Opinion
While the long-term risk from a current infection is 10 times less than it was in 2020-21, a lot of people are still suffering after getting Covid early in the pandemic
Fri 22 Mar 2024 19.00 EDT
Long Covid is one of the most controversial topics remaining about the pandemic. Depending on who you ask, it is either a real and current threat to the health of the globe, or a relatively minor issue that we should pay little attention to in the future. It is hard to weigh in on the topic without passionate advocates taking issue with the things that you say, which is true of quite a lot of the conversations we have had over the course of the pandemic.
A recent study from Queensland has injected further discord into this already complicated space. The press release about the study says that, in a large observational study, people who had tested positive for Covid-19 when the Omicron variant was spreading were no more likely to report ongoing symptoms or serious problems in their daily life than either people who tested negative or those who tested positive for influenza. This follows similar previous work by the same team showing almost identical results. According to Dr John Gerrard, one of the authors of the paper and Queenslands chief health officer, the findings call into question the entire conceptualisation of long Covid, arguing that it may be time to stop using terms like long Covid.
This has caused a number of articles arguing that long Covid is causing unnecessary fear, because of little difference between long-term symptoms caused by Covid-19 and other common viral infections.
The first issue here is that its hard to know what to make of the research. The results being reported are an early news release about a presentation that is going to happen at the European Congress of Clinical Microbiology and Infectious Diseases in April. In other words, we have no idea how robust this paper is, nor how useful the data may be. The fact that there are so many news stories about this unpublished, unpresented finding is itself something of a problem.
However, the reports on these findings are consistent with a range of other papers that have been published on Covid-19 in the last few years. We know that the risk of long Covid is strongly related to how severe initial infections are. In 2020, when Covid-19 was many times more problematic than flu, long Covid was fairly common, but after successful vaccination campaigns, effective new medications and wide-scale infection, the risk from a Covid-19 infection has gone down substantially. The risk of getting long Covid from an infection is now somewhere around 10times less common than it was in 2020. Given the decrease in severity of Covid-19, its not unlikely that rates of long-lasting symptoms are similar between Covid-19 and influenza in 2024. As Ive been saying for years, much of this comes down to how we define long Covid, and how we know which long-term symptoms are actually caused by Covid-19.
In other words, you could reasonably argue that Dr Gerrard is correct. The problem, however, is that a lot of people were infected in 2020 and 2021, before we had vaccines and treatments to reduce the severity of the disease. There is no question that a large group of people are still suffering serious problems from their initial Covid-19 infection, many of them years after first getting sick. Australia doesnt have a national estimate of how many, but data from the UK suggests that about 0.5% of the country might fall into this group. While its not a big percentage, that is still a lot of people a similar rate in Australia would mean about 100,000 Aussies suffering similarly. These people have been left largely without hope, because we still dont really know why they have long Covid, and have no effective interventions to treat their disease.
And herein lies the problem with long Covid discussions. There are two separate conversations going on at the same time. We can talk about the future, which seems a bit brighter long Covid rates are down drastically, and people who get infected with Covid-19 now are about as likely to experience serious, long-lasting issues as people who got the flu in 2019. But we also have to acknowledge the large number of people seriously injured by Covid-19 in the early stages of the pandemic who may never recover their health.
There may be nothing unique about long Covid in the future even without this new report the evidence is strong that Covid-19 is now quite similar in risk to influenza per infection and perhaps we should start talking more about post-viral conditions as a category rather than focusing on those symptoms caused by Covid-19 alone. But if we do, it is important that we do not leave behind the numerous people suffering seemingly endless problems caused by Covid-19 years ago.
Gideon Meyerowitz-Katz is an epidemiologist working in chronic disease in Sydneys west, with a particular focus on the social determinants that control our health
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The FDA issued an emergency use authorization (EUA) for pemivibart (Pemgarda) as COVID-19 pre-exposure prophylaxis in immunocompromised individuals who are unlikely to mount a sufficient immune response following vaccination, the agency announced on Friday.
A long-acting monoclonal antibody, pemivibart is specifically authorized for people ages 12 years and older (and weighing 40 kg or more) with moderate-to-severe immune compromise either because of a medical condition or due to immunosuppressant medications. Pemivibart is given as a single intravenous infusion and is not for use as post-exposure prophylaxis or in people currently infected with SARS-CoV-2.
