Category Archives: Corona Virus

COVINGTON, Ky.Just months ago, the parking lot at Gravity Diagnostics in Covington was filled as people waited hours to get tested for COVID-19. Now, the site is shutting down as fewer people look for in-person tests.

Kelly Theurer stopped by the site one day before closing to get tested and say goodbye.

"I'm terribly sad," Theurer said. "I've been coming here since they set up shop in this parking lot. I travel a lot for work ... and it's literally the only place in the Tri-State where I can come, drive-thru, get a quick test and get the results back really fast."

Jeff Wellens, director of field services for Gravity Diagnostics, said they are closing because their partnership with the city is ending and the number of people getting tested continues to decrease.

"Last January, we were hitting about 2,000 a day and that was sustained for a good number of weeks after the holiday and at the present time we are just under about 10% of that now about 200 tests a day between the site here and the Florence Mall," Wellens said.

Ashley Auciello with the Health Collaborative said the overall number of tests in the Tri-State has dropped. Dr. Stephen Feagins, medical director for Hamilton County Public Health, said that doesn't mean the positivity rate is lower than before.

"Right now, it feels like things are kind of normal, but yet the positive rate for Southwest Ohio was like 1.6% this week last year, and it's almost 12% this week this year," Feagins said.

Feagins said that number is partly because testing is less frequent, but noted COVID has not become endemic.

"Endemic really isn't that term because endemic really means that you can predict when the flu season is going to start, you know kinda what's it going to be like, you know when you need to vaccinate for the flu each year," Feagins said. "You're not sure about that with COVID yet."

Theurer said she isn't sure where she'll go to get tested in the future. Aucielle recommended visiting TestAndProtectCincy.com to find COVID testing locations.

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Gravity Diagnostics closes COVID-19 testing sites as fewer in the Tri-State get tested - WCPO 9 Cincinnati

In the last two years, COVID-19 has followed a predictable, if painful, pattern: When coronavirus transmission has rebounded, California has been flooded with new cases and hospitals have strained under a deluge of seriously ill patients, a distressing number of whom die.

But in a world awash in vaccines and treatments, and with healthcare providers armed with knowledge gleaned over the course of the pandemic, the latest wave isnt sticking to that script.

Despite wide circulation of the coronavirus the latest peak is the third-highest of the pandemic the impact on hospitals has been relatively minor. Even with the uptick in transmission, COVID-19 deaths have remained fairly low and stable.

And this has occurred even with officials largely eschewing new restrictions and mandates.

In some ways, thats what is supposed to happen: As health experts get better at identifying the coronavirus, vaccinating against it and treating the symptoms, new surges in cases shouldnt lead to excessive jumps in serious illnesses.

But todays environment is not necessarily tomorrows baseline. The coronavirus can mutate rapidly, potentially upending the public health landscape and meriting a different response.

The one thing that is predictable about COVID, in my mind, is that its unpredictable, said UCLA epidemiologist Dr. Robert Kim-Farley.

While its too soon to say for certain, there are signs the current wave is starting to recede. Over the weeklong period ending Thursday, California reported an average of just over 13,400 new cases per day down from the latest spikes high point of nearly 16,700 daily cases, according to data compiled by The Times.

By comparison, last summers Delta surge topped out at almost 14,400 new cases per day, on average.

And more than 8,300 coronavirus-positive patients were hospitalized statewide on some days at the height of Delta almost three times as many as during the most recent wave.

The difference in each surges impact on intensive care units has been even starker. During Delta, there were days with more than 2,000 coronavirus-positive patients in ICUs statewide. In the latest wave, however, that daily census has so far topped out at around 300.

That gap in hospitalizations illustrates how the pandemic has changed.

At the very beginning of the pandemic, we noted right away the game-changers were going to be vaccines, easy access to testing and therapeutics and now we have all those things, said Los Angeles County Public Health Director Barbara Ferrer.

It doesnt say the pandemics over. Thats not what weve accomplished, she stressed. What weve accomplished is weve reduced the risk, but we havent eliminated the risk.

And though hospitalizations have been lower, in the aggregate, during the latest wave, Ferrer noted that each infection still carries its own dangers not just severe illness, but the chance of long COVID, as well. Taking individual action to protect yourself, she said, carries the added benefit of helping safeguard those around you, including those at higher risk of serious symptoms or who work jobs that regularly bring them into contact with lots of people.

For me, it makes clear that layering in some protection is still the way to go while enjoying just about everything you want to enjoy, she said.

Californias most restrictive efforts to rein in the coronavirus ended almost exactly a year ago, when the state celebrated its economic reopening by scrapping virtually all restrictions that had long provided the backbone of its pandemic response.

Roughly a month later, with the then-novel Delta variant on the rampage, some parts of the state reinstituted mask mandates in hopes of blunting transmission.

Toward the end of the year, another new foe would arise: the Omicron variant. This highly transmissible strain brought unprecedented viral spread, sending case counts and hospitalizations soaring and prompting officials to reissue a statewide mask mandate for indoor public spaces.

The fury with which those two surges struck left some fearing, and others advocating for, the return of the stringent orders that restricted peoples movements and shut down broad swaths of the economy. However, both waves came and went without California officials resorting to that option.

And during this latest wave fueled by an alphanumeric soup of Omicron subvariants, including BA.2 and BA.2.12.1 such aggressive action seems off the table.

I think, deep in my heart, unless we see a new variant that evades our current vaccine protection, we are not going to need to go back to the more drastic tools we had to use early on the pandemic when we didnt have vaccines, when we didnt have access to testing, when we didnt have therapeutics, Ferrer said in an interview.

During both Delta and the initial Omicron surge, California carefully evaluated the unique characteristics of each variant to determine how to best handle the changes in the behavior of the virus, and used the lessons of the last two years to approach mitigation and adaptation measures through effective and timely strategies, according to the state Department of Public Health.

