By Kwasi Gyamfi Asiedu, PolitiFact
From spring break parties to Mardi Gras, many people remember the last major normal thing they did before the novel coronavirus pandemic dawned, forcing governments worldwide to issue stay-at-home advisories and shutdowns.
Even before the first case of covid-19 was detected in the U.S., fears and uncertainties helped spur misinformations rapid spread. In March 2020, schools closed, employers sent staff to work from home, and grocery stores called for physical distancing to keep people safe. But little halted the flow of misleading claims that sent fact-checkers and public health officials into overdrive.Some peoplefalselyasserted covids symptoms were associated with 5G wireless technology. Faux cures anduntested treatmentspopulated social media and political discourse. Amid uncertainty about the viruss origins, some people proclaimedcovid didnt exist at all. PolitiFact named downplay and denial about the virus its2020 Lie of the Year.
Four years later, peoples lives are largely free of the extreme public health measures that restricted them early in the pandemic. But covid misinformation persists, although its now centered mostly on vaccines and vaccine-related conspiracy theories.
PolitiFact has publishedmore than 2,000 fact checksrelated to covid vaccines alone.
From a misinformation researcher perspective, [there has been] shifting levels of trust, said Tara Kirk Sell, a senior scholar at the Johns Hopkins Center for Health Security. Early on in the pandemic, there was a lot of: This isnt real, fake cures, and then later on, we see more vaccine-focused mis- and disinformation and a more partisan type of disinformation and misinformation.
Here are some of the most persistent covid misinformation narratives we see today:
A Loss of Trust in the Vaccines
Covid vaccines were quickly developed, with U.S. patients receiving the first shots in December 2020, 11 months after the first domestic case was detected.
Experts credit the speedy development with helping tosave millions of livesand preventing hospitalizations. Researchers at the University of Southern California and Brown University calculated thatvaccines saved 2.4 million livesin 141 countries starting from the vaccines rollout through August 2021 alone. Centers for Disease Control and Prevention data shows there were 1,164 U.S. deaths provisionallyattributed to covidthe week of March 2, down from nearly 26,000 at the pandemics height in January 2021, as vaccines were just rolling out.
But on social media and in some public officials remarks, misinformation about covid vaccine efficacy and safety is common.U.S. presidential candidate Robert F. Kennedy Jr. has built his 2024 campaign on a movement that seeks to legitimize conspiracy theories about the vaccines. PolitiFact made that its 2023 Lie of the Year.
PolitiFact has seen claims that spike proteins from vaccines arereplacing spermin vaccinated males. (Thatsfalse.) Weve researched the assertion that vaccines can change your DNA. (Thatsmisleading and ignores evidence). Social media posts poked fun at Kansas City Chiefs tight end Travis Kelce for encouraging people to get vaccinated, asserting that the vaccine actually shuts off recipients hearts. (No, it doesnt.)And some people pointed to an American Red Cross blood donation questionnaire as evidence that shots are unsafe.(PolitiFact rated that False.)
Experts say this misinformation has real-world effects.
A September 2023 survey byKFF found that 57% of Americanssay they are very or somewhat confident in covid vaccines. And those who distrust them are more likely to identify as politically conservative: Thirty-six percent of Republicans compared with 84% of Democrats say they are very or somewhat confident in the vaccine.
Immunization rates for routine vaccines for other conditions have also taken a hit. Measles had been eradicated for more than 20 years in the U.S. but there have been recent outbreaks instates including Florida,Maryland, and Ohio. Floridas surgeon general has expressedskepticismabout vaccines andrejectedguidancefrom the CDC about how to contain potentially deadly disease spread.
The vaccination rate among kindergartners has declined from 95% in the 2019-20 school year to 93% in 2022-23, according to theCDC. Public health officials have set a 95% vaccination rate target to prevent and reduce the risk of disease outbreaks. The CDC also foundexemptions had risen to 3%, the highest rate ever recordedin the U.S.
Unsubstantiated Claims That Vaccines Cause Deaths or Other Illness
PolitiFact has seen repeated and unsubstantiatedclaims that covid vaccines have caused mass numbers of deaths.
A recent widely shared post claimed17 million people had diedbecause of the vaccine, despite contrary evidence from multiple studies and institutions such as the World Health Organization and CDC that the vaccines are safe and help to prevent severe illness and death.
Another online post claimed the booster vaccine hadeight strains of HIVand would kill 23% of the population. Vaccine manufacturers publish theingredient lists; they do not include HIV. People living with HIV were among the peoplegiven priority accessduring early vaccine rollout to protect them from severe illness.
Covid vaccines also have been blamed forcausing Alzheimersandcancer. Experts have found no evidence the vaccines cause either conditions.
You had this remarkable scientific or medical accomplishment contrasted with this remarkable rejection of that technology by a significant portion of the American public, said Paul Offit, director of the Vaccine Education Center at the Childrens Hospital of Philadelphia.
More than three years after vaccines became available, about 70% of Americans have completed a primary series of covid vaccination,according to CDC figures. About 17% have gotten the most recentbivalent booster.
False claimsoften pullfrom and misuse datafrom theVaccine Adverse Event Reporting System. The database, run by the CDC and the FDA, allows anybody to report reactions after any vaccine. The reports themselves are unverified, but the database is designed to help researchers find patterns for further investigation.
AnOctober 2023 surveypublished in November by the Annenberg Public Policy Center at the University of Pennsylvania found 63% of Americans think it is safer to get the covid-19 vaccine than the covid-19 disease that was down from 75% in April 2021.
