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22 Jun 2020, 1:10 pm



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22 Jun 2020, 7:22 pm

Behind Paywall
Patients grapple with breathing issues, exhaustion in aftermath of COVID-19

Quote:
Debbie Rifenbury survived a harrowing bout with COVID-19 in April that included 17 days in the hospital and six days on a ventilator.

But the Oceanside woman has yet to completely beat the disease, which left her with a series of health problems, including persistent cough and fatigue, as well as an unstable heart rate and blood pressure.

“I used to be a powerhouse,” Rifenbury, 61, said. “Now I’m weak as a kitten. They said it’s going to take time … I pray to God it comes sooner than later. It’s rough.”

Medical experts are still trying to understand the long-term impact of COVID-19 on patients who have recovered from the disease caused by the novel coronavirus. The spectrum of illness among patients is broad and complex. Some were able to stay home and battle the virus. Others needed hospital care. Many seem to have fully recovered, but doctors are seeing patients released from the hospital continue to grapple with breathing issues, crippling exhaustion and worse.

Doctors continue to gather information on the virus as they treat new patients and plan for a possible second wave of the pandemic.

“During the height of the crisis, I had a whole research team collecting data samples,” said Dr. Thomas McGinn, deputy physician-in-chief at Northwell Health and director at The Feinstein Institutes for Medical Research in Manhasset.

“It was kind of like cooking in your kitchen while it was on fire,” he said. “But we did it. I’m very proud of my team."

A lingering fatigue
McGinn said every case is unique, but about 80% of people with COVID-19 never went to the hospital and about half of that number had mild forms of the disease and are fine.

Even some people who were not admitted to the hospital had a “pretty significant battle” with the virus.

“A lot of those people end up having issues around lingering fatigue and weakness because they were home in bed for a long time,” McGinn said. “We are doing a lot of rehab with those people and getting them physically fit again.”

That’s how Jackie Sanchez, a model and makeup artist from Roosevelt, said she felt — even after testing negative for the virus weeks after she first felt ill. She said her doctor believes she had it in March.

“It took me a solid two months to break out of the tiredness,” Sanchez, 54, said. “I was in a deep exhaustion.”

Eve Dorfman, vice president of Home Healthcare at NYU Winthrop Hospital, said many of their patients are feeling “completely wiped out” and receiving physical therapy at home.

“It’s taking longer than it would take for a regular medical patient to get their strength back,” she said. “They are walking 10 feet six weeks later and they are still short of breath.”

Karla Duarte, a 16-year-old who beat COVID-19 in April, said she was thrilled to be able to ride her bike the other day. Despite a difficult hospital stay, she finished her work to complete 11th grade.

“I’m feeling much better … like I am coming back now 100%,” she said from her Queens Village home. “I’m at physical therapy two times a week. I’m able to walk a little faster.”

Vascular issues
One of the biggest complications doctors are seeing is the prevalence of vascular issues associated with COVID-19, said Dr. Anthony P. Ardito, vice president of the primary care service line at Catholic Health Services of Long Island. Those issues include blood clots in the lungs and kidney problems.

“A small number of patients are coming back after being discharged with strokes, pulmonary embolism, blood clots in their legs, persistent renal complications,” he said. “COVID clearly causes an inflammatory response in the body, which is what eventually causes most of the lung damage and kidney issues.”

Ardito said that is why many patients were placed on blood thinners for several weeks after they were discharged from the hospital.

“The vascular complications are much higher in those patients who were in the intensive care unit for a prolonged period of time,” Ardito said. “But the risk is pretty much for anyone who has had COVID.”

Anxiety and depression
Isolation during the pandemic has been especially difficult for some COVID-19 patients, experts said. Coupling that with the stress and anxiety of being sick has left many patients depressed.

“I think the world is feeling pretty strange right now with the isolation and lack of human contact,” Dorfman said. “We do our best to make them feel like they are not alone.”