These lessons and experiences informed our approach to manage each surge and variant. In addition, there were more tools available for disease control during each subsequent surge, including the Delta and Omicron surges, the department wrote in response to an inquiry from The Times. So, rather than using the same mitigation strategies that had been used previously, CDPH focused on vaccines, masks, tests, quarantine, improving ventilation and new therapeutics.

The state has also eschewed its previous practice of setting specific thresholds to tighten or loosen restrictions in favor of what it calls the SMARTER plan which focuses on preparedness and applying lessons learned to better armor California against future surges or new variants.

Each surge and each variant brings with it unique characteristics relative to our neighborhoods and communities specific conditions, the Department of Public Health said in its statement to The Times.

Chief among those, the department added, are getting vaccinated and boosted when eligible and properly wearing high-quality face masks when warranted.

The U.S. Centers for Disease Control and Prevention recommends public indoor masking in counties that have a high COVID-19 community level, the worst on the agencys three-tier scale. That category indicates not only significant community transmission but also that hospital systems may grow strained by coronavirus-positive patients.

We certainly are not at a level at these numbers where you would say, OK, its now, quote, endemic, and we just go about business as usual, Kim-Farley said. I think, though, it is probably indicative of what we might see in the future going forward, that we will see low levels in the community, people can relax and let their guard down a bit. But there will then be other times when we might see surges coming in. ... Thats a time when we mask up again. So I think there may be some on and off a little bit, and hopefully these surges become fewer, more spread out and less intense as we go forward.

As of Thursday, 19 California counties were in the high community level Alameda, Butte, Contra Costa, Del Norte, El Dorado, Fresno, Kings, Lake, Madera, Marin, Monterey, Napa, Placer, Sacramento, San Benito, Santa Clara, Solano, Sonoma and Yolo. However, only Alameda County has reinstituted a public indoor mask mandate.

Ferrer has said Los Angeles County would do the same should it fall in the high COVID-19 community level for two consecutive weeks.

L.A. County, like the state as a whole, continues to strongly recommend residents wear masks indoors in public. But Ferrer acknowledged its a very tough needle to thread and said an unintended consequence of years of health orders might be that people dont grasp the urgency of a recommendation.

People are now assuming if we dont issue orders and require safety measures then its because its not essential, and thats not what we meant, she said. We have always benefited from having folks that are able to listen, ask questions and then, for the most part, align with the safety measures. And I think because its been such a long duration, because theres so much fatigue at this point and desperation in some senses to get back to customary practices, people are waiting for that order before they go ahead and take that sensible precaution.

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This new California coronavirus wave isn't sticking to the script: Big spread, less illness - Los Angeles Times

With recent UK data suggesting that the BA.4 and BA.5 Covid variants are kicking off a new wave of infections, experts answer the key questions about reinfection and prevention.

Though rare at the start of the pandemic, reinfections have become increasingly common as the months and years wear on particularly since the arrival of Omicron, which prompted a 15-fold increase in the rate of reinfections, data from the Office for National Statistics suggests.

In part, this is because of a decline in protective antibodies triggered by infection and/or vaccination over time, but the virus has also evolved to evade some of these immune defences, making reinfection more likely.

The original Omicron BA.1 variant was itself massively immune-evasive, causing a huge breakthrough caseload, even in the vaccinated, said Danny Altmann, a professor of immunology at Imperial College London. It is also poorly immunogenic, which means that catching it offers little extra protection against catching it again. On top of that, theres now further evidence of the very marginal ability of prior Omicron to prime any immune memory for BA.4 or 5, the sub-variants that seem to be driving the latest wave of infections.

The virus has also evolved to become more transmissible, meaning even fleeting exposure to an infected person means you may inhale enough viral particles to become infected yourself.

There are definitely a lot of people who got Covid at the start of the year who are getting it again, including some with BA.4/5 who had BA.1/2 just four months ago, who thought they would be protected, said Prof Tim Spector, who leads the Zoe Health Study (formerly known as the Zoe Covid Study).

We still dont have enough data to work out exactly when the susceptible periods [for reinfection] are, which is one reason why we need people to keep logging their symptoms. We do know its still quite rare within three months, and it used to also be rare within six months, but thats not the case any more.

According to unpublished data from Denmark, which looked at reinfections with the BA.2 Omicron sub-variant within 60 days of catching BA.1, such reinfections were most common among young, unvaccinated people with mild disease. Other studies have similarly suggested that Covid-19 vaccination provides a substantial added layer of protection against reinfection by boosting peoples immune responses.

However, Omicron infection in itself appears to be a poor booster of immunity, meaning that if you were infected during earlier pandemic waves, your immune response is unlikely to have been strengthened by catching it again earlier this year.

In general, infections should be less severe the second, third or fourth time around, because people should have some residual immunity particularly if theyve also been vaccinated, which would further raise their levels of immune protection. However, there are always exceptions to this. Anecdotally, some people are getting it for longer this time around than they did the last time, Spector said.

It is also too early to know about the risk of long Covid associated with BA.4/5, he added.

As the UK heads into a period dominated by BA.4 and 5, the potential for reinfection seems high. Were in quite a serious situation due to a convergence of factors: a country where a moderately successful third booster campaign is now long past, with immunity waned and successive large waves of Omicron through to the emerging dominance of BA.4/5, said Altmann.

The bottom line is that we should all consider ourselves essentially unprotected, except perhaps from intensive care unit admission and death, and then, as before, with the risks increasing with age.

Face masks and ventilation continue to provide important additional layers of protection especially in crowded settings. I still wear a mask, but not a cheap mask I wear a proper FFP2 or 3 mask, said Spector. These new variants are still very much airborne and you need an even smaller amount to get infected, so I think a mask is definitely a good idea when as many as one in 30 people have it again.

