Rochelle Walensky, director of the Centers for Disease Control and Prevention, said in an interview with the Wall Street Journal that the messaging around the COVID-19 pandemic and changing guidance should have been clearer.
State of play: Walensky is being coached by media experts and is planning to have more press briefings by herself in order to ensure that CDC is seen as an independent, scientific entity, rather than as a political one, the Journal reports.
What she's saying: "I think what I have not conveyed is the uncertainty in a lot of these situations," Walensky said, adding that she is committed to communicating CDC guidance more clearly.
The big picture: The CDC recently changed its isolation guidance to say that the people who have tested positive for the virus should isolate for at least five days, and did not initially recommend that a negative COVID test be the condition to end isolation.
The CDC later added testing recommendations saying that anyone ending isolation who "has access to a test" and "wants to test" can do so. This new language was added after it was clear that people wanted guidance on how to use rapid tests to check if they're infections.
Go deeper: Another point of confusion over COVID guidance
Austin's new COVID-19 business order takes effect and compliance is mixed KEYE TV CBS Austin
In 2020, the shop had its best year ever. And 2021 was even better.
COVID changed everything at our store, Titcomb said. It made us a better business by far.
The pandemic crushed many small companies, as health concerns, supply chain issues, and labor shortages converged. But some were able to adapt and thrive. They upgraded technologies and expanded online offerings. They sought out new customers and jump-started new lines of business. Others, like Titcomb, saw an opportunity and ran with it.
The pandemic didnt kill them, it made them stronger.
For nearly two years, there has been a global scrambling as companies try to stay afloat, said Sridhar Tayur, professor of operations management at Carnegie Mellon University. And this crisis mindset has sparked changes that could have a lasting impact. Businesses are tracking customers online orders in ways they never did for in-person sales, he said. Operations are being automated and simplified.
Necessity is the mother of invention, he said. I dont think theyve had this amount of necessity at least in the last 20 or 30 years.
Lightyear Strategies, a marketing firm in Boston, witnessed the shift in its clients. At first, the mindset seemed to be, the worlds ending ... lets get rid of the marketing, said chief executive Nima Olumi. But a few months later, clients realized they needed help adapting to a changed and largely virtual world.
A New York property management firm asked Lightyear to figure out how to e-mail thousands of residents about new sanitization measures. Boston hospitals wanted videos educating patients about safety protocols.
At the same time, Olumi realized he needed to narrow his focus rather than trying to be a jack-of-all-trades yes man. Today, his recurring monthly revenue is more than 10 times what it was in 2019.
If you make hot dogs, he said, stick to making hot dogs.
For other business owners, though, the pandemic was the right time to branch out. Runamok Maple in Fairfax, Vt., saw its online syrup sales skyrocket, while restaurant and hotel sales slumped. So the company decided to launch Sparkle Syrup, infused with edible pearlescent mica, to bring a little bit of joy, said co-owner Eric Sorkin. And its been a huge hit. All the working dads out there were now at home, and what does a working dad know how to make? he said. They make breakfast.
At Copper Dog Books in Beverly, mastering online orders when nobody wanted to shop in person opened the door to shipping gift boxes, including a monthly subscription with two sci-fi novellas, a snack, and a small item such as a journal or key chain. Scenic Roots Garden Center in Sandwich launched a virtual landscape design business and started selling produce from a nearby farm. Both businesses have had record-breaking sales for the past two years.
Adopting new technologies has been a game-changer for many companies. In response to COVID restrictions, the owner of a nautical jewelry business in Washington state put scannable QR codes next to each necklace and bracelet in her window display, directing shoppers who couldnt come inside to the items on her website. A business consultancy in Utah started digitizing operations when the world went online, including using artificial intelligence to help predict employee turnover, a major challenge during the pandemic. Financial services firms have turned to facial recognition technology from Bedford biometric software provider Aware to give mobile customers a more secure way to check their accounts.
Many companies have embarked on a digital transformation during the pandemic, said Mark Tina, vice president of sales for Verizon Business in the eastern US. New high-speed Internet-based services not only have more capabilities than older technologies, they are less expensive, he said, which is key for businesses struggling to survive.
