Hong Kong will ease some social distancing measures later this month, allowing people to dine in at restaurants in the evening and lifting restrictions on private gatherings, as the number of COVID-19 infections declined in recent weeks
ByThe Associated Press
April 14, 2022, 7:34 AM
2 min read
HONG KONG -- Hong Kong will ease some social distancing measures later this month, allowing people to dine in at restaurants in the evening and lifting restrictions on private gatherings, as the number of COVID-19 infections declined in recent weeks.
From April 21, restaurants will be able to operate until 10 p.m. with a maximum of four people per table, officials said Thursday.
Other businesses that were ordered to temporarily close due to Hong Kongs fifth wave of infections, such as beauty parlors, gyms, theme parks and cinemas, will also be allowed to re-open, although capacity will be limited to 50%. Bars and pubs will remain closed.
Restrictions that currently only allow two households to gather will also be lifted.
To relax these measures, to allow some degree of normal activities in society, with more interactions among citizens, inevitably they will come with some transmission risks, Hong Kong leader Carrie Lam said during a news conference Thursday.
Lam appealed to the public to comply with the social distancing measures that remain in place and to get vaccinated.
While the number of positive cases reported every day has dropped to a relatively low level, in absolute terms they are still rather high, she said.
The city reported 1,260 cases in the community on Wednesday, down more than 95% from the peak of the outbreak in March, when over 30,000 daily infections were reported.
Lam said the city is now much, much better prepared to handle another wave if it hits, due to increased levels of vaccination and more facilities to handle patients, such as community isolation and treatment centers.
Lam also said the government has not given up on mass testing for the city, but that timing was important.
Other restrictions will be also lifted later this month. Local tours will be allowed to resume and public gatherings of four people instead of two will also be permitted.
In late February, the CDC made big changes to its recommendations for monitoring and responding to Covid-19 surges. Now, as US cases are once more on the rise, these recommendations face their first test. But how will we know if they are working?
The CDC used to prioritize cases and positive tests to determine the Covid-19 threat level. Starting in February, the agency placed more weight on hospitalizations. The move invited a lot of scrutiny, and it reflected changes in the CDCs pandemic response goals: The agency is moving away from trying to eliminate transmission of the virus and toward reducing deaths and health care system strain.
The hard truth, several public health experts tell Vox, is that determining whether they are effective will be difficult.
Even in the best-case scenario, where institutions follow the guidelines and the latest wave recedes, it would be hard to prove that the CDCs framework deserves the credit.
Well certainly know if it fails, said Jeremy Faust, an emergency doctor and health policy expert in Boston. The guidelines face the same challenges many public health initiatives do: Failures are easier to spot than successes.
As a new wave begins, its worth setting some expectations about what these guidelines can reasonably do, and how easy or hard it will be to measure their success. Ultimately, we might never know how well the guidelines work and even if they do work, the CDC might not get any credit.
For the first two years of the pandemic, there were two main metrics for determining the pandemics severity: case counts and test positivity.
Case counts were determined by summing up the positive results of PCR tests conducted in a given time period. And test positivity was determined by calculating the percentage of positive PCR tests. Together, these provided a rough, real-time picture of the Covid-19 threat, which public health agencies and institutions used to guide rollouts of testing programs, mask and vaccine requirements, and other public health measures.
For as long as PCR testing remained vastly more accessible than home-based testing, this approach made sense. However, at-home tests became more widely available over the latter half of 2021; because reporting those tests results is not mandatory the way reporting PCR test results is, PCR results have become increasingly unrepresentative of the actual state of play.
The proliferation of home tests rendered the CDCs key metrics almost functionally meaningless, said Jennifer Nuzzo, an epidemiologist and pandemic preparedness expert at Brown Universitys public health school. And so, Nuzzo explained, the CDC needed to find a new method for taking the temperature of the pandemic in real time.
The February guidelines did just that, introducing a new way of estimating each countys Covid-19 burden. The calculation is still partially based on the rate of new cases over the past week, but now it is based largely on the number of new hospital admissions due to Covid-19 and the percent of hospital beds occupied by Covid-19 patients. From this, the CDC assigns each county a low, medium, or high level of burden.
For each level, the guidelines offer a set of recommendations for institutions and public health departments, and a separate one for individuals. The specifics of the recommendations range from ensuring testing and vaccine access on the low end to calling in backup health care staff on the high end.
Some people balked at the change, in part because hospitalizations are a lagging indicator of transmission intensity, rising one to two weeks after cases increase. However, the model used to create the guidelines accounted for that lag and deliberately set hospitalization thresholds at a level to allow institutions a few weeks to prepare for a rise in deaths.
The new framework also reflected a change in the CDCs pandemic goals. No longer would the agency focus on eliminating transmission; instead, it would aim to prevent severe illness and death, minimize the burden on the health care system, and protect vulnerable people by using vaccines, therapeutics, and prevention strategies. The new estimates would help accomplish this by focusing on metrics that actually quantified the main indicators of health care system strain and setting the alarms to go off early enough to let public health authorities act.
Many public health experts felt the shifts were necessary, and organizations representing state, local, and county health officials reported broad support for the changes among their membership.
A focus on hospitalizations makes a lot of sense right now, said Justin Lessler, an epidemiology professor at the University of North Carolinas public health school. He expects that with increasing population immunity, each waves severity will likely decrease, making case numbers less relevant. As case numbers do an increasingly bad job of predicting hospitalizations and deaths, theres just less incentive to focus on them.
Wed love to prevent infections, but thats the hardest game of whack-a-mole, said Nuzzo. However, she said, we can prevent severe illness and death, and we can prevent our hospitals from becoming overwhelmed, and that is absolutely critical.
At the moment, the CDCs US outbreak severity map shows most counties in green, indicating they have a low community burden of infections.