Celebrity Deaths Falsely Attributed to Vaccines
Betty White, Bob Saget,Matthew Perry, andDMXare just a few of the many celebrities whose deaths were falsely linked to the vaccine. The anti-vaccine filmDied Suddenly tried to give credence to false claims that the vaccine causes people to die shortly after receiving it.
Cline Gounder, editor-at-large for public health at KFF Health News and an infectious disease specialist, said these claims proliferate because of two things:cognitive bias and more insidious motivated reasoning.
Its like saying I had an ice cream cone and then I died the next day; the ice cream must have killed me, she said. And those with preexisting beliefs about the vaccine seek to attach sudden deaths to the vaccine.
Gounder experienced thispersonally when her husband, the celebrated sports journalist Grant Wahl, died while covering the 2022 World Cup in Qatar. Wahl died of a ruptured aortic aneurysm but anti-vaccine accounts falsely linked his death to a covid vaccine, forcing Gounder topubliclyset the record straight.
It is very clear that this is about harming other people, said Gounder, who was aguestat United Facts of America in 2023. And in this case, trying to harm me and my family at a point where we were grieving my husbands loss. What was important in that moment was to really stand up for my husband, his legacy, and to do what I know he would have wanted me to do, which is to speak the truth and to do so very publicly.
Out-of-Control Claims About Government Control
False claims that thepandemic was plannedby government leaders and those in power abound.
At any given moment, Microsoft Corp. co-founder and philanthropist Bill Gates, World Economic Forum head Klaus Schwab, or Anthony Fauci, former director of the National Institute of Allergy and Infectious Diseases, are blamed for orchestrating pandemic-related threats.In November, Rep. Matt Rosendale (R-Mont.) falsely claimed Fauci brought the virus to his state ayear before the pandemic.There isno evidenceof that. Gates, according to the narratives, is using dangerous vaccines to push a depopulation agenda. Thatsfalse. And Schwab has not said he has an agenda to establish a totalitarian global regime using the coronavirus to depopulate the Earth and reorganize society. Thats part of aconspiracy theorythats come to be calledThe Great Resetthat has beendebunkedmanytimes.
The United Nations World Health Organization is frequently painted as a global force for evil, too, with detractors saying it is using vaccination to control or harm people. But the WHO has not declared thata new pandemicis happening, as some have claimed. Its current pandemic preparedness treaty is in no way positioned to remove human rights protections or restrict freedoms, asone post said. And the organization has not announced plans to deploy troops to corral people andforcibly vaccinate them. The WHO is, however, working on a new treaty to help countries improve coordination in response to future pandemics.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFFan independent source of health policy research, polling, and journalism. Learn more about KFF.
This story can be republished for free (details).
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFFan independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News free Morning Briefing.
Previously Published on kffhealthnews.org
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Topline
Researchers are pitching a new vaccine method for infants that offers continued protection with just a single dose, even if the virus mutates, according to a new study that could set the stage for universal vaccines.
A patient getting vaccine.
Vaccines for diseases like the flu are updated annually to accommodate for new variants, while vaccines for some diseases like COVID-19 are updated less frequently to target dominant variants of the virus circulating in the U.S.
There are different ways to create vaccines, but one of the most popular ways to make them is by including a weakened or inactive version of the virus, which in turn causes the bodys immune system to produce T-cells that attack the virus and prevent it from spreading.
This new vaccine strategytested on micealso uses a modified version of a virus, but instead of relying on the bodys immune system response, it uses small interfering RNA molecules (siRNA), which stop the spread of disease, to create separate vaccines that target different diseases, according to a study published Monday in the Proceedings of the National Academy of Sciences.
Diseases thrive because they produce a protein that can block the production of siRNAs, but the new vaccine strategy creates and uses a mutant virus that cant produce these proteins, which allows the bodys siRNAs to weaken the virus, regardless of if it mutates and makes a new variant.
The research team from the University of California, Riverside, believes because this strategy doesnt rely on the bodys immune response to disease, it will also be suitable for babies, whose immune systems are still developing.
The researchers tested this method in baby mice and discovered they also produce siRNA, so they vaccinated them against a mouse disease called Nodamura, and they found the vaccine induced rapid and complete protection against the virus.
It is broadly applicable to any number of viruses, broadly effective against any variant of a virus and safe for a broad spectrum of people, Rong Hai, a study author and virologist at the University of California, Riverside, said in a statement. This could be the universal vaccine that we have been looking for.
Though there are some approved vaccines for infants, vaccines for diseases like measles, COVID-19 and the flu can only be administered to people over the age of six months. This is because of their immature immune systems that cause a diminished response to these vaccines, and a potential lack of effectiveness, according to a study published in Vaccine. However, this group of people is one of the most susceptible to severe infection. Infants younger than six months have the highest risk of being hospitalized due to flu infection, according to the Centers for Disease Control and Prevention. In order to protect this population from infection, its recommended that all household members and people who come into close contact with them get vaccinated from these diseases. Some research shows vaccinated mothers may pass antibodies to fetuses through the umbilical cord, and newborns via breast milk that can continue to protect the babies from infection. Respiratory syncytial virus (RSV) vaccines given to pregnant mothers have proven to protect infants up to six months after birth, according to the CDC.
Though there arent any approved siRNA vaccines, researchers are working on ones that target COVID-19 and the flu. It was previously debated whether humans and other mammals use interfering RNA to kill viruses. However, the same team from the University of California, Riverside also conducted research in 2013 that discovered this theory was true. The team later went on to prove flu infection causes the body to produce interfering RNA, so theyre in the process of developing a flu vaccine that uses this strategy.
