Energy conservation
If you experience symptom flares after any kind of exertion, a therapist may recommend that you manage your daily activity levels or keep a diary to help anticipate which activities may be too mentally or physically draining. This self-pacing technique, often used by those with chronic fatigue syndrome (also known as myalgic encephalomyelitis, or ME/CFS), assumes that people have a set quota of energy they can spend each day. So small tasks, like showering or getting dressed, may use up less of their energy, whereas vacuuming or walking to the end of the driveway may drain their energy much faster, leading to something called post-exertional malaise.
April 10, 2022, 9:59 a.m. ET
Conserving energy throughout the day can help reduce post-Covid fatigue while patients recover, Ms. Ridgway said. Its a little bit of a different treatment approach than a lot of other physical therapies, but we really want to make sure were doing everything that we can to empower these patients.
Doctors and therapists agree that people with long Covid need to return to exercising at a very slow pace, often by starting with relearning basic aerobic conditioning and doing recumbent strength training before advancing to more intense, upright movement. This may involve trying to activate your core while in a supine or sideways position, performing balance exercises or doing seated cardio on a recumbent bike or rowing machine. A health care provider will likely monitor your heart rate, blood pressure and oxygen levels while you perform these exercises and ensure that you dont experience a skipping heart beat or any other cardiovascular symptoms, Dr. Titano said.
Eventually, you may feel comfortable trying an elliptical or walking on a treadmill. Your doctor or physical therapist may also ask you to count your steps or attempt to climb the stairs in your home a certain number of times every day. One of the goals that Ms. Fagans cardiologist set was to walk 5,000 steps a day a target the specialist suggested in October 2021. Its March now and I just reached it, she said.
Progress in managing long Covid symptoms can be excruciatingly slow, so it is often encouraging to be able to see your improvements over time. People may track their data using a heart rate monitor in a smartwatch, a blood pressure cuff or pulse oximeter if they have one at home. Health care providers may advise that you enlist a family member or friend to help you use some of these devices, and to ensure that you remain safe while performing any exercises. Its nice to be able to track progress, Ms. Fagan said. It personally helps me because the progress is so incredibly slow. You just dont see it day to day. You do not even see it month to month. Its more yearlong progress.
If you experience really debilitating symptoms that prevent you from doing everyday tasks like the laundry, going to work or taking care of your kids, for example you may need additional help from prescription medication and closer monitoring by a health care professional, Dr. Hayek said. Depending on your individual heart disease risk and current symptoms, certain blood pressure medications like beta blockers or calcium channel blockers can help alleviate extreme dizziness and treat chest pain and abnormal heart rhythms, he said. And these drugs can be tapered off once your cardiovascular symptoms abate.
Adolescents and young children with long Covid, however, are not eligible for many heart drugs. When seeing young patients, Dr. Sindhu Mohandas, an infectious disease expert at Childrens Hospital Los Angeles, said she tends to recommend more lifestyle changes that, in addition to physical therapy, may help patients focus in school and rebuild their endurance for sports.
For months, some American and European leaders have foretold that the coronavirus pandemic would soon become endemic. Covid-19 would resolve into a disease that we learn to live with. According to several governors, it nearly has.
But we are still in the acute phase of the pandemic, and what endemic Covid might look like remains a mystery. Endemic diseases can take many forms, and we do not know yet where this two-year-old disease will fall among them.
40 cases per day
per 100,000
March 2020
W.H.O. declares
Covid-19 a pandemic
40 cases per day
per 100,000
March 2020
W.H.O. declares Covid-19
a pandemic
Sources: Local governments; Center for Systems Science and Engineering at Johns Hopkins University; National Health Commission of the Peoples Republic of China; World Health Organization Note: Data is as of April 5. Chart shows seven-day average.
At its most basic, an endemic disease is one with a constant, predictable or expected presence. Its a disease that persists. Beyond that, there is no fixed definition.
Endemic diseases infect millions of people around the world each year, and some endemic diseases kill hundreds of thousands. Some we can treat and vaccinate against. Yet they can also cause unexpected outbreaks and significant suffering.
Interviews with two dozen scientists, public health experts and medical historians suggest the rush to recast Covid as endemic may be missing the point.
