Category: Corona Virus

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Although COVID-19 has faded from the headlines, SARS-CoV-2the coronavirus behind the pandemicis still rampantly infecting people around the world. Public health officials fear as the virus continues to evolve, it will eventually hit upon a diabolical mutation that renders current treatments ineffective, triggering a new wave of severe infection and social disruption.

In pursuit of new therapies to avoid this dark fate, researchers at Stanford have now unveiled a compound that measures up as a potentially powerful anti-coronavirus drug, detailed in a paper published March 13 in Science Translational Medicine.

Dubbed ML2006a4, the compound works in the same way as Paxlovidthe most effective oral drug available to dateby binding to coronavirus particles and preventing the virus from making copies of itself. Compared to Paxlovid, though, ML2006a4 binds more tightly and durably, courtesy of the Stanford team custom-crafting the compound atom-by-atom.

In preclinical experiments, the compound prevented deadly infections in mice at a superior rate compared to Paxlovid. In addition, the new compound is potent enough that it could likely be formulated without an additional component present in Paxlovid that poses severe drug interaction concerns.

Importantly, ML2006a4 also performed well against coronavirus variants that have already evolved degrees of resistance to Paxlovid, suggesting the compound's honed affinity makes it less vulnerable to mutant virus strains.

"At this point entering the fifth year of the pandemic, Paxlovid is our only really good drug against SARS-CoV-2, but it's proven fairly easy for the virus to evolve resistance to it," said Michael Lin, the senior author of the study, who is an associate professor of neurobiology and of bioengineering in the schools of Medicine and Engineering and a member of Stanford Bio-X.

"As new waves of coronavirus keep crashing down, we need to have alternative drugs that are more tolerant of mutations and not as easy for the virus to defeat."

For the study, Lin worked closely with lead author Michael Westberg, now an assistant professor at Aarhus University in Denmark. From 2018 until 2022, Westberg worked in Lin's lab as a visiting scholar at Stanford Bio-X through a joint program designed to strengthen international collaborations and the exchange of scientific expertise between Stanford and Denmark.

Before the pandemic outbreak in 2020, Lin's lab had already been investigating the broad class of drugs known as viral protease inhibitors. These drugs target protease enzymes that viruses need for disassembling bulky viral proteins as part of their replication cycle. Like a key fitting into a lock, protease inhibitors occupy the spaces, or active sites, where proteases normally link up with those bulky proteins, thus nipping replication in the bud.

Specifically, the Stanford researchers had gained familiarity with hepatitis C virus protease, which has similarities to coronavirus versions. Although Westberg had come to Stanford to work on other projects, the global emergency prompted a pivot. "When the pandemic hit, we asked if we could put our expertise to good use," said Lin.

Their early research, posted online in September 2020, demonstrated that a hepatitis C drug, boceprevir, slotted reasonably well into the coronavirus protease site. Other scientists built off those findings, including at the pharmaceutical company Pfizer, which ultimately created Paxlovid and received regulatory approval for its use in December 2021.

"We knew then that we were on the right track," said Lin, "and we were motivated to keep going and make an even more effective drug."

The Lin lab pooled its collective chemical knowledge to design improvements to their iterative boceprevir-based compounds. Much of the work involved modifying the compound on the atomic scale in intricately detailed computer models to fit more snugly in the coronavirus protease active site.

"Basically, you put your drug in the active site and you look for gaps where it doesn't tightly fit. Then you fill those gaps," said Lin.

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The Stanford researchers approached this challenge in a rational way by adding different configurations of atoms of carbon, nitrogen, and oxygen to the compounds as permitted by the laws of biochemistry.

"There's a lot of creativity and intuition involved because everyone is working with the same three atoms, but there are essentially infinite ways to arrange them," said Lin. "Making these modifications, it's like playing atomic Tetris."

The resulting compounds were then tested against actual coronavirus particles at the Stanford In Vitro Biosafety Level 3 Service Center. After multiple rounds of honing, Lin's team arrived at the compound designated ML2006a4.

In studies with SARS-CoV-2-infected mice, ML2006a4 worked as well as Paxlovid in promoting survival, while offering better protection of the rodents' lungs and lowering overall virus load in the body.

The researchers attribute this success to ML2006a4's extremely refined fit inside coronavirus protease, where the compound boasted a 20-fold higher binding affinity than Paxlovid. That better fit equates to stronger chemical bonds, meaning the drug can stay bound to the protease for a longer time.

