Category: Covid-19

Nineteen of the remaining provisions are terminated immediately, according to a release from the governor's office.

SACRAMENTO, Calif. Gov. Gavin Newsom has lifted a majority of the state's overall emergency declaration set in place during COVID-19, but is keeping measures to continue testing and vaccinating Californians.

Since the start of the pandemic, Newsom has issued about 70 executive orders containing 561 provisions. Now, Newsom's office says just 30 will remain in effect. According to the governor's office, those that will remain are critical to the state's SMARTER plan.

Californias early and decisive measures to combat COVID-19 have saved countless lives throughout the pandemic, and as the recent Omicron surge made clear, we must remain prepared to quickly and effectively respond to changing conditions in real time, said Governor Newsom in a press release. As we move the states recovery forward, well continue to focus on scaling back provisions while maintaining essential testing, vaccination and health care system supports that ensure California has the needed tools and flexibility to strategically adapt our response for what lies ahead.

Under the order signed by the governor Friday, 19 of the remaining provisions are terminated immediately, an additional 18 will be lifted on March 31 and 15 will expire on June 30.

Seventeen of the executive actions still in effect are related to bolstering the states COVID-19 testing and vaccination programs and preventing potential strain on the health care delivery system, according to a press release.

Thirteen other provisions still in place are related to COVID workplace safety.

"(The) remaining provisions ensure COVID workplace safety standards remain aligned with the most current public health guidance and evidence and provide important flexibility to state and local agencies to administer the emergency response while the state of emergency remains open," wrote the governor's office in a press release.

Meanwhile, aside from Newsom lifting "all but 5 percent of COVID-19 related executive order provisions," he signed a proclamation ending a dozen open states of emergency relating to natural disasters dating back to 2015.

To read the governor's full announcement, click here.

Originally posted here:

Gov. Newsom to lift 95% of COVID-19 related executive actions - ABC10.com KXTV

GOV. JUSTICE DISCUSSES RUSSIAN INVASION OF UKRAINEGov. Justice also took time out of his remarks on COVID-19 to ask West Virginians for their prayers amid escalating conflict as Russia continues its invasion of Ukraine.

We offer up our prayers for those people, Gov. Justice said. Its just really sad.

We dont know the extent of what Putin really wants to do, other than hed like to put everything back together how the Soviet Union was at one time, Gov. Justice continued. We dont know what the repercussions will be yet for us in this country. But we know its not going to be good.

We need to realize we have made one whale of a mistake in this country. The pipeline should be finished in West Virginia; the Keystone Pipeline ought to be up and going. When it boils right down to it, weve got to realize theres some real bad actors out there. The United States of America could be totally energy independent and the bad actors would be minimized.

The Governor added, The Biden administration needs to step back and say this country needs to be totally energy independent. If we were, wed feel stronger today. With where we are, inflation-wise, and all the challenges we have right now, its not going to be good.

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COVID-19 UPDATE: Gov. Justice announces third round of P-EBT benefits to be allocated to eligible West Virginia students - Governor Jim Justice

People walk past artwork on the side of a shop as the outbreak of the coronavirus disease (COVID-19) continues in Reykjavik, Iceland, September 3, 2020. REUTERS/John Sibley

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COPENHAGEN, Feb 23 (Reuters) - Iceland will lift all remaining COVID-19 restrictions on Friday, including a 200-person indoor gathering limit and restricted opening hours for bars, the Ministry of Health said on Wednesday.

"Widespread societal resistance to COVID-19 is the main route out of the epidemic," the ministry said in a statement, citing infectious disease authorities.

"To achieve this, as many people as possible need to be infected with the virus as the vaccines are not enough, even though they provide good protection against serious illness," it added.

All border restrictions would also be lifted, it said.

Iceland, with a population of some 368,000 people, has registered between 2,100 and 2,800 daily infections recently. More than 115,000 infections have been logged throughout the epidemic and 60 have died due to COVID-19.

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Reporting by Nikolaj Skydsgaard and Stine Jacobsen; Editing by Alex Richardson

Our Standards: The Thomson Reuters Trust Principles.

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Iceland to lift all COVID-19 restrictions on Friday - Reuters

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US Patent Office Grants Patent for COVID-19 Risk Test

By Apoorva Mandavilli, The New York Times

For more than a year, the Centers for Disease Control and Prevention has collected data on hospitalizations for COVID-19 in the United States and broken it down by age, race and vaccination status. But it has not made most of the information public.

