States Want to Approve COVID-19 Vaccines Themselves. Will That Lead to More TrustOr Less?10/30/2020 Getting a COVID-19 vaccine—and fast—has been a main focus in the fight against the coronavirus. But when a vaccine is ultimately made available to the American public, California Governor Gavin Newsom said at a press conference last week, another factor will come into play: what he called the “speed of trust.” “You have to have confidence in the efficacy of the vaccine, confidence that we’re not rushing to judgment in terms of its distribution and its accessibility,” said Newsom. His comments came while announcing that his state is convening a scientific review panel to double-check the U.S. Food and Drug Administration’s data regarding any eventual coronavirus vaccine before it is available to Californians. In the following days, leaders in Washington, Oregon and Nevada announced that they were joining California’s team; New York laid out a similar plan in September. Leaders in these states view the move as a way to ensure whatever COVID-19 vaccine eventually arrives is safe and effective for their residents—a potential counter to fears that the federal government, under the Trump Administration, is rushing the process for political gain. Those concerns are only growing as we get closer to the potential arrival of a vaccine—only 58% of Americans said in early October that they’d be willing to get a COVID-19 vaccine as soon as one’s available, according to a recent STAT-Harris Poll, down from 69% in mid-August. A vaccine could be available in the U.S. as soon as January, at least for some vulnerable groups, if all goes well, with a wider rollout over the following months. Many public-health experts say these states’ efforts may pay off. Trust is essential for ensuring vaccine adoption, and hearing from multiple credible sources that a shot is safe can be especially convincing, they say. While getting people to take any new vaccine can be a challenge, a number of recent incidents, including U.S. President Donald Trump’s attacks on scientific experts and his promotion of unfounded COVID-19 treatments like hydroxychloroquine, are significantly complicating pro-vaccination efforts. “What we’re hearing is that individuals feel that the process has been tainted,” says Rupali Limaye, an associate scientist at Johns Hopkins Bloomberg School of Public Health. “Having an independent agency or board review the safety data would go a long way in actually restoring some confidence.” However, the states’ plans could backfire. The mere existence of these review panels could potentially signal to some vaccine skeptics that there is indeed good reason to be concerned. Moreover, some experts are worried about what might happen if a vaccine is green-lit at the federal level, but then shot down by one of the state groups. “I am very concerned it will further undermine the FDA and trust in their decision-making,” says Sandra Quinn, professor and chair of the department of family science at the University of Maryland. “It’s the ‘what if’ that could be worrisome.” In the meantime, Quinn argues that the responsibility is still on the FDA and the pharmaceutical companies making COVID-19 vaccines to follow proper procedures and ensure that approved shots are both safe and effective. “We’ve got to be as confident as we could possibly be, because if we get this wrong, the consequences are really dire,” she says. from https://ift.tt/34JowxY Check out https://takiaisfobia.blogspot.com/
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As more and more people are diagnosed with COVID-19, the question of how long immunity to SARS-CoV-2, the virus that causes the illness, lasts, is increasingly important. Understanding that would help patients know whether they can get re-infected, and potentially even help doctors to better understand what type of protection we can expect from vaccines. Previous research found that levels of antibodies in recovered patients start to wane about three months from when those patients first experience symptoms. But in a study published in Science this week, researchers at Icahn School of Medicine at Mt. Sinai report that antibodies may last as long as five months. The scientists analyzed blood plasma, which contains immune cells including antibodies, from more than 30,000 people who were sick with COVID-19 between March and October. The majority of recovered patients experienced mild to moderate symptoms and weren’t hospitalized. They donated their plasma as part of the hospital’s study of whether this plasma, enriched with immune cells, could be used to treat coronavirus infections. Nearly half of them generated high level of antibodies To get a better idea of how long the antibodies last, the researchers focused on a smaller group of 121 participants and measured their antibody levels several times: starting a month after they first experienced symptoms, then again at 52, 82 and 148 days. They found substantial levels of antibodies in most of the participants all the way to the end of the study. What’s more, these antibodies continued to neutralize SARS-CoV-2 at pretty much the same levels in the lab throughout the five months. Ania Wajnberg, associate professor of medicine at the Icahn School of Medicine at Mt. Sinai and leading author of the new paper, says that the reason why she and her team found consistently robust antibody levels for longer than previous studies may have to do with the test they used. It was developed at Mt. Sinai and is specific to a portion of the coronavirus spike protein that’s a particularly attractive target for the immune system—“the body produces a lot of antibodies to that area,” she says. Other researchers may have used different assays for detecting antibodies that might be directed at different parts of the COVID-19 virus, which, she says, may wane more quickly. Her team was also able to analyze the types of antibodies they found over time, which may help explain why they were able to pick up antibodies for a longer period of time. The antibodies they collected from people soon after their recovery included IgG antibodies, which circulate in the blood and generally decline in number after about a month since they are designed to quickly respond to new viruses. On the other, hand, they also found antibodies that remained at the five month mark—these antibodies are most likely made by immune cells in the bone marrow whose job is to keep the immune system supplied with the right defensive cells over the long term, based on whatever viruses or bacteria the body has recently seen. It’s possible that once these bone marrow-based cells are involved, the level of antibodies could remain stable for several months. Exactly how long these antibodies may remain to protect against infection isn’t clear yet, but Wajnberg plans to continue collecting plasma and analyzing the antibodies in the smaller group of donors for a year. If the antibody levels remain stable, that’d be a sign that recovered patients do likely develop a high level of immunity from the virus—and it bodes well for the efficacy of future vaccines. “Presumably if there is longevity of these