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It has been four years since the World Health Organization (WHO) declared COVID-19 a pandemic on March 11, 2020. The week following the announcement, institutions and organizations worldwide shut down to curb the extent of the virus, affecting billions of lives. Much has occurred since daily and weekly reports slowed down, despite WHO maintaining COVID-19 is still a pandemic. Here is a summary of events and the current state of COVID-19 at a city, state and national level.
San Antonio
The first confirmed COVID-19 case in San Antonio and in Texas occurred on Feb. 13, 2020, within a group of evacuees from China at Lackland Air Force Base. Mayor Nirenberg proactively declared a public health emergency on March 2, the same day city officials sued the Centers for Disease Control and Prevention (CDC), demanding the federal agency raise standards for releasing quarantined people. Nirenberg banned future evacuees from entering San Antonio.
Following the WHOs declaration, the Spurs suspended further games, Fiesta was canceled and postponed until 2022 and many schools and workplaces went remote. On Dec. 14, 2020, UT Health received 6,000 doses of the Pfizer vaccine. By Jan. 9, 2021, mass vaccination sites were created at the Alamodome and the WellMed Elvira Cisneros Senior Community Center on the south side.
By the end of 2020, San Antonio had 118,057 total COVID-19 cases and 1,538 deaths from the virus. As of March 5, 2024, there were 754,187 cumulative cases and 6,262 confirmed total deaths. Bexar County stopped updating COVID-19 data dashboards on March 12 due to COVID-19 no longer being a reportable condition as of March 1, 2024.
Texas
I am at this moment declaring a state disaster for all counties in the state of Texas, announced Governor Abbott on March 13, 2020. The Texas Supreme Court halted evictions on March 19, and unemployment rates spiked 860% the following week. In June, Abbott insisted that closing Texas would be the last option. That November, Texas breached 1 million cases and Abbott reiterated at least twice that there would be no lockdown.
In January 2021, the number of COVID-19 cases passed 2 million. By February, 1 million Texas residents were fully vaccinated, and on March 10, 2021, Abbott removed the mask mandate and re-opened businesses to 100% capacity. Several businesses maintained their COVID-19 policies. After California, Texas had the highest number of confirmed cases in the country. On Aug. 17, Abbott tested positive for COVID-19. The city of Austin announced the end of the COVID-19 National Public Health Emergency Declaration in alignment with national agencies on May 11, 2023. The end of the national public health emergency unfortunately does not mean the end of COVID-19, said Dr. Desmar Walkes of Austin-Travis County Health Authority.
Between March 6, 2020, and the latest report published on Jan. 15, 2024, 9,030,821 confirmed and probable cases were reported in Texas. For 2024, 38,018 confirmed and probable cases have been reported.
United States
The CDC began investigations into the then-unknown illness on Jan. 5, 2020, following a report to WHO by China two days earlier. The first confirmed infections were reported in Illinois on Jan. 24. On March 27, President Trump signed the Coronavirus Aid, Relief and Economic Security Act (CARES), providing $1,200 checks to support Americans financially, expanding funding to state and local governments and more. Other federal acts paused student loan repayments indefinitely. By the end of August, new cases would average over 1,000 a day and total cases were over 5.4 million. On Oct. 2, Trump tested positive for COVID-19.
Meanwhile, Pfizer and Moderna progressed in a COVID-19 vaccine, testing to be at least 94% effective after several trials. Both options were authorized for emergency use by Dec. 18. The Department of Health & Human Services had announced in September that vaccines would be free of charge. By the end of the year, the death toll had surpassed 300,000, and 2.8 million people had received the first dose.
By the end of January 2021, over 23 million doses had been administered. In February, the death toll surpassed 500,000 and the Johnson & Johnson one-shot vaccine was approved for emergency use. In January 2022, the United States reported the highest daily total worldwide, with almost 1 million new COVID-19 cases. June recorded over 84 million infections and slightly above 1 million deaths.
