Category Archives: Covid-19

When telogen effluvium occurs, the hair loss is rapid. We all lose about 100 hairs per day on average, but in the case of telogen effluvium, youre suddenly losing way more than that, Dr. Bhanusali says. He adds that people tend to notice it when they see large clumps in their hands after washing their hair, see lots of hair in the shower drain, or notice that their brush or comb is filling up much faster than normal. This isnt a gradual type of hair loss or subtle hair thinningits an acute, intense, sudden shedding that can leave your hair feeling less full overall and often manifests as noticeable thinness and sparseness along the sides of the temples.5

Its unclear if hair loss after COVID-19 correlates with any other specific symptoms of the virus or how sick you get. The American Academy of Dermatology has a COVID-19 registry and we hope over time we will be able to extrapolate some data to find associations, but so far there are no clear relationships, Dr. Kuhn says. I have seen severe shedding following a mild case of COVID, and mild shedding following severe illness.

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How long does hair loss after COVID-19 last?

Telogen effluvium, whether its caused by COVID-19 or another trigger, usually isnt permanent. Shedding can occur, however, for three to six months before it stops, Dr. Kuhn says. With telogen effluvium the hair growth cycle eventually normalizes and, because there is no damage to the scalp or hair follicles, all of the hair should grow back.

According to the American Academy of Dermatology, your hair will likely regain normal fullness after telogen effluvium within six to nine months. Although Dr. Kuhn says, in her experience, it often takes even longeranywhere from one to two yearsfor someones hair to reach its pre-shed status.

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Have any of the COVID-19 vaccines been linked to hair loss?

Theres no research to indicate that the COVID vaccines trigger hair shedding, Dr. Kuhn says, adding that, in her experience, she hasnt seen any people dealing with hair loss postvaccine. Dr. Bhanusali underscores the fact that theres currently no direct data to connect the two.

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How to stop hair loss after COVID-19

Most importantly, be patient. Though losing hair can be scary, I always reassure patients that they wont go bald from COVID-related shedding, Dr. Kuhn says. Typically, the best thing to do is simply wait it out. In the meantime, practicing healthy hair habits is paramount.

You want to make sure that youre doing everything you can to minimize the risk of losing any more hair, Dr. Bhanusali notes. That means avoiding heat styling and/or using the lowest temperature whenever you do, minimizing intense chemical processes such as highlighting and straightening, and avoiding tight hairstyles that put tension on the hair.

You can also consider getting tested for nutrient deficiencies to ensure thats not exacerbating the situation. If you are, in fact, lacking in a certain vitamin or mineral thats associated with hair healthDr. Bhanusali notes that vitamin D and iron deficiencies are commontalk to your doctor about how to incorporate more of it into your diet and/or if youll need to try a supplement (and if so, what the dosage should be).

And while its always easier said than done, lowering your stress levels may also help. Practicing self-care and engaging in things such as meditation and breathing exercises can be helpful as you deal with COVID-related hair loss, Dr. Ziering suggests. Breaking long-term stress can be helpful in helping normal hair function resume more consistently. That said, lowering stress levels may feel nearly impossible given whats going on in the world or in your personal life, so if self-care isnt cutting it, consider talking to a therapist if youre able.

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Hair Loss After COVID-19: Why It Happens and How to Treat It - Self

Spallanzani infectious disease hospital Director Francesco Vaia talks to reporters at the end of a news conference Friday in Rome. Andrew Medichini/AP hide caption

Spallanzani infectious disease hospital Director Francesco Vaia talks to reporters at the end of a news conference Friday in Rome.

The recent headlines about a sudden emergence of an unusual disease, spreading case by case across countries and continents may, for some, evoke memories of early 2020.

But monkeypox is no COVID-19 in a good way.

Health officials worldwide have turned their attention to a new outbreak of monkeypox, a virus normally found in central and west Africa that has appeared across Europe and the U.S. in recent weeks even in people who have not traveled to Africa at all.

But experts say that, while it's important for public health officials to be on the lookout for monkeypox, the virus is extremely unlikely to spin out into an uncontrolled worldwide pandemic in the same way that COVID-19 did.

"Let's just say right off the top that monkeypox and COVID are not the same disease," said Dr. Rosamund Lewis, head of Smallpox Secretariat at the World Health Organization, at a public Q&A session on Monday.

For starters, monkeypox spreads much less easily than COVID-19. Scientists have been studying monkeypox since it was first discovered in humans more than 50 years ago. And its similarities to smallpox mean it can be combated in many of the same ways.

As a result, scientists are already familiar with how monkeypox spreads, how it presents, and how to treat and contain it giving health authorities a much bigger head start on containing it.

Here are some of the other ways the public health approach to monkeypox is different from COVID-19:

Monkeypox typically requires very close contact to spread most often skin-to-skin contact, or prolonged physical contact with clothes or bedding that was used by an infected person.

By contrast, COVID-19 spreads quickly and easily. Coronavirus can spread simply by talking with another person, or sharing a room, or in rare cases, being inside a room that an infected person had previously been in.

"Transmission is really happening from close physical contact, skin-to-skin contact. It's quite different from COVID in that sense," said Dr. Maria Van Kerkhove, an infectious disease epidemiologist with the WHO.

The classic symptom of monkeypox is a rash that often begins on the face, then spreads to a person's limbs or other parts of the body.

