SC sees nearly 16600 new cases of COVID-19 and 9 deaths – Charleston Post Courier

(NewMediaWire) - July 26, 2022 - DALLAS People who reported smoking or vaping prior to their hospitalization for COVID-19 were more likely than their counterparts who did not smoke or vape to experience severe complications, including death, from the SARS-CoV-2 infection. The findings are from a new study based on data from the American Heart Association's COVID-19 CVD Registry and published in PLOS ONE, a peer-reviewed, open access scientific journal published by the Public Library of Science.

Researchers examined data on people over 18 years of age who were hospitalized with COVID-19 in 107 registry-participating hospitals across the nation between January 2020 to March 2021. Smoking status was self-reported and people were classified as smoking if they reported currently using either traditional, combustible cigarettes or e-cigarette products, with no distinction between the two and no information on duration of smoking or former smoking status. For the final analysis, records were selected for 4,086 people with a 1:2 ratio of people who smoked (1,362) to people who did not smoke (2,724), with the two groups matched for no statistically significant difference in age, sex, race, medical history or medication.

The study findings indicate smoking or vaping are associated with more severe COVID-19 independent of age, sex, race or medical history:

People who reported smoking were 45% more likely to die and 39% more likely to receive mechanical ventilation when compared with those who did not smoke.

Although the excessive risk due to smoking was independent of medical history and medication use, smoking was a stronger risk factor for death in people between 18-59 years of age and those who were white or had obesity.

"In general, people who smoke or vape tend to have a higher prevalence of other health conditions and risk factors that could play a role in how they are impacted by COVID-19. However, the robust and significant increase in the risk of severe COVID-19 seen in our study, independent of medical history and medication use and particularly among young individuals, underscores the urgent need for extensive public health interventions such as anti-smoking campaigns and increased access to cessation therapy, especially in the age of COVID," said the study's senior author, Aruni Bhatnagar, Ph.D., FAHA, a professor of medicine, biochemistry and molecular biology at the University of Louisville in Louisville, Kentucky. "These findings provide the clearest evidence to date that people who smoke or vape have a higher risk of developing severe COVID-19 and dying as a result of SARS-CoV-2 infection."

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Bhatnagar is co-director of the American Heart Association's Tobacco Center for Regulatory Science which supported the study in part with funding from the U. S. National Institutes of Health and the Food and Drug Administration research grants.

"We established the COVID-19 CVD Registry early on in the pandemic to better understand the link between COVID-19 and cardiovascular disease, specifically, to identify increased risk to help inform the diagnosis and care of people who are at highest risk for complications," said Sandeep R. Das, M.D., M.P.H., M.B.A., FAHA, co-chair of the steering committee for the American Heart Association(R) COVID-19 CVD Registry Powered by Get With The Guidelines(R) and director for Quality and Value in the Cardiology Division at UT Southwestern Medical Center in Dallas, Texas. "The findings of this study deliver on that goal and provide invaluable information individuals and their health care teams."

The American Heart Association launched the registry in 2020 to gather data specific to all patients hospitalized with COVID-19 as part of the Get With The Guidelines(R) quality improvement program. Registry participation was offered at no cost to all U.S. hospitals caring for adults with active COVID-19 and with the infrastructure to support accurate data collection. More than 160 hospitals provided data on more than 79,000 patient records between 2020 and June 2022.

The American Heart Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers and the Association's overall financial information are available here.

Additional Resources:

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public's health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

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For Media Inquiries: 214-706-1173

Cathy Lewis: cathy.lewis@heart.org; 214-706-1324

Michelle Rosenfeld: michelle.rosenfeld@heart.org; 214-706-1099

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

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WELLINGTON, New Zealand (AP) Micronesias first outbreak of COVID-19 grew in one week to more than 1,000 cases by Tuesday, causing alarm in the Pacific island nation.

Last week, Micronesia likely became the final nation in the world with a population of more than 100,000 to experience an outbreak of the disease, after avoiding it for 2 1/2 years thanks to its geographic isolation and border controls.

Health officials said cases were rapidly increasing. It reported 140 new cases Monday, bringing the total to 1,261, a figure which includes some cases caught at the border before the outbreak.

Eight people have been hospitalized and one older man has died, officials said.

Many top lawmakers and senior officials have caught the disease, including Vice President Yosiwo George, who has been hospitalized, officials said. They said the vice presidents condition was improving.

Camille Movick, whose family owns Fusion Restaurant in Pohnpei State, told The Associated Press that a lot of people have been posting on Facebook asking, for instance, that others stay away from their homes.

Initially there was quite a bit of panic and worry with most people, she said.

She said her restaurant remained open although business was slow because many people were afraid to dine in. She said some other restaurants had closed their dining rooms and were only offering takeaway services.

Movick said authorities had issued a directive that all people must wear masks in public even outdoors and that they faced fines of $1,000 for noncompliance.

She said one positive outcome was the outbreak had prompted many previously unvaccinated people to get their shots.

She said many people suspected the virus might have been circulating before the first community case was confirmed last week because health authorities werent routinely testing patients for the disease.

Last year, Micronesia became one of the few countries to impose a broad mandate requiring all eligible citizens get vaccinated against the coronavirus.

The government threatened to withhold federal funds from any individuals or business owners who didnt follow the rules. Health officials said this week that 75% of people aged 5 and over were fully vaccinated.

Movick said many parts of society were continuing to function as before, including many people who were working from their offices.

Were hoping things get back to normal soon, Movick said. Just like in other countries, over time, theyve gotten over it, and lifted the restrictions.

As 'Covid-19 refugees' go back home, rent increases expected to return to normal - South Florida Business Journal  The Business Journals

Introduction

In December 2019, a pneumonia outbreak that started in Wuhan, China had spread rapidly to the entire world.14 In response, the WHO had declared it a Corona Virus Disease (COVID-19) pandemic on March 11, 2020.5,6 The second wave of the pandemic peaked all over the world in the mid-summer of 2020 due to the relaxation of precautionary measures by the local governments.7 It reached a plateau and then gradually declined as a result of social distancing, mandatory use of face masks in public areas, the use of sanitizers, and tracing, testing, and isolation of the close contacts of identified cases. Then, several new variants of concern with higher transmissible and more severe disease emerged in the UK, South Africa, USA, and Japan/Brazil and were cautioned by the CDC of the US.8,9 The following third wave turned out to be more deadly but by then vaccination programs have rolled out.10 The COVID-19 pandemic, which has entered the third wave in most countries by May 2021, has affected the lives of all walks of people globally.

COVID-19 can affect all levels of society. Health-care workers (HCW) have been the predominant front-line defense workforce during the pandemic; they have a greater risk of getting infected at the workplace through contact with COVID-19 positive patients who seek treatment at clinics and hospitals. The Italian National Institute of Health11 reported 13,000 cases and the International Council of Nurses (ICN)12 claimed that more than 90, 000 cases of OHCW have been infected across the globe during the first wave when the protective equipment was scarce. OHCW also experienced burnout due to additional workload while attending the COVID-19 patients.13 The pandemic also causes psychological distress among the HCW as a result of overwork, lack of rest, anxiety related to fear of getting infected and infecting others; thus, a timely assessment and proper interventions are important.14,15 Although there are voluminous studies on the psychological effect on HWCs, few studies involved the oral health-care workers (OHCWs) who are equally vulnerable to the disease and under unprecedented pressure because of the nature of the profession.5 The reports suggested that OHCWs experience distress and anxiety during the pandemic psychological distress the picture is less than clear. This review was aimed to determine the understanding about the potential factors influencing psychological distress of OHCW during the pandemic.

