Category: Covid-19

Years after the U.S. began to slowly emerge from mandatory COVID-19 lockdowns, more than half of olderadults still spend more time at home and less time socializing in public spaces than they did pre-pandemic, according to new CU Boulder research.

Participants cited fear of infection and more uncomfortable and hostile social dynamics as key reasons for their retreat from civic life.

The pandemic is not over for a lot of folks, said Jessica Finlay, an assistant professor of geography whose findings are revealed in a series of new papers. Some people feel left behind.

The study comes amid what the U.S. Surgeon General recently called an epidemic of lonelinessin which older adultsespecially those who are immune compromised or have disabilitiesare particularly vulnerable.

We found that the pandemic fundamentally altered neighborhoods, communities and everyday routines among aging Americans, and these changes have long-term consequences for their physical, mental, social and cognitive health, said Finlay.

As a health geographer and environmental gerontologist, Finlay studies how social and built environments impact health as we age.

In March 2020 as restaurants, gyms, grocery stores and other gathering places shuttered amid shelter-in-place orders, she immediately wondered what the lasting impacts would be. Shortly thereafter, she launched the COVID-19 Coping Study with University of Michigan epidemiologist Lindsay Kobayashi. They began their research with a baseline and monthly survey. Since then, nearly 7,000 people over age 55 from all 50 states have participated.

The researchers check in annually, asking open-ended questions about how neighborhoods and relationships have changed, how people spend their time, opinions and experiences of the COVID-19 pandemic, and their physical and mental health.

By the numbers

How aging adults spend their time

Source: Data from COVID-19 Coping Study survey results from May2022. A more recent survey found that more than half still had not returned to pre-pandemic social routines.

Weve been in the field for some incredibly pivotal moments, said Finlay, noting that surveys went out shortly after George Floyd was murdered in May 2020 and again after the attack on the U.S. Capitol on Jan. 6, 2021.

Collectively, the results paint a troubling picture in which a substantial portion of the older population remains isolated even after others have moved on.

In one paper published in February in the journal Wellbeing, Space and Society, 60% of respondents said they spend more time in their home while 75% said they dine out less. Some 62% said they visit cultural and arts venues less, and more than half said they attend church or the gym less than before the pandemic.

The most recent survey, taken in spring 2023, showed similar trends, with more than half of respondents still reporting that their socialization and entertainment routines were different than they were pre-pandemic.

In another paper titled I just cant go back, 80% of respondents reported there are some places they are reluctant to visit in person anymore.

The thought of going inside a gym with lots of people breathing heavily and sweating is not something I can see myself ever doing again, said one 72-year-old male.

Those who said they still go to public places like grocery stores reported that they ducked in and out quickly and skipped casual chitchat.

Its been tough, said one 68-year-old female. You dont stop and talk to people anymore.

Many respondents reported they were afraid of getting infected with a virus or infecting young or immune-compromised loved ones, and said they felt irresponsible for being around a lot of people.

Some reported getting dirty looks or rude comments when wearing masks or asking others to keep their distanceinterpersonal exchanges that reinforced their inclination to stay home.

Jessica Finlay, a health geographer and environmental gerontologist, studies how built environments impact aging.

The news is not all bad, stresses Finlay.

At least 10% of older adults report exercising outdoors more frequently since the pandemic. And a small but vocal minority said that their worlds had actually opened up, as more meetings, concerts and classes became available online.

Still, Finlay worries that the loss of spontaneous interactions in what sociologists call third places could have serious health consequences.

Previous research shows that a lack of social connection can increase risk of premature death as much as smoking 15 cigarettes a day and exacerbate mental illness and dementia.

For some older adults who live alone, that brief, unplanned exchange with the butcher or the cashier may be the only friendly smile they see in the day, and they have lost that, Finlay said.

Societal health is also at risk.

It is increasingly rare for Americans with differing sociopolitical perspectives to collectively hang out and respectfully converse, she writes.

Finlay hopes that her work can encourage policymakers to create spaces more amenable to people of all ages who are now more cautious about getting sickthings like outdoor dining spaces, ventilated concert halls or masked or hybrid events.

She also hopes that people will give those still wearing masks or keeping distance some grace.

It is a privilege to be able to just get over the pandemic and many people, for a multitude of reasons, just dont have that privilege. The world looks different to them now, she said.How can we make it easier for them to re-engage?

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'An epidemic of loneliness': How the pandemic changed life for aging adults - University of Colorado Boulder

We developed an age-stratified dynamic transmission model for SARS-CoV-2, which was further stratified by IMD decile, and by urban or rural classification in England. Here, we detail how the model was modified to incorporate the characteristics of each decile and geography.