"The incubation from time of exposure to appearance of lesions is anywhere between five days to about 21 days, so can be quite long," said Dr. Boghuma Kabisen Titanji, an infectious disease physician and virologist at Emory University in Atlanta.

The current outbreak has seen some different patterns, experts say particularly, that the rash begins in the genital area first, and may not spread across the body.

Either way, experts say, it is typically through physical contact of that rash that the virus spreads.

"It's not a situation where if you're passing someone in the grocery store, they're going to be at risk for monkeypox," said Dr. Jennifer McQuiston of the Centers for Disease Control and Prevention, in a briefing Monday.

The people most likely to be at risk are close personal contacts of an infected person, such as household members or health care workers who may have treated them, she said.

"We've seen over the years that often the best way to deal with cases is to keep those who are sick isolated so that they can't spread the virus to close family members and loved ones, and to follow up proactively with those that a patient has contact with so they can watch for symptoms," McQuiston said.

With this version of virus, people generally recover in two to four weeks, scientists find, and the death rate is less than 1%.

One factor that helped COVID-19 spread rapidly across the globe was the fact that it is very contagious. That's even more true of the variants that have emerged in the past year.

Epidemiologists point to a disease's R0 value the average number of people you'd expect an infected person to pass the disease along to.

For a disease outbreak to grow, the R0 must be higher than 1. For the original version of COVID-19, the number was somewhere between 2 and 3. For the omicron variant, that number is about 8, a recent study found.

Although the recent spread of monkeypox cases is alarming, the virus is far less contagious than COVID-19, according to Jo Walker, an epidemiologist at Yale School of Public Health.

"Most estimates from earlier outbreaks have had an R0 of less than one. With that, you can have clusters of cases, even outbreaks, but they will eventually die out on their own," they said. "It could spread between humans, but not very efficiently in a way that could sustain itself onward without constantly being reintroduced from animal populations."

That's a big reason that public health authorities, including the WHO, are expressing confidence that cases of monkeypox will not suddenly skyrocket. "This is a containable situation," Van Kerkhove said Monday at the public session.

Monkeypox and smallpox are both members of the Orthopox family of viruses. Smallpox, which once killed millions of people every year, was eradicated in 1980 by a successful worldwide campaign of vaccines.

The smallpox vaccine is about 85% effective against monkeypox, the WHO says, although that effectiveness wanes over time.

"These viruses are closely related to each other, and now we have the benefit of all those years of research and diagnostics and treatments and in vaccines that will be brought to bear upon the situation now," said Lewis of the WHO.

Some countries, including the U.S., have held smallpox vaccines in strategic reserve in case the virus ever reemerged. Now, those can be used to contain a monkeypox outbreak.

The FDA has two vaccines already approved for use against smallpox.

One, a two-dose vaccine called Jynneos, is also approved for use against monkeypox. About a thousand doses are available in the Strategic National Stockpile, the CDC says, and the company will provide more in the coming months.

"We have already worked to secure sufficient supply of effective treatments and vaccines to prevent those exposed from contracting monkeypox and treating people who've been affected," said Dr. Raj Panjabi of the White House pandemic office, in an interview with NPR.

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Monkeypox and COVID-19 are different in a good way - NPR

The global excess mortality associated with COVID-19 was 14.91 million in the 24 months between 1 January 2020 and 31 December 2021, representing 9.49 million more deaths than those globally reported as directly attributable to COVID-19.

The impact of the pandemic has been over several waves with each characterized by unique regional distributions, mortality levels and drivers. Twenty countries, representing approximately 50% of the global population, account for over 80% of the estimatedglobal excess mortality for the January 2020 to December 2021 period. These countries are Brazil, Colombia, Egypt, Germany, India, Indonesia, the Islamic Republic of Iran, Italy, Mexico, Nigeria, Pakistan, Peru, the Philippines, Poland, the Russian Federation, South Africa, the United Kingdom of Great Britain and Northern Ireland, Turkey, Ukraine, and the United States of America (USA). We are able to observe the evolution of the pandemic over these 24 months as different regions and countries were impactedby and responded to the threat of COVID-19.

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Global excess deaths associated with COVID-19, January 2020 - December 2021 - World Health Organization

They were the words everyone has been waiting to hearthat the COVID-19 pandemic is dialing down from the five-alarm fire that flared up in 2020 to a somewhat lesser conflagration. On April 27, the U.S.s chief medical advisor, Dr. Anthony Fauci, described the country as in a transitional phase, from a deceleration of the numbers into hopefully a more controlled phase and endemicity in an interview with the Washington Post.

His comments come almost two years to the day after pharmaceutical manufacturers shipped the first batches of their COVID-19 vaccines for early testing. Fauci noted that those vaccines, as well as drug treatments that can control the virus in infected people, are largely responsible for the fact that the initial urgency of the pandemic as a public health threat is over. But COVID-19 itself isnt quite finished with us. The virus continues to mutate, and the latest variations being reported out of South Africanew subvariants of Omicron including BA.4 and BA.5are sobering reminders that the virus isnt standing still.

Although we may be out of the urgent pandemic phase, were not quite ready to call COVID-19 endemic, which would mean the virus is still among us but relatively under control, similar to influenza.

And its not clear when that will happen. And even if it does, health experts may not all agree about the transition. There are no hard and fast definitions for pandemic and endemic, and no thresholds for case numbers or deaths that mark a shift from one to the other. The World Health organization considers a pandemic to be an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people. Experts have noted that these parameters say nothing about how quickly the outbreak is spreading, how much disease its causing, or what role immunity in the population plays.

