Category: Corona Virus

TALLAHASSEE A state appeals court this month will wade into a dispute about whether the University of Florida should refund fees to students who were forced to switch to remote learning in 2020 during the onset of the COVID-19 pandemic.

A panel of the 1st District Court of Appeal is scheduled to hear arguments July 20 after an Alachua County circuit judge last year refused to dismiss the potential class-action lawsuit. At least two other state appellate courts have taken up similar cases from other schools and reached different conclusions.

A key issue in the cases is whether schools breached contracts by not providing on-campus services in 2020 after students had paid fees.

The University of Florida disputes that an express contract existed with plaintiff Anthony Rojas, who was a graduate student in 2020. As a result, it contends Alachua County Circuit Judge Monica Brasington should have dismissed the case.

None of the documents attached to the complaint (the lawsuit) expressly establish that UF is obligated to provide services at a certain place, in a certain manner, at a certain time, or even at all, UFs lawyers wrote in a brief at the Tallahassee-based appeals court. To the extent Mr. Rojas and others had a unilateral expectation that the fees students paid during the semesters in question would guarantee the provision of certain services, or even that fees would be expended for services to be delivered during that semester i.e., a pay-as-you-go model there is no evidence of mutual assent on that essential term. It is decidedly not an express promise on the part of UF as Mr. Rojas contended and as the circuit court found below.

But attorneys for Rojas countered in a brief that UF declares that students cannot bring claims against it for failing to provide the on-campus services for which students paid fees while maintaining that UF can put students into debt collections for failing to pay those very fees.

Put simply, UF asserts a contract exists when it wants to collect money from its students, but disavows that same contract when students seek refunds of fees they paid for unperformed services, Rojas attorneys wrote.

The case involves fees for such things as activities, transportation and athletics, not tuition. Campuses were shut down across the state in spring 2020 to try to prevent the spread of COVID-19.

Brasington did not issue a final ruling about whether UF should be required to refund portions of fees that students paid, but she refused to dismiss the case.

Generally, state agencies are shielded from lawsuits by the legal concept of sovereign immunity. But sovereign immunity does not provide protections from breach-of-contract claims. In arguing that it did not breach an express contract, UF contends the case should be dismissed because of sovereign immunity.

Numerous similar cases have been filed against other schools in Florida and across the country.

A panel of Floridas 2nd District Court of Appeal on June 1 refused to dismiss a similar case against the University of South Florida. The university last week asked the full appeals court to hear the case or to request that the Florida Supreme Court resolve the issue.

Meanwhile, the 3rd District Court of Appeal in April ordered the dismissal of a fees-refund case filed against Miami Dade College. The South Florida appeals court last month rejected a request for a rehearing in the case.

Also, a Leon County circuit judge last month tossed out a similar case against Florida State University.

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An appeals court will take up the case of UF charging fees during the coronavirus campus shutdown - WUFT

Imagine a future with safer bars, restaurants, health clinics, and other public indoor spaces where the risk of the spread of infectious diseases such as COVID-19 is greatly minimized.

Research by Akula Venkatram, a mechanical engineering professor at the University of California, Riverside, suggests this could happen in the not-too-distant future. An important step, he said, is a simple change in the direction of the air forced through indoor gathering spaces by heating, air conditioning, and ventilation systems.

Fresh air should be emitted from floor vents, while the outgoing air should be removed with ceiling vents. Such systems would allow for a continuous upward movement of air that would most expediently carry away virus-containing microdroplets exhaled by infected people.

You don't want to have horizontal transport, which can spread viruses from person to person, Venkatram said. You should encourage vertical transport of air. It doesn't matter whether the air is coming from the top or bottom, but it's easier for it to come from the bottom because your breath is warm. So it goes up automatically. You might as well take advantage of that.

Venkatrams conclusions are based on a fresh look at data from several previous studies about the behavior of aerosols, or airborne particles, in indoor settings. Venkatram and his collaborator, Jeffrey Weil of the National Center for Atmospheric Research in Boulder, Colorado, published their findings and recommendations for ventilation systems last year in a paper published in Indoor Air titled Modeling Turbulent Transport of Aerosols Inside Rooms Using Eddy Diffusivity.

For his analysis, Venkatram tapped his decades of experience researching how air pollution behaves outdoors. This work includes his collaboration with the U.S. Environmental Protection Agency to develop pollution dispersion models that are used by regulatory agencies to estimate the air quality impact of pollutants emitted by sources such as power plants and vehicles on roads.