Each epidemic was simulated on the population of a given IMD decile in either an urban or rural area, to account for the distinct underlying age structures in these areas. We used 17 age groups (01, 15, every 5 years to 75, and over 75). The mid-2020 (30 June) age-specific population of each lower layer super output area (LSOA), which is on average 1500 people, was linked via LSOA codes to their IMD decile and urban/rural classification (where urban is defined as a settlement with over 10,000 residents) [16,17,18,19]. We calculated the size of each age group, specific to each IMD decile and geography, and used this to determine the average age structure of each IMD- and geography-specific population, (n=({n}_{1},dots ,{n}_{17})), where (sumlimits_{a=1}^{17}{n}_{a}=1) in each population. We also calculated the median age for each urban and rural IMD decile and the proportion of each IMD decile residing in urban or rural LSOAs (Additional file 1: Section 1).

To define contact between the age groups, we used age-specific social contact data for the United Kingdom (UK) for physical and conversational contacts, accessed via the socialmixr R package [20, 21]. The contact matrices are highly age-assortative, with the highest daily contact patterns occurring between individuals in the same age group for those aged 519. We projected the contact patterns onto the age structure of each IMD- and geography-specific population in 2020, using the density correction method, by constructing an intrinsic connectivity matrix and scaling this matrix to match the populations age structure [22].

The intrinsic connectivity matrix was calculated from the 2006 UK contact matrix ({M}^{2006}={left({M}_{ij}^{2006}right)}_{i,j=1,dots ,17}) and age structure ({N}^{2006}=left({N}_{1}^{2006}, dots ,{N}_{17}^{2006}right)) as follows:

$$Gamma ={left({Gamma }_{i,j}right)}_{i,j=1,dots ,17}$$

$${Gamma }_{i,j}={M}_{ij}^{2006}frac{sum_{a=1}^{17}{N}_{a}^{2006}}{{N}_{j}^{2006}}$$

The new contact matrix for a population with age group sizes (N=left({N}_{1},dots ,{N}_{17}right)) and proportions (n=left({n}_{1},dots ,{n}_{17}right)) had entries:

$${M}_{ij}=frac{{Gamma }_{ij}{N}_{j}}{sum_{a=1}^{17}{N}_{a}}={Gamma }_{ij}{n}_{j}$$

We separated infections of SARS-CoV-2 as in [23], into clinical or subclinical cases. Clinical cases of COVID-19 are infections that lead to noticeable symptoms such that an individual may seek clinical care. Subclinical infections do not seek care and are assumed to be less infectious than clinical cases. We defined a populations clinical fraction as the probability of an individual in the population developing a clinical case of COVID-19 upon infection. Here, we related an individuals probability of being a clinical case of COVID-19 to the self-reported health status of their IMD- and age-specific population in England, as a proxy for the relative presence of comorbidities in each population, and then examined how differences in self-reported health status by IMD decile, coupled with differences in age distribution, affect the burden in each IMD decile.

To define health status, we used data from the 2021 Census, specifically the question How is your health in general?, with response options of very good, good, fair, bad, and very bad [24]. This is provided by the Census stratified by IMD and by age. We then defined health prevalence as the proportion of individuals reporting very good or good general health, stratified by the same age groups and the deciles of IMD:

$$Health;prevalence;=;frac{Number;in;'Very;good';health;+;Number;in;'Good';health}{Number;in;all;health;statuses}$$

(1)

To map a populations health prevalence to clinical fraction, we used locally weighted regression (LOESS), which fits a smooth curve without any assumptions about the underlying distribution of the data, trained on age-specific health prevalence data from Census 2021 and age-specific clinical fraction values from Davies et al. [23, 24]. Any populations with health prevalences outside of the training datasets range were assigned the most extreme clinical fractions found by Davies et al. [23], to avoid extrapolation outside of observed values. Health prevalence was highest in children, but children have separate risk factors for severe disease (such as smaller airways), and children under 10 have been found to be subject to a higher risk of clinical COVID-19 cases and a greater infection fatality ratio (IFR) [23, 25] (as observed for other infections such as influenza [26]). Therefore, we fixed the clinical fraction of the 09 age group at 0.29, matching that found by [23].

The transmission model includes a single SARS-CoV-2 variant, no existing immunity in the population, and natural history parameters drawn from the first wave of the pandemic. We considered the non-pharmaceutical intervention (NPI) of school closures and also explored the effect of vaccinating adults over the age of 65. We developed an age- and IMD-stratified deterministic compartmental model in R (version 4.3.1) (Fig. 1c). There is no mixing between IMD deciles in the model. The aim is to demonstrate the importance of health prevalence and differences in age and social mixing in epidemic impact, rather than to reproduce the COVID-19 epidemic in England.

a Proportion of each geography-specific IMD decile in each age group. b Age- and IMD-specific health prevalence (1, most deprived decile; 10, least deprived). c Age-stratified SEIRD model, specific to IMD decile and geography. Subscript a denotes age-specificity, c clinical parameters, and s subclinical parameters