As of March 10, the total number of cases is 103,804,263, or about 1 in 3 Americans, who have had COVID-19. The death toll is 1,123,836.
Worldwide, 676,609,955 people have had COVID-19, and 6,881,955 have died. The total number of vaccine doses administered internationally is 13,338,833,198.
Long Covid
People with excessive flexibility 30% more likely to say they had not fully recovered from Covid, research finds
Tue 19 Mar 2024 18.30 EDT
People with excessively flexible joints may be at heightened risk of long Covid and persistent fatigue, research suggests.
Hypermobility is where some or all of a persons joints have an unusually large range of movement due to differences in the structure of their connective tissues that support, protect and give structure to organs, joints and other tissues.
Up to 20% of adults are hypermobile and many of them are completely healthy. Hypermobility can even be beneficial, with many musicians and athletes having very flexible joints. However, it can also create problems, such as an increased propensity to pain, fatigue, joint injuries and stomach or digestive problems.
Dr Jessica Eccles, of the University of Sussex, and her colleagues had been investigating a potential link between hypermobility, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and fibromyalgia (a condition that causes pain all over the body), when the Covid pandemic hit.
We started thinking, if hypermobility is potentially a factor in ME/CFS, is it also a factor in long Covid? Eccles said.
She teamed up with researchers from Kings College London and examined data from 3,064 participants in the Covid symptom study (now the Zoe health study) to see if they had hypermobile joints, had fully recovered from their last bout of Covid, and if they were experiencing persistent fatigue.
The research, published in BMJ Public Health, found that people with hypermobile joints were about 30% more likely to say they hadnt fully recovered from Covid-19 than those with normal joints, and were significantly more likely to be affected by high levels of fatigue.
Although the study doesnt prove that hypermobility caused their illness, there is a plausible mechanism through which it could contribute symptoms such as fatigue, brain fog and postural tachycardia syndrome (PoTS) where peoples heart rates rapidly increase when they stand up.
Eccles added: Weve known for some time that PoTs is closely associated with hypermobility. The theory is that loose connective tissue in peoples veins and arteries can cause blood to pool in their tissues, meaning the heart has to work harder to pump blood to their brains when they stand up, triggering symptoms such as palpitations and dizziness.
It may be that some of these abnormalities were always there, but Covid unmasked them in a vulnerable person, Eccles said.
One theory she is investigating is whether reduced blood flow to the brain could contribute to brain fog and fatigue in a subset of individuals. However, there are other possibilities.
Eccles said: We also know that hypermobility is related to conditions such as ADHD and autism, and ME/CFS and fibromyalgia, so fatigue might be a consequence of that.
She stressed that long Covid was unlikely to be a single entity, but said a better understanding of the link with hypermobility may aid the development of new treatments.
What this work suggests is that there may be a subgroup of people with long Covid who are more likely to be hypermobile, she said.
This is important to identify. It may be that some of the same things that help people with hypermobility and pain, such as strengthening and supporting the core muscles, could help across the board.
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The airport reported more than 50,000 passengers last month.
Author: wqad.com
Published: 4:53 PM CDT March 19, 2024
Updated: 4:53 PM CDT March 19, 2024
CAROLYN JONES CalMatters
After years of cash windfalls, California schools are bracing for a stretch of austerity that could jeopardize students already precarious recovery from the pandemic.
An end to billions of dollars in federal COVID-19 relief funds, declining enrollment, staff raises, hiring binges and stagnant state funding should combine over the next few months to create steep budget shortfalls, with low-income districts affected the most.
The fiscal cliff is going to vary, said Marguerite Roza, director of the Edunomics Lab at Georgetown University. The districts that got the most COVID relief dollars, those that have the most low-income students, are going to face the biggest losses.
In his budget proposal released in January, Gov. Gavin Newsom largely spared schools, keeping intact popular initiatives like transitional kindergarten, universal school meals, community schools and after-school programs. He proposed dipping into reserves and delaying some expenses to make up a projected multibillion-dollar shortfall.
