In your recent article, Far more Maryland students are missing too much school, an important topic isnt addressed: absences due to illness. Focusing on attendance might be harming children who need to rest and recover from seasonal and other infections.
Studies show that schools ranked highest as public sources of COVID-19 exposure, and 1 in 6 children have persistent COVID symptoms for three months after infection. Most infections in children are asymptomatic, but chronic symptoms may still develop in the absence of acute symptoms. We must protect children in school settings.
Clean air, high-quality masks and encouraging staying home when sick can substantially reduce acute and chronic illness. The only way to prevent long COVID is to prevent COVID infection.
Long COVID is an umbrella term describing long-term effects after acute COVID infection. Nearly half of those with long COVID meet the diagnostic criteria for myalgic encephalomyelitis (ME or ME/CFS), a chronic neurologic disease. No approved treatments exist for ME or long COVID.
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As a child with undiagnosed ME, I pushed through symptoms to meet attendance requirements in school. I continued this pattern in university and work settings until I became permanently disabled. I wish I had received more encouragement to rest and recover and more guidance on managing symptoms.
#MEAction Maryland is advocating for our news publications, elected officials and health department leaders to communicate the risks for long-term effects after infection. We urge you to encourage readers to rest and stay home while sick to limit spread and prevent long-term illness.
Whitney Fox, Windsor Mill
Whitney Fox is the co-chair and co-founder of the #MEAction Maryland State Chapter.
The Baltimore Banner welcomes opinion pieces and letters to the editor. Please send submissions to communityvoices@thebaltimorebanner.com or letters@thebaltimorebanner.com.
EDITOR'S NOTE: This story was originally published Jan. 24, 2024.
RICHMOND, Va. -- John Bolecek's family loves being outdoors.
"I was a huge cyclist, I built my career off of it," Bolecek said. "I mean, I love to be interactive with my kids too. We would ride bikes down to Belle Isle to the kid's mountain bike skills course all the time."
Provided to WTVR
Bolecek, who used to work for the Virginia Department of Transportation as a planner for pedestrian and cyclist projects, moved to Richmond's Oregon Hill neighborhood to be able to ride his bike close to the James River and to his job downtown.
Unfortunately, it's something he doesn't do anymore.
"It was a joy to be able to teach my youngest son how to ride his bike, and it's a tragedy to me that I can't be active with my children right now," he explained.
Provided to WTVR
About two years ago, Bolecek's family was infected with COVID-19. He explained he was vaccinated and boosted at the time, only suffered a mild infection, and expected to eventually get over the infection.
He never did.
"I started waking up feeling like I hadn't gone to sleep at all," he explained. "So I would sleep eight solid hours, and then wake up and I was like, 'I feel horrible right now.' And that feeling has never gone away."
Bolecek said he felt as if he was progressively getting weaker. In April 2022, his symptoms worsened.
"My body just slowly shut down. I got so weak that I could barely walk from my bed to the bathroom. I couldn't sleep, I couldn't think," Bolecek explained. "And that permanently lowered my baseline."
Provided to WTVR
His doctors told him the symptoms were brought on by his COVID infection.
"It's been very challenging getting medical care," he explained. "There's no specialist for Long COVID. My symptoms exactly match what's called myalgic encephalomyelitis, and there's very, very few specialists for that, in this country."
Bolecek explained the process of through research studies, even traveling out of state to be seen by researchers.
One research study found he had the cardiovascular capacity to take in oxygen at the rate of a 94-year-old.
WTVR
Now, the 40-year-old has to track how far he walks, trying not to overexert himself.
"Some of the most nervous I've been, is a situation where there's nowhere to sit or I have to go somewhere, and I don't know how long it is," he explained.
Bolecek is not alone. Roughly one in eight people who are infected with COVID-19 will likely experience a Long COVID symptom. Over 200 symptoms have been reported and researched, some of the most common including, fatigue, a linger cough, shortness of breath, and loss of taste or smell.
Provided to WTVR
Why are some people getting them? Why are some people recovering quickly? What is about these, this individual, where the symptoms are persisting? Or is it something about a certain population of people? And so were really digging deeply into that question," Dr. Patricia Kinser, the Assistant Dean of Research at VCU's School of Nursing.
VCU is conducting its own studies on Long COVID symptoms, including the RECOVERkids research study focusing on COVID-19's impacts on children.
"It's heartbreaking. A lot of families are at their wit's end about how to get help for these children," Kinser said.
Kinser and Dr. Amy Salisbury, the Associate Dean for Research and a Professor at VCU's School of Nursing, said more participants are needed for research studies, to help not only better understand Long COVID, but other viruses that can impact those infected in a similar manner.