Theres been a political reframing of the idea of endemic as something that is harmless or normal, said Lukas Engelmann, a historian of medicine and epidemiology at the University of Edinburgh. But epidemiologists use endemic to mean something we should watch carefully, he said, because an endemic disease can become epidemic again.
Endemic diseases can be mild or deadly
When people think of endemic disease, they often think of the common cold. Upper respiratory infections, including colds, are estimated to infect billions of people worldwide every year but kill several thousand. Other endemic diseases can be much more lethal. Malaria killed more than 600,000 people globally in 2019, and flu killed more than 200,000, though estimates suggest these tolls could be much higher.
New global cases per 100,000 in 2019
New global deaths per 100,000 in 2019
New global cases per 100,000 in 2019
New global deaths per 100,000 in 2019
Many scientists predict that endemic Covid may have a similar burden to other respiratory viruses.
It will be no more deadly than seasonal flu, or may be mild like one of the cold-causing coronaviruses, said Lone Simonsen, the director of the PandemiX Center at Roskilde University in Denmark.
The reason for this is that we have a lot of immunity and we keep getting boosted from the infections that we run into, she said.
Some scientists warn that immune protection from vaccination and infection may wane over time, and future variants might sidestep those defenses. And mutations are random, so there is always a chance a variant that causes more severe disease could arise in the future.
Endemic diseases can have epidemic periods
The common cold and the flu are widespread endemic diseases that persist year round, but their levels are not constant. Instead they cause seasonal epidemics, where infections rise beyond baseline endemic levels, often in the winter when people gather indoors.
2020
Covid-19
policies
disrupt spread
2020
Covid-19
policies
disrupt
spread
These patterns are predictable, but people can change them: The control measures used to blunt the Covid pandemic dampened flu and cold waves in recent years, too.
Scientists say that endemic Covid could be seasonal, but it could also have irregular and significant epidemic waves.
Covid is much, much more transmissible than the flu, said Jeffrey Shaman, an infectious-disease modeler at Columbia University. Only a small portion of the population needs to be susceptible for an outbreak to foment, and that can happen at any time of year.
The burden of endemic disease is unequal
One communitys experience with endemic disease can be vastly different from anothers, often depending on who is getting sick and whether they have access to tests, treatments and health care.
H.I.V., which has persisted across the globe for more than 40 years, is one example, though scientists and public health workers use both epidemic and endemic to describe the virus.
One definition of endemic is defined by geographic location, said Dr. Diane Havlir, an infectious disease specialist and professor of medicine at the University of California, San Francisco. Through that lens, H.I.V. is endemic in the United States, where approximately 1.2 million persons are living with H.I.V.
But H.I.V. is epidemic in subpopulations in the U.S., she added.
Changes in data methodology
Changes in data methodology
Infectious diseases often remain in communities where poverty or discriminatory systems prevent access to health care, Dr. Havlir said.
Disease disparities increase over time unless they are addressed at the outset, she said. And that raises the question: Are we addressing those disparities with Covid or are we on that same trajectory?
With one-third of the global population unvaccinated against Covid and life-saving treatments not available to all, the viruss burden will likely continue to be unequal, experts say, even as parts of the world decide their levels are endemic.
Endemic disease is all about control
Among the many forms endemic disease can take, one thing is clear: Endemic does not mean the end of the disease.
Instead, it means living with, and often managing, a disease that has not been, or cannot be, stamped out. Health experts say that countries must use control measures, like testing, treatments and vaccinations, to keep endemic diseases in check.
Countries with endemic malaria aspire to eradicate the mosquito-borne disease and rely on interventions like insecticides and preventative treatments to reduce its incidence. These control measures can drastically alter the course of endemic malaria, as they have in South Africa.
2000 epidemic
DDT use resumes
2001
New treatment
introduced
2000 epidemic
DDT use resumes
2001
New treatment
introduced
In addition to environmental controls, vaccination programs can reduce cases and deaths. But when communities do not adhere to vaccination recommendations, outbreaks can happen.
Measles, for example, remained endemic in the United States for 40 years after the introduction of vaccines. During that period, unvaccinated people remained vulnerable, fueling occasional outbreaks. In 2019, two decades after the disease was declared eliminated in the United States, several outbreaks, many associated with unvaccinated travelers, infected more than a thousand people.