But the exact numbers are shifting. The Legislative Analysts Office predicted that the shortfall may be much higher than Newsom calculated and cuts will be unavoidable. Newsom will release a revised budget in May, and the Legislature has until June 15 to pass a final budget.
Meanwhile, federal COVID-19 relief funding for schools will end in September. In a series of grants known as Elementary and Secondary School Emergency Relief, the federal government gave California schools $23.4 billion to pay for everything from air purifiers to after-school tutoring.
That funding was distributed based on the number of low-income students districts have. Districts with lots of low-income students got more money, which means theyll lose the most when the funding ends.
At the beginning of the pandemic, schools tended to spend the money on one-time expenses, like tablet computers and Wi-Fi hotspots for students attending school virtually. But as schools reopened, they started spending money on ongoing programs intended to help students catch up academically and recover from the mental health hardships of remote learning. That could include tutors, longer school days or summer and after-school programs.
San Bernardino City Unified used $8 million of its $230 million in COVID-19 relief funds to beef up its after-school program. Thanks to the extra funding, the district has been able to offer free after-school activities, tutoring, transportation and mental health support at every school.
Mia Cooper, a parent with three children in San Bernardino City Unified, said her children's after-school program has been a life-saver. In fact, its the main reason they want to go to school, she said.
They not only benefit from tutoring, but they get to enjoy ballet and acting lessons, field trips to science museums and Disneyland, robotics classes, performances by folklrico dance troupes and other fun activities.
During the pandemic, one of Coopers daughters was withdrawn and depressed, but the after-school program helped her reconnect with friends and fall in love with school again. Keeping the program intact should be a priority, Cooper said.
The kids were exposed to so many different activities and cultural things, she said. If a program is working for kids and were seeing good outcomes, I think its something we need to keep. We shouldnt lose that sparkle in kids eyes.
But some districts use of pandemic-era relief funds could worsen their budget prospects, said Roza of Edunomics. Districts that invested one-time funds in ongoing expenses, such as new staff, raises and bonuses, might be headed for a reckoning. Nationwide, school staffing has increased 2% since the pandemic while enrollment has decreased 2%, according to the Georgetown lab.
Salaries for existing teachers have risen, too. Districts in San Francisco, Oakland, San Diego and Los Angeles all of which have declining enrollment agreed to hefty teacher raises and bonuses in the past year.
Still, the fiscal outlook is not as dire as it was during the Great Recession in 2008, according to Julien Lafortune, a research fellow at the Public Policy Institute of California. School funding generally in California has risen dramatically since then, lifting it from the bottom half of states in school funding to above the national average. In addition, the states shift to the Local Control Funding Formula a decade ago has provided more money for students with higher needs, although inequities persist.
But that doesnt mean those cuts wont hurt, Lafortune said, especially for students who were most affected by the pandemic. Low-income, Black and Latino students disproportionately bore the brunt of school closures, research has shown, because they were more likely to suffer economically from the pandemic, less likely to have adequate technology at home, and less likely to have a parent available to help them with distance learning.
Its not like the Great Recession, but I think the challenges are greater now, Lafortune said. A lot of the academic progress we made was erased by the pandemic.
Roza worries that arguments over potential cuts in the next year will eclipse concern over learning loss. Potential school closures and teacher layoffs will inevitably elicit loud protests, but school boards should stay focused on services that directly help students, such as math tutoring and literacy, she said.
Some districts will be focusing on staff retention instead of kids needs, Roza said.
These decisions may be so divisive that Roza predicts a high rate of turnover among school administrators and board members unwilling to make unpopular decisions. She also expects to see some districts refuse to make sufficient cuts and risk insolvency or state takeover.
Fresno Unified is among the districts facing a double whammy of declining enrollment and a large loss of relief funds. The 70,000-student district received more than $787 million in state and federal relief money, one of the largest allotments in California.
