COVID-19 patients are treated using a noninvasive ventilation system at a field hospital in Manaus, Brazil.
By Robert F. ServiceJul. 7, 2021 , 2:15 PM
Sciences COVID-19 reporting is supported by the Heising-Simons Foundation.
It would be the best news by far in COVID-19 treatment: According to a preprint published on 22 June, an experimental prostate cancer drug named proxalutamide reduced deaths in hospitalized COVID-19 patients by 77% in a clinical trial in Brazil. The preprint also claims the drug, which blocks the activity of androgensmale hormones such as testosteronecut patients average hospital stay by 5 days, far more than any other treatment yet tested. Interim results of the study, announced at a press conference in March, led President Jair Bolsonaro to tout proxalutamide as a wonder cure and spurred Brazilian doctors to dose patients with similar drugs.
But many scientists are wary. Alleged irregularities in the clinical trial have reportedly triggered an investigation by a national research ethics commission in Brazil. Top medical journals have rejected a paper about the study, and its main author, Flavio Cadegiani, an endocrinologist at the biotech company Applied Biology, has previously touted unproven COVID-19 medications, such as ivermectin, azithromycin, and antiworm compounds. And to many, the claims simply seem implausible.
These results are too good to be true, says Eric Topol, executive vice president of Scripps Research Translational Institute. There are almost no medical interventions in the history of medicine that have this magnitude of benefit, no less with COVID-19.
But the idea behind the study makes sense, some scientists say. Men are more susceptible to hospitalization and death from COVID-19, and androgens may play a role. Although other studies with antiandrogens have come up empty, some researchers are keeping an open mind about the Brazilian trial. It seems pretty convincing, says Christina Jamieson, a prostate cancer researcher at the University of California (UC), San Diego. If they did what they say they did, it looks really good. Matthew Rettig, a prostate cancer oncologist at UC Los Angeles who is leading a similar trial with another drug, says the oversize impact gives him pause, but If this can be confirmed it would be a home run for sure, he says.
Proxalutamide is not approved in any country for any condition, but its manufacturer, Kintor Pharmaceuticals in China, is recruiting patients to test it for prostate cancer at multiple centers in the United States. For the COVID-19 study, Kintor teamed up with Applied Biology, a hair loss treatment company based in California where Cadegiani is a clinical director. In February, Cadegiani's team reported an encouraging early finding: Proxalutamide helped nonhospitalized patients with mild to moderate symptoms clear the virus much faster than those given a placebo.
The new study tested the drug in hospitalized patients in COVID-19s later stages. Doctors at eight hospitals in Brazil's Amazonas state enrolled 645 patients, according to the preprint. None initially required mechanical ventilation, and all were receiving usual care, which included approved anti-inflammatory drugs such as dexamethasone but sometimes also unproven compounds such as ivermectin. Roughly half also got proxalutamide; the other half got a placebo for 14 days.
In March, little more than a month after the trial began, Cadegiani and his colleagues announced their stunning interim results at a press conference. A doctor has to see their patients with proxalutamide to truly understand what we have seen. It is unfeasible to describe through words or translation into scientific language the dramatic response, Cadegiani tweeted around that time. The final analysis is in the new preprint, which reports that almost half of patients in the placebo group died, versus only 11% in the treatment arm, a 77% reduction in mortality. Patients on proxalutamide also had shorter hospital stays and less need for mechanical ventilators throughout the course of their treatment, and nearly 81% recovered after 2 weeks, compared with 36% of those not on the drug.
But on 8 June, the Brazilian newspaper O Globo reported that the Brazilian National Research Ethics Commission was investigating the study because the authors failed to report trial deaths as quickly as required by clinical trial rules in Brazil, and at different times reported a total of 170 and more than 200 deaths during the trial. The agency would not confirm the investigation, noting that all data from the research protocols under analysis are confidential, but Cadegiani confirms to Science that the commission is expected to issue a report on the trial.
Numerous researchers, including Topol and Jason Pogue, an infectious diseases clinical pharmacist at the University of Michigan, Ann Arbor, caution that the number of deaths in the trial is startling. In the placebo group the fatality rate was 49.4%, which made the drug look better but is far larger than the less than 10% of hospitalized COVID-19 patients who die in the United States. The speed of the trial, which only began in early February yet reported interim results in March, is suspicious as well, says Ana Carolina Peanha, an intensive care physician at the Federal University of Rio Grande do Sul. To [recruit] and monitor about 600 patients in a study in less than 30 days is unbelievable, she says.