Oral health-care workers (OHCW) are equally vulnerable to the disease and under unprecedented pressure because of the nature of the profession.5 Dentists have been reported to be in a state of fear and suffered from psychological distress while at work during the pandemic.16 Dentists in the UK, USA, and Ireland are reported to close their practices temporarily or permanently and suffer large financial losses due to suspension of care.17,18 The recommendation to limit services to emergency procedures only has increased the anxiety and insecurity levels and financial issues among oral health practitioners. It has been suggested that mental instability among the HCWs, including OHCWs, might precipitate Post Traumatic Stress Disorder, anxiety, and depression.1922 There is currently a dearth of review on the psychological impact of the COVID-19 pandemic on OHCWs. Therefore, this scoping review aimed to describe the psychological health of oral health-care workers during the COVID-19 pandemic and identify the interventions and strategies that can improve the mental health status of OHCWs.

The participants, context, and concept mentioned in the study are explained below:

OHCW includes dental surgeons, dental assistants, dental technicians, individual professionals, representatives of professional bodies and dental academics (lecturers/Assistant professors/Professors, etc).

This review considered only the psychological health of OHCWs related to COVID-19 pandemic and the interventions are training and counselling sessions for those who have been psychologically affected by the pandemic.

Outcomes related to dental practices of OHCWs and the adverse effects of this pandemic on their practices will be identified.

The setting is the work premises of the OHCW which included dental hospitals and clinics and teaching dental hospitals and dental colleges.

The search for articles was carried out in the PubMed, Web of Science and Science Direct databases and gray literature in Google scholar but limited to original research reports in English Language published between January 2020 and February 2021. The keywords and terms used in the online search were derived by two primary investigators (A.F. and F.A.C.) and had been reviewed by other co-authors and included oral health-care workers, COVID-19, pandemic, dentistry, and dental practice. Reports in other languages, case reports, book chapters and short communications were excluded.

All records were merged into a single file and duplicate reports were removed. The titles and abstracts of the records were then screened to identify the relevant reports by two investigators (A. F. and F. A. C.). In case of disagreement, the record was referred to the third investigator (M.H.) to arrive at a decision. Then, the full text of only the relevant studies were retrieved and screened based on eligibility criteria by the same two investigators. Pre-screening was done by recording the results from different search bases.

Data extracted from reviewed OHCWs centred care framework and model were included in data extraction records and synthesized in summary format. Data extraction was carried out using a charting form in Microsoft Excel and had included the information on authorship, article type, year, population, and OHCW-centered care approach. The charted data was used to identify themes relating to psychological status, and potential causes of psychological distress in OHCWs.

The search process to identify the relevant articles is presented in the Flow Diagram in Figure 1. Only 16 full-text reports were retrieved, seven studies were excluded due to incomplete information (n = 965), and short communication (n = 3). The remaining nine studies were screened based on eligibility criteria, and after which only eight studies were found to be relevant to the current study.

Figure 1 PRISMA 2009 flow diagram showing study characteristics.

This study had identified five themes in research on OHCW during the pandemic: psychological impacts, preparedness, concerns, epidemiological factors, and future of practice.

Three studies had assessed the psychological impact of the pandemic on OHCW. One study reported that 11.5% of dentists experienced anxiety, based on assessment using Kesslers K6. In the same study, lower psychological distress was found to be in relation with being in a committed relationship (p = 0.021) and having higher self-efficacy (p = 0.005).

Three main sub-themes identified were: financial, concern of infection, work (sub: workload, intervention/training).

Four studies had linked the impact of the pandemic to financial issues, since the dentists are unable to practice, which affected their financial status.

Dentists being a high-risk population among the front-line workers showed greater concerns regarding the current pandemic. However, fear of being in contact with COVID-19 infected people was found to be more among those people with some chronic illnesses, psychological distress, or those with the greater workload, since existing comorbidities make them a better candidate to get the disease.23,24

Increased workload had been a reason to worry for the dentists during this pandemic. Lack of training and equipment created an unsettled state among the dentists. One study reported that only 12.6% dental staff was being trained for this pandemic.23

The preparedness of dentists can be explained in two sub-themes: knowledge about COVID-19 among dentists, and guidelines.

Arora et al explained that the majority of dentists had enough knowledge about COVID-19 and were worried about the adverse effects caused by this pandemic.

The feedback was received from 26 countries. The overall response rate from United States and Indonesia was 14.3%. The rate of response being higher in Indonesia. 92% of the dentists were aware about the transmission of COVID-19. Nearly all the participants recognized breathing problems as an alarming sign of COVID 19. A few dentists had a limited knowledge about breathing issues being an alarming symptom. 91% of the subjects knew that there is no vaccine for COVID-19. The knowledge about the diagnosis of COVID-19 was higher among the respondents, while it was significantly low about the transmission, symptom, treatment and protection methods. The level of knowledge was low among the undergrads as compared to specialists and PHD holders. Clinicians who saw more number of patients had higher scores. Countries that were affected the most and had highest number of COVID-19 cases had more knowledge.25

Dentists were recommended to follow CDC and WHO guidelines during this pandemic.26

Four studies included that dentist were concerned about this alarming situation of pandemic, adversely affecting the dental practice. Chaudhary et al stated that although dentists were concerned about the current situation, they responded that their institutions were not well prepared to cater to this pandemic situation.27 The academics were found to be worrisome about the professional responsibilities and restricted mobility. There was direct dose-dependent association found between the worries and fear of the dental academics and the spread of pandemic. Greater fear and worries were found to be associated with frequent hand washing among the participants during this pandemic.

Only 12.6% of the population responded that infection control sessions have been conducted in their institutions. Overall, the dental community was concerned regarding the future of dentistry.28,29

The epidemiological aspects include epidemiology, and epidemiological investigations.

89.6% of dentists showed concerns about the future of dentistry. This increased number is thus an alarming situation for the dentists.

Meng et al summed up that provision of emergency dental procedures along with using advanced PPE is found to prevent the spread of COVID-19 infection. Although maintaining a balance between the provision of dental care and COVID-19 infection control is required.30

Ugo et al expressed that during the current pandemic, either complete closure of dental clinics or only restricted dental practice was observed following standard operating procedures (SOPs) strictly. The dental practice has been compromised severely due to this pandemic.

Albeit guidelines for dental practice during the pandemic have been regulated throughout the world, and financial constraints had been observed among dentists from various regions of the world. These include America, China, Saudi Arabia, the United Kingdom, and Spain. It has been concluded that governments should address ways to overcome this issue by making changes in the policies.18 Another study explained that during this pandemic, guidelines issued by CDC and WHO need to be followed.26

Themes and sub-themes formed by concluding this scoping review are given in Table 1. The summary of the included studies is mentioned in Table 2.