But the district was careful to build reserves, rely on state grants when possible and not overly invest in ongoing staff salaries. Instead, it used most of its money to train teachers in math and literacy, extend the school day and provide a high-quality summer program. It also brought in social workers, restorative justice counselors, attendance specialists and other staff to boost students mental health.
The investments have apparently paid off. The number of students meeting Californias math benchmark rose almost 3 percentage points last year, even as the state average remained unchanged. And chronic absenteeism fell significantly, from 51% in 2022 to 35% last year.
Still, the district expects to make some cuts, probably affecting the district office but not schools directly at least at first, said the districts chief financial officer, Patrick Jensen.
Its like were in a boat and we can see a storm coming, Jensen said. Were not going to be dashed against the rocks but we still need to find a safe harbor..
San Bernardino City Unified, among Californias lowest-income districts, also received a high relief funding payout: $230 million for 46,000 students. But the district isnt anticipating a financial disaster once the funding expires. It plans to shift some of its state block grant money to pay for programs funded with relief money, where necessary, and has been conservative with planning. Its also closely monitoring the state budget and economic outlook, said Associate Superintendent Terry Comnick.
But theres still likely to be some cuts, and the district will have to look closely at what programs have been effective and which didnt live up to expectations. In addition to the after-school program, a resident guest teacher program had positive results, Comnick said. The district hired substitute teachers to work one-on-one or in small groups with students who were the furthest behind. The $4.5 million program, which was at every school, resulted in higher test scores among the highest-needs students.
So far, it looks like the district will be able to keep both programs, at least for the next few years, Comnick said.
People call it a (Elementary and Secondary School Emergency Relief) cliff because the money just ends, Comnick said. But for us it will hopefully be a gentle slope.
Justin-Siena senior India De Vere's shot hits the Granite Bay sidepost during the first half in Napa on March 7.
Players run through a sign as they are introduced during the Napa Junior Girls Softball League Opening Day ceremony Saturday morning.
Players dance as they wait for the Napa Junior Girls Softball League Opening Day ceremony to begin Saturday morning.
Players and coaches line up during the Napa Junior Girls Softball League Opening Day ceremony Saturday morning.
Vintage High senior Dessianna Garcia throws the ceremonial first pitch to senior teammate Mia Griffith during the Napa Junior Girls Softball League Opening Day ceremony Saturday morning.
Diana Corzo sings the national anthem during the Napa Junior Girls Softball League Opening Day ceremony Saturday morning.
Players walk through the crowdduring the Napa Junior Girls Softball League Opening Day ceremony Saturday morning.
Napa Mayor Scott Sedgley, right, Napa Police Lieutenant Keri Sedgley, middle, and Napa Vice Mayor Beth Painter are recognized during the Napa Junior Girls Softball League Opening Day ceremony Saturday morning.
Players and parents arrive for the Napa Junior Girls Softball League Opening Day ceremony Saturday morning.
A player runs to accept the bike she won in a raffle during the Napa Junior Girls Softball League Opening Day ceremony Saturday morning.
A hot air balloon flies overhead during the Napa Junior Girls Softball League Opening Day ceremony Saturday morning.
Young softball players run onto the field as they are introduced during the Napa Valley Junior Girls Softball League Opening Day ceremony on Saturday, March 16.
Young softball players run onto the field as they are introduced during the Napa Valley Junior Girls Softball League Opening Day ceremony on Saturday, March 16.
A scene from Opening Day of the Napa Valley Junior Girls Softball League on Saturday, March 16.
A scene from Opening Day of the Napa Valley Junior Girls Softball League on Saturday, March 16.
A scene from Opening Day of the Napa Valley Junior Girls Softball League on Saturday, March 16.
A scene from Opening Day of the Napa Valley Junior Girls Softball League on Saturday, March 16.
