BATON ROUGE, La. (AP) Three years after COVID-19 vaccines became widely available in the United States, Louisiana continues to debate policies related to inoculation mandates, including civil liabilities if a workplace mandates vaccines or not and a bill that would prohibit schools from requiring students to receive the vaccine.
The ongoing debates, which are often marred by anti-vaccination rhetoric, come on the cusp of relaxed guidelines from the Centers for Disease Control and Prevention and COVID-19 no longer beingthe public health menaceit once was. This legislative session, Louisiana lawmakers conversations on COVID-19 vaccines have broadened to also apply to experimental or emergency use vaccinations for fear of future pandemics.
Louisianas GOP-controlled House passed a bill Wednesday that protects businesses from being sued because they dont mandate experimental or emergency use vaccines including COVID-19 shots.
Under the proposed legislation, if a person believes they got sick from contact at a business, they would be unable to file a lawsuit against the business.
Rep. Danny McCormick, who authored the measure, said the bill would do away with any frivolous lawsuits. The Republican added that it would be difficult to directly pinpoint, before a judge, where or from whom a person contracted COVID-19. Opponents of the bill, such as Democratic Rep. Denise Marcelle, said while that is true, McCormicks bill wouldnt give people the chance to even reach that point.
The legislation passed mainly along party lines and now heads to the Senate.
In a narrow vote, the House rejected another bill that would allow people who suffer from vaccine injuries to sue their school or employer if they are required to receive a COVID-19 vaccine as a condition of employment.
Louisiana GOP Rep. Mike Echols, who authored the bill, said he knows of several constituents who died or were maimed and injured by the COVID-19 vaccine. Across the country, conspiracy theorists and anti-vaccine activists haveincorrectly and baselessly blamedthe injuries and deaths of hundreds of children, teens, athletes and celebrities on COVID-19 shots. Deaths caused by vaccination are extremely rare, and rigorous study and evidence from hundreds of millions of administered shots have provenCOVID-19 vaccines are safe and effective.
The bill received an influential note of disapproval from a powerful lobbying organization that represents business industry interests, describing the measure as harmful to the long-established purpose of workers compensation throughout the country.
The bill failed 51-50, but Rep. Echols said he plans to bring the measure back in another attempt of passage.
This session, the GOP-dominated legislature will also take up a measure that would prohibit schools from requiring students to get COVID-19 vaccines.
A nearly identical bill easily won legislative approval last year, but was vetoed by then-Gov. John Bel Edwards, a Democrat. Since then, conservative Gov. Jeff Landry has taken office.
In his veto message, Edwards said the bill is unnecessary as the vaccine is not mandated by the state. In addition, Edwards said the measure seeks to undermine public confidence in COVID-19 vaccines.
Arguments in Louisianas capitol echo those from statehouses throughout the country since COVID-19 vaccines became widely used in 2021. Vaccines have helped to dramatically reduce instances of serious disease and death from COVID-19.
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This story is part of CBC Health's Second Opinion, a weeklyanalysis of health and medical science news emailed to subscribers on Saturday mornings. If you haven't subscribed yet, you can do that by clicking here .
In Canada, measles was once a disease of the past. But it's increasingly becoming a health threat of the present, after backsliding vaccination rates allowed the virus to creep back into circulation.
Canada officially eliminated measles nearly three decades ago, but for years, medical experts warned it was poised to make a comeback and disruptions to routine childhood immunization efforts throughout the COVID-19 pandemic may have sped that up.
Now, after tens of thousands of cases in Europe, and close to100 recentinfections across Canada and the U.S., health officials are on high alert.
There are warnings about travel abroad, calls for people to ensure their families are up-to-date on the measles vaccine, and fresh reminders that the virus is highly contagious and capable of causing pneumonia, brain inflammation, and even death.
"A lot of people are worried," said Dr. Alykhan Abdulla, a family physician in Ottawa. "Measles hasn't really been around in our society for a long time."
So how should Canadians navigate the latest guidance around measles vaccination, and who's actually protected? And if you've already had at least one measles shot, are you now set for life?
If you or your child has never had a combined measles,mumpsand rubella (MMR) vaccine and never had a prior measles infection the official guidance is simple: Get vaccinated.
But after that, it gets a little more complicated.
For Canadian children, the typical schedule is now two doses, both administered before they enterschool. The first MMR dose should be given when a child is 12 to 15 months of age and the second dose at 18 months,or any time after that, but no later than around school entry, notes the Canadian immunization guide.
As for adults, if you were born after the two-dose MMR vaccine became routine, youprobably had both rounds as a child.
Some adults might've only had one dose, however. That includes people born before 1970, who were likely exposed to the virus, given how widely measles used to circulate and federal guidance assumes those individuals have natural immunity.
However, the same guidance suggests anyone who's at a higher risk of being exposed like health-care workers, military personneland international travellers should get an MMR vaccine, regardless of their year of birth.
Confused yet?
