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ASPartOfMe
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09 May 2022, 4:52 pm

British Commission says Long Covid is not a disability

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People suffering from long Covid have reacted with alarm to comments by government’s equalities watchdog that the condition should not be treated as a disability.

Under the Equalities Act, anyone with a physical or mental impairment that has lasted for longer than 12 months and substantially impacted their ability to carry out normal day-to-day activities qualifies as disabled and is entitled to protection to ensure that they aren’t discriminated against in the workplace. This includes requesting that their employer makes “reasonable adjustments”, such as flexible working hours or home working, to ensure that they can continue working.

In a tweet posted on Sunday night, the Equalities and Human Rights Commission (EHRC), which was set up to promote and enforce equality and non-discrimination laws said: “Discussions continue on whether ‘long Covid’ symptoms constitute a disability. Without case law or scientific consensus, EHRC does not recommend that ‘long Covid’ be treated as a disability.”

The statement prompted immediate concern and confusion from long Covid support groups and unions.

Dr Jenny Ceolta-Smith, an employment advocate for Long Covid Support and co-founder of Occupational Therapy for Long Covid, said: “There is already disbelief of workers’ long Covid symptoms within the workplace, and this harmful announcement by the EHRC may make it much harder for workers to gain the support that they need from colleagues and line managers. It may even mean more jobs are lost.”

According to the latest data from the Office for National Statistics (ONS), an estimated 1.7 million people in the UK (2.7% of the population) were experiencing long Covid symptoms lasting longer than four weeks as of 5 March 2022. Of these, 784,000 said they’d been affected for longer than a year, and 74,000 had been experiencing symptoms for at least two years. Of those affected, 322,000 reported that their ability to undertake their day-to-day activities had been “limited a lot”.

Within this group, there will almost certainly be people who would qualify as disabled. However, “It’s not like a lottery ticket; just because you say something could be considered as a disability, it doesn’t automatically get people blue badges and benefits,” said Lesley Macniven, an HR consultant and founder of Long Covid Work, which supports long Covid sufferers with workplace issues.

“All it does is put a little bit more pressure on employers to make sure they try and help that person. People that we support want to get back to work, they want to stay in work, and be able to pay the bills and keep a roof over their head.”

Catherine Hale, founder and director of Chronic Illness Inclusion, which advocates for people with chronic illness and energy-limiting conditions, said being able to access reasonable adjustments was critical to people staying in work. “They should be able to confidently go to their employer and have those conversations,” she said.

A spokesperson for the EHRC said: “We would recommend that employers continue to follow existing guidance when considering reasonable adjustments for disabled people and access to flexible working, based on the circumstances of individual cases.

“Given that long Covid is not among the conditions listed in the Equality Act as ones which are automatically a disability, such as cancer, HIV and multiple sclerosis, we cannot say that all cases will fall under the definition of disability.

“This does not affect whether ‘long Covid’ might amount to a disability for any particular individual. This will be determined by the employment tribunal or court considering any claim of disability discrimination.”


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11 May 2022, 6:55 pm

Half of Covid-hospitalised still symptomatic two years on, study finds

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More than half of people hospitalised with Covid-19 still have at least one symptom two years after they were first infected, according to the longest follow-up study of its kind.

While physical and mental health generally improve over time, the analysis suggests that coronavirus patients discharged from hospital still tend to experience poorer health and quality of life than the general population. The research was published in the Lancet Respiratory Medicine.

“Our findings indicate that for a certain proportion of hospitalised Covid-19 survivors, while they may have cleared the initial infection, more than two years is needed to recover fully,” said the lead author, Prof Bin Cao, of the in China.

For the new study, researchers sought to analyse the long-term health outcomes of hospitalised Covid-19 survivors, as well as specific health impacts of long Covid. They evaluated the health of 1,192 participants with acute Covid-19 treated at Jin Yin-tan Hospital in Wuhan, China, between 7 January and 29 May 2020, at six months, 12 months and two years. The average age was 57 at discharge.

Assessments involved a six-minute walking test, laboratory tests, and questionnaires on symptoms, mental health, health-related quality of life, whether they had returned to work and healthcare use after discharge. Health outcomes at two years were determined using an age, sex and comorbidities-matched control group of people in the general population with no history of Covid-19 infection.

Six months after initially falling ill, 68% of the patients reported at least one long Covid symptom. Two years after infection, more than half – 55% – still reported symptoms. Fatigue or muscle weakness were those most often reported. Regardless of the severity of their initial illness, two years later, one in 10 patients – 11% – had not returned to work.

Two years after initially falling ill, the patients were in poorer health than the general population, with 31% reporting fatigue or muscle weakness and 31% reporting sleep difficulties. The proportion of non-Covid-19 participants reporting these symptoms was 5% and 14% respectively. The Covid-19 patients were also more likely to report a number of other symptoms including joint pain, palpitations, dizziness and headaches. In quality of life questionnaires, Covid-19 survivors also more often reported pain or discomfort and anxiety or depression than non-Covid-19 participants.

The authors acknowledged limitations to their study. Being a single-centre study from early in the pandemic, the findings may not directly extend to the long-term health outcomes of patients infected with subsequent variants, the Lancet Respiratory Medicine said


It may seem like everyone’s getting COVID. What a local doctor says you should know.
Quote:
With COVID-19 cases rising both nationwide and in Massachusetts, you may know more and more people who are testing positive.

Responding to the increasing case trends, Dr. Megan Ranney, an emergency room physician and academic dean at the Brown University School of Public Health, is sharing some advice for the public to navigate the current moment of the pandemic.

As has always been true with coronavirus, no protective measure is 100% effective, and everything comes with a caveat, but Ranney emphasized Tuesday on Twitter how important testing and being vaccinated still are if you want to avoid contracting COVID-19 and becoming seriously ill.

Ranney pointed to research from the Centers for Disease Control and Prevention that found when no one in a household is vaccinated or isolating, about two-thirds of people living with someone who has omicron get infected.

Being vaccinated and boosted reduces that risk by about 30 to 50%, Ranney said, which leaves you with about a 30% risk of infection if someone in your household has COVID.

That might be even lower, however, Ranney said, if the infected person masks and isolates.

“It’s a funny thing: we’re literally all at risk… but also, #VaccinesWork,” Ranney tweeted.

Ranney said new omicron variants, which are spreading quickly, may change the game since different strains of the virus have different levels of transmissibility.

f you do test positive, isolating is key, Ranney said.

Ideally, the emergency room doctor said you should isolate until you have a negative rapid test or for at least 5 days. Any close contacts need to quarantine if they are not vaccinated, and if they are vaccinated they should test five or more days after exposure just to be sure.

Ranney said masking is recommended and “the right thing to do” for everyone for 5-10 days.

The doctor said the risks associated with testing positive are less than earlier in the pandemic. She said many people — those who are vaccinated, boosted and healthy — would likely feel crappy for days or weeks due to the virus, but the risk of long COVID is lower and they “will almost certainly be ok.”

While BA.2 cases have been rising “dramatically” for more than a month (and, as Ranney points out, are still being undercounted because of at-home tests), one note of good news is that hospitalizations and deaths are only rising slightly.

Ranney said one “caveat” for the risk of catching COVID is that for people who aren’t vaccinated and boosted; are immunosuppressed; or have several chronic diseases, the virus can still be dangerous.

If you are immunosuppressed, Ranney recommended asking your doctor about Evusheld, a prevention therapy that can help protect people from future COVID-19 infections.

Bolding=mine


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11 May 2022, 11:19 pm

Pandemic gets tougher to track as COVID testing plunges

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Experts say testing has dropped by 70 to 90% worldwide from the first to the second quarter of this year — the opposite of what they say should be happening with new omicron variants on the rise in places such as the United States and South Africa.

Reported daily cases in the U.S., for example, are averaging 73,633, up more than 40% over the past two weeks, according to data compiled by Johns Hopkins University. But that is a vast undercount because of the testing downturn and the fact tests are being taken at home and not reported to health departments. An influential modeling group at the University of Washington in Seattle estimates that only 13% of cases are being reported to health authorities in the U.S. — which would mean more than a half million new infections every day.