But those are the factors that are critical for public health experts and political leaders as they manage a pandemic. There are no metrics for determining when to dial down an initial urgent response, or to pull back on drastic measures such as lockdowns and mask mandates.

Thats what the world is grappling with nowfiguring out whether the risk of SARS-CoV-2 is now at a point where we can treat it more like influenza, by protecting ourselves as much as we can with immunization and basic hygiene such as washing our hands and covering our coughs, or whether we still need to manage SARS-CoV-2 as a serious enough threat for most people that we should maintain public health measures such as mask-wearing and social distancing.

Read more: Most Americans Have Had COVID-19. That Doesnt Mean They Wont Get It Again

Fauci argues that we are somewhere in between those two situations, describing our current status as a controlled pandemicnot quite the urgent threat of a pandemic, but again not quite ready for the ease of mind that comes with being in an endemic phase of an outbreak. And the numbers support that: Since the beginning of the year, cases in the U.S. have dropped dramatically, from an average of 700,000 to 800,000 a week to 30,000 to 50,000 a week. About 66% of the U.S. population is now fully vaccinated against COVID-19, and deaths from the disease have declined steadily since January. We are clearly not in the same vulnerable place we were in 2020. The vaccines have provided some barrier to the virus, and that counts for a lot. But that immunity still isnt enough to declare COVID-19 over.

Nevertheless, those numbers encouraged a push to loosen public health restrictions that have been in place since 2021federal mandates that people wear masks in indoor settings, and on public transportation including subways, buses, trains and planes, as well as requiring proof of vaccination for certain gatherings at sports and entertainment complexes. In April, a U.S. District judge in Florida struck down the federal mask mandate, declaring that it was unlawful and that the Centers for Disease Control had overstepped its authority in imposing it. The Biden Administration is appealing the ruling, but in the meantime, airlines and most public transit systems no longer require passengers to wear masks.

That coincided with an uptick in cases of COVID-19theres no direct way to prove one caused the other, but the coincidence is hard to ignore. After remaining at about 24,000 to 25,000 new infections a week in early April, cases started to inch upward again at the end of the month to nearly 50,000 a week on average. Hospitalizations are also creeping upward, although those trends lag behind case rates.

Those trends suggest that it may be too early to relax our vigilance over COVID-19, which remains a potent threat for a number of reasons. First, no vaccine is 100% effective in protecting against infection or disease, and the COVID-19 shots are no exception. While highly effective in warding off the worst COVID-19 symptoms from the original virus strain emerging from China, the shots are less effective in protecting against newer variants of SARS-CoV-2. And the virus continues to mutate, with each version appearing to improve on the last strains ability to infect quickly and efficiently. Fortunately these changes havent led to a more virulent strain so far, but they could veer in that direction, and cause more serious disease on top of being more transmissible. If that happens, the vaccines and drug treatments currently available might provide little, if any, protection at all.

That leads to the second reason that COVID-19 isnt fading into the background any time soon. Despite the effectiveness of the vaccines, scientists still dont know exactly what it takes to fully protect someone from COVID-19. That question actually breaks down into two related queries: What does it take to prevent infection in the first place, and what level of immunity is needed to protect against serious illness? Even into the third year of the COVID-19 pandemic, scientists still dont have solid answers for either.

Read more: Many Americans Are Celebrating the End of COVID-19. Heres What It Feels Like When Youre Not

While the mRNA shots in particular are effective at curbing COVID-19 disease, reducing the rates of COVID-19 symptoms by more than 90% among people who were immunized, the vaccines have been less effective in protecting people from getting infected in the first place. Thats not unusual for a vaccine, since the best way to block infection is with a pre-existing store of antibodies that can stick to the virus and interrupt them from infecting cellsand before getting immunized, most people in the world didnt have any antibodies against SARS-CoV-2. And even after getting vaccinated, antibody levels drop after a few months, which is why health officials have recommended booster doses. Those boosters have been slightly better at reducing risk of infection for this reason, but the vaccines are still not designed as a powerful way to stop infection.

They are far better at preventing serious COVID-19 disease. But even there, its still not clear exactly how much of an immune response, or what type, is enough to stop severe COVID-19 symptoms that can lead to hospitalization and even death. Studies of people who have been vaccinated, as well those involving people who have been naturally infected with SARS-CoV-2, are trying to shed some light on this, but scientists still cant point to exactly what kind of immune reaction will be essential to finally push SARS-CoV-2 back.

Such knowledge about what scientists call the correlates of immunity could go a long way toward shaping U.S. policy on booster shots in the fall. For now, the Food and Drug Administration and other public health experts are relying on antibody level data as a proxy to gauge how well vaccines work and what type of immunity is needed. But in a recent meeting of the FDAs vaccine advisory committee, the experts raised concerns about how reliable the current metrics of antibody levels are in serving as surrogates for these correlates of immunity. Until further research reveals how much immune protection is enough, its not likely that the world will move past seeing COVID-19 as a continuing pandemic threat, albeit, as Fauci proposed, one that is under better control now than when it first emerged in 2020.

Thats why the White House, with the support of the CDC, is pushing back on lifting the federal mandate for mask-wearing on public transit, and stressing that while the hospitalization and death numbers are trending in the right direction, the virus is far from gone and is still a threat to public health.