But within the last month, a handful of counties have changed color to yellow or orange, indicating medium or high Covid-19 levels. Those color changes are intended to provoke public health authorities to make changes, like ramping up testing programs for asymptomatic people and restricting visitation in high-risk settings like nursing homes and prisons. Mask requirements are also on the menu, Nuzzo said.
The timing here is key: The color change is intended to happen early enough to provoke policy changes in time to prevent hospital bed shortages.
Here, we could see clear signs if the guidelines were failing.
If a county goes from green to orange, there should be time to flatten the curve before theres a big strain on resources. If we see hospitals overflowing and the CDCs mask thresholds had not been met, that would be straightforward, incontrovertible proof that [the guidelines] failed to achieve the objective, said Faust.
Other red flags would include signs that state and local public health authorities and policymakers are not using the metrics to make decisions. That could suggest a number of problems, including a lack of health department resources, burnout among key personnel, a lack of trust in the CDCs methods, or insufficient political will to follow the metrics and implement the changes the guidelines suggest.
After all, while the CDCs guidelines are authoritative, they are not requirements; ultimately, state and local governments can do what they want.
Its not the metrics, necessarily, that I think are the thing to test, but its how we choose to respond to a change in the metrics, said Nuzzo. Thats the wild card.
To determine whether the guidelines are doing their job, we first need to define what it would mean for them to be successful and thats currently an open question, said Lessler.
For the CDCs recommendations to be successful, state and local public health authorities need to use them as the basis for their policy recommendations; policymakers need to act on those recommendations; people and institutions need to follow those recommendations; and the recommendations need to have the desired effect of reducing transmission and increasing access to vaccination and treatment.
But just knowing where the guidelines are being implemented and where they are not is a challenge due to the decentralization of our public health system. Although Covid-19 policy trackers exist, differences in the particulars and the enforcement of different policies impede connecting the dots between mitigation efforts and outcomes. There are 3,006 counties in the US, and its hard to keep track of the policies in place in all of them.
One of the arguments for a diverse public health system is it becomes a laboratory, said Lessler, but thats only true if theres some sort of central tracking and good reporting of whats actually being trialed. In a sense, the CDCs new guidelines are an experiment in which results cannot be compiled in one place.
Another complication in evaluating the success of the guidelines is that individuals nationwide do what they think makes the most sense for themselves, regardless of local policy. Thats not necessarily a sign of anarchy. The CDCs guidelines actually recommend that people use the agencys suggested metrics to guide individual choices.
However, individual action tends to happen late in a surge, only when things are obviously really bad, said Joshua Salomon, a health policy professor at Stanford University. For example, people in a county where hospitals are overflowing might choose to wear masks even if their governor has forbidden mask mandates. Individual actions like this happening at a large scale change the outcomes, making it even more challenging to link those outcomes with policies.
Theres another major challenge to evaluating the new guidelines: If the burgeoning BA.2 omicron subvariant wave of Covid-19 is small, the guidelines may not face a big test at all.
Cases have been rising in the US, and hospitalizations are now rising in several northeastern states, albeit far more slowly than during the explosive wintertime omicron BA.1 wave. The sluggishness of BA.2s spread (so far) may be attributable to the large number of people who have retained some immunity following infection during that earlier wave.
If BA.2 does not end up producing a large surge of infections in the US, that will be a welcome surprise, said Salomon, but it wont necessarily be validation of the new community guidance. Our health care system cant be threatened and the CDC guidelines cant be tested by a surge that doesnt happen.
Of course, a big test might be just over the horizon if a variant worse than BA.2 comes into play.
Even if the CDCs guidelines help prevent disastrous outcomes, people may see the absence of catastrophe as evidence that the guidelines were unnecessary, not as evidence that they worked. Those situations are just as confusing as when people credit public health policies for good outcomes that wouldve happened anyway.
If the CDC throws a mask mandate on and if things appear to get better, even then that will be correlation, not causation, said Faust. Itll be really hard to tease out.
Burning US five and one dollar bills, London, 8th August 2011. (Photo by Tom Stoddart/Getty Images)
The Bureau of Labor Statistics released its monthly inflation report this week showing a jump in year-over-year CPI at 8.56%. You must go back over 40 years to December 1981 to find a higher reading. Whats the cause? Whos to blame? Is it President Biden? Is it the Federal Reserve? Is it government spending? Is it Covid? More importantly, how can we get inflation down to a more normal level? Some expect inflation will normalize in the coming months. I believe inflation will persist for a while. Heres why.
Inflation is caused when demand exceeds supply. In other words, when there is too much money chasing too few goods and services, prices rise. Its really that simple. Lets go a bit deeper.
Supply: The pandemic caused the greatest supply-chain disruption of the modern era. Businesses rely on its workers to produce. When workers are in short supply, production falls, reducing supply. Thats precisely what happened. From acquiring the needed materials to processing them for production, to shipping them to distribution centers to transporting goods to the retail outlet, to staffing the retail outlet, the pandemic has caused a major disruption. Thus, supply has declined substantially due to Covid-19. Moreover, some locations are experiencing yet another wave of Covid cases. Remember, supply is not just a U.S. issue, its a world-wide issue.
Demand: At the onset of the pandemic, the U.S. government, in an effort to prop up the economy, passed several pieces of legislation, resulting in a great deal of money in the hands of consumers and businesses. Generous unemployment benefits paid low-wage workers more money than they earned when working. Congress also sent direct payments to families. For example, the child tax credit paid $300 per month for each child under age 6, and $250 per month for each child 6-17 years old. This expired at the end of 2021. Government support led to the shortest recession in U.S. history, lasting only two months.
Politicians learned a great lesson during this period. I noticed republicans adopted part of the democrats play book. Democrats are largely perceived as the party of the worker. In the past, democrats sought to put money in the hands of citizens through social programs. Republicans have been more focused on businesses. Why? If business is strong, theyll hire workers. This time, however, republicans put a great deal of money directly in the hands of consumers. Its likely politicians will continue to spend excessively, and record budget deficits will become the new normal.
