The global excess mortality associated with COVID-19 was 14.91 million in the 24 months between 1 January 2020 and 31 December 2021, representing 9.49 million more deaths than those globally reported as directly attributable to COVID-19.
The impact of the pandemic has been over several waves with each characterized by unique regional distributions, mortality levels and drivers. Twenty countries, representing approximately 50% of the global population, account for over 80% of the estimatedglobal excess mortality for the January 2020 to December 2021 period. These countries are Brazil, Colombia, Egypt, Germany, India, Indonesia, the Islamic Republic of Iran, Italy, Mexico, Nigeria, Pakistan, Peru, the Philippines, Poland, the Russian Federation, South Africa, the United Kingdom of Great Britain and Northern Ireland, Turkey, Ukraine, and the United States of America (USA). We are able to observe the evolution of the pandemic over these 24 months as different regions and countries were impactedby and responded to the threat of COVID-19.
Providence Regional Medical Center in Everett, Wash., identified the United States first known COVID-19 patient on January 20, 2020, marking the onset of a health care crisis whose proportions would have been difficult to imagine at the time. Soon afterward, the health system also took on a pioneering role in treating COVID-19 patients with the antiviral drug remdesivir.
As of April 2022, the US has counted 81 million cases of coronavirus infection and almost 1 million deaths nearly a sixth of the worlds total lives lost to date and the pandemic has done no less than permanently alter the way health care organizations operate and practice medicine.
In a conversation with SmartBrief, Darren Redick, chief executive of the Providence Swedish North Puget Sound health system, offered some constructive hindsight on challenges the crisis has presented and solutions his organization found to address them.
SB: Looking back on the last two years, what has Providence learned about handling the high-stress and high-volume patient care demands of a pandemic? What processes and precautions did you already have in place before the COVID-19 crisis?
DR: As the hospital that admitted the first known COVID-19 patient in the United States, Providence Everett has been on the frontlines of the pandemic from the very beginning. We were uniquely prepared, however, and our Biocontainment, Evaluation, and Specialty Treatment (BEST) team had just run through a full drill two weeks prior to the first patient arriving, in which they practiced receiving and caring for an infectious disease patient. We have a special unit we can set up for infectious disease patients, and that unit was used for the first COVID patient. For years, we have done regular drills for that unit going back to when we were preparing for the possibility of an Ebola patient. Our drills include our community partners, such as the Health District, EMS, the Northwest Healthcare Response Network, and more. One reason the process for the initial patient went well is the drill we had a couple of weeks prior included our community partners.
We also have a medical tower that was designed with a pandemic in mind, so an entire floor has reverse air flow capabilities. These pandemic HVAC systems are available for 64 beds across two units. In addition, as part of the Providence health system, we had a relatively good supply of PPE available. These factors have been extremely helpful throughout the pandemic to help limit exposures in the hospital. The high-stress and high-volume demands of the pandemic have been extremely difficult, but our caregivers have endured with compassion and strength, and I am so proud of them and humbled to work with them. Our Providence mission calls for us to be steadfast in serving all, and our caregivers have indeed provided excellent care throughout the pandemic.
Also, for years we have had in place a Service Operations and Transfer Center to manage operations, and that has proven invaluable throughout the pandemic.
SB: When the next pandemic arrives, how will your staff and facilities be better prepared for it? Have you added equipment, permanent training programs, more treatment space, technology, other tools that can help?
DR: Health care has been fundamentally altered by the pandemic in many ways. For example, we quickly pivoted to provide many telehealth and virtual care options for our patients during the pandemic, and many of those programs will continue. This is a great option for many patients and also allows resources to be deployed to more critical patients. Specifically, at Providence Everett, we have developed many new training programs and protocols around infection prevention, care and treatment of infectious disease patients, and more. We also have the ability to quickly flex and adjust our operations based on the situation. All of these experiences, and many more, will be important as we face future COVID-19 surges, another pandemic, or other challenges.
From a building system standpoint, I think we have also been well prepared. We understand that health care is a larger, connected system and that impacts to any portion of the system (primary care, specialty care, ambulatory care, post-acute services, long term care services) all affect one another. As a community of health care services and organizations, it is clear we need to plan and work together to best manage the effects of pandemics and other critical community health issues.
SB: What is it like handling the psychological uncertainty and stress of a pandemic especially when you know more infectious diseases will appear, but you dont know how much differently they will present, or how severe they will be?