When the CDC published the first significant data two weeks ago on the effectiveness of boosters in adults younger than 65, it left out the numbers for a huge portion of that population: 18- to 49-year-olds, the group the data showed was least likely to benefit from extra shots, because the first two doses already left them well-protected.

The agency recently debuted a dashboard of wastewater data on its website that will be updated daily and might provide early signals of an oncoming surge of COVID-19 cases. Some states and localities had been sharing wastewater information with the agency since the start of the pandemic, but it had never before released those findings.

Two full years into the pandemic, the agency leading the countrys response to the public health emergency has published only a tiny fraction of the data it has collected, several people familiar with the data said.

Much of the withheld information could help state and local health officials better target their efforts to bring the virus under control. Detailed, timely data on hospitalizations by age and race would help health officials identify and help the populations at highest risk. Information on hospitalizations and death by age and vaccination status would have helped inform whether healthy adults needed booster shots. And wastewater surveillance across the nation would spot outbreaks and emerging variants early.

Without the booster data for 18- to 49-year-olds, the outside experts whom federal health agencies look to for advice had to rely on numbers from Israel to make their recommendations on the shots.

Kristen Nordlund, a spokesperson for the CDC, said the agency has been slow to release the different streams of data because basically, at the end of the day, its not yet ready for prime time. She said the agencys priority when gathering any data is to ensure that its accurate and actionable.

Another reason is fear that the information might be misinterpreted, Nordlund said.

Dr. Daniel Jernigan, the agencys deputy director for public health science and surveillance said the pandemic exposed the fact that data systems at the CDC, and at the state levels, are outmoded and not up to handling large volumes of data. CDC scientists are trying to modernize the systems, he said.

We want better, faster data that can lead to decision making and actions at all levels of public health, that can help us eliminate the lag in data that has held us back, he added.

The CDC also has multiple bureaucratic divisions that must sign off on important publications, and its officials must alert the Department of Health and Human Services which oversees the agency and the White House of their plans. The agency often shares data with states and partners before making data public. Those steps can add delays.

The CDC is a political organization as much as it is a public health organization, said Samuel Scarpino, managing director of pathogen surveillance at the Rockefeller Foundations Pandemic Prevention Institute. The steps that it takes to get something like this released are often well outside of the control of many of the scientists that work at the CDC.

The performance of vaccines and boosters, particularly in younger adults, is among the most glaring omissions in data the CDC has made public.

Last year, the agency repeatedly came under fire for not tracking so-called breakthrough infections in vaccinated Americans, and focusing only on individuals who became ill enough to be hospitalized or die. The agency presented that information as risk comparisons with unvaccinated adults, rather than provide timely snapshots of hospitalized patients stratified by age, sex, race and vaccination status.

But the CDC has been routinely collecting information since the COVID-19 vaccines were first rolled out last year, according to a federal official familiar with the effort. The agency has been reluctant to make those figures public, the official said, because they might be misinterpreted as the vaccines being ineffective.

Nordlund confirmed that as one of the reasons. Another reason, she said, is that the data represents only 10% of the population of the U.S. But the CDC has relied on the same level of sampling to track influenza for years.

Some outside public health experts were stunned to hear that information exists.

We have been begging for that sort of granularity of data for two years, said Jessica Malaty Rivera, a public health researcher and part of the team that ran the COVID Tracking Project, an independent effort that compiled data on the pandemic until March 2021.

A detailed analysis, she said, builds public trust, and it paints a much clearer picture of whats actually going on.

Concern about the misinterpretation of hospitalization data broken down by vaccination status is not unique to the CDC. On Thursday, public health officials in Scotland said they would stop releasing data on COVID-19 hospitalizations and deaths by vaccination status because of similar fears that the figures would be misrepresented by anti-vaccine groups.

But the experts dismissed the potential misuse or misinterpretation of data as an acceptable reason for not releasing it.

We are at a much greater risk of misinterpreting the data with data vacuums, than sharing the data with proper science, communication and caveats, Rivera said.

When the delta variant caused an outbreak in Massachusetts last summer, the fact that three-quarters of those infected were vaccinated led people to mistakenly conclude that the vaccines were powerless against the virus validating the CDCs concerns.

But that could have been avoided if the agency had educated the public from the start that as more people are vaccinated, the percentage of vaccinated people who are infected or hospitalized would also rise, public health experts said.

Tell the truth, present the data, said Dr. Paul Offit, a vaccine expert and adviser to the Food and Drug Administration. I have to believe that there is a way to explain these things so people can understand it.