When workers stopped going into their offices, Dependable Cleaners, based in Quincy, saw its business drop to a fraction of what it used to be, driving the dry cleaner to look for ways to become more efficient, said director of operations Carlyn Parker. It switched to a Verizon service that assigns one business number to ring on multiple mobile devices and desk phones, and it added a texting feature to its biweekly pickup-and-delivery service.
Now, instead of visiting every home-delivery customer twice a week, the drivers only go where requested, allowing the company to add more customers without more drivers. Before Omicron drove companies to push back office reopening dates, Dependable Cleaners had climbed back to 80 percent of pre-pandemic levels.
Were in the fourth generation, said Parker, whose grandparents started the company. Were here to stay.
Finding new customers has also been a life-saver. When travel came to a halt in March of 2020, revenues dropped to nearly zero for LugLess, a Boston company that ships luggage for travelers. But it quickly started playing up the fact that using its services meant less human contact, said chief executive Aaron Kirley. No more waiting in line at the airport to check bags, no more gathering with the masses at the baggage carousel. The company also partnered with moving companies to reach the surge of digital nomads who could suddenly work wherever they wanted and likely didnt have room in their cars for all their stuff. And when people complained they could no longer print out shipping labels because they werent at work, LugLess developed digital labels.
By the fall of 2020, business had tripled from its pre-pandemic high, then tripled again last year.
It kind of forced us to open our eyes and look at new opportunities, Kirley said.
Some of the new opportunities revealed during the pandemic arent just boosting revenues. Theyre also saving lives.
Groups Recover Together, an addiction therapy provider based in Burlington, has almost doubled the number of people it serves around the country since it started offering virtual sessions. Before COVID, people battling opioid abuse had to attend group therapy in person due to the medication being provided, said chief executive Colleen Nicewicz.
But when that requirement was rescinded during the shutdown, Groups Recover Together started holding sessions over Zoom, and then through a new app. The organization now reaches more than 10,000 people a week, nearly a third of whom live in counties with no physical site. Opioid addiction is rampant in rural areas, Nicewicz said; in one Indiana county with a population of just 10,000, Groups Recover is serving one out of every 200 residents, even without a clinic.
Crucially, data show that virtual group therapy is just as effective at keeping people off drugs as in-person sessions, she said. At a time when the opioid epidemic is worse than ever overdose deaths rose nearly 29 percent in the 12 months ending in April 2021 compared to the year before reaching more people is critical, said Nicewicz, who is hopeful virtual therapy will become a permanent offering.
We really met an unmet need, she said.
Katie Johnston can be reached at katie.johnston@globe.com. Follow her on Twitter @ktkjohnston.
The World Health Organization issues a strong recommendation for baricitinib and a conditional one for sotrovimab.
A World Health Organization (WHO) group has issued a strong recommendation for the use of baricitinib to treat patients with COVID-19 and a conditional recommendation for the use of sotrovimab to treat the disease.
Baricitinib, a type of Janus kinase (JAK) inhibitor, is used to treat rheumatoid arthritis, but can also treat individuals with critical or severe COVID-19 in combination with corticosteroids, according to a WHO Guideline Development Group of International experts and published in The BMJ.
Their recommendation is based on moderate certainty evidence that baricitinib improves survival and reduces the need for ventilation, with no observed increase in adverse effects.
The WHO experts said that baricitinib has similar effects to other arthritis drugs called interleukin-6 (IL-6) inhibitors, so when both are available, they recommend choosing a treatment based on availability, clinician experience, and cost.
Using both drugs at the same time is not recommended.
The experts advise against the use of 2 other JAK inhibitors, ruxolitinib and tofacitinib, for individuals with critical or severe COVID-19, because low certainty evidence from small trials failed to show a benefit and suggests a possible increase in serious adverse effects with tofacitinib.
In the same guidelines update, the WHO experts also conditionally recommended the use of the monoclonal antibody sotrovimab for individuals with non-severe COVID-19 but only those who are at highest risk of hospitalization, reflecting trivial benefits in those at lower risks.
The WHO experts made a similar recommendation for casirivimab-imdevimab, another monoclonal antibody drug.