antibodies after infection, that is good news for a vaccine,” she says. “But we don’t know how much longevity yet. We just need to follow these people for more time.” However encouraging the results are that some type of immunity against the COVID-19 might be possible, Wajnberg warns that people who have recovered from infections should still take precautions. “This is a large data set and the study is encouraging in terms of there being some protection in the majority of people who had SARS-CoV-2 infection in the past,” she says. “However, until we know more about what actually protects against the virus, we should still continue to follow all the recommended precautions around hand washing, masking and social distancing.” from https://ift.tt/37VQI2P Check out https://takiaisfobia.blogspot.com/ If you watched the presidential debates, you could be forgiven for thinking former Vice President Joe Biden’s COVID-19 containment plan boils down to “not Trump’s.” When asked during the final debate on Oct. 22 how he would respond to the next phase of the pandemic, Biden spent much of his allotted two minutes attacking President Donald Trump, arguing that “anyone who’s responsible for that many deaths”—about 220,000—”should not remain as President of the United States of America.” Biden flicked at his own plan, which he said would encourage masking, increase investments in rapid testing and produce clear national reopening standards, but the response was light on details. “The President thus far still has no plan,” Biden argued. But does Biden? Biden gave a speech on his COVID-19 plan on Oct. 23, and he and running mate Senator Kamala Harris have circulated a seven-point plan for “beat[ing] COVID-19 and get[ting] our country back on track.” It is, experts say, what they’ve asked for since the pandemic began—but “the real devil’s in the details,” says Eric Toner, a senior scholar at the Johns Hopkins Center for Health Security. Everything comes down to execution and specifics. And on that front, it’s too early to say how things would go if Biden is elected. Most of the Biden/Harris plan is unlikely to ruffle feathers among health experts. The seven points include:
Reading the plan, “I couldn’t stop thinking, ‘What if we had this all along during the pandemic?’ What a different place we would be in,” says Dr. Leana Wen, a professor of health policy and management at the George Washington University Milken School of Public Health. Toner agrees that the plan is solid, but says he’d like more specificity. It’s great to establish task forces and promise vaccine distribution, Toner says, but it’s hard to judge their efficacy without knowing exactly how they’ll work. Dr. Howard Forman, who has advised the Biden campaign and is the director of the Yale University School of Public Health’s health care management program, says the plan is good overall, particularly with respect to its focus on coordination between states and the federal government, but agrees that it’s just “a broad outline at this point.” The vaccine-distribution plan, in particular, needs to be far more detailed than what Biden’s campaign website currently offers, Forman says. “The logistics of getting all these entities involved and then the coordination of the final mile is going to be very challenging,” he says. Actually distributing a vaccine is hard enough, but a Biden administration would also have to convince people to get one—and potentially come back for a second dose, depending on which type of vaccine is approved. “A vaccine could be very effective but if the vaccination program is not, it’s not effective,” Forman says. “Period.” A Biden campaign adviser who spoke with TIME says it’s difficult to predict the vaccine situation a possible Biden administration would inherit in January. “The trajectory of the virus, the advances of the trials and the work that the [current] administration is doing or not doing to lay the groundwork for an efficient, equitable distribution of the vaccine are all unknowns for us right now,” the adviser says. Ensuring the safety and efficacy of a vaccine, and depoliticizing the development process, are top priorities, the adviser says. While vaccine trials continue, the campaign is also considering where Americans will be able to get vaccinated while adhering to social-distancing restrictions and working with community leaders who can help build public trust. Toner says Biden’s seven-point plan doesn’t do enough to address how his administration would fulfill those responsibilities. “The most important thing that a President Biden could do is really communicate strongly and effectively the public health message,” Toner says. During Trump’s first term, decisions that should have been purely about public health—like wearing a mask—became political statements, Forman says, and it will take a strong, clear communications push to help reverse that. A potential Biden Administration should push for daily press briefings from credible public-health experts and partner with a diverse roster of celebrities, influencers and community leaders who can push out accurate scientific information, Toner says. “They should really have a communication campaign that looks like a political campaign,” he says. “They should be flooding social media and the airwaves with public health messages.” Biden plans to do all of that, the campaign adviser says. “You don’t know how much you miss it—basic, honest communication between a government and its citizens—until it’s gone,” the adviser says. The plan’s final point, about universal masking, is likely to be its most controversial, given how polarized mask-wearing has become. There’s science to support a mask mandate--recent estimates suggest universal masking in the U.S. could save about 60,000 lives by February 2021—but people would likely chafe at the idea of a mandate. Biden has said he would mandate face coverings on all public interstate transportation and in federal buildings, but the bulk of the policy would likely entail asking governors and mayors to implement mandates at the state and local levels—a U.S. president likely can’t actually enforce a full national mandate. The question is whether those governors and mayors would hear a presidential plea—and whether constituents would even listen to a local mandate. “I’m very concerned that large swaths of this country will not only not heed the guidance from a new administration, but will openly rebel against the guidance because it’s from this administration,” Wen says. “They need to win the hearts and minds of the American public by enlisting the most trusted messengers.” Without that trust, Biden’s plan—if he gets a chance to use it—may stall before it starts. from https://ift.tt/3mFuXYS Check out https://takiaisfobia.blogspot.com/ Several federal agencies on Wednesday warned hospitals and cyber-researchers about “credible” information “of an increased and imminent cybercrime threat to U.S. hospitals and health-care providers.” The FBI, the Department of Health and Human Services and the Cybersecurity and Infrastructure Security Agency, part of the Department of Homeland Security and known as CISA, said hackers were