Its not likely that there will be consensus any time soon on when the pandemic shifts from even Faucis so-called controlled phase into becoming endemic. In the meantime, rather than waiting on broad declarations on whether the pandemic is over, some health experts are urging people to start making their own informed decisions about which behaviors and situations feel safe to them. If they have underlying chronic conditions that can put them at higher risk of severe COVID-19, such as diabetes or asthma, for example, or if they have compromised immune systems, it makes sense for them to continue wearing masks even on planes and trains where they arent required. Or if people live in households with elderly people or with children under six years old who arent eligible to get vaccinated yet, then continuing to wear masks in certain indoor settings and avoiding crowded situations might be wise.

Government and global health organization statements about the pandemic are critical for helping nations to navigate responses and allocate resources for addressing public health, but once those tools are in place, its up to us as individuals to use them in the combination and frequency that provides us with the most protection in our specific circumstances. Even if SARS-CoV-2 becomes endemic like the flu, it will remain a threat for certain groups, just as influenza does. For those people, it will be important to maintain all the behaviors that protect them from infection. For those who are less vulnerable, easing some of those protection measures might make more sense. While mandates have served as guides for the best way to battle the pandemic, going forward it will likely fall increasingly on individuals to rely on those guides to forge their own path forward as each of us learns to live with COVID-19, in whatever form it takes.

More Must-Read Stories From TIME

Contact us at letters@time.com.

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Why COVID-19 Isn't the Endemic Phase in the US Yet - TIME

The advice laid out in the 20202025 Dietary Guidelines for Americans says adults should consume just 1.52 cups of fruit and 23 cups of vegetables each day.

Yet only a small percentage of American adults end up meeting those thresholds, says a report published in the Centers for Disease Control and Preventions Morbidity and Mortality Weekly Report. And that fact has severe public health implications.

One in ten isnt good

A healthy diet supports healthy immune function and helps to prevent obesity, type 2 diabetes, cardiovascular diseases and some cancers, wrote the authors of the report, adding that having some of these conditions can predispose persons to more severe illness and death from COVID-19.

Examining 2019 survey data, researchers found that fruit and vegetable intake was low, with only about one in 10 adults meeting either recommendation.

Overall, they noted, just 12.3% of adults got enough fruit and only 10% met the mark on vegetables. The study, Adults Meeting Fruit and Vegetable Intake RecommendationsUnited States, 2019, was published earlier this year.

Discover what doctors wish patients knew about healthy eating.

Data tells a bleak story

The researchers also noted that meeting vegetable intake recommendations was highest among those 51 or older. There were also differences in vegetable intake between groups defined by income level and race. While 12.2% of adults in the highest-income households got enough veggies, only 7.7% of those living in middle-income households did. Meanwhile, 6.9% of Black adults met vegetable intake recommendations, compared with 10.1% of white adults.

This is an old public health issue, said Kate Kirley, MD, director of chronic disease prevention and programs at the AMA. Examining the national and state data only tell part of the story, but unfortunately the story that these data tell is quite bleak. We see very low fruit and vegetable intake across the population, and that is true regardless of how you break down the data according to different groups defined by demographics.

Vegetable intake, in particular, has a very concerning pattern with significant differences between groups defined by gender, race and incomedifferences that are the result of longstanding inequities, Dr. Kirley added. As you delve into more local datanot included in this studythese inequities often become even more stark.

Why today is different

Perceived barriers to fruit and vegetable consumption include cost, as well as limited availability and access, the report notes, adding that for some persons, such barriers might have worsened during the COVID-19 pandemic related to economic and supply chain disruptions that could further limit ability to access healthier foods.

Dr. Kirley said she hopes the pandemic will draw attention to this longstanding problem and that well start to see more investment in innovative solutions to promote health through better nutrition.

Tailored intervention efforts to increase fruit and vegetable intake are needed. States and communities should support food-policy councils to build a more sustainable food system, the report says. They also canimplement nutrition-incentive and produce-prescription programs that help people buy fruits and vegetables. Education and social marketing can also help raise awareness.

TheCME module Nutrition Science for Health and Longevity: What Every Physicians Needs to Know isenduring material and designated by the AMA for a maximum 4AMA PRA Category 1 Credit and helps physicians begin an effective nutrition conversation with patients. The four-hour, self-paced course is developed and hosted by theGaples Institute for Integrative Cardiology, a nonprofit focused on enhancing the role of nutrition and lifestyle in health care.

This course includes four modules that are distributed in collaboration with theAMA Ed Hub, an online platform with high-quality CME/MOC from many trusted sources to support lifelong learning of physicians and other medical professionals.

Learn more aboutAMA CME accreditation.

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Need another reason to boost fruit, veggie intake? Try COVID-19 - American Medical Association

As the United States transitions out of a pandemic footing and into a new normal, it is also undergoing a shift in which Covid-19 metrics most accurately tell the story of the pandemic. The old standbys case numbers, namely arent as reliable anymore. So whats going to replace them?

At least three data sets are now being watched closely by the public health experts who spoke to Vox. Together, they help shed light on whats happening now, whats likely to happen, and how well were doing at dealing with whats already happened over the course of the pandemic.

