Global life expectancy the average number of years a person can expect to live from their time of birth dropped by 1.6 years at the peak of the COVID-19 pandemic, new research shows.
Global life expectancy had been on the rise until the pandemic struck, jumping from 49 years in 1950 to more than 73 years in 2019, according to the new study, published Tuesday (March 12) in the journal The Lancet. But between 2019 and 2021, this historical trend was reversed. This time frame captures the first two years of the pandemic, in which death rates peaked.
"For adults worldwide, the COVID-19 pandemic has had a more profound impact than any event seen in half a century, including conflicts and natural disasters," lead author Austin Schumacher, an acting assistant professor of health metric sciences at the University of Washington in Seattle, said in a statement.
In 2020 and 2021 combined, approximately 16 million people died either directly from COVID-19 or from the knock-on effects of the global outbreak, which included delays in seeking health care. This excess death toll reduced global life expectancy from 73.4 years in 2019 to below 71.8 years in 2021, with stark regional differences not reflected in these global averages.
The study presents updated mortality estimates from the 2021 Global Burden of Disease Study, which quantified global health trends across places and over time. In the work, researchers analyzed data from 204 countries and territories. Of these, only 32 showed an increase in life expectancy between 2019 and 2021. Those countries included Australia, New Zealand, Japan, Iceland, Ireland and Norway, which are all high-income countries.
Related: Rare clotting effect of early COVID shots finally explained what could that mean for future vaccines?
"Life expectancy declined in 84% of countries and territories during this pandemic, demonstrating the devastating potential impacts of novel pathogens," Schumacher said.
Among countries, Peru and Bolivia had some of the largest drops in life expectancy across all age groups from 2019 to 2021, according to the statement. In addition, Mexico City saw a particularly large drop compared with other subnational locations.
When the researchers looked at age groups separately instead of lumping them all together, they found that the South African provinces of KwaZulu-Natal and Limpopo had some of the highest excess mortality rates and largest life expectancy declines in the world. These provinces have relatively young populations whose data can skew the overall life expectancy averages, so parsing the data in this way can help reveal the true impact of COVID-19 on older groups, in particular.
Accounting for the age distribution of the population in a given location also revealed high excess mortality rates in Jordan and Nicaragua, where the death toll had previously been concealed by grouping all age categories together, according to the statement.
New Zealand, Barbados, and Antigua and Barbuda, on the other hand, had some of the lowest age-adjusted excess mortality rates from the pandemic, despite life expectancy declining between 2019 and 2021 in the two Caribbean countries.
According to the study authors' estimates, the pandemic caused global mortality to jump among all people over age 15, with a 22% increase in mortality for males and a 17% increase for females between 2019 and 2021. Child mortality, on the other hand, declined by 7% during the same period, with half a million fewer deaths among children under age 5 in 2021 compared with in 2019.
"Our study suggests that, even after taking stock of the terrible loss of lives the world experienced due to the pandemic, we have made incredible progress over 72 years since 1950, with child mortality continuing to drop globally," co-lead author Hmwe Kyu, an associate professor of health metric sciences at the University of Washington, said in the statement.
Although this global trend stayed on track, stark differences in child mortality rates persisted among regions. The highest rates were recorded in South Asia and sub-Saharan Africa, even after adjusting for mortality linked to the ongoing AIDS epidemic in these regions.
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For over 70 years, humanity enjoyed a steady climb in life expectancy. From a mere 49 years in 1950, the average person could expect to live over 73 years by 2019. But a new study published in The Lancet reveals a sobering setback. The COVID-19 pandemic has reversed this trend, causing a global decline in life expectancy.
The research, led by the University of Washington, analysed data from 204 countries. Life expectancy plummeted from 73.4 years in 2019 to 71.8 years in 2021 a direct consequence of the 16 million deaths attributed to COVID-19 or its ripple effects on healthcare access. This comes as a serious blow after researchers recently revealed that climate change could reduce our life expectancy by up to six months on average.
"The pandemic's impact on global life expectancy is unlike anything we've seen in the past 50 years," stated lead author Austin Schumacher. This decline surpasses the effects of wars and natural disasters.
While this paints a concerning picture, the impact wasn't evenly felt. High-income countries like Australia, New Zealand, and Japan actually saw a rise in life expectancy, likely due to their robust healthcare systems and effective pandemic measures. But places like Bolivia and parts of South Africa experienced some of the steepest declines, particularly among younger populations. This highlights how COVID's impact goes beyond overall life expectancy, disproportionately affecting specific demographics.
Accounting for age distribution revealed additional disparities. Jordan and Nicaragua, for instance, concealed a high death toll when data was lumped together. Conversely, New Zealand and some Caribbean nations had lower age-adjusted mortality rates despite declining life expectancy.
Meanwhile, despite the grim overall picture, there's a bright spot. The study found a 7% decrease in child mortality rates between 2019 and 2021, with half a million fewer deaths of children under 5.
