As Colorado slogs through its fourth winter of the COVID-19 pandemic, a curious trend has emerged.
This season at least so far the state reached its peak for hospitalizations of people with COVID in the second-to-last week of November. Thats almost exactly when a peak happened last year. And the year before that. And the year before that.
Four years, four different predominant variants of the virus, four different levels of vaccination and immunity in the population. And four times that COVID hospitalizations began rising in late summer or early fall and, more notably, began to decline in Colorado right around Thanksgiving.
Fascinating and beguiling, is how Elizabeth Carlton, a professor of epidemiology at the Colorado School of Public Health, described the phenomenon.
I think, by now, there probably is something happening driving this pattern, she said instead of the trend being a statistical fluke.
What that something is, though, no one knows.
It is an interesting pattern, said Dr. Rachel Herlihy, the state epidemiologist at the Colorado Department of Public Health and Environment. I dont think we can fully explain it.
As it seems like everyone you know is sniffling or coughing or otherwise testing positive for something, here is what we know about Colorados current COVID trends:
Carlton said its important to remember that even if COVID levels are falling or arent as severe as in prior years, we are still in the middle of the high season for all kinds of respiratory illnesses such as flu, RSV and that weird hacky-cough virus going around this year that no one can quite seem to identify.
That means people should continue to take precautions, such as staying home if theyre not feeling well, seeking treatment when sick and considering wearing a mask in crowded places. Its also not too late to get vaccinated with an annual flu shot, an updated COVID booster or, if eligible, an RSV vaccine.
Colorados late-November COVID peaks are unusual because they tend to happen earlier than peaks across the rest of the country. Last year, hospitalizations peaked nationally in January, same as the year before.
They have also sometimes had the effect of blunting the arrival of a new variant. When a new variant called XBB.1.5 swept across the country last year, it had little impact in Colorado, perhaps because our earlier-breaking wave had built up a layer of fresh immunity in the state.
This is not always the case. In early 2022, Colorado saw a significant rebound in infections and hospitalizations in January, driven by the arrival of the original omicron variant. This years trends may prove to be a smaller-scale version of that.
But the November peak has remained a COVID constant in Colorado, sticking to a much tighter turnaround schedule than other respiratory viruses like the flu, which sometimes hits early and sometimes later in winter. It is also intriguing because, with holiday travel in late November and December, one would normally expect to see cases increasing as a result.
Carlton said shes thought of a few theories that might help explain the peaks. One possibility is weather patterns viral transmission changes as temperature and especially humidity levels do, with drier air more favorable to infection.
Were just a drier state and we know this virus seems to spread under dry conditions, she said.
The school calendar may have an impact. Colorados school year tends to start earlier than in some other states. Mobility and travel habits may also play a role say, more people heading to the mountains to go skiing or spending more time indoors.
But none of these quite fits either, she said. Some falls have been wetter than others over the past four years. And, in order for hospitalizations from COVID to start falling in late November, infections would need to begin slowing at least a couple weeks prior, before ski season and school breaks really start.
Four winters in and there is still so much left to learn about this virus.
I think what COVID has taught us is that it evolves incredibly rapidly, Carlton said. So what we think we know today may change by tomorrow.
Based on facts, either observed and verified directly by the reporter, or reported and verified from knowledgeable sources.
On Jan. 15, 2020, a male resident of Kanagawa Prefecture in his 30s who had returned from a trip to the city of Wuhan, China, was found to be infected with the coronavirus, becoming the first confirmed case of COVID-19 in Japan.
This marked the beginning of Japans four-year battle with the viral disease, which had killed over 95,000 people in the country as of last summer and is confirmed to have infected at least 33 million, though given the number of untested cases, the actual figures are very likely to be much higher.
Four years later, the nation has returned to its pre-COVID norm on most levels. Businesses have bounced back, international tourism has returned and people are enjoying life without masks in most situations, with hand sanitizers at storefronts being one of the few remnants of the pandemic habits the nation adopted.
A street painting in Mumbai, India, reinforces the importance of masks amid a surge of COVID. The photo was taken on January 11. Indranil Aditya via Reuters Connect hide caption
A street painting in Mumbai, India, reinforces the importance of masks amid a surge of COVID. The photo was taken on January 11.
We regularly answer frequently asked questions about life in the era of COVID-19. If you have a question you'd like us to consider for a future post, email us at goatsandsoda@npr.org with the subject line: "Coronavirus Questions." See an archive of our FAQs here.
New year, new COVID surge or at least that's what it feels like.
It seems like everyone I've talked to either caught COVID over the holidays or knows someone who did.
With that in mind, I decided finally to get my COVID booster (it had been about 8 months since my last dose) and flu shot.
So while sitting in bed, popping ibuprofen to deal with the post-vaccine aches and chills (pretty mild this time around, thankfully), I reached out to some experts to get the scoop on readers' latest COVID questions.
Are we really in a surge? Is this what we can expect every winter? What should I do if my whole family gets COVID? Read on for those answers and more.
Is a surge of COVID happening? With lots of folks taking at-home tests and not reporting the results, how do we know the data that's out there is accurate?
"The most reliable data shows that a surge is happening," says Jeremy Kamil, a virologist at Louisiana State University Health Shreveport.