The first, hospital data, covers the present, showing the level of severe illness in a given area and the strain being put on the local health care system. The second, new data on emerging variants, concerns the future and the potential for radical mutations to send the pandemic spinning out into a dangerous new direction. And the third, data on long Covid, reaches from the past and further into the future, as scientists attempt to gain a better grasp of the collateral damage the virus has left in its wake after infecting roughly 60 percent of the US population in the past two years.

Keep in mind that the most important pandemic metrics have been a moving target since 2020. The percentage of tests that came back positive was watched closely as an indication of how widespread the virus was in a given place at a given time. But nowadays, with so many people taking at-home antigen tests and never reporting the results to anyone, most experts consider that metric now to be unreliable. Case numbers, the raw count of positive tests, were an obvious signal to watch for a long time too; not only did they track the crests and dips of different waves, any growth in cases was predictably followed by a rise in hospitalizations and deaths in the subsequent weeks.

But many experts have stopped tracking cases too closely as well. They have the same reporting problem if you get a positive at-home test result but dont report it, your case doesnt show up in the official count but its more than that. Covid-19 is going to be around in the future, as society and the economy are adjusting to a new reality in which most people are expected to tolerate a certain risk of contracting Covid-19. If the public health goal is no longer to constrain case numbers, then they arent as meaningful in telling us whether or not our public health strategy is achieving its goals.

Instead, what many public health experts are tracking now is severe illness, meaning hospitalizations and deaths. The data coming out of local hospitals can still give us a good idea of the toll Covid-19 is exacting, the strain its putting on local health systems, and early indications that existing immunity may be fading.

Im not watching case rates. We expect there to be lots of mild cases, Bill Schaffner, the medical director of the National Foundation for Infectious Diseases and a professor at Vanderbilt University, told me. But if hospitalization rates start to go up, theres probably more substantial waning immunity from vaccines and previous infections.

This is a new phase in the pandemic. Theres broader testing, vaccines, treatments, and new variants. Public health interventions are ending, leaving individuals to make their own risk assessments and choices about how to protect themselves. All of that demands a new approach to the coronavirus data that has become omnipresent in the last two years.

The dozen public health experts I contacted for this story were unanimous: They will watch hospital data most closely going forward. Some of those experts are still keeping tabs on cases as a general sign of the trends on the ground and because of the potential effect of long Covid to have a lasting effect in even mild cases.

But others said they were discarding cases as a major indicator, given the reporting limitations and the reality that society is shifting into a new phase of the pandemic where contracting Covid-19 is treated, for many people, as a tolerable risk. Theyre relying instead on metrics that measure the amount of severe disease in a community.

The vaccines cannot prevent every infection but are excellent in terms of preventing severe disease, and so I am looking at that metric as our metric of success in managing Covid-19 in this country, Monica Gandhi, an infectious diseases doctor at the University of California San Francisco, told me.

The overall number of hospitalizations is a good indicator of how prevalent Covid-19 is in a given community at a given time. But some number of Covid-19 hospitalizations may end up proving incidental, like if a person came to the hospital for a different reason and merely tested positive for the coronavirus as part of routine screening.

Thats why some experts said they were also looking specifically at the number of ICU patients admitted with Covid-19, more likely to be a real indicator of a severe Covid case, and the number of deaths attributed to the virus. Increases in those numbers would be a sign of something worrisome, either the virus evolving to become more lethal or existing immunity starting to wane.

ICU beds filling up would also mean the hospital runs the risk of not being able to care for all of its patients, which could worsen outcomes for patients and even contribute to unnecessary deaths. As Amesh Adalja, a senior scholar at Johns Hopkins University, told me, seeing hospital operations compromised because of an influx of Covid-19 admissions is one of the things that would cause him serious concern.

A rising mortality rate could also be a sign that the virus is evolving to become more dangerous. When I asked David Celentano, who leads the epidemiology department at the Johns Hopkins Bloomberg School of Public Health, what in the metrics would freak him out, he said: A major increase in mortality, which might be associated with a new variant. That is my nightmare.

For now, hospitalizations (down 8 percent over the last two weeks), ICU occupancies (down 21 percent), and deaths (down 25 percent) are still declining from their omicron peak. That is part of the reason that, in spite of a recent uptick in case numbers, the US government and businesses are continuing to push toward resuming normal activities. Theyre not trying to restrain case numbers anymore; these measures of severe illness have become paramount instead.

Data on new variants were top of mind for all of the public health experts I consulted. Radical mutations in the coronavirus are one development that could disrupt societys attempt to get back to normal. New variants are identified through genomic sequencing, though clues about emerging iterations of the virus can also be found in sewage, which is becoming a more integral part of our Covid-19 surveillance network.

Whenever any new variant is identified, experts told me that they are interested in three specific data points: how easily can it be transmitted, whether it causes more severe illness, and how easily it evades immunity from vaccines and previous infections.

If we had a virus that were to some degree substantially transmissible and could notably evade the protection of our vaccines, then wed be in trouble, Schaffner said.

The other set of data that will determine Covid-19s long-term consequences is on long Covid. Such long-term symptoms after an infection have loomed large over the pandemic, inspiring fears that a mild case of Covid-19 could still end up affecting patients for months after they ostensibly recover.

But there is still a lot we dont know about long Covid. Some preliminary surveys have suggested as many as 30 percent of people who get infected with Covid-19 may end up having persistent symptoms. But experts are doubtful the number is actually that high and are pushing for standardized attempts to quantify the problem. In the coming months and years, we should start to get an empirical understanding of how many people are affected, who they are, and what the consequences have been.