Individuals are first assumed to be susceptible (S) and become exposed (E) but not yet infectious after effective contact with an infected individual (Fig. 1c). Each exposed individual then progresses to one of two infected states: subclinical infection (Is) and clinical infection, which is represented by a pre-symptomatic (but infectious) compartment (Ip) followed by a symptomatic compartment (Ic). Each individual then moves into the recovered (R) or dead (D) compartment, at which point they are assumed to no longer be infectious and to be immune to infection. This susceptible-exposed-infectious-recovered-dead (SEIRD) is an extension of [23], with the addition of a D compartment. We ran the epidemic for 365 days, which allowed the completion of each epidemic in each decile and geography. Each epidemic was run on a synthetic population of a fixed IMD decile and urban/rural geography, with no births, non-infection-related deaths, or ageing between the age groups, as the time frame of each epidemic was less than a year. The model also assumed that contact patterns remain constant throughout the epidemic.

The force of infection in age group k is given by:

$${lambda }_{k}=psum_{a=1}^{17}{M}_{ak}frac{{Ip}_{k}+{Ic}_{k}+{xi Is}_{k}}{{n}_{k}}$$

where (p) is the probability of a contact between an infected and susceptible individual resulting in transmission of infection, ({M}_{ak}) is the mean daily number of contacts that an individual in age group a has with individuals in age group k, and (xi) is the relative infectiousness of subclinical cases. The age-specific clinical fraction is denoted by ({pi }_{a}) and depends on the IMD decile. Rates of transition from each disease state are given in Table 1.

We assumed the relative subclinical infectiousness ((xi)), to be equal to 0.5, and tested this assumption in a sensitivity analysis (see Additional file 1: Section 12). The transmission probability during a contact was assumed to be (p=0.06) as in [23]. The remaining parameter estimates were taken from [23] where possible, to replicate the conditions used to derive the clinical fraction estimates. The mortality probability of subclinical infections was assumed to be 0 for all age groups ((a)). The age-specific probability of mortality of clinical cases was estimated using age-specific IFRs (left({phi }_{a}right)) found by Verity et al. in 2020 [27] (Additional file 1: Table S4). As the IFR is ({phi }_{a}={pi }_{a}{mu }_{ca}+left(1-{pi }_{a}right){mu }_{sa}={pi }_{a}{mu }_{ca}), since ({mu }_{sa}=0), the age-specific clinical mortality probabilities were estimated by:

$${mu }_{ca}=frac{{phi }_{a}}{{pi }_{a}}$$

where ({pi }_{a}) is the age-specific clinical fractions for the general population in [23] (Additional file 1: Table S4).

We calculated the total infections, clinical cases, and fatalities per 1000 people, the peak number of clinical cases per 1000 people, the IFR, and the basic reproduction number (R0) for each IMD decile in urban and rural areas. We also calculated age-standardised measures of total infections, clinical cases, and fatalities within a specific geography for increased comparability. The age-standardised results were of the form:

$${D}^{{text{standard}}}left(365right)=sum_{a=1}^{17}frac{{D}_{a}left(365right){n}_{a}^{u}}{{n}_{a}}$$

where ({n}^{u}=left({n}_{1}^{u},dots ,{n}_{17}^{u}right)) is the standard urban population, defined as the proportion of people living in urban LSOAs who are in each age group, similarly ({n}^{r}=left({n}_{1}^{r},dots ,{n}_{17}^{r}right)) for rural areas.

R0 in each IMD decile in urban and rural areas was calculated as the absolute value of the largest eigenvalue of the next-generation matrix N:

$$N={left({N}_{ij}right)}_{i,j=1,dots ,17}$$

$${N}_{ij}={pM}_{ij}left({pi }_{j}left(gamma +{r}_{c}right)+xi left(1-{pi }_{j}right){r}_{s}right)$$

To determine the epidemic burden attributable to the difference in underlying health status between IMD deciles, we created the counterfactual health prevalence scenario, where all deciles were assigned the age-specific health prevalence of decile 10 (the least deprived). We calculated the total clinical cases and fatalities in each IMD decile under this assumption. In order to reflect the size of each population (while each IMD decile comprises 10% of the population of England, geography-specific IMD deciles vary widely in size, see Additional file 1: Table S1), we scaled mortality to mid-year 2020 population sizes and totalled over the 20 populations.

We also created the counterfactual scenario of constant age structure, where we held the age structure constant at the average of each geography-specific England population, independent of the IMD decile. This allowed us to determine the impact of clinical vulnerability separately from the differences in age distribution in each IMD decile. The health prevalence by age remained at the IMD-specific value.

