Using Your Safety Management System (SMS) to Mitigate Infectious … – Federal Transit Administration

Using Your Safety Management System (SMS) to Mitigate Infectious … – Federal Transit Administration

CDC study: People with HIV have elevated COVID reinfection rate – University of Minnesota Twin Cities

CDC study: People with HIV have elevated COVID reinfection rate – University of Minnesota Twin Cities

October 21, 2023

Moha El-Jaw / iStock

A new Centers for Disease Control and Prevention-led study finds that people with HIV (PWH) have higher COVID-19 reinfection rates than those without HIV (PWOH).

The study, published yesterday in Emerging Infectious Diseases, involved 453,587 adults in Chicago infected with SARS-CoV-2 from their first infection through May 2022. The investigators matched COVID-19 test results and vaccination data to Chicago's Enhanced HIV/AIDS Reporting System.

"HIV can compromise the immune system; persons with HIV (PWH), especially those not receiving antiretroviral therapy (ART), might be vulnerable to SARS-CoV-2 infection," the researchers wrote. "Understanding how COVID-19 affects PWH is important because approximately half of PWH are>50 years of age and have higher rates of medical comorbidities, compared with persons without HIV (PWOH)."

A total of 5.3% of the 453,587 COVID-positive residents were reinfected, including 192 of 2,886 (6.7%) PWH and 23,642 of 450,701 (5.2%) PWOH. Reinfection rates among PWH were 66 per 1,000 person-years, compared with 50 of 1,000 person-years among PWOH. PWH had a higher adjusted rate of COVID-19 reinfection (1.46 per 1,000 person-years) than PWOH.

Among reinfected residents, PWH were older (median age, 43 years) than PWOH (36 years). Relative to PWOH, PWH were more likely to be men (79.3% vs 40.9%) and Black (53.7% vs 27.0%) and to have received a primary COVID-19 vaccine series and booster (31.8% vs 22.1%). Of those reinfected, PWH were less likely than PWOH to be unvaccinated at their first infection (87.5% vs 91.0%).

PWH should follow the recommended COVID-19 vaccine schedule, including booster doses, to avoid SARS-CoV-2 reinfections.

Of 131,682 residents vaccinated before their first SARS-CoV-2 infection, 54.2% had completed a primary Pfizer/BioNTech vaccine series. Of 23,834 reinfected residents, 39.6% (9,444 of 23,834) had completed a primary series but had not received a booster before reinfection.

Regardless of variant wave and calendar quarter, PWH consistently had a higher rate of reinfection than PWOH. The highest incidence for PWH occurred during Omicron strain predominance (50 cases per 1,000 person-years). Overall, an excess of 16 reinfections per 1,000 person-years were reported among PWH.

"PWH should follow the recommended COVID-19 vaccine schedule, including booster doses, to avoid SARS-CoV-2 reinfections," the authors wrote.


Originally posted here: CDC study: People with HIV have elevated COVID reinfection rate - University of Minnesota Twin Cities
COVID-19 raises the risk of cardiovascular disease in people with HIV – aidsmap

COVID-19 raises the risk of cardiovascular disease in people with HIV – aidsmap

October 21, 2023

People with HIV who were diagnosed with COVID-19 had a 35% higher risk of a major cardiovascular event in the following year compared to other people with HIV, a Spanish study presented on Thursday at the 19th European AIDS Conference (EACS 2023) in Warsaw reported.

The difference in risk was concentrated in three types of cardiovascular problem: thrombosis (disorders caused by blood clots), heart failure (failure of the heart to pump sufficient blood) and other heart disorders including aneurysms (where a blood vessel balloons and may suddenly rupture). People with HIV with a diagnosis of COVID-19 did not have higher rates of heart attack or stroke.

Several large studies in the general population have reported that people diagnosed with COVID-19 are at higher risk of experiencing a major cardiovascular event such as heart attack compared to the rest of the population.

A large study of people receiving care through US Veterans hospitals found that a COVID-19 diagnosis raised the risk of numerous cardiovascular outcomes during the following year, from stroke and heart attack to deep vein thrombosis, angina and disturbances in heart rhythm such as atrial fibrillation. The study found that the risk was raised regardless of whether people were hospitalised with COVID-19 or not, and regardless of whether they had a prior history of cardiovascular disease.