"Even amidst this tragedy, we've made significant progress in reducing child mortality," remarked co-lead author Hmwe Kyu. However, stark regional disparities remain, with South Asia and sub-Saharan Africa still grappling with the highest rates.
This research sheds light on the pandemic's devastating toll and highlights the need for targeted interventions to protect vulnerable populations and ensure continued progress in child health.
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1. In this retrospective study, in patients with prolonged symptoms of coronavirus disease 2019 (COVID-19), cognitive deficits lasting a year or longer were more likely to be reported.
2. The greatest associations with cognitive deficits were found in individuals affected by COVID-19 near the beginning of the pandemic and those hospitalized.
Evidence Rating Level: 2 (Good)
Study Rundown: Coronavirus disease has been implicated in having negative long-term effects such as brain fog and poor memory. In the present study, participants were tasked with completing eight cognitive tests on their devices. The cognitive aspects included immediate memory, two-dimensional mental manipulation, spatial working memory, spatial planning, verbal analogical reasoning, word definitions, information sampling, and delayed memory. Participants were separated into six groups based on their COVID-19 infection history, with category 1 meaning no COVID-19 up to category 6 meaning the presence of symptoms at least 12 weeks after infection began and had not resolved by the initiation of the cognitive assessment. Approximately 800,000 individuals aged 18 or older were invited to participate in the study by completing an online cognitive function assessment. To limit the amount of confounding, propensity-score matching was used. The studys results showed that COVID-19 infection was associated with longer-term cognitive defects. Furthermore, as the pandemic continued, the association between COVID-19 and cognitive losses decreased. The study could not assess causality as baseline cognitive data was not recorded, so cognitive change could not be measured. Overall, cognitive deficits had the strongest association with hospitalization, longer illness, and infection during the period of the original or alpha variant.
Click here to read the study in the NEJM
In-Depth [retrospective cohort]: This study included a total of 112,964 individuals who responded to an online survey. The multiple regression analysis found similar deficit results when comparing the resolved-symptoms groups with the no-COVID-19 group (e.g., in the group with resolved symptoms at <4 weeks, -0.23 SD [95% Confidence Interval [CI], -0.33 to -0.13]; and in the group with resolved symptoms at 12 weeks, -0.24 SD [95% CI, -0.36 to -0.12]). Participants who were infected with COVID-19 during either the original virus period or the alpha variant period had some of the greatest deficits in cognitive scores compared to those infected during a later variant (e.g., -0.17 SD for the alpha variant vs. the omicron variant; 95% [CI], -0.20 to -0.13). The greatest deficits were also seen when comparing the unresolved persistent symptom group to the no-COVID-19 group (-0.42 SD; 95% CI, -0.53 to -0.31) and among those hospitalized for COVID-19 compared with those not hospitalized (e.g., intensive care unit admission, -0.35 SD; 9% CI, -0.49 to -0.20). Similar deficit results were found when comparing the resolved-symptoms groups with the no-COVID-19 group (e.g., in the group with resolved symptoms at <4 weeks, -0.23 SD [95% CI, -0.33 to -0.13]; and in the group with resolved symptoms at 12 weeks, -0.24 SD [95% CI, -0.36 to -0.12]). When compared to the no-COVID-19 group, the COVID-19 group with unresolved symptoms experienced a deficit in memory, reasoning, and executive function tasks (-0.33 to -0.20 SD). Overall, COVID-19 infection may lead to cognitive deficits persisting for a year or longer.
Image: PD
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Its been four years since Maine recorded its first case of COVID-19, and far more is known today about the coronavirus that causes the disease and how to contain it.
We have come a long way since that first case in Maine, said Dr. Puthiery Va, director of the Maine Center for Disease Control and Prevention. We had minimal understanding of what the virus did and how it spread. We didnt have vaccines or treatment.
But much is still not known about why some patients develop chronic symptoms and about how to treat them. And health experts continue to warn that vaccination is the best defense.
As the coronavirus spread into Maine in March 2020, much of the world was shutting down, with limits on gatherings and mask mandates among a suite of pandemic restrictions and closures that followed. Widespread immunization began in Maine in early 2021, and more than 80% of Maine people received at least one dose of the life-saving vaccine. Restrictions were lifted over time, with the federal government ending the public health emergency last May.
Over the four years, more than 9,000 Maine people have been hospitalized with COVID-19 and 3,356 have died.
Hospitalizations and deaths still occur, but with widespread vaccination and more overall immunity in the population, they happen at a much lower rate. There were typically 50-100 people hospitalized with COVID-19 in Maine during the past few months, compared to a peak of 436 patients hospitalized statewide on Jan. 13, 2022. There were 440 deaths in Maine in 2023, compared to 1,272 deaths in 2022, according to the Maine CDC.
We have effective vaccines and treatments, Va said. The shift happened because we now have the tools. Its made COVID-19 more on par with flu in terms of hospitalizations and death.