Ardito said calls to mental health hotlines from people seeking help have soared.

Rifenbury said she has started speaking with a counselor and encouraged other recovering patients to seek help.

That fact that the number of COVID-19 cases in New York has declined in recent weeks should not give people a false sense of security, she said.

“It’s great that everything is opening again, but don’t think everything is hunky-dory, because it’s not,” she said. "Thank God I am here today."


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23 Jun 2020, 5:52 pm

States might not need to do an ‘absolute shutdown’ if they run into coronavirus trouble, Dr. Fauci says

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States with growing coronavirus outbreaks might not need to shut down again like many did in March, but they might need to consider pausing or rolling back stages of reopening, White House coronavirus advisor Dr. Anthony Fauci said Tuesday.

Fauci specifically cited Texas, Arizona, Florida and other states with “a serious problem” as places that might need to consider such measures.

“I wouldn’t necessarily say an absolute shutdown, lockdown, but if someone is going from gateway to phase one to phase two and they get into trouble in phase two, they may need to go back to phase one,” Fauci, director of the National Institute of Allergy and Infectious Diseases, told members of Congress during a hearing before the House Energy and Commerce Committee. “I don’t think they necessarily need to go back to lockdown.”

“Gateway” refers to requirements the Centers for Disease Control and Prevention laid out in its reopening guidelines that the agency says should be satisfied before a state considers moving into the next phase of reopening. The gateway requirements include indicators like 14 days of decreasing daily new cases and decreases in emergency department visits.

Cases have been rising in recent weeks in more than two dozen states, mostly across the American South and West. On Tuesday, California, Arizona and Texas all reported more new cases in a single day than ever before. In some parts of the country, including the Houston area in Harris County, Texas, hospitals are nearing ICU capacity and could be forced to move to surge operations “in a few weeks,” according to Harris County Judge Lina Hidalgo’s office.

Some parts of the country continue to successfully drive down transmission while gradually easing restrictions, Fauci said, citing New York City and Washington D.C.

“There are other areas, other states, other cities that have not done so well. I have a considerable concern about those because I want to make sure that we get everything under control,” he said. “It now really is a mixed bag. We have some doing really well and some really in trouble.”

Some of the states seeing surges in new cases were among the first and most aggressive to reopen. Florida, for example, allowed most restaurants and stores to open with limited capacity on May 4. The heavily populated Miami-Dade and Broward counties did not reopen until May 18. On June 5, most of the state moved deeper into reopening, allowing more stores to reopen as well as for gyms and some stores to operate at full capacity.

“We’re not shutting down. We’re going to go forward ... We’re not rolling back,” Republican Gov. Ron DeSantis said at a news briefing one week ago. “You have to have society function.”

In some other states, the recent surge in new cases around the country has prompted officials to delay reopening plans. In Maine, Democratic Gov. Janet Mills announced Monday that bars would not be allowed to reopen for indoor service on July 1, as previously scheduled. In her announcement, she cited “the outbreaks we have seen across the country associated with indoor service” as cause for the delay.

In Oregon, Democratic Gov. Kate Brown earlier this month announced the state would pause applications from counties to move further into reopening for seven days due to a spike in new infections.

“This one-week pause will give public health experts time to assess what factors are driving the spread of the virus,” Brown said in a statement on Twitter on June 11. “I will use the data we see in the next week to determine whether to lift this pause or extend it.”

States that delay reopenings or even reimplement some restrictions should take the time to build up capacity to conduct testing, contact tracing and isolating of infected and exposed people, Fauci said. All three systems help to detect chains of spread and cut them off before they have the chance to balloon into full-on outbreaks.

“I hope as the weeks and months go by, we will be able to do what you’re referring to and mobilize the identification, isolation and contact tracing in those states,” he told members of Congress Tuesday. “The ones that have recently been in the news. Florida, Arizona, Texas and those states that are now having a serious problem.”