As mentioned, inflation rose by 8.56% on a year-over-year basis. Energy prices rose a whopping 32% during the period with gasoline surging 48%. Prices for used cars and trucks rose 35.3% but showed signs of slowing in March. Food inflation was only slightly higher, rising 8.8%. Beef prices rose 16.0% and dairy products increased 7.0% over the previous 12 months.
Inflation in the Southern region of the U.S. rose 9.1%; compared to the West (8.7%); Midwest (8.6%); and the Northeast (7.3%). The Mountain region experienced the worst rise at 10.4%.
How do we get inflation back to 2.0% or less? This problem will not be fixed by a single entity. It will need coordination between the Federal Reserve and the federal government. Heres why.
The Federal Reserve is responsible for monetary policy. Its tools include changing short-term interest rates, the money supply, and bank reserve requirements. Thus, the Fed can reduce demand by raising its fed funds rate, reducing the money supply, and increasing bank reserve requirements. While these will reduce demand, the fed has often started too late and gone too far. In fact, the fed is considered a primary cause of many U.S. recessions. Some believe the fed is behind the curve today. The fed is only now beginning a series of rate hikes and will begin removing billions each month from the economy. Thus, the fed is changing its stance from an easy monetary policy to a tightening policy. While this will certainly reduce demand, will it reduce it too much? What about the federal governments role in this mission?
The U.S. government is responsible for fiscal policy, which includes spending, taxation, and transfer payments such as Social Security. Government spending is at an all-time high topping $6.8 trillion during fiscal year ending September 30, 2021. Federal receipts are also at an all-time high exceeding $4.0 trillion during the same period. Unfortunately, that leaves the second largest deficit in U.S. history at more than $2.7 trillion (the worst was a year earlier at over $3.1 trillion) and a public debt exceeding $29 trillion. Excessive spending is inflationary while raising taxes will slow demand. Yes, these conflict with each other as one serves to increase demand while the other reduces it. This is why I suggest coordination between the federal government and the Federal Reserve is needed, but I dont expect it. Why? Because the fed seeks to remove itself from politics and the federal government leads with politics. Therefore, the two opposing forces will not work together, and politicians will continue to spend as much as they can to secure their place in government.
So, whos to blame for the surge in inflation? While the federal government and the fed are culpable, Covid-19 is the unknown variable. We do not know when the pandemic will subside to the point where workers are no longer concerned with contracting the virus. In the meantime, the government will expand spending and raise taxes (at some point) while the fed will tighten. Both will have an effect on demand. Hence, it depends on Covid-19. And this unknown variable plus the lack of coordination between the Federal Reserve and the federal government makes it impossible to accurately predict when inflation will normalize.
Stay tuned.
The number of new COVID-19 cases in Maine jumped Wednesday to the highest level in nearly six weeks as the latest version of coronavirus, omicron BA.2, raises infection rates across the Northeast.
Meanwhile, the Mills administration announced Wednesday that Maine schools will stop conducting pooled testing for the virus on May 13, in part because the BA.2 is so contagious that weekly tests are no longer as effective at keeping the virus out of schools. The administration said free at-home test kits, which it is providing to schools, are a better tool to prevent the virus from spreading among students and staff.
Maine reported 605 new cases of COVID-19 on Wednesday, the highest one-day total since March 4. The spike pushed up the seven-day average from about 200 cases a day to 255. The state also reported seven additional deaths.
The jump in new cases follows a slow rise in Maines case counts over the past two weeks.
Dr. Nirav Shah, Maine director of the Maine Center for Disease Control and Prevention, noted the overall upward trends in COVID-19 cases in a series of tweets Tuesday, although he also pointed out that hospitalizations have not increased by as much. Shah said the increases are being driven by the more contagious BA.2 omicron subvariant.
What does all this mean? COVID is not over, though, as of now, it is not coming back with the same force as, say, BA.1 did in January, Shah said.
The number of patients hospitalized in Maine with COVID-19 dropped to 94 on Wednesday from 103 on Tuesday. There were 20 patients in critical care and four on ventilators.
Maine hospitalizations hovered below 100 for most of the past three weeks after a steep drop from a peak of 436 patients on Jan. 13. Hospitalization counts also have remained stable in other Northeast states despite the rise in daily case counts.
New cases have begun rising nationwide, with the Northeast recording the most significant spike.
Maine has the fifth highest infection rate in the United States, with 142 cases per 100,000 residents over the past seven days, according to the U.S. Centers for Disease Control and Prevention. The national infection rate is 64.3 cases per 100,000 people.
Infection rates in Maine range from 261 cases per 100,000 people in Aroostook County to 77.5 in Piscataquis County. Cumberland Countys infection rate is 123.73 cases per 100,000 and York County has a rate of 114.6 cases per 100,000, according to the federal data.
The U.S. CDC data was last updated Tuesday and does not account for the jump in cases Maine recorded Wednesday. Washington, D.C., Rhode Island, New York and Massachusetts had the four highest infection rates.
On Tuesday, Philadelphia became the first major city in the United States to reinstate a mask mandate amid rising case numbers. Starting Monday, masks will again be required in indoor spaces in the city.
A number of institutes of higher education including Columbia University in New York and American University and Georgetown University in Washington D.C. have also reinstated mask mandates.
But in Maine, the state is dropping one of its key strategies for reducing the spread of COVID in schools. The state plans to end pooled testing on May 13, the state Department of Health and Human Services announced Wednesday.
The department said pooled testing is significantly less effective with the extremely contagious BA.2 variantthan it was with previous variants
Since May 2021 the state has funneled money to schools to test groups of students and staff for Covid. The federally funded program has cost an average of almost $2.5 million per month. A positive result in the group tests is followed by tests of individuals to find out who is infected. The surveillance testing has been used to identify infected individuals who dont have symptoms before they can pass it along to others.