Knowing which groups of people were being hospitalized in the U.S., which other conditions those patients may have had and how vaccines changed the picture over time would have been invaluable, Offit said.

Relying on Israeli data to make booster recommendations for Americans was less than ideal, Offit noted. Israel defines severe disease differently than the U.S., among other factors.

Theres no reason that they should be better at collecting and putting forth data than we were, Offit said of Israeli scientists. The CDC is the principal epidemiological agency in this country, and so you would like to think the data came from them.

It has also been difficult to find CDC data on the proportion of children hospitalized for COVID-19 who have other medical conditions, said Dr. Yvonne Maldonado, chair of the American Academy of Pediatrics Committee on Infectious Diseases.

The academys staff asked their partners at the CDC for that information on a call in December, according to a spokesperson for the AAP, and were told it was unavailable.

Nordlund pointed to data on the agencys website that includes this information, and to multiple published reports on pediatric hospitalizations with information on children who have other health conditions.

The pediatrics academy has repeatedly asked the CDC for an estimate on the contagiousness of a person infected with the coronavirus five days after symptoms begin but Maldonado finally got the answer from an article in The New York Times in December.

Theyve known this for over a year and a half, right, and they havent told us, she said. I mean, you cant find out anything from them.

Experts in wastewater analysis were more understanding of the CDCs slow pace of making that data public. The CDC has been building the wastewater system since September 2020, and the capacity to present the data over the past few months, Nordlund said. In the meantime, the CDCs state partners have had access to the data, she said.

Despite the cautious preparation, the CDC released the wastewater data a week later than planned. The COVID Data Tracker is updated only on Thursdays, and the day before the original release date, the scientists who manage the tracker realized they needed more time to integrate the data.

It wasnt because the data wasnt ready, it was because the systems and how it physically displayed on the page wasnt working the way that they wanted it to, Nordlund said.

The CDC has received more than $1 billion to modernize its systems, which may help pick up the pace, Nordlund said. Were working on that, she said.

The agencys public dashboard now has data from 31 states. Eight of those states, including Utah, began sending their figures to the CDC in the fall of 2020. Some relied on scientists volunteering their expertise; others paid private companies. But many others, such as Mississippi, New Mexico and North Dakota, have yet to begin tracking wastewater.

Utahs fledgling program in April 2020 has now grown to cover 88% of the states population, with samples being collected twice a week, according to Nathan LaCross, who manages Utahs wastewater surveillance program.

Wastewater data reflects the presence of the virus in an entire community, so it is not plagued by the privacy concerns attached to medical information that would normally complicate data release, experts said.

There are a bunch of very important and substantive legal and ethical challenges that dont exist for wastewater data, Scarpino said. That lowered bar should certainly mean that data could flow faster.

Tracking wastewater can help identify areas experiencing a high burden of cases early, LaCross said. That allows officials to better allocate resources like mobile testing teams and testing sites.

Wastewater is also a much faster and more reliable barometer of the spread of the virus than the number of cases or positive tests. Well before the nation became aware of the delta variant, for example, scientists who track wastewater had seen its rise and alerted the CDC, Scarpino said. They did so in early May, just before the agency famously said vaccinated people could take off their masks.

Even now, the agency is relying on a technique that captures the amount of virus, but not the different variants in the mix, said Mariana Matus, CEO of BioBot Analytics, which specializes in wastewater analysis. That will make it difficult for the agency to spot and respond to outbreaks of new variants in a timely manner, she said.

It gets really exhausting when you see the private sector working faster than the premier public health agency of the world, Rivera said.

This article originally appeared inThe New York Times.

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CDC Isn't Publishing Large Portions of the COVID-19 Data It Collects - Good Times Weekly

CNN

As the world approaches the second anniversary of the declaration of the Covid-19 pandemic by the World Health Organization, on March 11, more nations are rolling out or are discussing the possibility of fourth doses of coronavirus vaccine for their most vulnerable. In the United States, leading public health officials say they are very carefully monitoring if or when fourth doses might be needed.

Israel was the first nation to roll out fourth doses, announcing in December that adults 60 and older, medical workers and people with suppressed immune systems were eligible to receive the extra shot if at least four months have passed since their third dose.

More recently, the Public Health Agency of Sweden announced last week that second booster doses are recommended for everyone 80 and older in the country. The United Kingdoms Department of Health and Social Care announced Monday that an extra booster dose of coronavirus vaccine will be offered in the spring to adults 75 and older, residents in care homes for older adults and immunosuppressed people 12 and older.

In the United States, health officials emphasized late last year that fourth doses were not yet needed and said it was too premature to be discussing a potential fourth dose of coronavirus vaccine for most people.