The drop in testing is global but the overall rates are especially inadequate in the developing world, Udayakumar said. The number of tests per 1,000 people in high income countries is around 96 times higher than it is in low income countries, according to the Geneva-based public health nonprofit FIND.

What’s driving the drop? Experts point to COVID fatigue, a lull in cases after the first omicron wave and a sense among some residents of low-income countries that there’s no reason to test because they lack access to antiviral medications.

At a recent press briefing by the World Health Organization, FIND CEO Dr. Bill Rodriguez called testing “the first casualty of a global decision to let down our guard” and said “we’re becoming blind to what is happening with the virus.”

Testing, genomic sequencing and delving into case spikes can lead to the discovery of new variants. New York state health officials found the super contagious BA.2.12.1 variant after investigating higher-than-average case rates in the central part of the state.

Going forward, “we’re just not going to see the new variants emerge the way we saw previous variants emerge,” Rodriquez told The Associated Press.

Testing increases as infections rise and people develop symptoms — and it falls along with lulls in new cases. Testing is rising again in the U.S. along with the recent surge.

But experts are concerned about the size of the drop after the first omicron surge, the low overall levels of testing globally, and the inability to track cases reliably. While home tests are convenient, only tests sent to labs can be used to detect variants. If fewer tests are being done, and fewer of those tests are processed in labs, fewer positive samples are available for sequencing.

Also, home test results are largely invisible to tracking systems.

Mara Aspinall, managing director of an Arizona-based consulting company that tracks COVID-19 testing trends, said there’s at least four times more home testing than PCR testing, and “we are getting essentially zero data from the testing that’s happening at home.”

That’s because there’s no uniform mechanism for people to report results to understaffed local health departments. The CDC strongly encourages people to tell their doctors, who in most places must report COVID-19 diagnoses to public health authorities.

Generally, though, results from home tests fall under the radar.

Aspinall said one potential solution would be to use technology like scanning a QR code to report home test results confidentiality.

Another way to keep better track of the pandemic, experts said, is to bolster other types of surveillance, such as wastewater monitoring and collecting hospitalization data. But those have their own drawbacks. Wastewater surveillance remains a patchwork that doesn’t cover all areas, and hospitalization trends lag behind cases.

At the same time, he said, steps must be taken to boost testing in lower-income countries.

Georges Benjamin, executive director of the American Public Health Association, said there will come a point when the world stops widespread testing for COVID-19 – but that day isn’t here yet.

With the pandemic lingering and virus still unpredictable, “it’s not acceptable for us to only be concerned about individual health,” he said. “We have to worry about the population.”


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12 May 2022, 8:08 am

ASPartOfMe wrote:

Yikes >_<


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ASPartOfMe
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13 May 2022, 7:29 pm

Experts perplexed over number of people getting long COVID

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Initially, public health officials believed that only a small minority of people would suffer from long COVID-19. But some studies now indicate a majority of those infected with the coronavirus are experiencing long COVID-19 symptoms.

Still, estimates on the numbers of people with long COVID are all over the map.
Researchers from the Penn State College of Medicine found that more than half of COVID-19 survivors had long COVID-19.

Another study from the University of Arizona found that about 2 out of 3 people who experienced mild or moderate cases of coronavirus had long-lasting symptoms.

Other reports have been more conservative, estimating anywhere between 10 to 30 percent of those infected develop long-term symptoms. Those who experience ongoing symptoms from long COVID-19 have sometimes come to be known as COVID-19 long haulers.

It’s generally believed that people who developed severe cases of COVID-19 are more likely to have long COVID-19, but even those who had asymptomatic cases have reported lingering after-effects months after testing negative.
One problem in figuring out how many people get long COVID-19 is defining it.

Apart from the wide range of symptoms, there is still debate over when a person is considered to have long COVID-19. Some health care authorities consider a patient to have the condition if symptoms persist after three to six weeks, while other think it should be considered on a longer basis.

Jim Heath, president and professor at the Institute for Systems Biology, is leading the Pacific Northwest consortium researching long COVID-19 as part of the National Institute of Health’s (NIH) RECOVER initiative, which is looking into the post-COVID-19 condition and potential ways of preventing and treating it.

Heath told The Hill that if one definition of long COVID-19 was being used — one in which symptoms lingered about four to six weeks after infection — then roughly half of those infected would be considered to have long COVID-19.
“But if you look at like six months out, which is for people that are really going to have to live with something, it’s probably more like 15 percent, something like that. I don’t know if we have really firm numbers on that yet,” Heath said.

According to Heath, an estimate of 15 to 20 percent of coronavirus survivors experiencing long COVID-19 after six months was a reasonable “educated guess” and he added that there was evidence to support that rate of occurrence.
When reached for comment by The Hill, the NIH said initial studies have found that at least half of COVID-19 patients who were hospitalized reported “persistent weakness or fatigue” months after their recovery.

Studies on the prevalence of long COVID-19 have been “relatively few,” according to the NIH, and they have all focused on people who had symptomatic cases of COVID-19.

What makes long COVID-19 unique is its occurrence in those who had mild cases, Heath said.

The NIH said numerous observational studies in both children and adults are being conducted to find potential treatments for long haulers. The agency has requested applications for new clinical trials to launch this summer to test potential ways of preventing and treating long COVID-19.

“In contrast to the wealth of prior knowledge that led to the vaccines for Sars-CoV-2 and a host of other viruses, there is much less known about what causes persistent symptoms following infectious illnesses or how to best treat them.

Bolding=mine

China labels WHO remarks on ‘zero-COVID’ ‘irresponsible’
Quote:

China on Wednesday defended sticking to its strict “zero-COVID” approach, calling critical remarks from the head of the World Health Organization “irresponsible.”

The response from the Foreign Ministry came after WHO Director-General Tedros Adhanom Ghebreyesus said he had been discussing with Chinese experts the need for a different approach in light of new knowledge about the virus.

“When we talk about the ‘zero-COVID,’ we don’t think that it’s sustainable, considering the behavior of the virus now and what we anticipate in the future,” Tedros said.

Ministry spokesperson Zhao Lijian said at a daily briefing Wednesday, “We hope that relevant people can view China’s policy of epidemic prevention and control objectively and rationally, get more knowledge about the facts and refrain from making irresponsible remarks.”


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16 May 2022, 8:59 pm

How Often Can You Be Infected With the Coronavirus? The spread of the Omicron variant has given scientists an unsettling answer: repeatedly, sometimes within months.

Quote:
A virus that shows no signs of disappearing, variants that are adept at dodging the body’s defenses, and waves of infections two, maybe three times a year — this may be the future of Covid-19, some scientists now fear.

The central problem is that the coronavirus has become more adept at reinfecting people. Already, those infected with the first Omicron variant are reporting second infections with the newer versions of the variant — BA.2 or BA2.12.1 in the United States, or BA.4 and BA.5 in South Africa.

Those people may go on to have third or fourth infections, even within this year, researchers said in interviews. And some small fraction may have symptoms that persist for months or years, a condition known as long Covid.

“It seems likely to me that that’s going to sort of be a long-term pattern,” said Juliet Pulliam, an epidemiologist at Stellenbosch University in South Africa.

“The virus is going to keep evolving,” she added. “And there are probably going to be a lot of people getting many, many reinfections throughout their lives.”

This is not how it was supposed to be. Earlier in the pandemic, experts thought that immunity from vaccination or previous infection would forestall most reinfections.

The Omicron variant dashed those hopes. Unlike previous variants, Omicron and its many descendants seem to have evolved to partially dodge immunity. That leaves everyone — even those who have been vaccinated multiple times — vulnerable to multiple infections.

“If we manage it the way that we manage it now, then most people will get infected with it at least a couple of times a year,” said Kristian Andersen, a virologist at the Scripps Research Institute in San Diego. “I would be very surprised if that’s not how it’s going to play out.”

The new variants have not altered the fundamental usefulness of the Covid vaccines. Most people who have received three or even just two doses will not become sick enough to need medical care if they test positive for the coronavirus. And a booster dose, like a previous bout with the virus, does seem to decrease the chance of reinfection — but not by much.

At the pandemic’s outset, many experts based their expectations of the coronavirus on influenza, the viral foe most familiar to them. They predicted that, as with the flu, there might be one big outbreak each year, most likely in the fall. The way to minimize its spread would be to vaccinate people before its arrival.

