Category: Corona Virus

Coronavirus cases are once again on the rise in Los Angeles County, according to data released Monday, prompting officials to urge residents to keep up safety protocols as the spring break holiday season arrives.

Data show that for the seven-day period that ended Monday, an average of 960 new cases were reported daily countywide, which equates to 67 cases a week for every 100,000 residents. Thats up 23% from the previous week, when L.A. County reported an average of 783 cases a day.

Caseloads of this magnitude remain a far cry from the tens of thousands of new daily infections during the height of the Omicron surge. In mid-January, L.A. County was reporting 42,000 new coronavirus cases a day.

Nevertheless, the trendline is the source of some concern, especially given the proliferation of BA.2 an Omicron subvariant estimated to be 30% to 60% more contagious than the earlier version that swept the globe last fall and winter.

Scientists are also now tracking an even more potentially contagious subvariant, XE, which some early estimates indicate may be 10% more transmissible than BA.2.

The evidence is becoming clearer that given the current approved vaccines and the reality of a mutating virus, some of us will need to boost our immune systems a couple of times during the year in order to be optimally protected, county Public Health Director Barbara Ferrer said in a statement. This includes those infected with Omicron over the winter, since natural immunity ... also wanes over time.

Given that many residents are likely to travel or gather in the coming weeks either for spring break or to mark holidays such as Easter, Ramadan or Passover Ferrer said it remains important to do our very best to make use of the powerful tools at hand, vaccinations, boosters, testing, and masking, to keep ourselves and those most vulnerable to severe illness, as safe as possible.

There are more than 1.7 million L.A. County residents age 5 and up who havent received a single vaccination dose, and an additional 2.8 million vaccinated residents who havent received a booster, even though theyre eligible for one.

L.A. Countys coronavirus case rate hit a post-winter surge low of about 609 cases a day from March 18 to 24. That was about two weeks after the region ended its universal requirement to wear masks in indoor public spaces one of the last counties in California to do so.

Since then, the countywide case rate has ticked upward, a development officials have said is likely fueled by a combination of waning immunity, the loosening of masking rules and the spread of BA.2.

The daily reported caseload is just one of many metrics health officials utilize to track and assess the pandemics trajectory. Another, the proportion of conducted tests that are confirming coronavirus infection, has also inched up slightly as of late, but remains low at 1%, county health officials said.

And while cases have crept up a bit, the number of people hospitalized with COVID-19 countywide has continued to trend downward. As of Sunday, 265 coronavirus-positive patients were hospitalized countywide down about 8% from a week ago.

Experts in California have said there are unmistakable signs of an uptick in coronavirus cases in the state. But whether this latest uptick ultimately proves to be a temporary blip or the harbinger of something more significant, however, remains to be seen.

For the weekly period that ended Thursday, California was averaging about 2,800 cases a day, or 50 cases a week for every 100,000 residents, up 9% over the prior week.

Orange Countys case rate is also increasing. Orange Countys case rate is about 134 cases a day, or 30 cases a week for every 100,000 residents, up 12% over the prior week.

San Francisco, which now has one of Californias highest case rates, on Thursday was recording about 127 cases a day, or 102 cases a week for every 100,000 residents, a 6% increase over the prior week.

A coronavirus case rate of 50 or more cases a week for every 100,000 residents is considered substantial, while a rate of 100 or more is considered high.

Dr. Robert Wachter, chair of UC San Franciscos Department of Medicine, tweeted Thursday that the percentage of asymptomatic patients testing positive at UC San Franciscos hospitals had risen to 2%, up from 1% in late March.

If youve let guard down, time to be more careful, he wrote.

By Monday, the rate had dipped back down to 1.6%, Wachter said in an email. That means that in San Francisco, theres a 28% chance that at least one person attending a party with 20 asymptomatic people will test positive for the coronavirus.

Some experts are optimistic that the case numbers so far offer glimmers of hope that this spring will not bring a second Omicron surge on the magnitude of those seen elsewhere such as Britain, where hospitals have once again come under strain.

Dr. Eric Topol, director of the Scripps Research Translational Institute in La Jolla, tweeted Saturday that its clear that wave 6 (BA.2), yet still in the works, will not resemble the fifth surge of the pandemic, or last winters Omicron surge.

But Myoung Cha, chief strategy officer for San Francisco-based Carbon Health, disagreed with confident takes that this surge wont be big. He noted many people this year are self-diagnosing with at-home tests the results of which are not reliably reported to the government.

By contrast, lab tests conducted at official facilities are automatically reported to the authorities.

The current case rates are massively undercounted versus prior surges, Cha tweeted Sunday.

As is the case anytime COVID-19 shows signs of resurgence, the question on many peoples minds is when, or whether, health authorities may consider reimplementing restrictions.

In Philadelphia, where cases have jumped by more than 50% over the last 10 days, officials on Monday announced the return of an indoor mask mandate, effective April 18.

Philadelphia had preexisting criteria in place that would trigger a return to a mask order when average new cases a day exceeded more than 100 and when cases have risen by more than 50% in the previous 10 days. On Monday, officials reported that the city of 1.58 million people was averaging 142 new cases a day, or 63 cases a week for every 100,000 residents.

Philadelphia Mayor Jim Kenney said the return of the mask mandate in indoor public settings was needed to prevent higher case rates.

Our city remains open; we can still go about our daily lives and visit the people and places we love while masking in indoor public spaces, Kenney tweeted.

A number of universities in the Northeast have announced a return to universal mask policies. Columbia University, Georgetown University and American University have announced the return of indoor mask requirements recently.

So far, officials in L.A. County and the state have not indicated that conditions warrant the imposition of new measures or mandates though, in both cases, they still urge residents to mask up indoors while in public.

