Category Archives: Corona Virus

The Chief Clinical Officer of the HSE has said he is "very concerned" about the rise in the number of people in hospital with, or because of, Covid-19.

It comes as 606 confirmed cases of Covid-19 were reported in the country's hospitals this morning.

As of 8am there were 153 more people in hospital with Covid today than there were last Monday.

There were 453 people with confirmed cases in hospital on Monday 13 June.

Speaking on RT's Today with Claire Byrne, Dr Colm Henry said the rise is largely driven by a sub-type of the Omicron variant.

"This sub-type enjoys what is called a growth advantage over previous sub-types and is now displacing it as the dominant variant here. It's about 100% of cases in Portugal and now over 70% here."

Dr Henry said that although it is much more transmissible, it does not seem to be more virulent or aggressive.

"While hospitalisations are going up, we are seeing ICU numbers steady which is of some assurance," he said.

"Those who previously had immunity from previous variants, be they Delta or otherwise, can get infected again but they are much less likely to get seriously ill."

'Not too late to get vaccinated'

Dr Henry said there has been an increase in outbreaks in nursing home settings and residential care facilities but "nothing like we saw when we peaked in March following the surge of Omicron cases with earlier sub-variants but nevertheless, we have seen a rise at our operational clinical meeting this morning".

There has also been a rise in cases among healthcare workers.

Dr Henry said they are hearing that "they are not particularly sick but because they test positive, it does have that impact on services".

There has also been a rise in hospital-acquired infections, Dr Henry said.

On vaccinations and hospital cases, Dr Henry said: "The harsh reality is that if you look at hospitalisations, 606 this morning, unfortunately over half have not received their booster and over a third haven't even got vaccinated in the first place."

He said it is not too late to get vaccinated and "people who are unvaccinated in the first place have no protection from serious illness, no protection from being hospitalised and going to ICU or worse. It's not too late for those people to get vaccinated".

Latest wave of infection was 'predictable'

Dr Gerald Barry, Assistant Professor of Virology at University College Dublin, said the rise in case numbers in hospitals is reflective of what is going on in the general population.

He told RT's Morning Ireland that we are experiencing a further wave of Covid-19 and while around half of the cases identified in hospital are 'incidental' - that is patients are in hospital for another reason - infections are being picked up due to the ongoing testing in hospital settings.

Dr Barry said that this wave of infection was predictable up to eight weeks ago and talk of the reintroduction of mandatory mask wearing now was like "closing the stable door when the horse had bolted".

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He said it was likely that we were close to the peak of the current wave and he couldnt be sure that a mandatory mask wearing order would have much impact at this stage.

Dr Barry said the public should have been informed a month ago that this wave was coming. He said the focus then should have been about mask wearing, increased antigen testing and people adjusting their behaviour, to help reduce the peak of infection.

He said the virus is still causing a huge burden on the general population and the Government and the HSE needed to be more proactive in their ongoing communication and response to help reduce that burden.

Current wave to last 'two or three weeks'

Professor of Experimental Immunology at Trinity College Dublin, Kingston Mills, said he does not think there is a public appetite for mask wearing but that if everybody was wearing masks, it would make an impact on the transmission of the virus.

He said that there needs to be an "all or nothing" approach and that Covid is not seasonal.

He said that the current 'mini wave' could go on for two or three weeks, but long term we cannot give up on vaccines and boosters.

Professor Mills told RT's Drivetime that the big problem with hospitals is that the system is being stressed; healthcare workers are being infected and this is putting pressure on other healthcare procedures that have to be reduced, such as elective procedures, which is impacting people who do not have Covid.

Amid concerns that new variants may evade the vaccines currently in use, Professor Mills said updated vaccines are being produced and if they are rolled out in the autumn, with the flu vaccine, they will be closer to the strain of the disease that is circulating.

He said that another wave could come in the autumn but it totally depends on the virus and its mutation.

Dr Eoghan De Barra, consultant in infectious diseases at Beaumont Hospital in Dublin, said for the first time in a long time he is seeing patients admitted because of Covid rather than incidental Covid, where they tested positive while in hospital for another reason.

Dr De Barra said it is largely immunocompromised people, who have had some level of vaccination.

"They're not as sick as in earlier waves but still needed hospital care," said Dr De Barra.

He said it was really hard to say if we have reached the peak of this wave.

"When I see very immunocompromised patients, who have been very careful over [the] past two years, come in with Covid, I suspect there is a very high level in the community because they're the real tip of the iceberg of infection," he said.

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HSE 'concerned' over rise in Covid-19 hospital numbers - RTE.ie

WASHINGTON The White House on Thursday outlined the early stages of its plan for making coronavirus vaccines available this month to roughly 18 million children younger than 5, should the doses be cleared by federal regulators for the last group of Americans yet to be eligible.

With the goal of the first shots being given the week of June 19, the Biden administration has already made 10 million doses available to states and health providers, with roughly 85 percent of children in that age group living within five miles of possible vaccination sites, according to White House estimates shared with reporters.

Half of the 10 million doses were made available for order last week, the other half this week, with equal numbers of Pfizer-BioNTech and Moderna vaccines, the two that federal regulators are reviewing and could authorize as soon as next week.

Lets actually take a moment to understand what a historic moment this is, said Dr. Ashish K. Jha, President Bidens coronavirus response coordinator. It would mean that for the first time, essentially every American from our oldest to our youngest would be eligible for the protection that vaccines provide.

Health officials may confront a complicated persuasion campaign in many parts of the country, after an initial wave of vaccinations among eager families who have waited much longer than families of older children.

Uptake of the vaccine in other age groups offers a discouraging suggestion: Just over a third of children ages 5 to 11 have received at least one dose of a vaccine, a number that some health experts worry could forecast even lower interest among parents of younger children.

Orders from states have been somewhat tepid so far, according to data that senior administration officials provided to reporters in a briefing on Wednesday evening. Of the five million doses offered last week, 58 percent of those made by Pfizer-BioNTech have been ordered, as have roughly a third of those made by Moderna.

The officials, who spoke on the condition of anonymity to preview the formal announcement on Thursday, said the initial orders were typical of Covid-19 vaccination campaigns thus far, as states typically increase their orders over time.

A Kaiser Family Foundation survey conducted in April found that just 18 percent of parents with children under 5 said they would get them vaccinated right away, while 38 percent said they would wait and see. Their hesitation could be at least partly due to the fact that the virus is typically less risky for young children.

But Dr. Vivek H. Murthy, the surgeon general, said the risks were still significant. More than 30,000 children under 5 have been hospitalized with the virus, and almost 500 have died, outcomes he said could be prevented by vaccination.

As of Wednesday, new confirmed cases in the United States have been roughly flat at around 110,000 a day on average over the past two weeks, according to a New York Times database, after rising from lower than 30,000 a few months ago. Infections, though, are thought to be widely underestimated. Death counts have been volatile in recent weeks but remain below 400 per day on average.

We are not done with the pandemic. The virus is still here, Dr. Murthy said. Were still losing several hundred people a day to this virus.

He warned parents of a possible glut of misinformation targeting the shot for younger kids, the subject of an advisory his office issued last year.

Please make sure the information you are relying on is coming from trusted sources like your doctor, your local childrens hospital, your department of health, medical associations like the American Academy of Pediatrics, and the F.D.A. and C.D.C., he said, referring to the Food and Drug Administration and the Centers for Disease Control and Prevention.

Dr. Jha said on Thursday that health officials expected many children under 5 to be vaccinated by pediatricians and primary care physicians, a contrast to other age groups. But he and other officials on Thursday said they had organized a network of other locations that would work to get shots to families, including pharmacies and childrens hospitals.

To reach smaller pediatric offices and rural providers, the White House said Thursday, doses are being packaged by the hundred.

Government programs such as Medicaid, the Childrens Health Insurance Program, and the Women, Infants and Children Program will work with families to encourage vaccination. Other groups, including the American Academy of Pediatrics, the Association of Childrens Museums and the National Diaper Bank Network, will provide educational materials.

