ReportWire

Tag: Pandemic

  • Home-based workers became younger, more diverse in pandemic | Long Island Business News

    Home-based workers became younger, more diverse in pandemic | Long Island Business News

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    People working from home became younger, more diverse, better educated and more likely to move during the worst part of the COVID-19 pandemic, according to survey data from the U.S. Census Bureau.

    In many respects, the demographic makeup of people working from home from 2019 to 2021 became more like workers who were commuting, while the share of the U.S. labor force working from home went from 5.7% in 2019 to 17.9% in 2021, as restrictions were implemented to help slow the spread of the virus, according to a report released last week based on American Community Survey data.

    “The increase in homebased workers corresponded with a decline in drivers, carpoolers, transit riders, and most other types of commuters,” the report said.

    The share of people working from home between ages 25 and 34 jumped from 16% to 23% from 2019 to 2021. The share of home-based workers who are Black went from 7.8% to 9.5%, and it went from 5.7% to 9.6% for Asian workers. It remained flat for Hispanic workers, the report said.

    The share of home-based workers with a college degree also jumped from just over half to more than two-thirds, and people working from home were more likely to have moved in the past year than commuters.

    The two industry groups that saw the greatest jumps in people working from home were in information, where it went from 10.4% to 42%, and finance, insurance and real estate, going from 10.8% to 38.4%. Professional and administrative services, also went from 12.6% to 36.5%.

    The smallest gains were in agriculture and mining; entertainment and food services; and armed forces.

    While every income level saw jumps in people working from home, those in the highest income bracket were most likely to work from home. While it doubled from 2019 to 2021 for workers in the lowest income bracket, it tripled for those in the highest, the report said.

    Home-based work also varied by region. By 2021, it was more prevalent in the West and Northeast, making up about a fifth of the workforce, compared to 16.2% in the South and 15.8% in the Midwest. The variation may have been caused by the availability of Internet access, the cluster of information technology jobs on the coasts and the way people commute, whether by car or public transportation, the report said.

    The tech-heavy San Francisco and San Jose metro areas had more than a third of their labor force working from home in 2021 — the largest share among metros with more than 1 million residents.

    Since most pandemic restrictions have been lifted since the 2021 survey was taken, it is unknown at this point if the growth in work-from-home is permanent.

    “If only temporarily, the COVID-19 pandemic generated a massive shift in the way people in the United States related to their workplace location,” the report said. “With the centrality of work and commuting in American life, the widespread adoption of home-based work was a defining feature of the pandemic era.”

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  • Long COVID Hitting Some States, Minorities, Women Harder

    Long COVID Hitting Some States, Minorities, Women Harder

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    April 7, 2023 – More than 3 years into the COVID-19 pandemic, lasting symptoms are becoming quite common, with residents of certain states, women, Hispanic people, and transgender people more at risk, a new report shows. 


    More than one in four adults sickened by the virus go on to have long COVID, according to a new 

    report

    from the U.S. Census Bureau. Overall, nearly 15% of 

    all American adults

    – more than 38 million people nationwide – have had long COVID at some point since the start of the pandemic, according to the report. 


    The report, based on survey data collected between March 1 and 13, defines long COVID as symptoms lasting at least 3 months that people didn’t have before getting infected with the virus. 


    It is the second recent look at who is most likely to face long COVID.

    A similar study

    , published last month, found that women, smokers, and those who had severe COVID-19 infections are most likely to have the disorder


    The Census Bureau report found that while 27% of adults nationwide have had long COVID after getting infected with the virus, the condition has impacted some states more than others. The proportion of residents hit with long COVID ranged from a low of 18.8% in New Jersey to a high of 40.7% in West Virginia. 


    Other states with long COVID rates well below the national average include Alaska, Maryland, New York, and Wisconsin. At the other end of the spectrum, the states with rates well above the national average include Kentucky, Mississippi, New Mexico, Nevada, South Carolina, South Dakota, and Wyoming.


    Long COVID rates also varied by age, gender, and race. People in their 50s were most at risk, with about 31% of those infected by the virus going on to have long COVID, followed by those in their 40s, at more than 29%. 


    Far more women (almost 33%) than men (21%) with COVID infections got long COVID. And when researchers looked at long COVID rates based on gender identity, they found that transgender adults were more than twice as likely to have long COVID than cisgender males. Bisexual adults also had much higher long COVID rates than straight, gay, or lesbian people. 


    Long COVID was also much more common among Hispanic adults, affecting almost 29% of those infected with the virus, than among White or Black people, who had long COVID rates similar to the national average of 27%. Asian adults had lower long COVID rates than the national average, at less than 20%.


    People with disabilities were also at higher risk, with long COVID rates of almost 47%, compared with 24% among adults without disabilities.

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  • The Post-Covid Leader — How the CEO’s Role Has Changed in the Past 3 Years | Entrepreneur

    The Post-Covid Leader — How the CEO’s Role Has Changed in the Past 3 Years | Entrepreneur

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    Opinions expressed by Entrepreneur contributors are their own.

    So much has changed since Covid-19 first hit the U.S. in March 2020 — from how and where we work to what’s expected from employers to how we prioritize our values. We have been a witness to the Great Resignation, record-low unemployment and skyrocketing inflation. Over the past three years, the role of the CEO has adapted to the rapidly transforming needs of the workforce and customers.

    I’ve had the privilege of watching new best-in-class leadership practices emerge as a direct result of the immense change brought on by the pandemic. While mission, vision and values remain the central tenants determining every company’s North Star, great leaders know they cannot be stagnant in their search for success.

    Below are some of the big shifts I’ve noticed exemplary leaders have made due to the many lessons learned over the past three years:

    Related: Top 3 Leadership Skills to Maintain in a Post-Pandemic World

    Mastering the new CEO mindset

    With no playbook in hand, the pandemic forced business leaders across the board to give up long-standing beliefs and lean into the moment to make real-time decisions. Great leaders were able to let go of their sense of control and learn how to thrive amid uncertainty and turmoil with a collaborative mindset. Now, as the pandemic lifts, CEOs are finding success by remaining open-minded and nimble.

    They listen to customers and employees and also test and iterate to arrive at the best solution. Giving up a fixed mindset has created opportunities to learn, adapt and create something brand new. Many are seeing how offering new flexibility to employees has actually made their companies more productive and competitive. The world of work is continuing to change at a rapid rate. In today’s world, it’s equally important to anticipate and plan for a variety of possibilities as it is to be ready to pivot on a dime if unexpected circumstances arise.

    Making vulnerability and transparency a superpower

    Before Covid, many CEOs saw vulnerability as a sign of weakness. During the pandemic, great CEOs learned to embrace open, transparent and honest communication — even when the truth was difficult to share. And it is now well established that there is no weakness in listening to a variety of opinions. Now, hierarchies and command and control structures are being replaced by leaders who really seek to understand what’s happening on the front lines of their business by regularly speaking to employees who connect directly to customers. Leaders now listen to and learn from employees at all levels of the business, rather than feeling like they have to arrive at all the answers on their own.

    Related: Why Vulnerability Is a Strong Business Leader’s Most Powerful Weapon

    Thinking bigger and anticipating

    Now more than ever, top CEOs are actively seeking outside perspectives. When organizations make decisions in a vacuum, groupthink and confirmation bias can set in. Great leaders accept that they often need to get away from the business to work “on the business.” The world is more complex than ever. And CEOs are responsible for taking what’s happening in the surrounding world, making sense of it and building plans around it. By anticipating the business impact of everything from inflation to supply chain and economic factors, leaders are making better decisions and uncovering new solutions.

    Recruiting and retaining the right team

    CEOs are still responsible for setting the strategy, culture, organization, results and execution for their company. And Covid reaffirmed just how important it is to hire and retain the right people to execute those plans. When the talent wars picked up during The Great Resignation, it became clear that loyal and engaged employees are an unmatched differentiator during challenging times. These are the individuals who are willing to roll up their sleeves and pitch in to help the organization overcome obstacles.

    Without the right people on staff, a company will always be spending resources on attracting and training a new wave of talent instead of focusing on customer experience and the bottom line. Great CEOs have always known their team is most engaged when employees understand how their work connects to the company’s purpose. Now, successful CEOs are implementing strategies that cascade down the organization. With a strong team in place, everyone has a voice, from intern to C-suite — which both increases engagement and uncovers alternate ways of thinking.