1963
Measles vaccine
licensed in U.S.
1989
Many measles
outbreaks
2000
Measles declared
eliminated in U.S.
1963
Measles vaccine
licensed in U.S.
2000
Measles declared
eliminated in U.S.
1989
Many measles
outbreaks
Unlike malaria or measles, public health experts say that Covid cannot be eradicated, so control measures will help determine the size and course of future waves. (We have eradicated just one human disease: smallpox, which behaved quite differently from Covid.)
Keeping up with Covid means staying focused on vaccinating, treating and updating vaccines, said Dr. Monica Gandhi, an infectious disease specialist and professor of medicine at the University of California, San Francisco. Its going to take constant vigilance to keep it not to eradicate it, which would be what humans want but to keep it under control.
When will we know what Covids endemic phase looks like?
Probably not for a while. Scientists usually determine a diseases endemic pattern after observing it for many years.
Pandemics can take years to settle, and the consequences of widespread illness can last long after new infections fade.
Much of what we know about the transition out of pandemics comes from flu humans have witnessed four influenza pandemics in the last 100 years. The 1918-19 pandemic, which killed more than 50 million people globally, dwarfs them all.
195758
and 1968
pandemics
Change in data methodology
Change in data methodology
195758
and 1968
pandemics
Change in data
5 lessons I learned after testing positive for coronavirus abroad
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A requirement for federal workers to be vaccinated against the coronavirus was recently upheld by a federal appeals court panel. The groups that challenged the vaccination directive, however, could ask the full appeals court or the U.S. Supreme Court to review the matter.
We've gathered articles on the news fromSHRM Onlineand other media outlets.
Pursuing Administrative Remedies
The vaccine requirementfor federal employees was put on hold after a district judge in Texas blocked the directive in January. In a 2-1 order on April 7, the 5th U.S. Circuit Court of Appeals reversed the district judge's ruling and dismissed the lawsuit against the vaccination directive. The appeals court said the district judge did not have jurisdiction in the case. Instead, the employees who challenged the requirement could have pursued administrative remedies through the Merit Systems Protection Board or Office of Special Counsel in accordance with the Civil Service Reform Act.
(AP News)
Directive Applies to Executive Branch Workers
Biden issued the executive order in September 2021 requiring vaccinations for all executive branch agency employees, unless they qualified for an exemption based on a medical or religious objection.
TheExecutive Order on Requiring Coronavirus Disease 2019 Vaccination for Federal Employeesapplies to employees of the executive branch of the federal government. Employees in the judicial and legislative branches are not covered by the order. The Safer Federal Workforce Taskforce has issuedguidanceon the vaccination requirement for federal agencies.
(Safer Federal Workforce Taskforce)
Most Covered Employees Vaccinated
Federal agencies had mostly not been enforcing the directive after the district court issued theinjunctionin Januarythough some agencies did continue to enforce their own vaccination requirements and process requests for medical and religious exemptions. At the time the injunction was issued, about 98 percent of federal employees were following the executive order and 93 percent of employees were vaccinated.
(Government Executive)
Supreme Court Nixed OSHA Directive for Private Employers
Other vaccination directives have also been challenged. The Occupational Safety and Health Administration(OSHA)withdrewits COVID-19 vaccination-or-testingEmergency Temporary Standard (ETS) in light ofa Supreme Court rulingthat halted the directive. The ETS would have applied to private-sector employers with at least 100 employees. However,the high court allowedthe Centers forMedicare& Medicaid Services (CMS) to proceed with a vaccinedirective that applies to health care workers at Medicare- and Medicaid-certified providers and suppliers.
(SHRM Online)
What to Do When Workers Refuse a COVID-19 Vaccination
Employers should note thateven though some federal directives have been blocked by courtsjudges have generallysided with the employerin lawsuits challenging a private company'svaccinationrequirements. Many businesses continue to review and revise their COVID-19 vaccination policies as the pandemicpersistsand employers may be asking what they can do if workers refuse to get the jab. Some employers are firing workers or putting them on unpaid leave. Others are requiring unvaccinated employees to submit to weekly testing and take other safety precautions.