DR: The uncertainty and stress for all frontline health care workers has been intense, and Providence has implemented a multitude of programs and resources to help with mental health concerns, child care challenges, work-life balance, and much more. As a specific example, we have trained and deployed Critical Incident Stress Management teams to help caregivers after they have been through a difficult situation. These teams allow caregivers to debrief after an incident, share how theyre feeling, be connected to resources, and more. Our caregivers are here because they are passionate about caring for others. Health care is a calling, and that has never been more apparent than during the last two years.
SB: Were there any pandemic protocols or technologies that you thought would be effective in managing patient care, but that turned out to be less helpful? What did you learn from those situations?
DR: Throughout the pandemic we have followed guidance from the CDC and the Department of Health, which is based on evidence-based best practices. The entire world has seen science play out in real time throughout the pandemic, and weve all learned that the process is not always linear. However, by following proven treatments and established protocols, we have provided excellent care to our patients.
SB: What kinds of organizations have you partnered with to educate and prepare staff and the hospital for future outbreaks?
DR: Beginning with the very first COVID patient and even before that, during drills we worked closely with our local health department, EMS, fire department, and more. Throughout the pandemic, weve partnered with other hospitals in the state to level patient load so that no single hospital got overwhelmed during a surge. This helped keep Washington state from declaring crisis standards of care. This coordination of care among hospitals and health organizations throughout our state is extremely important and has positioned us well for future challenges.
SB: Have other hospitals approached you to advise them on establishing better pandemic protocols? If so, how do you handle those requests?
DR: Since we successfully treated the first COVID-19 patient in the US, weve been getting calls from other hospitals around the country for two years. Health care is all about sharing information and best practices to help advance patient outcomes. For example, in March 2020, our team published a case report of the first patient in the New England Journal of Medicine to help share our experience and how the patient was successfully treated with remdesivir. Throughout the pandemic, we have also worked closely with the Washington State Hospital Association to share information, and WSHA has done a tremendous job helping hospitals coordinate and respond.
SB: What have been the most rewarding and encouraging outcomes from your preparedness efforts? Can you share any data or study results on efficiencies, cost savings, patient health impact?
DR: The most rewarding and encouraging part is the stories of the patients who recover. For example, USA Today featured this story of a Providence Everett patient who spent 25 days on a ventilator, but made a full recovery and was reunited with her family. Knowing that the drills and the training, the protocols and procedures, the foresight to have a floor with reverse air flow, and most of all, the dedication, care, bravery and expertise of our caregivers, all played a role in saving so many lives is extremely powerful. Throughout the pandemic, we have also been at the forefront of research and new therapies.
We were the first in the world to administer remdesivir to a COVID-19 patient. We have published numerous studies about care and treatment of COVID-19, and shared a lot of information with the public to help educate them and promote best practices. Examples include this paper on Remdesivir and Mortality Rates in Patients with COVID, as well as this account on the role of technology in COVID-19 care and delivery.
In late September of 2020, captive mink on a farm in Michigan suddenly fell ill. They stopped eating, struggled to breathe and bled from the nose, according to a report from the World Organization for Animal Health. Two thousand animals died.
Laboratory testing soon confirmed that the mink were infected with the coronavirus.
The Centers for Disease Control and Prevention dispatched a team of outbreak investigators, who collaborated with other agencies to swab mink, farm workers and a menagerie of other animals, from rats to raccoons, to determine how the virus had spread.
We tried to leave no stone unturned, said Dr. Casey Barton Behravesh, who directs the C.D.C.s One Health Office.
Last month, the C.D.C. confirmed that four Michigan residents, including two farm employees, had been infected with the same unique coronavirus variant that was found in the mink. It was the first, and so far only, known instance of possible animal-to-human transmission in the United States.
But many questions remain: When, and in whom, did the variant first emerge? How did a taxidermist with no connection to the farm contract it? Could there be a link between the Michigan mink outbreak and a white-tailed deer variant that scientists recently discovered in neighboring Ontario?
It really feels very much like a puzzle, said Dr. Samira Mubareka, a virologist at Sunnybrook Research Institute and the University of Toronto. Its not just pieces that are missing its contiguous, interlocking pieces that are missing.
Since the early days of the pandemic, when the coronavirus tore through fur farms, scientists have worried that mink might become a long-term reservoir for the virus and a potential source of new variants.