Delivery of the vaccines is contingent on the F.D.A. authorizing pediatric doses a step that could take place as soon as next week and the C.D.C. recommending them, which would formally initiate the campaign. The F.D.A. and its outside panel of vaccine advisers are set to meet Wednesday to discuss the shots for young children; the C.D.C.s own expert committee is scheduled to meet days later.

Dr. Rochelle P. Walensky, the C.D.C. director, would be the last to sign off.

Dr. Jha said he expected vaccinations to begin in earnest the following week, but suggested it could take time for some families to gain access.

Realistically, it means we could see shots in arms of kids under 5 as early as the week of June 20, he said of the federal review timeline, adding that the federal Juneteenth holiday on that Monday would mean many offices would begin administering the shots on Tuesday, June 21.

The vaccination program is going to ramp up in the days and weeks that follow with more and more doses and more and more appointments becoming available, he said.

Moderna is seeking authorization of its two-dose shot for children under 6, while Pfizer is asking regulators to clear its three-dose vaccine for those under 5.

Federal officials have said they are not pre-empting regulatory actions by announcing distribution plans for the vaccine before it is authorized. Instead, they have said, they are working to prepare families and physicians for the possible rollout. Last year, the White House was criticized for subverting the regulatory review that usually precedes vaccination campaigns when it announced a broad booster shot campaign before F.D.A. officials or their outside advisers had weighed in, a decision that proved divisive.

The deliberations over the vaccine for the youngest children are not expected to provoke the same kind of dissent. Parents were briefly given hope over the winter when F.D.A. officials worked to make an initial two doses of Pfizer-BioNTechs shot available to children as they studied a third dose. That plan backfired when data showed that two doses did not provide significant protection against the Omicron variant.

Moderna is proposing a two-dose regimen for children 6 months through 5 years old, using one-fourth the strength of an adult dose. Pfizer and BioNTech are working on a three-dose regimen for children 6 months through 4 years old, at one-tenth the strength of the adult dose.

Sarah Cahalan contributed reporting from Chicago.

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Covid-19 Testing and Mandate News - The New York Times

Babies whose mothers were infected with the coronavirus during pregnancy may face a higher risk of brain development disorders such as autism and bipolar disorder, a new study that examined more than 7,500 births suggests.

The finding, published Thursday in the journal JAMA Network Open, adds to the urgency to get coronavirus transmission under control even though newer variants are less likely to cause severe cases of COVID-19.

Other viruses, such as influenza and measles, are thought to make babies more vulnerable to conditions such as autism, schizophrenia and depression if they are exposed in utero. Researchers at Massachusetts General Hospital and Harvard Medical School wondered whether the same might be true about SARS-CoV-2, the coronavirus that causes COVID-19.

There are more than a decade of studies that suggest viral infection during pregnancy might be associated with neurodevelopmental disorders, so there was reason to be concerned likewise with this virus, said Dr. Roy Perlis, director of the Center for Quantitative Health at Massachusetts General Hospital and the studys senior author.

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The researchers examined data from electronic health records of deliveries that took place in eight medical centers in Massachusetts in the early months of the pandemic, between March and September 2020. The records tracked the babies development for a year after birth, looking for specific codes that would indicate a diagnosis of a developmental disorder related to motor function, speech or language, among other things.

The researchers found that among 7,550 babies whose mothers were infection-free during their pregnancies, 3% were diagnosed with a brain development disorder before their first birthdays. Among the 222 babies who were exposed to SARS-CoV-2 in utero, 6.3% received a diagnosis by the time they turned 1.

After the researchers accounted for other factors that could affect a childs risk for a neurodevelopmental issue such as preterm births, the mothers age and the babys gender they calculated that babies with prenatal exposure to SARS-CoV-2 were 86% more likely to be diagnosed in their first year compared with babies who werent exposed before they were born.

Perlis emphasized that the overall risk of developing these disorders remains low for all babies.

He added that one year is not enough to completely understand how prenatal coronavirus exposure affects children. Still, he said, he was surprised to find any link in the first place.

Candidly, I would have been much happier if we had seen nothing at all, he said.

In a commentary that accompanies the study, Dr. Torri Metz suggested that the coronavirus might not be directly responsible for the babies developmental issues.

We wonder whether it is the virus itself or the societal changes and stresses of the pandemic that are adversely affecting childhood outcomes, wrote Metz, a maternal-fetal medicine specialist at University of Utah Health.

But Dr. Kristina Adams Waldorf, an obstetrician-gynecologist who studies infectious diseases in pregnancy at University of Washington Medicine, said the findings were similar to research looking at infections caused by other viruses.

We know from previous studies, including one involving millions of pregnancies in Sweden, that exposure to different kinds of infections such as influenza during pregnancy can impact neurodevelopment of the child, said Adams Waldorf, who was not involved in the new study.

With the coronavirus, further research will be necessary to see whether the severity of a mothers infection matters.

Unfortunately, it is very possible that asymptomatic or mild infections might also be linked to neurodevelopmental disorders in the child, she said.

Regardless, the medical advice for pregnant women remains unchanged.

This should be another wake-up call for pregnant women to get vaccinated, and boosted, and stay masked and take as many precautions as they can, Adams Waldorf said.

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Coronavirus infection during pregnancy linked to brain development problems in babies - Los Angeles Times

The three sizable urban centers in the United States where the coronavirus is spreading fastest right now have something in common: They are major warm-weather tourist destinations.

Miami-Dade County, Fla., Honolulu County, Hawaii, and San Juan, P.R., are all averaging at least 85 new cases a day per 100,000 residents, with test positivity rates above 20 percent, according to a New York Times database. By contrast, the nation as a whole is averaging 34 newly reported cases a day per 100,000 residents, with a positivity rate of 13 percent.

As of Wednesday, new confirmed cases in the United States have been roughly flat at around 110,000 a day on average over the past two weeks, according to a New York Times database, after rising from lower than 30,000 a few months ago. And those are just the reported cases; widespread use of at-home testing means that many positive test results never make it into official tallies, experts say, and many people with mild or no symptoms may never be tested at all.

Much of the U.S. is experiencing summer weather, yet Covid-19 cases are surging, said Dr. Sandra Albrecht, an assistant professor of epidemiology at Columbia University. So I wouldnt expect to see this pattern look any different for warm weather destinations.

The only places in the country with higher recent figures than those three urban centers are smaller communities in Puerto Rico or Hawaii and a few isolated rural counties elsewhere.

Some U.S. regions that were hit early by the latest surge, like the Northeast, have been showing signs of improvement lately. But Miami-Dade has gotten steadily worse since early April, with its daily new-case average rising more than tenfold, hospitalizations more than tripling and deaths ticking upward.

The C.D.C. now considers it, along with much of Florida, to be a high-virus-level area where extra precautions are recommended, including wearing masks on public transportation and in indoor public spaces.

Dr. Mary Jo Trepka, who heads the epidemiology department at Florida International University, pointed to several factors that could be driving the surge, including flocks of spring-break tourists, recent big events like the Miami Grand Prix race, and widening public apathy about the pandemic.

I think people are no longer taking precautions as they did before, Dr. Trepka said. People were masking more here in the county, and we are seeing less of that. People are being less careful, because they are tired.

Mayor Daniella Levine Cava dropped all of Miami-Dades pandemic safety mandates in February, around the time the C.D.C. shifted its strategy on measures such as masks and social distancing. At the time, the federal agency said, many such restrictions were no longer needed in most of the country, although counties should calculate their own risk as conditions change.

When the latest surge took hold in April, Ms. Levine Cava urged residents to get vaccinated, wear masks, disinfect surfaces and maintain social distance, but the county has not made any of those measures mandatory.

In a statement on Wednesday, Ms. Levine Cava once again called on residents to take precautions on their own: get vaccinated and boosted, get tested if they show symptoms, and stay home if they feel sick. The best tools to fight the virus are the same ones we know and continue to use, she wrote.

