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COVID-19 Updates

Many Post-Covid Patients Are Experiencing New Medical Problems, Study Finds

By Pam Belluck | NYTimes.Com

Troy Warren #covid-all

An analysis of health insurance records of almost two million coronavirus patients found new issues in nearly a quarter — including those whose Covid infection was mild or asymptomatic.

Hundreds of thousands of Americans have sought medical care for post-Covid health problems that they had not been diagnosed with before becoming infected with the coronavirus, according to the largest study to date of long-term symptoms in Covid-19 patients.

The study, tracking the health insurance records of nearly two million people in the United States who contracted the coronavirus last year, found that one month or more after their infection, almost one-quarter — 23 percent — of them sought medical treatment for new conditions.

Those affected were all ages, including children. Their most common new health problems were pain, including in nerves and muscles; breathing difficulties; high cholesterol; malaise and fatigue; and high blood pressure. Other issues included intestinal symptoms; migraines; skin problems; heart abnormalities; sleep disorders; and mental health conditions like anxiety and depression.

Post-Covid health problems were common even among people who had not gotten sick from the virus at all, the study found. While nearly half of patients who were hospitalized for Covid-19 experienced subsequent medical issues, so did 27 percent of people who had mild or moderate symptoms and 19 percent of people who said they were asymptomatic.

“One thing that was surprising to us was the large percentage of asymptomatic patients that are in that category of long Covid,” said Robin Gelburd, president of FAIR Health, a nonprofit organization that conducted the study based on what it says is the nation’s largest database of private health insurance claims.

More than half of the 1,959,982 patients whose records were evaluated reported no symptoms from their Covid infection. Forty percent had symptoms but didn’t require hospitalization, including 1 percent whose only symptom was loss of taste or smell; only 5 percent were hospitalized.

Ms. Gelburd said the fact that asymptomatic people can have post-Covid symptoms is important to emphasize, so that patients and doctors can know to consider the possibility that some health issues may actually be aftereffects of the coronavirus. “There are some people who may not have even known they had Covid,” she said, “but if they continue to present with some of these conditions that are unusual for their health history, it may be worth some further investigation by the medical professional that they’re working with.”

The report, which will be posted publicly on Tuesday morning on the organization’s website, analyzed records of people diagnosed with Covid-19 between February and December 2020, tracking them until February 2021. It found that 454,477 people consulted health providers for symptoms 30 days or more after their infection. FAIR Health said the analysis was evaluated by an independent academic reviewer but was not formally peer-reviewed.

“The strength of this study is really its size and its ability to look across the range of disease severity in a diversity of age groups,” said Dr. Helen Chu, an associate professor of medicine and infectious diseases at the University of Washington School of Medicine, who was not involved in the report. “This is a hard study to do with that much data.”

The report “drives home the point that long Covid can affect nearly every organ system,” said Dr. Ziyad Al-Aly, chief of the research and development service at the VA St. Louis Health Care System, who was not involved in the new study.

“Some of these manifestations are chronic conditions that will last a lifetime and will forever scar some individuals and families,” added Dr. Al-Aly, who was an author of a large study published in April of lingering symptoms in Covid patients in the Department of Veterans Affairs health system.

In the new study, the most common issue for which patients sought medical care was pain — including nerve inflammation and aches and pains associated with nerves and muscles — which was reported by more than 5 percent of patients or nearly 100,000 people, more than a fifth of those who reported post-Covid problems. Breathing difficulties, including shortness of breath, were experienced by 3.5 percent of post-Covid patients.

Nearly 3 percent of patients sought treatment for symptoms that were labeled with diagnostic codes for malaise and fatigue, a far-reaching category that could include issues like brain fog and exhaustion that gets worse after physical or mental activity — effects that have been reported by many people with long Covid.

Other new issues for patients, especially adults in their 40s and 50s, included high cholesterol, diagnosed in 3 percent of all post-Covid patients, and high blood pressure, diagnosed in 2.4 percent, the report said. Dr. Al-Aly said such health conditions, which have not been commonly considered aftereffects of the virus, make it “increasingly clear that post-Covid or long Covid has a metabolic signature marked by derangements in the metabolic machinery.”

Relatively few deaths — 594 — occurred 30 days or more post-Covid, and most were among people who had been hospitalized for their coronavirus infection, the report found.

The study, like many involving electronic records, only addressed some aspects of the post-Covid landscape. It did not say when patients’ symptoms arose or how long the problems persisted, and it did not evaluate exactly when after infection patients sought help from doctors, only that it was 30 days or more.


 

 

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COVID-19 Updates

How Gay Bars Are Bouncing Back in L.A. Post-Pandemic Restrictions

BY KIRSTEN CHUBA | HollywoodReporter.Com

Troy Warren #covid-all

“This is going to be the roaring ’20s,” says The Abbey owner David Cooley, as LGBTQ nightspots await California’s June 15 reopening.

