Category Archives: Covid-19

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

NC rural hospital leaders talk about financial challenges

The COVID-19 pandemic has worsened staff shortages in rural hospitals, their leaders said Thursday, with the steps taken to compensate for those shortages contributing to the increased financial strain at their institutions.

After the constant stress of caring for critically ill COVID-19 patients, growing numbers of hospital staff retired, resigned, or left staff jobs to make more money working for agencies where they travel from hospital to hospital.

The stresses that were put on the healthcare systems, especially the rural hospitals, during the pandemic are actually continuing, Dr. James Hoekstra, president of High Point Medical Center, said during a webinar sponsored by the NC Healthcare Association. The hospital in High Point is a part of Atrium Health Wake Forest Baptist. Hoekstra is also on the Alleghany Health board of directors in Sparta.

Rural hospitals have faced financial troubles for years. A lot of the newer money problems come from the high cost to replace workers, Hoekstra said.

We have lost a lot of providers to retirement, he said. Weve lost a lot of providers to going to different areas of the country to travel and earn more money. Weve lost a lot of providers and staff to burnout and what weve been left with is a situation where weve had to hire a lot of what we call travelers or contract labor.

What weve been left with is less staff, more overburdened, and more expensive, he said.

The pandemic had accelerated some changes to healthcare increased use of telehealth medical appointments, for example, that include something called Hospital at Home, for people who are stable but sick enough to be in the hospital but receive care at home. Those patients are monitored electronically, and medical staff visit their homes.

Like most healthcare issues, telehealth is wrapped up in questions about money, specifically, how much it should cost.

A legislative committee on expanding Medicaid and improving access to health care heard presentations on telehealth this week. Chris Evans, vice president for public relations at Blue Cross NC, asked whether insurance companies should be charged facility fees for telehealth visits.

Blue Cross NC saw telehealth claims increase 7,500% in 2020 over the previous year, Evans said, while private insurers nationwide saw a 4,347% increase.

Behavioral health and primary care accounted for 92% of the 2.7 million telehealth visits Blue Cross NC paid for, she said.

The legislative committee also recently heard presentations on the states Certificate of Need law. Companies that want to build new hospitals, nursing homes, dialysis centers and other health facilities, or buy expensive medical equipment, must get permission from the state. Proponents of Certificate of Need laws say they prevent over-building. Critics say the laws stifle competition. Senate Republicans have for years pushed to repeal the states law.

Hospitals fear that repealing the law will result in competitors offering select medical services to people with private insurance, leaving the hospitals to care for patients who are uninsured or use government health insurance plans such as Medicare and Medicaid, which dont pay as much.

Repealing Certificate of Need will increase hospital financial losses and further imperil rural hospitals, Maria Parham Health CEO Bert Beard said during the webinar Thursday. Maria Parham Health, a Duke LifePoint hospital, has a hospital in Henderson and an emergency department in Louisburg.

That will put us under, he said. It will impact us from a workforce standpoint. It will take all the payers that have anything that support our safety net services, and all youll be left with is 24/7 urgent cares.

Dr. Roxie Wells, president of Hoke Healthcare, said legislators could help rural hospitals by applying for a federal program that increases payments for Medicaid patients hospital care. Hoke Healthcare is part of Cape Fear Valley Health.

North Carolina hospitals run a $2.3 billion deficit providing safety-net services to low-income patients, Healthcare Association spokeswoman Cynthia Charles said in an email. The federal program would help make up for part of that loss.

It really doesnt cost North Carolinians anything, Wells said, but it would be beneficial to be able to obtain those funds and use them for fixing outdated buildings, having services, strengthening the workforce and so many other things.

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COVID-19 increased financial strain on NC's rural hospitals, their leaders say - The Progressive Pulse

The Berkeley Unified School District on Thursday said is experiencing a COVID-19 outbreak, with the number of new on-site cases more than tripling to 91 last week and similar numbers appearing this week, according to the district's online dashboard.

Superintendent Brent Stephens said in a letter to the school community the district has seen a "significant uptick" in cases. The dashboard also shows 77 new cases at Berkeley High School in April compared to eight a month earlier.

"We are also experiencing a growing number of multiple-case infections in individual classrooms, on sports teams or among other groups," Stephens wrote. "This is likely due to the increased transmissibility of the Omicron BA.2 variant and may also be exacerbated by the loosening of masking restrictions. We work closely with the City of Berkeley Public Health Department to develop response strategies in these multiple-case instances."