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Covid reinfections in the UK: how likely are you to catch coronavirus again? - The Guardian

THE HAGUE, NETHERLANDS: Director of the Dutch RIVM (Center for Infectious Disease Control) Jaap van ... [+] Dissel. (Photo by Niels Wenstedt/BSR Agency/Getty Images)

The Dutch RIVM (Center for Infectious Disease Control - CDC counterpart in the Netherlands) is conducting a long-term study on long Covid. The agency released interim results on Tuesday, June 21st, which show that approximately 50% of patients enrolled in a large ongoing study still have one or more symptoms three months after becoming infected with the coronavirus SARS-CoV-2. In addition, among adults under the age of 65, researchers detected no difference between those who are vaccinated and unvaccinated in terms of most long Covid symptoms, except for sense of smell and taste. Vaccinated adults reported less loss of smell and taste than than those who were unvaccinated.

Long Covid is a hotly debated subject. In particular, some experts have worried about lack of clarity around long Covids characterization, and causal inferences which arent necessarily well established. And so, the key questions become, what exactly are long Covid symptoms, and how likely is it that a coronavirus infection caused them?

There isnt a firm consensus on long Covids precise definition, and causality is still being analyzed by clinical researchers. Yet, since fairly early in the pandemic, a broad set of symptoms we now refer to as long Covid the literature used to label sufferers as long-haulers has been very well documented. The Dutch RIVM, in particular, has meticulously collected data on long Covid, both to characterize the syndrome and attempt to figure out whats causing symptoms.

Its evident that many people who contract the coronavirus struggle for months with lingering Covid-19 symptoms which can be debilitating. Patients exhibit shortness of breath, extreme fatigue, intermittent fevers, cough, concentration issues, chest pressure, headaches, and heart palpitations, among other symptoms.

There is a very wide range in estimates of long Covid prevalence among those who recover from a symptomatic coronavirus infection. A University of California Davis study found that 10% of Covid-19 patients suffer from long Covid symptoms. In a CDC-sponsored study, it was estimated that around 20% of adults under 65 who recover from Covid-19 experience at least one health condition that could be considered long Covid. Here, CDC researchers identified persistent health problems in different organs of the body, including the heart, lungs, and kidneys. Yet another study suggested that 30% develop at least one long Covid symptom over time.

Fatigue, shortness of breath, brain fog, and loss of smell are particularly common long-term effects of Covid-19. This is apparent from the studies mentioned above, but also the interim results of the RIVM's study released on June 21st. For some, symptoms are relatively minor. For others, however, they can be disabling and life-altering.

The preliminary findings from the RIVM investigation refer to data gathered from May to December 2021. As such, they concern people who became infected with the Alpha or Delta variants of the coronavirus.

The results derive from a health survey questionnaire taken by a total of 14,572 participants. 9,166 people took the survey shortly after testing positive for SARS-CoV-2. The control group consisted of 5,406 people who tested negative for the coronavirus and applied to take part in the survey or were invited by letter from the general population. RIVM requested that all survey participants fill out questionnaires about their health at intervals of three months.

Around 33% of study participants who became infected with coronavirus still suffer from fatigue three months later. Persistent shortness of breath occurs in 16% of respondents, 15% have ongoing brain fog, and 12% have chronic loss of their normal sense of smell and taste for at least three months after their initial infection.

Whats striking is that these reported symptoms are 1.5 times more common among Covid-19 patients than among those who have had other (non Covid-19) respiratory infections.

The Dutch research also demonstrates that fully vaccinated people under 65 years of age who contracted coronavirus have fewer problems with smell and taste after three months. For other symptoms, however, no difference was found between vaccinated and unvaccinated people.

The RIVM will continue to follow up with study participants for at least one year. And, the agency will eventually include results from those who became infected with the Omicron variant.

The Dutch investigation not only shows that a large percentage of Covid-19 patients continue to have symptoms after recovery from the acute, initial coronavirus infection, but also suggests that the constellation of long Covid symptoms is much more common in these patients than in people in the general population, and in patients who experienced other (non Covid-19) respiratory infections.

While there continue to challenges regarding how to precisely define long Covid and how to determine cause and effect, ignoring or downplaying the long Covid syndrome isnt going to make it go away. Its vital that more research is carried out to determine causality and to find therapies that work for long-haulers.

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Dutch Research On Long Covid Shows 50% Of Study Participants Have 1 Or More Symptoms 3 Months After Becoming Infected With Coronavirus - Forbes

Mike Stucka USA TODAY NETWORK| The Gaston Gazette

North Carolina reported 24,464 new cases of coronavirus in the week ending Sunday, down 8.7% from the previous week. The previous week had 26,785 new cases of the virus that causes COVID-19.

North Carolina ranked 10th among the states where coronavirus was spreading the fastest on a per-person basis, a USA TODAY Network analysis of Johns Hopkins University data shows. In the latest week coronavirus cases in the United States decreased 0.7% from the week before, with 730,572 cases reported. With 3.15% of the country's population, North Carolina had 3.35% of the country's cases in the last week. Across the country, 15 states had more cases in the latest week than they did in the week before.

Gaston County reported 443 cases and two deaths in the latest week. A week earlier, it had reported 450 cases and 11 deaths. Throughout the pandemic it has reported 67,978 cases and 865 deaths.

Across North Carolina, cases fell in 55 counties, with the best declines in Wake County, with 3,831 cases from 4,879 a week earlier; in Durham County, with 1,165 cases from 1,348; and in Cumberland County, with 740 cases from 922.