We need a much better study of long Covid. It is real and will likely lead to a sustained cost in terms of chronic illness for a large number of people, but how large that number is remains uncertain, William Hanage, a Harvard University epidemiologist, told me. Claims that 30 percent of people who recover have long Covid are not credible. However, even 1 percent would mean a lot.

The US government, businesses, and society at large are making the pivot to living with Covid-19. The virus is going to be with us going forward, so from hospitals to sewers to long Covid, its through these three metrics that the next revelations about where things are heading will be found.

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Covid-19 case numbers arent as reliable anymore. What are public health experts watching now? - Vox.com

The indie-rock band Sunsleeper returned to the studio to see how far down the rabbit hole we could go.

(Trent Nelson | The Salt Lake Tribune) Indie rock band Sunsleeper in Salt Lake City on Monday, April 11, 2022. From left are Jeff Mudgett, Jacob Lara, Matt Mascarenas, Cody Capener, and Scott Schilling.

| April 29, 2022, 12:00 p.m.

The Utah-based indie-rock band Sunsleeper were on tour in March 2020, and already had finished a couple of shows in South Dakota, when news from another Utah group on a road trip shook the world.

That other group was the Utah Jazz, and their game against the Oklahoma City Thunder on March 11, 2020, was abruptly canceled because Jazz center Rudy Gobert had tested positive for COVID-19. Within a day, the NBAs season was suspended, and other activities like rock shows were canceled around the country.

We were really looking at most of the year being out on tour, guitarist Matt Mascarenas said.

With touring off the table because of the COVID-19 pandemic, the band regrouped, added to its line-up, and started writing and recording new music. Listeners are starting to hear the results, with their recent single In the Clouds. The bands second album, whose name has not been announced, will be released later this year.

If we were touring, we wouldnt have [had] the time to write and also tour, said guitarist Cody Capener, one of the new additions to the band. He and bassist Jacob Lara joined the three original band members: Mascarenas, drummer Scott Schilling and guitarist/vocalist Jeffery Mudgett.

With nothing to distract us, it was just like lets be creative and see how far down the rabbit hole we can go, Mudgett said.

The bands new music came from all five members of the band compared to Sunsleepers debut album, You Can Miss Something & Not Want It Back, whose songs were mostly written by Mudgett and Schilling.

We all just wrote on our own, [brought] an idea to the collective and built it from there, Mudgett said.

In the studio, they built each song up, both vocally and instrumentally. That sometimes could be a juggling act with three guitars in the mix, which makes it easy to overplay. Lara said the band stuck to a mantra: The song is king, meaning they would do whatever it took being quiet, or coordinating riffs based on the needs of the song.

Thats carried over in the bands live performance, Mudgett said. Now we have an intention to have a really nice mix of all of our instruments [to] let everybody shine, he said.

In the Clouds is a nod to the bands new elevated sound. In press materials, Mudgett said the song was inspired by the summer of 2020, when the COVID-19 pandemic and civil unrest dominated the headlines. Many peoples true colors bubbled to the surface, he said. This song recounts the realization that many people I held in high esteem in my life ended up not being the people I thought they were, including myself.

The songs the band created during the pandemic are not as vague as what they made before, Capener said. I can look at each one of the songs weve recorded, and in each one either has a person that songs about, or something specific, he said.

(Trent Nelson | The Salt Lake Tribune) Indie rock band Sunsleeper in Salt Lake City on Monday, April 11, 2022. From left are Matt Mascarenas, Scott Schilling, Jacob Lara, Cody Capener, and Jeff Mudgett.

As the music industry starts to resume its regular cycles, the ones disrupted by the pandemic, the members of Sunsleeper say theyre more appreciative of the work they do.

Culturally, we all value art more [on] this side of the pandemic, Schilling said.

Mascarenas said the bandmates are more attentive to the little things like noticing how they stand on stage, or if their shoulders are hurting in a certain position. Its about being more present in the moment.

Lara agreed, saying, you just never know when its going to be taken away from you again.

Theyre proud of being from Salt Lake City, and motivated by being part of a flourishing music scene. They say their versatility is their strength, because it allows them to fit on just about any bill.

They agree that their favorite local venues to play are Kilby Court where theyre scheduled to play as an opening act for Slow Crush on May 9 and The Urban Lounge, though they appreciate a good house show, too.

They will be playing a few festivals later this summer, and have another single coming out in May. Beyond that, the band has a bucket list of bands theyd like to play with and places theyd like to perform with Tokyo a specific location where they want to make music someday.

Wherever they go, its kind of a dream for each of them that they get to play music at all.

It feels like a trick, Mascarenas said, like we won for a second.

Editors note This story is available to Salt Lake Tribune subscribers only. Thank you for supporting local journalism.

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When COVID-19 stopped the tour, a Utah band reworked their sound - Salt Lake Tribune

People who have been diagnosed with COVID-19 may be at a higher risk of developing the autoimmune disease Type 1 diabetes, according to a study of more than 27 million people across the United States.

Researchers found that patients who were infected with SARS-CoV-2, the coronavirus that causes COVID-19, were 42% more likely to develop Type 1 diabetes than those who did not contract COVID-19 during the study period.

