Monthly Archives: September 2022

Tracking COVID-19 in Alaska: State reports another week of declining cases and hospitalizations – Anchorage Daily News

Posted: September 29, 2022 at 12:58 am

By Anchorage Daily News

Updated: 2 hours ago Published: 4 hours ago

There were 34 COVID-positive patients hospitalized in Alaska as of Wednesday, according to the state health department. Hospitalizations were down from the previous week, when 37 COVID-positive patients were reported.

Here are other highlights from this weeks updated COVID-19 data from the Alaska Department of Health:

The state health department reported no additional COVID-19 deaths among residents. There have been 1,329 COVID-19 deaths reported among Alaska residents since the beginning of the pandemic.

In Alaska, 800 new cases were reported over a seven-day period, a decrease from 1,111 cases reported last week. That data doesnt include at-home tests, which dont get reported.

Alaskas seven-day case rate per 100,000 fell to 32nd among U.S. states, according to a CDC tracker.

Statewide, 68.1% of Alaskans six months and older had received at least one dose of the COVID-19 vaccine, while 28.3% had received at least one booster shot.

[Five things about COVID we still dont understand - at our peril]

Note: The state health department said that it will no longer release a weekly COVID-19 data overview on Wednesdays, but it will continue to produce a weekly update on COVID-19 and flu that contains similar information.

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Tracking COVID-19 in Alaska: State reports another week of declining cases and hospitalizations - Anchorage Daily News

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Expect an uptick in COVID-19 and flu cases, Connecticut’s public health expert warns – Connecticut Public

Posted: at 12:58 am

Nows the time to get the COVID-19 booster and flu shots especially with winter approaching.

Mark Mirko

/

Connecticut Public

We hit 400 patients with COVID in the hospital about a week ago, said Dr. Manisha Juthani, Connecticuts public health commissioner.. I do expect that that number will continue to rise over the next couple of weeks.

Juthani told Connecticut Public Radios Where We Live that her department is also monitoring the flu across the state. Less mask usage this winter may result in more flu cases.

Flu has been low for the last couple of years, Juthani said. We do anticipate its going to be much higher this year; we already see activity. Were expecting a worse flu season than usual.

Still, theres good news. According to the CDC and hospital systems, with vaccines, people are protected against the severity of both the flu and COVID-19. Juthani said the new COVID bivalent booster would prevent people from getting severely sick. Connecticut has administered close to 100,000 doses since early September.

Workforce shortages

Ahead of the anticipated uptick in COVID and flu cases, Connecticut, like the rest of the U.S., is facing nursing shortages.

Healthcare workers are still doing their part that they do every single day in hospitals, Juthani said. There are people who certainly have left the workforce. There have been several state initiatives to bolster workforce development. But these types of initiatives take time.

Connecticut launched a higher education program earlier this year to build up the pipeline of nurses, funded by the American Rescue Plan Act.

Emily Caminiti contributed to this report.

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Exposure to air pollution worsens COVID-19 outcomes, even among the fully vaccinated – EurekAlert

Posted: at 12:58 am

COVID-19 is a respiratory illness, so its not surprising that exposure to poor air quality worsens patient outcomes. But how does air pollution affect people who are vaccinated?

To answer that question, a team of researchers analyzed data from more than 50,000 COVID-19 patients across Southern California. By comparing publicly available air quality monitoring data with deidentified patient medical records, they first established that regardless of air pollution exposure, vaccines go a long way in reducing COVID-19 hospitalizations.

Fully vaccinated people had almost 90% reduced risk of COVID hospitalization, and even partially vaccinated people had about 50% less risk, saidZhanghua Chen, PhD, assistant professor of population and public health sciences at the Keck School of Medicine of USC and co-first author of the study.

But air pollutantsin particular fine particles (PM2.5) and nitrogen dioxide (NO2)are still harmful. Even among people who were vaccinated, exposure to those two pollutants over the short or long term increased the risk of hospitalization up to 30%.

Among vaccinated people, the detrimental effect of air pollution exposure is a little smaller, compared to people who were not vaccinated, Chen said. But that difference is not statistically significant.

The study was just published in theAmerican Journal of Respiratory and Critical Care Medicine. The research builds on the teamsearlier findings, which helped establish the link between air pollution exposure and COVID-19 severity.

These findings are important because they show that, while COVID-19 vaccines are successful at reducing the risk of hospitalization, people who are vaccinated and exposed to polluted air are still at increased risk for worse outcomes than vaccinated people not exposed to air pollution, said corresponding author Anny Xiang, PhD, MS, a senior research scientist at Kaiser Permanente Southern Californias (KPSC) Department of Research & Evaluation.

Short-term and long-term exposures

The researchers analyzed medical records, which were deidentified to protect patient privacy, from KPSC patients. Across the health care network, 50,010 patients, ages 12 and up, were diagnosed with COVID-19 in July or August of 2021, when the Delta variant was circulating and many people had been vaccinated.

Then, the researchers calculated estimated air pollution exposure levels for each participant based on residential addresses. They looked at average PM2.5, NO2, and ozone (O3) levels during the one-month and one-year periods before each patient received a COVID-19 diagnosis.

We investigated both long-term and short-term air pollution exposure, which may influence COVID-19 severity through different mechanisms, said Chen.

Over the long term, pollution is linked to increases in cardiovascular and lung diseases, which are in turn linked to more severe COVID-19 symptoms. In the short term, air pollution exposure may worsen inflammation in the lungs and could even alter the immune response to the virus.

Chen, Xiang, and their colleagues found that among 30,912 people who were unvaccinated, high short-term PM2.5 exposure increased the risk of COVID-19 hospitalizations by 13%, while long-term exposure increased the risk by 24%. For NO2, short-term exposure raised hospitalization risk by 14% and long-term exposure raised the risk by 22%. The pollutant O3 was not significantly associated with COVID-19 hospitalizations.

For those who were partially or fully vaccinated, the hospitalization risks related to air pollution exposure were slightly lowerbut the difference was not statistically significant.

Using data from medical records and neighborhood-level databases, the researchers were able to control for the effects of vaccination status, age, sex, race/ethnicity, health insurance status, body mass index, smoking history, health comorbidities, education level, income level and population density.

Improving indoor air quality

The findings suggest that in order to reduce severe cases of COVID-19, we need to improve air quality. This spring, the Biden Administration launched theClean Air in Buildings Challenge, an effort to install high-efficiency particulate absorbing(HEPA) filters in schools and other public buildings.

Chen recently received funding to conduct clinical trials of HEPA filters to determine whether they reduce the risk of diabetes and cardiovascular disease. Her team will also continue their collaboration with KPSC to study the direct impacts of indoor air purifiers on COVID-19 patients.