In this temporal regard, ML2006a4 indeed proved quite sticky: The inhibitor remained attached for approximately 330 minutes, or greater than five hours, whereas the corresponding Paxlovid inhibitor typically fell off its target in just about two minutes.

From a medication perspective, such staying power translates to spaced-out, smaller doses that can still prevent disease from worsening while giving the immune system a chance to kill off the invaders. "The long-lived drug-enzyme complex helps ensure that the virus doesn't escape and replicate before your next medication dose," said Lin.

In this way, ML2006a4 offers other advantages compared to Paxlovid. Technically, Paxlovid is two drugs packaged together: nirmatrelvir, the actual protease inhibitor, and ritonavir, a drug that prevents the liver from quickly breaking down nirmatrelvir, boosting nirmatrelvir's performance. Yet the slowing of the liver's metabolism by ritonavir means that other drugs can toxically build up, forcing patients to take the risk of temporarily stopping their normal medications.

According to Lin, an oral pill based on ML2006a4 might not require ritonavir to prop up drug levels enough between typical 12-hour administrations to effectively keep coronavirus in check, but "this would need to be tested to make sure," said Lin. "We also continue to make improved versions of ML2006a4 with better potency and duration of activity," he added.

For the promising compounds to move forward, Lin and colleagues are seeking additional investment. The group now feels their compounds are ready for expanded preclinical testing with an eye toward clinical trials in human patients.

"We're very excited how far we've come and how successful our drug discovery has been on a shoestring budget," said Lin. "We hope to see this promising compound developed further to stay ready for what SARS-CoV-2 throws at us next."

More information: Michael Westberg et al, An orally bioavailable SARS-CoV-2 main protease inhibitor exhibits improved affinity and reduced sensitivity to mutations, Science Translational Medicine (2024). DOI: 10.1126/scitranslmed.adi0979. http://www.science.org/doi/10.1126/scitranslmed.adi0979

Journal information: Science Translational Medicine

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Drug design at the atomic level to thwart COVID-19 - Medical Xpress

Del. Bill Anderson, R-Wood, reads through the House of Delegates version of the budget bill during a March 4 meeting of the House Finance Committee. (Photo Provided)

CHARLESTON West Virginia is likely to receive its second waiver for not meeting rules put in place by the U.S. Department of Education to keep state education spending at a certain level in exchange for use of more than $1.1 billion in COVID-19 funds, department officials said.

Officials with the U.S. Department of Education held a background briefing with reporters last week regarding the approximately $465 million the state might have to pay towards education expenses if the department does not grant West Virginias second and final waiver request from the departments maintenance of effort (MOE) requirements after the state received three tranches of Elementary And Secondary School Emergency Relief (ESSER) funds during the COVID-19 pandemic.

The officials, who declined to be identified, said that a decision on a waiver could be rendered before June, opening a possible window for a special session of the West Virginia Legislature to restore certain line items in the fiscal year 2025 general revenue budget passed on the final day of the 2024 session Saturday night.

I cant promise any specific timeline, but I personally will be distraught if it takes us until June, a department official said. Im hoping we can do something more quickly.

The state received more than $1.1 billion through the Coronavirus Aid Relief, and Economic Security (CARES) Act, the Coronavirus Response and Relief Supplemental Appropriations (CRRSA) Act, and the American Rescue Plan Act (ARPA) between 2020 and 2021. Those funds went to all 55 county school systems. Of that, more than $834 million has been spent as of the end of 2023.

But the final rules put in place for states to remain eligible to spend the CRRSA and ARPA funds with final guidance released in August 2022 required states to maintain their total education spending as a certain average compared to total budget expenditures. The percentage was based on an average of the three fiscal years (2017, 2018, and 2019) prior to the COVID-19 pandemic that began in 2020.

West Virginias baseline proportional educational spending level was 41.6%. But state support for K-12 education in fiscal year 2022 was $2 billion, or 37.5%, falling short of the required spending level. Gov. Jim Justice and state Department of Education officials under former state superintendent of schools Clayton Burch applied for a waiver on June 14, 2022.

State officials explained that the states student aid formula to counties was based on per-pupil enrollment, though it could show an increase in K-12 spending in prior fiscal years despite enrollment drops during the same period. State officials were also able to show increases in education spending through other means, including pay raises for teachers, increased funding for School Building Authority projects, deferred maintenance on existing schools, and the Governors Communities in Schools program.