Speaking with reporters last week, though, Ferrer said people should be concerned about the rise in the number of school outbreaks countywide. There were 14 new outbreaks in K-12 schools in L.A. County for the week that ended Thursday. For the previous week, there were four.

She noted that in some other settings where masking is still required like nursing homes and homeless shelters there has not been an increase in outbreaks.

Ferrer also expressed some optimism that a second increase in Omicron cases this spring wouldnt be as bad as the winter surge. People who have been infected with the earlier Omicron subvariants earlier this winter, BA.1 or BA.1.1, are likely to have a degree of immune protection against the latest Omicron subvariant, BA.2, at least for the near future.

I am hopeful that given what weve seen and what were doing, we should be able to avoid a really big surge, Ferrer said.

In a round of interviews with morning network shows, Dr. Ashish Jha, the incoming White House COVID-19 Response Coordinator, said hes not overly concerned right now about the rise in cases nationally.

Case numbers are rising. We were expecting this, because we saw this in Europe a few weeks ago, Jha said on NBCs Today show. But the good news is: Were coming off of some very low infection numbers. Hospitalizations right now are the lowest they have been in the entire pandemic.

So weve got to watch this very carefully. Obviously, I never like to see infections rising, I think weve got to be careful, but I dont think this is a moment where we have to be excessively concerned, Jha said.

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Coronavirus cases on the rise in L.A. County, prompting calls for spring break caution - Los Angeles Times

When Queen Elizabeth came down with COVID-19 in late February, the palace only said that she was experiencing mild cold-like symptoms, and further details were unavailable. Within two weeks, she was back to doing her usual work, including an in-person meeting with Justin Trudeau, but the effects apparently lingered. In a conversation with National Health Service workers organized by the Royal London Hospital last week, she went into more detail about her course of the virus.

After hearing former patient Asef Hussain discuss the lingering effects of his battle with COVID, the queen responded with a question that hinted at her own experience. It does leave one very tired and exhausted doesn't it, this horrible pandemic? she said. Its not a nice result.

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When speaking to a patient who had a severe case of COVID, she asked about what it was like to battle the illness while isolated from family. It obviously was a very frightening experience to have COVID very badly, she said in response to the patients story.

She spoke to the NHS employees to commemorate the opening of the new Queen Elizabeth Unit, a 155-bed wing of the hospital devoted to accommodating patients with breathing issues. According to the Guardian, the units construction was accelerated due to rising case counts in London, and it was completed in only five weeks, when a similar project would usually take about five months.

One construction worker on the project said it was an example of Dunkirk spirit, in reference to the World War II battle where commercial ships from across the U.K. helped evacuate British soldiers who were trapped on beaches under Nazi siege. Thank goodness it still exists, she said in response. It is very interesting, isnt it, when there is some very vital thing, how everybody works together and pulls together marvelous, isnt it?

Though the queen has seemingly recovered from her bout with COVID, she is still dealing with ongoing health issues that began when she was briefly hospitalized in October. Last month she canceled a planned appearance at the annual Commonwealth Day church service amid mobility problems and only announced her decision to attend a memorial service for Prince Philip on the morning of. This week, she is sitting out the annual Maundy Thursday celebration where she hands out a traditional sack of coins to a group of elderly people. On Friday, the palace announced that she would be replaced by Prince Charles.

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Here's what to know about the second COVID-19 booster shot and if you are eligible for it.

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Thousands of doses of COVID-19 therapeutics and preventive treatments sit unused in Michigan because doctors haven't been prescribing them, the state's top doctortold the Free Press last week.

"The issue in the beginning had been that we thought demand would outpace supply and that didn't really happen in the state of Michigan or in most of the country,"said Dr. Natasha Bagdasarian, the state's chief medical executive.

"What we really saw was the clinicians were a little bit hesitant to prescribe it ...because they were still learning about it."

Doctors haven't been prescribing Evusheld, the preventive coronavirus antibodytherapyfor people who are immunocompromised and who may not respond well to vaccines, at the rate at which Bagdasarian hoped they would.

More: Beaumont study: Booster dose cut risk of COVID-19 death 45% compared with unvaccinated

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Evusheld,made by AstraZeneca, was shown in clinical trials to protect 77% of vulnerable peoplefrom developing COVID-19 for as long as six months after the double-injection treatment.

They also haven't been prescribing the COVID-19 antiviral pills Paxlovid and Molnupiravir as much as expected orbebtelovimab, a monoclonal antibody infusionthat can be administered soon after a person is infected to reduce the risk of hospitalization, Bagdasarian said.

As of Friday, the Michigan Department of Health and Human Services reported a supply of:

"With therapeutics, while theoretically, the issue we thought would be supply, in reality, we had a harder time actually getting it out to folks to be used."

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Part of the reason also is because not as many people are sick right now with COVID-19 in Michigan, so demand is down.

Case rates have fallen to one-year lows, and hospitals are getting a reprieve from the crush of sick patients who filled their rooms and lined their halls just a few months ago.

The Biden administration is concernedthat this moment of relative pandemic quiet could leave the nation unprepared for another wave of sickness and deathas the BA.2 omicron subvariant rages in someother parts of the world.

The administration lobbiedheavily for billions more dollars infederal funding to buy additional coronavirus tests and antiviral treatments,to pay for more COVID-19 research,vaccines and monoclonal antibody therapy. But a bipartisan bill that would have delivered $10 billion to partially fund those efforts stalledlast weekin Congress.

More: FDA, CDC authorize 2nd COVID-19 booster shot for some Americans. Should you get it?

"Make no mistake: Inaction will leave our nation less prepared for any future surges and variants," said Jeff Zients, White House Coronavirus Response coordinator,in a statement issued Friday. "It will mean fewer vaccines, treatments, and tests for the American people. This is deeply disappointing and it should be unacceptable to every American.