Ms. Levine Cava noted that Miami-Dade was the most vaccinated county in Florida: and those efforts have paid off with fewer hospitalizations than in past surges. But caution was still warranted.

We have not beaten this virus, but we know how to control it, she wrote.

Mayor Rick Blangiardi of Honolulu County has taken a similar approach.

Coronavirus is not going away, he wrote in a statement on Wednesday. I encourage everyone to continue to demonstrate personal responsibility and wear your masks when around others, get tested if you are not feeling well and please make sure to get your booster.

Mr. Blangiardi said his administration was not considering reinstating mask mandates or other restrictions but that it would consider all possible solutions to any situation that warrants a response.

The county, which includes the islands of Oahu, Molokai and Lanai, has experienced a significant surge akin to Miami-Dades since early April, but in Honolulus case there are signs that it may have peaked. New virus cases have declined slightly over the past two weeks to 85 cases a day per 100,000 residents, and the positivity rate stopped climbing in mid-May.

Hawaii had some of the strictest travel restrictions in the country, requiring everyone arriving to the state to complete a 14-day quarantine. In March, it lifted its travel restrictions, allowing travelers from the continental United States to enter without testing and became the last state in the nation to remove its indoor masking requirement.

A month later, the states tourism industry recorded its highest traffic figures since the beginning of the pandemic, with more than 800,000 visitors arriving in the Hawaiian Islands, according to the states Department of Business, Economic Development and Tourism.

Mike McCarthy, the departments director, said in a statement that the tourism sector was showing strong recovery from the Covid-19 pandemic. He said he expected a gradual resumption of international travel by Japanese citizens typically a major share of visitors to Hawaii to strengthen the rebound.

In Puerto Rico, Gov. Pedro Pierluisi lifted nearly all pandemic restrictions in March, and new confirmed cases soon started rising. But tourism to the island has bounced back: Though arrivals from cruise ships had not yet reached prepandemic levels, business travel for meetings and conventions was improving, Discover Puerto Rico, the islands official tourism website, said in late April.

Kenira Thompson, president of the coalition of scientists and vice president for research at Ponce Health Sciences University in Puerto Rico, said that older and immunocompromised people there should consider continuing to wear masks in crowded places, and that those who are eligible for booster shots should seek them out.

Dr. Alain Labrique, the director of the Johns Hopkins University Global Health Initiative, said the summer tourism season meant large gatherings and increased contacts between people, a recipe for the easy spread of infection, even if fewer people are experiencing serious illness.

Covid-19 hasnt disappeared as much as our patience for precautions has, he said.

See the article here:

Miami-Dade, San Juan and Honolulu Have Become Covid Hot Spots - The New York Times

Throughout the pandemic, the SARS-CoV-2 virus has laid bare weak points in the worlds health care systems. This has been true in arguably every country and every community, but the fractures have been especially apparent in rural areas, where poor access to health care long predated the pandemic.

In this three-part story, Undark explores the gaps in rural health care systems around the world, following the daily work of a village health worker in a small township in central Zimbabwe; a newly graduated rural doctor on a required year-long stint at a remote clinic in northern Ecuador; and a family doctor at a private practice in upstate New York.

Rural life in each of these countries is vastly different, and the challenges that the health care workers face, in some cases, also vary. In Hoja Blanca, Ecuador, for instance, its a three-day round trip just to send a Covid-19 test for analysis, requiring travel by motorcycle, bus, and ferry, and in Makusha Township, Zimbabwe, the health care worker gets around on a bike. Meanwhile, doctors in New York State have access to couriers and can hop in a car for house calls. There are also inequalities when it comes to vaccine availability, funding, and even access to basic medicines like ibuprofen.

But Covid-19 has also revealed common problems. There are far fewer doctors and nurses in these remote areas compared to their urban counterparts. Each rural community feels the pinch of badly broken health care systems on the national level. Covid misinformation and disinformation, as well as pandemic fatigue, reaches even the most remote areas. And as the pandemic lingers, all of the health care workers, no matter their country of origin, continue to toil to keep their villages safe.

This reporting project was created in partnership with Undark and produced with the support of the International Center for Journalists and the Hearst Foundations as part of the ICFJ-Hearst Foundations Global Health Crisis Reporting Grant.

On a recent Sunday, Lucia Chinenyanga, 42, navigates her bicycle through the bumpy terrain of Makusha Township in Shurugwi District in rural Zimbabwe, 200 miles outside the countrys capital city of Harare.

Chinenyanga, a village health worker, is headed to a nearby home to educate a family on vaccines and other Covid-19 protection measures. On her way, she meets Robert Nyoka, a local. As they talk, he expresses concern about his pregnant wife receiving her second dose of the Covid-19 vaccination.

Chinenyanga assures him its safe. Your wife can receive her second jab, she says. But should she feel any slightest side effect afterwards, she must report to the nurses to check her.

As a village health worker, Chinenyanga oversees and responds to the health needs of people in Makusha Townships Ward 9. She works at the local clinic. Her tasks include education around tuberculosis, home-based care for the elderly, monitoring pregnant women, and health awareness programsespecially on Covid-19 vaccines. The position required three weeks of training conducted by the Ministry of Health and Child Care, which coordinates health workers. She has worked in the village since 2019, the year before the pandemic hit Zimbabwe.

While nearly two-thirds of Zimbabwes 15.3million people lived in rural areas like Makusha Township as of 2020, rural health facilities in the country are often under-resourced, with fewer nurses and doctors compared to urban hospitals. Village health workers such as Chinenyanga fill the gap. And although the village health workers play an essential role in the primary health care system, providing care for the marginalized or remote communities in rural areas, they receive little paythe equivalent of $42 every month from nongovernmental organizations that work with the government.

The health sector in Zimbabwe is a mix of public and private facilities; the latter are costly, charging more and offering better services compared to government-run institutions. In Shurugwi, there are three private facilities, but most local residents cannot afford those services due to poverty and opt for the public clinics. Others rely entirely on the services of health workers who do community rounds. Shurugwi consists of 13 wards, with a population of 23,350 according to a 2014 census.

The pandemic has stretched the system even more. Over the past months, Covid-19 has increasingly become a dominant problem, killing high numbers of community members, Chinenyanga says in January following a spike in Covid-19 cases in the country. The deaths came with shortages of pretty much every necessity: quarantine facilities, personal protective equipment, medicines, and doctors. Like many places around the world, the country has also struggled with people sharing fake news about the dangers of vaccination.

Enforcing Covid-19 protocols can be draining for Chinenyanga. Every day she has to convince the rural villagers, mostly small-scale gold miners in the area, many of whom are skeptical of vaccines, to mask up, practice physical distancing, sanitize, and avoid gatherings at places like pubs, where people tend to forgo prevention measures.

Despite some pockets of vaccine hesitancy, as ofJune 7,2022, a total of4.3million Zimbabweans have been fully vaccinated for Covid-19, amounting to about28percent of the population.More than a millionhave received a booster shot.

In Shurugwi, people grew scared when family members started dying of Covid-19, Chinenyanga says. One family would lose both the wife and the husband at the same time. This is when locals started understanding that Covid-19 wasnt just a flu, but a deadly disease which had come to our community.

***

When Zimbabwe gained independence from the United Kingdom in 1980, the new countrys health sector adopted a strong focused health care system, moving from only providing more advanced health care services for the urban population to involving more vulnerable sections of the society in rural areas. Health workers like Chinenyanga now play a pivotal role in the countrys health systems, says Samukele Hadebe, a senior researcher at the Chris Hani Institute, a South African think tank.

In rural areas, the health workers must be empowered with both finances and resources to do their job effectively, he adds, as a majority of people rely on them.

If you come from a health background you will realize those who have succeeded in building universal health care or a viable health care system, it is not the specialist doctors, he says. Wherever there is a successful health care system, it is actually the basic community health care, the one that in some countries where they dont even earn salaries. Those are the people fighting to just get recognized. Those are the people who manage the fundamental work.

