crawgarden said: Reading the article, it sounds like they can only detect if you had a covid infection, the long covid info comes from the individual themselves. Since a huge proportion of the population has had covid, think it would be very difficult not to get a transfusion from someone that did not have it. When you need a blood transfusion it is normally because of less than optimum circumstances.

Yes. Hoping that having had COVID, and probably long COVID isn't a problem.

https://www.cidrap.umn.edu/cov...

Three studies spotlight long-term burden of COVID in US adults
Mary Van Beusekom, MS 59 minutes ago.
COVID-19

Three new studies shed new light on long COVID in the United States, with one finding that two thirds of severely ill patients reported persistent impairments for up to 1 year, another showing that US veterans were at three times the risk of preventable hospitalization in the month after infection, and the last revealing that one third of COVID-19 survivors had lingering symptoms at one time.

57% of very ill had persistent physical problems
Today in Critical Care Medicine, University of California San Francisco (UCSF) researchers describe their study of 156 critically ill COVID-19 patients transferred to long-term acute-care hospitals in Georgia, Kentucky, Nebraska, and Texas for weaning from ventilation and rehabilitation from March 2020 to February 2021.

Patients completed online or phone interviews 1 year after hospital release. The average patient age was 65, and average hospital stay was 2 months. Most spent an average of 1 month on mechanical ventilation and were healthy before their infection.

Of the 156 patients, almost two-thirds (64%) said they had a persistent impairment, including physical (57%), respiratory (49%), psychiatric (24%), and cognitive (15%) problems, 1 year later. Nearly half (47%) reported more than one type of impairment, and 19% still needed supplemental oxygen.

"We have millions of survivors of the most severe and prolonged COVID illness globally," first author Anil Makam, MD, said in a UCSF news release. "Our study is important to understand their recovery and long-term impairments, and to provide a nuanced understanding of their life-changing experience."

About 79% of patients said they hadn't fully recovered at 1 year, 99% were back at home, and 60% of the previously employed had returned to work. Many patients said they were more affected by hospital-related issues such as bedsores and nerve damage that limited use of their extremities than by COVID-related problems. Participants attributed improvement to exercise and rehabilitation, support, and time.

"The long-lasting impairments we observed are common to survivors of any prolonged critical illness, and not specific to COVID, and are best addressed through multidisciplinary rehabilitation," Makam said.

Veterans at much higher risk for 1 year
Today in JAMA Network Open, a team led by researchers from the Veterans Affairs (VA) Portland Health Care System in Oregon used an emulated-target randomized trial design with monthly sequential trials to compare the risk of potentially preventable hospitalization among COVID-infected veterans to those of matched uninfected controls.

The study enrolled 189,136 veterans diagnosed as having COVID-19 from March 2020 to April 2021 and 943,084 controls. The average patient age was 60.3 years, 89.1% were men, 69.4% were White, and 23.4% were Black. The primary outcome was a potentially preventable hospitalization at a VA facility, VA-purchased community care, or Medicare fee-for-service care.

"Delayed or inadequate treatment of ambulatory care–sensitive conditions (acute or chronic conditions that can be treated effectively through quality ambulatory care [ACSCs]) can result in hospitalization," the study authors wrote.

An increased risk of preventable hospitalization in veterans with SARS-CoV-2 ... highlights the need for research on ways in which SARS-CoV-2 shapes postinfection care needs and engagement with the health system.
"Thus, hospitalizations for ACSCs (hereinafter referred to as potentially preventable hospitalizations) are widely recognized as an indicator of ambulatory care access and quality. They are also increasingly used as a measure of health system performance during public health emergencies."

A total of 3.1% of participants (3.8% of COVID-19 survivors and 3.0% of controls) had a potentially preventable hospitalization during the 1-year follow-up. The risk of hospitalization was higher among COVID-19 survivors at 0 to 30 days (adjusted hazard ratio [AHR], 3.26), 0 to 90 days (AHR, 2.12), 0 to 180 days (AHR, 1.69), and 0 to 365 days (AHR, 1.44).

"In this cohort study, an increased risk of preventable hospitalization in veterans with SARS-CoV-2, which persisted for at least 1 year after initial infection, highlights the need for research on ways in which SARS-CoV-2 shapes postinfection care needs and engagement with the health system," the researchers wrote. "Solutions are needed to mitigate preventable hospitalization after SARS-CoV-2."

17 million adults currently have long COVID
Yesterday, KFF reported its latest long-COVID data, which show that rates of the condition have remained relatively steady for a year, suggesting that the burden will persist unless new methods of prevention and treatment are developed.

The data follow the March 2024 release of updated Centers for Disease Control and Prevention (CDC) COVID-19 recommendations, which don't instruct people to isolate after testing positive.

"The new CDC guidance brings a unified approach to the risks from respiratory viruses and reflects the nation's progress against severe illness from COVID-19," wrote author Alice Burns, PhD, KFF associate director of the Program on Medicaid & Uninsured.

Although rates of long COVID have stabilized, the 17 million adults with long COVID may experience many employment and material hardships.
"However, as the nation moves further from the COVID-19 pandemic, rates of long COVID remain steady and 7% of all adults—roughly 17 million people—reported currently having long COVID in March 2024."