"Weve worked too hard and come too far to leave ourselves and our economy vulnerable to an unpredictable virus. The virus is not waiting on Congress to negotiate. Congress must act with urgency."

In the meantime, Bagdasarian said state health leaders are doing all they can to ensure doctors know about the availability of the current supply oftreatments in Michigan and that theyare prescribing them to people who need them.

"We need to be able to encourage physicians to prescribe therapeutics and Evusheld as pre-exposure prophylaxis in the appropriate clinical situations," she said. "We've been doing things like webinars, but clearly we need more clinician education.

"We need to educate patients and families so that they can be strong advocates … and then working with with communities and working with individuals so that they can ask for these medications ... themselves.

"One of the things we've been talking about is going around and speaking to all of our health care systems in the state to really talk about how to integratethese COVID-19 tools into our everyday patient encounters."

With COVID-19vaccines, she said, it's a similar situation.

When they first came to market in December 2020, there wasn't enough supply to meet demand. But now, Bagdasarian said, "vaccines are widely available and recommended for individuals over the age of 5 and there remains almost half of our state who are not fully vaccinated."

Nearly 60% of Michiganders almost 6 million people have been fully vaccinated against COVID-19 as of Friday, according to the U.S. Centers for Disease Control and Prevention. That compares with roughly 67% of the overall U.S. population.

But only about 3.2 million Michigan residentshave gottenat least one booster dose,the CDC reported, roughly one-third of the state's population. Far fewer people ages 50 and older and those who are immunocompromised, noweligible for a second booster dose, have gotten them.

While booster doses are important, Bagdasarian said, especially against the omicron variant, reaching the people who've yet to get a single dose of a COVID-19 vaccine remains among state health leaders' biggest challenges.

"We have been working with community leaders, with communities, with trusted messengers and really trying to talk about vaccines and trying to communicate about vaccines in different ways," she said.

"Early on in the pandemic, we did a great job reaching out to people who were over the age of 65. And we've got great (vaccination) rates in our older Michigan residents. Where we are really struggling is with younger Michigan residents and with communities of color."

Vaccination rates in Michigan are above 70%among people ages 50 and older, state data shows, but among younger age groups, the percentage of those fully vaccinated is much lower:

And among Black Michiganders, just 40.7% are fully vaccinated. That compares with a vaccination rate of 61% among Asian and Pacific Islanders; nearly 55% for Hispanic and native Hawaiian, American Indian and Alaska Native populations, and 53% of non-Hispanic white Michiganders.

"That means we need a different communication strategy and a different approach and to work with different trusted messengers and to really get out there and talk to communities more," Bagdasarian said.

"Individuals who had fewer reservations about vaccines, who had more trust in vaccines, they are already vaccinated. And now we need to work on partnering with communities who are maybe still a little hesitant and showing them the evidence and showing them why vaccination is a good option.

"There are no easy solutions."

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With coronavirus case rates so low right now, people aren't as concerned about the virus as they might have been a year ago, she said.

"We're in a recovery period right now," Bagdasarian said. "That doesn't mean that the pandemic is over. It means that we are just getting ready for what's in the future."

That future is likely to include another surge, she said, whether that's driven by BA.2, which now accounts for more than half of all coronavirus cases in the state,or another strain of the virus.

"We know that the proportion of BA.2 isolated in the U.S. and in our region of the United States has increased," Bagdasarian said. "We are watching very carefully for impacts here in our state. ... There are some early signs that BA.2 is having an impact here."

More: Michigan coronavirus cases: Tracking the pandemic

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There hasbeen an uptick in the number of Michigan wastewater facilities reporting plateaus or increases in detection of coronavirus in sewage compared with previous weeks, according to a state health departmentreport released Thursday.

COVID-19 hospitalizations have plateaued, too.

Because so many people are using at-home rapid antigen tests when they have symptoms of the virus rather thanseeking tests at health care providers that report to the state health department, case rates and the percentage of positive testsare no longer the most accurate measures of how much spread is happening in the community.

Even if this isn't the start of another COVID-19 surge, Bagdasarian saidthe BA.2 subvariant"will not be the last ... we're concerned about."

"COVID isn't now some pandemic that's on the side that will be gone soon," she said."It's a part of our society. It's something that's here to stay and we have to be able to live with it and treat it as any other preventable disease."

Contact Kristen Jordan Shamus: kshamus@freepress.com. Follow her on Twitter @kristenshamus.

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Thousands of COVID-19 treatments sit unused in Michigan. Doctors aren't prescribing them - Detroit Free Press

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Two-plus years into the Covid-19 pandemic, you probably know the basics of protection: vaccines, boosters, proper handwashing and masks. But one of the most powerful tools against the coronavirus is one that experts believe is just starting to get the attention it deserves: ventilation.

The challenge for organizations that improve air quality is that its invisible, said Joseph Allen, director of the Healthy Buildings Program at the Harvard T.H. Chan School of Public Health.

Its true: Other Covid tools are more tangible. But visualizing how the virus might behave in poorly ventilated spaces can help people better understand this mitigation measure.

Allen likens it to cigarette smoke. If Im smoking in the corner of a classroom and you have low ventilation/filtration, that room is going to fill up with smoke, and everyone is breathing that same air.

Then apply that to the outdoors.

I could be smoking a cigarette, you could be a couple of feet from me, depending which way the wind was blowing, you may not even know Im smoking.

If youre indoors, you could be breathing in less fresh air than you think.

Everybody in a room together is constantly breathing air that just came out of the lungs of other people in that room. And depending on the ventilation rate, it could be as much as 3% or 4% of the air youre breathing just came out of the lungs of other people in that room, Allen said.