As a result, the state was able to improve the percentage of education spending from 37.5% to 40.6%. The U.S. Department of Education granted the states fiscal year 2022 waiver on June 12, 2023. But despite an increase in state support for K-12 education to $2.1 billion, the states percentage of education spending compared to overall state spending was 34.7%, caused in part by maintaining an artificially flat general revenue budget and ending fiscal year 2023 with more than $1.8 billion in surplus tax collections.

West Virginia applied once again to the U.S. Department of Education for a second waiver for fiscal year 2023 on Feb. 21. According to department officials, five states have also applied for waivers for fiscal year 2023, including West Virginia. States also have until Friday, March 15, to submit additional data to the department which will be used to determine whether to grant a waiver.

West Virginia is not alone. There are other states, a department official said. We dont have final data from those states because it isnt due until March 15. So, kudos to West Virginia for acting on this before the March 15 deadline.

West Virginias monetary gap to meet the 41.6% baseline proportional educational spending level is $465 million according to state officials, though the U.S. Department of Education was unable to confirm the specific dollar amount. The Legislature just passed Senate Bill 200, the budget bill for fiscal year 2025 beginning in July, which also includes funding for teacher pay raises and $150 million for the School Building Authority.

State officials also plan to use ongoing base funding increases, such funding for the Third Grade Success Act that went into effect this school year, in order to close the education funding gap. The Third Grade Success Act included ongoing funding to place aids in early elementary school classrooms.

While there are several mechanisms the U.S. Department of Education can consider against states if waivers are not granted including clawing back the federal COVID-19 funds officials said to date that it was never not granted a waiver.

In some respects, West Virginia is ahead of the game compared to other states because they have worked to update their data and their waiver prior to the March 15th deadline, which was sooner than some other states, one department official said.

SB 200, the budget bill, set the general revenue budget beginning Monday, July 1, at $4.996 billion. However, the section known as the back of the budget which lists budget priorities to be funded from available surplus tax revenue at the end of the current fiscal year on Sunday, June 30 was left skinny in case the waiver is not granted.

The state is expected to end this fiscal year with nearly $800 million above revenue estimates. Once the waiver is granted, lawmakers hope to return to Charleston for a special session as soon as May to restore reduced appropriations in the fiscal year 2025 and to add items to the back of the budget.

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State likely to receive waiver on U.S. Department of Education COVID-19 fund rules - Parkersburg News

The pandemic caused a global reduction in life expectancy for the first time since the study began ... [+] three decades ago.

Global life expectancy decreased between 2019 to 2021 due to deaths from the Covid-19 pandemic, according to the results of a new study.

The research published in The Lancet featured updates from the Global Burden of Disease Study and showed that global average life expectancy declined by 1.6 years between 2019 and 2021. The study began in the 1990s and this is the first time that a decline in life expectancy has been documented as opposed to a steady overall rise.

For adults worldwide, the Covid-19 pandemic has had a more profound impact than any event seen in half a century, including conflicts and natural disasters, says co-first author Dr. Austin E. Schumacher, Acting Assistant Professor of Health Metrics Sciences at the University of Washington and one of the authors of the study.

The researchers estimated that 15.9 million people died from Covid-19 in 2020 and 2021 worldwide who would have been alive if it were not for the pandemic. 5.9 million of these were recorded in 2020 and just under 10 million in 2021.

However, the pandemic did not affect mortality equally all over the globe. Eighty countries had mortality rates in excess of 150 per 100,000 people, per year during one or more years of the pandemic, with the highest rates being Peru in 2020 (413 people per 100,000) and Bulgaria in 2021 (697.5 people per 100,000).

Life expectancy declined in 84% of countries and territories during this pandemic, demonstrating the devastating potential impacts of novel pathogens, said Schumacher.

There was however, some good news from the report. There were a few countries where life expectancy increased during the early years of the pandemic from 2019-2021, including Australia, New Zealand and China. All of these countries had lower numbers of Covid-19 infections than many other parts of the world during that time, although the report did not suggest this as a cause.

Additionally, child mortality continued to decrease even during the pandemic, with half a million fewer deaths in children under five years old in 2021 compared to 2019.