After 15 months of pandemic restrictions that have kept Los Angeles’ gay bars partly or completely closed, nightlife owners like The Abbey founder and CEO David Cooley are finally seeing the light at the end of the tunnel. California is set to fully reopen June 15, allowing nightlife to return just in time for Pride month (though West Hollywood’s huge Pride parade is canceled for 2021, for the second year in a row).

“For this year’s Pride, there’s no parades, there’s no festivals in West Hollywood, but we will make sure The Abbey is really ready and decorated for Pride,” says Cooley, who recently oversaw the iconic bar’s 30th anniversary celebration, which included a visit from Lady Gaga. “This is going to be the roaring ’20s, people are ready to get up and dance, and it was proven when Gaga came in. I could not tell people to sit down.”

“It’s almost like burn your bra,” he adds of the lifted mask mandates on the horizon. “People want to burn their mask and hear our DJs and start dancing and looking at our go-go girls and go-go guys. They want to party.”

When patrons do return to West Hollywood this Pride month, though, it will look quite different from years past. Flaming Saddles, Gold Coast, Rage and Gym Bar were all victims of the pandemic (plus Studio City’s Oil Can Harry’s), leaving WeHo’s Santa Monica Boulevard strip without some of its signature clubs. That’s on top of the fact that L.A. has been without a lesbian bar in the entire county since Van Nuys’ Oxwood Inn closed in 2017. But, as COVID-19’s threat lessens, several of those shuttered bars have announced plans to reopen in new spaces, and where “before it used to be ‘For Lease’ sign, ‘For Lease’ sign, ‘For Lease’ sign, now you can’t find anything, they’re all taken up,” says Cooley. “There are some new exciting bars that will be opening.”

Singer-producer Lance Bass, co-owner of popular West Hollywood bar and Italian restaurant Rocco’s, is among those planning new venues, taking over the old Rage space for what is being promoted as the biggest gay nightclub in the United States.

“It was truly devastating to see what happened to WeHo during the pandemic. So many of my favorite places had to close. For their patrons these venues weren’t just bars, they were safe places for so many LGBTQ+ members. It scared me to think these venues would be replaced with mainstream places that wouldn’t cater specifically to our community,” says Bass, promising that his upcoming spot will “bring back major entertainment to West Hollywood, complete with an epic dance floor.”

Silver Lake’s Akbar is a nightlife favorite that was brought back from the edge during the pandemic, after a GoFundMe launched in December raised more than $200,000 to help it stay afloat. Since then, the bar has begun outdoor service with Akbar Al Fresco and has events set throughout June, including a Pride celebration June 13.

“One can Zoom and have a cocktail for the rest of their lives now that we all know how it works, but nothing can replace face-to-face,” says Akbar co-owner Scott Craig. “Especially when you’re in a category of citizens who are slightly marginalized and, especially in some other states, being really horribly treated.”

And while many bars have been able to reopen to some degree in recent weeks, taking over parking lots and sidewalks, downtown L.A.’s nightlife scene has struggled to pivot because of limited outdoor options. Precinct, one of the most popular DTLA clubs, will reopen for the first time since the start of the pandemic June 17, after months of surviving on community fundraisers.

“There’s been a lot of quiet down here during the shutdown,” says co-owner Brian McIntire, as general manager James Eason adds, “I look at similar people in WeHo, and they’ve been working really closely with the city, which has been great for them, but it’s been hard to watch. I just wish that we’d been seen as a valuable asset.” Eason says the bar has received little aid in clsoing off streets and sidewalks for outdoor tables, as has happened in other areas of the city. Downtown has also witnessed an explosion of underground parties, which now pose competition as bars return.

“There are a lot of us that have held on as tight as we can, and I believe we’ll all be coming back, and these places need everyone’s support,” says McIntire. “I’m hoping that the other venues that people went to before all of this aren’t forgotten, and people start returning to them as well.”

And after the traumatic events of the past year, the significance of a restriction-free Pride is not lost. Says Eason, “June’s going to be both things for so many of us. It’s like re-bonding with our gay family as well as celebrating Pride. I think it means more to everyone this year.”


 

 

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COVID-19 Updates

Moscow orders new restrictions as COVID-19 infections soar

By JIM HEINTZ | APNews.Com

Troy Warren #covid-all

 

MOSCOW (AP) — Moscow’s mayor on Saturday ordered a week off for some workplaces and imposed restrictions on many businesses to fight coronavirus infections that have more than doubled in the past week. 

The national coronavirus task force reported 6,701 new confirmed cases in Moscow, compared with 2,936 on June 6. Nationally, the daily tally has spiked by nearly half over the past week, to 13,510. 

After several weeks of lockdown as the pandemic spread in the spring of 2020, the Russian capital eased restrictions and did not reimpose any during subsequent case increases. But because of the recent sharp rise, “it is impossible not to react to such a situation,” Moscow Mayor Sergei Sobyanin said. 

