Category: Covid-19

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Covid-19 is no longer the biggest issue facing hospitals. Staffing is – STAT

January 19, 2022

Health care providers have been the frontline of our nations battle against the Covid-19 pandemic, and they have responded heroically. That said, the initial set of seemingly insurmountable challenges that hospitals had to overcome in every community across the U.S. like accessing sufficient personal protective equipment so they could safely provide care have now been replaced with a new problem of epic proportions: a tsunami of staffing and labor challenges.

These challenges were the number one issue that CEOs and CFOs from 20 of Americas most prominent health systems shared at this years recently concluded 40th Annual J.P. Morgan Health Care Conference. While nearly every industry is currently facing staffing problems, the issue in health care is especially acute due to the demands and burnout associated with being on the frontlines of care throughout the last two years.

This stress is contributing to a perfect storm driving significant staffing shortages. All hospitals and health systems are seeing increases in turnover, with major increases in early retirements, job changes to other opportunities, and exits to other professions. They are also seeing major increases in wages and taking on significant incremental costs due to the need to leverage agency and traveling nurses, whose rates typically come at a 200% to 300% premium. Since staff salaries represent more than 50% of a hospitals budget, executives and leadership must think strategically about how best to manage these issues.

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The scale of the financial aspect of this challenge is stunning, as there are thousands of open roles at provider organizations across the country and the problem is only expected to get worse. New York and California, for example, are each projected to fall short by 500,000 health care workers as early as 2026. In response, organizations like Northwell Health in New York have been hiring 250 full-time employees per week just to keep pace with its current needs.

Many organizations, including Utah-based Intermountain Healthcare and Childrens Hospital of Philadelphia, built good karma with their workforce at the beginning of the pandemic by not furloughing non-essential personnel, not cutting pay, and not taking away bonuses. But that was then, and those actions and the good feelings that came from them are water under the bridge. Leadership teams at all hospitals are now huddling to determine how to address these problems right now.

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Based on the presentations major health systems made during the JPM conference, here is a summary of what I see as the top five actions organizations are taking to help address their staffing challenges:

Investing in their current workforce. AdventHealth, headquartered in Florida, has invested more than $440 million in additional compensation for employees. Many health systems are also putting additional incentives in place for 2022, including offering additional benefits such as enhanced training for their teams. One example is Intermountain Healthcare, which is partnering with inStride to offer an education platform for caregivers and their families. Other critical investments include workflow tools that reduce administrative burdens on staff, like budgeting and planning, and help improve the productivity of their teams.

Accelerating clinician education. Many health care systems have invested in advanced training programs. CommonSpirit Health, the largest health system in Illinois, now has the largest nurse residency program in the country. Prisma Health, the largest health system in South Carolina, is partnering with colleges and universities to build out and accelerate training programs and, in some cases, will offer help with tuition. Childrens Hospital of Philadelphia shared at JPM that in order to address this issue in the long term, its focus may extend to high schools and even earlier.

Looking outside the U.S. for recruiting. Henry Ford Health in Michigan, which had already been recruiting nurses from Canada, is now looking to the Philippines for nurses, which it last did back in the 1980s. Many other organizations are also trying to develop international relationships to help develop long-term recruiting pipelines.

Developing a flexible approach to staffing. Some organizations are creating their own float pools of nurses. They are also cross-staffing between departments and facilities, as well as flexing from inpatient to outpatient. This approach also extends to non-caregivers. Ascension, a national health care system, currently has 40,000 employees working remotely, and many organizations will use remote employees on a permanent basis.

Deploying telehealth to increase access and efficiency. The rise in the use of telehealth spiked in mid-2020, as it was required due to limited access to in-person visits. According to data from the StrataSphere data consortium, which represents a cohort of the 2,000 hospitals my colleagues and I work with at Strata Decision Technology, the percentage of potential ambulatory visits that are now being conducted virtually has normalized at about 7%. In addition to other benefits like improving access to care, telehealth, E-ICUs, and other virtual platforms will be essential in ensuring a more efficient use of limited staff.

Its clear that health systems have developed some strategies to better weather the Covid-19 storm, which has given them the ability to start looking to the future. However, no strategy or initiative will be successful without the resources to support it, and the primary focus for health systems right now must be addressing their labor challenges. As the last two years have proven, there is no one more important on the frontlines than caregivers.

Dan Michelson is the CEO of Chicago-based Strata Decision Technology, which provides a cloud-based financial planning, analytics, and performance platform that serves more than 2,000 hospitals.