targeting the sector, “often leading to ransomware attacks, data theft and the disruption of health-care services,” according to an advisory. The advisory warned that hackers might use Ryuk ransomware “for financial gain.” The warning comes as COVID-19 cases and hospitalizations surge across the country. The cybersecurity company FireEye Inc. said multiple U.S hospitals had been hit by a “coordinated” ransomware attack, with at least three publicly confirming being struck this week. Ransomware is a type of computer virus that locks up computers until a ransom is paid for a decryption key. The attack was carried out by a financially motivated cybercrime group dubbed UNC1878 by computer security researchers, according to Charles Carmakal, FireEye’s strategic services chief technology officer. At least three hospitals were severely affected by ransomware on Tuesday, he said, and multiple hospitals have been hit over the past several weeks. UNC1878 intends to target and deploy ransomware to hundreds of other hospitals, Carmakal said. “We are experiencing the most significant cybersecurity threat we’ve ever seen in the United States,” he said. “UNC1878, an Eastern European financially motivated threat actor, is deliberately targeting and disrupting U.S. hospitals, forcing them to divert patients to other health-care providers.” Multiple hospitals have already been significantly affected by Ryuk ransomware and their networks have been taken offline, Carmakal added. “UNC1878 is one of most brazen, heartless, and disruptive threat actors I’ve observed over my career.” Attackers using Trickbot malware, which is also cited in the federal advisory, claimed Monday in private communications channel to have attacked more than 400 hospitals in the U.S., said Alex Holden, the founder of the cyber investigations firm Hold Security. By Tuesday, the Trickbot attack group — which frequently works with ransomware operators Ryuk — claimed to have ransomed about 30 medical facilities around the country, Holden said. Noncriminals running these malware and ransomware operations are known to embellish their achievements, he said. St. Lawrence Health System in New York, Sonoma Valley Hospital in California, and Sky Lakes Medical Center in Oregon on Tuesday all publicly stated they were affected by ransomware attacks, according to local news reports. The ransomware that has targeted hospitals, retirement communities and medical centers this year has typically started with emails that purport to be corporate communications and sometimes contain the name of the victim or their company in the text or its subject line, according to a FireEye report released Wednesday. However, the emails can contain malicious Google Docs, typically in the form of a PDF file, that contains a link to malware. The use of multiple links, as well as PDF files, can help trick email filters designed to spot simpler phishing tactics. —With assistance from Alyza Sebenius. from https://ift.tt/2TCc392 Check out https://takiaisfobia.blogspot.com/ Young Adults Are Less Likely to Wear Masks Take Other Measures Against COVID-19 CDC Survey Finds10/28/2020 Survey data released Oct. 27 from the U.S. Centers for Disease Control and Prevention shows that age is a strong predictor of public-health behaviors. According to the agency’s analysis of the survey results, older respondents are more likely to take certain actions or refrain from certain activities in order to mitigate the chances of spreading and contracting COVID-19. Younger adults, on the other hand, were the slowest to embrace the behaviors and continued to lag behind their older counterparts over the seven-week period that the survey was conducted. The survey asked respondents whether they engage in any of 19 mitigation behaviors, six of which were analyzed in the agency’s published results:
The questions were posed at three intervals: in late April, early May and early June. As shown in the below chart, which captures the situation in June, 38% of 18-to-29 year olds engaged in all six behaviors, while 53% of people age 60 and older did the same. The CDC suggests that older adults are more likely to take multiple prevention methods because “they might be more concerned about COVID-19, based on their higher risk for severe illness compared with that of younger adults.” To be sure, the majority of respondents, including those in the youngest group, engaged in at least four behaviors over the survey time period, and only 6% from the entire sample reported one or fewer behaviors. Not all behaviors stuck over the seven week period, however. Only face mask use increased, going from 78% in April to 89% in June. The other prevention measures declined marginally, except avoiding restaurants, which stayed flat. Yet despite these fluctuations, the age trend stayed the same: the older the group, the more likely they were to engage with a given behavior. The below chart shows in detail how the prevalence of each behavior changed for the oldest and youngest groups. The lower prevalence of mitigation behaviors in younger adults “might contribute to the high incidence of confirmed COVID-19 cases” among that group, the CDC notes. Indeed, young adults now have the greatest share of COVID-19 cases in the U.S. While this group is less likely to suffer severe illness from COVID-19, it isn’t out of the question. Additionally, young people’s risk tolerance for COVID-19, and their decisions to forego social health measures, affects not just their peers but also their older and more vulnerable neighbors. The CDC concludes that if younger groups implement public health behaviors more widely, they could “protect persons of all ages by preventing the spread of SARS-CoV-2.” That should be reason enough to step up. from https://ift.tt/2Hzq0SV Check out https://takiaisfobia.blogspot.com/ Archana Ghugare’s ringtone, a Hindu devotional song, has been the background score of her life since March. By 7 a.m. on a mid-October day, the 41-year-old has already received two calls about suspected COVID-19 cases in Pavnar, her village in the Indian state of Maharashtra. As she gets ready and rushes out the door an hour later, she receives at least four more. “My family jokes that not even Prime Minister Modi gets as many calls as I do,” she says. Ghugare, and nearly a million other Accredited Social Health Activists (ASHAs) assigned to rural villages and small towns across India, are on the front lines of the country’s fight against the coronavirus. Every day, Ghugare goes door to door in search of potential COVID-19 cases, working to get patients tested or to help them find treatment. With 8 million confirmed COVID-19 cases, India has the second-highest tally in the world after the United States and its health infrastructure struggled to cope with the surge in COVID-19 patients this summer. India spends only 1.3% of its GDP on public health care, among the lowest in the world. The situation is stark in rural areas where 66% of India’s 1.3 billion people live and where health facilities are scant and medical professionals can be hard to find. India’s ASHA program is likely the world’s largest army of all-female community health