Earlier Tuesday, Fauci said parts of the U.S. are beginning to see a “disturbing surge” in coronavirus infections. As of Monday, the seven-day average of new infections across the U.S. increased more than 30% compared with a week ago, according to a CNBC analysis of Johns Hopkins University data.

Unlike many other countries in Europe and Asia, which were able to drive down the rate of spread from their peaks to a containable level of dozens or hundreds of new cases per day, the U.S. struggled to bring daily new infections closer to zero. U.S. cases had risen to about an average of 30,000 infections per day at the peak of the outbreak before plateauing to around 20,000 infections per day, Fauci said.

“Now we’re going up [again]. A couple of days ago, there were 30,000 new infections,” he said. “That’s very troublesome to me.”


California Breaks Highest Single-Day Coronavirus Record With 6,000 New Cases
Quote:
alifornia broke its highest single-day coronavirus record Tuesday with a reported 6,000 new cases.

According to data compiled by the San Francisco Chronicle, there were more than 6,000 new confirmed cases reported by county health departments across the state by Monday night, with multiple counties yet to report.

The reported case count is a new high for the state that previously reported a high of 4,515 new daily cases on June 20.

However, the California Department of Public Health told Newsweek in an email that the state reported 5,019 cases for Monday, not 6,000, though it is still a new single-day record. Sonia Angell, the director of the CDPH, said "continued increases in COVID-19 cases are expected and likewise, hospitalizations are starting to increase."

"The safest place for all of us is at home, and when we go out for essential needs or services, we must wear face coverings and keep physical distance from others because that's what helps us protect one another. Our ability to move forward as a state depends upon it," Angell said.

The state reported 4,230 new cases on Monday, bringing the overall totals at the time to 178,054 confirmed cases of the novel coronavirus since the start of the pandemic and 5,515 deaths attributed to the virus, according to California's COVID-19 tracker.

The state data indicates there are 4,804 patients currently hospitalized that are either suspected to have COVID-19 or have already tested positive. The number includes 1,412 patients in intensive care units. There are 72,337 hospital beds in the state across 377 hospitals, according to the data, with 38 percent of ICU beds still available.


5,489 New COVID-19 Cases: Texas Reports All-Time Daily High
Quote:
Today, Texas will report an all-time high in the number of cases of people testing positive" for the coronavirus, Gov. Greg Abbott said Tuesday, adding that for the first time, his state would surpass 5,000 new cases in a single day.

Hours later, the Texas Department of State Health Services reported 5,489 new cases.

Abbott initially revealed the daunting new record during an interview with TV station KBTX in which he urged people to take the deadly disease seriously, telling them to wear a mask in public, stay home when possible and take other precautions.

"The hospitalization rate is at an all-time high," he said. "The coronavirus is serious. It's spreading in Brazos County, across the entire state of Texas."

Texas is seeing a sharp rise in cases; it was just days ago that the state crossed the 4,000-case mark for the first time in its daily tally.

New cases have hit the Houston area so hard that the Texas Children's Hospital is now admitting adult patients. The move comes despite the fact that Houston is home to the massive Texas Medical Center — deemed the largest medical center in the world.

"Texas Children's is committed to providing additional capacity through ICU and acute care beds across our hospital campuses to take on both pediatric and adult patients," the hospital said in a statement to NPR.

The adult patients include people have COVID-19 and other cases. Those diagnosed with the coronavirus are being cared for in an expanded special isolation unit, according to Texas Children's Hospital.

Texas has steadily boosted its capacity to test for the coronavirus that causes COVID-19, but experts said that's not enough to explain the flood of new cases.

"Probably the greater factor that's pushing our numbers up is that the positivity rate is now gone from around 3% to around 9% — that's a threefold increase," said Dr. David Persse, public health authority for the Houston Health Department, according to Houston Public Media.