There is insufficient data to recommend 1 monoclonal antibody treatment over another, and the WHO experts acknowledged that their effectiveness against new variants, such as omicron, is still uncertain.
The guidelines for monoclonal antibodies will be updated when additional data become available, the WHO experts said.
The new recommendations are based on new evidence from 7 trials that include 4000 individuals with critical, non-severe, and severe COVID-19 infection.
These recommendations are part of a living guideline, developed by WHO and the methodical support of MAGIC Evidence Ecosystem Foundation, to provide guidance on the management of COVID-19 and help physicians make better decisions for patients.
Living guidelines are useful in fast-moving research areas, such as COVID-19, because they allow investigators to update previously peer-reviewed and vetted evidence summaries as new information becomes available.
The panel considers a combination of evidence assessing relative benefits, feasibility, harm, preferences, and values to make their recommendations.
The new guidance adds to previous recommendations for the use of conditional recommendations for the use of casirivimab-imdevimab, another monoclonal antibody treatment, in selected individuals; IL-6 receptor blockers and systemic corticosteroids for individuals with critical or severe COVID-19; and against the use of convalescent plasma, hydroxychloroquine, or ivermectin in individuals with COVID-19, regardless of disease severity.
Reference
WHO recommends two new drugs to treat patients with COVID-19. EurekAlert. News release. January 13, 2022. Accessed January 14, 2022. https://www.eurekalert.org/news-releases/939923
SIOUX FALLS, S.D. (KELO) As of the afternoon of Monday, January 17, there are a number of pharmacies in Sioux Falls where you can buy COVID-19 at-home test kits.
Supply of kits may vary and the list below reflects only availability at the time this story was published. This is not a guarantee of test kit availability.
KELOLAND News spoke on the phone with Lewis Drug VP of Merchandise, Bob Meyer, who said that the company had received a shipment earlier in the day and was in the process of distributing them to stores in the city.
According to Meyer, all Sioux Falls Lewis locations (with the exception of the Phillips Ave. store) as well as the store in Brandon would be receiving test kits by this evening, and by Tuesday, all Sioux Falls locations should be fully stocked.
Lewis locations in Sioux Falls are:136 S Phillips Ave1301 E 10th St Suite 1002700 W 12th St2901 S Minnesota Ave4409 E 26th St5500 W 41st St6109 S Louise Ave2525 S Ellis Rd
3020 E 10th St.The Hy-Vee at E 10th St. received a shipment of tests today, and the store currently has over 1,000 tests according to an employee.
1601 S Sycamore Ave.A south Sycamore store employee also said that the store was in-stock, possessing around 1,000 tests.
1231 E 57th St.The 57th St. Hy-Vee currently has around 700 tests according to an employee.
It is unknown to KELOLAND News whether the Louise Avenue Hy-Vee, located at 4101 S Louise Ave, has tests. Neither the 1900 S Marion Road nor 3000 S Minnesota Ave. locations have tests in-stock as of Monday.
Walmart and Walgreens pharmacies are not included on this list due to issues getting information from the stores. This does not necessarily mean that these locations do not have tests.
KANSAS CITY, Mo. Missouri's Show Me Strong Recovery Task Force, a group created by Gov. Mike Parson to assess the recovery of small businesses, has released its final report.
The report makes recommendations that the task force believes will help small businesses recover from struggles brought by COVID-19.
"In addition to a seven-city listening tour, the Task Force worked closely with the Federal Reserve Bank of St. Louis to analyze the impact of the COVID-19 pandemic on small businesses across Missouri," a release from the governor's office said. "The analysis confirmed that businesses in some industries, such as hospitality and retail, were particularly negatively affected, and businesses across all sectors are experiencing ongoing difficulties with hiring, supply chain issues, and workforce challenges."
The recommendations included improving child care availability and affordability, expanding apprenticeships in the hospitality industry and promoting state programs that support small, women and minority-owned businesses, among an array of other things.
The full report, with a complete list of its recommendations, can be found here.
The COVID-19 pandemic has challenged our state in many ways, and Missouri small businesses are among those hardest hit, Anna Hui, the director of the Department of Labor and Industrial Relations and chair of the task force, said. Our hope is these findings will be helpful in addressing the needs of business owners and securing a prosperous future.