What if you don't have your immunization record, or can't remember if you had a measles infection in childhood? Experts suggest simply getting an MMR dose, to be safe.
"If there's any concern about whether you've been vaccinated, it's actually cheaper and easier just to get vaccinated again," said McMaster University associate professor and immunologist Dawn Bowdish.
More than 50 countries are reporting "large and disruptive" measles outbreaks, World Health Organization officials warned this week.
So if you or a family member hasn't been vaccinated against measles before travelling, there's a higher risk of catching it, medical experts warn, making it even more important to be up-to-date on your shots.
That's because measles is capable of lingering in the air for up to two hours (yes, hours) after someone infected enters a space.
Infants under the age of one are "particularly vulnerable" to a measles infection, according to the Public Health Agency of Canada (PHAC),since their routine shots typically start at 12 months of age.
In a statement, PHAC told CBC News the current advice for people travelling internationally is as follows:
WATCH |How to protect yourself against measles:
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If you need an MMR shot, medical experts suggest speaking to your primary care provider such as a family doctor or nurse practitioner if you have one or reaching out to your local community health centre or public health team.
Travel clinics are also an option to quickly get a shot before a trip, though private businesses can charge $75 or more for a dose.
Still, it's not always easy.
Despite the guidance around staying up-to-date on measles vaccinations, multiple Canadians told CBC News that some doctors and pharmacies are either short on supply, or simply discouragingpatients from getting another round because they're either deemed too young or too old to need one.
"I think we're all adjusting to this reality of measles resurgence from abroad," said Shelly Bolotin, director of the Centre for Vaccine Preventable Diseases at the University of Toronto. "And perhaps that is why different people are in different places."
If you do need a dose, there are two MMR vaccines being used in Canada right now, from drug makers Merck and GSK.
Shortage notices have also been posted for both brands' shots, but Health Canada said the companies have assured they'll be able to "fully meet demand" for public immunization programs, including routine childhood vaccines.
GSK told CBC News the "temporary" shortage for its Priorix vaccine is linked to an increase in demand in the Canadian private market, adding it continues to meet the demand in the public sector. Merck Canada said it is working with provincial and federal health authorities to provide a consistent supply "in a timely manner."
What's unclear to Canadian health-care teams is whether an ongoing spike in demand will further complicate vaccination efforts.
"We have to be judicious, we have a resource that is limited," said Abdulla, in Ottawa. "And we have to be thoughtful in the way that we use [the available supply]."
Family physician Dr. Allan Grill, in Markham, Ont., said his team is currently distributing measles vaccines on an as-needed basis.
"You can imagine how overwhelmed family medicine would get if we decided all of a sudden to just focus all of our attention on everybody's measles vaccine status."
Meanwhile, Andrew Sisnett, president of Summit Health, a travel vaccine provider, said the companyrarely doled out MMR shots before this year. Yet demand recently shot up, and he'shaving issues ordering more.
"There are concerns that, from a private-sector perspective, that we're not going to be able to procure enough."
WATCH | Measles is spreading in some Canadian communities:
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If you've had a prior measles infection, there's a silver lining.
Peer-reviewed research from a team including Bolotinstressed that immunity from measles is thought to be life-long.
The study cited evidence from Denmark'sremote Faroe Islands, located in the North Atlantic, which experienced a measles outbreak in 1781. The next outbreak in 1846 spared all those older than 65 as in, all the people who would have been infected exactly 65 years earlier.
"This early observation remains some of the best evidence of life-long immunity to measles," the team wrote.
That'sbecause of how the measles virus operates, Bowdish said.
"Unlike RSV, or influenza or other respiratory infections ...it actually infects our immune cells," she said. "And then it hijacks those immune cells to travel to our lymph nodes, where there's millions and millions more immune cells to infect."
A serious infection like that requires a serious immune response, Bowdish said. It's a bit like your body fighting a major war, giving it deep, lasting memories of how to fend off that attacker if it ever invades again.
So, is the same thing true for getting a full set of MMR shots?
To some extent, yes.
The measles vaccine contains small amounts of live virus, making itone of the most protective shots available, Bolotin said, with two doses showing 97 per cent efficacy (how well it does in an ideal and controlled environment) in studies, and 94 per cent effectiveness(real-world performance) in field estimates.
"It's actually a mini infection in your body. And so it creates something very, very similar to what you would see if you're infected."
There can be instances where immunity after the shots does wane over time, both Bowdish and Bolotin agreed, and various global studies have documented occasional breakthrough infections.Even so, evidence suggests the shots still protect against serious illness and help curb transmission.
"For most vaccines, what we do is we modify or minimize the severity of infections as opposed to preventing them 100 per cent," said Bowdish.
"But the measles vaccine is a different case, where it really does seem to prevent infections from getting started in most people, most of the time."