Everyone 5 years old or older should get the updated 2023-24 vaccine if they have not already, according to the U.S. Centers for Disease Control and Prevention.People 65 and older who have not had a dose in four months or longer are recommended to receive another dose of the updated vaccine. Children between 6 months and 5 years old are eligible for one or two doses depending on previous vaccine doses.
The reduced impact of the virus is part of what led the U.S. CDC last week to eliminate isolation guidelines for those who have tested positive for COVID-19.
The agency eliminated the recommended five days of isolation for those with COVID-19 symptoms and now urges that people stay home and away from others until at least 24 hours after both their symptoms are getting better overall, and they have not had a fever (and are not using fever-reducing medication).
We can now be a little bit more flexible with COVID-19, Va said. If you are not feeling well, you should still be staying home.
LONG COVID REMAINS A PROBLEM
But while the world is in a better place in responding to COVID-19, long COVID remains a persistent problem. For some, COVID-19 symptoms remain long after the initial infection.
Dr. Clifford Rosen, principal investigator for the MaineHealth RECOVER program, which is part of a national effort to research long COVID, said about 10% of people who were infected with COVID-19 before the 2022 omicron wave developed long COVID symptoms, while about 5% to 8% of those who got infected more recently are contracting long COVID.
Symptoms of long COVID includebrain fog, fatigue, post-exertional malaise, dizziness, heart palpitations, loss of smell or taste, and chest pain.
We are making progress, but its slow and people are impatient, Rosen said. But no one should doubt that this is a real condition.
Rosen said one of the most important ways people can protect themselves against long COVID is to remain updated with their COVID-19 vaccines.
Treatments are still being researched, and Rosen said his research group is currently examining whether Paxlovid is an effective treatment for long COVID. Primary care doctors should consider prescribing Paxlovid for those with long COVID, Rosen said.
Other medications undergoing study include metformin, which is used to treat diabetes, and Immulina, a supplement that boosts the immune system.
Rosen said a proposal by Sen. Susan Collins, R-Maine, if successful, could help improve access to treatment for long COVID patients, by spending at least $5 million to establish COVID-19 Centers for Excellence. If the funding is approved, Maine could be one of the Centers for Excellence.
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The CDCs Advisory Committee on Immunization Practices made the recommendation at a February meeting that also included discussion of the chikungunya vaccine for people who work in or travel to certain environments; diphtheria, tetanus and pertussis vaccines for children; and other issues.
The AAFP has updated its Immunizations & Vaccines and COVID-19 Vaccine webpages with the latest information.
The new recommendation says people 65 or older who have already had a 2023-2024 COVID-19 vaccine should get an additional dose of an updated vaccine this spring, at least four months after the earlier immunization.
Data show that the COVID-19 virus circulates year-round, and not only in seasonal patterns like influenza and respiratory syncytial virus, though seasonal peaks in COVID-19 cases also occur along with influenza and RSV, said Pamela Rockwell, D.O., of Ann Arbor, Mich., the Academys liaison to the ACIP. It is important that older adults receive a second updated COVID-19 booster four months from their last booster since older adults show waning immunity to vaccines more quickly than younger adults and children.
An ACIP recommendation approved last fall already allows people who are moderately or severely immunocompromised to receive more than one COVID-19 booster in a given year. People who are immunocompromised must wait two months between doses, with additional doses given following a discussion with a health care professional.
The CDC also recommended chikungunya vaccination for laboratory workers with potential for exposure to chikungunya virus, and for adults who are traveling to a country or territory with a chikungunya outbreak.
In addition, chikungunya vaccination may be considered for either of the following groups of people traveling to an area that does not have an outbreak, but where there is evidence of chikungunya virus transmission among humans within the last five years:
The CDC also approved tetanus-diphtheria vaccine for children younger than age 7 for whom receipt of the pertussis component is contraindicated and updated language regarding administration of the Tdap booster in individuals ages 11 to 18 years.
The Vaccines for Children Program Information for Providers webpage has the latest information on each vaccine offered through the VFC program.
The ACIP also received updates on vaccines for influenza, polio, RSV, meningococcal disease and pneumococcal disease, and reviewed a presentation on Vaxelis, a vaccine for active immunization against diphtheria, tetanus, pertussis, poliomyelitis, hepatitis B, and invasive disease due to Haemophilus influenzae type b in children 6 weeks through 4 years of age.
Officials with the National Center for Immunization & Respiratory Diseases also gave a presentation that suggested moving up the timeline for the annual COVID-19 vaccine schedule to relieve many lead time and planning issues, and to give vaccine manufacturers more time to determine vaccine strain composition.
Rockwell agreed with the suggestion, telling AAFP News,noting that the change would increase opportunity for children to be vaccinated prior to the school year starting in the fall before they enter their classrooms, resulting in more protection for children, their families and our communities from the effects of COVID-19 communicable disease.
ACIP is expected to vote on the 2024-2025 COVID-19 vaccine recommendations in June.