The researchers intend on creating this vaccine as a nasal spray rather than a shot. Respiratory infections move through the nose, so a spray might be an easier delivery system, Hai said. Theres already an approved nasal spray flu vaccine thats shown to be as effective in children as flu shots, according to the CDC. Several research teams are working on nasal COVID-19 vaccines, and both China and India have approved the use of nasal sprays in the form of boosters.
A recent study published in the journal Nature Communications observed antibody breadth and effector functions as important immune correlates that can be used to develop universal influenza vaccines. This vaccine could be effective against all influenza virus strains, even those having pandemic potential.
Study: Influenza antibody breadth and effector functions are immune correlates from acquisition of pandemic infection of children. Image Credit:Africa Studio / Shutterstock
Children are particularly vulnerable to influenza viruses that cause seasonal epidemics and sporadic pandemics. Seasonal influenza epidemics not only lead to an upsurge in hospital admissions but also increase mortality rates in older adults with comorbidities. Many studies have shown that seasonal influenza vaccines provide limited protection against influenza viruses that have the potential to cause a pandemic. However, the 2009 H1N1 pandemic (pH1N1) revealed the effectiveness of seasonal vaccines in protecting children and older adults from the infection. This protection could be due to cross-reactive antibody responses.
Compared to children, adults possess additional immune correlates, such as T-cell responses and non-neutralizing antibody functions. This is the reason why children require higher concentrations of HAI antibodies for an equivalent amount of immune protection from the infection. To design a next-generation vaccine, it is important to identify immune correlates of protection. In the context of pH1N1 infection, HA-stem-specific antibodies play a crucial role in providing protection, which is mediated by the Fc Receptor (FcR) function.
Some antibodies that can cross-react between pandemic, seasonal, and avian influenza viruses could reduce the severity of influenza virus infection. In this context, serum antibodies, particularly IgG, can facilitate effector functions, such as directing immune cells to kill infected cells, engulfing infected cells via antibody-dependent phagocytosis (ADCP), and promoting antibody-dependent cellular cytotoxicity (ADCC). These functions are mediated by Fc gamma receptors (FcR) 3a and FcR2a.
Mechanistically, FcR 3a and FcR2a employ macrophages and natural killer (NK) cells to remove viruses-infected cells. Cross-reaction of ADCC antibodies has been associated with targeting conserved antigenic sites of influenza virus hemagglutinin (HA), the Nucleoprotein (NP), and Matrix 1 (M1).
The current study identified several gaps in research regarding antibody effector functions. For instance, few studies have assessed the vaccine-induced ADCC changes, longitudinal durability of vaccine-induced antibody FcR binding and isotype changes, and the alterations in HA-specific antibody responses with vaccination and infection. The currently performed randomized placebo control trial (RCT) investigated the influenza-specific antibody breadth and function of seasonal (S1) H1N1 vaccination and pH1N1 infection.
The antibody features, particularly HAI titer, from seasonal vaccination that could have helped in reducing or delaying contraction of pH1N1 were assessed using selected archived samples. These samples were collected from NCT00792051, a randomized placebo-controlled trial and its follow-up study that used school children between 6 and 17 years old.
A subset of children who received any influenza vaccination in Year 1 (V1) or not (placebo-V0) was selected for secondary analyses, which helped determine the effectiveness of vaccination against pH1N1 infection.
The current study indicated that non-neutralizing antibodies are highly cross-reactive between different influenza strains and subtypes, which could play an important role in reducing the incidence and severity of infection.
Detecting antibody functions other than HAI is vital to developing next-generation vaccines. This study identified the serological correlates that play an important role in protecting children from pandemic infection. In 2009, when schools were closed for two months, H1N1 transmission was low. However, soon after schools reopened in September 2009, more than 50% of the students were infected within a few months. A very low community uptake of the monovalent pH1N1 vaccine has been documented.
The half-life of different antibody subclasses alters significantly. The current study observed that seasonal vaccination enhances Fc effector functions of pH1N1 specific NP, HA, and neuraminidase (NA) antibodies. However, their function was short-term as it waned off within one year of vaccination. A greater antibody decline was observed in unvaccinated children.
Seasonal vaccination did not boost FcR effector functions to other seasonal-specific antibody responses. Unvaccinated, uninfected children also exhibited increased FcR-mediated effector functions of pandemic-specific NA, HA, and NP antibodies. These children displayed a higher antibody level of NK cell function. pH1 antibodies against H3-HA responses were associated with cross-reactive avian H5-specific IgG, FcR2a, and FcR3a responses. This finding implies that cross-reactive responses are less focused and are not trained by seasonal virus exposure of other groups.
Considering the experimental results, vaccination and prior infection are not associated with the lack of infection in unvaccinated, uninfected children or susceptibility of V1S1 children. More research is required to understand the host factors leading to these outcomes.
Results also indicated that group 2 H3 HA-specific IgG3 antibodies are negative predictors of infection. However, seasonal H1 and pH1-IgG3 antibodies before infection were positively associated and, therefore, protected against infection.
This study shows how universal influenza vaccines, effective against seasonal to pandemic viruses, can be developed. Antibody breadth and FcR effector functions are two important immune correlates that could be exploited to develop this vaccine.
Journal reference:
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For the first time, we have vaccines that can protect older adults against three leadingand sometimes fatalrespiratory viral diseases: influenza, COVID and respiratory syncytial virus (RSV). This is a breakthrough; studies show that these vaccines are effective at protecting older adults from severe disease outcomes, including hospitalization and death.