We want to hear from you on what resources Kansas City families might benefit from to help us all through the pandemic. If you have five minutes, feel free to fill out this survey to help guide our coverage: KSHB COVID Survey.
Vials of the Moderna, Jannsen and Pfizer-BioNTech vaccines.
Spains sixth coronavirus wave, driven by the highly transmissible omicron variant, has multiplied positive cases among both unvaccinated and vaccinated people, with almost 1.4 million infections reported since the beginning of January and thousands more going unreported. However, Covid-19 vaccines are proving highly effective in protecting against severe infection. While pinpointing the exact level of this protection is complex, partial data collected in Spain and extensive analysis in the United Kingdom show that vaccinated individuals are at a much lower risk of being hospitalized or dying from the virus.
The most detailed information in Spain has come out of Catalonia, where the data is broken down by vaccination status. Analyzing the deaths in this northeastern region between December 23 and January 12 per 100,000 inhabitants, the mortality rate among individuals aged 70 and 80 is five times higher for the unvaccinated. Something similar occurs in other age demographics. In the 70-79 population, 50 deaths per 100,000 people are reported among the unvaccinated, compared to 10 per 100,000 among the vaccinated, i.e. five times less. Meanwhile, in the 60-69 demographic, the disparity is repeated: the mortality rate among the unvaccinated is 15 per 100,000 people while, for the vaccinated, it is 5.5 per 100,000.
The Catalan data also shows that vaccine protection helps prevent hospital and intensive care unit (ICU) admissions. For those vaccinated between 70 and 79, the probability of ending up in hospital is almost six times lower than for those who are not immunized. Meanwhile, the chance of being admitted to an ICU for Covid-19 is up to 10 times lower for the vaccinated than the unvaccinated.
The Spanish Health Ministry also publishes hospitalization data throughout Spain broken down by vaccination status, although in this case it is based on estimates: to calculate the number of unvaccinated in each age group, they subtract the number of vaccinated from the population in 2020. However, the target population will have grown since then, so it is possible that the ministrys calculations overestimate the incidence among the unvaccinated. While the element of overestimation may explain why this figure is much higher than in Catalonia, the ministrys figures yield similar conclusions: for people between 60 and 79, for example, hospital admission is 18 times higher among the unvaccinated.
In other countries, hospital data leads to the same conclusions. In Italy, where the sixth wave is following a similar pattern to Spain, the gap between vaccinated and unvaccinated is evident and maintained over time. The probability of hospital admission is 10 times higher for the unvaccinated in the 60-79 age group, a figure also echoed in Switzerland.
In the UK, the Health Security Agency (HSA) has analyzed more than half a million omicron infections in the last weeks of 2021. In order to draw accurate conclusions when comparing vaccinated and unvaccinated groups, many factors influencing the probability of infection and admission were taken into account, such as age, gender and region of residence as well as whether a person had previously tested positive, traveled to other countries or suffered from any health conditions. The aim is to monitor the effectiveness of vaccines by measuring the extent to which the risk of infection, hospitalization and death is reduced by vaccination.
The HSA results confirm that the vaccines continue to protect those who are fully vaccinated, particularly against severe disease, but they also note a loss of effectiveness over a period of weeks. Soon after receiving the second dose, the effectiveness of the vaccines with regard to preventing hospital admission is around 72%, but this drops to 52% after six months. In this sense, the good news is that a booster shot strengthens protection; for those over 65, for example, Covid-19 vaccines are 90% effective at preventing severe disease.
The new variant is very capable of infecting vaccinated individuals, as studies from the UK have shown: the effectiveness of two doses against symptomatic infections could drop to almost zero after six months, whereas with the delta variant it remained at 40%. Even after the booster shot, vaccine effectiveness against omicron is partial, with rates of between 40% and 60%, again with figures worse than those recorded against delta (90%).
These results are adjusted according to many variables. In fact, when the basic infection rates are compared for the vaccinated and unvaccinated without factoring in the variables, they are very similar or even worse for the vaccinated group than for those who have not received any shots. This could be the case if there are many more individuals among the unvaccinated who have natural immunity from a previous infection and may explain why some studies find what looks like negative vaccine effectiveness, as has been noted in reports from the UK and a preliminary study in Denmark.
