This story contains descriptions of stillbirths.
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Late one afternoon last October, Dr. Shelley Odronic sat in her office and, just as she had thousands of times before, slid a rectangular glass slide onto her microscope.
A pathologist who works in rural Ohio, Odronic leaned forward to examine tissue from the placenta of a woman who had recently given birth. She increased the magnification on the microscope. Never had she seen so many tiny, congealed reservoirs of blood or such severe inflammation of the tissue, a sign the placenta had been fighting an infection.
Right away, I knew it wasnt compatible with life, Odronic said.
She asked her secretary to print out the patients chart. In dark letters were the words fetal demise. A stillbirth, the death of a fetus at 20 weeks or more of pregnancy. But that didnt solve the mystery. Odronic had examined many placentas from pregnancies that ended in stillbirth. None looked like this withered and scarred.
Odronic kept reading. No chronic medical conditions. Good prenatal care. Then, buried in the middle of the report, she spotted something. Seven days before the stillbirth, the mother had tested positive for COVID-19. Odronic wondered if the virus could explain the damage to the placenta. In the world of placenta pathology, a new affliction is unusual, especially one so dramatic in presentation and so devastating in effect.
Her mind traveled to Dr. Amy Heerema-McKenney, a pathologist at Cleveland Clinic and an expert on the placenta, who had trained Odronic during residency. Odronic went to sleep that night with a pit in her stomach and a plan to call her former teacher in the morning.
Heerema-McKenney was in her office when the phone rang. As she listened, she knew that what Odronic was describing was what she and her colleagues had observed repeatedly over the past several months: a patient positive for the coronavirus, a placenta destroyed by COVID-19, a baby stillborn.
Their next discovery was equally stunning. None of the stillbirths they studied involved a pregnant person who had been fully vaccinated. The doctors checked with colleagues across the country and around the world. The fatal pattern held.
Unvaccinated women who contracted COVID-19 during pregnancy were at a higher risk of stillbirths. They also were more likely to be admitted to the intensive care unit, give birth prematurely or die. Yet their greatest protection the COVID-19 vaccine sat largely untouched, buried under doubt, polluted by disinformation.
How Misinformation About COVID Vaccines and Pregnancy Took Root Early On and Why It Wont Go Away
Pharmaceutical companies and government officials failed to ensure that pregnant people were included in the early development of the COVID-19 vaccine, a calamitous decision made amid the urgency of a rapidly spreading pandemic. That decision left pregnant people with little research to rely on when making a critical decision on how best to keep the babies growing inside of them safe.
At the same time that research was excluding pregnant people from vaccine trials, a full-scale assault on vaccination was unfolding online. Taking advantage of the lack of data, conspiracy theorists, anti-vaxxers and even some medical professionals spread false claims about the vaccines safety in pregnancy, leading many pregnant people to delay or refuse the vaccine. Even now, with numerous studies unequivocally announcing the safety of the vaccine for pregnant people, some doctors have failed to communicate the dangers of COVID-19 to pregnant people or the vaccines role in mitigating it.
The Centers for Disease Control and Prevention contributed to the confusion with vague early messaging about whether pregnant people should get vaccinated. While Americans lined up at pharmacies and stalked vaccine websites in hopes of securing a shot last year, pregnant people had some of the lowest vaccination rates among adults, with only 35% fully vaccinated by last November. Meanwhile, many Americans were already moving on to their boosters after federal officials that month expanded eligibility for the additional shots to anyone 18 or older. And much of the country was beginning to return to pre-pandemic life. The Sunday after Thanksgiving, for instance, set the record for the busiest day of air travel since March 2020.
November also marked a key moment in the understanding of COVID-19s impact on stillbirths. A CDC study looking at 1.2 million births in the first 18 months of the pandemic found that more than 8,000 pregnancies ended in stillbirths, including more than 270 of them in patients with a documented COVID-19 diagnosis at the time of delivery.
Although stillbirths were rare overall, babies were dying. The risk of a stillbirth nearly doubled for those who had COVID-19 during pregnancy compared with those who didnt. And during the spread of the delta variant, that risk was four times higher.
Indeed, doctors discovered that some stillbirths resulted from COVID-19 directly infiltrating the placenta, a condition they named SARS-CoV-2 placentitis. Cases were found even in people whose COVID-19 symptoms were mild or nonexistent. In some cases, however, placentas were discarded with medical waste without being tested for COVID-19, and parents never learned what led to their babys stillbirth.
COVID-19 also led to stillbirths among pregnant people who became exceedingly ill after contracting the virus. It damaged their lungs and clotted their blood, putting their babies in such severe distress that they were born before they could take their first breath.
These are pregnancies that should not have ended, Heerema-McKenney said.
She and others had tried to alert the CDC as well as maternal and state health organizations to their findings, but she said they either didnt get a response or were told they needed to collect more data and publish studies. Pathologists are experts in disease diagnosis, dealing with death and illness from the safe distance of their labs. Convincing obstetricians who met with patients daily or doctors who were making policy recommendations was a challenge.
I tried to sound the alarm. We tried so hard to get people to listen, Heerema-McKenney said. It was a really frustrating place to be as pathologists doing these autopsies, looking at these placentas and saying, God, no, not another case.
Around the same time Heerema-McKenney was examining the damaged placentas, Ginger Munro was on life support in a hospital 250 miles away in another part of Ohio.
She and her husband, Kendal, had been trying to have a child for five years. They hadnt expected that shed get pregnant in the middle of a pandemic. But when her pregnancy test came back positive in the spring of 2021, she rushed to post a picture of it in an online pregnancy group. Is it just me or can you see the 2 lines?? she asked.
The pandemic had already brought much change to their lives. Ginger, who lives in the small town of Washington Court House in southwest Ohio, quit her job as assistant nutrition director with the countys Commission on Aging. She stationed hand sanitizer throughout her house and in her car, and she only went grocery shopping early in the morning. If she noticed someone in an aisle, she skipped it.
I knew the virus was real, she said, but I was terrified to take the vaccine.
