COVID-19 Pandemic (Coronavirus)

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A blood test for long Covid is possible, new research suggests

Scientists can now show key differences in the blood of those who recover from Covid — and those who don't.

www.nbcnews.com

A blood test for long Covid is possible, a study suggests​

Scientists can now show key differences in the blood of those who recover from Covid — and those who don't.



Sept. 25, 2023, 11:01 AM EDT

By Erika Edwards

More than three years into the pandemic, the millions of people who have suffered from long Covid finally have scientific proof that their condition is real.

Scientists have found clear differences in the blood of people with long Covid — a key first step in the development of a test to diagnose the illness.


The findings, published Monday in the journal Nature, also offer clues into what could be causing the elusive condition that has perplexed doctors worldwide and left millions with ongoing fatigue, trouble with memory and other debilitating symptoms.

The research is among the first to prove that "long Covid is, in fact, a biological illness," said David Putrino, principal investigator of the new study and a professor of rehabilitation and human performance at the Icahn School of Medicine at Mount Sinai in New York.

Dr. Marc Sala, co-director of the Northwestern Medicine Comprehensive Covid-19 Center in Chicago, called the findings "important." He was not involved with the new research.

"This will need to be investigated with more research, but at least it's something because, quite frankly, right now we don't have any blood tests" either to diagnose long Covid or help doctors understand why it's occurring, he said.

Putrino and his colleagues compared blood samples of 268 people. Some had Covid but had fully recovered, some had never been infected, and the rest had ongoingsymptoms oflong Covid at least four months after their infection.

Several differences in the blood of people with long Covid stood out from the other groups.

The activity of immune system cells called T cells and B cells — which help fight off germs — was "irregular" in long Covid patients, Putrino said. One of the strongest findings, he said, was that long Covid patients tended to have significantly lower levels of a hormone called cortisol.

A major function of the hormone is to make people feel alert and awake. Low cortisol could help explain why many people with long Covid experience profound fatigue, he said.

"It was one of the findings that most definitively separated the folks with long Covid from the people without long Covid," Putrino said.

The finding likely signals that the brain is having trouble regulating hormones. The research team plans to dig deeper into the role cortisol may play in long Covid in future studies.

Meanwhile, doctors do not recommend simply boosting a person's cortisol levels in an attempt to "fix" the problem.

"There is no evidence that replacing cortisol in someone with long Covid would be a safe or effective thing to do," Sala said.

The study also found that dormant viruses, such as the one that causes mononucleosis, Epstein-Barr, come alive again in long Covid patients. It's unclear, however, whether those old viruses are causing symptoms or flagging a problem within the immune system.

"We were looking for signals, and we found them," said Akiko Iwasaki, one of the researchers and a professor of immunobiology and molecular, cellular and developmental biology at the Yale School of Medicine. "Now what we need to do is home in on each of these signals and understand better how the disease has been driven by these signals."

The investigators did not find significant evidence that long Covid is the result of an autoimmune disorder, in which the body attacks itself.

Joshua Roman practices the cello at his New York City home on Sunday. Long Covid left Roman with uncontrollable trembling, threatening his career.Jonathan Yap

Dr. Clinton Wright, director of the National Institute of Neurological Disorders and Stroke's division of clinical research, said additional studies will be necessary to find other ways Covid may lead to long-term symptoms. One theory is that the virus is hiding in brain tissue or other organs.

"We're really interested in whether the virus still exists in reservoirs in the body," he said. "It's really hard to do that by measuring blood." He was not involved with the new study.
Long Covid affects 1 in 13 U.S. adults, or 7.5%, according to the Centers for Disease Control and Prevention.

The findings offer hope to patients like Joshua Roman, 39, of New York City, who participated in the study.

"We're in such a mysterious swamp of symptoms," he said. "My long Covid treatment is just management of symptoms."

Roman, a professional musician who plays the cello, takes daily medication to ease the lingering physical trembling that affects his ability to perform.

"It would be great if we could get to the thing that's causing me to shake in the first place, but we still don't know exactly what that is," he said

 

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Covid deaths are on the rise again, so what happens? Mask-wearing in hospitals is scrapped | George Monbiot

The only masking that’s going on is that of the government’s continued failure to get to grips with the virus, says Guardian columnist George Monbiot

www.theguardian.com

Covid deaths are on the rise again, so what happens? Mask-wearing in hospitals is scrapped​

George Monbiot

The only masking that’s going on is that of the government’s continued failure to get to grips with the virus

Mon 16 Oct 2023 01.00 EDT

Illustration: Matt Kenyon

For some people, going to hospital may now be more dangerous than staying at home untreated. Many clinically vulnerable people fear, sometimes with good reason, that a visit to hospital or the doctors’ surgery could be the end of them. Of course, there have always been dangers where sick people gather. But, until now, health services have sought to minimise them. Astonishingly, this is often no longer the case.

Across the UK, over the past two years, the NHS has been standing down even the most basic precautions against Covid-19. For example, staff in many surgeries and hospitals are no longer required to wear face masks in most clinical settings. Reassuring posters have appeared even in cancer wards, where patients might be severely immunocompromised. A notice, photographed and posted on social media last week, tells people that while they are “no longer required to wear a mask in this area”, they should use hand sanitiser “to protect our vulnerable patients, visitors and our staff”. Sanitising is good practice. But Covid-19 is an airborne virus, which spreads further and faster by exhalation than by touch.


The story this policy tells, which the government would have us believe, is that Covid-19 is all but over. It’s not true. Despite a collapse in testing, which means the figures will be grossly understated, the number of death certificates giving Covid-19 as a cause has been climbing steadily as autumn approaches, rising from 80 per week in early August to 306 in late September. Who knows what the real number may be?

Forget it, be happy, keep shopping: if you don’t live and work as though the virus has vanished, you’re holding the country back. There could scarcely be a more powerful symbol of the all-clear than doctors and nurses greeting their patients without masks.