Characteristics of study cohorts
Among 18,210,937 people in the pre-vaccination cohort, 1,150,299 had a COVID-19 diagnosis during follow-up of whom 75,667 (6.6%) were hospitalised. There were 844,235 COVID-19 diagnoses (15,342 (1.8%) hospitalised) among 13,572,399 people in the vaccinated cohort and 162,103 (9,250 (5.7%) hospitalised) among 3,161,485 people in the unvaccinated cohort (Table1). Among 75,667 people in the pre-vaccination cohort who were hospitalised because of COVID-19 37,881 (50.1%) were hospitalised on the day of diagnosis and 6,278 (8.3%) were hospitalised the day after diagnosis: the remainder were hospitalised 228 days after diagnosis (TableS1). In the pre-vaccination cohort, the median age was 49 years (interquartile range (IQR) 3464), a slight majority (50.2%) were female, and 78.0%, 6.4% and 2.2% were recorded as being White, South Asian and Black ethnicities respectively. Differences between the vaccinated and unvaccinated cohorts reflected predictors of COVID-19 vaccine uptake20. The median (IQR) age was 54 (IQR 3968) years in the vaccinated cohort, compared with 36 (IQR 2847) years in the unvaccinated cohort. The proportions of females were 52.1% and 42.0% in the vaccinated and unvaccinated cohorts respectively, while the proportions recorded as of White ethnicity were 82.1% and 61.6% respectively, and the proportions living in the most deprived areas were 16.4% and 29.8% respectively. Compared with the vaccinated cohort, people in the unvaccinated cohort were more likely to be smokers, less likely to consult their GPs and less likely to have prior medical problems recorded (TableS2).
The numbersof events, person-years, and incidence rates per 100,000 person-years of vascular events before any COVID-19 diagnosis, after hospitalised COVID-19 and after non-hospitalised COVID-19, are presented, for each cohort and outcome, in Table2. There was a total of 212,557, 57,425 and 3,316 ATE in the pre-vaccination, vaccinated and unvaccinated cohorts respectively. The corresponding total numbers of VTE were 117,730, 29,107 and 3,178 respectively. In each cohort, the incidence of each arterial thrombotic and venous thrombotic event was higher after COVID-19 than before or without COVID-19. For each outcome and cohort, the highest incidence rates were after hospitalised COVID-19. Incidence rates were generally lower in the unvaccinated cohort than in the vaccinated cohort, as expected given that the median age of the unvaccinated cohort (36 years) was much lower than that of the vaccinated cohort (54 years).
Adjusted hazard ratios were estimated using Cox-proportional hazards models to quantify the associations between COVID-19 diagnosis (time-varying exposure) and a first cardiovascular event including arterial thrombotic, venous thrombotic and other cardiovascular events. Minimally adjusted models accounted for age, sex and region and maximally adjusted models accounted additionally for ethnicity, area deprivation, smoking status, number of GP-patient interactions and history of comorbidities. In each cohort, maximally adjusted HRs (aHRs) comparing the incidence of each outcome after COVID-19 diagnosis with the incidence before or without COVID-19 diagnosis were attenuated compared with age-, sex- and region-adjusted HRs (Tables35, TableS3). For all outcomes, hazard ratios were extremely high on the day of COVID-19 diagnosis (day 0), particularly among individuals hospitalised with COVID-19 on the day of diagnosis. The incidence of each outcome in each cohort was also elevated during weeks 14 after COVID-19 diagnosis, compared with before or without COVID-19 diagnosis. aHRs were lower in subsequent time periods than during weeks 14 after COVID-19 diagnosis, though they were generally greater than 1 throughout follow-up in each cohort (Figs.2 and 3, Tables35). aHRs during weeks 1-4 after COVID-19 diagnosis were substantially lower in the vaccinated cohort than in the pre-vaccination and unvaccinated cohorts, and generally remained lower than in other cohorts during weeks 428 (Figs.2 and 3, Tables35). For each outcome and in each cohort, aHRs were substantially higher after hospitalised than non-hospitalised COVID-19 (Fig.2, Tables3 and 4, TableS3).
Upper panels: Maximally adjustedhazard ratios and 95% CIsfor arterial thrombotic events. Lower panels: Maximally adjustedhazard ratios and 95% CIsfor venous thrombotic events. Left panels: all COVID-19 diagnoses: Middle panels: hospitalised COVID-19. Right panels: non-hospitalised COVID-19. The numbers of people in the pre-vaccination, vaccinated and unvaccinated cohorts were 18,210,937; 13,572,399 and 3,161,485 respectively. The numbers of COVID-19 diagnoses were 1,150,299 (75,667 hospitalised) in the pre-vaccination cohort, 844,235 (15,342 hospitalised) in the vaccinated cohort and 162,103 (9250 hospitalised) in the unvaccinated cohort. Maximally adjustedhazard ratios and 95% CIsare plotted at the median time of the outcome event within each follow up period in each cohort. Events on the day of COVID-19 diagnosis (day 0) were excluded. The numerical values of hazard ratios and their95% CIs are displayed in Tables3 and 4.
