My hope is that more people will continue to get these vaccines as long as we have these sites open so we can continue moving forward safely.

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UAB begins COVID-19 vaccinations for ages 12 and over, sets closing dates for several community vaccination sites - UAB News

We're making this important information available without a subscription as a public service. But we depend on reader support to do this work. Please consider supporting independent journalism in Alaska, at just $3.69 a week for an online subscription.

Alaskas average daily case counts are now trending down significantly statewide, though a few regions in the state are still in the highest alert category based on their current per capita rate of infection.

Health officials continue to encourage Alaskans to wear face coverings in crowded public spaces, wash their hands frequently and get vaccinated against COVID-19 to prevent further spread.

By Thursday, there were 40 people with confirmed or suspected cases of COVID-19 in hospitals throughout the state, far below a peak in late 2020.

The CDC on Thursday updated its guidance for fully vaccinated people to say this group can largely stop wearing masks outdoors and indoors, except in crowded settings like buses, planes, hospitals, prisons and homeless shelters.

Anyone 12 and older who lives or works in Alaska can now receive a COVID-19 vaccination, health officials said this week. Previously, only those 16 and older in Alaska had been eligible for the vaccine.

Parents and others can visit covidvax.alaska.gov or call 907-646-3322 to sign up for a vaccine appointment; new appointments are added regularly. The phone line is staffed from 9 a.m. to 6:30 p.m. on weekdays and 9 a.m. to 4:30 p.m. on weekends. Only Pfizers vaccine is approved for children as young as 12; the Moderna and Johnson & Johnson vaccines are approved only for those 18 and older.

By Thursday, 310,431 people 52% of all Alaskans 16 and older had received at least their first dose. At least 271,092 people about 47% of Alaskans 16 and older were considered fully vaccinated, according to the states vaccine monitoring dashboard.

Of the 81 cases reported Thursday among Alaska residents, there were 15 in Anchorage plus one in Eagle River; 13 in Ketchikan; eight in Fairbanks; five in North Pole; five in Metlakatla; four in Anchor Point; four in Palmer; three in Healy; three in Tok; two in Cordova; two in Seward; two in Nome; one in Kenai; one in Soldotna; one in Houston; one in Utqiagvik; one in Juneau; one in Petersburg; one in Craig; and one in Unalaska.

In smaller communities that are not named to protect residents privacy, there was one in the Prince of Wales and Hyder Census Area and one in an unknown region of the state.

One new nonresident case in Anchorage was also identified Thursday.

While people might get tested more than once, each case reported by the state health department represents only one person.

The states data doesnt specify whether people testing positive for COVID-19 have symptoms. More than half of the nations infections are transmitted from asymptomatic people, according to CDC estimates.

Read this article:

Tracking COVID-19 in Alaska: 82 infections and no deaths recorded Thursday - Anchorage Daily News

Racial/Ethnic Disparities In COVID-19 Exposure Risk, Testing, And Cases At The Subcounty Level In California  Health Affairs

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Racial/Ethnic Disparities In COVID-19 Exposure Risk, Testing, And Cases At The Subcounty Level In California - Health Affairs

J.T. Realmuto did not fly with the Phillies to Florida on Thursday, but the team remains hopeful that the catcher can return this weekend after being placed on the COVID-19-related injured list.

The Phillies sent Realmuto away from Nationals Park on Thursday morning after he reported feeling sick during Wednesday nights game. Realmuto tested negative for the coronavirus, but the leagues safety protocols forced him to be quarantined.

The Phillies begin a three-game series on Friday in Dunedin, Fla., against the Toronto Blue Jays and there is no minimum amount of time a player must stay on the COVID-19 list. Realmuto could return as soon as Friday if he is cleared by Major League Baseball.

The catcher had a fever and a stomachache during Wednesday nights 5-2 win in Washington while sitting in the dugout after his sore knee held him out of the lineup.