But the time between contracting BA.2 and showing symptoms is estimated to be much shorter than it was with previous variants only 1.2 to 1.4 days, according to DHHS. And it usually takes longer than that around two days according to DHHS to get results from the PCR tests used for pool testing, defeating the purpose of the surveillance testing. Incubation periods for earlier strains of COVID have ranged between two to 14 days.
Because the BA.2 variant is significantly more contagious than previous strains of the virus and given the longer time period to receive PCR results, the likelihood of detecting, identifying, and isolating an individual with COVID-19 through pooled testing before that individual has spread the virus to others is now significantly lower, said DHHS.
To replace pooled testing, DHHS and the Department of Education will make 1.1 million at-home rapid test kits available to all K-12 schools in the state, enough to provide every student and school staff member one test kit with five to six tests. Rapid test results can come back in a matter of minutes. The department announced its plan to offer these free COVID tests to schools last week.
Schools can place orders for at-home tests up until Friday. DHHS said it will start shipping the kits to schools the week of April 25, and they may take a few weeks to arrive.
Xavier Botana, superintendent for Portland Public Schools, said he wants to learn more about why pooled testing is no longer an effective COVID mitigation strategy before calling off the program. However, at a Tuesday night school board meeting Botana noted that the school district has always followed the science when making decisions about COVID protocols and will continue to do so.
The Maine CDC also announced Wednesday it had overstated the number of Maine residents who were fully vaccinated by nearly 33,000.
The agency said some clinics misreported doses that had been used for second booster shots as the final doses of initial vaccinations. As a result, the number of people fully vaccinated was reduced from more than 1 million back to 996,919, or 74 percent of the Maine population.
Invalid username/password.
Please check your email to confirm and complete your registration.
Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.
Previous
Next
On April 7, Provost Michael Kotlikoff, Vice President for Student and Campus Life Ryan Lombardi and Vice President and Chief Human Resources Officer Mary Opperman addressed the Cornell community in an email providing updates regarding the new COVID-19 booster shot, surveillance testing policies and vaccination requirements for the 2022-2023 academic year.
According to the email, the University will continue to require that all Cornell students and employees be fully vaccinated against COVID-19 unless they have received a valid exemption.
The decision has received support from students like Shannon Brewi 24, who sees vaccination as a public health necessity
All students should be vaccinated against COVID-19 because it is a group effort to protect each other from getting sick. I feel safer being at school knowing that my peers and the faculty are all vaccinated, Brewi said.
Ariana Ishkanian 24 felt similarly, arguing that the vaccine mandate would return campus to a state of post-pandemic normalcy faster.
With everyone doing their part, classes, clubs and in-person events can get back to normal [pre-covid conditions] faster, allowing for us to have the best and most normal college experience possible, Ishkanian said.
However, the April 7 emails announcement that booster shots will no longer be required for University students and employees has left some students feeling that the University is relaxing its anti-COVID-19 measures too quickly.
Cornell is getting lazy on their policies, Alex Taylor 24 said. This shortcut they are taking is unfortunate because it seems they are ignoring their own science that getting a booster will help people not catch COVID-19 or [not] get severe symptoms if they do catch it.
Alejandro Cuellar 24 said he believes the decision to not require a booster shot in the fall is a temporary measure to avoid backlash as boosters come under attack in the U.S.
I think Cornell not requiring the booster allows them to avoid backlash. However, as time passes, I believe they will require students to have the booster, said Cuellar.
Because some students have increased natural immunity for 90 days after being infected with COVID-19, Talia Dror 25 said she supports booster shots not being required so that students can use up their 90 days of immunity before getting the booster shot in order to have the greatest amount of time with increased immunity.
Since Feb. 21, fully vaccinated students have not been required to undergo weekly COVID-19 testing. Cornell administrators said in their April 7 email that the University will continue to offer COVID-19 tests for those who want them, and will allow students to opt into weekly surveillance testing.
The April 7 email also explained that the University will be making significant changes to surveillance testing procedures. As of April 11, unvaccinated students and employees working or taking classes on campus will only have to participate in surveillance testing once per week, and fully vaccinated individuals who did not get a booster shot will no longer be required to undergo weekly testing.
Jing Su 24 said she supports this policy as a way to reduce stress on students.
Having students test more than once a week could disrupt their education and remove focus from school, Su said.
While Sagal Mohamud 23 said she enjoys not having to get tested since the requirements were lifted for fully vaccinated and boosted students, she feels that the lack of testing is a bad policy.
Cornell is giving up on its students health and safety, Mohamud said. I know we have been in a pandemic for the past 2 years and learned to live with this virus but as you can see before spring break we still have flare-ups and outbreaks so implementing the booster or testing once a week can maybe stabilize cases.
But as restrictions fall and Cornell begins to once again resemble what it did before the pandemic, Alexandra Yiachos 24 said she is happy.
I think its great that Cornell is beginning to resemble a normal college experience and that students can interact in meaningful ways, said Yiachos.
With cases slowly but steadily rising over the past month in our region, were taking a closer look at what we know about the state of the pandemic locally. The bottom line is that although ongoing ups and downs in COVID-19 activity are likely, its best not to become infected and there are effective ways to reduce our risk.
Heres a brief look at the current COVID-19 situation in King County and recommended strategies for anyone who wants to reduce their risk for COVID-19 and long COVID, especially people at higher risk for severe infection.
Cases
Cases are rising slowly but steadily over the past month. In our region, the Omicron surge rose rapidly in December and peaked in early January. A steep decline followed, hitting a low point in mid-March. Since that time, cases have started to rise again more slowly, but are much lower than the peak we saw in January.
To put our current number of cases in perspective, at the peak of the Omicron surge, we were seeing an average of 6,500 new cases reported daily.
Currently, were seeing an average of 484 new cases each day. Thats about three times the number of cases reported at the low point we experienced a month ago, but 7% of the number at the Omicron peak.
Our current case rate is very likely an undercount of the actual level of infection in our community right now. While reported case numbers have always represented a fraction of cases in the community, the current data may be more of an underestimate at this stage in the pandemic as more rapid at-home tests are used and not often reported.