Table 1 Themes and Sub- Themes

Table 2 Summary of Studies Included in the Scoping Review

In this study, we reviewed the impact of COVID-19 on the dental practice of oral health-care workers (OHCWs), and how it has affected their psychological health. The majority of OHCWs showed greater concern regarding the risk of being infected, as they are most exposed to the infection. Similar findings were found in a study conducted in Singapore during the SARS outbreak.31 Same results were also found while considering long-term psychological and occupational effects on HCWs those provided hospital health care during the SARS outbreak in Toronto, Canada during SARS outbreak.32

In this study, Arora et al26 concluded that about 80.8% of the participants had fair knowledge (4070%) about the disease. In contrast to this, Kamate et al showed a higher percentage of respondents (92.7%) with fair knowledge among females and post-graduate residents. This difference of knowledge might have appeared due to the choice of areas where the studies have been conducted; since the former study is of developing country India, and the latter is of developed countries like America and Australia.33 This study varied from the other one conducted by Putrino et al in which males dentist were found to be more aware of this disease than females.34 However, it showed similar results to the study conducted by Quadri et al in which specialists showed higher levels of knowledge than the graduates.35 In the current study, OHCWs did not suggest quarantine in the absence of symptoms, which is contrary to the study of the SARS outbreak in 2002 where people were asked to quarantine even if they were asymptomatic.36

Overall, the dental community was found to be endangered to practice in the current situation, which might be an influence of vast media coverage, lack of technical equipment and shortage of personal protective equipment (PPE), extended working hours, and many other reasons.37,38 Moreover, in this study, it was concluded that dental staff exhibited greater psychological stress problems amid this pandemic because of greater exposure to risk. This finding is relevant to the study that showed unwillingness by dentists to treat patients diagnosed with some infectious diseases like HIV39,40 and tuberculosis.41

Regarding self-efficacy, higher self-efficacy reflects lower psychological distress levels. Self-efficacy plays the most important role since improved self-efficacy levels can enhance personal performance in different tasks and other related behaviours.42 While considering the stress levels with dental staff with some other comorbidities, they were found to exhibit greater psychological distress possibly because they were going through the distress caused by already existing comorbidities.43 Albeit dentists showed concerns regarding the future of dentistry, only a few among the dental population looked to change their profession and the majority continued with dental practice amid this pandemic. This finding was found to be consistent with the findings of other studies carried out in Singapore and the USA during the SARS and influenza outbreak, where HCWs continued to practice their profession.31,44 However, in contrast to these findings, HCWs were unwilling to work during infection outbreaks in Taiwan, Hong Kong, and the UK. They preferred other jobs over working in health-care settings.4547

This pandemic had severe adverse effects on dental practice. Partial to complete closure of the dental clinics/hospitals has been implemented due to the COVID-19 pandemic, which has led to major economic setbacks to the dentists.48 Only a small proportion (12.6%) of OHCWs had attended sessions in their institutions, which in comparison to the study in Singapore is much lower (88%) during the SARS outbreak. This is the need of the hour that OHCWs should get proper training sessions to cater to this current pandemic situation.29,49 This pandemic has been a major setback for dental students too. Dental education has been affected adversely during this time since dental practice plays a major role in learning dentistry, which cannot be achieved by online learning.50

Focus on the provision of preventive dental care with minimal aerosol production procedures is required to be practised. Check on patients who have had dental treatment from the dental clinics should be kept under observation to check if they get the infection due to treatment. Advanced teledentistry should be made practical during this pandemic.5154 Many countries including Pakistan have recommended guidelines for dental practice during COVID-19 which needs to be implemented on the ground to stop the spread of this pandemic. This study highlights the importance of precautionary measures required to be taken by the OHCWs amid COVID-19 since the world has hit the third wave of this infectious disease. Focusing on the mental health of OHCWs in the current situation is the need of the hour. This would be beneficial to cope with the future challenges faced during implications regarding training sessions on infection control for the dentists and dental staff.5557 The imitations of this study were, since this is a new virus, more research is required to be done to see its impact and due to limited access to the search engines, a restricted number of studies could be accessed.

Overall, this study shed light on the psychological effects on OHCWs amid the COVID-19 pandemic, and how this pandemic has affected their lives. Our results show that OHCWs are fully aware with knowledge regarding COVID-19 and showed concerns for dentistry and dental health-care workers during this pandemic. Complete or partial closure of dental clinics has had adverse effects on the future of dentistry, economically as well as psychologically. Institutions need to upgrade their strengthening systems to cater to any such situation efficiently. Focus from diagnosis and treatment needs to be shifted towards preventive oral care to reduce the burden of outpatient departments. All the oral health-care workers/providers should be readily vaccinated following all the standard operating procedures to minimize the chance of cross-infection. Along with these, proper counselling sessions should be conducted for the OHCWs to monitor, identify and treat the cases found. However, policy and decision-makers need to make policy in this regard followed by its implementation.

The authors report no conflicts of interest in this work.

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Last Christmas, as the Omicron variant was ricocheting around the United States, Mary Carrington unknowingly found herself at a superspreader eventan indoor party, packed with more than 20 people, at least one of whom ended up transmitting the virus to most of the gatherings guests.

After two years of avoiding the coronavirus, Carrington felt sure that her time had come: Shed been holding her great-niece, who tested positive soon after, and she was giving me kisses, Carrington told me. But she never caught the bug. And I just thought, Wow, I might really be resistant here. She wasnt thinking about immunity, which she had thanks to multiple doses of a COVID vaccine. Rather, perhaps via some inborn genetic quirk, her cells had found a way to naturally repel the pathogens assaults instead.

Carrington, of all people, understood what that would mean. An expert in immunogenetics at the National Cancer Institute, she was one of several scientists who, beginning in the 1990s, helped uncover a mutation that makes it impossible for most strains of HIV to enter human cells, rendering certain people essentially impervious to the pathogens effects. Maybe something analogous could be safeguarding some rare individuals from SARS-CoV-2 as well.

Read: America is running out of COVID virgins

The idea of coronaviral resistance is beguiling enough that scientists around the world are now scouring peoples genomes for any hint that it exists. If it does, they could use that knowledge to understand whom the virus most affects, or leverage it to develop better COVID-taming drugs. For individuals who have yet to catch the contagiona fast-dwindling proportion of the populationresistance dangles like a superpower that people cant help but think they must have, says Paula Cannon, a geneticist and virologist at the University of Southern California.

As with any superpower, though, bona fide resistance to SARS-CoV-2 infection would likely be very rare, says Helen Su, an immunologist at the National Institutes of Allergy and Infectious Disease. Carringtons original hunch, for one, eventually proved wrong: She recently returned from a trip to Switzerland and found herself entwined with the virus at last. Like most people who remained unscathed until recently, Carrington had done so for two and a half years through a probable combination of vaccination, cautious behavior, socioeconomic privilege, and luck. Its entirely possible that inborn coronavirus resistance may not even existor that it may come with such enormous costs that its not worth the protection it theoretically affords.

Of the 1,400 or so viruses, bacteria, parasites, and fungi known to cause disease in humans, Jean-Laurent Casanova, a geneticist and an immunologist at Rockefeller University, is certain of only three that can be shut out by bodies with one-off genetic tweaks: HIV, norovirus, and a malaria parasite.

The HIV-blocking mutation is maybe the most famous. About three decades ago, researchers, Carrington among them, began looking into a small number of people who we felt almost certainly had been exposed to the virus multiple times, and almost certainly should have been infected, and yet had not, she told me. Their superpower was simple: They lacked functional copies of a gene called CCR5, which builds a cell-surface protein that HIV needs in order to hack its way into T cells, the viruss preferred human prey. Just 1 percent of people of European descent harbor this mutation, called CCR5-32, in two copies; in other populations, the trait is rarer still. Even so, researchers have leveraged its discovery to cook up a powerful class of antiretroviral drugs, and purged the virus from two people with the help of 32-based bone-marrow transplantsthe closest that medicine has come to developing a functional HIV cure.

The stories with those two other pathogens are similar. Genetic errors in a gene called FUT2, which pastes sugars onto the outsides of gut cells, can render people resistant to norovirus; a genomic tweak erases a protein called Duffy from the walls of red blood cells, stopping Plasmodium vivax, one of several parasites that causes malaria, from wresting its way inside. The Duffy mutation, which affects a gene called DARC/ACKR1, is so common in parts of sub-Saharan Africa that those regions have driven rates of P. vivax infection way down.