Instead, the coronavirus is behaving more like four of its closely related cousins, which circulate and cause colds year round.

If reinfection turns out to be the norm, the coronavirus is “not going to simply be this wintertime once-a-year thing,” he said, “and it’s not going to be a mild nuisance in terms of the amount of morbidity and mortality it causes.”

Reinfections with earlier variants, including Delta, did occur but were relatively infrequent.

Omicron seems to be evolving new forms that penetrate immune defenses with relatively few changes to its genetic code.

“This is actually for me a bit of a surprise,” said Alex Sigal, a virologist at the Africa Health Research Institute. “I thought we’ll need a kind of brand-new variant to escape from this one. But in fact, it seems like you don’t.”

An infection with Omicron produces a weaker immune response, which seems to wane quickly, compared with infections with previous variants. Although the newer versions of the variant are closely related, they vary enough from an immune perspective that infection with one doesn’t leave much protection against the others — and certainly not after three or four months.

Still, the good news is that most people who are reinfected with new versions of Omicron will not become seriously ill. At least at the moment, the virus has not hit upon a way to fully sidestep the immune system.

Each infection may bring with it the possibility of long Covid, the constellation of symptoms that can persist for months or years. It’s too early to know how often an Omicron infection leads to long Covid, especially in vaccinated people.

To keep up with the evolving virus, other experts said, the Covid vaccines should be updated more quickly, even more quickly than flu vaccines are each year.

“Every single time we think we’re through this, every single time we think we have the upper hand, the virus pulls a trick on us,” Dr. Andersen said. “The way to get it under control is not, ‘Let’s all get infected a few times a year and then hope for the best.’”


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18 May 2022, 6:27 pm

What Paxlovid Rebound Could Mean for Patients
Michael Mina, MD, PhD, formerly an epidemiologist at Harvard and now chief science officer of eMed, discusses the cause of viral rebound with ritonavir/nirmatrelvir (Paxlovid), what it could mean for the evolution of COVID, and how to advise patients.

The following is a transcript of his remarks:

Quote:
So there's been a major concern around Paxlovid rebound.

What is happening when people have a rebound of virus after they take Paxlovid is we're seeing as people will get infected, they'll get on treatment, which is very good that we have these effective treatments available today. But then what we're seeing is after people come off the treatment – after their 5 day course is over – they might become negative on tests, but clearly the virus hasn't completely diminished. And after a couple of days, they rebound. They get detectable virus on both PCR and oftentimes antigen tests. And many people are actually now getting symptomatic with disease that looks a lot like an initial COVID infection.

So what we're seeing is that, while the treatment is clearly serving to protect the individual while they're on the treatment, it might need to be extended to actually ensure that the body has cleared all of the virus before coming off of the treatment.

Should we be concerned about resistance occurring from rebound? Absolutely. I think that it is a major concern. Paxlovid is one of the most important tools that we've had in this pandemic since the beginning of the pandemic. We want to do everything we can to not encourage, from an evolutionary perspective, resistance to occur.

But we know, from basic evolutionary principles and what we know of drug resistance in the past, is that whenever you let up on a drug before the pathogen is totally cleared, that sort of creates this sweet spot where now the virus is growing up and there's still a little bit of the drug left and they get to interact. That just helps facilitate the potential advantage of a random mutation that does allow escape and resistance from this treatment to sort of flourish in that short amount of time when the drug is coming off and the virus is growing back up.

So that does create a sort of breeding ground for resistance or to improve the probability that a resistance mutation will occur. That's the last thing we want here. We absolutely do not want resistance to occur against Paxlovid.

This is why I think there is a massively urgent need to understand what's the rate of this. Is this all social media buzz, or is this really occurring? And I think it is. I feel very confident that it's really occurring at a higher rate. We don't know if it's certain populations. We don't know if there's a way to predict it after somebody comes off Paxlovid.

Should we be testing people with a rapid test at home on the last day of Paxlovid? And if they're still positive, should we keep them on a further course? But we also know that people become negative, fully negative, and then rebound back to positive. So they go below the threshold of detection on the test.

All of these questions are absolutely critical for us to start to understand today and to really start focusing on. We need to run the clinical trials. It's something that we are starting to do here at eMed with our test-to-treat program at home. We're actually able to take the individuals who are on Paxlovid and send them additional tests so that they can test themselves when they come off of Paxlovid, and we can start monitoring that incidence.

So we have to be studying this. It should be a priority of the CDC and the FDA right now, as well as the NIH, to really get to the bottom of how often is it [occurring] and what is the frequency in certain demographics, in different populations.

What I would like people to recognize is that this is not a failure of Paxlovid. It might be that we need to just change the duration, but we know that Paxlovid is saving lives today. We know it is a highly, highly effective treatment. So people shouldn't look at this as a negative of Paxlovid, they should recognize that this is a fast-moving pandemic. When new treatments come along, we have to tighten up what the appropriate regimen and duration of treatment is.

So I think that we should really be able to take this information and say, "Look, it's a good thing that we have testing out in people's homes so that we can actually recognize that this is occurring." And we should use all of these tools to be able to monitor this process, to start giving physicians the appropriate recommendations.

Right now, what I would recommend for the average person or the average patient is to say, if you're putting your patient on Paxlovid, encourage them to test again once they come off. Encourage them to look to see if they have rebound so that they can act appropriately afterwards, if it does occur.

Ideally, it's not the majority, not even close to the majority. But we don't want people to get off Paxlovid, have sky high viral loads, and just assume that they are totally cured and can go hug grandma.

We really want to encourage people to continue being safe in this pandemic. And part of that is to test yourself after you're done with your course of treatment. And you know, unfortunately, if you're still positive, then talk to your physician or talk to your patient if they come to you and try to work out with them what the best course of action is for them.

If they're not symptomatic, maybe they continue isolating. If they are symptomatic, maybe you put them on another course or monoclonals. But at the moment, it's going to be kind of a patient-by-patient decision making process.

As if we do not already do not have a huge cynicism problem already (SMH)


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“My autism is not a superpower. It also isn’t some kind of god-forsaken, endless fountain of suffering inflicted on my family. It’s just part of who I am as a person”. - Sara Luterman


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19 May 2022, 5:41 pm

Diabetes risk rises after COVID, massive study finds

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People who get COVID-19 have a greater risk of developing diabetes up to a year later, even after a mild SARS-CoV-2 infection, compared with those who never had the disease, a massive study1 of almost 200,000 people shows.

The research, published in The Lancet Diabetes & Endocrinology earlier this month, is one of a growing number of studies2 showing that COVID-19 can increase a person’s risk of diabetes, months after infection.

“When this whole pandemic recedes, we’re going to be left with the legacy of this pandemic — a legacy of chronic disease” for which health-care systems are unprepared, says study co-author Ziyad Al-Aly, chief researcher for the Veterans Affairs (VA) St Louis Healthcare System in Missouri.


Al-Aly and Yan Xie, an epidemiologist also at the VA St Louis Healthcare System, looked at the medical records of more than 180,000 people who had survived for longer than a month after catching COVID-19. They compared these with records from two groups, each of which comprised around four million people without SARS-CoV-2 infection who had used the VA health-care system, either before or during the pandemic. The pair previously used a similar method to show that COVID-19 increases the risk of kidney disease3, heart failure and stroke4.

The latest analysis found that people who had had COVID-19 were about 40% more likely to develop diabetes up to a year later than were veterans in the control groups.

The chance of developing diabetes rose with increasing severity of COVID-19. People who were hospitalized or admitted to intensive care had roughly triple the risk compared with control individuals who did not have COVID-19.

Even people who had mild infections and no previous risk factors for diabetes had increased odds of developing the chronic condition, says Al-Aly. Of the people with COVID-19 who avoided hospitalization, an extra 8 people out of every 1,000 studied had developed diabetes a year later compared with people who were not infected. People with a high body-mass index, a measure of obesity — and a considerable risk factor for type 2 diabetes — had more than double the risk of developing diabetes after a SARS-CoV-2 infection.