Provided to WTVR
"I think thats what its going to take, is people to keep interested, keep asking these questions, so that the lawmakers and people who are in that position of making decisions know that this is real, and that this is really impacting so many people," Salisbury said.
Bolecek traveled to Washington, D.C. alongside Senator Tim Kaine, who's experienced Long COVID, and others impacted, vouching for permanent funding for national research.
WTVR
Ive been dealing with long COVID symptoms for about 4 years now," Senator Tim Kaine said Wednesday. "I'm going to be battling for it in the appropriations bill, I have a couple pieces of Long COVID legislation that are bi-partisan."
That's why we need treatment is because there's, there's millions of people suffering. And, you know, it's a strain on the economy, it's a strain on families. And the sooner we can get people, you know, treatment that improves their quality of life, you know, the better it will be for everyone," Bolecek said.
Provided to WTVR
I think thats what its going to take, is people to keep interested, keep asking these questions, so that the lawmakers and people who are in that position of making decisions know that this is real, and that this is really impacting so many people," Salisbury said.
People interested in joining VCU's RECOVERkids program can find more information here.
Depend on CBS 6 News and WTVR.com for in-depth coverage of this important local story. Anyone with more information canemail newstips@wtvr.com to send a tip.
Difficulty: Summiteer (Lexile 1010-1200)
Hong Kong medical experts expect an increase in Covid-19 cases in the next two months. They are asking people who are considered high-risk to get the latest vaccine jabs before the Lunar New Year begins.
Professor Ivan Hung Fan-ngai works at the University of Hong Kong (HKU). He said the rise in Covid-19 cases could affect vulnerable groups such as elderly people, children and people whose bodies struggle to fight disease.
He added that everyone should get another jab, but high-risk groups should prioritise it as they are more likely to be hospitalised or die from Covid-19.
Hung encouraged high-risk groups to get the latest vaccine targeting the XBB virus variant soon. This will give their immune systems time to strengthen before the holiday. This XBB-targeting jab is also effective against the JN.1 strain. The scholar said this vaccine offered a much better boosting effect of up to about 20 to 30 times.
Medical experts also recommended people get mixed jabs. For example, people who got the Sinovac jab could get BioNTech or Moderna mRNA booster shots next.
Some studies actually showed that if you have been receiving BioNTech and cross over to receive the Moderna vaccine, the antibody ... is even better, Hung noted.
When do Hong Kong medical experts expect a rise in Covid-19 cases?
Which types of people are considered to be high risk?
Why does Professor Hung recommend that vulnerable groups get the latest vaccine as soon as possible?
According to medical experts, what is the purpose of getting mixed jabs?
Hong Kong medical experts expect a rise in Covid-19 cases over the next two months.
Elderly people, children and people who struggle to fight off infections are considered high risk.
Getting the latest vaccine as soon as possible will help their immune systems to strengthen before the holiday. The latest jab will also protect from the newer virus strains.
Getting a Covid-19 booster made by a different company compared to their initial shots could make the antibody better, meaning it can help us fight off infection.
The omicron variant of COVID-19 poses enormous challenges for governments. In America, cases are at three times their previous peak in January 2021, hospitals are as busy as they have ever been and deaths have risen by 40% in two weeks to 1,800 per day. Meanwhile, China has recorded just one death from COVID in the past 12 months and fewer than 17,000 cases.
Xi Jinping, Chinas president, hails its record on COVID-19 as proof of the superiority of the one-party system. But his strategy has necessitated strict border controls and severe lockdowns for cities that suffer an outbreak. The 13m residents of Xian, a city in western China, have been confined to their homes since December 23rd. Another 10m are subject to lockdowns elsewhere in the country.
To determine how life has been upended by COVID-19, The Economist devised a global normalcy index. It tracks day-to-day behaviour relating to eight indicators split into three categories: transport, recreation and commercial activity. The index monitors 50 countries, which together account for 75% of the global population and 90% of GDP. Our overall global index is a population-weighted average of the country scores which are, in turn, an average of the eight indicators, where 100 is equivalent to the pre-pandemic norm.
Our overall index stands at 75 points, up from a nadir of 35 points in April 2020. China scores 66 points, placing it 34th in our table, which is topped by Egypt and Pakistanthe only two countries where normalcy is higher than 100, suggesting that activity is above pre-pandemic levels. Normalcy is lowest in the Netherlands, which shut bars, restaurants and many shops in December to reduce infections. America, despite its high infection rate and the pressure on hospitals, scores 70 points, placing it 26th.