The study also looked at trends in population numbers around the world. Since 2021, 56 countries have had their populations shrink, but population growth has continued to rise in lots of lower-income countries. People in many countries around the world are also getting older on average. In the two decades leading up to 2021, the number of people over 65 grew more rapidly than the number of individuals under age 15 in 188 countries and territories all over the world.

Slowing population growth and aging populations, along with the concentration of future population growth shifting to poorer locations with worse health outcomes, will bring about unprecedented social, economic, and political challenges, such as labor shortages in areas where younger populations are shrinking and resource scarcity in places where population size continues to expand rapidly. These issues will require significant policy forethought to address in the affected regions added Schumacher.

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Covid-19 Causes Global Life Expectancy Drop For First Time In 30 Years - Forbes

Laurie McLean, left, and Cheryl Brown-McLean were part of the 'Cauls cluster' of COVID-19 cases at the very beginning of the COVID-19 pandemic in Newfoundland and Labrador. Four years later, they're looking back at what the experience was like. (Mark Quinn/CBC - image credit) Laurie McLean, left, and Cheryl Brown-McLean were part of the 'Cauls cluster' of COVID-19 cases at the very beginning of the COVID-19 pandemic in Newfoundland and Labrador. Four years later, they're looking back at what the experience was like.

Laurie McLean, left, and Cheryl Brown-McLean were part of a notorious cluster of COVID-19 cases at the very beginning of the pandemic in Newfoundland and Labrador. Four years later, they're looking back at what the experience was like. (Mark Quinn/CBC)

As Newfoundland and Labrador marks the fourth anniversary of its first announced presumptive case of coronavirus, two people at the heart of an early outbreak are reflectingon the pandemic's early days.

Laurie McLean andCheryl Brown-McLeanremember the shift: from total normalcy to the complete unknown.

Things changed after they went to a wake at Caul's Funeral Home in St. John's in March 2020.

"We weren't concerned at all, really, when we chose to go to Caul's. We went to the wake of a brother of a neighbour, so all the neighbours were going," Cheryl told CBC News on Thursday.

"There had been some warnings about COVID, you know, potentially coming here. And the warnings were I believe at the time, 'Be careful of anybody who's coughing, sneezing. Stay out of their range,' so to speak."

Laurie fell ill a few days later, and spent 19 days in hospital with COVID-19. The McLeans became part of what became known as Caul'scluster, which represented about 170 connected cases and was one of the first reportedclusters of coronavirus in Canada.

"It was like I was hit by a truck, right? Like I could feel this sickness almost welling inside of me," Laurie said. "I thought I was dying. Iliterally couldn't breathe."

Newfoundland and Labrador reported its first case of COVID-19 on March 14, 2020, and implemented a public health emergency four days later. At a March 17 briefing at Confederation Building, then health minister John Haggie and Janice Fitzgerald, the chief medical officer of health, demonstrated the principle of physical distancing. (CBC)

Newfoundland and Labrador reported its first case of COVID-19 on March 14, 2020. While in hospital, the McLeans watched the world shut down around them.

Story continues

Schools and daycare facilities across the province closed two days later, and a public health emergency came into effect on March 18. The emergency status was lifted two years later in March 2022.

The first death as a result of COVID-19 was reported on March 30. Four years later, about 400 people in Newfoundland and Labrador have died due to the virus, according to statistics reported by the province.

Laurie McLean said he has select memories of battling the virus, like being put under to have a ventilator installed to help him breathe and the strange, drug-induced dreams that followed.

"There was humans just being lined up and the aliens were just looking at us. And they just came in, they shook their heads and they threw me out. So you know, the aliens rejected me," he said with a laugh.

"I think now, that [was] my body winning the battle."

Cheryl said it was difficult to be away from Laurie for so long at the start of the pandemic and knows how it must have challenged other families. She credits the medical staff at the Health Sciences Centre for caring for the both of them and giving her peace of mind.

Four years and a second COVID-19 diagnosis later, Laurie said the events of the 2020sare still hard to believe at times.

But these days, the couple say, life is pretty much back to normal.

"I don't dwell on it at all," Cheryl said. "Idon't think about it from day to day. Icertainly don't worry about it."

Download ourfree CBC News appto sign up for push alerts for CBC Newfoundland and Labrador.Click here to visit our landing page.

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4 years after N.L.'s first case of COVID-19, this couple recalls being part of an early outbreak - Yahoo News Canada

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Darnelle Clark is known for going the extra mile for her students and always showcasing her bubbly personality and passion for educating.

