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Here's how the COVID-19 pandemic has impacted weddings - CBS News
In this study we have characterized the demographic, clinical and laboratory aspects of COVID-19 among a population that experienced a disproportionate impact of the pandemic. Among the patients admitted with COVID-19, approximately 1 in 2 received supplemental oxygen, 1 in 3 received high-flow oxygen, and 1 in 10 died during their hospitalization. Our analysis is consistent with other reports of substantial early impact of COVID-19 in Louisiana. Together with evidence from other studies, our findings suggest that several factors may have been important in explaining the high case-severity in this cohort.
We found that patients with COVID-19 requiring high-flow oxygen were more likely to be older, which is consistent with other studies7. Nevertheless, approximately 66% of patients hospitalized with severe COVID-19 were younger than age 65, indicating that other factors were also important. Among all patients included in our analysis, 95% had underlying health conditions, and 80% had multiple comorbidities. Patients most frequently had cardiac disease, obesity, and diabetes mellitus, each of which are risk factors for severe outcomes from COVID-1912. Notably, we found that comorbidity was reflected in hospitalized cases, whether or not they received high-flow supplemental oxygen. Since we conditioned the analysis on hospital admission, comorbidity among non-severe cases might reflect an increased likelihood of admission, leading to potential collider bias20. A lower threshold for admission with underlying health conditions among patients without severe COVID-19 might explain why we did not find overall differences in underlying conditions by illness severity. Our finding that patients with more than two underlying conditions tended to be admitted more rapidly than other patients is suggestive of this. In view of these considerations, the lack of an overall difference in comorbidity by severity does not negate the importance of comorbidities in driving case-severity. Instead, the high prevalence of known risk factors suggests these factors were important drivers of adverse outcomes.
Among patients included in our analysis, 60.5% had Black non-Hispanic race and ethnicity. This proportion is slightly higher than that of inpatients documented to have COVID-19 in the participating hospitals (approximately 50%), and is similar to the proportion reported for New Orleans in the U.S. census (58%)21. Consistent with previous analyses, we did not find a difference in case-severity by race and ethnicity among hospitalized patients5,22. However, Black race was associated with an increased risk of hospitalization with COVID-19 in Louisiana after adjusting for comorbidity and socioeconomic status5, and this elevated risk might reflect an array of other factors, including those related to accessing care6.
Compared with non-severe hospitalized patients, we found that those requiring high-flow supplemental oxygen were more likely to be admitted greater than five days after symptom onset. This suggests that delayed access to healthcare might have contributed to adverse outcomes. In our analysis, patients received high-flow oxygen a median of 8days after symptom onset, and inpatient deaths occurred a median of 24days after illness onset. Severe COVID-19 typically progresses over 12weeks23, and patients who were admitted more than five days after illness onset were likely to have more severe illness by the time of presentation. We also found that patients with severe illness were more likely to have received treatment with remdesivir, dexamethasone, or other non-antiviral treatment (baricitinib or convalescent plasma). Since patients who met criteria for severe illness were likely to have been unwell at presentation, this is likely to reflect more treatment for patients presenting with more advanced disease, rather than any effect of treatment on severity; such an interpretation is supported by other evidence from other studies24.
Only 5% of hospitalized patients had completed a primary COVID-19 vaccine series during the period of analysis. This low proportion is likely to reflect both low vaccine coverage early in the pandemic, and an increased risk of COVID-19 if unvaccinated25. Similarly, approximately 20% of the U.S. population were estimated to have had prior infection during the period of analysis26. Since infection-induced immunity confers substantial protection against severe illness, patients admitted with COVID-19 would be expected to have a lower prevalence of prior infection during the period of analysis27. Although we did not have baseline serology results, low antibody titers during 07days is consistent with a low prevalence of prior infection in the cohort.
Our finding that 43% of patients did not have a positive anti-nucleocapsid result within 14days of illness onset is consistent with other evidence that it can take up to 14days or longer for new antibodies to develop28. Since a similar proportion of patients with severe and non-severe disease had evidence of seroconversion, we did not find evidence that severe disease reflected inadequate immune responses. However, our modeled estimates were limited by sparse data.