Cadegiani says it isnt surprising so many people died in the trial because the Gamma variant (also known as P.1) was widespread in northern Brazil at the time and overwhelming hospitals. According to official data, about 43% of hospitalized COVID-19 patients in Amazonas state were dying when the study started in February. And as for the rapid recruitment, Cadegiani says as word got out in hospitals that patients in the proxalutamide trial were recovering within days and being released, others clamored to get into the trial.
Cadegiani believes the criticism stems from the fact that Bolsonaro and other officials have praised the drug. That "made it quite political," he says. He says it also explains why he has had trouble getting the data published, he says. Bolsonaro made [journal] editors afraid to publish positive results, Cadegiani says. He submitted the full results to The New England Journal of Medicine in the spring but says the paper was rejected despite what he calls "extremely constructive" reviews. When Cadegiani asked for the reason, Eric Rubin, the journals editor-in-chief, responded in an email, Its simplethe results are unexpectedly good. Given how good they are, the reviewers felt the data needed a primary review, meaning they needed to see not just the analysis, but also the original data. We simply dont have the capacity to do that, Rubin wrote in his email, which Cadegiani shared with Science. The Lancet rejected the paper as well.
The study is already having an impact in Brazil, however. Because proxalutamide is not yet approved or sold in Brazil, some doctors have begun to treat COVID-19 with other antiandrogens and prostate cancer drugs, such as dutasteride and bicalutamide. They are adding to a tide of unproven drugs being used to treat COVID-19 in Brazil, alarming infectious disease experts. "We cannot put the health of the Brazilian population at risk with guidelines without scientific evidence," Clvis Arns da Cunha, who heads the Brazilian Society for Infectious Dieases, wrote in a statement last year.
There are almost no medical interventions in the history of medicine that have this magnitude of benefit, no less with COVID-19.
Yet there is good reason to hope antiandrogens could combat COVID-19, some scientists say. According to the latest monthly statistics compiled by Global Health 50/50, which tracks gender disparities in COVID-19 patients, men account for 56% of COVID deaths worldwide. That disparity has prompted speculation that androgens may promote COVID-19 and encouraged studies of whether anti-androgen drugs can curb the disease.
Antiandrogens have been studied for decades as a treatment for prostate cancer, a disease fueled by androgens. In the prostate, when male hormones bind to receptor molecules, cells boost their production of a membrane protein called TMPRSS2 and divide more rapidly. Androgens also increase production of another protein, the angiotensin converting enzyme 2 (ACE2) receptor. Both molecules play key roles in coronavirus infections: TMPRSS2 cuts the virus outer spike protein, which enables it to bind to ACE2 receptors and slip into cells interiors.
With the exception of the Brazilian trial, tests of antiandrogens in COVID-19 patients so far have not been encouraging. A February study in the Journal of Urology, led by prostate cancer researcher Nima Sharifi of the Cleveland Clinic, found that in 1779 men with prostate cancer, androgen-deprivation therapy (ADT) had no effect on their risk of being infected with SARS-CoV-2. Another study, led by researchers from Vanderbilt University and presented at a recent meeting of the American Society of Clinical Oncology, found ADT treatment in nearly 600 prostate cancer patients had no effect on the number who died from COVID-19.
Im not saying [the proxalutamide results] are not true, Sharifi says. But its hard to make complete sense of them. It's also not clear why a drug that acts on SARS-CoV-2's receptors and should be best at preventing early stage viral infection would be effective at late stages of disease, when the surge of infection is largely over and a hyperactive immune system causes the problems. Cadegiani and co-authors believe proxalutamide tamps down cytokines that stimulate immune responses and encourage the production of estrogen, which lowers them further.
Other clinical trials may soon provide additional data. Kintor is currently recruiting male, nonhospitalized patients in California for a U.S. phase 3 trial of proxalutamide. Cadegiani says his colleagues in Brazil hope to soon test bicalutamide, a similar U.S. Food and Drug Administration-approved androgen receptor blocker to see whether it produces comparable results.
Separate clinical trials of bicalutamide are ongoing at the University of Florida and Johns Hopkins University. Swedish researchers are testing a similar drug called enzalutamide. And Rettig says his team is now conducting an interim analysis of trial results on degarelix, another antiandrogen. For now, most researchers are waiting to see what, if anything, is real in the seemingly improbable results from the heart of the Amazon.
With reporting by Sofia Moutinho in Brazil.
Correction, 9 July 2021, 8:00 a.m.: A previous version of this story identified Ana Carolina Peanha as a pulmonologist. She is an intensive care physician.
British Prime Minister Boris Johnson, basking in his role of host after a year of sterile Zoom diplomacy, implored his fellow leaders to vaccinate the whole world against Covid-19 by the end of 2022. But when the spin about the Cornwall huddle supposedly being one of the most vital global summits ever had faded, it became clear that the rich nations club had fallen disastrously short in globalizing the miracle of vaccines.