Upper left panel: Acute myocardial infarction. Upper right panel: Ischaemic stroke. Second row left panel: Pulmonary embolism. Second-row right panel: Deep vein thrombosis. Third row left panel: Heart failure. Third row right panel: Angina. Lower left panel: Transient ischaemic attack. Lower right panel: Subarachnoid haemorrhage and haemorrhagic stroke. The numbers of people in the pre-vaccination, vaccinated and unvaccinated cohorts were 18,210,937; 13,572,399 and 3,161,485, respectively. The numbers of COVID-19 diagnoses was 1,150,299 in the pre-vaccination cohort, 844,235 in the vaccinated cohort and 162,103 in the unvaccinated cohort. Maximally adjustedhazard ratios and 95% CIsare plotted at the median time of the outcome event within each follow-up period in each cohort. Events on the day of COVID-19 diagnosis (day 0) were excluded. The numerical values of hazard ratios and 95% CIsare displayed in Tables3, 4 and 5.
The incidence of ATE during weeks 1-4 after COVID-19 diagnosis, compared with before or without COVID-19 diagnosis, was elevated in the pre-vaccination and unvaccinated cohorts (aHRs 4.40 (95% CI 4.164.65) and 8.53 (7.2010.1) respectively) but less markedly elevated in the vaccinated cohort (2.09 (1.922.28)) (Fig.2, Table3). The incidence of ATE remained elevated during weeks 5-28 in the unvaccinated cohort (1.54 (1.162.04)) and up to weeks 53102 in the pre-vaccination cohort (1.22 (1.141.30)). During weeks 14 the aHRs for ATE were substantially lower in the vaccinated cohort than in the unvaccinated or pre-vaccination cohorts (ratios of aHRs 0.28 (0.250.32) and 0.36 (0.330.38) respectively, TableS4). Although attenuated, aHRs remained lower in the vaccinated cohort than in the unvaccinated or pre-vaccination cohorts during weeks 528 (ratios of aHRs 0.70 (0.520.94) and 0.73 (0.660.82), respectively).
The aHRs for ATE were substantially higher during weeks 14 after hospitalised COVID-19, versus before or without COVID-19 diagnosis (pre-vaccination cohort 12.1 (11.213.1), unvaccinated cohort 19.6 (15.624.5)) than after non-hospitalised COVID-19 (pre-vaccination cohort 2.70 (2.502.92), unvaccinated cohort 4.35 (3.365.64)). In sensitivity analyses restricted to primary diagnoses of ATE, aHRs during weeks 14 after hospitalised COVID-19 (including both day 0 and the rest of that period) were attenuated compared with aHRs for all ATEs (FigureS1). Estimated hazard ratios were similar in sensitivity analyses removing censoring at first vaccination in the unvaccinated cohort (TableS5). In additional analyses splitting follow-up during weeks 1-4 into shorter time intervals, hazard ratios for ATE declined steadily from days 16 to days 2127 after COVID-19 diagnosis, in all cohorts (TableS6).
The aHRs for VTE during weeks 1-4 after COVID-19 diagnosis, versus before or without COVID-19 diagnosis, were substantially higher than for ATE, particularly in the pre-vaccination and unvaccinated cohorts (aHRs 16.6 (95% CI 15.917.2) and 29.6 (26.732.9) respectively), but less markedly in the vaccinated cohort (4.87 (4.535.23)) (Fig.2, Table4). The incidence of VTE remained elevated, compared with before or without COVID-19 diagnosis, during weeks 528 in all cohorts and up to weeks 53102 in the pre-vaccination cohort (1.20 (1.091.32)). During weeks 14 the aHRs for VTE were substantially lower in the vaccinated cohort than in the unvaccinated or pre-vaccination cohorts (ratios of aHRs 0.17 (0.150.19) and 0.24 (0.230.26) respectively, TableS4). Although attenuated, aHRs remained lower in the vaccinated cohort than in the unvaccinated or pre-vaccination cohorts during weeks 528 (ratios of aHRs0 0.63 (0.490.80) and 0.61 (0.550.68), respectively).
The aHRs for VTE were substantially higher during weeks 14 after hospitalised COVID-19 (pre-vaccination cohort 88.5 (84.193.2), vaccinated cohort 46.7 (42.251.6), unvaccinated cohort 199.8 (174.7228.5)) than after non-hospitalised COVID-19 (pre-vaccination cohort 5.99 (5.616.40), vaccinated cohort 2.13 (1.912.38), unvaccinated cohort 7.64 (6.349.20)). The incidence of VTE was still markedly elevated during weeks 528 after hospitalised COVID-19 in the pre-vaccination, vaccinated and unvaccinated cohorts (aHRs 4.39 (4.014.80), 5.67 (4.636.94) and 7.50 (5.0711.1) respectively). In sensitivity analyses restricted to primary diagnosis of VTE, aHRs after COVID-19 diagnosis were attenuated compared with aHRs for all VTEs (FigureS2). This attenuation was particularly marked during weeks 14 (including both day 0 and the rest of that period) and after hospitalised COVID-19. In additional analyses splitting follow-up during weeks 14 into shorter time intervals, hazard ratios for VTE were generally similar during days 16 and days 713 after hospitalised COVID-19, then declined during days 1420 and days 2127 (TableS6). Hazard ratios after non-hospitalised COVID-19 did not markedly decline between days 1-6 and days 2127.