>> See how your community has fared with recent coronavirus cases

Within North Carolina, the worst weekly outbreaks on a per-person basis were in Mitchell County with 454 cases per 100,000 per week; Jones County with 372; and Durham County with 362. The Centers for Disease Control says high levels of community transmission begin at 100 cases per 100,000 per week.

Adding the most new cases overall were Wake County, with 3,831 cases; Mecklenburg County, with 2,708 cases; and Guilford County, with 1,260. Weekly case counts rose in 41 counties from the previous week. The worst increases from the prior week's pace were in Onslow, Cleveland and Haywood counties.

In North Carolina, 46 people were reported dead of COVID-19 in the week ending Sunday. In the week before that, 434 people were reported dead.

A total of 2,823,979 people in North Carolina have tested positive for the coronavirus since the pandemic began, and 25,140 people have died from the disease, Johns Hopkins University data shows. In the United States 86,246,101 people have tested positive and 1,013,413 people have died.

>> Track coronavirus cases across the United States

USA TODAY analyzed federal hospital data as of Sunday, June 19.

Likely COVID patients admitted in the state:

Likely COVID patients admitted in the nation:

Hospitals in 29 states reported more COVID-19 patients than a week earlier, while hospitals in 25 states had more COVID-19 patients in intensive-care beds. Hospitals in 31 states admitted more COVID-19 patients in the latest week than a week prior, the USA TODAY analysis of U.S. Health and Human Services data shows.

The USA TODAY Network is publishing localized versions of this story on its news sites across the country, generated with data from Johns Hopkins University and the Centers for Disease Control. If you have questions about the data or the story, contact Mike Stucka at mstucka@gannett.com.

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Gaston County reported 443 additional COVID-19 cases this week - Gaston Gazette

During COVID, the level of several enzymes in the liver elevates. Presence of these enzymes in a higher amount in the liver means it is damaged.

As per a study, COVID-19 associated hepatic injury should be defined as Alanine amino transaminase or Aspartate amino transaminase exceeding 3 times the upper limit of the normal value, and ALP, -Glutamyl transpeptidase or total bilirubin of these enzymes the patients were categorised as hepatocellular, cholestatic and mixed type.

In addition to this, people with chronic liver conditions can be severely affected by the viral attack. With serious health complications already in the body, the immune system which is already highly compromised is unable to protect the body and thus the risk of the infection increases.

Apart from these, the medications that are administered to treat COVID can also pose a serious risk for the health of the liver.

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Coronavirus explainer: Potential effects of COVID on liver health; know the key indicators - Times of India

WASHINGTON President Joe Biden on Wednesday will call on Congress to suspend federal gasoline and diesel taxes for three months an election year move meant to ease financial pressures at the pump as the public is increasingly concerned about high gas prices and inflation.

The Democratic president will also call on states to suspend their own gas taxes or provide similar relief, the White House said.

At issue is the 18.4 cents-a-gallon federal tax on gas and the 24.4 cents-a-gallon federal tax on diesel fuel. If the gas savings were fully passed along to consumers, people would save roughly 3.6% at the pump when prices are averaging about $5 a gallon nationwide.

It's unclear, though, if Biden could push such a proposal through Congress, where many lawmakers, including some in his own party, have expressed reservations. And even many economists view the idea of a gas tax holiday with skepticism.

Barack Obama, during the 2008 presidential campaign, called the idea a "gimmick" that allowed politicians to "say that they did something." He also warned that oil companies could offset the tax relief by increasing their prices.

Biden energy adviser Amos Hochstein pushed back on Wednesday, saying consumers could save about 50 cents per gallon if Congress and the states heed the president's call.

"That's not a gimmick," Hochstein, senior adviser for global energy security at the State Department, said on CNN. "That's a little bit of breathing room for the American people as we get into the summer driving season."

It was not immediately clear if the White House has the votes in Congress to suspend the federal tax.

High gas prices pose a fundamental threat to Biden's electoral and policy ambitions. They've caused confidence in the economy to slump to lows that bode poorly for defending Democratic control of the House and the Senate in November.

Biden's past efforts to cut gas prices including the release of oil from the U.S. strategic reserve and greater ethanol blending this summer have done little to produce savings at the pump, a risk that carries over to the idea of a gas tax holiday.

Biden has acknowledged how gas prices have been a drain on public enthusiasm when he is trying to convince people that the U.S. can still pivot to a clean-energy future. In an interview with The Associated Press last week, Biden described a country already nursing some psychological scars from the coronavirus pandemic that is now worried about how to afford gas, food and other essentials.

"If you notice, until gas prices started going up," Biden said, "things were much more, they were much more optimistic."

The president can do remarkably little to fix prices that are set by global markets, profit-driven companies, consumer demand and aftershocks from Russia's invasion of Ukraine and the embargoes that followed. The underlying problem is a shortage of oil and refineries that produce gas, a challenge a tax holiday cannot necessarily fix.

Mark Zandi, chief economist at Moody's Analytics, estimated that the majority of the 8.6% inflation seen over the past 12 months in the U.S. comes from higher commodity prices due to Russia's invasion and continued disruptions from the coronavirus.

"In the immediate near term, it is critical to stem the increase in oil prices," Zandi said last week, suggesting that Saudi Arabia, the United Arab Emirates and a nuclear deal with Iran could help to boost supplies and lower prices. Republican lawmakers have tried to shift more blame to Biden, saying he created a hostile environment for domestic oil producers, causing their output to stay below pre-pandemic levels.

Senate Republican leader Mitch McConnell mocked the idea of a gas tax holiday in a February floor speech. "They've spent an entire year waging a holy war on affordable American energy, and now they want to use a pile of taxpayers' money to hide the consequences," he said.

Congressional Democrats largely appeared cool to the idea of a gas tax holiday, which Speaker Nancy Pelosi and others have long worried would simply allow oil companies to reap additional profits with no guarantee the savings would be passed along to consumers at the pump.