Yet some seniorsincluding many who live in nursing homesarent getting these vaccines. And the prevaccine days of the COVID pandemic showed us how deadly respiratory illness could be among older people in group settings. As scientists at the Centers for Disease Control and Prevention, we have been tracking vaccination rates among older people. Given how easily these diseases are spread, and the possibility of severe disease with long and complex hospitalizations, we must do more to help inoculate them.
As this winter respiratory virus season winds down, its crucial we start planning for the next one. We can use the lessons weve learned from the vaccine rollouts for flu, COVID and RSV to give seniors the best shot at protection.
Older adults have a higher risk of severe disease and death from these respiratory virus infections compared to other age groups. Both their first-line innate immune responses and their slower, infection-specific adaptive immune responses decline. This decline, combined with higher rates of chronic diseases such as heart disease and diabetes andfor people who live in long-term care facilitiesan increased chance of disease spread, leaves older folks at risk for severe disease and death.
Improving the use of these vaccines through the fall and winter respiratory illness seasons could mean healthier seniors and fewer visits to urgent care and the emergency department and fewer hospitalizations.
In 20222023, experts estimate that flu vaccination prevented nearly 31,000 hospitalizations and 2,500 deaths among people ages 65 and older. COVID vaccination greatly lowered rates of hospitalizations and deaths among adults ages 65 years and older too. And in clinical trials, the new RSV vaccines had an efficacy of 83 to 89 percent in preventing symptomatic RSV in the lower respiratory tract in adults ages 60 years and older.
The CDCs latest data show that as of late March, 74 percent of adults age 65 years and older had gotten the flu vaccine and just 42 percent had received the updated COVID vaccine. Although coverage for influenza vaccine is trending slightly higher than at this point last year, COVID vaccine coverage remains about as low as last year. Among those ages 60 years and older, 24 percent had gotten an RSV vaccine. As of late March, only 43 percent of nursing home residents had received an updated COVID vaccine; as of December 10, 72 percent had received an influenza vaccine and 10 percent had received an RSV vaccine.
The fact that nearly three quarters of older adults received a flu vaccine this season, as opposed to less than half for the COVID vaccine, shows us that we have a lot of work to do to help people get up-to-date on COVID vaccines. And there is more to be done to help people and their providers understand whether an RSV vaccine is right for them.
The CDC surveyed unvaccinated older folks to better understand their reasons for not getting vaccinated, and the results varied. People 65 and older who said they were probably or definitely not going to get the influenza vaccine were concerned primarily about vaccine effectiveness and side effects and said they were not worried about the flu. For the COVID vaccine, participants most often shared concerns about heart-related or unknown serious side effects, followed by concerns about effectiveness and having vaccine fatigue, meaning they were likely burned out on vaccine information. The primary reasons for people age 60 and older not getting the RSV vaccine were not being worried about RSV, not knowing enough about RSV or the RSV vaccine, and the vaccine being too new.
These reasons for not getting vaccinated and the differences across vaccines are perhaps understandable in the context of where we are in the vaccine rollouts. Influenza vaccines have been licensed in the U.S. since the 1940s. In contrast, COVID vaccines were introduced little more than three years ago, and while these vaccines have undergone the most rigorous safety monitoring in U.S. history, some people still have misconceptions about the vaccines safety.
In addition, the vaccine fatigue expressed by respondents to the CDC survey is a genuine challenge. In the early days of COVID vaccines, older adults enthusiastically accepted vaccination. But over time, fewer and fewer seniors have been willing to get additional recommended doses. Many people are also less concerned about COVID itself, despite the fact that many people are still dying from it each day in the U.S.
RSV vaccines were licensed in 2023and from prior new vaccine rollouts we know that it can take years for vaccination coverage to increase. Moreover, instead of recommending that all adults 60 years and older get vaccinated, the CDC recommended that people and their health care providers have a conversation to determine if RSV vaccination is right for them. As a result, not all eligible adults are likely to get the vaccine.
Plus it is hard for some people to access vaccines. On one hand there is ample supply of all three vaccines, and they are covered by Medicare and many private insurance plans at no out-of-pocket cost. Still, there are around 400,000 people age 65 and older who are uninsured. Nonetheless, the health care provider or facility has to absorb the up-front costs of purchasing vaccines and then seek reimbursement for vaccination.
Furthermore, disparities in access to health care among ethnic and racial groups make getting respiratory vaccines challenging for some communities in the U.S. For example, during the 20222023 season, influenza vaccination coverage among adults ages 65 years and older ranged from 54 percent in American Indian/Alaska Native people to 71 percent in non-Hispanic white people.
There also are barriers to receiving these three vaccines within a relatively short period of time. Even though the CDC says that influenza, COVID and RSV vaccines can be given at the same time, not everyone is open to that. Furthermore, each of these vaccines became available at different points in time during this past season, which made it more difficult for people to receive these vaccines at once. For some, it may not have been a priority or a possibility to return for a follow-up visit for additional vaccines that they were unable to receive on prior visits.
Long-term care facilities face additional unique challenges to vaccinating residents, including the monumental task of strengthening vaccine confidence and demand not only among residents but also among staff at the facilities and family members involved in residents medical decisions. In addition, long-term care facilities may not have the necessary infrastructure, staffing and financial resources to routinely offer vaccines to residents. Furthermore, the end of the Public Health Emergency and transition from a federal COVID vaccine distribution system to a commercialized market ended certain regulatory flexibilities and continued the shift to more sustainable channels for vaccinating residents, though with fewer dedicated resources.