He describes this as respiratory backwash.

Normally, thats not a problem, right? We do this all the time. Were always exchanging our respiratory microbiomes with each other. But if someones sick and infectious those aerosols can carry the virus. Thats a problem.

Weve known for decades how to keep people safe in buildings from infection, from airborne infectious diseases like this one, Allen said.

From the beginning of the pandemic, Allen and other experts have waved red flags, saying that the way we were thinking about transmission of Covid-19 surfaces, large respiratory droplets was missing the point.

Hand washing and social distancing are appropriate but, in our view, insufficient to provide protection from virus-carrying respiratory microdroplets released into the air by infected people. This problem is especially acute in indoor or enclosed environments, particularly those that are crowded and have inadequate ventilation, hundreds of scientists stated in an open letter in July 2020.

Eventually, the World Health Organization and the US Centers for Disease Control and Prevention acknowledged what the experts had been saying all along: that Covid-19 could also spread by small aerosolized particles that can travel more than 6 feet.

The coronavirus itself is very small about 0.1 microns but that doesnt affect how far it can travel.

The size of the virus itself doesnt matter because, as we say, the virus is never naked in air. In other words, the virus is always traveling in respiratory particles that develop in our lungs. And those are all different sizes, Allen said.

Singing or coughing can emit particles as large as 100 microns (almost the width of a human hair), he said, but the virus tends to travel in smaller particles between 1 and 5 microns.

The size of these particles affects not only how far it can travel but how deeply we can breathe it into our lungs, and how we should approach protecting ourselves from this virus.

When youre talking about an airborne disease, theres the whats right around you, you know, the sort of the people who you know can cough in your face, the 6 feet thing, and then theres the broader indoor air, because indoor air is recirculated, said Max Sherman, a leader on the Epidemic Task Force for the American Society of Heating, Refrigerating and Air-Conditioning Engineers.

Outdoors is safer than indoors has become an accepted mantra with Covid-19. Allen points out that protecting ourselves indoors is where our focus should always be, even beyond the pandemic.

Were [an] indoors species. We spend 90% of our time indoors. The air we breathe indoors has a massive impact on our health, whether you think about infectious disease or anything else, but it just has escaped the public consciousness for a long time, he said.

Making sure our indoor air is healthy is not that complicated, Sherman said. You just want to reduce the number of particles that might be carrying Covid or any other nasty [virus].

The way you do that is through ventilation and filtration.

Filtration just like it sounds is filtering or cleaning the air, removing the infected particles. But think of ventilation as diluting the air. Youre bringing more fresh air in to reduce the concentration of those particles.

Dilution is exactly why we havent seen superspreader events outdoors, Allen says.

We have hardly any transmission outdoors. Why is that? Unlimited dilution, because you have unlimited ventilation. And so, even in crowded protests or outdoor sporting events like the Super Bowl, we just dont see superspreading happening. But if we did, wed have the signal be loud and clear. We just dont see it. Its all indoors in these underperforming, unhealthy spaces.

Even before the advent of HVAC systems, ventilation was integrated into many building designs.

The 1901 Tenement Housing Act of New York required every tenement building a building with multifamily households to have ventilation, running water and gas light.

Builders added ventilation to many of these buildings with a shaft in the middle that runs from the roof to the ground, allowing more airflow.

In the late 19th century, people are finally starting to understand how disease spreads. So airshafts and the accompanying ventilation were seen as a solution to the public health crises that were happening in tenement buildings, said Katheryn Lloyd, director of programming at the Tenement Museum. There were high cases of tuberculosis, diphtheria and other diseases that spread. Now we know that spread sort of through the air.

Today, were facing the same challenge.

Getting basic ventilation in your home is important, full stop, Sherman said.

One of the easiest, cheapest ways to do that is to open your windows.

Open doors or windows at opposite ends of your home to create cross-ventilation, the Environmental Protection Agency advises. Opening the highest and lowest windows especially if on different floors of a home can also increase ventilation. Adding an indoor fan can take it even further.

If a single fan is used, it should be facing (and blowing air) in the same direction the air is naturally moving. You can determine the direction the air is naturally moving by observing the movement of drapes or by holding a light fabric or dropping paper clippings and noting which direction they move, the EPA says.

Just cracking a window can help a lot, Allen says: Even propping a window open a couple inches to really facilitate higher air changes, especially if you do it in multiple places in the house, so you can create some pressure differentials.

Its important to note that if you have an HVAC system, it must be running to actually circulate or filter the air. The EPA says that these systems run less than 25% of the time during heating and cooling seasons.

Most of the controls these days have a setting where you can run the fan on low all the time. And thats usually the best thing to do because that makes sure youre getting youre pushing air through the filter all the time and mixing the air up in your in your home, Sherman advised.

This could be something to keep in mind if youre going to have visitors or if someone in the household is at higher risk for severe illness.

Choose the most efficient filter your HVAC system can handle, and make sure you routinely change the filters.

Filters have a minimum efficiency reporting value, or MERV, rating that indicates how well they capture small particles. The American Society of Heating, Refrigerating and Air-Conditioning Engineers recommends using at least a MERV-13 filter, which it says is at least 85% efficient at capturing particles from 1 to 3 microns.

If thats not an option, portable air filters can also work well, but the EPA says to use one that is made for the intended room size and meets at least one of these criteria:

When you walk into a space, theres no good rule of thumb to look around and gauge how well-ventilated it might be, and that can be a challenge when people have been tasked with assessing their own risk.

Allen suggests starting with the basics: Make sure youre up to date with vaccinations and aware of where Covid-19 numbers stand in your community.