School closures were a major NPI implemented in the UK during the pandemic, and were implemented evenly across all IMD deciles, unlike some other contact-reducing interventions. We therefore modelled school closures to determine the impact of this intervention across IMD deciles. To quantify the potential differences in the impact of school closures in different IMD deciles, we calculated the effect of school closures on R0 and total fatalities. The social contact data used is a combination of location-specific contact matrices, defined by home, work, school, and other locations. We removed the school-specific contacts from the contact matrix (retaining contacts in home, work, and other locations), re-projected onto the 2020 age structure, and recalculated the next-generation matrix, N, and its largest eigenvalue, R0. While assuming that the closure of schools results in a complete subtraction of school-specific contacts may not be realistic (as some contacts would likely be replaced by social interactions in other locations [28]), the results demonstrate the maximum potential impact of school closures.

We simulated the closure of schools after a certain cumulative proportion, P, of the population developed clinical COVID-19 cases. The use of cumulative clinical cases as a threshold for implementation is reflective of using total confirmed cases as a measure of the size of an early epidemic. We assumed a value of P = 0.05 but tested different values in sensitivity analyses (Additional file 1: Section 11).

To quantify the relative impact of vaccination rollouts on populations of different levels of deprivation, we calculated the change in mortality rates in each population after vaccinating all adults over the age of 65. This correlates with the earliest vaccination programmes in England, where the first target populations were individuals of older ages. We assumed that vaccination reduced the likelihood of an individual developing a clinical case of COVID-19 upon infection but did not prevent infection. We assumed 76.5% vaccine efficacy against symptomatic infection [29] and reduced the clinical fraction of vaccinated individuals in line with this estimate. To estimate the maximum impact of vaccination, we assumed coverage in over 65s of 100%. We then calculated the change in mortality rates and the number of deaths prevented in each population. We also calculated how many vaccine doses would be given to each population.

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COVID-19 inequalities in England: a mathematical modelling study of transmission risk and clinical vulnerability by ... - BMC Medicine

CHICAGO (WLS) -- A street on Chicago's Southwest Side was named in honor of Chicago Police Officer James Svec.

It took place at West 77th Place and South Kolmar Avenue.

Svec died in December 2021 from complications from COVID-19, which he contracted in the line of duty.

He served with the department for 20 years.

"I want them to remember his awesome personality and the way that he lived life. Every day like it was his last, and he took every opportunity that he could," she said.

Svec's daughter said her parents bought their first home on the block in 1989.

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Street renaming held at West 77th Place and South Kolmar Avenue for Chicago Police Officer James Svec, who died from COVID-19 - WLS-TV

FILE -{ }Research shows that lingering viral fragments after a COVID-19 infection and lingering spike protein after a COVID-19 injection can affect our memory, concentration, processing, speed and mood behavior. (TND)

WASHINGTON (TND)

Research shows that lingering viral fragments after a COVID-19 infection and lingering spike protein after a COVID-19 injection can affect our memory, concentration, processing, speed and mood behavior.

Research%20shows%20that%20lingering%20viral%20fragments%20after%20a%20COVID-19%20infection%20and%20lingering%20spike%20protein%20after%20a%20COVID-19%20injection%20can%20affect%20our%20memory,%20concentration,%20processing,%20speed%20and%20mood%20behavior.%20(TND)

Fatigue, headache and brain fog are common symptoms after being infected with COVID-19. A lasting impairment can potentially lead to a higher risk of Alzheimers. However, some lifestyle modifications and treatment strategies can build a better brain.

Front Line COVID-19 Critical Care Alliance (FLCCC) Advisor Dr. Suzanne Gazda joined The National Desks Jan Jeffcoat to discuss the issue.

I always say that the brain has taken a terrible hit since 2020, 2021 and that it is not a lingering virus but is lingering viral fragments that are wreaking havoc on the brain, she said. Many studies have shown cognitive impairment as one of the main post-COVID side effects. So this also potentially happens with people that are vaccine-injury.

Gazda says there are 11 studies correlating having had COVID to the risk of developing Alzheimers disease within 6 months-12 months which has never been seen before.

Lifestyle modifications such as changing your diet to a low-inflammatory diet are recommended as well as intermittent fasting can also be a strong component toward improving brain health.

A recent study out of New England Journal of Medicine looked at about 100,000 people and they found a significant portion of these individuals that recovered from COVID had lasting memory issues, Gazda said. That's typically what we're seeing in our practice is that these brain fog, cognitive issues, sometimes are not getting better just with the tincture of time.

Learn more about post-COVID-19 cognitive impairment here.

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COVID-19 raises Alzheimer's risk: Lifestyle changes can help with memory impacts - KEYE TV CBS Austin

Africa CDC notes with disappointment that Moderna has put its plans to establish vaccine manufacturing in Kenya on hold. While we acknowledge that the need and demand for COVID-19 vaccines has indeed decreased significantly, both in Africa and globally, it is important that we reflect on the nuances of this.