The EUA was based on immunobridging data involving other human monoclonal antibodies against SARS-CoV-2 demonstrating that pemivibart may be effective for COVID prevention.
"Serum neutralizing antibody titers of Pemgarda were consistent with the titer levels associated with efficacy in prior clinical trials of adintrevimab and certain other monoclonal antibody products," the FDA stated.
According to the EUA, individuals who would qualify for the antibody include those undergoing active treatment for cancer (including those receiving CAR T-cell therapy or stem cell transplant); patients with hematologic malignancies associated with poor responses to COVID vaccines regardless of their treatment status; solid-organ transplant recipients; those with moderate-or-severe primary immunodeficiency; people with advanced or untreated HIV; and those on high-dose corticosteroids, B-cell depleting agents, and other immunosuppressants.
No long-acting monoclonal antibody has been available for preventing COVID infection in individuals with moderate-to-severe immune compromise since the agency pulled the EUA for tixagevimab-cilgavimab (Evusheld) in January 2023 -- the move followed data showing the combination was unlikely to be sufficiently active against circulating SARS-CoV-2 variants. At the time, the CDC recommended that immunocompromised individuals receive the latest COVID booster (if they had not already), wear a well-fitting high-quality mask in public, maintain distance in crowded areas, and improve indoor ventilation.
Pemivibart is administered at a dose of 4,500 mg over a 60-minute infusion, with repeat dosing every 3 months recommended if ongoing protection is needed.
FDA cautioned that anaphylaxis occurred in 0.6% of clinical trial participants who received pemivibart. Therefore, patients should be monitored for 2 hours after the infusion is finished, and pemivibart should be administered in settings where health providers have immediate access to medications to reverse severe allergic reactions and can alert EMS if necessary.
Other potential side effects noted in the labeling include infusion-related reactions, fatigue, nausea, and headache.
Ian Ingram is Managing Editor at MedPage Today and helps cover oncology for the site.
Nearly
The small study, which was published in the journal Nature Neuroscience, analyzed blood samplesspecifically, serum and plasmafrom 76 patients who were hospitalized with COVID-19 in March or April 2020, along with those from 25 people taken before the pandemic. The researchers discovered that people who said they had brain fog had higher levels of a protein in their blood called S100 than people who didnt have brain fog.
S100 is made by cells in the brain and isnt normally found in the blood. That suggests that the patients had a breakdown in the blood-brain barrier, which blocks certain substances from getting to the brain and spinal cord, the researchers noted.
The scientists then did MRI scans with dye of 22 people with long COVID (11 of them who reported having brain fog), along with 10 people who recovered from COVID-19. They found that long COVID patients who had brain fog had signs of a leaky blood-brain barrier. Specifically, the dye injected into the bloodstream leaked into their brains and pooled in regions that play a role in language, memory, mood, and vision.
Traditional imaging approaches havent shown any real sign of damage in the brains of patients [with long COVID brain fog], says study co-author Matthew Campbell, Ph.D., a genetics professor and head of genetics at Trinity College Dublin. Our approach made use of a dye called a contrast agent as well as a special type of analysis to pinpoint blood vessel leakiness in distinct regions of the brain.
What does this mean for long COVID patients with brain fog? Heres what we know right now.
Brain fog is a term used to describe a range of neurocognitive symptoms that can include trouble with focus, concentration, and memory, according to the National Institutes of Health (NIH). That can lead to an inability to perform effectively at work or in school or making a significant financial error, says Scott Kaiser, M.D., a board-certified geriatrician and director of Geriatric Cognitive Health for the Pacific Neuroscience Institute at Providence Saint Johns Health Center in Santa Monica, CA.
But, the definition of brain fog is a little vague. You can ask 10 patients and 10 healthcare providers and get literally 20 different answers, says Jim Jackson, Psy.D., neuropsychologist and professor of medicine at Vanderbilt Medical Center and author of the book Clearing the Fog: From Surviving to Thriving with Long CovidA Practical Guide.
Nizar Souayah, M.D., a neurology professor at Rutgers New Jersey Medical School, agrees. You can ask patients to describe their brain fog, and they will have totally different answers, he says.
Brain fog is listed by the Centers for Disease Control and Prevention (CDC) as one of the main symptoms of long-COVID, along with fatigue, chronic cough, and shortness of breath. But brain fog isnt just related to COVID-19lack of sleep, certain medications, and a poor diet can also contribute to brain fog.