He ordered enterprises that do not normally work on weekends to remain closed for the next week while continuing to pay employees. Food courts and children’s play areas in shopping centers also are to close for a week beginning Sunday, and restaurants and bars must limit their service to takeout from 11 p.m. to 6 a.m.

Earlier in the week, city authorities said enforcement of mask- and glove-wearing requirements on mass transit, in stores and in other public places would be strengthened and that violators could face fines of up to 5,000 rubles ($70).

Although Russia was the first country to deploy a coronavirus vaccine, its use has been relatively low; many Russians are reluctant to get vaccinated.

President Vladimir Putin on Saturday said 18 million Russians have received the vaccine — about 12% of the population. 

For the entire pandemic period, the task force has reported nearly 5.2 million infections in the country of about 146 million people, and 126,000 deaths. However, a report from Russian state statistics agency Rosstat on Friday found more than 144,000 virus-related deaths last year alone.

The statistics agency, unlike the task force, counts fatalities in which coronavirus infection was present or suspected but is not the main cause of death. 

The agency’s report found about 340,000 more people died in 2020 than in 2019; it did not give details of the causes of the higher year-on-year death toll. 

The higher death toll and a lower number of births combined to make an overall population decline of 702,000, about twice the decline in 2019, Rosstat said.


 

 

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COVID-19 Updates

The U.S. investigation into coronavirus origins

By Christina Larson and Nomaan Merchant, Associated Press

Troy Warren #covid-all

WASHINGTON — Once dismissed by most public health experts and government officials, the hypothesis that COVID-19 leaked accidentally from a Chinese lab is now receiving scrutiny under a new U.S. investigation.

Experts say the 90-day review ordered on May 26 by President Joe Biden will push American intelligence agencies to collect more information and review what they already have. Former State Department officials under President Donald Trump have publicly pushed for further investigation into virus origins, as have scientists and the World Health Organization.

Virologists also say it is unlikely that any definitive answer about virus origins will be possible in 90 days. The work to fully confirm origins and pathways of past viruses — such as the first SARS or HIV/AIDS — has taken years or decades.

A look at what is known about the U.S. investigation of the virus.

What intelligence agencies are reviewing

Biden ordered a review of what the White House said was an initial finding leading to “two likely scenarios,” an animal-to-human transmission or a lab leak. The White House statement says two agencies in the 18-member intelligence community lean toward the hypothesis of a transmission in nature; another agency leans toward a lab leak.

One document drawing new attention is a State Department fact sheet published in the last days of Trump’s administration. The memo notes that the U.S. believes three researchers at a Wuhan, China, lab sought medical treatment for a respiratory illness in November 2019. However, the report is not conclusive: The origin and severity of the staffers’ illness is not known — and most people in China regularly go to hospitals, not primary-care physicians, for routine care.

The memo also pointed to “gain of function” studies — which in theory could enhance the lethality or transmissibility of a virus — allegedly done at the Wuhan lab with U.S. backing. However, National Institutes of Health Director Francis Collins has since adamantly denied that the U.S. supported any “gain-of-function” research on coronaviruses in Wuhan.

China’s lack of transparency

The White House statement criticized China for a lack of transparency, echoing previous criticisms by Democrats and Republicans. “The failure to get our inspectors on the ground in those early months will always hamper any investigation into the origin of COVID-19,” the White House said.

The Associated Press has reported on China’s interference in the World Health Organization’s probes of the virus and its fanning of conspiracy theories online. China has also forced journalists to leave the country in recent years and silenced or jailed whistleblowers from Wuhan and elsewhere.

The lack of transparency in China is a significant and familiar challenge. But that does not in itself signal that something in particular is being hidden.

What scientists believe

The most compelling argument for investigating the possibility of a lab leak is not any new hard evidence, but rather the fact that another pathway for virus spread has not been 100% confirmed.

“The great probability is still that this virus came from a wildlife reservoir,” said Arinjay Banerjee, a virologist at the Vaccine and Infectious Disease Organization in Saskatchewan, Canada. He pointed to the fact that spillover events – when viruses jump from animals to humans – are common in nature, and that scientists already know of two similar beta coronaviruses that evolved in bats and caused epidemics when humans were infected, SARS1 and MERS.

However, the case is not completely closed. “There are probabilities, and there are possibilities,” said Banerjee. “Because nobody has identified a virus that’s 100% identical to SARS-CoV-2 in any animal, there is still room for researchers to ask about other possibilities.”

How long it will take to confirm

Confirming with 100% certainty the origin of a virus is often not fast, easy, or always even possible.

For example, scientists never confirmed the origin of smallpox before the disease was eradicated through a global vaccination program.

In the case of Severe Acute Respiratory Syndrome (SARS) – a disease caused by a beta coronavirus, like the current coronavirus – researchers first identified the virus in February 2003. Later that year, scientists discovered the likely intermediary hosts: Himalayan palm civets found at live-animal markets in Guangdong, China. But it wasn’t until 2017 that researchers traced the likely original source of the virus to bat caves in China’s Yunnan province.