Among patients with available SARS-CoV-2 RT-PCR results, we found that severe COVID-19 was associated with a lower cycle threshold value in saliva specimens that were collected before any antiviral treatment was started. Cycle threshold values reflect the number of RT-PCR amplification cycles needed to detect viral RNA in a specimen, and are inversely related to the level of viral RNA; lower Ct values therefore imply the presence of higher RNA levels. Higher cycle threshold values over time are likely to reflect declining viral load after initial infection29,30. Lower cycle threshold values among patients with severe disease is broadly consistent with evidence of higher viral load in severe illness, after adjusting for other characteristics15,17,19. Detection of SARS-CoV-2 in saliva may reflect involvement of the oral cavity31. Previous studies have found similar detection of SARS-CoV-2 RNA in nasal and saliva specimens early after symptom onset32,33, although with differences in cycle threshold that may reflect differences in specimen collection33,34. Our findings were similar when restricted to patients with paired saliva and nasal specimens on the same day. However, data were sparse for paired specimens, and reasons for an association with saliva but not nasal specimens is unknown. Our findings of an association between case-severity and lower Ct value in saliva are consistent with those of others, who have reported that abundance of SARS-CoV-2 RNA in saliva was significantly higher in patients with risk factors for severe COVID-19, correlated with more severe COVID-19, and was superior to nasopharyngeal viral load as a predictor of mortality35. We did not find an association between lower cycle threshold and severity after treatment that might lower the viral load36,37, possibly because patients with severe illness were also more likely to received such medications, thereby masking differences in viral load.
Before considering implications of our analysis, several strengths and limitations need to be considered, in addition to those listed above. First, although we provided a detailed description of more than 500 patients with severe COVID-19, for some analyses we were limited by sparse data, resulting in wide confidence intervals. Second, our capture of potential confounding factors was incomplete, which might lead to residual or unmeasured confounding in multivariable analyses. Third, although we found a relatively high mortality among hospitalized patients, we may have underestimated deaths that occurred in the community or that did not meet our definition of severe illness. For example, two patients who died without meeting this definition might have had extrapulmonary manifestations of infection2. Fourth, for analysis purposes we used a relatively low threshold (6L/min) to determine severity based on oxygen level, limiting comparability with some other studies that have used 1015L/min as a threshold, and with guidelines that define severe illness based on oxygen saturation rather than supplemental flow38,39. Lastly, generalizability of our findings to other populations may be limited. Patients included in the analysis had similar overall demographic characteristics to other patients with COVID-19 in participating hospitals, but might have differed from patients admitted to other hospitals in the New Orleans area. Similarly, although overall patient characteristics were similar by availability of laboratory results, patients with laboratory data might be considered as a convenience sample within the main cohort. Overall, our scope was limited to analysis of patients who were hospitalized before widespread transmission of the Omicron SARS-CoV-2 variant and its subvariants.
Since predominance of the Omicron variant, average case-severity of SARS-CoV-2 infection has become milder3, both because of increased immunity from vaccination and infection40, and because of lower virulence compared with the Delta SARS-CoV-2 variant and ancestral variants13. Nevertheless, severe infections and deaths have continued to occur, both in individuals with and without clear risk factors. In our analysis, substantial comorbidity coupled with late presentation in an unvaccinated population are likely to have contributed to the high case-severity. Our study is relevant both in highlighting a patient population who experienced a disproportionate burden of COVID-19, and in describing severe COVID-19 in this group. Our findings of a correlation between severe illness and low cycle threshold in saliva may support the use of saliva PCR tests as a potential alternative to nasal PCR in the inpatient setting, though more work is needed to explore this association. To prepare for future epidemic and pandemic threats, our findings support broader efforts to address underlying inequalities and strengthen access to healthcare access and resilience of health systems6,41.
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As the COVID-19 pandemic was raising anxiety levels around the world, psychologist David H. Rosmarin noticed something surprising: Patients being treated for anxiety werent reporting the worsening symptoms he expected.