In recent years, as genetic technologies have advanced, researchers have begun to investigate a handful of other infection-resistance mutations against other pathogens, among them hepatitis B virus and rotavirus. But the links are tough to definitively nail down, thanks to the number of people these sorts of studies must enroll, and to the thorniness of defining and detecting infection at all; the case with SARS-CoV-2 will likely be the same. For months, Casanova and a global team of collaborators have been in contact with thousands of people from around the world who believe they harbor resistance to the coronavirus in their genes. The best candidates have had intense exposures to the virussay, via a symptomatic person in their homeand continuously tested negative for both the pathogen and immune responses to it. But respiratory transmission is often muddied by pure chance; the coronavirus can infiltrate people silently, and doesnt always leave antibodies behind. (The team will be testing for less fickle T-cell responses as well.) People without clear-cut symptoms may not test at all, or may not test properly. And all on its own, the immune system can guard people against infection, especially in the period shortly after vaccination or illness. With HIV, a virus that causes chronic infections, lacks a vaccine, and spreads through clear-cut routes in concentrated social networks, it was easier to identify those individuals whom the virus had visited but not put down permanent roots within, says Ravindra Gupta, a virologist at the University of Cambridge. SARS-CoV-2 wont afford science the same ease of study.

Read: Is BA.5 the reinfection wave?

A full analogue to the HIV, malaria, and norovirus stories may not be possible. Genuine resistance can manifest in only so many ways, and tends to be born out of mutations that block a pathogens ability to force its way into a cell, or xerox itself once its inside. CCR5, Duffy, and the sugars dropped by FUT2, for instance, all act as microbial landing pads; mutations rob the bugs of those perches. If an equivalent mutation exists to counteract SARS-CoV-2, it might logically be found in, say, ACE2, the receptor that the coronavirus needs in order to break into cells, or TMPRSS2, a scissors-like protein that, for at least some variants, speeds the invasive process along. Already, researchers have found that certain genetic variations can dial down ACE2s presence on cells, or pump out junkier versions of TMPRSS2hints that there could be tweaks that further strip away the molecules. But ACE2 is very important to blood-pressure regulation and the maintenance of lung-tissue health, said Su, of NIAID, whos one of many scientists collaborating with Casanova to find SARS-CoV-2 resistance genes. A mutation that keeps the coronavirus out might very well muck around with other aspects of a persons physiology. That could make the genetic tweak vanishingly rare, debilitating, or even, as Gupta put it, not compatible with life. People with the CCR5-32 mutation, which halts HIV, are basically completely normal, Cannon told me, which means HIV kind of messed up in choosing CCR5. The coronavirus, by contrast, has figured out how to exploit something vital to its hostan ingenious invasive move.

The superpowers of genetic resistance can have other forms of kryptonite. A few strains of HIV have figured out a way to skirt around CCR5, and glom on to another molecule, called CXCR4; against this version of the virus, even people with the 32 mutation are not safe. A similar situation has arisen with Plasmodium vivax, which we do see in some Duffy-negative individuals, suggesting that the parasite has found a back door, says Dyann Wirth, a malaria researcher at Harvards School of Public Health. Evolution is a powerful strategyand with SARS-CoV-2 spewing out variants at such a blistering clip, I wouldnt necessarily expect resistance to be a checkmate move, Cannon told me. BA.1, for instance, conjured mutations that made it less dependent on TMPRSS2 than Delta was.

Read: The BA.5 wave is what COVID normal looks like

Still, protection doesnt have to be all or nothing to be a perk. Partial genetic resistance, too, can reshape someones course of disease. With HIV, researchers have pinpointed changes in groups of so-called HLA genes that, through their impact on assassin-like T cells, can ratchet down peoples risk of progressing to AIDS. And a whole menagerie of mutations that affect red-blood-cell function can mostly keep malaria-causing parasites at baythough many of these changes come with a huge human cost, Wirth told me, saddling people with serious clotting disorders that can sometimes turn lethal themselves.

With COVID-19, too, researchers have started to home in on some trends. Casanova, at Rockefeller, is one of several scientists who has led efforts unveiling the importance of an alarm-like immune molecule called interferon in early control of infection. People who rapidly pump out gobs of the protein in the hours after infection often fare just fine against the virus. But those whose interferon responses are weak or laggy are more prone to getting seriously sick; the same goes for people whose bodies manufacture maladaptive antibodies that attack interferon as it passes messages between cells. Other factors could toggle the risk of severe disease up or down as well: cells ability to sense the virus early on; the amount of coordination between different branches of defense; the brakes the immune system puts on itself, so it does not put the hosts own tissues at risk. Casanova and his colleagues are also on the hunt for mutations that might alter peoples risk of developing long COVID and other coronaviral consequences. None of these searches will be easy. But they should be at least simpler than the one for resistance to infection, Casanova told me, because the outcomes theyre measuringserious and chronic forms of diseaseare that much more straightforward to detect.

If resistance doesnt pan out, that doesnt have to be a letdown. People dont need total blockades to triumph over microbesjust a defense thats good enough. And the protection were born with isnt all the leverage weve got. Unlike genetics, immunity can be easily built, modified, and strengthened over time, particularly with the aid of vaccines. Those DIY defenses are probably what kept Carringtons case of COVID down to a mild course, she told me. Immune protection is also a far surer bet than putting a wager on what we may or may not inherit at birth. Better to count on the protections we know we can cook up ourselves, now that the coronavirus is clearly with us for good.

The House passed a bill on Tuesday to allow a government agency to award grants into the cognitive effects of COVID-19.

The legislation, titled the Brycen Gray and Ben Price COVID-19 Cognitive Research Act, passed in a 350-69 vote, with all opposition coming from Republicans. Eight Republicans and four Democrats did not vote.

The measure calls on the director of the National Science Foundation to award grants to eligible entities including higher education institutions or other groups made up of universities and nonprofit organizations to assist them in researching the disruption of regular cognitive processes associated with both short-term and long-term COVID-19 infections.

Research eligible under the bill includes studies on the effects COVID-19 infections have on cog4 nition, emotion, and neural structure and function as well as the influence coronavirus-related psychological and psychosocial factors have on the disruption of cognitive processes.

The grants should be awarded on a competitive, merit-reviewed basis, according to the bill.

In a statement announcing the bill in October, Rep. Anthony Gonzalez (R-Ohio), a co-sponsor of the measure, cited research from The Lancet Psychiatry that says roughly 1 in 3 patients diagnosed with COVID-19 received a neurological or psychiatric diagnosis in the six months after their positive test.

The legislation is named after Brycen Gray, 17, and Ben Price, 48, both of whom died by suicide after experiencing mental health issues following their bouts with COVID-19.

During debate on the House floor Tuesday, Gonzalez spoke about Gray and Price, saying the two tragically passed after battles with cognitive impairments caused by COVID-19.

Despite having no history of mental illness, each of them began to battle symptoms such as anxiety, panic and paranoia. The disease took Brycen and Ben from two of the healthiest, most vibrant people you could find to individuals so debilitated that they could not bear to live another day. While they fought to the bitter end, each chose to end their pain, he added.

The Ohio Republican said the bill would help learn why COVID-19 has an impact on the brain.

If we believe in protecting our families, we need to act now and start finding answers to why COVID-19 can have such a significant impact on the brain. The legislation before us today is another important step in that effort, he said.

Rep. Don Beyer (D-Va.) said researchers are raising alarms about the risk of mental health issues and suicide following COVID-19 diagnoses, adding that improved data collection and additional research is needed to better understand the mental health implications of COVID-19 infection.