The relatively high influenza vaccination coverage among older adults suggests that it is possible to get more older people vaccinated for all recommended vaccines. The CDC is working to improve access to adult vaccines through programs such as the Bridge Access Program, which provides COVID vaccines at no cost to uninsured or underinsured adults. The CDC is working to strengthen confidence in and demand for vaccines; to communicate the benefits of vaccination to the public, and to use data to target vaccination efforts. In addition, because a strong recommendation from a health care provider remains the leading reason why people choose to get vaccinated, the CDC has worked to equip providers with resources on vaccine recommendations and on having effective conversations with patients about vaccines.
It will take ground-up efforts across every community, vaccination provider location and household around the U.S. to ensure that older adults get not only the respiratory virus vaccines but all recommended vaccines.
The views expressed in this article do not necessarily represent those of the Centers for Disease Control and Prevention.
This is an opinion and analysis article, and the views expressed by the author or authors are not necessarily those of Scientific American.
Each year, the flu vaccine undergoes a meticulous process to ensure its efficacy in combating the influenza virus. With numerous strains of influenza circulating, it is important to accurately predict which strains will dominate each flu season. The effectiveness of the vaccine hinges on the accuracy, as it aims to either prevent individuals from contracting the flu or decrease the severity of illness if infection does occur.
To achieve this level of precision, scientists use multiple approaches. One such method is epidemiologic data analysis, which involves tracking the spread and prevalence of different flu strains across populations. By monitoring patterns of infection and transmission, researchers can identify trends and anticipate which strains are likely to predominate in the upcoming season.
Genetic data also plays a crucial role in the forecasting process. Laboratories worldwide conduct genetic sequencing on viral samples obtained from infected individuals, enabling scientists to analyze the genetic makeup of different flu strains. By comparing the genetic sequences of these strains, researchers can discern patterns of mutation and evolution, providing insights into how the virus may evolve over time and which strains are most likely to circulate in the future.
Furthermore, scientists examine the antigenic properties of flu viruses to assess their similarity to previous strains and predict their potential impact on vaccine effectiveness. Antigens, found on the surface of viruses, stimulate the production of antibodies in the bodys immune system. By studying these antigens, researchers can see how well the current vaccine will combat circulating flu strains.
Human serology studies also contribute valuable data to the forecasting process. These studies involve analyzing blood samples from individuals exposed to different flu strains to measure their immune response. By assessing levels of antibodies specific to various flu viruses, researchers can gauge population immunity and susceptibility to different strains, aiding in the prediction of which viruses are likely to cause outbreaks in the future.
Global surveillance efforts coordinated by organizations like the World Health Organization (WHO) further enhance the accuracy of flu forecasting. Through year-round monitoring of flu activity worldwide, including peak seasons in both the northern and southern hemispheres, epidemiologists can identify emerging strains and assess their potential threat to global public health. This global perspective enables researchers to anticipate how flu viruses may spread and evolve, informing vaccination strategies and pandemic preparedness efforts.
In addition to these methods, evolutionary analysis plays a critical role in flu forecasting. By examining the evolutionary dynamics of flu viruses, researchers can predict how different strains may compete with one another and evolve to evade immune detection. This understanding of viral evolution helps inform the development of vaccines that target the most prevalent and virulent flu strains, maximizing their effectiveness in protecting against seasonal influenza.
Olivia Khangi is a participant in the Niagara County NYS Public Health Corps Fellowship program at Mount St. Mary's and Lockport Memorial hospitals. The Right Way to Care by Catholic Health is produced by the hospitals' public relations and marketing department.
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In just the first few months of the pandemic, Healthcare at Foster Creek quickly became the state's largest outbreak site; 30 residents died.
Author: kgw.com
Published: 11:07 PM PDT April 12, 2024
Updated: 11:07 PM PDT April 12, 2024
Topline
A federal task force says its seized more than $1.4 billion in fraudulently obtained Covid-19 relief funds over the last three years, though its potentially only a fraction of the total amount of aid money stolen by fraudsters.
FILE - The Justice Department in Washington, Nov. 18, 2022. (AP Photo/Andrew Harnik, File)
In its annual report released Tuesday, the Department of Justices Covid-19 Fraud Enforcement Task Force says its members have filed charges against more than 3,500 defendants for fraudulently obtaining funding meant for pandemic relief efforts since the task force was formed in 2021cases believed to account for total losses of more than $2 billion.
Of the 3,500 defendants charged by U.S. Attorneys Offices around the country, 2,005 defendants have pleaded guilty or were convicted at trialbut the report says there are a similar number of investigations open that are yet to be charged.
Members of the task force have also secured more than 400 civil settlements and judgements totaling more than $100 million.
The money seized by the DOJ was fraudulently obtained through the Coronavirus Aid, Relief and Economic Security (CARES) Act, the landmark 2020 stimulus bill that established programs to distribute trillions of dollars in aid to individuals impacted by the pandemic.
In one example cited in the report, a Washington business owner pleaded guilty to fraudulently obtaining more than $16 million in pandemic-relief funding by applying for funding for dozens of businesses purportedly owned by him or his associates using false informationwith many of the businesses inactive.
But defendants werent limited to business ownersthe U.S. Attorneys Office in the Southern District of Florida, for instance, prosecuted 17 employees with the Broward Sheriffs Office for each independently fraudulently applying for pandemic relief and receiving a combined $500,000 illegally.
The total amount of money fraudulently taken during the pandemic could amount to hundreds of billions of dollars. In 2023, the Government Accountability Office estimated that the total amount of unemployment insurance fraud during the pandemic was between $100 billion and $135 billionaccounting for 11 to 15% of the total unemployment benefits paid during the pandemic. A 2023 Associated Press investigation estimated that up to $280 billion in pandemic relief funding was obtained fraudulently, while another $123 billion was misspent or otherwise wasted. U.S. Attorney General Merrick Garland established the Covid-19 Fraud Enforcement Task Force in 2021, acknowledging at the time it is impossible to keep all those intent on carrying out illegal COVID fraud schemes from doing so, but vowing to work to hold bad actors accountable.