Rep. Peter DeFazio, D-Ore., chairman of the House Transportation and Infrastructure Committee, said late Tuesday that he is urging colleagues to see the gas tax holiday "for what it is: a short-sighted proposal that relies on the cooperation of oil companies to pass on miniscule savings to consumers."

But Dan Kildee, D-Mich., said he is a longtime supporter of a federal gas tax holiday.

"I admit to some frustration because I think it would have been more effective if we had done this a few months ago," Kildee said. "But it's never too late to do the right thing."

One Democratic aide, who insisted on anonymity to frankly discuss the situation Wednesday, said it appears unlikely the proposal could pass the House without first clearing the evenly split Senate.

Administration officials said the $10 billion cost of the gas tax holiday would be paid for and the Highway Trust Fund kept whole, even though the gas taxes make up a substantial source of revenue for the fund. The officials did not specify any new revenue sources.

The president has also called on energy companies to accept lower profit margins to increase oil production and refining capacity for gasoline.

This has increased tensions with oil producers: Biden has judged the companies to be making "more money than God." That kicked off a chain of events in which the head of Chevron, Michael Wirth, sent a letter to the White House saying that the administration "has largely sought to criticize, and at times vilify, our industry."

Asked about the letter, Biden said of Wirth: "He's mildly sensitive. I didn't know they'd get their feelings hurt that quickly."

Energy companies are scheduled to meet Thursday with Energy Secretary Jennifer Granholm to discuss ways to increase supply.

___

Associated Press writers Lisa Mascaro, Matthew Daly and Kevin Freking contributed to this report.

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Biden to call for 3-month suspension of gas and diesel taxes - Star Tribune

Introduction

Healthcare workers (HCWs) are the foundation of the response to a pandemic. Also termed as frontline workers, not only are they at a health risk but also suffer from emotional and psychological stress.

The objective of the study was to determine the emotional impact of novel coronavirus on healthcare workers.

An online survey was completed by 239 HCWsfrom five different countries during the peak of the coronavirus disease 2019 (COVID-19) outbreak amidst the lockdown. Their feelings and concerns as well as the safety measures they adopted were identified.

The response rate was 100%. Most of the respondents were 20-40 years old (85.36%)and working as doctors (73.22%); 44.77% were working at middle grade. The majority felt confused (19.67%), whereas others felt stressed/overworked (17.15%), unhappy (16.74%), scared (13.81%), nervous (13.39%), motivated (8.79%), and privileged (5.86%). A few felt pressurized to perform their duty (4.6%), and 69.87% felt that it was their moral obligation to continue their duty, whereas 13.39% felt administrative pressure for the same. Of the respondents, 53.97% feared transferring the disease to their family and friends, while others feared the lack of personal protective equipment (PPE) (13.39%). According to the majority of the respondents (25.94%), support from family and friends had them going through the crisis. The most common safety measure adopted by the HCWs was strict hand hygiene (43.51%). The HCWs (28.87%) felt that adequate and easy access to PPE would have helped them better during the pandemic.

Healthcare institutions are responsible for protecting HCWs or frontline workers during pandemics so they can continue with their duty. From our study, we have concluded that simple protective measures as uninterrupted and easy access to PPE would have helped HCWs deal with their stress and concerns.

Since the severe acute respiratory syndrome (SARS) outbreak in 2003, the 21st century has seen numerous pandemics [1]. Epidemiologically speaking, these infections have no borders to spread because of extensive international travel [2], hence infecting huge numbers all around the globe.

Similarly, the year 2020 has been faced with a new pandemic starting in December 2019 in Wuhan, China, as unusual pneumonia caused by a new coronavirus [3,4]. This is the third outbreak caused by a coronavirus, the first and second being SARS and Middle East respiratory syndrome (MERS), respectively. The novel coronavirus 2019 is officially named SARS-CoV-2 [3]. It was declared a global emergency of international concern by the World Health Organization (WHO) on January 30, 2020 [3].

As of April 28, 2020, the total number of confirmed cases of the disease has been 2,954,222, with 202,597 deaths globally [5]. On the other hand, China alone has had 82,875 confirmed cases and 4,633 deaths as of May 2, 2020 [6].

When the pandemic gained global attention, a sudden decline in personal protective equipment (PPE) supplies [7], startling media reports, a huge influx of patients into hospitals, and a shortage of utilities secondary to bulk buying in lieu of an impending crisis and comparison with previous Coronaviridae outbreaks lead to uncertainty, vulnerability, panic, fear, distress, anger, and feelings of loss of control. Then, social distancing and finally a lockdown were set in place, which made coping with the pandemic even more difficult as peoples financial circumstances changed.

As with any other pandemic, there is a dual effect seen with this virus; not only is there fear and panic in the population but also an increased burden on the healthcare system including healthcare workers (HCWs) [2]. As the experience with SARS showed that HCWs were the most infected with high mortality [1,8-10], fear and uncertainty are markedly present among the HCWs. Other feelings varied from anxiety, to stress, to frustration, to stigmatization [3,11]. Frontline workers were relocated to different departments and were asked to work in different institutions as a part of task force reassignment to deal with the suspected surge, as was previously observed during the SARS outbreak [11].

Frequently changing guidelines on infection control procedures and public health recommendations stirred confusion and anxiety [11].

We wanted to study the emotional impact of novel coronavirus 2019 on HCWs and how they chose to address these concerns.

This prospective, cross-sectional study was conducted using an open online survey filled by HCWs from hospitals caring for COVID-19 patients in the UK, the USA, Pakistan, Libya, and Saudi Arabia. The survey was conducted from April 23, 2020, to May 18, 2020. HCWs from all fields were eligible for participation. The survey was completely anonymous, and responses were kept confidential. The survey was completed by 239 participants. The work has been reported in line with the Strengthening The Reporting Of Cohort Studies in Surgery (STROCSS) criteria [12].