(SHRM Online)
ManagingChanging COVID-19 Workplace Safety Obligations
Employers may be tempted to lift their pandemic-related safety requirements as federal and state authorities ease masking and other COVID-19 rules. But employers should note that they have ongoing obligations to protect the health and safety of their workers. Employment law attorneys recommend that employers designate a point person to provide periodic updates to their leadership team and work with experienced employment counsel to keep informed of any new safety rules. The point person should check the Centers for Disease Control and Prevention, OSHA and state health department websites for new guidelines and rules on a daily or weekly basis.
(SHRM Online)
CLAIM: COVID-19 vaccines are causing a form of AIDS that is not related to HIV, long established as the cause of acquired immunodeficiency syndrome.
THE FACTS: There is no evidence that the COVID-19 vaccines cause any kind of immune deficiency condition, let alone AIDS, nor is there evidence that the COVID-19 vaccines damage the immune system, experts say. In a video circulating widely on social media, Dr. Robert Malone, a frequent critic of COVID-19 vaccines who once researched mRNA vaccine technology, made the claim that the vaccines are damaging T cell responses and causing a form of AIDS.
People think, when they hear AIDS, they hear HIV. No, the vaccines arent causing you to be infected with the HIV virus, said Malone, during a taped interview with a website that focuses on COVID-19. They are causing a form of acquired immunodeficiency syndrome, thats what AIDS stands for.
In the interview, published April 1, Malone claimed that lots of scientific data support his claim, but cited no evidence. The claims are unfounded. As The Associated Press previously reported, there is no evidence that COVID-19 vaccines damage the immune system or cause AIDS, and there is also no evidence that the vaccines are causing a form of AIDS that doesnt stem from HIV, experts tell the AP. John Swartzberg, a clinical professor of infectious diseases and vaccinology at the University of California, Berkeley, said he knows of no data showing that mRNA vaccines cause immunodeficiency of any kind, including AIDS.
What is widely accepted is that vaccines, including COVID-19 vaccines, cause short-term immune activation, not deficiency, Richard E. Chaisson, the director of the Johns Hopkins Center for AIDS Research, wrote in an email. Dr. Malone is distorting and misrepresenting data.
The AP has previously reported on false claims that COVID-19 vaccines damage T cells. Research shows the vaccines boost the immune response. HIV attacks the bodys immune system, according to the Centers for Disease Control and Prevention. It is often spread through sexual contact, shared or contaminated needles and infected blood. If untreated, it can lead to AIDS. Both Chaisson and Swartzberg wrote that the term AIDS is strictly used to describe the condition caused by HIV. Chaisson described Malones use of the term as deliberately provocative and irresponsible. There are forms of inherited immunodeficiency, such as severe combined immunodeficiency, that result in life-threatening infections, Chaisson noted. But, he said, there is no evidence that these conditions are caused by COVID-19 vaccines. Malone did not respond to a request for comment.
Associated Press writer Josh Kelety in Phoenix contributed this report.
I was supposed to be getting my second vaccine booster this week. Instead, I failed a COVID test.
I tested because my daughter, a teacher, had a positive test and Id spent time with her. Still, I was dumbstruck by my positive result.
My daughter wound up coughing and aching and couldnt smell the candle she loves, but I have yet to experience a single symptom. In fact, with all the vitamin-taking and oxygen-monitoring and resting Ive done while I quarantine, I feel healthier than Ive felt in months.
When a few days passed, with no signs of illness, the skeptic in me figured the test I took must be wrong. But the doctor I spoke with ruled that out. Its a highly reliable rapid test that detects genetic material from the virus at exquisitely low levels, he said.
Its almost embarrassing to finally confront the demon Ive feared for two years and find that the version afflicting me packs a punch I cannot even feel. Im apparently among the 30% to 40% of people with the coronavirus whose infections are so mild, they are asymptomatic.
I would like to take some credit for that: Im vaxxed and boosted and still masking around strangers and indoors in public places.
But the truth is that while we know that vaccinations blunt the severity of the disease, we dont yet fully understand why some infected people have no symptoms at all, while others wind up hospitalized and so many die. And no one can say whether long-haul COVID-19 difficulties await asymptomatic people down the line.
I know all this because I have spent my quarantine holed up in my bedroom, panic-Googling, trying to figure out what is going to happen to my asthmatic, senior-citizen self.