Texas is facing "a steep terrifying rise" in COVID-19 hospitalizations and intensive care unit admissions at the Texas Medical Center, said Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, in a tweet about the current situation.

"We now face a public health crisis," Hotez added.

The dramatic new numbers do not represent a second wave in Texas, which was among the first states to start the reopening process. The state health department's graph of daily new cases shows a steady rise since the COVID-19 pandemic began to take hold in March. The curve began to arc even higher earlier this month, continuing with Tuesday's spike.

Abbott has urged people to observe social and physical restrictions to curb the coronavirus. He recently called the idea of shutting down the Texas economy again "the last option" to fight COVID-19. But on Tuesday, he also said agencies will clamp down on bars that have allowed overcrowding since restrictions began to lift.

And the governor hinted at the possibility of new limits, referring to "additional announcements that may be coming later today" or sometime this week.

"COVID-19 is now spreading at an unacceptable rate in the state of Texas, and it must be corralled," Abbott said Monday.

Calling on people to follow safety rules about washing their hands, social distancing and wearing face coverings, he added, "Texans have shown that we don't have to choose between jobs and health — we can have both. We can protect lives while also restoring livelihoods."

Texas now has 120,370 cases, trailing New York, California, New Jersey and Illinois.


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24 Jun 2020, 8:16 am

VIRAL LOAD

I finished reading a long winded article that compared virus transmission to air pollution transmission in order to look at transmission mechanisms. Here is a link: Coronavirus, As An Air Pollutant But the article does touch upon a subject that I am interested in which is "viral load".

If you come in contact with one virus (a parasite), it will likely not cause a problem because your immune system will be energized and destroy it. But if you come in contacted with million of viral parasites at once, your immune system will become overloaded and it may cause your body to succumb to the disease. IMHO the degree that the human body is affected by a viral load depends on the concentration of viruses one is exposed to. So if one receives a minimal dose, it might produce no visible symptoms resulting in an asymptomatic carrier. Those who receive a small dose might result in illness whereas a large dose results in death. It also depends on the host. For example the elderly and those with preexisting health conditions are more susceptible to dying.

So it is a function of the "viral load" one is exposed to combined with the vulnerability level of the host.

According to Wikipedia: Viral load, also known as viral burden, viral titre or viral titer, is a numerical expression of the quantity of virus in a given volume of fluid; sputum and blood plasma being two bodily fluids. Some viruses such as the Norovirus has not only prolonged viral shedding and has the ability to survive in the environment but a minuscule inoculum is required to produce infection in humans: less than 100 viral particles

Direct transmission of COVID-19 by contact with surfaces, packages or counters, seems to play a smaller role, despite earlier concerns. Airborne respiratory transmission now appears to be the predominant means of transmission.

So from my perspective, I see this in terms of radiation physics. The effects of radiation exposure is a function of the dosage of radiation one receives over a short period of time. One can use a radiation exposure dosimeter to measure this exposure rate. The effects of a radiation exposure can be graphed:

Image

The greater the dose, the deadlier the effects.

Now as we transition from winter to summer, the dosage rate is dropping. This is because sunlight kills the virus and because indoor ventilation disperses the viruses which reduces concentration levels. Recent trend data shows the mortality rate of COVID-19 is dropping. But this is not due to the virus genetically changing but instead due to the environmental seasonal factors. As the viral load falls, the symptoms decrease. It is analogous to radiation. As the radiation exposure levels fall, the symptoms decrease. Therefore a few months ago, an exposure resulted in death for an elderly person but today the same patient would just get severely sick and survive.


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24 Jun 2020, 3:32 pm

In Houston the ICUs are now 90% full and it is to the point that Texas Children's Hospital is reporting that the have start accepting adult patients


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24 Jun 2020, 5:47 pm

NY, NJ and CT require travelers from states with high coronavirus rates to quarantine for two weeks

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New York, New Jersey and Connecticut issued a travel advisory Wednesday that requires people arriving from states with high coronavirus rates to quarantine for 14 days.