This is still being explored, but science has uncovered a few things. In the latest study, people with long COVID brain fog had blood vessel leakage in areas of the brain that are involved in memory and attention, Campbell points out. This leakiness likely disrupts the integrity of neurons in the brain by shifting the delicate balance of materials moving into and out of the brain, he says. Cue the brain fog.
This phenomenonhaving a leaky blood-brain barrieris a very common route through which cognitive impairment occurs in a wide array of diseases and syndromes, Jackson says, listing off multiple sclerosis, sepsis, and major depression as a few examples.
Research published last year in the journal Cell also found a link between low levels of serotonin, a chemical that sends signals between nerve cells, and brain fog. For that study, researchers analyzed data from 1,540 people with symptoms of long COVID, as well as blood samples from 58 people who had brain fog between three and 22 months after they had COVID-19.
The researchers found that people who had recovered from COVID-19 but had brain fog had much lower levels of serotonin than people who were in the early stages of a COVID-19 infection and those who had no symptoms after recovering from COVID-19. The researchers pointed out that, while its normal for the bodys production of hormones and chemicals to be lower than usual during a viral infection, those levels usually bounce backand serotonin was the only one that didnt recover in patients with brain fog.
Overall, though, theres still a great deal of uncertainty about what causes COVID-19 brain fog, Dr. Kaiser says.
If you have brain fog and suspect its due to long COVID, Dr. Kaiser recommends contacting your healthcare provider. There are now many specialty resources available to support people experiencing prolonged symptoms and there may be opportunities to better understand the nature of an individuals cognitive dysfunction and tailored strategies to address this, he says. However, Dr. Souayah points out that it can be difficult to get an appropriate diagnosis. We don't have any good biomarkers for this, he says.
Still, Dr. Kaiser says that lifestyle moves that can be good for overall brain health may also help, including:
Some people may even benefit from a formal cognitive rehabilitation program, Dr. Kaiser says. Jackson agrees. We see many people with cognitive impairment after COVID make significant improvements over time with the help of cognitive rehabilitation, he says. It isn't a 'magic pill' but, for many, it is the treatment that allows them to function again.
But Campbell notes that there are currently limited treatments for patients. We do hope that drugs that have the potential to treat blood vessel damage might have utility, he adds.
Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Mens Health, Womens Health, Self, Glamour, and more. She has a masters degree from American University, lives by the beach, and hopes to own a teacup pig and taco truck one day.
New research indicates COVID-19 is making us dumber and leading to measurable cognitive decline.
The study published in the New England Journal of Medicine found that even a mild infection with the virus leads to a fall in intelligence and it is worse if you have long-COVID or are hospitalised.
Researchers at Imperial College London tested the cognitive ability of nearly 113,000 people who had previously had COVID-19. They found that those who had been infected had significant deficits in the ability to remember, reason and plan.
Lead author Dr Adam Hampshire said the group with the largest cognitive deficit was on average people who were in intensive care.
"They showed a difference of around about minus nine IQ points. People who have ongoing persistent symptoms, that is the ones who may have long COVID, they perform at about minus six IQ points and that's enough that it could have affected your daily function," he said.
Seven IQ points was equivalent to aging 10 years.
People who had been infected and no longer had symptoms also scored slightly lower than people who had never been infected, by the equivalent of three IQ points.
New Zealand epidemiologist, Professor Michael Baker, said those with COVID-19 have often talked about a feeling of brain fog.
"Some people describe it, yeah, as crippling brain fog and the fact that they do not feel that they can remember things very well or actually handle complex thought processes," he said.
Prof Baker said after four years we were seeing evidence mounting and the case getting stronger, not weaker, that this was a virus that affected the brain severely, along with being a vascular disease.
He said most people were affected because they've now had the virus.
"We're all getting, unfortunately, a little less intelligent at a whole population level. That is devastating not just for us as people but also in terms of productivity and many other things," Prof Baker said.
It could be brain damage that we can't get back with experts saying we will need to follow COVID-19 for many more years to know if there is any return to normal brain function, and warned that if you've had brain loss symptoms for more than a year then it's likely to be permanent.