Ginger worried that the vaccines development had been rushed, and she hadnt seen any data showing it was safe for pregnant people. At this point, the CDC had not explicitly recommended the vaccine during pregnancy. Ginger already worried she was tempting fate by getting pregnant at 40; she said she didnt want to risk endangering her baby by taking the vaccine.
Besides, if it was really important, her doctor would have mentioned it, and, she said, she would have followed his advice. But, she said, he never did. Her family hadnt gotten vaccinated either. In a mostly rural county where less than half of the residents were vaccinated, they were hardly alone.
Her doctor declined to comment through a spokesperson at the hospital system where he works; the spokesperson said the hospital couldnt disseminate information about the vaccine to pregnant patients before it was recommended.
Gingers pregnancy progressed without complications. She and Kendal shared the news of a new baby with Gingers two daughters from a previous marriage. At their kitchen table, near a sign that read eat cake for breakfast, Sophia, then 14, covered her mouth with both hands while Hailee, then 18, simply beamed.
At a backyard gender reveal three months later, Gingers growing belly resembled a basketball against her tiny frame. She leaned in to kiss her husband, her long, dark hair falling onto her shoulders. Red confetti rained down on the deck.
Kendal, an aircraft maintenance and avionics manager at an airport two counties away, worked through the pandemic. In the summer, when they realized his cough was actually COVID-19, it was too late. Ginger was sick.
What the Placenta Does
The placentas job is as critical as it is clear: keep the baby alive.
For the most part, it does that well. The placenta is the first organ to develop after conception, and it connects to the fetus through the umbilical cord, which delivers oxygen. The placenta provides nourishment, expels waste and does much of the work of the fetuss lungs, kidneys and liver as they develop. The dark-red organ typically is solid, with a sponge-like texture and blood vessels that spread out like the branches of a tree.
The placenta also acts as a shield against most viruses, but when its attacked by COVID-19, the branches can collapse, killing the cells, cutting off oxygen to the fetus, leaving holes to be filled by pools of blood. In response to the infected and dying cells, inflammation and scarring spread throughout the placenta.
Unable to survive the damage to the placenta, many babies were stillborn.
Having trouble reaching her doctor, she went to two different emergency rooms. One, she said, declined to treat her with monoclonal antibodies, which research had shown can be an effective treatment for pregnant people with COVID-19. The other, which described her in medical records as an exceedingly pleasant individual admitted with symptomatic COVID-19 pneumonia, transferred her about an hour away to the University of Cincinnati Medical Center. There, records show, she was admitted with acute respiratory distress syndrome due to COVID-19.
The University of Cincinnati doctor asked Ginger and Kendal who was on FaceTime because of the hospitals COVID-19 protocols about fetal priority. Ginger made her wishes clear: Save the baby, their baby, the baby they had tried so hard to have. Kendal, who was worried about both his wife and their unborn child, said he went along with Ginger in that moment.
You were so scared, Kendal wrote in a notebook that night. We told each other over and over how much we loved each other.
They hung up so the doctors could insert a breathing tube. Before they could begin, Kendal called back three more times just to hear her voice.
Doctors put Ginger on ECMO, a form of life support reserved for the sickest patients. Kendal, Hailee, Sophia and Gingers mother and sister were later allowed in the hospital two at a time, and they prayed at her bedside nearly every night. Ginger was sedated, her face swollen and obscured by tubing, her cheeks flattened by the crush of the ventilator straps, her wrists tied down so she wouldnt accidentally pull out her breathing tube.
Her family took solace in knowing the babys heartbeat was steady and her ultrasounds were normal. The doctors gave Ginger medication to help the babys lungs mature in case she was born early. After more than 30 days on ECMO, doctors took Ginger off the machine only to put her back on the next morning. She was the first patient in the hospitals history to be placed on ECMO twice.
The plan, records show, was to deliver at 28 weeks. But the day after Ginger was put back on life support, Kendal got the call telling him the baby was on her way. As doctors prepared for the delivery in Gingers intensive care room, the family camped out in the waiting room, jittery from excitement and vending machine snacks. They talked about baby names and future family outings. They pulled the waiting room chairs together to form makeshift beds and covered themselves with blankets they brought from home.
They dont know if they actually fell asleep before a nurse burst through the doors screaming at them to follow. Shes coming! Shes coming! They didnt make it far before they were blocked by doctors and nurses, some huddled over an incubator in the middle of the hall and the rest crowded around Ginger.
Hailee tried to peer over the sea of blue scrubs to catch the first glimpse of her little sister. She smiled beneath her black mask. Shell be OK, she said to herself.
But after a few minutes of trying to revive the baby, a doctor told Kendal it was time. Kendal nodded, asked for a chair and collapsed as he tried to process his daughters death.
Then another wave of grief washed over him. Someone would have to tell Ginger.
Content Warning
Warning: The following image shows a stillborn baby. The Munro family had photos taken of their daughter to preserve their memory of her.
Gingers medical records describe a baby born at 27 weeks without signs of life after an uncomplicated delivery. Her placenta had separated from the wall of the uterus, the risk of which studies have shown increases with COVID-19.
When Ginger woke up, she looked down at her sunken belly and realized she had given birth. She assumed her daughter was in the newborn intensive care unit. Ginger was barely able to speak around the tube in her trachea, but after a few days in which no one brought the baby to her, she couldnt wait any longer. Ginger turned to her mother and sister and mouthed the words, Wheres the baby?
The room fell silent. They called Kendal, who rushed to the hospital. He told her what had happened. He described their daughters dark hair and her long fingers and toes, just like her mothers.
Ginger, who had always loved the sweet smell of a newborns breath, whispered to her husband.
Did you smell her breath?
She wasnt breathing, he said.
In the hurried quest for a safe and effective COVID-19 vaccine, pharmaceutical companies and government officials did not include pregnant people in their initial plans. Its a failure that continues to reverberate.
They absolutely should have been included in COVID vaccine trials from the beginning, said Kathryn Schubert, president and CEO of the Society for Womens Health Research, a Washington, D.C.-based nonprofit that advocates for the inclusion of women in research and clinical trials.