New York Gov. Andrew Cuomo, New Jersey Gov. Phil Murphy and Connecticut Gov. Ned Lamont said the travel advisory applies to anyone coming from a state with a positive test rate higher than 10 per 100,000 residents over a 7-day rolling average or a state with a 10% or higher positivity rate over a 7-day rolling average.

"We have to make sure the virus doesn't come in on a plane," Cuomo said.

"We worked very hard to get the viral transmission rate down, and we don't want to see it go up," he added.
As of Wednesday, the advisory applies to Alabama, Arkansas, Arizona, Florida, North Carolina, South Carolina, Washington, Utah and Texas. It begins tonight at midnight.

n late March, President Donald Trump considered placing the three states under a quarantine, Rhode Island police stopped vehicles with New York license plates, and Florida directed all travelers from the tri-state area to isolate or quarantine for two weeks.

Months of strict lockdown rules, widespread testing and imperfect attempts at contact tracing have brought cases under control in the tri-state area and the region. New cases are on the decline this past week compared to the week before in New York, New Jersey and Connecticut.

How the restrictions will work
Each of New York, New Jersey and Connecticut will be responsible for its own enforcement of the quarantine. The states' health commissioners will pursue an aggressive public relations campaign at airports, highways and other locations.
In New York, Cuomo said, those violating the quarantine could be subject to a judicial order and mandatory quarantine, and fines are $2,000 for the first violation, $5,000 for the second violation, and $10,000 if you cause harm.

Gov. Murphy of New Jersey said the advisory applies to everyone, including New Jerseyans returning home.
"This is not a polite recommendation, this is a strong advisory built on the back of the healthcare professionals," he said. "We are asking folks to take on a big amount of personal responsibility here, to do the right thing for themselves as well as for their families, communities and the rest of us."

When asked about the possibility of fines, he said the health commissioner "has within her powers to directly address an individual who is non-compliant."

Gov. Lamont of Connecticut said the governors "reluctantly" decided to institute the travel advisory.
"The northeast region has taken this seriously," he said. "But we're not an island. And as we look around the rest of the country, you know, we have seen not just spikes, but we've seen real community spread."
He described the advisory as voluntary but considered it "urgent guidance."

Lack of national infrastructure
The interstate travel restrictions are just another consequence of the federal government's inability to create a robust national public health infrastructure. The lack of nationwide rules and effective supply chains has largely left each state on its own and had the effect of pitting them against each other.

Even now, 19 states have no requirements for residents to wear facemasks -- the simplest and cheapest layer of defense against a virus with no vaccine and no widely effective treatment.

Indeed, Gov. Cuomo has openly mocked other states that he said were acting politically rather than scientifically.

"New York went from one of the highest infection rates in the country to one of the lowest because we made decisions based on science -- not politics," he said Tuesday. "We're seeing in other states what happens when you just reopen with no regard for metrics or data. It's bad for public health and for the economy, and states that reopened in a rush are now seeing a boomerang."

As part of its phased reopening, New York required regions to meet certain metrics around testing, contact tracing, and hospital admissions and available beds. New York City, the final region to reopen, moved to the second phase of its reopening on Monday after seeing continued improvement in each metric.

Still, Dr. Richard Besser, former acting director of the US Centers for Disease Control and Prevention, said no state has yet effectively reopened its economy safely.

"We have to figure out how to make that transition in a successful way, or every state that reopens, even those that have done a really good job at tamping this down, are going to see pretty dramatic rises and we're going to end up back to where we were," Besser said.


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25 Jun 2020, 5:37 am

Live updates: State officials, companies delay reopening measures after record high in new infections

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As new coronavirus cases in the United States reached their highest single-day level yet on Wednesday, companies and state officials appeared to be taking matters into their own hands.