Republican no votes included Reps. Rick Allen (Ga.), Jodey Arrington (Texas), Jim Banks (Ind.), Jack Bergman (Mich.), Andy Biggs (Ariz.), Dan Bishop (N.C.), Lauren Boebert (Colo.), Mo Brooks (Ala.), Ken Buck (Colo.), Tim Burchett (Tenn.), Michael Burgess (Texas), Kat Cammack (Fla.), Madison Cawthorn (N.C.), Ben Cline (Va.), Michael Cloud (Texas), Andrew Clyde (Ga.), James Comer (Ky.), Warren Davidson (Ohio), Scott DesJarlais (Tenn.), Byron Donalds (Fla.), Ron Estes (Kan.), Pat Fallon (Texas), Scott Fitzgerald (Wisc.), Virginia Foxx (N.C.), Russ Fulcher (Idaho), Matt Gaetz (Fla.), Louie Gohmert (Texas), Bob Good (Va.), Lance Gooden (Texas), Paul Gosar (Ariz.), Mark Green (Tenn.), Marjorie Taylor Greene (Ga.), Morgan Griffith (Va.), Glenn Grothman (Wisc.), Andy Harris (Md.), Diana Harshbarger (Tenn.), Kevin Hern (Okla.), Yvette Herrell (N.M.), Jody Hice (Ga.), Clay Higgins (La.), Ashley Hinson (Iowa), Darrell Issa (Calif.), Ronny Jackson (Texas), Mike Johnson (La.), Jim Jordan (Ohio), John Joyce (Pa.), Debbie Lesko (Ariz.), Barry Loudermilk (Ga.), Nicole Malliotakis (N.Y.), Tracey Mann (Kan.), Thomas Massie (Ky.), Brian Mast (Fla.), Tom McClintock (Calif.), Dan Meuser (Pa.), Marry Miller (Ill.), Barry Moore (Ala.), Troy Nehls (Texas), Ralph Norman (S.C.), Greg Pence (Ind.), Scott Perry (Pa.), August Pfluger (Texas), Chip Roy (Texas), David Schweikert (Ariz.), Mike Simpson (Idaho), Van Taylor (Texas), Claudia Tenney (N.Y.), Tom Tiffany (Wisc.), Jeff Van Drew (N.J.) and Beth Van Duyne (Texas).

The world has experienced a slew of surges caused by an alphabet of variants since the onset of the COVID-19 pandemic in March 2020. Thankfully, none of the variants has led to a significant increase in disease severity.

Becker's spoke to Jonathan Abraham, MD, PhD, an infectious diseases physician at Boston-based Brigham & Women's Hospital, to learn more about why the SARS-CoV-2 virus's evolution hasn't led to significant changes in disease severity from the ancestral strain, and what are the chances that it eventually mutates to cause severe illness.

"It's something that even as a scientific community, we don't understand yet," Dr. Abraham said. He is an assistant professor of microbiology at Harvard Medical School and runs the Abraham Lab, which studies how pathogens interact with the cells of their hosts.

Two questions that remain:

When will immunity significantly wane?

While each new variant appears to be better at infecting vaccinated people than the last, vaccines have still largely protected against severe illness from each of them.

The question of whether the SARS-CoV-2 virus could eventually evolve to cause more severe illness then depends, at least in part, on the level of immunity a population has.

"Overtime, we've seen this virus mutate and mutate, but the question is still when will the immunity we have either from vaccines or from prior exposure [wane,] and by then, will the virus have disappeared or will it have continued to mutate?" said Dr. Abraham.

If the virus continues to mutate over time and the population's immunity wanes significantly, more severe disease is a possibility, "but the question is really hard to separate from one of the infected host, which has some degree of immunity," he said.

In a vaccine-less world where there were no levels of immunity and a mutating virus, variants like omicron would likely cause severe illness. But in a world where most people have been vaccinated or previously infected, that's not the case.

Could the virus evolve to evade T-cell responses?

Even with the virus able to evade antibodies, there is evidence that T-cells a separate arm of the immune system's response play a role in maintaining immunity from COVID-19.

In someone with prior immunity from vaccination, infection or both, "I think most would believe T-cells probably account for why disease severity is not as significant when someone gets infected now," Dr. Abraham said.

"T-cells are really the work horses that may be protecting us from getting sicker," he said, but if the virus mutates in a way that allows it to evade both antibody and T-cell responses, that may be a recipe for more severe disease.

Some research has shown people who have COVID-19 generate T-cells that target at least 15 to 20 different fragments of SARS-CoV-2 virus' protein, according to a Nature report. The targeted protein fragments can vary widely among different people, meaning a population could generate a broad variety of T-cells against the virus.

"That makes it very hard for the virus to escape cell recognition," Dr. Alessandro Sette at the La Jolla Institute for Immunology in California, told the news outlet, adding its "unlike the situation for antibodies."

Good evening. Im Karen Kaplan, and its Tuesday, July 26. Heres the latest on whats happening with the coronavirus in California and beyond.

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Were still in a pandemic. The number of coronavirus infections is high and rising. But something fundamental about COVID-19 has changed: It isnt as scary anymore.

Over the last week, the U.S. has averaged a whopping 120,000 new cases per day. (And those are just the ones reported to authorities; the true number is even higher.)

Contrast that to the early weeks of the outbreak, when society all but shut down in an effort to steer clear of the virus and bend the curve. All it took to get our attention back then was fewer than 30,000 cases per day.

They say familiarity breeds contempt, but in this case its having the opposite effect. The more time we spend with the coronavirus, the less we seem to worry about it.

Indeed, infections are now so commonplace that the fear of the unknown is fading, said Dr. Peter Chin-Hong, an infectious diseases expert at UC San Francisco.

You get it yourself and know tons of people who got it, and you fear it less, he said.

That explains why face masks were few and far between among the shoppers packed into the air-conditioned Westfield Valencia Town Center in Santa Clarita on a recent hot summer day, my colleagues Rebecca Schneid, Heidi Prez-Moreno and Hailey Brandon-Potts report.

People are just exasperated and over it, said Hailey Jimenez, 21, who was mask-free during a recent shift tending a jewelry kiosk there. I know Im over it.

Nicki Spravka knows the feeling. The 20-year-old moved from store to store without a mask or much angst.

I go to school in Colorado, and basically for the past year people have been acting like it doesnt exist anymore, she said of the virus. I mean, I guess I care. But it feels like what we do isnt really going to affect it because infections are still going to happen.

People, with and without masks, shop in L.A.'s Santee Alley in mid-July.

(Irfan Khan / Los Angeles Times)

This attitude is not unique to California or the West. The Pew Research Centers most recent survey about Americans attitudes about the pandemic found that only 41% considered the coronavirus a major threat to public health. Thats the lowest figure Pew has ever recorded. (An additional 45% considered the virus a minor threat and 13% called it not a threat.)

Likewise, only 34% of respondents were either somewhat or very concerned that the virus would land them in the hospital, and 50% were somewhat or very concerned that theyd spread an infection to someone else. Those figures also represent all-time lows for the pandemic.

Nationwide, daily COVID-19 deaths have averaged around 365 over the last week. The count hasnt been that low for a year, since the lull before the Delta surge. The only other time it has been lower was the initial weeks of the outbreak. So perhaps there is less reason to fear the coronavirus.

If your metric is infections, it looks hopeless, Chin-Hong said. But if your metric is people getting seriously ill and dying wow, thats a huge victory.

For the most part, the public is focused on the latter metric. But the health establishment is mostly focused on the former, especially the speed with which new variants are emerging and the possibility that one of them will be impervious to our vaccines and treatments, effectively sending us back to square one.