The importance of understanding the origin of the virus

From a scientific perspective, researchers are always keen to better understand how diseases evolve. From a public health perspective, if a virus has transitioned to being spread mostly by human-to-human contact, discovering its origins is not as essential to strategies for containing the disease.

“Questions of origins and questions of disease control are not the same thing once human-to-human transmission has become common,” said Deborah Seligsohn, an expert in environment and public health at Villanova University.


 

 

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COVID-19 Updates

COVID science officer says vaccines work against ‘delta’ variant

By Ariel Hart, The Atlanta Journal-Constitution

Troy Warren #covid-all


 

Health officials say race is on to vaccinate more Georgians before delta variant proliferates in state

The highly contagious coronavirus variant first seen in India and now overrunning Great Britain has been detected in Georgia, a potential threat to progress the state has made unless more people get vaccinated, health officials say.

The Georgia news came on the same day that the White House raised the alarm for the U.S. about the variant, designated B.1.617.2 and now called the “delta” variant. White House leaders including Dr. Anthony Fauci publicly urged people to get vaccinated ahead of the spread.

The vaccines do work against the delta variant, Dr. David Kessler, the White House’s Chief Science Officer on COVID-19, told The Atlanta Journal-Constitution.

In Britain, almost all of the people who have been hospitalized with the delta variant were not vaccinated. And while there are “breakthrough” cases where those who have been vaccinated catch the variant, they tend not to get as sick, health authorities say.

The trick is that with a two-shot vaccine, one shot is seriously insufficient to protect against the variant, Kessler said. People need to complete their vaccination regimens: One shot for Johnson & Johnson, or two shots for Pfizer or Moderna.

“Remember, there was a debate about whether maybe one dose is enough?” Kessler said. “In fact, they see that two doses against the delta, in the UK are some 80-plus % effective. But if you get only one dose, it drops remarkably fast to about something like 30%,” he said, noting these were initial findings.

“These mutations are real, they are challenging,” Kessler said. “But the good news is that the vaccines that we have been using protect against death and hospitalization from these variants. Period. Get vaccinated, get both doses if it’s an mRNA vaccine, and there is remarkable protection.”


 

The delta variant is significantly more contagious than the original COVID-19 strain and appears to carry a higher risk of hospitalization, health officials say. In India, where the variant was first detected in January, hospitals this spring have been overwhelmed with cases and the country set a global record for daily COVID deaths.

The variant has now spread to dozens of countries. Just days ago, it became the dominant strain in the United Kingdom. In spite of success from rigorous lockdowns there, the delta variant has caused a rise in infections and is threatening to cause a delay in the end of lockdown measures. A long decline in British cases seen on graphs is suddenly starting to turn back upward.

“We cannot let that happen in the United States,” said Fauci, director of the National Institutes of Allergies and Infectious Diseases, at a White House press briefing Tuesday.

The U.S. is at a tipping point, he indicated: The delta variant has been detected in about 6% of cases that have been sequenced here, Fauci said, the point where the variant took over in England.

The variant has shown up in more than a dozen states, according to a tracking map maintained by the company Helix, which performs genetic sequencing on the virus variants.

Beginning to spread

Helix had detected just a few cases in most of those states, except Florida, blooming with at least 32 cases.

Helix shows Georgia with seven cases of the delta variant detected so far, as well as four cases of a slightly different variant, B.1.617.1, called “Kappa,” that also was first seen in India at about the same time.

Those numbers are likely an undercount, however: Not everyone who is sick gets tested, not every test sample gets genetically sequenced, and not every sequencing is done by the Helix company.

The Georgia Department of Public Health confirmed that Georgia had cases of the variant. The department said it does not have county-level data on where those are.

“Vaccination is critical to stopping the spread of COVID and decreasing the number of variants that emerge,” the department told the AJC in an emailed statement. “People who are unvaccinated or skip their second dose of vaccine are targets for infection.”

Those who receive either Moderna or Pfizer vaccine are considered fully vaccinated two weeks after their final dose, DPH said.

Only 35% of Georgians have completed their vaccinations, a dismal number for a state seeking to safely get back to normal.

According to the Centers for Disease Control and Prevention, just 51.9% of Georgia adults have had at least one shot, compared to 63.5% nationwide. President Biden has set a goal of 70% of U.S. adults getting at least one shot by July 4.

Getting shots—the full regimen—is crucial to maintaining the return to regular life that more Georgians are starting to feel, Kessler said.

“So far, we’re very, very close,” Kessler said. “I just don’t want to turn around and find that we could have done more.

“Once that virus takes over the body, I don’t know ways to easily stop it. I can stop it with a vaccine; it can give you immunity. But you’ve got to make that decision for yourself.”

Vaccinations lag

Overall, about 41% of Georgians have received one dose of COVID-19 vaccine, according to the Department of Public Health.

In some Georgia counties, however, that rate drops to under 20%. DPH reports that Long County has the lowest rate, at 12%, followed by Chattahoochee County, at 13%.