Researchers and advocates have spent more than four decades trying to dismantle the belief that its unsafe or unethical for pregnant women to participate in clinical trials. A couple years ago, it seemed like they had finally prevailed.
Shortly before leaving office, President Barack Obama signed into law the 21st Century Cures Act, which established the Task Force on Research Specific to Pregnant Women and Lactating Women. The group found longstanding obstacles, including liability concerns, to including pregnant and lactating people in clinical research. It concluded that recommending halting medication or forgoing treatment while pregnant may actually endanger the health of the mother and her fetus more than the treatment itself.
The need for everything from asthma to depression medication doesnt stop when a person gets pregnant, and when a catastrophic event such as a pandemic hits, experts said, pregnancy should not preclude someone from receiving life-saving treatment.
Around the same time, researchers discovered that the Zika virus, which was mainly transmitted through mosquitoes, could pass from a pregnant person to their fetus and cause severe birth deformities. A second group of experts joined together to develop separate guidance on including pregnant people in the research, development and deployment of pandemic vaccines.
Both groups pushed to remove pregnant women from a list of vulnerable populations that required additional review before being allowed to participate in research. Instead of proving that pregnant women should be included, manufacturers would need to provide compelling evidence for why they shouldnt.
In 2018, the federal task force issued recommendations calling for including pregnant and breastfeeding people in biomedical research, and the Department of Health and Human Services adopted some of the guidance. But a gap remained between what the task force and others insisted was needed and what was actually happening.
We were frustrated because COVID-19 provided an opportunity to implement the recommendations of the task force, said Dr. Diana Bianchi, the director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the chair of the task force.
In February 2021, Bianchi and her colleagues published an article lamenting the exclusion of those who were pregnant or breastfeeding from the initial COVID-19 vaccine clinical trials. Pregnant and lactating persons should not be protected from participating in research, but rather should be protected through research, they wrote.
Ruth Faden, the founder of the Johns Hopkins Berman Institute of Bioethics, helped lead the group that issued the guidance after Zika. She and others urged manufacturers to include pregnant people in the development of the COVID-19 vaccine as part of Operation Warp Speed, the federal program that provided billions of taxpayer dollars to pharmaceutical companies to speed up vaccine production.
There is a playbook in place so that when the U.S. launches Operation Warp Speed, it should be pretty obvious what should be done, she said. Its not like no one knows how to do this, either ethically or technically.
Nevertheless, it doesnt happen, Faden added. Once again, pregnant people are left behind.
A spokesperson for Pfizer said the company followed guidance from the Food and Drug Administration. Although pregnant people were not included in the initial vaccine clinical trials, Pfizer tested its vaccine on pregnant rats and did not identify any safety concerns. The company subsequently launched a clinical trial with pregnant women but halted it because at that point the vaccine had already been recommended for pregnant people.
Similarly, Moderna also studied its vaccine on pregnant animals, but the company said it made the decision to prioritize the study of the safety and efficacy of the vaccine in adults who werent pregnant. It called that approach consistent with the precedent to study new vaccines in pregnant women only after demonstration of favorable benefit and risk in healthy adults.
In response to questions from ProPublica, Johnson & Johnson referred a reporter to its website, which didnt address the relevant issues.
Some government officials, including several from the Food and Drug Administration, said they support having pregnant women take part in clinical studies of vaccines for emerging infectious disease, including COVID-19. A spokesperson for the National Institute of Allergy and Infectious Diseases, which is part of the National Institutes of Health, said the agency did not dictate the protocol development for the trials and said that responsibility lies with the companies.
The failure to include pregnant people early on in COVID-19 vaccine trials was, at least in part, a casualty of the tremendous urgency to respond to an intense public threat and develop the vaccine as quickly as possible, Faden said. But multiple groups had published road maps on how to ethically include pregnant people without slowing down that process.
I cant tell you how many pregnant people might not have died or how many stillbirths might not have occurred if the playbook had been followed, she said, but Im willing to bet it was a significant chunk that would have been prevented if there had been a full-throated, evidence-based recommendation for COVID-19 vaccines in pregnancy almost simultaneous to when it was available for the rest of the adult population.
By the time the CDC specifically recommended the vaccine for pregnant people, in August 2021, the damage had been done.
A dizzying and vague series of advisories led to confusion and delayed vaccinations. When the COVID-19 vaccines were first made available in December 2020, the CDC said health care workers and residents of long-term care facilities should be prioritized, but the shots were not explicitly recommended for pregnant people. Instead, the agency said on its webpage for vaccines and pregnancy that pregnant health care workers may choose to be vaccinated. In explaining that decision, the CDC said that experts had considered how mRNA vaccines, which do not contain the live virus, work. They concluded that the vaccines are unlikely to pose a risk for people who are pregnant.
However, the CDC added, the potential risks of mRNA vaccines to the pregnant person and her fetus are unknown because these vaccines have not been studied in pregnant women.
In January, the World Health Organization recommended against pregnant people getting the vaccine unless they faced increased risk, such as complicating comorbidities or exposure to the virus due to a job in health care, but the agency later reversed course.
A few months later, in March 2021, the CDC continued its lukewarm messaging that pregnant people may choose to be vaccinated. The agency listed some points for pregnant people to consider discussing with their health care providers, starting with how likely they are to be exposed to COVID-19.
After a promising study showed that the vaccine was safe for pregnant people, CDC Director Dr. Rochelle Walensky said at a White House briefing in late April that the CDC was recommending the vaccine for them. But the CDC did not update its website to reflect her comments and said the agencys guidance had not changed: Pregnant people may choose to be vaccinated.
Once again, pregnant people were put in the precarious position of receiving ambiguous and inconsistent recommendations. In May 2021, the CDC reiterated that pregnant people faced an increased risk of getting severely ill from COVID-19, but the language surrounding the vaccine If you are pregnant, you can receive a COVID-19 vaccine was noncommittal.