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Covid-19 is no longer the biggest issue facing hospitals. Staffing is - STAT

French education minister criticized for announcing Covid-19 measures from Ibiza – CNN

January 19, 2022

"I regret the symbolism" of Ibiza, Jean-Michel Blanquer told lawmakers on Tuesday.

However he did caveat his regret. "In winter it's not at all like in summer," he told French TV channel TF1 Tuesday, "I was just outside, in contact with the government."

Blanquer announced the measures in a telephone interview with French newspaper Le Parisien, published on January 2, the magazine's editor said on Twitter, although reporters did not know he was in Spain at the time.

The measures included increased testing for school-age children following a classmate testing positive, to avoid closing classes.

"There's really a break between what Ibiza represents and what colleagues were living daily the day before this return to school," Guislaine David, spokersperson for teaching union SNUipp-FSU told French broadcaster Franceinfo Wednesday. French teachers went on strike on January 13 over the new Covid-19 measures.

Speaking before the National Assembly, Blanquer said that his presence in Ibiza did not affect his decision about schools' Covid-19 protocols, or his ability to perform his functions as minister of education. Blanquer did not break French travel restrictions by holidaying in Spain.

France on Tuesday reported a record high of 464,769 new Covid-19 cases in a day, surpassing its previous daily record registered last week by nearly 100,000 cases, according to French health ministry data. There were 375 more fatalities, bringing the country's death toll to 128,629, according to Johns Hopkins University.

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French education minister criticized for announcing Covid-19 measures from Ibiza - CNN

COVID-19: Top news stories about the pandemic on 19 January – World Economic Forum

January 19, 2022

Confirmed cases of COVID-19 have passed 334.1 million globally, according to Johns Hopkins University. The number of confirmed deaths has now passed 5.55 million. More than 9.73 billion vaccination doses have been administered globally, according to Our World in Data.

Japan is set to widen COVID-19 curbs to the capital, Tokyo, and a dozen regions covering half the population as the Omicron COVID-19 variant drives record new infections.

There is no evidence at present that healthy children and adolescents need booster doses of COVID-19 vaccine, the World Health Organization's chief scientist Soumya Swaminathan said yesterday.

China has reported its lowest daily count of local confirmed COVID-19 infections in two weeks.

The US government's new website that allows American households to order four free COVID-19 tests is up and running ahead of its official launch today, the White House said yesterday.

The US Centers for Disease Control and Prevention has warned against travel to 22 countries and territories as a result of rising COVID-19 cases.

Finland is set to ease COVID-19 restrictions from mid-February, Prime Minister Sanna Marin said yesterday.

Britain has reported its highest daily COVID-19 death toll in almost a year, with 438 new deaths.

Viet Nam has reported its first cases of the Omicron COVID-19 variant in the community, state media has reported.

Daily new confirmed COVID-19 cases per million people in selected countries.

Image: Our World in Data

As part of work identifying promising technology use cases to combat COVID, The Boston Consulting Group recently used contextual AI to analyze more than 150 million English language media articles from 30 countries published between December 2019 to May 2020.

The result is a compendium of hundreds of technology use cases. It more than triples the number of solutions, providing better visibility into the diverse uses of technology for the COVID-19 response.

To see a full list of 200+ exciting technology use cases during COVID please follow this link.

Countries around the world continue to report record daily COVID-19 infections as the Omicron variant causes cases to surge.

The Czech Republic has reported 28,469 new COVID-19 cases - the highest figure since the start of the pandemic in 2020.

In Bulgaria, more than 11,000 confirmed daily COVID-19 cases have been reported for the first time, as infections hit 11,181. Total confirmed infections are more than 840,000 in the eastern European nation.

Mexico has reported its own record daily confirmed caseload - some 49,343 in a single day.

New daily COVID-19 cases have crossed 100,000 in Germany for the first time, reporting 112,323 on Wednesday.

And in Brazil, 137,103 new confirmed COVID-19 cases were reported in the last 24 hours, the Health Ministry said yesterday.

An expert panel has told a Davos Agenda virtual session that vaccine equity is vital to getting out of the pandemic phase of COVID-19.

World Health Organization's (WHO) Emergencies Director Mike Ryan said that over half of the world's population has received both doses of a COVID-19 vaccine, but only 7% of the population has been fully vaccinated in Africa.