When we forget the virus, we forget the clinically vulnerable people – an estimated 2.2 million in the UK – trapped by our insouciance. Some can scarcely leave their homes, as the danger to them of infection is so great. They are the shadow that falls across the sunny story the government tells, a shadow that must be ignored and denied.

Clinical staff, long after the clapping died away, have continued to carry the weight of this disease. A recent British Medical Association (BMA) survey of hundreds of doctors with long Covid revealed its ruinous impact on their lives. From junior doctors to consultants, they’ve been abandoned by the system, unable to get appointments or referrals, left alone to face the loss of their careers and almost every other aspect of their lives.

Long Covid is so debilitating that a study in the British Medical Journal (BMJ) this year found many who suffer it reported a lower quality of life than people with stage 4 lung cancer. Another study found that typical symptoms of long Covid “had an impact on health as severe as the long-term effects of traumatic brain injury”. Some doctors, the BMA survey found, are unable to work, to care for their children, cook, perform basic arithmetic, even brush their hair. Some are now facing the loss of their homes, bankruptcy and destitution. Though most caught the virus in the line of duty, they’ve been bright-sided, sacrificed to the officially sanctioned delusion that it’s over, and we should all get on with our lives. They must wish they could.
Masks work, especially if they’re N95 respirators or equivalent. They work best when everyone uses them, and are kept on throughout the time we spend in an enclosed space. This is because the aerosols that carry the virus can keep circulating in a room, long after they’ve been exhaled.

But unmasking isn’t the end of it. Testing for Covid-19 in hospitals has also been largely curtailed. As the Observer revealed, clinical staff in some places are being discouraged from testing themselves. If they want a test, they must buy it. Why would hospitals want less information about infection?

Now we discover that the government is stockpiling vaccines rather than deploying them. It’s senseless for two reasons. First, because it should be maximising protection before the full autumn surge begins; second, because by the time they’re used, new mutations could render them worthless.

Bad enough? Oh no. Current government guidance advises staff who think they’re infected to stay at home, but only if they “have a high temperature or do not feel well enough to go to work”. Even then, they’re not required to take a test. If they feel well enough to work, it seems, they’re welcome to spread it around.

The same advice has been issued by the government to schools: “If your child has mild symptoms such as a runny nose, sore throat or mild cough, and they feel well enough, they can go to school or childcare.” Were you to devise a formula for spreading the disease as far and wide as possible, you could scarcely do better than this.

We know how to minimise infection: ventilation, air filtration and germicidal ultraviolet light in indoor public spaces; N95 masks and Covid tests provided free to those who want them; mask mandates in clinical settings; vaccines that are widely available and up to date; proper support for workers and for the parents of children who test positive, so they can stay at home without losing their income.

There’s plenty of masking going on, but not the kind that prevents infection. The government is masking its failure to get to grips with this virus. It’s masking the fact that, thanks to three years of such failures, Covid-19 is now a constantly evolving endemic infection likely to kill or disable many thousands every winter. It’s masking the ableism its rhetoric has encouraged: the othering and blaming of those who contract the disease, driven by the widespread but wholly mistaken belief that fit and healthy people don’t catch it. It’s masking the cruelty of a system that shuts down the lives of clinically vulnerable people.

These facts – and these people – are treated as social embarrassments, locked in the government’s moral attic like a relative with a mental illness in Victorian England. They’re the country’s family secret. That coughing noise upstairs? Nothing that need concern you.

• George Monbiot is a Guardian columnist

 

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Dr. Lucky Tran :verified: (@luckytran@med-mastodon.com)

Attached: 2 images Pfizer says it will price Covid treatment Paxlovid at nearly $1,400 for a five-day course, which researchers estimate only costs Pfizer $13 to produce. That's a 10,000%+ markup. Shameful.

med-mastodon.com

WSJ News Exclusive | Pfizer Prices Covid Drug Paxlovid at $1,400 for a Five-Day Course

The drugmaker, which has begun negotiating with pharmacy-benefit managers and health plans this week, is expected to offer steep discounts to ensure wide access.

www.wsj.com

https://archive.ph/DTdzO {full article}

'For Shame': Pfizer to Charge $1,390 for Lifesaving Covid Drug That Costs Just $13

"Pfizer treats Paxlovid like a Prada handbag; a luxury for the few rather than a treatment for the many," said one consumer advocate.

www.commondreams.org

"Pfizer's new price is an estimated 100 times the cost of production," Peter Maybarduk, director of Public Citizen's Access to Medicines program, said in a statement.

"Pfizer chose to double its U.S. price just as pandemic funding falters and the precarious winter viral season begins."

It's also more than 2.5 times the federal government's purchase price for Paxlovid. The government has bought and distributed the antiviral drug to the public free of charge since December 2021, when the U.S. Food and Drug Administration approved the treatment. Starting next year, Pfizer will sell Paxlovid directly to health insurance companies.

"Pfizer has made tens of billions in Paxlovid sales, largely through major government purchases," Maybarduk noted. "Pfizer could choose now to support the fight against Covid and ease treatment access by lowering its already inflated prices."

 

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Schools cut covid-19 sick days by 20 per cent using HEPA air filters

The eagerly awaited finding comes from the first randomised trial of putting HEPA filter machines into classrooms

www.newscientist.com

Schools cut covid-19 sick days by 20 per cent using HEPA air filters​

Placing HEPA air filters into classrooms in the Bradford area of the UK reduced the number of covid-19-related absences among students by more than 20 per cent

By Clare Wilson

20 October 2023

A HEPA filter in a classroom at Bowling Park Primary School in Bradford, UK

University of Leeds

Air filter machines put into a handful of UK schools reduced the number of covid-19-related sick days by more than 20 per cent, the first such randomised trial of the intervention has found.