To date, coronavirus infections have been detected in mink on 18 American farms, the most recent in Wisconsin in February. Even as Congress considers a ban on mink farming, there is still no national system for proactive surveillance on mink farms, which are not required to report cases to federal authorities. And officials have not released much information about the outbreak investigations they have conducted; some of those details are reported here for the first time.
Together, the secrecy and spotty surveillance make it difficult to determine how much of a risk mink farms pose, scientists say. And it threatens to leave experts blind to the emergence of worrisome new variants that could spill back into humans, extending the pandemic.
Combined with a desperate need for better more systematic surveillance in humans and animals, we could really benefit from increased transparency regarding spillover and spillback risk, said Vivek Kapur, a veterinary microbiologist at Penn State University.
The Netherlands and Denmark were the first countries to report mink farm outbreaks, in the spring and summer of 2020. Scientists pieced together an unsettling chain of events: It appeared that humans had transmitted the virus to mink; that the virus had mutated as it moved among the mink, and that the animals then spread the altered virus back to humans.
All of that jumping back and forth over the fence is what we saw, said Dr. Marion Koopmans, a virologist at Erasmus University Medical Center in Rotterdam. And thats something that, as a virologist, you dont really like.
The Netherlands and Denmark took quick and decisive action, said Adriana Diaz, a doctoral student at the University of London who studied these responses. Dutch authorities conducted antibody testing on all farms and required farmers to report respiratory symptoms in mink and regularly submit carcasses for examination. Still, the virus proved difficult to control, and both nations ultimately shuttered their mink farms.
The United States took a different tack, developing a set of voluntary guidelines to help farmers keep the virus at bay, including asking farm workers to wear masks and notifying authorities of suspected cases.
But there was no national screening program and federal officials relied upon farm owners to self-report outbreaks. All of our federal surveillance efforts are voluntary, said Dr. Tracey Dutcher, the science and biodefense coordinator for the Animal and Plant Health Inspection Service at the United States Department of Agriculture.
The C.D.C. investigated outbreaks only when officially invited. Some owners of affected farms declined to participate, and field teams only performed on-site investigations on eight farms, Dr. Barton Behravesh said.
On the Michigan farm, C.D.C. investigators worked with the U.S.D.A. and state agencies to test humans and animals for the virus. They collected swabs and samples from 159 mink on the farm; all but two were actively infected, Dr. Barton Behravesh said.
None of the other animals tested around the farm two dogs, a cat, raccoons, opossums, striped skunks, rats, groundhogs and rabbits were infected, but one dog tested positive for antibodies, officials said.
Two of the farms employees were infected with the same version of the virus that was spreading among the mink. The variant had two mutations that had also been found in farmed mink in Europe and in people connected to mink farms.
Officials found the same mutations in a sample collected from another Michigan resident nearly two months after the mink outbreak and then in a fourth person connected to that resident. The third case was a local taxidermist, according to internal health department emails obtained by the Documenting Covid-19 Project and the Detroit Free Press, and the fourth case was the mans wife, the organizations later reported. (Michigans Department of Health & Human Services declined to confirm these details for privacy reasons.) Neither had any known connection to the mink farm.
These findings suggest a likely scenario, experts said: A person passed the virus to the mink, and the mutations emerged as the virus spread among the animals, which then transmitted them back to the farm workers. We concluded that there was likely mink-to-person spread on this particular Michigan farm, Dr. Barton Behravesh said.
But determining when, and in whom, the mutations first appeared requires many more virus samples from farm workers, local residents and mink, collected before and after the outbreak. That data doesnt exist, said Arinjay Banerjee, a virologist at the University of Saskatchewan.
Throughout 2020, testing was difficult for Americans to access and few patient samples were being sequenced. Surveillance in animals was even worse; until this spring, federal officials explicitly recommended against routinely testing animals for the virus.
Widespread testing wasnt available, then there became a shortage of certain supplies, Dr. Behravesh said. So we didnt want there to be, you know, a mad rush to test animals.
Without more samples, its impossible to rule out the possibility that the variant emerged in humans, who then spread it to mink, scientists said.
A bigger puzzle is how the taxidermist and his wife got it. The most likely possibility, several experts said, is that the variant was circulating more widely in the human population than was known, and the couple caught it from another infected person.
Another, more speculative, possibility is that they picked up the variant from another animal species. Taxidermists deal with other dead animals, said Linda Saif, a virologist and immunologist at Ohio State University.