workers. They are the foot soldiers of the country’s health system. Established in 2005, a key focus of the program was reducing maternal and infant deaths, so all recruits are women. They have also played an essential role in India’s efforts to eradicate polio and increase immunization, according to numerous studies. Read More: How the Pandemic Is Reshaping India But even as health authorities have leaned on ASHAs to quell the spread of COVID-19 in rural areas, where a substantial number of new cases have been reported, many of these health care workers say the government is failing them. Pay was meager to begin with, but some workers have reported not being paid for months. Their hours have increased dramatically, but pay rises, when they have come, have not reflected the increased demands. Many ASHAs have also complained about not being provided adequate protective equipment for their high-risk work. “They are the unsung heroes who are fighting to contain the unfettered spread of the virus in rural areas,” says Dr. Smisha Agarwal, Research Director at the John Hopkins Global Health Initiative. She argues it is vital to improve pay to boost morale and sustain this frontline workforce. -- Ghugare was chosen from her village of 7,000 people in 2011. Since then, she has overseen countless births, meticulously monitored the health of thousands of newborn babies and strictly ensured immunization through door-to-door awareness campaigns. The personal relationships she built over the years have helped in the fight against COVID-19, giving her a good grasp of the medical histories of most of the 1,500 people assigned to her. “It’s all in here,” she says pointing to her head. Before the pandemic, she was expected to work two to three hours per day, for which she was paid about 2,000 rupees ($27) a month, with incentives for completing tasks in the community. Now, she’s spending 9 to 10 hours a day working to combat COVID-19. She had to cut back her other job working at a farm, and most of the bonuses have dried up as well. The Indian government has given her a 1,000-rupee ($13.50) COVID-19 stipend, but that doesn’t make up for the lost income. Conditions like these are pushing many of these women to breaking point. Some 600,000 ASHAs went on strike in August to demand better pay and recognition as permanent government employees. (They are currently classified as volunteers, which renders them ineligible for minimum wages and other benefits.) “The extra work we used to do earlier to ensure our stomachs weren’t empty has stopped now,” Ghugare says.
Heading out the door, she puts on a face mask and headscarf to protect herself while mentally running through the symptoms of one of the possible COVID-19 patients she had been phoned about earlier. Knowing that the individual suffers from diabetes, which makes people more vulnerable to coronavirus, Ghugare begins working out how to prioritize the case and arrange transportation to a center, about 40 minutes away, for urgent testing. Some cases are particularly challenging. There are days when villagers refuse to talk to her. Worried about being forced to go to the hospital and missing work—a major hardship when people depend on daily wages for a hand-to-mouth existence—people often hide symptoms. Then there is also the menace of fake news, often spread on WhatsApp. Ghugare arrives at a house in the sweltering heat, where it takes her almost 20 minutes to persuade a man to get his wife tested for COVID-19. Because of a false rumor spread via messaging apps, he is convinced his wife’s kidneys will be removed if she goes to hospital. In the end, he relents. “Dealing with fake WhatsApp forwards is one of the most exhausting parts of the job,” Ghugare says. By around 1:30 p.m., she has already worked six hours. Before the pandemic, she would have wrapped up and headed to her second job. But now she still has a long list to get through to meet her daily target of visiting 50 houses. -- Demands like these have driven many ASHAs to protest. “We are warriors who were sent to war without any weapons,” says Sunita Rani, an ASHA from the northern state of Haryana. She has been protesting against the state government since July and says she won’t give up until their demands are met. “If we can fight a virus, we definitely know how to fight our governments.” The Indian government hasn’t yet responded to their demands for permanent government employment. Most health experts seem to agree that ASHAs are underpaid. But some say that making their roles full-time is more complicated. “The beauty of this role is the mix of incentives that tend to energize ASHAs to perform better,” says Dr. Jyoti Joshi, the director of South Asia at the Center for Disease Dynamics, Economics and Policies, a public health research organization. She says retaining the incentives for completing tasks, while adding benefits like free family health checkups, might be one solution. Pay varies by state, and salaries can range from 2,000 rupees ($27) to 10,000 rupees ($135) per month, according to a national union for ASHAs. Many workers also depend on receiving bonuses. For instance, Ghugare receives 100 rupees ($1.25) if she vaccinates a child against measles, mumps and rubella and 600 rupees ($8) for delivering a baby for a family living below the poverty line. Some economists argue that making nearly a million female health care workers full-time employees, and paying them more, will not only benefit India’s health system but might also help revive the country’s battered economy, one of the worst hit by the pandemic. “Employing and putting wages into the hands of so many people will definitely be beneficial to the rural economy, ” says Dipa Sinha, an economist at the Ambedkar University in New Delhi. It might also help recover India’s plummeting rate of female workplace participation, for which the country is among the bottom 10 in the world. Experts have attributed this to cultural attitudes and the slowdown in the agricultural sector, where most rural women work. Sinha says that this gender disparity plays into the issue of ASHAs not being recognized for their work. “Who volunteers for six to eight hours a day?” she says. “It’s because they are women that their work is undermined. You can’t do this to a cadre of men.” Ghugare shares that sentiment although she didn’t take part in the protests. With her two children growing older, expenses are increasing. An increased salary with benefits would help her give her family a better life. As she walks back home at dusk, she knows her day isn’t done yet. There is household work to get to before getting started with a report on the day’s survey. It will be midnight before she calls it a day. That is, if the phone doesn’t ring again. “It feels like there is a sword over our heads,” she says. “A hanging sword.” from https://ift.tt/3mrDgrm Check out https://takiaisfobia.blogspot.com/ For months, there’s been a relatively easy way to socialize safely during the pandemic: take it outside. But now, with cold weather creeping into many parts of the world, park picnics, socially distant walks and outdoor dining are about to get less appealing for lots