Other studies in the United Kingdom, Sweden and Denmark have also reported an increased risk of major cardiovascular events in people who had been diagnosed with COVID-19.

Although studies have shown that unvaccinated people with HIV have a somewhat higher risk of being admitted to hospital and dying of COVID-19, the risk of new cardiovascular events after a COVID-19 diagnosis has not been studied in people with HIV.

The question is especially important for people with HIV, as numerous studies have shown that people with HIV have raised cardiovascular risks due to HIV itself, dyslipidaemia caused by antiretroviral treatment and lifestyle factors such as smoking and weight. Does COVID-19 exacerbate the existing risks for people with HIV?

To investigate the risk of cardiovascular events in people with HIV after a COVID-19 diagnosis, Dr Raquel Martin Iguacel and colleagues looked for COVID-19 diagnoses in the PISCIS HIV cohort database between March 2020 and July 2022 and for cardiovascular events in the PADRIS database, which compiles data on health service utilisation in the Spanish region of Catalonia.

Cardiovascular events eligible for inclusion in the analysis consisted of dysrhythmia (disturbances in heart rhythm); cerebrovascular disease (stroke or brain haemorrhage); ischaemic heart disease (any disease caused by narrowing of the arteries supplying the heart, including heart attack and angina); thrombotic disorders such as deep vein thrombosis or blood clots; heart failure; inflammatory heart disease; peripheral vascular disease; aneurysms (ballooning or ruptured artery) or other disorders such as cardiac arrest.

The analysis identified 4199 people with HIV with COVID-19 and 14,004 without COVID-19. The study population was predominantly male (82%) with a median age of 45 in the COVID group and 48 in the non-COVID group. Approximately 3% had CD4 counts below 200 (a risk factor for severe COVID-19 outcomes) and the median CD4 count was 688 in the COVID-19 group. Ninety per cent had an undetectable viral load.

An interruption of blood flow to the brain, caused by a broken or blocked blood vessel. A stroke results in sudden loss of brain function, such as loss of consciousness, paralysis, or changes in speech. Stroke is a medical emergency and can be life-threatening.

The result of a statistical test which tells us whether the results of a study are likely to be due to chance and would not be confirmed if the study was repeated. All p-values are between 0 and 1; the most reliable studies have p-values very close to 0. A p-value of 0.001 means that there is a 1 in 1000 probability that the results are due to chance and do not reflect a real difference. A p-value of 0.05 means there is a 1 in 20 probability that the results are due to chance. When a p-value is 0.05 or below, the result is considered to be statistically significant. Confidence intervals give similar information to p-values but are easier to interpret.

The presence of one or more additional health conditions at the same time as a primary condition (such as HIV).

Disease of the heart or blood vessels, such as heart attack (myocardial infarction) and stroke.

Forty per cent of those with COVID-19 and 36% of those without COVID-19 had at least one co-morbidity associated with increased COVID-19 risk, most commonly chronic liver disease (11%), a cancer of the blood (13%) or dyslipidaemia (10%) and there was no substantial difference between study arms in the prevalence of any co-morbidity except high blood pressure, which was more common in people who did not contract COVID-19 (11% vs 6%).

Cardiovascular disease had been previously diagnosed in 11.8% prior to COVID-19 diagnosis, compared to 10.5% of the non-COVID group.

Among those diagnosed with COVID-19, 7% were admitted to hospital and 25 people out of 4199 required intensive care after hospitalisation. Thirteen per cent of those diagnosed with COVID-19 experienced at least two infections with COVID-19.

During a median follow-up period of 243 days, 211 people with a COVID-19 diagnosis and 621 without COVID-19 had a cardiovascular event, an incidence rate of 70.2 and 56.8 per 1000 person-years, respectively.

In a multivariable analysis that adjusted for demographic factors, HIV-related factors, COVID-19 and co-morbidities associated with COVID-19, a diagnosis of COVID was associated with 35% increased risk of any cardiovascular event (adjusted hazard ratio 1.35, 95% CI 1.13-1.60).

The elevated risk was present in all subgroups and was especially pronounced in those people with HIV diagnosed with COVID-19 who had chronic lung disease or chronic kidney disease.