But because the cases were detected weeks to months after the two fell ill, testing any animals they may have been in contact with was either not feasible or not indicated, said Lynn Sutfin, a spokesperson for the Michigan D.H.H.S.
The pair also had close contact with deer while hunting on or very near to their own illness onset dates, according to the health department emails obtained by the Documenting Covid-19 Project and the Free Press.
Studies suggest that humans have repeatedly introduced the virus to white-tailed deer, which then transmit it easily among themselves. People could have passed the mink variant to deer, which might have transmitted it to the taxidermist and his wife. Given the very high viral burdens that have been noted in white-tailed deer, the spillover to them could certainly have occurred from the deer, Dr. Kapur said.
Alternately, deer might have picked up the virus directly from infected mink, which have been known to escape from farms. Feral cats on mink farms have also tested positive for the virus and may act as vectors between captive mink and wildlife.
Or deer might come into contact with mink farm waste, Dr. Kapur said. On farms with outbreaks, airborne dust, as well as the straw and hay that the mink bed down on, can be highly contaminated with virus, Dutch researchers found.
Another finding makes a potential deer link intriguing, scientists said. Canadian researchers recently detected a unique coronavirus variant circulating in deer in southwestern Ontario. Although the deer variant was strikingly different from other known variants, the closest matches were viral samples collected from people and mink in Michigan in late 2020.
One possibility, still theoretical, is that whatever version of the virus was circulating among mink and humans made its way into deer, where it evolved into a new variant. There could be interactions and interspecies transmission that have been cryptic and we havent really picked up on , said Dr. Mubareka, an author of the Ontario study.
Dr. Banerjee was skeptical that deer played a role in the case of the taxidermist and his wife. I think thats just speculation at best, he said. But he acknowledged that the data are so sparse that many possibilities remain. Are there other animals we are missing? he asked.
Even the data that exist are not always clear-cut. As part of another investigation in the fall of 2020, the U.S.D.A. tested a dozen cattle on a Wisconsin mink farm with a coronavirus outbreak. Although the cattle tested negative for the virus, three had low levels of antibodies, said Travis Weger, a U.S.D.A. spokesperson.
However, these findings did not meet the criteria for a positive result, Mr. Weger said in an email, and could have been triggered by antibodies to other coronaviruses known to infect cattle. Experimental studies suggest that cattle are not susceptible to SARS-CoV-2, he added.
Still, outside experts said that it is difficult to draw conclusions without more analysis and that the findings suggest a need to monitor livestock, especially as new variants emerge.
Some also expressed concern that officials have not disclosed these and other findings from the mink investigations.
Dr. Barton Behravesh, of the C.D.C., said that the viral sequences obtained during the investigations are available on GISAID, a repository of viral genomes, and that more details would eventually be published in scientific journals.
The U.S.D.A. is using funding from the American Rescue Plan to ramp up animal surveillance and would like to do more active monitoring on mink farms, Dr. Dutcher said: Were still working through some of the questions and conversations with industry.
Although the U.S.D.A has no reports of active outbreaks after 2020, mink infections can be silent. Researchers found antibodies in mink on a Wisconsin farm in February 2022 and on a farm in another, unnamed state in May 2021. There was no evidence of symptomatic outbreaks on either farm, which had supplied samples from healthy animals for research, Mr. Weger said in an email.
But the presence of antibodies suggests that the virus spread on the farms undetected.
Without surveillance, how would you know? said Dr. Jim Keen, the director of veterinary sciences at the Center for a Humane Economy, a nonprofit animal welfare organization that supports banning mink farming in the United States.
Some mink herds have now been vaccinated, which might help slow transmission on farms. But vaccination could make infections more likely to be asymptomatic, Dr. Keen said.
The United States should be regularly testing both mink and farm employees, sequencing positive samples and communicating the results in a timely way, Ms. Diaz said.
As new variants emerge, some perhaps capable of infecting new species, ongoing surveillance is needed to understand the web of transmission that may be going on with wildlife, farmed animals and humans, Dr. Saif said. If you dont look for something, youre not going to find it.
A once-in-century challenge
The COVID-19 (coronavirus) pandemic has seen governments around the world grappling with unprecedented and uncharted challenges. Leaders across Africa, including in South Africa and Nigeria, sub-Saharan Africas largest economies, have needed to make major decisions to navigate a twin public health crisis and economic crisis throughout 2020 and 2021. Many of the choices they faced had no textbook. No one had been here before.