The Africa CDC recalls the considerable efforts of Africa to timely access vaccines as Member States of the Union considered vaccines as the most effective means in the pandemic response. Through its Heads of States and Government, the AU and Africa CDC called for equitable and timely access to and receipt of vaccines. A call which in many instances went unanswered by the international community and industry.

Its public evidence that Covid-19 vaccines were delivered late to Africa, long after vaccines were made available to the developed world. Such actions significantly contributed to lower the demand for vaccines once these eventually were made available for Africa. We must also acknowledge that this late availability of vaccines to Africa, significantly affected the course of the pandemic, as well as the uptake and demand for vaccines.

With the view to mobilise funds and find a responsive solution, African Union established the AU Covid-19 response fund and launched the African Vaccine Acquisition Trust (AVAT) with the African Export and Import Bank (Afrexim Bank). AVAT acquired 400 million vaccines from manufacturers other than Moderna, simply because Moderna vaccines were not made available, despite attempts to buy. In fact, less than 5% of the covid-19 vaccines administered in Africa, were from Moderna. Despite these African efforts, Covid-19 vaccines were still delivered late to Africa, long after vaccines were made available to the developed world.

Through its consortium for Covid-19 Vaccine Clinical Trials (CONCVACT) Africa CDC also played a coordination role in facilitating the start and successful completion of clinical trials during the pandemic, strengthening enablers of high-quality vaccines clinical trials on the continent, and in accelerating post-trial vaccines regulatory approval.

Therefore, to blame Africa and Africa CDC for lack of demand for covid-19 vaccines and therefore the reason to put on hold plans to manufacture vaccines in Africa, only serves to perpetuate the inequity that characterized the response to the Covid19 pandemic. While other vaccine manufacturers are progressing with their plans and construction in Africa, Moderna is abandoning a commitment to build highly needed and relevant vaccine manufacturing capabilities in Africa, in truth, demonstrating that Modernas commitment is in fact not to vaccine equity and access to vaccines, through building manufacturing in Africa.

Africa CDC, as mandated by Heads of State of African governments, will continue to advocate, and support the establishment of a strong local vaccine manufacturing ecosystem, which supports research and development, and local manufactures capacity to serve the African Union continental vision of producing 60% of vaccines, therapeutics, and other medical products by 2040. Nevertheless, Africa CDC acknowledge that building vaccine manufacturing infrastructure and capabilities, is complex, takes a long time, and requires significant investment. That is why we, through our Partnership for African Vaccine manufacturing (PAVM), now renamed PHAHM Platform for Harmonized African Health Products Manufacturing, will continue to work towards building and strengthening African manufacturing, with our member states, international finance institutions, regulators, and partners, including vaccine manufacturers. This forms part of our comprehensive and African approach to pandemic preparedness and prevention, and we encourage Moderna, as an experienced vaccine manufacturer, to contribute to, and support, Africas ambitious goal of a secure and safe Africa on public health security for the betterment of African health security and beyond.

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Africa CDC's Statement on Moderna's plan to reassess commitment to African vaccine manufacturing Africa CDC - africacdc.org

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Distinct Patterns of Liver Chemistry Changes in Pediatric Acute Hepatitis of Unknown Origin and COVID-19 Patients: A ... - Cureus

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In just the first few months of the pandemic, Healthcare at Foster Creek quickly became the state's largest outbreak site; 30 residents died.

Author: kgw.com

Published: 11:07 PM PDT April 12, 2024

Updated: 11:07 PM PDT April 12, 2024

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Families receive settlement over COVID-19 deaths at Portland nursing home - KGW.com

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A federal task force says its seized more than $1.4 billion in fraudulently obtained Covid-19 relief funds over the last three years, though its potentially only a fraction of the total amount of aid money stolen by fraudsters.

FILE - The Justice Department in Washington, Nov. 18, 2022. (AP Photo/Andrew Harnik, File)

In its annual report released Tuesday, the Department of Justices Covid-19 Fraud Enforcement Task Force says its members have filed charges against more than 3,500 defendants for fraudulently obtaining funding meant for pandemic relief efforts since the task force was formed in 2021cases believed to account for total losses of more than $2 billion.

Of the 3,500 defendants charged by U.S. Attorneys Offices around the country, 2,005 defendants have pleaded guilty or were convicted at trialbut the report says there are a similar number of investigations open that are yet to be charged.

Members of the task force have also secured more than 400 civil settlements and judgements totaling more than $100 million.

The money seized by the DOJ was fraudulently obtained through the Coronavirus Aid, Relief and Economic Security (CARES) Act, the landmark 2020 stimulus bill that established programs to distribute trillions of dollars in aid to individuals impacted by the pandemic.

In one example cited in the report, a Washington business owner pleaded guilty to fraudulently obtaining more than $16 million in pandemic-relief funding by applying for funding for dozens of businesses purportedly owned by him or his associates using false informationwith many of the businesses inactive.