The risk of cardiovascular events was also elevated in heterosexual men (aHR 1.28, 95% CI 1.01-1.62) and in people with a previous history of cardiovascular disease (aHR 27.44, 95% CI 21.83-34-49), chronic kidney disease (aHR 1.66, 95% CI 1.17-2.37) and chronic liver disease (aHR 1.34, 95% CI 1.04-1.73).

The elevated risk was still evident when people with previous cardiovascular disease were excluded from the analysis (aHR 1.60, 95% CI 1.13-2.28).

The most frequent cardiovascular events were ischaemic heart disease (affecting 1.6% of all people diagnosed with COVID-19), heart failure (1%) and stroke (0.9%). But the only events which occurred more frequently in people with COVID-19 were thrombotic disorders (p=0.007), heart failure (p=0.009) and other cardiac disorders including aneurysms (p=0.001). There was no significant difference in rates of dysrhythmia, cerebrovascular disease, inflammatory heart disease, peripheral vascular disease, or ischaemic heart disease.The study investigators conclude that among people with HIV diagnosed with COVID-19, even if COVID-19 didnt lead to hospitalisation, cardiovascular health needs to be a focus of care in people recovering from COVID-19. Ensuring that people with HIV are vaccinated against COVID-19 and keep up to date with booster doses is important for a population that already has an increased risk of heart disease.


Visit link: COVID-19 raises the risk of cardiovascular disease in people with HIV - aidsmap
AdvaMed Statement on USITC report, "COVID-19 Diagnostics and … – AdvaMed

AdvaMed Statement on USITC report, "COVID-19 Diagnostics and … – AdvaMed

October 21, 2023

WASHINGTON, D.C. The United States International Trade Commission (USITC) released its highly anticipated report,COVID-19 Diagnostics and Therapeutics, Supply, Demand, and TRIPS Agreement Flexibilities on October 17. Evidence presented in the 496-page report supports AdvaMeds position that there is no justification for the World Trade Organization (WTO) to waive intellectual property protection for products used to treat or diagnose COVID-19.

The report contains and reinforces many of AdvaMeds objections to limiting IP protection for COVID-19 products, said Ashley Miller, Executive Vice President, Global Strategy and Analysis. As we did throughout the pandemic, AdvaMed and our members will continue to work with the U.S. Government, other governments, and multilateral organizations to address impediments to patient access to diagnostics, including those reflected in the report.

Other key findings for diagnostics in the report include:

First, manufacturers of COVID-directed diagnostics, located in countries with a wide variety of income levels, including China and India, rapidly developed and scaled up production of COVID-19 tests early in the pandemic even before effective vaccines were widely available. New manufacturers entered the market throughout 2022 and 2023 even as demand for testing declined and has since remained low. To achieve this rapid production rise, WTO members did not need to use voluntary or compulsory licenses for COVID-19-directed diagnostics. As the USITC observed, the best evidence that patents did not act as a primary barrier to the production of these tests is that many new producers and products, including in developing countries, came online relatively quickly. The USITC noted, instead, that only R&D agreements were used in connection with COVID-19-directed diagnostics, which highlights the industrys cooperative response through which the industry was able to meet global demand in record time.

Second, the USITC stressed that defining the vast scope of COVID-19 diagnostics covered by patents is complicated and subject to interpretation, which means that a potential waiver would risk undermining IP protection for almost any diagnostic and therapeutic device determined by any government as being needed for COVID-19 and could lead to abuse of the IP waiver by countries seeking to gain competitive economic advantage.

# # #


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AdvaMed Statement on USITC report, "COVID-19 Diagnostics and ... - AdvaMed
Impact of COVID-19 gap in MS likely to cost over $500M in Canada – Multiple Sclerosis News Today

Impact of COVID-19 gap in MS likely to cost over $500M in Canada – Multiple Sclerosis News Today

October 21, 2023

The overall financial impact of changes in treatment and delayed diagnoses for people with multiple sclerosis (MS) in Canada due to the COVID-19 pandemic likely will be in the hundreds of millions of dollars between 2020 and 2024 in terms of extra healthcare costs and lost productivity, as well as worsened well-being for patients.