of people. Experts have warned for months that indoor gatherings are prime places for the virus to spread—but does that mean there’s no way to see anyone aside from your housemates this winter? Here’s what five experts said about indoor socializing. Why is outside safer than in?SARS-CoV-2, the virus that causes COVID-19, can spread when someone comes into contact with large respiratory droplets, like those that escape with a sick person’s cough or sneeze. These large droplets are unlikely to travel further than six feet, hence the ubiquitous guidance around social distancing—which is usually easier to achieve outside than in. But someone infected with SARS-CoV-2 is also constantly exhaling tiny respiratory particles, known as aerosols, that linger in the air. (Wearing a mask reduces the number of droplets and aerosols that get into the atmosphere.) In outdoor air, aerosols dissipate fairly quickly. But in an enclosed space, particularly one that is poorly ventilated, they can build up over time and potentially endanger anyone in the room, even people sitting more than six feet away from the sick person. An Oct. 27 study published in Physics of Fluids found that aerosol transmission is not as much of a risk as droplet transmission, but confirmed that COVID-19 can spread via aerosols, especially in poorly ventilated spaces. Some “super shedders” also produce an above-average number of particles, unknowingly placing those around them at greater risk of infection, the paper found. “If you walk into a bar and somebody starts smoking, initially you won’t really notice it,” says Shelly Miller, an indoor air expert from the University of Colorado, Boulder. “But eventually the smoke fills the whole bar, and it will stay in there because there’s no ventilation.” The same thing happens with the virus—and the more people who are exhaling aerosols into the air, the faster they build up. Is there any good way to socialize inside?Any time you invite someone into your home, you’re increasing your risk of catching or passing on the virus, since people can be infectious without showing symptoms. It’s still best to see people outdoors or virtually. But if you do decide to have an indoor gathering, try to replicate the things that make outdoor hangs safer, suggests Dr. Beth Thielen, an assistant professor of pediatrics and infectious disease at the University of Minnesota Medical School. Pick as large a space as you can and open windows for ventilation. You should also keep the group small and try to wear masks the whole time, Thielen says. If it’s too cold to open all the windows, switch up which ones are open, says Lidia Morawska, a World Health Organization consultant and aerosol expert from Australia’s Queensland University of Technology. Studies have shown that people sitting downwind of an infected person are the most likely to get infected, so mixing up airflow may help neutralize risk. “Don’t stay in one place. Mix. Move. Change how you open the windows,” Morawska suggests. The length of your exposure matters too, Miller says. “If you have really high levels [of particles in the air] but you’re breathing them for a shorter time, your risk is going to be lower,” she says. Miller says she’s invited friends over for 30-minute catch-up sessions, ideally wearing masks, to get in some socializing without spending too long together. Are public places okay?In most indoor establishments, you likely have little control over whether windows are open and how many people are inside; you also have no idea whether your fellow patrons have been exposed to the virus. But some public places are likely safer than others. Dining or drinking inside means you’ll inevitably be around maskless people, which removes a layer of protection. (Speaking loudly over the din of others also leads people to expel more droplets and viral particles, studies have shown.) Sit-down restaurants where people mostly stay at their own tables are likely safer than bars, where people tend to mingle and may ignore public-health guidelines after they’ve had a few drinks, says Dr. Tom Hennessy, an infectious disease epidemiologist at the University of Alaska. In either case, try to pick places that have limited capacity, and avoid establishments that feel hot and stuffy or don’t have many windows—they probably don’t have good ventilation, Miller says. Public places not meant for eating and drinking, like malls and museums, have some advantages over bars and restaurants, since everybody can remain masked the whole time they’re inside. They also tend to be much larger, allowing viral particles to disperse—especially if they’re operating at reduced capacity. “If you’re in a large room and the room is well-ventilated and there’s not too many people…then the risk [of aerosol transmission] is actually fairly small,” says Daniel Bonn, co-author of the new Physics of Fluids study and an engineering professor at the University of Amsterdam. Bonn’s study found that aerosol transmission was most likely to occur in enclosed, poorly ventilated places. Very small spaces, like public elevators and bathrooms, were the riskiest, while larger, better-ventilated places, like office buildings, were fairly safe. Bars, restaurants and private homes are likely somewhere in between. What about quarantine pods?Some people have formed quarantine “pods” by picking a few close friends or family members to see indoors, while cutting out nearly all other in-person contact. This can be a good system, Thielen says, as long as you’re very clear about ground rules. “You have to know that the people within your pod are not having 10 other pods that they’re getting together with,” Thielen says. There’s no exact threshold at which a pod gets too big, Hennessy says, but smaller is always better. Each person you add to the group increases the chances of someone having a risky encounter and exposing others. Before you start or expand your pod, it’s also a good idea for everyone to quarantine for a couple weeks and get tested to ensure nobody is unknowingly infected. Can my kids see their friends?Early in the pandemic, some studies suggested children are unlikely to catch and spread COVID-19, leading some parents to carry on with indoor playdates. While it’s true that kids are much less likely than adults to develop severe cases of coronavirus, they can and do catch and transmit the virus, as recent studies and case reports have shown. “There are certainly enough well-documented cases of kids transmitting that we should generally be exercising the same precautions as for older family members,” Thielen says. “Even more than adults, kids are comfortable being outside,” Thielen adds. Take advantage of their resilience by setting up (short) outdoor playdates, even when the weather gets snowy. Can I see family for the holidays?Any indoor gathering is risky this year, no matter who you’re seeing or for what purpose. Even for holidays, small, masked gatherings are safest. If you decide to have prolonged visits with relatives—particularly if they’re elderly or otherwise vulnerable—Hennessy recommends first getting tested, isolating for at least a week and then getting tested again to