Among the findings:

Of adult COVID-19 survivors (60%), 3 in 10 report having long COVID at one time, and about 1 in 10 say they still have it.
Roughly 17 million adults currently have long COVID.
A total of 79% of adult with long COVID say their condition has limited their participation in activities, with 25% reporting it limits their activities "a lot."
Persistent symptoms occur most often among people who are transgender or have disabilities.
Regarding COVID-19 as just another respiratory virus may make accessing healthcare more difficult for groups disproportionately affected by persistent symptoms.
A total of 5% to 10% of adults may continue to have long COVID at any point, and research to improve diagnosis and treatment takes time.
"Although rates of long COVID have stabilized, the 17 million adults with long COVID may experience many employment and material hardships, with 4 in 10 reporting food insecurity, 2 in 10 reporting difficulty paying rent or mortgage, and 1 in 10 reporting that they had to stop working for a period of time because of their symptoms," Burns wrote.
Three studies spotlight long-term burden of COVID in US adults
Mary Van Beusekom, MS 59 minutes ago.
COVID-19
Long COVID dominos
Jikaboom / iStock

Three new studies shed new light on long COVID in the United States, with one finding that two thirds of severely ill patients reported persistent impairments for up to 1 year, another showing that US veterans were at three times the risk of preventable hospitalization in the month after infection, and the last revealing that one third of COVID-19 survivors had lingering symptoms at one time.

57% of very ill had persistent physical problems
Today in Critical Care Medicine, University of California San Francisco (UCSF) researchers describe their study of 156 critically ill COVID-19 patients transferred to long-term acute-care hospitals in Georgia, Kentucky, Nebraska, and Texas for weaning from ventilation and rehabilitation from March 2020 to February 2021.

Patients completed online or phone interviews 1 year after hospital release. The average patient age was 65, and average hospital stay was 2 months. Most spent an average of 1 month on mechanical ventilation and were healthy before their infection.

Of the 156 patients, almost two-thirds (64%) said they had a persistent impairment, including physical (57%), respiratory (49%), psychiatric (24%), and cognitive (15%) problems, 1 year later. Nearly half (47%) reported more than one type of impairment, and 19% still needed supplemental oxygen.

"We have millions of survivors of the most severe and prolonged COVID illness globally," first author Anil Makam, MD, said in a UCSF news release. "Our study is important to understand their recovery and long-term impairments, and to provide a nuanced understanding of their life-changing experience."

About 79% of patients said they hadn't fully recovered at 1 year, 99% were back at home, and 60% of the previously employed had returned to work. Many patients said they were more affected by hospital-related issues such as bedsores and nerve damage that limited use of their extremities than by COVID-related problems. Participants attributed improvement to exercise and rehabilitation, support, and time.

"The long-lasting impairments we observed are common to survivors of any prolonged critical illness, and not specific to COVID, and are best addressed through multidisciplinary rehabilitation," Makam said.

Veterans at much higher risk for 1 year
Today in JAMA Network Open, a team led by researchers from the Veterans Affairs (VA) Portland Health Care System in Oregon used an emulated-target randomized trial design with monthly sequential trials to compare the risk of potentially preventable hospitalization among COVID-infected veterans to those of matched uninfected controls.

The study enrolled 189,136 veterans diagnosed as having COVID-19 from March 2020 to April 2021 and 943,084 controls. The average patient age was 60.3 years, 89.1% were men, 69.4% were White, and 23.4% were Black. The primary outcome was a potentially preventable hospitalization at a VA facility, VA-purchased community care, or Medicare fee-for-service care.

"Delayed or inadequate treatment of ambulatory care–sensitive conditions (acute or chronic conditions that can be treated effectively through quality ambulatory care [ACSCs]) can result in hospitalization," the study authors wrote.

An increased risk of preventable hospitalization in veterans with SARS-CoV-2 ... highlights the need for research on ways in which SARS-CoV-2 shapes postinfection care needs and engagement with the health system.
"Thus, hospitalizations for ACSCs (hereinafter referred to as potentially preventable hospitalizations) are widely recognized as an indicator of ambulatory care access and quality. They are also increasingly used as a measure of health system performance during public health emergencies."

A total of 3.1% of participants (3.8% of COVID-19 survivors and 3.0% of controls) had a potentially preventable hospitalization during the 1-year follow-up. The risk of hospitalization was higher among COVID-19 survivors at 0 to 30 days (adjusted hazard ratio [AHR], 3.26), 0 to 90 days (AHR, 2.12), 0 to 180 days (AHR, 1.69), and 0 to 365 days (AHR, 1.44).

"In this cohort study, an increased risk of preventable hospitalization in veterans with SARS-CoV-2, which persisted for at least 1 year after initial infection, highlights the need for research on ways in which SARS-CoV-2 shapes postinfection care needs and engagement with the health system," the researchers wrote. "Solutions are needed to mitigate preventable hospitalization after SARS-CoV-2."

17 million adults currently have long COVID
Yesterday, KFF reported its latest long-COVID data, which show that rates of the condition have remained relatively steady for a year, suggesting that the burden will persist unless new methods of prevention and treatment are developed.

The data follow the March 2024 release of updated Centers for Disease Control and Prevention (CDC) COVID-19 recommendations, which don't instruct people to isolate after testing positive.