"The problem is we are leaving huge swathes of the world behind...But vaccines are absolutely central. There is no way out of the pandemic right now without vaccines as the central strategic pillar."

John Nkengasong, director of the Africa Centres for Disease Control, said it was "unacceptable" that Africa was lagging so far behind other countries in vaccination and called it 'collapse of global cooperation and solidarity'

"The only way to prevent other variants challenging the global efforts and advances we have seen is to vaccinate on scale, including Africa," said John Nkengasong.

Written by

Joe Myers, Writer, Formative Content

The views expressed in this article are those of the author alone and not the World Economic Forum.

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COVID-19: Top news stories about the pandemic on 19 January - World Economic Forum

Covid-19 Cases Fall Sharply in Indias Biggest Cities, Raising Hopes for Nearing Peak – The Wall Street Journal

January 19, 2022

NEW DELHICovid-19 cases in New Delhi and Mumbai have fallen sharply in recent days as a surge of the Omicron variant peaks in some of Indias biggest cities, raising hopes that prior infections will offset a relatively low vaccination rate and help prevent a repeat of last years catastrophic wave.

India is still a few weeks away from a nationwide peak, as the virus continues to spread in rural areas and smaller cities, according to doctors and public-health experts, who also warn that daily hospitalizations and deaths will likely continue climbing even as infections slow down.

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Covid-19 Cases Fall Sharply in Indias Biggest Cities, Raising Hopes for Nearing Peak - The Wall Street Journal

At Michigan Tech, COVID-19 Impacts Are Wide, Disparate and Ongoing – Michigan Technological University

January 19, 2022

As we approach a two-year milestone in pandemic response and stare down the omicron variant, COVID-19s impacts have become increasingly wide and increasingly disparate.

Be kind, for everyone you meet is fighting a hard battle. attributed to Ian Maclaren, pen name of the Rev. John Watson

April 8, 2020: Four weeks since Michigan Tech announced a switch to remote instruction and two weeks since Michigans Stay Home, Stay Safe protocol took effect.

Campus is closed.

At home, an administrator from Department MTU stares at his computer screen, reflecting on the trepidation he initially felt at the transition to remote work. Most of those fears have been put to rest hed quickly grown comfortable with the technology, all Zoom meetings had run smoothly (for the most part) and interruptions were sparse. More time with the dog was an unexpected benefit. Thus far, the administrator thinks, time spent in lockdown has been minimally stressful and largely productive. But then the phone rings the administrators aging parent, who falls within the viruss high-risk group, has tested positive for COVID-19.

A few streets away, a Department MTU researcher exits a Zoom call after her toddler crashed the meeting for the third time in 10 minutes. The call was intended to be a brainstorm with colleagues on how to keep research afloat in the face of a closed lab and looming deadlines. It had been scheduled during a timeframe in which she was responsible for child care; her partner will be watching the kids in the afternoon during the researchers online lectures. At this rate, she expects her work to be delayed by months, possibly years. She takes a deep breath, turns on a Disney movie (screen time restrictions are officially out the window) and tries to prepare for the afternoons classes.

Across town, one of Department MTUs administrative assistants tries not to think about the rumors that have been circulating since the lockdown was announced. Layoffs and furloughs are coming. The states economy might never recover. Not too long ago, the assistant thought COVID-19 restrictions would be short-lived a month-long blip in an otherwise normal year. With two kids in college and a partner laid off from the service industry, the assistant makes a mental note to take some time over the weekend to revisit the family budget and strike out all but the essentials. He prays the safety net will hold.

January 19, 2022: Weve been at this for almost two years now. Weve stayed six feet apart, worn face coverings and tried to flatten the curve. Weve gotten tested, debated whether to homeschool our kids, and read up on the pros and cons of vaccination. Weve shared all the memes, rolled all the eyes and cried all the tears (mostly in private, but sometimes in public).

Our latest hurdle is the omicron variant which experts say causes milder illness but is far more contagious. Throughout the country, were facing new variations of a shutdown: facilities are closed and shelves are empty due to sick employees and supply chain disruptions. Parents in the local community are gearing up for what might be an inevitable announcement that schools need to close.

To put it mildly, we are beyond ready for the pandemic to end. As writer Glennon Doyle says, Were over it, but its not over. The impacts of COVID-19 continue, and each of us is facing down different stressors and disruptors. All of us are fighting a hard yet different battle.