About this study

In addition to Chen and Xiang, the studys other authors are Brian Z. Huang and Frank D. Gilliland of the Department of Preventive Medicine, Keck School of Medicine of USC; Margo A. Sidell, Ting Chow and Mayra P. Martinez of the Department of Research & Evaluation, Kaiser Permanente Southern California; and Fred Lurmann of Sonoma Technology, Inc.

This work was supported by the National Institute of Environmental Health Sciences at the National Institutes of Health [3R01ES029963-01] and the Keck School of Medicine of USCs Department of Preventive Medicine COVID-19 Pandemic Research Center (CPRC).

About Keck School of Medicine of USC

Founded in 1885,theKeck School of Medicine of USCis one of the nations leading medical institutions, known forinnovative patient care, scientific discovery, education and community service. Medical and graduate students work closely with world-renowned faculty and receive hands-on training in one of the nations most diverse communities. They participate in cutting-edge research as they develop into tomorrows health leaders.The Keck School faculty are key participants in training of 1200 resident physicians across 70 specialty and subspecialty programs, thus playing a major role in the education of physicians practicing in Southern California.

American Journal of Respiratory and Critical Care Medicine

Meta-analysis

People

The independent effect of COVID-19 vaccinations and air pollution exposure on risk of COVID-19 hospitalizations in Southern California

20-Sep-2022

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Socio-Demographic, Health, and Transport-Related Factors Affecting the COVID-19 Outbreak in Myanmar: A Cross-Sectional Study – Cureus

Posted: at 12:58 am

Introduction

The coronavirus disease 2019 (COVID-19) pandemic is a worldwide threat in many aspects, making developing countries with scarce primary health care and medical services more vulnerable. Evaluation of the relationship between the COVID-19 pandemic, sociodemographic variables, and medical services provides useful information to take countermeasures to stop the infection spread and could mitigate the damage. Therefore, this study investigated the relationship between the spread of COVID-19 and sociodemographic variables, medical services, and the transportation system in Myanmar.

This study was a cross-sectional study and was conducted using data on COVID-19 cases from August 20, 2020 to January 31, 2021 in Myanmar. We evaluated the association between the COVID-19 cases and 13 independent variables that were sociodemographic, medical services, and transportation system factors using simple linear regression analysis and multiple linear regression analysis in three phases (increasing (from August 20th to October 10th), stable (from October 11st to December 4th) and decreasing phases (from December 5th to January 31st)) on the infection timeline.

It was found that the population density wasparallelly associatedwith COVID-19 cases. On the other hand, among the medical services factors, the number of doctors was parallelly associated with COVID-19 cases and the number of nurses was inversely related to COVID-19 cases.

The result indicated that a high population density area was a risk factor for the increase of COVID-19 cases. This supported the worldwide countermeasures to deal with the spread of the infection, such as social distancing, banning largegatherings, working from home, and implementing quarantine procedures for suspected individuals to reduce person-to-person contact. Finally, at least in Myanmar, employing a large number of nurses could reduce the emergence ofnew COVID-19 cases. We believe that our study can make valuable contributions to tackling future epidemics like COVID-19 not only in Myanmar but also in other developing countries.

This article was previously presented as an abstract at the 91stconference of The Japanese Society for Hygiene (JSH ) on March 08, 2021.

The first case of the coronavirus disease 2019 (COVID-19) was reported in Wuhan, the capital city of Hubei Province of China on December 8, 2019[1]. The infection subsequently spread rapidly across the world, turning the epidemic into a pandemic. The World Health Organization (WHO) reported that by July 2022, over 564 million people were infected and suffering and of these nearly 6.4 million people died worldwide, while in Myanmar, the number of cumulative COVID-19 cases was 614,009 and deaths were 19,434 [2]. Coronavirus belongs to theCoronaviridaefamily, which consists of enveloped viruses with positive-sense single-stranded RNA. Primal clinical symptoms are high fever, cough, myalgia, and dyspnea, which could develop into acute respiratory distress syndrome or multiorgan failure[3], finally causing death. COVID-19 spreads from person to person via droplet infection [4]. Since the R naught (R0: basic reproduction number) of COVID-19 has been measured at 3.0 and above[5], it is more contagious than the influenza virus (R0 of Influenza A(H1N1) is 1.4 to 1.6) [6]. The average incubation period of the virus is between three and seven days, and over 80% of the virus may have been transmitted - asymptomatically or symptomatically - with the early onset of symptoms[7,8]. Since the vaccine had not yet been invented, during the early stages of the COVID-19 pandemic, countermeasures such as keeping social distancing, maintaining personal hygiene, wearing masks, and lockdowns of cities[9,10] were implemented.The transmission of the virus and the infection rate was restrainedby various government policies such as mitigation and containment strategies [11].

The COVID-19 pandemic has been associated with several factors like socioeconomic factors, demographic factors, climate, and individual immunity [10,12-14], but the impact of these factors has varied across countries. Therefore, it is important to detect the factors that affected the COVID-19 infection in each area. While there has been a considerable amount of literature on the topic available with regard to developed countries, the literature is scant in developing countries,and there is none pertaining to Myanmar.Medical services are now vulnerable in Myanmar. Therefore, we tried to evaluate the relation between the COVID-19 cases and some independent variables such as sociodemographic factors, medical services, and the transportation system. We believe that our findings are a valuable contribution for formulating government policies and handling further outbreaks.

The first COVID-19 case in Myanmar was reported on March 23, 2020, and the first death was confirmed on March 31, 2020[15]. Since the rise in patients started on August 20, 2020 and converged in February 2021,we used the COVID-19 data from August 20, 2020 to January 31, 2021.

Myanmaris dividedintoseven regions, seven states, and one union territory, and its total population is 51,486,253[16]. Therefore, we set the 15 survey areas as our evaluation fields.

The number of COVID-19 cases from August 20, 2020, to January 31, 2021 was retrieved from the Ministry of Health and Sport (Myanmar)[15]. Our evaluation of independent variables in this study, such as population density; aging rate (population aged 65 years and above); unemployment rate; average monthly income; average annual temperature; number of doctors, nurses, midwives, hospitals and rural health centers; number of cars, buses, and two-wheelers were derived from the Myanmar Population Census[16]and the official government websites of Myanmar (Ministry of Labor, Employment, and Social Security[17], Ministry of Transportation and Communication[18], Ministry of Health and Sports[15], Department of Meteorology and Hydrology[19], and Myanmar Statistical Information Services[20]). The population density, aging rate, and unemployment rate were of 2014[16]; the year 2017 was considered for the average income per month [21]; average annual temperature was based upon the years 2008-2017[20]; medical facility and staff data was from 2021 [15]; and transportation data was from 2020 [18].Since Myanmar is a developing country, its electronic database system is not very advance; therefore, it was very difficult to assemble independent variables data of the same year. However, we have conducted this research with limited datasets without ignoring the fact that there have been some changes in these datasets for several years.