You cant let someone with a stomachache and a small fever walk around your clubhouse today, manager Joe Girardi said before Thursdays 5-1 loss. In a normal year, you wouldnt worry about it. But you cant do that now.

The Phillies listed Realmuto as day to day with a bruised knee after he was lifted from Tuesday nights game, when he was hit in the knee by a foul tip. The Phillies were hoping Realmuto would be able to start Thursdays series finale but had to shift their plans when he felt sick. Andrew Knapp started a second straight game and Rafael Marchan was promoted from triple A.

The protocol is through the league, Girardi said. Im not sure when well get him back.

Didi Gregorius is expected to miss a few more games with the elbow stiffness that kept him out of Thursdays lineup, but the Phillies do not yet believe the injury is enough to place the shortstop on the injured list.

Gregorius left Wednesday nights game in the fifth inning after feeling discomfort in the same elbow that cost him two games last month when he was hit by a pitch.

It just kind of acted up, Girardi said. He didnt feel it in batting practice. He must have taken a swing in the game that he felt it and he told us. I think it was after his second at-bat maybe. And thats when we made the switch. I imagine he might be out a couple days, like the last time.

The Phillies will increase the seating capacity at Citizens Bank Park by 5,000 fans later this month before opening the stadium to 100% capacity on June 12.

The city announced earlier this week that it was loosening coronavirus restrictions and that stadiums could have up to 50% capacity starting May 21. The Phillies will increase their capacity from 11,000 fans to 16,000 fans when they begin a three-game series on May 21 against Boston.

Theyll be able to host that many fans for nine games before the city said they can fill the stadium on June 12 against the Yankees. The Yankees drew an average of 43,244 fans per game when they visited South Philadelphia in 2018.

Fans will be still required to wear face coverings, and tailgating will be permitted in the parking lots. A limited number of seating pods will be available, the Phillies said, for fans who prefer to remain in a socially-distanced environment.

The Phillies said they will be in touch with season-ticket holders regarding their seating locations, and single-game tickets are on sale for games through June 10. The tickets for the remaining games go on sale May 25.

The Blue Jays are playing the first part of their home schedule at their Florida spring-training home before moving to Buffalo next month. Like last season, the Jays are unable to play in Canada because of the countrys travel restrictions during the coronavirus pandemic. The ballpark in Dunedin is just six miles from the Phillies spring home. ... Vince Velasquez will start Fridays series opener against left-hander Steven Matz. Aaron Nola will start Saturday and Chase Anderson will start Sunday. The Jays have not named a starter for Saturday. Left-hander Robbie Ray will start Sunday.

More:

Phillies place J.T. Realmuto on COVID-19 injured list after he felt sick - The Philadelphia Inquirer

A man sorts yams in a supply truck at a wholesale market in Mumbai, India, December 14, 2018. REUTERS/Francis Mascarenhas

Indian inflation eased to a three-month low in April as food costs rose more slowly, but lockdowns to contain the country's raging coronavirus epidemic risk creating supply bottlenecks that could fuel price pressures in coming months.

Annual retail inflation (INCPIY=ECI) rose 4.29%, down from 5.52% in March and near the 4.20% forecast in a Reuters poll of economists.

Food prices, which account for nearly half of the Ministry of Statistics' inflation basket, rose 2.02% compared with 4.87% in the previous month.

"Any comfort from this could be illusory," Rupa Rege Nitsure, chief economist at L&T Financial Services said, warning of a build-up of inflationary pressures that risked affecting wholesale prices first.

Concern about high global commodity prices and supply chain disruptions amid widespread curbs on movement led the central bank last month to raise its inflation projection for the six months to September to 5.2%.

That still places it within the bank's target range of 2-6%.

India's second COVID-19 wave, which official figures show is infecting around 350,000 people and killing around 4,000 per day, has forcednearly two-thirds of the country to introduce tough curbs that have slowed economic activity.