The White House set a goal of having 70% of adults receive at least one COVID-19 by July 4. So far, 13 states have met that goal: California, Connecticut, Hawaii, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New Mexico, Pennsylvania, Rhode Island, Vermont and Washington.


 

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COVID-19 Updates

Despite ample shots and incentives, vaccine rates lag far behind in the South

By Rick Rojas – The New York Times

Mitch Smith – The New York Times

Troy Warren ##covid-all

NASHVILLE, Tenn. — Public health departments have held vaccine clinics at churches. They have organized rides to clinics. Gone door to door. Even offered a spin around a NASCAR track for anyone willing to get a shot.

Still, the country’s vaccination campaign is sputtering, especially in the South, where there are far more doses than people who will take them.

As reports of new COVID-19 cases and deaths plummet, and as many Americans venture out mask-free into something approaching normalcy, the slowdown in vaccinations presents a new risk. As coronavirus variants spread and restrictions are eased, experts fear that the virus could eventually surge again in states such as Alabama, Louisiana and Mississippi, where fewer than half of adults have started the vaccination process.

“A lot of people have the sense, ‘Oh, dodged that bullet,’ ” said Dr. Jeanne Marrazzo, the director of the Division of Infectious Diseases at the University of Alabama at Birmingham. She added, “I don’t think people appreciate that if we let up on the vaccine efforts, we could be right back where we started.”

A range of theories has emerged about why the South, which as of Wednesday was home to eight of the 10 states with the lowest vaccination rates, lags behind the rest of the country: hesitancy from conservative white people, concerns among some Black residents, long-standing challenges when it comes to health care access and transportation.

The answer, interviews across the region revealed, was all of the above.

“It’s kind of a complex brew, and we’re teasing apart the individual pieces,” said Dr. W. Mark Horne, president of the Mississippi State Medical Association. He added: “There’s no magic bullet. There’s no perfect solution. There’s no pixie dust we can sprinkle on it.”

Vaccines, once a scarce commodity, are now widely available in the United States, and everyone age 12 and older is eligible for a shot. But daily vaccinations nationwide are down to about 1.1 million doses from a peak of more than 3.3 million doses a day in mid-April.

Barring a sudden uptick, the country will fall just short of President Joe Biden’s goal of getting 70% of American adults a first dose by July 4. Through Tuesday, the country was on pace for 68% of adults to have received a first dose by the holiday.

Thirteen states, mostly in the Northeast and on the West Coast, have already given vaccines to at least 70% of adult residents, and several others remain on pace to do so in the coming weeks. Experts now believe that the United States may never reach herd immunity, the point at which the virus dies out, but Biden has said getting 70% of adults a shot by July 4 would constitute “a serious step toward a return to normal.”

But in parts of the South, it is uncertain whether that milestone is attainable anytime soon — or ever.

“I certainly don’t expect us to get to 70% by Fourth of July. I don’t know that we’ll get to 70% in Alabama,” said Dr. Karen Landers, Alabama’s assistant state health officer. “We just have a certain group of people, of all walks of life, that just aren’t going to get vaccinated.”

From rural Appalachian towns to urban centers like Memphis, Tennessee, and Birmingham, Alabama, the slowdown has forced officials to refine their pitches to skeptical residents. Among the latest offerings: mobile clinics, Facebook Live forums and free soccer tickets for those who get vaccinated.

In the small central Mississippi town of Forest, the Rev. Odee Akines implored congregants at his church to get vaccinated by sharing the story of his own nearly fatal brush with COVID, which included being hospitalized for 80 days and in a coma for roughly a month. In Alabama, Nick Saban, the championship-winning football coach, urged fans to get vaccinated so they could attend games safely this fall.

So far, there have been individual stories of success, but no major change in the trend. When Alabama officials set up a clinic at Talladega Superspeedway and let vaccine recipients drive around the famed track, about 100 people took them up on the offer. Landers said organizers had hoped for more people.

No single reason explains why the South’s vaccination campaign is faltering, which means that no one fix is likely to change the trend. Many common barriers to vaccination are not unique to the South, but are especially prevalent there.

Some Republicans distrust the government’s role in the development and promotion of the vaccines, polls show. Some Black people distrust the medical profession because of generations of discriminatory care and experiments. And others are busy, or biding their time, or unable to get to a vaccination site, or have unanswered questions.

The three vaccines granted emergency use authorization by the federal government have been shown to be safe and highly effective in preventing COVID-19. But Americans who were eager to get vaccinated already received their shots weeks ago. Now, health officials are trying new methods to convince the uninterested and the skeptical, and to keep case numbers down in the months ahead.

“My concern is the fall,” said Susanne Straif-Bourgeois, an epidemiologist at Louisiana State University Health in New Orleans. “Because then everyone goes back to school, to college, to universities.”