Thats according to a new report by Deloitte Access Economics on the so-called COVID-19 gap in Canada as it relates to MS. The research report put the costs of reduced patient well-being due to pandemic-related disruptions in care by itself at more than $400 million (about $290 million). More than $100 million (about $73 million) was estimated for increased costs of healthcare and drops in productivity for patients.

Based on these findings, MS Canada is calling on the Canadian government to invest money into MS specialty care and research into ways to prevent or treat the neurodegenerative disease, in an attempt to close the pandemic gap.

If we want to mitigate this impact to the MS community, governments can step up and ultimately save themselves money by doing these things: investing $15 million [about $11 million] immediately in prevention and treatment research building on the breakthrough discovery linking Epstein-Barr virus (EBV) to MS, and boosting MS specialist care by funding additional MS healthcare professionals from MS nurses to neurologists, Pamela Valentine, PhD, president and CEO of MS Canada, said in a press release from the organization.

Australia has just announced $18 million in research funding to follow up on a breakthrough link between MS and Epstein-Barr virus (EBV), which could foreseeably lead to a preventative vaccine. Canada must do the same, Valentine said.

Living with MS carries a hefty price tag. In addition to the cost of care for medications and other types of medical care and support, MS can make it harder to consistently work a job, resulting in lost economic productivity. The disease also can reduce patients wellbeing, which in economic terms can be quantified as lost value.

In this report, the researchers first estimated the total cost of MS care in Canada in 2019, before the COVID-19 pandemic. That number was estimated to be $3.4 billion (about $2.5 billion), which based on the frequency of MS in Canada works out to $42,880 (about $32,000) per person. Direct costs related to healthcare and indirect costs related to lost productivity made up most of these costs in the models.

During the first years of the COVID-19 pandemic from 2020 to 2022 spending on MS-related healthcare decreased by a total of about $566 million (about $413 million) in Canada, in comparison with what would have been expected based on trends before the pandemic.

This decrease in spending is likely reflective of pandemic-related disruptions in MS care, such as patients not receiving appropriate treatment or not getting diagnosed in a timely manner, according to the researchers.

The impact of these pandemic-related disruptions in care, sometimes termed the COVID-19 gap, has worrying implications for the future, especially in terms of patient health. Available treatments for MS are able to slow the diseases progression, but they cannot undo damage once it occurs. As such, people with MS who didnt get adequate care as a result of the pandemic are likely going to experience more severe disability and need more intensive care in the future.

Early diagnosis and timely intervention with the most effective treatment is key to protecting brain health, preserving function, and minimizing the impact on our healthcare system, Valentine said.

The COVID-19 gap has led to a health services backlog and unmet health needs for Canadians living with MS, Valentine said, adding, It has led to progression of MS in many Canadians, due to delayed or halted treatments this will impact these individuals and their families quality of life and livelihood.

This is especially concerning, according to MS Canada, as the country has one of the highest rates of MS in the world. An average of 12 Canadians are diagnosed with MS daily, and more than 90,000 people in Canada are living with the disorder, per the nonprofit.

Delays and changes to treatment can lead to irreversible disease progression and disability, Valentine said.

There is a saying that time is brain meaning delayed care means irreversibly worse outcomes for the patient, she said, adding, When nervous tissue is lost or damaged, it cannot be recovered. You cant catch up later with treatment.

While the changes in the provision of health services reduced MS-related health expenditure between 2020 and 2022, evidence from this study suggests that these costs are now rising above the level that would have been expected in the absence of the pandemic to clear the backlog in health services.

From the economic models, the researchers estimated that pandemic-related disruptions will lead to about $578.2 million (about $425 million) in additional MS-related costs between 2020 and 2024. This included $138 million in increased healthcare costs and lost productivity, as well as more than $400 million in reduced wellbeing for patients.

While the changes in the provision of health services reduced MS-related health expenditure between 2020 and 2022, evidence from this study suggests that these costs are now rising above the level that would have been expected in the absence of the pandemic to clear the backlog in health services, the scientists wrote.

Coupled with significant excess costs related to a worsening in the disease state of many people with MS due to treatment changes and delayed diagnoses, this trend towards higher costs is expected to continue and rise in future years, they added.