In the process, I stopped feeling odd and began to feel uncommonly lucky. Somehow a global disease that has killed more than 6 million people, and is still causing untold suffering, had spared me the worst of its misery.
During the past few months Ive felt increasingly safe, as infections declined and Los Angeles Countys COVID-19 hospitalizations plunged from 4,800 to less than 300.
But I knew that a few days of symptom-free infection didnt guarantee I was out of the woods. It can take as long as two weeks after exposure for debilitating symptoms of COVID-19 to emerge. And that knowledge has made every allergy-related sneeze feel like it could be a death knell.
But six days in, two separate tests have found no more virus in my system.
That is not surprising, according to Dr. George Rutherford, an epidemiologist at UC San Francisco and one of Californias foremost COVID-19 experts. He says people with asymptomatic infections dont necessarily have less virus in their bodies, but they may be able to clear the virus more efficiently.
We were doing a lot of contact tracing in the early days, Rutherford recalled. Thats when the virus had a longer incubation period, and we could get to people before they were infectious so they would not unknowingly infect others.
Now that the disease can incubate in three days, we just have to throw up our hands and look for new ways to stop asymptomatic spread, Rutherford said.
Im grateful to be in the asymptomatic category. But a positive test result still carries a taint; like a scarlet letter declaring to the world that you have done something wrong.
Perhaps I failed to pay enough attention to the rise of the supercontagious BA.2 Omicron subvariant.
Im certified negative now, but Im following CDC guidelines: quarantining at home and wearing a mask every time I leave my room. Still, its hard to have full confidence in the rules any more when they cant necessarily keep up with the virus evolution.
Dont get me wrong. I will resume masking in public when my home confinement ends. But I will also stop expecting this pandemic to ease anytime soon. Many asymptomatic people wont know they have the virus and move through their days unmasked.
Im going to stop obsessing over fluctuating COVID rates and new, more infectious varieties. Ill stop poring over the numbers which told me that people my age are the least likely to be asymptomatic. And Im going to start taking better care of myself, day in and day out.
What this past week has taught me is that we are just pretending to understand this virulent, mysterious and unpredictable pandemic.
We bury ourselves in statistics, as if that gives us a sense of control. But what does the case count even mean now that so many folks are testing themselves at home and no one is tallying those results?
I appreciate all the work the researchers are doing. Rutherford said there are now tantalizing hints that blood type may be linked to COVID-19 immunity. That kind of revelation might lead to new ways to prevent or treat the disease. But even a perfect understanding of the big picture wont mean we can predict the course of an individual infection.
From a public health standpoint, were not worried about you. ... Youre a good outcome, Rutherford said. Not as good as having no infection. But having an asymptomatic infection, well chalk that up as a win.
And right now, that sounds pretty good to me.
From Saturday 9 April, we will update the figures on the coronadashboard on working days, and no longer on weekends and public holidays. This is in line with the current situation regarding the coronavirus. We will continue to closely monitor the development of the virus.
For Kaia Brooke, little has changed this spring, even as others declare that California and the country are finally getting back to normal.
She has not gone out to dine inside a restaurant or sat down in a movie theater. She avoids going out much, save for outdoor walks and drives, and is still wearing her KN95 mask when she ventures out of her Monrovia home.
We cant move on like everyone else has been doing, said the 24-year-old autistic woman, who has chronic illnesses, including a metabolic disorder that requires iron infusions. Her eyes, over the top of her maroon mask, are the color of the sea.
At times, she said, its hard to shake the feeling of our lives feeling disposable.
As government agencies have loosened pandemic protections, advocates for immunocompromised and disabled people have raised concerns. Were doing all the things that dont protect people with disabilities, said Bethany Lilly, senior director of income policy at the Arc, which advocates for people with intellectual and developmental disabilities.
Mask mandates have been rolled back, but crucial medications to prevent COVID-19 in immunocompromised people can still be hard to get. Federal money for testing and treating uninsured people has been drying up, just as a coronavirus subvariant that has driven spikes in Europe is on the rise.