confirm the negative result. “One test isn’t enough, really,” he says. The equation gets even more complicated if you have to travel to see family. Though airplanes do have good air filtration systems, Hennessy says it’s still risky to sit shoulder-to-shoulder with lots of other people, potentially for hours. For that reason, people traveling for the holidays should aim to get tested pre- and post-trip, ideally with about a week of isolation after getting off the plane or train. If the logistical headache of isolating for a week post-flight is too much, this may be a year to skip holiday travel, Hennessy says. from https://ift.tt/35FmSgc Check out https://takiaisfobia.blogspot.com/ Europe is clearly in the grip of a second wave of the coronavirus pandemic. In the past week, countries throughout Europe—including Belgium, Croatia, the Czech Republic, France, Germany, Hungary, Poland, Portugal, Slovakia, the U.K, and Ukraine—have all recorded their highest daily caseloads since the pandemic started. But two of these stand out. As of Oct. 25, Belgium and the Czech Republic are currently reporting about 146 and 115 new daily cases per 100,000 people, respectively, according to TIME’s coronavirus tracker, which compiles data from Johns Hopkins University. That’s dramatically higher than the E.U. average of 33 per 100,000. The Czech Republic hit a new daily record of 15,258 new infections on Oct. 23; a day later, Belgium set its own record with 17,709 new daily cases. Belgium is now the epicenter of the E.U’s second wave, with the continent’s highest per-capita case rate (besides tiny Andorra). The country also has the world’s third highest number of COVID-19-related deaths per capita after Peru and tiny San Marino. Experts speaking to TIME say they can’t point to anything specific that has made the Czech Republic or Belgium unique among E.U. states in their handling of the pandemic, instead attributing the rise in cases to a combination of factors, and the relatively arbitrary nature by which a virus spreads through populations. Increased testing doesn’t fully explain the rise in case numbersMarc Van Ranst, a virologist from the University of Leuven in Belgium, says the rise in cases can be partly explained by the increase in testing in his country. The number of daily tests has increased from about two out per 1,000 people each day in September to nearly six in recent days. Testing has also increased in the Czech Republic over the same period, from about one per 1,000 people to around 3.5. However, that cannot entirely account for the overall rise in cases, because the positivity rate—the share of tests that come back positive—rose in Belgium from around 2% in mid-September to over 18% in late October. In the Czech Republic, that number soared from around 4% in to nearly 30% in the same period. Population density may be a factorAnother potential factor for the situations in Belgium and the Czech Republic is their relatively high population densities. “You have to look at Belgium as one big city,” says Ranst. “That’s why in Brussels, where the population density is particularly high, the problem is acute.” For every square kilometer of land in Belgium there are 377 people; in the Czech Republic that number is 137. Compare those to the E.U. average of 112. Pierre Van Damme, an epidemiologist in Belgium, said the reopening of universities at the end of September, in particular, has been a driver of transmission in the country. As students typically go home on the weekend, “they then expose the infection to their parents, driving transmissions among the 40 to 60 plus age group. These are the people entering the hospitals,” he says. Jan Pačes, a virologist from the Czech Academy of Sciences, notes that cases in the Czech Republic began to soar shortly after schools were reopened on Sept. 1. “The rise in new infections in September were reported mostly among young people, and now it has reached higher ages,” he says. Within the first two weeks of reopening, 144 out of the country’s approximately 11,000 schools (kindergartens, elementary, secondary, and higher vocational schools) reported cases of coronavirus, according to official data cited in Kafkadesk. An estimated 30% of new infections were caught from people mixing in their homes, according to Pačes. What happens when you don’t listen to health expertsExperts also say the governments did not heed advice from public health officials about the need to reintroduce restrictions when the number of cases were rising at the end of summer and in early autumn. Olga Loblova, a Prague-based sociology research associate at the University of Cambridge, said the Czech government dismissed advice from public health experts at the end of summer, a move “that is now proving inadequate.” At the end of August, as new infections began to rise, Prime Minister Andrej Babis overruled a decision by then-Czech Health Minister Adam Vojtech that would have made the wearing of face masks mandatory in public places and schools. Babis later admitted that ignoring the advice may have been a mistake, during a press conference on Sept. 21; the country recorded 1,474 new cases that day. Vaces says the Czech senate elections, the first round of which were on Oct. 2 and 3, and the second on Oct. 9 and 10, may have led the government to postpone new measures, noting that strict measures were introduced after citizens cast their votes. On Oct. 12, the authorities banned events bringing together more than 10 people indoors and 20 people outdoors were banned, and ordered high schools and universities to switch to online learning. Pubs, bars and restaurants were closed and gatherings were limited to six people on Oct 14. A week later, Babis reintroduced the strict face mask mandate that had been in place in the spring, requiring everyone to wear masks outside of their homes. “These measures should have been introduced earlier. There is now too much of the virus around to use the same methods that we used in the spring,” says Vaces. In Belgium, some public health experts opposed the government’s decision to ease coronavirus prevention measures, including no longer mandating masks in most outdoor places from Sept. 23, when the country reported 1,661 new confirmed cases. “The most surprising” decision, says Van Damme, “offered everyone the possibility to have close contact with five other people, and these five can change every other month. That was really the wrong relaxation.” In addition, on Oct. 1, the government reduced the period of time people were required to quarantine if they were potentially exposed to the virus or have tested positive from two weeks to one. Implementing adequate testing and tracing systems before lifting restrictions was crucial to helping stop the spread of coronavirus. “That’s basically the answer. But only a few countries have done this, like Finland, Taiwan and South Korea,” says Martin McKee, a professor of European public health at the London School of Hygiene and Tropical Medicine. Creating an effective test and trace system has been a struggle for some countries in Europe, including Belgium and the Czech Republic. In the Czech Republic, only one