Those tasked with advising presidents faced a similarly daunting task. How do you provide the best possible advice in such conditions? Like the rest of the world, African governments had little precedence to rely on when formulating economic policy options. And the approaches being deployed in Asia and Europe might not be suitable for the specific conditions and constraints they faced at home. And how might the World Bank be able to help?
What was needed was a way of pooling their knowledge while drawing on outside expertise to quickly get insight into what we knew about the pandemic. To provide a place where these advisors could exchange with one another and get feedback on their approaches to the unique challenges that the pandemic was generating.
So, when chief economic advisors to the Presidents of South Africa and Nigeria, along with 40 other African countries, needed to pool knowledge and gain critical insights and feedback on their approaches to the pandemic and economic responses, they turned to the Chief Economists of Government (CEoG) network, an initiative of the Africa Office of the Chief Economist at the World Bank. This network comprises chief economic advisors to heads of the executive from more than 40 of the 48 Sub-Saharan African countries.
These chief economic advisors have met every few weeks throughout the pandemic since March 2020, via virtual meetings convened by the World Bank. These meetings have provided a safe space to discuss difficult questions and get peer feedback on the issues of the day they are grappling with.
CEoG: An African network to address Africas problems
The Chief Economists of Government initiative aims to promote economic growth and transformation by strengthening knowledge-based policymaking in African countries. It was initiated by the Africa Chief Economists Office, recognizing an absence of support and peer exchange for this special group of individuals; those tasked with advising the President or Prime Minister on critical economic matters.
Not knowing the COVID-19 pandemic was just around the corner, the network was launched in February 2019 with an inaugural event at Oxford University bringing together the network of African chief economic advisors, and connecting them to those who had played this role in the past, both in Africa and from countries such as Malaysia.
Then COVID-19 struck. However, a crisis often comes with an opportunity: as the first African governments started implementing COVID-19 response measures, CEoG started hosting regular peer-learning webinars, offering advisors a space to share their countries pandemic response measures and economic recovery plans, discuss and receive feedback on investment incentives or climate mitigation and adaptation strategies, and get together to discuss, formulate and agree on specific inputs to the Abidjan Declaration, calling for IDA donors to support an ambitious IDA20 replenishment with success! Transparency, trust and flexibility has allowed this demand-driven network to be owned by its members, choosing the topics and requests for outside experts.
CEoG members straddle economies totaling almost two trillion US dollars with the typical economy almost as large as $40 billion and per capita income of almost $2,500. The goal is to have the CEoG network facilitate more rapid economic growth and transformation of its member countries.
Throughout the pandemic and going forward, the CEoG Secretariat continue to organize demand-driven thematic workshops and virtual peer-learning events for the advisors. The advisors will also identify specific challenges where additional support may be useful. For instance, when our network member from the Democratic Republic of Congo (DRC) was tasked with formulating a plan to reduce the dollarization of the economy in DRC, they turned to the CEoG network to help convene other advisors and experts to help share insights that could inform the countrys de-dollarization efforts.
The future
The network now regularly brings together the chief economic advisors from each of almost every country in the Sub-Saharan Africa region. This year the network is launching the CEoG Presidential Fellowship program, to give the most talented African economists the opportunity to work in the highest levels of government across the region.
To support future chief economic advisors, the network is also documenting the experiences of current and former advisors to President, to form a guide to the experiences associated with this unique and challenging job.
We invite you learn more about the CEoG network.
Republican gubernatorial nominee Bob Stefanowski tested positive for COVID-19 on Monday and will follow isolation protocols set by the Centers for Disease Control and Prevention.
Stefanowski, who turned 60 over the weekend, tested positive after learning he had been exposed to the disease, his campaign said in a statement.
I just wanted to let everyone know that I tested positive for COVID-19 this morning after finding out I had a positive exposure, Stefanowski said. I am vaccinated, boosted, and feeling fine so far. I will continue to follow all CDC protocols.
His campaign did not say where the exposure occurred.
He campaigned on Sunday at the Freedom Family Cookout sponsored in Marlborough by @CTLibertyRally, a group that organized against mask mandates, restrictions on public events and other COVID-19 precautions.
The CDC protocols include five days of isolation after a positive test for individuals who are asymptomatic or have mild symptoms and a recommendation against travel for 10 days.
The CDC also recommends wearing a mask for 10 days.