Testing data may not be as reliable as it was a few years ago before home tests became widespread, but there are other metrics to estimate the amount of COVID circulating. For one, hospitalizations and deaths due to COVID are both up. About 5,000 people in the U.S. are being hospitalized per week, up from under 1,000 per week at the last low point in June. The weekly death toll has tripled since that point too, from around 500 a week to more than 1,600. That's got hospitals from Mass General to Johns Hopkins Medicine reinstating universal masking requirements and other precautionary measures. Abroad, governments in India, Spain and elsewhere are bringing back masks in health-care facilities.
But the clearest picture showing how much COVID is circulating among people who don't end up in the hospital (or worse) may be in the sewage.
Kamil says that wastewater surveillance "is an imperfect but highly reliable tool to show that COVID is on the uptick" over the past few months. In places like Boston, wastewater data showed COVID peaking right before the new year. And even though the wastewater data and hospital data are showing a slight dip since that latest peak, there's still plenty of COVID to go around.
Is COVID just the new flu? I've been vaccinated and had COVID in the past, why is this still a big deal?
After the last few years of crisis, it's understandable that many folks are sick of hearing about COVID. "It's four years now [since COVID first emerged], and we're starting the fifth year," says Dr. Preeti Malani, an infectious disease physician at the University of Michigan. "That's hard to believe."
But that doesn't mean we can let up on precautions entirely. The number of cases right now may be fewer than in past surges, but "relatively speaking, it's a lot," according to Dr. Abraar Karan, an infectious disease physician at Stanford, who authored our most recent coronavirus FAQ answering the question: "My partner/roommate/kid got COVID. And I didn't. How come?"
We should also be careful about underplaying the flu. Influenza has a devastating impact on people year after year, even if we don't always hear much about it. Still, the number of deaths from the flu don't come close to that of COVID: The CDC reports there have been roughly 9,500 deaths from the flu this season and approximately 34,000 deaths from COVID in the last three months.
Not everybody shares the same level of risk, of course. But while Kamil says COVID is most dangerous for elderly and immunocompromised people, he also stresses that COVID is a disease that specializes in "making healthy people sick."
Which is why even if you're young and healthy, you should consider getting a booster shot. "Boosters are really important," Kamil says. "If more Americans got them they would be avoiding the very worst that this virus can serve."
So does the uptick in COVID cases we're seeing now mean that this coronavirus is basically a seasonal disease and will surge around this time every year?
It's reasonable to think that COVID is just another bug joining our wintery mix of sicknesses. But experts stress that, unlike the flu, it's not mainly a seasonal problem.
"We had an increase [of COVID cases] in the late summer," says Dr. Karan. "So it's not exactly the same as the flu or RSV in that way." Part of the reason COVID can pop up any time of year is because of how quickly new strains can emerge and break through our immunity. The strain currently circulating most widely in the U.S. is called JN.1, and experts say it's highly transmissible.
The spread of JN.1 is helped, in no small part, by the fact that more people have been gathering indoors because of colder weather and holiday and other celebrations.
Dr. Malani expects her community to see an uptick in COVID cases for that reason. "'I'm in Ann Arbor, Michigan, where we won the [College Football Playoff National] Championship," she says. "There was a lot of indoor activity on Monday night in this town. A lot of people were packed into bars or people's living rooms, so we'll probably see some of that effect in a few days."
So even though COVID is likely to be a year-round concern, it does seem to gain strength around holidays and other big events. As Dr. Kamil puts it, "COVID has joined the team of critters that are going to be attending your Christmas party, your Thanksgiving gathering and any other kind [of gathering]."
What happens if you were celebrating with your family, and now everybody has COVID? Does each family member have to isolate from one another?
If your whole family gets COVID, our experts say, there's no need to make things harder on yourselves.
"Getting more exposed from the other individuals in your house isn't going to prolong your COVID," Kamil says. All isolating will do in that case, he says, is "cause you inconvenience and additional misery on top of feeling tired and ill."
Isolating is tough to do, especially if you have to separate from your partner and children. "Loneliness is an issue," Dr. Malani says. "If you can't do a lot of things and you don't feel well, at least be together."
That being said, we do need to reiterate some obvious advice: Don't hang out with members of your family who aren't sick or testing positive.
But if you've all been bitten by the bug, go ahead: Binge TV and eat meals with the rest of your sick family. Our experts are unanimous that there's nothing to fear from hanging out together if you're all infected.
Max Barnhart is a Ph.D. candidate and science journalist studying the evolution of heat-stress resistance in sunflowers at the University of Georgia.
Its winter, that cozy season that brings crackling fireplaces, indoor gatherings and a wave of respiratory illness. Nearly four years since the pandemic emerged, people are growing weary of dealing with it, but the virus is not done with us.
Nationally, a sharp uptick in emergency room visits and hospitalizations for COVID-19, influenza, and respiratory syncytial virus, or RSV, began in mid-December. Here are a few things to know this time around:
Whats circulating now?
The COVID virus is continually changing, and a recent version is rapidly climbing the charts. Even though it appeared only in September, the variant known as JN.1, a descendant of omicron, is spreading, according to the Centers for Disease Control and Prevention.