HEPA filters, devices about the size of a tall kitchen waste bin, were placed in the classrooms of schools in the Bradford area. The results haven’t yet been published in a peer-reviewed journal, but one of the researchers revealed the 20 per cent fall …
at a conference last month.
“You could still have outbreaks even if you have HEPA filters in your classrooms, but the underlying illness absence was over 20 per cent reduced when you have got the air cleaners in place,” said Catherine Noakes at the University of Leeds, UK, at the World Health Organization Europe Indoor Air Conference.

The trial was carried out between September 2021 and March 2022, during which time the UK had a large wave of covid-19 infections caused by the omicron variant of the coronavirus.

Ten schools were given HEPA filters, with two or three put into each classroom, depending on the room size. These were compared with another 20 schools – similar to the first 10 in terms of buildings, the students’ ethnicities and their families’ income levels – that didn’t have the filters.

The 20 per cent fall was only in absences related to covid-19, but the machines probably also cut sickness due to flu and other pathogens that cause coughs and colds, says team member Mark Mon-Williams, also at the University of Leeds. “This should reduce school absences related to any airborne illness,” he says. “There’s nothing fundamentally different between covid and flu, they’re both a virus that gets filtered out of the air.”

Having air filters in schools could also make families less likely to keep children off school as a precaution during a surge of flu or covid-19, says Mon-Williams. “We need to demonstrate that schools are safe, healthy environments.”

But when the full trial results are published, funders will need to weigh up the benefits of the machines compared with their cost, says Michael Absoud at King’s College London. HEPA filters can cost several hundred pounds each.

Read more

Covid boosters: Why are US and UK vaccine policies so different?


There might be more benefit from spending the money on school nurses or support for children with special needs, he says. “People say that’s a false dichotomy, but it’s not. There are a lot of other priorities.”

Air filters have other potential downsides. They can be noisy and tend to generate a cold draught, says Stephen Baker at the University of Cambridge, who helped run a trial of HEPA machines in two wards at Addenbrookes Hospital in Cambridge, the results of which are still awaited. And the number of machines needed for the air volume of a room is unclear, he says.

Nevertheless, the headline result from the schools trial is “excellent”, says Baker. “The dream scenario would be as we rebuild public places, then having appropriate air filtration in them would make them safer long term for a whole host of things.”

 

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What Went Wrong with a Highly Publicized COVID Mask Analysis?

The Cochrane Library, a trusted source of health information, misled the public by prioritizing rigor over reality

www.scientificamerican.com

PUBLIC HEALTH

What Went Wrong with a Highly Publicized COVID Mask Analysis?​

The Cochrane Library, a trusted source of health information, misled the public by prioritizing rigor over reality

• By Naomi Oreskes on November 1, 2023
  Scientific American November 2023 Issue

Credit: Izhar Cohen

The COVID-19 pandemic is ongoing, but in May officials ended its designation as a public health emergency. So it's now fair to ask if all our efforts to slow the spread of the disease—from masking, to hand washing, to working from home—were worth it. One group of scientists has seriously muddied the waters with a report that gave the false impression that masking didn't help.

The group's report was published by Cochrane, an organization that collects databases and periodically issues “systematic” reviews of scientific evidence relevant to health care. This year it published a paper addressing the efficacy of physical interventions to slow the spread of respiratory illness such as COVID. The authors determined that wearing surgical masks “probably makes little or no difference” and that the value of N95 masks is “very uncertain.”

The media reduced these statements to the claim that masks did not work. Under a headline proclaiming “The Mask Mandates Did Nothing,” New York Times columnist Bret Stephens wrote that “the mainstream experts and pundits ... were wrong” and demanded that they apologize for the unnecessary bother they had caused. Other headlines and comments declared that “Masks Still Don't Work,” that the evidence for masks was “Approximately Zero,” that “Face Masks Made ‘Little to No Difference,’” and even that “12 Research Studies Prove Masks Didn't Work.”

Karla Soares-Weiser, the Cochrane Library's editor in chief, objected to such characterizations of the review. The report had not concluded that “masks don't work,” she insisted. Rather the review of studies of masking concluded that the “results were inconclusive.”

In fairness to the Cochrane Library, the report did make clear that its conclusions were about the quality and capaciousness of available evidence, which the authors felt were insufficient to prove that masking was effective. It was “uncertain whether wearing [surgical] masks or N95/P2 respirators helps to slow the spread of respiratory viruses.” Still, the authors were also uncertain about that uncertainty, stating that their confidence in their conclusion was “low to moderate.” You can see why the average person could be confused.

This was not just a failure to communicate. Problems with Cochrane's approach to these reviews run much deeper.

A closer look at how the mask report confused matters is revealing. The study's lead author, Tom Jefferson of the University of Oxford, promoted the misleading interpretation. When asked about different kinds of masks, including N95s, he declared, “Makes no difference—none of it.” In another interview, he called mask mandates scientifically baseless.

Recently Jefferson has claimed that COVID policies were “evidence-free,” which highlights a second problem: the classic error of conflating absence of evidence with evidence of absence. The Cochrane finding was not that masking didn't work but that scientists lacked sufficient evidence of sufficient quality to conclude that they worked. Jefferson erased that distinction, in effect arguing that because the authors couldn't prove that masks did work, one could say that they didn't work. That's just wrong.

Cochrane has made this mistake before. In 2016 a flurry of media reports declared that flossing your teeth was a waste of time. “Feeling Guilty about Not Flossing?” the New York Times asked. No need to worry, Newsweek reassured us, because the “flossing myth” had “been shattered.” But the American Academy of Periodontology, dental professors, deans of dental schools and clinical dentists (including mine) all affirmed that clinical practice reveals clear differences in tooth and gum health between those who floss and those who don't. What was going on?

The answer demonstrates a third issue with the Cochrane approach: how it defines evidence. The organization states that its reviews “identify, appraise and synthesize all the empirical evidence that meets pre-specified eligibility criteria.” The problem is what those eligibility criteria are.