The likelihood that India will receive an average amount of rain in the 2021 monsoon should however help ease inflationary pressure as a normal rainy season generally translates into higher farm output. read more

April core inflation, excluding food and fuel costs, was estimated in the range of 5.4% to 5.43% by three economists, compared with 5.9% to 6.0% in March. India does not release official core inflation data.

Our Standards: The Thomson Reuters Trust Principles.

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Indian inflation eases, but COVID-19 curbs risk stoking prices - Reuters

"There is only this way that we have established over the months of performing together, and what it is congruent with isn't 'ourselves' but past performances -- we're has-beens at heart, routinely trotting out the old, old act."

-- Philip Roth, The Counterlife

The counterfactual is a term for what would have happened if not for some intervention, action, or policy. Here, I want to explore the COVID-19 counterlife. What would have happened if. Obviously, this is an act of imagination, but anchored by over 10 years of studying science, medicine, and policy, and how people respond.

So, what would have happened if...

Twitter and Facebook Did Not Exist

If social media did not exist, the pandemic would have been fundamentally different. The selection of "experts" given airtime on popular media, such as cable news and newspapers, would have been turned on its head. Instead of the current cast of characters, researchers with longer histories and reputations would have been chosen. Op-ed submissions would have swelled even more, and successful writers would have been featured on TV.

Instead, in our world, there is a strange reciprocity. News outlets select visible Twitter personalities whose inclusion leads them to retweet the story. The paper gets the clicks, the Twitter personality gets the exposure, and polarizing and illogical views that get likes and retweets drive the conversation. Nuance and reflection die; sensationalism and groupthink thrive.

Without social media, the news itself would have been less extreme and drifted to consensus. Without the seduction of clicks, the media would have acknowledged trade-offs. Centrist policy positions, such as those espoused by former FDA Commissioner Scott Gottlieb, MD, would be favored. Zero-COVID and vaccine passports would have gotten little airtime -- as these are positions driven by one extreme worldview.

Extreme feelings on vaccines, including staunch opposition, would likely have been diminished. These poles have been fueled by social media platforms for years. Finally, there would be much less public discussion of long-COVID, and instead it would be viewed principally as an ongoing research topic. This is because long-COVID gained traction from social media advocacy.

Trump Had Not Been President

I am not here to judge former President Trump, but merely to point out that he generates strong feelings. Some love him, others loathe him. And, we must acknowledge that a sizable subset of the academy is strongly opposed to him, and vocal about it. This fact alone affected the pandemic in numerous ways, apart from the specific decisions made during his presidency.

Although it is clear that Trump played a role in popularizing hydroxychloroquine without good evidence, his advocacy also generated a backlash, and the harms of hydroxychloroquine were broadcast loudly, and at times exaggerated. Both unjustified optimism and unnecessary pessimism diminished interest in clinical trials. Some wanted the drug, and others wanted no chance of getting it. Ironically, the best path is always to be quiet about investigational agents while trials are ongoing.

School closures would have been dramatically different had Trump never advocated to reopen them. Some opposed this (sensible) policy simply because he said it. Indeed, we saw school closures disproportionately in liberal strongholds and regardless of virus-related factors such as cases per 100,000, hospitalizations, or deaths.

Countless other decisions may have been different with a different administration, and I imagine entire books will be written on this topic. I wish to highlight just one more: Had former President Obama, a Democrat, been in office at the time, I imagine that far left progressives would have felt differently about restrictions without resources. Lockdowns protect the rich more than the poor; had a Democrat enforced these restrictions, a vocal backlash would have emerged from within the academy. But because Trump was reluctant to advocate for prolonged use of these measures, many progressives demanded more restrictions, perhaps in part to oppose him.

In short, replacing Trump with a more typical politician would have led to different policy decisions, and also, would have changed the academy's response. Those who opposed his recommendations merely because he said so would not have done so in the counterlife.