Lab data indicates that the updated vaccines, as well as existing COVID rapid tests and medical treatments, are effective with this latest iteration. More good news is that it does not appear to pose additional risks to public health beyond that of other recent variants, according to the CDC. Even so, new COVID hospitalizations 34,798 for the week that ended Dec. 30 are trending upward, although rates are still substantially lower than last Decembers tally. Its early in the season, though. Levels of virus in wastewater one indicator of how infections are spreading are very high, exceeding the levels seen this time last year.
And dont forget, other nasty bugs are going around. More than 20,000 people were hospitalized for influenza the week ending Dec. 30, and the CDC reports that RSV remains elevated in many areas.
The numbers so far are definitely going in the not-so-good direction, said Ziyad Al-Aly, the chief of the research and development service at the Veterans Affairs St. Louis Healthcare System and a clinical epidemiologist at Washington University in St. Louis. Were likely to see a big uptick in January now that everyone is back home from the holidays.
In Oregon
In Oregon, COVID infection rates have plateaued at relatively low levels in most communities, including Portland and Hillsboro, as measured by wastewater monitoring. But some cities, including Bend and Newport, have seen sustained upticks, according to the Oregon Health Authoritys wastewater reports.
That method of measurement has become increasingly significant as fewer Oregonians test themselves for COVID infection and even fewer test results are reported to the state.
It may be the case that Oregon is experiencing an uptick in infections from the JN.1 variant. Nearly 47% of people whose germs were sequenced for the most recent period the state has tracked, Dec. 11 through Dec. 17, were infected by JN.1.
But only 15 people statewide who tested positive for COVID that week had their samples sequenced, according to the state health authority. Laboratories in Oregon are encouraged but not required to submit results for sequencing, health authority spokesperson Jonanthan Modie told The Oregonian/OregonLive.
A rise in JN.1 infections, if true, doesnt matter much, Modie said.
Its really not significantly different from any of the other COVID-19 omicron subvariants. ... All the subvariants have some immune-escape properties, they all have some transmissibility properties, but nothing that stands out in terms of severity, he told the newsroom in an email.
Things are better than 2020
Certainly, compared with the first COVID winter, things are better now. Far fewer people are dying or becoming seriously ill, with vaccines and prior infections providing some immunity and reducing severity of illness. Even compared with last winter, when omicron was surging, the situation is better. New hospitalizations, for example, are about one-third of what they were around the 2022 holidays. Weekly deaths dropped slightly the last week of December to 839 and are also substantially below levels from a year ago.
The ratio of mild disease to serious clearly has changed, said William Schaffner, a professor of medicine in the division of infectious diseases at Vanderbilt University School of Medicine in Nashville, Tennessee.
Even so, the definition of mild is broad, basically referring to anything short of being sick enough to be hospitalized.
While some patients may have no more than the sniffles, others experiencing mild COVID can be miserable for three to five days, Schaffner said.
How will this affect me?
Am I going to be really sick? Do I have to mask up again? It is important to know the basics.
For starters, symptoms of the COVID variants currently circulating will likely be familiar such as a runny nose, sore throat, cough, fatigue, fever, and muscle aches.
So if you feel ill, stay home, said Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials. It can make a big difference.
Dust off those at-home COVID test kits, check the extended expiration dates on the FDA website, and throw away the ones that have aged out. Tests can be bought at most pharmacies and, if you havent ordered yours yet, free test kits are still available through a federal program at COVID.gov.
Test more than once, especially if your symptoms are mild. The at-home rapid tests may not detect COVID infection in the first couple of days, according to the FDA, which recommends using multiple tests over a certain time period, such as two to three days.
With all three viruses, those most at risk include the very young, older adults, pregnant people, and those with compromised immune systems or underlying diseases, including cancer or heart problems. But those without high-risk factors can also be adversely affected.
While mask-wearing has dropped in most places, you may start to see more people wearing them in public spaces, including stores, public transit, or entertainment venues.
Although a federal mask mandate is unlikely, health officials and hospitals in at least four states California, Illinois, Massachusetts, and New York have again told staff and patients to don masks. Such requirements were loosened last year when the public health emergency officially ended.
Such policies are advanced through county-level directives. The CDC data indicates that, nationally, about 46.7% of counties are seeing moderate to high hospital admission rates of COVID.
We are not going to see widespread mask mandates as our population will not find that acceptable, Schaffner noted. That said, on an individual basis, mask-wearing is a very intelligent and reasonable thing to do as an additional layer of protection.
The N95, KN95, and KF94 masks are the most protective. Cloth and paper are not as effective.
And, finally, if you havent yet been vaccinated with an updated COVID vaccine or gotten a flu shot, its not too late. There are also new vaccines and monoclonal antibodies to protect against RSV recommended for certain populations, which include older adults, pregnant people, and young children.
Generally, flu peaks in midwinter and runs into spring. COVID, while not technically seasonal, has higher rates in winter as people crowd together indoors.
If you havent received vaccines, Schaffner said, we urge you to get them and dont linger.
What about repeat infections?
People who have dodged COVID entirely are in the minority.
At the same time, repeat infections are common. Fifteen percent of respondents to a recent Yahoo News/YouGov poll said theyd had COVID two or three times. A Canadian survey released in December found 1 in 5 residents said they had gotten COVID more than once as of last June.