Health officials have started focusing more heavily on hospitalizations than COVID-19 cases to gauge risk levels in communities a measure that focuses more on strain to the health system, but fails to reassure immunocompromised people who face danger from high levels of coronavirus transmission. And although the White House recently announced a new push to clean indoor air, some critics say the government should have acted much sooner to ensure public spaces are safe.
If we actually cared about chronically ill, disabled and immunocompromised Americans including children every state in the country would be doing proactive wastewater monitoring, said Matthew Cortland, senior fellow on healthcare and disability at Data for Progress, a progressive think tank. As for air purifiers, they should be so plentiful, we should be tripping over them.
For Emily Brooke Holth, the situation has been maddening.
Kaia Brooke, 24, reads to her twin brother, Ry, who has Down syndrome. Both twins are autistic and immunocompromised, and Kaia has a chronic illness and metabolic disorder that requires iron infusions. Their mom, Emily Brooke Holth, background, is their caregiver.
(Gina Ferazzi / Los Angeles Times)
Holth is mother to Kaia and her twin brother, Ry Brooke, who is also disabled and immunocompromised. Ry, who speaks a few words and phrases, is autistic, has Down syndrome and uses a feeding tube. As their caregiver, Holth is constantly assessing risks when she heads outside. If the Trader Joes looks too full, she turns away to find another store or pays for grocery delivery.
As masking and other measures have been dropped, it puts the burden on the individual, Holth said.
Most of the pandemic has passed the same way for the family. Kaia rests in bed, reads, plays video games and messages friends. When she feels up to it, they go for a drive or head for a walk. Their mother feeds Ry every three hours through his tube, helps him bathe, and makes phone calls to schedule appointments for both twins with a gaggle of specialists.
Most of the time, they saw friends only through the glass door of their townhouse, waving to them from inside as they spoke on the phone. During surges, they would sometimes go on walks at a nearby cemetery. Holtz remembers her unease and then dawning anguish when it suddenly became crowded that first winter, as mourners gathered around a rash of new graves.
After they had all gotten vaccinated, the family had been tiptoeing back into the world. Holth got married last June and invited seven vaccinated people into their home to celebrate, sharing hugs and wedding cake at their Monrovia townhouse. She had begun to plan for Ry to return to a day program for people with developmental disabilities.
Instead, the Delta variant began to drive up cases, and they retreated. When the Omicron wave arrived this winter, we went back to the strictest stay-at-home, as if it were the beginning of the pandemic, Holth said. We were like that for two and a half months.
As that wave receded, they were beginning to think about venturing out again. Maybe a masked trip to a museum, Holth thought, eyeing the Hayao Miyazaki exhibit at the Academy Museum of Motion Pictures. She was grateful that Los Angeles County had been stricter than other parts of California when it came to masking and other pandemic rules.
But when those rules were stripped away, she decided against it. It has felt like were a little raft off in the middle of the ocean.
I would love to take him to Disneyland, Holth said of Ry, who she remembers being delighted on the Alice in Wonderland ride. His room features a framed photo of him and his family plunging on the Splash Mountain ride.
I dont think its going to be anytime soon, Holth said wistfully.
We talk to all of their specialists ... and theyre like, Dont go. Its not safe.
Emily Brooke Holth and her son, Ky, and daughter, Kaia, watch a movie. Holth had planned for the family to start venturing outside their home, but then the Delta and Omicron waves sent them back inside.
(Gina Ferazzi / Los Angeles Times)
The latest phase of the pandemic comes on the heels of a pair of grueling years for disabled and immunocompromised people.
Disabled advocates say that the threat has not only been the virus, but the biases of the health system itself. Early in the pandemic, they complained that guidelines put forward by many states on how to allocate scarce resources such as ventilators were discriminatory against people with disabilities.
In January, the head of the Centers for Disease Control and Prevention outraged disability groups by publicly declaring that it was encouraging that a study had found that the bulk of vaccinated people who died of COVID-19 had at least four co-morbidities, calling them unwell to begin with.
Dozens of groups reacted with a letter complaining that the public health response to COVID-19 has treated people with disabilities as disposable. The CDC chief apologized, calling her remarks hurtful but unintentional. Months later, she angered many disabled activists again by likening masks to a scarlet letter that was annoying and inconvenient.
Saying the quiet part out loud is what has happened with the pandemic, said Christine Mitchell, a public health researcher and advocate with the Public Health Justice Collective in the Bay Area. Mitchell herself has a connective tissue disorder.