Lauren Pelley Senior Health & Medical Reporter
Lauren Pelley covers health and medical science for CBC News, including the global spread of infectious diseases, Canadian health policy, pandemic preparedness, and the crucial intersection between human health and climate change. Two-time RNAO Media Award winner for in-depth health reporting in 2020 and 2022. Contact her at: lauren.pelley@cbc.ca
(file image) Photo: 123rf.com / Composite Image - RNZ
There have been 4666 new cases of Covid-19 reported in the past week, and 20 further deaths attributed to the virus.
Of the new cases, 3865 were probable cases and 3012 were reinfections.
There were 55 cases in hospital.
The number of cases in intensive care units was not available on the Ministry of Health's website.
The seven-day rolling average of new cases was 667 per day.
Last Monday, 4803 new cases and 24 deaths attributed to the virus were reported for the previous week, with 171 cases in hospital.
Earlier this month, Health NZ said it no longer recommended that asymptomatic household contacts of people with Covid-19 should test daily.
A new Covid-19 vaccine, which could fight newer strains of the virus, would be available from 7 March.
Health NZ also confirmed earlier this year free RATs would be available until at least the end of June.
In spring 2020, France shut down schools and businesses as the world faced a mysterious new illness Covid-19. The first of three lockdowns was imposed but why did people accept strict limits on movement in a country that is so used to protests and debates?
Issued on: 22/03/2024 - 18:20Modified: 22/03/2024 - 18:33
3 min
Starting 17 March 2020, people in France were not allowed to circulate freely for 55 days.
After shuttering schools, restaurants and other businesses, the French government imposed its firststrict lockdownto contain the spread of Covid.
The population was required to present certificates whenever they left home. They were permitted a maximum of one hour outside for shopping or exercising, and only those working essential jobs could travel further than a kilometre.
And for the most part, people followed the rules.
Nicolas Moriot, a historian who has co-writtena book about the lockdown, describes it as an act of mass obedience.
Listen to this story on the Spotlight on France podcast:
Based on a survey of 16,000 people, he found that 80 percent of people stuck to lockdown rulesnot necessarily to avoid Covid, but because they were put off by the potential for run-ins with the police and a 135 fine for off-limits outings.
A quarter of those surveyed said they followed restrictions on movement but not health recommendations, like staying a metre apart and washing hands.
So you cannot say their fear of the virus was very high, Moriot concludes.
He compares France with northern European countries, which closed businesses but did not impose full lockdowns. Frances reaction, he says, comes from its history of reacting to societal issues with security measures.
You can say that its a question of habit for the government to put in place things like certificates and restrictions on public freedom, he said.
While debate in France emerged over health passes, vaccines and later lockdown measures, very few people protested initial restrictions in the spring of 2020 which Mariot attributes to the fact that there was little opportunity to organise, or even exchange.
Associations, unions and political parties were shut down, as well as social and athletic gatherings. All that was completely cancelled. And this is the way French people shape their political opposition, he explains.
As a result, individual citizens found themselves alone. We were in a direct relationship with the state, and I think that played a fundamental role in the fact that there was not much opposition.
Four years later, it is clear that lockdowns impacted mental health, notably for young people and students. Studies showedan increase in depression and anxiety during the first lockdown, growing with subsequent lockdowns and restrictions.
But there has been little reflection about lockdowns and their longer-term impacts on society, with relatively few questions about the measures themselves and the powers they gave to the state.
Police carried out 21 million checks during the first lockdown and issued 1.1 million fines.
Moriot is surprised that no one has questioned these penalties.
What happened to them? Did people pay them? We know nothing, he said.
In May 2023, the Spanish Supreme Court ruled that their Covid lockdown was unconstitutional and annulled the 1.2 million fines handed out.
Though France's constitutional courtruled on the vaccine passes used to access public venues later in the pandemic judging that they were constitutional so long as it was temporarythey were never asked to pronounce on the lockdown and the fines.
French lawmakers questioned ministers in parliamentary committees,but focused more on mask availability than the lockdown itself.
There was no public discussion or debate or questioning, said Moriot. Its surprising and quite worrying for the future.
More on this story on the Spotlight on Francepodcast, episode 108.
How did you become involved in COVID-19 response for the CDC?
I trained as an EIS officer at CDC and was familiar with how to investigate outbreaks. During my time in HIV, Ive helped with a national response to other outbreaks. I worked on the anthrax terrorist event in Washington, D.C., (when letters with anthrax spores were sent to some politicians and media figures in 2001, leading to multiple infections and five deaths), then on SARS (severe acute respiratory syndrome), then on Ebola, and each time, was growing in what I was doing.
COVID came along and they said, we really need your help on this. At first it didnt seem like much, but it rapidly snowballed into this major pandemic, and I ended up being the chief medical officer on it for more than two years.
At first, Id wake up and get on my computer and get to work. [Later], we'd all meet in rooms and share information. One of my most important jobs was to make sure that I was learning what was going on outside of CDC. Who else was studying the key questions in outbreak control? The first thing is to stop transmission. To do that, you must know, how is it transmitted? Who are the people who are transmitting it? When are they infectious to other people? How are they getting it? What can we do to interrupt that process?