Aside from the drag of being sick and missing work or school for days, debate continues over whether repeat infections pose smaller or larger risks of serious health effects. There are no definitive answers, although experts continue to study the issue.
Two research efforts suggest repeat infections may increase a persons chances of developing serious illness or even long COVID which is defined various ways but generally means having one or more effects lingering for a month or more following infection. The precise percentage of cases and underlying factors of long COVID and why people get it are among the many unanswered questions about the condition. However, there is a growing consensus among researchers that vaccination is protective.
Still, the VAs Al-Aly said a study he co-authored that was published in November 2022 found that getting COVID more than once raises an additional risk of problems in the acute phase, be it hospitalization or even dying, and makes a person two times as likely to experience long COVID symptoms.
The Canadian survey also found a higher risk of long COVID among those who self-reported two or more infections. Both studies have their limitations: Most of the 6 million in the VA database were male and older, and the data studied came from the first two years of the pandemic, so some of it reflected illnesses from before vaccines became available. The Canadian survey, although more recent, relied on self-reporting of infections and conditions, which may not be accurate.
Still, Al-Aly and other experts say taking preventive steps, such as getting vaccinated and wearing a mask in higher-risk situations, can hedge your bets.
Even if in a prior infection you dodged the bullet of long COVID, Al-Aly said, it doesnt mean you will dodge the bullet every single time.
-- Julie Appleby: jappleby@kff.org, @Julie_appleby
The Oregonian/OregonLives Betsy Hammond contributed to this report.
Covid-19 vaccinations saved more than 1.4 million lives across Europe, according to the World Health Organization (WHO).
A new study analysing the impact of Covid-19 vaccines in 34 countries across Europe, found that they reduced deaths by 57 per cent between December 2020, when the vaccine rollouts began, and March 2023.
The cumulative death toll, currently at 2.5 million, might be as high as 4 million without the vaccines, says the study, with the first vaccine booster saving 700,000 lives alone.
Most people saved were aged 60 and over, the group most vulnerable to risk of severe illness and death from the respiratory virus. The study also found that Covid-19 vaccinations saved most lives during the Omicron wave, from December 2021 to April 2023 when huge numbers became infected.
Previous WHO estimates had put lives saved by the vaccine at 470,000, but that only covered the first months of the vaccine rollout.
Dr Hans Henri P. Kluge, WHOs Regional Director for Europe, welcomed the new data.
[There are] 1.4 million people in our region, most of them elderly, who are around to enjoy life with their loved ones because they took the vital decision to be vaccinated against Covid-19, he said.
This study documents the result of countries implementing that advice. The evidence is irrefutable.
Across the WHOs Europe region, Israel saw the biggest benefits from the vaccine, with a 75 per cent reduction, followed by Malta and Iceland with a 72 and 71 per cent decrease, respectively.
Countries that executed early roll-out programmes - such as Belgium, Ireland, the Netherlands and the UK - saw a greater number of lives saved overall by vaccination.
A landmark NHS study, published earlier this month, analysing the health data from every person in the UK, found that an additional 7,100 hospital admissions and deaths might have been saved in the summer of 2022 if everybody had received all their vaccinations and boosters.
Countries that vaccinated early and vaccinated at high levels were likely to see much higher deaths averted than countries who were vaccinating a bit later, said Dr Marc-Alain Widdowson, WHO Europes lead on infectious hazard management.
As cold weather intensifies across the Northern Hemisphere, Europe is facing a tridemic of respiratory diseases including flu, Covid-19 and RSV that threatens to push health systems to the brink.
Spain and Italy are among the worst affected countries, with Spain reintroducing mandatory face masks in hospitals and health centres earlier this month the decision was made just six months after the obligatory use of masks was stopped.
Dr Kluge said that society has now gained a base level of immunity, either through vaccination, infection, or both.
Covid-19 hasnt gone away. We have merely learned to live with it, he said.
Protect yourself and your family by learning more about Global Health Security
Throughout the world, COVID-19 infections, hospitalizations and deaths are surging amid the fourth winter of the pandemic, as the highly infectious and immune-resistant JN.1 variant spreads globally. Wherever wastewater sampling is conducted, levels of viral transmission are currently at the highest or second-highest levels of the entire pandemic.
This ongoing wave of mass infection underscores the utter criminality of the World Health Organization (WHO), Biden administration and other national health agencies ending their respective COVID-19 public health emergency (PHE) declarations last May. The result of these unscientific and politically motivated decisions was that virtually all pandemic surveillance was lifted, while masses of people were led to falsely believe that the pandemic was over.
In two extraordinary press briefings last week, WHO officials made clear the ongoing dangers of the pandemic, while hypocritically admonishing the global population for no longer taking precautions, ignoring their own culpability in this process.
On Wednesday, January 10, WHO Director-General Dr. Tedros Adhanom Ghebreyesus noted that in December the world had seen a surge in COVID-19 transmission fueled by holiday gatherings and the evolution of the JN.1 variant. He added:
Almost 10,000 deaths from COVID-19 were reported to the WHO in December and there was a 42 percent increase in hospitalizations and 62 percent increase in ICU admissions compared to November. However, the trends [on mortality] are based on data from less than 50 countries, mostly in Europe and the Americas. Its certain that there are also increases in other countries that are not being reported.