Early in the pandemic, researchers raised concerns based on anecdotal reports in young people and children that SARS-CoV-2, like other viruses, might damage cells in the pancreas that produce insulin, triggering type 1 diabetes.

But data on a link between SARS-CoV-2 infection and newly diagnosed cases of type 1 diabetes remain mixed. Several studies5–7 have found no evidence that the disease is causing the uptick in cases of type 1 diabetes in younger adults or children. And a laboratory study published in February also challenged the idea that SARS-COV-2 destroys insulin-producing pancreatic cells8.

A lingering question is whether the metabolic changes observed in people who had COVID-19 persist after one year. More research is needed to clarify long-term trends in new-onset diabetes at a population level and to tease apart what might be causing them, says Shaw.




Most Diagnosed With Long COVID Were Never Hospitalized
Quote:
The majority (75.8%) of patients diagnosed with a post-COVID condition had never been hospitalized for COVID-19, according to a new study from FAIR Health. Among patients who presented with a post-COVID diagnosis, 81.6% of females had not had a COVID-19 hospitalization compared with 67.5% of males.

The study was among the first to use the official ICD-10 diagnostic code (U09.9) for post-COVID conditions that became effective October 1, 2021. Analyzing private claims data from 78,252 patients diagnosed with the U09.9 code from October 1, 2021, to January 31, 2022, the study was released on May 18 as a white paper entitled Patients Diagnosed with Post-COVID Conditions: An Analysis of Private Healthcare Claims Using the Official ICD-10 Diagnostic Code.

Females were more likely than males to be diagnosed with U09.9 post-COVID conditions. Females made up 59.8% of the population of patients with that diagnosis, while males made up 40.2%

Of patients who presented with a U09.9 post-COVID condition, 30.7% had no identified preexisting chronic comorbidities.

The 3 diagnoses most commonly co-occurring on the same claim line with the U09.9 post-COVID diagnosis in patients across all ages and genders were abnormalities of breathing (23.2% of patients with post-COVID conditions), cough (18.9%) and malaise and fatigue (16.7%).

In patients with a U09.9 post-COVID diagnosis, certain co-occurring diagnoses were more common in some age groups than across all age groups: for example, multisystem inflammatory syndrome in patients aged 0 to 12; abnormalities of heartbeat in the age group 13 to 22; generalized anxiety disorder in patients aged 23 to 35; and hypertensive diseases in the age group 65 and older.

“Other and unspecified myopathies” (diseases that affect the muscles that control voluntary movement) occurred in patients in the post-COVID population 11.1 times more often than in the same population prior to COVID-19. Pulmonary embolism occurred 2.6 times more often. “Other disorders of brain,” including post-viral fatigue syndrome and certain forms of encephalopathy, occurred two times more often.

On average, in all age groups, patients with a U09.9 post-COVID condition had higher Department of Health & Human Services-Hierarchical Condition Category (HHS-HCC) risk scores after their diagnosis of COVID-19 than before. HHS-HCC risk scores identify which patients are likely to consume more healthcare resources and potentially incur more healthcare-related costs in the long run.


Vaccines administered after infection may reduce risk of long COVID
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Getting a COVID-19 shot after you've been infected could reduce your risk of developing prolonged COVID-19 symptoms, or so-called long COVID, according to a new study.

"Our results suggest that vaccination of people previously infected may be associated with a reduction in the burden of long COVID on population health, at least in the first few months after vaccination," co-author Daniel Ayoubkhani, of the U.K. Office for National Statistics, and colleagues wrote.

For the study, the researchers analyzed data on more than 28,000 adults, aged 18 to 69, in the United Kingdom who received at least one COVID-19 vaccine dose after testing positive for infection.

Over seven months of follow-up, 24% of participants reported long COVID symptoms of any severity at least once. Before vaccination, there was little change in their chances of experiencing long COVID.

A first vaccine dose was associated with an initial 13% decrease in the likelihood of long COVID, but whether this reduction was sustained until the participants received another vaccine dose 12 weeks later is unclear.

A second vaccine shot was associated with a further 9% decrease in the odds of long COVID, and this was sustained for at least an average follow-up of nine weeks.

Similar results were also found when the researchers focused on long COVID severe enough to limit day-to-day activities, according to the study.

Because it's an observational study, it can't prove that getting vaccinated after infection protects against long COVID, the authors said in a journal news release.

However, they noted that their results were consistent after they accounted for income levels, health-related factors, vaccine type and length of time between infection and vaccination.



Long covid is shrinking the British workforce
Quote:
Millions of people globally have missed work in the last two years because of acute covid-19 infection. But lack of data about long covid—a little-understood condition with a wide range of symptoms—has made it difficult to gauge how much ongoing sickness linked to the pandemic is impacting the workforce.

Now, an analysis from a Bank of England monetary committee member is one of the first to draw links between long covid and the tightening of the labor market. The chronic condition has been one of the main drivers of the shrinking labor pool in the UK, according to a May 9 speech from Michael Saunders, an external member of the bank’s nine-member committee.

The total UK workforce shrank by 440,000 people up to February 2022, compared to the fourth quarter of 2019, just before the pandemic, according to Saunders. “The scale and persistence of this drop in labor supply has been a surprise to many forecasters, including us,” Saunders said in his speech.

Some of the drop was due to “the interaction of Brexit and the pandemic,” which prevented much migration to the UK of people who could fill open jobs, as well as retirements, he said. But there was also a marked drop in participation rates, especially among people aged 50 to 64, he said, most of which was due to long-term sickness.



North Korea's suspected COVID-19 caseload approaching 2 million
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North Korea on Thursday reported 262,270 more suspected COVID-19 cases as its pandemic caseload neared 2 million - a week after the country acknowledged the outbreak and scrambled to slow infections in its unvaccinated population.

The country is also trying to prevent its fragile economy from deteriorating further, but the outbreak could be worse than officially reported since the country lacks virus tests and other health care resources and may be underreporting deaths to soften the political impact on authoritarian leader Kim Jong Un.

North Korea's anti-virus headquarters reported a single additional death, raising its toll to 63, which experts have said is abnormally small compared to the suspected number of coronavirus infections.

After maintaining a dubious claim that it had kept the virus out of the country for two and a half years, Pyongyang acknowledged its first COVID-19 infections May 12 and has described a rapid spread since. Kim has called the outbreak a "great upheaval," berated officials for letting the virus spread and restricted the movement of people and supplies between cities and regions.

Workers were mobilized to find people with suspected COVID-19 symptoms who were then sent to quarantine - the main method of curbing the outbreak since North Korea is short of medical supplies and intensive care units that lowered COVID-19 hospitalizations and deaths in other nations.

State media images showed health workers in hazmat suits guarding Pyongyang's closed-off streets, disinfecting buildings and streets and delivering food and other supplies to apartment blocks.

Despite the vast numbers of sick people and the efforts to curb the outbreak, state media describe large groups of workers continuing to gather at farms, mining facilities, power stations and construction sites. Experts say North Korea cannot afford a lockdown that would hinder production in an economy already broken by mismanagement, crippling U.S.-led sanctions over Kim's nuclear weapons ambitions and pandemic border closures.

North Korea also must urgently work to protect its crops from a drought that hit during the crucial rice-planting season - a worrisome development in a country that has long suffered from food insecurity. State media also said Kim's trophy construction projects, including the building of 10,000 new houses in the town of Hwasong, are being "propelled as scheduled."

"All sectors of the national economy are stepping up the production to the maximum while strictly observing the anti-epidemic steps taken by the party and the state," Korean Central News Agency reported.

The virus controls at workplaces include separating workers by their job classifications and quarantining worker units at construction sites and in its key metal, chemical, electricity and coal industries, KCNA said.

While Pyongyang says more than 1.2 million people have already recovered, it's clear officials are simply releasing people from shelters or other quarantine facilities like schools after their fevers subside, according to South Korean lawmaker Ha Tae-keung, who attributed the information to the spy agency briefing. Although the North may lack medical equipment, it does seem to have enough thermometers to check temperatures, likely imported from China, Ha said.

Kee Park, a global health specialist at Harvard Medical School who has worked on health care projects in North Korea, said the country's number of new cases should start to slow because of the strengthened preventive measures.