Rosmarin, associate professor of psychology at Harvard Medical School and a clinical psychologist at McLean Hospital, decided to take a closer look. Now in work published this month in the journal PLOS One, Rosmarin and colleague Steven Pirutinsky of Touro University, showed that the two main therapies used, cognitive behavioral therapy and dialectical behavior therapy, appear to have been protective against pandemic-related anxiety in the cohort of 764 individuals being treated in McLeans clinic during the pandemic.
Rosmarin spoke with the Gazette to highlight an encouraging take-home message for those with the condition. The interview was edited for length and clarity.
How did this study get started? Did you see the chance for a natural experiment on anxiety when COVID struck?
It started with clinical observation. At the start of the pandemic, we had 500 active patients in our cognitive/dialectical behavior-therapy outpatient center, and I was expecting their mental health to plummet.
I actually felt anxious myself, thinking that it was going to be a total disaster. But disaster did not happen.
Our patients seemed to be fine. Many of my colleagues reported the same. We werent getting emergency phone calls from patients who were in treatment before March 2020. We didnt need to hospitalize a single one of those patients since they were not threatening suicide or decompensating.
About 18 months ago, I wondered if these clinical observations might map onto our data, because you dont know unless you take a look at the numbers. Working with my long-time colleague Dr. Steven Pirutinsky from Touro University we sorted our patients, based on when they commenced treatment, into four groups mapping onto recommendations from Yale University: prepandemic, pandemic onset, during the pandemic, and post-pandemic.
We then compared their treatment trajectories, from intake to discharge and at all points in between. This allowed us to compare not only whether they had the same levels of anxiety at the beginning and at the end of treatment, but whether the slopes of treatment change were the same.
We found that patients who initiated treatment before the pandemic prior to Dec. 31, 2019, or in the first months of 2020 did not have any bump in anxiety in mid-March through May, when the whole world was anxious.
In addition, the trajectories of patients in different groups were no different from each other, demonstrating that therapy was equally effective, even when patients initiated treatment during the pandemic. I believe this is a pretty cool finding, since it shows that CBT and DBT are powerful to protect against once-in-a-century levels of distress.
When people get the skills and the tools that they need specifically CBT and DBT skills they can be protected against surges in anxiety even in the context of wild uncertainty.
So the data came retrospectively, from questionnaires routinely filled out at each visit?
Yes, we administered the GAD-7 at intake and every subsequent visit. The measure contains seven questions to measure generalized anxiety disorder, and its the American Psychiatric Associations gold standard self-report measure.
What is the message that you get out of the apparent stability of anxious people during undoubtedly anxious times?
When people get the skills and the tools that they need specifically CBT and DBT skills they can be protected against surges in anxiety even in the context of wild uncertainty. We have known for many years that these are effective treatments, but to see it in the context of the pandemic is, I think, quite unique and striking.
The second message is that having anxiety can be a good thing and help us to thrive. When anxiety leads us to get the help we need, it can inoculate us against future distress. If you compare the trajectories of prepandemic patients from our sample all of whom had pre-existing anxiety disorders to the general public, you find that the patients did better.
An analogy might be someone whos overweight, and they finally say, I cant do this anymore. They diet, exercise, and even get a nutritionist and a trainer. They do what they have to do to lose weight and because of that, in the end, they may have a better trajectory in terms of metabolic syndrome and heart disease compared to others who were never overweight.
You see a similar trend in relationships. When couples hit a rough patch, and they say, We have to work on our dynamics, and they go and get the help they need, the resulting connection is often much stronger for many more years, as opposed to those who trudge through since it never got so bad that they needed help. There are plenty of other examples of this in behavioral health, but its the same concept.
Had any of these people completed therapy and were using tools learned in therapy on their own?
Thats a good question. The length of therapy depends on a number of different factors. One is how severe symptoms are at intake. Two is how much people are implementing these skills between sessions on their own. Sometimes people take to them quickly; sometimes people need to hear it several times before they are ready. So everybodys treatment trajectory was unique, but the mean average was just over seven sessions, which is not a high dose.