The great conservative thinker William F. Buckley in 1963 wrotethat he would rather "live in a society governed by the first 2,000 names in the Boston telephone directory than in a society governed by the 2,000 faculty members of Harvard University." Buckley recognized the great "brainpower" among the university's faculty, but feared the "intellectual arrogance that is a distinguishing characteristic of the university which refuses to accept any common premise."
I thought of that oft-quoted line four years after the COVID-19 panic. It was a very real public health threat, so much so that it enabled Americans to transfer wide-ranging and largely unchecked powersto the experts. For two years, it was exactly as if Buckley's fears came true and we were ruled by the type of people found in the faculty lounge.
It's no secret that American universities are dominated by progressives, who don't typically accept the "common premise" of limited governance. A core principle ofprogressivism, dating to its early 20th century roots, is the rule by experts. Disinterested parties would reform, protect, and re-engineer society based on their superior knowledge. Although adherents of this worldview speak in the name of the People, they don't actually trust individuals to manage their own lives.
Looking back, COVID-19 shows the nation's foundersrather than intellectual social engineershad it right. The founders created a system of checks and balances that made it hard for leaders to easily have their way. "A dependence on the people is, no doubt, the primary control on the government; but experience has taught mankind the necessity of auxiliary precautions," wroteJames Madison. The pandemic stripped away those precautions, albeit (mostly) temporarily.
In fairness, the response to COVID by many ordinary Americans left much to be desired. Social media provided a megaphone forconspiracy theoriesand idiotic home remedies. Instead of acting responsibly by voluntarily embracing the best-known practices at the time, many Americans defied even the most sensible rules and acted out against store clerks and others. I was left disgusted by the edicts of our leaders and the behavior of many of my fellow citizens.
Nevertheless, the skeptics generally were correct. "The coronavirus shutdowns have created a dichotomy between those who tend to trust whatever the authorities sayand those who don't seem to trust any official information at all," I wrotein May 2020. "It's not even slightly conspiratorial, however, to question the forecasts, data and presuppositions of those officials who are driving these policies. They have shut down society, forced us to stay at home, driven businesses into bankruptcy, caused widespread misery, and suspended many civil liberties."
Yes, many of us told you so.
The experts and politicians touted the "science" even though that was really just a way of telling us to shut up and follow orders while they muddled their way through it. We've since learned that masks and plastic sneeze bars, lockdowns, school shutdowns, and the panoply of makeshift protections were, likely, of marginal value. Critics who questioned official death statistics were tarred as conspiratorialists. But even a 2023 Washington Post reportfound that officials seemed to be counting people who died "with" COVID rather than "from" it.
And don't get me started on how politicians reacted. Some of the initial emergency edicts were justifiable, but then governors realized they could ram through unrelated (or tangentially related) political priorities by invoking fear. One former Assembly member compiled a 123-pagelistof Gov. Gavin Newsom's COVID-related executive orders. The courts ultimately struck down a handful of them, but the governor certainly didn't let a good crisis go to waste.
The nation is still reeling from pandemic blowback. Inflation is soaring, sparked by supply chain disruptions and federal spending sprees that started with the shutdowns. Big cities such as San Francisco have hemorrhaged population as workers learned they no longer needed to commute into offices. Transit ridershipplummeted, sparking yet another funding crisis. Large segments of the public have become more dependent on government handouts. Municipal budgets are in shambles. Anti-eviction edicts further screwed up our rental markets.
Many downtowns, such as Sacramento, have yet to recover from the lockdowns, as shuttered businesseseach reflecting a personal tragedy for their ownersremain boarded up. And don't get me started on the impact on education, especially for the poor. There's a lost generation of students, victimized by school systems that couldn't master distance learningresulting dismal test scoresand soaring absentee rates. We saw unions resist school re-openings because their priorities are workers, not students. Even some experts nowresearchthe resulting psychological harms.
I'm not saying that COVID didn't require a reasonable response, but by listening solely to the equivalent of progressive academics and ignoring the concerns of Buckley's proverbial first 2,000 names in the phone book, our governmentfailedits people.
This column was first published in The Orange County Register.
A high-poweredintervention by 23 former national Presidents, 22 former Prime Ministers, a former UN General Secretary and 3 NobelLaureates is being made today to pressfor an urgent agreement from international negotiators on a Pandemic Accord, under the Constitution of the World Health Organizaion,to bolster the worlds collective preparedness and response to future pandemics.