Over the past four weeks normalcy has declined in 42 of the countries we track as they reel from the spread of Omicron. But compared with January last year, when few people were vaccinated, it has improved in 47 of the 50 countries, by an average of 22 points. Vaccines have given governments room to loosen restrictions. Britains government hopes to remove most covid rules in England by the end of March, including mandatory self-isolation for those testing positive.
China is one of three countries where normalcy is lower today than it was a year ago. Vietnam imposed stern restrictions last June in response to a surge in cases and is now normalising again. New Zealand had a zero-covid policy in January 2021, under which life continued largely as normal, albeit with strict border controls. It abandoned that approach in October after it was hit by a wave of Delta infections that it could not suppress, and has now adopted a traffic-light system of restrictions. But although 90% of Chinas adults are double-vaccinated, there is no sign that its government plans to follow the same path. That may be because it does not trust the efficacy of its domestically produced vaccines, particularly when faced with a variant that is at least twice as transmissible as the last.
Omicron is likely to expose any gaps in Chinas defences. Cases, still mostly Delta, have spread slowly around the country in recent weeks. Tianjin, a city 110km from Beijing, has recorded 365 infections over the past fortnight. On January 15th an Omicron case was discovered in Beijing. The citys health authorities blamed it on a contaminated parcel from Canada, echoing the central governments anti-Western propaganda. They will hope it is an isolated incident. Beijing can ill afford restrictions as it prepares to host the Winter Olympic Games, beginning on February 4th.
For a look behind the scenes of our data journalism, sign up to Off the Charts, our weekly newsletter.
2023, The Economist Newspaper Limited. All rights reserved. From The Economist, published under licence. The original content can be found on www.economist.com
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Mostly its criminal dockets still affected at this point
Today at 1:00 a.m.
by Ron Wood
FAYETTEVILLE -- Courts around Northwest Arkansas have been playing catch-up since reopening after the covid-19 pandemic largely shuttered them for more than a year.
"I cannot say we're caught up, and I can't tell you how long it's going to be, but we're doing the best we can," said Washington County...
If you've tried to look up the number of COVID cases in your area recently, you may have found it a frustrating exercise.
The reporting frequency in states and territories has been slowing down, from daily to weekly, and now fortnightly or monthly.
On top of that, what do the numbers even mean now? And how many are being missed?
It's been a long time since we were asked to get a PCR test at the slightest sign of a tickly throat.
Now, the vast majority of cases are going undiagnosed or unreported.
That degradation in data quality is visible for everyone to see, and it's no surprise: it would've been a big ask for us to keep up the COVID surveillance effort of 2020 and 2021 forever.
Likewise, behind the scenes governments have been steadily dismantling many other elements of a surveillance system that we were so reliant on in the emergency period of the COVID-19 pandemic.
Some public health experts think it's a shame that we're apparently returning back to the pre-pandemic ways we handled respiratory disease, after we've learned so much.
The most recent thing to be discontinued is a weekly series of forecasts and "situational assessment reports" for federal and state officials.
The federal government had been contracting a group of mathematical modellers across multiple institutions to produce it, and it was one of the key regular pieces of advice they received.
The forecasts gave assessments of the COVID situation, including estimates for the effective reproduction number and transmission potential in each state and territory.
But the government has decided not to continue with that work, and in December, the contract ended.
The health department says the forecasting was in place for the emergency response phase, and has been ended given that COVID-19 is no longer a "Communicable Disease Incident of National Significance".
Professor James Wood from the UNSW school of population health was one of the researchers involved in the work. "I'm not surprised," he says. "For some time, the government hasn't been changing its decisions based on the epidemiological or modelling reports.
"Whether or not cases were going up might be of interest in terms of planning to some extent but hospital capacity wasn't being continuously strained and so on, so I think the value of it in the short term was less for government."
It's a return toward our pre-pandemic approach to respiratory disease, and that's precisely the strategy: ministers and health officers have been saying for a long time that COVID is now being managed consistent with other communicable diseases like flu.
But some experts argue that we could use the lessons from COVID to do a much better job of tracking and managing flu than we did before.
"It does leave a gap in terms of epidemic intelligence and what's happening not only with COVID, but flu and RSV and probably in the next year or two, whooping cough as well will be one we'll want to watch," Professor Wood says.
In 2022 the US went through a "tripledemic", where COVID, the flu and RSV all circulated simultaneously in high numbers.
The reality now is that when respiratory diseases are putting pressure on health systems, it won't be because of a single pathogen. It could be several at once.