Figure1indicates the epidemic curve of COVID-19 casesin Myanmar.The period was divided visually into three phases as shown in Figure 1 - the increasing, the stable, and the decreasing phase - and we evaluated the relationship between the COVID-19 cases and the independent variables for each phase.

Simple linear regression analysis and multiple linear regression analysis were obtained with p < 0.05 being considered statistically significant. We used the variance inflation factor (VIF) index to evaluate the degree including multicollinearity and removed some variables to reduce the VIF index (about 5.0 or less) and to fit the model. High VIF contains much multicollinearity that needs to be corrected generally [22].We evaluated the relation between the number of COVID-19 cases and the independent variables usingmultiple linear regressionanalysis. Excel 2003 (Microsoft Corporation, Redmond, USA) and JMP 16 (SAS Institute, Cary, USA) were used for the analysis.

Figure1shows the epidemic curve of COVID-19 cases in Myanmar. The number of COVID-19 cases for increasing, stable, and decreasing phases are 25668, 71983, and 42059, respectively. Table1summarizes the outline of the number of COVID-19 cases, the sociodemographic variables and other independent variables. Yangon is the biggest city in Myanmarand ranked first in population, population density, average income, number of doctors, and number of cars.

We separately evaluated the correlation between the number of COVID-19 cases(per 10,000 people) and the variables in each of the three phases by using a simple linear regression analysis (Table2) in each phase. The results indicated a parallel relationship between COVID-19 cases and population density, average income, and the number of doctors, cars, and buses.

Additionally, we verified the relationship between the number of COVID-19 casesand the variables using multiple linear regression analysis (Table3, Model 1). Thereafter, we eliminated the number of cars, buses, nurses, midwives, and hospitals from the variables to minimize VIF (about 5.0 or less) for reducing multicollinearity, and re-evaluated the relationship (Table3, Model 2). We detected a statistically significant parallel relationship between the cases and population density. However, this relationship was not observed for the decreasing phase.

After we divided the variables into two categories - the variables excluding medical services and the variables concerning medical services, we also investigated the relationship between the number of COVID-19 cases and the variables (Tables 4, 5 ) while excluding the number of cars, buses, midwives, and hospitals to minimize VIF. The results showed that the population density was statistically significantly associated with increased cases during all three phases (increasing, stable, and decreasing) (Table 4 Model 4). The number of doctors displayed a significant parallel association, while the number of nurses revealed a significant reverse association statistically (Table 5 Model 6).

The COVID-19 pandemic has caused immense suffering and many deaths worldwide. This disease has had a detrimental impact globally and affected both developed and developing countries, including Myanmar. Immunization by vaccination was limited to developed countries, and it took a long time for the vaccine to be available in developing countries. Therefore, it is important to understand the risk factors that can cause the infection to spread, and to put into place effective countermeasures.

Since the coronavirus gets transmitted from person to person through droplet infection, contact with people is a high-risk factor. Living in urban or major cities [10,23] and a crowded public transportation system [24-26]could be assumed risk factors for increasing COVID-19 cases. It was reported that there was a parallel relation between population density and virus contagion and morbidity [27,28]. Moreover, the number of buses was considered a more important factor for rapid contagion than the number of cars[24,26,29,30]. Using public transportation could increase the risk of contagion [24,26,29,30]. Other factors such as high unemployment rate [14], being senior citizens [31], and residing in areas with poor medical facilities [32,33] could be factors causing the rise of COVID-19 cases. Additionally, high income, a developing economy, and high employment rate could induce the rapid spread of emerging infectious diseases due to increased human mobility necessitated by economic activity [14,34]. Therefore, it is important to detect risk factors for the increase of COVID-19 cases, and prevent the infection when effective vaccines are not available. We evaluated the relationship between the COVID-19 cases and the variables such as sociodemographic and other factors (population density, aging rate, unemployment rate, average income per month, average annual temperature, numbers of hospitals, health centers, doctors, nurses, and transportation system (buses, cars and two-wheelers)).

Table2indicates that population density, average income per month, and the number of doctors, cars, and buses had a parallel correlation with the number of COVID-19 cases. Our results aligned with those of other studies [24-28,35,36].

We also re-evaluated the relationship using multiple linear regression analysis to evaluate the influence of the variables individually with reducing multicollinearity. We found that only population density was significantly associated with the increased number of COVID-19 cases (Table3 Model 2). It means that living in urban or major cities could be a potential risk for the infection spread. Therefore, staying at home, keeping social distance, and banning large gatherings could be effective countermeasures to contain the spread of the COVID-19 infection, especially for those living in densely populated areas. During the decreasing phase, the population density was not associated with the increase in COVID-19 cases. Though the reason is unclear, we believe that the preventive countermeasures were already effective in the decreasing phase. We could not evaluate the relation between the COVID-19 cases and the transportation system, such as the number of cars and buses, because of high multicollinearity with other variables.

Some references suggest that medical services were a mitigating factor in containing the spread of COVID-19 [33,37,38]. However, we could not evaluate this due to high multicollinearity with other variables. Therefore, we evaluated the relation between the COVID-19 cases and the variables excluding medical services and the variables concerning medical services (Tables 4, 5). Our finding was that there was a significant parallel correlation between the population density and the number of doctors with the number of COVID-19 cases, while there was an inverse correlation with the number of nurses. Some studies showed that medical services could be an important protective measure for COVID-19 infection [33,37,38]. However, the relation between the number of doctors and the number of COVID-19 cases in our study did not align with the results of other studies [33,39]. A plausible reason is that we detected a high correlation between the population density and the number of doctors. First, there are not many doctors in Myanmar, and they are concentrated in the highly populated areas; moreover, their main role is that of curative care. The infection prevention activities are mainly carried out by nurses. Previous studies have also indicated that nurses played an important role in the successful prevention and control of mosquito-borne outbreaks, such as the zika and dengue viruses [40]. The results of our study did not show a correlation between the number of nurses and the population density. Notably, there is an imbalance between doctors and nurses in Myanmar [41].

Some studies have reported that high incomes and increasing employment rates are factors responsible for the spread of emerging infectious diseases [14,34]. Additionally, elderly people are more prone to infection [31]and could be a risk factor for contagion. However, we could not find any significant association between the COVID-19 cases and the aging rate, unemployment rate, or average income in Myanmar. Though we could not provide sufficient reasons for this, the difference in the unemployment rate, average income and aging rate between areas was small (Table 1) when compared to other reports [42].