"The new CDC guidance brings a unified approach to the risks from respiratory viruses and reflects the nation's progress against severe illness from COVID-19," wrote author Alice Burns, PhD, KFF associate director of the Program on Medicaid & Uninsured.

Although rates of long COVID have stabilized, the 17 million adults with long COVID may experience many employment and material hardships.
"However, as the nation moves further from the COVID-19 pandemic, rates of long COVID remain steady and 7% of all adults—roughly 17 million people—reported currently having long COVID in March 2024."

Among the findings:

Of adult COVID-19 survivors (60%), 3 in 10 report having long COVID at one time, and about 1 in 10 say they still have it.
Roughly 17 million adults currently have long COVID.
A total of 79% of adult with long COVID say their condition has limited their participation in activities, with 25% reporting it limits their activities "a lot."
Persistent symptoms occur most often among people who are transgender or have disabilities.
Regarding COVID-19 as just another respiratory virus may make accessing healthcare more difficult for groups disproportionately affected by persistent symptoms.
A total of 5% to 10% of adults may continue to have long COVID at any point, and research to improve diagnosis and treatment takes time.
"Although rates of long COVID have stabilized, the 17 million adults with long COVID may experience many employment and material hardships, with 4 in 10 reporting food insecurity, 2 in 10 reporting difficulty paying rent or mortgage, and 1 in 10 reporting that they had to stop working for a period of time because of their symptoms," Burns wrote.

https://www.cidrap.umn.edu/avi...

Avian flu detected in North Carolina dairy herd
Lisa Schnirring Today at 2:16 p.m.
Avian Influenza (Bird Flu)

The North Carolina Department of Agriculture & Consumer Services (NCDAC) today announced that tests have confirmed highly pathogenic avian influenza (HPAI) in one of the state's dairy herds, raising the number of affected states to seven.

Officials didn't detail the potential source of the virus, but said movements of cattle from earlier affected states has been suspended.

The NCDAC said testing was conducted by the US Department of Agriculture National Veterinary Services Laboratory (NVSL) in Ames, Iowa.

Across US, 21 herds now affected
Steve Troxler, North Carolina's agriculture commissioner, said, "This is an evolving situation, and we are waiting for more diagnostics from NVSL and will work collaboratively with our federal partners and dairy farmers in North Carolina."

He said animal health officials in the state have spent years developing steps to manage HPAI in poultry. "But this is new, and we are working with our state and federal partners to develop protocols to handle this situation."

This is an evolving situation, and we are waiting for more diagnostics.
Meanwhile, the number of dairy herds in previously affected states continue to grow, with the total now at 21. Among other recent detections, Michigan now has a second positive herd, along with more detections on farms in Texas and New Mexico.

In addition to North Carolina, 17 other states have tightened their cattle import rules to varying degrees.

https://www.cidrap.umn.edu/cov...

Bernie Sanders calls for $1 billion for long-COVID moonshot
Lisa Schnirring Today at 1:33 p.m.
COVID-19

Sen Bernie Sanders, Ind.-VT, who chairs the Senate's Health, Education, Labor, and Pensions (HELP) committee, yesterday released a draft of proposed long-COVID moonshot legislation, which would earmark $1 billion for long-COVID research over the next decade.

Input sought to help shape language
In a statement, Sanders asked the long-COVID community, especially patients, families, researchers, and the medical community, to comment on how the proposal can be strengthened and improved before he formally introduces the legislation. He included an email link for comments, which are due by the end of the business day on April 23.

Far too many patients with Long COVID have struggled to get their symptoms taken seriously.
Sanders said the time is overdue for Congress to treat long COVID as the public health emergency that it is. "Congress must act now to ensure a treatment is found for this terrible disease that affects millions of Americans and their families," he said. "Far too many patients with Long COVID have struggled to get their symptoms taken seriously."

Along with the major boost in research support, the draft legislation also creates a centralized long-COVID research coordinating entity within the National Institutes of Health (NIH), require the NIH to establish a new grant process for long-COVID clinical trials, require the NIH to establish a long-COVID database, and require federal agencies to provide continued education and support to patients, providers, and the public.

'A step in the right direction'
In January, the Senate HELP committee held a hearing to get input from patients and healthcare providers on challenges with battling long COVID, a condition that affects an estimated 22 million Americans.

This is a significant step in the right direction
The NIH had launched a $1.5 billion Researching COVID to Enhance Recover (NIH RECOVER) Initiative to study how to identify and treat long COVID. Last August, the Department of Health and Human Services announced the formation of the Office of Long COVID Research and Practice to manage the nation's response and coordinate clinical trials across federal departments.

However, researchers and advocates have said a moonshot initiative is urgently needed, due to a disjointed response and slow progress with treatments.

Ziyad Al-Aly, MD, a clinical epidemiologist at Washington University in Saint Louis and is part of a team that first characterized long COVID, testified at the January hearing. On X (formerly known as Twitter) yesterday he said he was delighted to see the draft legislation. "This is a significant step in the right direction."

https://www.cidrap.umn.edu/cov...

Repeat COVID testing may be better strategy than quarantine, daycare study finds
News brief Today at 12:16 p.m.
Mary Van Beusekom, MS
Topics COVID-19

Serial COVID-19 testing of 50,000 children in 714 German daycare facilities over 1 year didn't result in increased infections and averted 7 to 20 days of post-exposure quarantine per child, according to a study published today in Pediatrics.