In each cohort, aHRs for acute MI during weeks 14 after COVID-19 diagnosis, versus before or without COVID-19 diagnosis, were similar to those for ischaemic stroke (Fig.3, Table3). In the pre-vaccination cohort, aHRs for acute MI remained elevated during weeks 2952 (1.16 (1.091.24)) and weeks 53102 (1.31 (1.191.45)), but the incidence of ischaemic stroke was only slightly elevated from 29 weeks onwards (aHR 1.16 (1.051.27) during weeks 53102). In all cohorts, aHRs during weeks 14 were markedly higher for PE (pre-vaccination 31.7 (30.333.1)), vaccinated cohort (9.10 (8.369.90), unvaccinated cohort 82.8 (72.794.3)) than for DVT, and aHRs for PE remained higher than for DVT during weeks 528 (Fig.3, Table4). By contrast, in the pre-vaccination cohort aHRs for DVT during weeks 29102 were higher than for PE.
The incidence of heart failure, angina, and subarachnoid haemorrhage and haemorrhagic stroke during weeks 14 after COVID-19 diagnosis was substantially elevated in each cohort, versus before or without COVID-19 diagnosis, although aHRs were lower in the vaccinated cohort than the pre-vaccination or unvaccinated cohorts (Fig.3, Table5). Compared with these outcomes, the incidence of transient ischaemic attack was less markedly elevated during weeks 14. Though greater than 1, aHRs for these four outcomes were markedly lower during weeks 528 than weeks 1-4 after COVID-19 diagnosis. In the pre-vaccination cohort, the incidence of heart failure during weeks 53102 was similar to the incidence before or without COVID-19 diagnosis (aHR 1.04 (0.981.11)). The incidence of angina and transient ischaemic attack was slightly elevated (aHRs between 1.10 and 1.16) and remained elevated during weeks 29102. aHRs for subarachnoid haemorrhage and haemorrhagic stroke were 1.32 (1.141.52) during weeks 2952 and 1.42 (1.151.76) during weeks 53102.
In subgroup analyses, aHRs for both ATE and VTE were generally lower in younger age groups, in females, and in those reporting white ethnicity (TablesS7, S8, FiguresS3, S4). Estimated excess risks of ATE 6 months post-COVID-19 diagnosis were 642, 229 and 718 per 100,000 people diagnosed with COVID-19 in the pre-vaccination, vaccinated and unvaccinated cohorts respectively (Fig.4, TableS9). Corresponding estimated excess risks of VTE were 797, 270, and 1094 per 100,000 people diagnosed with COVID-19, respectively.
Upper panels: Estimated absolute increase in risk for arterial thrombotic events. Lower panels: Estimated absolute increase in risk for venous thrombotic events. Left panels: pre-vaccination cohort. Middle panels: vaccinated cohort. Right panels: unvaccinated cohort. The numbers of people in the pre-vaccination, vaccinated and unvaccinated cohorts were 18,210,937; 13,572,399 and 3,161,485 respectively. The number of COVID-19 diagnoses was 1,150,299 in the pre-vaccination cohort, 844,235 in the vaccinated cohort and 162,103 in the unvaccinated cohort. Increases in risks were estimated within sex and age groups, and the estimated overall increase in risk is the average of these(shown in black), weighted according to the proportions in each sex and age group in the pre-vaccination cohort. Estimated excess events at 28 weeks are displayed in TableS9.
It was not that long ago that collaboration between scientists, pharmaceutical manufacturers, academics, the government and others sped the creation of COVID-19 vaccines in less than a year, putting the world on a path to return to a new normalcy.
Dr. Archana Chatterjee, dean of the Chicago Medical School at Rosalind Franklin University, sits on the Federal Food and Drug Administrations Vaccines and Related Biological Products Advisory Committee which oversaw the development of the vaccine.
Chatterjee said the vaccines were developed in less than a year because some of the technology was already in place. Some shifting of methodology was necessary, but the cooperation between everyone involved helped get shots in arms in a relatively short period of time.
There were so many reasons it happened so quickly, said Chatterjee, who is also the vice president of medical affairs at Rosalind Franklin. Everyone pulled together to develop the vaccine. They worked together to secure a vaccine as soon as possible.
The development of safe, effective vaccines and (the) technology behind doing so was nothing short of a modern-day miracle, added Dr. Michael Bauer, the medical director at Northwestern Medicine Lake Forest Hospital.
The coronavirus pandemic was declared a national health emergency in the United States, and the first case was reported in Lake County four years ago this week, creating changes in the way Americans still live their lives today.