Venkatram and Weil examined the transport of virus-carrying aerosols emitted from an infected person that behave as passive tracers of air motion in a room. The simple acts of breathing, talking, walking, standing up, or just moving your hands stirs ups air, and creates random turbulent motion that disperses these aerosols across a room. Consider what happens when someone lights up a cigarette, he said.

As soon as you smoke, you can see smoke going all over the place, he said. Forced or natural ventilation enhances this turbulent motion.

Venkatram and Weil used a concept called turbulent diffusivity to model transport by turbulent motion in a room. They used mathematical models to interpret data from experiments that released aerosols inside rooms with varying ventilation rates.

We looked at the transport as soon as you emit stuff, and how the concentration of aerosols falls off with distance from the source, Venkatram said. What you are breathing in depends on the number of aerosols per unit volume, multiplied by the volume you breathe in. So, the viral load depends on the total amount of viruses the dose that you inhale.The dose falls off with distance from the source, he said. The dose at 2 meters from a source is still half of that at 1 meter, he said

Venkatram said the paper does not rely on models that make simplistic assumptions about the behavior of indoor pollutants. Such models, still used by researchers today, assume that emitted aerosols are instantaneously mixed through the volume of a room so that the concentrations are equal. These models provide little guidance on the engineering of ventilation systems to reduce the spread of virus laden aerosols, he said.

Venkatram and Weil showed that an increased ventilation rate does not always lead to reduced doses of the pollutant someone may breathe. Their models suggest that ventilation, especially that creating directed air motion in the room, is not always beneficial and might make matters worse by spreading emissions.

The conclusion supports a Chinese study that blamed an air conditioning system for the spread of coronavirus in a restaurant in Guangzhou, Chinas third-largest city. Done in the early days of the COVID-19 pandemic, this study found that 10 people became infected when they sat at tables downwind of an infected person from the pandemics epicenter in Wuhan.

The results presented by Venkatram and Weil also support a body of evidence that face masks reduce the risk of infection, especially when worn by an infected person. Researchers have well established that masks prevents the high velocity ejection of liquid droplets during coughing and sneezing. What is not appreciated, the study says, is that a mask also increases the size of the puff of exhaled air, which reduces the concentration of droplets at the source, and also facilitates the subsequent dilution of the puff by turbulent eddies as it is transported across a room.

Upward ventilation would then further enhance safety by carrying away the virus-laden droplets before they can infect another person.

Header image by Getty Images.

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Upward ventilation offers better protection from indoor coronavirus transmission - UC Riverside

At a glance, the pandemic picture in the United States may seem remarkably stable. The average number of new confirmed coronavirus cases per day has hardly budged for weeks, hovering between 95,000 and 115,000 a day each day in June.

A closer look shows that as public testing sites run by state and local governments have winnowed, more states have also stopped giving daily data updates, creating a foggier look at the state of virus across the country.

That comes as new federal estimates on Tuesday showed that the rapidly spreading Omicron subvariant known as BA.5 has become dominant among new coronavirus cases. As of the week ending Saturday, BA.5 made up about 54 percent of new cases in the United States, according to the Centers for Disease Control and Prevention. Just a week ago, the agencys estimates had put BA.5 and BA.4, another Omicron subvariant, together as dominant, a trend experts had predicted. The new statistics, released Tuesday morning, are based on modeling and can be revised as more data comes in.

The reduction in U.S. public testing means that lab-based P.C.R. testing capacity in July will be only half of what it was in March, according to a recent estimate by Health Catalysts Group, a research and consulting firm. Even a few testing companies announced layoffs and closures last week.

The vast majority of the positive results from popular home test kits are not included in official data, and not everyone who gets infected knows or gets tested. Many Americans appear to be moving even further away from focusing on daily case counting which, to be sure, have always been an undercount of total infections as a measure of the nations pandemic health. But other Americans with risk factors have said that they feel ignored and abandoned as their governments and neighbors have sought a return to normal.

And some scientists estimate that the current wave of cases is the second largest of the pandemic.

One of my favorite lines from somebody at the C.D.C. was You dont need to count the raindrops to know how hard its raining, Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, said in late June at a conference in Aspen, Colo. So we can tell by the half a million to a million P.C.R.s were doing every day how were doing in areas around the country.