in five users who test positive self-report their status on the contact tracing app eRouška (“eFacemask”), the government’s chief hygienist, Jarmila Rážová said on Oct. 16, according to local media. (The chief hygienist declares and implements measures to protect public health). The Minister of Health said that 6 million people would need to download the app for maximum effectiveness, but so far only 1.2 million people are users, according to local media on Oct. 16. The Czech Republic’s contact tracers—local groups of people who get in touch with those who may have been exposed to an infected individual—have been overwhelmed by the spike in cases. For example, Prague’s chief hygienist Zdeňka Jágrová, who oversees local public health measures, told reporters on Sep. 4 that contact tracers working for the city—the country’s most populous metro area—have been unable to track all the contacts. Belgium’s team of 2,000 contact tracers likewise have been unable to keep up with its rise in new infections. In mid-September, local media reported that the staff had only contacted half of the people who tested positive in the capital of Brussels. The government recently brought in a track-and-trace app, “Coronalert,” so far downloaded by more than 1.6 million people in a population of 11.5 million, to bolster contract tracers’ efforts. The efforts to reverse courseLike many other European countries, both Belgium and the Czech Republic are now taking restrictive measures to stem the spread of the virus and prevent their healthcare systems from being overwhelmed. In addition to closing bars, cafes and restaurants, and banning cultural events in some areas, Belgium has suspended all non-urgent surgeries for a month to free up hospital capacity for coronavirus patients. The Czech Republic ordered bars and restaurants to close, and most schools to move to remote learning from Oct. 14, and is closing non-essential stores from Oct. 22. The country is building capacity to care for a massive rise in COVID-19 patients; hospitals are cutting other types of care, while the government has started building a makeshift hospital in the capital Prague and has made preliminary agreements with bordering Germany that their hospitals will take Czech patients. The government said that it might impose a full lockdown in two weeks depending on the results of the current restrictions. However, it may be too late to avoid a catastrophic second wave. Lockdowns at this stage are, says McKee, an “indication of policy failure, of not having driven the numbers down enough in the first wave and not putting in place a well-functioning test and trace system.” from https://ift.tt/35C8iWO Check out https://takiaisfobia.blogspot.com/ U.S. COVID-19 Cases Are Skyrocketing But Deaths Are FlatSo Far. These 5 Charts Explain Why10/26/2020 In just the last two weeks, the global daily tally for new COVID-19 cases has jumped more than 30%, according to TIME’s coronavirus tracker, which compiles data from Johns Hopkins University. The steep upward trend is driven by viral waves in Europe and the United States that started in August and mid-September, respectively. On Oct. 23, the daily case count in the U.S. reached a new record high, suggesting that this wave will be worse than the one that swept the country over the summer. But despite this rapid uptick in cases, the daily death count in the U.S. is not yet rising at the same rate, and remains at lower levels than in April. At face value, a lower case-to-fatality rate suggests that fewer people who test positive for the virus are dying from it. But the virus hasn’t necessarily become less lethal; it isn’t mutating quickly enough for that to be the case. What’s happening now is not a result of how the virus treats humans, but rather how humans are treating the virus—that is, how we test for it, how we avoid it and how we combat it. The following five charts explain how human-driven factors are, at least for the moment, keeping deaths from spiking as high as they did early in the pandemic, even as cases rise dramatically. 1. The big pictureThe below chart shows the number of new daily COVID-19 cases and deaths on a per-capita basis. Compared with the U.S., the E.U. had the virus under better control in the early summer, but cases began to tick back up late in the season. The death count stayed low for some time, but surged in recent weeks, and is now on par with the U.S for the first time since April. The U.S. could follow the same path; deaths are a lagging indicator. But so far, U.S. deaths have stayed relatively flat at about 750 deaths a day, even though cases have been rising. Of course, that situation could change as winter approaches, especially if Americans become more complacent and “pandemic fatigue” sets in. It’s also vital to also keep in mind that a coronavirus infection doesn’t have a binary outcome—that is, people don’t either fully recover or die. Many of those who survive their initial bout with the disease go on to experience mysterious and sometimes disabling symptoms for months.
2. More testingWidespread testing is not the entire reason for U.S. cases going up (testing has been steadily increasing over the course of the pandemic, while cases have gone up and down, as shown above). But if more people are getting infected, a robust testing system can help uncover that trend—and that’s a good thing. Having better data helps researchers estimate the prevalence of the virus in a community, while rapid testing also allows people to protect others by isolating after they’ve been in contact with someone who tested positive. Widespread testing will identify the most severe cases as well as the most benign ones, including asymptomatic cases, which may account for up to 40% of all infections. Early in the pandemic, many countries, including the U.S., were short on testing supplies. As a result, many mild cases went undetected. One U.S. study estimated that there were likely 10 times more infections between late March and early May than reported. Because only the sickest patients were being tallied as confirmed cases, the case-fatality rate was high, and the virus appeared more deadly. This is why the case-to-fatality rate isn’t a perfect indicator of how likely a person is to die from the illness: the ratio will vary depending on the number of people in a given population getting tested. Because the U.S. is now doing more testing, this metric is more useful today than it was earlier in the pandemic, at least to assess general trends. And what we’re seeing now is a declining case-fatality rate, stemming from rising case counts and flat death death counts. 