Gov. Ned Lamont tested positive for COVID-19 in April and had a mild case.
COVID-19 deaths are decreasing nationwide in the wake of this winter's omicron surge, but CDC modeling suggests this trend may change over the next four weeks.
Three COVID-19 forecasts to know:
Cases: Daily COVID-19 cases are projected to increase 92.2 percent in the next two weeks, according to modeling from Mayo Clinic. Forecasts suggest daily average cases will jump from 93,401 cases on May 21 to 179,547 by June 4. During the omicron surge, this figure hit a peak of more than 800,000, according to data tracked by The New York Times.
The nation's case rate is also expected to increase from 33.3 cases per 100,000 population to 54.7 per 100,000 over the same period.
Hospitalizations: Nationwide, daily COVID-19 hospital admissions are projected to increase over the next four weeks, with 1,300 to 11,000 new admissions likely reported June 10, according to the CDC's ensemble forecast from 18 modeling groups.
Hospitalizations are increasing, but the nation's current seven-day average (3,250) is still far lower than the more than 20,000 new admissions seen at the height of the omicron surge, according to data tracked by the Times.
Deaths: U.S. COVID-19 deaths are also expected to increase over the next month, according to the CDC's ensemble forecast from 22 modeling groups. The forecast projects 2,000 to 5,300 deaths likely reported in the week ending June 11, which would bring the nation's total COVID-19 death tally to a range of 1,008,000 to 1,018,000.
The CDC said its ensemble forecasts are among the most reliable for COVID-19 modeling, but they cannot predict rapid changes in cases, hospitalizations or deaths. Therefore, they should not be relied on "for making decisions about the possibility or timing of rapid changes in trends," the agency said.
Note: Mayo Clinic uses a Bayesian statistical model to forecast cases that automatically updates as new data becomes available. There is an uncertainty interval for forecast values, with lower and upper bounds that are not included in this list. To learn more about the data Mayo Clinic uses to forecast hot spots, click here. Becker's pulled the forecast values May 23 at 9:10 a.m. CDT.
COVID-19 has been frustrating for gym rats. Even before scientists knew much about this particular virus, it was pretty clear that breathing heavily in a confined space with lots of other people around doing the same was an easy way to catch a respiratory illness, and gyms were among the first businesses to close early in the pandemic. These suspicions have since been borne out by science: aerosolstiny droplets that spread through the air when we breathehave been identified as a major source of COVID-19 transmission, especially when people are breathing faster and more deeply. Throughout the pandemic, exercise at spin classes, fitness clubs and sports games has been identified as the source of dozens of new cases.
Now a new experiment has given us a more exact sense of just how many aerosols a single person can spew during an intense workoutand the results arent pretty. According to research by scientists in Germany published in PNAS on May 23, people emit about 132 times as many aerosols per minute during high intensity exercise than when theyre at rest, which the researchers warn raises the risk of a person infected with COVID-19 setting off a superspreader event. At rest, people emitted an average of 580 particles each minute, but during maximal exercisein which researchers gradually increased intensity until the subjects were exhaustedpeople emitted an average of 76,200 particles a minute.
The study authors acknowledge that their work has limitations. First and foremost, the sample size was just 16 people. In addition, none of the subjects were infected by COVID-19; in the paper, the researchers note there was no way to do so safely, due to ethical concerns about the health risks for participants.
Nevertheless, there were some valuable findings to come out of the work. [As an exercise physiologist], and we knew before that when you exercise, theres more air coming out of a person, says Henning Wackerhage, a co-author and professor of exercise biology at Technische Universitt Mnchen. But we didnt know before, and which, quite frankly, I didnt expect, is that also when we exercise hard: there are more particles per liter of air.
The unusual experiment design enabled the researchers to get a more exact sense of the particles released. While exercising on a stationary bike, each of the 16 subjects breathed clean air through a silicone face mask, and then exhaled into a plastic bag. This enabled the researchers to eliminate sources of contamination and get more reliable results, says Christian Khler, a professor at the Institute of Fluid Mechanics and Aerodynamics at Universitt der Bundeswehr Mnchen who co-authored the study.
Some of the participants also emitted much more aerosols during high-intensity exercise than others; in particular, fitter people with more experience in endurance training emitted 85% more aerosols than people without such training. Dr. Michael Klompas, a hospital epidemiologist and infectious disease physician at Brigham and Womens Hospital who did not participate in the study, explains that this may be a function of the way individuals bodies become more efficient at moving large amounts of air. They make their muscles do an enormous amount of work, and they need to support that by giving their muscles enormous amounts of oxygen and helping to clear waste products, he says.