Former UN General Secretary Ban-ki Moon,New Zealands former Prime Minister Helen Cark, former UK Prime Ministers Gordon Brown andTony Blair, former Malawi President Joyce Banda, former Peru President Franciso Sagasti,and 3 former Presidents of the UN General Assembly are amongst 100+ global leaders, from all continents and fields of politics, economics and health management who todayissued a joint open letter urgingaccelerated progressin current negotiations to reach the worlds first ever multi-lateral agreement onpandemic preparedness and prevention.
A pandemicaccord is critical to safeguard our collective future. Only a strong global pact on pandemics can protect future generationsfrom a repeat of the COVID-19 crisis, which led to millions of deaths and caused widespread social and economic devastation, owing not least to insufficient international collaboration, the leaders write in their joint letter.
In the throes of the COVID-19 disaster which, officially, claimed 7 million lives and wiped $2 trillion from the world economy, inter-governmentalnegotiations to reach international agreement on future pandemic non-proliferation were begun in December 2021 between 194 of the worlds 196 nations. Nations set themselves the deadline of May 2024 by which they should reach agreement on what would be theworlds first ever Pandemic Accord.
TheNinth round of Pandemic Accord negotiationsare underway this week and next. Signatories of todays open letter hope their combined influence willencourage all 194 nations to maintain the courage of their Covid-years conviction and make their own collectiveambition of an international pandemic protocol a reality bythe intended May deadline to enable ratification by the World HealthAssemblyat its May 2024 Annual General Assembly.
And they urge negotiators to redouble their efforts to meet the imminent deadline and not let their efforts be blown off courseby malicious misinformation campaigning against the WHO, the international organisation which would be tasked with implementing the new health accord.
Taking a swipe at those who wrongly believe national sovereignty may be undermined by this major international step forward for publichealth the signatories say there is no time to waste and they call on the leaders of the 194 nations taking part in the current negotiations to redouble their efforts to complete the accord by the May deadline.
The letter, hosted on the website of The Office of Gordon and Sarah Brown states, Countries are doing this not because of some dictumfrom the WHO like the negotiations, participation in any instrument would be entirely voluntary but because they need what the accord can and must offer. In fact, a pandemic accord would deliver vast and universally shared benefits, including greater capacityto detect new and dangerous pathogens, access to information about pathogens detected elsewhere in the world, and timely and equitable delivery of tests, treatments, vaccines, and other lifesaving tools.
As countries enter what should be the final stages of the negotiations, governments must work to refute and debunk false claims aboutthe accord. At the same time, negotiators must ensure that the agreement lives up to its promise to prevent and mitigate pandemic-related risks. This requires, for example, provisions aimed at ensuring that when another pandemic threat does arise, all relevantresponses from reporting the identification of risky pathogens to delivering tools like tests and vaccines on an equitable basis are implemented quickly and effectively. As the COVID-19 pandemic showed, collaboration between the public and private sectorsfocused on advancing the public good is also essential.
A new pandemic threat will emerge; there is no excuse not to be ready for it. It is thus imperative to build an effective, multisectoral,and multilateral approach to pandemic prevention, preparedness, and response. Given the unpredictable nature of public-health risks, a global strategy must embody a spirit of openness and inclusiveness. There is no time to waste, which is why we are callingon all national leaders to redouble their efforts to complete the accord by the May deadline.
Beyond protecting countless lives and livelihoods, the timely delivery of a global pandemic accord would send a powerful message:even in our fractured and fragmented world, international cooperation can still deliver global solutions to global problems.
President Joe Biden didnt pull punches during a recent fundraising stop, mocking former President Donald Trumps false 2020 suggestion that household cleaning products like bleach might be a remedy to COVID-19.
Just a few days ago, [Donald Trump] asked a famous question in one of his rallies: Are you better off today than you were four years ago? Biden reportedly told a crowd of supporters during a Thursday fundraising stop in Houston, Texas. Well, Donald, Im glad you asked that question, man. I hope everyone in the country takes a moment to think back to what it was like in March of 2020.
Biden was referring to the onslaught of COVID-19 infections sweeping the country at that time. As millions of Americans got sick and thousands more died, Trump routinely downplayed the severity of the virus and floated combating the virus using sunlight and disinfectant.