But it will be challenging for North Korea to provide treatment for the already large number of people with COVID-19. Deaths may possibly approach tens of thousands, considering the size of its caseload, and international assistance would be crucial, Park said.

It's unclear, however, if North Korea would accept outside help. It already shunned vaccines offered by the U.N.-backed COVAX distribution program, and the nation's leaders have expressed confidence the country can overcome the crisis on its own.

Kim Tae-hyo, deputy national security adviser for South Korean President Yoon Suk Yeol, told reporters on Thursday that North Korea has ignored offers of help from South Korea and the United States to contain the outbreak.

Experts have said North Korea may be more willing to accept help from China, its main ally. South Korea's government had said it couldn't confirm media reports that North Korea flew planes to bring back emergency supplies from China this week.


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20 May 2022, 4:27 pm

CDC urges older Americans to get Covid booster shots as hospitalizations soar again

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The Centers for Disease Control and Prevention this week urged older Americans to get a Covid booster shot to increase their protection against the virus amid another surge in hospitalizations, particularly among those 70 and older.

“Over the past few weeks we’ve seen a steep and substantial increase in hospitalizations for older Americans,” CDC Director Dr. Rochelle Walensky told the public health agency’s committee of independent vaccine experts during a public meeting on Thursday.

Only 43% of people ages 65 and older have received a vaccine dose in the past six months and just 38% of people ages 50 to 64 have done so, Walensky said.

“This leaves about 60% of older Americans without the protection they may need to prevent severe disease, hospitalization and death,” Walensky said. “We know immunity wanes over time, and we need to do all we can now to protect those most vulnerable.”

Walensky said people ages 50 and older should get a fourth Covid shot, and those 12 and older with weak immune systems should get a fifth shot.

Hospitalizations have increased 25% among those 70 and older over the past week, with more than 1,500 people in the age group admitted with Covid per day on average as of Tuesday, according to CDC data. The U.S. is reporting more than 100,000 new Covid infections per day on average, an 18% increase over the week prior, as more transmissible omicron variants weep the U.S.

In people ages 50 and older, two doses of Pfizer and Moderna’s vaccines are about 50% effective at prevent emergency department and urgent care visits due to omicron infection six months after receiving the second shot, according to data presented at a CDC committee meeting in April. A third dose boosts that protection to about 77%.

The Food and Drug Administration and the CDC authorized second boosters for older Americans in March based primarily on data from Israel. Scientists in Israel found that a fourth dose reduced the death rate from Covid in people ages 60 and older by 78% compared with those who received three shots. The study, which hasn’t undergone peer review, examined the health record of more than 500,000 people from January through February at Israel’s largest health-care provider, Clalit Health Services.


Tales of Covid-19 reinfection
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The top-line news on Covid-19 this week is that about a third of the US population is in an area of high or medium community-level spread. Plus, the US Food and Drug Administration has granted emergency use authorization for a vaccine booster dose for kids ages 5 to 11 who are fully vaccinated. And the Biden administration is giving out more free Covid-19 tests.

But here's an individual story for anyone coming to terms with the persistence of Covid-19 and a lesson that if you've had it, you can easily test positive again.

Late-night host Jimmy Kimmel did. And it's wreaking havoc on his schedule just like infection does for school kids, teachers, service workers, office workers or anyone else who does the responsible thing and goes into isolation.
"I'm such a positive person, I tested positive AGAIN. I am feeling fine," Kimmel said on Twitter this week, announcing guest hosts for his show.

There are many examples of people who got Covid-19 multiple times. Jen Psaki, the former White House press secretary, leaps to mind. But Kimmel's second positive test came a very short time after his first.

The lesson is that no, you are not exempt from Covid-19 awareness for 90 days after a positive test, since new variants are emerging and infection rates are rising in much of the country.

A New York Times report this week suggested there could be multiple mini-outbreaks of Covid-19 each year and people could be reinfected multiple times as variants like Omicron emerge and evolve into subvariants like the one infecting most Americans today.


About a third of the US population is in an area with high or medium infection rates, according to a warning this week from the US Centers for Disease Control and Prevention.

From CNN's report: More than 32% of people nationwide live in areas with medium or high Covid-19 community levels, (CDC Director Dr. Rochelle) Walensky said. That breaks down to 9% living in areas with high Covid-19 community levels and 23% living in medium areas.

The high-transmission areas at this moment are in the Northeast, particularly New York and New Jersey, and stretch over to Michigan and Wisconsin.

Despite the high community spread in New York City, Mayor Eric Adams said he has no plans to reinstate mask requirements there, suggesting we've got to learn to live with Covid-19.

"Variants are going to come," he said, according to CNN's report. "If every variant that comes, we move into shutdown thoughts, we move into panicking, we're not going to function as a city."

He argued the city's hospitalization rate is stable. Roughly 78% of city residents are fully vaccinated, which is above the US population's 67% vaccination rate.

Less than half of fully vaccinated Americans have received a booster dose, while about 38% of New Yorkers have.


On the heels of the FDA's authorization earlier this week, CDC vaccine advisers voted on Thursday to recommend a booster dose of the Pfizer/BioNTech vaccine for children ages 5 to 11. Walensky has signed off on the recommendation.


Another round of free Covid-19 tests for all Americans was made available by the Biden administration on Monday. Up to 16 have been authorized for each household through CovidTests.gov.

zabo spoke with multiple researchers and experts who argued the federal government has not focused nearly enough on getting the word out about booster shots.

"The booster program has been botched from day one," Dr. Eric Topol, founder and director of the Scripps Research Translational Institute, told her. "This is one of the most important issues for the American pandemic, and it has been mismanaged."

CNN medical analyst Dr. Leana Wen talked to Katia Hetter about what to do if you test positive at this stage of the pandemic.

Be careful

Wen: A more transmissible variant means that the activities we thought were relatively safe before are now higher risk. This doesn't mean that we should avoid all activities, but rather that people who have been very careful before may be getting infected now because of how contagious this subvariant is.

5 days of isolation may feel more like 6 days
Wen: The day that you take your positive test is day zero. If you had symptoms before then, say the day before, that day is day zero -- whichever is first. Day 1 is 24 hours after the positive test or appearance of symptoms.

You need to be isolated from others for five days. That means not being in the same room at home with people you live with and not going to work in person. If you have to share, say, a bathroom, make sure to wear a well-fitting N95, KN95 or KF94 while in these common areas, minimize your time in them, and open the windows as much as possible.

And after the 5th day ...
Wen: The CDC says that after the fifth day of isolation, if you have no fever and your symptoms are improving, you can go into public spaces like grocery stores and to work and school, as long as you wear a well-fitting mask the entire time.

A lot of workplaces and schools have their own policies that are more stringent than this and may require, for example, a full 10 days before you return.


Do you need a negative test after 5 days?
Wen: Many public health experts, including me, would recommend testing out of isolation as an additional level of precaution that also reduces inconvenience.

This is not what the CDC says, but I think it's reasonable to start testing with a home rapid test from day 5. If you test negative on day 5 and day 6, and you have no fever and improved symptoms, then you could exit isolation.

That would make for a less onerous isolation period, especially for families who live in small spaces or have young children to care for.



COVID is definitely raging here in New York. My niece and nephew caught it and I am hearing reports of high absenteeism.


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24 May 2022, 10:44 pm

More than 1 in 5 adult Covid survivors in the U.S. may develop long Covid, a C.D.C. study suggest

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One in five adult Covid survivors under the age of 65 in the United States has experienced at least one health condition that could be considered long Covid, according to a large new study by the Centers for Disease Control and Prevention. Among patients 65 and older, the number is even higher: one in four.

In an indication of how seriously the federal health agency views the problem of long Covid, the authors of the study — members of the C.D.C.’s Covid-19 Emergency Response Team — recommended “routine assess­ment for post-Covid conditions among persons who survive Covid-19.”

In both age groups, Covid patients had twice the risk of uninfected people of developing respiratory symptoms and lung problems, including pulmonary embolism, the study found. Post-Covid patients aged 65 and older were at greater risk than the younger group of developing kidney failure, neurological conditions and most mental health conditions.