The C.D.C.s monitoring of community risk levels shows that in its latest update, 33 percent of the American population lived in a high-risk county, in most regions outside the Northeast. In May, the map had been flipped, with the Northeast comprising most of the high-risk counties. The C.D.C. recommends wearing a mask indoors in public under such a designation.

In most of the Northeast, cases have decreased continuously throughout June, according to a New York Times database. In the South, many states have seen cases double or triple over the same time. As of Sunday, more than 113,000 new coronavirus cases are being reported each day in the United States.

Thats not really a reflection of the total amount of virus circulating in the communities, said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health. He said that his back of the envelope estimate was about one million cases per day.

As states report less frequently, changes in the trajectory of the virus are slower to reveal themselves. Nearly every state reported the number of new coronavirus cases, hospitalizations and deaths for five days a week or more in 2020 and 2021, but 23 states now release new data only once a week, according to Times tracking.

California, which once updated its cumulative case and death figures every weekday, now does so only twice weekly. In Florida, case and death data are released just once every two weeks. Just last week, many more public testing sites closed in Alaska, Colorado and Rhode Island; Iowa is shutting many sites by the end of next week.

Recent virus figures have hiccuped around holidays like Memorial Day and Juneteenth, during which many states often pause reporting and then restart tracking afterward, a trend that is sure to continue this week, after the Fourth of July holiday weekend.

Following the daily test count is less instructive than it was, Dr. Adalja said, citing the close link between cases and hospitalizations in the past. Todays numbers should not be treated like checking a sports teams daily standings or scores, he added.

I think testing is taking a different role, he said. Even when testing was at a different point, it has always been an underestimate.

To get a localized look at how the virus is faring, Dr. Adalja said that he has come to rely on hospitalizations as a percentage of its capacity. He also checks the C.D.C.s community levels tracker, which includes new hospital admissions and how many beds are used. He urges a shifting focus to severe disease, rather than tracking the booms and busts of cases.

Hospitalizations have increased modestly throughout June, though they remain low. Just over 33,000 people are in American hospitals with the coronavirus on an average day, and fewer than 4,000 are in intensive care. Reports of new deaths remain below 400 a day, down from the countrys daily death toll peak of more than 3,300 deaths in January 2021.

Lisa Waananen, Christine Chung, Emily Anthes and Alain Delaqurire contributed reporting.

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Reduced Testing and Reporting Blur Covid Picture in U.S. - The New York Times

The fast-changing coronavirus has kicked off summer in the U.S. with lots of infections but relatively few deaths compared to its prior incarnations.

COVID-19 is still killing hundreds of Americans each day, but is not nearly as dangerous as it was last fall and winter.

Its going to be a good summer and we deserve this break, said Ali Mokdad, a professor of health metrics sciences at the University of Washington in Seattle.

With more Americans shielded from severe illness through vaccination and infection, COVID-19 has transformed for now at least into an unpleasant, inconvenient nuisance for many.

It feels cautiously good right now, said Dr. Dan Kaul, an infectious diseases specialist at the University of Michigan Medical Center in Ann Arbor. For the first time that I can remember, pretty much since it started, we dont have any (COVID-19) patients in the ICU.

As the nation marks July Fourth, the average number of daily deaths from COVID-19 in the United States is hovering around 360. Last year, during a similar summer lull, it was around 228 in early July. That remains the lowest threshold in U.S. daily deaths since March 2020, when the virus first began its U.S. spread.

But there were far fewer reported cases at this time last year fewer than 20,000 a day. Now, its about 109,000 and likely an undercount as home tests arent routinely reported.

Today, in the third year of the pandemic, its easy to feel confused by the mixed picture:Repeat infections are increasingly likely, and a sizeable share of those infected will face the lingering symptoms oflong COVID-19.

Yet, the stark danger of death has diminished for many people.

And thats because were now at a point that everyones immune system has seen either the virus or the vaccine two or three times by now, said Dr. David Dowdy, an infectious disease epidemiologist at Johns Hopkins Bloomberg School of Public Health. Over time, the body learns not to overreact when it sees this virus.

What were seeing is that people are getting less and less ill on average, Dowdy said.

As many as 8 out of 10 people in the U.S. have been infected at least once, according to one influential model.

The death rate for COVID-19 has been a moving target, but recently has fallen to within the range of an average flu season, according to data analyzed by Arizona State University health industry researcher Mara Aspinall.

