COVID-19 Pandemic (Coronavirus)

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900,000 New Yorkers Lost at Least 3 Loved Ones to Covid​


And nearly one in four New Yorkers lost at least one person close to them, according to a newly released survey. The toll was even higher among people of color.

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Lymarie Francisco visits the gravesite where her grandmother is buried in the Bronx. She lost two other relatives to Covid during the first year of the pandemic.Credit...Christopher Lee for The New York Times

By Sharon Otterman
May 5, 2023

Josefa Santana, 96, did not leave her Washington Heights apartment when New York City shut down to slow the spread of the coronavirus in March 2020. But her son, a butcher, had to work. He was the only one to leave the apartment in those weeks, so he probably was the one who brought the virus in.

Despite her family’s efforts to protect her, Ms. Santana got sick, and then died. She was one of three relatives whom her granddaughter, Lymarie Francisco, lost to Covid-19 in the first year of the pandemic, Ms. Francisco said last week.

The toll was devastating for her. It was also emblematic of the scale of loss and trauma in New York in the early stages of the pandemic, which new city data, released to The New York Times, shows in stark detail.

An estimated two million New Yorkers — nearly one in four — lost at least one person close to them to Covid within the first 16 months of the virus’s arrival, according to the data, which was collected in mid-2021 by federal census workers on behalf of the city. Nearly 900,000 New Yorkers lost at least three people they said they were close to, an open-ended category that included relatives and friends, the survey found.

Ms. Francisco, 36, lost an uncle about two months after her grandmother, and later, she also lost an aunt. But it was the loss of her grandmother, who raised her, that most affects her to this day.

“I’m constantly thinking about my grandma,” she said. “I go every other Sunday to the cemetery and just sit there. And I just speak to her.”

The finding about the scale of loss was among several from the survey, known as the New York City Housing and Vacancy Survey, that shed new light on the impact of the pandemic in the city. The survey consisted of in-person interviews with a statistically representative sample of more than 7,000 New York City households. While the primary role of the survey, conducted every three years, is to assess New Yorkers’ housing conditions, questions about Covid were added to the 2021 version.

Its findings echoed earlier studies that documented how Black and Hispanic New Yorkers died from Covid at higher rates than white New Yorkers in 2020. In part, this was because of higher poverty levels and less access to high-quality medical care. But another likely reason was that people of color made up the bulk of the essential workers who reported to work during the city’s initial 11-week shutdown, when all schools and nonessential businesses were ordered to close and people urged to stay home, the survey found.
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Josefa Santana did not leave her apartment when New York City shut down during the early days of the pandemic. But she still contracted the virus and died.Credit...Christopher Lee for The New York Times


About 1.1 million of the city’s 8.4 million residents kept going to work between March and June 2020, the survey reported. Of those, about 800,000, or 72 percent, were people of color, a broad category that included all New Yorkers who did not identify as non-Hispanic and white.

The areas that were hit hardest by Covid, including southeast Brooklyn, the Bronx, Upper Manhattan and the southeast corner of Queens, had high numbers of essential workers. The people who went to work delivered food, staffed restaurants, provided child care and cleaning, or worked in health care and transit.

Losing loved ones to the virus was more common among those workers, especially those who were low-income and people of color, the survey found. While about a quarter of all New Yorkers lost at least one person they were close to, about a third of low-income essential workers who were people of color did. Eleven percent of all New Yorkers lost at least three people to Covid, compared with 16 percent of low-income essential workers, the survey found.

Janeth Solis, 52, of the Bronx, lost four loved ones during the first year and a half of the pandemic. Her mother, step-grandmother and grandmother, who lived together in a house in Ridgewood, Queens, died one by one in the pandemic’s first weeks. Her mother-in-law died in April 2021.

It wasn’t until this year that Ms. Solis was able to visit her grandmother’s ashes, which had been shipped to her native Colombia in June 2020. The visit and therapy have helped her heal.

“We didn’t really have closure,” she said.

Rates of depression and anxiety in New York rose during the pandemic, particularly among those who had lost loved ones and those under financial strain. Based on research from past disasters, these effects are likely to continue for months or years to come, researchers at the Department of Health have said.
“Mental health needs are on the rise everywhere,” said Dr. Ashwin Vasan, the city’s health commissioner. “And it’s very difficult to separate that from the impact of trauma and grief.”

By May 2021, about 33,000 New Yorkers had died from Covid-19, according to a New York Times tracker. At least 6,000 New Yorkers have died since then.
Many New Yorkers are also connected to people who died elsewhere.