Outside of your cohort, how much did mental health issues rise among the general public during the pandemic?
In the first year of the COVID pandemic, anxiety and depression increased 25 percent among adults, according to the World Health Organization.
I should clarify something: Uncertainty does not cause anxiety. It is intolerance of uncertainty that causes anxiety.
Does this belie a general perception of people with anxiety, whether theyre in therapy or not, that they are very fragile or frail?
Yes, this is the core of the issue: This is the perception, but its not true. In fact, it was my assumption going into the pandemic that my patients wouldnt make it. But they were actually much more resilient because they had been taught what to do.
One of the things we teach our patients in CBT is to do things that make them anxious and learn that the feelings will subside. This is called exposure therapy, and it directly makes people more resilient to face uncertain situations, which tend to make us anxious.
You can have a lot of uncertainty in your life, but if youre able to tolerate that uncertainty, youre able to weather it. If you understand what to do, then youre not seeking to eliminate uncertainty all the time, you understand thats par for the course. Youre not judging yourself or catastrophizing about it. And when you have a higher tolerance for uncertainty, then it doesnt need to lead you in the direction of worsening anxiety.
And thats healthier simply because uncertainty is just part of life?
Definitely, and during the pandemic it was a part of everyones life. But I should clarify something: Uncertainty does not cause anxiety. It is intolerance of uncertainty that causes anxiety.
Would it be accurate to say that one of the core principles of cognitive behavioral therapy is to expose yourself in different ways to your fears and your anxieties?
Yes, this is a key strategy. It is fair to say that a core tenet of CBT is facing ones anxieties head-on.
And what about DBT?
DBT is similar, but it balances change and acceptance: Yes, I want to change. I want to face my fears, but I need to accept that Im not quite ready to do that. Im a little bit further away from where I really want to be.
In DBT, we are more attentive to this and gradually help patients to move in the direction they want, while accepting that were not always going to get there. Thats as opposed to CBT, which is like, You have OCD? OK, were sticking your hands in the toilet today. Were doing this!
Do patients start with DBT and then move to CBT?
Well, when it comes to anxiety disorders, often its the reverse. We first try to get patients to move forward, and if its not working, then well have to balance with acceptance. We move back, pause, stay where we are, or coast in neutral for a while.
Is there a take-home message for people who have anxiety?
Yes, use the opportunity of your anxiety to build your resilience and get the skills that you need, because you never know when youre going to need them. And they can make a massive difference when a crisis hits.
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How the already anxious avoided global spike in COVID anxiety Harvard Gazette - Harvard Gazette
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COVID-19 illness may include symptoms such as a sore throat, fever, cough, and fatigue. In January, the United States Centers for Disease Control and Prevention (CDC) issued its most recent guidelines for the use of over-the-counter (OTC) drugs for COVID-19. Specifically, its guidelines state that most people with COVID-19 have mild illness and can recover at home while treating symptoms with OTC medicines such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil).
Researchers from Florida Atlantic University's Schmidt College of Medicine and academic colleagues say it's more complicated. They suggest that selecting an OTC medication to alleviate mild symptoms of COVID-19 should be based on the entire benefit-to-risk profile of the patient. Moreover, they say the health care provider should make clinical decisions for each of his or her patients.
In a review published in The American Journal of Medicine, researchers take a closer look at both the potential benefits and risks of acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs)such as ibuprofen, as well as aspirin for the selection of OTC drugs to treat mild symptoms of COVID-19.
Traditional nonspecific NSAIDs, such as shorter-acting ibuprofen and longer-acting naproxen, have been used to treat COVID-19. These widely used OTC drugs reversibly and non-specifically inhibit both cyclooxygenase enzyme isoforms. This results in a systematic reduction in the synthesis of prostaglandins, resulting in anti-inflammatory and fever-reducing effects.
The researchers caution, however, that both ibuprofen and naproxen have similar but greater side effect profiles than aspirin, such as gastroenteritis and peptic ulcers.