The schools chief urged the school community to stay vigilant by staying up-to-date on COVID-19 vaccinations, masking, monitoring for symptoms and testing. He also urged people with symptoms to stay home.

Testing remains available at all district schools, Stephens said. Students and staff also can test at the Curtis Street entrance of Berkeley Adult School from 9 am to 4:30 p.m. weekdays.

The district also will distribute a limited supply of at-home tests to Berkeley High School students as they leave campus Friday.

For more information of Berkeley Unified's response to COVID-19, visit the online dashboard on the district website.

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Berkeley Unified COVID-19 Cases More Than Triple in a Week - NBC Bay Area

AMARILLO, Texas (KAMR/KCIT) Earlier this week, White House Health Advisor Dr. Anthony Fauci, said the country is coming out of the pandemic phase of COVID-19.

With the country exiting the pandemic phase and entering an endemic phase, many health experts are breathing a little easier now.

The first word I would think of is relieved, said Scott Milton, M.D, FACP, Regional Medical Director for the Department of State Health Services. This is a good thing.

You might be asking yourself, Whats the difference between a pandemic and an endemic?.

A pandemic is obviously what weve seen the last two years, which is uncontrolled spread of a virus across multiple communities, or countries, said Dr. Brian Weis, Chief Medical Officer at Northwest Texas Healthcare System.

When youre talking about endemic, youre talking about now a certain area where you find an outbreak, a geographic area limited to certain communities or to a certain time of year, so theres a seasonality to endemics, he said.

Dr. Weis added that a good example of seasonal endemics are influenza and RSV (Respiratory Syncytial Virus) for kids.

The phasing down of covid-19 will have an effect in a few areas, from a medical standpoint, is there a seasonality to it? We really have to have a way of detecting when it hits us, so theres a surveillance mechanism, Dr. Weis said. Once you do detect it, you have to be able to care for people that get sick with it.

Dr. Weis told KAMR that plans for isolation, protection of staff, medications, would need to be implemented.

Then theres the different ways of re-assessing resources due to changes in demand.

We have vaccination teams that have assisted the state for this period of time, and because sheer number of vaccination has gone down remarkably, we wont need those contracted teams, said Dr. Milton.

Despite the devastation and tragedy surrounding the pandemic the last two years, both Dr. Weis and Dr. Milton say theyre proud of how the medical community and humanity has responded.

Thats the way science works, it starts usually with a small bit of knowledge, and then it grows over time and youre able to apply that, and thats what Im most proud of, Dr. Milton emphasized.

Weve also seen some spectacular science, weve seen some spectacular humanity and the goodness of humanity, and the spirit of community, Dr. Weis said.

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COVID-19 moves into endemic phase, whats the difference? - KAMR - MyHighPlains.com

The Allegheny County Health Department reported 1,582 new COVID cases in the week ending April 27, marking four weeks of consecutive case increases.

The county health department reported 1,208 new infections for the previous week, which ended April 20. The current data shows the county now has roughly triple the 487 cases recorded at the beginning of April.

According to health department data, there were 72 hospitalizations in the last seven-day period, compared with 0 hospitalizations in the previous seven-day period. There were also three deaths due to COVID.

The seven-day moving average increased to 182.9 infections per day, up from 146.1 infections per day in the previous seven-day period.

Viral counts in county wastewater samples remained stable from the second to third week of April. The BA.2 subvariant accounted for about 85% of the detected virus.

The Centers for Disease Control and Prevention classifies the community level as low in Allegheny County.

About 72% of eligible people in the county are fully vaccinated.

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Allegheny County COVID-19 cases and hospitalizations on the rise - 90.5 WESA

Health personnel are preparing injection syringes with Covid-19 vaccine in 2021 in Copenhagen, Denmark. the country has now announced it will suspend its vaccination program and will review whether it's needed later in the year.

Ole Jensen | Getty Images News | Getty Images

Denmark has become the first country to halt its Covid vaccination program, saying it is doing so because the virus is now under control.

"Spring has arrived, vaccine coverage in the Danish population is high, and the epidemic has reversed," the Danish Health Authority said in a statement Wednesday.