The group promised 1 billion doses of Covid-19 vaccines to poorer nations. US President Joe Biden, who backed lifting patents on Covid vaccines, pledged to buy 500 million doses alone. The UK offered 100 million. This sounds a lot. But around 11 billion shots are needed to protect the global population. It's not surprising that world leaders took care of their own nations first. Politicians in democracies obsess about keeping power. But the rich nations failed to use their fortunes and unique assets to build the kind of infrastructure that might speed global vaccinations and end the pandemic.
The failure to do so is becoming clear even as nations like the US and the UK benefit from their own high vaccination rates and reopen. Their progress is being threatened by the more infectious Delta variant of the coronavirus, which first emerged in India -- an area of low vaccine penetration. Experts fear the next variant that evolves in vast pools of unvaccinated humanity might evade the vaccines that are restoring the developed world.
G20, it's over to you.
'The Haitian diaspora is upset and in search of answers'
The assassination of Haiti's President sent shock waves through his compatriots living in the United States, and sparked concern that a country already scarred by its violent history, political tumult and natural disasters is in for even more pain.
"The Haitian diaspora is upset and in search of answers," Vania Andrew, publisher of The Haitian Times, an influential newspaper for the Haitian diaspora in the US, told Meanwhile.
"Although Jovenel Moise was wildly unpopular, with several calls for him to step down, there's still a feeling of disappointment given what this indicates for the state of the country. Folks are scared about what's to come next and there are very real fears about whether or not violence in the streets will ensue.
"This generation of Haitians in the diaspora is living in two worlds, where they are confronted with the challenges of being Black in America, championing Black Lives Matter, fighting against gun violence and impacted by what they see happening with George Floyd, Breonna Taylor and the countless other Black Americans that have died at the hands of police, while also dealing with the persistent political and social problems in Haiti that also have racial and class undertones.
"For a while Haitians in the diaspora were hopeful about Haiti's future, especially given the outpouring of support for the country in the wake of the 2010 earthquake. There was a sense that Haiti was going to build back bigger and better. Folks left their corporate jobs and stability in the US to be a part of that reawakening for Haiti, and sadly the reality has been the complete opposite, and Moise's assassination is the final nail in the coffin for them.
"This is a generation of change. Anyone who had a nonprofit, a business, an idea for initiatives that support sustainability in the country, will now think twice on whether Haiti is worth it."
Jul 3rd 2021
WHEN WILL it end? For a year and a half, covid-19 has gripped one country after another. Just when you think the virus is beaten, a new variant comes storming back, more infectious than the last. And yet, as the number of vaccinations passes 3bn, glimpses of post-covid life are emerging. Already, two things are clear: that the last phase of the pandemic will be drawn-out and painful; and that covid-19 will leave behind a different world.
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This week The Economist publishes a normalcy index, which reflects both these realities. Taking the pre-pandemic average as 100, it tracks such things as flights, traffic and retailing across 50 countries comprising 76% of Earths population. Today it stands at 66, almost double the level in April 2020.
Yet the ravages of covid-19 are still apparent in many countries. Consider our indexs worst performer, Malaysia, which is suffering a wave of infections six times more deadly than the surge in January and scores just 27. The main reason for this is that vaccination remains incomplete.
In sub-Saharan Africa, suffering a lethal outbreak, just 2.4% of the population aged over 12 has had a single dose. Even in America, where vaccines are plentiful, only around 30% of Mississippians and Alabamans are fully protected. Although the world is set to produce around 11bn doses of vaccine this year, it will be months before all those jabs find arms, and longer if rich countries hog doses on the off-chance that they may need them.
The lack of vaccination is aggravated by new variants. Delta, first spotted in India, is two to three times more infectious than the virus that came out of Wuhan. Cases spread so fast that hospitals can rapidly run out of beds and medical staff (and sometimes oxygen), even in places where 30% of people have had jabs. Todays variants are spreading even among the vaccinated. No mutation has yet put a dent in the vaccines ability to prevent almost all severe disease and death. But the next one might.
None of this alters the fact that the pandemic will eventually abate, even though the virus itself is likely to survive. For those fortunate enough to have been fully vaccinated and to have access to new treatments, covid-19 is already fast becoming a non-lethal disease. In Britain, where Delta is dominant, the fatality rate if you become infected is now about 0.1%, similar to seasonal flu: a danger, but a manageable one. If a variant required a reformulated vaccine, it would not take long to create.
However, as vaccines and treatments become more plentiful in rich countries, so will anger at seeing people in poor ones die for want of supplies. That will cause friction between rich countries and the rest. Travel bans will keep the two worlds apart.