Now, the US Food and Drug Administration is indeed continually looking at the emerging data on the pandemic and variants in the United States and overseas in order to evaluate the potential utility and composition of booster doses, FDA spokesperson Alison Hunt wrote in an email to CNN on Friday.

She confirmed that although Dr. Peter Marks, director of the FDAs Center for Biologics Evaluation and Research, has noted that there is still much uncertainty as to how the pandemic may further evolve, he also has said it is possible that a fourth dose might be recommended as we move into fall.

A fall timeline coincides with the administration of flu shots, which could be convenient for people and makes sense scientifically because respiratory viruses like the coronavirus and influenza tend to peak in the winter months that follow.

As more data become available about the safety and effectiveness of COVID-19 vaccines, including the use of a booster dose, we will continue to evaluate the rapidly changing science and keep the public informed, Hunt wrote. Any determination that additional booster doses are needed will be based on data available to the agency.

If or when the FDA authorizes a fourth dose for the public, the next step would be for the US Centers for Disease Control and Prevention to review the data before making a recommendation for use, as the agency has done for other coronavirus vaccine recommendations.

The United States has seen significant improvements recently in Covid-19 cases, hospitalizations and deaths. As of Friday, cases were down 44% from the prior week, hospitalizations dropped 26%, and deaths were 13% lower, according to Johns Hopkins University data.

Vaccination and boosting will be critical in maintaining that downward trajectory, particularly when youre talking about the red curve of severe disease leading to hospitalization, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said during a White House Covid-19 Task Force briefing Wednesday.

The potential future requirement for an additional boost or a fourth shot of the Pfizer/BioNTech or Moderna mRNA vaccines or a third dose of the Johnson & Johnson vaccine is being very carefully monitored in real time, Fauci said. And recommendations, if needed, will be updated according to the data as it evolves.

The CDC has no recommendation of fourth doses of coronavirus vaccine for the general public, but the agency updated its guidelines in October to note that certain people who are moderately or severely immunocompromised may receive a fourth dose of the Moderna or Pfizer/BioNTech vaccines.

For the immunocompetent people, a single booster shot continues to provide high levels of protection against severe disease caused by Omicron, Fauci said Wednesday. This should not be confused with the fact that for many immunocompromised people, already a second booster shot namely a fourth dose of an mRNA is recommended because of what we know about their poor response to the initial regimen.

Meanwhile, vaccine makers continue to study fourth doses in broader populations.

Pfizer announced in January that it has been studying the safety and efficacy of a fourth dose as part of its ongoing study of an Omicron-specific coronavirus vaccine among healthy adults ages 18 to 55.

For that study, participants have been separated into three cohorts. One includes 600 people who got three doses of the current Pfizer/BioNTech coronavirus vaccine before enrolling in the study. As part of the research, they will receive either a fourth dose of the current vaccine or a dose of the Omicron-based vaccine.

While current research and real-world data show that boosters continue to provide a high level of protection against severe disease and hospitalization with Omicron, we recognize the need to be prepared in the event this protection wanes over time and to potentially help address Omicron and new variants in the future, Kathrin Jansen, senior vice president and head of vaccine research and development at Pfizer, said in the companys announcement of the study.

A study published by the CDC last week showed that protection against Covid-19 hospitalization and emergency department or urgent care visits is much higher after a third vaccine dose than a second dose but that protection wanes with time.

With the Omicron variant dominant in the United States, vaccine effectiveness was 87% against Covid-19 emergency department or urgent care visits and 91% against hospitalizations in the two months after a third dose. Effectiveness fell to 66% and 78%, respectively, by the fourth month, the data showed.

Nonetheless, the level of 78 is still a good protective area, Fauci said Wednesday.

Dr. Christopher Murray, director of the University of Washingtons Institute for Health Metrics and Evaluation, told CNN on Friday that he thinks having a fourth dose makes very little sense right now but possibly makes more sense this upcoming fall or winter.

Because Omicron is going away, he said, third dose immunity wanes, and so fourth dose will probably wane as well. So we would want to time a fourth-dose push for when either theres a new variant or for next winter. So I think right now, unless youre immunocompromised or youre older, unless you have some personal risk, it doesnt make a lot of sense.

The research showing some waning immunity after a third dose has led to more discussion around if or when fourth doses could be needed.

Just like with everything else, the health departments look at this data thats coming out and wait for guidance from the CDC and from the drug manufacturers. The drug manufacturers have been monitoring vaccine effectiveness, Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials, told CNN on Friday.