But over the years, Hadebe says, Zimbabwes government neglected the rural health sector by not taking care of its health care professionals and paying them inadequate salaries, which pushed many qualified workers to leave the country for better opportunities overseas. In Zimbabwe, the infrastructure is gone, he adds, and health workers from the basic to the specialist are leaving the country. Why? Not just because of the salaries, but because someone will leave the country because they are worried about social security.

Zimbabwes 2010 Health System Assessment from USAID, a U.S. federal agency focused on foreign development, shows that there was a dramatic deterioration in Zimbabwes key health indicators beginning in the early 1990s. The current life expectancy for Zimbabwe in 2022 is just under 62 years, a 0.43 percent increase from 2021, according to projections from the United Nations.

With little hospital funding from the government, village health workers have to do their work with limited resources. Clinics likeChinenyangasin Makusha are poorly resourced and cannot accommodate patients with severe Covid-19 or other critical ailments, as there are no relevant medicines or oxygen tanks.

Even larger hospitals in Zimbabwe dont always provide oxygen to every patient, especially if the patient cant pay. You must have money upfront, Hadebe says. And how many people can access that? So, its a dire situation.

Itai Rusike, who heads the Community Working Group on Health in Zimbabwe, agrees that most rural health care facilities in the country were not equipped to deal with severe cases of Covid-19. In addition to the lack of oxygen tanks, he says, we also do not have intensive care units in our rural health facilities. Most of the rural facilities have no doctors, he adds, and the nurses who do work in rural areas may also not be well-equipped and skilled enough to deal with severe cases of Covid-19.

In November 2021, the Minister of Finance and Economic Development, Mthuli Ncube, announced that the country had acquired 20 million doses of vaccines. China reportedly committed in mid-January to donating 10 million doses over the course of 2022, which can be used for both initial and booster shots.

Rusike says that to ramp up the vaccination drive program, community outreach is needed, especially in rural areas. We need to take vaccination to the people, he says, rather than just wait for the people to come to the health facility and get vaccinated.

I think it is important, especially in remote locations, we come up with innovative strategies to take vaccination to the people, he adds. We know there are certain hard-to-reach areas where we can even use motorbikes to make sure that people can be vaccinated where they are, in their communities.

***

In addition to resource shortages, Chinenyanga has experienced another serious challenge most days in her work: vaccine misinformation and disinformation.

The problem is common across rural Zimbabwe, according to Rutendo Kambarami, a communication officer at UNICEF, who says that the most common reason communities are not taking the vaccine is fear.

Even though much of Zimbabwes population lives in rural areas, they still are connected on social media through mobile devicesand the mobile devices and social media platforms allow for plenty of access to inaccurate information and outright conspiracies about vaccines. So we realized that we needed to give more information in order to dispel misinformation, she said at a December workshop on Covid and mental health for journalists in Zimbabwe.

Village health workers, as front line workers, and even the teachers were saying: We needed to do more interpersonal communication within those areas. So, front line workers play an incredibly huge role in terms of even misinformation and disinformation.

As Chinenyanga wraps up her day, after visiting several homes, she agrees that social media has contributed to misinformation. The people she serves in the Makusha community often share with her unproven remedies to treat Covid-19. She lists some of the misinformation that shes seen so far. People believe in steaming, that it helps. They also believe that eating Zumbani, a woody shrub that grows in the country, also prevents Covid-19, she says.

Still, she manages to smile as she leans against her bicycle. She says she loves her job and its usefulness to the community. As village health workers, our role is to share information we are taught by the Ministry of Health, she says. We prioritize prevention as the most effective tool against Covid-19.

Karen Topa Pilalooks around the windowless reception area in the small health care station of Hoja Blanca, Ecuador, its pale yellow walls stained with patches of mold. When did the electricity go out last night? Topa Pila, a doctor in this remote corner of the country, asks. Her co-workers shrug, throwing worried glances at a small container filled with ice packs. Its only 8:30 a.m. one morning in December 2021, but outside its already over 70 degrees.

Topa Pila closes a cooler containing 52 Covid-19 nasal swabs. Those tests need to be refrigerated and we only have one fridge, which is exclusively for vaccines, she says. Her team has nowhere to store the tests, she adds, and so to avoid getting them spoiled in the jungle heat, the clinic wants to use up all of them on the same day. The very next morning, a health care worker is going to take them to the laboratory in the district hospital.

Topa Pila, 25, and her team arrived in Hoja Blanca, a village of 600 located in the heart of Ecuadors Esmeraldas province, in September 2021. As freshly graduated health care professionals, they all are required to serve an ao rural, working one year in a rural community in order to get their professional license or advance into postgraduate courses in medicine. (The Ministry of Public Health implemented the ao rural in 1970, and the practice is also common across Latin America.) Topa Pilas team is the third deployed in Hoja Blanca since the start of the pandemic. The Hoja Blanca station is also responsible for six other communities, made up of mestizos, Indigenous Chachis, and Afro-Ecuadoriansabout 3,000 people in total. Some of the communities are so remote that to reach them, the health care workers traverse thick rainforest and then travel by canoe for a whole day.

Ecuador has suffered big losses from the pandemic. In the early months,corpseslittered the streets of the countrys biggest city, Guayaquil. By June 2020, the mortality rate from the virus reached8.5 percent, one of the highest in the world at the time. As of June 5, 2022, the countryrecorded35,649 official Covid deaths, although the real count is likely far higher.

Many public health experts agree that Covid-19 has also surfaced deep-rooted systemic problems in Ecuadors rural health care system. In 2022, Ecuador, the smallest of the Andean nations, reached more than 18 million inhabitants; an estimated 36 percent live in rural communities. As with private health care providers, the countrys public health care system is fragmented, divided among various social security programs and the Ministry of Public Health. There are about 23 physicians and 15 nurses per 10,000 people on average. But only a small portion of the countrys health care professionalsroughly 9,800, by the estimate of Dr. John Farfn of the National Association of Rural Doctors serve the more than 6.3 million rural Ecuadorians.

Although Ecuador is relatively financially stable, many Ecuadorians lack access to adequate medical care and the country has some of the highest out-of-pocket health spending in South America. In rural areas, access to hospitalas well as clinics like Hoja Blancasis hampered by bad infrastructure and long distances to facilities. Before the pandemic, Ecuador was undergoing budget cuts to counter an economic crisis; public investment in health care fell from $306 million in 2017 to $110 million in 2019. As a result, in 2019, around 3,680 workers from the Ministry of Public Health were laid off. Ecuador has also experienced long-standing inconsistencies in health leadership. Over the last 43 years, the country has had 37 health ministersincluding six since the start of the pandemic.

Before the Ministry of Public Healths selection system placed Topa Pila for her service, she had never been to Hoja Blanca, and it took her more than eight hours to get there. She says that when she first arrived at the modest health care station, she thought, This is going to collapse.

Early in the pandemic, Ecuador weathered shortages in everything: face masks, personal protective equipment, medications, and even health care workers. By April 2020, the government had relocated dozens of doctors and nurses from rural areas to urban hospitals and health centers, leaving many communities without medical attention.

At one point, says Gabriela Johanna Garca Chasipanta, a doctor who spent her ao rural in Hoja Blanca between August 2020 and August 2021, her team didnt even have basic painkillers like acetaminophen or ibuprofen. It was an infuriating experience, she says. I even had to buy medication out of my own pocket to give to some patients, the ones who really needed it and didnt have the economic means to get it. Some rural outposts had to resort to desperate DIY solutions during the worst months of the pandemic, says Esteban Ortiz-Prado, a global health expert at the University of Las Americas in Ecuadorjury-rigging an oxygen tank to split it between four patients, for instance, and using plastic sheets to create isolation tents in a one-room health center.

The pandemic has strained rural doctors in other ways, too. In 2020 and 2021, Ecuadors National Association of Rural Doctors received many complaints of delayed salaries, some more than three months late. There were rural health care workers who were even threatened by their landlords that they were going to be evicted, saysFarfn, a doctor and former association president.