“So many of us are close to people outside of the five boroughs, and outside of the country,” said Elyzabeth Gaumer, the chief research officer at the Department of Housing Preservation and Development.">
 

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Unable to walk and housebound at the age of 12 – the extreme consequences of long COVID​



15 May 2023


At 11 years old, Jay from the United Kingdom was just like many boys of his age. He loved playing football with his friends, had a passion for boxing and spent hours trying to get to the next level of the latest computer game. In short, he was a normal boy on the verge of becoming a teenager, fit and healthy and doing well at school. The idea that he might get seriously ill was the very last thing on his, or his parents’, mind.

His mother, Neera, a general practitioner (GP), explains how his severe illness following a COVID-19 infection was a shock to them all. “During the worst of the pandemic, we had moved house to accommodate my elderly mother who was struggling being on her own at such a difficult time. We’d deliberately chosen a house that was easy to get around in case she needed to use a walking frame or wheelchair – not realizing, of course, that it would be Jay who would need to be using such things.”

Initial COVID-19 infection and subsequent aftereffects​

Following a period of having a sore throat, runny nose and slight fever, Jay tested positive for COVID-19 on 11 January 2022. “When I first got COVID, it wasn’t that bad,” Jay tells us. “I felt a bit ill and was sleeping more than usual, but then things got a lot worse.”

By February 2022 he had developed bad stomach pains, which his mother, as a doctor, could not understand. Jay’s parents took him to the accident and emergency department of the local hospital, in the Croydon area in south London, but despite numerous blood tests and investigations, the doctors were unable to find a cause. The recurring pains meant that Jay had to be sent home from school on several occasions.

Not long afterwards, he began to develop a range of other debilitating and seemingly random symptoms, including dizziness, chest pains, night sweats, a face rash, peeling fingers, fatigue and diarrhoea.

Long COVID diagnosis​

Desperate to get some answers and treatments for Jay’s severe symptoms, the family paid to see a private consultant paediatrician in April 2022. Without being able to find a conventional explanation for Jay’s illness, and given that he was suffering symptoms long after his original infection, the consultant made a diagnosis of post COVID-19 condition, commonly known as long COVID.

“It was a relief to finally have it confirmed that Jay’s condition was caused by his original COVID-19 infection, after everything else had been ruled out,” says Neera. “With it, we would hopefully be taken more seriously, and not just dismissed as we had been by some professionals who did not understand or did not believe the severity of Jay’s symptoms. It also gave us more of an idea of what we were dealing with, so we could do some research and try out suggested treatments.”

Trying to find treatments​

In an attempt to treat Jay’s recurring stomach aches, the consultant put him on an elemental diet – a liquid meal regimen that offers a complete nutritional profile – in the belief that he was suffering from an irritable bowel. The only solids that Jay could eat as part of this strict 4-week diet were chicken and rice. By following this diet, Jay’s stomach pains seemed to subside for a while.

However, by his follow-up appointment in June, Jay’s chest pains were worse than ever – he was waking up in the night in agony – and an attempt to take him off the elemental diet resulted in the return of his stomach problems. Although Jay was prescribed new medication, his painful symptoms stubbornly refused to go away.

A brief window of respite​

Over the summer months of 2022, things started to look up. Through gentle pacing of activities, Jay was feeling less fatigued, his night sweats stopped and his abdominal pain resolved itself.

As Jay explains, “During the summer holidays, I could just sit and sleep and pace myself because I didn't need to do any schoolwork. When the holidays ended, I was fit enough to return to school and even had the energy to do boxing and play football. It was amazing – I could do all the things I wanted to do again!”

A year on from his COVID-19 infection: relapse​

But this was not to last. Exactly 1 year on from his original COVID-19 diagnosis, Jay started becoming ill again, registering a high temperature and having swollen lymph nodes and a sore throat. Through a telephone consultation with his GP, this was treated as a possible Group A streptococcal infection as there was a large outbreak at that time. Medication was prescribed accordingly.

However, as his father had tested positive for COVID-19 the previous month, the family suspected that this was in fact a COVID-19 reinfection. As widespread testing was no longer available, there was no way to know for sure.

Losing mobility​

Regardless of the cause, Jay’s symptoms worsened again. The fatigue and stomach pain returned, he lost his appetite and, worse still, intense pain developed in his legs that severely limited his mobility. Jay explains, “My legs ached so much that it got to the point where I couldn’t walk and had to crawl round on the floor. I struggled to get up the stairs and had to haul myself up on the doorframe to be able to stand up long enough to go to the toilet and, even then, my legs would shake like jelly.”

Since the end of January 2023, Jay has been receiving home visits from a private paediatric physiotherapist who gives him gentle muscle exercises to do. He has tried using a walking frame, but can only manage up to 10 steps at a time. A mobility scooter also helps, giving him the opportunity to move around the ground floor and get fresh air in the back garden, but he still doesn’t know when he might be able to walk properly again.