We do a lot of those studies at our agency, but people over the world were doing them. I wanted to pull in that knowledge as we made critical decisions. The biggest thing I got involved with was the science of masking, and the effectiveness of masks to interrupt transmission.
One of the most important things in successful public health is talking to the public. You build trust by being a reliable partner for information. People had a lot of questions. It was important that we could communicate with the public, which became more difficult for complex reasons and may have contributed to some of the bad feelings people have about CDC.
Many people from our agency would've liked to talk more directly to the public. You want to tell people everything you know, establish what you don't know, and then explain that there's always uncertainty. You want to help them deal with that uncertainty but let them know things will probably change. You help them understand that history has shown us that what we thought the answer was sometimes changes, and they have to be ready for that but well be there with them, helping them get through it. That is probably one of the most important parts of public health that people underestimate that communication.
One of the most fundamental unexpected things was recognizing that it could be transmitted in people who were not symptomatically ill with the disease.
Everybodys expectation at the beginning was SARS-CoV-II, the virus that causes COVID-19, would behave like its very close sibling, SARS-CoV-I, the cause of SARS. The evidence at the time was that those diseases are only transmitted by people who are exhibiting symptoms of illness. To help prevent transmission, wed say, As soon as you have any symptoms, whether its COVID or not, go isolate. If you dont have symptoms, its fine to go out in public and do your regular thing. Well, that changed. And that was a big, abrupt change.
This is a truism, but its even more true with outbreaks: Expect the unexpected.
The worlds a big place and theres a lot to learn. I cant stress how valuable it is to travel abroad and see how other people manage their lives and work through health crises. And to understand how people view our country from the outside. Its a little painful sometimes. It builds a lot of humility when you learn that you can best help people by teaching them how to help themselves.
Nearly 25 years ago, measles was officially eliminated in the U.S. Sadly, that did not mean measles was gone forever. That designation meant that infection had not been transmitted continuously anywhere in the country for more than a year. But measles could come back, and it has: at a Disney on Ice event in Cincinnati, a migrant shelter in Chicago, a hospital in Sacramento and other places.
As of this articles deadline, the Centers for Disease Control and Prevention (CDC) has reported 58 measles cases in these 17 states:
That is the same number of cases of measles reported in all of 2023. And there are concerns it could be as high as the 1,274 cases that were confirmed in 31 states back in 2019the year that holds the record for the most U.S. measles cases since 1992.
With measles, you always have to be concerned that your numbers can just exponentially rise because it's so contagious of a virusit can stay in the air for two hours after the person has left the area, said Erica Kaufman West, MD, director of infectious diseases at the AMA. When you're talking about communal areas it has a big potential to spread extremely fast.
To put in plain terms just how contagious this disease is, if you had 10 people who were unvaccinated in a room after somebody with measles walked out, nine of them would get infected, Dr. Kaufman West said.
Meanwhile, federal health authorities encourage maintaining a target vaccination rate of 95% measles, mumps and rubella (MMR) for the best protection. But that rate has been on the decline since 2019. For example, last year the MMR immunization rate dropped to 93.1% among kindergarteners nationally. This, according to the CDC, leaves about 250,000 kindergarteners at risk of infection.
Most physicians in the U.S. have never treated a case of the measles in their career, which means many may lack familiarity with the disease. But now that it is back, here is what physicians should know about measles and the recent rise in cases as they step up to the plate to help their patients.
Identify symptoms of measles
Proper protective measures are needed for patients who are exhibiting symptoms of measles. That is why it is important for physicians to be aware of the signs of measles.
Symptoms of measles include high fevers. These are really high fevers of about 103 F, 104 F, 105 F in adults, Dr. Kaufman West said. Kids can get up that high and its not terribly unusual, but an adult with a fever of 103 F, 104 F is extremely unusual.
Then there is a rash that starts at the hairline, even behind the ears and neck, which might be difficult for patients to see, she added, noting the rash travels downward to the trunk and then outward to the arms and legs.
Something that starts on the feet and travels upthats not going to be measles. It really starts at the top and heads down and patients are contagious from four days before through four days after that rash starts, Dr. Kaufman West said, noting if patients call for an acute visit its always a good point to ask why, and if the fever and rash comes up, then its worth having a way to see them that doesnt involve them sitting in the waiting room.
The risk is low with vaccination
It cannot be emphasized enough just how important it is for patients to get vaccinated against measles. Thats because for people who are vaccinated, the risk is extremely low, said Dr. Kaufman West. For people who are vaccinated, I dont think that theres really much risk at all for going around like usual. Its for those folks who are unvaccinated or for parents of children who are very small and not yet fully vaccinated where the risk is higher.
The first measles vaccine is given between 12 and 15 months, so babies who are less than 1 year old are very susceptible, she said, emphasizing that those parents should be asking questions at daycare or wherever they have their child care if its not in their own home.