If this gives you pause about your current exercise regimen, keep in mind that not all gyms are alikeand the right policies and set-up can help to keep you safe. For instance, the amount of space per person is essential; large spaces, especially those with high ceilings, give the air more space, says Thomas Allison, director of Cardiopulmonary Exercise Testing Laboratories at the Mayo Clinic. Other things to look for at a gym, says Klompas, are a vaccination requirement, a facility that has professionally measured the air flow and put in place air filters, and, ideally, a testing requirement. In Klompas opinion, masks are potentially helpful, but arent likely to be reliable during workoutslooser masks wont do much during vigorous exercise, and its impractical to expect people to wear N95s while exerting themselves.
The researchers note that factors besides fitness status can also affect how many aerosols people emit. Wackerhage says they are also looking into how factors like body mass index, age, and lung condition play a role.
Ultimately, says Klompas, whether or not you go to a gym comes down to your risk tolerance, and weighing the costs and benefits of going to the gym for you, personally. However, he says, you shouldnt pretend that working out indoors, and around other people, doesnt pose risks. If youre not willing to get COVID dont go, says Klompas. At a time like now, when theres a lot of COVID around, it is a high risk proposition.
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"Ask the Expert" articles provide information and insights from MSU scientists, researchers and scholars about national and global issues, complex research and general-interest subjects based on their areas of academic expertise and study. They may feature historical information, background, research findings, or offer tips.
Peter Gulick, a professor of medicine in the Michigan State University College of Osteopathic Medicine and an infectious disease expert,speaks about COVID-19 and the recent surge in cases. Gulick elaborates on the future of vaccines, masking and how to stay safe as more discoveries are made about the virus.
What is causing the current surge in cases? Cases were declining this time last year.
I believe the surge is because the omicron variant is much more infectious, even in those vaccinated. People at high risk are having a symptomatic response and those not at risk are having no symptoms or mild symptoms. There is less testing, so those with fewer symptoms or who are asymptomatic may be spreading the virus more, especially since masks are not worn as much.
Is the surge proving that masks need to be worn year-round?
I believe masks are needed in crowds, on airplanes and in airports, andin areas with poor ventilation.If you are outdoors, then masks arent needed, but indoors, especially with a lot of people,you need to wear a mask. I was in the gym working out and there were many people, yet I was the only one wearing a mask. All immunocompromised patients or patients older than 50 years of age should wear them more, rather than less, tostay safe.
Have new variants emerged?
The predominant variant is omicron B2, which is still treated with Paxlovid, an oral antiviral pill, if one is infected.The vaccines with the booster still give you protection. Beware though, because South Africas population is getting infected with omicron 4 and 5, which are more infectious and those may reach the U.S. soon.
Are most of the new cases omicron?
Yes, 100% of cases in the U.S. are omicron and the majority are the B2 variant.
How prevalent are reinfections?
Reinfections are more prevalent with omicron, even in those who are vaccinated, but they are only severe in those who are unvaccinated or immunocompromised. People are not testing as much, so it is hard to determine frequency unless they use wastewater testing in communities that appears accurate.
It was previously thought that COVID-19 cases declined in warm weather like the flu. Does the current surge prove this is not true?
Omicron appears year-round, especially with the new variants and the increased infectiousness, even more so than influenza. New strains are mainly upper respiratory, so symptoms include sore throat, congestion, headaches and achiness.
Will vaccines be subject to change as new variants emerge?
Yes, vaccines may change, and Moderna is looking to have a bivalent vaccine for omicron by fall, which would target both the original strain of the virus and the variant. Other companies are looking to develop a vaccine that may cover more variants.
Will yearly boosters be recommended?
I believe we will probably need yearly boosters, like we get for illnesses like influenza, and change them according to what variants are prevalent at the time.We still need more data on our immune system and memory cells to see the entire picture of how our immune system stores the information on variants of omicron either through natural infection, vaccine or both.
Are vaccines for children 5 and under coming soon?
Moderna is currently asking the Food and Drug Administration to authorize vaccines for children 6 months to 6 years.
Prior COVID-19 Decreases Risk for Recurrent Infection in Unvaccinated Adults Infectious Disease Advisor