And then I see the disinfectant where it knocks it out in a minute one minute and is there a way we can do something like that by injection inside, or almost a cleaning? Trump said during an April 2020 press briefing. Because you see it gets in the lungs and it does a tremendous number on the lungs, so it would be interesting to check that.
The statement caused the makers of household cleaning products Lysol and Dettol to issue a statement reminding people not to ingest dangerous cleaning products.
At his Houston fundraiser, Biden took the opportunity to insult Trumps past remarks.
Remember when he said inject bleach? Biden asked, according to reporters at the event. I think he mustve done it.
Trump himself contracted COVID-19 in October 2020 and was hospitalized for three days. In an attempt to show his supporters he was healthy, Trump took a drive in his presidential vehicle with Secret Service members while he was still sick with the virus.
Nearly 900 Secret Service agents were ultimately infected with the virus between March 2020 and March 2021. More than half were in the division directly responsible for protecting the president and vice president.
Manitoba First Person
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Souradet Shaw - for CBC News
Posted: 8 Hours Ago
This First Person column is the experience of Souradet Shaw, a Winnipeg epidemiologist.For more information about CBC's First Person stories, please see the FAQ .
My sister Jin died three days before the first known case of COVID-19 was identified in Canada.
Being an infectious disease epidemiologist, I had read reports of a novel respiratory disease emerging from China in early December of 2019. But weeks later, in early January 2020as I walked into the Toronto hospital to see Jin for the last time, the chaos of what was happening in China had not yet reached our shores.
Jin greeted me from her wheelchair, smaller and frailer than the last time I saw her.
We stayed up and reminisced, tracing our family's journey from southern China to Southeast Asia to North America. My mom, two of my sisters and I arrived as refugees in Winnipeg in 1979. After a few years we were reunited with my two oldest sisters. One of them was Jin.
She trained as a nurse in Taipei and would spend the rest of her life in hospitals in Manitoba and Ontario, working in labour and deliveryuntil her cancer diagnosis.
I am grateful for the time I had with herduring her final days of life. I am grateful that we spent our afternoons watching terrible soap operas in Mandarin, and hearing her laughter as I pretended to know what the characters were saying.
I am grateful that she recognized me when I reached out one last time to stroke her hair, before she closed her eyes and succumbed to the blackness of her sleep.
There is a strange cadence at the end of a loved one's journey with cancer: the flurry of activity as everyone adapts to new realities; the routines that are learned and adopted; and then, eventually, an almost impossible nothingnessas you look for the traces of someone who is no longer there, at an empty bed and rooms full of half-filled pill containers.
Jin died on Jan. 22. I flew home to Winnipeg the same night. I moved through Pearson airport like a ghost, tethered to the earth by sorrow and the still-fresh memories of my sister's death.
During the pandemic, I started a faculty position at the University of Manitoba. InJanuary of this year, I found myself in Kenya to visit some of my university's projects in East Africa. It was the fourth anniversary of Jin's death, and four years since COVID-19 had also changed the world as we know it.
It was here that I found myself thinking of Jin. This was my fifth work trip to Kenya, and I am certain Jin would have been delighted to hear about my travels. About things as mundane as the mangoesand how they compared with the ones in Taiwan, where we went to inter our father after he died of malaria.
After an intense week of work I found myselfwalking along a beach on the Kenyan coast.
The sky was aquamarine, and I watched families playing in the water, next to aged dhows (fishing vessels) and wooden boats withglass-bottoms. I saw the beach vendors take shelter from the sunbeneath palm treeson ancient, bleached branches washed up against the shore. I sat down in the white sands and dipped my toes in the Indian Ocean, breathing in its saltiness and its cadence.
I thought of my dead sister, and of us on a beach in Kaohsiung in southern Taiwan, 30 years ago and 10,000 kilometres away. I looked for my sister in the clouds, in the water, in the smiles of families bursting with laughter.I gazed across the blue of the Indian Ocean and I thought about the push and pull of grief, and how it advances and recedes like waves.
I thought of how beautiful it was that my sister's face was one of the first things that thousands of babies saw as they entered the world. I thought about how Jin's friends would visit her after their 12-hour overnight shiftsto provide comfort and care in her final days.
And I thought of how humbling it was that these women could so effortlessly shift from welcoming a newborn life to caring for a dying friend. I thought about grace and the sacrifices you make for the people you love.
The tide came in on its interminable cadence, and warm water washed over my feet. I dusted the sand off my legs and got up to leave.The faint contours of my feet remained, only to be washed away by the next wave.