The researchers called for further study to quantify the impact of COVID-19 in MS, and said the given estimates will need to be updated as the longer-term outcomes from the pandemic are realised.


Read the original: Impact of COVID-19 gap in MS likely to cost over $500M in Canada - Multiple Sclerosis News Today
Study finds high prevalence of drug interactions in adults taking … – University of Minnesota Twin Cities

Study finds high prevalence of drug interactions in adults taking … – University of Minnesota Twin Cities

October 21, 2023

Adults who were treated with nirmatrelvirritonavir (Paxlovid) for their COVID infections in an outpatient setting during the earlier Omicron variant months had a high prevalence of drug-drug interactions, Canadian researchers reported yesterday in PLOS One.

In its clinical guidance, the Centers for Disease Control and Prevention (CDC) urges health providers to be aware of Paxlovid eligibility criteria and the potential for drug interactions. The drug carries a boxed warning about significant drug interactions. Treatment guidelines from the National Institutes of Health urge clinicians to carefully review patients medications but adds that many commonly used drugs can be safety administered, despite the interaction potential.

For the study, they assessed 637 consecutive patients who were prescribed Paxlovid at a Toronto clinic between March 3, 2022, and September 20, 2022. The median age was 70, and the median number of risk factors for severe disease was two, with 45% having immunocompromising conditions. Most (82%) of patients had received at least three COVID vaccine doses.

About 95% of the patients completed their 5-day Paxlovid course, with 68% reporting full symptom resolution by 28 days. Sixty (11%) of the patients had rebound symptoms. Only 3.3% of patients were hospitalized, with 1.2% linked to COVID. No known deaths were reported.

The median number of concurrent medications was seven. Researchers found that 70% had at least one drug-drug interaction (DDI), which increased to 82% in patients ages 70 and older. Most DDIs required clinical intervention, with most needing assistance from a pharmacist. The most common drugs involved with the DDI events were cardiovascular drugs and those for benign prostatic hyperplasia, followed by central nervous system drugs and oral antithrombotic agents.

Researchers also found a high rate of adverse drug events, at 62%, though they pointed out that effects didnt usually prompt patients to stop Paxlovid treatment. The most common ones were a persistent bad taste in the mouth (dysgeusia) and diarrhea.

The team said Paxlovid continues to be a mainstay for treating mild COVID in people at risk for severe disease and that the study findings underscore the need to manage drug interactions for patients taking Paxlovid. They urged prescribers to be aware of the high real-world prevalence of DDIs and adverse events, as well as strategies to mitigate them, which they said helps support treatment adherence.


See more here: Study finds high prevalence of drug interactions in adults taking ... - University of Minnesota Twin Cities
NYC regains nearly all jobs lost during the COVID-19 pandemic – FOX 5 New York

NYC regains nearly all jobs lost during the COVID-19 pandemic – FOX 5 New York

October 21, 2023

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FOX 5 NY's Morgan McKay has a closer look at the numbers and the industries that are leading the charge.

NEW YORK - New York City has recovered the nearly 1 million jobs that were lost during the COVID-19 pandemic, bringing the total to now a record high at more than 4.7 million jobs.

At an event that felt more like a re-election rally, Mayor Eric Adams touted that New York City is back in business.

Adams says this is all thanks to his administrations work prioritizing public safety, putting more officers on the streets, combating crime on the subway, and boosting union salaries.

"No one wanted to be on our subway system," Mayor Adams said. "We were hemorrhaging jobs and people were taking flights to Florida. Well you know what, they want to be back now."

But Andrew Rein from the Citizens Budget Commission says the citys recovery is a year behind the rest of the nations. There are also still around 80,000 fewer jobs in leisure, hospitality, retail, and wholesale trades.

"Thats because with remote work and the acceleration of online retail, fewer people are buying stuff in stores, fewer people are coming downtown every day," Rein said.

New York City is also headed toward a fiscal cliff with a budget gap ranging from $9 - 13 billion.

Rein says that while migrants are one reason the city is hemorrhaging money, the majority of this budget gap comes from the fact the city has been relying heavily on leftover COVID aid to fund programs.

The problem is much of this money is set to run out next year and the following year.