That helps explain why Los Angeles County is probably on the verge of reinstating an indoor mask mandate. Unless conditions substantially improve in the next couple of days, the county is likely to learn Thursday that it is entering its third consecutive week with a high COVID-19 community level because it has more 200 new infections and more than 10 new COVID-19 hospital admissions per 100,000 people over the last seven days. (As of last Thursday, there were 481 new infections and 11.4 new hospital admissions per 100,000 people per week.)

Bringing those numbers down is necessary to protect the vulnerable among us, such as the elderly and people who are immunocompromised, said Dr. Robert Kim-Farley, an epidemiologist and infectious diseases expert at UCLA.

What we need to do is have a mindset, or social norm, that we are going to expect somewhat of a roller-coaster ride as new variants arise and sweep through the population, he said. We can go back to more business as usual, but when rates are high, we should all do our part in reducing transmission.

Julisa Carrillo hopes people hear that message. She was hospitalized because of COVID-19 twice before the vaccines became available. Both of those hospitalizations included time on a ventilator.

More than a year and a half later, her lungs still dont feel the same. In her view, wearing a mask feels like a reasonable trade-off to help people avoid that same fate.

This is a virus that is hurting so many people, she said as she waited for a bus in Huntington Park. I myself dont feel safe.

California cases and deaths as of 6:30 p.m. Tuesday:

Track Californias coronavirus spread and vaccination efforts including the latest numbers and how they break down with our graphics.

The coronavirus can come for anyone, even the leader of the free world. Then-President Trumps illness in 2020 may have seemed like a bit of bad luck though if were being honest, his White House wasnt being particularly careful but current President Bidens diagnosis confirms that even those who take abundant precautions are vulnerable.

But its not all bad news for Biden. Catching the coronavirus in the summer of 2022 is not at all like catching it in the fall of 2020, my colleague Melissa Healy reports. Unlike Trump, Biden is benefiting from a full 2 years of scientific and medical advances against the once-novel virus. Plus, the virus itself has changed in ways that make it harder to evade but easier to survive.

Biden said Monday that hes feeling better every day. His schedule is lighter than it would have been while hes isolating at the White House, but Im meeting all my requirements that have come before me, he said.

Heres a look at the many advantages for Biden and the roughly 850,000 other Americans who caught the virus in the last week that werent available to Trump:

VACCINES: When Trump was diagnosed in early October 2020, the first COVID-19 vaccine from Pfizer and BioNTech was more than two months away from being authorized for emergency use by the Food and Drug Administration.

By the time Biden was diagnosed, he had received two primary doses of the companies Comirnaty vaccine, plus two booster doses. His most recent shot was on March 30. A letter from Dr. Kevin C. OConnor, the White House physician, described him as maximally protected.

Im doing well, getting a lot of work done, he said in a video. (Hes following Dr. Anthony Faucis lead and trying to power through instead of taking the time to rest and recover.)

Biden himself credited his four shots for his mild illness. His symptoms included a runny nose, cough, sore throat and some body aches.

Data from the Centers for Disease Control and Prevention back him up. Among Americans 65 and older, those who are unvaccinated are 3.8 times more likely to wind up hospitalized with COVID-19 than those who have been vaccinated and boosted at least once.

Whats more, people in Bidens age group 65 to 79 who are unvaccinated are nearly 9 times more likely to die of COVID-19 than their counterparts who are vaccinated and boosted. The second booster is important: The risk of death for Americans 50 and older who received it was four times lower than for their peers who stopped at one booster.

President Biden receives his first booster dose of Pfizer and BioNTechs COVID-19 vaccine on Sept. 27, 2021.

(Anna Moneymaker / Getty Images)

TREATMENTS: By the time Bidens illness was announced, he had already begun a course of Paxlovid. In clinical trials, patients at high risk of becoming severely ill were 88% less likely to be hospitalized or die if they took the antiviral (which is administered in pill form over five days). Biden falls into the high risk category because of his age (hell turn 80 in November).

Paxlovid received emergency use authorization in December, more than a year after Trumps bout with COVID-19. After initial shortages, it is now available at test to treat sites around the country, and as of this month, pharmacists have clearance to prescribe it to patients.

Should Biden take a turn for the worse and develop symptoms such as low oxygen levels, blood clots or problems with his heart or kidney function, there are plenty of other tools available to his doctors.

Remdesivir, which was given to Trump, would be available as a backstop, said Dr. Roy M. Gulick, who co-chaired the National Institutes of Healths panel on COVID-19 treatment guidelines. Today, physicians could also turn to one or more of the specialized drugs that calm an overactive immune system; although these were developed to treat other diseases, theyve been found to help those with COVID-19 as well.

Doctors have refined a variety of treatments while tending to Americas 90-million-plus patients over the course of the pandemic, Gulick said. For instance, theyre quicker to prescribe blood thinners for hospitalized patients to reduce the risk of blood clots. Theyve streamlined their use of steroids. Theyre more cautious about putting patients with breathing difficulties on ventilators, since they have the potential to do more harm than good. Theyve also figured out how to position patients with obesity to help keep their airways clear.

So much has changed since Trump got COVID, Gulick said. We have made substantive progress in treating people with severe COVID who are admitted to hospital, and fewer are dying as a result.

THE VIRUS ITSELF: We may lament the seemingly endless parade of variants and subvariants. But if you had to be infected with the SARS-CoV-2 coronavirus, youd rather have a version of Omicron than the original strain from Wuhan, China.

Trump fell ill before the emergence of the Alpha variant in the U.K., so its a safe bet that he was sickened by a virus that closely resembled the one that left China in late 2019. Virtually all of the SARS-CoV-2 coronaviruses circulating in the U.S. today are some version of Omicron, with the BA.5 subvariant alone accounting for an estimated 82% of specimens, according the CDC, and OConnor said thats probably the strain that got Biden.

For most of the pandemic, the COVID-19 death rate among those infected stood at about 2% of reported cases. But that figure dropped significantly after Omicron arrived, according to Beth Blauer, an associate vice provost at Johns Hopkins University. Now, fewer than 0.5% of reported infections results in death.

Population immunity from vaccines and past infections may help explain that progress, she wrote, but the data trends clearly demonstrate that Omicron is a much less deadly variant.

See the latest on Californias vaccination progress with our tracker.

Through parts of June, Los Angeles County and the San Francisco Bay Area had similar COVID-19 mortality rates. Then July came along, and deaths rose in L.A. but that increase was not matched up north.

As of Monday, the Bay Area had 56 deaths per 10 million residents over the last week. L.A. County, meanwhile, recorded 96 deaths per 10 million residents in the same period, a figure that was 70% higher.

Its not clear why deaths went up here but not there. L.A. has a higher poverty rate and more overcrowded housing. That means if one member of a household is infected, the number of people at risk of exposure is greater. Vaccination rates are also lower here than they are up north. According to The Times tracker, 73.7% of L.A. County residents are fully vaccinated; that percentage is lower than in all but one Bay Area county (Solano).

There are hints that L.A.'s death toll may begin to fall soon. The official count of new infections here has begun to decline, as has the number of infected patients in the countys hospitals. Last Wednesday, that number stood at 1,329; by Friday, it was down to 1,200, before rising somewhat to 1,286 on Monday.

As for coronavirus cases, the county was averaging about 6,100 infections per day over the week that ended Monday. During the previous week, the average number of daily infections was nearly 6,900.

Those improved trend lines are fueling hope that L.A. County Public Health Director Barbara Ferrer might not implement an indoor mask mandate later this week even if the county still has a high COVID-19 community level.

Should we see sustained decreases in cases, or the rate of hospital admissions moves closer to the threshold for medium, we will pause implementation of universal indoor masking as we closely monitor our transmission rates, Ferrer said. No decision will be made until after the CDC updates its community-level assessments on Thursday.