Not surprisingly, all of this leaves Jay somewhat depressed and frustrated. “I’m feeling annoyed and really sad because I can't do all the things I used to be able to do,” he tells us. “And the doctors have not been able to help me much, because they simply don’t understand my condition.”

Where Jay is now​

Jay describes what his life is like after 14 months of being ill. “On a normal day, I wake up, usually after an interrupted sleep, and sit on the bed for a while before finding the energy to get up. Getting dressed takes a lot of effort and my mum and dad have to help me. And I have no appetite. Mum has to make me eat, so I'll eat something small, like toast.”

He continues, “During the day, I might do some schoolwork or physiotherapy, but I can’t manage both on the same day. Any activity I do has to be in 15-minute bursts; otherwise I crash out from exhaustion. Mum helps me with my schoolwork and has to really explain things, because I have problems processing information. I spend a lot of time lying on the sofa now as I just don’t have the energy to move very far around the house.”

Although Jay is now housebound, the family’s many pets provide some comfort. Neera believes the animals support his mental health. “Having pets has helped Jay greatly. When he is lying on the sofa, the pugs snuggle up to him and whenever he tries to walk using his walking frame they join him. He loves just lying next to them and stroking them. He also likes taking the lizard and hamster out of their cages to play on his lap.”

Neera is surprised by and very proud of how well Jay has coped with such a drastic and difficult change in his life. She notes the resilience he has shown after such a long time being ill.

The whole family affected​

With Jay effectively disabled, restrictions have now been put on the whole family. “We used to be a really active family, going to the theatre, going out together for Sunday roasts, walking the dogs – but we’ve had to cancel so much at the last minute because Jay just doesn’t have the energy to go out to do those things,” Neera says.

“Life is now just about work and being at home to look after Jay and to arrange physio and osteopath appointments. It’s affected all of us. The support we’ve received from the patient group Long COVID Kids has been invaluable, though. It's been a relief to connect with other parents who have children in similar circumstances and to find out more information about the condition.”

The shadow pandemic​

Of those infected by SARS-CoV-2, the virus that causes COVID-19, 1 in 10 will go on to develop long COVID, defined as the continuation or development of new symptoms 3 months after the initial infection, with these symptoms lasting for at least 2 months with no other explanation.

Long Covid can develop in people of all ages, regardless of severity of original symptoms. It is also known that the chance of developing the condition increases the more times a person gets reinfected by the SARS-CoV-2 virus.

The United Kingdom’s Office of National Statistics estimates that 1.9 million people (equivalent to 2.9% of the country's population) were experiencing self-reported long COVID symptoms as of 5 March 2023.

We still have so much more to learn about long COVID and in particular how it presents in children, which is why WHO/Europe, in partnership with Long COVID Europe, is calling for Member States to increase the 3 Rs – recognition, research and rehabilitation – for post COVID-19 condition (long COVID).
 

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Modi govt ‘wholly untrustworthy’ on Covid data, censored criticism on pandemic: Lancet​

Cnxtoday May 8, 2023 3 min read


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By Our Representative

One of the world’s most prestigious health journals, brought out from England, has sharply criticised the Narendra Modi government for being “wholly untrustworthy on Covid-19 health data”, stating, the “official government figures place deaths at more than 530 000, while WHO excess death estimates for 2020 and 2021 are near 4·7 million.”

The Lancet in its latest unsigned editorial commentary insisted, “The fact that the Indian government attempted to delay the publication of such figures while also censoring criticism during the pandemic seriously undermines its integrity.”

The journal said, this was happening at a time when press freedom in India “has diminished since Modi’s ascent to power in 2014” (the ranking is down to 161, down 11 in a year), adding, this also happened at a time when “Civil society is increasingly constrained and violent Hindu nationalism is suppressing non-Hindu voices. Without a space for debate, activism and accountability are impossible, and India’s place as the world’s largest democracy is threatened.”

Given this framework, it stated, “Ultimately, the leadership of any country on the global stage depends upon its legitimacy. The Modi government has failed to show a commitment to transparency, integrity, and equity. As a result, India risks squandering its formidable opportunities.”

The Lancet said, the situation has worsened despite India’s new digital health programme, the Ayushman Bharat Digital Mission, “could serve as a model for other countries to follow, and India’s “vaccine distribution platform, Co-Win, an open-source digital health programme, could be put to “public good for international use.”

While such actions suggest “India could enhance South–South cooperation”, The Lancet, which is considered the world’s “highest-impact academic journal”, however, regretted, “There is danger that India’s domestic potential and its international aspirations will amount to little more than platitudes, given the direction that Modi is taking the country.”