“It is sobering to see the results of this study again confirming the breadth of organ dysfunction and the scale of the problem,” said Dr. Ziyad Al-Aly, chief of research and development at the V.A. St. Louis Health Care System and a clinical epidemiologist at Washington University in St. Louis, who was not involved in the research.

The study evaluated electronic medical records for nearly two million people — comparing those who had been infected with the coronavirus with those who were not. The most common post-Covid conditions, regardless of age, were respiratory problems and musculoskeletal pain.

The risk of post-Covid patients aged 65 and older developing the 26 health conditions the study evaluated was between 20 percent and 120 percent greater than people who didn’t get Covid. Those aged 18 to 64 had a 10 percent to 110 percent greater risk than uninfected people of developing 22 of the health conditions. But in that age group, Covid survivors were no more likely than uninfected people to develop most mental health conditions, substance use disorders or strokes and similar cerebrovascular conditions.

Dr. Al-Aly said the study results “can potentially translate into millions of people with new diabetes, heart disease, kidney disease, neurologic problems. These are lifelong conditions — certainly manageable, but not curable conditions.”

The study analyzed records of 353,164 people who were diagnosed with Covid-19 in the first 18 months of the pandemic, beginning in March 2020. It compared them with the records of 1.64 million people who had a medical visit in the same month in which the Covid patients were diagnosed but did not become infected with the coronavirus during the study period, which ended on Oct. 31, 2021.

People in both groups who had a history of one of the 26 health conditions in the previous year were excluded from the study — an attempt by the researchers to consider medical issues that patients developed only after they had Covid.

The study, which involved patients seen at health facilities that use a record system managed by Cerner Corp., a large medical data company, said the Covid patients included people admitted to hospitals, seen in emergency departments or diagnosed in an outpatient setting. The researchers did not indicate how many patients were in each group, one of several limitations of the study’s findings.

Between 30 days and 365 days after their coronavirus diagnosis, 38 percent of the patients experienced one or more new health problems, compared to 16 percent of the non-Covid patients, the study said. The younger age group, 18-to-64, was somewhat less likely to have those problems — 35 percent developed long Covid issues, compared with 15 percent of uninfected people. In the 65-and-older group, 45 percent had new health conditions, compared with 19 percent of uninfected people.

Based on those percentages, the study authors calculated that nearly 21 percent of the younger group and nearly 27 percent of the older group developed health problems that could be attributed to long Covid.

The study did not look at the vaccination status of the patients and did not report characteristics like race, ethnicity, sex or geographic location. It also did not identify which coronavirus variants were linked to each case.

The C.D.C. authors concluded that post-Covid conditions might “affect a patient’s ability to contribute to the work force and might have economic consequences for survivors and their dependents.” They added that “care requirements might place a strain on health services” in “communities that experience heavy Covid-19 case surges.”


Brain fog, other long Covid symptoms can last more than a year, study finds
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The devastating neurological effects of long Covid can persist for more than a year, research published Tuesday finds — even as other symptoms abate.

The study, published in the journal Annals of Clinical and Translational Neurology, is the longest follow-up study of the neurological symptoms among long Covid patients who were never hospitalized for Covid.

The neurological symptoms — which include brain fog, numbness, tingling, headache, dizziness, blurred vision, tinnitus and fatigue — are the most frequently reported for the illness.

The new study, from researchers at Northwestern University, is a follow-up to a shorter-term study published last spring that focused on 100 patients with long Covid. That research found that 85 percent of the patients reported at least four lasting neurological problems at least six weeks after their acute infections.

For the follow-up, the team continued to survey 52 of the original participants, who were patients at the university’s Neuro COVID-19 Clinic — a long Covid clinic — for up to 18 months. The cohort was three-quarters female, and the average age was 43. Almost 80 percent were vaccinated, and all had mild Covid symptoms that did not require hospitalization.

Most neurological symptoms persisted after an average of 15 months, the study found. While most patients did report improvements in their cognitive function and fatigue, the symptoms had not gone away completely and still affected their quality of life.

“A lot of those patients still have difficulties with their cognition that prevent them from working like they used to,” said a study co-leader, Dr. Igor Koralnik, the chief of neuro-infectious diseases and global neurology at Northwestern Medicine, who oversees the Neuro COVID-19 Clinic.

The study also found that some symptoms, including heart rate and blood pressure variation, as well as gastrointestinal problems, increased over time, while loss of taste and smell tended to improve. Covid vaccination did not alleviate symptoms, but it also did not make long Covid any worse.

The Northwestern study did not look at why some of the symptoms persist and others fade away or why they occur in the first place.



What's ailing long COVID patients? A new federal study looks for clues
Quote:
Soon after the COVID-19 pandemic began, a team of researchers at the National Institutes of Health started putting hundreds of people under the microscope to try to get clues to why some patients might end up with long-lasting health problems.

The scientists knew from previous outbreaks of infections diseases, like Ebola, that some patients would likely be left struggling with symptoms that could be debilitating.

Doctors combed through the volunteers' medical records looking for anything that might predispose them to the lingering health problems that later would be called long COVID, symptoms like fatigue, headaches, and shortness of breath. The researchers also put the subjects through more than 130 tests for any signs their vital organs were damaged, that the virus was still hiding in their bodies, or their immune systems were malfunctioning.

On Tuesday, the scientists released the first results from the study, which is ongoing. The study, published in the Annals of Internal Medicine, compared 189 patients diagnosed with COVID-19 to 120 similar patients who did not get sick.

The results are both disappointing and provocative.

"An extensive medical evaluation failed to reveal a cause for these persistent symptoms in most cases," Dr. Michael Sneller, an infectious disease specialist, who led the study, told NPR.

"We were not able to find evidence of the virus persisting or hiding out in the body. We also did not find evidence that the immune system was overactive or malfunctioning in a way that would produce injury to major organs in the body," Sneller says.

The researchers did, however, find that women and those suffering from anxiety were more likely to end up with long COVID. But the researchers stress that their findings don't mean patients' problems are psychological.

"I clearly don't want to send the message that this is all not real. And in peoples' heads. And just go home and stop worrying about it. That's not the message," Sneller says.

Sneller says he hopes his findings will help doctors better treat long COVID patients. For example, by identifying what's not wrong, doctors could avoid unnecessary, potentially harmful treatments. Some doctors are prescribing inhalers which can cause side effects, to people with normal lung function, he says.

nstead, Sneller says his research could prompt more doctors to focus on interventions that might help, such as physical and cognitive behavioral therapy.

But some worry the findings could send the wrong message. The fear is doctors will dismiss patients, especially when nothing shows up on standard tests.

"We know that invisible illnesses are often psychologized," says David Putrino, a professor of rehabilitative medicine, who studies and treats long COVID patients at Mount Sinai Medicine in New York.

"We know that most people with infection-associated chronic illness are constantly first misdiagnosed with anxiety. Regular cookie-cutter testing isn't going to show up anything in your long-COVID patients. We need to look deeper," Putrino said.

New clues to the biology of long COVID are starting to emerge

For example, Putrino says other researchers have found evidence of abnormal levels of immune system modulators in patients suffering from long-COVID. Others have found evidence of chronic inflammation, which is a sign of an overactive immune system.

In an editorial accompanying the study, Dr. Aluko Hope of the Oregon Health & Science University calls the results a "valuable contribution" to understanding long COVID by providing a baseline of patients' health early on in their disease.

But he notes the researchers didn't focus enough on understanding the fatigue many long-COVID patients experience when they try to exercise or otherwise exert themselves.

"As we emerge from the hell of the COVID-19 pandemic, it is time to insist on painstaking study and care of survivors of COVID-19. Without a fuller understanding of pathophysiology and disease course, we must not allow normal objective tests to negate our patients' subjective experiences," Hope says.

"While we gather evidence, our patients deserve personalized care pathways that acknowledge the many biopsychosocial factors involved in illness recovery," he says.

At the same time, a new NIH study aims to follow about 20,000 COVID-19 patients, conducting detailed analysis of their health and comparing them to people who don't get COVID.

In the end, many experts think research will show that long COVID likely has many different causes, depending on such factors as the severity of the initial illness and an individual's predisposing characteristics.


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25 May 2022, 6:13 pm

Nation's latest COVID-19 wave largely hidden from view, health experts say

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Current COVID-19 cases are just a fraction of what they were at the peak of the omicron wave.