A scene from Opening Day of the Napa Valley Junior Girls Softball League on Saturday, March 16.
A scene from Opening Day of the Napa Valley Junior Girls Softball League on Saturday, March 16.
A scene from Opening Day of the Napa Valley Junior Girls Softball League on Saturday, March 16.
A scene from Opening Day of the Napa Valley Junior Girls Softball League on Saturday, March 16.
A scene from Opening Day of the Napa Valley Junior Girls Softball League on Saturday, March 16.
A scene from Opening Day of the Napa Valley Junior Girls Softball League on Saturday, March 16.
A scene from Opening Day of the Napa Valley Junior Girls Softball League on Saturday, March 16.
A scene from Opening Day of the Napa Valley Junior Girls Softball League on Saturday, March 16.
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Four years after hospitals in New York City overflowed with covid-19 patients, emergency physician Sonya Stokes remains shaken by how unprepared and misguided the American health system was.
Hospital leadership instructed health workers to forgo protective N95 masks in the early months of 2020, as covid cases mounted. We were watching patients die, Stokes said, and being told we didnt need a high level of protection from people who were not taking these risks.
Droves of front-line workers fell sick as they tried to save lives without proper face masks and other protective measures. More than 3,600 died in the first year. Nurses were going home to their elderly parents, transmitting covid to their families, Stokes recalled. It was awful.
Across the country, hospital leadership cited advice from the Centers for Disease Control and Prevention on the limits of airborne transmission. The agencys early statements backed employers insistence that N95 masks, or respirators, were needed only during certain medical procedures conducted at extremely close distances.
Such policies were at odds with doctors observations, and they conflicted with advice from scientists who study airborne viral transmission. Their research suggested that people could get covid after inhaling SARS-CoV-2 viruses suspended in teeny-tiny droplets in the air as infected patients breathed.
But this research was inconvenient at a time when N95s were in short supply and expensive.
Now, Stokes and many others worry that the CDC is repeating past mistakes as it develops a crucial set of guidelines that hospitals, nursing homes, prisons, and other facilities that provide health care will apply to control the spread of infectious diseases. The guidelines update those established nearly two decades ago. They will be used to establish protocols and procedures for years to come.
This is the foundational document, said Peg Seminario, an occupational health expert and a former director at the American Federation of Labor and Congress of Industrial Organizations, which represents some 12 million active and retired workers. It becomes gospel for dealing with infectious pathogens.
Late last year, the committee advising the CDC on the guidelines pushed forward its final draft for the agencys consideration. Unions, aerosol scientists, and workplace safety experts warned it left room for employers to make unsafe decisions on protection against airborne infections.
If we applied these draft guidelines at the start of this pandemic, there would have been even less protection than there is now and its pretty bad now, Seminario said.
In an unusual move in January, the CDC acknowledged the outcry and returned the controversial draft to its committee so that it could clarify points on airborne transmission. The director of the CDCs National Institute for Occupational Safety and Health asked the group to make sure that a draft set of recommendations cannot be misread to suggest equivalency between facemasks and NIOSH Approved respirators, which is not scientifically correct.
The CDC also announced it would expand the range of experts informing their process. Critics had complained that most members of last years Healthcare Infection Control Practices Advisory Committee represent large hospital systems. And about a third of them had published editorials arguing against masks in various circumstances. For example, committee member Erica Shenoy, the infection control director at Massachusetts General Hospital, wrote in May 2020, We know that wearing a mask outside health care facilities offers little, if any, protection from infection.
Although critics are glad to see last years draft reconsidered, they remain concerned. The CDC needs to make sure that this guidance doesnt give employers leeway to prioritize profits over protection, said Jane Thomason, the lead industrial hygienist at the union National Nurses United.
Shes part of a growing coalition of experts from unions, the American Public Health Association, and other organizations putting together an outside statement on elements that ought to be included in the CDCs guidelines, such as the importance of air filtration and N95 masks.