Thus, said Lancet, while India has shown “global leadership in access to medicines”, and it alongside South Africa was “one of the first nations to propose intellectual property waivers during the Covid-19 pandemic”, questions have been raised how its “immense generics manufacturing industry” offered contaminated medicines, raising “questions over regulatory oversight.”

Citing the example of providing “affordable medicines to many parts of the world, including about two-thirds of antiretroviral drugs for HIV”, the contaminated medicines, it complained, “resulted a series of fatalities.”


Without a space for debate, activism and accountability are impossible, and India’s place as the world’s largest democracy is threatened

Conceding that “India has undoubted strengths”, The Lancet said, it would wrong to call demography a destiny. It noted, “While China’s population is declining, India’s is projected to continue increasing. The number of young people entering the workforce is increasing, presenting a potential demographic dividend.”

The Lancet agreed that “India has shown some enthusiasm for building greenhouse gas infrastructure”, though added, “But softening of the language on coal at COP26 invites scepticism. Despite low health sector and per capita emissions, India remains the world’s third largest CO2 emitter.”

It said, “India’s climate policies are a contradiction. It is seeking more than US$100 billion annually to support renewable energy transition in LMICs. Huge investments in green hydrogen and solar energy could reduce its dependence on fossil fuels, which account for more than 80% of India’s energy needs.”

It added, “India is already feeling the consequences of failing to act. Last year, devastating heatwaves wreaked havoc, and India recorded its hottest March on record. Articulating a clear pathway towards net zero, and having the data to support it, are imperative.”

In fact, it said, “India’s climate policies are a contradiction. It is seeking more than US$100 billion annually to support renewable energy transition in LMICs. Huge investments in green hydrogen and solar energy could reduce its dependence on fossil fuels, which account for more than 80% of India’s energy needs.”

Commenting on India holding the G20 presidency, taking over from Indonesia, with its New Delhi Leader’s Summit in September will be the first to be hosted in south Asia, The Lancet wondered, “What will these developments mean for its role in the international system? India says that it wants to amplify the voice of the Global South, and its G20 goals reflect this ambition.”

However, it pointed out, “The nationalist agenda of Narendra Modi’s government, its resistance to multilateralism, and a raft of pressing domestic concerns threaten the chances of making these aims a reality.”
 

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China braces for new Covid wave with up to 65 million weekly cases​



China braces for new Covid wave with up to 65 million weekly cases

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By CNBCTV18.com May 22, 2023 4:27:34 PM IST (Published)​

XBB is expected to result in 40 million infections per week by the end of May before peaking at 65 million a month later. This comes nearly six months after Beijing dismantled its Covid Zero curbs, allowing the virus to spread rapidly among the country’s 1.4 billion residents.​


China is facing a new wave of Covid-19 infections that could see as many as 65 million cases per week by the end of June. This alarming prediction was made by respiratory disease specialist Zhong Nanshan at a biotech conference in Guangzhou. Zhong’s estimate provides a rare glimpse into the potential impact of the latest omicron variant, XBB, which has been fueling a resurgence in cases across China since late April.


According to a Bloomberg report, XBB is expected to result in 40 million infections per week by the end of May before peaking at 65 million a month later. This comes nearly six months after Beijing dismantled its Covid Zero curbs, allowing the virus to spread rapidly among the country’s 1.4 billion residents. In the wake of this pivot to living with the virus, the Chinese Center for Disease Control and Prevention stopped updating its weekly statistics earlier this month, leaving many questions about the true impact of Covid-19 in China.

Zhong’s estimate suggests that this latest wave of infections will be more muted compared to the previous wave that hit China late last year and into January. At that time, a different omicron sublineage likely infected 37 million people every day, overwhelming hospitals and crematoriums and causing residents to scramble for limited supplies of fever medicine.


Also Read: 91% deaths of preterm babies in low, middle-income countries are related to air pollution: UN report


In response to this new threat, China is rushing to bolster its vaccine arsenal with new immunizations that specifically target XBB. The country’s drug regulator has already given preliminary approval to two such vaccines, with another three or four expected to be cleared soon. “We can lead the pack internationally in developing more effective vaccines,” Zhong said.

A World Health Organization (WHO) advisory group recently recommended that this year’s COVID-19 booster shots be updated to target one of the currently dominant XBB variants. New formulations should aim to produce antibody responses to the XBB.1.5 or XBB.1.16 variants, and other formulations or platforms that achieve neutralizing antibody responses against XBB lineages could also be considered.