Clark is known for going the extra mile for her students and always showcasing her bubbly personality and passion for educating.

When she contracted the corona virus during the pandemic, her road to recovery was fraught with unexpected challenges and weak organs.

Learning to walk again became her new reality, but after months of recovering, she made it back to the classroom using oxygen full time to help her breathe.

However, just as she was starting to rebuild her life, the virus struck her again last December.

"She's very very weak and I know her lungs are really struggling and her glucose levels have been low," Dunlap said.

Clark is now receiving care from the Cleveland Clinic, and doctors say there are several treatments that can help her, but those treatments come with a hefty price tag that her insurance is refusing to cover.

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Beloved Liberty teacher battling Covid-19 again, loved ones start a GoFundMe for life-saving treatment - WFMJ

Tiara Vian/KJZZ

On Friday, the U.S. Centers for Disease Control and Prevention relaxed some of its recommended coronavirus safety protocols.

The change means those with no symptoms, but who test positive, do not need to quarantine.

As you fight the virus off, you become less infectious even if youre still testing positive. If your symptoms have resolved, then you're unlikely to be spreading the virus, said Will Humble, director of the Arizona Public Health Association.

Humble also said those who test positive should still stay home and treat their condition as if they were suffering from the flu or other respiratory illnesses. He predicts the virus is on track to be associated with the common cold, but still kills a few hundred people in Arizona.

Originally posted here:

CDC relaxes some of its recommended COVID-19 safety protocols - KJZZ

The quandemic concept has clear roots in Michael Foucaults notion of biopower [11, 12]. Foucault introduced the concept of biopower to denote state power over populations and individuals that hinges fundamentally on expert knowledge of the populations biological quality and longevity [13]. Biopower seeks to optimize a populations vitality mainly through rationalized mechanisms of population monitoring and medicalization [14]. One important expression of and prerequisite for biopower is quantification. In the 1970s, Foucault described how this practice became apparent during a smallpox outbreak in the eighteenth-century. The primary focus was no longer understanding the pathology of the epidemic itself but to track the number of the infected, their age, medical consequences, and mortality using statistical methods. In the words of Foucault: when quantitative analyses are made of smallpox in terms of success and failure [] the disease no longer appears in this solid relationship of the prevailing disease to its place or milieu, but as a distribution of cases in a population circumscribed in time or space [15]. Since then, numbers and statistics have come to play a crucial role in epidemic and crisis management. However, Foucault reminds us that metrics are not only important pieces of evidence but, simultaneously, they are expressions of biopower. Decisions of what metrics to promote or ignore, and how to measure them have the power to frame the pandemic in a certain political light and therefore shape responses.

We propose four distinct dynamics that characterize a quandemic:

A few metrics tend to dominate both political, expert, and public spheres and they exhibit a great deal of rigidity over time. The metrics are produced and reproduced by key stakeholders within and across the different spheres of influence without much open debate and discussion of alternatives. Instead, the metrics are followed and reported regularly by health agencies, politicians, and major media outlets. In addition, the same metrics dominate throughout the pandemic. While new metrics might emerge, such as vaccination rates, they largely serve to accentuate the importance of the existing metrics.

These few metrics appear to crowd-out other forms of evidence relevant to pandemic response. These alternative sources of evidence can be qualitative and quantitative in nature and represent socio-economic or public health dynamics. Examples of crucial but deprioritised evidence could include anthropological perspectives of vaccine hesitancy and community engagement, economic approaches to vulnerability, and quantitative tracking of mental health impacts (public health); gender violence (social) or differences in student attainment following prolonged periods of distance teaching (educational). While it is important to emphasize that this evidence was far from ignored during COVID-19, the quantitative metrics would often constitute the point of departure for debates and deliberations and the additional evidence would primarily be an addendum used to contextualize and qualify [16, 17].

The metrics tend to favour certain outcomes of pandemic management. During COVID-19, non-pharmaceutical interventions would almost certainly improve these metrics (to varying degrees), while the potential adverse impacts of the interventions would not be the focus on these metrics. These adverse consequences would, therefore, need to be considered on an ad-hoc basis. The benefits of lockdowns would be captured by the metrics, e.g. a drop in cases, hospitalizations, and deaths. Whereas the costs of these interventions were largely beyond these dominant metrics. Disaster management studies have long been attentive of the need to address the socio-economic consequences of both the hazard itself as well as the mitigating measures [18]. The dominant metrics during COVID-19 appeared ill-equipped to capture the nuanced and longer-term impacts of the pandemic response.