Our study is not without limitations. We acknowledge that vaccination is an important countermeasure for infectious diseases. However, since most people were not vaccinated before January 31, 2021, we could not evaluate the influence of vaccination on the spread of the infection. Moreover, Myanmar was faced with a military coup on February 1, 2021, which hindered our efforts to obtain additional detailed information on the COVID-19 contagion and vaccination status.

The formulation of governmental policies with regard to COVID-19 is an important countermeasurefor reducing infection. The countermeasures employed in Myanmar were social distancing, restricting gatherings of more than 15 people, a temporary ban on international commercial flight landings, establishing public health labs, and home quarantining, which isolated infected individuals. However, the Myanmar government was unable to systematically implement these countermeasures, and it was difficult to obtain the data regarding state- and region-wise anti-COVID-19 infection policies. Therefore, we could not evaluate the relation between the number of COVID-19 cases and the policies.

In general, using the latest data that are also of the same year is important for high validity. Myanmar is a developing country, and its electronic database is still not fully developed. Additionally, the political situation in Myanmar is currently unstable. The latest national demographic survey (census) was carried out in 2015, and the largest national survey, Myanmar Living Conditions Survey, was carried out in 2017. It is impossible to obtain the data for the same year as the timeline of COVID-19 outbreak. Therefore, this study had to be carried out with limited valuable data. Additionally, it is essential to identify the difference in the variables mediating the COVID-19 cases between urban and rural areas. However, unfortunately, we could not obtain detailed data on COVID-19 cases and variables area-wise (urban and rural).

Despite the limitations mentioned above, this research was the first report concerning the relationship between COVID-19 cases and variables, such as sociodemographics and other factors. We believe that this report could help to formulate countermeasures in Myanmar if and when confronted with an epidemic in the future.

This study was conducted to evaluate the relationship between the COVID-19 cases and the variables concerning the sociodemographic, medical, and transportation systems. We identified population density to be a contributing factor to the spread of infection and the number of nurses as a protective factor, in Myanmar. However, we could not indicate any correlation between the COVID-19 cases and aging rate, unemployment rate, and average income, unlike other previous studies. This is the first study to investigate the various factors regarding the COVID-19 contagion in Myanmar. It aims to provide useful information to control the spread of infectious diseases like COVID-19and makes valuable contributions for policy-makers to consider in times of future epidemics not only in Myanmar but also in other developing countries.

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Socio-Demographic, Health, and Transport-Related Factors Affecting the COVID-19 Outbreak in Myanmar: A Cross-Sectional Study - Cureus

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Flu shot and Omicron COVID-19 booster: What to know about doubling up – Medical News Today

Posted: at 12:58 am

It is that time of year. In many places, there is a chill in the air, and soon there will be dazzling colors.

It is also the season when updated influenza shots become available, and this year, the new bivalent COVID-19 vaccines targeting multiple SARS-CoV-2 strains are also being considered.

Each February, the Food and Drug Administration (FDA) experts gather to predict the strains of flu most likely to be circulating in the following fall, and now freshly formulated, 2022-2023-specific, flu shots are available.

The two manufacturers of COVID-19 vaccines in the United States, Pfizer/BioNTech and Moderna, have also been busy developing a new bivalent booster vaccine designed to adapt more readily to ever-changing Omicron strains of the virus that causes COVID-19, SARS-CoV-2. Both companies have now received FDA approval for their new vaccines.

Which one, or both, should you get?

We asked three experts to answer a few questions for us about this autumns vaccines. Our experts are:

Dr. Farley: The bivalent Moderna COVID-19 vaccine is for individuals 18 years of age and older, whereas the bivalent Pfizer-BioNTech COVID-19 vaccine is for individuals 12 years of age and older.

Dr. Schaffner: The win is, youre eligible now, and so I would urge people to [get their COVID-19 booster].

Dr. Adajla: The people who would benefit most from an Omicron booster are those high-risk individuals who have never been boosted.

Dr. Adajla: If you fall into a high-risk category, you should not wait to be boosted.

Dr. Schaffner pointed out the things you should be mindful of before receiving a COVID-19 booster:

Dr. Schaffner: Now, there are some people who are thinking about this very carefully. For example, they have a trip planned sometime toward, lets say, the beginning of November or end of October, and theyre planning to get their updated COVID vaccines two weeks before they take their trip.

[Whether this makes sense,] I think that a lot depends on who you are. If youre younger and stronger, and dont have any underlying illnesses, if your vaccine is otherwise up-to-date, you could consider that.

If youre older, if youre frail with underlying illnesses, if you have diabetes, heart disease, lung disease, if you are immune-compromised in any way, I would urge you to get it now, rather than put it off because there are risks in the community. These Omicron variants are still circulating briskly across the country.

Dr. Schaffner: The answer is, as they would say in Minnesota, You bet!

And there are a couple of reasons for this. Your COVID-19 vaccine will not protect against influenza, and the reverse is also true: Influenza vaccine will not protect you against COVID-19. Theyre two separate viruses.

Influenza and we may have to remind people of this is another very serious winter respiratory virus.

It puts people in the same risk groups older frail, underlying illnesses, immunocompromised at increased risk of complications of influenza: pneumonia, hospitalization, and dying.

Dr. Adajla: Like is the case with every year, flu vaccination is also an important measure to take.

Dr. Farley: Yes, individuals should receive their annual flu vaccination this year, especially given that the formulation has changed to better match the anticipated circulating influenza viruses in the 2022-23 flu season.

All three experts agreed that there is no difference between getting one or the other vaccine first and that they are safe to receive together.

Dr. Adajla: As flu season has not really begun in the Northern Hemisphere, the [Omicron] booster is more important at this time.

Dr. Schaffner: Theres no contraindication for getting them at the same time. Some people will want to spread them out, simply because they dont want two sore arms at the same time. In fact, I was just giving a lecture and one of my colleagues was there. He said just yesterday he got them both, in one arm and one in the other.

Dr. Schaffner said he wanted to ease any concerns pregnant people may have about vaccines:

Should pregnant women receive these two vaccines? The answer is an unqualified yes. Its so recommended by the American College of Obstetricians and [Gynecologists]. Its clear from the data that both of these vaccines are safe during pregnancy.

We have data from influenza vaccine that [it] not only protects the mother, but some of those antibodies will cross the placenta and give the newborn protection during the first four to six months of its life.

He noted that this hasnt been as well-studied with COVID-19.