I get it. People are tired. People are annoyed. People dont want to wear masks, Mitchell said. But my life and the lives of disabled people and immunocompromised people and all the people who are at high risk is worth more than someones convenience.
Few expect broad mandates to return, short of a massive surge in hospitalizations.
Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases, said that the practical reality now for immunocompromised people is that all of those folks are going to have to look to themselves for protection by masking, gauging the risk of events and activities, and staying up to date on vaccines.
Mask mandates have become a nonstarter, he said, so the initiative will have to remain with the individuals who are affected and those closest around them. Society has moved on.
Matan Koch, vice president for workforce and faith programs at the nonprofit RespectAbility, said that easing pandemic restrictions doesnt mean that we all need to go back to, Screw it, youre all on your own.
His hope is that governments and employers will take steps to protect and include vulnerable people, including guaranteeing paid leave so that sick workers do not come in to infect others, retaining the flexibility of remote work, and streaming live events.
During the pandemic, all of a sudden the impossible was possible, Koch said. I really hope the artificial limitations will go away.
Holth, sitting with Ry and Kaia outside their home in Monrovia on a sunny weekday, wanted to make clear that they do not feel sorry for themselves. Their life lived at home is a good one, filled with music and videos and Christmas decorations that stay up long after Christmas because Ry loves the holiday so dearly.
But if people really want to protect the immunocompromised, acknowledging us would be a good start, Kaia said.
Let's stop all the fighting. Let's stop letting social media companies monetize our differences. Let us study this fascinating, new phenomenon.
Tom Benzoni| Guest columnist
Omicron study: Longest living variant on skin and plastic
According to researchers' report on bioRxiv.org, the omicron variant's high "environmental stability" might have helped it spread so rapidly.
STAFF VIDEO, USA TODAY
A frequent topic of discussion lately is how the COVID-19 pandemic ends. As is usual when trying to predict the future, the near-term is pretty much anybody's guess. The longer-term view is clearer: COVID-19 will become incorporated into our lifecycle, just like the other four coronaviruses.
Yes, you read that right. There are already four coronaviruses in the human population: 229E, NL63, OC43, HKU1. These are a few of the viruses that cause the common cold.(Im easing back on terminology here: 229E, NL63, OC43, HKU1 = Coronavirus 1-4.Coronavirus 5 = COVID-19. Just easier.) Donald Trump may have spoken clumsily, but he was right when he said that COVID-19 is just a common cold. That is what it eventually will become. The eventually part is the problem.
First lets try to understand a bit about coronaviruses. They have been with humans for centuries. The 1889 flu pandemic, the so called Russian flu, is thought to be OC43 entering the human population. The Wikipedia article on Russian flu describes the waves of infections that swept the globe. It's a worthy read. (Interesting factoid: the 1918 flu pandemic was called influenza because that was the bacterium most frequently recovered from many people who died. Viruses weren't known for another 20 to 30 years. And this was not the Spanish flu, it was the Kansas flu, but that's not nearly as interesting a name. Revising opinions is nothing new!)
So how do coronavirus infections look? Coronaviruses cause that runny, snotty nose that kids bring home from daycare. They can have a cough for a week to 10 days and be "off the feed. Additionally, that child can bring this loving gift home to their parent, giving them a runny, snotty nose for a couple of days. (Thanks, kids!) This is key to understanding coronaviruses and their transmission: essentially everyone alive today got Coronavirus OC43 as a child. The parent (obviously) had this when a child. Then, if the parent had OC43 as a child, why does the parent get sick again? (This is Question #1.) Should the parent not be resistant? Answer #1. This is what the body does with coronavirus do. Infection does not impart absolute lifelong immunity; any immunity is temporary. (This is common; get your tetanus shot updated?) The immune system cannot maintain a permanent defense against all pathogens all the time; you wouldn't have the time or energy to do anything else! Corollary #1. This is likely the reason why COVID immunizations don't give permanent absolute immunity; that simply is what the immune system does with coronavirus.