In the journal Emerging Infectious Diseasesthis month, a group of public health experts called it a "critical time" to review disease surveillance practices, suggesting an "integrated model of surveillance" that considers multiple respiratory viruses.
"Resuming pathogen-specific surveillance approaches, such as those for monitoring influenza, would represent a missed opportunity to build on learnings from emergency response efforts," the authors wrote.
And ongoing surveillance is important if you want to catch emerging waves, new variants of concern, and entirely new pandemics early.
In order to monitor trends you have to monitor the inter-epidemic period as well the emergency period.
If you only stand things up when concerns arise overseas, you run the risk of acting too late.
Professor Wood states it more clearly: "We don't have a clear forward plan."
"We've missed a little bit of an opportunity while COVID was in front of everyone's minds to initiate more changes."
The government says something is in the works, and that a National Surveillance Plan for COVID-19, influenza, and RSV is being developed.
"As part of this development process, a comprehensive review of national viral respiratory infection surveillance is being undertaken, including an assessment of current gaps in surveillance, potential novel and/or enhanced surveillance systems and data sources to fill these gaps, and the benefits and limitations of each," the health department says.
"This will include an assessment of the cost-effectiveness and sustainability of population prevalence surveys within the Australian surveillance context."
Professor Wood says this is all happening while COVID-19 continues to have a significant impact.
"Obviously, we're very glad that it's dropped from being something where we were worried about losing 100,000 lives a year in the initial phase, to 15,000 in the Omicron year to maybe 5,000 last year," he says.
"It's a lot better, but that's still worse than flu, right?"
"I do think we have an opportunity here to take that a bit more seriously in terms of how we view it, how we measure it, and how we advise the community on how to deal with it."
Outside Australia, governments have clearly recognised the value of forecasting in public health.
In the US, the Centers for Disease Control and Prevention announced more than US$250 million over five years to establish a network of infectious disease forecasting centres.
That's one of the actions of the CDC's Center for Forecasting and Outbreak Analytics.
It was launched in 2022, directly in response to the COVID-19 pandemic.
The European Union's equivalent to the American CDC, the ECDC, also launched a respiratory forecasting programlate last year.
It shows how other countries are investing in the intelligence that they saw had value through the pandemic, and seemingly prioritising it more than Australia.
The Australian government is in the process of setting up a CDC here. It exists in interim form right now, with staff recruitment expected to happen this year.
That body may have some role in respiratory forecasting, but it is still in its infancy.
The health department says it is now focusing on "the adoption of novel and cost-effective surveillance strategies, with a reduced focus on case notifications".
"The use of sentinel surveillance, healthcare utilisation data, genomic sequencing, and wastewater analysis will allow us to shift our surveillance approach to a more sustainable and integrated system that is more appropriate to the current epidemiological situation," the department said in response to the ABC's questions.
Wastewater analysis was one of the big new developments of the COVID pandemic, but Professor Wood says there's a bit of work to do before we can rely more heavily on it.
"Tools like wastewater or some of the surveys like flu tracking may be promising ways to do this, but they haven't been validated," he says.
"And until we invest in doing some actual prevalence surveys and comparing with a known technique where we know the percentage positive and so on, we're not really confident that this is actually consistently a good measure.
"We don't know. There's been some slightly weird results to wastewater in Europe in the most recent wave."
In the meantime, modellers and public health experts plan to continue some of their work.
"Myself and others in Australia are going to continue to do some forecasting this year," Wood says.
"But we have to set up new data agreements with state carriers, we have to rely on them being interested, and we'll have to find some way to make this something we can continue to fund."
by Timothy McQuiston, Vermont Business Magazine COVID-19 cases and hospitalizations remained relatively low last week after a long period of edging higher from last summer through early January. Cases and hospitalizations increased slightly for the week. However, fatalities have not seen a related spike nor decline. Deaths reported by the Vermont Department of Health continue to average about 6 a week, for a pandemic total now of 1,112 as of January 20, 2024 (the most recent data available). Total deaths in January are 23 so far and are nearing a monthly level not seen in a full year.
The VDH reported January 31, 2024, that COVID-19 hospitalizations were up 7 last week to a statewide total of 46. COVID-19 activity remains in the "Low" range, according to the VDH. Reported cases last week were 307, up 32 for the week.
Of the total deaths to date, 895 have been of Vermonters 70 or older. There have been 3 deaths of Vermonters under 30 since the beginning of the pandemic.
CDC states that already an estimated 97% of Americans have some level of immunity, from either vaccination or infection or both, which they said will help keep down new transmission and lessen serious outcomes.