We would think its likely because thats been true in other circumstances. When moms are immunized with other vaccines TDAP, for example those antibodies go over into the baby. So, it is likely that is the case with COVID also.

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Flu shot and Omicron COVID-19 booster: What to know about doubling up - Medical News Today

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Democrat Blocks Resolution to End National COVID-19 Emergency – The Epoch Times

Posted: at 12:58 am

Sen. Ron Wyden (D-Ore.) on Sept. 28 blocked a resolution that would aim the national emergency declaration over COVID-19.

Wyden stepped in after Sen. Roger Marshall (R-Kan.), a doctor, introduced the resolution.

The one-page measure would terminate the national emergency declaration, which was initially declared by the Trump administration and has been extended through the present day by the Biden administration.

It is this declaration, coupled with other additional emergency powers currently invoked by the president, which this administration is using to supersize government in order to continue their reckless inflationary spending spree and enact their partisan agenda, Marshall said on the Senate floor in Washington. In fact, the White House uses these emergencies to justify their inflationary out-of-control spending, their unconstitutional vaccine and mask mandates, and to forgive student loans.

The declaration has enabled the U.S. Centers for Disease Control and Prevention to require data reporting and the Department of Health and Human Services to waive certain requirements for Medicare and Medicaid. It was cited by the Biden administration when officials announced in August that they would cancel thousands of dollars in student debt for millions of Americans.

Marshall, a member of the Senate Health Committee noted that President Joe Biden, a Democrat, recently said that the COVID-19 pandemic is over, which he said should mean the end of the emergency.

Wyden, the chairman of the Senate Finance Committee and a member of the Subcommittee on Health Care, said that ending the emergency would exacerbate doctor and nursing shortages.

Right now, there are requirements in Medicare for a lengthy process that must be completed before its possible to hire healthcare providers to serve Medicare patients, Wyden said. If the Marshall proposal goes into effect as written, Health and Human Services could not waive this complicated process to take care of patients. So that would leave our country short of health care providers when theres an acute, even more serious need for them.

I have never had a constituent at home, an Oregonian, say, Ron, what we need is more complicated processes and red tape in American health care. Usually, theyre talking to us about waiving things. So for those reasons I object, he added later.

Marshall took the floor after the objection, saying he agrees the shortages are a problem.

But the difference is, I dont think the government is the solution to the problem. I think the government has created the problem, he said.

The senator said that the solution is to remove some of the red tape, not to continue letting the administration utilize emergency powers.

Its my feeling that this emergency declaration allows the president and the White House to expand those powers, to take our constitutional rights away from us, Marshall said. I have encouraged people to take the vaccine and do all the right things. But I still think that its time to end the emergency, give us our God-given constitutional rights back.

I think that we should support ending this declaration of emergency.

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Zachary Stieber covers U.S. and world news. He is based in Maryland.

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Democrat Blocks Resolution to End National COVID-19 Emergency - The Epoch Times

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Local veteran finds success with TMS therapy | Local News | thenewsenterprise.com – Elizabethtown News Enterprise

Posted: at 12:57 am

In Radcliff, Army veteran Kevin Smith changes his shirt and wipes off his boots before he enters Oasis TMS, a place he has been visiting at least every week for the past year and a half.

Kevin sits down at a chair and has a peculiar-looking skullcap put on by intake coordinator Sarah Johnson, and the treatment begins.

He owns and operates a landscaping and excavating business with his wife, Annette Smith. Every Wednesday, he takes some time out of his morning for his therapy after working outside.

Transcranial magnetic simulation, a physical therapy for the brain, has has helped Kevin with his depression and been more effective than numerous other treatments he has tried.

Kevin retired from the United States Army in 2000. He then went to work at a local Burger King franchise as a district manager.

He said the job was stressful, but nothing he couldnt do. After leaving the job, he said it triggered his first major bout with depression. Shortly before leaving the job, a house fire destroyed their home.

It was so fast. I couldnt believe it. I mean, it happened (leaving the job) and then, two or three hours later, I was in full-fledged depression, Kevin said.

He said he had always had anxiety and some PTSD. Kevin said he served in Saudi Arabia and Kuwait, among other places. He said with some therapy and medication, he was able to get out of that bout within eight months.

In 2016, he and Annette began their business. It was doing well, and they had been going to Florida every winter to visit with his brother who had moved there.

In 2020, Kevin said he was in the camper traveling home from Florida when he suddenly started to not feel well. He said, by the time he got home, it was clear he was depressed again.

Kevin described his depression as dry spaghetti noodles that have fallen to the floor, scattered, and hes frantically trying to pick everything up and get it organized. He said, at one point in his depression, he lost 80 pounds and found himself not wanting to do anything.

During both bouts of depression, Kevin had thought about suicide, and had attempted to kill himself with a gun, but it failed.

Medication wasnt working. He then spent two nights voluntarily in rehabilitation at the veteran affairs clinic in Louisville. He said it wasnt helpful, so he checked out of it.

Kevin then attended a three-week inpatient program in Chillicothe, Ohio. He went reluctantly, but said the program helped him to meet and talk with soldiers like him who were also going through what he was going through.

When he got home, he said he wasnt feeling well again after two days. However, at inpatient, he found out about TMS therapy.

Currently, TMS is FDA approved to treat depression and OCD. A typical TMS therapy session involves a patient coming, sitting down and being given a cap which helps to aim at the brains dorsolateral prefrontal cortex. That part of the brain, when underactive for some patients, can result in depression.

Then, an MRI-strength magnet is placed on that spot, and for 18 and a half minutes, magnetic pulses from it are sent through. Typically, patients go for a handful of weeks, five days a week.

Holly Wolfe, Oasis TMS area director, said she was the first employee hired onto the company.

Wolfe said TMS therapy has been around since the 1980s. Wolfe said that TMS is not like electric shock therapy, which can be painful.

During Kevins weekly therapy, he said the only kind of physical feeling he experiences during it is a slight tingle. His eyebrow will also move involuntarily. Other side effects patients might have are headaches, which eventually dissipate.

Wolfe said the magnet opens up lines of communication for that part of the brains pathways. TMS can also make a patients medications more effective.

She said there are ongoing studies that are looking to use TMS to treat addiction, especially cocaine, and ADHD.

Theres a lot of stuff in the pipeline, Wolfe said.

Dave Easterling is the founder of Oasis TMS. He mostly works in custom software development and founded the company after seeing his sister, who has MS, anxiety and depression, have positive results after going to TMS therapy.

I was surprised just how successful TMS was and how long it had been around. Its FDA approved and insurance covers it and I was like, Why doesnt everybody know about this? he said.