The national outlook has improved drastically in recent weeks. The country is averaging about 14,000 new cases a day, the fewest since testing became widely available, and deaths and hospitalizations have plummeted. Gov. Tate Reeves of Mississippi, a Republican, recently called Biden’s July 4 goal arbitrary, and said he was encouraged by the relatively low hospitalization and case numbers in his state, which has the country’s lowest vaccination rate.

Across the South, doctors and public health officials repeatedly cited two factors as making a difference with the hardest-to-reach people: easy access and a personalized pitch.

Dr. Kelly Rodney Arnold, the founder of Clínica Médicos, which treats underserved and uninsured people in Chattanooga, Tennessee, said she knew that the trust she had built over years with her patients, many of whom are Latino, would be critical in overcoming skepticism.

The vaccines’ staggered rollout, she said, had allowed misinformation to spread and had complicated the campaign.

“They’re not going to knock on the ER’s door to get a vaccination,” Arnold said. “They’re not going to approach something that’s novel and full of a lot of scary information surrounding it.”This article originally appeared in The New York Times.


 

 

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COVID-19 Updates

Concerns mount that Johnson & Johnson vaccine doses could go to waste

By Noah Weiland – The New York Times

Daniel E. Slotnik – The New York Times

Troy Warren #covid-all

State health officials are growing increasingly concerned about whether doses of the Johnson & Johnson coronavirus vaccine may expire this month, warning they could go to waste if they go unused in the coming weeks or are not sent elsewhere.

Gov. Mike DeWine of Ohio has pleaded with health providers in his state to use about 200,000 doses of the vaccine that he said Monday were set to expire June 23. The state’s health department directed providers to adopt a “first-in, first-out” process for the shot to ensure doses with earlier expiration dates were used first. Arkansas’ state epidemiologist said last week that as many as 60,000 doses of Johnson & Johnson may not be used there in time.

Dr. Marcus Plescia, who represents state health agencies as the chief medical officer for the Association of State and Territorial Health Officials, said he believed the expiration risk for Johnson & Johnson was a problem in every state. More than 10 million doses of the vaccine have been delivered to states but not administered, according to data collected by the Centers for Disease Control and Prevention.


 

Andy Slavitt, a White House pandemic adviser, said Tuesday at a news conference that the federal government was encouraging governors to consult with the Food and Drug Administration on storage procedures as the agency examines how to possibly extend the shelf life of the vaccine. He said the agency was “looking at opportunities for continued storage.”

An FDA spokeswoman Tuesday referred questions about the vaccine’s shelf life to Johnson & Johnson.

“We continue to work with the U.S. government and health authorities to support the use of our vaccine, which continues to play an important role, including among those who wish to be fully vaccinated with one shot,” the company said in a statement. “We also continue to conduct stability testing with the goal of extending the amount of time our COVID-19 vaccine can be stored before expiry.”

The single-dose Johnson & Johnson vaccine can be stored at normal refrigeration temperatures for three months, conditions that have allowed states to reach more isolated communities that may find it more difficult to manage the two-dose vaccines made by Pfizer-BioNTech and Moderna, which have stricter storage requirements. Pfizer’s vaccine expires six months from its manufacture date.

Concerns among state health officials about the Johnson & Johnson doses have dovetailed with a significant drop in vaccination rates across the nation. As of Monday, providers were administering about 1.13 million doses per day on average, around a 67% decrease from the peak of 3.38 million reported April 13. About 64% of U.S. adults have received at least one shot, according to federal data.

“There is a very, very small fraction of doses that have been sent out to states that will ultimately not be used. These will be fractional amounts and really will not have any significant bearing on our ability to commit to distribute vaccines globally.”

– Andy Slavitt, a White House pandemic adviser

Dr. Tedros Adhanom Ghebreyesus, the director-general of the WHO, bemoaned at a news conference Monday what he called a “two-track pandemic,” with wealthy countries using much of the world’s vaccine supply.

“The inequitable distribution of vaccines has allowed the virus to continue spreading, increasing the chances of a variant emerging that renders vaccines less effective,” Tedros said, adding “the biggest barrier to ending the pandemic remains sharing: of doses, of resources, of technology.”

At the White House news conference, Slavitt said it was unrealistic to expect that the United States could avoid wasting some vaccine doses, adding that any expired Johnson & Johnson doses would not significantly affect the administration’s efforts to help vaccinate other countries.

“There is a very, very small fraction of doses that have been sent out to states that will ultimately not be used,” he said. “These will be fractional amounts and really will not have any significant bearing on our ability to commit to distribute vaccines globally.”


 

 

 

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Johns Hopkins’ Dr. Marty Makary: Americans have an ‘entirely distorted perception’ of Covid risk

Kevin Stankiewicz | CNBC.Com 

Troy Warren #covid-all

 

KEY POINTS

“People have an entirely distorted perception of risk” around Covid, Dr. Marty Makary told CNBC on Tuesday.

“There’s a lot of good news out there, and I think that people need to hear that good news right now,” the Johns Hopkins surgeon and professor said.