This column is part ofCBC's Opinion section.For more information about this section, please read this editor's blogand our FAQ.
Souradet Shaw is a first generation Canadian and refugee from Laos. He is an infectious diseases epidemiologist and assistant professor at the University of Manitoba and holds a Tier II Canada Research Chair in Program Science and Global Public Health, with research projects in Canada and sub-Saharan Africa.
image:
IGTP's Biostatistics team
Credit: IGTP
TheBiostatistics Unit, a recent addition to the technologies and services offered by Germans Trias i Pujol Research Institute (IGTP), consists of a team of statisticians and mathematicians who conduct and support biomedical research. They have recently published two notable articles. The first paper, appearing inScientific Reports, reveals the role of socioeconomic inequalities and vaccination in the spread of the COVID-19 pandemic. The second, published inBMC Medical Research Methodology, introduces REDCapDM, a new R package designed to enhance efficiency and reliability in the management of research data collected through the popular REDCap platform.
A new scientific study, published inScientific Reportsby researchers Pau Satorra and Cristian Teb, sheds light on the evolution and consequences of the COVID-19 pandemic in Catalonia. Using spatio-temporal Bayesian models, the analysis reveals how the incidence of the virus and hospitalizations varied among different basic health areas (ABS) over time, highlighting key factors that may have influenced these trends.
The findings indicate that urban areas experienced a higher incidence of cases and hospitalisations compared to rural areas, suggesting an association with population density and living conditions in these areas. This underscores the need for specific public health strategies in densely populated urban environments.
The study also points out the impact of socioeconomic inequality on the effects of the pandemic. ABS with higher levels of socioeconomic deprivation have suffered higher hospitalisation rates, highlighting how socioeconomic conditions can exacerbate the effects of a global health crisis.
One of the most significant findings is the protective effect at the ABS level of complete vaccination against the virus, demonstrating the vital importance of vaccination campaigns in combating the pandemic.Full vaccination coverage has been shown to significantly reduce the risk of cases and hospitalizations, reaffirming the public health message about vaccination as a key tool for controlling the spread and impact of the virus.
For this research, open data provided by the Generalitat de Catalunya was used, underlining the importance of access to reliable and transparent information for advancing epidemiological research. The discoveries of this study not only contribute to a better understanding of COVID-19 dynamics at the local level but also highlight the critical importance of vaccination intervention and attention to socioeconomic inequalities as key components in an effective response to the pandemic.
"The use of Bayesian hierarchical modeling was very useful in describing the spatial, temporal, and spatio-temporal trends of the COVID-19 epidemic in Catalonia", says Pau Satorra, the first author of the article."We showed that urban basic health areas had a higher risk of COVID-19 cases and hospitalisations compared to rural areas, while socioeconomic deprivation of the area was a risk factor for hospitalisations. Additionally, it was demonstrated that complete vaccination coverage of the basic health area also had a protective effect on the risk of COVID cases and hospitalisations per area".
In this second article, led by Joo Carmezim and Pau Satorra, IGTP's Biostatistics Unit developed REDCapDM, a new R package aimed at facilitating data management for REDCap projects, a web application for creating and managing databases and online surveys. REDCap is widely used in clinical research for its flexibility and security features. However, managing REDCap data through R can be complex, often requiring programming work to maximise its efficiency. The REDCapDM package responds to this need, providing specific functions for importing, transforming, identifying discrepancies, and managing data.
Using REDCapDM, researchers can optimize the clinical data management process while ensuring the quality and reliability of the information analyzed. This tool is of particular interest to data scientists and clinical data managers working with REDCap and R, offering a comprehensive solution for research data management tasks.
The implementation of REDCapDM in R, version 4.3.0, and its availability through the Comprehensive R Archive Network (CRAN) opens new doors for efficient data management in clinical studies. This package not only simplifies the import and processing of data from REDCap to R but also enhances the data validation process, essential for generating quality data in research.
The development of REDCapDM marks a step forward in automating and improving data management in clinical research, providing researchers with robust tools for data analysis and validation.With ongoing support from the R community and integration with other packages and tools, REDCapDM is set to become a valuable resource for the global clinical research community.