Acetaminophen is one of the most frequently used OTC drugs in the U.S. and worldwide as a treatment for fever, allergic symptoms, headaches, myalgia, symptoms of the common cold, and, most recently, COVID-19. Acetaminophen was originally marketed as an alternative to aspirin for the treatment of mild to moderate pain based on reduced mucosal gastrointestinal side effects.
The authors caution that even at daily doses of 4,000 milligrams per day, generally accepted as safe for adults, acetaminophen can be toxic to the liver and may result in the onset of acute liver failure. In the U.S., acetaminophen is the leading reason for calls to Poison Control Centers, with more than 100,000 cases per year. These circumstances account for more than 2,600 hospitalizations and 450 deaths in the U.S. due to acute liver failure.
Aspirin, or acetylsalicylic acid, inhibits the production of prostaglandins, which are responsible for mediating pain, inflammation, and fever. The authors say that the beneficial effects of aspirin include anti-platelet, analgesic, antipyretic or anti-fever, and anti-inflammatory properties. Aspirin is rapidly absorbed when taken orally and has a half-life of around four hours, after which the kidneys mostly metabolize it.
The researchers note that the anti-inflammatory benefits of aspirin should provide symptomatic relief of fever and body aches during COVID-19. They underscore, however, that health providers should view these in the context of the increased risks of bleeding, principally gastrointestinal. Further, COVID-19 itself may already predispose individuals to bleeding as well as to clotting abnormalities.
"We believe that health care providers should make individual clinical judgments for each of his or her patients in the selection of OTC drugs to treat symptoms of COVID-19. This judgment should be based on the entire benefit-to-risk profile of the patient," said Charles H. Hennekens, M.D., Dr.PH, senior author, first Sir Richard Doll Professor, and senior academic advisor in FAU's Schmidt College of Medicine.
"It is our belief that the individual health care provider knows far more about each of his or her patients than anyone, including expert members of guideline committees."
The authors conclude that when the totality of evidence is complete, health care providers can make the most rational individual clinical judgments for their patients and policymakers for the health of the general public.
The authors believe that, at present, the totality of evidence is incomplete and requires reliable evidence from large- scale randomized trials designed a priori to do so, which is necessary to develop rational guidelines. They also believe that any guidelines should provide only guidance to health care providers. Currently, these considerations pose new clinical challenges for health care providers in prescribing OTC drugs to treat COVID-19.
"The astute and judicious individual clinical decision-making of health care providers for each individual patient based on all these considerations has the potential to do far more good than harm. Finally, guidelines should provide guidance to individual health care providers," said Hennekens.
More information: Gage Collamore et al, Guidance for healthcare providers on newest guidelines for over-the-counter drug treatment of mild symptoms of COVID-19. (word count=18; limit=20), The American Journal of Medicine (2024). DOI: 10.1016/j.amjmed.2024.03.003
Journal information: American Journal of Medicine
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Choosing over the counter drugs for COVID 19? It's complicated - Medical Xpress
A sign announcing a face mask requirement is displayed at a hospital in Buffalo Grove, Ill., Friday, Jan. 13, 2023. COVID-19 hospital admissions are inching upward in the United States since early July 2023. It's a small-scale echo of the three previous summers. (AP Photo/Nam Y. Huh)
PORTLAND, Ore. (KOIN) Following the Center for Disease Control and Preventions lead, Washington health officials have laid out relaxed guidelines for those experiencing respiratory viruses.
The Washington State Department of Health has told the public they can return to normal activities after at least 24 hours if their symptoms have improved and if they havent had a fever without using medication to treat it.
The CDC previously advised people with COVID-19, influenza or the respiratory syncytial virus to isolate for at least five days after noticing symptoms. The national agency has since reduced its recommended isolation period, saying COVID-19 is still a threat to public health, but it is no longer an emergency.
According to the CDC, weekly hospitalizations for the disease have dropped by more than 75% since January 2022. COVID-19 deaths have also declined by more than 90% in the same time period.
This updated respiratory virus isolation guidance reflects that were in a better place now in the COVID-19 pandemic, Washington health department Chief Science Officer Tao Sheng Kwan-Gett said.