But many people in the country may be noticing what seems to be a flood of cases in their social circles.

Health experts say this anecdotal evidence may not be simply coincidence, as the U.S. may be in a “hidden” wave — one much larger than reported data would suggest.

“There's a lot of COVID out there. I see it in my social circles, in my kids' schools and in the hospital employee infection numbers,” Dr. Shira Doron, an infectious disease physician and hospital epidemiologist at Tufts Medical Center in Boston, told ABC News. “We are clearly in a wave.”

Although it is clear that infection rates have been steadily rising in recent weeks to their highest reported level since mid-February, scientists acknowledge that it is difficult to know how high COVID-19 case and even hospitalization numbers truly are, given the likely “substantially” undercounting of infections.

This is due in part to changes in data collection and reporting and the proliferation of at-home tests. Some state officials report that health departments and healthcare facilities have also ended traditional tracking of COVID-19 patients, which epidemiologists say make it more difficult to know how many patients are coming into hospitals in need of care.

Last month, former FDA Commissioner Dr. Scott Gottlieb estimated that officials were likely only picking up “one in seven or one in eight” infections.

And President Joe Biden’s new coronavirus response coordinator, Dr. Ashish Jha, acknowledged that there are "a lot of infections" last week, likely the result of highly infectious omicron subvariants spreading across the country.

The nation's reported daily case average, which officials say consists largely of PCR tests, now stands at more than 100,000 new cases reported a day, according to data from the Centers for Disease Control and Prevention (CDC).

In recent weeks, nearly every state in the country has reported an increase in COVID-19 infections and the number of virus-positive people who are admitted to the hospital.

The Northeast remains the nation’s most notable known COVID-19 hotspot, though surges in some cities, like Boston, appear to be showing initial signs of slowing.

Nationally, according to the CDC’s community levels, more than 45% of Americans live in an area with a medium or high COVID-19 risk.

The high community level suggests there is a "high potential for healthcare system strain" and a "high level of severe disease,"

Hospitalization numbers have been increasing in recent weeks, but not at a rate as significant as infections.

However, over the course of the spring and winter, hospitalization data, too, has become less accessible, leading some experts to suggest patient totals could also be undercounted.

Earlier this year, the Department of Health and Human Services ended the requirement for hospitals to report several key COVID-19 metrics, including a daily total of the number of COVID-19 deaths, the number of emergency department overflow and ventilated patients and information on critical staffing shortages.

Further, certain states have stopped outright reporting of statistics including hospital bed usage and availability, COVID-19 specific hospital metrics and ventilator use.

However, Doron said a possible significant surge in infections, without an overwhelming number of hospitalized COVID-19 patients, could be a promising sign.

Even so, Doron added, “at a population level, however, COVID poses more risk because there are so many cases, and hospitals are already so full with both COVID and non-COVID patients.”

In recent months, states from coast to coast, have moved to shutter public testing sites, with an abundance of rapid COVID-19 tests now available in pharmacies and through the federal government.

According to ABC News' analysis last summer of pharmacy locations across the country, there are 150 counties where there is no pharmacy, and nearly 4.8 million people live in a county where there's only one pharmacy for every 10,000 residents or more.

“What concerns me even more is what might be happening in communities and among families with fewer resources. Public testing sites have closed, home tests are expensive at the drugstore, and navigating the system to order free tests or get tests reimbursed by insurance requires literacy and technology,” Doron said.

Broader insights on infection through home testing and wastewater sampling will be critical in the future to fully understand the scope of surges and protect all Americans, Brownstein said.


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27 May 2022, 4:21 am

Long COVID risk falls only slightly after vaccination, huge study shows

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Vaccination against SARS-CoV-2 lowers the risk of long COVID after infection by only about 15%, according to a study of more than 13 million people. That’s the largest cohort that has yet been used to examine how much vaccines protect against the condition, but it is unlikely to end the uncertainty.

Another mystery has been whether long COVID is less likely to occur after a breakthrough infection — one in a person who has been vaccinated. In a 25 May study in Nature Medicine, nephrologist Ziyad Al-Aly at VA Saint Louis Health Care System in St Louis, Missouri, and his colleagues — the same team that authored the November study — looked at VA health records from January to December 2021, including those of about 34,000 vaccinated people who had breakthrough SARS-CoV-2 infections, 113,000 people who had been infected but not vaccinated and more than 13 million people who had not been infected.

The researchers found that vaccination seemed to reduce the likelihood of long COVID in people who had been infected by only about 15%. That’s in contrast to previous, smaller studies, which have found much higher protection rates. It’s also a departure from another large study, which analysed self-reported data from 1.2 million UK smartphone users and found that two doses of a COVID-19 vaccine halved the risk of long COVID.

The authors of the latest study also compared symptoms such as brain fog and fatigue in vaccinated and unvaccinated people for up to six months after they tested positive for SARS-CoV-2. The team found no difference in type or severity of symptoms between those who had been vaccinated and those who had not. “Those same fingerprints we see in people who have breakthrough infections,” Al-Aly says.

There have been more than 83 million COVID-19 infections in the United States alone, he notes. If even a small percentage of those turn into long COVID, “that’s a staggeringly high number of people affected by a disease that remains mysterious”.

The limited protection provided by vaccines means that withdrawing measures such as mask mandates and social-distancing restrictions might be putting more people at risk — particularly those with compromised immune systems. “We’re literally solely reliant, now almost exclusively, on the vaccine to protect us and to protect the public,” says Al-Aly. “Now we’re saying it’s only going to protect you 15%. You remain vulnerable, and extraordinarily so.”

“Generally speaking, this is horrifying,” says David Putrino, a physical therapist at Mount Sinai Health System in New York City who studies long COVID. He praises the study, which was difficult to perform because of the amount and quality of data, but adds that it is limited because it does not break the data down by key factors, such as the participants’ medical history. “These are very important questions we need answers to,” Putrino says. “We don’t have any really well constructed studies just yet.”

Steven Deeks, an HIV researcher at the University of California, San Francisco, points out that the study includes no data from people infected during the period when the Omicron variant was causing the majority of infections. “We have no data on whether Omicron causes long COVID,” he says. The findings, he adds, “apply to a pandemic that has changed dramatically”.

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29 May 2022, 5:22 pm

You Are Going to Get COVID Again … And Again … And Again

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Two and a half years and billions of estimated infections into this pandemic, SARS-CoV-2’s visit has clearly turned into a permanent stay. Experts knew from early on that, for almost everyone, infection with this coronavirus would be inevitable. As James Hamblin memorably put it back in February 2020, “You’re Likely to Get the Coronavirus.” By this point, in fact, most Americans have. But now, as wave after wave continues to pummel the globe, a grimmer reality is playing out. You’re not just likely to get the coronavirus. You’re likely to get it again and again and again.

“I personally know several individuals who have had COVID in almost every wave,” says Salim Abdool Karim, a clinical infectious-diseases epidemiologist and the director of the Center for the AIDS Program of Research in South Africa, which has experienced five meticulously tracked surges, and where just one-third of the population is vaccinated. Experts doubt that clip of reinfection—several times a year—will continue over the long term, given the continued ratcheting up of immunity and potential slowdown of variant emergence. But a more sluggish rate would still lead to lots of comeback cases. Aubree Gordon, an epidemiologist at the University of Michigan, told me that her best guess for the future has the virus infiltrating each of us, on average, every three years or so. “Barring some intervention that really changes the landscape,” she said, “we will all get SARS-CoV-2 multiple times in our life.”

If Gordon is right about this thrice(ish)-per-decade pace, that would be on par with what we experience with flu viruses, which scientists estimate hit us about every two to five years, less often in adulthood. It also matches up well with the documented cadence of the four other coronaviruses that seasonally trouble humans, and cause common colds. Should SARS-CoV-2 joins this mix of microbes that irk us on an intermittent schedule, we might not have to worry much. The fact that colds, flus, and stomach bugs routinely reinfect hasn’t shredded the social fabric. “For large portions of the population, this is an inconvenience,” Paul Thomas, an immunologist at St. Jude Children’s Research Hospital, in Tennessee, told me.