Hospitalizations and deaths
Deaths and hospitalizations currently are comparable to the lowest levels weve seen during the pandemic.
Since the low point of mid-March, hospitalizations remain low and comparable to pre-Delta surge in June 2021. When there are small numbers, percentage increases may look large, so its important to look at the actual numbers of hospitalizations, which have been stable over the past month at 4-6 hospitalizations daily.
Although our current case and hospitalization numbers put King County in the LOW COVID Community level, its important to be aware of increasing COVID-19 trends locally and take steps now to prevent further increases and reduce cases as much as possible, without adding any new mandates or restrictions on our activities. (Note that there may be differences at any given time in how CDC reports the COVID-19 Communtiy Level compared to our local data.)
A key reason there are currently fewer hospitalizations and deaths than previously in the pandemic is because so many King County residents have been vaccinated and boosted.
There is also some additional protection from immunity after recent infections that happened during the Omicron surge.
People who remain at highest risk are those who are unvaccinated or not boosted, people who have weakened immune systems or other underlying high-risk health conditions, and older adults. Learn about the best vaccine schedule for you if you are high risk or underlying health conditions.
People who are eligible for a booster but have not received it are at higher risk for infection, hospitalization and death when cases rise. And booster dose uptake in King County differs by race and ethnicity, age, and neighborhood.
We could see a rise in cases that could last for several weeks, and although I dont expect the extent of the rise or the number of associated hospitalizations and deaths to be as severe as our recent wintertime Omicron surge, if cases do surge, we could see a rise in hospitalizations and deaths among the vulnerable. We are especially concerned about low booster rates and disparities in booster coverage by race/ethnicity. Low booster coverage could lead to perpetuating the disproportionate impact the COVID-19 pandemic has already had on some communities of color. We continue to work with our teams to conduct outreach to communities that have not yet been boosted.
Systemic and structural inequities shape who first has access to vaccines and who has more barriers to getting vaccinated. To address these inequities, Public Health Seattle & King County set goals to provide equitable access to vaccine by focusing on communities that are at highest risk for COVID, live in areas that have had the most cases and face the most barriers to vaccination. Partnerships with community and outreach have been instrumental in increasing vaccination.
Long COVID (also called post-COVID conditions) is a complication of COVID-19 infection that has been reported to occur in 10-30% of cases, more often in severe cases, but also can occur in less severe and even mild cases. Vaccination decreases the risk for developing long COVID.
There is much we dont know about long COVID, including how best to diagnose and treat it. Many people recover after several weeks to months. However, even among young, healthy people, long COVID can be serious and longer lasting, affecting the brain and nervous system, heart, lungs, and other organs; COVID-19 can also increase the risk for developing diabetes. Difficulty thinking, weakness and other symptoms can make it difficult or impossible to work or do other activities of daily living.
To decrease your risk for COVID-19, including long COVID, proven prevention strategies can make a big difference.
The following strategies are recommended. These strategies should be used in combination and are especially important for people at high risk for severe COVID-19, people who are in contact with people at high risk, and anyone who wants to reduce their risk for COVID-19.
While we cant predict the future course of the pandemic, including whether or how much cases will continue to rise or when they may fall, we know preventing cases through layered prevention strategies can help individuals stay safe and healthy and decrease the risk for surges.
Additional resources:
Originally published April 12, 2022.
Country
United States of AmericaUS Virgin IslandsUnited States Minor Outlying IslandsCanadaMexico, United Mexican StatesBahamas, Commonwealth of theCuba, Republic ofDominican RepublicHaiti, Republic ofJamaicaAfghanistanAlbania, People's Socialist Republic ofAlgeria, People's Democratic Republic ofAmerican SamoaAndorra, Principality ofAngola, Republic ofAnguillaAntarctica (the territory South of 60 deg S)Antigua and BarbudaArgentina, Argentine RepublicArmeniaArubaAustralia, Commonwealth ofAustria, Republic ofAzerbaijan, Republic ofBahrain, Kingdom ofBangladesh, People's Republic ofBarbadosBelarusBelgium, Kingdom ofBelizeBenin, People's Republic ofBermudaBhutan, Kingdom ofBolivia, Republic ofBosnia and HerzegovinaBotswana, Republic ofBouvet Island (Bouvetoya)Brazil, Federative Republic ofBritish Indian Ocean Territory (Chagos Archipelago)British Virgin IslandsBrunei DarussalamBulgaria, People's Republic ofBurkina FasoBurundi, Republic ofCambodia, Kingdom ofCameroon, United Republic ofCape Verde, Republic ofCayman IslandsCentral African RepublicChad, Republic ofChile, Republic ofChina, People's Republic ofChristmas IslandCocos (Keeling) IslandsColombia, Republic ofComoros, Union of theCongo, Democratic Republic ofCongo, People's Republic ofCook IslandsCosta Rica, Republic ofCote D'Ivoire, Ivory Coast, Republic of theCyprus, Republic ofCzech RepublicDenmark, Kingdom ofDjibouti, Republic ofDominica, Commonwealth ofEcuador, Republic ofEgypt, Arab Republic ofEl Salvador, Republic ofEquatorial Guinea, Republic ofEritreaEstoniaEthiopiaFaeroe IslandsFalkland Islands (Malvinas)Fiji, Republic of the Fiji IslandsFinland, Republic ofFrance, French RepublicFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabon, Gabonese