    Related: 5 Lessons the Pandemic Has Taught Entrepreneurs

    When the pandemic hit, every leader had to be willing to throw their three-year plan out the door and start from scratch. While the pandemic presented devastating hardships and uncharted challenges, it also allowed us to open our minds to a new wave of leadership. CEOs who were able to embrace the changing tide have created a framework for what works moving forward.

    No longer is the CEO acting alone in a closed-door corner office, reporting out plans with little to no feedback. Today’s leader is best described as nimble, humble, vulnerable, transparent, inquisitive, collaborative and employee-centric. For CEOs, there has never been a more exciting time than now to make a lasting impact on the future of leadership.

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    Sam Reese

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  • China is not only asserting itself geopolitically but openly questioning the U.S.’s central role on the world stage

    China is not only asserting itself geopolitically but openly questioning the U.S.’s central role on the world stage

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    It’s been a busy few months for China — and sobering ones for the United States.

    Days later, Beijing announced it had brokered a deal that will see Persian Gulf rivals Saudi Arabia and Iran normalize relations, a shocking diplomatic coup in an area long dominated by the United States. Xi was reportedly personally involved in the negotiations.

    “This landmark agreement has the potential to transform the Middle East by realigning its major powers,” the journal Foreign Affairs declared, adding that the gambit is “weaving the region into China’s global ambitions. For Beijing, the announcement was a great leap forward in its rivalry with Washington.”

    But the biggest news came two weeks ago, when Xi flew to Moscow and met with Vladimir Putin, just days after the International Criminal Court in the Hague issued an arrest warrant for the Russian president on charges of war crimes in Russia’s year-old invasion of Ukraine.

    ‘China has seen a space where it is hard for the West to really block off — heading into issues [that the Western powers] feel are too intractable or too toxic to touch and trying to demonstrate that there might be a different way to mediate or involve yourself in these problems.’


    — Kerry Brown, King’s College London

    “There are changes coming that haven’t happened in 100 years,” Xi told Putin as the self-described “dear friends” concluded their talks. “When we are together, we are driving these changes.”

    China’s assertiveness comes after three years of COVID restrictions that saw the country close off from the world in an attempt to tame the virus, a policy that was suddenly scrapped in December.

    “It has sunk in that China needs friends. It has ended up too isolated, and that has cut across the narrative of the Xi third term, which was due to be somewhat more sunny,” Kerry Brown, director of the Lau China Institute at King’s College London, told MarketWatch.

    Others agreed. “China certainly is exiting a period of diplomatic isolation during the height of COVID,” said Victor Shih, the Ho Miu Lam chair in China and Pacific relations at the University of California, San Diego, and an expert on Chinese elite politics.

    That exit has been swift, with Beijing taking concrete steps toward a belief that previously had been mostly rhetoric — that the U.S.-led global system is not the only path.

    “China has seen a space where it is hard for the West to really block off — heading into issues [that the Western powers] feel are too intractable or too toxic to touch and trying to demonstrate that there might be a different way to mediate or involve yourself in these problems,” Brown said.

    Those sentiments are increasingly pervasive across China, particularly in government, academia and media.

    “The U.S., which is accustomed to enjoying the spotlight, is now puzzled for it never thought that one day China would be more popular than it,” state tabloid Global Times said in a front-page story last Thursday.

    Wang Yong, director of the Center for International Political Economy and the Center for American Studies at Peking University, told MarketWatch, “The rise of China as a great power is facing an increasingly complicated situation, mainly because U.S. elites judge China as the foremost strategic and systemic threat, and attack China’s development.”

    Wang highlighted concerns over Washington’s policy toward self-ruled Taiwan, which Beijing claims as a renegade province.

    In fact, Taiwanese President Tsai Ing-wen is stopping over in the U.S. this week after visits to the island’s few remaining allies in Central America. Beijing has threatened for weeks against her being welcomed by any high-level American officials.

    Those threats turned to ire on Monday, when Republican House Speaker Kevin McCarthy said he would meet with Tsai on Wednesday in California. China said this could lead to “serious confrontation” and that Beijing would “resolutely fight back” — without giving specifics.

    ‘Why is it assumed we live in a U.S. world?’


    — Alan Ma, graduate student, Tsinghua University.

    “Gradually deviating from the past promise of ‘one China,’ promoting Taiwan independence and using Taiwan to contain China’s development — these could trigger a China-U.S. war,” Peking University’s Wang said from Beijing.

    See: U.S. tells China not to ‘overreact’ to Taiwan leader’s stopover

    Average citizens including younger people expressed frustration with U.S. policy.

    Taiwan’s president, Tsai Ing-wen, arrives on Thursday at her hotel in New York.


    AP/John Minchillo

    “Why isn’t it China’s time to lead? Why is it assumed we live in a U.S. world?” asked 27-year-old Alan Ma, a graduate student in politics at Beijing’s Tsinghua University.

    Other areas are reaching heightened levels of tension. China’s military said last month it drove out an American destroyer ship that had “illegally” entered the South China Sea. And the CEO of Chinese-owned video sensation TikTok appeared before U.S. lawmakers in hopes of preventing an American ban on the app over national-security concerns.

    Context: Biden White House and bipartisan group of 12 senators back TikTok ban

    Also: TikTok is the next Chinese product the U.S. could shoot down

    But China’s rise, however rapid, must be put in a realistic context, experts said.

    “I don’t think that we can say China has entered a new period as a global power until it has deployed large troop contingents overseas on its own,” said UC San Diego’s Shih.

    Tanner Brown covers China for MarketWatch and Barron’s.

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  • Many U.S. soldiers packed on pounds during pandemic, making 10,000 obese, study shows

    Many U.S. soldiers packed on pounds during pandemic, making 10,000 obese, study shows

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    After gaining 30 pounds during the COVID-19 pandemic, U.S. Army Staff Sgt. Daniel Murillo is finally getting back into fighting shape.

    Early pandemic lockdowns, endless hours on his laptop and heightened stress led Murillo, 27, to reach for cookies and chips in the barracks at Fort Bragg in North Carolina. Gyms were closed, organized exercise was out and Murillo’s motivation to work out on his own was low.

    “I could notice it,” said Murillo, who is 5 feet, 5 inches tall and weighed as much as 192 pounds. “The uniform was tighter.”

    Murillo wasn’t the only service member dealing with extra weight. New research found that obesity in the U.S. military surged during the pandemic. In the Army alone, nearly 10,000 active duty soldiers developed obesity between February 2019 and June 2021, pushing the rate to nearly a quarter of the troops studied. Increases were seen in the U.S. Navy and Marines, as well.

    “The Army and the other services need to focus on how to bring the forces back to fitness,” said Tracey Perez Koehlmoos, director of the Center for Health Services Research at the Uniformed Services University in Bethesda, Maryland, who led the research.

    Overweight and obese troops are more likely to be injured and less likely to endure the physical demands of their profession. The military loses more than 650,000 workdays each year because of extra weight and obesity-related health costs exceed $1.5 billion annually for current and former service members and their families, federal research shows.

    More recent data won’t be available until later this year, said Koehlmoos. But there’s no sign that the trend is ending, underscoring longstanding concerns about the readiness of America’s fighting forces.

    Military leaders have been warning about the impact of obesity on the U.S. military for more than a decade, but the lingering pandemic effects highlight the need for urgent action, said retired Marine Corps Brigadier General Stephen Cheney, who co-authored a recent report on the problem.

    “The numbers have not gotten better,” Cheney said in a November webinar held by the American Security Project, a nonprofit think tank. “They are just getting worse and worse and worse.”

    In fiscal year 2022, the Army failed to make its recruiting goal for the first time, falling short by 15,000 recruits, or a quarter of the requirement. That’s largely because three-quarters of Americans aged 17 to 24 aren’ot eligible for military service for several reasons, including extra weight. Being overweight is the biggest individual disqualifier, affecting more than 1 in 10 potential recruits, according to the report.

    “It is devastating. We have a dramatic national security problem,” Cheney said.

    Extra weight can make it difficult for service members to meet core fitness requirements, which differ depending on the military branch. In the Army, for instance, if soldiers can’t pass the Army Combat Fitness Test, a recently updated measure of ability, it could result in probation or end their military careers.

    Koehlmoos and her team analyzed medical records for all active duty Army soldiers in the Military Health System Data Repository, a comprehensive archive. They looked at two periods: before the pandemic, from February 2019 to January 2020, and during the crisis, from September 2020 to June 2021. They excluded soldiers without complete records in both periods and those who were pregnant in the year before or during the study.