We aimed at assessing the feelings of HCWs during the SARS-CoV-2 pandemic, the reason behind their feelings, how they addressed their concerns, and their suggestions.

Demographic data including age, healthcare category, grade, and department (for physicians and nurses) were recorded and separately used to analyze risk factors.

Data analysis was done using the SPSS software version 25.0 (IBM Corp., Armonk, NY, USA).

Of the 239 participants, the completion rate was 100%. A total of 204 (85.36%) respondents were between 20 and 40 years, 33 (13.81%) between 41 and 60 years, and two (0.84%) more than 60 years (Figure 1, Table 1).

Of the 239 respondents, 175 (73.22%) were physicians, 32 (13.39%) were nurses, 14 (5.86%) were operating department practitioners (ODPs), nine (3.77%) were administrative staff, three (1.26%) were laboratory/radiology personnel, and two (0.84%) each of paramedics, clinical assistants, and pharmacists (Figure 2, Table 2).

Most of the HCWs belonged to the middle grade (107 (44.77%)), whereas junior and senior grades constituted 63 (26.36%) and 69 (28.87%) of the respondents, respectively (Figure 3, Table 3).

Physicians and nurses were optionally required to record their department. Out of the 175 physicians,163 answered this question, and the majority of them (55) belonged to general surgery, followed by general practitioners (13), anesthetists (10), and orthopedic surgeons (9). Seven physicians were from medicine;six each from pediatrics, accident and emergency, and otolaryngology;five each from nutrition and radiology; four each from gynecology/obstetrics, dermatology, and neurosurgery; three each from urology, intensive care, and dentistry;two each from pathology, nephrology, and maxillofacial; and one each from infectious diseases, ophthalmology, endocrinology, cardiology, neurology, elderly care, vascular surgery, physical medicine and rehabilitation, and public health.

The majority of the respondents felt confused (47 (19.67%)) during the pandemic. Forty-one (17.15%) felt stressed/overworked, 40 (16.74%) felt unhappy, and 33 (13.81%) felt scared. Other feelings included feeling nervous(32 (13.39%)), being motivated (21 (8.79%)), being privileged (14 (5.86%)), and feeling pressurized to perform duty (11 (4.60%)) (Figure 4, Table 4).

Of the HCWs, 68.87% (167) felt it to be their moral obligation to continue duty, while others felt administrative pressure (32 (13.39%)) for continuation. Twenty-five (10.46%) HCWs chose financial incentives as the main reason to continue working during the pandemic, and 15 (6.28%) had other reasons (Figure 5, Table 5).

Fear of spreading the disease to their family and friends was prevalent among the HCWs. Overall, 129 (53.97%) respondents chose this as their major concern. Lack of personal protective equipment (PPE) bothered 32 (13.39%) of the respondents. The HCWs were concerned about contracting the disease (17 (7.11%)), lack of established guidelines (11 (4.60%)), lack of a vaccine (8 (3.35%)), inadequate screening (8 (3.35%)), lack of knowledge about the virus or disease (7 (2.93%)), being overworked/understaffed (7 (92.93%)), and lockdown (7 (2.93%)). The lack of established treatment for the disease caused unrest among five (2.09%) of the respondents. Others feared media reports (4 (1.67%)), conflict among staff members (2 (0.84%)), and improper isolation (2 (0.84%)) (Figure 6, Table6).

The responses to how HCWs addressed their concerns included support from family and friends (62 (25.94%)), teamwork (47 (19.67%)), senior support (37 (15.48%)), established hospital guidelines (31 (12.97%)), relatively small number of patients testing positive (20 (8.37%)), hospital meetings (15 (6.28%)), support groups (5 (2.09%)), hospital psychiatry support (2 (0.84%)), and ongoing HCW benefits (1 (0.42%)). A total of 19 respondents had other ways to help them out during the crisis (Figure 7, Table 7).

Strict hand hygiene was adopted by 104 (43.51%) HCWs as a safety measure. Thirty-eight (15.90%) considered all patients as carriers, 32 (13.39%) adopted strict PPE use, 26 (10.88%) resorted to self-isolation/social distancing, and 18 (7.53%) had separate scrubs for hospital duty. Seven (2.93%) HCWs went on leave, and six (2.51%) strictly followed updates on the disease. Eight of them adopted other measures (Figure 8, Table 8).

When asked what would have helped them better deal with the situation, 69 (28.87%) responded with adequate and easily accessible PPE, and 67 (28.03%) thought better-established guidelines on screening, isolation, and treatment should have been in place. Thirty-seven (15.48%) suggested strict hand hygiene monitoring; for 33 (13.81%), a vaccine or treatment would have been reassuring, while eight ( 3.35%) wished for a financial incentive, seven (2.93%) asked for a compensatory time off, four (1.67%) suggested a voluntary opt-out of duty, and three (1.26%) carved for a little appreciation from authorities. Eleven (4.60%) had other suggestions (Figure 9, Table 9).

Our survey including 239 participants revealed a high prevalence of confusion and stress/being overworked in HCWs involved in the care of COVID-19 patients (19.67% and 17.15%, respectively). This is comparable to studies done during the SARS outbreak [13]. During a pandemic, HCWs are prone to a multitude of feelings [3,11]. Feeling unhappy, scared, nervous, motivated, privileged, and pressurized to perform duty were reported by 16.74%, 13.81%, 13.39%, 8.79%, 5.86%, and 4.60%, respectively. Previous studies during the SARS pandemicreported similar outcomes [3]. The long-term psychological implications of a pandemic have been studied with SARS and need to be kept in mind and assessed during the current pandemic [14,15]. HCWs should be trained in dealing with stress during an infectious outbreak to optimize their response and efficiency.