Cochrane Reviews base their findings on randomized controlled trials (RCTs), often called the “gold standard” of scientific evidence. But many questions can't be answered well with RCTs, and some can't be answered at all. Nutrition is a case in point. It's almost impossible to study nutrition with RCTs because you can't control what people eat, and when you ask them what they have eaten, many people lie. Flossing is similar. One survey concluded that one in four Americans who claimed to floss regularly was fibbing.

In fact, there is strong evidence that masks do work to prevent the spread of respiratory illness. It just doesn't come from RCTs. It comes from Kansas. In July 2020 the governor of Kansas issued an executive order requiring masks in public places. Just a few weeks earlier, however, the legislature had passed a bill authorizing counties to opt out of any statewide provision. In the months that followed, COVID rates decreased in all 24 counties with mask mandates and continued to increase in 81 other counties that opted out of them.

Another study found that states with mask mandates saw a significant decline in the rate of COVID spread within just days of mandate orders being signed. The authors concluded that in the study period—March 31 to May 22, 2020—more than 200,000 cases were avoided, saving money, suffering and lives.

Cochrane ignored this epidemiological evidence because it didn't meet its rigid standard. I have called this approach “methodological fetishism,” when scientists fixate on a preferred methodology and dismiss studies that don't follow it. Sadly, it's not unique to Cochrane. By dogmatically insisting on a particular definition of rigor, scientists in the past have landed on wrong answers more than once.

We often think of proof as a yes-or-no proposition, but in science, proof is a matter of discernment. Many studies are not as rigorous as we would like, because the messiness of the real world prevents it. But that does not mean they tell us nothing. It does not mean, as Jefferson insisted, that masks make “no difference.”

The mask report—like the dental floss report before it—used “standard Cochrane methodological procedures.” It's time those standard procedures were changed.

This article was originally published with the title "Masked Confusion" in Scientific American 329, 4, 90-91 (November 2023)
doi:10.1038/scientificamerican1123-90

ABOUT THE AUTHOR(S)​

Naomi Oreskes is a professor of the history of science at Harvard University. She is author of Why Trust Science? (Princeton University Press, 2019) and co-author of The Big Myth (Bloomsbury, 2023).

 

[El Bombi]

A $100 vaccine incentive may have spurred 29,000 people in Harris County to get their first shot | Houston Public Media

A $100 vaccine incentive may have spurred 29,000 people in Harris County to get their first shot

A county public heath data analysis found roughly 28,700 people getting vaccinated who otherwise wouldn’t do so as of Sept. 18, the last day of available data.

PAUL DEBENEDETTO | POSTED ON OCTOBER 1, 2021, 8:08 AM

Lucio Vasquez / Houston Public Media
Lina Hidalgo at a vaccination site in Spring Branch, on April 1, 2021.

About 29,000 Harris County residents who would otherwise go unvaccinated received their first shot in the last month and a half thanks to a $100 incentive, according to Harris County Judge Lina Hidalgo.

A public heath data analysis shared with Houston Public Media found an uptick in vaccinations after Aug. 17, when Hidalgo announced that anyone getting a first shot at a Harris County Public Health vaccination site would receive a $100 cash card. That was followed by a second surge after the program was expanded on Aug. 26 to include any provider in the county.

The result, according to the county, was roughly 28,700 people getting vaccinated who otherwise wouldn’t do so as of Sept. 18 — the last day of available data. Hidalgo said she expected that number to be above 30,000 through Thursday, the last day of the incentive program.

“Thirty-thousand people would not have gotten the vaccine were it not for the program,” Hidalgo said. “That’s 30,000 people who almost have a 0% chance of dying from COVID, who have an extremely low chance of being hospitalized by it, and who have a much, much lower chance of transmitting COVID to their loved ones. So, I would say that’s a victory.”

The analysis looked at the seven-day average of first doses in Harris County and compared it to the collective average in Galveston, Brazoria, Montgomery and Fort Bend counties. Harris and the combined counties followed a similar pattern from July through mid-August, beginning to see a decline around Aug. 11.

But while those four counties saw their rates continue to decline, Harris County saw a noticeable increase from the beginning of the program through early September. Researchers then looked at the raw number totals in that gap between Harris and those surrounding counties to estimate the number of additional people who received their first shot.

Data Provided By Harris County
*Chart data scaled to peak value for comparison.
What’s more, the analysis only counted Harris County residents, not those who traveled to Harris County from other areas, leading researchers to believe the analysis could be an undercount.

Getting a first shot doesn’t guarantee those people who participated will return for a second dose, though the county says its rate of follow-up is more than 96%. There is no incentive for a second shot.

The county originally spent $2.3 million to run the program through Aug. 31, pulling from $900 million in federal American Rescue Plan funds. Within its first week, county officials said the number of people looking to get vaccinated at county sites increased by more than 500%.

Nearly 76% of all eligible Harris County residents had received at least one dose of the vaccine as of Friday morning. That’s higher than the state of Texas as a whole, of which 71% of the eligible population has received at least a first shot. The total vaccination rate in Harris County is about 65%.

Hidalgo said she expected the fully vaccinated number to “catch up” in a matter of weeks.

“Very soon, 75% of our population will be fully vaccinated, and we’re seeing those hospital numbers drop at an accelerating rate,” Hidalgo said. “Over the past couple of weeks, we’ve had to recalibrate our projections on the kind of positive side, progress side. I think some of that, undoubtedly, we can attribute to vaccines.”

El Paso County announced on Sept. 20 that the city of El Paso was the largest in the state to reach what it called “herd immunity” — a 75% vaccination rate. Scientists have disputed that number, claiming the vaccination rate needed to naturally control the virus in a given area is closer to 85%.

That number also doesn’t account for unknown variants, which could continue to emerge without higher levels of vaccination, according to medical experts.