A CDC spokesperson, responding to questions from ProPublica, said in an email that pregnant people were part of the first recommendations in December 2020 that encouraged people 16 and older to get vaccinated. At that time, data about the safety and efficacy of the vaccine during pregnancy was limited because pregnant people had been excluded from pre-authorization clinical trials, so the CDC included additional supporting language for pregnant people, saying they were eligible and could choose to receive the vaccine. The agency said its recommendations were based on available evidence and evolved throughout the pandemic.
Before making changes to its guidance, the CDC had its team of scientists review available data to ensure that there was an abundance of evidence.
For each update to the statement of risks during pregnancy, multiple types of studies and the strength of evidence for each were reviewed, another CDC spokesperson said. These reviews of the evidence were accompanied with discussions among subject matter experts both internally and externally with clinical partners for an ultimate determination of risk.
Dr. Cynthia Gyamfi-Bannerman, a perinatologist and chair of the department of obstetrics, gynecology and reproductive sciences at the University of California, San Diego School of Medicine, shared the daunting task of making vaccine recommendations for pregnant people as part of COVID-19 task forces for two leading organizations, The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine.
In the beginning, she said, the only pregnancy-specific data they had came from a few dozen participants who were inadvertently included after becoming pregnant during the clinical trials and from some pregnant animal data.
It played out in real time in the COVID pandemic because we see the effects of not including pregnant people in these trials, Gyamfi-Bannerman said. We couldnt make a strong recommendation, so pregnant people were hesitant. I think that directly led to fewer people using the vaccine than we would have wanted.
At the end of June 2021, the CDC added a general update to its website to reflect the dangers of the delta variant tearing across much of the country. Getting vaccinated prevents severe illness, hospitalizations, and death, it wrote. Unvaccinated people should get vaccinated and continue masking until they are fully vaccinated.
But it wasnt until Aug. 11, eight months after the first vaccine was administered, that the CDC issued its formal recommendation that pregnant and breastfeeding people get vaccinated.
The vaccines are safe and effective, Walensky said in a statement at the time, and it has never been more urgent to increase vaccinations as we face the highly transmissible Delta variant and see severe outcomes from COVID-19 among unvaccinated pregnant people.
August would prove to be the deadliest month for COVID-19-related deaths of pregnant people. The CDC issued an emergency call the next month strongly recommending the vaccine to pregnant people, noting that approximately 97% of pregnant people hospitalized with COVID-19 were unvaccinated. The dangers to symptomatic pregnant people included a 70% increased risk of death, and their developing babies could face a host of perils, including stillbirths.
Researchers have yet to determine exactly why some pregnant people with COVID-19, vaccinated and unvaccinated alike, deliver stillborn babies, while others do not. Attempts to answer that question have been hindered, in part, by incomplete data. The CDCs statistics on COVID-19-related fetal and maternal deaths are undercounts. The CDC has data on less than 73,000 birth outcomes following a mothers confirmed COVID-19 diagnosis in 2020 and 2021, of which 579 were pregnancy losses.
That information was sent in by fewer than three dozen health departments, and those estimates dont include states like Mississippi, which in September reported 72 COVID-19-related stillbirths since the start of the pandemic, nearly double what the state would have expected, according to data from the Mississippi State Department of Health. Preliminary state data shows total stillbirths increased there in 2020 then dipped in 2021, but were still higher than pre-pandemic numbers.
A separate CDC database shows more than 220,000 COVID-19 cases and at least 305 deaths among pregnant people.
CDC recognizes that pregnant people faced challenging decisions about how to best protect themselves in the setting of uncertainty related to both the infection and the COVID-19 vaccine, a CDC spokesperson said, adding, COVID-19 vaccination remains one of the best ways to protect yourself and your family from serious illness from COVID-19.
Heartbroken and determined, Jaime Butcher has emerged as an unofficial ambassador for the vaccine, posting in online pregnancy and stillbirth forums about the risks of being pregnant and unvaccinated.
No one, she said, told her of the risks. Doctors, the CDC and health officials, she continued, arent doing enough to inform people. Even now, well into the pandemics third year, the message still isnt getting through.
I kept seeing it happening more and more to women and it wasnt talked about, she said. They just say, Oh, get the vaccine, which is great, but they dont talk about what getting the virus can do to pregnant women.
As a wedding planner, Butcher was surrounded by love. She found it with her husband, then in the daughter growing in her belly, who they named Emily after Butchers grandmother.
Since July 22 a second booster dose has been available for people in the 60-79 age group and an additional vaccination for people aged over 12 years with immune deficiency. Before, the fourth dose had been offered to everybody over 80. Marcin Bielecki/PAP
Over 840,000 Poles have already registered for the second booster jab of coronavirus vaccine and 420,000 have already been vaccinated, a deputy health minister has announced.
"These figures are quite promising," Waldemar Kraska told a Polish public radio programme on Thursday.
"There are over 4 million Poles who are entitled to receive the second booster jab," he said, adding that nearly 25 percent had already registered.
Since July 22 a second booster dose has been available for people in the 60-79 age group and an additional vaccination for people aged over 12 years with immune deficiency. Before, the fourth dose had been offered to everybody over 80.
Referring to announcements by pharmaceutical companies, Kraska said that new vaccines would probably be available in early September.
He also encouraged Poles to get vaccinated now as, in his opinion, a new wave of Covid-19 infections would likely be seen at the turn of September and October.
Poland will likely allow a fourth dose of coronavirus vaccine to be given to people aged over 18 in September.
As experts attempt to unravel the tangle of symptoms and long-term effects of what is collectively known as long COVID, a new study seeks to provide some clarity.
Working with data collected in a health study app by personalized nutrition company ZOE, researchers from Kings College London in the U.K. have begun to discern some order in the chaos.
The study finds that long COVID can be grouped into three symptom-cluster types: neurological symptoms, respiratory symptoms, and systemic/inflammatory and abdominal symptoms.
For the study, researchers analyzed data for 336,652 individuals collected by ZOEs COVID Symptom Study. Of this group, 1,459 reported post-COVID symptoms defined as more than 12 weeks after acute COVID-19 infection.