Throughout the fall 2021 semester, we dedicated Unscripted space for community members to share their personal pandemic stories and describe the challenges they face and the solutions theyre working on to uplift their research, scholarly work and creative endeavors. None of them told the same story and all of their stories are ongoing.

A Facilities building mechanic who cant work from home. A principal investigator whose face-to-face data collection has been significantly disrupted. A faculty member still dealing with the fallout of the initial lockdown kids at home, research halted, supply chain upended more than a year after the strictest restrictions were lifted. Each of them (and all of us) could use a little grace and space as the pandemic drags on.

If you missed any of the installments in our pandemic impacts series, you can find them here:

Michigan Technological University is a public research university founded in 1885 in Houghton, Michigan, and is home to more than 7,000 students from 55 countries around the world. Consistently ranked among the best universities in the country for return on investment, the University offers more than 125 undergraduate and graduate degree programs in science and technology, engineering, computing, forestry, business and economics, health professions, humanities, mathematics, social sciences, and the arts. The rural campus is situated just miles from Lake Superior in Michigan's Upper Peninsula, offering year-round opportunities for outdoor adventure.

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At Michigan Tech, COVID-19 Impacts Are Wide, Disparate and Ongoing - Michigan Technological University

Utah adds over 39k new COVID-19 cases and 28 deaths – ABC 4

January 19, 2022

SALT LAKE CITY (ABC4) The Utah Department of Health is reporting 39,882 new COVID-19 cases on Tuesday, January 18, and 28 new deaths since Friday.

Cases

With 39,882 new COVID-19 cases reported, Utahs case total has reached 790,216.

Of todays new cases, 8,490 are school-aged children. UDOH is reporting 2,556 cases in children ages 5-10, 1,875 cases in children ages 11-13, and 4,059 cases in children ages 14-17.

Vaccines

A total of 4,723,232 vaccine doses have been administered in Utah.

This is an increase of 27,470 doses since Friday.

Vaccinated vs. unvaccinated risk ratio

In the last 28 days, people who are unvaccinated are at 13.3 times greater risk of dying from COVID-19, 6.1 times greater risk of being hospitalized due to COVID-19, and 2.3 times greater risk of testing positive for COVID-19 than vaccinated people.

Since February 1, 2021, people who are unvaccinated are at 6.8 times greater risk of dying from COVID-19, 4.9 times greater risk of being hospitalized due to COVID-19, and 1.6 times greater risk of testing positive for COVID-19 than vaccinated people.

Lab tests

Lab reports from the Utah Department of Health show 4,611,947 people have been tested. This is an increase of 78,112 since Friday.

UDOH reports a total of 8,484,276 total tests, an increase of 151,176 tests since Friday.

Trends

The rolling 7-day average for positive tests is 10,652 per day.

The rolling 7-day average for percent positivity of people over people is 41.3%. The rolling 7-day average for percent positivity of tests over tests is 29%.

Hospitalizations

There are 681 people currently hospitalized with COVID-19. Total hospitalizations from the beginning of the outbreak are 29,496.

Deaths

There are 3,979 total deaths, which is 28 more deaths than Friday.

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Utah adds over 39k new COVID-19 cases and 28 deaths - ABC 4

UK seven-day COVID-19 infections down 37% on week before – Reuters UK

January 19, 2022

People wearing protective face masks walk through Waterloo train station, amid the coronavirus disease (COVID-19) outbreak, in London, Britain, January 3, 2022. REUTERS/Henry Nicholls

LONDON, Jan 19 (Reuters) - The United Kingdom reported 108,069 new cases of COVID-19 on Wednesday, leaving the seven-day tally down by 37.2% on the previous week.

It reported 359 deaths of people who had tested positive for the disease within the previous 28 days. The seven-day total for deaths was up 8.2% on the week before, following a record spike in infections in recent weeks.

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Reporting by William Schomberg. Editing by Andrew MacAskill

Our Standards: The Thomson Reuters Trust Principles.

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UK seven-day COVID-19 infections down 37% on week before - Reuters UK

My COVID-19 infection: Oregonians whove had it share their advice – OPB News

January 19, 2022

Sure, there are official CDC quarantine guidelines and a new state hotline and website for people who test positive. You should consult both. But sometimes its good to hear from another human. These Oregonians share what was hard and what helped them get through.

Tyson Bittrich

Courtesy of Tyson Bittrich

Name: Tyson Bittrich

Variant: probably delta.