New COVID-19 variant JN.1: Experts explain symptoms, how to spot and treat the new strain
(see data tables below)
Report Timeframe: January 21 to January 27, 2024
The hospitalizations dataset contains day-level data reported from all Vermont hospitals each Tuesday. Reported numbers are subject to correction.
The number of reportable COVID-19 cases is still available in this report, below. Laboratory-confirmed and diagnosed COVID-19 cases and COVID-19 outbreaks must still be reported to the Vermont Department of Health.
There were 4 outbreaks last week, 1 at schools, and 3 at long-term care facilities (LTC). There were 9 outbreaks the week before.
Vermont Department of Health recommendations: Preventing COVID-19 (healthvermont.gov)
Vermont has the second lowest fatality rate in the US (128.7 per 100K; Hawaii 102.5/100K). Mississippi (441.1/100K) and Oklahoma (438.7/100K) have the highest rates. The US average is 294.1/100K (CDC data).
There has been a total of 1,174,626 COVID-related deaths to date in the US (CDC) and 7,023,271 globally (WHO).
Following an analysis of COVID-19 data, the VDH reported in January 2023 a cumulative 86 additional COVID-associated deaths that occurred over the course of the pandemic but had not been previously reported. Most of those deaths occurred in 2022.
COVID-19 Update for the United States
Early Indicators
Test Positivity
% Test Positivity
6.3%
(January 21 to January 27, 2024)
Trend in % Test Positivity
-4.6% in most recent week
Emergency Department Visits
% Diagnosed as COVID-19
2.0%
(January 21 to January 27, 2024)
Trend in % Emergency Department Visits
-11% in most recent week
These early indicators represent a portion of national COVID-19 tests and emergency department visits. Wastewater information also provides early indicators of spread.
Severity Indicators
Hospitalizations
Hospital Admissions
22,636
(January 21 to January 27, 2024)
Trend in Hospital Admissions
-10.9% in most recent week
Deaths
% of All Deaths in U.S. Due to COVID-19
3.6%
(January 21 to January 27, 2024)
Trend in % COVID-19 Deaths
No change in most recent week
Total Hospitalizations
6,771,932
CDC | Test Positivity data through: January 27, 2024; Emergency Department Visit data through: January 27, 2024; Hospitalization data through: January 27, 2024; Death data through: January 27, 2024. Posted: February 2, 2024 12:00 PM ET
The Delta variant took off in August 2021, which resulted in the heaviest number of deaths before vaccines and their boosters helped alleviate serious COVID cases. Multiple Omicron variants are now circulating and appear more virulent than previous variants, but perhaps not more dangerous, according to the CDC.
AP April 5, 2023: WHO downgrades COVID pandemic, says it's no longer a global health emergency
Walk-in vaccination clinics run by the state closed on January 31, 2023. Learn more
Vermonters are reminded that all state COVID testing sites were closed as of June 25, 2022. PCR and take-home tests are available through doctors' offices, pharmacies and via mail from the federal government. The federal government officially ended its pandemic response as of May 11, 2023. See more information BELOW or here: https://www.healthvermont.gov/covid-19/testing.
Starting May 11, 2023, the CDC and Vermont Department of Health will no longer use the COVID-19 Community Level to measure COVID-19 activity in the U.S. and Vermont. Instead, Vermont's statewide COVID-19 level will be measured by the rate of COVID-19 in people being admitted to the hospital, per 100,000 residents.
Focusing on hospitalization data is a better estimate of how COVID-19 is impacting the community now that reported COVID-19 cases represent a smaller proportion of actual infections. This also allows us to compare Vermonts hospitalization levels with other parts of the country.
The Delta variant caused a surge in COVID-related fatalities last fall and into the winter.
The highest concentration of deaths was from September 2021 through February 2022. Overall, December 2020 and January 2022 were the worst months with 72 fatalities each.
The US confirmed its first case of COVID-19 on January 20, 2020.
Vermonters ages 6 months and older are eligible for COVID-19 vaccines. Getting vaccinated against COVID-19 is the safer way to build protection from serious illnesseven for those who have already had COVID-19. Learn more about COVID-19 vaccines (CDC)
COVID-19 vaccines are free and widely available. Anyone can get vaccinated in Vermont, including those who live in another state, are non-U.S. citizens, or who have no insurance. See Vermont's current vaccine rates
Know your rights when getting free vaccines.