At first, some people said coronavirus was no more deadly than the flu, and for a long period of time, that wasnt true, Aspinall said. Back then, people had no immunity. Treatments were experimental. Vaccines didnt exist.

Now, Aspinall said, the built-up immunity has driven down the death rate to solidly in the range of a typical flu season. Over the past decade, the death rate for flu was about 5% to 13% of those hospitalized.

Big differences separate flu from COVID-19: The behavior of the coronavirus continues to surprise health experts and its still unclear whether it will settle into a flu-like seasonal pattern.

Last summer when vaccinations first became widely available in the U.S. was followed by the delta surge and then the arrival of omicron, which killed 2,600 Americans a day at its peak last February.

Experts agree a new variant might arise capable of escaping the populations built-up immunity. And the fast-spreading omicron subtypes BA.4 and BA.5 might also contribute to a change in the death numbers.

We thought we understood it until these new subvariants emerged, said Dr. Peter Hotez, an infectious disease specialist at the Baylor College of Medicine in Texas.

It would be wise, he said, to assume that a new variant will come along and hit the nation later this summer.

And then another late fall-winter wave, Hotez said.

In the next weeks, deaths could edge up in many states, but the U.S. as a whole is likely to see deaths decline slightly, said Nicholas Reich, who aggregates coronavirus projections for the COVID-19 Forecast Hub in collaboration with the Centers for Disease Control and Prevention.

Weve seen COVID hospitalizations increase to around 5,000 new admissions each day from just over 1,000 in early April. But deaths due to COVID have only increased slightly over the same time period, said Reich, a professor of biostatistics at University of Massachusetts Amherst.

Unvaccinated people have a six times higher risk of dying from COVID-19 compared with people with at least a primary series of shots, the CDC estimated based on available data from April.

This summer, consider your own vulnerability and that of those around you, especially in large gatherings since the virus is spreading so rapidly, Dowdy said.

There are still people who are very much at risk, he said.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institutes Department of Science Education. The AP is solely responsible for all content.

For more coronavirus coverage, visit longislandpress.com/category/coronavirus.

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For Now, Wary US Treads Water With Transformed Coronavirus - Long Island Press

The OC Health Care Agency reported 2,662 more cases of the coronavirus between Friday, July 1, and Tuesday, July 5, increasing the cumulative total since tracking began in the county to 606,717.

There were 13,896 new cases reported in the last two-week period as of Tuesday. The county is averaging 31 new cases a day per every 100,000 residents.

There were 227 people reported in Orange County hospitals with coronavirus on Tuesday, including 30 who required intensive care.

The county reported no new deaths on Tuesday, keeping the count of Orange County residents who have died from the virus to 7,126.

The data on deaths in the county is compiled from death certificates, or gathered through the course of case investigations, and can take weeks to process. The most recent death recorded was on June 28.

Of the 7,126 deaths reported from the virus, 1,354 were skilled nursing facility residents, 714 were in assisted living facilities, two were OC jail inmates, and 21 were listed as homeless.

It is estimated 575,284 people in the county have recovered from the virus. The count of people who have recovered is based on the prior 28-day cumulative case count.

Data posted each day is preliminary and subject to change, officials emphasize. More information may become available as individual case investigations are completed. The Orange County Health Care Agency dashboard can be found here.

Click here to download a pdf copy of the daily tracker.

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Coronavirus: Orange County reported 2,662 new cases over the holiday weekend - OCRegister

A week before the UKs first coronavirus lockdown, a lab worker at Aneurin Bevan University Health Board in Newport was screening nose and throat swabs from an intensive care patient. The paperwork carried no clinical details and the swabs were not double-bagged to indicate high risk. As such, the work was done on an open bench. But the swabs were more dangerous than thought. It later emerged that they came from a patient who was fighting for their life with Covid.

The incident in March 2020 was among the first of dozens of mishaps, blunders and failures involving Covid that the Health and Safety Executive (HSE) investigated over the course of the pandemic. With so many labs, hospitals, universities and test centres handling the virus, such incidents came as no surprise.

Two blunders at the Royal Wolverhampton hospitals NHS trust in April 2020 were typical of incidents early in the pandemic. Covid samples from infected patients were knocked off racks into lab areas where staff were working. Whilst no actual harm occurred, the consequences of the incidents could potentially have been more serious, the HSE found.