Days in isolation: 13

Most useful coping strategies: living on separate floors, buying a pulse oximeter.

Tyson Bittrich, 40, is a musician whos studying renewable energy engineering at the Oregon Institute of Technology in Wilsonville.

He started feeling cruddy on the Tuesday after Halloween. He went to get a test on Thursday with his partner, but it took two days to get the results.

Saturday morning I woke up and I couldnt smell my coffee. I couldnt smell my oatmeal. And sure enough, my results came back Saturday afternoon that I was a positive case, he said.

Bittrich says hed been doing all the right things: wearing a mask; getting vaccinated twice with Pfizer.

I guess there was a sense of surprise and also guilt or shame or something, Bittrich said.

When you test positive for something like this, its not just like a: Oh, wow. Im in harms way. Its: Oh, wow, Im letting the team down.

Before testing positive, Bittrich and his partner were cooking, eating, sleeping, even practicing yoga together. But when he tested negative, they wore masks whenever they got close. Friends offered to put his partner up for the duration, but they decided to stay together and distance, especially because there are two floors in their apartment.

I stayed in the top floor and she stayed in the bottom floor. Since I was feeling fairly crummy, she took care of me. I would have not made it through as well without her of course.

They separated their toiletries in the bathroom. She cooked and when they ate together he sat 15 feet away. They separated their toothbrushes, but didnt sanitize the door handles in the apartment, figuring the greater risk was from breathing in aerosolized virus, rather than via contaminated surfaces.

He contacted any friends and bandmates that he thought he might have infected, but hasnt heard that anybody else caught COVID-19 from him. After testing positive at Zoomcare, Bittrich talked online to an advice nurse.

The advice I got from the nurse, which I followed, was just keep track of two vitals, high fever and your oxygen saturation, he said.

He bought a pulse oximeter, delivered to the house by Target for about $30, to keep track of his oxygen levels. He took his temperature and measured his oxygen saturation three times a day.

I didnt get my taste back until Thanksgiving, but it gave me peace of mind, right? That Im not doing the wrong thing by not going into urgent care, he said.

Bittrichs partner did not get the virus, even though they were in close proximity before he started feeling sick. Their theory is that shed received a booster three weeks earlier, so she had high levels of antibodies to ward off infection.

The times I felt the scariest were the days when my lungs felt the heaviest and head felt like an over-inflated balloon.

Natasha Schwartz

Courtesy of Natasha Schwartz

Name: Natasha Schwartz

Variant: omicron

Days in isolation: 20

Advice: Take the time you need to recover five days wont be enough for some health workers. Use a primary care doctor or immediate care/urgent care clinic, rather than the emergency department. An Apple watch can serve as a heart rate and oxygen-saturation monitor.

Schwartz is an acute care nurse at Oregon Health & Science University, working in the emergency general surgery unit. She lives with her partner, a medical student at OHSU, and has been vaccinated and boosted. Schwartz says shes spent the last two years limiting her social contact to avoid the virus.

Schwartz believes she was likely exposed at work by a patient or co-worker. Until recently, OHSU only tested patients on her unit for COVID-19 if they were showing symptoms, she said.

Her symptoms started on Dec. 23. At first, it was just a headache.

I get migraines, so I thought it was just another migraine, Schwartz said, and then as my shift progressed, I developed some congestion.

After her shift she got a rapid PCR test, and through that OHSUs occupational health program found out she was positive for COVID-19.

She felt angry, defeated, and guilty that shed gotten the virus in spite of wearing a mask and PPE at work and being so careful to protect herself from exposure over the last two years.

I was at work and I knew that I could have been contagious, you know, two days prior to that. Just thinking about potentially exposing my co-workers and patients to COVID really was the biggest thing, she said.

Understanding how much more contagious the omicron variant is than previous variants has helped her with those feelings.

Schwartz called her unit and let the charge nurse and her manager know shed tested positive, and asked her to share the news with the people shed interacted with.

Christmas was coming up and people were going to probably go see family members and you know elderly relatives and I just didnt want people to potentially infect their family members over the holidays, she said.

She canceled her own in-person Christmas with her parents and video chatted over Zoom instead.

Schwartz takes a medication that suppresses her immune system and is considered immunocompromised. At home, she monitored her heart rate and oxygen levels using an Apple watch, kept track of her temperature, and took Tylenol.

She experienced a wide range of symptoms: fever, body aches, severe fatigue and shortness of breath. Five days after she tested positive, her symptoms worsened and she decided to see a doctor. She was too sick to walk around the house or prepare food for herself.