The timing for fourth doses not only depends on waning immunity but also depends on whether we see any more variants emerge and what we discover in terms of additional vaccine effectiveness for any emerging new infections, Freeman said.

If fourth doses are needed, health departments would go into the mode of preparing to administer the fourth dose in the way they have done previous doses, Freeman said. However, of greater concern among local public health officers is the slow and declining pace of people completing their third doses, she said.

About 65% of the US population is fully vaccinated with at least their initial series, and about 28% of the population has received a booster dose, according to the CDC, as of Friday. But the pace of booster doses being administered has dropped to one of the slowest rates yet.

As time goes on, if there is the necessity of a fourth dose, were already behind with people getting the third dose, Freeman said. So all of a sudden, we could have a fairly large segment of the population that is not up to date on vaccines because theyre behind by two doses, potentially, and more people could get sick.

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A fourth Covid-19 shot might be recommended this fall, as officials 'continually' look at emerging data - CNN

Good morning, Mission, and welcome to Virus Village, your (somewhat regular) Covid-19 data dump.

With a long way to go, hospitalizations, positivity rates and recorded infections continue trending downward while recent R Number models show San Francisco well below 1.

Through most of 2020 and into 2021, lockdowns, masking and other public health non-pharmaceutical interventions were predicated upon protecting hospitals from getting overwhelmed. Has the experience of the past two years changed matters? It does not appear so. Wealthier hospitals with the capacity to take patients from safety net and rural hospitals crushed by Covidarent incentivizedto do so. It makes more sense for them to keep more lucrative elective surgeries and other procedures going.

In San Francisco, we are lucky to have UCSF, one of the best hospitals in the country with a core of outstanding doctors and healthcare workers which treats most local covid patients. It seems very likely that the relatively low number of covid-related deaths in SF is due in part to the outstanding work of UCSF, which has also generously lent its expertise to San Franciscos Department of Public Health.

Yet we know next to nothing about how UCSF operates, even less about the Citys for-profit hospitals, and much less what has learned over the past two years and what changes need to be made. Unfortunately, instead of leading a community-wide discussion on our hospitals, one of the countrys (worlds?) leading hospitalists regularly tweets about individual risk-taking.

In any case, Indivdual risk evaluations like these can be problematic.

The Centers for Disease Control and Prevention has released a new report on 2 dose and 3 dose effectiveness of mRNA vaccines. Perhaps this report was prompted by criticism that the agency has withheld critical data on boosters, hospitalizations and, until recently, wastewater analyses. As the article points out, timely data on hospitalizations by age and race would help . . . identify and help the populations at highest risk.

Update on the Fourth Shot. Some say it wont be necessary. The UK is now offering a fourth shot to those over 75 and those who are immunocompromised. What will happen in the U.S. this fall when Big Pharma has a new vaccine ready?

Multiple vaccine doses and annual boosters are not uncommon.

Heres a critical review of the Biden Administrations first year in response to the virus. It reminds me of the title of the Joan Didion book, The Year of Magical Thinking.

Scroll down for todays covid numbers.

As of Feb. 20, DPH reports 782,785 residents have been vaccinated, more than89 percent of all San Francisco residents have received one dose, and over 83 percenthave received two. For residents 5 and older, DPH reports the figures rise above 90 percent and above 87 percent while for those 65 and older over 90 percent have received two doses. SFDPH reports that as of Feb. 20, approximately 467,833 SF residents (65 percent of all residents, 82 percent of residents 65 and older) have received a COVID-19 booster dose.

For information on where to get vaccinated in and around the Mission, visit ourVaccination Page.

On Feb. 17, DPH reports there were 138 covid hospitalizations,or about15.7 covid hospitalizations per 100,000 residents (based on an 874,000 population). ICU patients have dropped to their lowest level since Jan. 8. Today, the California Department of Public Health reports 133 covid patients in SF hospitals and 26 ICU patients. Much like the CDC, DPH does not make public information as to vaxxed and unvaxxed hospitalizations nor any demographic data whatsoever making it impossible for the public to know the degree to which populations and neighborhoods have been affected.

The latest report from the federal Department of Health and Human Services shows Zuckerberg San Francisco General Hospital with 25 covid patients and 6 ICU beds available, while across the Mission, CPMC had 20 covid patients and 2 ICU beds available. Of 225 reported covid patients,96 were at either SFGH or UCSF, with at least 67 ICU beds available among reporting hospitals (which does not include the Veterans Administration). The California DPH currently reports 79 ICU beds available in San Francisco. Note: The Government Accountability Office (GAO) has issued a scathing report for sustained public health crisis failures at HHS. The failures cited include collecting and analyzing data to inform decisionmaking.