The group also suggested no longer including the original COVID-19 strain in future vaccines, based on data that it no longer circulates in human beings and shots targeting it produce “undetectable or very low levels of neutralizing antibodies” against currently circulating variants.

Also Read: WHO warns against artificial sweeteners, says there are no long-term benefits

COVID-19 vaccine makers like Pfizer/BioNtech, Moderna Inc and Novavax Inc are already developing versions of their respective vaccines targeting XBB.1.5 and other currently circulating strains. The US Food and Drug Administration is also set to hold a meeting of outside experts in June to discuss the strain compositions of COVID-19 shots for later this year; vaccine manufacturers will be expected to update their shots once the strains are selected.

As China prepares for this new wave of infections, it remains to be seen how effective these new vaccines will be in curbing the spread of XBB. With millions of cases expected each week, it is clear that the fight against Covid-19 is far from over.
 

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Covid kills one person every four minutes as vaccination rates fall​

Covid is still a leading killer, the third-biggest in the US last year behind heart disease and cancer​


Bloomberg
Photo: Bloomberg, Covid-19


Photo: Bloomberg
6 min read Last Updated : May 23 2023 | 9:34 PM IST
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By Michelle Fay Cortez

After more than three years, the global Covid emergency is officially over. Yet it’s still killing at least one person every four minutes and questions on how to deal with the virus remain unanswered, putting vulnerable people and under-vaccinated countries at risk.


A key question is how to handle a virus that’s become less threatening to most but remains wildly dangerous to a slice of the population. That slice is much bigger than many realize: Covid is still a leading killer, the third-biggest in the US last year behind heart disease and cancer. Unlike with other common causes of death such as smoking and traffic accidents that led to safety laws, though, politicians aren’t pushing for ways to reduce the harm, such as mandated vaccinations or masking in closed spaces.
“The general desire in the world is to move beyond the pandemic and put Covid behind us, but we can’t put our heads in the sand,” said Ziyad Al-Aly, director of the Clinical Epidemiology Center at the Veterans Affairs St. Louis Health Care System in Missouri. “Covid still infects and kills a lot of people. We have the means to reduce that burden.”

Even before the World Health Organization declared earlier this month that Covid no longer constitutes an emergency, most governments had already relaxed lockdowns and guidelines. After spending heavily in earlier phases of the pandemic, global leaders have dialed back efforts and are reluctant to pursue preventative measures for which the public no longer has much patience.
Meanwhile, the infection that caused at least 20 million deaths worldwide continues to evolve, leaving the elderly and those with pre-existing conditions at the mercy of luck, uneven access to medicine and little protection from others without face masks or recent vaccinations.

Why No Long-Term Plan?
A global, long-term plan to protect the vulnerable and to keep a resurgence at bay hasn’t materialized, partly because of how difficult it is to forge any consensus around Covid. From the start, polarized political discourse overshadowed official guidelines on masking and vaccinations.


Even in developed countries where the vaccine became available in less than a year into the pandemic, many people refused to take it. Lack of immunization led to more than 300,00 excess American deaths, or one out of every two from Covid, throughout 2021. Globally, it could have saved half a million more, studies show.
“We know that politicizing public health is one of the tragedies of the pandemic,” Al-Aly said. “Political leaders leveraged their responses not only to advance public health but to advance their own narrative and drum up support for themselves.”


Global coordination has also been hampered by politics. China’s refusal to allow independent experts unfettered access to a wet market thought to be a crucible for Covid or to the Wuhan Institute of Virology added to diplomatic tension and mistrust. Today, Chinese representatives aren’t participating in many global preparation efforts, said Linfa Wang, a virologist and director of the emerging infectious diseases program at Duke-NUS Medical School in Singapore.
“It’s hindering academic collaboration, and China/US collaboration is almost zero,” Wang said. “With these two superpowers, if they don’t collaborate, how can we say the world is ready for the next disease?”


A waning sense of emergency has also meant the surge of investment in Covid vaccines and therapeutics has also cooled. While companies including Moderna Inc and Pfizer Inc are still updating their shots, trying to make them easier to manufacture and store, many of the hundreds of novel approaches that were initially conceived have fallen by the wayside.
In the US, experts are due to meet in June to advise on what strain of the virus vaccines should target for the remainder of the year. Those vaccines will only launch in the fall, with just 100 million doses expected in the US according to Moderna’s estimates, far less than in previous years.


Why Is This a Problem?
Long Covid, estimated to affect around 10% of infected people, is considered one of the biggest post-pandemic medical challenges. The economic costs are also significant.