Lake County Health Department Executive Director Mark Pfister oversaw the countys effort to deal with the pandemic, protect against the disease and get people vaccinated. He spread the message of the three Ws wash your hands, watch your distance and wear a mask.
I call this the fourth anni-misery of the start of the pandemic, Pfister said. I cant call it an anniversary because Im not celebrating it. I am marking it.
Lessons learned from the pandemics three Ws continue to be practiced. Utilizing those habits makes a difference, which is one reason there were fewer cases of flu last year, he said. Pfister said those who do are, being good stewards of the community.
Many people are continuing to stay home when they are sick, wear masks, wash their hands or use hand sanitizer, he said. Thats one of the reasons we do not see that many cases. I have not had a cold in the last four years.
Though few places require wearing masks to enter, there are still signs on doors recommending people wear them or saying masks are optional. Medical facilities warn people to use a face covering if they have symptoms of a disease.
With 98% of the American population developing strong immunity to COVID-19, Pfister said it is because they received vaccinations, got the disease or both. That is why there are fewer hospitalizations and deaths.
Its not killing us anymore, he said.
Along with people developing natural immunity to COVID, Bauer said the virus has undergone mutations lowering the severity of the disease. Both Pfister and Bauer said people should continue taking the vaccine.
Fortunately, the virus has mutated and evolved into what we typically see with many other respiratory illnesses, including other coronaviruses, Bauer said. We encourage everyone to stay up to date with vaccines and other protective mechanisms, especially those at high risk.
While there were a lot of negatives during the pandemic, Pfister said there were also positives. Companies like AbbVie, Abbott and Baxter along with Rosalind Franklin, other schools, the health department and public officials banded together to get people vaccinated, he said.
Stockpiling personal protection equipment for the next time a pandemic occurs is crucial. Pfister said supply-chain issues and other situations caused critical shortages. That should be avoided. Some youngsters did not learn as much as normal through online schooling.
Some students got less education, and we need to do everything we can help them catch up, Pfister said.
Members of the medical profession had adjustments to make, Bauer said. Peoples habits changed, forcing doctors and nurses to modify what they were doing. People stopped coming to emergency rooms and medical offices for fear of getting the disease.
It literally turned the medical and hospital world upside down, Bauer said. Surgeries outside of emergency conditions were halted, and people lived in fear of dying from this new, awful disease.
Before March of 2020, Chatterjee said the medical community was aware of what was happening with the virus in China and the possibility of a spread. By spring, the FDA held discussions about a vaccine. They were virtual, no longer face-to-face. By June, they began dealing with ways to create it.
We talked about how to design the clinical testing, Chatterjee said. With the mRNA formula, there was a much faster platform. They ran clinical testing. The manufacturers got involved and started making it.
Four years ago this week, as fears were growing about a novel coronavirus, then-Massachusetts Gov. Charlie Baker declared a state of emergency. The World Health Organization declared the threat a pandemic. Businesses and schools started to close, and a new disease called COVID-19 suddenly upended our lives.
The virus has now touched just about everyone and taken a tremendous toll, contributing to nearly 22,000 deaths and more than 118,000 hospitalizations in Massachusetts alone.
Today, the social distancing era is over, and millions have received COVID vaccines. The U.S. Centers for Disease Control and Prevention recently loosened precautions by droppinga five-day isolation rule, treating COVID much like other common respiratory illnesses.
But COVID is still with us, even if it is not as dangerous as it once was, experts say, largely because so many people have built up immunity from vaccinations and prior infections.
The most recent data from Massachusetts health officials shows COVID-related emergency department visits are minimal and hospital admissions are low though hospitals remain crowded with patients suffering from other ailments.
On this fourth anniversary of the pandemic, WBUR reached out to several experts who have been on the front lines of studying and fighting COVID since its early days. Here are some of their thoughts about COVID then and now lightly edited and condensed:
Shira Doron, hospital epidemiologist, Tufts Medical Center: When I think back to what was happening four years ago, I think of it as a time when we were doing both too much and too little. We should not have allowed prolonged school closures, restrictions on the use of playgrounds and beaches, or extended delays on elective medical care to occur. At the same time, we should have had widespread testing much earlier, and we should have been more prepared to tackle supply chain and capacity shortages.
Bill Hanage, associate professor of epidemiology, Harvard T.H. Chan School of Public Health: Lots of very intense memories both professional and personal, given the far reaching impact of the pandemic on all our lives. And the truly ghastly memory of knowing the outline of what was coming at us and trying to convince people of it.
Sandeep Jubbal, infectious disease physician, UMass Memorial Medical Center: The outset of the pandemic was chaotic and stressful due to lack of treatment and vaccines, and the spread of misinformation. But the silver lining was the unprecedented global collaboration, knowledge sharing, and application of cutting-edge technology that allowed the rapid development of treatments and vaccines. Without these tools, our world would have been a very different place with mortality numbers beyond imagination.