But that input may not be taken into consideration.
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The CDC has not publicly announced the names of experts it added this year. It also hasnt said whether those experts will be able to vote on the committees next draft or merely provide advice. The group has met this year, but members are barred from discussing the proceedings. The CDC did not respond to questions and interview requests from KFF Health News.
A key point of contention in the draft guidance is that it recommends different approaches for airborne viruses that spread predominantly over short distances versus those that spread efficiently over long distances. In 2020, this logic allowed employers to withhold protective gear from many workers.
For example, medical assistants at a large hospital system in California, Sutter Health, werent given N95 masks when they accompanied patients who appeared to have covid through clinics. After receiving a citation from Californias occupational safety and health agency, Sutter appealed by pointing to the CDCs statements suggesting that the virus spreads mainly over short distances.
A distinction based on distance reflects a lack of scientific understanding, explained Don Milton, a University of Maryland researcher who specializes in the aerobiology of respiratory viruses. In general, people may be infected by viruses contained in someones saliva, snot, or sweat within droplets too heavy to go far. But people can also inhale viruses riding on teeny-tiny, lighter droplets that travel farther through the air. What matters is which route most often infects people, the concentration of virus-laden droplets, and the consequences of getting exposed to them, Milton said. By focusing on distance, the CDC will obscure what is known and make bad decisions.
Front-line workers were acutely aware they were being exposed to high levels of the coronavirus in hospitals and nursing homes. Some have since filed lawsuits, alleging that employers caused illness, distress, and death by failing to provide personal protective equipment.
One class-action suit brought by staff was against Soldiers Home, a state-owned veterans center in Holyoke, Massachusetts, where at least 76 veterans died from covid and 83 employees were sickened by the coronavirus in early 2020.
Even at the end of March, when the Home was averaging five deaths a day, the Soldiers Home Defendants were still discouraging employees from wearing PPE, according to the complaint.
It details the experiences of staff members, including a nursing assistant who said six veterans died in her arms. She remembers that during this time in late March, she always smelled like death. When she went home, she would vomit continuously.
Researchers have repeatedly criticized the CDC for its reluctance to address airborne transmission during the pandemic. According to a new analysis, The CDC has only used the words COVID and airborne together in one tweet, in October 2020, which mentioned the potential for airborne spread.
Its unclear why infection control specialists on the CDCs committee take a less cautious position on airborne transmission than other experts, industrial hygienist Deborah Gold said. I think these may be honest beliefs, she suggested, reinforced by the fact that respirators triple in price whenever theyre needed.
Critics fear that if the final guidelines dont clearly state a need for N95 masks, hospitals wont adequately stockpile them, paving the way for shortages in a future health emergency. And if the document isnt revised to emphasize ventilation and air filtration, health facilities wont invest in upgrades.
If the CDC doesnt prioritize the safety of health providers, health systems will err on the side of doing less, especially in an economic downturn, Stokes said. The people in charge of these decisions should be the ones forced to take those risks.
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Former president of Brazil Jair Bolsonaro has been indicted for allegedly falsifying his Covid-19 vaccine records.
Federal police allege that Mr Bolsonaro falsified information in the countrys public health database in December 2022 to falsely make it appear that he, his daughter and several other close allies had received the Covid-19 vaccine, according to The Associated Press.
He also faces charges of criminal association.
The indictment comes after a long investigation by federal police into whether Mr Bolsonaro falsified his Covid-19 vaccine card to get around US requirements.
Mauro Cid, former aide to Mr Bolsonaro, was also indicted as part of the investigation, according to Reuters.
Last year, Mr Bolsonaro denied allegations that he falsified the data and said he had never claimed to be vaccinated.
A legal analyst told The AP that Mr Bolsonaro faces between two to twelve years behind bars if convicted of falsifying health data. Meanwhile, the criminal association charge carries a four-year sentence, the analyst said.