Dr. Jai Marathe of Boston University School of Medicine in Massachusetts, who was not involved in the study, told Medical News Today, This study definitely improves our understanding of post-COVID syndrome and more importantly, who might be at risk of prolonged illness and debility.
Physicians and patients, Dr. Marathe pointed out, are both looking for answers regarding who is at risk for developing long COVID, how long symptoms will last, what will help resolve the symptoms, etc. While this study does not answer all these questions, it provides a strong framework to build on.
The study, which has not yet been peer-reviewed, has been published on the pre-print server medRXiV.
The researchers were also able to begin to identify the symptom clusters associated with SARS-CoV-2 variants and with vaccinations.
Dr. Liane S. Canas, corresponding author of the study and postdoctoral research associate at Kings College London, told Medical News Today:
Our results suggest that chest-related symptoms (respiratory cluster) in the U.K. population were more evident among unvaccinated patients infected by the initial form of the virus [referred to as the wild variant].
Differently, Dr. Canas continued, patients with either the Alpha or Delta variants have shown a higher incidence of neurological symptoms, such as anosmia and brain fog.
Unfortunately, we could not robustly evaluate the effect of vaccination for these two variants. For Alpha, we didnt have enough individuals vaccinated at the time of infection. For Delta, we didnt have enough unvaccinated individuals at the time of infection who developed long COVID, she pointed out.
Systemic/inflammatory and abdominal conditions were lightly associated with all variants.
On average, said Dr. Canas, the wild-type form of the virus has shown a longer prevalence of symptoms, 30 weeks when compared with Delta and Alpha at 24 and 25 weeks respectively.
However, she noted, since we only analyzed data from individuals with illness for longer than 12 weeks, these results are less significant than the profiling of the clusters, and would require further research, which would also consider the effect of vaccination.
The findings of the study, said Dr. Marathe, suggest that individuals struggling with long COVID, who experience severe shortness of breath, hoarse voice, loss of smell, fatigue, delirium, anosmia, headache, and fever were more likely to [experience] prolonged and severe symptoms.
Physicians armed with this information, she said, may be able to better counsel their patients and expectations for symptom improvement. They may also work towards targeted treatment approaches that address the symptom cluster impacting, and hopefully improving, clinical care for the patients.
The authors of the study are still analyzing data related to the Omicron variants, but have shared some early insights.
Dr. Canas said, Initial results have shown that the prevalence of long COVID among Omicron variant-infected patients is much lower than that of the other variants.
An article about the research from ZOE says that the chances of getting long COVID from Omicron were 20%-50% less than from other variants, with Omicron cases representing just 4.4% of the cases studied, compared to the Delta variants 10.8% of cases.
Dr. Marathe cited other research into the relationship between Omicron variants and long COVID:
Some studies have reported a lower risk of developing long COVID following COVID-19 infection with the Omicron variant compared to the Delta variant, while others have noted that patients who develop long COVID following Omicron variant infection have less severe disease. This is also true for the overall decreased severity of symptoms during acute Omicron infection.
Even though a lower percentage of people with COVID-19 infections from Omicron variants develop long COVID, the strains greater infectiousness means that more people are being infected, and thus, more people are developing long COVID.
While the overall number of patients with long COVID in the community may be lower, at Boston Medical Center, the number of patients seeking care in the long COVID clinic has remained steady throughout the post-Delta and post-Omicron surges, said Dr. Marathe.
In terms of long COVID symptoms with recent variants, not much has changed, she said:
We have not noticed a big difference in long COVID symptoms between the Omicron variants that were circulating during the winter and spring months. Fatigue, shortness of breath, mood disorders, and brain fog were still the most common complaints reported by patients with long COVID.
Dr. Marathe regarded the new study as valuable:
This may pave the way for additional research efforts to evaluate the different pathobiological pathways that may contribute to the development of long COVID, and help us define the condition more successfully.
I think we still dont know who is at risk for developing long COVID and why they are at risk. As we increase our understanding of this disease, it will help inform strategies regarding treatment and prevention of long COVID, she added.
Research questionUse of mRNA technology by two drug companies, Pfizer and Moderna, in the design of vaccines against SARS-CoV-2, the virus that causes COVID-19, revolutionized the response to this infection. But now, more than two years into the COVID-19 pandemic, development of strains of virus resistant to the original vaccines illustrate the need to reconfigure these products. It is likely that such COVID-19 vaccines will be available in the U.S. by mid-September. But what might serve as the best platform to combat future SARS-CoV-2 variants?
FindingsThe structural protein analyses of the SARS-CoV-2 envelope S protein that enabled design of the highly effective mRNA vaccines originated in research on the HIV envelope. Dr. Barney Graham, deputy director of the NIH Vaccine Research Center, acknowledged that [i]t really was HIV driving most of this.
Now researchers working in the U.S., Switzerland, and at the Institut Pasteur in Paris have used similar technology to focus on a part of the S protein known as RBD, which is the target for 90% of the virus-neutralizing antibodies present in recovering COVID-19 patients. They constructed a flexible, nanoparticle-based vaccine that protected genetically engineered mice against the SARS-CoV-2 Delta variant.
ImpactThe authors concluded that their nanoparticle mRNA-based vaccine platform should be of value for rapid development of effective vaccines against current and future SARS-CoV-2 variants of concern.
amfARs roleamfAR was a funder of this research
Original articlehttp://www.ncbi.nlm.nih.gov/pubmed/35874687
Dr. Laurence is amfARs senior scientific consultant.
The district also has revised its religious exemption form to include a section specific to the COVID-19 vaccine.
Catholic schools in Washington, D.C., are subject to a new COVID-19 vaccination requirement for children 12 and older issued by the districts health department.
Under therules, to attend classes in the coming school year students 12 and older attending all public, charter, private, and parochial schools in D.C. are required to either be fully vaccinated, have a medical exemption on file, or obtain approval for a religious exemption.
The district also has revised itsreligious exemption formto include a section specific to the COVID-19 vaccine. In addition to requiring parents to provide a written personal statement supporting their religious objection to the vaccine, the new form asks for the following information:
The reason you do not get vaccinations based on your sincerely held religious beliefs;
The religious principles that guide your decision to not get vaccinated;
A statement on whether you are opposed to all vaccinations and if not, an explanation of the religious beliefs you follow that will not allow you to get the COVID-19 vaccination.