Something similar is observed in the official data coming out of Iceland: the 14-day incidence rate is higher among the vaccinated population who have not received a booster shot than among the unvaccinated (5,600 cases per 100,000 inhabitants, compared to 4,000 in the unvaccinated group). However, the lowest incidence is among Icelanders with three doses.
This coincides with the data emerging from Catalonia: in November the incidence was lower for the vaccinated than for the unvaccinated in all age groups. But since the arrival of omicron, among the under-50 population a demographic that has received few boosters the infection rates seem to be higher among the vaccinated.
English version by Heather Galloway.
By Julie Appleby and Phil Galewitz, KHN
Julie Ann Justo, an infectious disease clinical pharmacist for a South Carolina hospital system, hoped Christmas week would finally be the time her family could safely gather for a reunion.
Before the celebration, family members who were eligible were vaccinated and boosted. They quarantined and used masks in the days leading up to the event. And many took solace in negative results from rapid COVID-19 tests taken a few days before the 35-person indoor gathering in South Florida to make sure no one was infectious.
But within a week, Justo and at least 13 members of her extended family tested positive for COVID-19, with many feeling typical symptoms of an upper respiratory virus, such as a sore throat and a runny nose.
Like many other Americans, Justos family learned the hard way that a single negative result from an at-home rapid test, which takes about 15 minutes, is no guarantee that a person is not ill or carrying the virus.
There are just so many variables. Testing may come either too soon, before enough virus is present to detect, or too late, after a person has already spread the virus to others.
And most rapid tests, even according to their instructions, are meant to be used in pairs generally a day or two apart for increased accuracy. Despite that, a few brands are sold one to a box and, with the tests sometimes expensive and in short supply, families are often relying on a single screening.
While home antigen testing remains a useful and underutilized tool to curb the pandemic, experts say, it is often misused and may provide false confidence.
Some people mistakenly look at the home tests like a get-out-of-jail-free card, said Dr. William Schaffner, a specialist in infectious diseases at the Vanderbilt University School of Medicine in Nashville, Tennessee. Im negative, so I dont have to worry anymore.
That is even more true now that the new more transmissible variant dominates the country.
Omicron is so transmissible that it is challenging to use any kind of testing strategy in terms of get-togethers and be successful, said Dr. Patrick Mathias, vice chair of clinical operations for the Department of Laboratory Medicine & Pathology at the University of Washington School of Medicine.
Rapid tests are pretty good at correctly detecting infection in people with symptoms, Mathias said, with a 70% to nearly 90% range of accuracy estimated in several studies. Other studies, some that predate current variants or were performed under more controlled settings, have shown higher rates, but, even then, the tests can still miss some infected people. That raises the risk of spread, with the chance rising dramatically as the number of people attending an event grows.
Results of antigen tests are less accurate for people without symptoms.
For the asymptomatic, the rapid tests, on average, [correctly] detect infection roughly 50% of the time, said Shama Cash-Goldwasser, an adviser for Prevent Epidemics at Resolve to Save Lives, a nonprofit group run by Dr. Tom Frieden, a former director of the Centers for Disease Control and Prevention.
Looking back, Justo said her family took precautions, but she acknowledges missteps that put them at increased risk: Not all family members were tested before getting together because of a shortage of test kits. Some members of her family who could find rapid tests tested just once because of the need to ration tests. And in attendance were several children under age 5 who are not yet eligible for a COVID-19 vaccine. They were later among the first to show symptoms.
We probably were relying too heavily on negative rapid tests in order to gather indoors with others without other layers of protections, she said.
Even if everyone tested properly before the party, health experts said, it wouldnt mean all attendees are safe from getting COVID-19. Testing merely reduces the risk of exposure; it doesnt eliminate it.
Other factors in assessing risk at a gathering: Is everyone vaccinated and boosted, which can help reduce the likelihood of infection? Did attendees properly follow all the steps outlined in the test kits instructions, which can differ by brand? Did anyone test too early after exposure or, conversely, not close enough to the event?
One critical detail is the timing of the test, said Schaffner at Vanderbilt. Another, he said, is how well the tests can spot true positives and true negatives.