    Of the cohort of nearly 200,000 soldiers who remained, the researchers found that nearly 27% who were healthy before the pandemic became overweight. And nearly 16% of those who were previously overweight became obese. Before the pandemic, about 18% of the soldiers were obese; by 2021, it grew to 23%.

    The researchers relied on standard BMI, or body mass index, a calculation of weight and height used to categorize weight status. A person with a BMI of 18.5 to 25 is considered healthy, while a BMI of 25 to less than 30 is considered overweight. A BMI of 30 or higher is categorized as obese. Some experts claim that the BMI is a flawed measure that fails to account for muscle mass or underlying health status, though it remains a widely used tool.

    In Murillo’s case, his BMI during the pandemic reached nearly 32. The North Carolina Army soldier knew he needed help, so he turned to a military dietician and started a strict exercise routine through the Army’s Holistic Health and Fitness, or H2F, program.

    “We do two runs a week, 4 to 5 miles,” Murillo said. “Some mornings I wanted to quit, but I hung in there.”

    Slowly, over months, Murillo has been able to reverse the trajectory. Now, his BMI is just over 27, which falls within the Defense Department’s standard, Koehlmoos said.

    She found increases in other service branches, but focused first on the Army. The research squares with trends noted by the Centers for Disease Control and Prevention, which warned that in 2020, nearly 1 in 5 of all service members were obese.

    The steady creep of obesity among service members is “alarming,” said Cheney. “The country has not approached obesity as the problem it really is,” he added.

    Putting on extra pounds during the pandemic wasn’t just a military problem. A survey last year of American adults found that nearly half reported gaining weight after the first year of the COVID-19 emergency. Another study found a sharp rise in obesity among kids during the pandemic. The gains came in a country where more than 40% of American adults and nearly 20% of children struggle with obesity, according to the CDC.

    “Why would we think the military is any different than a person who is not in the military?” said Dr. Amy Rothberg, an endocrinologist at the University of Michigan who directs a weight-loss program. “Under stress, we want to store calories.”

    It will take broad measures to address the problem, including looking at the food offered in military cafeterias, understanding sleep patterns and treating service members with issues such as PTSD, or post-traumatic stress disorder, Rothberg said. Regarding obesity as a chronic disease that requires comprehensive care, not just willpower, is key. “We need to meet military members where they are,” she said.

    A new category of effective anti-obesity drugs, including semaglutide, marketed as Wegovy, could be a powerful aid, Rothberg said. TRICARE, the Defense Department’s health plan, covers such drugs, but uptake remains low. Since June 2021, when Wegovy was approved, just 174 service members have received prescriptions, TRICARE officials said. Novo Nordisk, which makes Wegovy, funded the security group’s report, but didn’t influence the research, Rothberg said.

    “People are working hard at their weight and we have to give them whatever tools we have,” Rothberg said.

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  • COVID cases and hospitalizations are on the decline but long COVID cases prevail. Here’s why.

    COVID cases and hospitalizations are on the decline but long COVID cases prevail. Here’s why.

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    COVID cases and hospitalizations are on the decline but long COVID cases prevail. Here’s why. – CBS News


    Watch CBS News



    It has been three years since the COVID-19 pandemic first hit, and while cases and hospitalizations are on the decline across the country, millions of long COVID patients are still battling lingering symptoms. CBS News contributor Dr. Celine Gounder visits a facility to learn more about the puzzling condition.

    Be the first to know

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  • Bias, Lack of Access Make Long COVID Worse for Patients of Color

    Bias, Lack of Access Make Long COVID Worse for Patients of Color

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    March 28, 2023 – Over and over, Mesha Liely was told that it was all in her head. That she was just a woman prone to exaggeration. That she had anxiety. That she simply needed to get more rest and take better care of herself. 

    The first time an ambulance rushed her to the emergency room in October 2021, she was certain something was seriously wrong. Her heart raced, her chest ached, she felt flushed, and she had numbness and tingling in her arms and legs. And she had recently had COVID-19. But after a 4-day hospital stay and a battery of tests, she was sent home with no diagnosis and told to see a cardiologist. 

    More than a dozen trips to the emergency room followed over the next several months. Liely saw a cardiologist and several other specialists: a gastroenterologist; an ear, nose, and throat doctor; a vascular doctor; and a neurologist. She got every test imaginable. But she still didn’t get a diagnosis. 

    “I believe more times than not, I was dismissed,” said Liely, 32, who is Black. “I am female. I am young. I am a minority. The odds are up against me.”

    By the time she finally got a diagnosis in May 2022, she felt like a bobble-head with weakness in her arms and legs, rashes and white patches of skin along the right side of her body, distorted vision, swelling and discomfort in her chest, and such a hard time with balance and coordination that she often struggled to walk or even stand up.

    “I was in a wheelchair when the doctor at Hopkins told me I had long COVID,” Liely said. “I just broke down and cried. The validation was the biggest thing for me.”

    Stark racial and ethnic disparities in who gets sick and who receives treatment have been clear since the early days of the pandemic. Black and Hispanic patients were more likely to get COVID than white people, and, when they did get sick, they were more likely to be hospitalized and more apt to die.

    Now, an emerging body of evidence also suggests that Black and Hispanic patients are also more likely to have long COVID – and more likely to get a broader range of symptoms and serious complications when they do. 

    One study recently published this year in the Journal of General Internal Medicine followed more than 62,000 adults in New York City who had COVID between March 2020 and October 2021. Researchers tracked their health for up to 6 months, comparing them to almost 250,000 people who never had COVID. 

    Among the roughly 13,000 people hospitalized with severe COVID, 1 in 4 were Black and 1 in 4 were Hispanic, while only 1 in 7 were white, this study found. After these patients left the hospital, Black adults were much more likely than white people to have headaches, chest pain, and joint pain. And Hispanic patients were more apt to have headaches, shortness of breath, joint pain, and chest pain.

    There were also racial and ethnic disparities among patients with milder COVID cases. Among people who weren’t hospitalized, Black adults were more likely to have blood clots in their lungs, chest pain, joint pain, anemia, or be malnourished. Hispanic adults were more likely than white adults to have dementia, headaches, anemia, chest pain, and diabetes. 

    Yet research also suggests that white people are more likely to get diagnosed and treated for long COVID. A separate study published this year in the journal BMC Medicine offers a profile of a typical long COVID patient receiving care at 34 medical centers across the country. And these patients are predominantly white, affluent, well-educated, female, and living in communities with great access to health care. 

    While more Black and Hispanic patients may get long COVID, “having symptoms of long COVID may not be the same as being able to get treatment.,” said Dhruv Khullar, MD, lead author of the New York City study and a doctor and assistant professor of health policy and economics at Weill Cornell Medical College in New York City.

    Many of the same issues that made many Black and Hispanic patients more vulnerable to infection during the pandemic may now be adding to their limited access to care for long COVID, Khullar said. 

    Nonwhite patients were more apt to have hourly jobs or be essential workers without any ability to telecommute to avoid COVID during the height of the pandemic, Khullar said. They’re also more likely to live in close quarters with family members or roommates and face long commutes on public transit, limiting their options for social distancing. 

    “If people that are going out of the home that are working in the subways or grocery stores or pharmacies or jobs deemed essential were disproportionately Black or Hispanic, they would have a much higher level of exposure to COVID than people who could work from home and have everything they needed delivered,” Khullar said. 

    Many of these hourly and low-wages workers are also uninsured or underinsured, lack paid sick time, struggle with issues like child care and transportation when they need checkups, and have less disposable income to cover copays and other out-of-pocket fees, Khullar said. “They can get access to acute urgent medical care, but it’s very hard for a lot of people to access routine care like you would need for long COVID,” Khullar says.

    These longstanding barriers to care are now contributing to more long COVID cases – and worse symptoms – among Black and Hispanic patients, said Alba Miranda Azola, MD, co-director of the Post-Acute COVID-19 Team at Johns Hopkins University School of Medicine in Baltimore. 

    “They basically push through their symptoms for too long without getting care either because they don’t see a doctor at all or because the doctor they do see doesn’t do anything to help” said Azola, who diagnosed Mesha Liely with long COVID. “By the time they get to me, their symptoms are much worse than they needed to be.”

    In many ways, Liely’s case is typical of the Black and Hispanic patients Azola sees with long COVID. “It’s not unusual for patients have 10 or even 15 visits to the emergency room without getting any help before they get to me,” Azola said. “Long COVID is poorly understood and underdiagnosed and they just feel gaslit.”