In the US, long Covid was estimated to cost around $50 billion a year in lost salaries as of late 2022. In the UK, the Institute for Fiscal Studies last year estimated that about one in 10 people with long Covid have to stop working as a result. The number of people with those symptoms, including brain fog, breathing difficulties and fatigue, are rising even as infections are decreasing.
It’s particularly scary for high-risk people, who’ve had to return to work and public spaces where masks are sparse and the dangers are invisible. A family wedding can still turn into a super-spreader event, and a flight can be catastrophic.


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Epidemiologist Steffanie Strathdee is painfully aware of this. Her husband Tom survived a drug-resistant infection with a rare superbug in 2016, but was left with scarred lungs and other medical issues. They understood the potential risk if he contracted Covid, so they were vigilant, limiting travel through the pandemic. Both were fully vaccinated and avid maskers.
But a recent visit to their son in Canada led to an infection. In the hospital, where Tom was treated with acute respiratory distress, she was taken aback by how cavalier some younger staff were about contracting Covid as they considered themselves low-risk, even though they could transmit it to patients.


“It’s not mild for everybody and we know repeated exposures increase your risk,” said Strathdee, also associate dean of Global Health Sciences at the University of California, San Diego.
While people with active health issues may know to take precautions, some will learn that they’re vulnerable only after an infection lands them in the hospital. Repeated bouts can add to damage, and that applies to everyone, not just those with pre-existing conditions.


What Should We Be Doing?
The silver lining is that the world now has vaccines and better treatments. Tests can uncover infections in minutes, and new outbreaks can be quickly spotted.


Health experts say immunization is the best way to protect against it. Only about 16% of Americans have gotten a bivalent booster, according to Pfizer Inc., compared with almost 70% vaccinated in the first inoculation drive. Increased out-of-pocket costs and vaccine fatigue could cause uptake rates to fall further. Longer term, the hope is that innovative new shots or nasal sprays will provide better protection.
There are other improvements that could help, ranging from ventilation and air quality testing to better masks. There needs to be more investment in surveillance systems so threats can be caught early, experts said.


The US is also planning to spend $5 billion on a new project aimed at developing advanced vaccines and treatments for coronaviruses in concert with drugmakers. The goal is to make medicines available quickly as the virus mutates, so the targeted strain isn’t ebbing when they hit the market.
“Even if governments are tired, we have to face the reality that the virus is still evolving,” said Duke-NUS’s Wang.
 

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Tally of covid-19 cases after CDC conference climbs to 181​


By Lena H. Sun
May 26, 2023 at 1:00 p.m. EDT

The Centers for Disease Control and Prevention is advising people attending a June agency event to wear their “own high-quality masks and, if possible, also carry covid-19 rapid tests with them.” (Tami Chappell/Reuters)

The tally of people infected with the coronavirus after attending a high-profile Centers for Disease Control and Prevention conference in April has risen to at least 181, the agency reported Friday. No one was hospitalized.


The CDC’s Epidemic Intelligence Service officers and alumni — the disease detectives deployed to identify and fight outbreaks — met April 24-27 at an Atlanta hotel. The conference drew 1,800 in-person attendees, the first in-person Epidemic Intelligence Service gathering in four years. Like many conferences, it was crowded, with much face-to-face contact, many events held in small rooms and lots of socializing, according to attendees. About 70 percent of participants who responded to a CDC survey said they did not wear masks at the event.

The outbreak of covid-19 cases at the conference underscores the persistence of an evolving and highly infectious virus.

Another CDC global health meeting is scheduled for the same hotel in early June; about 300 to 400 people are expected to attend in person, said one CDC employee who spoke on the condition of anonymity because they were not authorized to speak.

In a “Know Before You Go” document shared with The Washington Post, CDC organizers encourage attendees at the June conference to wear their “own high-quality masks and, if possible, also carry covid-19 rapid tests with them.” Organizers of the second conference were informed about the covid outbreak at the earlier event, CDC spokeswoman Kristen Nordlund said. The agency will have masks available if employees want to wear one, she said.

With in-person conferences and summer travel underway, infectious-disease experts say the CDC event is a reminder that the coronavirus is not going away.


“This outbreak dramatically illustrates that if the circumstances are right, this virus can really spread to a lot of people,” said William Schaffner, an infectious-disease doctor at the Vanderbilt University School of Medicine. One of his colleagues attended the April CDC conference, and even though the person had a mild illness, like many others at the event, “these were people who were quite discomforted for several days,” Schaffner said.

Covid-19 hospitalizations and deaths have fallen dramatically because of immunity conferred by vaccines and prior infections, public health experts have said. Tracking viral circulation or cases has become problematic because many Americans are testing at home, or not all. The end of the public health emergency on May 11 also meant cases and positive test results stopped being reported to the CDC.