"Two- thirds of that gap is really of the city's own making, in part using the Wall Street bonuses and really using that federal one time COVID aid to bolster grow and fund programs that are going to continue," Rein said. "But that money is going to go away so the city needs to figure out which of the priority programs to continue and which it has to shrink."


Link: NYC regains nearly all jobs lost during the COVID-19 pandemic - FOX 5 New York
What We’re Reading: Senators Demand Answers on COVID-19 … – AJMC.com Managed Markets Network

What We’re Reading: Senators Demand Answers on COVID-19 … – AJMC.com Managed Markets Network

October 21, 2023

Senators Demand Answers From Social Security on COVID-19 Relief Clawbacks

Three US senators asked the Social Security Administration (SSA) to respond to a news report that said it reduced or suspended the benefits of people who received COVID-19 relief payments, according to . KFF Health News reported that the COVID-19 relief payments totaling as much as $3200 per person led the SSA to claw back other federal benefits, like monthly support payments for those impoverished, disabled, or aged 65 years or older. Also, the SSA sent notices to some people receiving Supplemental Security Income benefits who had more money than the $2000 asset limit due to COVID relief that alleged they were overpaid, asking them to repay the government; in some cases, SSA cut off benefit payments. The senators letter requested answers to a list of questions within 30 days.

Mifepristone, a drug taken almost exclusively to induce abortions or manage miscarriages, is tightly regulated by the federal and state governments and remains widely unavailable to patients experiencing pregnancy loss, according to Stateline. The American College of Obstetricians and Gynecologists recommended the use of both mifepristone and misoprostol to aid in passing pregnancy tissue, but a study revealed that only 1% of patients received the recommended 2-drug protocol due to mifepristone restrictions. These restrictions resulted in disparities in miscarriage care nationwide, even affecting states without abortion restrictions, as mifepristone is only available at hospitals, health clinics, and doctors offices that routinely provide abortions. Also, federal law requires all patients who receive the drug to sign a form acknowledging their desire to end their pregnancy, even if they experienced a miscarriage. Efforts to increase mifepristone access for miscarriage care are being opposed by anti-abortion groups who feel it is part of a larger campaign to make it more available for elective abortion.

Pharmaceutical companies are conducting trials in an attempt to get weight-loss shots approved for patients 6 years and older with obesity, according to Bloomberg. Eli Lilly & Co is planning to test its diabetes drug tirzepatide (Mounjaro), and Novo Nordisk A/S is planning to test (liraglutide) Saxenda, in patients as young as 6. If either drug is approved, it would be the first glucagon-like peptide-1 receptor agonists available to patients that young anywhere in the world, as the FDA and the European Medicines Agency have only greenlit them in adolescents 12 and older thus far. Pediatric obesity experts say the availability of these medications is a game-changer, as according to the CDC, about 20% of children 6 and older are obese. For pharmaceutical companies, making these medications available to a younger demographic has a huge financial upside. Despite these benefits, it is currently unclear how widely the medications would be used.


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What We're Reading: Senators Demand Answers on COVID-19 ... - AJMC.com Managed Markets Network
Researchers estimate 1% or 2% of hospital patients in England … – University of Minnesota Twin Cities

Researchers estimate 1% or 2% of hospital patients in England … – University of Minnesota Twin Cities

October 21, 2023

During the countrys second COVID wave, 95,000 to 167,000 hospital patients in England were infected with SARS-CoV-2 in the hospital, partly due to a lack of single rooms, suggests a study published yesterday in Nature.

University of Oxford researchers analyzed data on in-hospital COVID-19 transmission, probable pathways of spread, and factors tied to elevated transmission risk at 356 National Health Service (NHS) hospitals during England's second pandemic wave, from June 2020 to March 2021.

"Hospital transmission directly affects patients likely to have multiple factors associated with poor outcomes; it puts healthcare workers (HCWs) at risk and compromises their ability to provide safe patient care; it disrupts service delivery; and it can have a major role in disseminating infection to vulnerable groups in the community," the study authors wrote.

An estimated 95,000 to 167,000 hospital patients (1% to 2% of all admissions) were infected with SARS-CoV-2 over the study period. A time-series analysis suggested that patients who acquired COVID-19 in the hospital were the main source of viral spread to other patients.