There Was No Uber, Amazon Prime, or Zoom

Many hail these technologies as services that allowed us to survive the pandemic, but were it not for their existence, we might have fared better. If COVID-19 were COVID-99 or even COVID-09, the use of telework for more than a year would not have been tenable for most white-collar workers (Internet was too slow!). Layoffs would have resulted, and as such, white-collar workers would have rebelled against continued restrictions. In fact, many workers would have embraced the harm-reduction philosophy. We would have gone back to work in the summer of 2020 in larger numbers, with rotating schedules, ventilation, and masks. Anxiety and depression would have been lower, and we could have been open about trade-offs.

Ironically, the upper-middle class would not have been able to construct a delivery service moat around their castles, and as such, the well-being of the poor, the marginalized, the destitute, and the neglected would have been more on their minds. Their own lives would be more tied to that. I imagine we would have spent far more on resources. Free hotels for folks with fever. Better paid sick leave. We would truly all be in it together. We might even have had fewer cases and deaths.

The services that many hail as our salvation accelerated our doom. They allowed folks with money to separate further, grow more anxious and angry, and more indifferent to the well-being of the least well off. Long-lasting school closures were only tolerated because of these services. If adults had to go back to work twice a week (with mitigation) then schools would have to perform their duty as well.

Ironically, these technology platforms censored the opinion of legitimate scientists who were critical of some aspects of lockdown or who favored loosening restrictions. This is a fundamental conflict of interest. If your product is addicting people to their screens and stopping them from being participants in the world, you are not the best arbiter on the truth in matters of policy that would keep people glued to their screens and as non-participants in the world.

We Reacted Proactively in January 2020

The biggest COVID-19 question might be, what if we reacted strongly in early January 2020? What if we were able to deploy a multinational team of experts into China. Could we have stopped the virus before it escaped? This technical question has no easy answer, and will likely also be the topic of many books. I wish only to suggest that the answer is not immediately obvious. It is not "we definitely could have stopped spread" or "it was hopeless from day one," but something that requires a great deal of detective work. A mix of science and investigative journalism from a place of open-mindedness. We are not ready to do this work right now.

What If Anthony Fauci or Scott Atlas Did Not Exist?

Many lament that national policy would have played out differently if not for Scott Atlas, MD, or Anthony Fauci, MD; the Great Barrington Declaration or the John Snow Memorandum; if we didn't have Deborah Birx, MD, or Robert Redfield, MD. The truth is that all these people were secondary characters, and if you remove any of them, the void would be filled by other people. I doubt any of them uniquely changed policy.

After it became clear that this virus has a massively steep age gradient of risk -- the risk to an 80-year-old is thousands of times greater than it is to an 8-year-old -- it was only a matter of time before someone argued that our policies should leverage this difference, an idea at the center of the Great Barrington Declaration. It was also inevitable that other scientists would oppose this view, believe it impossible to target this age group, and advocate that the risk to younger age groups is intolerable and broader measures are needed (the John Snow View).

Recognizing that these characters are replaceable -- and the bench is a thousand deep -- can provide humility. There is no need to have strong emotions about any of these people. Pick whomever you wish, without them, we'd be right where we are today.

We Did a Cluster RCT of Masks

Early in the pandemic, Margaret McCartney, MD, writing in The BMJ, said we need better evidence for non-pharmacologic interventions, such as face shields, masking, plexiglass, and other restrictions. Imagine if we did this. What if the U.S. did for restrictions what the U.K. RECOVERY trial did for drugs? What if we performed a cluster randomized controlled trial (RCT) of regions (or even a stepped-wedge roll out), and tested all of these interventions?

I believe that these results would have defused the mask polarization bomb. The mere fact that the trial was ongoing would have relaxed some of the most ardent proponents and opponents of these interventions. It's harder to become an impassioned anti-masker (indoors in a grocery store) or a zealot masker (outdoors, with a rare passerby, on a run) if one knew that randomized data was coming to show if one is right or wrong. The mere presence of a well-done, large, clean study would result in temperance and humility. Contrary to the many vociferous and passionate critics of RCTs, I believe that a meaningful cluster trial could have been conducted. If launched in early March 2020, contamination (use of mask in the control group) would have been so low, it would be a non-issue. Instead, we settled for mannequin mask studies a year into the pandemic -- a.k.a. a useless study.