Eventually flights will resume, but other changes in behaviour will last. Some will be profound. Take America, where the booming economy surged past its pre-pandemic level back in March, but which still scores only 73 on our indexpartly because big cities are quieter, and more people work from home.
So far it looks as if the legacy of covid-19 will follow the pattern set by past pandemics. Nicholas Christakis of Yale University identifies three shifts: the collective threat prompts a growth in state power; the overturning of everyday life leads to a search for meaning; and the closeness of death which brings caution while the disease rages, spurs audacity when it has passed. Each will mark society in its own way.
When people in rich countries retreated into their houses during lockdowns, the state barricaded itself in with them. During the pandemic governments have been the main channel for information, the setters of rules, a source of cash and, ultimately, providers of vaccines. Very roughly, rich-country governments paid out 90 cents for every dollar of lost output. Slightly to their own amazement, politicians who restricted civil liberties found that most of their citizens applauded.
There is a vigorous academic debate about whether lockdowns were worth it. But the big-government legacy of the pandemic is already on display. Just look at the spending plans of the Biden administration. Whatever the probleminequality, sluggish economic growth, the security of supply chainsa bigger, more activist government seems to be the preferred solution.
There is also evidence of a renewed search for meaning. This is reinforcing the shift towards identity politics on both the right and the left, but it goes deeper than that. Roughly one in five people in Italy and the Netherlands told Pew, a pollster, that the pandemic had made their countries more religious. In Spain and Canada about two in five said family ties had become stronger.
Leisure has been affected, too. People say they have had 15% more time on their hands. In Britain young women spent 50% longer with their nose in a book. Literary agents have been swamped with first novels. Some of this will fade: media firms fear an attention recession. But some changes will stick.
For example, people may decide they want to escape pre-pandemic drudgery at work, and tight labour markets may help them. In Britain applications to medical school were up by 21% in 2020. In America business creation has been its highest since records began in 2004. One in three Americans who can work from home wants to do so five days a week, according to surveys. Some bosses are ordering people into the office; others are trying to entice them in.
It is still unclear whether the appetite for risk is about to rebound. In principle, if you survive a life-threatening disease, you may count yourself as one of the lucky ones and the devil may care. In the years after the Spanish flu a century ago, a hunger for excitement burst onto the scene in every sphere, from sexual licence to the arts to the craze for speed. This time the new frontiers could range from space travel to genetic engineering, artificial intelligence and enhanced reality.
Even before the coronavirus came along, the digital revolution, climate change and Chinas rise seemed to be bringing the post-second-world-war, Western-led order to an end. The pandemic will hasten the transformation.
Dig deeper
All our stories relating to the pandemic and the vaccines can be found on our coronavirus hub. You can also listen to The Jab, our podcast on the race between injections and infections, and find trackers showing the global roll-out of vaccines, excess deaths by country and the viruss spread across Europe and America.
This article appeared in the Leaders section of the print edition under the headline "The long goodbye"
PeopleImages | E+ | Getty Images
LONDON When the coronavirus pandemic first emerged in early 2020, governments quickly put out information on what symptoms to look out for, little knowing then that much of the transmission was asymptomatic.
The public was told to look out for a high temperature and a new continuous cough, with a loss of taste or smell, fatigue and a sore throat also named as possible symptoms (some added at different points of the pandemic).
Fast forward to the present day and more symptoms are being reported and recognized. The variation in symptoms has happened over time as several variants of the virus such as the alpha strain and now the highly transmissible delta variant have gone on to replace the "original" strain of Covid-19 first discovered in China in late 2019.
Read more: Covid delta variant: Symptoms, spread and what to look out for
Now, an ongoing U.K.-based study which enables the public to enter their Covid symptoms on an app which enables scientists to then analyze the data says there are new coronavirus symptoms being widely reported.
TheZoe Covid Symptom study has identified the current top five symptoms that have emerged in recent weeks which seemingly differ depending on whether you've been vaccinated, and how many doses you've had.
The symptoms highlighted below were first published in late June but still represent the top five symptoms being reported, the Zoe Covid Symptom study told CNBC Wednesday.
The symptoms rankings are based on members of the public's reports in the app alone and do not take into account which variant caused the virus or demographic information.
These are the top five symptoms being reported by people who are fully-vaccinated, have had one dose of a vaccine or are unvaccinated.
The Zoe Covid Symptom study says that, generally, it has seen similar symptoms of Covid-19 being reported overall in the app by people who had and hadn't been vaccinated.
However, fewer symptoms were reported over a shorter period of time by those who had already had the shot, suggesting that they were falling less seriously ill and getting better more quickly.