My heart rate was getting really elevated and I was just having so much physical pain from the body aches. I just really wasnt able to move much, she said.

To avoid a long wait in the emergency department, she emailed her primary care doctor and ended up getting seen at an immediate care facility. There, she was prescribed monoclonal antibodies, and treated through an at-home infusion service.

I think the hardest part of it was getting access to care and the fear that, if I needed to go to the hospital, the system is just really overwhelmed. Even as a nurse, I may not have access to the care I need, she said.

Schwartz said after three weeks, shes mostly recovered and getting ready to return to work. She believes the antibody treatment helped.

However, she still has lingering symptoms. She wears a heart monitor to track her heart rate, which is still elevated.

Her partner only had symptoms for a few days and has no residual symptoms.

Schwartz says her doctors recommended that she quarantine for a full 20 days because of her compromised immune system, which might lead a person to shed the virus for a longer period of time.

Shes returning to work. New guidelines from the Centers for Disease Control and Prevention allow hospitals with staffing shortages and high patient demand to return COVID-19 positive staff to work after just five days of quarantine, with or without a negative test.

Those guidelines have been condemned by nursing organizations, including the Oregon Nurses Association where Schwartz sits on the board.

Schwartz says OHSU is requiring a negative antigen test first from anyone returning five to 10 days after their symptoms start, an additional step she finds reassuring.

But after her experience with COVID-19, shes concerned about the pressure other nurses may face to work while they are still sick.

Even if my symptoms had improved and I wasnt contagious, theres no way I could have gone back to safely taking care of patients after five days, she said.

Her advice to other nurses is to take the time they need to recover and to accept their physical limitations.

Aarti Kamalahasan

Courtesy of Aarti Kamalahasan

Name: Aarti Kamalahasan

Variant: omicron

Days in quarantine: five

Advice: Get your kids their boosters as soon as you can.

Kamalahasan is an instructional coach for a large school district in Washington County. Shes recently remarried and lives with her husband and a 22 year-old daughter who works in health care. Her son, who is in high school, splits his time between living with her and with his dad.

Kamalahasan and her children have a history of asthma, so shes been afraid COVID-19 could hit them all particularly hard. She got a booster for herself, and pushed to get both her children boosters in mid-December, as soon as they qualified.

After Christmas, her son got a Snapchat message from a school friend who had tested positive for COVID-19. Within a few days, that had snowballed into five or six friends whod all tested positive.

Kamalahasan spent several days hunting for at-home antigen tests after both her son and daughter started experiencing possible symptoms exhaustion and a scratchy throat but was unable to find them anywhere.

They decided to assume they were positive until they knew otherwise.

Tests were hard to come by, and we didnt know what to do, she said. We finally got both of them into their pediatrician and they tested positive. And then I started showing symptoms later that day.

Kamalahasan usually works in-person, supporting and coaching other teachers. She got permission to shift to online-only work.

She went through a rollercoaster of symptoms: serious nausea, chills, a headache and body aches, and shortness of breath.

I kept telling myself, this is mild, she said.

Kamalahasan says they stuck to her sons parenting schedule, so he quarantined at his dads house. Her adult daughter, who usually lives with her, also ended up quarantined at a separate home.

Neither got as sick as she did, but not being able to see her children while they were sick was the hardest part of the experience. Shed try to listen to how their breathing sounded over the phone.

I was just not able to sleep at all, constantly texting, calling, snapchatting. My kids were like, mommy were okay. Im like, okay, but Im going to call you again in an hour.

They were all able to manage their symptoms with over the counter pain medication, lots of hydration, and their inhalers. Mainly what we realized we needed was loads and loads of rest, she said.

Ultimately, knowing her children had their boosters was a major relief. She wasnt afraid theyd wind up hospitalized.

Science had my back, she said.

She was able to finally get antigen tests from Walmart and all three have now tested negative.

Name: Eva McCarthy

Variant wave: wild-type (original)

Days in quarantine: 21

Advice: Accept that it may take time to fully recover and be ready to adapt your routines.

McCarthy practices family medicine in Sublimity, Oregon.

She had a mild case of COVID-19 in the relatively early days of the pandemic, before vaccines were available, in November 2020.

McCarthy was symptomatic for about a week with sinus congestion and upper respiratory symptoms.

At the time, there were much longer isolation guidelines in place, so she had to wait a full 21 days before returning to in-person work.