Finally, the metrics are easily standardized across countries, and give rise to competitive dynamics based on international comparisons and benchmarking. While the metrics during COVID-19 faced limited competition internally from other types of evidence, they exhibited a substantial potential for generating external competition between countries and different administrations. Pandemic successes and failures were evaluated and compared in terms of this limited subset of metrics. Political leaders were faced daily with these metrics and were often held accountable for unfavourable developments compared to other similar countries and over time. This created a textbook suboptimal situation where decision makers would pursue policies that carried concentrated and visible benefits (lowering mortality rates, for example) while keeping the costs dispersed and less visible [19]. Policymaking can be caught in a self-fulfilling loop where the initial focus on these metrics continuously reinforces the political salience of the same metrics.

To be clear, having access to standardized measures on a wide range of health outcomes constitutes best practice during pandemic management. In fact, many countries with limited capacity faced a substantial impediment to effective pandemic management because they had little access to these types of timely and disaggregated national metrics. However, a quandemic concerns the overreliance on these metrics and the resulting unproductive competitive comparisons. We observed these quandemic dynamics in the Nordic region. From the very initial phases of the pandemic, it was clear that a few metrics permeated the political and public debates. Across the Nordic countries, the main newspapers outlets carried the development of these key metrics daily on their frontpage and/or main website. Cases and fatalities came to embody the success of the pandemic response. Only towards the end of the first wave did Finland, for example, assemble a group of scientists that were to monitor COVID-19-related results in a way that paid attention to other factors including education, the economy, to technological innovation, misinformation, and resilience [20]. Sweden famously pursued slightly more lenient non-pharmaceutical interventions in 2020, motivated by the Swedish Health Agencys emphasis on additional longer-term objectives that were not easily caught in the metrics. Equity was stated as the overarching focus of agencys mission statement and was highlighted as a key guiding principle by the actors involved in key advice making during COVID-19 [21, 22]. The decision not to close primary schools down for physical attendance nationally, for example, was rooted in a concern for ensuring educational attainment, access to school meals, and the social well-being of children and had full support of the Swedish Childrens Ombudsman the highest legal authority for the rights of children [22, 23].

This approach was met with scepticism internationally, and to some extent nationally, as the dominant metrics deteriorated in the Autumn and Winter of 2020 compared to other Nordic countries of Denmark, Norway and Finland [24,25,26]. These numbers became overtly political, with the other Nordic governments using Sweden as a cautionary tale of laissez faire pandemic management. Danish and Norwegian newspapers carried many comparisons to the Swedish strategy equating the success of their pandemic response by the lower rates of cases and deaths in 2020 compared to Sweden [27, 28]. In February 2021, the Danish government emphasized that Denmark only had one fourth of the infected compared to Sweden [29]. The correctness of Sweden's initial pandemic strategy is not the point here.Rather success or failure at the time was primarily assessed by a handful of quantitative metrics that did not reflect the national pandemic response goals.Therefore, debating achievements based only on these metrics risks obscuring comprehension.

Three years later, the media and politicians engaged rigorously in yet another comparison of pandemic responses across the Nordic countries. This time the comparison was based on excess mortality rates during the pandemic and was reported in the Norwegian media, [30] Danish media, [31] Finnish media, [32] and the Swedish media [33]. The various measures of excess mortality suggested that Sweden fared well compared to the other Nordic countries, when using population-adjusted excess mortality rates for 20202022. While the new excess mortality metric was used to vindicate parts of the Swedish pandemic strategy, the point here is much broader: that such comparison still reinforces the same quandemic mindset that had been dominant in the early phases of the pandemic: a competition of biopower where successes or failures are reduced to a few select metrics. Even excess mortality rates are insufficient to fully gauge the impact of the pandemic as well as the policies implemented to combat it. It leaves out important aspects such as morbidity, the impact on education, equity, economy, mental health, and general wellbeing.