    What sets Liely apart is that her job as 911 operator comes with good health benefits and easy access to care. 

    “I started to notice a pattern where when I go to the ER and my co-workers are there or I am in my law enforcement uniform, and everyone is so concerned and takes me right back,” she recalled. “But when I would go dressed in my regular clothing, I would be waiting 8 to 10 hours and nobody would acknowledge me, or they would ask if I was just here to get pain medicines.”

    Liely can easily see how other long COVID patients who look like her might never get diagnosed at all. “It makes me mad but doesn’t surprise me,” she says. 

    After months of long COVID treatment, including medications for heart issues and muscle weakness as well as home health care, occupational therapy, and physical therapy, Liely went back to work in December. Now, she has good days and bad days. 

    “On the days I wake up and feel like I’m dying because I feel so bad, that’s when I really think it didn’t need to be like this if only I had been able to get somebody to listen to me sooner,” she said.

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  • Who Is Most Likely to Get Long COVID? Patient Data May Tell

    Who Is Most Likely to Get Long COVID? Patient Data May Tell

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    March 27, 2023 – Good news and bad news on the long COVID front: Certain groups of people – like women, smokers, and those who had severe COVID-19 infections – are at a higher risk of long COVID, a review of more than 800,000 patients has found. 

    That’s the bad news. Yet, researchers also found that patients who had at least two doses of the COVID vaccine had a significantly lower risk of getting long COVID down the line. 

    “Not only is it important to recognize which individuals may be at high risk of developing PCC [post−COVID-19 condition] and to offer follow-up care; it is imperative to plan population-level public health measures,” wrote lead author Vassilios Vassiliou, PhD, a professor of cardiac medicine at the University of East Anglia in Norwich, England, and his team. 

    The research, published in the journal JAMA Internal Medicine, combined 41 previously published articles that included information from 860,783 patients. The review uncovered a slew of demographic traits that were significantly linked to long COVID, including female sex, being over 40 years old, smoking, having a high body mass index (BMI), and hospitalization due to a COVID-19 infection. 

    Long COVID, as defined by the World Health Organization, is the continuation of COVID symptoms or the start of new symptoms at least 3 months after initial infection.

    Having other conditions – like anxiety, depression, asthma, diabetes, and being immunocompromised – were also connected to a higher likelihood of getting long COVID, researchers reported. 

    That cisgender women are at a higher risk of long COVID falls in line with previous analyses, suggesting that hormones might play a role “in perpetuating the hyperinflammatory status of the acute phase of COVID-19 even after recovery.” 

    The same goes for previous studies on vaccination status and long COVID risk – like much of the previous research on the subject, vaccinations were found to have a protective effect on long COVID. 

    But long COVID – all the ways it presents itself, how widespread it is, and what we can do about it – still remains somewhat of a mystery, even 3 years into the pandemic. 

    “While this and other data on vaccines suggest that there are factors that can reduce the risk of long COVID, nothing as of yet can completely eliminate the risk of long COVID. The only guarantee against long COVID is not to get COVID,” said Stanford University primary care professor Linda Geng, MD, PhD. 

     

    “Furthermore, we still do not have any effective therapy established for the millions who already have long COVID, and we urgently need randomized controlled trials to help provide those answers,” she said.

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  • ‘We’re Struggling’: Long COVID Mystery Has Doctors in the Dark

    ‘We’re Struggling’: Long COVID Mystery Has Doctors in the Dark

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    March 23, 2023 — This month, I took care of a patient who recently contracted COVID-19 and was complaining of chest pain. After ruling out the possibility of a heart attack, pulmonary embolism, or pneumonia, I concluded that this was a residual symptom of COVID. 

    Chest pain is a common lingering symptom of COVID. However, because of the scarcity of knowledge regarding these post-acute symptoms, I was unable to counsel my patient on how long this symptom would last, why he was experiencing it, or what its actual cause was. 

    Such is the state of knowledge on long COVID. That informational vacuum is why we’re struggling and doctors are in a tough spot when it comes to diagnosing and treating patients with the condition.

    Almost daily, new studies are published about long COVID (technically known as post-acute sequelae of COVID-19 [PASC]) and its societal impacts. These studies often calculate various statistics regarding the prevalence of this condition, its duration, and its scope. 

    However, many of these studies do not provide the complete picture — and they certainly do not when they are interpreted by t

    he lay press and turned into clickbait. 

    Long COVID is real, but there is a lot of context that is omitted in many of the discussions that surround it. Unpacking this condition and situating it in the larger context is an important means of gaining traction on this condition. 

    And that’s critical for doctors who are seeing patients with symptoms.

    Long COVID: What Is It?   

    The CDC considers long COVID to be an umbrella term for “health consequences” that are present at least 4 weeks after an acute infection. This condition can be considered “a lack of return to the usual state of health following COVID,” according to the CDC.

    Common symptoms include fatigue, shortness of breath, exercise intolerance, “brain fog,” chest pain, cough, and loss of taste/smell. Note that it’s not a requirement that that symptoms be severe enough that they interfere with activities of daily living, just that they are present.

    There is no diagnostic test or criteria that confirms this diagnosis. Therefore, the symptoms and definitions above are vague and make it difficult to gauge prevalence of the disease. Hence, the varying estimates that range from 5% to 30%, depending on the study. 

    Indeed, when one does routine blood work or imaging on these patients, it is unlikely that any abnormality is found. Some individuals, however, have met diagnostic criteria and have been diagnosed with postural orthostatic tachycardia syndrome (POTS). POTS is a disorder commonly found in long COVID patients that causes problems in how the autonomic nervous system regulates heart rate when moving from sitting to standing, during which blood pressure changes occur. 

    How to Distinguish Long COVID From Other Conditions

    There are important conditions that should be ruled out in the evaluation of someone with long COVID. First, any undiagnosed condition or change in an underlying condition that could explain the symptoms should be considered and ruled out. 

    Secondly, it is critical to recognize that those who were in the intensive care unit or even hospitalized with COVID should not really be grouped together with those who had uncomplicated COVID that did not require medical attention. 

    One reason for this is a condition known as post-ICU syndrome or PICS. PICS can occur in anyone who is admitted to the ICU for any reason and is likely the result of many factors common to ICU patients. They include immobility, severe disruption of sleep/wake cycles, exposure to sedatives and paralytics, and critical illness. 

    Those individuals are not expected to recover quickly and may have residual health problems that persist for years, depending on the nature of their illness. They even have heightened mortality

    The same is true, to a lesser extent, to those hospitalized whose “post-hospital” syndrome places them at higher risk for experiencing ongoing symptoms. 

    To be clear, this is not to say that long COVID does not occur in the more severely ill patients, just that it must be distinguished from these conditions. In the early stages of trying to define the condition, it is more difficult if these categories are all grouped together. The CDC definition and many studies do not draw this important distinction and may confuse long COVID with PICS and post-hospital syndrome.

    Control Groups in Studies Are Key

    Another important means to understand this condition is to conduct studies with control groups, directly comparing those who had COVID with those that did not. 

    Such a study design allows researchers to isolate the impact of COVID and separate it from other factors that could be playing a role in the symptoms. When researchers conduct studies with control arms, the prevalence of the condition is always lower than without. 

    In fact, one notable study demonstrated comparable prevalence of long COVID symptoms in those who had COVID versus those that believe they had COVID. 

    Identifying Risk Factors

    Several studies have suggested certain individuals may be overrepresented among long COVID patients. These risk factors for long COVID include women, those who are older, those with preexisting psychiatric illness (depression/anxiety), and those who are obese. 

    Additionally, other factors associated with long COVID include reactivation of Epstein-Barr virus (EBV), abnormal cortisol levels, and high viral loads of the coronavirus during acute infection. 

    None of these factors has been shown to play a causal role, but they are clues for an underlying cause. However, it is not clear that long COVID is monolithic — there may be subtypes or more than one condition underlying the symptoms. 

    Lastly, long COVID also appears to be only associated with infection by the non-Omicron variants of COVID.

    Role of Antivirals and Vaccines 

    The use of vaccines has been shown to lower, but not entirely eliminate, the risk of long COVID. This is a reason why low-risk individuals benefit from COVID vaccination. Some have also reported a therapeutic benefit of vaccination on long COVID patients. 