University Hospital Cologne researchers led the study, which linked polymerase chain reaction (PCR) COVID-19 test results with data on reported infections to evaluate the change in infection frequency with serial testing ("test-to-stay" approach) versus quarantine among children aged 2 to 6 years from March 2021 to April 2022.

From weeks 11 to 36 in 2021, daycares quarantined exposed children for up to 14 days, switching to the test-to-stay strategy from week 37 in 2021 to week 14 in 2022. Under test-to-stay, COVID-exposed children were tested with single PCRs for 5 days.

The study period spanned the Alpha, Beta, and Omicron BA.1 and BA.2 variants. The 7-day incidence of COVID-19 in Cologne ranged from about 9 per 100,000 people in week 25 of 2021 to 2,573 per 100,000 in week 9 of 2022.

While quarantine reduces COVID spread, it can lead to impaired cognitive development, executive functions, and mental and physical health.

"Furthermore, quarantine was shown to negatively impact parents, increasing negative mood or likelihood of losing temper and punishment," the study authors wrote. "Additionally, high-frequent and unexpected disruption of daycare attendance impacts workforce participation of parents because of the necessity of at-home childcare."

Test-to-stay appears safe, effective
Of the 219,885 pooled PCRs performed, 2.9% were positive for COVID-19, and 17,208 infections were reported.

This approach offers a promising option to avoid use of quarantine after exposure to respiratory pathogens in daycare settings.
The test-to-stay strategy avoided an estimated 7 to 20 days of quarantine per child, with no significant increase in infections. A regression-discontinuity-in-time analysis suggested a 26% reduction in COVID-19 cases. The results held true regardless of 7-day incidence, season, variant, or socioeconomic status.

"Our analyses provide evidence that suggest safety of the test-to-stay approach compared with quarantine measures," the researchers wrote. "This approach offers a promising option to avoid use of quarantine after exposure to respiratory pathogens in daycare settings."

THREATENED STATUS —
Measles could once again become endemic in the US, the CDC warns
This year's measles cases are over 17x higher than cases seen in the first quarters of 2000 to 2023.

https://arstechnica.com/scienc...

crawgarden said: THREATENED STATUS —
Measles could once again become endemic in the US, the CDC warns
This year's measles cases are over 17x higher than cases seen in the first quarters of 2000 to 2023.

https://arstechnica.com/scienc...

A completely preventable scenario if people would just cease believing and indulging in asinine quackery. It's insane we are to this point!

https://www.cidrap.umn.edu/cov...

Minority healthcare workers experienced COVID testing delays in first 2 years of pandemic
Mary Van Beusekom, MS Today at 2:18 p.m.
COVID-19

Black and non-Hispanic healthcare professionals (HCPs) of other races and those without graduate degrees were more likely than their White peers and clinical HCPs with graduate degrees to experience delayed COVID-19 testing in the first 2 years of the pandemic, finds a multicenter, test-negative case-control study.

The Brigham and Women's Hospital–led study used data from the Preventing Emerging Infections Through Vaccine Effectiveness Testing study, which enrolled HCPs tested for COVID-19 after experiencing symptoms from December 2020 to April 2022.

The research was published yesterday in JAMA Network Open.

Delays can lead to transmission
Of the 5,551 HCPs, 82.9% were women, 35.2% were aged 25 to 34 years, 76.3% were White, 6.7% were Black, and 5.8% were Asian. The vast majority of participants (84.4%) had two or fewer underlying illnesses, 19.9% had a clinical role and a graduate degree, and 28.1% had a clinical role and some college education, a college degree, or technical degree.

Time to testing may substantially alter personal and professional decisions to isolate, thus having the potential to impact the spread of infection.
A total of 18.5% were nonclinical HCPs who had a graduate degree; 30.1% were nonclinical with some college education, a college degree, or a technical degree; 3.3% were nonclinical with a high school education or less; and educational and job information was unknown for four participants. Of all HCPs, 74.6% had completed the COVID-19 primary vaccination series.

"This metric is important because time to testing may substantially alter personal and professional decisions to isolate, thus having the potential to impact the spread of infection," the study authors wrote. "Second, delays in testing may also lead to false-negative results. Third, understanding the timeliness of testing allows us to compare subgroups for demographic disparities in testing as well as to identify organizational or structural constraints."

Chronic illnesses, obesity tied to delayed tests
In total, 37.1% reported delayed testing (3 or more days after symptom onset), and 3,491 (62.9%) reported early testing (within 2 days). Relative to White HCPs, Black participants were more likely to report delayed testing (adjusted risk ratio [aRR], 1.18), as were non-Hispanic HCPs of other races (aRR, 1.17). There were no significant differences by age or sex.

Compared with graduate-level clinical HCPs, clinical HCPs with some college, a college degree, or technical degree (aRR, 1.25) and nonclinical HCPs with graduate-level training were more likely to report testing delays (aRR, 1.26). Participants with a high school education or less (clinical or nonclinical) had a higher risk of delayed testing than graduate-level clinical HCPs (aRR, 1.36).

The proportion of delayed testing differed by month (ranging from 25.5% in March 2022 to 54.1% in July 2021) and site (27.7% to 61.1% among the 15 healthcare facilities).