A month later, a scientist at Public Health Englands Porton Down laboratory was bitten on the forearm while scooping a Covid-infected ferret from its cage. On removing their PPE and protective suit, the researcher noticed the bite had drawn blood. They showered to clean the wound and on advice from the on-call medic, went home to self-isolate and monitor the wound.

The HSE met with Public Health England in April 2021, 11 months after the ferret incident, and reported significant progress at Porton Down, but managers at the site acknowledged a substantial amount of work that remains outstanding. The same day, the lab received an enforcement letter from the HSE about a January 2021 mix-up over Covid samples, which led to scientists pipetting live virus on the lab bench, believing it had been killed.

PHE was not the only government agency brought up on safety concerns. One Sunday morning in November 2020, a staff member at the National Institute for Biological Standards and Control, operated by the UKs Medicines and Healthcare products Regulatory Agency, found that a room housing Covid-infected marmosets and hamsters had flooded. The water, pouring from a hose left on in a sink, was a few inches deep but had not entered the animals cages. Some of the water was collected and poured down the sink, without being disinfected first.

According to HSE reports, the flood spread to the neighbouring corridor and leaked into the office below. There, staff in full PPE and breathing equipment quickly covered electrical equipment and bagged up damaged ceiling tiles. The remaining wastewater was disinfected and poured down the drain. Whilst it cannot be fully concluded whether or not live virus might have [been] present in the leaked water, the likelihood appears to be minimal, the HSE concluded.

To meet the massive demand for Covid tests, the government swiftly created and staffed its Lighthouse laboratories, which ran millions of PCR tests each week. The HSE reports highlight numerous times when samples were spilled on technicians or found to have leaked, with whole trays of test samples sometimes dropped or knocked over.

A week before Christmas in 2020, as the Alpha variant was fuelling the UKs deadliest wave of Covid, the Milton Keynes lab was ordered, at the last minute, to divert more than 3,000 samples to the Alderley Park Lighthouse lab in Cheshire. Without proper mediboxes to package them in, staff secured the samples in waterproof wrap and sent them off in a transport cage.

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The decision was made in an effort to salvage specimens for testing, rather than discarding and not testing 3,000 plus patients, the HSE report notes. But staff at Alderley Park were not impressed and considered it a breach of transport regulations. Luckily no leaked or damaged samples were detected, they told the investigation.

Further incidents highlighted problems with home test kits. Some swabs failed to snap in the right place, meaning people had to force them into sample tubes before closing the lids. On being opened at Lighthouse labs, these sprang out and sometimes splattered PPE-clad technicians. Robots had their moments too. At the Leamington Spa Lighthouse lab in July 2021, a robot flicked a swab out of a containment cabinet and on to the floor, prompting a swift evacuation until a spillage team arrived.

In spring 2021, the Department of Health was rolling out an alternative to PCR known as the Lamp test. A lab run by the UK Health Security Agency and Manchester University NHS foundation trust was having problems with the test and hosted an expert from the University of Central Lancashire to help troubleshoot. After running tests on what were thought to be harmless control samples, it emerged that two were Covid-positive saliva. Because the work had been done without appropriate precautions, all five people in the room, including a member of the Department of Healths Tiger Team were sent home to self-isolate.

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Handle with care: mistakes and near-misses at UK Covid labs - The Guardian

COVID-19 was the third-leading cause of death in the U.S. between March 2020 and October 2021, according to an analysis of federal data released Tuesday.

Researchers at the National Cancer Institute, part of the National Institutes of Health, analyzed death certificate data and found that the coronavirus accounted for 350,000 deaths 1 in every 8 in the U.S. during that 20-month period.

The data illustrates the toll of the pandemic, as COVID-19 was a top-five cause of death in every age group aged 15 years and older.

Heart disease was the No. 1 cause of death, followed by cancer, whichaccounted for a total of 1.29 million deaths combined.

Compared with 2020, deaths from COVID-19 in 2021 decreased in ranking among those aged 85 years and older but increased in ranking among those aged 15 to 54 years and became the leading cause of death among those aged 45 to 54 years.

Among those aged 85 and older, the coronavirus was the second-leading cause of death in 2020 but dropped to third in 2021, likely because of targeted vaccination efforts in this age group.

According to the study, COVID-19 increased from the fifth- to the second-leading cause of death among people aged 35 to 44 years, from 6,100 deaths up to 13,000.

Compared with 2020, COVID-19 became the fourth-leading cause of death in 2021 among those aged 25 to 34 years, at 5,000 deaths, and those aged 15 to 24 years, with 1,100 deaths.