Information on the number of hospitalizations admissions is being provided by only 29 countries, while only 21 countries are providing data on ICU admissions. Again, these data are so scant because the vast majority of countries completely dismantled their pandemic surveillance systems in response to the WHOs ending of the PHE last May.
Speaking two days later at another press conference held by the WHO on their UN Web TV, devoted to the co-circulation of COVID, flu and respiratory pathogens, Dr. Maria Van Kerkhove, the WHOs Technical Lead on COVID-19, remarked, Essentially, given the lifting of the public health and social measures, with the world opened up, these viruses, these bacteria that pass efficiently between people through the air, take advantage.
Van Kerkhove stated that access to vaccines remains a challenge in much of the globe, noting that where vaccines are available, demand and uptake are quite low, raising concerns about the elderly and most vulnerable, including immunocompromised people and pregnant women. She then warned starkly:
What is critical to know right now is that the public health risk from COVID remains high globally. We have a pathogen that is circulating in all countries case-based data that is reported to the WHO is not a reliable indicator and has not been a reliable indicator for a couple of years now. If you look at the epidemiology curve it looks like the virus is gone, but it hasnt.
Van Kerkhove added, According to wastewater estimates we have from a number of countries, the actual circulation of SARS-CoV-2 is anywhere from two to 19 times higher than what is being reported. And what is difficult is that the virus is continuing to evolve. Although she noted that the number of deaths has reduced drastically from two years ago, there continues to be around 10,000 official COVID deaths per month.
However, Van Kerkhove cautioned that this represents less than a quarter of all countries reporting data, and half of official deaths were just from the US, meaning there is a massive undercounting simply from lack of reporting. She stated bluntly, We are missing deaths from countries around the world. Just because those countries arent reporting deaths doesnt mean they arent happening.
Official figures for January are expected to rise given the intense circulation of JN.1 and many large indoor gatherings that have taken place surrounding the holidays.
After acknowledging that the pandemic continues unchecked, Van Kerkhove noted:
On the one hand, while we are seeing a reduced impact, we feel that there is far too much burden in countries from COVID when we can prevent them with adequate tests, with adequate access to and use of antivirals, with appropriate clinical care, medical oxygen, and, of course, vaccination COVID is still a public health threat and is causing far too much burden and we can prevent it.
Van Kerkhove estimated that presently hundreds of thousands are hospitalized around the world for COVID, based on the limited data available.
Van Kerkhove then acknowledged that the post-acute phase of COVID-19 infections known as Long COVID is considerable. She said that 6-10 percent of symptomatic cases can evolve into Long COVID, potentially affecting multiple organs throughout the body, with debilitating conditions that can last for 12 months or longer.
Simple math means that tens or hundreds of millions of people will develop some level of Long COVID in the current global surge alone. It is no hyperbole to characterize Long COVID as a mass disabling event and a pandemic within a pandemic.
Van Kerkhove then warned, We dont know the long-term impacts of repeat infections Our concern is in five years from now, ten years from now, in 20 years from now, what are we going to see in terms of cardiac impairment, of pulmonary impairment, of neurological impairment; we dont know. We dont know everything about this virus. She continued to state that the problem is significant and research in better understanding and treating Long COVID is severely financially under-resourced.
Mehring Books
COVID, Capitalism, and Class War: A Social and Political Chronology of the Pandemic
A compilation of the World Socialist Web Site's coverage of this global crisis, available in epub and print formats.
The dire reports from these two leading WHO officials begs the question: why are they not moving to quickly reinstate the PHE and urge all world governments to reimpose strict anti-COVID mitigation measures to slow the spread of the virus.
Clearly, the WHOs abrupt scrapping of their PHE last May, one week before the Biden administration, came under intense pressure from US imperialism, to which they acquiesced. They were motivated by political pressures and not any meaningful change in the ongoing public health threat that COVID-19 clearly still posed.
In light of recent evidence that the JN.1 lineage of Omicron appears to have a higher predilection for the lower respiratory airways and the concomitant risk of the virus reverting to earlier, more virulent forms, it is imperative that the PHE be reimplemented and comprehensive public health programs be massively funded in every country.
Instead, all world governments have imposed a brutal forever COVID policy of endless waves of infections with a highly dangerous virus that harms more than just the respiratory organs, but every organ system in the body, with accumulating evidence that long-term consequences of pursuing these policies will have significant implications for the health of the global population.
As the second part of the World Socialist Web Sites New Year 2024 statement makes clear, the only viable solution to the present and future public health crises is a global elimination strategy that had proven possible even in the face of the highly infectious Omicron variant, as evidenced by efforts in Shanghai in spring of 2023.
Point 28 of the statement notes:
The longstanding success with Zero-COVID in China proved the viability of an elimination strategy towards COVID-19, even in less developed and densely-populated countries. At the same time, its ultimate demise reaffirmed the unviability of any nationally-based program in the epoch of imperialism. What proved to be unviable was the national framework, not the policy itself. Elimination remains both viable and necessary, but can now be attained only through the building of a mass movement fighting for the following principles:
The fight against the pandemic is a political and revolutionary question which requires a socialist solution.