    Similarly, there are indications that antivirals may also diminish the risk for long COVID, presumably by influencing viral load kinetics. It will be important, as newer antivirals are developed, to think about the role of antivirals not just in the prevention of severe disease but also as a mechanism to lower the risk of developing persistent symptoms. 

    There may also be a role for other anti-inflammatory medications and other drugs such as metformin.

     Long COVID and Other Infectious Diseases 

    The recognition of long COVID has prompted many to wonder if it occurs with other infectious diseases. Those in my field of infectious disease have routinely been referred patients with persistent symptoms after treatment for Lyme disease or after recovery from the infectious mononucleosis. 

    Individuals with influenza may cough for weeks post-recovery, and even patients with Ebola may have persistent symptoms (though the severity of most Ebola causes makes it difficult to include). 

    Some experts suspect an individual human’s immune response may influence the development of post-acute symptoms. The fact that so many people were sickened with COVID at once allowed a rare phenomenon that always existed with many types of infections to become more visible.

    Where to Go From Here: A Research Agenda

    Before anything can be definitely said about long COVID, fundamental scientific questions must be answered. 

    Without an understanding of the biological basis of this condition, it becomes impossible to diagnose patients, development treatment regimens, or to prognosticate (though symptoms seem to dissipate over time). 

    It was recently said that unraveling the intricacies of this condition will lead to many new insights about how the immune system works — an exciting prospect in and of itself that will advance science and human health.

    Armed with that information, the next time clinicians see a patient such as the one I did, we will be in a much better position to explain to a patient why they are experiencing such symptoms, provide treatment recommendations, and offer prognosis. 

    Amesh A. Adalja, MD, is an infectious disease, critical care, and emergency medicine specialist in Pittsburgh, and senior scholar with the Johns Hopkins Center for Health Security.

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  • Credit cards outstanding up a record 29.6% in FY23 till end-Jan

    Credit cards outstanding up a record 29.6% in FY23 till end-Jan

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    The total credit card outstanding in the current financial year so far, has increased significantly, at 29.6 per cent, compared with last year, according to Reserve Bank of India (RBI) data.

    The credit card outstanding stood at ₹1,86,783 crore as on January 27, 2023, (first 10 months of FY23) as against ₹1,44,162 crore in the year-ago period. In the comparable period of FY22, credit card outstanding grew by 9.3 per cent compared with the previous financial year (FY21).

    “Credit card usage has recently surged due to an increased discretionary spending on vacation, travel, entertainment and consumer durables,” BIbekananda Panda, Senior Economist, State Bank of India, told businessline.

    ‘Dramatic shift’

    “Following the pandemic, the credit card space has undergone a dramatic shift as ease of payments, mass acceptance of credit cards without additional fee. An analysis of the RBI data shows that the spurt in credit card outstanding is primarily driven by positive factors,’‘ Panda added.

    According to Krishnan Sitaraman, Senior Director and Deputy Chief Ratings Officer, Crisil Ratings, this is “clearly a reflection of the economy bouncing back’‘ and rebounding well after the pandemic.

    “We see a spurt in card usage in hospitality, travel/leisure, utility bill payments, healthcare, education, consumer durables, and e-commerce in general. More than 60 per cent of the card spends are now for online transactions. There has been a growth in incremental spends as well as spend per card. Cards in force have also gone up. From an asset quality perspective, we are not seeing any material increase in delinquencies as of now but that is what will be important to monitor and manage if NPAs are to be kept under control,” he added.

    The incremental credit card spend in the current financial year so far (till January end) has gone up by 50 per cent along with an increase in spend per card. The current data should be read in the context of low credit card penetration in India, said Prasanna Tantri, Executive Director, Centre for Analytical Finance, Indian School of Business (ISB).

    “The total outstanding credit card balance is less than 2 per cent of bank credit and 2.5 per cent of our annual savings,’‘ he added.

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  • The Affordable Care Act has significantly reduced racial disparities in healthcare access, report says

    The Affordable Care Act has significantly reduced racial disparities in healthcare access, report says

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    The Affordable Care Act, passed in 2010 by former President Barack Obama, has expanded health insurance coverage across the U.S. and significantly reduced racial and ethnic disparities in access to healthcare, according to a new report by the Commonwealth Fund.

    Percentage of U.S. adults ages 19–64 who are uninsured, by race/ethnicity
    Coverage inequities between Black, Hispanic, and white adults have narrowed substantially since 2013. All groups reported improvements between 2019 and 2021.

    The Commonwealth Fund


    “Since its passage in 2010, the Affordable Care Act (ACA) has helped cut the U.S. uninsured rate nearly in half while significantly reducing racial and ethnic disparities in both insurance coverage and access to care — particularly in states that expanded their Medicaid programs,” reads the report.

    Data shows that prior to the 2013 implementation of the Medicaid expansion — a provision of the ACA that made more families eligible for Medicaid coverage — 40.2% of the Hispanic population, 24.4% of the Black population, and 14.5% of the White population were uninsured in America. However, by 2021, those numbers dropped significantly to 24.5%, 13.5%, and 8.2%, respectively.

    Percentage-point change in uninsured rate for U.S. adults ages 19–64 from 2019 to 2021, by state and race/ethnicity
    Uninsured rates for Black and Hispanic adults improved considerably in several states between 2019 and 2021, while white adults experienced modest gains in most regions. 

    The Commonwealth Fund


    With more than five million people gaining coverage between 2020 and 2022 over the course of the pandemic, the overall uninsured rate in the U.S. dropped to just 8%, a historic low, according to the report.

    The report highlights specific ACA successes, including improved coverage rates for Black, Hispanic and White adults.

    “The coverage gap between Black and White adults dropped from 9.9 to 5.3 percentage points, while the gap between Hispanic and White adults dropped from 25.7 to 16.3 points,” according to the the study. 

    Additionally, the report found that adult uninsured rates for Black, Hispanic, and White people all improved during the first two years of the pandemic across all states — whether they had expanded their Medicare coverage or not —  and that Black and Hispanic adults experienced larger gains in insurance coverage than their White counterparts between from 2019 to 2021.

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  • Records may show double billing for some US-supported work done at Chinese research facilities

    Records may show double billing for some US-supported work done at Chinese research facilities

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    Records may show double billing for some US-supported work done at Chinese research facilities – CBS News


    Watch CBS News



    CBS News has reviewed records that may show the U.S. government paid twice for aspects of projects carried out at a research lab in Wuhan and other facilities in China. Now USAID’s internal watchdog has opened a probe after receiving information from Republican Sen. Roger Marshall. Senior investigative correspondent Catherine Herridge reports. Editor’s note: Graphics in the video have been updated and the web version of this report has been updated to include a comment about our report by Peter Daszak of EcoHealth Alliance.

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  • New genetic analysis finds clues to animal origin of COVID outbreak

    New genetic analysis finds clues to animal origin of COVID outbreak

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    The World Health Organization called Friday for Chinese health authorities to release genetic sequences of SARS-CoV-2 the country recently took down from an international database, after an analysis of the data found it offered new clues that might point towards an animal origin for the COVID-19 pandemic.

    The plea comes after a group of scientists outside China analyzed genetic sequences of SARS-CoV-2 viruses that had been initially posted late last month to the GISAID database by China’s Center for Disease Control and Prevention. The database is a site where scientists worldwide can access and share genetic sequencing and other data.

    The data came from samples taken in early 2020 around the Huanan animal market in Wuhan, which investigations by U.S. and Chinese authorities had pointed to as a potential early epicenter for the outbreak.

    Analysis of those samples found “molecular evidence” of animals like raccoon dogs at the market intermingled in swabs from the same spots that turned up the shedding from the virus itself in the market. 

    Raccoon dogs are a species susceptible to SARS-CoV-2 infection that could potentially have served as an intermediate host, carrying the virus from bats or another source to humans. However, the samples only indicate that both raccoon dogs and the virus were present at the market; it is not direct proof that the species was the carrier.

    Raccoon dog - file photo
    File photo of a raccoon dog 

    ARTERRA/Universal Images Group via Getty Images


    “We need to make clear that the virus has not been identified in an animal in the market or in animal samples from the market, nor have we actually found the animals that infected humans. What this does is provides clues. It provides clues to help us understand what may have happened,” the WHO’s Maria Van Kerkhove told reporters Friday of the findings.

    This new data prompted a meeting Tuesday of the WHO’s Scientific Advisory Group for the Origins of Novel Pathogens for the international scientists to present their analysis, as well as with the Chinese CDC researchers who had initially posted the data.