The implementation of REDCapDM in R version 4.3.0, its availability through CRAN and Github ensures open access to this tool and transparency, which are essential for the progress of scientific research. This project, available for all operating systems and under the GNU General Public License Version 2, demonstrates the positive impact of open collaboration and the use of open-source technologies in advancing medical research.
An R package is a collection of functions, data, and documentation developed to extend the functionalities of the R statistical software. Packages allow users to add new analysis techniques, statistical methods, graphics, data import and export capabilities, and more to their R working environment. These packages are created by the R user and researcher community with the goal of sharing solutions and facilitating work on specific projects or in particular research areas.
Scientific Reports
Data/statistical analysis
People
Bayesian spatio-temporal analysis of the COVID-19 pandemic in Catalonia
20-Feb-2024
C.T. has received fees for speaker lectures and talks from Amgen, Boehringer Ingelheim, and Gedeon Richter, outside the submitted work.
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Spring break is here and while its a fun time, being the first proper vacation many of us have this calendar year, it also comes with the risk of getting sick. With everyone traveling to and from various places across the country, and many clustering in popular spots such as beaches, spring break is rife for the spread of viruses.
In fact, wastewater analysis shows several viruses such as norovirus and influenza (the flu) increasing in prevalence as we head into spring. Dont let the presence of viruses keep you from enjoying your spring break vacation, however. Instead, read tips to help keep you from getting sick, no matter whats floating around.
No matter what virus your dealing with, the CDC advises to wash your hands frequently and thoroughly.Thoroughly washing your hands means lathering them with soap for 20 seconds (or about the time it takes to sing Happy Birthday) and rinsing with warm water.
The CDC notes that hand sanitizer is not effective at killing norovirus, thus it can't be used as a substitute for hand washing. It can be used, however, in conjunction to curb the spread of other germs.
Softsoap Liquid Hand Soap
Wash your hands.
Where washing your hands isnt possible, the CDCrecommends using hand that's comprised of at least 60% alcohol. Note that, there isnt a way to get around washing your hands when dealing with norovirus, as its less effective against this particular virus.
Purell Advanced Hand Sanitizer Refreshing Gel
Use hand sanitizer.
Wearing a mask remains the most effective way to curb the spread of respiratory illnesses such as COVID-19, RSV, and influenza. KN95 and N95 masks are the gold standard when it comes to effectiveness, as they filter up to 95% of the particles responsible for airborne illnessessuch as COVID-19 and influenza.
MAGID N95 Respirator Masks
Wear a mask.
Another way to combat the spread of germs responsible for illness is by making sure surfaces are rid of germs. Usingdisinfectant wipesis a convenient way to make sure the surfaces you touch will be clean. If you're traveling, consider wiping down your airplane seat, tray table, and other high-contact surfaces.
Lysol Disinfectant Handi-Pack Wipes
Disinfect high-contact surfaces.
You may have heard horror stories about drinking local water when traveling. To give you peace of mind (and peace of stomach) to travel with confidence during spring break trip, we recommend using LifeStraw to filter your water. Its a straw-shaped filter that protects against bacteria, viruses, parasites, microplastics, dirt, and sand.
LifeStraw Personal Water Filter
Filter your water with confidence.
Staying hydrated can both help your immune system stave off sickness and add make symptoms less excruciating if you do get sick. Plus, using a water bottle has the added benefit of avoiding using faucets that may have been used by sick individuals. We recommend using our favorite water bottle, the Owala Freesip, which is spill-proof and keeps water cool for up to 24 hours.
Owala FreeSip Insulated Stainless Steel Water Bottle
Stay hydrated during spring break.
As the saying goes, the best laid plans of mice and men often go awry, so its important to acknowledge that despite your preventive measures you, still can get sick. Seeing as nearly all the viruses you should be worried about are associated with fevers (which the CDC defines as temperature of 100.4F or higher), you should pack a thermometer for your spring break trip. Thebest thermometeryou can buy is the Femometer thermometer. It gives accurate results quickly, has a silent mode and conveniently warns of high temperatures.
Femometer Forehead Thermometer
Monitor your symptoms.
If you happen to come down with something, you can rule out COVID and two strains in one fell swoop with this combination test kit by Pfizer. We tested it ourselves and it's just as easy to use as a standard COVID test, but can give you more information.
LUCIRA by Pfizer COVID-19 & Flu Home Test
Rule out COVID and two strains of the flu in one fell swoop.
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