Here is the current ranking of Covid symptoms after two vaccinations:
The study noted that "traditional" Covid symptoms such asanosmia(loss of smell),fever and shortness of breathranked way down the list, at five, 12 and 29 respectively. "Apersistent coughnow ranks at number 8 if you've had two vaccine doses, so is no longer the top indicator of having Covid."
The ranking changes again after one dose of the vaccination as observed below:
With the protection from only one vaccine dose, one of the original indicators of a persistent cough has made the top five symptoms, Zoe noted.
If you've not yet been vaccinated then the symptoms are more recognizable to the traditional ranking, Zoe said, "however we can still observe some changes from when Covid-19 first appeared over a year ago."
"Loss of smell comes in at number 9 and shortness of breath comes far down the list at number 30, indicating the symptoms as recorded previously are changing with the evolving variants of the virus," the study found.
Covid cases attributed to the much more contagious delta variant are surging in parts of Europe, the U.K. and the U.S., particularly among young people and the partially vaccinated and unvaccinated.
Read more: The delta variant is spreading in Europe and can't be stopped
While two doses of the Oxford-AstraZeneca or Pfizer-BioNTech vaccine provide protection against the delta variant,both were significantly less effective after only one shot.
The latest research from Israel on Monday found a decrease in the effectiveness of thePfizer-BioNTech vaccine in preventing infections and symptomatic illness, coinciding with the spread of delta, but said it remained highly effective in preventing serious illness.
A medical staffer wearing protective gear gestures after collecting a swab from a visitor to test for the coronavirus at a temporary testing station in Seoul in December 2020. South Korea on Friday announced it would raise restrictions in the capital region to the highest level as a fourth wave of infections is gaining speed. Jung Yeon-Je /AFP via Getty Images hide caption
A medical staffer wearing protective gear gestures after collecting a swab from a visitor to test for the coronavirus at a temporary testing station in Seoul in December 2020. South Korea on Friday announced it would raise restrictions in the capital region to the highest level as a fourth wave of infections is gaining speed.
SEOUL, South Korea Despite early successes last year in controlling the pandemic, South Korea on Friday announced it would raise restrictions in the capital region to the highest level as a fourth wave of infections is gaining speed.
The country recorded 1,316 cases Friday, breaking records for a second straight day. That's not high by international standards, but health authorities say the peak of this fourth wave of infections is likely yet to come, and barring effective countermeasures, could see case numbers nearly double.
Driving the surge are residents of the greater Seoul region, accounting for four-fifths of cases, and people in their 20s and 30s, who made up 43% of confirmed cases on Thursday. Many of them frequent the capital's eateries and night spots, and most are unvaccinated.
But to some extent, the young consumers were just taking their cues from the government's muddled messaging, authorities say.
The government was trying to "strike a balance between recovery of everyday life and prevention of outbreaks," Sohn Young-rae, a spokesperson for the health ministry, told reporters on Wednesday.
In a bid to give the impression of normalcy, authorities planned to relax restrictions this month and encourage people to get vaccinated by allowing inoculated citizens to go mask-free outdoors, even as case numbers remained steady or edged upward.
The government tried to remind citizens to remain vigilant toward the virus, "but faced with the current outbreak," Sohn conceded, "we do have some regrets that these messages should have been delivered more effectively."
The current restrictions send a sterner message.
For the next two weeks in the capital region, gatherings after 6 p.m. of more than two people are banned, as are protests and rallies. Bars and nightclubs are to close. Attendance at weddings and funerals is limited to family members. Even private gatherings are discouraged.
Following instructions from President Moon Jae-in, the government is adding more COVID-19 testing stations and mobilizing soldiers, police and civil servants to help out with contact tracing.
Vaccinations in South Korea still lag behind other developed economies with only about 11% of the population fully vaccinated.
Residents, local businesses and employees throughout Orange County are navigating a new world of relatively no pandemic restrictions compared to last Summer as questions are being raised on how to verify if workers and customers are vaccinated.
The decision to verify peoples vaccination status is left to businesses and employers, except for large indoor venues with more than 5,000 people.
The questions also come after a series of confusing guidelines from Californias Occupational Safety and Health Standards board members a workplace safety regulatory body over the past month.
While the workplace safety board members ultimately voted to allow fully vaccinated people drop their masks at work and align with the state Department of Public Health guidelines, the safety board didnt touch on how exactly businesses could verify if their employees are vaccinated.
[Read: Fully Vaccinated Workers in OC Can Now Drop Their Masks While on the Job]
Fully vaccinated means the employer has documented that the person received, at least 14 days prior, either the second dose in a two-dose COVID-19 vaccine series or a single-dose COVID-19 vaccine, reads the guidelines.