While Vice President Pence urged senators to focus on “encouraging signs,” several governors and CEOs were instead responding to mounting indications of a deadly surge in cases across the South and West. Nevada and North Carolina ordered residents to wear masks in public, and Virginia moved to implement new workplace safety rules that would force companies to protect workers from infection. Disneyland delayed plans to reopen, and the governors of New York, New Jersey and Connecticut announced a mandatory 14-day quarantine for visitors from certain hard-hit states.

The 38,173 new infections reported by state health departments Wednesday underscored the changing geography of the U.S. outbreak. The bulk of the cases were posted in Texas, Florida and California, while Oklahoma also set a new statewide record in infections.

Since the start of the pandemic, the United States has recorded more than 2.3 million coronavirus cases and at least 119,000 deaths, while the global number of cases has soared past 9 million.

Here are some significant developments:
Worried about a simultaneous assault of the novel coronavirus and seasonal influenza this winter, public health officials and vaccine manufacturers are making millions of extra flu vaccine doses to protect the most vulnerable.

Apple has again shut down its retail stores in the Houston area, where intensive care units are nearly filled.

The World Health Organization said the global pandemic’s hotbed is now in Latin America, which has reported 100,000 fatalities as of this week. New flare-ups have also been reported in Australia, Germany and South Korea.

The Dow Jones industrial average fell 709 points, as investors grappled with spreading outbreaks that some said will further delay an economic recovery. Globally, too, the recovery from economic collapse will be sluggish, the International Monetary Fund said Wednesday.

Amid reports that the federal government is poised to stop providing federal aid to testing sites in hard-hit states like Texas, one top federal official responded by saying testing is in fact on the rise.


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25 Jun 2020, 9:09 am

SUNLIGHT AND THE GREAT OUTDOORS

Midday sunlight is capable of inactivating 90 percent or more of the SARS-CoV-2 virus after 34 minutes of exposure, a recent study found.

Study authors calculated the expected inactivation by UVC and solar UV radiation in cities around the world at different times of the year. They concluded SARS-CoV-2 should be inactivated “relatively fast” during summer in many populous cities worldwide, pointing to the role of sunlight in the occurrence, spread rate, and duration of coronavirus pandemics.

Jose-Luis Sagripanti and C. David Lytle wrote the study, which was published in the journal Photochemistry and Photobiology earlier this month. The scientists are retired from the US Army and Food and Drug Administration, respectively, the New York Post noted.

Further, they found only Miami and Houston get enough solar radiation to inactivate 99 percent of the virus in the spring. During winter, most cities will not receive enough solar radiation to produce 90 percent viral inactivation during midday exposure, they wrote.

From December until March, "the virus will persist infectious for a day or more in winter, with risk of re-aerosolization and transmission in most of these cities," the study found.

The two authors conducted their calculations using a model for estimating solar inactivation of viruses of biodefense concerns, they said, adding that the methodolgy was validated with Ebola and Lassa viruses.

If sunlight plays a possible destructive role of the virus, authors theorized stay-at-home orders forcing people to remain indoors might have increased contagion among members of the same households.

"In contrast, healthy people outdoors receiving sunlight could have been exposed to lower viral dose with more chances for mounting an efficient immune response," they wrote.

Source: Summer rays can inactivate coronavirus in 34 minutes, study says

The coronavirus infections are primarily occurring indoors, not outdoors. Sunlight quickly kills off the virus outdoors and the fresh breezes disperse the viral particles reducing viral load. That is why these viruses primarily occur during the winter when we spend the least amount of time outdoors.

How do you translate that into actions?

I have eaten out a half dozen times since the coronavirus lockdown has ended. But I always choose a restaurant that provides outdoor seating. Some restaurants in my area are setting up special outdoor seating in their parking lots or streets are being sealed off to permit outdoor seating. It is like the cafe model that predominates European culture. Some grade schools are considering holding some of their classes outdoors. In the times of the coronavirus the great outdoors is your greatest friend.