After one dose, the efficacy is 93%, which is great. A second dose is given at 4 to 6 years old, and that ups the measles vaccine efficacy to 97%, Dr. Kaufman West added. Then anybody who has an immunocompromising condition is also at high risk of measles even if they are vaccinated.
Meanwhile, for anybody born before 1957, measles was so rampant that they are considered immune by exposure, Dr. Kaufman West said, noting that testing for immunity should be done on a case by case basis.
Encourage MMR vaccination
After years of declining vaccination rates, measles cases are popping up around the country. And most of the measles cases have been in young children and adolescents who were eligible but didnt receive the MMR vaccine.
In fact, the CDC notes that about 61 million doses of the MMR vaccine were postponed or missed between 2020 and 2022 due to the COVID-19 pandemic. Coupled with the anti-vaccine sentiment that is growing, were seeing the ramifications of declining vaccine rates.
That is why it cannot be emphasized enough how important it is for physicians to talk with parents and their patients about receiving the MMR vaccine. The best way to fight the measles is to get vaccinated if a patient has not already. The MMR vaccine is safe and effective at preventing measles.
The AMA urges everyone who isnt vaccinated to get themselves and their families vaccinated against the measles, said AMA President Jesse M. Ehrenfeld, MD, MPH. Vaccination not only prevents infection, measles-related complications and even death, but also helps prevent further spread to loved ones, neighbors, co-workers and others in close contact.
We are reminding physicians to talk with their patients about the health risks associated with not being vaccinated and to make a strong recommendation for vaccinations, unless medically inadvisable, Dr. Ehrenfeld said. We also urge physicians to educate patients on the signs and symptoms, severity and complications of measles given that many people are unfamiliar with the impact of the disease.
On March 18, the CDC issued a Health Alert Network (HAN) Health Advisory,warning of an increase in both global and domestic measles cases, and urging vaccination. The advisory emphasizes the importance of measles prevention, especially for international travelers 6 months or older, as well as children 12 months or older who do not plan to travel internationally.
Incubation can take up to 21 days
Once a patient has been exposed to measles, the incubation period is seven to 21 days. Its three weeks where you have to wait, watch and wonder if youre going to develop symptoms if you dont have immunity, Dr. Kaufman West said, noting it can be a long and tedious time.
As soon as a patient presents with a rash, they are contagious from four days before to four days after, she said. After the four days of that rash starting, then youre not considered contagious anymore.
Testing for measles is vital
Physicians should test for measles even if you have a classic case in high suspicion, Dr. Kaufman West said, noting that testing involves a blood sample to look for antibodies and then also the most important is getting a nasopharyngeal swab or an oropharyngeallike a strep test.
The antibodies are good because it tells us if the person has immunity and what sort of stage theyre at. But the swab becomes really important because thats a PCR [polymerase chain reaction] test, she said. You can get cross-reaction between different viruses, so just because the antibody test is positive, its not 100% knockout that this is measles, but that swab is super important for two reasons.
No. 1, just like with COVID-19, it looks for the actual virus, so theres no mistaking it and, No. 2, it allows health departments and even higherCDCto do genetic analysis to be able to say: Does this persons virus RNA match another persons virus RNA? And then they can track where that particular strain is spreading so that they can do better contact tracing, Dr. Kaufman West added.
If positive, tell the health department
Physicians and other health care professionals are required to report measles cases to their local health department.
So, physicians should make sure that they are gathering a decent amount of social history from the patientswhere do they work or go to school, where they have traveled, Dr. Kaufman West said. This is important because we want to try to get ahead of this because its such a contagious virus.
You really want to be able to then reach outif you know the person works at a particular businessand tell everybody to keep an eye out for these symptoms, Dr. Kaufman West said. And if someone is not vaccinated and they work with this person, we can vaccinate them and try to prevent them from getting infected.
Anyone who has been exposed to measles and cannot readily show they have evidence of immunity against the disease should be offered post-exposure prophylaxis. The MMR vaccine is effective at preventing measles when administered to a person who is susceptible within 72 hours following exposure. Administering immunoglobulin within six days of exposure may also prevent or modify measles in those who are susceptible.
Bring up international travel
The CDC has a great travel website and theres a section where you put in where youre going and it tells you everything, Dr. Kaufman West said, noting it tells you what you need, what you should know. Maybe the whole country isnt at risk, but certain pockets of it are for malaria or typhoid or those kinds of things.
Beyond that, anybody traveling outside the U.S. should know that they are immune to measles because its endemic in multiple countries around the world, she said. While measles immunization is not something physicians need to ask about at every visit, if you have a patient who you know likes to travel, its a good conversation to have.
Take steps to protect yourself
For physicians and other health professionals, if they have that patient where they are concerned about measles, make sure you have an N95 because that 3% risk is still there, but its very low, Dr. Kaufman West urged. If the patient is coughing, go ahead and wear eye protection and a gown so you dont get those secretions on you.
Most physicians have access to N95s or other respirators now, but if they have a bunch of cases that go through and stock gets depleted, that can be an issue, she said. That is why it is also important to make sure youre staying up to date with whats in your stockpilejust being sure that youve got the necessary equipment to protect them and their staff.