You are considered up-to-date if you are over the age of 6 years old and have received a bivalent (updated) COVID-19 vaccine.Learn more about kid vaccines
If you are unable or choose not to get a recommended bivalent mRNA vaccine, you will be up to date if you received the Novavax COVID-19 vaccine doses approved for your age group.
Find more on recommended doses from CDC
COVID Vaccine Information for Health Care Professionals
More on COVID-19 Vaccines (CDC)
Recommended COVID Vaccine Doses (CDC)
Find a COVID-19 vaccine near you.
Image
Use Vaccines.gov to find a location near you, then call or visit the location's website to make an appointment.
Vaccines.gov
Everyone 6 months of age and older is eligible to get a COVID-19 vaccination.Most children are also now eligible for a bivalent dose that offers increased protection against the original strain and omicron variants.
See more on recommended vaccine doses by age group (CDC)
Resources for parents and caregivers
https://www.vermontfamilynetwork.org/ccfk/
Tips for Helping Kids Feel Ready for Any Vaccine (Vermont Family Network)
#factsheet
What Families with Children Should Know About COVID-19 Vaccines (translated)
https://www.youtube.com/watch?v=lWcqHOgQIVg&t=5s
Conversations About COVID-19 Vaccines for Children with Vermont Pediatricians (American Academy of Pediatrics)
If you cannot get vaccines through any of the options above, our local health offices
offer immunization clinics by appointment.
Need a ride? If you do not have transportation to get a free COVID-19 vaccine or booster, please contact your local public transportation provider or callVermont Public Transportation Association (VPTA)
at 833-387-7200.
English language learners, or immigrant or refugee community members, who would like to learn about more about vaccine clinics can contact theAssociation of Africans Living in Vermont
(AALV) at 802-985-3106.
If you lost your vaccine card or your information is wrong:
Recommendations for keeping your vaccination card and record up to date
Find more COVID-19 translations
COVID-19 resources for people who are deaf and hard of hearing
Report your COVID-19 test results
Study shows increase in STIs in adolescents during the COVID-19 pandemic: New Africa - stock.adobe.com
In the United States, nearly 1 in 4 female adolescents and young adults test positive for sexually transmitted infections (STIs) annually, a statistic made even more troubling by the fact that these young women often avoid health care due to cost, transportation, and confidentiality concerns. With more than 33% of adolescents reporting no primary care provider, this demographic often relies on emergency departments (EDs) and inpatient (IP) settings for their health care needs.
With the COVID-19 pandemic having decreased healthcare access in the United States, adolescents at risk for sexually transmitted diseases were further compromised. At the time, health experts warned of adverse outcomes on sexual and reproductive health (SRH) for adolescents.
Recently, a study published in Hospital Pediatrics compared changes in STI diagnoses during adolescent visits at childrens hospitals during the COVID-19 pandemic to diagnoses before the pandemic. Investigators conducted the retrospective cohort study using the Pediatric Health Information System database comparing adolescent (aged 11 to 18 years) hospital visits with an STI diagnosis by the International Classification of Diseases, 10th revision, during COVID-19 from 2020 to pre-COVID-19 (2017 through 2019).
A total of 2,747,135 adolescent visits from 44 hospitals in the United States were studied, of which 10,941 resulted in an STI diagnosis. The majority (54.5%) of the STI diagnoses were the primary diagnosis: an STI was the primary diagnosis for 36% of IP visits and 66% of ED visits. Where an STI was a secondary diagnosis, the most common primary diagnoses included urinary tract infections, sepsis, acute vaginitis, and unspecified abdominal pain.
During the summer of 2020, compared to the pre-COVID-19 period, there was an increase (30.4%) in median inpatient weekly visits overall with an STI diagnosis, as well as an increase in visits in fall 2020 (27.3%). Investigators also acknowledged that other recent studies have shown decreased STI testing and increased STI diagnoses in various clinical settings during COVID-19 periods of 2020. Our findings may be partially driven by changes in health care utilization (eg, loss of primary care access and school-based sexual education) and increased reliance on nontraditional settings for SRH care, including hospital-based care, noted the authors.
Researchers concluded that as a result of this increase in adolescent inpatient visits with an STI diagnosis in 2020, further work is needed to improve STI care, particularly for this demographic. In the study, the authors noted, Given our findings and recent literature on SRH care of adolescents during COVID-19, efforts are needed to optimize SRH care and offset risk for increased STIsto prepare for future pandemics. To optimize STI testing and treatment, innovative efforts are needed, including virtual and in-person outreach, to increase adolescent access to SRH education and care. These efforts are instrumental to reduce the risk for STIs among adolescents cared for in the hospital with the potential to improve related health outcomesin future health care crises.