But then it gets harder. Even the number of people in a space isnt a giveaway of a higher-risk situation.

The more people in there could be higher-risk because youre more likely to have someone whos infectious, but if the ventilation is good, it really doesnt matter.

Ventilation standards are based on an amount of fresh air per person, plus the amount of fresh air per square foot, Allen explained. So if you have a good system, the more people that enter the room, the more ventilation is brought in to the room.

One tool that can help you assess ventilation in a room is a CO2 monitor, something Allen wishes he saw more in public spaces. He likes to carry a portable one, which you can order online for between $100 and $200.

If you see under 1,000 parts per million, generally, youre hitting the ventilation targets that are the design standard. But remember, these are not health-based standards. So we want to see higher ventilation rates.

Allen prefers to see CO2 at or under 800 parts per million. He also notes that just because a space has low CO2 levels, it might not be unsafe if filtration is high, like on an airplane.

Atlanta Public Schools Superintendent Lisa Herring says the installation of 5,000 air filtration units enough for every classroom in her school district is a gamechanger.

The district had begun upgrading HVAC systems in several schools even before the pandemic, but federal funding allowed it to add filtration units during a crucial time when masks have become optional.

It gives a greater level of confidence for us as a system to know that our air filtration systems are in place, Herring said.

School districts all over the country have been jumping at the opportunity for ventilation upgrades made possible by an influx of federal funding.

An analysis in February by FutureEd, a think tank at Georgetown Universitys McCourt School of Public Policy, found that public schools had earmarked $4.4 billion for HVAC projects, which could grow to almost $10 billion if trends continued.

New Hampshires Manchester School District is pouring almost $35 million into upgrading HVAC systems, and interim Superintendent Jennifer Gillis says federal funding is absolutely key.

You think about a district of our size with all the competing demands and the need to be fiscally responsible, a $35 million project, thats a large project to introduce to our budget. Having those funds available to us lets us do 19 projects and 19 projects in a very short span of time.

For Gillis, ventilation has been an important mitigation strategy and an unobtrusive way to keep people safe.

Its something that most in the building dont think about, but its a very passive way for us to create safety within the schools. Since the beginning, the goal was always lets get our kids in, lets get our staff in, but lets do it in a way thats safe for all of them.

Good ventilation isnt only about keeping students safe from Covid-19, Sherman says. It can also improve their performance in school.

Theyre going to learn better; theyre going to be awake more; theyre going to be more receptive. Theyre going to be healthier if theyve got good indoor air quality, he said.

Helping solidify ventilations role in the Covid-19 battle, the Biden administration announced a Clean Air in Buildings Challenge last month.

The challenge calls on building operators and owners to improve ventilation by following guidelines laid out by the EPA.

The main actions include creating a clean indoor air action plan, optimizing fresh air ventilation, enhancing air filtration and cleaning, and engaging the building community by communicating with occupants to increase awareness, commitment and participation.

The message may seem overdue, but its one that Allen enthusiastically welcomed.

The White House used its pulpit to say unequivocally that clean air and buildings matter. Thats massive. Regardless of what you think about what will happen next with implementation or what happens with the funding. That is a crystal-clear message that is already being heard by businesses, nonprofits, universities and state leaders. I see these changes happening already.

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This invisible Covid-19 mitigation measure is finally getting the attention it deserves - CNN

From heat rash, cramps to heat exhaustion and heat stroke, heat waves can give light to different types of heat-related illnesses. Depending on the illness, you can develop various symptoms.

A heat rash may involve red, itchy skin, small bumps or blisters on the sweaty areas of the body, which can also lead to an infection.

Heat cramps are painful and can cause discomfort in the legs, arms and abdomen. Muscle spasms are common.

Heat exhaustion could lead to fast, shallow breathing along with muscle aches, headache, irritability, weak pulse and gastrointestinal issues. Dizziness, weakness and loss of consciousness are other common symptoms.

A heat stroke can go from mild to severe symptoms. It could lead to dizziness, red, inflamed skin, nausea, high body temperature upto 105 degrees. In severe cases, a person could have seizures, may hyperventilate, experience confusion, agitations and hallucinations.

As far as a COVID-19 infection is concerned, there could be some resemblance to the heat wave symptoms such as high temperature, fast, shallow breathing, headache, mental confusion and so on. However, one must take note of the associated symptoms. Look out for other respiratory ailments, such as a sore throat, runny nose, cough or impaired sense of smell and taste. If the body temperature cools down on its own and your symptoms ease off quickly after treatment, it is probably not COVID.

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COVID vs. regular flu vs. heat wave: Whats causing you COVID like symptoms - Times of India

A person takes a COVID-19 test in Times Square as the Omicron coronavirus variant continues to spread in Manhattan, New York City, U.S., December 26, 2021. REUTERS/Andrew Kelly

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April 11 (Reuters) - The World Health Organization said on Monday it is tracking a few dozen cases of two new sub-variants of the highly transmissible Omicron strain of the coronavirus to assess whether they are more infectious or dangerous.

It has added BA.4 and BA.5, sister variants of the original BA.1 Omicron variant, to its list for monitoring. It is already tracking BA.1 and BA.2 - now globally dominant - as well as BA.1.1 and BA.3.

The WHO said it had begun tracking them because of their "additional mutations that need to be further studied to understand their impact on immune escape potential".

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Viruses mutate all the time but only some mutations affect their ability to spread or evade prior immunity from vaccination or infection, or the severity of disease they cause.

For instance, BA.2 now represents nearly 94% of all sequenced cases and is more transmissible than its siblings, but the evidence so far suggests it is no more likely to cause severe disease. read more

Only a few dozen cases of BA.4 and BA.5 have been reported to the global GISAID database, according to WHO.