Officials in Beverly Hills would be happy to see the county demur on a mask mandate. The City Council voted unanimously Monday night not to enforce an indoor mask rule, should one materialize.

I support the power of choice, Mayor Lili Bosse said in a statement. This is a united City Council and community that cares about health. We are not where we were in 2020, and now we need to move forward as a community and be part of the solution.

Restaurants and bars, on the other hand, are already bracing for the stink eye they expect to get from customers if they have to go back to enforcing an indoor mask mandate. The job will be even more difficult this time around because the BA.5 subvariant has forced eating and drinking establishments to operate with skeletal staffing.

Im fearful and Im nervous and theres a lot of anxiety behind it, said Robert Fleming, who opened the Capri Club bar in Eagle Rock in June.

Plenty of other employers are dealing with COVID-induced staffing shortages too. Notable among them is the Transportation Security Administration.

The L.A. County health department says at least 233 cases have been confirmed among TSA workers at Los Angeles International Airport since June 9. The federal agency acknowledged an outbreak at LAX but said the figures released by the county overstated the current state of infections.

President Biden wasnt the only politico to catch the coronavirus in the last week. Democratic Sen. Joe Manchin III of West Virginia tweeted Monday that he tested positive for an infection and was experiencing mild COVID-19 symptoms. His Republican colleague Sen. Lisa Murkowski of Alaska tweeted similar news Monday and said she was experiencing flu symptoms.

On the research front, a study from USC has identified some new potential risk factors for developing long COVID. Like previous studies, the analysis found that patients who had obesity prior to their illnesses were more likely to have the lingering symptoms associated with long COVID. The USC team also found that patients who had sore throats, headaches and hair loss after becoming infected with the coronavirus were more likely to have long COVID.

The researchers dont think hair loss itself causes long COVID. Rather, they suspect that hair loss reflects extreme stress, potentially a reaction to a high fever or medications, said Eileen Crimmins, a demographer at USCs Leonard Davis School of Gerontology who worked on the study that appeared in Scientific Reports. So its probably some indication of how severe the illness was.

Separately, a pair of studies by an international team of experts used different analytical approaches to home in on the epicenter of the pandemic that has killed more than 6.4 million people around the world. Both methods point to the same conclusion: The coronavirus probably jumped from animals to humans at the Huanan Wholesale Seafood Market in Wuhan, China. In fact, it probably happened at least twice.

Several researchers who worked on the new papers had been open to the possibility that the virus had escaped from a Wuhan lab. But sleuthing over the last year or so has convinced them that the market is a far more plausible culprit.

In a city covering more than 3,000 square miles, the area with the highest probability of containing the home of someone who had one of the earliest COVID-19 cases in the world was an area of a few city blocks, with the Huanan market smack dab inside it, said one of those researchers, University of Arizona virologist Michael Worobey.

And finally, it looks as though there are no countries left that have more than 100,000 people but are still coronavirus-free. The island nation of Micronesia (population 115,000) appears to have been the last to fall and its outbreak is a doozy. It began last week and has already spread to at least 1,261 people. Eight people have been hospitalized with COVID-19, and one has died.

Turkmenistan is now the only remaining country with a population of at least 100,000 and no official coronavirus cases. Outside experts believe, however, that the virus is there and the countrys autocratic leaders are simply ignoring it.

Todays question comes from readers who want to know: Should I let the county health department know that I got a positive result on a rapid test?

If you live in L.A. County, you dont have to.

That said, there are some calls you should make. If you have a regular healthcare provider, let them know that youve tested positive.

You should also inform your recent close contacts so they can be tested. A close contact is someone whos been within 6 feet of you for a total of 15 minutes over a 24-hour period. Anyone who fits that bill in the two days leading up to your first COVID-19 symptoms or your positive test result (whichever came first) deserves to hear from you.

If you need help tracking down your close contacts, you actually do have a good reason to call the L.A. County Department of Public Health. The department has set up a hotline to assist residents with issues like these. The folks there can also answer questions you may have and can help you get a prescription for an antiviral medication, if warranted. The number for the hotline is (833) 540-0473.

The county health department is keeping track of the positive home test results they hear about. But a spokeswoman told my colleagues Jon Healey and Karen Garcia that department officials dont need you to tell them that youve tested positive and they definitely dont want you to tell them if youve tested negative.

Its not just that health officials are too busy to take your call. Its that they cant gauge the reliability of the home test you (and everyone else) used, or whether you (and everyone else) used it correctly. Thats why they tally only the results of tests performed in a laboratory.

L.A. County is hardly alone in this regard even the CDC takes this approach.

We want to hear from you. Email us your coronavirus questions, and well do our best to answer them. Wondering if your questions already been answered? Check out our archive here.

(Mariah Tauger / Los Angeles Times)

The hands in the photo above belong to chef Genet Agonafer. Shes the proprietor of Meals by Genet, the bistro in L.A.'s Little Ethiopia that helped make the berbere-centered flavors of her native country one of the important pieces of the mosaic that defines Los Angeles cuisine, as my colleague Laurie Ochoa writes.

Ochoa selected Agonafer as The Times 2022 Gold Award honoree. The award is bestowed not just for excellent cooking but also for broadening our culinary horizons.

In light of this praise, you might expect Meals by Genet to have a packed dining room. But when restaurants were able to reopen their dining rooms, Agonafer decided to keep hers closed. (She makes occasional exceptions for weddings and other private parties.) She hadnt missed the stress of full-on restaurant work, but she didnt want to close down altogether. So she opted for a compromise, offering takeout dinners on Thursdays through Sundays.

Although the limited hours mean less money, Agonafer said its a worthy trade-off.

Everything is just peaceful and easygoing, she said. There is still that stress when the rush happens or when we have events here, but things are going so incredibly well.

Resources

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Practice social distancing using these tips, and wear a mask or two.

Watch for symptoms such as fever, cough, shortness of breath, chills, shaking with chills, muscle pain, headache, sore throat and loss of taste or smell. Heres what to look for and when.

Need to get a test? Testing in California is free, and you can find a site online or call (833) 422-4255.

Americans are hurting in various ways. We have advice for helping kids cope, as well as resources for people experiencing domestic abuse.

Weve answered hundreds of readers questions. Explore them in our archive here.

For our most up-to-date coverage, visit our homepage and our Health section, get our breaking news alerts, and follow us on Twitter and Instagram.

As highly infectious Omicron subvariants continue to fuel a new coronavirus wave, there is growing concern about long COVID, in which symptoms or increased risk of illness can persist for months or even years.

Efforts to understand the scale of long COVIDs effects have taken on additional urgency given the number of people who have come down with the virus since Omicron was first detected in California shortly after Thanksgiving. Some experts think this latest surge may exceed the record-high case counts seen over the fall and winter, leaving more people at risk of developing the condition.

Because of the sheer volume of people that were infected, we can expect to see more long COVID cases, said Dr. Anne Foster, vice president and chief clinical strategy officer for the University of California Health system.

For these long-haul sufferers, maladies such as a cough, chest pain, shortness of breath, heart palpitations and brain fog have marred their lives and sometimes made it impossible to work. The most enduring cases can trace their initial coronavirus infection as far back as 2020, from the beginning of the pandemic.

Vaccinations and boosters may help reduce the risk of long COVID, but at least one study suggests the protective effect could be relatively limited. Thats why, officials and experts say, it remains important to take reasonable steps to avoid infection.

Its hard to predict the prevalence of long COVID, given the lack of a uniform definition, its sweeping array of symptoms and no easy way to test for it. Different studies have placed the percentage of people reporting symptoms for 12 weeks after an initial infection at anywhere from 3% to 50%.