The organization of public health must be on the basis of social need, not corporate profit.
The profit motive must be entirely removed from all healthcare, pharmaceutical and insurance companies.
Only a globally coordinated strategy can address the COVID-19 pandemic and create the conditions to develop comprehensive strategies to prevent potential epidemic and pandemic pathogens. The remarks made by the WHO leaders affirm the conclusions drawn by the WSWS in the New Year statement:
After four years of the pandemic, it is abundantly clear that such a global strategy will never arise under world capitalism, which subordinates all public health spending to the insatiable profit interests of a money-mad financial oligarchy. The very idea that an illness should be eliminated or eradicated, a central concept in public health, has been abandoned. Only through world socialist revolution will it be possible to end the pandemic, as well as stop the further descent into capitalist barbarism and World War III.
Join the fight to end the COVID-19 pandemic
Someone from the Socialist Equality Party or the WSWS in your region will contact you promptly.
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Long COVID patients are at a higher risk for digestive diseases, for up to one year, according to a study.
The study, published in the journal BMC Medicine, showed that people who suffered both severe and mild COVID-19 infections suffered from digestive diseases like gastrointestinal (GI) dysfunction, peptic ulcers, gastroesophageal reflux disease (GERD), gallbladder disease, nonalcoholic liver disease, and pancreatic disease.
Our study provides insights into the association between COVID-19 and the long-term risk of digestive system disorders. COVID-19 patients are at a higher risk of developing digestive diseases, said the researchers in the paper.
The risks exhibited a stepwise escalation with the severity of COVID-19, were noted in cases of reinfection, and persisted even after 1-year follow-up. This highlights the need to understand the varying risks of digestive outcomes in COVID-19 patients over time, particularly those who experienced reinfection, and develop appropriate follow-up strategies, they added.
In the study, the team from Southern Medical University in China and University of California Los Angeles, US, compared rates of digestive diseases among COVID survivors 30 or more days after infection (112,311), a contemporary comparison group (359,671), and a pre-COVID group (370,979) in the UK.
Participants were adults aged 37 to 73, and COVID-19 survivors were infected from January 2020 to October 2022. The contemporary group was made up of people who lived at the same time as recruitment of the COVID-19 group, and the historical group was made up of uninfected participants with data from January 2017 to October 2019.
Relative to the contemporary group, elevated risk in COVID-19 survivors was 38% for GI dysfunction, 23% for peptic ulcers, 41% for GERD, 21% for gallbladder disease, 35% for severe liver disease, 27% for nonalcoholic liver disease, and 36% for pancreatic disease.
The risk of GERD rose stepwise with COVID-19 severity, and the risk of GERD and GI dysfunction persisted 1 year after diagnosis. Reinfected participants had a higher likelihood of having pancreatic disease.
This underscores the significance of ensuring that healthcare systems are equipped to provide appropriate care to this population of mild cases, as well as varying degrees of COVID severity.
In addition, the risks of GI dysfunction and GERD did not decrease after 1-year follow-up, revealing the long-term effect of COVID and the risks of digestive disorders.
The researchers said that the reasons for the increased risks may be faecal-oral viral transmission, interactions between the SARS-CoV-2 spike protein and the expression of angiotensin-converting enzyme 2 (ACE2) receptors in the digestive tract, or virus-associated inflammation.
"This underscores the significance of ensuring that healthcare systems are equipped to provide appropriate care to this population of mild cases, as well as varying degrees of COVID-19 severity," they wrote.
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The above article has been published from a wire agency with minimal modifications to the headline and text.
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TTHealthWatch is a weekly podcast from Texas Tech. In it, Elizabeth Tracey, director of electronic media for Johns Hopkins Medicine in Baltimore, and Rick Lange, MD, president of the Texas Tech University Health Sciences Center in El Paso, look at the top medical stories of the week.
This week's topics include a proteomic approach to cancer screening, vegetarian diet and COVID risk, performance of dialysis centers, and medical errors in hospitalized patients.
Program notes:
0:40 Incentivizing dialysis centers
1:40 Over 1,000 dialysis centers
2:40 How to adjust for neighborhood?
3:41 Comprehensive approach needed
4:00 Vegetarian diet and COVID risk
5:03 Importance of diet and disease
6:00 Immunity and foods
6:12 Diagnostic errors in hospitalized patients
7:12 Problems assessing the patient
8:18 Novel proteomics-based cancer screening
9:18 10 proteins with high accuracy
10:18 Different in men and women
11:18 Most useful biomarkers the low concentration ones
12:05 End
Transcript:
Elizabeth: Does being a vegetarian help you avoid COVID infection?
Rick: How often do we see diagnostic errors in hospitalized patients who die or are transferred to the ICU?
Elizabeth: Looking at proteomics to look for multiple cancers.
Rick: And looking at social risk and how it affects dialysis facility performance.
Elizabeth: That's what we're talking about this week on TTHealthWatch, your weekly look at the medical headlines from Texas Tech University Health Sciences Center in El Paso. I'm Elizabeth Tracey, a Baltimore-based medical journalist.
Rick: And I'm Rick Lange, president of Texas Tech University Health Sciences Center in El Paso, where I'm also dean of the Paul L. Foster School of Medicine.