The risk is highest among the youngest of pediatric patients (those under the age of 1 were at an increased risk of 584%) and elevated among older adult patients with COVID-19. The researchers also observed differences across race and ethnicity, with risk of Type 1 diabetes associated with a COVID-19 infection being most pronounced among American Indian/Alaskan Native (130% increased risk), Asian/Pacific Islander (101%), and Black patients (59%).

Trenton Honda, clinical professor and associate dean in the Bouv College of Health Sciences at Northeastern University

Particularly in pediatric populations, [COVID-19] is not usually a life-threatening, oftentimes not serious, condition. But Type 1 diabetes is usually a lifetime illness that requires dramatic amounts of contact with the medical community, increases your risk of death, increases your risk of long-term comorbidity, says Trenton Honda, clinical professor and associate dean in Northeasterns Bouv College of Health Sciences, and a member of the research team led by Fares Qeadan at Loyola University Chicago.

Our interest is really looking at the question, Are there going to be hidden costs, even among those who are not at high risk from COVID itself, because of COVID, later on? Honda says.

The scientists also probed whether patients who had Type 1 diabetes before contracting COVID-19 were more likely to suffer a serious, life-threatening complication called diabetic ketoacidosis after being infected with the virus. They found that those patients who had Type 1 diabetes and then were infected had a 126% increased risk of developing diabetic ketoacidosis compared to those who did not get infected. Their results were published in the journal PLOS One earlier this month.

Honda uses the word association when referring to the increased risk, careful not to say that a COVID-19 infection causes Type 1 diabetes onset.

We are the first study in the U.S. population in a really, really big national dataset to be able to say that people who got COVID appear to be at higher risk of developing Type 1 diabetes, although were not able to say that COVID caused that increased risk. It could be any number of things, he says. To establish that causal connection, Honda says, researchers would need to do a randomized controlled trial. Instead, the team looked at the anonymized data of more than 27 million people who came into contact with hospital medical care across the U.S. from December 2019 through the end of July 2021.

Theres other evidence that links COVID-19 infection to increased risk of being diagnosed with Type 1 diabetes. SARS-CoV-2 is not the first virus to be associated with an increased risk of Type 1 diabetes onset. It has also been linked to several viral infections such as mumps, rubella, cytomegalovirus, and Epstien-Barr virus.

It all comes down to the pancreas.

All of the cells in your body rely on sugar (glucose) for fuel, Honda explains. But some cells require prompting by a hormone called insulin in order to absorb glucose from the blood. Insulin is produced by the pancreas in response to changes in blood sugar.

Type 2 diabetes is typically an issue of insulin resistance developing in those cells that require it. But Type 1 diabetes is an autoimmune disease, Honda explains. Essentially your body produces antibodies and immune cells that go in and destroy the cells that produce insulin. So you end up with this precipitously low insulin level over time. And what that means is that the cells in our body that need insulin to get sugar into them stop using sugar and they start using fats. And by doing so, they change the entire metabolism of the body and institute an acidotic state that ultimately is fatal.

Before what Honda calls one of the greatest moments in all of medical history when insulin was purified from pigs, Type 1 diabetes was a death sentence. Now, its a lifelong disease that is survivable with glucose monitoring and insulin injections.

With other viruses, scientists think that the way the virus invades the cells in the pancreas causes them to spontaneously die, Honda explains. And when they die, the immune system mobilizes to destroy those dead cells. The idea, he says, is that this might foster the development of an autoimmune response to those cellsand it could get out of control and continue attacking those vital insulin-producing cells in the pancreas.

This is the way that other viruses are presumed to lead to Type 1 diabetes, Honda says. So thats the logic behind this study.

This study focused on COVID-19 cases in the absence of vaccines. Honda says the next big question is to determine whether immunization against SARS-CoV-2 is linked to any further or minimized risk of Type 1 diabetes.

The research team also aims to study associations between 40 other autoimmune diseases and COVID-19 infections.

If we think about just the burden of disease that COVID causes, its quite possible that the immediate disease is going to have a much, much smaller impact, particularly on people who are at low risk from the disease itself, Honda says. And we might end up with a huge number of lifelong disorders that developfrom the exposure to COVID.

For media inquiries, please contact Marirose Sartoretto at m.sartoretto@northeastern.edu or 617-373-5718.

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Study finds link between COVID-19 infections and Type 1 diabetes - Northeastern University

FRIDAY 4/29/2022, 1:52 p.m.

The Wisconsin Department of Health Services has reported 1,415,864 total positive coronavirus test results in the state and 12,883 total COVID-19 deaths.

The number of known cases per variant is no longer tracked as The Wisconsin Department of Health Services has updated its website, deleting that section.

Unable to view the tables below?Click here.

The DHS announced an attempt to verify and ensure statistics are accurate, some numbers may be subject to change. The DHS is combing through current and past data to ensure accuracy.

Wisconsins hospitals are reporting, that the 7-day moving average of COVID-19 patients hospitalized was 213 patients. Of those,29 are in an ICU. ICU patients made up 14.4%of hospitalized COVID-19 patients.

The Wisconsin Department of Health Services reports that 9,461,595 vaccine doses and 2,007,406 booster doses have been administered in Wisconsin as of April 29.

Unable to view the tables below?Click here.

The Wisconsin Department of Health Services is using a new module to measure COVID-19 activity levels. They are now using the Center for Disease Control and Preventions (CDC) COVID-19 Community Levels. The map is measured by the impact of COVID-19 illness on health and health care systems in the communities.