Officials from the state Department of Industrial Relations said its largely up to employers on how theyll verify if their workers are vaccinated.
Vaccination status must be documented. The revised [guidelines do] not specify a particular method. The employer must record the vaccination status for any employee not wearing a face covering indoors and this record must be kept confidential, officials said in a June 24 email.
That means employers can check someones vaccination record or use an honor system, officials said similar to the overall guidelines from the California Department of Public Health.
The state is kind of interesting theyre giving businesses the option of self attestation, versus everyone showing proof. But to be perfectly safe, you probably have to assess that. Its very hard for the public-facing businesses, like retailers and restaurants, etc., to ask the public to show proof of vaccine before they order a hamburger, said Lucy Dunn, president and CEO of the Orange County Business Council.
But, Dunn said verifying vaccination status in workplaces like offices would be a good idea.
When youre in an office setting or places with closer quarters indoors, it does make sense just to have every tool in the toolbox just to make it easier for employers to keep workers safe and to keep customers safe, she said.
Daniel Parker, an epidemiologist and public health expert at UC Irvine, echoed that sentiment.
You cant require everyone at the grocery store to be vaccinated, that sounds like an operational nightmare to me. But where I do see it is in workplaces, especially when you have people crammed in together in a tight space, Parker said.
Given the rise of the Delta variant, Parker said making everyone wear masks in places where vaccine status cant be verified is ideal because the variant appears to transmit easier.
Of course we cant check everybodys records before they go into a grocery store, but you could still have face masks, Parker said. We could still work around these things.
He also noted theres people who cant take the vaccine that should be taken into consideration.
We all know somebody whos been through cancer, or something similar, where theyre immunocompromised and they cant take the vaccine. Theyre still working in grocery stores. I feel like were forgetting that its not as simple as if you want the vaccine, you can get it.
State officials rolled out a digital vaccine verification program last month so people can download their documents to their phone as the economy restarts and some businesses are asking their employees to verify their shot status.
Gloria Alvarado, executive director of the OC Labor Federation, said she and other local labor leaders are pleased with the states vaccine documentation system.
So this tool is very helpful. Not only for workers, butk when you travel its going to make a big difference, Alvarado said in a Wednesday phone interview, adding it would be helpful for international flights.
Its just an additional system for people who chose to be vaccinated, she said.
Alvarado also said some employers require vaccine documentation, while others use the honor system before people can drop their masks at work.
Dunn said shes seen a similar approach by local employers and added she doesnt know of any businesses verifying the vaccine status of their customers.
The digital documentation is also an issue thats received a lot of local criticism from some Orange County residents.
In May, OC Supervisors stopped the county Health Care Agency from looking into issuing people digital vaccine documents following waves of protests at board meetings.
Many residents cited privacy concerns.
Others compared the documents to the Holocaust, relating it to yellow stars Nazi Germany made Jews wear.
The comparisons drew the ire of local Jewish community leaders.
[Read: OC Supervisors Cancel Digital Coronavirus Vaccine Records, Hundreds of People Rail Against Vaccine Passports & OC Jewish Community Calls For An End On Comparing Coronavirus Vaccine to Holocaust]
Dunn and Alvarado both said they wanted county Supervisors to approve the digital documentation service.
Meanwhile, Parker said hes concerned a vaccine-resistant variant could pop up in areas of the world where the virus is spreading unimpeded.
Theres just so many cases globally the pandemic is not over. What that means is all those cases happening in places where theres no vaccine, few vaccines it brings up lots of possibilities for variants to emerge where it could be more transmissible, more deadly, evade vaccines. So we need to stay vigilant.
Spencer Custodio is a Voice of OC staff reporter. You can reach him at scustodio@voiceofoc.org. Follow him on Twitter @SpencerCustodio
ANNAPOLIS, Md. (WJZ) Maryland reported 145 new COVID-19 cases and three new deaths, according to state health department data released Friday morning.
The state of emergency was lifted in Maryland, officially ending all covid-19 related restrictions.
During a press conference, Gov. Larry Hogan said unvaccinated Marylanders accounted for 100% of covid-related deaths in June, 95% of all new cases and 93% of hospitalizations.
More than 3.44 million Maryland adults are fully vaccinated. State officials also reported that the state positivity went up slightly to 0.82%.
Hospitalizations decreased by two to 113. Of those hospitalized, 79 remain in acute care and 34 remain in the ICU.
Since the pandemic began, there were 462,980 total confirmed cases and 9,544 deaths.
There are 3,446,199 Marylanders fully vaccinated. The state has administered 6,949,861 doses. Of those, 3,503,662 are first doses with 4,826 administered in the past 24 hours. They have given out 3,181,945 second doses, 7,134 in the last day.