RepublicGambia, Republic of theGeorgiaGermanyGhana, Republic ofGibraltarGreece, Hellenic RepublicGreenlandGrenadaGuadaloupeGuamGuatemala, Republic ofGuinea, RevolutionaryPeople's Rep'c ofGuinea-Bissau, Republic ofGuyana, Republic ofHeard and McDonald IslandsHoly See (Vatican City State)Honduras, Republic ofHong Kong, Special Administrative Region of ChinaHrvatska (Croatia)Hungary, Hungarian People's RepublicIceland, Republic ofIndia, Republic ofIndonesia, Republic ofIran, Islamic Republic ofIraq, Republic ofIrelandIsrael, State ofItaly, Italian RepublicJapanJordan, Hashemite Kingdom ofKazakhstan, Republic ofKenya, Republic ofKiribati, Republic ofKorea, Democratic People's Republic ofKorea, Republic ofKuwait, State ofKyrgyz RepublicLao People's Democratic RepublicLatviaLebanon, Lebanese RepublicLesotho, Kingdom ofLiberia, Republic ofLibyan Arab JamahiriyaLiechtenstein, Principality ofLithuaniaLuxembourg, Grand Duchy ofMacao, Special Administrative Region of ChinaMacedonia, the former Yugoslav Republic ofMadagascar, Republic ofMalawi, Republic ofMalaysiaMaldives, Republic ofMali, Republic ofMalta, Republic ofMarshall IslandsMartiniqueMauritania, Islamic Republic ofMauritiusMayotteMicronesia, Federated States ofMoldova, Republic ofMonaco, Principality ofMongolia, Mongolian People's RepublicMontserratMorocco, Kingdom ofMozambique, People's Republic ofMyanmarNamibiaNauru, Republic ofNepal, Kingdom ofNetherlands AntillesNetherlands, Kingdom of theNew CaledoniaNew ZealandNicaragua, Republic ofNiger, Republic of theNigeria, Federal Republic ofNiue, Republic ofNorfolk IslandNorthern Mariana IslandsNorway, Kingdom ofOman, Sultanate ofPakistan, Islamic Republic ofPalauPalestinian Territory, OccupiedPanama, Republic ofPapua New GuineaParaguay, Republic ofPeru, Republic ofPhilippines, Republic of thePitcairn IslandPoland, Polish People's RepublicPortugal, Portuguese RepublicPuerto RicoQatar, State ofReunionRomania, Socialist Republic ofRussian FederationRwanda, Rwandese RepublicSamoa, Independent State ofSan Marino, Republic ofSao Tome and Principe, Democratic Republic ofSaudi Arabia, Kingdom ofSenegal, Republic ofSerbia and MontenegroSeychelles, Republic ofSierra Leone, Republic ofSingapore, Republic ofSlovakia (Slovak Republic)SloveniaSolomon IslandsSomalia, Somali RepublicSouth Africa, Republic ofSouth Georgia and the South Sandwich IslandsSpain, Spanish StateSri Lanka, Democratic Socialist Republic ofSt. HelenaSt. Kitts and NevisSt. LuciaSt. Pierre and MiquelonSt. Vincent and the GrenadinesSudan, Democratic Republic of theSuriname, Republic ofSvalbard & Jan Mayen IslandsSwaziland, Kingdom ofSweden, Kingdom ofSwitzerland, Swiss ConfederationSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania, United Republic ofThailand, Kingdom ofTimor-Leste, Democratic Republic ofTogo, Togolese RepublicTokelau (Tokelau Islands)Tonga, Kingdom ofTrinidad and Tobago, Republic ofTunisia, Republic ofTurkey, Republic ofTurkmenistanTurks and Caicos IslandsTuvaluUganda, Republic ofUkraineUnited Arab EmiratesUnited Kingdom of Great Britain & N. IrelandUruguay, Eastern Republic ofUzbekistanVanuatuVenezuela, Bolivarian Republic ofViet Nam, Socialist Republic ofWallis and Futuna IslandsWestern SaharaYemenZambia, Republic ofZimbabwe
Auckland, New Zealand-based in vitro diagnostics company Pictor is partnering with Mobility Health, a laboratory service provider based in Mason, Ohio, to distribute Pictors Covid-19 antibody test that assesses if a patient has Covid-19 antibodies, and if they do, if the antibodies are from vaccination or from having contracted Covid-19. This partnership comes at the same time as a $6.1 million investment led by Marko Bogievski and K One W One Ltd. for Pictor.
Pictors PictArrayTM SARS-CoV-2 assay can identify if a patient has antibodies for Covid-19 as well as determine if those antibodies can be attributed to a previous Covid-19 infection or if they are from vaccination alone. The test does so by identifying if a person has nucleocapsid protein (NP) antibodies as well as spike protein (SP) antibodies present or if the person only has SP antibodies. If only SP antibodies are identified, the person has not contracted Covid-19 and the antibodies present can be attributed to vaccination.
The test has an additional useful application: determining if at risk patients do not have an adequate antibody response even if they have previously been vaccinated or infected.
Pictor sees this test as an opportunity to inform if those patients should then receive additional boosters, explained Howard Moore, CEO of Pictor, in an interview. On the flip side, if someone has a very high antibody count, then the test could indicate that person should perhaps not receive a booster yet. For example, if patients have too high of antibody levels, they may benefit from delaying additional boosting, according to Moore.
You have to be somewhat careful in administering vaccination. We believe you should be careful about administering vaccines to those people who have been infected. Their antibodies level may be reasonably high, said Moore.
Though not proven, a correlation could exist between high antibody levels and autoimmune diseases, according to Moore. As a result, Pictors test could prove useful in this regard since it can determine the antibody levels in addition to their origin.
Patients will have access to the test via doctor or hospitals ordering it on their behalf, Moore explained in an email forwarded by a representative.
The $6.1 million investment will fund Pictors marketing for the test as well as its other diagnostics. This funding will go towards US, EU, and ANZ market development; it will also help fund research and development efforts, Moore said. To date, Pictor has raised $17 million.
Current tests that assess antibody levels can determine if a person has had Covid-19 and if the antibodies present are from that infection. However, a person has to take an entirely separate test to see if antibodies present are due to vaccination.