"Therefore, the National Board of Health is now ending the broad vaccination efforts against Covid-19 for this season," it said. People will not be invited for vaccines from May 15, it said, although everyone will be able to finish their course of vaccination.

Denmark's Covid vaccination campaign began soon after Christmas in 2020. Some 4.8 million citizens have been vaccinated, the health authority said, with more than 3.6 million people receiving a booster shot.

At the same time, many people have been infected since the omicron variant became the dominant strain of the virus, it said, meaning immunity levels among the population are high.

"We are in a good place," Bolette Soborg, unit manager at the National Board of Health, commented.

"We have good control of the epidemic, which seems to be subsiding.Admission rates [to hospitals] are stable and we also expect them to fall soon.Therefore, we are rounding up the mass vaccination program against Covid-19."

Soborg insisted that the public can still be vaccinated over the spring and summer if they want, and that vaccination sites will remain open around the country.

He added that immunization was still recommended to people for whom Covid poses a heightened risk, such as those over the age of 40 and for unvaccinated pregnant women. "We also continue to recommend that you complete your started vaccination course," he said.

Denmark's move to suspend its vaccination program comes as the Covid situation around the world remains mixed. Europe and the U.S. have abandoned most Covid restrictions, but China is still imposing (or considering) lockdowns as the virus spreads in major cities like Shanghai and Beijing.

Far from scrapping its vaccination program altogether, however, the Danish Health and Medicines Authority said there will probably be a need to vaccinate against Covid-19 again in the fall as the virus continues to mutate.

New variants have emerged over the course of the pandemic, which is now into its third year. These have eroded the efficacy of the Covid vaccines that were developed in record time in 2020, although the shots authorized for use in the West remain effective at preventing serious infection, hospitalization and death from Covid-19.

With the vaccination program likely to restart in a few months' time, Denmark's health experts will be looking at who should be vaccinated, when the shots should be given and which vaccines should be used.

The Danish Health and Medicines Authority said it would continue to follow the development of the epidemic closely, and is ready to restart vaccination efforts again if there is a need to immunize additional target groups before the fall.

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Denmark becomes the first country to halt its Covid vaccination program - CNBC

Editor's note: This story was updated on March 11 to include all Commonwealth Campus locations as having CDC yellow or green COVID-19 Community Levels.

UNIVERSITY PARK, Pa. With cases of COVID-19 declining on Penn State campuses and across the state and nation, University officials are adjusting Penn States indoor masking policy to no longer require face masks be worn in many indoor common spaces on campuses in counties designated by the Centers for Disease Control and Prevention (CDC) to have low or medium COVID-19 Community Levels beginning Monday, March 7.

Based on the new CDC guidance, at this time, all Penn State campuses except for the College of Medicine will adjust their masking requirements. At this time, the College of Medicine will continue the mask mandate in alignment with Penn State Health to support patient care.

The masking requirement will remain in effect in classrooms, labs and other academic and creative spaces on all campuses, regardless of CDC COVID-19 Community Level designation, due to high-density congregation. Face masks will continue to be encouraged in all other common indoor spaces. Additionally, masks will continue to be required where mandated by law, regulation or rule includingunder guidance particular to individual workplaces or health care settings, COVID-19 testing centers and public transportation.

On Feb. 25, the CDC announced new, county-by-county COVID-19 Community Levels, as a new tool to help communities decide what prevention steps to take based on the latest data. Levels can be low (green), medium (yellow) or high (orange), and are based on the number of new COVID-19 cases in each county as well as new hospital admissions and hospital capacity.

Green counties: CDC recommendations call for individuals to stay up-to-date on their vaccinations and to get tested if they have symptoms of COVID-19.

Yellow counties: The recommendations advise those who are at high risk for severe illness to talk to their healthcare provider about their individual need to wear a face mask.

Orange counties: CDC recommends all individuals wear a mask indoors.

Our community really stepped up in January and February, embracing our mitigation measures to help us be successful in maintaining in-person classes and activities, allowing our campuses to thrive, said Penn State President Eric Barron. In consultation with our COVID-19 operations team, and recognizing that all but one of our campuses (Schuykill) are in counties currently designated by the CDC to have low or medium COVID-19 Community Levels, we have determined that we have reached a point where we can allow each individual to choose to wear a mask and no longer mandate that they be worn indoors, except in our academic and creative spaces. We are hopeful the diligence of our community in mitigating this disease will continue throughout the spring semester.