In its report, the Covid-19 Fraud Enforcement Task Force noted significant challenges in continuing its work. It advocated, for instance, for an extension of statute of limitations on all COVID-19 fraud-related offenses, noting in the coming years, investigative targets will increasingly argue that their conduct falls outside the statute of limitations. In 2022, the U.S. passed legislation increasing the statute of limitations for fraud related to the so-called Paycheck Protection Program and Economic Injury Disaster Loan program from five to 10 years. Sens. Ron Wyden, D-Ore., and Mike Crapo, R-Idaho, have introduced a legislative framework to extend the statute of limitations for pandemic unemployment insurance fraud to 10 years. The Task Force also calls for the renewal of the Pandemic Response Accountability Committee, a body of 20 federal inspectors general that oversees pandemic relief spendingits funding is set to end next year.
Later on Tuesday, Senate Democrats proposed a new $1.3 billion bill maimed at giving authorities more tools to investigate and prosecute pandemic relief fraud. The bill, which is modeled off a White House budget request, would fund new Covid-19 fraud investigative teams, provide funding to federal agencies to hire investigators that would specialize in recovering lost pandemic funds and more.
A new cross-sectional study in JAMA Internal Medicineof 238,828 blood donors finds that 43.3% of those with a history of SARS-CoV-2 infection reported new long-term symptoms, compared with 22.1% without a history of infection.
"The difference in these proportions suggests that 21.2% of donors with prior SARS-CoV-2 infection likely experienced long-term symptoms attributed to their infection," the authors said
This is one of the first long COVID studies to compare those with a history of COVID infection and long-term symptoms to a nonSARS-CoV-2infected control population. Such a comparison, the author said, helps to distinguish background prevalence of symptoms from those following COVID-19.
The study included adult American Red Cross blood donors surveyed from February 22 to April 21, 2022. the survey asked about new long-term symptoms arising after March 2020, and their SARS-CoV-2 infection status.
Fifty-eight percent of respondents were female, and the average age was 59 years. All participants also underwent at least one serologic test for antinucleocapsid antibodies from June 15, 2020, to December 31, 2021. Those antibodies appear in the blood only after COVID-19 infection and not following vaccination.
"Serologic testing to confirm prior infection may be particularly helpful for the evaluation of postCOVID-19 conditions because many SARS-CoV-2 infections are not detected and many individuals who are asymptomatic or experience mild symptoms may not be tested during the acute phase of infection," the authors wrote.
The study authors defined long-term symptoms as those lasting 4 or more weeks after COVID-19 infection. In the surveys, long-term symptoms were grouped by system: neurologic, gastrointestinal, respiratory or cardiac, mental health, and other.
Of the 83,015 people with a history of SARS-CoV-2 infection, 43.3% reported new long-term symptoms compared with 22.1% of those without a history of SARS-CoV-2 infection (adjusted odds ratio [AOR], 2.55; 95% confidence interval [CI], 2.51 to 2.61).
Being a woman and having history of chronic health conditions was associated with long COVID symptoms.
Among blood donors with prior SARS-CoV-2 infection, 23.6% reported long-term neurologic symptoms, 23.1% reported other symptoms (including changes in taste or smell), 15.8% reported respiratory or cardiac symptoms, 11.9% reported mental health symptoms, and 4.6% reported gastrointestinal symptoms
Long-term symptoms in the "other" and the respiratory/cardiac categories were most associated with prior COVID-19 infection (AOR, 4.14; 95% CI, 4.03 to 4.25; and AOR, 3.21; 95% CI, 3.12 to 3.31, respectively).
The two most common individual long-term symptoms among those with SARS-CoV-2 infection were difficulty thinking or concentrating (12.7%) and fatigue (11.1%). Six percent of those without a history of COVID-19 reported anxiety, making it the most common long-term symptom.
"Mental health symptoms occurred almost as often in both those with and without prior SARS-CoV-2 infection, suggesting the presence of indirect effects," the authors concluded.
Kaleigh Levine was running drills in the gym with her lacrosse team at Notre Dame College in South Euclid, Ohio, when everything turned black.
The coach wanted me to get back in the line, but I couldnt see, she remembered.
Her vision returned after a few minutes, but several months and a half-dozen medical specialists later, the 20-year-old goalie was diagnosed with a mysterious condition known as POTS.
First described more than 150 years ago, the syndrome has proliferated since the coronavirus pandemic. Before 2020, 1 million to 3 million people suffered from POTS in the United States, researchers estimate. Precise numbers are difficult to come by because the condition encompasses a spectrum of symptoms, and many people have still never heard of it. Recent studies suggest 2 to 14 percent of people infected with the coronavirus may go on to develop POTS.
The syndrome tends to strike suddenly, leaving previously healthy people unable to function, with no clear cause. In recent years, doctors specializing in the condition have noticed a curious and disproportionate subset of patients: young, highly trained athletes who are female.
Short for postural orthostatic tachycardia syndrome, POTS is diagnosed when a patients heart rate goes berserk, jumping way above normal when changing position from lying down to standing.
Teens and young adults at peak fitness are generally regarded as being extremely healthy, so the burst of POTS cases has puzzled doctors.