Unvaccinated students would have 20 days to present proof of vaccination or the necessary medical or religious exemption before being removed from school.
The Archdiocese of Washington did not respond to CNAs requests for comment. The archdioceses online school directorylists17 schools in Washington, D.C. An official at one Catholic K-8 school located in the district told CNA that the school had not yet received guidance on how the mandate would be implemented.
A U.S. Army officer was deemed a possible threat, according to newly disclosed emails.
Maj. Samuel Sigoloff, a doctor, was ordered to stop seeing patients earlier this year after granting exemptions to the militarys COVID-19 vaccine mandate. Sigoloff has attempted to leave the force but the Army has refused to process his resignation, according to his lawyer.
On Aug. 1, Sigoloff was sent an email from David Prince, a plans officer at Fort Huachuca in Arizona. Four other officers were also sent the message.
ALCON, Here is some information on the subject of tomorrows Threat Working Group, Prince wrote.
The subject was Sigoloff, according to the missive, which was reviewed by The Epoch Times.
Why are they having a meeting about a doctor being a threat when hes not made any threats? That doesnt make any sense, Sean Timmons of Tully Rinckey, who is representing the major, told The Epoch Times.
Timmons thinks the message was meant to signal to Sigoloff that the military is focusing on him for what hes done.
Theyve been so frustrated by his exposure of the corruption that theyre now engaged in Hail Mary desperation and reprisal through intimidation, he said.
A spokeswoman forFort Huachuca told The Epoch Times in an email: In an abundance of concern, the U.S. Army frequently assesses situations in order to ensure the health and welfare of its Soldiers, families and team members. At this time Maj. Sigoloff has not been deemed a threat.
Asked what situation arose in this instance, she said that Sigoloff is under a lot of stress.
Prince did not respond to a request for comment.
Sigoloff responded to Prince and the others, telling them that he needed more information about the meeting in order to attend.
I will bestanding by for the time and place. Thank you for the invite, he wrote.
Frederick Ubungen, another officer, said that the meeting would be at a certain building but indicated it might not happen because a key participant in the threat group was traveling.
I must not have been on the email that said the meeting was going to be rescheduled. Please let me know when the new meeting will take place so that I can help. In the meantime I would be happy to answer questions. I, like you, always want to help uphold our oath to protect the Constitution, Sigoloff later wrote to the group.
Timmons said he spoke with a person at the base who said that when the meeting was being set up, Prince likely inserted Sigoloffs email to make sure he was spelling Sigoloffs name correctly, and forgot to remove it before he clicked send.
That doesnt pass the smell test to me, Timmons said. He believes what has unfolded is illegal, since Sigoloff has served in a whistleblower capacity for Sen. Ron Johnson (R-Wis.).
The fort spokeswoman said it was unclear whether the meeting was ultimately held and whether Sigoloff was intentionally included in the message.
Update: This story has been updated with comments from the fort spokeswoman.
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Zachary Stieber covers U.S. and world news. He is based in Maryland.
This is the weekly edition of CNNs coronavirus newsletter. Look out for your roundup every Wednesday. If you havent subscribed yet, sign up here.
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If weve learned anything over the past two and a half years, its that Covid-19 is one strange disease. The latest case in point: the coronavirus rebound.
The condition grabbed international attention last week when US President Joe Biden tested positive for the virus six days after testing negative following his first bout of the illness.
The White House said Biden, who is back in isolation, was experiencing a bit of a loose cough but did not have a fever and his lungs were clear.
The President tested positive again after being treated with the antiviral Paxlovid. White House officials had previously suggested a rebound case of Covid was unlikely, based on reports of cases around the country, but Bidens doctors continued to monitor his health and test him.
Dr. Ashish Jha, the White House Covid response coordinator, said clinical data shows the rate of rebound infections is low and noted that even those who suffer them are still generally protected from serious illness.
Biden is not the only high-profile patient to develop the condition. National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci also experienced rebound Covid-19. Unlike Bidens, his symptoms got worse when they returned after treatment with Paxlovid, and his doctors prescribed another course of the drug.
Experts have been calling for more systematic research into the instances of rebound to understand who is most at risk and whether the standard five-day course of Paxlovid should be lengthened to prevent it.
Studies have shown that people can pass the infection to others during a rebound, which is another reason to try to understand it better.
The United States Centers for Disease Control and Prevention (CDC) issued a health alert to doctors in May about the potential for Covid-19 rebound, saying symptoms sometimes come back, and that may just be how the infection plays out in some people, regardless of whether theyre vaccinated or treated with medications like Paxlovid.
The CDC said most cases of rebound involve mild disease and that Paxlovid continues to be recommended for early-stage treatment of mild to moderate COVID-19 among persons at high risk for progression to severe disease.
Pfizer, the company that makes Paxlovid, has said its studies showed rebounds were rare, and that they happened in both people who took the drug and those who took a placebo pill. Because investigators noted the phenomenon in both groups, the company doesnt believe it is tied to the medication.
Q: How does Paxlovid work?
A: Considered a game-changer when it was authorized in December because of its strong performance in lowering the risk of severe Covid-19, Paxlovid in combination with vaccines and boosters is thought to be one of the best ways to protect people at high risk for severe illness.
The drug suppresses the coronavirus, blocking an enzyme that helps it reproduce inside the body.
As with all antivirals, the treatment is thought to work best if started within five days of the first symptoms appearing.
Clinical trials of Paxlovid showed that it reduced the risk of hospitalization and death by 88% when given within five days of the start of symptoms.
Send your questions here. Are you a health care worker fighting Covid-19? Message us on WhatsApp about the challenges youre facing: +1 347-322-0415.
Most US public schools plan to keep masks optional for start of classes
Students are heading to another school year amid the Covid-19 pandemic, but this time, there seem to be fewer discussions and less fretting about masks and other mitigation measures despite a rise in infections across the country.