Test too early, such as within a day or two of exposure, and results wont be accurate. Similarly, testing several days before an event wont tell you much about who might be infectious on the day of the gathering.
Schaffner and others recommend that self-testing start three days after a known exposure or, if one feels ill, a few days after the onset of symptoms. Because the timeline for detecting an infection is uncertain, its always a good idea to use both tests in the kit, as instructed the second one 24 to 36 hours after the first. For an event, make sure one of the tests is performed on the day of the gathering.
Antigen tests work by looking for proteins from the surface of the virus, which must be present in adequate amounts for a test to spot. (Lab-based PCR tests, or polymerase chain reaction tests, are more accurate because they can detect smaller amounts of the virus, but they take longer to get results, possibly even days, depending on the backlog at the labs.)
COVID-19 markers may linger as remnants long after live virus is gone, so some scientists question the use of tests whether antigen or PCR as a metric for when patients can end their isolation, particularly if they are looking to shorten the recommended period. The CDC recommends five days of isolation, which can end if their symptoms are gone or resolving, with no fever.
Some patients will test positive 10 days or more after their first symptoms, although it is unlikely they remain infectious by then.
Still, that means many people are using the rapid tests inappropriately not only over-relying on them as a safeguard against COVID-19, but also as a gauge for when an infection is over.
Rapid home tests need to be used over multiple days to increase the chance of an accurate result.
Each individual test does not have much value as serial testing, said Dr. Zishan Siddiqui, chief medical officer at the Baltimore Convention Center Field Hospital and an assistant professor of medicine at Johns Hopkins University. And, because the tests are less reliable in those without symptoms, he said, asymptomatic people should not be relying on a single rapid test to gather with friends or family without taking other mitigation measures.
Worse still, a recent study looking at the omicron variant found that rapid tests could not detect the virus in the first two days of infection, even though lab-based PCR tests did find evidence of COVID-19.
The study examined 30 vaccinated adults in December 2021. Most omicron cases were infectious for several days before being detectable by rapid antigen tests, according to the study, which has not been peer-reviewed.
False negatives are also more likely when the extent of the disease in a certain area, called community spread, is rampant, which is true for most of the United States today.
If theres a lot of community spread, that increases the likelihood that you have covid at a gathering, explained Cash-Goldwasser, since one or more attendees who tested negative may have received a false result. Positivity rates are running over 25% now in some U.S. cities, indicating a lot of virus is circulating.
So, right now, if you get a negative result, its important to be more suspicious, she said.
Vaccinations, boosters, masking, physical distancing, ventilation and testing separately are all imperfect strategies to prevent infection. But layered together, they can serve as a more effective barrier, Schaffner said.
The rapid test is useful his own family used them before gathering for Thanksgiving and Christmas but its a barrier with holes in it, he added.
The virus moved through those gaps to crash the party and infect the Justo family. While most of the attendees largely had mild symptoms, Justo said she was short of breath, fatigued and experienced headaches, muscle pain and nausea. It took about 10 days before she felt better.
I certainly spent a lot of time going back to what we could have done differently, Justo said. Thankfully no one needed to go to the hospital, and I attribute that to the vaccinations and for that I am grateful.
LITTLE ROCK, Ark. The number of active cases of COVID-19 in Arkansas dropped by more than 3,000 in new data released Monday, marking the first daily decline in active cases since December 26 of last year.
The new data from the Arkansas Department of Health showed that active cases fell by 3,068 to 93,311. Overall, the state saw 3,600 new cases reported in the last 24 hours, moving the number of cases reported during the pandemic to 684,776.
In a social media post, Gov. Asa Hutchinson attributed the drop in cases in part to a weekend decline in testing.
There were three more deaths added to the states count since the previous day, pushing the total to 9,437.
Hospitalizations saw an increase for the 18th day in a row, climbing by 35 patients to 1,420, while the number of patients on ventilators ticked up by four to 172.
Hutchinson used the increase in hospitalizations as a way to stress that Arkansans should seek out vaccinations. There were only 1,896 doses given in the past 24 hours. The number of Arkansans with full immunity rose to 1,528,481, while there are 370,688 people in the state with partial immunity.