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25 Jun 2020, 9:28 am

^ I agree. I feel safer in the great outdoors and while running. I only push my (mandatory in public) mask up over my face when shopping in the malls and shopping centres. They keep having to close down supermarkets (and schools) here as soon as someone on the staff, or a school learner is tested positive. Then they have to deep clean the whole place.

Personally I think they're taking too long to find an anti CV19 vaccine - it should be easier with today's technology - it took many years for the efficacious prevention of polio, leprosy and smallpox but there should be more state of the art resources in 2020 surely?


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25 Jun 2020, 10:52 am

Foods high in copper could help.
https://www.sciencedirect.com/science/a ... 7720308136


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25 Jun 2020, 11:52 am

envirozentinel wrote:

Personally I think they're taking too long to find an anti CV19 vaccine - it should be easier with today's technology - it took many years for the efficacious prevention of polio, leprosy and smallpox but there should be more state of the art resources in 2020 surely?


Exactly what I've been saying since February.


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25 Jun 2020, 12:11 pm

it's also quite possible that a vaccine is never found.



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25 Jun 2020, 4:31 pm

CDC expands list of at risk groups

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Based on a detailed review of available evidence to date, CDC has updated and expanded the list of who is at increased risk for getting severely ill from COVID-19.

Older adults and people with underlying medical conditions remain at increased risk for severe illness, but now CDC has further defined age- and condition-related risks.

As more information becomes available, it is clear that a substantial number of Americans are at increased risk of severe illness – highlighting the importance of continuing to follow preventive measures.

“Understanding who is most at risk for severe illness helps people make the best decisions for themselves, their families, and their communities,” said CDC Director Robert Redfield MD. “While we are all at risk for COVID-19, we need to be aware of who is susceptible to severe complications so that we take appropriate measures to protect their health and well-being.”

COVID-19 risk related to age
CDC has removed the specific age threshold from the older adult classification. CDC now warns that among adults, risk increases steadily as you age, and it’s not just those over the age of 65 who are at increased risk for severe illness.

Recent data, including an MMWR published last week, has shown that the older people are, the higher their risk of severe illness from COVID-19. Age is an independent risk factor for severe illness, but risk in older adults is also in part related to the increased likelihood that older adults also have underlying medical conditions.

COVID-19 risk related to underlying medical conditions
CDC also updated the list of underlying medical conditions that increase risk of severe illness after reviewing published reports, pre-print studies, and various other data sources. CDC experts then determined if there was clear, mixed, or limited evidence that the condition increased a person’s risk for severe illness, regardless of age.

There was consistent evidence (from multiple small studies or a strong association from a large study) that specific conditions increase a person’s risk of severe COVID-19 illness:

Chronic kidney disease
COPD (chronic obstructive pulmonary disease)
Obesity (BMI of 30 or higher)
Immunocompromised state (weakened immune system) from solid organ transplant
Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
Sickle cell disease
Type 2 diabetes
These changes increase the number of people who fall into higher risk groups. An estimated 60 percent of American adults have at least one chronic medical condition. Obesity is one of the most common underlying conditions that increases one’s risk for severe illness – with about 40 percent of U.S. adults having obesity. The more underlying medical conditions people have, the higher their risk.

CDC also clarified the list of other conditions that might increase a person’s risk of severe illness, including additions such as asthma, high blood pressure, neurologic conditions such as dementia, cerebrovascular disease such as stroke, and pregnancy. An MMWR published today further adds to the growing body of research on risk by comparing data on pregnant and nonpregnant women with laboratory-confirmed SARS-CoV-2 infection. Pregnant women were significantly more likely to be hospitalized, admitted to the intensive care unit, and receive mechanical ventilation than nonpregnant women; however, pregnant women were not at greater risk for death from COVID-19.