    It is not clear why China’s CDC later requested to remove the sequences they had originally posted to GISAID last month or why they waited three years to release the data. 

    “We have been told by GISAID that the data from China CDC is being updated and expanded. But again, we have called on China CDC directly to make that data accessible in full. And so that remains absolutely fundamental,” Van Kerkhove said.

    The data had initially been posted by the Chinese researchers as part of work on a publication initially released last year as a preprint, she said. 

    Researchers from China’s CDC released a preprint last year, which is now “under review,” that concluded that the Huanan market “might have acted as an amplifier” for spread of the virus introduced to the market by humans.

    George Gao, the preprint’s lead author and the former head of the Chinese CDC, downplayed the significance of the new analysis to Science magazine. Gao said that it “had been known there was illegal animal dealing and this is why the market was immediately shut down.”

    Gao declined to comment on why the sequences were initially posted and then taken down, deferring comment to GISAID. GISAID did not immediately return a request for comment.

    Questions also are unanswered about the new analysis, which was first reported by The Atlantic. For example, Van Kerkhove declined to specify additional details about how and what other animals were identified in the sequencing analysis, deferring comment to the researchers.

    French scientist Florence Débarre, named by The Atlantic as the researcher who initially spotted the sequences, did not respond to a request for comment. 

    On Twitter, Débarre wrote that they were “not planning to communicate results before our report was finished. Finishing the report is my current priority.”

    But even if Chinese health authorities repost the sequences they removed from GISAID, Van Kerkhove cautioned that far more research would be needed to understand if COVID-19’s origins could be conclusively linked to animals sold at the market. 

    “We have repeatedly asked for studies to be done in other markets in Wuhan and in Hubei and across China. We have repeatedly asked for studies to trace those animals back to their source farms so that we can go back in time and actually look to see where the animals came from and if any testing had been done,” said Van Kerkhove.

    While scientists have discovered evidence that suggests COVID-19 likely had zoonotic origins — that the virus emerged from animals that infected humans, similar to previous viruses — some elements of the U.S. intelligence community have concluded that it’s plausible the pandemic originated from a laboratory accident.

    “Based on my initial analysis of the data, I came to believe, and I still believe today, that it indicates that COVID 19 more likely was the result of an accidental lab leak than a result of a natural spillover event,” former Trump administration CDC Director Dr. Robert Redfield told a hearing organized by House Republicans earlier this month.

    In an interview with CBS News on Thursday, Dr. Anthony Fauci, who helped lead the U.S. response to the pandemic, said it’s possible we may never get a conclusive answer to the question of COVID’s origins.

    “There really is no definitive proof,” he said. “We may not ever know precisely and definitively.”

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  • It’s (Finally) Time to Stop Calling It a Pandemic: Experts

    It’s (Finally) Time to Stop Calling It a Pandemic: Experts

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    March 17, 2023 — It’s been 3 years since the World Health Organization officially declared the COVID-19 emergency a pandemic. Now, with health systems no longer overwhelmed and more than a year of no surprise variants, many infectious disease experts are declaring a shift in the crisis from pandemic to endemic.

    Endemic, broadly, means the virus and its patterns are predictable and steady in designated regions. But not all experts agree that we’re there yet.

    Eric Topol, MD, founder and director of the Scripps Research Translational Institute in La Jolla, CA, and editor in chief of Medscape, WebMD’s sister site for health professionals, said it’s time to call COVID endemic.

    He wrote in his Substack, Ground Truth, that all indications — from genomic surveillance of the virus to wastewater to clinical outcomes that are still being tracked — point to a new reality: “[W]e’ve (finally) entered an endemic phase. “

    No new SARS-CoV-2 variants have yet emerged with a growth advantage over XBB.1.5, which is dominant throughout much of the world, or XBB.1.9.1, wrote Topol. 

    But he has two concerns. One is the number of daily hospitalizations and deaths – hovering at near 26,000 and 350, respectively, according to The New York Times COVID tracker. That’s far more than the daily number of deaths in a severe flu season.

    “This is far beyond (double) where we were in June 2021,” he wrote.

    Topol’s second concern is the chance that a new family of virus might evolve that is even more infectious or lethal – or both – than the recent Omicron variants.

    Three Reasons to Call It Endemic

    William Schaffner, MD, infectious disease expert at Vanderbilt University Medical Center in Nashville, is in the endemic camp as well for three reasons.

    First, he said, “We have very high population immunity. We’re no longer seeing huge surges, but we’re seeing ongoing smoldering transmission.”

    Also, though noting the concerning numbers of daily deaths and hospitalizations, Schaffner said, “it’s no longer causing crises in health care or, beyond that, into the community economically and socially anymore.”

    “Number three, the variants causing illness are Omicron and its progeny, the Omicron subvariants. And whether because of population immunity or because they are inherently less virulent, they are causing milder disease,” Schaffner said. 

    Changing societal norms are also a sign the U.S. is moving on, he said. “Look around. People are behaving endemically.”

    They’re shedding masks, gathering in crowded spaces, and shrugging off additional vaccines, “which implies a certain tolerance of this infection. We tolerate the flu,” he noted.

    Schaffner said he would limit his scope of where COVID is endemic or close to endemic to the developed world.

    “I’m more cautious about the developing world because our surveillance system there isn’t as good,” he said.

    He added a caveat to his endemic enthusiasm, conceding that a highly virulent new variant that can resist current vaccines could torpedo endemic status.

    No Huge Peaks

    “I’m going to go with we’re endemic,” said Dennis Cunningham, MD, system medical director of infection prevention of the Henry Ford Health System in Detroit.

    “I’m using the definition that we know there’s disease in the population. It occurs regularly at a consistent rate. In Michigan, we’re no longer having those huge peaks of cases,” he said.

    Cunningham said though the deaths from COVID are disturbing, “I would call cardiovascular disease endemic in this country and we have far more than a few hundred deaths a day from that.”

    He also noted that vaccines have resulted in high levels of control of the disease in terms of reducing hospitalizations and deaths. 

    The discussion really becomes an academic argument, Cunningham said. 

    “Even if we call it endemic, it’s still a serious virus that’s really putting a lot of a strain on our health care system.”

     Not So Fast

    But not everyone is ready to go all-in with “endemic.”

    Stuart Ray, MD, professor of medicine in the Division of Infectious Diseases at Johns Hopkins School of Medicine in Baltimore, said any endemic designation would be specific to a certain area.

    “We don’t have much information about what’s happening in China, so I don’t know that we can say what state they’re in, for example,” he said.

    Information in the U.S. is incomplete as well, Ray said, noting that while home testing in the U.S. has been a great tool, it has made true case counts difficult.

    “Our visibility on the number of infections in the United States has, understandably, been degraded by home testing. We have to use other means to glean what’s happening with COVID,” he said.

    “There are people with infections we don’t know about and something from that dynamic could surprise us,” he said.

    There are also a growing number of young people who have not yet had COVID, and with low vaccination rates among young people, “we might see spikes in infections again,” Ray said.

    Why No Official Endemic Declaration?

    Some question why endemic hasn’t been declared by the WHO or CDC.

    Ray said health authorities tend to declare emergencies, but are slower to make pronouncements that an emergency has ended if they make one at all.

    President Joe Biden set May 11 as the end of the COVID emergency declaration in the U.S. after extending the deadline several times. The emergency status allowed millions to receive free tests, vaccines, and treatments. 

    Ray said we will only truly know when the endemic started retrospectively. 

    “Just like I think we’ll look back at March 9 and say that Baltimore is out of winter. But there may be a storm that will surprise me,” he aid.

    Not Enough Time to Know

    Epidemiologist Katelyn Jetelina, PhD, MPH, director of population health analytics at the Meadows Mental Health Policy Institute in Dallas, and a senior scientific consultant to the CDC, said we haven’t had enough time with COVID to call it endemic.

    For influenza, she said, which is endemic, “It’s predictable and we know when we’ll have waves.”  

    But COVID has too many unknowns, she said.

    What we do know is that moving to endemic does not mean an end to the suffering, said Jetelina, who also publishes a Substack called Your Local Epidemiologist

    “We see that with malaria and [tuberculosis] and flu. There’s going to be suffering,” she said.

    Public expectations for tolerating illness and death with COVID are still widely debated. 

    “We don’t have a metric for what is an acceptable level of mortality for an endemic. It’s defined more by our culture and our values and what we do end up accepting,” she said. “That’s why we’re seeing this tug of war between urgency and normalcy. We’re deciding where we place SARS-CoV-2 in our repertoire of threats.”