Thus, we propose that the four quandemic characteristics risk producing suboptimal conditions for balanced public debate and policymaking, as evidenced by the Nordic example. A quandemic obscures important syndemic dynamics, as more diverse scientific evidence capturing socio-economic vulnerabilities of the outbreak tends to be muffled by the few dominant metrics. Further, it increases exposure to infodemic dynamics because the dominance of these metrics might create an information void in spaces which they do not capture. Misinformation, pseudo-science, and scientific polarisation can roam in areas where these metrics fall short.

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The COVID-19 quandemic | Globalization and Health | Full Text - Globalization and Health

L.L. Bean has just added a third shift at its factory in Brunswick, Maine, in an attempt to keep up with demand for its iconic boot.

Orders have quadrupled in the past few years as the boots have become more popular among a younger, more urban crowd.

The company says it saw the trend coming and tried to prepare, but orders outpaced projections. They expect to sell 450,000 pairs of boots in 2014.

People hoping to have the boots in time for Christmas are likely going to be disappointed. The bootsare back ordered through February and even March.

"I've been told it's a good problem to have but I"m disappointed that customers not getting what they want as quickly as they want," said Senior Manufacturing Manager Royce Haines.

Customers like, Mary Clifford, tried to order boots on line, but they were back ordered until January.

"I was very surprised this is what they are known for and at Christmas time you can't get them when you need them," said Clifford.

People who do have boots are trying to capitalize on the shortage and are selling them on Ebay at a much higher cost.

L.L. Bean says it has hired dozens of new boot makers, but it takes up to six months to train someone to make a boot.

The company has also spent a million dollars on new equipment to try and keep pace with demand.

Some customers are having luck at the retail stores. They have a separate inventory, and while sizes are limited, those stores have boots on the shelves.

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Older US adults should get another COVID-19 shot, advisers say - NBC Bay Area

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The Centers for Disease Control and Prevention has relaxed the guidelines associated with COVID-19 to be more in line with the flu or RSV. Here's what to do if you get sick.

ATLANTA - The Centers for Disease Control and Prevention issued new guidance on COVID-19.

The new guidelines state someone who is infected no longer needs to be isolated for 5 days after testing positive for the virus. Thats as long as the fever goes away without medication and symptoms improve.

"COVID messes me up. The first time I got it, I was fully sick for more than a month. Like, very, very, dangerously ill," said Sam Levine.

That was the first time Levine was diagnosed with COVID, but he says hes since gotten it again, each time being less severe.

That tracks with the national trend.

"We are seeing less hospitalizations, less deaths from COVID, which is a great sign," said CDC Director Dr. Mandy Cohen.

She says their data shows the collective immunity in the community is stronger now than ever.

"We could tell from our wastewater data that there was a lot of virus spread, but the trends and reduction of hospitalizations and death continued. That's why we felt comfortable moving to this unified guidance," Dr. Cohen said.

The unified guidance now states self-isolation should only last for 24 hours after a fever is broken without the aid of medication or if symptoms improve.

That is now in line with guidance for influence or RSV.

This replaces the CDC guidance which called for people to self-isolate for 5 days after contracting COVID.

"You can return to work or return to school faster. That's one of the positive consequences of a guideline change like this," said Dr. Jodie Guest, senior vice chair for the Rollins School of Public Health Department of Epidemiology at Emory University.

She adds that while this is good news for those who can't afford to miss work and kids who need to be in school more, people still need to take COVID-19 seriously.

"We do want to consistently point out that COVID-19 is much more deadly than either of those other two infections," Dr. Guest said.

She points to the part of the new guidelines which say to take extra precautions for up to 5 days after the 24-hour isolation period is over, like masking and social distancing.

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CDC relaxes COVID-19 isolation requirements | What you need to know - FOX 5 Atlanta

BOSTON

Four years after the COVID-19 pandemic closed schools and upended child care, the CDC says parents can start treating the virus like other respiratory illnesses.

Gone are mandated isolation periods and masking. But will schools and child care centers agree?

In case you've lost track: Before Friday, all Americans, including school children, were supposed to stay home for at least five days if they had COVID-19 and then mask for a set period of time, according to the Centers for Disease Control and Prevention.

Now, with COVID deaths and hospitalizations dropping, the CDC says children can go back to school when their overall symptoms improve and they're fever-free for 24 hours without taking medication. Students are "encouraged" to wear a mask when they return.

Still, the change may not affect how individual schools urge parents to react when their children fall sick. Schools and child care providers have a mixed record on following CDC recommendations and often look to local authorities for the ultimate word. And sometimes other goals, such as reducing absences, can influence a state or district's decisions.