In the meantime I did telemedicine from home and received a lot of pies and chicken soup on my porch, which I couldnt taste but were very thoughtful, she said.

Even though McCarthy considers herself lucky to have had had only a mild case, she says she still hasnt fully recovered her sense of taste and smell.

Speaking with co-workers who are more recently recovering from COVID, there is a general consensus of surprise over how long the alteration in taste and smell has lasted and how it has changed the things we used to enjoy. For example, I no longer like cilantro or sour foods. Lemon, lime, and orange flavors also have a bad aftertaste and my tolerance of spice has gone way down (and Im Korean so that is sad), she said.

I also hear from colleagues and patients that brain fog and fatigue is real and it has affected work performance for some.

McCarthy wishes shed received better guidance on what to expect, and how long symptoms can last for some people.

Everyones recovery will be slightly different, and in her experience, it helps to focus on the things you can control. Change what you eat to accommodate your new taste buds, or spend more time walking and stretching rather than jumping right back into high intensity workouts.

I also want people to remain fully vigilant of the potential to get re-infected as I have personally known people who have had it again after being fully vaccinated, she said. While I hope that I will not get re-infected and have been boosted, I am not ruling it out and I dont think my taste buds could tolerate another round of COVID.

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My COVID-19 infection: Oregonians whove had it share their advice - OPB News

What is the end of COVID-19? – KELOLAND.com

January 18, 2022

SIOUX FALLS, S.D. (KELO) Its been just about two years since the first COVID-19 case was reported in the United States. As surges spike and fade, many are wondering when well be past this pandemic.

The simple answer for what the end of COVID-19 will look like is that there wont be an actual official end.

The pandemic ends, in this case, with the virus becoming endemic, Dr. Jeremy Cauwels, Chief Physician at Sanford Health, said. So an endemic virus is a virus that lives with us all the time. Chicken pox never goes away. Kids can always get chicken pox. Influenza never goes away. It cycles, year to year, but it never disappears. And so an endemic virus is one that lives with us in some way shape or form.

Doctors are hopeful the status of endemic is inching closer.

When you look back at history, at most pandemics, they do tend to end with a strain somewhat similar to omicron, which is highly contagious but overall slightly less severe or leads to less severe illnesses, Dr. Kevin Post, Chief Medical Officer at Avera Medical Group, said. So I think were hopeful that omicron is the strain or a similar strain to that and hopefully not, in the not-so-distant future.

Cauwels says there is a list of things to check off to reach an endemic status.

Number one you have to have a virus thats freely circulating; that its doing a pretty good job of, Cauwels said. Number two, you got to quit seeing the ups and downs or the spikes. Its just got to find some steady state. And then the other parts are actually up to us. Do we have ways to control it? So do we have vaccines and do we use them appropriately? And number two, do we have therapies that could affect the virus when we need to.

Cauwels says both the monoclonal antibody treatments and anti-viral oral pills are important tools in the fight against COVID-19.

What that does is move us from a place where we have to worry about people getting a new infection because were not sure we can treat it effectively to a place where we can turn this into something like the flu where if you get it, we have a pill for you to take and we know what to do for you to try to get you through it as best we can, Cauwels said.

As for COVID-19 booster shots, both Cauwels and Post believe well be seeing those again, or at least a variation of them.

There are small trials being done of combination vaccines of coronavirus with influenza, Post said. And of course, like we do with the influenza vaccine, that would likely have to adapt through the years as the virus mutates. But I do think well see some version of boosters versus an annual vaccine as we kind of continue to learn about this and sort this out in the future.

And then comes the understanding of what happens next.

I think one thing that we have to be very aware of is we dont know all the complications yet of COVID-19 long-term such as on heart conditions, lung conditions, Post said. So I think well continue to learn about almost that second phase of the effect of COVID-19 as we move forward. And also theres been a delay in care of chronic disease, cancer screenings, et cetera. So we are going to have to, you know, catch up, you would say, in the medical field for patients preventative care as well.

For Post and Cauwels, though, hope is out there.

When people write history books, theyre going to write a chapter on the last two and a half, three years, Cauwels said. Theyre going to write a chapter about what this was and kids and grandkids are going to ask us about the fact that we lived through this.

In looking back, I hope we can have learned from the situation, Post said. I hope we can have, once again, are more united as a people, as a nation. And I hope we can look back on it and say, It was difficult but we learned some valuable lessons that well take with us the rest of our lives.'