The PictArra SARS-CoV-2 Antibody Test is a high performance, all-in-one, NP/SP COVID-19 antibody test with serological differentiation. This is the only test that separately measures antibodies from vaccines and SARS-CoV-2 infection in one test, said Tadd Lazarus, chief medical officer of Pictor, in a news release. The separate detection of SP and NP enables more precise clinical intervention.
Additionally, Pictors two-in-one test costs roughly the same as one of the competitors tests, allowing Pictors test to potentially cut down the total cost of testing by 50%, according to Moore. Further, money can be saved by paying a lab technician to administer only one test instead of two.
They [our competitors] could do what we do, but they [would] have to sell two tests to do it, Moore added. The lab technician only has to administer one test. These are the advantages that we have. We intend to leverage them as we proceed with our U.S. launch in particular.
Photo: peterschreiber.media, Getty Images
Acute COVID-19 illness complications include stroke, encephalopathies, neuropsychiatric and inflammatory syndromes, whereas non-severe cases may suffer from longitudinal brain structure and cognition changes.
In a preprint version of a study posted to SSRN*, researchers investigated the potential of therapeutic drugs, remdesivir and dexamethasone, when used alone or in combination on neurological complications that arise incoronavirus disease 2019 (COVID-19) affected individuals.
The current prospective, observational, non-blinded study involved 89,297 adult COVID-19 patients admitted to hospital screened from 184,986 patients. Of these 89,297 patients, 64,088 were grouped into severe COVID-19 and the remaining 25,209 into non-hypoxic COVID-19.
Inclusion criteria included participants aged 18 and above (median age 71) admitted to the hospital between January 31st, 2020, and June 29th 2021, with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Exclusion criteria defined COVID-19 vaccinated individuals and participants who tested positive for COVID-19 in hospitals. Fifty-six percent were male, whereas 71 % were of white ethnicity. Neurological complications occurred in 4.8% (4,245) of the cohort and consisted of seizures (925), meningitis/encephalitis (194), stroke (1,259), and others (not defined) (2,227)
Covariates involved age, sex, ethnicity, Dalhousie University Clinical Frailty score, smoking status, time from symptom onset to hospital admission, the severity of pulmonary infection, and eligibility for remdesivir.
Treatment groups included under both severe COVID-19 and non-hypoxic were no treatment, dexamethasone alone, remdesivir on day 1, remdesivir at any time, combined treatment on day 1, and combined treatment at any time.
Participants were treated with either remdesivir or dexamethasone or both. Treatment comparison groups included remdesivir alone vs. standard of care, dexamethasone alone vs. standard of care, and combined treatment vs. standard of care. Analysis was done separately for severe (supplemental oxygen required) or non-hypoxic (no supplemental oxygen required) patients. The case duration was considered from admission to the day of discharge, death, or continued admission.
The researchers studied the effects of treatment groups on mortality in severely infected patients. Dexamethasone treatment reduced mortality, while it was found that remdesivir failed in reducing mortality. However, the combined treatment led to a significant reduction in mortality.
Intensive care unit (ICU) admissions were also reduced with the dexamethasone, whereas they increased when treated with remdesivir. This increase in ICU admission probably reflected the increased likelihood of its prescription to the sickest patients requiring higher levels of care. Both the treatments were not associated with worse self-care at discharge. With both the treatment strategies, either with dexamethasone or remdesivir, the incidence of neurological complications with increased mortality, ICU admission, worse self-care at discharge, and increased recovery time was reduced. Combined treatment showed a larger reduction in complications.
In non-hospitalized patients (50% male, 72% white), the treatment reduced ICU admission (0.9%), mortality (9.2%) worse self-care at discharge (13%), length of inpatient stay (5 days). Neurological complications were associated with increased mortality, ICU admission, worse self-care on discharge, and recovery time. This may be attributed to the possibility that patients with non-hypoxic COVID-19 had severe disease affecting organs outside the respiratory system. Treatment with dexamethasone reduced neurological complications. However, the combined treatment led to higher reductions.
The results demonstrated were consistent with the previous pivotal randomized controlled trials and ISARIC cohort studies.
This study suggests that remdesivir and dexamethasone can reduce neurological complications in patients suffering from severe COVID-19. Moreover, their synergistic effect was significantly greater than dexamethasone alone.
Despite having strengths such as a large study with real-life data and the use of the same control population for comparisons, the study has several limitations. The data was not collected on the onset of neurological complications or dexamethasone treatment, and the final diagnosis of these complications was not made. Furthermore, the time of the pandemic's start was not included in the propensity score, compromising the correct confounding effect.