Omicron revived SFs normal pandemic pattern, hitting the lower socioeconomic sectors of the City the hardest. Between Dec. 18 and Feb. 16, DPH recorded 4406 new infections among Mission residents or 750 new infections per 10,000 residents. Bayview Hunters Point had the highest number of recorded new infections (4621) with a rate of 1219 new infections per 10,000 residents. Of 38 neighborhoods, 14 had rates above 700 per 10,000 residents, 13 in the east and southeast sectors of the City. Seacliff had the lowest rate with 383 new infections per 10,000 residents and Lakeshore, the only neighborhood in the City with a vaccination rate below 50 percent, had the second-lowest rate at 433 new infections per 10,000 residents.

DPH reports on Feb. 13, the 7-day average of daily new infections recorded in the City dropped to 256 or approximately 29.2 new infections per day per 100,000 residents (based on an 874,000 population). According to DPH, the 7-day average infection rate among vaccinated residents was 26.1 per 100,000 fully vaccinated residents and 62.8 per 100,000 unvaccinated residents. It is unclear whether fully vaccinated includes boosters or the infection rate among those vaccinated with 2 doses.

As of Feb. 16., DPH reports Asians had 1,272 newly recorded infections in Februrary or28.5 percentof the months total so far; Whites had 1,041 or 23.3 percent; Latinxs had 736 or 16.5 percent; Blacks had 271 or 6.1 percent; Multi-racials had 62 or 1.4 percent; Pacific Islanders had 31 or .7 percent; and Native Americans had 8 newly recorded infections or .2 percent of the Februrary total so far.

As of Feb. 16, DPH reports that so far in Februrary San Franciscos Latinx residents have had a positivity rate of 7.7 percent, ; Multi-racials 7.7 percent; Blacks 7.4 percent; Asians 6.5 percent; Native American 6.2 percent; Pacific Islanders 6.1 percent; and White San Franciscans have had a February positivity rate so far of 4.9 percent.

Another covid-related death has been recorded in Februrary. There have been 69 covid-related deaths since the beginning of the year. Probably most are related to omicron. DPH wont say how many were vaxxed and how many unvaxxed. Nor does it provide information on the race/ethnicity or socio-economic status of those who have recently died. Note: According to DPH, the highest monthly SF covid-related death total was 165, recorded in January 2021. According to DPH COVID-19 deaths are suspected to be associated with COVID-19. This means COVID-19 is listed as a cause of death or significant condition on the death certificate. Using a phrase like suspected to be associated with indicates the difficulty in determining a covid death. The ambiguity is heightened when currently it is unknown whether or not 34.5 percent of the deaths had one or more underlying conditions. As of Feb. 16, DPH continues to report only 21 of the 762 deaths are known to have had no underlying conditions, or comorbidities.

Covid R Estimation has not updated its San Francisco R Number since Feb. 8. It is still at 1.07. I will try to find out why the delay. On Feb. 19, it estimates the California R Number at a remarkably low .39. The ensemble lowered its average San Francisco R Number to .67 and slightly raised its average California R Number to .57. All ensemble models currrently reporting estimate the SF R Number well below 1.

As of Feb. 16, DPH reports San Franciscans aged 0-4 had 192 newly recorded infections or 4.3 percent of the Februrary total so far; 5-11 had 300 or 6.7 perecnt, 12-17 had 184 or 4.1 percent, 18-20 had 110 or 2.5 percent, 21-24 had 276 or 6.2 percent, 25-29 had 501 or 11.2 percent, 30-39 had 979 or 22 percent, 40-49 had 605 or 13.6 percent, 50-59 had 507 or 11.4 percent, 60-69 had 424 or 9.5 percent, 70-79 had 207 or 4.6 percent, and those San Franciscans 80+ had 170 newly recorded infections or 3.8 percent of the Februrary total so far.

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Covid-19 Tracker: The long way down - Mission Local

COVID-19 has sent nearly 900,000 Americans to the hospital in the past two years. A new study shows that the ZIP codes they came from had a lot to do with how sick they were when they got to the hospital, and how much care they needed once they were there.

But those differences disappeared by the time their stays were donewhether they left the hospital alive or dead.

The new findings, published in the Annals of Internal Medicine, show the importance of social and economic inequality in the way the pandemic is playing outincluding how early in their illness people seek or get access to care.