The authors noted that the increased ranking of COVID-19 as a leading cause of death in some age groups matches a downward age shift in the distribution of COVID-19 deaths in the U.S. in 2021 compared with 2020. This trend could be attributed to higher vaccination rates among elderly and more vulnerable people.

Vaccines are now authorized for every American at least 6 months old, but only about 67 percent of the population is up to date with the shots. Booster shots are authorized and recommended for everyone down to age 5, but less than 50 percent of the eligible population has received one.

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COVID-19 was third-leading US cause of death between March 2020 and October 2021 - The Hill

(WXYZ)The State of Michigan added 13,102 confirmed and probable cases of COVID-19 over the past week, according to new numbers released from the Michigan Department of Health and Human Services.

That comes out to an average of around 1,872 confirmed and probable cases per day.

According to the state, there were also 64 deaths from confirmed or probable cases of COVID-19.

In all, there have been 2,619,533 confirmed and probable cases of COVID-19 since the pandemic began in Michigan and 36,982 deaths from the virus.

The MDHHS said it will now release COVID-19 case and death data on Tuesdays instead of Wednesdays.

Cases have dropped significantly from May, when metro Detroit was at a high transmission level. Last week, the CDC placed most of Southeast Michigan back at a low level of community transmission. Some parts of Michigan remain at a high transmission level. All of those counties at a high transmission level are in Northern Michigan.

Additional Coronavirus information and resources:

View a global coronavirus tracker with data from Johns Hopkins University.

See complete coverage on our Coronavirus Continuing Coverage page.

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Michigan adds 13,102 cases of COVID-19 over past week, 64 deaths - WXYZ 7 Action News Detroit

In a recent study published in the Journal of Clinical Ultrasound, researchers assessed the influence of severe coronavirus disease 2019 (COVID-19) on scrotal infections.

During the COVID-19 pandemic, various patients reported different types of symptoms. Some patients also experienced symptoms like epididymitis and acute orchitis.

In the present study, researchers investigated the association between COVID-19 disease severity and scrotal infections.

The study cohort included adult men who were hospitalized following a positive COVID-19 diagnosis via a reverse transcriptase-polymerase chain reaction (RT-PCR) test and underwent scrotal ultrasonography (US) testing from October 2021 to February 2022. Before the US examinations, each study participant was investigated for medical history as well as symptoms related to scrotal infections.

Patients who had a positive RT-PCR result for COVID-19 and a chest computed tomography (CT) were eligible for the study. The eligible participants were classified into groups based on the disease severity: (1) type 1 included patients displaying mild symptoms without any abnormal radiological findings, (2) type 2 included patients displaying mild symptoms as well as the presence of pneumonia on the chest CT scans, (3) type 3 included patients exhibiting either a low oxygen partial pressure or a high respiratory rate in the arterial blood, and (4) type 4 included patients who needed mechanical ventilation and had a history of either shock or organ dysfunction resulting in an intensive care unit (ICU) admission.

The patients were examined using US for scrotal findings 15 days after the positive COVID-19 diagnosis. During US, the team assessed unilateral or bilateral involvement, heterogeneity in echogenicity, enlargement of and increased blood flow in the epididymis and testis, as well as detection of an epididymal abscess.

Enlargement of and increased blood flow in the epididymis and testis and heterogeneous echogenicity are the primary US findings correlated to acute orchitis while minor manifestations included a thickened tunica albuginea, scrotal wall edema, and hydrocele. The detection of all the three main features, or any two main features along with a minimum of one minor feature was deemed as the diagnostic standard for acute orchitis. Additionally, the detection of all three main features, or any two main characteristics with one minor feature was the diagnostic standard for acute epididymitis.

Scrotal US findings of the study cohorts were investigated and compared while the ages and laboratory test results of the patients were assessed and classified. The team assessed the association of acute scrotal infections with comorbidities including hyperlipidemia, hypertension, coronary artery disease, hepatic cirrhosis, chronic liver disease, diabetes, and chronic obstructive pulmonary disease (COPD).

The study results showed that among the 213 eligible patients, 7% had acute orchitis, 3.7% had acute epididymitis, and 7.9% had acute epididymo-orchitis. A total of 40 scrotal infection findings were detected among the patients. The average age of the patient cohort was 61.7 8.3 years while that corresponding to patients belonging to the type 1 category was 53.3 9.1 years, type 2 category was 67.8 10.7 years, type 3 category was 72.8 9.1 years, and type 4 category was 86.9 6.2 years.