SSRN publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
Journal reference:
Philadelphia became the first major U.S. city to reinstate its indoor mask mandate on Monday after reporting a sharp increase in coronavirus infections, with the city's top health official saying she wanted to forestall a potential new wave driven by an omicron subvariant.Confirmed COVID-19 cases have risen more than 50% in 10 days, the threshold at which the citys guidelines call for people to wear masks indoors, said Dr. Cheryl Bettigole, the health commissioner. Health officials believe the recent spike is being driven by the highly transmissible BA.2 subvariant of omicron, which has spread rapidly throughout Europe and Asia, and has become dominant in the U.S. in recent weeks.If we fail to act now, knowing that every previous wave of infections has been followed by a wave of hospitalizations, and then a wave of deaths, it will be too late for many of our residents, said Bettigole, noting about 750 Philadelphia residents died in the wintertime omicron outbreak. This is our chance to get ahead of the pandemic, to put our masks on until we have more information about the severity of this new variant.Health inspectors will begin enforcing the mask mandate at city businesses on April 18.Most states and cities dropped their masking requirements in February and early March following new guidelines from the U.S. Centers for Disease Control and Prevention that put less focus on case counts and more on hospital capacity. The CDC said at that time that with the virus in retreat, most Americans could safely take off their masks.Philadelphia ended its indoor mask mandate March 2, and Bettigole acknowledged it was wonderful to feel that sense of normalcy again.Confirmed cases have since risen to more than 140 per day still a fraction of what Philadelphia saw at the height of the omicron surge while only 46 patients are in the hospital with COVID-19. The CDC says community spread in Philadelphia remains low, a level at which the agency says that masking can be optional.The restaurant industry pushed back against the city's reimposed mask mandate, saying workers will bear the brunt of customer anger over the new rules.This announcement is a major blow to thousands of small businesses and other operators in the city who were hoping this spring would be the start of recovery, said Ben Fileccia, senior director of operations at the Pennsylvania Restaurant & Lodging Association.PolicyLab at Childrens Hospital of Philadelphia said Friday that while it expects some increased transmission in the northern U.S. over the next several weeks, hospital admissions have remained low and our team advises against required masking given that hospital capacity is good.Bettigole said requiring people to mask up will help restaurants and other businesses stay open, while a huge new wave of COVID-19 would keep customers at home. She said hospital capacity was just one factor that went into her decision to reinstate the mandate.I sincerely wish we didnt have to do this again, Bettigole said. But I am very worried about our vulnerable neighbors and loved ones. In New York City, Mayor Eric Adams has paused his push to unwind many of the citys virus rules as cases have risen, opting for now to keep a mask mandate for 2 to 4-year-olds in city schools and preschools. But Adams, a Democrat who has said New Yorkers should not let the pandemic run their lives, has already lifted most other mask mandates and rules requiring proof of vaccination to dine in restaurants, work out at gyms or attend shows.Adams was asked at a virtual news conference Monday afternoon if he was considering reimposing the New York City mask mandate in light of Philadelphias decision. The mayor said he would listen to his team of medical doctors for their advice on whether to bring back any restrictions. Adams himself tested positive for COVID-19 on Sunday.New York City is now averaging around 1,800 new cases per day, about three times higher than in early March when New York began easing rules. That does not include the many home tests that go unreported to health officials.The latest outbreak has struck many high-profile officials in Washington, including Cabinet members and House Speaker Nancy Pelosi, and the governors of New Jersey and Connecticut. Some universities have reinstated mask mandates.D.C. health officials say they have no immediate plans to change virus protocols, but they reserve the right to change course down the road.___Rubinkam reported from northeastern Pennsylvania. Associated Press reporter Michelle L. Price in New York contributed to this story.
Philadelphia became the first major U.S. city to reinstate its indoor mask mandate on Monday after reporting a sharp increase in coronavirus infections, with the city's top health official saying she wanted to forestall a potential new wave driven by an omicron subvariant.
Confirmed COVID-19 cases have risen more than 50% in 10 days, the threshold at which the citys guidelines call for people to wear masks indoors, said Dr. Cheryl Bettigole, the health commissioner. Health officials believe the recent spike is being driven by the highly transmissible BA.2 subvariant of omicron, which has spread rapidly throughout Europe and Asia, and has become dominant in the U.S. in recent weeks.
If we fail to act now, knowing that every previous wave of infections has been followed by a wave of hospitalizations, and then a wave of deaths, it will be too late for many of our residents, said Bettigole, noting about 750 Philadelphia residents died in the wintertime omicron outbreak. This is our chance to get ahead of the pandemic, to put our masks on until we have more information about the severity of this new variant.
Health inspectors will begin enforcing the mask mandate at city businesses on April 18.
Most states and cities dropped their masking requirements in February and early March following new guidelines from the U.S. Centers for Disease Control and Prevention that put less focus on case counts and more on hospital capacity. The CDC said at that time that with the virus in retreat, most Americans could safely take off their masks.
Philadelphia ended its indoor mask mandate March 2, and Bettigole acknowledged it was wonderful to feel that sense of normalcy again.
Confirmed cases have since risen to more than 140 per day still a fraction of what Philadelphia saw at the height of the omicron surge while only 46 patients are in the hospital with COVID-19. The CDC says community spread in Philadelphia remains low, a level at which the agency says that masking can be optional.
The restaurant industry pushed back against the city's reimposed mask mandate, saying workers will bear the brunt of customer anger over the new rules.
This announcement is a major blow to thousands of small businesses and other operators in the city who were hoping this spring would be the start of recovery, said Ben Fileccia, senior director of operations at the Pennsylvania Restaurant & Lodging Association.
PolicyLab at Childrens Hospital of Philadelphia said Friday that while it expects some increased transmission in the northern U.S. over the next several weeks, hospital admissions have remained low and our team advises against required masking given that hospital capacity is good.
Bettigole said requiring people to mask up will help restaurants and other businesses stay open, while a huge new wave of COVID-19 would keep customers at home. She said hospital capacity was just one factor that went into her decision to reinstate the mandate.
I sincerely wish we didnt have to do this again, Bettigole said. But I am very worried about our vulnerable neighbors and loved ones.
In New York City, Mayor Eric Adams has paused his push to unwind many of the citys virus rules as cases have risen, opting for now to keep a mask mandate for 2 to 4-year-olds in city schools and preschools. But Adams, a Democrat who has said New Yorkers should not let the pandemic run their lives, has already lifted most other mask mandates and rules requiring proof of vaccination to dine in restaurants, work out at gyms or attend shows.
Adams was asked at a virtual news conference Monday afternoon if he was considering reimposing the New York City mask mandate in light of Philadelphias decision. The mayor said he would listen to his team of medical doctors for their advice on whether to bring back any restrictions. Adams himself tested positive for COVID-19 on Sunday.
New York City is now averaging around 1,800 new cases per day, about three times higher than in early March when New York began easing rules. That does not include the many home tests that go unreported to health officials.
The latest outbreak has struck many high-profile officials in Washington, including Cabinet members and House Speaker Nancy Pelosi, and the governors of New Jersey and Connecticut. Some universities have reinstated mask mandates.
D.C. health officials say they have no immediate plans to change virus protocols, but they reserve the right to change course down the road.
___
Rubinkam reported from northeastern Pennsylvania. Associated Press reporter Michelle L. Price in New York contributed to this story.