The Center for Disease Control and Prevention (CDC) reports two counties in Wisconsin are experiencing high COVID-19 community levels. none of them are in northeast Wisconsin.

Five counties in Wisconsin are experiencing medium COVID-19 community levels, including Green Lake in northeast Wisconsin.

Every other county in Wisconsin is experiencing low COVID-19 community levels.

For more information on how the data is collected, visit the CDCs COVID-19 Community Levels data page.

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Two counties in Wisconsin jump up to high COVID-19 community levels - WeAreGreenBay.com

BEIJING/SHANGHAI, April 29 (Reuters) - China's capital Beijing closed more businesses and residential compounds on Friday, with authorities ramping up contact tracing to contain a COVID-19 outbreak, while resentment at the month-long lockdown in Shanghai grew.

In the finance hub, fenced-in people have been protesting against the lockdown and difficulties in obtaining provisions by banging on pots and pans in the evenings, according to a Reuters witness and residents.

A video shared on social media, whose authenticity could not be immediately verified, showed a woman warning people via a loud-hailer not to do so, saying such gestures were being encouraged by "outsiders."

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The Shanghai government did not immediately respond to a request for comment.

In Beijing, authorities were in a race against time to detect COVID cases and isolate those who have been around them.

A sign placed outside a residential complex read "Entry only. No exit."

Polish resident Joanna Szklarska, 51, was sent to a quarantine hotel as a close contact, but she refused to share the room, which had only one bed, with her neighbour.

She was sent back home, where authorities installed a front door alarm. Then she was called back to the hotel, where she now has her own room.

"Nothing makes sense here," the English-language consultant said by phone.

At a regular press conference on Friday, Chinese health officials did not respond to questions on whether Beijing will go under lockdown or what circumstances might prompt such measures.

The severe curbs in China have appeared surreal to many parts of the world where people have chosen to live with the virus.

And the frequent signs of frustration among citizens will be uncomfortable for China's ruling Communist Party, especially as President Xi Jinping is widely expected to secure a third leadership term this fall.

Nomura estimates 46 cities are currently in full or partial lockdowns, affecting 343 million people. Societe Generale estimates that provinces experiencing significant mobility restrictions account for 80% of China's economic output.

New COVID cases in Beijing remain in the dozens, officials said on Friday, a far cry from Shanghai's numbers.

In Beijing's Chaoyang district, the first to undergo mass testing this week, started the last of three rounds of screening on Friday among its 3.5 million residents. Most other districts are due for their third round of tests on Saturday.

More apartment blocks were sealed, preventing residents from leaving, and certain spas, KTV lounges, gyms, cinemas and libraries and at least two shopping malls closed on Friday.

Medical workers in protective suits collect swabs from residents at a makeshift nucleic acid testing site amid the coronavirus disease (COVID-19) outbreak in Beijing, China April 29, 2022. REUTERS/Carlos Garcia Rawlins

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People who had recently visited venues in areas authorities declared as "at risk" have received text messages telling them to stay put until they get their test results.

"Hello citizens! You have recently visited the beef noodles & braised chicken shop in Guanghui Li community," one such text read. "Please report to your compound or hotel immediately, stay put and wait for the notification of nucleic acid testing."

"If you violate the above requirements and cause the epidemic to spread, you will bear legal responsibility."

The April 30-May 4 Labour Day break is one of China's busiest tourist seasons, and the travel industry is taking losses. read more

Companies reopening factories in Shanghai are booking hotel rooms to house workers and turning vacant workshops into on-site isolation facilities as authorities urge them to resume work under COVID curbs. read more

Many foreigners want to flee mainland China's most cosmopolitan city. read more

In response to COVID and other headwinds, China will step up policy support for the economy, a top decision-making body of the Communist Party said on Friday, lifting stocks (.CSI300), (.SSEC) from recent two-year lows. read more

Details were scarce, but markets reacted to a shift in messaging away from the single-focus on COVID, analysts say.

"Now the goal is to balance containing outbreaks and economic growth," said Zhiwei Zhang, president of Pinpoint Asset Management, who expects China's economy to contract in the second quarter.

"This suggests the government may fine-tune the 'zero tolerance' policy to allow some flexibility."

Chinese authorities say fighting COVID is vital to save lives.

"The battle against the COVID epidemic is a war, a war of resistance, a peoples war," said Liang Wannian, head of the National Health Commission's COVID response panel.

In Shanghai, authorities said more people have been gradually allowed in principle to leave their homes recently. More than 12 million, nearly half the population, are now in that category. read more

Still, many cannot leave their compounds, while those who can have few places to go as shops and other venues are closed. Often one of the 52,000 police mobilised for the lockdown asks them to return home.

Many residents have grumbled at the inflexible policing, which sometimes does not take into account health emergencies or other individual circumstances.

"Some individual policemen...are emotional or mechanical," Shu Qing, head of the Municipal Public Security Bureau, told reporters, admitting "shortcomings."

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Reporting by Martin Quin Pollard, Eduardo Baptista, David Stanway, Brenda Goh, Tony Munroe, Roxanne Liu, Albee Zhang, Wang Yifan, and the Beijing and Shanghai bureaus; Writing by Marius Zaharia; Editing by Lincoln Feast & Simon Cameron-Moore

Our Standards: The Thomson Reuters Trust Principles.

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'Entry only. No exit:' Beijing sees more COVID closures as anger grows in Shanghai - Reuters