Several factors may be conspiring, said Robert Wilson, a neurologist who runs the Cleveland Clinics POTS practice. It could be that women of childbearing age are more vulnerable to inflammation. It could reflect the damage that comes with being hit with a virus unknown to humans until 2020. And the stress associated with repetitive physical exhaustion could leave athletes at risk.
Its something of a perfect storm of susceptibility, Wilson said.
Dongngan Truong, a pediatric cardiologist at University of Utah Health, speculated that the surge in cases might reflect athletes often unusual physiology, or could simply be reporting bias.
It could just be athletes generally keeping in touch with their bodies more, Truong said.
Concerns about the health of athletes made headlines early in the pandemic but the focus wasnt on POTS. It was on another heart condition.
Prominent sports figures including Boston Red Sox pitcher Eduardo Rodriguez revealed that after enduring covid-19, they experienced inflammation of the heart muscles known as myocarditis, a leading cause of sudden death in athletes.
The NCAA started a registry to track athletes. Professional sports teams and schools introduced heart screenings before allowing athletes to return to play. It turned out myocarditis was not as common as feared, and a study published later in the journal Heart showed that elite athletes who were affected had no long-lasting heart damage.
But the scrutiny led to a wave of important research.
At the University of Alabama at Birmingham, Sara Gould, an orthopedic surgeon, and Camden Hebson, a pediatric cardiologist, opened a sports clinic in 2021 to help young athletes navigate their health post-covid. It drew patients from across the South and beyond, but the physicians were surprised to find that few of the patients had myocarditis. Most were coming in with POTS.
And POTS is a lot of what we see to this day, Gould said.
When oxygen flow to the brain is reduced, it sparks sometimes vague and confusing POTS symptoms including lightheadedness, fainting, nausea, tremors, fatigue, headache, brain fog, blurry vision, palpitations and chest tightness, and shortness of breath. The impact can be measured by elevations in heart rate when people change position.
Many athletes, especially those in endurance sports, tend to have lower resting heart rates than non-athletes making the jumps even bigger. An athletes resting heart rate might be 30 to 50 beats a minute, while another persons resting heart rate sits at 60 to 100 beats.
A 19-year-old female college volleyball player described in a case study by the American Medical Society for Sports Medicine had a heart rate that jumped from 56 beats a minute to 120. A presentation from North Central College in Illinois details the illness of a nationally ranked high school swimmer whose heart rate spiked from the 40s and 50s to as high as 172 when moving from lying down to standing.
Gould and Hebson quickly noticed that most of their patients could be categorized into two groups.
The larger cohort was predominantly female and included a lot of cross-country runners and volleyball players. Many could not pinpoint a clear event that marked the onset of symptoms although most had experienced covid or another viral illness in the recent past.
Its not a lock-and-key situation with just anybody getting covid and then POTS, Hebson theorized. Its that some patients had a predisposition to POTS to begin with, and then something comes along it could be mono or covid or something else to give them a push.
The second group was dominated by men, including football players, and they reported experiencing symptoms of dysautonomia the bouncing heart rate that is the main characteristic of POTS after a concussion.
Their findings, published in the journal the Physician and Sportsmedicine, are consistent with the first documented cases of POTS. During the Civil War, POTS was among a number of distinct syndromes once known collectively as soldiers heart because so many members of the military exhibited symptoms. Medical historians speculate that head injuries during combat triggered some cases.
Gould believes several aspects related to being an athlete might increase susceptibility to the syndrome.
Some of her patients have hypermobility in their joints, meaning they have greater than normal range of motion. That can be an advantage in sports including gymnastics, diving, swimming and hurdles, but it has also been associated in studies with POTS. Gould described hypermobility as being related to blood vessels being more stretchy, which could impact heart rate and blood pressure.
Gould said many clinic patients tend to be taller than average, which can be an advantage in certain sports. Gene association studies have shown that height increases the risk of heart palpitations and circulatory problems symptoms seen in people with POTS.
Intense exercise may itself be a trigger. In a two-hour practice, athletes can lose 2 to 3 percent of their body weight in water, which can further upset how blood flows and exacerbate POTS symptoms.
Since the end of the 19th century, scientists have observed that intensive exercise can reshape the heart. Athletes hearts tend to be bigger and pump more slowly. Exercise requires more oxygen, so the heart has to work more vigorously and over time gets bigger and thickens. When an athlete is resting, the heart does not need to work as hard so it pumps less.
The changes make the heart more efficient, but the stress of athletic exertion has other impacts on the body.
We learned a lot from covid athletes in 2020-21 and about how having a really conditioned heart may be something that plays a role in different conditions, Wilson, the Cleveland Clinic neurologist, said.
Wilson has been collecting data on POTS patients since 2017. In a database of several hundred people, women of childbearing age represent a disproportionately high percentage of patients. Scientists suspect women may be more at risk because they are more often in a pro-inflammatory state during menstrual cycles and pregnancy in which the immune system readies itself to fight against something that is potentially harmful.
Another early finding is that 90 percent of the POTS patients had been exercising regularly before being struck with the condition. Only 28 percent of Americans exercise regularly, according to the Centers for Disease Control and Prevention.
Aubrey Hutzler, 19, a catcher for the womens softball team at Nova Southeastern University in Davie, Fla., noticed she wasnt herself when jumping up from a crouching position to catch a ball thrown to home plate while practicing with her high school team.
I was training nationally and playing in front of college coaches and then suddenly I couldnt handle a normal day. It was really hard mentally, Hutzler said.
Sophia LeRose had been in the goal for a preseason lacrosse game for Duke University, when she felt like her heart was going to bounce out of her body. She grabbed the side of the cage.