Even under better conditions, remote health care outposts are only equipped to provide primary care. Anything more serious requires referral to the district hospital, which in Hoja Blancas case means a 300-mile round trip to the parish of Borbn.

The health administration used to take into account Ecuadors geographical and cultural diversity and the poor infrastructure in rural areas. But in 2012, the government restructured the system into nine coordination zones that public health experts say no longer follow a geographical logic. You cannot make heads or tails of it, saysFernando Sacoto, president of the Ecuadorian Society of Public Health. This is not just a question of bureaucracy, but also something that has surely impacted many peoples health.

Although there have also been significant developments in the health care sector in the past 15 yearsincluding universal health coverage and a $16 billion investment in public health from 2007 to 2016it mostly focused on the construction of hospitals, says Ortiz-Prado. But the countrys leadership didn't pay too much attention to prevention and primary health care, he adds. The system was not built to prevent diseases, but was built to treat patients.

In 2012, the government also dismantled Ecuadors Dr. Leopoldo Izquieta Prez National Institute of Hygiene and Tropical Medicinewhich was responsible for emerging diseases research, epidemiological surveillance, and vaccine production, among other things. (It was replaced by several smaller regulatory bodies, one of which failed completely, according to Sacoto.) The majority of a nationwide network of laboratories shut down as well. Sacoto and other experts believe that if the government had continued investing in the Institute rather than dismantling it, it would have lessened the severity of the pandemics impacts in Ecuador.

Initial plans to track and trace Covid-19 cases faltered; the country had barely any machines to process PCR tests, the gold-standard Covid-19 tests. During the first days of the pandemic, samples collected in Guayaquil were taken to Quito by taxi, Sacoto says, because that was the only place PCR tests were being analyzed. But public transportation to rural communities is limited, so even the few rural residents who had access to tests sometimes waited two weeks for test results.

***

Topa Pilas team tries to convince everyone they cross paths withthe butchers wife, people waiting for the bus, men at the cockfighting arenato take a Covid-19 test. While the PCR results are faster than they used to be, they still take a week, as one of the health care workers has to personally shuttle the samples to Borbna 3-day roundtrip that involves a motorcycle, two different buses, and crossing a river with a shabby ferry. Up until yesterday, we had Covid-19 rapid tests. Today, the [district] leader took all the tests we had, says Topa Pila. The district hospital had requested the rapid tests, she adds, because theyve run out of tests and they need them.

Since Hoja Blanca is fairly isolated, the community has had very few Covid-19 cases, and all were mild. Topa Pila fears having any patients in a critical condition, Covid-19 or otherwise, because all she can do is ask the villagers and ferry operator for help with transport. There are no ambulances. We dont have oxygen because the tank we have over there is expired and you cant use it anymore, she says. Weve asked for replacement but nothing has happened.

The way Topa Pila sees it, its a lot to ask of the inexperienced health care workers on their ao rural. We start from zero without knowing anything every year, she says, recalling that the previous team had already left by the time she arrived in Hoja Blanca. And all of those patients whose treatments have been supervised by a doctor for a year lose their treatments, because they knew the doctor would come to their house, she says. We arrive and dont know where they live, since as you can see there are no addresses here. The Covid-19 pandemic has further distanced the rural doctors from their patients, she adds. Between the lockdowns and the coronavirus, other health matters like childhood vaccinations have been put off.

As in other parts of Latin America, the Covid-19 crisis in Ecuador also allowed corruption to fester. Sacoto says he believes the health care sector has become a bargaining chip among politicians. There really are mafias embedded in, for example, public procurement, he says, because the public procurement system is so convoluted that only the person who knows how the fine print works benefits. Between March and November 2020, the countrys Attorney Generals office reported196corruption cases related to the Covid-19 pandemic, including allegations of embezzlement and inflated pricing of medical supplies.

Lately, there have been signs of improvement. After taking office in May 2021, the government of Guillermo Lasso has accelerated vaccination efforts against Covid-19, approved a new program to tackle childrens malnutrition, and announced a Ten-Year Health Plan to improve health equity.

Sacoto says he remains skeptical whether these plans will translate to concrete and lasting actions. A good start would be decentralizing the health care system by building more rural clinics, he says, which could build up a network for preventative care for everything from childhood malnutrition to future pandemics. Ortiz-Prado says the country should better integrate its fragmented health care systems to make it easier for patientsand their recordsto move between them when needed. And it needs to improve the working conditions and salaries of rural health care workers to make the work more appealing, Farfn says, while also creating more permanent positions focused on rural communities. There is a lack of concern, lack of budget, he says, adding, Its a vicious circle, and sadly, governments are trying to apply Band-Aid solutions for the health issues here.

But all of that is in the future. Now, back at the Hoja Blanca health care station, the lights flicker back on in less than a day. The vaccines in the fridge are safe. But the 52 Covid-19 tests are still at risk: A health care worker must take the cooler to the lab in Borbn. There were heavy rains the night before, though, and water levels havent dropped enough for the river ferry to restart operations. Its just the first leg of what will ultimately be a 13-hour journey, and the icepacks are quickly melting amid the balmy equatorial heat.

Before Covid-19, there were no doctors in the village of Otego in central New York. Now there is one. During the pandemic, Mark Barreto quit his job at the Veterans Affairs hospital 89 miles away in Albany and opened a family medicine practice in his basement.

Just 910 people live in Otego, which sits along the Susquehanna River in Otsego County, a pastoral landscape of rolling hills and narrow creek valleys. Barreto lives on a dead-end road, a single street with pastureland on both sides. The downstairs waiting room looks like it could be anywhere in rural Americaa row of identical burgundy chairs against a pale beige wall, kids art hanging above.

In early December 2021, two of Barretos neighbors make an appointment. April Gates and her spouse Judy Tator are both in their 70s. They live around the corner. A friend joined them for Thanksgiving dinner and subsequently came down with Covid. Two weeks later, neither woman has symptoms and both got negative results with at-home tests. But theyre worried. Theyve come to take PCR tests, plus get a blood pressure check for Tator.

You dont have to be symptomatic. Its never bad to get tested if youve had a positive exposure, says Barreto. Are we being overly precautious? Maybe. But particularly with your cardiac history, youre at higher risk.

I worry most about giving it to someone else, Gates says. Thats the biggest thing.

New York State has an estimated 20.2 million residents. Two years into the pandemic, over one quarter of the population has had Covidmore than 5 million cases and more than 71,000 deaths, according to the state department of health. In the first six months of the pandemic, New York hospitals were overwhelmed with more Covid patients than beds. While they've continued to be overstretched, thelimiting factoris staffing. A similar situation has played out across the country: Medical personnel have quit in record numbers, according to the U.S. Bureau of Labor Statistics. Turnover rates were four times higher for lower-paid health aides and nursing assistants than physicians, peaking in late 2020, JAMA reported in April.

The problems are most acute in rural areas that were already chronically understaffed. We have a health care shortage in the county, in the region, says Amanda Walsh, director of public health for Delaware County, just across the river from Otego. Walsh and her nursing staff averaged 12 hour days, seven days a week, for all of 2020. It was an insane amount of time, she says. The hours only eased after the state established phone banks with remote contract tracers, and Walsh started sending her team home by six, even though the work wasnt done.

In Barretos office, after 40 minutes chatting with Gates and Tator about their health concerns, Barreto swabs both patients, walks them out, and then calls a courier to pick up the tests. While he waits, he pulls up the Otsego County webpage. The Covid dashboard shows 7,235 total cases, and the county recently broke its record for most active cases, at 386. Before December, that number had never climbed above 300.

Barreto swivels away from his desk. In the first months of Covid, he says, medical systems that were already dysfunctional simply fell apart. Commuting to Albany on empty highways, hed pass a digital DOT sign reprogrammed to read: Stay home, save lives. He took the message to heart, wondering, he recalls: What is my role as a health care provider? Because we're expected to put ourselves in harm's way to help people. The problem is we didn't know what to do to help them.