Reference
Masonbrink AR, Abella M, Hall M, Gooding HC, Burger RK, Goyal MK. Sexually transmitted infection diagnoses at childrens hospitals during COVID-19. Hosp Pediatr. 2024;14(1):e1-35. doi:10.1542/hpeds.2022-006750
A patient receiving a COVID-19 vaccine.
(Adobe Stock 639765475 by Talia Mdlungu/peopleimages.com)
Despite the appearance of the public emergency waning, the battle against COVID-19 persists. An integral aspect of this ongoing struggle involves the tireless global pursuit of novel vaccines. The quest for innovative and effective vaccine candidates remains crucial in fortifying our defenses against the virus, adapting to emerging variants, and achieving comprehensive immunity in the face of the pandemics evolving challenges. This commitment to exploring new vaccine possibilities underscores the collective determination to safeguard communities worldwide and mitigate the long-term impact of the COVID-19 threat.
Answering questions from Infection Control Today (ICT) about the groundbreaking approval of ARCT-154, the world's first self-amplifying mRNA (sa-mRNA) COVID-19 vaccine by Japan's Ministry of Health, Jonathan Edelman, MD, Senior VP of CSL's Vaccines Innovation Unit, discusses this historic milestone. Edelman elaborates on the vaccine's significance, clinical findings, collaboration with Meiji Seika Pharma, and how sa-mRNA technology addresses challenges, ushering in a new era for vaccine platforms.
ICT: Can you elaborate on the significance of Japan's Ministry of Health, Labour and Welfare granting approval for ARCT-154, the self-amplifying mRNA (sa-mRNA) COVID-19 vaccine, and how it reflects CSL's commitment to global public health?
Jonathan Edelman, MD: This approval in Japan is a historic milestone for CSL, as it marks the worlds first self-amplifying mRNA vaccine approved for COVID-19 in adults. The milestone underscores CSLs promise to develop and deliver innovations where there is a public health need. The approval also expands CSLs comprehensive portfolio of innovative vaccines that combat respiratory viral diseases and is the first sa-mRNA vaccine.
ICT: With ARCT-154 being the first sa-mRNA vaccine in the world to be registered, how does this milestone contribute to the evolution of mRNA vaccine technology and its potential impact on protecting against COVID-19 and other infectious diseases?
JE: We believe the technology behind our novel, self-amplifying messenger RNA vaccine, ARCT-154, has the potential to create more potent cellular immune responses with increased duration of protection, all with lower doses of mRNA.
ICT: The approval is based on positive clinical data, including studies conducted in Vietnam and a Phase 3 COVID-19 booster trial. Could you share key findings from these studies and how they demonstrate the efficacy and safety profile of ARCT-154 compared to standard mRNA COVID-19 vaccines?
JE: The efficacy of ARCT-154 was established in a Phase 1,2,3 study conducted in Vietnam during the height of the Delta wave of the pandemic, showing 95% protection against severe disease, including death, and 55% protection against all infections, published on MedRxiv and under peer review currently.
The Phase 3 booster study published in The Lancet Infectious Diseases found that ARCT-154 produced a higher (noninferior) immune response after 4 weeks against the original Wuhan-Hu-1 virus and, importantly, a superior immune response against the Omicron BA4/5 variant of COVID-19 compared to the standard mRNA vaccine Comirnaty. [This was a double-blind, multicenter, randomized, controlled, phase 3, non-inferiority trial.]
ICT: CSL Seqirus partnered exclusively with Meiji Seika Pharma to distribute ARCT-154 in Japan. How does this collaboration strengthen CSL's position in providing innovative vaccines for respiratory viral diseases, especially in the ongoing global efforts to combat COVID-19?
JE: Collaborating with Meiji Seika Pharma provides a partner with the infrastructure in Japan to market and distribute our self-amplifying mRNA COVID-19 vaccine and will mark CSLs entry into the COVID-19 vaccine market with differentiated, self-amplifying mRNA technology.
ICT: The sa-mRNA technology used in ARCT-154 can potentially create more potent cellular immune responses and increase the duration of protection. Could you discuss how this innovation addresses key challenges in vaccine development and administration and what implications it may have for future vaccine platforms and strategies?
JE: One challenge with the original mRNA vaccines for COVID-19 is that their protection seems to wane within 6 months of administration, requiring frequent revaccination. A second challenge is that they have limited ability to protect against emerging variants until the vaccine is updated to that new variant. We believe sa-mRNA technology found in ARCT-154 can address both of these limitations by providing protection that lasts up to 1 year from vaccination and offering a broader range of coverage for variants of concern as evidenced by the Japan booster study and other data presented at the recent mRNA meeting in Berlin last year.