Doctors formed the majority of the respondents (73.22%), followed by nurses (13.39%). Most of the respondents were between 20 and 40 years of age (85.36%), and 44.77% of them were in the middle grade of their careers.

Another important aspect highlighted by our study was that 69.87% of the HCWs felt motivated to perform their duty during the pandemic despite all the fear, anxiety, and confusion. Because of their direct contact with COVID-19 patients and the fact that this disease has cross communicability [3], 53.97% of the HCWs feared transferring the disease to their family members and friends. Our survey also found out that support from family and friends (25.94%) and teamwork (19.67%) helped HCWs continue to perform their duty despite mounting pressure and fear.

As with any other infectious disease, hand hygiene was opted for by a mere 43.51% of the respondents as the primary safety measure, the numbers not as significant as would have been expected from HCWs. We want to stress the need for further infection control training and strict hand hygiene compliance monitoring for effective infection control and prevention. We would like to suggest that future pandemic response training should include infection control training as an integral part.

Our survey identified that measures as simple as adequate and easily accessible PPE would have made a huge difference in terms of reassuring HCWs as mentioned by 28.87% of the respondents. As observed initially, the sudden shortage of PPE was a rather important factor in causing emotional distress among HCWs as was noted earlier during previous infection outbreaks [7,11]. On the other hand, an almost equal number of respondents (28.03%) thought it would have been better if there were well-established guidelines on screening, isolation, and treatment of COVID-19 patients. Dealing with an unknown pathogen and a rather unfamiliar disease pattern makes it difficult, but diverting resources toward research, as observed during the coronavirus pandemic, was of paramount importance.

This survey demonstrated the emotional impact of SARS-CoV-2 on HCWs. The mental and emotional well-being ofHCWs is of paramount significance if they were to work efficiently. It is the responsibility of healthcare institutions to safeguard their HCWs and provide them with the means to cope with stress and anxiety. Working under stressful conditions during an infectious outbreak would lead to long-term psychological morbidity in HCWs, as previously identified.

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The Emotional Impact of Novel Coronavirus on Healthcare Workers: A Cross-Sectional Study - Cureus

As coronavirus cases continue to rise in Utah and the rest of the country, Summit County is one of five places in the state with a high coronavirus transmission risk.

The county in May was the first to have its designation increased from low to medium as cases reached the double digits nearly every day. As of Friday, 15 of Utahs 29 counties were rated as having medium to high transmission risks, according to the Centers for Disease Control and Preventions COVID database. Salt Lake and Tooele counties were in the top risk category with Summit County on Thursday with Grand and San Juan counties also receiving a high designation on Friday.

There were 250 confirmed COVID cases in the county between May 16 and May 31, according to the Summit County Health Departments COVID dashboard. The data also shows 116 additional cases 103 of which were reported in the unvaccinated population between June 1 and June 7.

Phil Bondurant, the countys health director, speculated the higher number of unvaccinated cases may be because those who are sick are likely experiencing severe symptoms, which leads to more COVID tests being administered.

He said individuals who are vaccinated often report mild, allergy-like symptoms that some people dont associate with the virus. In certain cases, an individual may choose to self-isolate or take other precautions, but those who dont suspect theyre sick may continue the cycle of spread and contribute to the uptick, Bondurant said.

Cases have been increasing on the West Coast over the last few months and he compared it to the rise in cases the East Coast experienced in late April. However, Bondurant said, the case numbers locally may be skewed because at-home testing kits can be inaccurate and its hard for health officials to gauge who is using them. Summit County is also testing at higher rates than the rest of Utah following the closure of state testing sites at the end of March.

The good news is hospitalization rates, which are considered an important metric in the fight against COVID, appear to be stable and indicate the countys situation is still manageable, the health director said. There have been nine hospitalizations with one person in the intensive care unit in the last 30 days and one COVID-related death has been reported since March, according to the Health Department.

Approximately 47% of people living in Summit County who are eligible to receive the COVID-19 vaccine have received a booster shot as of Friday. Close to 88% of residents have completed their vaccination series and 100% have received at least one dose of a vaccine.

Bondurant said several factors play a role in why the county hasnt been able to reach the 50% mark. First, many people may be waiting to receive their booster in the fall when they anticipate theyll have the highest level of protection against COVID or they consider themselves at a lower risk during the summer. Others may expect theyre going to catch the virus either way and dont want to go through the inconvenience of the shot, according to the health director.

Bondurant admits hed like to see the booster number higher and said the Health Department is continuing messaging about the importance of the vaccine, while also recognizing its a personal choice.

Its likely a COVID vaccine similar to a seasonal flu shot, or one combining the two, will be offered sometime soon, he said. Until then, the CDC recommends a second booster for adults over 50 and people 12 and older who are moderately immunocompromised.

Everybody is aware and everyone knows what COVID is and how to protect yourself, the risks, those different things, Bondurant said. People know where [the booster and vaccine is] available so at this point we continue to take those appointments and help people make the decision thats best for them and their families.

With summer here and tourists likely on their way, Summit County health officials urge Parkites and visitors to follow precautions to limit their exposure to COVID. Individuals who are unsure if they have contracted the virus are also encouraged to get tested. Testing is available from 9 a.m. to 1 p.m. on Thursdays in Coalville and Tuesdays in Kamas as well as 9 a.m. to 4 p.m. on weekdays in Park City.

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Summit County one of five in Utah with high coronavirus transmission risk - The Park Record

Long COVID continues to offer more questions than answers 27 months into the coronavirus pandemic, though researchers are slowly gaining a better understanding.