The Counterlife

The COVID-19 counterlife illustrates that so much of our unique and unprecedented response to the pandemic was contingent on our times. Technology was supposed to liberate us, but it divided us and chained us to this response. Changing leadership might have changed outcomes, but it so easily might have shifted allegiances and tribes and resulted in different battles and partnerships. I am confident that had we had a Democratic president, the left-most progressives would have viewed these choices differently. And, at last, if one can rewind the tape to the early days in China, could we have stopped the virus before it was too late? That is the toughest question of all, and I have no answer for now. Instead, I merely ponder what might have been.

Vinay Prasad, MD, MPH, is a hematologist-oncologist and associate professor of medicine at the University of California San Francisco, and author of Malignant: How Bad Policy and Bad Evidence Harm People With Cancer.

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The Counterlife of COVID-19: What Might Have Been - MedPage Today

The study reports on the first 100 patients to participate in Mayo Clinic's COVID-19 Activity Rehabilitation program (CARP), one of the first multidisciplinary programs established to evaluate and treat patients with post-COVID-19 syndrome. The patients were evaluated and treated between June 1 and Dec. 31, 2020. They had a mean age of 45, and 68% were female. They were evaluated a mean of 93 days after infection.

The most common symptom of patients seeking evaluation for post-COVID-19 syndrome was fatigue. Of the patients in the study, 80% reported unusual fatigue, while 59% had respiratory complaints and a similar percentage had neurologic complaints. More than one-third of patients reported difficulties performing basic activities of daily living, and only 1 in 3 patients had returned to unrestricted work activity.

"Most patients in the study had no preexisting comorbidities prior to COVID-19 infection, and many did not experience symptoms related to COVID-19 that were severe enough to require hospitalization," says Dr. Greg Vanichkachorn, medical director of Mayo Clinic's COVID-19 Activity Rehabilitation program and first author of the study. "Most of the patients had normal or nondiagnostic lab and imaging results, despite having debilitating symptoms. That's among the challenges of diagnosing PCS in a timely way and then responding effectively."

Nonetheless, the symptoms often resulted in significant negative effects as patients tried to return to normal daily activities, including work. "Most patients with whom we worked required physical therapy, occupational therapy or brain rehabilitation to address the perceived cognitive impairment," Vanichkachorn says. "While many patients had fatigue, more than half also reported troubles with thinking, commonly known as 'brain fog.' And more than one-third of patients had trouble with basic activities of life. Many could not resume their normal work life for at least several months."

Mayo Clinic developed the COVID-19 Activity Rehabilitation program at Mayo Clinic in Rochester in June 2020 to care for patients experiencing persistent symptoms after COVID-19 infection. In addition to Vanichkachorn, Mayo Clinic staff from many specialty fields are involved in diagnostics and treatment. Among services provided are psychosocial support for patients who frequently report feelings of abandonment, guilt and frustration during initial evaluation.

Mayo Clinic is conducting intensive research on post-COVID-19 syndrome, in part to better define how the condition presents across different socioeconomic groups and ethnicities. Prolonged symptoms, such as those experienced with post-COVID-19 syndrome, have been reported in prior epidemics.

"As the pandemic continues, we expect to see more patients who experience symptoms long after infection, and health care providers need to prepare for this, know what to look for, and know how to best provide for their patients' needs," Vanichkachorn says.

Patients who have recovered from acute infection shouldn't wait to be evaluated if they are experiencing prolonged symptoms, though Vanichkachorn says providers should be judicious in recommending expensive diagnostic tests, which often aren't covered by insurance and don't reveal significant information.

The authors of the study have no conflicts of interest to disclose, Mayo Clinic News Network noted.

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Fatigue, perceived cognitive impairment and mood disorders associated with post-COVID-19 syndrome, Mayo Clinic study says - INFORUM