Even with the new guidance, Washington DOH notes that people with COVID-19 can be contagious for up to 10 days, people with the flu can be contagious for up to seven days and those with RSV can be contagious for up to eight days.
The health department advised people to take extra steps to protect themselves and others within the first five days of having a respiratory virus. Recommendations include wearing a mask, social distancing, and improving ventilation and air quality indoors.
DOH added that people who are sick should be especially cautious of staying away from those who are at a higher risk for severe diseases, such as young children and the elderly.
while life is returning to normal in many ways, we must remember that for many in our community with chronic conditions and weakened immune systems, respiratory virus infections such as COVID-19, flu, and RSV remain a deadly threat. Each week, more than a dozen people in our state lose their lives to COVID-19 each week. We must not rest until that number is zero, Sheng said.
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Washington cuts respiratory virus isolation period to at least 24 hours - KOIN.com
Around 17.6 million American adults are grappling with Long COVID, according to a recent survey conducted by the US Centers for Disease Control and Prevention (CDC). The uptick comes as the CDC eases COVID-19 isolation guidelines, a decision that has divided experts.
The percentage of Americans with Long COVID now stands at 6.8% and has risen by 1.5% since the last estimate of 5.3% in October 2023. The rise follows the second-biggest surge of infections across the US this winter, in which some health facilities returned to mask and limited-visitation policies.
The proportion of US adults currently experiencing Long COVID has not been this high since November 2022. Globally, around 65 million people are estimated to have Long COVID, but that is likely to be an underestimate.
Up to one in five people with SARS-CoV-2 infection can go on to develop Long COVID symptoms, according to the World Health Organization. And CDC data published last month indicates that COVID-19 infection quadruples the risk that people will develop chronic fatigue.
Symptoms of Long COVID are varied, ranging from brain fog, depression and memory loss to insomnia, muscle ache and fatigue. There have been several hypotheses about the biological mechanisms underpinning the symptoms, from dysregulated immune systems to neurological dysfunction. Now, evidence is starting to emerge to support some of these theories and explain Long COVID symptoms.
There is no diagnostic test or treatment yet, however, and many people who have had their lives put on hold, at best, or, at worst, destroyed by the condition, have received very little support.
While Long COVID patients are suffering worldwide, those in high-income countries are likely to have access to some health care at least. In low- and middle-income countries, the situation is even more dire.
Dr Caroline Hilari, who coordinates a Long COVID study in children in Bolivia, said: "I think the fact that Long COVID has not been in the media here is basically because we have more deadly diseases. Just recently we've had kids dying of dengue and scorpion stings. When people die, that gets into the media. But chronic, disabling conditions do not and maybe that's the cruelty of being in a less developed country."
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Nearly 7% of Americans struggle with Long COVID as infections surge - Gavi, the Vaccine Alliance
A new study based on outcomes seen at European intensive care units (ICUs) suggests higher is not better when it comes to targets for supplemental oxygenation levels for COVID-19 patients experiencing low oxygen, or hypoxia.
The study is published today in JAMA, and looked at Pao2, the partial pressure of oxygen in the arterial blood, at supplemental levels of 60 and 90 millimeters of mercury (mm Hg), with the main outcomes being number of days alive without life support.
Lower risk of death in lower-oxygen group
The study included 726 adults with COVID-19 receiving at least 10 liters per minute (L/min) of oxygen or mechanical ventilation in 11 ICUs in Europe from August 2020 to March 2023. ICUs in Denmark, Switzerland, Norway, Iceland, and Wales participated in the trial.
Hypoxemic respiratory failure was defined as necessitating supplemental oxygen of at least 10 L/min in an open system or mechanical ventilatory support.
Patients were randomized 1:1 to receive either 60 mm Hg (lower-oxygenation group, 365) or 90 mm Hg (higher-oxygenation group, 361) and followed for 90 days. Oxygen levels were measured via arterial lines, which were place on all patients.
Sixty-eight percent of patients were men, and average patient age was 66 years.