In a recent study published in Frontiers in Public Health, researchers from the United States of America (US) investigated the racial and ethnic variation in symptoms, activity level, health status, and missed work.
They assessed this via follow-ups post-initial infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the symptoms were equally prevalent among the groups, they found that three and six months post-infection, Hispanic participants reported poorer health and reduced activity compared to non-Hispanic participants.
Further, racial minority participants reported more negative impacts on health status, activity, and absence from work as compared to the White population.
The coronavirus disease 2019 (COVID-19) pandemic highlighted disparities, wherein ethnic and racial minoritized populations were observed to face greater infection risks due to the essential nature of their work, limited remote work options, and challenges in practicing social distancing.
The infected individuals faced barriers to care, including underinsurance and lack of primary care, with economic consequences. Disparities persisted in health outcomes, for example, higher hospitalization and mortality rates among Black and Hispanic populations.
Despite these challenges, recovery-related differences after SARS-CoV-2 infection remained understudied, with existing studies having limitations like varied follow-up durations, inconsistent findings, and insufficient consideration of social health determinants.
Researchers in the present study aimed to address this gap. The study assessed symptoms and health-related effects following SARS-CoV-2 infection across ethnicities and races, aiming to guide equitable health interventions effectively.
In the present study, a secondary analysis was performed using data from a US-based, prospective, multicenter, longitudinal cohort study named Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE). The primary cohort involved adults positive for SARS-CoV-2 infection enrolled from December 2020 to July 2022, along with a SARS-CoV-2-negative group for considering non-SARS-CoV-2-related effects.
A total of 3,161 participants completed enrollment and reported symptoms and other outcomes every three months via surveys. Out of these participants, 2,402 were SARS-CoV-2-positive and 759 SARS-CoV-2-negative.
Among the SARS-CoV-2-positive participants, 14.0% were Hispanic, 11.0% were Asian, 7.9% were Black, 9.9% were categorized as Other/Multiple races, and 71.1% were White. Among the SARS-CoV-2-negative participants, 16.5% were Hispanic, 14.8% were Asian, 13.1% were Black, 8.1% were categorized as Other/Multiple races, and 64% were White.
The researchers evaluated 21 COVID-19-like symptoms and "other symptoms" at enrollment and three and six months post-infection using the Centers for Disease Control and Prevention's symptom list.
During the follow-ups, health status (rated on a 5-point scale from excellent to poor), activity level compared to pre-SARS-CoV-2 symptoms (same, somewhat less, much less), and missed work in the past three months (categorized into workdays) were assessed.
Data were collected on ethnicity and race. Interactions between ethnicity or race and SARS-CoV-2 infection status were considered.
Generalized estimating equations (GEE) logistic regression was used to estimate marginal odds ratios (ORs) for various outcomes, adjusting for SARS-CoV-2 infection status, demographic factors, substance use, social determinants of health, pre-existing health conditions, COVID-19 vaccination status, and survey time point.
Post SARS-CoV-2 infection, symptoms were found to be mostly similar across ethnic and racial groups over time. At three months, Hispanic individuals had higher odds of reporting fair/poor health (OR = 1.94) and reduced activity compared to their non-Hispanic counterparts. No significant differences by ethnicity were observed at six months.
At three months, participants of Other/Multiple races had higher odds of reporting fair/poor health (OR = 1.9) and reduced activity compared to White participants. At six months, Asian participants had a greater probability of reporting fair/poor health (OR = 1.88), Black individuals reported more missed work (OR = 2.83), and Other/Multiple race participants reported more health issues (OR = 1.83), reduced activity, and missed work (OR = 2.25).
The findings help to improve our understanding of the ethnic and racial disparities in outcomes after SARS-CoV-2 infection and could be used to inform clinical and public health initiatives and policy.
However, the study is limited by small sample sizes in ethnic and racial subgroups, lack of adjustment for insurance and frontline worker status, potential participant representativeness issues, variations in response rates, lack of exploration of neurological and mental health sequelae, recruitment at different pandemic stages, and the absence of adjustments for multiple comparisons.
In conclusion, the findings suggest that while the symptom prevalence was similar among the groups, the ethnic and racial minority groups suffered adverse effects on health status, activity level, and absence from work as compared to non-Hispanic and White populations, respectively.
Examining the underlying factors contributing to these differences could aid the efforts to promote health equity and improve our preparedness for future pandemics.
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