The UK's Health Security Agency said last week BA.4 had been found in South Africa, Denmark, Botswana, Scotland and England from Jan. 10 to March 30.

All the BA.5 cases were in South Africa as of last week, but on Monday Botswana's health ministry said it had identified four cases of BA.4 and BA.5, all among people aged 30 to 50 who were fully vaccinated and experiencing mild symptoms.

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Reporting by Jennifer Rigby, additional reporting by Brian Benza in Gaborone; Editing by Josephine Mason and Hugh Lawson

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WHO says it is analysing two new Omicron COVID sub-variants - Reuters

While COVID-19 cases in Philadelphia are rising to the point that the city will reimpose a mask mandate, a different metric heralded the uptick a few weeks earlier in other parts of the country. The clues were in poop.

For months, the citys public health department has been trying to set up a wastewater surveillance system as an early warning signal for coronavirus outbreaks. As home testing becomes more popular and diagnostic testing less accessible to the uninsured, wastewater numbers are an important supplement to increasingly imperfect testing data.

Philadelphia was early on the scene with a pilot program in May 2020, but the city has gone about a year since that initiative ended without studying its wastewater, even as the technique became more popular. It hopes to restart the program in a few weeks.

In September 2020, the CDC launched a National Wastewater Surveillance System, which has set up testing sites in 44 different states across the U.S. At least 13 counties in Pennsylvania, including Chester and Montgomery, are currently monitoring COVID levels in wastewater, and the state health department is setting up a statewide program using $4 million in CDC funding.

Philadelphia has fallen behind, but this game is a long way from being over, said Howard Nadworny, an infectious disease doctor who heads Erie Countys wastewater surveillance system, which was set up in 2020.

We are at great risk in public health of getting more blind to the state of the pandemic, Nadworny said, maybe even similar to what happened in the beginning of 2020.

Wastewater testing can be a canary in the coal mine for COVID because it doesnt rely on testing people, which may only happen after known exposures or the onset of symptoms.

The lead time depends on the delay in reported cases, said Scott Olesen, a researcher at Biobot, a private wastewater testing company. Wastewater monitoring can be particularly helpful during surges, when health departments can be overwhelmed by the volume of tests.

When Philly ran its 12-month pilot program in 2020 and 2021, we did find signals in the data, and they were nice signals. They tended to precede the case data by about three days. But not always, said Jos Lojo, an epidemiologist at the citys public health department. In other cases, the wastewater data was coincident with the testing data, and so it appears to be a nice adjunct.

Wastewater data has also been a good predictor of hospital admissions, which lag cases because it takes time for infections to become severe enough to warrant hospitalization. Some health systems have looked to wastewater data to help manage hospital capacity, such as deciding whether to schedule elective surgeries.

Wastewater data isnt just an earlier indicator it could also be a more comprehensive one. Recent research has shown that wastewater has the potential to help estimate the true number of cases in a community.

Wastewater sampling, if done hyperlocally, can also be a way to monitor specific populations without subjecting them to routine testing.

When the University of Pennsylvania ran a pilot wastewater program last year, it sampled from dormitory sewers and libraries. At the time, the university also tested students twice a week. That data aligned closely with results from wastewater testing, showing that wastewater data could track disease spread, said Jennifer Pinto Martin, an epidemiologist at Penns School of Nursing. Penn no longer requires constant testing of students, so the university is considering whether to bring back wastewater testing.

In practice, wastewater testing comes with its own challenges. For one, the extent to which monitoring can serve as an early warning system depends on which variants are circulating, said Jordan Peccia, a Yale University engineering professor who has been studying wastewater. With omicron, youre usually in the hospital pretty quickly, he said, which shortens the lead time that wastewater offers.

Researchers also dont know how much viral matter a person sheds, or for how long.

We have two confounding factors: One is that these variants impact people differently and they likely shed differently, Peccia said. And No. 2 is, depending on your vaccination status you respond to the infection differently.

Peccia has gotten around the problem by studying concentrations over time together with other testing data.

The CDC emphasizes trends in concentrations on its wastewater dashboard, as opposed to the concentrations themselves, in part because different sites may have different sampling methodologies making it difficult to compare numbers. Natural phenomena like rainfall can also affect readings.

The CDC is still figuring out how best to convert viral wastewater concentrations into estimates of the number of people infected with COVID, Lojo said, which could correct undercounts in the reported case numbers.

Thats the million-dollar question, he said.

Philadelphia first started testing wastewater in May 2020, just two months after the citys first reported case. Over the next year, as part of a $140,000 pilot program, the Philadelphia Water Department each week sampled wastewater from three sewage treatment plants that handle all the wastewater the city produces.

Then Heather Murphys lab at Temple University took over.

We essentially take 100 milliliters of wastewater and concentrate it down into a pellet that we then analyze for the virus, said Murphy, an epidemiology professor.

Murphy shipped the pellets to Michigan State University, where they were analyzed. Researchers also did preliminary work to identify the presence of specific variants, Murphy said.

After the pilot program ended and the city stopped wastewater testing, Philadelphia was hit with the delta and omicron waves, both of which other jurisdictions detected early in wastewater. Unable to test wastewater in real time, the city has been freezing samples since this January to better understand the omicron surge retroactively.

Philadelphia was awarded funding last August to restart surveillance and join the CDCs national program. It took almost seven months before the city signed a $700,000 contract with Temple, two weeks ago, to conduct wastewater testing through July. That will likely be extended by three to six months.

Its unfortunate that its taken so long, Lojo said.

The city described the delay as a routine part of contracting. A new city law requiring disclosure on the diversity of recipients of city contracts added to the delay, said health department spokesperson James Garrow.

Sample testing is expected to resume soon once Temple finalizes a subcontract with Michigan State. The lab expects to start producing real-time data in a few weeks.