Until we can look back on these years in reflection, though, there are still ways we can each help reach that endemic status.

I think now, you know, as we move forward, what were trying to achieve is herd immunity with the cooperation of the public, Post said. And that can be natural immunity from having had a COVID-19 infection or, you know at best, ideally would be immunity from a vaccine plus the full booster series, which still seem to be the most effective at preventing severe disease, hospitalizations and death from COVID-19.

What I would tell people is for right now, the right thing to do is still be vaccinated and boosted, Cauwels said.

Doctors in South Dakota have predicted the peak of the omicron surge is still weeks away.

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What is the end of COVID-19? - KELOLAND.com

Covered Health Care Facilities Must Prepare for COVID-19 Vaccination Deadlines – SHRM

January 18, 2022

Employers that are covered by the federal government's COVID-19 vaccination directive for health care workers must take swift action to comply with looming deadlines. The U.S. Supreme Court recently declined to put the rule on hold while its merits are debated in court.

The Centers for Medicare & Medicaid Services (CMS) rule applies to health care workers at Medicare- and Medicaid-certified providers and suppliers. Covered workers must receive their firstCOVID-19 vaccine dose by Jan. 27 and be fully vaccinated by Feb. 28. Additionally, employers must track employees' vaccination statuses and develop policies that include medical and religious exemptions and accommodations.

"Covered employers should establish clear, confidential procedures for maintaining vaccination status and processing exemption requests," suggested Jody Ward-Rannow, an attorney with Ogletree Deakins in Minneapolis. "Covered employers need to be communicating with employees and any other staff who enter their facilities now in order to give staff time to get vaccinated and submit their vaccination status or apply for an exemption."

High Court Lifts Hold on Rule

The CMS health care worker mandate was challenged by several states in multiple lawsuits. In late November, lower courts in Missouri and Louisiana issued a stay that blocked enforcement of the CMS directivebut only in the states that had joined the lawsuits.

"As a result, the CMS vaccine mandate was in effect in some states but not others," noted Norma Zeitler, an attorney with Barnes & Thornburg in Chicago. "The Supreme Court lifted the stays of enforcement, paving the way for the CMS to enforce its vaccine mandate nationwide."

The CMS rule is tied to federal funding and applies only to organizations that voluntarily participate in the Medicaid and Medicare programs. Congress authorized the secretary of health and human services "to impose conditions on the receipt of Medicaid and Medicare funds that the Secretary finds necessary in the interest of the health and safety of individuals who are furnished services," the Supreme Court noted in its ruling.

Who Is Covered?

The CMS rule applies to the following Medicare- and Medicaid-certified providers and suppliers:

The vaccination requirement applies to workers at covered facilities even if they don't have clinical responsibilities or patient contact. This includes facility employees, licensed practitioners, students, trainees and volunteers. Workers who provide care, treatment or other services for the facility or patients are also covered.

"These requirements are not limited to those staff who perform their duties within a formal clinical setting, as many health care staff routinely care for patients and clients outside of such facilities, such as home health, home infusion therapy, hospice, PACE programs, and therapy staff," according to the CMS.

Staff members who typically work remotely but occasionally have contact with other staff membersat worksites, administrative offices or in-person meetingsare also covered by the rule. The agency noted, however, that staff who perform 100 percent of their duties remotely are not required to get vaccinated.

"Facility staff vaccination rates under 100 percent constitute noncompliance under the rule," according to CMS guidance. But the agency will be flexible with its enforcement efforts. "Noncompliance does not necessarily lead to termination [from the programs], and facilities will generally be given opportunities to return to compliance."

Compliance Tips

The CMS issued aninterim ruleon the health care directive in November and updated guidance in December.Unlike the Occupational Safety and Health Administration's emergency temporary standardwhich the Supreme Court blocked on Jan. 13the CMS mandate does not allow covered facilities to implement a COVID-19 testing program as an alternative to requiring vaccination, Zeitler noted.

Jackson Lewis highlighted the following key provisions of the interim rule:

"CMS is expected to provide additional guidance with regard to the implementation of the interim rule for the states that had been covered by the stays," Jackson Lewis noted.

According to Fisher Phillips, the following components are critical parts of a successful plan:

Visit SHRM's resource hub page on the coronavirus and COVID-19.

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Covered Health Care Facilities Must Prepare for COVID-19 Vaccination Deadlines - SHRM

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