But defendants werent limited to business ownersthe U.S. Attorneys Office in the Southern District of Florida, for instance, prosecuted 17 employees with the Broward Sheriffs Office for each independently fraudulently applying for pandemic relief and receiving a combined $500,000 illegally.

The total amount of money fraudulently taken during the pandemic could amount to hundreds of billions of dollars. In 2023, the Government Accountability Office estimated that the total amount of unemployment insurance fraud during the pandemic was between $100 billion and $135 billionaccounting for 11 to 15% of the total unemployment benefits paid during the pandemic. A 2023 Associated Press investigation estimated that up to $280 billion in pandemic relief funding was obtained fraudulently, while another $123 billion was misspent or otherwise wasted. U.S. Attorney General Merrick Garland established the Covid-19 Fraud Enforcement Task Force in 2021, acknowledging at the time it is impossible to keep all those intent on carrying out illegal COVID fraud schemes from doing so, but vowing to work to hold bad actors accountable.

In its report, the Covid-19 Fraud Enforcement Task Force noted significant challenges in continuing its work. It advocated, for instance, for an extension of statute of limitations on all COVID-19 fraud-related offenses, noting in the coming years, investigative targets will increasingly argue that their conduct falls outside the statute of limitations. In 2022, the U.S. passed legislation increasing the statute of limitations for fraud related to the so-called Paycheck Protection Program and Economic Injury Disaster Loan program from five to 10 years. Sens. Ron Wyden, D-Ore., and Mike Crapo, R-Idaho, have introduced a legislative framework to extend the statute of limitations for pandemic unemployment insurance fraud to 10 years. The Task Force also calls for the renewal of the Pandemic Response Accountability Committee, a body of 20 federal inspectors general that oversees pandemic relief spendingits funding is set to end next year.

Later on Tuesday, Senate Democrats proposed a new $1.3 billion bill maimed at giving authorities more tools to investigate and prosecute pandemic relief fraud. The bill, which is modeled off a White House budget request, would fund new Covid-19 fraud investigative teams, provide funding to federal agencies to hire investigators that would specialize in recovering lost pandemic funds and more.

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Feds Say They've Taken Back $1.4 Billion In Fraudulent Covid Relief Funds - Forbes

Kaleigh Levine was running drills in the gym with her lacrosse team at Notre Dame College in South Euclid, Ohio, when everything turned black.

The coach wanted me to get back in the line, but I couldnt see, she remembered.

Her vision returned after a few minutes, but several months and a half-dozen medical specialists later, the 20-year-old goalie was diagnosed with a mysterious condition known as POTS.

First described more than 150 years ago, the syndrome has proliferated since the coronavirus pandemic. Before 2020, 1 million to 3 million people suffered from POTS in the United States, researchers estimate. Precise numbers are difficult to come by because the condition encompasses a spectrum of symptoms, and many people have still never heard of it. Recent studies suggest 2 to 14 percent of people infected with the coronavirus may go on to develop POTS.

The syndrome tends to strike suddenly, leaving previously healthy people unable to function, with no clear cause. In recent years, doctors specializing in the condition have noticed a curious and disproportionate subset of patients: young, highly trained athletes who are female.

Short for postural orthostatic tachycardia syndrome, POTS is diagnosed when a patients heart rate goes berserk, jumping way above normal when changing position from lying down to standing.

Teens and young adults at peak fitness are generally regarded as being extremely healthy, so the burst of POTS cases has puzzled doctors.

Several factors may be conspiring, said Robert Wilson, a neurologist who runs the Cleveland Clinics POTS practice. It could be that women of childbearing age are more vulnerable to inflammation. It could reflect the damage that comes with being hit with a virus unknown to humans until 2020. And the stress associated with repetitive physical exhaustion could leave athletes at risk.

Its something of a perfect storm of susceptibility, Wilson said.

Dongngan Truong, a pediatric cardiologist at University of Utah Health, speculated that the surge in cases might reflect athletes often unusual physiology, or could simply be reporting bias.

It could just be athletes generally keeping in touch with their bodies more, Truong said.

Concerns about the health of athletes made headlines early in the pandemic but the focus wasnt on POTS. It was on another heart condition.

Prominent sports figures including Boston Red Sox pitcher Eduardo Rodriguez revealed that after enduring covid-19, they experienced inflammation of the heart muscles known as myocarditis, a leading cause of sudden death in athletes.

The NCAA started a registry to track athletes. Professional sports teams and schools introduced heart screenings before allowing athletes to return to play. It turned out myocarditis was not as common as feared, and a study published later in the journal Heart showed that elite athletes who were affected had no long-lasting heart damage.

But the scrutiny led to a wave of important research.