     She said in the U.S., people don’t know what these waves are going to look like — whether they will be seasonal or whether people can expect a summer wave in the South again or whether another variant of concern will come out of nowhere. 

    “I can see a future where (COVID) is not a big deal in certain countries that have such high immunity through vaccinations and other places where it remains a crisis.

    “We all hope we’re inching toward the endemic phase, but who knows? SARS-CoV-2 has taught me to approach it with humility,” Jetelina said. “We don’t ultimately know what’s going to happen.” 

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  • NOVIDS: Do Some Have the Genes to Dodge COVID?

    NOVIDS: Do Some Have the Genes to Dodge COVID?

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    NOVIDS is the term some use to describe those who haven’t gotten COVID. But researchers are not overly fond of the word. They’re looking for the possible genetic underpinnings to a group of people they prefer to call “resisters.”

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  • WebMD Poll: Another Year of Tough COVID Questions

    WebMD Poll: Another Year of Tough COVID Questions

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    March 15, 2023 — Last year, on the second anniversary of the COVID-19 pandemic, we asked our audience questions about their pandemic experiences. A year later – and 3 years into living with COVID – we followed up with some more. 

    In total, our poll received 696 responses. Nearly 66% of those who answered identified as female, and 76% reported that they are older than 45. The confidence level used for editorial polls is 95%. 

    The fall of 2022 started out with President Joe Biden claiming that “the pandemic is over” on CBS’s 60 MinutesSince then, he has ordered an end to the COVID-19 emergency orders issued in 2020, causing people to wonder if this really might be the beginning of the end of the pandemic.

     In 2022, WebMD readers, for the most part (84%) did not see an end in sight. But a year later, attitudes seem to be shifting. Our current poll found that nearly a third – 30% – of our audience thinks the pandemic has  come to an end. However, 42% of men said the pandemic is over, compared to just 25% of women. 

    The data, however, says differently. While daily life may have returned to its normal pace and we’re no longer in the midst of a state of emergency, many experts agree that we shouldn’t let our guard down. New cases and the number of deaths per week have indeed leveled off since January 2022, but data shows that there are still thousands of new cases reported daily. And given the evolution of the virus’s many variants, doctors and public health officials continue to urge caution. 

    The availability of vaccines and boosters is a big part of why we all feel more comfortable doing the everyday tasks that we may have taken for granted during the pandemic’s first couple of years. How many people, though, are actually protected against the virus? According to our poll, 7 in 10 respondents have been fully vaccinated against COVID-19; nearly 6 in 10 of those fully vaccinated have received at least two boosters (57%).

    However, these numbers don’t totally reflect the reality of vaccine and booster uptake in the U.S. According to CDC data, Americans on the whole – quite similar to our findings – have completed their initial vaccination series at a rate of nearly 70%. But of those who have gotten fully vaccinated, only a little more than 23% have gotten at least one dose of the bivalent booster. 

    Sixty percent of respondents to our poll said that they have had COVID-19 at least once, which is notable when compared to an exhaustive nationwide survey that found that about half of Americans have had COVID. Within that study, however, researchers said there is a large chunk of positive at-home tests that have gone unreported. 

    Whether you had COVID-19 or not, the pandemic has undoubtedly changed the way we see and interact with the world around us. Last year, an overwhelming 88% of respondents agreed on this; this year, about half of our readers agreed with this statement – possibly indicating a growing acceptance of the changes happening around us.

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  • 3 Years On, Why Don’t We Know the Extent of Long COVID?

    3 Years On, Why Don’t We Know the Extent of Long COVID?

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    SOURCES:

    Amesh Adalja, MD, senior scholar, Johns Hopkins University Center for Health Security.

    Manali Mukherjee, PhD, immunologist, assistant professor, Division of Respirology, Department of Medicine, McMaster University.

    Sarah Wulf Hanson, PhD, research scientist, Institute for Health Metrics and Evaluation, University of Washington.

    Lisa McCorkell, co-founder, Patient-Led Research Collaborative.

    Julia Moore Vogel, PhD, program director, Participant Center, All of Us Research Program, Scripps Research Translational Institute.

    The BMJ: “Long COVID outcomes at one year after mild SARS-CoV-2 infection: nationwide cohort study.” 

    Nature Reviews Microbiology: “Long COVID: Major findings, mechanisms and recommendations.” 

    CDC National Center for Health Statistics: “Long COVID Household Pulse Survey.”

    Nature Medicine: “Unexplained post-acute infection syndromes.”

    Patient-Led Research Collaborative.

    World Health Organization: “Post COVID-19 condition (Long COVID).”

    CDC: “Post-COVID Conditions: CDC Science.”

    The European Respiratory Journal: “Circulating anti-nuclear autoantibodies in COVID-19 survivors predict long COVID symptoms.”

    Emerging Infectious Diseases: “Postacute Sequelae of SARS-CoV-2 in University Setting.”

    International Severe Acute Respiratory and emerging Infection Consortium (ISARIC): “Clinical Characterisation Protocol (CCP).”

     

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  • Future COVID Vaccines Must Be Better; Science Races to Respond

    Future COVID Vaccines Must Be Better; Science Races to Respond

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    SOURCES 

    David L. Hoey, president and CEO of Vaxxas, Cambridge, MA, and Brisbane, Australia.

    Pablo Penaloza-MacMaster, PhD, assistant professor of microbiology and immunology, Feinberg School of Medicine, Northwestern University, Chicago.

    Jasdave Chahal, PhD, co-founder and chief scientist, Tiba Biotech, Cambridge, MA, and Brisbane, Australia.

    Vaxart news release: “Vaxart Announced Positive Top-line Phase II clinical Study Data Demonstrating Safaety and Immunogenicity of Its Wuhan S-Only COVID-19 Pill Vaccine Candidate.”

    Mark Herr, spokesperson, Vaxart Inc. 

    The Commonwealth Fund: “Two Years of  U.S. COVID-19 Vaccines Have Prevented Millions of Hospitalizations and Deaths.”

    The Lancet Infectious Diseases: “Global impact of the first year of COVID-19 vaccination: a mathematical modelling study.” 

    CDC: COVID Data Tracker, “Needle Fears and Phobias—Find Ways to Manage.”

    U.S. Specialty Formulations news release: “Research Demonstrates Benefits of Oral COVID-19 Vaccine.”

    CanSino Biologics Inc. statement: “Inside Information.” 

    Coalition for Epidemic Preparedness Innovations:  Email statement; News releases: “The Race to Future-Proof Coronavirus Vaccines;.”  “Coming in from the cold: needle-free patch technology for mRNA vaccines aims to end need for frozen storage and improve access.” 

    Executive Office of  the President: “Statement of Administration Policy.”

    Science: “Mosaic RBD nanoparticles protect against challenge by diverse sarbecoviruses in animal models.”

    Caltech news release: “Nanoparticle Vaccine Protects Against a Spectrum of COVID-19-causing Variants and Related Viruses.”   

     

    U.S. Government Accountability Office. “Operation Warp Speed.”

    Bharat Biotech International Limited news release: “Bharat biotech launches iNCOVACC: World’s 1st intranasal COVID vaccine for Primary series and Heterologous booster.” 

    The Lancet preprints: “Immunogenicity and Tolerability of BBV154 (iNCOVACC®), an Intranasal SARS-CoV-2 Vaccine, Compared with Intramuscular Covaxin® in Healthy Adults: A Randomised, Open-Label, Phase 3 Clinical Trial.”

    Cell: “Intranasal pediatric parainfluenza virus-vectored SARS-CoV-2 vaccine is protective in monkeys.”

    National Institute of Allergy and Infectious Diseases news release: “NIAID Issues Further Awards to Support Pan-Coronavirus Vaccine Development.”

    CEPI news release: “CEPI and DIOSynVax partner in quest to develop broadly protective Betacoronavirus vaccine.” 

    CDC: “Understanding How COVID-19 Vaccines Work.” 

    Nature Immunology: “The T-cell immune response against SARS-CoV-2.”

    National Institutes of Health: “T cells protect against COVID-19 in absence of antibody response.”

    PNAS: “Vaccine-induced systemic and mucosal T cell immunity to SARS-CoV-2 viral variants.”

    Cell Reports: “Pre-existing immunity modulates responses to mRNA boosters.”

    University of Minnesota Center for Infectious Disease Research and Policy: “Coronavirus Vaccines R&D Roadmap.”