Additionally, if youre going to be doing swabs and all of that for testing for measles, wear gloves too, Dr. Kaufman West said.
Leave the room empty for two hours
The measles virus can stay in the air for up to2 hoursafter an infected person leaves an indoor space. For physicians treating a patient with measles, the room needs to be left alone for two hoursassuming its just a regular exam roomafter the patient leaves, Dr. Kaufman West said, noting emergency departments have negative pressure rooms and that turnaround time is about an hour or a little bit less.
But for just a regular physician office, its a two-hour time, so the door should be shut, and no one should use it for two hours, she added. After the two hours, its just your normal cleaning and wiping down surfaces because it can spread through respiratory secretions.
Treatment is supportive
There are no good treatments for measles. We dont have an antiviral for measles, For children with severe disease, physicians can give high dose vitamin A. Thats about all we have, Dr. Kaufman West said. But for post exposure prophylaxis, thats where things like vaccination are important if theyre unvaccinated.
Or giving someone antibodies. You can give them whats called IVIg, which stands for intravenous immunoglobulinsort of like the monoclonal antibodies that we heard about with COVID, she added. So, you give people antibodies to fight off a potential measles exposure so that they dont get measles.
Once theyve shown symptoms of measles, then the cats out of the bag. Theres nothing to do except supportive care, Dr. Kaufman West said.
On March 18, to strengthen global pandemic prevention, preparedness and response, the Member States of WHO are coming together for the ninth meeting of the Intergovernmental Negotiating Body (INB). Co-chair Roland Driece explains why the decisions and compromises made in the next few weeks will be crucial to making all of us safer from future pandemics.
The world has been through the biggest global healthcare challenge that we have seen for a long time, the COVID-19 pandemic. It is also pretty clear that we, as countries and collectively, were not ready. We had hardly any infrastructure to cooperate in an effective way and that led, in part, to the situation where some countries had a lot of access to medical countermeasures, while others had nothing. Also many countries did not have policies in place to prevent pandemics, so there were no systems with which to collaborate in that sense. That's what we are trying to improve on.
All the countries of the WHO, that is, every single country in the world working together through these negotiations. Thats the strength of them.
It depends on the outcome, of course. There are a lot of elements on the table, and we have to see in what way all the members of the World Health Organization, (basically all the countries in the world) can agree upon them. The level of ambition is still to be established. However, if we look on the bright side, if we accept the text as it stands today, we could make a commitment to strengthen our efforts to prevent pandemics even from happening. That's what you want, of course, because if you make sure that the chance of pandemics occurring is as small as possible, then you don't have to prepare or respond to them either.
Strengthening policies on spillovers from diseases from animals to humans, for example. Making sure that you have all the laboratory capacities, your search capacities in place, but also that you make sure that there is as much unhindered exchange and access to pathogenic information on diseases as possible. That is important because then you know what's happening in the world and how to prepare countermeasures.
What we are trying to do in the treaty is to establish a system that provides as good as possible access to pathogenic information, but also more equitable access to products deriving from it, vaccines, for example. We are also trying to coordinate much better all the financial instruments available for doing this important work.
In a perfect world, if we make the treaty as strong as we can, you would be less exposed to the chance of pandemics rehappening. That chance will never be zero, but if we do it right, the chances that pandemics occur in the same way and spread around the world are smaller. So then, as an individual, you won't notice anything, and that's a good thing! But, if prevention is not perfect, and a pandemic does occur, then your country will be much better prepared to deal with it and there will be systems in place between countries to help each other. There will be a better likelihood of access to medical countermeasures.
Another example of what we are trying to do is to strengthen production capacity in countries where its currently limited. We are trying to strengthen research capacities towards products that can be used in pandemic times.
There are two chairs to this meeting, me and a colleague from South Africa, Precious Matsoso. We have a man from the North and a woman from the South, just to acknowledge the fact that this is about all of us. What we try to do is facilitate, steer and manage the process of negotiations. We are not in charge of the outcomes of it. We do not determine what the treaty text will be. Thats the membership. That's the Member States of the WHO. What we try to do is help them in their endeavours, in their negotiations, as chairs of this meeting.
Its stimulating to do something that you believe is good for the world. Its also nice that people entrust you with such a role. The lows are sometimes that you have to sit for a very, very long time in a room listening to a lot of people repeating themselves many times. You have to make sure that when you get back to your hotel, you go to the gym and do some exercise!
It depends a little bit on how you define WHO, because WHO is an organization with a seat in Geneva, but it's also a group of 194 countries coming together to talk about global health. So, if you say WHO is those 194 Member States, it's correct. But when people say it's the WHO secretariat that is driving this, with its Director General at the top who wants to control a lot of processes he should not control, that is far from the reality. It's the Member States that do the negotiation, that decides what's in there. The secretariat helps us as chairs and as a bureau to manage the process.