At the University of Alabama at Birmingham, Sara Gould, an orthopedic surgeon, and Camden Hebson, a pediatric cardiologist, opened a sports clinic in 2021 to help young athletes navigate their health post-covid. It drew patients from across the South and beyond, but the physicians were surprised to find that few of the patients had myocarditis. Most were coming in with POTS.

And POTS is a lot of what we see to this day, Gould said.

When oxygen flow to the brain is reduced, it sparks sometimes vague and confusing POTS symptoms including lightheadedness, fainting, nausea, tremors, fatigue, headache, brain fog, blurry vision, palpitations and chest tightness, and shortness of breath. The impact can be measured by elevations in heart rate when people change position.

Many athletes, especially those in endurance sports, tend to have lower resting heart rates than non-athletes making the jumps even bigger. An athletes resting heart rate might be 30 to 50 beats a minute, while another persons resting heart rate sits at 60 to 100 beats.

A 19-year-old female college volleyball player described in a case study by the American Medical Society for Sports Medicine had a heart rate that jumped from 56 beats a minute to 120. A presentation from North Central College in Illinois details the illness of a nationally ranked high school swimmer whose heart rate spiked from the 40s and 50s to as high as 172 when moving from lying down to standing.

Gould and Hebson quickly noticed that most of their patients could be categorized into two groups.

The larger cohort was predominantly female and included a lot of cross-country runners and volleyball players. Many could not pinpoint a clear event that marked the onset of symptoms although most had experienced covid or another viral illness in the recent past.

Its not a lock-and-key situation with just anybody getting covid and then POTS, Hebson theorized. Its that some patients had a predisposition to POTS to begin with, and then something comes along it could be mono or covid or something else to give them a push.

The second group was dominated by men, including football players, and they reported experiencing symptoms of dysautonomia the bouncing heart rate that is the main characteristic of POTS after a concussion.

Their findings, published in the journal the Physician and Sportsmedicine, are consistent with the first documented cases of POTS. During the Civil War, POTS was among a number of distinct syndromes once known collectively as soldiers heart because so many members of the military exhibited symptoms. Medical historians speculate that head injuries during combat triggered some cases.

Gould believes several aspects related to being an athlete might increase susceptibility to the syndrome.

Some of her patients have hypermobility in their joints, meaning they have greater than normal range of motion. That can be an advantage in sports including gymnastics, diving, swimming and hurdles, but it has also been associated in studies with POTS. Gould described hypermobility as being related to blood vessels being more stretchy, which could impact heart rate and blood pressure.

Gould said many clinic patients tend to be taller than average, which can be an advantage in certain sports. Gene association studies have shown that height increases the risk of heart palpitations and circulatory problems symptoms seen in people with POTS.

Intense exercise may itself be a trigger. In a two-hour practice, athletes can lose 2 to 3 percent of their body weight in water, which can further upset how blood flows and exacerbate POTS symptoms.

Since the end of the 19th century, scientists have observed that intensive exercise can reshape the heart. Athletes hearts tend to be bigger and pump more slowly. Exercise requires more oxygen, so the heart has to work more vigorously and over time gets bigger and thickens. When an athlete is resting, the heart does not need to work as hard so it pumps less.

The changes make the heart more efficient, but the stress of athletic exertion has other impacts on the body.

We learned a lot from covid athletes in 2020-21 and about how having a really conditioned heart may be something that plays a role in different conditions, Wilson, the Cleveland Clinic neurologist, said.

Wilson has been collecting data on POTS patients since 2017. In a database of several hundred people, women of childbearing age represent a disproportionately high percentage of patients. Scientists suspect women may be more at risk because they are more often in a pro-inflammatory state during menstrual cycles and pregnancy in which the immune system readies itself to fight against something that is potentially harmful.

Another early finding is that 90 percent of the POTS patients had been exercising regularly before being struck with the condition. Only 28 percent of Americans exercise regularly, according to the Centers for Disease Control and Prevention.

Aubrey Hutzler, 19, a catcher for the womens softball team at Nova Southeastern University in Davie, Fla., noticed she wasnt herself when jumping up from a crouching position to catch a ball thrown to home plate while practicing with her high school team.

I was training nationally and playing in front of college coaches and then suddenly I couldnt handle a normal day. It was really hard mentally, Hutzler said.

Sophia LeRose had been in the goal for a preseason lacrosse game for Duke University, when she felt like her heart was going to bounce out of her body. She grabbed the side of the cage.

I felt like I had drunk five Red Bulls, she said. She was helped off the field, and when the athletic trainer measured her heart rate, it was 180 beats per minute, whereas it was typically in the 50s. While doctors dont know what triggered the onset of her symptoms, she suspects she got a virus or parasite while on a winter mission trip to Colombia, which may have played a role.

Doctors are experimenting with treatments for POTS, but theres no quick fix.