In a video released by the U.S. Department of State on Thursday, the president’s chief medical advisor Dr. Anthony Fauci stressed that an increase in the vaccination rate is an effective way of keeping those variants at bay.

“If you suppress the free distribution, spreading and transmission, the virus will absolutely do a very good job to prevent the emergence of mutations, which ultimately lead to the emergence of variants,” Fauci said.

 

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Demand Long Covid Antivirals , These Are Our Demands

Dear Friends, I wrote a letter for the Action Network letter campaign: Find a Cure For Long Covid, These Are Our Demands Demand $28B+ for Long Covid. Demand Novel Antivirals. Declare Long Covid A National Emergency. Stop Viral Persistence of SARS-CoV-2! In order to help all people with...

actionnetwork.org

https://www.cdc.gov/nchs/covid19/pulse/long-covid.htm

 

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https://thewest.com.au/news/coronavirus/covid-19-surge-in-wa-sparks-return-to-masks-in-hospitals-for-patients-and-staff-c-12588730

UPDATED

COVID-19 surge in WA sparks return to masks in hospitals for patients and staff​

John Flint The West Australian
Fri, 17 November 2023 2:52AM

Masks will become compulsory for patients and staff working in WA hospitals again after a surge of COVID cases. Credit: Paul Kane/Getty Images

WA Health is re-introducing mask-wearing requirements in public hospitals due to surging COVID cases.

From next Monday staff and patients must wear surgical masks in high-risk hospital clinical areas — including haematology, oncology, organ transplant and renal dialysis — and around vulnerable patients in critical care settings like intensive care units.

The West Australian is aware of cases of patients dying after contracting the disease in hospital after being admitted with different ailments.

WA Health doesn’t track hospital-acquired COVID cases.

There were 57 new hospital admissions and four admissions into an intensive care unit in the week up to November 12.

COVID claimed the lives of four elderly West Australians during the week.

WA’s chief health officer Andy Robertson said COVID cases had been increasing in the community since early September 2023 — primarily driven by the Omicron XBB variant EG.5.

“It’s an expected part of the ongoing evolution of COVID-19 in the community as people’s immunity wanes over time,” he said.

“Given the increase in COVID hospitalisations and health staff off sick, health service providers have agreed on consistent mask recommendations across our public health system.”

Previously rules on mask wearing had been devolved to individual units at WA hospitals.

WA Health said surgical masks were recommended for staff and visitors in all public hospital clinical areas and they were reminded to stay home if sick or recovering from COVID.

Dr Robertson on Friday also advised private hospitals and aged care facilities across WA to consider strengthening mask-wearing requirements for staff and visitors.

“COVID is very much still with us and my advice for the community remains the same — stay home if you are sick and do not visit high-risk settings such as aged care facilities and hospitals if you have cold or flu symptoms,” he said.

“Consider wearing a mask in crowded indoor settings or where physical distancing is not possible and get a booster COVID-19 vaccination — particularly if you have complex health issues or are over 65.”

The Australian Medical Association in WA welcomed the move as “very sensible” given the mounting wave of infections.

“I absolutely support the move,” president Michael Page said on Friday.

“It’s about protecting the most vulnerable patients. Patients who have low immunity, due to being on drugs for treating cancers and other reasons, remain vulnerable to severe illness from COVID, including death. For other members of the community to be asked to protect them, by wearing a mask when they’re in proximity to them in a clinical environment is not a big ask of them. I hope the community will understand that and support it”.

He encouraged private hospitals to adopt the same measures.

“There should be consistency across the health system based on the best clinical advice available at the time,” Dr Page added.

“To have inconsistency just leads to confusion. Consistency is key.”

WA Health said healthcare facilities would continue to implement infection prevention and control measures and precautions — including wearing P2/N95 masks — when caring for suspected or confirmed COVID-19 cases.

 

[bnew]

https://www.texastribune.org/2023/11/13/texas-disabled-covid-vaccine-ban/

“People aren’t thinking about us”: How new ban on COVID-19 vaccine mandates impacts medically-vulnerable Texans​

The ban applies to all private businesses, including health care facilities like hospitals, which can jeopardize the health of those with compromised immune systems or other underlying conditions.

BY NEELAM BOHRA

NOV. 13, 20235 AM CENTRAL

REPUBLISH

Alice Barton looks through a rack of homemade masks in her South Austin home on Nov. 10, 2023. A bill signed on Friday, which bans vaccine requirements on all private businesses, could risk the health of groups like organ transplant recipients, cancer patients and those with underlying conditions as common as severe asthma Credit: Julius Shieh/The Texas Tribune

Sign up for The Brief, The Texas Tribune’s daily newsletter that keeps readers up to speed on the most essential Texas news.

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A sweeping ban on COVID-19 vaccine requirements for all private businesses, including hospitals, is the latest blow to medically vulnerable Texans who rely on others’ immunization to shield themselves from highly transmissible viruses.

Tamer coronavirus variants and a soft vaccine booster rollout have contributed to a lessened sense of urgency around the virus. But the new measure, which Gov. Greg Abbott signed into law on Friday, could risk the health of groups like organ transplant recipients, cancer patients and those with underlying conditions as common as severe asthma.

These risks led to some bipartisan dissent during original Senate discussions of the bill, especially from state Sens.Borris Miles,D-Houston and Kelly Hancock, R-Fort Worth, who both take immunosuppressants for their respective kidney transplants.

“I live a pretty normal life and am not fearful, but it does make you think about others,” Hancock said. “There's just a balance we have to keep in mind — just try to always think of others and the positions they may be in.”

For one, vaccines are less effective in some of these patients because their conditions prevent their bodies from manufacturing the white blood cells that can recognize and fight off viruses. But even with protection, the virus can exacerbate underlying conditions and lead to long-term symptoms of the virus, known as long COVID.

Scientists and health experts agree that the vaccine is safe and effective for most people with functioning immune systems, in reducing both transmission and severity of the virus.