"Increased transmission to inpatients was associated with hospitals having fewer single rooms and lower heated volume per bed [the volume of heated areas divided by number of beds]," the researchers wrote. "Moreover, we show that reducing hospital transmission could substantially enhance the efficiency of punctuated lockdown measures in suppressing community transmission."

An analysis of the empirical length-of-stay distribution, the estimated incubation period distribution, and polymerase chain reaction (PCR) COVID-19 test sensitivity as a function of time since infection estimated that a policy of PCR testing of symptomatic patients would detect 26% of hospital-acquired infections, with 12% of infections meeting the criteria for definite healthcare-linked infection.

Adding PCR testing of asymptomatic patients 3 and 6 days after admission would boost the proportion of cases detected to 33% but wouldn't substantively alter the percentage considered definitely related to healthcare. Adding symptomatic PCR tests with testing for all patients at 7-day intervals would increase the proportion of detected hospital-acquired infections to 44% and the percentage considered definitely healthcare-associated to 17%.

These findings reveal the previously unrecognized scale of hospital transmission, have direct implications for targeting of hospital control measures and highlight the need to design hospitals better equipped to limit the transmission of future high-consequence pathogens.

"These low probabilities for detection and classification as definite healthcare-associated are a consequence of the typically short lengths of patient stay and low PCR sensitivities early in the course of infection," the researchers wrote.

Cumulative rates of hospital-acquired infection varied by region, with the highest rates in the northwest and the lowest in the southwest and London. Because the strongest predictor of in-hospital infections is the number of patients with healthcare-associated infections the previous week, so one patient with a healthcare-associated infection the previous week is associated with a further 1.07 patient infections the following week.

"Between 1% and 2% of hospital admissions are likely to have acquired SARS-CoV-2 infection while in hospital during the 'second wave' in England, with only a minority of these infections correctly classified as 'healthcare-associated' based purely on the time elapsed between admission and positive test," the authors wrote.

"These findings reveal the previously unrecognized scale of hospital transmission, have direct implications for targeting of hospital control measures and highlight the need to design hospitals better equipped to limit the transmission of future high-consequence pathogens," they added. "The role of hospital transmission in seeding COVID-19 into care homes and other vulnerable groups in the community must be further investigated."


See the rest here: Researchers estimate 1% or 2% of hospital patients in England ... - University of Minnesota Twin Cities
Immunizations keeping community safe: Opinion – Tulsa World

Immunizations keeping community safe: Opinion – Tulsa World

October 21, 2023

The season of flu, colds and COVID-19 is upon us, and its time for people to stay up-to-date on vaccines to stave off the severity of sickness.

We believe these inoculations have saved lives by reducing the severity of symptoms and curbed the spread of viruses. The pandemic unfortunately and unsafely turned trusted science into politicized tests. But, to prevent escalating illness, people who can get the vaccines ought to consider keeping their shots updated.

The U.S. Centers for Disease Control and Prevention recommends updated COVID-19 vaccines for those 5 and older. For children 6 months to 4 years, the vaccines can be dispensed in multiple doses. For influenza, the CDC recommends a vaccine for everyone 6 months and older. The CDC states it is safe to get the vaccines at the same time.

For people at high risk for serious illness from these diseases, getting the vaccines is particularly important, as stated in a press release by Tulsa Health Departments Interim Associate Director of Preventive Health Ellen Niemitalo.

This includes people who are 65 years of age and older, people with underlying health conditions and pregnant women. Vaccines are safe and effective, and they have been proven to help prevent serious illness, hospitalization and death. COVID-19 vaccines also reduce the chance of suffering the effects of Long COVID, which can develop during or following acute infection and last for an extended time.

Though the emergency measures of the pandemic arent necessary, COVID-19 still poses danger to vulnerable populations.

A recent CDC report shows the over-65 age group represents 63% of all COVID-related hospitalizations from January through August. The vast majority of these patients had two or more underlying health conditions, including obesity, diabetes, asthma or chronic lung disease, sickle cell disease and immunocompromised disorders.

Notably, only 24% of those hospitalized were fully up to date on their coronavirus vaccinations, including boosters. So far this year in the U.S., nearly 90% of people who have died from COVID-19 were over 65. Also, this age group makes up 61% of intensive care unit admissions.