The virus can cause significant illness, primarily in unvaccinated people, older adults, people with underlying health conditions and those with weakened immune systems. Among the 181 who were sickened at the CDC conference, the median age was 38, nearly all were younger than 65 and two-thirds were women, Nordlund said. No severe illnesses were reported.


Jeffrey Duchin, health officer for Seattle and surrounding King County, said four members of his team attended the conference. Two wore high-quality masks reliably, he wrote in an email. Of the two who did not, one was sickened by the virus.

“In my view, [Epidemic Intelligence Service] and other conference organizers should take reasonable steps to decrease the risk to participants by optimizing venue indoor air quality … opting for outdoor venues when possible, minimizing crowding, and providing N95 and KN95 masks for those who want to reduce their risk,” Duchin said.

“At a minimum, I think it would be useful for conference organizers to inform participants of what steps are being taken to reduce the risk for COVID-19 transmission, so that participants can make informed risk assessments about any additional steps they may want to take, like masking.”


At a large travel industry conference that drew nearly 5,000 attendees in San Antonio this week, delegates were told they could choose to wear a face mask. “Please respect the decision of attendees who choose to be masked,” said health and safety guidance that was provided.

Greg Staley, senior vice president for communications at the U.S. Travel Association, the conference organizer, said no cases of covid-19 have been reported.

To unravel the cluster of cases tied to the April CDC conference, the agency conducted a May 5-12 survey of in-person attendees, with more than 80 percent responding. Of those who reported testing positive, 52 percent said they had no known prior coronavirus infection. More than 99 percent of respondents had at least one dose of a coronavirus vaccine. About one-fourth of those who tested positive received antiviral medication.

The risk of infection was 70 percent greater among those who attended three or more days compared with those attending two or fewer days, an agency statement said.

The CDC statement said the findings support data that coronavirus vaccines, antiviral treatments and immunity from previous infection continue to provide people with protection against serious illness. It did not reference masking.
 

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More than 70% of US household COVID spread started with a child, study suggests​

Mary Van Beusekom, MS

June 2, 2023
COVID-19

Mom with sick girl on couch
grinvalds / iStock


A study published yesterday in JAMA Network Open suggests that 70.4% of nearly 850,000 US household COVID-19 transmissions originated with a child.

A team led by Boston Children's Hospital researchers gave smartphone-connected thermometers to 848,591 households with 1,391,095 members, who took 23,153,925 temperature readings from October 2019 to October 2022. Fevers were a proxy for infection.

Of all readings, 57.7% were from adults. Most households (62.3%) reported temperatures from only one person, while 37.7% included multiple participants taking 51.6% of all readings. Most children were 8 years or younger (58.0%), and more females than males participated in each age group.

Younger kids more likely to spread virus​

A total of 15.8% of readings met the criteria for fever, making up 779,092 fever episodes. The number of fever episodes predicted new COVID-19 cases, which the researchers said lends validity to using fever as a proxy for infection. Of these cases, 15.4% were considered household transmissions, the percentage of which rose from 10.1% in March to July 2021 to 17.5% in the Omicron BA.1/BA.2 variant wave.

Among 166,170 households with both adult and child participants (51.9% of households with multiple participants), there were 516,159 participants, 51.4% of whom were children. In these households, 38,787 transmissions occurred, 40.8% of which were child to child, 29.6% child to adult, 20.3% adult to child, and 9.3% adult to adult. The median serial interval between the index and secondary cases was 2 days.

Of all households transmissions, 70.4% began with a child, with the proportion fluctuating weekly between 36.9% and 87.5%. Pediatric transmissions reached a high of 68.4% the week of September 27, 2020, and fell to a low of 41.7% the week of December 27, 2020 (0.61 times less frequent). The next high was 82.0% the week of May 23, 2021, which stayed stable until June 27 (81.4%) and then declined to 62.5% by August 8 (0.77 times less frequent).

The percentage of household transmissions beginning with a child then rose to 78.4% by September 19, hovering there until November 14 (80.3%) and then dropping to 54.5% the week of January 2, 2022 (0.68 times less frequent). By March 6, the proportion rose to 83.8%, fell to 62.8% the week ending July 24 (0.75 times less frequent), and then climbed to 84.6% the week of October 9.

Children aged 8 years and younger were more likely to be the source of transmission than those aged 9 to 17 (7.6% vs 5.8%). During most of the pandemic, the proportion of transmission from children was negatively correlated with new community COVID-19 cases.

In-person school contributed to transmission

"More than 70% of transmissions in households with adults and children were from a pediatric index case, but this percentage fluctuated weekly," the study authors wrote. "Once US schools reopened in fall 2020, children contributed more to inferred within-household transmission when they were in school, and less during summer and winter breaks, a pattern consistent for 2 consecutive school years."