“Everybody’s going to be different, so it's not automatic that a compromised individual will end up in the hospital or in the ICU,” said Dr. Jimmy Widmer, an internal medicine specialist. “But what we do know throughout the past three and a half years of COVID, is that time and time again, study after study has shown that those who are immunocompromised are hospitalized at a higher rate.”

Gov. Greg Abbott signs a bill which bans COVID-19 vaccine requirements for all private businesses at the Governor's Mansion in Austin on Nov. 10, 2023. Credit: Julius Shieh/The Texas Tribune

In the past, state lawmakers’ efforts to stymie vaccine mandates have excluded hospitals and other medical facilities — partially because under federal emergency rules, the U.S. Centers for Medicare and Medicaid Services required vaccinations among employees.

The regulation was withdrawn over the summer, and since then, many facilities have differed on their rules. A “vast majority” of them did not even have a blanket mandate at this point, said Carrie Kroll, an advocacy leader for the Texas Hospital Association.

“We’re very hopeful that the worst of the COVID pandemic is behind us,” Kroll said. “But we know with infectious disease, what may rule today may not rule in six months, in terms of disease levels and what this disease morphs into.”

In the end, lawmakers included a provision that would allow hospitals to require unvaccinated employees to wear personal protective equipment despite advocates fighting for a complete exclusion from the bill.

Alice Barton, a retired infectious disease doctor living in Austin, said it's “impossible to imagine” this measure will be enforced. Barton, 70, has severe asthma and an autoimmune disease, and said she just received the triple vaccine for the flu, COVID, and RSV.

“I'm the only person still who wears a mask to the doctor's office. I'm one of two people in my church who wears a mask,” Barton said. “One becomes lonely. It's not just being physically isolated from other people. It's that other people aren't thinking about us anymore.”

Barton is one of many people worried that state lawmakers will continue further down the warpath against vaccine requirements, onto other immunizations like those for polio or measles.

But, with the law now in place, advocates hope to transform the idea that people “have” to get the vaccine into an idea that they “should” to protect their peers.

Barton, a retired physician, has severe asthma and an autoimmune disease and continues to take precautions such as masking. Credit: Julius Shieh/The Texas Tribune

Chase Bearden, a leader at the Coalition of Texans with Disabilities, said now that there’s less external pressure on Texans to make this decision, he hopes they realize it’s one they can make of their own accord.

“What can we all do on a personal level to keep everyone safe, especially those who may not have the great health that the rest of us do?” Bearden said. “There’s so many family members that are going through cancer treatment or living with a chronic health condition. And yes, you're a healthy person. You don't think you need it. But if you get it, you easily pass that on to the next person who takes it home.”

Stephanie Duke, an attorney who helps handle disaster management at Disability Rights Texas, said the state should be doing everything it can to promote public health, and that should include people with disabilities.

“People go in to get health care, and you would expect your health care provider to be doing everything they can to make that safe,” Duke said.

Duke said government officials often forget to include disabled people in disaster preparedness, and the global pandemic was no different than a hurricane evacuation. Several policies issued during the height of the public health emergency have hurt those who don’t have functioning immune systems or with chronic illnesses.

For instance, when the pandemic began, disabled people weren’t a specific category included in the demographic data that states began collecting on the virus, she said.

“shyt is going to happen. Lights are going to go out, we're going to have viruses again. This is the world that we live in,” Duke said. “But how we plan for it, is how we give people choices to promote their safety, autonomy and independence after an event and build that resilience.”

Neelam Bohra is a 2023-24 New York Times disability reporting fellow, based at The Texas Tribune through a partnership with The New York Times and the National Center on Disability and Journalism, which is based at the Walter Cronkite School of Journalism and Mass Communication at Arizona State University.

Disclosure: Coalition of Texans with Disabilities, Texas Hospital Association and The New York Times have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.

 

[bnew]

https://www.nytimes.com/2023/11/13/upshot/long-covid-disability.html

Can’t Think, Can’t Remember: More Americans Say They’re in a Cognitive Fog​

Adults in their 20s, 30s and 40s are driving the trend. Researchers point to long Covid as a major cause.

By Francesca Paris

In reporting for this article, Francesca Paris talked to 16 researchers and medical professionals who study disability, long Covid, cognition and census data.

Nov. 13, 2023

There are more Americans who say they have serious cognitive problems — with remembering, concentrating or making decisions — than at any time in the last 15 years, data from the Census Bureau shows.

The increase started with the pandemic: The number of working-age adults reporting “serious difficulty” thinking has climbed by an estimated one million people.

About as many adults ages 18 to 64 now report severe cognitive issues as report trouble walking or taking the stairs, for the first time since the bureau started asking the questions each month in the 2000s.

Percent of working-age people who said they had “serious difficulty” with …

Three-month rolling average. Includes people ages 18 to 64. Source: Current Population Survey via IPUMS

More Americans Say They’re in a Brain Fog. Long Covid Is a Factor. - The New York Times

And younger adults are driving the trend.

Percent of Americans who said they had “serious difficulty” remembering, concentrating or making decisions

Three-month rolling average. Source: Current Population Survey via IPUMS

The sharp increase captures the effects of long Covid for a small but significant portion of younger adults, researchers say, most likely in addition to other effects of the pandemic, including psychological distress. But they also say it’s not yet possible to fully dissect all the reasons behind the increase.

Richard Deitz, an economist at the Federal Reserve Bank of New York, analyzed the data and attributed much of the increase to long Covid. “These numbers don’t do this — they don’t just start suddenly increasing sharply like this,” he said.

In its monthly Current Population Survey, the census asks a sample of Americans whether they have serious problems with their memory and concentration. It defines them as disabled if they answer yes to that question or one of five others about limitations on their daily activities. The questions are unrelated to disability applications, so respondents don’t have a financial incentive to answer one way or another.