Elizabeth: Rick, the one that you served up from JAMA about what happens in these dialysis facilities is one that really speaks to my heart having had multiple patients who have had circumstances that have been a little questionable surrounding dialysis. Are you okay with it if we start with that one?
Rick: Yeah. No, I think it's great, Elizabeth. It's an attempt to try to improve performance in dialysis centers by using incentives. How effective is it? We know that individuals that are on Medicaid in low-income situations, certain races, their outcome oftentimes at dialysis centers isn't quite as good. Things that we're trying to push people towards -- that is, doing home dialysis, it's less likely that they're able to participate.
But what CMS has tried to do was to compose a model that would reward facilities that have really good outcomes, take money away from centers that have a poor outcome. They thought by doing this, by the way, that they could actually drive and improve outcomes. By the way, they did that in about 30% of dialysis studies.
What this study did was they looked to see how effective that was. They analyzed almost 126,000 patients at over 1,000 dialysis centers. They noticed that about 50% of them had no social risk -- that is, they weren't African American and they didn't live in a low-income area. Then about 22% had two or more of these risk factors.
If you had two or more of these risk factors, you were much more likely to have money taken away from you than if you had none. In fact, if you had none you were more likely to have an incentive provided. Well, that's just the opposite of what we're trying to do. What we want to do is we want to try to take those centers and actually contribute more money to get a better outcome.
Now, in fairness, they tried to adjust these for individual patient-centered differences, but what they discovered is there are things that happen in the neighborhood that aren't captured by things like this: education status, transportation, crime, and access. If you actually incorporated these things, that also added some predictive value. It may mean that we need to adjust our incentives not only based upon the individual, but also a neighborhood or societal things as well.
Elizabeth: Help me to construct that model. What would it look like to try to adjust for the neighborhood and for social factors that surround the center?
Rick: If you're in a neighborhood that has a high crime rate, doesn't have transportation, doesn't have healthy food, doesn't have a transport center nearby, it's not surprising that you're going to have a worse outcome. We want to take those centers where they're going to and actually provide them additional monies or additional resources, so they can improve the outcome. We don't want to take money away from them. We actually want to incentivize them.
One of the indexes you can use is what's called an area deprivation index (ADI). It looks at an individual neighborhood to say, "Is that neighborhood deprived of things that will provide good outcomes for the patient?" We can use that to help adjust for these things.
Elizabeth: Remember, last week we talked about this comprehensive approach to pre-pregnancy, pregnancy, and post-pregnancy with regard to early childhood outcomes. What this study says to me is that this comprehensive approach to health, which is, of course, one of those "duh" conclusions -- I'm really good at restating the obvious -- is really the important thing here.
Rick: Yes. We're trying to make sure that all individuals have the same quality of care and some individuals, some neighborhoods, just need more attention to get there. This is a societal problem. If we don't address this, it costs us more as a society.
Elizabeth: Since we're talking about cost of health care, let's turn to the BMJ Nutrition, Prevention & Health. This is an examination that came from Brazil, of vegetarian and plant-based diets and their association with COVID-19 infection. It's observational, 702 participants, where sociodemographic characteristics, dietary information, and COVID-19 outcomes were collected between March and July of 2022.
When they took a closer look at these folks, their omnivorous group comprised 424 people and their plant-based group 278. They adjusted for all kinds of confounders -- BMI, physical activity, preexisting medical conditions -- and found that the plant-based and vegetarian group had a 39% reduced incidence of COVID-19 infection compared with the omnivorous group. Gosh, this vegetarian and plant-based thing is something we should probably be looking at more closely from a societal and policy perspective.
Rick: We have talked before about the importance of diet in a number of disease entities in terms of reducing inflammation and reducing high blood pressure. I'm going to put a little bit of a cautionary note to this. First of all, do I think that eating healthy is good? Yes, I do. At best, this is an association. You and I know that these individuals that eat healthy also have other healthy lifestyle behaviors. They are more likely to exercise. They have less weight. They have less comorbidities. I'm wondering whether it's not that the diet, but we just have a group of individuals that are more likely to wear a mask, or more likely to be isolated, or more likely to wash their hands, or more likely to have other healthy lifestyle things that could account for it.
Elizabeth: There is no question that the vegetarians have a lower BMI, a lower prevalence of overweight, obesity, and metabolic syndrome, and that they exercised more. That probably had some impact on how often they got infected with COVID-19. Then they also make the point about the relationship between immunity and foods, which is something that we seem to be seeing a lot more.
Rick: In the end, Elizabeth, whether we decide there is a causality or association, I think we're both in agreement that a healthy diet is in fact a healthy diet.
Elizabeth: You got that right. Let's turn then to JAMA Internal Medicine, this issue of diagnostic errors.
Rick: We've known for well over a decade now that diagnostic errors play an important role in patients receiving care in the hospital. This particular study focused on two groups of individuals: those individuals who die in the hospital, or those who are hospitalized and then are transferred to an intensive care unit. They ask a very simple question: "How often do we see diagnostic errors in these individuals?"
To determine the presence, the underlying cause, and actually the harms of diagnostic errors, they did a retrospective study of 29 different academic medical centers. They had two trained clinicians comb the charts to see whether there were any diagnostic errors or not, and if so, did they result in harm?