The city now wants to go beyond measuring overall virus levels and known variants by sequencing viral particles to identify entirely new variants. Cities that have taken this step, such as New York, have discovered variants that previously went undetected.

Philadelphia plans to sample from each of the three wastewater sites twice a week, doubling its collection. Some readings cant detect COVID because of how theyre taken. Its not necessarily because there really is no virus in a sample, but because environmental conditions can affect the minimum level of virus needed to be measurable, Lojo said: Some days, the water is crystal clear. But say, after a rain on other days, the water is cloudier.

Increasing the number of samples a week should help us with respect to not only figuring out if we actually have signals, but also establishing better trend lines, Lojo said.

The city could also collect samples from more locations, getting a more detailed picture of COVID levels across different neighborhoods. That kind of hyperlocal data could, for example, help direct testing resources. Only people who actually know theyre sick in the first place can isolate and prevent spreading COVID further, so testing wastewater doesnt replace testing people. Instead, wastewater data can help officials understand where to focus their efforts. For instance, the Pennsylvania Department of Corrections studies wastewater to help determine how to more effectively deploy testing in state prisons.

City officials have discussed improving the geographic granularity by sampling from more sites.

There are some ideas trying to figure out how best to go upstream to sample wastewater in city sewers, Lojo said. Its not clear if well have enough money to be able to expand it, unfortunately.

Philadelphia could also incorporate the wastewater data into its weekly COVID alert system, but it doesnt currently have plans to do so, partly because the wastewater treatment plants also serve some of the suburbs. Theres no real good way to adjust for that in the analysis, Lojo said.

But the city isnt ruling out the possibility of using wastewater data to determine COVID restrictions in the future, Garrow said.

Wastewater sampling data were sourced from the Philadelphia Department of Public Health through a records request. The data for July 1, 2020 are excluded because the department identified it as an unexplained outlier that is not thought to be a lab error.

Hospitalization data are published by the state Department of Health. They include probable and confirmed cases of COVID-19 identified in a Philadelphia hospital setting.

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The clues are in the poop: COVID-19 sewage testing is coming to Philly - The Philadelphia Inquirer

A recent study posted to the medRxiv* preprint server assessed the impact of face masks on coronavirus disease 2019 (COVID-19) incidence among children aged between 10 and 12 years.

During the period of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant predominance in Finland, the use of face masks was recommended across the country in schools. However, there is insignificant data related to the impact of face masks in the prevention of COVID-19 transmission.

In the present study, the researchers compared the incidence of COVID-19 among children aged between 10 to 12 years, residing in different Finnish cities, with different recommendations regarding the usage of face masks in schools.

The team obtained the total number of COVID-19 cases from the National Infectious Disease Registry (NIDR) of the Finnish Institute for Health and Welfare. They also collected demographic information including the patients date of birth, sex, and residential area. The moving averages of 14-day case incidences were employed as a dependent variable. Furthermore, the team calculated the average percent changes (APC) occurring over one month.

The cities of Helsinki with a population of 6,61,887 and Turku with a population of 1,95,818 were compared for the present study since their baseline incidence of COVID-19 was comparable in August and September 2021. Helsinki had implemented face mask usage at schools while Turku had recommended face mask usage for individuals aged 10 years and above.

The team compared the 14-day incidences of COVID-19 among individuals aged seven to nine, 10 to 12, and 30 to 49 years.

The study results showed that there were no significant differences in APC values in August between Helinski and Turku. However, the APC value was higher in Turku in September and November while the APC value was higher in Helsinki in October.

Notably, the incidence of COVID-19 in children aged seven to nine years was similar to that in children aged 10 to 12 years, while no such similarity was observed for adults aged 30 to 49 years in the two cities.

Overall, the study findings showed that there were no substantial differences in the incidence of COVID-19 after wearing face masks in children aged between 10 to 12 years and residing in Helsinki and Turku.

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

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Impact of face masks on COVID-19 incidence in children in Finland - News-Medical.Net

New Jersey on Monday reported four confirmed COVID-19 deaths and 1,012 confirmed positive tests as the seven-day average for cases continues to steadily rise after hitting recent lows in March.

The states seven-day average for confirmed cases increased to 1,419 Monday, up 42% from a week ago and 83% from a month ago. The seven-day average had hit a recent low of 631 on March 17.

Mondays case total marks seven consecutive days of more than 1,000 new confirmed positive tests.

At his first public appearance last week since testing positive, Gov. Phil Murphy urged the public to continue to be smart and safe, and continue to use common sense and common courtesy.

There were 366 patients with confirmed or suspected coronavirus cases across 69 of the states 71 hospitals as of Sunday night. Two hospitals did not report data.

By comparison, hospitalizations hit a recent peak at 6,089 on Jan. 10 during the omicron wave that hit the state this winter.

There were at least 48 people discharged in that same 24-hour period ending Sunday night, according to state data. Of those hospitalized, 38 were in intensive care and 26 were on ventilators.

New Jerseys transmission rate increased to 1.23 on Monday from 1.19 Sunday. When the transmission rate is over 1, that means each new case is leading to at least 1 other new case and the outbreak is expanding.

The statewide daily positivity rate for tests conducted Wednesday, the most recent day available, was 5.3%.

The state on Monday also reported 205 probable cases from rapid antigen testing at medical sites. The daily case counts, however, come with the caveat that many people are now relying on free at-home COVID-19 tests, which are not reported to state health officials.

All of New Jerseys 21 counties were listed as having low rates of transmission, according to recently updated guidelines from the U.S. Centers for Disease Control and Prevention. Healthy people in the low and medium categories are no longer recommended to wear masks.