But there is agreement among a number of experts that its consequences can be significant, including an increase in the risk of death or problems with other organ systems including the heart long after an acute infection has cleared.

An estimated 1 in 13 adults nationwide, and 1 in 14 in California, had current long COVID symptoms in early July, according to data collected by the Census Bureau and analyzed by the U.S. Centers for Disease Control and Prevention. The condition in that study was defined as someone having symptoms lasting three months or longer that werent experienced prior to infection.

About 1 in 7 adults across the U.S., and 1 in 8 in California, reported ever having long COVID symptoms, the data showed. As of early June, adults in their 50s were three times as likely to report long COVID than those 80 or older.

Long COVID has resulted in a mass disabling event, Foster said.

The good news is that most long COVID will resolve, lets say, after a year. But theres going to be some smaller subset that will have lifelong disability and impact to their health, Foster added.

Among those is Hannah Davis, a co-founder of the Patient-Led Research Collaborative that focuses on long COVID.

Davis got COVID-19 in March 2020 and to this day has difficulty driving, reading and walking, and I still have not recovered, she told the U.S. House Select Subcommittee on the Coronavirus Crisis during a recent hearing.

Long COVID must be considered in every step of the COVID response, she said. It has already impacted our workforce. Many people with long COVID cant work or need reduced hours and struggle to apply for disability benefits. The financial impact is devastating and cannot be overstated.

The condition, she added, will disable a huge percentage of our society if we do not decrease new cases and prioritize a cure for existing ones.

A report published by the CDC in May estimated that 1 in 5 adults ages 18 to 64 who had COVID-19 suffered a health condition that might be related to the previous coronavirus infection. Problems can affect the lungs, heart, brain, kidneys, muscles and bones.

The more severe the acute infection, the more likely the risk of long COVID, said Dr. Steven Deeks, a professor of medicine at UC San Francisco and principal investigator of the Long-term Impact of Infection with Novel Coronavirus, or LIINC, study. But its not absolute, and people who are not particularly symptomatic and people who were even asymptomatic can go on to develop long COVID, no question about it.

Researchers are still trying to understand the cause of long COVID symptoms. Theories include that the coronavirus might cause tissue destruction during an acute infection, leading to longer-lasting illness; that the virus persists in the body even after someone is no longer infectious; that the virus revs up the bodys immune response, causing harmful inflammation; that infection triggers the development of antibodies that attack a persons tissues; or that infection leads to blood-clotting issues.

Its such a diverse condition that there probably are multiple different processes or causes for some of the different types of symptoms rather than one unifying disease process, said Dr. Lucy Horton, an infectious disease specialist at UC San Diego Health.

With the ability of the coronavirus officially called SARS-CoV-2 to get into the bloodstream, its thought that infection can provoke more inflammation, which can lead to further disease elsewhere in the body, said Dr. Ziyad Al-Aly, a clinical epidemiologist at Washington University in St. Louis and chief of research and development at the Veterans Affairs St. Louis Healthcare System.

The common thread here is that long COVID is real, Al-Aly said. People are getting diabetes and heart disease and kidney disease and its certainly the result of SARS-CoV-2, which can interact with other cells and lead to organ dysfunction.

Some factors that put patients at higher risk of long COVID include being overweight, high blood pressure or heart disease, said Dr. Nisha Viswanathan, director of the UCLA Health Long COVID Program. Women also appear to be at a relatively higher risk.

Often, underlying medical issues can become uncontrolled after a COVID-19 infection. But even those with no health problems still have some risk.

There are many patients with long COVID who are young and had no preexisting health conditions prior to being infected with COVID, Horton said. We know that children can develop long COVID. So I think anyone who says COVID only affects old, unhealthy people is just ignoring the truth, to be honest.

At UCLA, Viswanathan has an entire group of long COVID patients in their 20s who have no prior history of medical conditions and who werent terribly unwell when they had COVID, either.

Surprisingly, some now struggling most with fatigue are marathon runners, cyclists and others who, before they were initially infected, did quite a bit of cardio exercise, Viswanathan said.

Vaccinations and boosters are believed to be helpful at staving off long COVID, but there is no consensus on the degree to which they provide protection.

One report observing triple-vaccinated Italian healthcare workers who werent hospitalized for COVID-19 found that two or three doses of vaccine was associated with a lower prevalence of long COVID.

Another study, which Al-Aly co-authored and involved on U.S. veterans, found that being vaccinated brought only a 15% reduction in the odds of developing long COVID compared with unvaccinated people.

Other long COVID symptoms include worsening depression, anxiety and neuropathy, which causes pain in various parts of the body, according to Viswanathan. Patients can have isolated symptoms or a combination of any, and treatment plans need to be tailored accordingly, she said.

Symptoms also can include loss of smell or hair, ejaculation difficulty and reduced libido, according to a report published Monday in the journal Nature Medicine.

Some patients with professional degrees who had previously been high functioning are now struggling to work, Viswanathan said. Were talking about patients, who because of the brain fog, because of the fatigue, they either have really substantially decreased their work hours, or theyre completely on disability at this point.

She said most of her patients see some degree of improvement in symptoms, with some more dramatic than others. But it takes work to develop a plan theres no FDA-approved therapy for long COVID at this point, so treatment ideas include using whats known about other medical conditions.

For instance, those with persistent shortness of breath might undergo pulmonary rehabilitation, which is typically used for patients with asthma and chronic obstructive pulmonary disease. In some instances, physical therapy and acupuncture have helped patients with muscle pain.

And some have seen improvements by going on an anti-inflammatory diet with lower portions of refined carbohydrates and red meat which is otherwise suggested to reduce the risk of heart attacks and heart disease.

Sometimes, improving sleep quality helps. For some patients, its literally a matter of they just need to take time off for work ... time to rest, Viswanathan said, which gives the opportunity for their body to probably start focusing on healing itself.

In some cases, antidepressants (even when given to those who do not suffer from depression) can help clear brain fog, Viswanathan said, suggesting the condition may be caused by a hormonal imbalance in the brain. Other times, patients must learn how to live with brain fog, such as making lists, pacing themselves and letting others know of plans.

Some studies have shown how the coronavirus is effectively attacking your frontal part of your brain, Viswanathan said, and there have been autopsies of COVID-19 patients showing brain damage.

The thing with long COVID is we have no way of knowing what is now going to happen going forward. Will [our patients] brains heal with time? Will they not? Viswanathan asked.

There are other viral illnesses that produce a post-viral fatigue syndrome, such as infectious mononucleosis, often referred to as mono, which is more commonly caused by the Epstein-Barr virus. Most people usually feel better within weeks, but occasionally fatigue can persist for six months or a year.

While there are a number of different risk factors, the only surefire way to dodge long COVID is to avoid getting infected with the coronavirus.

Even though I think many people are kind of under a delusion that the pandemic is over, its not, Horton said. So I think its a good time to kind of go back to our basics that have protected us: masking when in crowded indoor settings, using rapid testing before visiting older vulnerable people or groups, and staying up to date on vaccinations.

Although it can be disconcerting that so many questions about long COVID remain, the uncertainty is not new as the virus and the science behind it have continued to evolve throughout the pandemic.

Every time we think weve got this virus figured out, it basically laughs at us, Deeks said. It moves on, it changes, and then we have new riddles to try and figure out. And thats the story of COVID for the last 2 years. As they say: The virus is not done with us yet.

Global COVID-19 (total) cases, deaths and vaccinations to date

Globally, the number of weekly cases has plateaued.

Numbers of new deaths slightly increased in the past week.

At the regional level, the number of weekly cases increased in the Western Pacific Region, the Region of the Americas and the South-East Asia Region, while it decreased in other regions.