Most of the largest public school districts in the US are not requiring masks for the new school year, making masking optional as students return to classes and the highly transmissible BA.5 subvariant spreads.
Dr. Sanjay Gupta: Are we making the same mistakes?
The pandemic, which has held the US and almost every other country in its grip, should have taught us valuable lessons about how to manage a public health emergency. But it seems we are making some of the same mistakes with the monkeypox virus that we made not even three years ago when the SARS-CoV-2 virus started to spread.
Testing for monkeypox, once very limited, is now more available, but underused. The demand for vaccines is outpacing the supply. There are nearly 2 million courses of the highly effective TPOXX antiviral sitting in the Strategic National Stockpile, but many health care providers are still having a hard time getting the medication for their patients.
At this time, only 336,710 doses have been shipped to states. Ordering only just began for about 800,000 more doses. This scarcity has created long lines in monkeypox hotspots like New York City, which has the highest number of cases in the country.
Updated Covid-19 booster shots could be available in September
Moderna and Pfizer booster shots updated to target Omicron coronavirus subvariants could be available in the US in the early fall, pending signoff by federal health agencies, the US Department of Health and Human Services said Friday.
The US Food and Drug Administration advised vaccine makers in June to update the boosters to add an Omicron BA.4/5 component and create a bivalent booster that would work for two different strains.
Pfizer and Moderna have indicated that they anticipate the modified vaccines being available as early as September, an FDA spokesperson said.
Many children will soon be returning to schools while coronavirus cases are still high.
Parents and caregivers have a lot of questions about what precautions they should take. Do kids need to wear masks again? How often should families test kids? What happens if their kids contract Covid-19? How long should they stay out of school? CNN Medical Analyst Dr. Leana Wen answers the most pressing questions.
By Nyima Sillah
As misconceptions continue around the covid-19 vaccine, Gibril Gando Baldeh, a senior health communications officer at the Ministry of Health highlighted the importance of the vaccine, saying it prevents people from the severe effects of coronavirus.
However, health officials say that the number of females that have taken the vaccines is more than males.
The vaccine can also prevent you from the signs and symptoms of the virus. Also, anyone that takes the vaccine within The Gambia and abroad is given a card as a reference and this card now is more important than the passport, Mr. Baldeh claimed.
Because the card is called a vaccine pass and if you dont have it, even Guinea-Conakry, and Mali they will not allow you to enter their countries, talk less of Saudi Arabia and Europe. So, everyone needs to be vaccinated.
He, therefore, urged those who have taken a half dose of the vaccine to take another injection as it will contribute to helping their body system to become strong and active to fight the virus.
Everyone knows that vaccines have contributed immensely towards the eradication of several viruses in The Gambia and therefore I urge the entire public to take the opportunity of this nationwide vaccination campaign seriously and get vaccinated.
However, from the updates received from Aja Kandeh of the Ministry of Health Communications Department, the vaccination data for persons who received at least one dose is 451, 778, whilst persons who received two doses is 32, 216 and the booster dose is 9,586.
The National Covid-19 vaccination coverage stands at 18.5%.
She likewise said the number of females that are vaccinated is more than the number of males and therefore urged the entire public be it male or female to go and get vaccinated.
Meanwhile, Dr Musa Marena, Obstetrician and Gynecologist at Edward Francis Small Teaching hospital, highlighted the importance of vaccination for women and children.
If more women and children are vaccinated then the increases in herd immunity among the population will reduce. Also, the spread of the virus Vaccinations helps build immunity hence when we are exposed to the virus our strong immunity will fight it.
More so, he said, the vaccine is important because it prevents severe illness, protects high risk of one dying from COVID 19, and also prevents the rapid spread of the virus.
Sireh Drammeh, a nurse, explained that since the beginning of the pandemic, they did a lot of counseling, trying to make people understand how the virus spread, the mode of transmission, and the benefits involved in taking the vaccine.
The Government should render more sensitisation exercise and let people know the benefits involved in taking the vaccines and also provide means of making it easy for people to get access to these vaccines by making it readily available in all health facilities.
Fatima Jabbie Touray, a nurse, said she has seen patients who did not take the vaccine.
We talked to them about the importance of the vaccine; how the vaccines minimize symptoms even when you are exposed to coronavirus.
We explain to them that vaccines dont stop one from having covid-19, but even when you have it, your chances of recovery will be higher than the one who has not taken the vaccine.
Halimatou Ceesay, a concerned citizen who is yet to be vaccinated said since the pandemic emerged, a lot of misinformation is going around on social media which has given her doubts about getting vaccinated.
I am scared that the vaccine might cause infertility and I am recently married and want to build a family. So, I cant take a vaccine that can prevent me from having a child, she said with dismay.
Another concerned citizen, Louis Mendy, even said I dont feel comfortable about the injection considering all these stories around it. I dont feel the need to take it and I dont think I will take it soon.
Also, I dont have confidence in the vaccine because I dont believe that this corona(virus) is as serious as they are portraying it. To me, its more like the flu, he talked ignorantly.
This story was produced with support from Journalists for Human Rights (JHR), through its Mobilizing Media in the Fight Against COVID-19 in partnership with Mai-Media and The Voice Newspaper.
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The summer coronavirus wave in Los Angeles County fueled by super-contagious Omicron subvariants appears to be cresting as cases continue to fall, but the picture is far from good.
COVID-19 deaths the result of weeks of substantial transmission remain on the rise and arent likely to decrease for some time. Moreover, cases remain highly elevated.
The latest data extend the trends health officials noted last week, when they canceled implementation of a long-looming mask mandate. And while the pandemic has regularly upended prognostications, metrics are moving in a promising direction almost across the board.
Although we had three instances earlier in the spring and summer where we saw dips in cases that, unfortunately, were followed shortly by increases, this decline is more pronounced, and its accompanied by decreases in our other metrics, county Public Health Director Barbara Ferrer said Tuesday.
Over the week ending Wednesday, the nations most populous county tallied an average of 5,200 new coronavirus infections per day, down 24% from mid-July the apparent peak of summers surge. Its the largest drop in average case counts that weve seen since the end of the winter surge, Ferrer told the county Board of Supervisors.