The parent with a runny snotty nose and cough that they got from their loving child knows better than to visit their elderly sick grandma in the nursing home. They know to wash their hands. They know to cough into their elbow. They know to throw away the used Kleenex. They know not to visit people with poor immunity. We knew all of this before COVID-19. Question #2: Why are we acting all surprised at the recommendations on COVID-19? Didn't we already know this before 2019? Answer #2. Common sense is not that common; cool heads do not always prevail. Theres no money in that! Corollary #2. Pay attention to what your parents taught you. Wash your hands. Don't share your pop cans. Put your used dinnerware in the sink. And don't visit old, sick people in the nursing home when you are sick yourself. (Full disclosure: My dad is 97 and living in a nursing home.)
More: Ag Secretary Vilsack joins Speaker Pelosi, Sen. Collins in testing positive for COVID as outbreak spreads among DC officials
So now that we understand this, what about COVID vs. those other four coronaviruses? They have been with us for well over a century and seem to be nothing more than a common cold; one wonders why all the excitement about COVID-19? It does seem we're getting all excited about a common cold. The answer is combining the first two ideas, COVID-19 and the other four coronaviruses. No one, from a newborn up to my father, had antibodies to COVID-19. That's because it wasn't present when my dad was a child, when I was a child or when you were a child (unless you're too young to be able to read this.)
Thus, when anyone older than a teenager gets COVID-19, their body has noidea how to fight it off. They don't have that wonderful, active, well-controlled immune system of a youngster. This is why children receive all those immunizations; their immune system knows how to handle them. The adult immune system has to be trained and doesnt do as well. It lacks the skills of a child's immune system in properly responding to challenges.
Thus, many older people, myself included, are known to have less-than-ideal immune systems. We've known this for 15 to 20 years. People my age (over 65) must get four times the amount of flu shot to get our immune systems just to respond. We know that older folks get sicker and die easier. Thus, when an older person (defined as anybody older than me) gets sick, they tend to get sicker and die more easily from a sickness that would not have so affected a young person. So Question #3: How are people going to get immunity? After all, people are all going to get immunity to this coronavirus, just like the other four. Answer #3: People are going to get immunity to COVID-19 the same way they got immunity to the other coronaviruses: by getting antibodies and T-cell immunity. They're going to get an infection or an injection. Period, end of discussion. This is 100% of the population … that survives. And the ones that don't survive, who die from COVID, do so through the infection route. It will be extremely rare to be damaged via the injection route.
Those who claim they don't have the immunization and yet don't get sick have antibodies they got from somewhere; no magic allowed. They could have had a stealth infection or a stealth injection; both occur. Corollary #3: At the end of this, everybody will have antibodies. If they die of COVID-19, they may not have developed antibodies in time. If they survive COVID-19, they will have antibodies from infection. Infection or injection, everyone will have antibodies to Coronavirus #5, (COVID-19) the same as the Coronaviruses 1 through 4.
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This final stage, when COVID is present everywhere, from childhood through the elderly, is called the endemic stage. It will take several decades to occur; the children will grow up and have children themselves. The young adults will become old adults. The old adults will have either died or had infection or injection which allows them to survive COVID. We will remain, of course, susceptible to all the usual vicissitudes of life. (That's a complicated way of saying that people are going to die anyway, whether they get COVID-19 or are in a car wreck or have a heart attack.)
In the meanwhile, we're all in this together. We are responsible for what happens to our neighbor. If our actions harm our neighbor, we are responsible for that harm. This is what personal responsibility is all about; adults take responsibility for their actions. So let's stop all the fighting. Let's stop letting social media companies monetize our differences. Let us study this fascinating, new phenomenon.
Never before have we been able to track a virus as it makes this way into the human population. The possibilities for new knowledge and research are incredible. I'm going to predict that we will find an answer to such things as chronic fatigue syndrome and fibromyalgia. We're going to find answers to disorders like Kawasaki disease, a cause of heart attacks in children. There's so much interesting research to be done and so many burning questions to be answered! Wasting this opportunity by fighting with each other is a sin of the gravest order.
How does end? Not with a bang, but with a whimper.
And that's my prediction for the future.
I won't be around to see if I'm right.
Thats my opinion; whats yours?
Dr. Tom Benzoni is an emergency physician, practicing locally. He is a spokesperson for the American College of the Emergency Physicians. All opinions expressed are exactly that, his opinion.