BA.2, the new strain of COVID-19, has been spreading in New Jersey for weeks, though at much lower rates than the omicron surge in December and January. Officials have said the omicron stealth subvariant appears to spread more easily but generally not cause more severe illness.

For the week ending March 26, BA.2 accounted for 81.2% of the positive tests sampled (up from 70.5% the previous week), while the omicron variant accounted for 18.8% of positive tests sampled.

New Jersey has reported 1,912,503 total confirmed cases out of more than 17.5 million PCR tests conducted in the more than two years since the state reported its first known case March 4, 2020.

The Garden State has also recorded 304,301 positive antigen or rapid tests, which are considered probable cases. And there are numerous cases that have likely never been counted, including at-home positive tests that are not included in the states numbers.

The state of 9.2 million residents has reported 33,308 COVID-19 deaths in that time 30,294 confirmed fatalities and 3,014 probable.

New Jersey has the seventh-most coronavirus deaths per capita in the U.S. behind Mississippi, Arizona, Oklahoma, Alabama, Tennessee and West Virginia as of the latest data reported Monday. Last summer, the state still had the most deaths per capita in the country.

More than 6.83 million of the 8.46 million eligible people who live, work or study in New Jersey have received the initial course of vaccinations and more than 7.76 million have received a first dose since vaccinations began here on Dec. 15, 2020.

While the number of N.J. residents fully vaccinated has reached over 6.8 million, the latest numbers also follow a major study that reveals even a mild case of COVID-19 can significantly affect the brain.

More than 3.38 million people in the state eligible for boosters have received one.

For the week ending March 27, with around 62% of schools reporting data, another 1,910 COVID-19 cases were reported among staff (547) and students (1,363) across New Jerseys schools.

Since the start of the academic year, there have been 106,425 students and 29,063 school staff members who have contracted COVID-19 in New Jersey, though the state has never had more than two-thirds of the school districts reporting data in any week.

The state provides total student and staff cases separately from those deemed to be in-school transmission, which is narrowly defined as three or more cases linked through contact tracing.

New Jersey has reported 557 total in-school outbreaks, including 3,941 cases among students and staff. That includes 21 new outbreaks from data reported last week.

At least 9,422 of the states COVID-19 deaths have been among residents and staff members at nursing homes and other long-term care facilities, according to state data.

There were active outbreaks at 134 facilities, resulting in 2,677 current cases among residents and 3,188 cases among staff as of the latest data.

As of Monday, there have been more than 498.1 million COVID-19 cases reported across the globe, according to Johns Hopkins University, with more than 6.17 million people having died due to the virus.

The U.S. has reported the most cases (more than 80 million) and deaths (at least 985,482) of any nation.

There have been more than 11 billion vaccine doses administered globally.

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Steven Rodas may be reached at srodas@njadvancemedia.com. Follow him @stevenrodasnj.

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N.J. reports 4 COVID deaths, 1,012 cases - 7th straight day with over 1K positive tests - NJ.com

Anthony Fauci predicts that the U.S. will eventually get to the point where COVID-19 vaccines are administered yearly, as the flu vaccine is. Kevin Dietsch/Pool/AFP via Getty Images hide caption

Anthony Fauci predicts that the U.S. will eventually get to the point where COVID-19 vaccines are administered yearly, as the flu vaccine is.

The U.S. could follow the trend of the United Kingdom and see a surge in COVID-19 cases driven by the BA.2 subvariant of the coronavirus, according to Dr. Anthony Fauci.

The chief medical adviser to President Biden said that though cases are still trending down across the U.S., some states are seeing a rise.

"I think without a doubt that we are going to see a turnaround as people get out more and into the inside venues without masks," he said. "That's going to be certainly resulting in infections, even in people who are vaccinated."

New modeling from the Commonwealth Fund shows the vaccination campaign in the U.S. has saved more than 2 million lives and has prevented 17 million hospitalizations.

Fauci said that a second booster shot may be needed for Americans by the fall and that eventually vaccination could shift to a yearly injection, like with the flu vaccine.

Speaking to All Things Considered, Fauci walks through what he sees coming for the U.S., the thinking behind boosters and the advice for masking indoors.

This interview has been edited for length and clarity.

On what the BA.2 subvariant will do in the U.S.

I think we're going to be seeing an uptick of cases that we are already seeing in certain states. We had a very sharp and steady decline in everything from cases to hospitalizations to deaths, and in general, on a countrywide basis, we're still seeing that. But there are some areas, particularly in the Northeast, where we are seeing a turnaround and an uptick in cases.

If our pattern follows that of the U.K., which we usually do and are usually about three to four weeks behind them, they are having a significant upsurge in the number of cases. We are hoping that if that does happen, the degree of background immunity that we have in the country ... [means] we will not see an increase in severity in the sense of a concomitant increase significantly in the number of hospitalizations.

On the need for a second booster shot by the fall

It's difficult to predict. But I would think, given the fact that immunity wanes over a period of time ... that we will need a boost by the time we get to the fall.

I don't foresee the need to boost every four months. But what I would imagine might happen, as all of this turns around, we will get into what might be a yearly, seasonal type of an approach. We have something perhaps similar to flu.

I'm saying this merely as extrapolations. No one knows for certain what will be required. We will have to just look at the data and make decisions.

On not masking at indoor events

The CDC was very clear when they modified their metrics to make recommendations for indoor masking and said that when the level of infection in the community gets low enough so that it's in what we call the green zone, you could do that with indoor events.

But if it changes and the cases go up, I for one will go back to masking indoors if we go with a high uptick of cases.

This interview was produced by Linah Mohammad and edited by Amy Isackson.

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What Fauci sees coming with the BA.2 coronavirus subvariant in the U.S. - NPR