Long-term effects from SARS-CoV-2 infection, known more commonly as long COVID, has been the topic of more than 1,650 papers published in the National Library of Medicine since 2020.

When asked about long COVID, most physicians will offer up their experience and/or research with a caveat -- more research is needed to know for sure.

Were really just starting to work this whole thing out, said Dr. Matthew Sims, director of infectious disease research at Beaumont Health. Its complicated, its confusing. To be honest, I think were going to find that long COVID is the same sort of problem we see with other things and all the research thatll end up being done on long COVID, because its such a big issue, may help other diseases like fibromyalgia or chronic fatigue syndrome, that are really hard to figure out right now. We dont know.

Researchers have made some progress however. Below are some common questions and answers related to long COVID.

What is long COVID?

The typical definition of long COVID is long-term symptoms from SARS-CoV-2 that might be experienced weeks, months or even years after primary infection.

As for specific symptoms that linger, those vary.

A recent survey conducted by the Center for Health and Research Transformation (CHRT) at the University of Michigan found breathing issues were the most common ongoing symptom, followed by loss or distorted sense of smell or taste, and lingering anxiety, depression, or other mental health issues.

Other common symptoms were nervous system symptoms, neurologic problems, diabetes, heart problems, kidney damage, and fatigue.

The Cover Michigan Survey is a public opinion telephone and online survey that includes a random sample of Michigan adults. Its results were analyzed by CHRT staff, who said many of their findings were supported by national data and additional research.

I like to think this is sort of the tip of the iceberg with long COVID, because everything about this virus and this pandemic and this disease is so new and every day were still learning more stuff, said Melissa Riba, director of research and evaluation at CHRT.

In July 2021, long COVID became a disability under the Americans with Disabilities Act. An individualized assessment is necessary to determine whether a persons long COVID condition substantially limits them.

How common is it?

The Cover Michigan Survey found more than one in three Michiganders who reported a COVID-19 diagnosis identified themselves as a COVID long hauler. While the sample size was limited -- 138 individuals with COVID, of which 48 reported long COVID -- it matched or followed trends found in other studies.

Stretching globally, the University of Michigan School of Public Health analyzed 50 studies and more than 1.6 million people and found the prevalence of long COVID to be around 43%.

With the overall rates, if you look at most of the literature, it generally falls among the range of between 25% and 43%, with most sources falling within a more narrow range between like 30% to 35%, said Jonathan Tsao, a project manager at CHRT.

Its not yet clear which demographics are more or less susceptible to long COVID, though researchers are gaining clarity on that issue.

The risk factors for getting long COVID are somewhat similar to those people who are at increased risk for severe disease, said Dr. Liam Sullivan, an infectious disease specialist at Spectrum Health. That being said, theres a lot of people whove had mild COVID cases who have had issues with long COVID as well. So thats not really been fully delineated yet.

A Swedish study of more than 205,000 COVID patients founds that 32% of those admitted to an ICU developed long COVID. Thats compared to 6% of those hospitalized but not placed into intensive care, and 1% of outpatients.

Other groups that have reported disproportionate levels of long COVID are women, individuals 40 to 54, and persons with preexisting conditions, according to a 2021 study conducted in California and published by the CDC.

In Michigan, CHRT found women were four times as likely to report long COVID, and diabetics were twice as likely, compared to their counterparts.

Does the vaccine offer protection against long COVID?

A study published last month in Nature Medicine used 2021 Veterans Affairs health records to assess potential vaccine-induced protection against long COVID. The St. Louis, Missouri study determined COVID vaccination reduced risk of long COVID by about 15%.

It was one of, if not the largest, study to date. Researchers looked at records from 34,000 vaccinated people with breakthrough infections, 113,000 non-vaccinated people who got COVID, and more than 13 million people who had not gotten COVID.

The study revealed no difference in specific lingering symptoms or the severity of symptoms.

Dr. Sullivan said you have to be careful extrapolating those results to the general population however, when the study population were veterans with an average age in their 60s with underlying risk factors.

Getting vaccinated doesnt eliminate your risk for long COVID, he said. You still have risk for long COVID; what is starting to probably become clear is the risk is probably lower and that people dont get quite as severe long COVID, but that question still has to be more fully answered.

Sullivan said he anticipates the results of a larger study being conducted by CDC and some partner universities to better define and understand the scope of long COVID.

Whatre the economic impacts of long COVID?

The latest Cover Michigan Survey found long haulers are more likely to be in a worse financial situation than a year ago, compared to those who recovered from COVID and those who never got infected.

Because long haulers may be unable to function at their pre-COVID capacity, they are more likely to take longer medical leave, work reduced hours, have their salary reduced, or quit their jobs, researchers found.

A national survey of more than 1,000 COVID patients found that 44% of workers experiencing long COVID reduced their weekly work hours. A majority of respondents said they needed to take medical leave due to long COVID symptoms.

Researchers who analyzed Michigans long COVID data said theres a need for further study on the impact of state-wide efforts to assist long haulers. They recommend:

By publishing its survey results, CHRT researchers said they hope to raise awareness among lawmakers and business leaders as to the prevalence of long haulers, as well as for individuals who are suffering and feeling like theyre alone with their long-term symptoms.

We want to raise an alarm, raise a flag to say hey, this is potentially going to be and could be a really big deal for policymakers, for the state, for the economy, for the health care system and we need to be prepared, Riba said.

If you have any COVID-19 questions that youd like answered, please submit them to covidquestions@mlive.com to be considered for future MLive reporting.

Read more on MLive:

11 counties in U.P., northern Michigan have high COVID-19 levels; CDC says, recommends masking

COVID therapeutics becoming more common: Michigan COVID data for Thursday, June 16

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Novavaxs more traditional COVID vaccine could combat hesitancy, doc says

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Long COVID answers are coming into focus, slowly - MLive.com