Hutzler has been living with POTS for more than five years. It took about a year of physical therapy, blood pressure medication and wearing compression sleeves before she started to return to her old self.

LeRose increased salt and fluid intake and was well enough to play some minutes at the end of her final season. The fact I was able to get back on the field was awesome, and my team was so supportive, she said.

LeRose, now 24, finished her graduate degree, works in Chicago and still struggles with POTS symptoms while trying to rebuild her strength and endurance.

They told me I would be lucky if I was able to run a couple of minutes, and I actually just got back from a 45-minute run class and did four miles. Im working my way up, she said.

Levine said her POTS symptoms may have started in early childhood she had an unusual set of on-again, off-again leg pains and nausea. Now, more than 15 years later, shes still struggling.

On a recent weekday, she was lying with her legs propped up on the wall filming a TikTok video, explaining that shed experienced blood pooling because of POTS. It was a typical day in August, and she started the day by taking medicine and Liquid I.V., an electrolyte supplement that packs 500 milligrams of sodium.

She started lacrosse when she was 9 and played so well that by eighth grade, colleges were making recruitment offers. The first three years she played for Notre Dame College, Levine had few health issues other than a bout of covid her freshman year that wasnt too bad.

Something changed in 2023. Not long after she blacked out during the drills, she did so again in the shower and then in her living room. When she was diagnosed with POTS at the Cleveland Clinic, it was almost a relief, she said.

She soon made the difficult decision to stop playing the sport she had loved for so long. Now a senior, Levine, who is studying marketing and communications, misses her teammates but says she has no regrets and is putting her energy into other pursuits, such as trying to raise awareness of POTS. In addition to making TikTok videos, she helps lead an online support group and works on a podcast.

I always give 100 percent and do the best that I can and felt like I was being misunderstood, she said. I was almost getting punished for being sick for so long that having some answers I was happy.

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They're young and athletic. They're also ill with a condition called POTS. - The Washington Post

A new cross-sectional study in JAMA Internal Medicineof 238,828 blood donors finds that 43.3% of those with a history of SARS-CoV-2 infection reported new long-term symptoms, compared with 22.1% without a history of infection.

"The difference in these proportions suggests that 21.2% of donors with prior SARS-CoV-2 infection likely experienced long-term symptoms attributed to their infection," the authors said

This is one of the first long COVID studies to compare those with a history of COVID infection and long-term symptoms to a nonSARS-CoV-2infected control population. Such a comparison, the author said, helps to distinguish background prevalence of symptoms from those following COVID-19.

The study included adult American Red Cross blood donors surveyed from February 22 to April 21, 2022. the survey asked about new long-term symptoms arising after March 2020, and their SARS-CoV-2 infection status.

Fifty-eight percent of respondents were female, and the average age was 59 years. All participants also underwent at least one serologic test for antinucleocapsid antibodies from June 15, 2020, to December 31, 2021. Those antibodies appear in the blood only after COVID-19 infection and not following vaccination.

"Serologic testing to confirm prior infection may be particularly helpful for the evaluation of postCOVID-19 conditions because many SARS-CoV-2 infections are not detected and many individuals who are asymptomatic or experience mild symptoms may not be tested during the acute phase of infection," the authors wrote.

The study authors defined long-term symptoms as those lasting 4 or more weeks after COVID-19 infection. In the surveys, long-term symptoms were grouped by system: neurologic, gastrointestinal, respiratory or cardiac, mental health, and other.

Of the 83,015 people with a history of SARS-CoV-2 infection, 43.3% reported new long-term symptoms compared with 22.1% of those without a history of SARS-CoV-2 infection (adjusted odds ratio [AOR], 2.55; 95% confidence interval [CI], 2.51 to 2.61).

Being a woman and having history of chronic health conditions was associated with long COVID symptoms.

Among blood donors with prior SARS-CoV-2 infection, 23.6% reported long-term neurologic symptoms, 23.1% reported other symptoms (including changes in taste or smell), 15.8% reported respiratory or cardiac symptoms, 11.9% reported mental health symptoms, and 4.6% reported gastrointestinal symptoms

Long-term symptoms in the "other" and the respiratory/cardiac categories were most associated with prior COVID-19 infection (AOR, 4.14; 95% CI, 4.03 to 4.25; and AOR, 3.21; 95% CI, 3.12 to 3.31, respectively).

The two most common individual long-term symptoms among those with SARS-CoV-2 infection were difficulty thinking or concentrating (12.7%) and fatigue (11.1%). Six percent of those without a history of COVID-19 reported anxiety, making it the most common long-term symptom.

"Mental health symptoms occurred almost as often in both those with and without prior SARS-CoV-2 infection, suggesting the presence of indirect effects," the authors concluded.

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Blood donor study finds 21% incidence of long-term symptoms attributed to COVID-19 - University of Minnesota Twin Cities