At the start of 2020, the survey estimated there were fewer than 15 million Americans ages 18 to 64 with any kind of disability. That rose to about 16.5 million by September 2023.


Nearly two-thirds of that increase was made up of people who had newly reported limitations on their thinking. There were also increases in census estimates of the number of adults with a vision disability or serious difficulty doing basic errands. For older working-age Americans, the pandemic ended a yearslong decline in reported rates of disability.

More on Covid-19​

• Long Covid: As more young Americans report serious cognitive problems, scientists suggest that the increase captures the effects of long Covid, most likely in addition to other effects of the pandemic, including psychological distress.
• Stroke Risk: The Covid vaccines made by Pfizer-BioNTech and Moderna may be linked to a slight increase in the risk of stroke when administered along with a high-dose flu vaccine that is usually given to older people, according to a new analysis by the F.D.A.
• Vaccine Side Effects: A new study has found that the chills, fatigue, headache and malaise that can follow a Covid shot may be signs of a vigorous immune response.
• Nasal Sprays: Some people are turning to over-the-counter nasal sprays that claim to protect against several respiratory infections, including Covid. But their formulas are not F.D.A. approved.
  

The rise in cognitive issues aligns with a common symptom that plagues many Covid long-haulers: “brain fog.”

Emmanuel Aguirre, a 30-year-old software engineer in the Bay Area, had Covid at the end of 2020. Within a month, he said, his life was transformed: “I felt like I was permanently hung over, drunk, high and in a brain freeze all at once.”

He stopped dating, playing video games and reading novels, though he managed to keep his job, working remotely. Some of his physical symptoms eventually abated, but the brain fog has lingered, disappearing at times only to steamroll him days later.

Cognitive impairment is a “hallmark of long Covid,” said Dr. Ziyad Al-Aly, chief of research and development at the V.A. St. Louis Health Care System and a clinical epidemiologist at Washington University in St. Louis.

Studies estimate some 20 percent to 30 percent of people who get Covid have some cognitive impairment several months later, including people with symptoms ranging from mild to debilitating. Research has also shown clear biological changes from the virus related to cognition, including, in some long Covid patients, lower levels of serotonin.

“It’s not just fog, it’s a brain injury, basically,” said Dr. Monica Verduzco-Gutierrez, chair of rehabilitation medicine at the University of Texas Health Science Center at San Antonio. “There are neurovascular changes. There’s inflammation. There are changes on M.R.I.s.”

Why the changes in reported cognitive impairment appear more common for younger adults is not clear. But older adults are more likely to have had some age-related cognitive decline pre-Covid, said Dr. James C. Jackson, a neuropsychologist at Vanderbilt Medical Center. Cognitive changes “stand out far more” for younger cohorts, he said.

And long Covid often presents differently in younger and older adults, said Dr. Gabriel de Erausquin, a professor of neurology at U.T. Health San Antonio. In his research, he has found that older adults with long-Covid-related cognition deficits have more issues linked to memory. But younger adults are more likely to experience difficulty with attention and concentration and, in some cases, fatigue or pain so severe their thinking is affected.

 

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{continued}

Heather Carr has been devastated by the physical and cognitive effects of long Covid. “I enjoyed what I did, I had hobbies outside of work,” she said. “Now I can’t have hobbies. I can’t work.” Credit...Lauren Petracca for The New York Times


Heather Carr, 31, sold agricultural machine parts in Syracuse, N.Y., but two coronavirus infections left her largely bed-bound and barely able to string together a basic train of thought. She had trouble staying awake while driving, and eventually had to give up her job.

“I cry when I try to think, now,” she said. “My brain short-circuits.”

The number of working-age Americans with a disability who are unemployed or out of the labor force, like Ms. Carr, has roughly held steady during the pandemic.

But the number of working-age Americans with a disability who are employed has increased by an estimated 1.5 million people, census data show.

Number of working-age people with a disability who are…

Three-month rolling average. Includes people ages 18 to 64. Sources: Current Population Survey via IPUMS

More Americans Say They’re in a Brain Fog. Long Covid Is a Factor. - The New York Times

The tight labor market and flexibility of remote work during the pandemic have made it easier for people who had disabilities pre-Covid to get jobs. It’s also likely that more workers became newly disabled, by the census definition, and held onto their jobs.

That could help explain what has been so far only a relatively subtle increase in Social Security disability applications.

Long Covid is probably not the only factor driving the increase in disability, experts say.

The reported rate of cognitive disability for younger adults in the census data had been increasing slowly for years prepandemic. Experts on disability data suggest that, among many factors likely responsible for the increase, rising A.D.H.D. and autism diagnoses in children could have led more people to recognize and report their cognitive difficulties.

Then, during the pandemic, Americans spent more time alone, reported higher rates of depression and were prescribed more psychiatric medications.

“The pandemic changed the world,” Dr. Jackson said. “I do think the sum total of the mental health challenges people are having impacts cognitive function.”

Younger adults appeared to experience significantly more psychological distress than older adults, and poor mental health has been linked to cognitive issues. Polling from Gallup found that depression rates for different age groups, which were relatively similar prepandemic, shot up for adults under 45 during the pandemic, while remaining flat for older adults.

Kristen Carbone has struggled with her memory and attention. “Since the pandemic, I mean, my memory is shot,” she said.Credit...Michelle V. Agins/The New York Times

Kristen Carbone, a 34-year-old actress in New York, said her anxiety and depression spiked when the pandemic hit, and her memory began to slip. Her issues fell short of the “serious difficulty” the census asks about, but they were worse than anything she’d experienced prepandemic — and she never tested positive for Covid, so she said it was unlikely an infection was at fault. At her second job as a server, she had to start writing down every customer’s order, even the ones she used to fill by memory.

“If I don’t deal with it immediately, it doesn’t exist,” she said.

Her mental health has since recovered, she says, but her memory and focus have not.