3. Public-health measuresIn early March, the U.S. Centers for Disease Control and Prevention began encouraging communities with reported COVID-19 cases to enforce social distancing to limit face-to-face contact. A month later, the agency began recommending that people wear masks when near others outside of their household. These preventative measures had immediate effect in places where the virus had already taken off. For example, at Boston’s Brigham and Women’s Hospital, new COVID-19 infections dropped by half among staff after a mandatory mask policy went into effect at the hospital in late March. Such measures have paid off for the broader population, too. While masks and social distancing can’t always prevent 100% of exposure to COVID-19, they can reduce the amount of viral particles a person is exposed to. They will then carry a smaller “viral load” in their systems, making them less likely to become severely ill. Researchers at Wayne State University School of Medicine who tracked the viral loads in nasal swab samples collected from hospitalized patients in Detroit discovered that patients who were initially swabbed in early April had a higher viral loads than those who were initially swabbed in late April and May. Lower viral load was associated with a decreased death rate. “Social distancing measures and widespread use of face masks may have contributed to a decrease in the exposure to the virus,” the authors wrote. 3. More young people are testing positiveThe coronavirus poses a greater mortality risk to the elderly compared to younger people. Among all Americans who have tested positive for COVID-19, the CDC’s current best estimate is that 5.4% died and were 70 or older, 0.5% died and were between 50 and 69, and only 0.02% died and were 20-49 years old. In the first weeks of the pandemic, the virus tore through assisted-living facilities and nursing homes, where lots of vulnerable elderly people lived. As a result, the death count skyrocketed. But over time, as the virus spread in places like bars and college campuses, the share of U.S. COVID-19 cases have skewed younger, meaning many of those becoming infected are less vulnerable to severe illness. The CDC reported last month that children and adults under 30 made up around 16% of COVID-19 cases in February through April, but by August, that group accounted for more than one in three cases. The number of younger people contracting the virus continues to grow, contributing to the rise in overall cases. Yet because they are less vulnerable to the virus, they are not driving up the number of deaths in tandem. (While young people are less vulnerable to COVID-19 in general, they can and do die from the disease, and can spread it to other people.) 5. Better treatmentsPharmaceutical companies have been racing to discover and produce drugs to treat COVID-19 patients since the onset of the pandemic. On Oct. 22, for example, the U.S. Food and Drug Administration officially approved the first drug for treating COVID-19, remdesivir, which was previously being used on an emergency-only basis. The agency has allowed other treatments via emergency-use authorizations, including dexamethasone, convalescent plasma, anti-inflammatory drugs and steroid treatments. In addition, doctors now better understand how the virus behaves in the body, and have learned how to more effectively treat patients—they’re using ventilators more sparingly and positioning patients on their stomachs to facilitate breathing, for instance. Thanks to these treatments, hospitalized patients often have shorter and less-intensive stays. A new study from New York University researchers found that COVID-19 patients admitted to NYU Langone hospital in early March had a 23% percent chance of dying; that dropped to 8% chance by mid-June. A research paper from the Houston Methodist hospital system found that in the spring, patients stayed a median of 7.1 days, but only 4.8 days during the summer surge. The below chart shows how the hospital system altered the frequency of certain treatments from the spring to the summer. The use of remdesivir increased, for instance, while the use of hydroxychloroquine decreased. In the U.S., about 750 people succumb to the virus’s assault every day. Worldwide, it’s more than 5,000 every day. There’s hope that another human intervention—a vaccine—will dramatically drive down both cases and deaths when and if one becomes available, likely next spring. Still, considering that a vaccine will not eradicate the virus completely, and a large percentage of Americans say they’re reluctant to get the vaccine at all, public-health practices like social distancing and wearing masks will be crucial to keep the virus from spreading both before a vaccine becomes available and perhaps for months beyond. from https://ift.tt/2HB6jtL Check out https://takiaisfobia.blogspot.com/ Four dozen people in South Korea have died after recently receiving their seasonal flu shots, but health officials there say the deaths were not related to the vaccinations. South Korean health officials found no direct link between the deaths and the flu shots and plan to continue the country’s immunization campaign to vaccinate people for free. “After reviewing death cases so far, it is not the time to suspend a flu vaccination program since vaccination is very crucial this year, considering … the COVID-19 outbreak,” Jeong Eun-Kyung, director of the Korea Disease Control Agency, said during a briefing. This year, countries are more aggressively carrying out flu vaccinations, as one way to potentially mitigate the continuing effects of the COVID-19 pandemic. However, concerns about the deaths led health officials in Singapore to temporarily halt vaccinations with two flu vaccines in wide use there—one made by South Korean company SK Bioscience, and the other by the French multinational Sanofi—according to the South China Morning Post. Each flu season in the U.S., the Centers for Disease Control (CDC) estimates that anywhere from 140,000 to 810,000 people are hospitalized for influenza, and up to 61,000 people die from the disease. Those rates would be considerably higher without the vaccines; studies have shown that flu shots can reduce the risk of serious disease and related hospitalization, which is especially important this year given the added burden COVID-19 is placing on the health care system. If fewer people need to go to the hospital for flu-related reasons, that provides more staff and resources to devote to caring for COVID-19 patients. The national flu vaccine campaign in South Korea did experience early stumbles. In September, the government temporarily suspended immunizations due to cold-chain problems, and in early October, about 600,000 doses of vaccines from one manufacturer were recalled after contaminants were found in some of the vials. But health officials in South Korea said the recent deaths do not seem to be related to the vaccines themselves; they occurred among people receiving shots from seven different manufacturers, and in people who were older and experiencing other health conditions including heart disease. The average age of the people who died after getting vaccinated was 74. Tracing deaths directly to the flu shot is trickier, but in the U.S., the CDC estimates that 1.31 cases of anaphylaxis occur for every 1 million doses, and an even smaller percentage of those result in deaths. Anaphylaxis is a severe reaction to the ingredients in the vaccine. Such reactions and deaths are extremely rare, however, and do not outweigh the benefits of the flu shot. from https://ift.tt/3mjvn76 Check out https://takiaisfobia.blogspot.com/ |
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