Sometimes people approach me directly and I say, Have you gone to the website of WHO? All the texts that we have are there for the public to see. Is there anything you can read in that text that says anything about handing over sovereignty? No, nothing. Nothing at all. It is not about that. It's about cooperation between Member States.
Do you really think that the government of the United States or the government of Russia, the government of the Netherlands or whoever would ever sign up to something like that? That's of course never going to happen and rightly so.
One of the principles we have in the text is that we live up to all agreed principles on human rights.
For just over two years now. The interesting, but worrying part is that when we agreed that we would start this, it was in the aftermath of the COVID-19 pandemic and that was still very fresh in our minds. But what you see happening is that the urgency is slipping, for very understandable reasons. COVID-19 is, for most people, more like a memory from a couple of years back and not one that they have very pleasant thoughts of, so sometimes they would rather forget about it. And there are also many other priorities that require our attention; we have wars in different places of the world; we have climate problems around the world; we have many things that require our attention and money and efforts. Finding money, for example, for doing a lot of the things that we deem necessary is not so easy. Compromising is not so easy when people do not feel the urgency as much as they did three years ago.
We risk making the same mistakes again, next time. It's all very understandable, but it's also a shame that we as human beings are not so good in solving problems which are not there anymore, or are not here yet. People find it easier to put 50 billion on the table when the problem is there than 1 billion when the problem is not yet there. And that's worrisome, but we have to see how we can deal with that.
The talks recommence on March 18, 2024. The difficult thing is that we do not have much time left. We just have a few more days of negotiations ahead of us, the next two weeks, and maybe a bit longer, but then it has to be done. We have to see how prepared countries are to compromise.
There have now been 60 known or suspected measles cases across 17 states this year, with 12 cases in Chicago alone. In other news, the CDC reports that marriage rates have returned to pre-pandemic levels.
CBS News: U.S. Measles Milestone: 60 Cases So Far In 2024 More Than All Of 2023 The U.S. has now tallied at least 60 confirmed or suspected measles cases investigated so far this year by authorities in 17 states more than the 58 cases reported nationwide in all of 2023. It comes as health officials are grappling with multiple major outbreaks of the highly contagious virus around the world.Friday's tally of measles cases is up from 45 counted by the CDC last week. Additional infections have since been announced in Arizona, California, Illinois and Ohio. (Tin, 3/15)
CIDRAP: Chicago Measles Total Rises To 12 Cases Amid a small but steady rise in infections nationally, Chicago has now reported 12 measles cases, 10 of them linked to people who recently arrived at a local migrant shelter. In a weekly update, the Chicago Department of Public Health said 6 of the cases involve children and 6 are in adults. A local media report said 2 of the patients had attended separate Chicago public schools, 1 of them reportedly a child who is staying at the migrant shelter. (Schnirring, 3/15)
CBS News: Health Officials Confirm Probable Measles Exposure In Merced County Health officials have confirmed a probable measles exposure in Merced County and are working with exposed individuals and health care providers in the area.Last week, officials said hundreds of people may have been exposedat a Sacramento hospital after an El Dorado County child was confirmed to have contracted it. That child appeared to have contacted it after a trip out of the country.Earlier this week, an unvaccinated Central Valley child was confirmed to have a case of measles. (Downs, 3/15)
In other health and wellness news
AP: Marriages In The US Are Back To Pre-Pandemic Levels, CDC Says U.S. marriages have rebounded to pre-pandemic levels with nearly 2.1 million in 2022. Thats a 4% increase from the year before. The Centers for Disease Control and Prevention released the data Friday, but has not released marriage data for last year. In 2020, the first year of the COVID-19 pandemic, there were 1.7 million U.S. weddings the lowest number recorded since 1963. The pandemic threw many marriage plans into disarray, with communities ordering people to stay at home and banning large gatherings to limit the spread of COVID-19. (Stobbe, 3/15)
ABC News: Scientists Take On 'Moonshot' Project Mapping The Human Brain In Hopes Of Fighting Disease To many other researchers, creating a map of the 86 billion neurons, or nerve cells, that make up the brain would be considered a nearly insurmountable project. However, researchers at the Allen Institute are pursuing that very task, saying it will lay the foundation for helping to better understand how the brain functions the way it does. The Allen Institute, founded by Microsoft co-founder and philanthropist Paul Allen in 2003, was originally created to map gene activity in the mouse brain, but researchers quickly began including studies of the human brain in their work. (Kekatos, 3/16)
CNN: Deep Brain Stimulation Didnt Work For A Young OCD Patient Until New Brain Maps Changed Everything Five years ago, in a wheelchair, Julia Hum was admitted to a state mental hospital in Massachusetts. After treatment with targeted deep brain stimulation, she hopes to walk out soon and, for the first time in her adult life, live independently, in her own apartment. (Goodman, 3/15)
People aged 75 years and older, residents in care homes for older people, and those aged 6 months and over with a weakened immune system will be offered a dose of COVID-19 vaccine this spring.