    NIH news release: “2NIAID Studies Highlight COVID-10 Natal Vaccine Potential.”

    U.S. Specialty Formulations news release: “Research demonstrates benefits of oral COVID-19 vaccine.” 

     

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  • COVID at 3 Years: Where Are We Headed?

    COVID at 3 Years: Where Are We Headed?

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    March 15, 2023 – Three years after COVID-19 rocked the world, the pandemic has evolved into a steady state of commonplace infections, less frequent hospitalization and death, and continued anxiety and isolation for older people and those with weakened immune systems.

    After about 2½ years of requiring masks in health care settings,  the CDC lifted its recommendation for universal, mandatory masking in hospitals in September 2022,. 

    Some statistics tell the story of how far we have come. COVID-19 weekly cases dropped to nearly 171,000 on March 8, a huge dip from the 5.6 million weekly cases reported in January 2022. COVID-19 deaths, which peaked in January 2021 at more than 23,000 a week, stood at 1,862 per week on March 8.

    Where We Are Now

    Since Omicron is so infectious, “we believe that most people have been infected with Omicron in the world,” says Christopher J.L. Murray, MD, a professor and chair of health metrics sciences at the University of Washington and director of the Institute for Health Metrics and Evaluation in Seattle. Sero-prevalence surveys — or the percentage of people in a population who have antibodies for an infectious disease, or the Omicron variant in this case — support this rationale, he says.

    “Vaccination was higher in the developed world but we see in the data that Omicron infected most individuals in low income countries,” says Murray. For now, he says, the pandemic has entered a “steady state.”

    At New York University Langone Health System, clinical testing is all trending downward, and hospitalizations are low, says Michael S. Phillips, MD, an infectious disease doctor and chief epidemiologist at the health system. 

    In New York City, there has been a shift from pandemic to “respiratory viral season/surge,” he says. 

    The shift is also away from universal source control – where every patient encounter in the system involves masking, distancing, and more – to a focus on the most vulnerable patients “to ensure they’re well-protected,” Phillips says. 

    Johns Hopkins Hospital in Baltimore has seen a “marked reduction” of the number of people coming to the intensive care unit because of COVID, says Brian Thomas Garibaldi, MD, a critical care doctor and director of the Johns Hopkins Biocontainment Unit.

    “That is a testament to the amazing power of vaccines,” he says. 

    The respiratory failures that marked many critical cases of COVID in 2020 and 2021 are much rarer now, a shift that Garibaldi calls “refreshing.”

    “In the past 4 or 5 weeks, I’ve only seen a handful of COVID patients. In March and April of 2020, our entire intensive care unit – in fact, six intensive care units – were filled with COVID patients.”

    Garibaldi sees his own risk differently now as well. 

    “I am not now personally worried about getting COVID, getting seriously ill, and dying from it. But if I have an ICU shift coming up next week, I am worried about getting sick, potentially having to miss work, and put that burden on my colleagues. Everyone is really tired now,” says Garibaldi, who is also an associate professor of medicine and physiology in the Division of Pulmonary and Critical Care Medicine at Johns Hopkins University School of Medicine. 

    What Keeps Experts Up at Night?

    The potential for a stronger SARS-CoV-2 variant to emerge concerns some experts.  

    A new Omicron  subvariant could emerge, or a new variant altogether could arise.  

    One of the main concerns is not just a variant with a different name, but one that can escape current immune protections. If that happens, the new variant could infect people with immunity against Omicron. 

    If we do return to a more severe variant than Omicron, Murray says, “then suddenly we’re in a very different position. 

    Keeping an Eye on COVID-19, Other Viral Illnesses

    We have better genomic surveillance for circulating strains of SARS-CoV-2 than earlier in the pandemic, Phillips says. More reliable, day-to-day data also helped recently with the respiratory syncytial virus (RSV) outbreak and for tracking flu cases.

     Wastewater surveillance as an early warning system for COVID-19 or other respiratory virus surges can be helpful, but more research is needed, Garibaldi says. And with more people testing at home, test positivity rates are likely an undercount. So, hospitalization rates for COVID and other respiratory illnesses remain one of the more reliable community-based measures, for now, at least. 

    One caveat is that sometimes, it is unclear if COVID-19 is the main reason someone is admitted to the hospital vs. someone who comes in for another reason and happens to test positive upon admission. 

    Phillips suggests that using more than one measure might be the best approach, especially to reduce the likelihood of bias associated with any single strategy. “You need to look at a whole variety of tests in order for us to get a good sense of how it’s affecting all communities,” he says. In addition, if a consensus emerges among different measures – wastewater surveillance, hospitalization and test positivity all trending up – “that’s clearly a sign that things are afoot and that we would need to modify our approach accordingly.”

    Where We Could Be Heading

    Murray predicts a steady pace of infection with “no big changes.” But waning immunity remains a concern. 

    That means if you have not had a recent infection – in the last 6 to 10 months – you might want to think about getting a booster, Murray says “The most important thing for people, for themselves, for their families, is to really think about keeping their immunity up.” 

    Phillips hopes the improved surveillance systems will help public health officials make more precise recommendations based on community levels of respiratory illness. 

    When asked to predict what might happen with COVID moving forward, “I can’t tell you how many times I’ve been wrong answering that question,” Garibaldi says.

     Rather than making a prediction, he prefers to focus on hope. 

    “We weathered the winter storm we worried about in terms of RSV, flu, and COVID at the same time. Some places were hit harder than others, especially with pediatric RSV cases, but we haven’t seen anywhere near the level we saw last year and before that,” he says. “So, I hope that continues.”

    “We’ve come very far in just 3 years. When I think about where we were in March 2020 taking care of our first round of COVID patients in our first unit called a biocontainment unit,” Garibaldi says. 

    Murray addresses whether the term “pandemic” still applies at this point. 

    “In my mind, the pandemic is over,” he says, because we are no longer in an emergency response phase. But COVID in some form is likely to be around for a long time, if not forever.  

    “So, it depends on how you define pandemic. If you mean an emergency response, I think we’re out of it. If you mean the formal definition you know of an infection that goes all over the place, then we’re going to be in it for a very long time.”

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  • More Sleep Boosts Vaccine Effectiveness: Study

    More Sleep Boosts Vaccine Effectiveness: Study

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    March 14, 2023 – Want to get the maximum level of protection out of vaccines? Then make sure to get at least 7 hours of sleep before and after getting a shot, a new study suggests.

    Compared to people who slept at least 7 hours, people who slept less than 6 hours in the days surrounding a vaccine shot generated significantly fewer antibodies, which are what recognize and kill viruses and bacteria in the body.

    Because the effectiveness of many vaccines declines over time, the boost essentially makes the vaccine’s protection last longer – by up to 2 months, the researchers found. 

    “Good sleep not only amplifies but may also extend the duration of protection of the vaccine,” researcher Eve Van Cauter, PhD, professor emeritus at the University of Chicago, said in a statement.

    The study, published Monday in Current Biology, reanalyzed past research on the connection between sleep and the effectiveness of vaccines for flu and hepatitis. The researchers sought to understand the connection because of indications that people developed varying levels of immunity after receiving the same COVID-19 vaccines. Sleep studies specific to COVID vaccines are not yet available, so the researchers decided to evaluate existing studies and translate those findings to what’s known about COVID vaccines.

    “How we stimulate the immune system is the same whether we’re using an mRNA vaccine for COVID-19 or an influenza, hepatitis, typhoid, or pneumococcal vaccine. It’s a prototypical antibody or vaccine response, and that’s why we believe we can generalize to COVID,” researcher Michael Irwin, MD, an expert from UCLA who specializes in the relationship between psychological processes, the nervous system, and immunity, told CNN.

    When the researchers looked at vaccine response in different groups, the effects of sleep were greatest among men and in people ages 18 to 60 years old. The researchers said more research on the effects in women is needed because variations in their hormone levels impact the immune system. 

    They also found that vaccine effectiveness was not as dramatically impacted by reduced sleep in people age 65 and older. The authors suggested that this is because older people already tend to sleep less than younger people.

    The findings are important because they offer a way for people to modify their own behavior to improve their health and immunity, Van Cauter said.

    “When you see the variability in protection provided by the COVID-19 vaccines — people who have preexisting conditions are less protected, men are less protected than women, and obese people are less protected than people who don’t have obesity,” she said. “Those are all factors that an individual person has no control over, but you can modify your sleep.”

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