Oasis TMS currently has the clinic in Radcliff, one in Louisville and two in the Indianapolis area. Easterling said he would like to have 25 clinics open in the next five years. He said theyre currently seeing 30 patients across all the clinics, but is expecting closer to 50 patients by the end of the year.

Id just like to see it be much more pervasive. Because it really, really helps people, Easterling said.

Annette said that within two weeks of starting the program, he and Kevin could tell a difference. She said, at one point, Kevin was on 13 different medications. Now, hes on two.

After his five-week treatment, Kevin has continued to go do TMS therapy for the past year or so, going in once a week for maintenance.

Wolfe said that 70% to 80% of Oasis TMSs patient population has had success with the therapy. She said she has treated patients between 16 to 84 years old.

However, she said TMS therapy is not a quick fix. Other treatments like medication are still necessary depending on the case.

Its another tool in their tool belt that they can use to decrease the symptoms, Johnson said.

Wolfe Insurance companies have covered the treatment, but have needed proof to show that other antidepressant methods have failed. Kevin said his is paid for through VA benefits.

He said, when October starts, hell start going to TMS therapy twice a month. In January, he and his family will be going on a trip for almost three weeks. He said he wants to see if being away from the therapy will have any effect.

Annette said she had a Vietnam War veteran uncle who died by suicide. She said she wants more veterans to know about this treatment and the effect it had on her husband.

Theres something out there that can help them so that they dont get to the point of suicide, Annette said.

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Racin’ Today Everything’s Big In Texas Including Criticism Of TMS – RacinToday.com

Posted: at 12:57 am

A good time was not had by all at Texas Motor Speedway over the weekend. (Photos courtesy of NASCAR)

By John Sturbin | Senior WriterRacinToday.com

FORT WORTH, Texas NASCARs Playoff weekend at Texas Motor Speedway provided compelling story lines via the feel-good victories scored by Tyler Reddick and Noah Gragson in their respective Cup and Xfinity series races.

Unfortunately, the on-track action around the high-banked/1.5-mile oval was almost an after-thought considering it played-out against a backdrop of blown Goodyear tires, flash fires and a flurry of grinding wall-bangers. Indeed, the overall cluster-effect conveniently fed into the narrative that The Great American Speedway is in need of a reconfiguration, repave and reboot.

A hot topic all summer on social media, the possible reconfiguration of TMS went all-out on the record Friday morning courtesy of reigning Cup Series champion Kyle Larson. Asked his opinion on how to improve the quality of racing on TMS uniquely-banked layout, Larson offered this not-so-subtle suggestion to the brain trust of Speedway Motorsports led by President and CEO Marcus G. Smith.

I would like them to demolish this place first, and then start over from scratch, Larson said.

Ouch! That was not what Smith and/or Mark Faber _ who began his tenure as TMS Executive Vice President and General Manager on Aug. 22 _ needed to digest over coffee and Krispy Kremes.

Tyler Reddick takes the checkers at TMS. (Photo by James Gilbert/Getty Images)

However, the quality of racing here in NASCARs three national touring series and the NTT IndyCar Series has come under increasing driver, fan and media scrutiny since completion of a major capital improvement project in March 2017.

Announced on Jan. 6, 2017 by Smith and former TMS President and General Manager Eddie Gossage, the key element was reduction of the banking in Turns 1 and 2 from 24 to 20 degrees. The Turn 1 apron also was flattened and widened. The banking in Turns 3 and 4 remained at 24 degrees and the entire layout was repaved. The intent was to break TMS out of the cookie-cutter mold associated with intermediate tracks and create added passing opportunities.

Complicating the issue, however, is the fact NASCAR has continued to apply a traction compound/resin that, if not properly heat-activated, reduces the racing surface to a single, slippery bottom lane. That compound has proven especially problematic for passing in the IndyCar Series.

Well, for one, they did a very poor job with the reconfiguration, initial reconfiguration, said Larson, the Hendrick Motorsports ace who won the 17th annual AutoTrader EchoPark Automotive 500 Cup Playoff race in October 2021 en route to his championship. I think I would like to see them go change it from your mile-and-a-half to something shorter. If I could build a track, itd probably be a three-quarter-mile Bristol _ basically pavement and progressive banking, all that. I dont know if thats even possible herebut anything would be better than what they did.

On Sunday, Reddick emerged as the fourth non-Playoff driver in as many 2022 races to earn a victory. Reddick led the final 24 laps of the 18th annual AEA 500 on his way to a 1.19-second victory over Playoff contender Joey Logano. The win was Reddicks first in Cup on an oval, following victories earlier this season at Road America in Elkhart Lake, Wis., and the Indianapolis Motor Speedway Road-Course.

Reddick, of Richard Childress Racing, led three times for a race-high 70 laps in the 334-lap/501-miler that set Cup track records for most lead changes (36), most leaders (19) cautions (16), caution laps (91) and longest race (4 hours, 21 minutes, 53 seconds). Included in the latter figure was a 56-minute red flag stoppage for unexpected lightning strikes and light rain in the Dallas-Fort Worth Metroplex.

Reddick, who fell two points short of advancing into the current Round of 12, continued the streak of a non-Playoff winners that began in the opening three-race Round of 16. Reddick followed Erik Jones (Darlington Raceway), Bubba Wallace (Kansas Speedway) and native Texan Chris Buescher (Bristol Motor Speedway) in the role of spoilers.

Chief among the tire issue victims Sunday was 2020 Cup champion Chase Elliott, who was leading on Lap 184 when the right rear tire on his Hendrick Motorsports Chevrolet blew exiting Turn 4. The No. 9 NAPA Auto Parts Camaro ZL1 slapped the wall with its right rear quarter panel and then the right front fender, sparking a brief fire before coasting into the infield grass. The Playoff point-leader as the race began, Elliott finished 32nd in the 36-car field and fell to eighth in the standings, 26 points behind new leader Logano.

Earlier, Cup regular Cody Ware of family-owned Rick Ware Racing escaped serious injury in a scary crash on Lap 168. Wares No. 51 Ford Mustang whacked the Turn 4 wall at speed, with the impact wadding-up the cars right front suspension. Disabled, the car slid down the 24-degree banking and onto pit road where it slammed the inside retaining wall before stopping in the box of BJ McLeod. Ware exited the cockpit with assistance of the tracks safety crew, but collapsed when he tried to stand up.

Ware was treated and released from the tracks infield care center after experiencing discomfort in his ankle. A team spokesman said Ware did not suffer a concussion and flew back with his team to North Carolina Sunday night.