COVID-19 is more serious in older people and in people with certain underlying health conditions. For these reasons, people aged 75 years and over, those in care homes, and those aged 6 months and over with a weakened immune system are being offered a spring dose of COVID-19 vaccine.
You should be offered an appointment between April and June, with those at highest risk being called in first. You will be invited to have your booster around 6 months after your last dose, but you can have it as soon as 3 months.
If you are turning 75 years of age between April and June, you do not have to wait until your birthday, you can attend when you are called for vaccination.
You will be invited for your booster, your GP may offer you the vaccine or you can book usingthe NHS appforAppleorAndroid.You can also find yournearest walk-in vaccination sitefrom the NHS website.
You will be given a booster dose of a vaccine made by Pfizer or Moderna and approved in the UK. These vaccines have been updated since the original vaccines and target a different COVID-19 variant. These updated vaccines boost protection well, and give slightly higher levels of antibody against the more recent strains of COVID-19 (Omicron).
As we cannot predict which variants of COVID-19 will be circulating this spring and summer, the Joint Committee on Vaccination and Immunisation (JCVI) have concluded that the vaccine used in the later weeks of the autumn 2023 programme should be used.
Please accept the vaccination that is offered to you as soon as you are able to you will be offered the right vaccine for you at the right time.
There are very few eligible people who should not have a dose this spring. If you have had a severe reaction to a previous dose of the vaccine you should discuss this with your doctor.
As with your previous dose, the common side effects are the same for all COVID-19 vaccines, including the updated vaccines being used this spring and include:
You can rest and take paracetamol (follow the dose advice in the packaging) to help you feel better.
Side effects following vaccination normally last less than a week. If your symptoms seem to get worse or if you are concerned, you can call NHS 111 or for text/phone use 18001 111.
You can also report suspected side effects of vaccines and medicines through the Yellow Card scheme.
Cases of inflammation of the heart (called myocarditis or pericarditis) have been reported very rarely after both the Pfizer and Moderna COVID-19 vaccines. These cases have been seen mostly in younger men and within several days of vaccination. Most of the people affected have felt better and recovered quickly following rest and simple treatments.
You should seek medical advice urgently if, after vaccination, you experience:
If you had a serious side effect after a previous dose you may be advised to avoid or delay further vaccination. You should discuss this with your doctor or specialist.
You can report suspected side effects of vaccines and medicines through the Yellow Card Scheme:
If you are unwell, wait until you have recovered to have your vaccine. You should not attend an appointment if you have a fever or think you might be infectious to others.
The COVID-19 vaccine will reduce the chance of you becoming severely unwell from COVID-19 this spring and summer. It may take a few days for your body to build up some extra protection from the dose. Like all medicines, no vaccine is completely effective. Some people may still get COVID-19 despite having a vaccination, but any infection should be less severe.
If you have not yet had either of your first 2 doses of the vaccine (or a third dose for those with a weakened immune system) you should have a dose during the seasonal campaign.
If you are eligible and you have missed an earlier booster, you should have a dose this spring to catch up. Most people do not need extra doses to make up for those you have missed.
If you have a severely weakened immune system your doctor may advise an extra dose 3 months after you have the spring vaccine.
If you have a history of allergies, or if you had a reaction immediately after a previous dose, you may be advised to stay for 15 minutes after the vaccine. Please make sure you tell the vaccinator.
You can read the COVID-19 guides below for more information:
Paper copies of this leaflet in English are available free to order or download. Translated translated versions are available to download.
Alternative and accessible formats of this leaflet will soon be available to order.
March 22, 2024
1 min read
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The FDA authorized emergency use of pemivibart for pre-exposure prophylaxis of COVID-19 in adults and adolescents aged 12 years and older weighing at least 40 kg.
Pemivibart (Pemgarda, Invivyd) a recombinant human monoclonal antibody is indicated for individuals not infected nor recently exposed to anyone with SARS-CoV-2, and who are moderately or severely immunocompromised due to medical conditions or immunosuppressive drugs and treatments and would be unlikely to mount an adequate immune response to COVID-19, Patrizia A. Cavazzoni, MD, director of the Center for Drug Evaluation and Research at the FDA, wrote in her emergency use authorization approval letter provided to the manufacturer.
Pemivibart targets the SARS-CoV-2 spike protein receptor, which inhibits the virus attachment to the human ACE2 receptor host cells, Cavazzoni wrote in her letter.
The agent did not get authorization as a COVID-19 treatment or for post-exposure prevention of COVID-19.
Pemivibart fills a need after tixagevimab plus cilgavimab (Evusheld, AstraZeneca) had its authorization pulled in January 2023.
Pre-exposure prophylaxis with Pemgarda is not a substitute for vaccination in individuals for whom COVID-19 vaccination is recommended, Cavazzoni wrote. Individuals for whom COVID-19 vaccination is recommended, including individuals with moderate to severe immune compromise who may derive benefit from COVID-19 vaccination, should receive COVID-19 vaccination.
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