For 15 years working in hospitals, Barreto had been dissatisfied with how he saw patients treated. He notes two problems. One is getting access in a reasonable amount of time. And two is continuity of care, he says. The ongoing relationship is key, someone who knows your full story, he says, because thats what your medical history is, its a story.

When Covid hit, he adds, things only got worse.

***

With each successive wave of Covid, the disease spikes in cities and then rolls out to rural areas. Towards the second half of 2020, both case rates and mortality rates were highest in rural counties, according to USDA researchespecially those only with communities of 2,500 people and under. The study pinpointed four contributing factors: older populations, more underlying health conditions, less health insurance, and long distances from the nearest ICU.

In December, omicron followed the same pattern, peaking in New York City two weeks before it really hit Otsego County, says Heidi Bond, who directs the countys department of public health. By early January, active cases in Otsego County shot up to 1,120 before the county abruptly stopped reporting the data. The health department was swamped, Bond says, and it was not possible to get an accurate number with the limited contact tracing and case investigation that is being done.

Sparsely populated regions like central New York, which have smaller health departments and hospitals, are easily overwhelmed during surges, says Alex Thomas, a sociologist at SUNY Oneonta who studies rural health care. Otsego County has fewer than 10 public health staff working on Covid, and 14 ICU hospital beds. Neighboring Delaware County has no ICUs.

In a 2021 study of New York public health staff, Thomas and his team found that 90 percent felt overwhelmed by work, and nearly half considered quitting their jobs. A survey from the Centers for Disease Control and Prevention of about 26,200 public health employees found similar results, with anxiety, depression, PTSD, and suicidal ideation among the fallouts. Thomas predicts dire consequences: We have a serious public health emergency, and there's nobody to take care of it.

Covid revealed long-term flaws in the system, and Barreto predicts the U.S. health care system will eventually collapse on itself. Bond has a more positive perspective: Health care is stronger now after the trial by fire, largely because we know a tremendous amount more than we did two years agoabout Covid, but also about how to help institutions adapt to evolving medical needs.

Before Covid, Bond adds, public health was certainly not a priority at the state or local level. Few elected officials wanted to invest enough or plan for providing robust care for a future crisis. Establishing better partnerships with community organizations let her team overcome these funding deficiencies. Having those in place moving forward, you know, things will happen much more quickly, she says, because we know who to reach out to, to just lend us a hand.

In Otsego County, dealing with the fallout of Covid became a community effort. Volunteers sent up a local Facebook group to share information and services; it quickly had more than 1,000 members. The local hospital organized an ad hoc County Health and Wellness Committee that met biweekly on Zoom. And between 50 and 100 locals representing medicine, public health, and social service agencies, non-profits, and churches exchanged information and ideas and then stepped up to help, says Cynthia Walton-Leavitt, a pastor at a church in Oneonta.

Still, Bond says she worries that public opinion will hamper her departments ability to prepare for the future. What I worry about is the fatigue, the kind of mental fatigue of Covid, she adds. We can't let our guard down.

***

Before Christmas, Barreto drives about 15 minutes to Oneonta to see his own doctor. Oneonta is the biggest city in six counties with 13,000 residents and has the closest hospital to Barretos home practice.

Barreto brings a list of questions, knowing how hard it can be to squeeze out answers from his doctor in the allotted 15 minutes. There are always two agendas. There's your agenda as a doctor, why you wanted to see the patient, he says. And then there's a patient's.

After his appointment, Barreto grabs breakfast and then heads to his first house call of the day. He says he enjoys making home visits like an old-time country doctor. He crisscrosses three counties to see patients, 50 miles in any direction, and gives them his cell number, encouraging them to call whenever they need him. He sees two or three people per daycompared to eight to 15 in former hospital jobs.

Barreto guides his minivan to the interstate and then climbs out of the valley to visit Al Raczkowski, age 88. A former combat medic, Raczkowski still struggles with PTSD, has partial heart failure and some dementia, and requires weekly visits from nurses and therapists through a palliative care agency.

The family has no yardthe hemlocks grow right to the door. Barreto knocks then peeks in. Raczkowski stands in his semi-finished basement wearing a winter coat. Hes not wearing his hearing aid so Barreto shouts: Al, is Maureen here? Do you know why I came?

Raczkowski sits down on a futon. You're here to check on me, he says. With that, Barreto gets to work. The room is crowdedfirewood and tools jumbled by a woodstove, cardboard boxes, cases of soda and seltzer. A miniature Christmas tree stands on one table, an unfinished instant soup cup on another. Barreto unearths a stool and sets up his laptop beside the soup.

Do you remember why were wearing these masks? Barreto asks. Raczkowski isn't sure. Remember about Covid? Were wearing these masks to prevent spreading disease. Raczkowski nods.

Maureen, Al's wife, appears and shuffles to a seat. For the next hour, the three converse as Barreto performs his examination, mostly asking Raczkowski questions that Maureen answers. How are things with the care agency? Without their help I dont even think we would be here, Maureen tells him. Living on this mountain for 76 years. The nurses give Raczkowski showers, check his blood pressure and vitals, and keep him company.

Barreto asks how the medication is going. Its OK, Raczkowski says, but youd do better with a bottle of brandy.

Maureen complains about her husbands other health care. She drove him 80 miles to the Albany VA to try his new hearing aid, only to learn it had been mailed. As for the new psychiatrist? She closed our case, Maureen says. An appointment scheduled for September never happened, she adds, and no one ever answered her phone calls.

After Raczkowskis appointment, back in his car, Barreto vents frustration: If you look at a hospital system, and you count the number of medical personnel, versus the number of administration, there's a skew that shouldn't be there. All that oversight, he adds, doesn't help your relationship with your patient. It doesn't help them get the medicine.

Then he winds back down the mountain road to his next appointment.

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On Three Different Continents, Rural Health Strains under the Weight of the Coronavirus - Scientific American

A positive result on a home COVID test. If you catch it once, can you catch it again? Turns out the answer is: Yes. Jakub Porzycki/NurPhoto via Getty Images hide caption

A positive result on a home COVID test. If you catch it once, can you catch it again? Turns out the answer is: Yes.

We regularly answer frequently asked questions about life during the coronavirus crisis. If you have a question you'd like us to consider for a future post, email us at goatsandsoda@npr.org with the subject line: "Weekly Coronavirus Questions." See an archive of our FAQs here.

You got sick with COVID back in January, so you figured you were done with the virus for a while. But then you began feeling a scratchy throat and a runny nose, took a home test just in case and that second line blazed red once again.

You might well be wondering: How this can happen? Is it possible to get COVID again just a few months or even weeks after recovering from a case?

We asked four specialists to answer frequently asked questions about reinfection.

I thought I was immune at least for a while after having COVID. Is that not the case?

If you caught a previous variant before the arrival of omicron that meant you had an 84% lower risk of infection, significantly lowering your risk of getting COVID again, especially in the months right after you were sick.

But the omicron variants changed that.

A study published in March found the risk of reinfection "increased substantially" with the emergence of omicron in November, says Juliet Pulliam, lead author of the study and director of the South African Centre for Epidemiological Modelling and Analysis.

There are several omicron variants now circulating around the world, and they are very transmissible and very good at overcoming immunity, whether it's from vaccination, prior infection or both.

These omicron variants don't just evade protection you might have gained from a non-omicron version of SARS-CoV-2; you can catch the newer variants of omicron even if you had the original omicron variant before.

And any protection from infection wanes over time, so if it's been a few months since your last COVID shot or since you recovered from a case, you're more likely to be susceptible to reinfection.

But there's some slightly good news: For now, the newest omicron variants don't seem better at overcoming immunity than the original omicron.

The most recent resurgence in South Africa is now being driven by omicron sub-lineages BA.4 and BA.5. With these variants, "the risk of reinfection seems to be about the same as it was for BA.1 so higher than for previous [non-omicron] variants but not any higher than the initially circulating omicron sub-lineage," Pulliam tells NPR in an email.

How soon could I get reinfected?