Trigger-fingers immediately pointed in the direction of Goodyear and Director of Racing Greg Stucker. Team-owner Childress pointed out he and Randall Burnett, crew chief on Reddicks No. 8 Lenovo/ThinkEdge Chevy, had opted for a conservative approach to tire pressures after Saturdays practice and qualifying.

Goodyear builds a great tire, Childress said. This was a great tire that Goodyear built for us. Like Randall said, theres a fine line to push that limit. It wasnt the tire as much as it is trying to be as competitive as you can.

Stucker said this particular tire compound package was introduced at Kansas Speedway, specifically for use on 1.5-mile intermediate layouts.

Were getting as much information from the teams, trying to understand where they are regarding their settings _ air pressures, cambers, suspension and so on, Stucker said during an impromptu infield media center presser. For sure, I can say without a doubt air pressure is playing into it. We know where a lot of the guys are, some more aggressive than others. We know that plays a part. Im not saying thats the only thing but its certainly a factor.

We know a lot of guys have had not had issues _ in fact, guys put full-runs on tires. But obviously, other guys have had issues so well be working with them to try to sort through exactly what that is and how theyre different from other guys.

Stucker added the aggressiveness ramped-up once racing resumed on Lap 224, after the red-flag downtime. We were running considerably faster than what we were before (the stoppage), so all those factors come into play, Stucker said. The resin, I think, kept the racetrack extremely fast. There was very little tire fall-off and when the bottoms not working the guys could move up (one lane). All those factors play into it. No excuses, were just trying to find exactly whats going on.

If you look at races these days, people dont ride very much anymore. When the green flag falls everybodys up on the wheel and they race hard. Everybodys trying to win so everybody gets aggressive. The tire is a new element, thats why we supply the data on setups.

Reddick suggested that all teams are still compiling information on NASCARs Next Gen Chevy Camaros, Ford Mustangs and Toyota Camrys. Sundays race was the first point-paying event at TMS for the Next Gen, which made its competitive albeit non-point debut at TMS during the 38th annual NASCAR All-Star Race in May.

Its a brand-new car, Reddick said. Its the first time in the history of our sport weve gone to an 18-inch wheel and independent rear suspension. All these things are way different, the diffuser. All these things, way different. Were all learning together. Unfortunately, just the nature of it, were having tire failures.

I dont really know all the details on this, to be honest. But I do feel like Goodyear will be able to correct this. I just think as these cars have gotten faster and were getting more speed out of them, hypothetically speaking, were putting the cars through more load and more stress on the tire than they ever really thought we would be.

Scott Miller, NASCARs senior vice president of competition, assured that Goodyear is working to eliminate tire failure. Were all learning about the setups, the tires, Miller said. Goodyear is learning about the construction, the new wheel. Its part of a learningits an unfortunate part of a learning process.

Asked about a possible reconfiguration of TMS, Miller said, Well, I think the general consensus _ this is just is my opinion _ this has been a difficult track to race on for a while now. What the plans are for it, anything like that, I dont have any details on any of that. But if you ask the drivers, if you ask the crew chiefs, its been a difficult place over the years, for sure.

The summers reconfiguration rumors were led by a possible copying of the recent revamping of the 1.54-mile Atlanta Motor Speedway in Hampton, Ga. A sister Speedway Motorsports facility to TMS, the D-shaped layout now is NASCARs highest-banked intermediate track. Banking was increased from 24 degrees to 28 degrees, while the racing surface was narrowed from 55-feet to 40-feet. The tracks straightaways have remained at 5-degrees.

Ive heard of those reconfiguration rumors (at TMS), for sure, said Logano, the 2018 Cup champion and driver of the No. 22 AAA Ford fielded by Team Penske. I dont know whats truth or whats rumor. My only opinion is dont make it like Atlanta. Were all (drivers) on the same page, so hopefully Marcus listens to the drivers this time.

Or, maybe Marcus might listen to NASCAR superstar Dale Earnhardt Jr. Winner of his first Xfinity and Cup series races here in 1998 and 2000, respectively, Junior chimed-in after Saturdays 18th annual Andys Frozen Custard 300. The 2022 Xfinity Playoffs opener was won by JR Motorsports Gragson, whose fourth consecutive victory tied a record set by Sam Ard in 1983.

Gragson, driver of the No. 9 Bass Pro Shops/True Timber/BRCC Chevrolet Camaro, finished 1.238-seconds in front of fellow-Playoff contender Austin Hill and his No. 21 Bennett Transportation and Logistics Chevy. However, only eight of 38 starters completed a 200-lapper marred by two major crashes and nine cautions for 52 laps.

Heres the reality of the situation, said Junior, on-site as the owner of JR Motorsports and as analyst for NBC Sports telecast. Obviously, the grandstands are going to stay and the condos in Turn 2 arent going anywhere. I doubt that Big Hoss (giant TV) is going anywhere. So, whatever youre going to do has to fit in this footprint. So, a half-mile short track is not happening and a 2.5-mile superspeedway is not happening. Whatever happens has to kind of fit where the track is now. With those parameters, what do you do with this track?

Honestly, I think that I would either do one of two options, and Im scared to put them out here. I would revert back to the original configuration in Turns 1 and 2 and leave Turns 3 and 4 the way its been. Go back to the way the place was before they changed (Turns) 1 and 2 or I meanthey could just repave the treated part of the racetrack. They could leave the bottom two grooves the way they are and literally just pave the upper grooves that have been treated. That new asphalt would have more grip, more speed, guys would be running up there. Youd basically have the racetrack you have now but without the treatment on it.

I think the treatment is a lot of our problem. We put this on the track and it grips and its great but I think long-term you dont want this stuff on the surface. Its re-apply and re-apply and re-apply and its got to be kind of affecting the asphalt in a negative way. So you see guys go up there and (say), I cant mess with it until we activate it. I think for a long period of time you dont want to be putting this on the surface of the racetrack.

I wonder where we might be today with this (tarmac) untreated _ entirely untreated. Thats basically what I think about it. I know that Marcus would love to put Atlanta 2.0 here but I really dont believe thats whats going to happen. I dont think anybody wants another Atlanta.

Parker Kligerman (racer/broadcaster) said it best. He said, This place should be different than anything else _ not like Atlanta, not like anything. Texas only offers X, Y and Z. Thats a great way to think about it going in _ how can you offer something that you dont get anywhere else? And so, start there.

Editors Note:John Sturbin is a Texas-based journalist specializing in motorsports. During a near 30-year career with the Fort Worth Star-Telegram, he won the Bloys Britt Award for top motorsports story of the year (1991) as judged by The Associated Press; received the National Hot Rod Associations Media Award (1995) and several in-house Star-Telegram honors. He also was inaugural recipient of the Texas Motor Speedway Excellence in Journalism Award (2009). His list of freelance clients includes Texas Motor Speedway, the Dallas Morning News, New York Newsday, Rome (N.Y.) Daily Sentinel, Corpus Christi (Texas) Caller Times, NASCAR Wire Service, Ford Racing and Used Car Dealer magazine).