The stressors of the pandemic could have worsened existing conditions such as A.D.H.D., said Dr. Margaret Sibley, a professor of psychiatry and behavioral sciences at the University of Washington.

“If that person’s under extreme duress or strain, those symptoms might be temporarily exacerbated,” she said.

Because the census relies entirely on self-reporting, experts say the data could also be capturing a shift in how people perceive their cognition, even absent changes to their health.

People with disabilities might have taken note of rising disability acceptance and become more likely to answer the census questions honestly, researchers say. Some young people may have been influenced by what disability researchers describe as increased awareness and acceptance of neurodiversity during the pandemic, as videos about mental illness and developmental disorders proliferated online, often encouraging people to self-diagnose. There was also an increase in advertisements for A.D.H.D. medication, Dr. Sibley said.

“Everyone was saying, ‘I’m getting this messaging online,’” she said. “The subjective experience of people receiving them was they could make anyone believe they had A.D.H.D.”

But those changes in perception are likely to have a relatively small influence on the numbers, said Monika Mitra, who directs the Lurie Institute for Disability Policy at Brandeis University. Most of the increase is probably capturing real changes in people’s health, she said.

“We need to take this very seriously as a society,” she said. “We need to understand who these people are, how they’re being impacted and what we can do about it.”

 

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Former British PM Boris Johnson was 'bamboozled' by COVID stats, inquiry hears

Boris Johnson struggled to come to grips with much of the science during the coronavirus pandemic, his chief scientific adviser tells a public inquiry.

www.abc.net.au

Former British PM Boris Johnson was 'bamboozled' by COVID stats, inquiry hears​

Posted 1h ago1 hours ago

Boris Johnson stood down as the UK's prime minister in 2022.(PA via AP: Ben Birchall)

Former British prime minister Boris Johnson struggled to come to grips with much of the science during the coronavirus pandemic, his chief scientific adviser has told an inquiry.

Key points:​

• Sir Patrick Vallance told the inquiry Mr Johnson was "bamboozled" by graphs and stats
  
• He claimed the same was true of several world leaders
  
• Mr Johnson's actions and decisions are being put under the microscope at the hearings
  
  

In a keenly awaited testimony to the country's public inquiry into the COVID-19 pandemic on Monday, Sir Patrick Vallance said he and others faced repeated problems getting Mr Johnson to understand the science and that he changed his mind on numerous occasions.

"I think I'm right in saying that the prime minister gave up science at 15," he said.

"I think he'd be the first to admit it wasn't his forte and that he struggled with the concepts and we did need to repeat them, often."

Extracts from Sir Patrick's mostly contemporaneous diary of the time were relayed to the inquiry.

In them, he wrote that Mr Johnson was often "bamboozled" by the graphs and data and that watching him "get his head round stats is awful".

Patrick Vallance makes a point at a press conference in London last year.(Supplied: Jack Hill/Pool via Reuters)

During the pandemic, Sir Patrick was a highly visible presence in the UK.

He and the chief medical officer, Chris Whitty, regularly flanked Mr Johnson at the daily COVID-19 press briefings given from the prime minister's offices on Downing Street.

Sir Patrick, who stepped down from his role as the British government's chief scientific adviser earlier this year, said Mr Johnson's struggles were not unique and that many leaders had problems in understanding the scientific evidence and advice, especially in the first stages of the pandemic in early 2020.

"I would also say that the meeting that sticks in my mind was with fellow advisers from across Europe, when one of them — and I won't say which country — declared that the leader of that country had enormous problems with exponential curves, and the telephone call burst into laughter, because it was true in every country," he said.

"So I do not think that there was necessarily a unique inability to grasp some of these concepts with the prime minister at the time, but it was hard work sometimes to try and make sure that he had understood what a particular graph or piece of data was saying," Sir Patrick added.

Johnson 'unable to concentrate' after diagnosis​

Mr Johnson was hospitalized with the virus in April 2020 less than two weeks after he put the country into lockdown for the first time.

Sir Patrick conceded the prime minister was "unable to concentrate" on things when he was really unwell but that after his recuperation "there was no obvious change between him and what he was like beforehand".

The UK has one of the highest COVID-19 death tolls in Europe, with the virus recorded as a cause of death for more than 232,000 people.

Mr Johnson, who was forced to step down as prime minister in September 2022 following revelations of lockdown rule-breaking parties at his Downing Street residence during the pandemic, is due to address the inquiry before Christmas.

The probe, led by retired judge Heather Hallett, is expected to take three years to complete.

Mr Johnson agreed in late 2021 to hold a public inquiry after heavy pressure from bereaved families, who have hit out at the evidence emerging about his actions.

The inquiry is set to hear from current Prime Minister Rishi Sunak, who was Mr Johnson's Treasury chief at the time, and as such had a particular focus on the economic impacts of Britain's lockdowns.

When he does appear at the inquiry, Mr Sunak is likely to face questioning about his "Eat Out to Help Out" initiative, which sought to encourage nervous customers back to restaurants in August 2020 as the first set of lockdown restrictions were being eased and before subsequent lockdowns were enacted.

Sir Patrick said scientists weren't aware of the restaurant program until it was announced and that the messaging around it ran "opposite" to the need to limit mixing between households.

"I think it would have been very obvious to anyone that this inevitably would cause an increase in transmission risk," Sir Patrick said.

Soon after, positive cases started rising and the government came under huge pressure to institute a second national lockdown, something Johnson eventually announced at the end of October 2020.

The inquiry was shown a diary entry Sir Patrick wrote before that lockdown and which referred to Dominic Cummings, Mr Johnson's chief political adviser at the time, saying that Mr Sunak "thinks just let people die and that's OK".

 

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[DJ Paul's Arm]

Bunch of republicans at my job are on leave because the all got covid bad

 

[Neo. The Only. The One.]

Still keep my mask on, ain't caught covid yet.

My brain is valuable, don't need it fogged up.