The team observed clinical scrotal symptoms in 11.2% of the total patients. Notably, the incidence of scrotal complaints was higher among patients experiencing severe disease symptoms. The team noted that the type 3 and type 4 patients were more likely to report hyperlipidemia, hypertension, coronary heart disease, chronic obstructive pulmonary disease, and chronic kidney disease. Moreover, increased levels of fibrinogen, neutrophil, lymphocyte, D-dimer, and C-reactive protein (CRP) were found in clinical severe patients.

Furthermore, almost 98% of the total patients recovered while 2.3% died from COVID-19 in the study. The team noted a significant statistical correlation between patient mortality and the severity of COVID-19 symptoms. Moreover, patients belonging to the type 3 and type 4 categories were found to have more testicular heterogeneous echogenicity, higher testicular vascular flow, epididymal abscess, as well as enlargement of the epididymis. Additionally, type 4 patients reported more epididymal heterogeneous echogenicity as well as higher epididymal vascular flow. Also, cases of acute orchitis, acute epididymitis, and acute epididymorchitis were substantially higher among type 3 and type 4 patients.

Overall, the study findings showed that acute scrotal infection was detected among COVID-19 patients even when no symptoms were displayed by the patients. Acute scrotal infections among COVID-19 patients were found to be significantly associated with COVID-19 disease severity.

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Acute scrotal infections among COVID-19 patients significantly associated with disease severity in new study - News-Medical.Net

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Print a poster version of this comic to hang up on your fridge or give away to friends. Download the poster here.

Outdoor events are way less risky than indoor events when it comes to COVID. They are still, by far, the safest way to gather as the country continues to see high levels of cases and rising hospitalizations.

But "way less risky" is not "zero risk." There's still a chance of catching COVID even at an outdoor event especially as the virus continues evolving to become more transmissible and to break through prior immunity from vaccination or earlier cases.

"With the more transmissible variants, it's likely that shorter periods of close contact will result in transmission," says Dr. Preeti Malani, an infectious diseases physician and a professor of medicine at the University of Michigan.

That means activities that once seemed pretty safe are potentially riskier and that includes outdoor activities.

As Maimuna Majumder, an assistant professor at Harvard Medical School and a computational epidemiologist at Boston Children's Hospital, puts it, "the more transmissible a variant is indoors, the more transmissible it is in outdoor settings, too."

So additional precautions during a surge like the one the U.S. is currently seeing may be in order particularly if you are vulnerable or are in frequent contact with someone who is, say the experts interviewed for this story.

"People are going to make judgments based on [their] own level of risk and comfort," says Donald Milton, a professor of environmental and occupational health at the University of Maryland School of Public Health.

But, Majumder says, "that transmissibility can be drastically reduced by ensuring that an outdoor event doesn't get too crowded." That means having plenty of room for guests to move around and making sure they are vaccinated, recently tested and symptom-free is also a very good idea, she says.

With the July 4 weekend upon us and wedding season in full swing, experts answered frequently asked questions about staying safe while gathering outdoors with family and friends.

When should guests get tested?

Majumder helped her friend plan a wedding with about 100 attendees, and they have not heard of any resulting cases of COVID.

First, they made sure everything was outdoors, including events that happen around the wedding rehearsal dinners, happy hours and so on.

They reminded everyone to be up-to-date on vaccinations and boosters, which can help prevent transmission of the virus.

They also asked guests to stay home if they were feeling any symptoms.

And everyone agreed to take a rapid test right before the event.

Majumder has thrown other events and parties with similar guidelines, and so far, she's not heard of anyone getting sick.

And for those who still think that you aren't contagious if you're not showing symptoms, a required pre-event test could surprise you.

"There have been multiple instances where folks without symptoms have tested positive, so they've stayed home," says Majumder, who asks everyone to get rapid tested within an hour of her events. She also keeps rapid tests on hand in case someone isn't able to test before they arrive.

Getting tested right before the event is key. Rapid tests are pretty good at telling someone whether they are positive and very contagious at that moment. But their status can change within hours, so if you take a rapid test in the morning, you could be contagious by night.

Rapid tests aren't always foolproof sometimes you have a false negative but they can be a very helpful layer of protection in addition to other precautions.