Jair Bolsonaro has been indicted on charges related to suspected falsification of his Covid-19 vaccine records
(AFP via Getty Images)
The former president has long rejected the Covid-19 vaccine, instead advocating for the use of hydroxychloroquine, a drug also touted by Donald Trump. However, hydroxychloroquine, an anti-malaria drug, has been proven to not be effective against Covid-19.
During the peak of the pandemic in 2020, Mr Bolsonaro also ignored emails from Pfizer offering to sell millions of vaccines to Brazil, The AP reported.
In 2021, he then faced accusations of corruption after finally purchasing vaccines from Indian pharmaceutical Bharat Biotech. A health ministry official at the time said he felt pressured to greenlight the agreement despite irregularities in invoices.
Both Mr Bolsonaro and the company denied any wrongdoing.
Aside from this case, the former president is also facing several separate legal challenges. Last year, a panel of judges barred Mr Bolsonaro from running for office until 2030 after ruling he abused his power during the 2022 election and cast unfounded doubts on the countrys electronic voting systems.
Federal police are also investigating Mr Bolsonaro for his suspected role in a series of attacks on government buildings on 8 January 2023 by his supporters after he lost the election to Luiz Incio Lula da Silva in a day that brought back memories of the January 6 riots on the US Capitol.
Mr Bolsonaro has denied any wrongdoing in connection to those attacks. Earlier this year, federal investigators launched Operation Tempus Veritatis Hour of Truth in Latin into the incident, by conducting dozens of searches and arresting several of Mr Bolsonaros allies.
Mr Bolsonaro has long aligned with Mr Trump and the American far-right. Last year, he spoke at several conservative events, including the 2023 Conservative Political Action Conference. He also gave remarks outside of one of Mr Trumps hotels in Miami, Florida, at an event hosted by conservative activist Charlie Kirk.
The COVID-19 vaccine can cut the risk of heart failure and blood clots after a COVID-19 infection, a new study in the British Medical Journal found.
Previous studies found that a SARS-CoV-2 infection can trigger cardiac and thromboembolic complications, and the risk for a person infected remains high for a year after becoming sick, researchers noted.
The new study found that while the risks remain, getting a vaccine slashes the risk of heart failure up to 55 percent and blood clots up to 78 percent after getting sick.
Using a sample of 10.17 million vaccinated people and 10.39 million unvaccinated people across three European countries, the study found the positive health effects were most significant in the 30 days following a vaccination but can last up to a year.
The study examined people who were vaccinated with Moderna, Pfizer, AstraZeneca and Johnson & Johnson.
After the COVID-19 vaccine became politicized and controversial despite medical professionals urging the public to receive the shot, doctors said this study shows complications from the infection itself are worse than complications that may come from receiving the vaccine.
“While there has been concern about the risk of myocarditis and other thromboembolic events following vaccination, this analysis highlights that the risk of such complications is notably higher when it comes from the SARS-CoV-2 infection itself,” Dr. John Brownstein, the chief innovation officer at Boston Children’s Hospital, told ABC News.
The results of the study show that a COVID-19 vaccination reduced the risk of cardiac and thromboembolic outcomes after a COVID infection. The effects were more pronounced in the few weeks following the infection, but are “consistent with known reductions in disease severity following breakthrough versus unvaccinated SARS-CoV-2 infection,” the study found.
The Centers for Disease Control and Prevention (CDC) recommends adults 65 years and older get an updated vaccine. The CDC released a report that the most recent vaccines from the fall were found to be 54 percent effective at preventing symptomatic infections among adults.
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Public health communicators have tried numerous methods to encourage people to accept COVID-19 vaccinations and boosters. And while some messages were ineffective, new University of Kansas research discovered a specific type of narrative messagea conversion messagecan directly improve attitudes and indirectly reduce resistance among people who have never been inoculated for COVID-19.
The experimental study also found that people were persuaded differently depending on their pre-treatment levels of general vaccine hesitancy beliefs.