After examining the records of about 2,400 patients, they discovered that about a fourth of these, 23%, had experienced a diagnostic error. This error was judged to have contributed to harm in about 20% (17.8%).
When they look at the most common diagnostic errors, they fell in primarily two groups: problems assessing the patient -- either we didn't get the right diagnosis or we didn't establish it quickly enough; or secondly, problems with test ordering and interpretation. We didn't order the right test, we ordered the test and didn't look at it, or we ordered the test and didn't see how it fit in the entire picture at all.
What this study doesn't tell us is, would the outcome of these patients have been any different? Regardless, this is an area that we still need to address.
Elizabeth: Yeah. This has, of course, emerged as a cause clbre in lots of arenas and it's unclear to me exactly how we're going to get our arms around it, because they seem like fairly variable kinds of errors.
Rick: Yep, and you're right. There were six or seven different types. I focused on the two that were most common. We're hopeful that artificial intelligence can help in some ways. Unfortunately, as we talked about a couple of weeks ago, it can actually make the problem worse if the data in and the way you're analyzing it isn't particularly helpful.
Are there other things that we can do? We can educate the physician workforce better, make sure we're not anchoring on a specific diagnosis, and not overburdening the physicians and healthcare providers. A number of different ways to address this.
Elizabeth: Finally, let's turn to BMJ Oncology and this is a look at a novel proteomics-based plasma test for early detection of multiple cancers in the general population. This is obviously an objective. Wouldn't it be great to be able to just draw blood and assess somebody for the presence of very early cancers? It's also helpful in terms of early detection, early treatment, and better outcomes, although that is not a solid-line relationship.
This paper describes this novel proteome-based multicancer screening test. They had 440 participants, healthy and diagnosed with 18 early-stage solid tumors. In this group, they measured more than 3,000 high-abundance and low-abundance proteins in each sample using a number of approaches. They identified a limited set of sex-specific proteins that could detect early-stage cancers and their tissue of origin with high accuracy.
They were able to boil this down to 10 proteins that showed high accuracy for both males and females -- in the males, 98%, and in the females, 98% at stage 1, and a specificity of 99%. Their panels were able to identify 93% of cancers among the males and 84% of the cancers among the females. They were able to identify in more than 80% of cases the tissue of origin of the cancer. A lot of pretty impressive results in people they already knew had cancer, and this proteome-based screening test is promising and they say clearly should be followed up.
Rick: Elizabeth, I would agree. It does need follow-up and validation. They're all patients from the Ukraine. They are all racially or ethnically very similar.
The thing that was fascinating is, they test over 3,000 proteins. They found that 10 specific proteins could identify the presence of cancer, but they were different in men than they were in women. The second thing that was fascinating is they tried to identify was the cancer present, but where was it located, and they had to use over 150 different proteins to do that.
It would be nice to take a blood test and to be able to screen. To be able to do that, it's got to be very sensitive and very specific. Ultimately, as you mentioned, it needs to improve cancer outcome. The thought is if you can detect it early, you can treat it, get rid of it early and improve outcomes. That may be true in some cancers and may not be true in others.
The other thing I would say is that most of the cancers they detected weren't as early as they thought. They weren't stage 1 cancers. Most of them were stage 2 and stage 3. We know as cancers evolve their proteins change, so a lot of work to be done, but I'm glad that people are pursuing this.
Elizabeth: Oh, absolutely. They cite something that I thought was really interesting. They say that nearly 60% of cancer-related deaths are due to cancers for which no screening test exists. I was really unaware of that particular statistic. The other thing I would note about their test, not only the fact that men and women screen very differently, but that their most useful biomarkers for early-stage cancers were those that were present in low concentrations, not the ones that were present in high concentrations, which is also a novel finding.
Rick: It is and what it means is that you've got to have very sensitive ways of looking for protein that's at a very low level. I hope that in 20 or 30 years we're able to crack this nut.
Elizabeth: I'm hoping it's not going to be 20 or 30 years. On that note then, that's a look at this week's medical headlines from Texas Tech. I'm Elizabeth Tracey.
Rick: And I'm Rick Lange. Y'all listen up and make healthy choices.
15:32 (IST), Jan 9
61 new COVID cases reported in Maharashtra
Sixty-one new cases were recorded in the state on Monday, as per an official update on COVID-19 from the Public Health Department of Maharashtra.The department also reported that 70 patients were discharged on the same day. The recovery rate in the state was recorded at 98.17 per cent while the case fatality rate stood at 1.81 per cent.A total of 2728 COVID tests were conducted in the state on Monday, which included 1439 first RT-PCR tests and 1305 RAT tests. The positivity rate for the day was 2.23 per cent. As of today, 250 patients have been infected with the JN.1 variant in the state.Meanwhile, according to sources, there were a total of 682 cases of JN. 1 sub-variant of COVID-19 has been reported from 12 states across the country as of January 6.199 cases were reported in Karnataka, 148 in Kerala, 139 in Maharashtra, 47 in Goa, 36 from Gujarat, 30 each from Andhra Pradesh and Rajasthan, 26 in Tamil Nadu, 21 in New Delhi, 3 in Odisha, 2 in Telangana and one in Haryana.