However, Americans who haven’t been vaccinated or previously infected with Covid need to “be careful,” Makary added.

Dr. Marty Makary told CNBC on Tuesday people have failed recognize that the threat presented by the coronavirus in the U.S. is dramatically lower now than during earlier stages of the pandemic.

“There’s a lot of good news out there, and I think that people need to hear that good news right now. People have an entirely distorted perception of risk,” the Johns Hopkins surgeon and professor said in an interview on “Squawk Box.”

The case fatality rate for Covid in the U.S. has become “much different” now that the disease is circulating more among younger populations, said Makary.

For those younger Americans, he said, the case fatality rate of Covid has become similar to seasonal flu. “Right now, we’ve got 1/50th the number of daily cases of this virus” compared with cases of flu during a mild season in the U.S., he added.

The seven-day average of new daily Covid cases in the U.S. is around 15,800, according to a CNBC analysis of Johns Hopkins University data. That’s down more than 60% from roughly a month ago, when the U.S. average of new daily coronavirus infections was around 45,000. The highest single day of new cases in the U.S. was 300,462 on Jan. 2.

The sharp drop in Covid cases has coincided with more Americans receiving vaccines. As of Monday, nearly 64% of U.S. adults had received at least one vaccine dose and 53% are fully vaccinated, according to data compiled by the Centers for Disease Control and Prevention.

The country’s seven-day average of new daily reported Covid deaths is around 460, according to CNBC’s analysis of JHU data. That’s down 21% from a week ago. The highest single day of new fatalities in the U.S. was 4,477 on Jan. 12.

People “need to be careful if they’re unvaccinated and not had the infection, but we need to move on at some point,” said Makary, author of many books, including “The Price We Pay: What Broke American Health Care — And How to Fix It.” It’s now in paperback with a new Covid section.

In February, Makary wrote an attention-grabbing op-ed in The Wall Street Journal titled “We’ll Have Herd Immunity by April.” Not everyone agreed with his prediction after the piece was published, with some seeing it as too aggressive at the time.

Makary said Tuesday he believes “the concept of herd immunity was one that got misinterpreted as eradication.” He noted that he acknowledged in the op-ed that the coronavirus will be around for decades.

“We’re using the term population immunity right now so people don’t misconstrue herd immunity as a finish line or something that’s binary,” Makary said. “I do think you’re going to see it circulate in younger communities and that’s different from the threat that was just posed just, say, two months ago.”


 

 

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COVID-19 Updates

Hometown Hall United States COVID-19 Update June 7

Troy Warren #covid-all


 

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COVID-19 Updates

Some US hospitals mark first time being Covid-free. Others still see surge of patients

By Christina Maxouris, CNN

Troy Warren #covid-all

 

(CNN)Dr. Raul Magadia and his team all gathered in the basement of their Anniston, Alabama, hospital last month for a big announcement he was preparing to make through the intercom system.

That system is usually reserved for emergency codes. 

But Magadia, an infectious disease specialist at the Northeast Alabama Regional Medical Center, had other plans on May 25. 

He was about to share that in a few minutes the hospital would discharge the last Covid-19 patient from their Covid unit. It was a surreal milestone, he later told CNN, for staff who have been on the front lines of the battle against the virus for more than a year.

“We were really aiming for some good news after 13, 14 months of horrible news,” Magadia said. “That moment … that we had zero (patients), it’s an unbelievable feeling.”

On May 25, Dr. Magadia announced to the hospital they were about to discharge their last Covid-19 patient. They have seen at least two patients since.

On the other side of the country, inside the Zuckerberg San Francisco General Hospital, similar celebrations took place in late May after hospital staff announced they had no Covid-19 patients — for the first time since March 2020. 

“It’s incredibly hopeful for us,” said Dr. Susan Ehrlich, the hospital’s CEO. “It was a very fatiguing year and a half, very stressful.”

Both facilities say they have since seen several Covid-19 patients — but numbers remain so low they don’t compare to the harsh peaks they experienced over the winter.

Across the United States, other hospitals have welcomed similar milestones in recent weeks, which health experts largely credit to Covid-19 vaccinations.

A Utah hospital said in mid-May they had no Covid-19 patients for the first time in more than 430 days, calling the news a “welcomed light.” Shortly after, a Minnesota hospital said it was shutting down its Covid-19 unit following a gradual decrease of patients. In Connecticut, one hospital recently saw its Covid-19 patients drop to one. 

More than 22,400 Americans are hospitalized with Covid-19 nationwide, according to data from the Department of Health & Human Services. That’s more than an 83% decrease from the country’s peak in early January, when more than 136,000 Americans were hospitalized with the virus. 

But with uneven vaccination rates across the US, some hospitals are still struggling amid recent upticks in Covid-19 patients — almost all of whom are unvaccinated — and worry about another surge fueled by summer gatherings.

It’s what concerns Magadia as well. 

“It’s really looking good. We’re seeing the light at the end of this long, long tunnel, but we’re not quite out of the woods yet,” he said.