On a per capita basis, L.A. County is reporting 363 new cases a week for every 100,000 residents, down 15% from the prior week. A rate of 100 or more is considered high.
The downward trend is evident across California, which is reporting 287 cases a week for every 100,000 residents, a 14% week-over-week decrease. The San Francisco Bay Area is reporting 256 cases a week for every 100,000 residents, a 10% decrease from the prior week. And Orange County is reporting 229 cases a week for every 100,000 residents, down 19% over the past week.
L.A. Countys weekly test positivity the proportion of conducted and reported tests confirming coronavirus infection also dipped from 15% a week ago to 13.7% Wednesday, officials said. The number of new coronavirus outbreaks reported at worksites, nursing homes and homeless settings have all also declined.
Hospitals, which have not been nearly as stressed as they were during the pandemics previous waves, have also begun to see some relief. As of Tuesday, 1,273 coronavirus-positive patients were hospitalized countywide, down about 4% from last months peak, recorded on July 20.
The share of emergency department visits associated with people seeking care for COVID-related symptoms has also fallen.
Thats not to say that the still-widespread community transmission isnt having an impact, however.
While the number of patients hospitalized for COVID are not currently putting strain on the DHS hospitals overall census, we are quite busy in the emergency departments and urgent cares and are continuing to experience a number of call-offs among staff that are COVID positive and following isolation protocols, said Dr. Nina Park, chief deputy director of population health at the county Department of Health Services, which runs four public hospitals.
However, she added that the latest test positivity rate and workforce member testing has decreased slightly over the last two weeks, which we hope to be a continuing trend.
One major metric still not heading in the right direction, however, is deaths. Over the last week, L.A. County reported 116 COVID-19 fatalities, a 7% increase from a week ago.
Since deaths always lag behind cases and hospitalizations, we are hopeful that the recent declines in cases and hospitalizations will bring declines in deaths in a few weeks, Ferrer said. Every death is heartbreaking.
The number of coronavirus-positive patients in L.A. Countys intensive care units has not yet seen a sustained downward trend, though the figure remains low overall. There were 138 such patients as of Tuesday, roughly the same as the prior week.
One reason for the recent downturn in infections could be that, eight months into the rapidly evolving Omicron era, the coronavirus may have stabilized.
Since late April, three different Omicron subvariants BA.2, BA.2.12.1 and BA.5 have, at times, been the most common version of the coronavirus circulating nationwide.
Its the last one that now has a stranglehold on viral transmission. According to the U.S. Centers for Disease Control and Prevention, BA.5 made up an estimated 85.5% of new cases for the week ending Saturday.
Given its dominance and transmissibility, its possible BA.5 is simply running out of people to infect. And unlike earlier phases of this most recent wave which were dominated by the BA.2 and BA.2.12.1 subvariants that transitioned directly into BA.5 there appears to be no readily visible successor on the horizon.
Still, there is uncertainty.
At a briefing Thursday, Ferrer said she had talked with state officials about whether BA.5 has run its course and has fewer people to infect.
The answers were unclear: The models are all over the place. Some of the models that the state shared with us showed a little bit of an increase or some plateauing, Ferrer said.
Sequencing data determining the dominant variants for a given week is typically delayed, and so were always kind of behind on recognizing how much spread BA.5 has been causing or has been responsible for, she added.
One thing is for sure: Its really crowding out everything else, clearly, both here and across the nation. Whether its run out of people to infect, I dont know that we can tell that for certain, Ferrer said.
BA.5 has been the source of so much worry among public health officials because of its ability to reinfect those who had previously come down with an earlier Omicron strain.
Its too soon to say for certain that the worst is behind L.A. County. But should recent trends continue, it would mean that the region was able to navigate the pandemics latest wave without resorting to the reimposition of universal indoor masking restrictions ordered by county officials.
Some businesses and institutions have decided on their own to impose restrictions, such as canceling large gatherings, moving events outdoors and instituting mask requirements.
Indoor requirements have been in place this summer at UCLA and in the TV and film industry in the L.A. area. The Television Critics Assn. shifted its in-person summer tour to virtual sessions, citing rising case rates while noting that shows in production cannot or do not want to break COVID bubbles and producers, writers, talent and publicists are not willing to appear in person.
Many officials have said the one-two punch of vaccines and widely available treatments, along with general changes in the nature of the coronavirus itself, had rendered most infections relatively mild and lessened the urgency for strict public health measures.
Only one California county, Alameda, instituted a new public indoor mask mandate in response to rising infections this spring, but that measure was short-lived. L.A. County came close to reviving its mask requirements but decided not to after seeing enough improvement in its pandemic metrics last week
Residents should still protect themselves, officials said. It is still strongly encouraged that masks be worn in public indoor spaces. BA.5 remains highly infectious, and in a group of 50 people, theres a 60% to 70% likelihood that someone in that group is infected, Ferrer has said.
While were relieved with the steady improvements in the county metrics, transmission does remain significantly elevated ... and that means that there is considerable risk of viral spread, Ferrer said. Being cautious and layering in protections such as testing before gathering, isolating away from others when infected or sick and masking indoors will continue to slow transmission.
Unvaccinated people in L.A. County are twice as likely to test positive for the coronavirus compared to people who have completed their primary vaccination series, according to figures presented Tuesday. They are also four times as likely to be hospitalized, and six times as likely to die, compared to those who have finished their primary vaccination series.
Getting vaccinated and boosted remains a critical tool for staying as safe as possible, especially when transmission is so high, Ferrer said.
STATEN ISLAND, N.Y. As the latest, most transmissible coronavirus (COVID-19) omicron subvariant, BA.5, powers a surge across New York City and the United States, experts recommend one good way to stop the newest strain in its track are booster shots, as they are critical to stopping COVID from continuing to mutate into more transmissible and more severe strains, according to experts.
Americans ages 5 and up are now eligible for a booster five months after completing their primary vaccine series, yet fewer than half of those eligible have actually received one.