The state began to administer the Johnson & Johnson vaccine again in April, after the CDC and FDA lifted their pause on the vaccine due to a rare blood clot found in some women.
A total of 264,254 Marylanders have received the Johnson & Johnson vaccine, 453 in the last day.
The state reported 75.3% of all adults in Maryland have received at least one dose of the vaccine.
CORONAVIRUS RESOURCES:
Heres a breakdown of the numbers:
By County
By Age Range and Gender
By Race and Ethnicity
For the latest information on coronavirus go to the Maryland Health Departments website or call 211. You can find all of WJZs coverage on coronavirus in Maryland here.
Inbound travelers will be required to isolate until they receive the results of the PCR test they underwent upon arrival and rapid corona tests also known as antigen tests will be performed at summer camps and programs for children and at the entrance of nursing homes, the coronavirus cabinet decided on Wednesday, announcing that the most important criteria to guide the governments action will be the number of serious patients, which has remained low throughout the current outbreak.
In a press conference later in day, Coronavirus Commissioner Prof. Nachman Ash also announced that the list of countries from which vaccinated and recovered individuals will be required to quarantine is going to be expanded to include not only nations under currently under travel ban that Israelis cannot visit unless they obtain a special governmental permission - but also countries under travel warning.
At the moment, the first includes Argentina, Brazil, India, Mexico, Russia and South Africa, the second Bolivia, Chile, Colombia, Costa Rica, Ethiopia, Maldives, Namibia, Nepal, Paraguay, Seychelles, Tunisia, Uganda, United Arab Emirates and Uruguay. The lists are updated every two weeks.
A cabinets spokesperson said that in order to increase the publics cooperation in observing quarantine regulations, the Health Ministry will start studying the question of whether the isolation period can be reduced. Ash said that they will consider all the data on the topic from Israel and from abroad and then they will see whether it is possible to recommend to shorten the period and of how many days.
Asked about whether vaccinated tourists will be allowed in starting from August 1 as planned, he said that the issue will be discussed in the coming days.
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The new measures approved by the cabinet are expected to come into effect in about a week, in order to give an appropriate window of time for the public to prepare, Ash said, adding that the rapid testing for children and visitors of nursing homes are expected to be funded by the state.
In light of the data we have, we are aiming for maximum protection for those who live in Israel and their health, along with a minimum of economic damage and disruption to daily life, Prime Minister Naftali Bennett said while opening the meeting.
We will try as much as possible to be transparent, to explain to the public what we are doing and to give appropriate notice before steps are taken, he added.
The ministers did not approve any new drastic restriction, such as requiring parents of an infected child to quarantine even if they are vaccinated or demanding an additional test for all those entering Israel after four days.
Instead, the authorities will focus on continue to encourage people to get vaccinated and to be careful to wear masks indoors, as it is currently required, as well as to step up enforcement.
The cabinet reconvened on Wednesday after the meeting was adjourned without any decision on Tuesday night.
Some 521 new virus carriers were identified on Tuesday, with over 85,000 tests processed. Both numbers mark the highest since March.
Some 46 patients were in serious condition as of Wednesday afternoon, six more than on the previous days. At the lowest on June 20, the number stood at 21.
While the serious morbidity has registered a slight increase since the beginning of the current outbreak which has seen the number of active cases in the country surging from less than 200 to almost 3,300 - the increase has been very limited compared to what was happening in the past.
A likely explanation for this development is that more than 40% of current virus carriers are schoolchildren, and almost half are people who were fully vaccinated. Both groups are unlikely to develop serious symptoms.
About 40% of the patients in serious conditions were also fully vaccinated. Ash said that most of them belonged to groups considered at risk (over 60 or with pre-existing conditions).
Asked about the possibility of a new lockdown, the commissioner said that he very much hoped that Israel is not going to need it.
It depends on the number of patients in serious conditions, if we were in a situation where the health system is in danger and we want to stop the increase, Ash noted. We are talking about a situation where we have hundreds of serious patients hospitalized.
All Deaconess employees will be required to receive the COVID-19 vaccine by the start of October 2021, a letter sent to employees on Thursday by Deaconess administration confirms.
"We are confident in the science behind the available vaccines, as well as their safety and efficacy. We also believe that vaccination is ultimately the only viable path to keeping staff and patients safe from COVID-19 and ending the pandemic," the letter sent to Deaconess employees says. "For those reasons, all Deaconess employees are required to be fully vaccinated for COVID-19 by October 1, 2021."
The letter says that Deaconess expects the COVID-19 vaccines to receive full FDA approval by the end of August, allowing employees enough time to get vaccinated by the Oct. 1, 2021 deadline.