If the timeliness and importance of testing is not recognized in HCP, it will continue to be a barrier that propagates the existing racial disparities from the pandemic.
Clinical factors tied to delayed testing were the presence of three or more underlying conditions (unadjusted risk ratio [uRR], 1.21), asthma (uRR, 1.14), and obesity (uRR, 1.17). Delayed testing was not different amid the Delta or Alpha variant waves (uRR, 0.97) but was lower in the Omicron wave (uRR, 0.84). Compared with the unvaccinated, those with incomplete (uRR, 0.84; 95% CI, 0.74-0.96) or full vaccination (uRR, 0.85) were less likely to experience testing delays.

Early in the pandemic, COVID-19 testing was a substantial challenge owing to the low availability of tests. But once testing became more broadly available, variability in symptomatic testing rates continued, the authors noted.

"These findings suggest that future investigations into the systemic factors or barriers contributing to race and ethnicity differences in COVID-19 testing after symptom onset must be explored in an effort to minimize COVID-19 spread," the researchers concluded. "If the timeliness and importance of testing is not recognized in HCP, it will continue to be a barrier that propagates the existing racial disparities from the pandemic."

https://www.cidrap.umn.edu/avi...

Avian flu virus detected in South Dakota dairy herd
News brief 28 minutes ago.
Lisa Schnirring
Topics Avian Influenza (Bird Flu)

The South Dakota Department of Agriculture and Natural Resources (DANR) and the state's Animal Industry Board today announced that tests have confirmed highly pathogenic avian influenza (HPAI) in a South Dakota dairy herd, a first for the state.

Testing was done by the US Department of Agriculture (USDA) National Veterinary Services Laboratory in Ames, Iowa. The detection in South Dakota dairy cows raises the number of affected states to eight and comes 1 day after animal health officials in North Carolina announced that state's first HPAI detection in dairy cows.

Marv Post, chairman of South Dakota Dairy Producers, said, "South Dakota Dairy Producers encourage all dairy producers to closely monitor their herd and contact their herd veterinarian immediately if cattle appear symptomatic." He added that the USDA continues to emphasize that pasteurization kills viruses and that milk and dairy products are safe to consume.

Similar to the North Carolina announcement, South Dakota officials did not say if the affected herd had received cows from an earlier-affected state.

https://www.cidrap.umn.edu/ant...

Study: Pathogens that cause surgical infections may be coming from patients' skin
News brief 37 minutes ago.
Chris Dall, MA
Topics Antimicrobial Stewardship Healthcare-Associated Infections

A study of patients who developed infections after spinal surgery found that for most, the bacteria causing the infection was present on their skin before surgery, researchers reported yesterday in Science Translational Medicine.

The study, conducted by researchers at the University of Washington School of Medicine, examined 210 adult patients undergoing spinal fusion. The researchers wanted to explore why surgical site infections (SSIs), which occur in roughly 1 in 30 surgical procedures, have not significantly declined despite adherence to infection-prevention measures like environmental cleaning and sterile processing. To get a better understanding of where the bacteria causing SSIs might originate, they combined multiple forms of genomic analysis to compare preoperative patient microbiomes with postoperative SSI isolates.

Of the 210 patients studied, SSI developed in 14 (6.8%), and preoperative nasal, rectal, and skin specimens were obtained from 204 (97.1%). Skin swabs were collected on the day of surgery from the region directly overlying the planned incision area. Whole-genome sequencing analysis of 22 SSI isolates found that 19 (86%) were genomically similar to a bacterial strain present in one or more preoperative patient samples.

Furthermore, when the researchers analyzed an additional 59 SSIs that occurred in patients who underwent surgery in the same environment during the study period, they found that none of the SSIs were caused by a common bacterial strain.

"This finding indicates that spine SSIs in our population were not caused by exogenous strains originating from shared reservoirs within the hospital environment at any measurable frequency," the study authors wrote.

Implications for infection-prevention strategy
The analysis also found that 59% of SSI isolates were resistant to the prophylactic (preventive) antibiotic administered before surgery, and their resistance phenotypes correlated with the patient's preoperative resistome.

The authors say the findings and methodologic framework carry practical implications for SSI prevention strategies.

"If these findings are replicated in other procedural cohorts, this model of SSI pathogenesis could drive important shifts in infection prevention strategy and enable more individualized and patient-centered approaches," they wrote.

https://www.cidrap.umn.edu/sex...

ChatGPT may help combat vaccine hesitancy, sexually transmitted infections
News brief Today at 1:42 p.m.
Stephanie Soucheray, MA
Topics Sexually Transmitted Infections Misc Emerging Topics Public Health

A new pair of pilot studies suggests ChatGPT, the free artificial intelligence software, could be an effective tool to fight vaccine hesitancy and provide helpful information about sexually transmitted infections (STIs).

The results of the studies will be presented later this month at the ESCMID (European Society of Clinical Microbiology and Infectious Diseases) Global Congress.

To conduct the study, a group of physicians in Singapore asked the software to answer 15 commonly asked questions on vaccine hesitancy, including questions on the efficacy of vaccines and adverse events. They also asked 17 questions about STIs.

All ChatGPT vaccine answers were assessed for accuracy based on recommendations from the US Centers for Disease Control and Prevention Advisory Committee on Immunization Practices, and two independent infectious disease doctors assessed the STI information.