At 90 days, the median time alive without life support was 80.0 days in the lower-oxygenation group and 72.0 days in the higher-oxygenation group. Death rate at 90 days was 30.2% in the lower-oxygenation group and 34.7% in the higher-oxygenation group (risk ratio, 0.86; 98.6% confidence interval, 0.66 to 1.13).
"The present result was hypothesized to occur due to more days alive without mechanical ventilation in the lower oxygenation group vs the higher oxygenation group," the authors wrote.
In an editorial on the study, Richard M. Schwartzstein, MD, of Harvard Medical School, writes that the less-is-more findings could be explained by a number of factors. More patients in the high-target group could have been intubated and started on mechanical ventilation because physicians could not achieve the target with noninvasive ventilation.
"The observation that initiation of mechanical ventilation to achieve a high target Pao2 may have occurred is less a failing of the study design than a consequence of using a high Pao2 target," Schwartzstein writes.
The observation that initiation of mechanical ventilation to achieve a high target Pao2 may have occurred is less a failing of the study design than a consequence of using a high Pao2 target.
Schwartzstein also suggests that high oxygen targets help patients in some ways, but may also cause inflammation, bronchial epithelial injury, and disruption of mitochondrial respiration in ICU patients.
He writes that the study "is one more piece in a growing collection of evidence suggesting that there is no clinical benefit and possibly harm associated with use of supplemental oxygen to achieve oxygen saturation of the blood beyond 90% to 93%."
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Brazil's Federal Police on Tuesday indicted former far-right President Jair Bolsonaro for falsifying his COVID-19 vaccination records.
The indictment said Bolsonaro tampered with a public health database to make it look as if he and several others in his circle were vaccinated.
Police detective Fabio Alvarez Shor signed off on the indictment, saying Bolsonaro and several others wanted to use fake COVID-19vaccination records to "cheat current health restrictions."
"The investigation found several false insertions between November 2021 and December 2022, and also many actions of using fraudulent documents," Shor explained.
Bolsonaro had expressed opposition to the COVID-19 vaccinewhile also downplaying the health impacts of the virus and the severity of the pandemic.
It's now up to Brazil's prosecutor-general to decide whether to file charges against Bolsonaro at the Brazilian Supreme Court.
Bolsonaro's attorney, Fabio Wajngarten, decried the police allegations as "absurd."
"While he served as president, [Bolsonaro]was completely exempt from presenting any type of certificate on his trips," Wajngarten said, while condemning "political persecution" towards the former Brazilian leader.
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It was the first indictment against the former Brazilian leader as more charges could potentially be broughton other issues as well.
The former president is currently being investigated over a possible military coup plot to stay in power after he was defeated by leftist Luiz Inacio Lula da Silva in the 2022 election.
On January 8, 2023, a mob of Bolsonaro supporters stormed buildings representing the three branches of government in the capital of Brasilia, several days after Lula's inauguration.Although their attempt to reinstall Bolsonaro's government failed, the event left a mark on Brazil's democracy and revealed the risks of polarization in South America's most populous country.
Bolsonaro also faces a probe over money he received from selling luxury watches he was gifted from Saudi Arabia during his time in office.
wd/sms (Reuters, AP, AFP)
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Brazil's Bolsonaro indicted over fake COVID certificate - DW (English)
Charleston County School District is trying to come up with tens of millions of dollars. The biggest challenge regarding the Fiscal Year 2025 budget is sunsetting ESSER funds COVID-19 funds. (WCIV)
Charleston, S.C. (WCIV)
The Charleston County School District is trying to come up with tens of millions of dollars.
The biggest challenge regarding the Fiscal Year 2025 budget is sunsetting ESSER funds COVID-19 funds.
All of which will be used by September.
The school district has $22 million of ESSER funds left.
Charleston%20County%20School%20District%20is%20trying%20to%20come%20up%20with%20tens%20of%20millions%20of%20dollars.%20The%20biggest%20challenge%20regarding%20the%20Fiscal%20Year%202025%20budget%20is%20sunsetting%20ESSER%20funds%20%E2%80%93%20COVID-19%20funds.%20(WCIV)
Now, the district is trying to come up with $90 million to sustain the programs and positions that are ESSER-funded.