 

Some hospitals still see surge of patients

Late last month, the University of Kansas Health System recorded several days with only one or two Covid-19 patients. That’s a far cry from early December, when staff were treating more than 200 Covid-19 patients, according to Dr. Steven Stites, the chief medical officer. 

“We had Covid-19 patients everywhere,” he said. “That was clearly the worst, darkest days of the pandemic for us.”

Now, those who are getting hospitalized because of the virus have not been vaccinated, Stites says.

“If you’re here sick with Covid, you’ve not been vaccinated,” he said. “We’ve had one person who had been vaccinated that I can think of off the top of my head.”

It’s a pattern other hospitals have noted, too. In Alabama, Magadia said close to 95% of patients hospitalized because of Covid-19 since vaccinations began have been unvaccinated. 

“It’s really a compelling point that vaccines work,” Magadia said. 

In central Oregon, Dr. Jeff Absalon, the chief physician executive for the St. Charles Health System, said they are still “in the middle of a surge of Covid patients.” Roughly 98% of hospitalized Covid-19 patients since March have been unvaccinated. 

“We have spent a few weeks near our highest point recently,” he said. “We’re still in the thick of the pandemic.”

Absalon is not sure why the numbers remain high.

Local leaders have continued to push vaccination efforts, but Absalon suspects the recent uptick may be due to increased community transmission among unvaccinated crowds as the weather warms up as well as due to the frequent tourists traveling to the area. 

He says they are also testing current Covid-19 patients for variants of the virus.

“Our vaccination rates in our county are quite good but, with all that being said, we’re clearly not at a herd immunity level,” he said.

Younger Americans hospitalized

Wyoming, which has one of the lowest Covid-19 vaccination rates in the US, recently saw hospitalization numbers climb again, state data shows. 

Dr. Jeffrey Chapman, chief medical officer at the Cheyenne Regional Medical Center in the southeastern part of the state, says he and staff members are worried over a recent rise in Covid-19 patients.

“When we see literally numbers doubling and tripling in a week, we get scared,” he said.

With lower age groups lagging in vaccination numbers, the hospital’s Covid-19 patient demographics have shifted younger. 

“Two-thirds of the people we have in the intensive care unit … are 50-60, whereas in the past, it was almost all 70s and 80s,” Chapman said. “And we’ve actually seen a small number of pediatric patients, which we haven’t seen for quite some time.”

“So I think one can postulate that, because younger age groups are vaccinated at a lower frequency … we’re seeing more people at a younger age that are requiring hospitalization,” Chapman said. “Can I say association? Yes. Can I say causation? I don’t have absolute data to back that up, but I don’t think it’s unreasonable to say that.”

Older Americans, who were prioritized for shots, have some of the highest Covid-19 vaccination coverage numbers. As a result, parts of the country have reported their Covid-19 patients have skewed younger, to crowds that aren’t vaccinated. 

But now that vaccines are widely available, US officials have stressed the importance of younger groups getting their shots, too — both for their own safety and to help their communities suppress the spread of the virus.

And a recent increase in Covid-19 hospitalizations among people 12 to 17 reinforced the importance of vaccinations as well as prevention measures against the virus, according to a study released Friday by the Centers for Disease Control and Prevention. 

“In the month leading up to the recommendations of the Pfizer Covid-19 vaccine for teens and adolescents 12 and older, CDC observed troubling data regarding the hospitalizations of adolescents with Covid-19,” CDC Director Dr. Rochelle Walensky said during a White House Covid-19 briefing. 

“More concerning were the number of adolescents admitted to the hospital who required treatment in the intensive care unit with mechanical ventilation,” Walensky said, adding the data “force us to redouble our motivation to get our adolescents and young adults vaccinated.” 

‘Post-Covid stress disorder’

As hospitals continue to treat Covid-19 patients, one of the biggest challenges they’re facing is exhausted, emotionally overwhelmed staffs. 

In Kansas, Stites said there is an underlying fatigue and mental and physical exhaustion. 

“There’s just been a lot of pain and suffering amongst healthcare personnel” who often were the last ones to see a Covid-19 patient alive and had to communicate the bad news to families, he said. “I think that there is a scar, there is a wound that is deep in your mental psyche about what this disease really means.”

It’s somewhat of a “post-Covid stress disorder,” he said.

“This is having a personal toll on the people that are committed to helping others,” Absalon, in Oregon, said. “One of the things that’s particularly difficult right now is that they’re taking care of people that have chosen not to be vaccinated. And it’s very heartbreaking to see that at this point in the pandemic a lot of what we’re seeing in the hospital is preventable.”

In Wyoming, Chapman looks at the hospital’s Covid-19 patients every morning and every night to ensure they’re prepared for another surge. 

“I don’t want to see people get sick, and I don’t want to see people die, so that’s part of my anxiety. What can I do to stop this?” he said. “I personally believe the vaccine is the answer to that.”