Or maybe not. This virus seems capable of tangling into just about every tissue in the body, affecting organs such as the heart, brain, liver, kidneys, and gut; it has already claimed the lives of millions, while saddling countless others with symptoms that can linger for months or years. Experts think the typical SARS-CoV-2 infection is likely to get less dangerous, as population immunity builds and broadens. But considering our current baseline, “less dangerous” could still be terrible—and it’s not clear exactly where we’re headed. When it comes to reinfection, we “just don’t know enough,” says Emily Landon, an infectious-disease physician at the University of Chicago.

For now, every infection, and every subsequent reinfection, remains a toss of the dice. “Really, it’s a gamble,” says Ziyad Al-Aly, a clinical epidemiologist and long-COVID researcher at Washington University in St. Louis. Vaccination and infection-induced immunity may load the dice against landing on severe disease, but that danger will never go away completely, and scientists don’t yet know what happens to people who contract “mild” COVID over and over again.

“Will reinfection be really bad, or not a big deal? I think you could fall down on either side,” says Vineet Menachery, a coronavirologist at the University of Texas Medical Branch. “There’s still a lot of gray.”

Most of us are “no longer starting from scratch,” says Talia Swartz, an infectious-disease physician, virologist, and immunologist at Mount Sinai’s Icahn School of Medicine. Bodies, wised up to the virus’s quirks, can now react more quickly, clobbering it with sharper and speedier strikes.

Future versions of SARS-CoV-2 could continue to shape-shift out of existing antibodies’ reach, as coronaviruses often do. But the body is flush with other fighters that are much tougher to bamboozle—among them, B cells and T cells that can quash a growing infection before it spirals out of control.

Gordon, who is tracking large groups of people to study the risk of reinfection, is already starting to document promising patterns: Second infections and post-vaccination infections “are significantly less severe,” she told me, sometimes to the point where people don’t notice them at all.

Immunity, though, is neither binary nor permanent. Even if SARS-CoV-2’s assaults are blunted over time, there are no guarantees about the degree to which that happens, or how long it lasts. Maybe most future tussles with COVID will feel like nothing more than a shrimpy common cold. Or maybe they’ll end up like brutal flus. Wherever the average COVID case of the future lands, no two people’s experience of reinfection will be the same. A slew of factors could end up weighting the dice toward severe disease—among them, a person’s genetics, age, underlying medical conditions, health-care access, and frequency or magnitude of exposure to the virus. COVID redux could pose an especially big threat to people who are immunocompromised. And for everyone else, no amount of viral dampening can totally eliminate the chance, however small it may be, of getting very sick.

Long COVID, too, might remain a possibility with every discrete bout of illness. Or maybe the effects of a slow-but-steady trickle of minor, fast-resolving infections would sum together, and bring about the condition. Every time the body’s defenses are engaged, it “takes a lot of energy, and causes tissue damage,” Thomas told me. Should that become a near-constant barrage, “that’s probably not great for you.” But Swartz said she worries far more about that happening with viruses that chronically infect people, such as HIV. Bodies are resilient, especially when they’re offered time to rest, and she doubts that reinfection with a typically ephemeral virus such as SARS-CoV-2 would cause mounting damage. “The cumulative effect is more likely to be protective than detrimental,” she said, because of the immunity that’s laid down each time.

Al-Aly sees cause for worry either way. He is now running studies to track the long-term consequences of repeat encounters with the virus, and although the data are still emerging, he thinks that people who have caught the virus twice or thrice may be more likely to become long-haulers than those who have had it just once.

There’s still a lot about SARS-CoV-2, and the body’s response to it, that researchers don’t fully understand. Some other microbes, when they reinvade us, can fire up the immune system in unhelpful ways, driving bad bouts of inflammation that burn through the body, or duping certain defensive molecules into aiding, rather than blocking, the virus’s siege. Researchers don’t think SARS-CoV-2 will do the same. But this pathogen is “much more formidable than even someone working on coronaviruses would have expected,” Menachery told me.

Studying reinfection isn’t easy: To home in on the phenomenon and its consequences, scientists have to monitor large groups of people over long periods of time, trying to catch as many viral invasions as possible, including asymptomatic ones that might not be picked up without very frequent testing.

Almost no one can expect to avoid the virus altogether, but that doesn’t mean we can’t limit our exposures. Putting off reinfection creates fewer opportunities for harm: The dice are less likely to land on severe disease (or chronic illness) when they’re rolled less often overall. It also buys us time to enhance our understanding of the virus, and improve our tools to fight it.

The outlooks of the experts I spoke with spanned the range from optimism to pessimism, though all agreed that uncertainty loomed. Until we know more, none were keen to gamble with the virus—or with their own health. Any reinfection will likely still pose a threat, “even if it’s not the worst-case scenario,” Abdool Karim told me. “I wouldn’t want to put myself in that position.”


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29 May 2022, 8:03 pm

Well I am back. At least around 98 percent of me is back. I suffered a massive stroke (not COVID) related about a year ago. As a result I was out of commission for awhile.

COVID variants has become more contagious but the good news is that these variants have become less deadly in the process. I never got COVID, nor my wife, nor my two children, nor their husbands and three of my grandchildren. But the two smallest ones got it. (They were too small for the mask and they were too young to get vaccines.) They brought it home from school. But they suffered little to no effects from it. Young children generally have a type of build in immunity that protects them.

Now the big question is WHERE DID THIS VIRUS COME FROM? If it came from CHINA, was it developed in one of their virus testing labs? If it did, I would guess they might try and do it again with another type of virus.

So what to do?

Well there are three steps you can take to protect yourself should that happen.
1. Get a few N95 mask and set them aside (inside the house to keep them from getting mildew). One mask can last for a month or two, if you purify the mask using UVC filtration each day for around 10 minutes.
2. Get an air purify for your home that has a UVC filtration system built in it. There are many available in the market place.
3. Realize the threat is when indoor humidity levels are lower than 40 percent or greater than 60 percent. And the threat rises exponentially the closer you get towards 0 percent or 100 percent indoor humidity. The threat is generally an indoor threat not an outdoor threat. (There are some risks if you use public transportation.)

One of the things about COVID that was disastrous was
YOU ARE SAFE IF YOU ARE 6 FEET FROM SOMEONE INFECTED WITH COVID.

This was wrong. DEAD WRONG. COVID spread and infected people 50 feet away. That is why it was so contagious.


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29 May 2022, 9:58 pm

jimmy m wrote:
One of the things about COVID that was disastrous was
YOU ARE SAFE IF YOU ARE 6 FEET FROM SOMEONE INFECTED WITH COVID.

I think the main issue with that is that most US citizens don't know what six feet looks like, or just don't care at all.

And once people decided to weaponize the Coronavirus into a political issue, there was really nothing (within reason) that we could have done to save ourselves.


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29 May 2022, 10:55 pm

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The AstraZeneca vaccine may increase the risk of the serious neurological condition Guillain-Barré syndrome (GBS) with the jab’s Trojan horse delivery system possibly to blame, scientists believe, in a discovery which may apply to similar vaccines.

GBS is a rare condition which causes muscle numbness and pain, and can hinder movement, walking, swallowing and, sometimes, even breathing.

It is commonly caused by the gastroenteritis bug Campylobacter, which has a surface coating which looks slightly human, and so can sometimes trigger the body to attack its own nerves instead of invading germs, leading to GBS.

Now, scientists at University College London (UCL) have found a rise in cases of GBS in the first two to four weeks after the AstraZeneca vaccine, but not in other vaccines, such as Pfizer or Moderna.

[...]

Recent data from the US also suggests that the Johnson & Johnson Janssen vaccine - which also uses an adenovirus entry system - raises the risk of GBS to similar levels as the AstraZeneca jab.

“We know that Pfizer and Moderna don’t cause BDS but Johnson & Johnson and AstraZeneca do and the only commonality link is an adenovirus vector,” added Prof Lund.

“Johnson & Johnson is not the same one because they use a human adenovirus but it’s similar and the implications are broad because adenoviruses are used in quite a lot of vaccines and genetic therapies.

Source: https://www.telegraph.co.uk/news/2022/05/28/astrazeneca-vaccine-may-increase-risk-serious-neurological-condition/