Correct but somewhat incomplete info
"Overall, ChatGPT's responses to vaccine hesitancy were accurate and may help individuals who have vaccine-related misconceptions," said lead author Matthew Koh, MD, from the National University Health System (NUHS) in Singapore, in an ESCMID press release.

The artificial intelligence platform gave correct information about mRNA vaccination for COVID-19, but did not mention other types of COVID vaccines. The software also provided accurate information about egg allergies and vaccines, measles vaccines, and flu vaccines.

For STIs, ChatGPT recommended safe sex practices, HPV vaccination, and abstinence, but failed to mention other strategies, such as HIV pre-exposure prophylaxis.

ChatGPT provided good general advice about STIs, but it lacked specificity.
"ChatGPT provided good general advice about STIs, but it lacked specificity and could not tailor its advice to individual's risk of acquiring STIs," said Koh.

https://www.medpagetoday.com/i...

CDC: COVID Vax Not Linked to Sudden Deaths in Young Adults
— Mortality from vaccine-related myocarditis not supported by Oregon death records

by Nicole Lou, Senior Staff Writer, MedPage Today April 11, 2024

The hunt for a signal of excess sudden cardiac deaths among young people after COVID-19 vaccination left Oregon health officials empty-handed, they reported.

Investigators searched death certificates for Oregon residents 16-30 years old who died from cardiac or undetermined causes of death from June 2021 to December 2022 and tried to match these deaths with mandatory statewide records of mRNA COVID vaccination, according to Juventila Liko, MD, and Paul Cieslak, MD, both of the Oregon Health Authority's Public Health Division in Portland, in the CDC's Morbidity and Mortality Weekly Reportopens in a new tab or window.

Among the 24 male decedents with an mRNA COVID-19 vaccination record, two died within 100 days of having received the vaccine: one recorded as dying of congestive heart failure attributed to hypertension, and the other had an undetermined cause of death.

As for the 16 female decedents logged as having received at least one mRNA COVID-19 vaccine dose, just one died within 100 days of vaccination. The immediate cause was recorded as undetermined, albeit related to chronic respiratory failure with hypoxia attributed to mitral stenosis.

Meanwhile, out of the 1,292 identified deaths of young people in the state, COVID-19 was cited as the cause for 30.

"These data do not support an association between receipt of mRNA COVID-19 vaccine and sudden cardiac death among previously healthy young persons. COVID-19 vaccination is recommended for all persons aged ≥6 months to prevent COVID-19 and complications, including death," study authors concluded.

Oregon residents over 16 years of age became eligible for COVID-19 vaccination on April 19, 2021. That month, reports of myocarditis after COVID-19 vaccination, particularly among young male vaccine recipients, began to appear in the voluntary Vaccine Adverse Event Reporting System (VAERSopens in a new tab or window).

This rare complication had not been reported in clinical trials leading to the authorization of the Pfizer/BioNTech and Moderna mRNA vaccines (Comirnaty and Spikevax, respectively).

Multiple studies subsequently described myocarditis associated with COVID vaccines as mostly mildopens in a new tab or window. Detailed recordsopens in a new tab or window showed that affected vaccine recipients tended to be men and boysopens in a new tab or window who were typically able to recover after a few days in the hospital.

Nevertheless, skeptics remained concerned about possible vaccine-related cardiac fatalities in teenagers and young adults. These fears were flamed by reports of sudden deaths among professional athletesopens in a new tab or window and cardiovascular events in this age groupopens in a new tab or window in 2022.

The present study from Oregon did not show evidence of these risks.

Liko and Cieslak acknowledged that their analysis did not account for any potential vaccine-associated cardiac deaths occurring more than 100 days after COVID vaccination. Additionally, Oregon's population may be too small to detect rare events such as sudden cardiac death among young people.

needrain said: A completely preventable scenario if people would just cease believing and indulging in asinine quackery. It's insane we are to this point!

https://www.cidrap.umn.edu/cov...

Study finds no evidence COVID-19 causes childhood asthma
Stephanie Soucheray, MA Today at 2:17 p.m.
COVID-19

A study today in Pediatrics says there is no evidence that COVID-19 infections lead to asthma in children.

The study, conducted by researchers at the Children's Hospital of Philadelphia (CHOP), included 27,423 patients ages 1 to 16 years who received polymerase chain reaction (PCR) testing for SARS-COV-2 from March 1, 2020, to February 28, 2021.

Patients were followed up for 18 months, with the main outcome the likelihood of receiving a new asthma diagnosis. Medical records from 1 year before inclusion in the study were also included to establish asthma-naive status among participants.

"During the early days of the pandemic, we could isolate the effects of COVID-19 from other viruses and follow these patients long enough to observe the onset of asthma," said first study author James Senter, MD, MPH, an attending physician at CHOP, in a press release from the hospital. "We were also testing so frequently that we had a built-in control group to compare asthma symptoms and whether COVID-19 was a critical factor."