Cassandra Pierre, infectious disease physician and associate hospital epidemiologist, Boston Medical Center: Over time, I've observed people tune out the ongoing impact of COVID for their own sanity and the need to move forward. The fact that the majority of these admissions and deaths occur among the elderly and the immunocompromised may have made COVID more predictable, tame and potentially ignorable. But the elderly and immunocompromised remain essential members of our community and our own families and even the young and healthy remain vulnerable to complications like long COVID. COVID is still impacting us, even if we're not acknowledging it.
Doron: It was anyones guess whether widespread immunity would ever bring us to the point we have reached today. I never imagined that we would have a vaccine in such a short time. So overall, I consider where we are today, after "only" four short years, to be better than I expected and a huge relief.
Hanage: On the one hand, I remain horrified at how much illness and death has been considered acceptable, here and elsewhere. On the other, Im astonished by the pace with which effective vaccines were developed and available and also the reluctance of some to make use of them leading to yet more preventable suffering and death.
Jubbal: Constant mutations are part of the natural viral evolution. The virus has had multiple variants, and may continue to evolve, but has gone "weaker." And at some point, it will die away, as we have seen historically with other coronaviruses.
Doron: Immunity is long-lasting, and it is working to protect us against severe disease. This has been the case despite the ongoing emergence of new variants. That gives me hope. What I am pessimistic about is trust in public health. We are seeing dangerously low levels of vaccination. Polls show that people dont want to listen to health authorities any more.
Hanage: I expect that bit by bit, the population immunity to COVID will continue to improve, and severe outcomes will dwindle although I dont know how long that will take. I am pessimistic that the reaction to the pandemic will be to withdraw resources from public health rather than renew them.
Pierre: I'm feeling optimistic and pessimistic about the same thing: vaccines. Optimistic because the pandemic did create the ideal conditions for the acceleration of vaccine development. That said, we have certainly seen an erosion in vaccine confidence and acceptance. I'm concerned that we'll see the resurgence of diseases we've previously eliminated and also worried that if another pandemic-level threat appears, low vaccine acceptance will negate the benefits of a rapid and safe vaccine development.
Ottawa (Precision Vaccinations News)
The Honourable Mark Holland, Canada's Minister of Health, issued a statement today marking the fourth National Day of Observance for COVID-19.
'Today's landscape is different than it was during the pandemic. COVID-19 vaccines and treatments are now more accessible to people in Canada, making it easier for everyone to protect themselves and their families from serious illness.'
Also, on March 11, 2024, Canada's National Advisory Committee on Immunization released updated guidance regarding the use of Nuvaxovid XBB.1.5, a subunit COVID-19 vaccine produced by Novavax Inc.
According to the committee's latest recommendations, announced on March 11, 2024, Novavax Inc.'sprotein-based Nuvaxovid XBB.1.5 can be administered to individuals aged 12 and older, regardless of whether they have previously been vaccinated.
This recommendation supports efforts to provide greater access to a non-mRNA protein-based COVID-19 vaccine option and could help achieve improved immunization rates in Canada.
COVID-19 vaccinations began in Canada on December 14, 2020.
As of February 25, 2024, about 17% of Canadians had received an XBB.1.5 vaccine.
The Public Health Agency of Canada has distributed the protein-based vaccine across the regions, and provincial public health programs can advise on specific availabilities.
Two messenger ribonucleic acid (mRNA)-based COVID-19 vaccines remain available in Canada.
Data from clinical trials continue to show broad neutralization responses to currently circulating forward-drift variants, including JN.1 and JN.,4 for our protein-based non-mRNA COVID-19 vaccine while maintaining a favorable side effect profile. Novavax says peer-reviewed effectiveness data is being published to show how immune responses in clinicaltrials translate into COVID-19 prevention in the real world.
Vaccine therapy and inflammation concerns have recently come into the spotlight, especially with the roll-out of the COVID-19 vaccine. The potential occurrence of brain inflammation in both children and adults post-vaccination has been a focal point of these discussions, underscoring the need for more extensive research into the inflammatory responses triggered by the vaccine. A key voice in this dialogue is Dr. Fred Harvey, who brings to the conversation his concerns about the COVID-19 vaccine potentially leading to an increase in inflammation and the onset of neurological issues such as ADHD and autism. Dr. Harvey stresses the importance of addressing both brain and vascular inflammation in long-haul COVID patients, proposing a therapeutic approach focused on reducing inflammation. His stance has been shaped by his experience and understanding of the potential risks presented by the new vaccine therapy and the imperative to safeguard the health and well-being of those receiving the COVID-19 vaccine.
(00:07:45) Brain Inflammation Risks in Vaccine Therapy
(00:12:56) Blocking Importin in Long COVID Treatment
(00:14:55) Mevacor Therapy for Long COVID Symptoms
(00:16:20) Inflammation Reduction with Curcumin for Hypertension
(00:26:57) Reversing Cognitive Decline Through Functional Medicine
(00:31:56) Inflammation Reduction with Hydroxychloroquine
(00:37:47) Reducing Infectivity Through Mask-Wearing Practices
(00:52:54) Holistic Approaches to Health and Wellness