There have also been times when people felt a bit off and stayed home from one of Majumder's events, only to test positive a day or two later which meant they would have been contagious during the party.

And in addition to monitoring symptoms, Malani says, "if you add testing and vaccination to a low risk outdoor setting, the risk of COVID becomes manageable."

Do the old rules of staying safe still apply once the event gets going?

Keeping a distance still helps enormously. Whether you're having a wedding or BBQ, that might mean putting families together at the same table, rather than mixing them in with other guests, and spacing each table a few feet apart.

The "15-minute rule" was developed for contact tracers to reach out to people who may have been exposed to COVID. If you're in close contact with someone for more than 15 minutes, you're likelier to get sick. But it is also possible to catch the virus in passing, especially indoors.

Australian authorities reported a case last summer where someone got sick after walking by an infected person for a few seconds at a shopping mall, according to video footage.

Whether you get sick all depends on several factors: how much virus a person is emitting, what your immunity level is from vaccination or prior infection and, importantly, how much fresh air is between you.

Where do masks fit in?

When it comes to COVID, the outdoors are great for two main reasons: there's plenty of fresh air outside, and you have more space to keep a distance, Milton says.

But if you're not able to keep a distance in a crowd at a concert, sporting event or protest, for instance masking up greatly reduces the risks of getting sick.

That's especially true if people are shouting and yelling, if you're near them for a long period of time and if you don't know their vaccination, test and symptom status.

"If you're close together, you're likely to share air with other people," says Milton.

Two of his colleagues believe they caught COVID outdoors early in the pandemic one at an outside brunch, and one who was waiting in line to pick up groceries in spring 2020.

"There's always been a risk outdoors," Milton says. "It's much lower [than indoors], but it's not nothing."

The closer you are physically to someone, the higher the risk. If you're close enough, say, to smell on their breath what they chose for dinner, you're close enough to inhale the viral particles on their breath.

There is also the off-chance of air blowing the wrong way.

Just like plumes of smoke, virus-laden exhalations can "travel the distance outdoors," Milton says. That means it's possible to get infected even if you're not right next to someone.

But the chances of getting COVID at a distance outdoors are significantly lower than pretty much any other form of interaction, such as talking closer together or meeting indoors.

"I think the most important thing to remember about the outdoors is that while it's safer, it's not 100% safe," Majumder says. "The more crowded an outdoor space is, the more it begins to mimic an indoor space in terms of our exposure to shared air."

But, she says, "I don't think masks are necessary while outdoors as long as the event isn't too crowded, everyone tested negative, no one is experiencing symptoms and everyone is up-to-date on their vaccinations."

What if we need to go inside during an outdoor event?

Even if your event is outside, people may need to go indoors briefly to use the bathroom or wash their hands "something I think many folks forget when planning an event," Majumder says.

Guests should wear a high-quality mask, like an N95 or KF94, anytime they need to dash inside. Hosts can keep masks "stocked and accessible" for any of these indoor forays, Majumder says.

"Masks remain very important and very effective," Malani says. Especially if you or a member of your household is high risk, "keep masks handy not so much for outdoor use, but when you go in and out."

(You can also improve ventilation and filtration indoors by opening doors and windows and running air purifiers in bathrooms or hallways.)

Outdoor tents that don't have side flaps enclosing the space can help protect from the sun or rain while allowing air to pass through. But "if the tent is enclosed, it's not that different than being indoors," Milton says.

And "sometimes, social gatherings end up moving indoors," Malani points out, because of bad weather, high or low temperatures, or annoying mosquitoes and "that's when transmission risk can go from low to high."

Should I invite people from out of town?

The nature of a big event with lots of out-of-town guests is a recipe for transmission when cases are high. Guests are likely to fly in, stay in hotels that may not have good ventilation, eat inside restaurants and meet up with family and friends. Even if the event that you're hosting is itself low-risk, these other activities may not be.

And "the larger the group, the higher the risk," Malani says, because there are more chances of someone having the virus and passing it on.

"Prevention means using a layered approach," she says. Try to take as many precautions as possible distancing, staying home if you're sick, testing and masks when needed.

When those measures are taken, she says, "being outdoors is a wonderful way to spend time together."

Melody Schreiber (@m_scribe) is a journalist and the editor of What We Didn't Expect: Personal Stories About Premature Birth.

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Could I catch COVID at an outdoor wedding or picnic? : Goats and Soda - NPR