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Start over from scratch: Race weekend at TMS stirs up track reconfiguration rumors – The Dallas Morning News

Posted: at 12:57 am

FORT WORTH Reigning NASCAR Cup Series champion Kyle Larson has a not-so-subtle suggestion for improving the quality of racing on Texas Motor Speedways uniquely banked 1.5-mile oval.

Fire up the bulldozers, Speedway Motorsports hierarchy, and have at it.

I would like them to demolish this place first and then start over from scratch, Larson said Saturday in the infield media center. The quality of racing here in NASCARs three national touring series and the NTT IndyCar Series has come under increasing driver, fan and media scrutiny since completion of a major improvement project in March 2017.

Rumors about an offseason reconfiguration and repaving emerged as a hot topic heading into Sundays 18th annual AutoTrader EchoPark Automotive 500.

Announced on Jan. 6, 2017, by Speedway Motorsports president and CEO Marcus Smith and former TMS president and general manager Eddie Gossage, the key element was reduction of the banking in turns one and two from 24 to 20 degrees. The turn one apron also was flattened and widened. The banking in turns three and four remained at 24 degrees, and the entire layout was repaved. The intent was to break TMS out of the cookie-cutter mold associated with intermediate tracks and create added passing opportunities.

Complicating the issue, however, is the fact NASCAR continues to apply a traction compound that if not properly heat-activated reduces the racing surface to a single bottom lane. That compound has proved especially problematic for passing in the IndyCar Series.

Well, for one, they did a very poor job with the reconfiguration, initial reconfiguration, said Larson, the Hendrick Motorsports ace who won this playoff event last October. I think I would like to see them go change it from your mile-and-a-half to something shorter. If I could build a track, itd probably be a three-quarter-mile Bristol basically pavement and progressive banking, all that. I dont know if thats even possible here but anything would be better than what they did.

Reconfiguration rumors ramped up on social media over the summer, led by a possible change to the recent revamping of the 1.54-mile Atlanta Motor Speedway. AMS banking was increased from 24 to 28 degrees and its tarmac narrowed from 55 to 45 feet weed the latter element resembling the width of the 2.5-mile Daytona International Speedway.

Smith declined to address the rumor earlier this month in a series of emailed questions pertaining to the August hiring of Mark Faber as TMS third chief executive.

John Sturbin is a senior writer atRacinToday.com, based in Fort Worth. He can be contacted atjsturbin@racintoday.com.

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$28 Billion Transportation Management System Markets – Global Forecast to 2027: Increasing Demand for TMS to Tackle High Demand from e-Commerce -…

Posted: at 12:57 am

DUBLIN--(BUSINESS WIRE)--The "Transportation Management System Market - Global Forecast to 2027" report has been added to ResearchAndMarkets.com's offering.

The publisher forecasts the global transportation management system market is expected to grow from USD 11.7 billion in 2022 to USD 28.0 billion by 2027, at a Compound Annual Growth Rate (CAGR) of 19.1%

The emerging technologies are digitalizing the entire end-to-end transportation process for the transportation industry while reducing the costs of a range of business processes is expected to drive the TMS market.

Modern businesses are mostly dependent on technology, in which large enterprises have their own IT department for managing and maintaining business processes, whereas, most startups and SMEs do not have a proper IT department system. The reason being, it requires extra cost to manage and maintain an IT department.

So, most of the SMEs and startups adopt the cloud-based transportation management system, where they can reap the benefits of an IT department through a cloud management system without needing to employ extra staff at extra costs. This facilitates in-house employees to focus on day-to-day business operations.

The flexibility in storage of the cloud-based transportation management system offers scalability, which is very important for SMEs and will help them with unpredictable growth during the first year of the business operation.

The cloud-based transportation management system offers cost savings and an attractive pay-as-you-go model, such as real-time payment through the cloud, while buying products that enable SMEs to establish themselves as efficient and competitive players among other enterprises.

SMEs can also use the cloud-based transportation management system to drive corporate strategies that enhance revenue and profits. Hence, the cloud transportation management system market is estimated to grow during the forecast period, and there are huge opportunities for cloud transportation management system providers due to the high adoption rate by SMEs.

The consulting segment to record the highest market share during the forecast period

In the transportation management system market by services, consulting segment is expected to hold the largest market size. Consulting services provide a cost-effective way to ensure performance at the highest level of in-house staff.

Also, it is important for end-users as certain companies do not have the expertise to understand the complexities involved in configuring TMS. The need to address specific business-process requirements most feasibly will drive the segment.

The SMES segment is expected to grow with the highest CAGR during the forecast period

In the transportation management system market by organization size, the SMEs segment is expected to record the highest CAGR during the forecast period.

The adoption of advanced technologies, such as cloud computing, big data tools, data-driven demand forecasting, and analysis would help SMEs grow in the TMS market. Also the need for SMEs to expand their businesses while increasing productivity and achieving greater RoI would drive the segment.

The cloud segment to record the highest market share during the forecast period

In the transportation management system market by deployment mode, cloud segment is expected to hold the largest market size. Cloud-based solutions and applications are being leveraged by various organizations all over the globe The need for easy deployment, scalability, enhanced collaboration, and cost-effectiveness would boost cloud segment.

North America is expected to have a largest market share during the forecast period

North America is estimated to dominate the transportation management system market and is projected to record the largest market share during the forecast period. The region has been segmented into US and Canada.

The transportation sector in North America is undertaken strong efforts to raise resource efficiency using advance technologies. The region has witnessed the earliest adoption of cloud computing and mobile technologies, which has been significantly responsive to adopting TMS solutions and services. Also the presence of key TMS vendor in the region would drive the market growth.

Competitive landscape

The report covers the competitive landscape and profiling of the major players, namely Oracle, SAP, Manhattan Associates, C H Robinson, Mercurygate International, Blueyonder, E2Open, Transplace, Alpega TMS, Trimble, Descartes, Worldwide Express, Infor Inc., Wisetech Global, Generix Group.

Premium Insights

Case Study Analysis

Market Dynamics

Drivers

Restraints

Opportunities

Challenges

COVID-19 Market Outlook for Transportation Management System Market

Technology Analysis

Regulatory Landscape

Company Profiles

Major Players

Startups/SMEs

For more information about this report visit https://www.researchandmarkets.com/r/wcniry

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