Researchers tested two-sided conversion messagesin which a person told a story about how they were initially resistant to getting vaccinated for COVID-19 but eventually refuted these beliefs and changed their mind after infectionagainst one-sided advocacy messages, in which people said they always intended to get vaccinated after contracting COVID-19. The results confirmed that conversion messages improved attitudes.
Jeff Conlin, assistant professor of journalism & mass communications, led the study, in which participants were randomly assigned one of three conversion messages or one of three advocacy messages. After reading the message, participants answered questions assessing how they perceived the strength of the argument and the extent to which the author of the message was similar to themselves.
"Overall, compared to advocacy messages, conversion messages were more effective in increasing positive attitudes toward COVID-19 vaccines. Since the entire sample was unvaccinated, we were also interested in how conversion messages could reduce their resistance," Conlin said. "Our findings revealed the route to decreasing resistance was circuitous but also significant."
The researchers employed an analytical method called structural equation modeling to reduce measurement error and understand the broader relationships, or paths, between message manipulations and cognitive variables. The analysis showed significant indirect effects of conversion messages on resistance to vaccination through intervening cognitive processes.
Results in the final accepted structural equation model showed that resistance was significantly reduced following conversion message exposure through a path that initially included homophily or participants' perceived similarity of the author to themselves. It was then tested through argument strength, or participants' assessment of how convincing the message seemed, and finally, through elevated attitudes about COVID-19 vaccination.
"We wanted to understand better the relationships between intervening variables, or what was happening after message exposure but before people formed their attitudes and resistance intentions because these constructs represent different mechanisms of cognitive processingfast and slow thinking," Conlin said.
The authors' explanation for the results was that there was likely a high degree of matching between the conversion message author's perceived psychological state and the beliefs held by the unvaccinated sample. As participants moved from homophily, or from a less effortful mode of fast-processing to argument strength, an effortful slow-scrutinizing process, they may have recognized that their judgment about vaccination was called into question.
More effortful processing was needed to compensate for a reduction in their confidence in self-judgments, which resulted in a need to evaluate the arguments in the message more closely.
"What's interesting is that participants were not just relying on a mental shortcut of recognizing the similarity between the author and themselves before forming attitudes and intentionsthey were also scrutinizing the argument," Conlin said. "Ultimately, participants found the outcome of the message was acceptable. Along with increasing positive attitudes, these results showed that participants' intentions to resist COVID-19 vaccines were indirectly reduced."
The researchers also found different indirect routes to reduce vaccination resistance depending on participants' self-reported levels of general vaccine hesitancy. Participants who exhibited higher levels of hesitancy (prior to receiving the message treatment) showed reduced resistance through homophily, followed by argument strength.
Meanwhile, participants who exhibited lower levels of vaccine hesitancy used only argument strength, not homophily, when processing the message. For this group, however, indirect message effects on intentions to resist were not significant.
According to the authors, the findings lend empirical support to established dual processing theories such as the Heuristic Systematic Model that describe additive and biased serial processing, which also can be applied to practice.
Practically speaking, if public health communicators know that both types of processing occur serially, as opposed to simultaneously, and that homophily plays a default role, they can look for matches between a storyteller with a compelling conversion story and the target audience, Conlin said.
"What the author of the conversion message reveals about their former beliefs should overlap with current beliefs held by the target audience. Not only that, but the reasons the author shares about their conversion experience need to be convincing and well-told," he said.
The research is published in the journal Health Communication.
The work builds on research Conlin and colleagues previously conducted that showed two-sided conversion messages were more effective in persuading vaccine-hesitant participants than one-sided advocacy messages prior to the mass availability of vaccines.
More information: Jeff Conlin et al, Re-Routing Persuasion: How Conversion Messages Boost Attitudes and Reduce Resistance Among Holdouts Unvaccinated for COVID-19, Health Communication (2023). DOI: 10.1080/10410236.2023.2289280