Even after the researchers took into account the underlying health of each person they studied, the social vulnerability index, or SVI, of their home ZIP code still made a difference. SVI combines multiple factors to create a score based on such things as a local areas average income, education level and household density to the percentage of households led by single parents or where English is not the primary language.

The findings could help policymakers target less-privileged areas with more services to prevent and respond to COVID-19 cases; SVI has already been used by the state of Michigan and other states to prioritize COVID vaccination outreach.

The study also shows the role of hospitals in equalizing outcomes for people from unequal backgrounds.

The research team behind the study, from the University of Michigan and the University of Colorado, used data from more than 2,300 patients hospitalized for COVID-19 in 38 hospitals across Michigan from March to December 2020.

People who lived in the most underprivileged ZIP codes were more likely to have severe symptoms such as low blood oxygen levels when admitted, and to need support for failing lungs and other organs through technologies such as ventilators and dialysis once they were in a hospital bed.

But they were no more likely to die than those from more-privileged areas, and no less likely to go back to their own homes instead of a nursing home.

Outcomes at hospital discharge appear equitable for these patients, but the question is, What leads to the initial disparities in seriousness of illness that they arrive with?' said Renuka Tipirneni, lead author of the new study and an assistant professor of internal medicine at Michigan Medicine, U-Ms academic medical center.

Are people not getting access to testing or treatment early in their illness? Are there other individual patient-level social risks such as ongoing difficulties with transportation, housing or sick leave at work? Did they delay seeking care because of lack of access?

Tipirneni and colleagues, including Vineet Chopra, the Robert W. Schrier Chair of Medicine at the University of Colorado School of Medicine, used data from a statewide database called Mi-COVID19 Initiative. Funded by Blue Cross Blue Shield of Michigan through its Collaborative Quality Initiative effort, it pools anonymous data on people hospitalized with COVID-19.

The study follows up on work that Tipirneni and colleagues published just over a year ago, showing SVI at the county level had much to do with COVID-19 case rates and death rates. But the new analysis of individual patient data and ZIP code-level SVI is much more indicative of the hyper-local conditions that can shape a persons access to and use of care.

Once theyre getting that care, there are equal outcomes, which is encouraging, said Tipirneni. This analysis zooms in on individual patients, and zooms out on whats influencing their outcomes in their neighborhood.

She notes that more disadvantaged (higher SVI) areas are found across the state and nation, from very rural areas to the centers of cities. In fact, anyone can use this CDC tool to find the SVI of any ZIP codethe numbers range from 0 (lowest level of social vulnerability) to 1 (highest level).

In the new study, the researchers divided SVI into four quartiles, and looked at differences in percentages of patients who experienced each type of severe symptom, treatment option and outcome by quartile. Differences of several percentage points emerged for most measures, even after factoring out individual patients underlying health status.

One of the things that policymakers, public health authorities and health systems might want to focus on as a result of the new study is how they make information available to people about when and how they should seek care for worsening COVID-19 symptoms, and when to prioritize seeking that care over anything else, the researchers say.

Making information available in multiple languages, and ensuring that outpatient treatment and transportation to appointments are available during the times people need it no matter what their schedule, are two specific things that could make a difference, they say.

High, or worse, SVI has also been shown to correlate with low COVID-19 vaccination rates, so once data from 2021 are available through Mi-COVID19, the team will look at how care and outcomes for people with severe COVID-19 changed once vaccines were available.

The team is also using the Social Determinants of Health Database created by the Agency for Healthcare Research and Quality to explore how other factors not included in the standard SVI measure interact with COVID-19 risks and outcomes.

In addition to Tipirneni and Chopra, the studys authors are Monita Karmakar, Megan OMalley and Hallie Prescott. Tipirneni and Prescott are current members of the U-M Institute for Healthcare Policy and Innovation, to which Chopra also belonged while at U-M before becoming chair of medicine at the University of Colorado.

Several CQIs were involved in data collection and analysis, including the Michigan Hospital Medicine Safety Collaborative, Michigan Value Collaborative, Michigan Arthroplasty Registry Collaborative Quality Initiative and Michigan Social Health Interventions to Eliminate Disparities

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ZIP codes matter when it comes to severe COVID-19 - University of Michigan News

While we're seeing far fewer people in the hospitals, there are still too many unknowns.

CLEVELAND Right now, Cleveland Clinic has 132 patients hospitalized for COVID.

It's a far cry from the packed ICUs and ER overflow of December and part of January. They're still busy, just in a different way.