Deaconess said in its letter that if the approval is delayed, the Oct. 1 deadline will be extended to allow for full FDA approval of the vaccines.
According to Deaconess, the health system's current vaccine exemption policy will be followed in regard to the COVID-19 vaccine mandate - allowing employees to fill out a "vaccine declination form" for religious reasons, health reasons, or other reasons, as laid out by the current policy.
In the letter, Deaconess said that it was attempting to address concerns and anxieties about getting the COVID-19 vaccine shared by many of its employees.
After being vaccinated against COVID-19, many people have reported unusual symptoms like swollen lymph nodes, COVID arm and blood clots. Understandably, these symptoms can be quite startling and concerning since many of us have never experienced them before. Some of the side effects reported are believed to be associated with your bodys immune response to the vaccine. But what about the reports of altered menstrual cycles after vaccination?
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While women across the country have noticed changes in their periods shortly after vaccination, there currently is no concrete evidence that COVID-19 vaccines can have a direct effect on womens menstrual cycles. Instead, these changes may be associated with the bodys response to stress.
Ob/Gyn George Fyffe, MD, FACOGshares his insights about why this is happening and gives some helpful tips to help women manage the effects of stress.
We might not realize that theres a connection between the uterus and the immune system, but there is one. Dr. Fyffe says that as a woman is about to ovulate, her immune system ramps itself up to prevent any infectious agents from interfering with the fertilization and implantation of the egg. Once the egg is fertilized and implants, the immune system dampens to accept the pregnancy.
Dr. Fyffe adds that the lining of the uterus also has immune cells, and those cells can be affected by hormonal changes. Uterine infections can also cause changes in a womans normal menstrual cycle.
The hypothalamus in the brain is the hormonal control center that works in conjunction with the anterior pituitary gland. Together, messages in the form of hormones are sent to the ovaries and the uterus to increase or decrease hormone levels to facilitate ovulation, pregnancy and the return of the menstrual cycle if fertilization doesnt occur. Emotional stress, physical stress, and chemical stress may affect the hormonal control center which can result in menstrual cycle changes.
Chemical stress applies to medications that can alter your period.
Women who are taking medications for seizure disorders, diabetes, thyroid conditions, hypertension, depression or other conditions might notice irregularities with their menstrual cycles. These medications can interfere with the hormones that are responsible for menstruation. Some may even cause loss of menstruation, says Dr. Fyffe.
Your healthcare provider can determine the best way to manage the disruption in your menstrual cycle. Dr. Fyffe says that its good to discuss any changes with your healthcare provider because theyll be aware of whats going on and you can work together to determine the best course of action.
Shared decision making between the provider and the patient will aid in determining and managing your bodys hormonal changes.
According to Dr. Fyffe, stress can increase your cortisol levels. Too much cortisol can lead to inflammation as well as a variety of physical and mental health issues.
Chronic stress can affect your bodys normal cortisol production rhythm. An overabundance of cortisol can affect your metabolism, which can lead to obesity. It can also lead to sleep disturbances as well as changes in menstruation.
According to Dr. Fyffe, three things that may promote health are exercise, rest and a healthy diet.
Exercise provides many benefits for your body. It can help your body manage blood sugar and insulin levels, it can help with weight management, it reduces your risk for heart disease and improves your mental health and well-being. Dr. Fyffe adds that in addition to stress, the pandemic has caused more of us to adopt a sedentary lifestyle. So by increasing exercise, you can lessen the effects of stress on the body.
While everyone has different schedules and obligations, Dr. Fyffe recommends getting seven to eight hours of sleep a night. Sleep disturbances and/or inadequate periods of rest, can affect your hormones and subsequently, your menstrual cycle.
Aim for a balanced diet which should include adequate levels of carbohydrates, proteins, low-fat, low-sugar, and iron-rich foods. And remember that when you eat too much or dont eat enough, it can affect your menstrual cycle. Also, make sure that youre drinking enough water. The recommended daily amount of water is 64 fluid ounces.
Dr. Fyffe says that a lot of factors in our environment can add to our stress. These things can influence our diet, sleep schedule, and medication regimen.
Do you have a child or a parent whos sick, or are you getting home late at night and not sleeping well? All of that can significantly affect your menstrual cycle. Just the idea of being so busy, not eating well, not getting enough sleep all those things can affect your brain. Another thing to think about is that were social animals. Before the pandemic, we all had routines. On the weekends, you would go see the people you care about. The pandemic took a lot of those social interactions away. So, when a lot of the things that we used to take for granted were taken from us, we probably didnt realize the impact that it would have on our minds and bodies.