That's something experts are still trying to figure out. But 60% of reinfections from non-omicron variants between March 2020 and March 2021 in Denmark occurred less than two months after the first infection, researchers found in a preprint study, which has not been peer-reviewed or published.

That means you may have a shorter time of maximum protection than you thought after an infection.

Keep in mind: The Danish researchers only looked at 15 confirmed reinfections among 593 suspected cases. The number is low for a few reasons: for one thing, reinfections weren't as common then.

Because the newer variants are much better at overcoming prior immunity, our specialists say that if you recovered from a case of COVID fairly recently and then begin showing COVID-like symptoms, you should get tested to see if you have it again.

Is a reinfection more likely to be mild or could it be severe?

Research from South Africa suggests that prior infection does protect against severe outcomes, including hospitalization and death.

With reinfection, hospitalization and death "does seem to happen occasionally but both natural infection and vaccination seem to provide good protection against severe outcomes in most individuals," Pulliam says.

Another study from Qatar found that previous infection was about 87% protective against severe or fatal COVID-19.

But keep in mind that certain conditions such as having had an organ transplant, ongoing cancer treatments or heart or lung disease make you more vulnerable to bad outcomes, even if you've encountered the virus before through vaccination or infection.

"In immunocompromised patients," the intensity of illness "depends on the patient and it depends on how impaired their immune system is," says Jacob Lemieux, an infectious disease doctor at Massachusetts General Hospital. "We can't precisely say what the effect would be."

But the intensity of your illness also depends on how long it's been since your last vaccination or previous bout with COVID, since such protection wanes over time so staying current on your vaccine schedule is a good idea.

I took Paxlovid, and a few days later I tested positive again. Is this a reinfection?

According to Robert Wachter, a professor and chair of the department of medicine at University of California, San Francisco, this is probably not an example of reinfection but something different, known as "rebound," when some patients begin experiencing symptoms and test positive again 2 to 8 days after taking the medication.

That's what happened to Wachter's wife. After taking Paxlovid, her symptoms improved markedly and she started testing negative on rapid tests. But four days later, she developed new symptoms for the first round, she had a sore throat, fatigue, and a headache, and when it came back, it felt like a really bad cold with congestion and she tested positive again.

The potential for rebound made him rethink the use of Paxlovid among younger people who aren't as at risk of severe outcomes, he says. But if he were to get sick, because of his own potential risk factors, he'd still take Paxlovid.

That's because in the clinical trials, Paxlovid lowered the rate of hospitalization by 89% among high-risk people, so those who have factors putting them at risk, like being immunosuppressed or over the age of 65, see a major benefit from taking the antiviral. That protection is true for both vaccinated and unvaccinated people who are at high risk, according to a new study.

"That's real," Wachter says. "How meaningful that is for you really depends utterly on your rate of hospitalization and how much risk you have for a bad case that would make you very sick and potentially put you in the hospital or potentially kill you."

Do vaccines help prevent reinfection?

Getting vaccinated can help prevent infection and reinfection, so it's a good idea to get the shots even if you've had COVID before and thought you were protected.

"For those who are vaccinated and those who have been infected, they are much better protected," says Peter Palese, a professor and chair of the department of microbiology at the Icahn School of Medicine at Mount Sinai.

Especially if you had a serious case before, getting up-to-date on your COVID shots now means you will likely have a less-severe case if you're reinfected, Palese says.

"Vaccination vaccination vaccination. Because yes, it will not protect you against the emergence of mild disease, but they will protect you from having a ventilator, being the ICU" or dying, he says.

But the immunity offered by vaccines, especially against infection, begins to wane after a few months, so getting a booster (or a second booster if you're eligible) is a very good idea.

If you were hospitalized before with COVID and then received two mRNA vaccines, that blend of protection was 35% effective in preventing subsequent hospitalizations during the first omicron wave. If you got a booster, that number rose to 68% effective against hospitalization.

And no vaccine is perfect, so continuing to take precautions wearing a mask, getting tested if you have symptoms or are exposed to COVID, improving ventilation, and more is still recommended, especially during surges like the one the U.S. is currently seeing.

Can getting COVID multiple times have long-term effects?

Long-term damage from repeat reinfections, like organ damage, is "the big question, and I haven't seen any data yet that can address it," Pulliam says.

And experts believe each COVID case could lead to long COVID, even if you were fine last time.

One in five adults experience continuing health issues after acute cases of COVID, including "persistent symptoms or organ dysfunction," according to a study published by the U.S. Centers for Disease Control and Prevention.

"There does seem to be a risk of long COVID or symptoms after resolution of the acute infection in a subset of people, and we don't really know how common that is yet or how long it lasts," says Lemieux.

How am I supposed to cope with the emerging and changing information about reinfection risks?

"It's a really frustrating situation, because I think everyone wants to be done with this virus, but we're just not. And we live in an era where we just want complete information at our fingertips, but we don't have it," Lemieux says.

That means we need to stay alert to the ways each new variant is changing, and how we respond to it especially in the age of reinfection.

The same precautions used to prevent infection masks, distancing, vaccinations, and more work just as well for avoiding reinfection.

Another other point to keep in mind is that reinfections aren't that unusual for coronaviruses. "I don't think it's surprising the reinfection happens, because that's a feature of coronavirus biology," says Lemieux. "It's actually surprising, if anything, that it didn't happen more often with the initial variants."

Melody Schreiber (@m_scribe) is a journalist and the editor of What We Didn't Expect: Personal Stories About Premature Birth.

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COVID reinfection: Can you catch SARS-CoV-2 twice? : Goats and Soda - NPR

The UK may be entering its third wave of coronavirus this year, researchers warn, as official figures show infections are on the rise again in England and Northern Ireland.

The Office for National Statistics said its latest analysis of swabs from households across Britain revealed a mixed picture with a small increase in positive tests in England and Northern Ireland, while the trend in Wales and Scotland remained unclear.

The ONS data, which give the most reliable picture of the state of the UK outbreak, suggest that the steady fall in infections over recent months may have gone into reverse as cases are driven up by the more transmissible BA.4 and BA.5 Omicron variants.

According to the ONS survey, an estimated 797,500 people in England and 27,700 in Northern Ireland would have tested positive for Covid in the week ending 2 June, up from 784,100 and 24,300 respectively in the week before.

The emergence in November last year of the first Omicron variant, BA.1, sparked waves of Covid around the world. This spring, a second UK wave was fuelled by a more contagious relative known as BA.2. While BA.2 is now in decline, it has two more transmissible descendants, namely BA.4 and BA.5, both of which are on the rise.

Public health officials are particularly concerned about BA.5 which is spreading faster than BA.4 and responsible for fresh spikes in cases in Europe, particularly in Portugal and Germany. At the end of May, BA.5 made up nearly 14% of Covid virus genomes analysed in England, nearly double that for BA.4.

The latest ONS report shows that the percentage of people testing positive for coronavirus increased in London, the south-east and the north-wwest, but fell in the east Midlands, and Yorkshire and the Humber. While infections had been falling in all age groups, rates have now either levelled out or started to rise, with clear increases evident in 35- to 49-year-olds.

Sarah Crofts, head of analytical outputs on the ONS Covid Infection Survey, said: Todays data shows a mixed picture for infection rates across the UK, with small increases in England and Northern Ireland, likely driven by increasing trends in Omicron BA.4 and BA.5 variants.

Dr Stephen Griffin, a virologist at the University of Leeds, said Jubilee celebrations might have contributed to the rise, but were only part of the large increase in mixing, travelling and interactions between large groups that continue unmitigated in the UK since all protections were dropped earlier this year.

He said a particular concern was the recent rise in Covid hospitalisations. This may be driven solely by a greater number of infections, but mutations in the newest Omicron variants could also play a role.

It is important to emphasise that we are better placed immunologically to counter much of the potential for severe disease than we were in 2020 or 2021 due to widespread vaccinations, Griffin said. As we enter, astonishingly, our third wave of 2022, a complex pattern of immunity exists induced by vaccines, boosters and prior infection.