During the early days of the pandemic, we could isolate the effects of COVID-19 from other viruses and follow these patients long enough to observe the onset of asthma.
Asthma tied to race, allergies
Instead of finding that COVID-19 infection raised the risk of childhood asthma, the researchers found that kids who were prone to developing asthma were more likely to test positive for COVID-19 during the 18-month study period. Known risk factors for asthma included race, food allergies, allergic rhinitis (or hay fever), and preterm birth

In total, 3,147 children (11.5%) were in the SARS-CoV-2–positive group and 24,276 (88.5%) were in the SARS-CoV-2–negative group, and 573 total received an asthma diagnosis during the 18 months.

SARS-CoV-2 positivity on PCR had no significant effect on the hazard of new asthma diagnosis (hazard ratio [HR], 0.96; 95% confidence interval [CI]: 0.73 to 1.27).

What did have an effect on asthma diagnosis was Black race (HR, 1.49; 95% CI, 1.13 to 1.95), food allergy (HR, 1.26; 95% CI, 1.03 to 1.55), and allergic rhinitis (hay fever; HR, 2.30; 95% CI, 1.93 to 2.74).

Secondary analysis finds similar results
In a secondary analysis that required two asthma medical codes, 418 participants received and maintained an asthma diagnosis in the 18-month follow-up period. Of those, 1.12% (35) of SARS-CoV-2–positive children were diagnosed as having asthma, compared with 1.59% (383) of SARS-CoV-2–negative children.

"SARS-CoV-2 PCR positivity was not associated with a new asthma diagnosis using this stricter definition. However, Black race, atopic comorbidities, and age were again associated with new asthma diagnosis when using the secondary asthma definition," the authors wrote.

"This well-powered study reaffirms risk factors we know contribute to asthma development and provides clinically useful information to pediatricians and providers on the absence of risk of developing asthma as a result of COVID-19," said senior author David A. Hill, MD, PhD, a physician in the Division of Allergy and Immunology at CHOP. "We are hopeful that this study will put to rest an outstanding question on the minds of many their families."

https://www.cidrap.umn.edu/cov...

Oregon data: COVID vaccines not tied to sudden cardiac death in young people
Mary Van Beusekom, MS Today at 1:24 p.m.
COVID-19
Myocarditis

A review of death certificates of previously healthy Oregon residents aged 16 to 30 years who died of cardiac or undetermined causes from June 2021 to December 2022 found no link between mRNA COVID-19 vaccination and sudden cardiac death.

For the study, published yesterday in Morbidity and Mortality Weekly Report, Oregon Health Authority researchers examined 1,292 death certificates and immunization data for documentation of COVID-19 mRNA vaccination within 100 days of death. A total of 925 males (72%) and 367 (28%) females in the 16- to 30-year age-group died during the study period.

Healthy Oregonians aged 16 and older became eligible for COVID-19 vaccination on April 19, 2021.

"COVID-19 vaccination has been associated with myocarditis in adolescents and young adults, and concerns have been raised about possible vaccine-related cardiac fatalities in this age group," the researchers wrote. "In April 2021, cases of myocarditis after COVID-19 vaccination, particularly among young male vaccine recipients, were reported to the Vaccine Adverse Event Reporting System."

No certificates list vaccination as cause of death
Among 1,292 identified deaths, COVID-19 was cited as the cause of death on 30 certificates. For 101 others, a cardiac cause of death couldn't be ruled out; of them, immunization data were available for 88, and 3 of them had received an mRNA COVID-19 vaccine dose within 100 days of death.

Of 40 deaths among mRNA COVID-19 vaccine recipients, 3 occurred within100 days of receipt. Two of these deaths were attributed to chronic illnesses, and no cause was listed for one. No certificate listed vaccination as the cause of death.

A total of 17 deaths among males (2%) were attributed to COVID-19. Death certificates cited noncardiac causes or other conditions for 842 (91%). Among the remaining 66 males (7%), a cardiac cause of death could not be excluded. Of these 66, vaccination records were available for 58 (88%), and receipt of at least one mRNA COVID-19 vaccine dose was documented for 24 (41%).

Of the 24 male vaccine recipients, 2 (8%) died within 100 days of vaccination. The cause of the first death was listed as natural 21 days after vaccination. The immediate cause of death was congestive heart failure attributed to high blood pressure; other significant conditions were morbid obesity, type 2 diabetes, and obstructive sleep apnea.

The second decedent had received a vaccine dose 45 days before death, which was categorized as "undetermined natural cause." Toxicology results were negative for alcohol, cannabinoids, methamphetamine, and opiates and positive for aripiprazole, ritalinic acid, and trazodone. Follow-up with the medical examiner couldn't confirm nor exclude a vaccine-associated adverse event as the cause.

These data do not support an association between receipt of mRNA COVID-19 vaccine and sudden cardiac death among previously healthy young persons.
Thirteen of the 367 female deaths (4%) were attributed to COVID-19, and 319 (87%) cited noncardiac causes. Among the remaining 35 female decedents (10%), vaccination records were available for 30 (86%), 16 (53%) of whom had received at least one mRNA COVID-19 vaccine dose.

Only one of these deaths occurred within 100 days of vaccination, at 4 days post-vaccination. The cause of death was listed as natural, and the immediate cause was undetermined, listing chronic respiratory failure with hypoxia attributed to mitral stenosis as a contributing factor.

Risk greater after COVID than after vaccination
"These data do not support an association between receipt of mRNA COVID-19 vaccine and sudden cardiac death among previously healthy young persons," the study authors wrote. "COVID-19 vaccination is recommended for all persons aged ≥6 months to prevent COVID-19 and complications, including death."