"All of those elective surgery patients that need to come in and have patiently waited for weeks to come in as they were delayed through the month of December and most of January," explained Chief Safety, Quality and Experience Officer Dr. Leslie Jurecko.

Infectious Disease Chair Dr. Steven Gordon agrees that the virus is trending in the right direction and says at this point, the amount of precautions people take will most likely be related to their personal comfort level as mandates expire. But he says it's too soon to know exactly what COVID will look like in our daily lives for the long-term.

"What we don't know, or at least what I don't know, is whether this is going to settle as a seasonal respiratory virus like the other coronaviruses. You know we're just going to have to wait and see," Gordon said.

California is the first state that will be treating COVID as "endemic," meaning it will likely be part of our long-term reality. More of a big picture approach he anticipates the CDC will also begin to take.

"In pivoting to preparedness for the next surge, or next respiratory pandemic as opposed to predicting the modeling," Dr. Gordon said.

So is COVID going away? No, but now the focus is on how to handle it moving forward.

And as those cases continue to trend down, the Clinic urges us to remember that health care workers haven't slowed down.

So, they're asking people who visit to agree to a form outlining appropriate behavior in the hospital, including being kind to employees.

"So, it feels better, but we still have stressed teams and we understand that our community is under a lot of stress, not only from the virus, but from everything else going on," Jurecko said.

Cleveland Clinic anticipates guests will be required to mask up for the foreseeable future, but they have expanded the number of visitors permitted for a patient to two now that the omicron surge is over in Northeast Ohio.

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Too soon to call COVID-19 an endemic, according to Cleveland Clinic - WKYC.com

Related Practices & Jurisdictions

Monday, February 21, 2022

On April 4, 2022, a merits panel of the D.C. Circuit Court of Appeals will hear oral arguments on a petition seeking to force OSHA to issue a permanent standard for healthcare occupational exposure to COVID-19 and to reinstate the Healthcare Emergency Temporary Standard on Occupational Exposure (Healthcare ETS) to COVID-19 pending the permanent standard. The D.C. Circuit Court of Appeals referral of this matter to a merits panel was initiated by the Courts own motion.

On December 27, 2021, OSHAannouncedthe withdrawal of the Healthcare ETS and confirmed its intent to issue a permanent infectious disease standard. Less than two weeks later, on January 5, 2022, National Nurses United and several other labor unions filed an Emergency Petition for a Writ of Mandamus and Request for Expedited Briefing and Disposition with the D.C. Circuit Court of Appeals.In re: National Nurses United, et al., No. 22-1002 (D.C. Cir. Jan. 5, 2022).

The unions argue that OSHA has failed to adequately protect nurses and other healthcare workers from COVID-19. OSHA filed its opposition to the petition on January 21, 2022, arguing, among other things, that OSHA was unable to finalize a permanent healthcare standard because it focused the agencys resources on its COVID-19 Vaccination and Testing Emergency Temporary Standard (which was alsowithdrawn). OSHA indicated it expects to complete rulemaking for a permanent healthcare standard within six-to-nine months.

The Healthcare ETS applied in settings where COVID-19 patients are treated, and it required healthcare employers with more than 10 employees to develop and implement written COVID-19 plans that included the following elements:

Assigning a designated safety coordinator;

Patient screening and management;

Policies and procedures to comply with CDC guidelines;

Facemask and PPE requirements;

Protections while using aerosol-generating procedures on persons with suspected or confirmed COVID-19;

Physical distancing;

Solid barriers at employee work stations;

Cleaning and disinfection protocols;

HVAC system requirements;

Health screening and medical management requirements;

Paid leave for vaccinations, vaccination recovery, and medical removal from work due to COVID-19 infection or certain COVID-19 exposures;

Employee training;

Anti-retaliation protections;

Employee COVID-19 logs; and

Reporting work-related COVID-19 fatalities and in-patient hospitalizations.

OSHA has indicated its forthcoming permanent infectious disease standard will cover all industries and address airborne, droplet, and non-bloodborne contact diseases.

While OSHA has indicated it may use the now-withdrawn Healthcare ETS to support citations against healthcare employers under the General Duty Clause of the OSH Act, only the COVID-19 log and reporting provisions formally remain in effect.

Reinstatement of the Healthcare ETS would have a significant impact on covered employers, particularly as COVID-19 cases appear to be dropping throughout the country and more jurisdictions are loosening restrictions.

Jackson Lewis P.C. 2022National Law Review, Volume XII, Number 52

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Impending Argument for Reinstating COVID-19 Healthcare ETS - The National Law Review