The spring booster programme and further shots in the autumn should prevent much of the severe disease seen in earlier waves of Covid, but Griffin said concerns remain about the situation in schools, since less than 10% of under-12s are vaccinated. Given the lack of protections in schools, this will likely prompt further infections in children and staff, with predictable disruption across the board and further increases in long Covid, he said.

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Covid infections on the rise in England and Northern Ireland - The Guardian

As the COVID-19 pandemic continues to impact people across the globe, different groups experience the virus and related restrictions differently. Children and adolescents face specific challenges based on their phase of life and how both the COVID-19 disease and measures designed to contain the disease impact them.

Children and adolescents are generally at low risk of infection, and if they become infected it is likely to be mild. However, some children and young people have had severe experiences with the disease, and a few have died.

Children and adolescents of all ages and in all countries are seriously suffering from the consequences of the pandemic. COVID-19-related measures are having a profound effect on their health and well-being and for some the impact will be lifelong.

For example, COVID-19 has created the largest disruption of education systems in history, affecting nearly 1.6 billion students in more than 190 countries.

In addition, according to the WHO Pulse survey on continuity of essential health services during the COVID-19 pandemic, published in August 2020, 90% of countries report disruptions to essential health services since the COVID-19 pandemic started. The most frequently disrupted areas reported include services essential for children, such as routine immunization including 70% of outreach services and 61% of facility-based services.

The harmful effects of the pandemic have not been distributed equally. Children living in vulnerable situations continue to be disproportionately affected in relation to their long-term health outcomes.

WHO/Europe continues to show its commitment to children and adolescents and to leaving no one behind as the world continues to grapple with COVID-19. Three areas of work are particularly important to ensure that children access health and social services according to their needs.

WHO/Europe has been engaging with Europes decision-makers and targeting parents, teachers and school administrators to ensure safe schooling during the COVID-19 pandemic.

WHO/Europe has been working with countries across the WHO European Region to minimize the disruption of essential health systems for children. A collaborative project with Kazakhstan, Tajikistan and Romania, funded by the Bill and Melinda Gates Foundation, aims to limit the indirect impacts of the COVID-19 pandemic on maternal, newborn, child, adolescent and aging health (MNCAAH) services.

WHO/Europe has been providing technical guidance to safeguard the quality of care for children affected by COVID-19 or other respiratory infections.

View original post here:

Considering the impact of COVID-19 on children - World Health Organization

MEMPHIS, Tenn. Coronavirus cases are on the rise across the country andShelby County is averagingmore cases than it has seen inmonths.

Like many cities nationwide, Memphis is dealing with another wave of the coronavirus.

Despite the exhaustion, Infectious Disease Specialist Dr. Manoj Jain feels he understands whats at stake.

I know people are frustrated about this, but really we have to be thinking about how we protect those who are vulnerable in our population, Jain said.

Over the last seven days, Shelby County is averaging 602 reported coronavirus cases a day. This is the most since February. Another trend health leadersare noticingis the increase in breakthrough infections, which Dr. Jain said was expected.

We know that the vaccine works. It works in preventing deaths and preventing hospitalizations. It doesnt work well in preventing cases that are mild or moderate, he said.

Another interesting stat from the Shelby County Health Department is over the last two weeks, nearly 1,000 children havetested positivefor COVID-19.

With cases ticking up, Dr. Jain recommendswearing a maskwhenyoure unable tosocial distance along with gettingvaccinated and boosted.

We know that second booster are clearly helpful. We know that second booster helps prevent the number of cases that occur. Weve seen it in other countries, weve seen it in our data in our own county, he said.

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Coronavirus cases on the rise in Shelby County - WREG NewsChannel 3

If you recently contracted COVID, how long are you protected and are you at risk of getting the virus again?

The question has been asked since the start of the pandemic, but as the virus continues to mutate, the answers have changed.

Omicron, for example, led to a major shift in "natural immunity," with many who had previously been infected susceptible to reinfection with the new version of the virus.

Now, as omicron makes up nearly all U.S. COVID cases, it's a question of how protection from one version of omicron will work against newer subvariants.

"At the beginning, we could very confidently, you know, sort of back in February, we could really confidently say that 90% of the people were not getting reinfected if they had COVID already," Chicago Department of Public Health Commissioner Dr. Allison Arwady said last week. "That's been dropping a little bit though around the world."

According to the Centers for Disease Control and Prevention, "after recovering from COVID-19, most individuals will havesome protection from repeat infections."

"However, reinfections do occur after COVID-19," the CDC states, adding that changes and mutations "can lead to theemergence of variantsthat can increase the risk of reinfection."

Last month, Chicago's top doctor said experts were seeing changes in immunity from infection.

"We are seeing people get COVID still, more of these what we call breakthrough infections," Chicago Department of Public Health Commissioner Dr. Allison Arwady said. "But importantly, 'natural immunity' also is not lasting. And so we know that when somebody has had COVID, it's as much about how recently they've had it in some ways, because we are still seeing pretty good protection if somebody had one version of omicron. But we are starting to see, as omicron has continued to evolve, we're starting to see some more people who had original omicron even in December, even getting some of these these new subvariants of omicron."

While such cases aren't the norm, Arwady said, they are starting to rise.

"If you have had COVID in the last few months, your production is pretty good, but we're starting to see some more there," she said.

Currently, Chicago and several surrounding counties remain under a "high community level" for COVID, per guidelines set by the CDC.

But Arwady also warned last week that people should not "try to 'get COVID to get it over with,'" in part because it remains unclear if they could still contract the virus after infection.

"Don't think that getting COVID means you'll never get COVID again," she said. "We see plenty of people get re-infected with COVID. The vaccine is the most important thing for protection."

The uncertainty surrounding natural immunity can be particularly confusing for those experiencing long COVID symptoms.

The CDC says most people with COVID-19 "get better within a few days to a few weeks after infection." But for some, symptoms may last even longer and in other cases may even disappear and then return.

"Post-COVID conditions can include a wide range of ongoing health problems," the CDC states. "These conditions can last weeks, months, or years."

A recent study from Northwestern Medicine showed that many so-called COVID "long-haulers" continue to experience symptoms including brain fog, tingling, headaches, dizziness, blurred vision, tinnitus and fatigue an average of 15 months after the onset of the virus.

"Long-haulers, are defined as individuals who have had COVID symptoms for six or more weeks,the hospital system has said.

But, according to the CDC, four weeks after infection is when post-COVID conditions could first be identified.

"Most people with post-COVID conditions experienced symptoms days after their SARS CoV-2 infection when they knew they had COVID-19, but some people with post-COVID conditions did not notice when they first had an infection," the CDC states.

Long-COVID symptoms can range from a wide variety of ailments, some of which may even disappear and then return later.

"Post-COVID conditions may not affect everyone the same way. People with post-COVID conditions may experience health problems from different types and combinations of symptoms happening over different lengths of time," the CDC reports. "Most patients symptoms slowly improve with time. However, for some people, post-COVID conditions may last months, and potentially years, after COVID-19 illness and may sometimes result in disability."

Testing can also become challenging for such groups as PCR tests can "stay positive for some time," experts said.

"Those PCR tests are very sensitive," Arwady said. "They keep picking up dead virus in your nose for sometimes for weeks, but you can't grow that virus in the lab. You can't spread it but it can be positive."

According to theCDC, some people who contract COVID-19 can have detectable virus for up to three months, but that doesn't mean they are contagious.

Public health officials recommend that even those who contract COVID remain up-to-date with their vaccinations and booster shots.

"I think realistically, this is a guess, but my guess - where we're heading, given that there's no sign yet that COVID has stopped mutating...we've got to keep it from turning into hospitalizations and deaths, which are actually pretty good at already between vaccines and treatments," Arwady said. "But I do think it's likely that in the fall, we probably will see an updated version of a booster that actually has been changed to be more protective against the ways in which COVID has mutated since then."

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How Long Are You Protected After Getting COVID and Can You Get COVID Twice? - NBC Chicago