"Although the rate was higher during the pandemic year of 2021, myocarditis remained an infrequent cause of death among persons in this age group," they wrote. "Detection of a small difference in mortality rate from myocarditis would require a larger sample size."

The authors noted that electronic health records from 40 US healthcare systems from January 2021 to January 2022 revealed that the risk of cardiac complications was significantly higher after COVID-19 infection than after mRNA COVID-19 vaccination among people aged 5 years and older.

Data from the Centers for Disease Control and Prevention's (CDC's) National Center for Health Statistics show background death rates from cardiac causes in Oregonians aged 15 to 34 years of 2.9 and 4.1 deaths per 100,000 in 2019 and 2021, respectively. During the first 2 years of US COVID-19 vaccine availability, vaccination prevented roughly 18.5 million hospitalizations and 3.2 million deaths, the researchers said.

https://www.cidrap.umn.edu/cov...

US respiratory virus activity declines, with few hot spots reported
News brief Today at 2:59 p.m.
Lisa Schnirring
Topics COVID-19 Influenza, General Respiratory Syncytial Virus (RSV)

Activity from the three main respiratory viruses continues to decline in the United States, with one of the main flu markers—outpatient visits for flulike illness—now below the national baseline for the first time since October, the Centers for Disease Control and Prevention (CDC) said today in its latest updates for flu, COVID, and respiratory syncytial virus (RSV).

Only one jurisdiction—North Dakota— reported high respiratory virus activity last week, down from six the previous week, the CDC said in its respiratory virus snapshot. No locations reported "very high" activity.

In its weekly FluView report, the CDC said activity is still elevated but continues to decline, with other indicators such as test positivity and hospitalizations also heading downward. Three areas of the country are still above their regional baselines for outpatient visits: the upper and central Midwest and the Northeast.

Five more pediatric flu deaths were reported, raising the season's total to 138. The deaths occurred between the middle of February and the end of March. Two were due to influenza A, and three were linked to influenza B.

COVID wastewater levels remain low
COVID data updates today from the CDC show declining trends for severity markers such as hospitalizations and deaths as well as for early indicators, which include emergency department visits and test positivity. Also, the CDC said wastewater SARS-CoV-2 detections remain low.

Also today, the CDC updated its SARS-CoV-2 variant proportions, which show that JN.1 is still dominant, at 83.7%, with slowly rising proportions of one of its offshoots, JN.1.13. The proportion of JN.1.13 viruses rose from 6.5% to 9.1% over the past 2 weeks.

https://www.cidrap.umn.edu/cov...

Younger people in wealthy New York City areas snatched up COVID vaccine reserved for seniors
News brief Today at 10:55 a.m.
Mary Van Beusekom, MS
Topics COVID-19

Many younger people in high-income New York City neighborhoods accessed COVID-19 vaccinations before they were eligible, risking the lives of older people in low-income areas by pushing them down the queue, according to research in the Journal of Urban Health.

Led by researchers at the University of Witwatersrand in South Africa and Columbia University, the study used linked data from the Census Bureau and New York City Health.

Starting on December 14, 2020, New York administered vaccines to high-risk hospital workers, expanding to adults 70 years and older on January 4, 2021, 60 and older on March 10, 50 and older on March 23, and those 30 and older on March 30.

Older age greatest risk factor for COVID death
In the first 3 months of COVID-19 vaccine availability, low-income neighborhoods with higher percentages of people 65 years and older had lower vaccine coverage (average vaccination rate, 52.8%; maximum coverage, 67.9%) than higher-income areas (average vaccination rate, 74.6%; maximum coverage in the wealthiest quintile, 99%). Over the year, low-income areas also had higher death rates.

If New York had focused limited vaccine supply on low-income areas with high proportions of residents 65 or older, overall mortality might have been lower.
Despite limited vaccine availability, many younger people—especially in high-income neighborhoods—jumped the queue to get vaccinated before they were eligible (average coverage, 60% among residents 45 to 64 years in the most affluent quintile). A year later, when vaccines were broadly available, older residents' median vaccine uptake was 87%, including in the poorest area.

"Our analysis provides clear evidence of why U.S. policymakers must target their distribution approach to providing access to lifesaving technologies in short supply, focusing first on those most at risk of severe morbidity and mortality," lead author Nina Schwalbe, of Columbia University, said in a Columbia news release.

The greatest risk factor for COVID-19 death was older age, the authors noted.

"When rolling out a new vaccine, policymakers must account for local contexts and conditions of high-risk population groups," they wrote. "If New York had focused limited vaccine supply on low-income areas with high proportions of residents 65 or older, overall mortality might have been lower."

In thinking about my next COVID vaccine, I'm wondering when the next one will be available, and what it will be. Is there any news I may have missed? I'm considering whether I should get one sometime soon, or wait for the most updated version.

Just a guess, but would think the "new" vaccine would be available, if there is one, for the fall season.

crawgarden said: Just a guess, but would think the "new" vaccine would be available, if there is one, for the fall season.

I was thinking the same thing, but I'm a bit concerned about maybe waiting until the fall. Then I read your post about how COVID levels seem to be going down, so...maybe it would be okay to wait until the fall after all???

What is everyone thinking about this?