The researchers said the finding that pediatric COVID-19 transmission was negatively correlated with new community cases during most of the pandemic is consistent with that of a previous study.

Once US schools reopened in fall 2020, children contributed more to inferred within-household transmission when they were in school, and less during summer and winter breaks.
"When the incidence of COVID-19 increases, adults in the community are at higher risk of infection; this may increase the likelihood that adults become the index case in a household transmission and explain the negative correlation we observed," they wrote. "Also, when the COVID-19 incidence is low, overall use of nonpharmaceutical interventions might decrease, leading to increased incidence of non–SARS-CoV-2 pathogens which may be more common in children."

The authors concluded that children had an important role in the spread of SARS-CoV-2 and that in-person school also resulted in substantial spread. "Future work could validate the inferred transmissions from a participatory network with onsite visits or other contract-tracing outreach for additional data collection and laboratory confirmation," they wrote. "Any system that leverages digital technologies must make every effort to ensure equitable access."
 

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More than 70% of US household COVID spread started with a child, study suggests​

Mary Van Beusekom, MS

June 2, 2023
COVID-19

Mom with sick girl on couch
grinvalds / iStock


A study published yesterday in JAMA Network Open suggests that 70.4% of nearly 850,000 US household COVID-19 transmissions originated with a child.

A team led by Boston Children's Hospital researchers gave smartphone-connected thermometers to 848,591 households with 1,391,095 members, who took 23,153,925 temperature readings from October 2019 to October 2022. Fevers were a proxy for infection.

Of all readings, 57.7% were from adults. Most households (62.3%) reported temperatures from only one person, while 37.7% included multiple participants taking 51.6% of all readings. Most children were 8 years or younger (58.0%), and more females than males participated in each age group.

Younger kids more likely to spread virus​

A total of 15.8% of readings met the criteria for fever, making up 779,092 fever episodes. The number of fever episodes predicted new COVID-19 cases, which the researchers said lends validity to using fever as a proxy for infection. Of these cases, 15.4% were considered household transmissions, the percentage of which rose from 10.1% in March to July 2021 to 17.5% in the Omicron BA.1/BA.2 variant wave.

Among 166,170 households with both adult and child participants (51.9% of households with multiple participants), there were 516,159 participants, 51.4% of whom were children. In these households, 38,787 transmissions occurred, 40.8% of which were child to child, 29.6% child to adult, 20.3% adult to child, and 9.3% adult to adult. The median serial interval between the index and secondary cases was 2 days.

Of all households transmissions, 70.4% began with a child, with the proportion fluctuating weekly between 36.9% and 87.5%. Pediatric transmissions reached a high of 68.4% the week of September 27, 2020, and fell to a low of 41.7% the week of December 27, 2020 (0.61 times less frequent). The next high was 82.0% the week of May 23, 2021, which stayed stable until June 27 (81.4%) and then declined to 62.5% by August 8 (0.77 times less frequent).

The percentage of household transmissions beginning with a child then rose to 78.4% by September 19, hovering there until November 14 (80.3%) and then dropping to 54.5% the week of January 2, 2022 (0.68 times less frequent). By March 6, the proportion rose to 83.8%, fell to 62.8% the week ending July 24 (0.75 times less frequent), and then climbed to 84.6% the week of October 9.

Children aged 8 years and younger were more likely to be the source of transmission than those aged 9 to 17 (7.6% vs 5.8%). During most of the pandemic, the proportion of transmission from children was negatively correlated with new community COVID-19 cases.

In-person school contributed to transmission

"More than 70% of transmissions in households with adults and children were from a pediatric index case, but this percentage fluctuated weekly," the study authors wrote. "Once US schools reopened in fall 2020, children contributed more to inferred within-household transmission when they were in school, and less during summer and winter breaks, a pattern consistent for 2 consecutive school years."

The researchers said the finding that pediatric COVID-19 transmission was negatively correlated with new community cases during most of the pandemic is consistent with that of a previous study.


"When the incidence of COVID-19 increases, adults in the community are at higher risk of infection; this may increase the likelihood that adults become the index case in a household transmission and explain the negative correlation we observed," they wrote. "Also, when the COVID-19 incidence is low, overall use of nonpharmaceutical interventions might decrease, leading to increased incidence of non–SARS-CoV-2 pathogens which may be more common in children."

The authors concluded that children had an important role in the spread of SARS-CoV-2 and that in-person school also resulted in substantial spread. "Future work could validate the inferred transmissions from a participatory network with onsite visits or other contract-tracing outreach for additional data collection and laboratory confirmation," they wrote. "Any system that leverages digital technologies must make every effort to ensure equitable access."
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