The flu doesnt get as much attention, but it affects millions annually with deadly possibilities for at-risk groups.

Being vigilant about vaccinations will keep our greater community healthy. Consistent handwashing is always important, and masks are another option for people with concerns about spreading viruses. Everyone plays a part in keeping others safe.

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Read the original: Immunizations keeping community safe: Opinion - Tulsa World
Updated Pfizer vaccine now available through the Health Department – Columbia Missourian

Updated Pfizer vaccine now available through the Health Department – Columbia Missourian

October 21, 2023

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Revolutionary People's Rep'c of Guinea-Bissau, Republic of Guyana, Republic of Heard and McDonald Islands Holy See (Vatican City State) Honduras, Republic of Hong Kong, Special Administrative Region of China Hrvatska (Croatia) Hungary, Hungarian People's Republic Iceland, Republic of India, Republic of Indonesia, Republic of Iran, Islamic Republic of Iraq, Republic of Ireland Israel, State of Italy, Italian Republic Japan Jordan, Hashemite Kingdom of Kazakhstan, Republic of Kenya, Republic of Kiribati, Republic of Korea, Democratic People's Republic of Korea, Republic of Kuwait, State of Kyrgyz Republic Lao People's Democratic Republic Latvia Lebanon, Lebanese Republic Lesotho, Kingdom of Liberia, Republic of Libyan Arab Jamahiriya Liechtenstein, Principality of Lithuania Luxembourg, Grand Duchy of Macao, Special Administrative Region of China Macedonia, the former Yugoslav Republic of Madagascar, Republic of Malawi, Republic of Malaysia Maldives, Republic of Mali, Republic of Malta, Republic of Marshall Islands Martinique Mauritania, Islamic Republic of Mauritius Mayotte Micronesia, Federated States of Moldova, Republic of Monaco, Principality of Mongolia, Mongolian People's Republic Montserrat Morocco, Kingdom of Mozambique, People's Republic of Myanmar Namibia Nauru, Republic of Nepal, Kingdom of Netherlands Antilles Netherlands, Kingdom of the New Caledonia New Zealand Nicaragua, Republic of Niger, Republic of the Nigeria, Federal Republic of Niue, Republic of Norfolk Island Northern Mariana Islands Norway, Kingdom of Oman, Sultanate of Pakistan, Islamic Republic of Palau Palestinian Territory, Occupied Panama, Republic of Papua New Guinea Paraguay, Republic of Peru, Republic of Philippines, Republic of the Pitcairn Island Poland, Polish People's Republic Portugal, Portuguese Republic Puerto Rico Qatar, State of Reunion Romania, Socialist Republic of Russian Federation Rwanda, Rwandese Republic Samoa, Independent State of San Marino, Republic of Sao Tome and Principe, Democratic Republic of Saudi Arabia, Kingdom of Senegal, Republic of Serbia and Montenegro Seychelles, Republic of Sierra Leone, Republic of Singapore, Republic of Slovakia (Slovak Republic) Slovenia Solomon Islands Somalia, Somali Republic South Africa, Republic of South Georgia and the South Sandwich Islands Spain, Spanish State Sri Lanka, Democratic Socialist Republic of St. Helena St. Kitts and Nevis St. Lucia St. Pierre and Miquelon St. Vincent and the Grenadines Sudan, Democratic Republic of the Suriname, Republic of Svalbard & Jan Mayen Islands Swaziland, Kingdom of Sweden, Kingdom of Switzerland, Swiss Confederation Syrian Arab Republic Taiwan, Province of China Tajikistan Tanzania, United Republic of Thailand, Kingdom of Timor-Leste, Democratic Republic of Togo, Togolese Republic Tokelau (Tokelau Islands) Tonga, Kingdom of Trinidad and Tobago, Republic of Tunisia, Republic of Turkey, Republic of Turkmenistan Turks and Caicos Islands Tuvalu Uganda, Republic of Ukraine United Arab Emirates United Kingdom of Great Britain & N. Ireland Uruguay, Eastern Republic of Uzbekistan Vanuatu Venezuela, Bolivarian Republic of Viet Nam, Socialist Republic of Wallis and Futuna Islands Western Sahara Yemen Zambia, Republic of Zimbabwe


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