Protecting yourself, your family, and your community
Every activity that involves contact with others has some degree of risk right now. Knowing if you are at increased risk for severe illness and understanding the risks associated with different activities of daily living can help you make informed decisions about which activities to resume and what level of risk you will accept. This information is especially critical as communities begin to reopen.

Everyone should continue to do their part to implement prevention strategies, such as focusing on activities where social distancing can be maintained, washing your hands frequently, limiting contact with and disinfecting commonly touched surfaces or shared items, and wearing a cloth face covering when you are around people you do not live with, especially when it is difficult to stay 6 feet apart or when people are indoors. By taking these steps, you can help protect yourself, your loved ones, and others around you, including those most vulnerable to severe illness.

CDC will continue to update and share information about risk for severe illness as more information becomes available. For more information on how to prevent getting sick with COVID-19, visit CDC’s website at https://www.cdc.gov/coronavirus/2019-nc ... index.html.




Texas Gov. Abbott pauses reopening amid coronavirus surge
Quote:
Texas Gov. Gregg Abbott on Thursday reversed course and put a stop to the reopening of the state’s economy amid record numbers of new coronavirus cases and hospitalizations.

“The last thing we want to do as a state is go backwards and close down businesses,” Abbott said in a prepared statement.

“This temporary pause will help our state corral the spread until we can safely enter the next phase of opening our state for business.”

Abbott also issued an executive order directing that hospitals in four hard-hit counties suspend elective surgeries, calling it a “precautionary step” to guarantee an “ample supply of available beds to treat COVID-19 patients.”

The Lone Star State’s biggest cities — Houston, San Antonio, Dallas and Austin — are all located in the counties covered by the order.

In May, Texas became one of the first states to aggressively reopen following coronavirus lockdowns, with retail stores, restaurants, gyms and other businesses allowed to resume operations at reduced capacities.

That decision remains in effect and it wasn’t immediately clear how Abbott’s order will affect other businesses, CNBC said.

On Wednesday, Texas reported more than 5,500 new coronavirus cases, one day after Abbot recommended that residents stay indoors to stop the spread of the deadly disease, CNBC said.

Hospitalizations in Texas reached 4,739 on Thursday morning, triple the number recorded on Memorial Day, little more than a month ago, according to the Texas Tribune.


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25 Jun 2020, 4:48 pm

Steve1963 wrote:
it's also quite possible that a vaccine is never found.


And then what? Suffer these social restrictions for the rest of our lives? We all might as well be dead if that's what life's going to be like forever more.


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blackicmenace
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25 Jun 2020, 4:53 pm

envirozentinel wrote:
^ I agree. I feel safer in the great outdoors and while running. I only push my (mandatory in public) mask up over my face when shopping in the malls and shopping centres. They keep having to close down supermarkets (and schools) here as soon as someone on the staff, or a school learner is tested positive. Then they have to deep clean the whole place.

Personally I think they're taking too long to find an anti CV19 vaccine - it should be easier with today's technology - it took many years for the efficacious prevention of polio, leprosy and smallpox but there should be more state of the art resources in 2020 surely?


Well, it's a process that takes time. We should all be thankful there were multiple vaccines that had a head start due to work already done on sars and mers. There is something like 4 that are very promising and around 20 that are ahead of schedule and 200 or so in the works, but none of that guarantees any of them will be successful. Now another issue is manufacturing if they manage to create a viable vaccine because we will need around 60% of the population to be vaccinated in order for herd immunity to be effective.


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26 Jun 2020, 2:42 am

I would quite happily volunteer for such tests if I knew it was helping in the fight. Why is there no guarantee that any of them will turn out successful? Even a 90%+ success rate rather than an 100% guarantee of immunity would be better than no vaccine or preventative drug at all.

Then there are others who are saying that the virus id losing its potency. But now's not the time to be complacent yet.

@Joe90: Let's hope we will see results before the end of this year - it sure is frustrating to be held hostage by an unseen enemy.


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