Daron Lee Calhoun II said the district is working hard with their new chief financial officer to tighten up their expenditures and come up with the money.
Calhoun said he supports the weighted student-based funding model that was presented at the most recent budget workshop.
Superintendent Anita Huggins says this would allow the district to maintain effective programs and positions currently funded by ESSER.
Schools are funded based on enrollment but the new model would allow the district to follow a different ratio.
Students in poverty, those receiving special education services, and multilingual learners would be weighted higher and increase the allocation of funds to their schools.
With this model, we can sustain a lot of those programs and a lot of the full-time employees under the general operating fund. How do we do it over the next three or five years? Can we do it over the next three to five years? If we can't, then how do we scale back on the model a little bit? Calhoun said. How do we sustain it? That's where my biggest question would come from.
Another question he has: how would this work with school voucher programs the state is potentially expanding?
This model is flatly a racist model. The voucher systems came about in 1964 because of school integration, Calhoun said.
The state program is essentially public dollars going to parents, allowing them to choose their students school.
As long as you keep pulling money out of the schools, were already strained trying to balance this billion-dollar budget that we have," Calhoun said. "That money coming out of our schools is not going to help us at all. We need to keep our public funds and our taxpayer funds within the public schools."
Calhoun says they won't know how this will affect the suggested model or CCSDs budget until they know how many students are participating in the voucher program.
If 200 students take that $6,000, that's a lot of money coming out of our schools," Calhoun said. "That can go to teacher increases. That can go to projects that were funded by ESSER. Every little bit of money coming out of our district takes away something else."
While the district is busy building its budget, it is simultaneously having to watch the states budget
Calhoun hopes the state passes its budget by April so they can build those numbers into their plan.
It will truly affect everything we're doing," He said. "We need those numbers soon."
The House passed the budget last week and now heads to the Senate.
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CCSD charts path forward without COVID-19 ESSER funds in Fiscal Year 25 budget - ABC NEWS 4
The Department of Transportation (DOT) hasn't created a national aviation preparedness plan for infectious disease outbreaks, despite a 2015 US Government Accountability Office (GAO) recommendation to do so, according to a new report on lessons learned from the COVID-19 pandemic.
When tasked with identifying pandemic lessons for the report, the GAO reviewed more than 20 of its previous reports and documents from offices of inspectors general and aviation stakeholders and interviewed officials from the DOT and the Department of the Treasury.
"In April 2020, U.S. commercial airline traffic fell to 3 million passengers, a 96 percent decrease from April 2019," the GAO noted in the report. "The federal government responded in many ways, including by providing $132 billion in financial assistance to airlines, aviation and other businesses, and airports."
Yet a DOT plan to avert replication of the disjointed response seen early in the pandemic didn't materialize even after stakeholders told the GAO in 2020 and 2021 that confidence in air travel could have recovered faster if there had been greater federal coordination. In December 2022, at the GAO's behest, Congress passed a law requiring the DOT to develop the plan.
In July 2022, the GAO said that federal leaders needed to advanceresearchon disease spread aboard airplanes, including in real-world scenarios and on the efficacy of mitigation methods. While the GAO urged Congress to require the Federal Aviation Administration (FAA) to create a research strategy, as of this month, legislators haven't done so.
This year and in 2023, DOT and FAA officials said they are working on developing a preparedness plan and identifying a research agenda. "By implementing GAO's recommendations, DOT and other aviation stakeholders would be better positioned to address a communicable disease threat while minimizing unnecessary aviation disruptions, which were significant in the case of COVID-19," the GAO said in the report.
Lessons learned from GAO's work on COVID-19 aviation-assistance programs from the Department of the Treasury's Payroll Support Program (PSP), the Coronavirus Aid, Relief, and Economic Security (CARES) Act loan program, and the DOT's Airport Grants and Aviation Manufacturing Jobs Protection Program include:
DOT and Treasury quickly awarded funds but did not always have safeguards in place in a timely manner.
The GAO will continue to monitor the federal COVID-19 pandemic response, including the DOT's and Treasury's production of aviation lessons learned, it said.
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