I felt like I had drunk five Red Bulls, she said. She was helped off the field, and when the athletic trainer measured her heart rate, it was 180 beats per minute, whereas it was typically in the 50s. While doctors dont know what triggered the onset of her symptoms, she suspects she got a virus or parasite while on a winter mission trip to Colombia, which may have played a role.
Doctors are experimenting with treatments for POTS, but theres no quick fix.
Hutzler has been living with POTS for more than five years. It took about a year of physical therapy, blood pressure medication and wearing compression sleeves before she started to return to her old self.
LeRose increased salt and fluid intake and was well enough to play some minutes at the end of her final season. The fact I was able to get back on the field was awesome, and my team was so supportive, she said.
LeRose, now 24, finished her graduate degree, works in Chicago and still struggles with POTS symptoms while trying to rebuild her strength and endurance.
They told me I would be lucky if I was able to run a couple of minutes, and I actually just got back from a 45-minute run class and did four miles. Im working my way up, she said.
Levine said her POTS symptoms may have started in early childhood she had an unusual set of on-again, off-again leg pains and nausea. Now, more than 15 years later, shes still struggling.
On a recent weekday, she was lying with her legs propped up on the wall filming a TikTok video, explaining that shed experienced blood pooling because of POTS. It was a typical day in August, and she started the day by taking medicine and Liquid I.V., an electrolyte supplement that packs 500 milligrams of sodium.
She started lacrosse when she was 9 and played so well that by eighth grade, colleges were making recruitment offers. The first three years she played for Notre Dame College, Levine had few health issues other than a bout of covid her freshman year that wasnt too bad.
Something changed in 2023. Not long after she blacked out during the drills, she did so again in the shower and then in her living room. When she was diagnosed with POTS at the Cleveland Clinic, it was almost a relief, she said.
She soon made the difficult decision to stop playing the sport she had loved for so long. Now a senior, Levine, who is studying marketing and communications, misses her teammates but says she has no regrets and is putting her energy into other pursuits, such as trying to raise awareness of POTS. In addition to making TikTok videos, she helps lead an online support group and works on a podcast.
I always give 100 percent and do the best that I can and felt like I was being misunderstood, she said. I was almost getting punished for being sick for so long that having some answers I was happy.
Anil Makam, MD, MAS, works with a patient in an ICU room at Zuckerberg San Francisco General Hospital in San Francisco. Makams research looks at the long-term effects of severe COVID-19 illness among the sickest of survivors early in the pandemic. Photo by Erin Lubin
UC San Francisco researchers examined COVID-19 patients across the United States who survived some of the longest and most harrowing battles with the virus and found that about two-thirds still had physical, psychiatric, and cognitive problems for up to a year later.
The study, which appears April 10, 2024, in the journal Critical Care Medicine, reveals the life-altering impact of SARS-CoV-2 on these individuals, the majority of whom had to be placed on mechanical ventilators for an average of one month.
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64% of study participants reported having a persistent impairment after one year, including:
Physical 57% Respiratory 49% Psychiatric 24% Cognitive 15% Continued use of supplemental oxygen 19%
Nearly half, or 47%, had more than one type of problem.
Too sick to be discharged to a skilled nursing home or rehabilitation facility, these patients were transferred instead to special hospitals known as long-term acute care hospitals (LTACHs). These hospitals specialize in weaning patients off ventilators and providing rehabilitation care, and they were a crucial part of the pandemic response.
Among the 156 study participants, 64% reported having a persistent impairment after one year, including physical (57%), respiratory (49%), psychiatric (24%), and cognitive (15%). Nearly half, or 47%, had more than one type of problem. And 19% continued to need supplemental oxygen.
The long-term follow up helps to outline the extent of the medical problems experienced by those who became seriously ill with COVID early in the pandemic.
We have millions of survivors of the most severe and prolonged COVID illness globally, said the studys first author, Anil N. Makam, MD, MAS, an associate professor of medicine at UCSF. Our study is important to understand their recovery and long-term impairments, and to provide a nuanced understanding of their life-changing experience.
Researchers recruited 156 people who had been transferred for COVID to one of nine LTACHs in Nebraska, Texas, Georgia, Kentucky, and Connecticut between March 2020 and February 2021. They questioned them by telephone or online a year after their hospitalization. The average total length of stay in the hospital and the LTACH for the group was about two months. Their average age was 65, and most said they had been healthy before getting COVID.
In addition to their lingering ailments from COVID, the participants also had persistent problems from their long hospital stays, including painful bedsores and nerve damage that limited the use of their arms or legs.
Many of the participants we interviewed were most bothered by these complications, so preventing these from happening in the first place is key to recovery, Makam said.
Although 79% said they had not returned to their usual health, 99% had returned home, and 60% of those who had previously been employed said they had gone back to work.
They were overwhelmingly grateful to have survived, often describing their survival as a miracle. But their recovery took longer than expected.
The results underscore that it is normal to for someone who has survived such severe illness to have persistent health problems.
The long-lasting impairments we observed are common to survivors of any prolonged critical illness, and not specific to COVID, and are best addressed through multidisciplinary rehabilitation, Makam said.
Authors: Additional UCSF co-authors include Oanh Kieu Nguyen, MD, MAS, Eddie Espejo, MA, Cinthia Blat, MPH, W. John Boscardin, PhD and Kenneth E. Covinsky, MD, MPH.
Funding: The work was supported by grants from the National Institutes of Health/National Institute on Aging (K23AG052603), the UCSF Research Evaluation and Allocation Committee (Carson and Hampton Research Funds) and the National Association of Long Term Hospitals. The authors had no conflicts of interest to disclose.