The result can be a confusing array of policies among states and districts, not to mention workplaces confounding parents whose lives have long been upended by the virus.

"This is so confusing," said Gloria Cunningham, a single mom in the Boston area. "I just don't know what I should think of COVID now. Is it still a monster?"

Cunningham, who manages a local store for a national restaurant chain, said her company requires her to take off 10 days if she gets COVID-19. And the school system where her son is in second grade has still been sending home COVID test kits for kids to use before returning to school after long breaks.

FILE - Fifth graders wearing face masks sit while social-distancing during a music class at Milton Elementary School in Rye, New York, May 18, 2021.

"I feel like we should just do away with anything that treats COVID differently or keep all of the precautions," she said.

The public education system has long held varying policies on COVID. During the 2021-22 school year, 18 states followed CDC recommendations for mask-wearing in class. When the CDC lifted its masking guidelines in February 2022, states such as Massachusetts followed suit, but California kept the mask requirement for schools.

And in the child care world, some providers have long used more stringent testing and isolation protocols than the CDC has recommended. Reasons have ranged from trying to prevent outbreaks to keeping staff healthy both for their personal safety and to keep the day care open.

Some states moved to more lenient guidelines ahead of the CDC. California and Oregon recently rescinded COVID-19 isolation requirements, and many districts followed their advice.

In an attempt to minimize school absences and address an epidemic of chronic absenteeism, California has encouraged kids to come to school when mildly sick and said that students who test positive for coronavirus but are asymptomatic can attend school. Los Angeles and San Diego's school systems, among others, have adopted that policy.

But the majority of big-city districts around the country still have asked parents to isolate children for at least five days before returning to school. Some, including Boston and Atlanta, have required students to mask for another five days and report positive COVID-19 test results to the school.

Some school leaders suggest the CDC's previous five-day isolation requirement was already only loosely followed.

Official policy in Burlington, Massachusetts, has been to have students stay home for five days if they test positive. But Superintendent Eric Conti said the real policy, in effect, is: "It's a virus. Deal with it."

That's because COVID is managed at home, using the honor system.

"Without school-based testing, no one can enforce a five-day COVID policy," he said via text message.

FILE - Students line up to enter Christa McAuliffe School in Jersey City, New Jersey, April 29, 2021.

Ridley School District in the Philadelphia suburbs was already using a policy similar to the new CDC guidelines, said Superintendent Lee Ann Wentzel. Students who test positive for COVID must be fever-free without medication for at least 24 hours before returning to school. When they come back, they must mask for five days. Wentzel said the district is now considering dropping the masking requirement because of the new CDC guidance.

A school or day care's specific guidelines are consequential for working parents who must miss work if their child can't go to school or child care. In October 2023, during simultaneous surges of COVID, respiratory syncytial virus and influenza, 104,000 adults reported missing work because of child care issues, the highest number in at least a decade. That number has fallen: Last month, child care problems meant 41,000 adults missed work, according to the Bureau of Labor Statistics.

Melissa Colagrosso's child care center in West Virginia dropped special guidelines for COVID about a year ago, she said. Now, they're the same as other illnesses: A child must be free of severe symptoms such as fever for at least 24 hours before returning to the center.

"We certainly are treating COVID just like we would treat flu or hand, foot and mouth" disease, said Colagrosso, CEO of A Place To Grow Children's Center in Oak Hill.

As for kids without symptoms who test positive for COVID? Most parents have stopped testing kids unless they have symptoms, Colagrasso said, so it's a quandary she has not encountered.

Still, some parents worry the relaxed rules put their communities at greater risk. Evelyn Alemn leads a group of Latino and Indigenous immigrant parents in Los Angeles County. The parents she represents, many of whom suffer from chronic illnesses and lack of access to health care, panicked when California did away with isolation requirements in January.

"I don't think they're considering what the impact will be for our families," she said of California officials. "It feels like they don't care that we're almost expendable."

Other impacts of the pandemic linger, too, even as restrictions are lifted. In Ridley, the Philadelphia-area district, more students are reclusive and struggle to interact in-person with peers, said Wentzel, the superintendent. Interest in school dances has plummeted.

"Emotionally," Wentzel said, "they're having trouble."

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CDC Relaxes COVID Guidelines; Will Schools, Day Cares Follow Suit? - Voice of America - VOA News