Penn State officials will continue to closely monitor changing pandemic conditions nationally and in the areas surrounding Penn State campuses. The University will alter plans, including the reinstatement of indoor masking mandates, if necessary.

Regardless of a campus COVID-19 Community Level, individuals who have not indicated to the University they are fully vaccinated for COVID-19 must still test weekly for the virus. University contact tracing will continue, and quarantine and isolation space for students will remain available.

Individuals who are experiencing symptoms of COVID-19 should not come to campus and should stay home. Faculty and staff should seek out symptomatic testing through their health care provider. At University Park, students living on campus or in the local community who are exhibiting symptoms of COVID-19 should continue toschedule testing appointments with University Health Services (UHS) via myUHS.Students living on or nearother Penn State campusesshould seek symptomatic testing via their campus health servicesor a local provider.

Kelly Wolgast, director of Penn States COVID-19 Operations Control Center, reaffirmed that since the beginning of the pandemic, Penn State has not seen any indications of virus transmission in classrooms or workspaces.

Our campuses are highly vaccinated communities and, along with declining case numbers, we are seeing hospitalizations decline as well at our local health care facilities, Wolgast said. Even with this shift in the masking mandate, individuals who feel that masking is something they wish to continue can of course continue this mitigation strategy.

Employees at Penn State who work in their own individual offices may request that visitors wear masks while in their private offices, and the University asks that community members cooperate with these requests.

Additional research protocols for mask wearing will be determined and disseminated by the Office of the Senior Vice President for Research.

The University continues to strongly encourage students, faculty and staff to stay up-to-date with their vaccinations, including booster doses. Students at University Park, Commonwealth Campuses and Dickinson Law who have received their booster shot canupload their vaccination records through myUHS.Faculty and staff who have received their booster shot can upload an image of their COVID-19 vaccination card into Penn StatesSalesforce Health Cloud, a secure online platform for collecting and storing health data.

For the latest information on the Universitys response to the coronavirus pandemic, visit https://virusinfo.psu.edu.

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PHOTO ILLUSTRATION BY EMILY SCHERER / GETTY IMAGES

As COVID-19 testing sites close and experts warn that case numbers are capturing a small minority of infections, many public health experts are turning to a newer source that might tell us whats going on with the virus: our poop.

In the past two years, scientists have developed systems that can detect COVID-19 in our wastewater. This is a great early warning system, since the virus can show up in peoples waste days before they begin to experience symptoms or are able to get tested. Its also less biased than case data: Not everyone can find a COVID-19 test and not every positive result will get reported but everybody poops.

As with so many other COVID-19 metrics, however, interpreting wastewater data is not as simple as it seems. Before COVID-19, this type of data hadnt been used to track respiratory viruses. This means the Centers for Disease Control and Prevention has little established infrastructure to build upon. The agency is attempting to standardize reporting from researchers across the country, many of whom have different water sampling methods. Plus, the state and local health officials who cite wastewater as a potential replacement for underreported case numbers arent used to interpreting data from the environment, which has unique caveats and requires a learning curve for those used to looking at numbers from hospitals and health clinics.

The Documenting COVID-19 project surveyed 19 state and local health agencies, as well as scientists who work on wastewater sampling, to learn about the challenges theyre facing. We found that many states are months away, if not longer, from being able to use wastewater data to guide public health decisions, even as the rise of an omicron subvariant, BA.2, looms. Meanwhile, the CDCs highly shared wastewater surveillance dashboard is a work in progress, and is difficult to interpret for users who might hope to follow the trends in their areas.

People are saying, We cant trust the [PCR] testing data now, and shifting to rely more on data from wastewater, said Steve Balogh, research scientist at the Metropolitan Council, a local agency in the Twin Cities, Minnesota, metro area that started wastewater surveillance in late 2020.

But health departments cant just flick a switch or gaze into the bottom of a toilet bowl and suddenly get comprehensive COVID-19 trends from wastewater. It takes time to set up sampling technology, understand the environment around a wastewater site and collect enough data for trends to be easily interpretable.

Some universities and their public health partners in California began investing in wastewater surveillance early in the pandemic. San Diego, for example, began wastewater sampling in fall 2020 as part of the campus reopening efforts for the University of California, San Diego, said Smruthi Karthikeyan, a postdoctoral researcher who works on the surveillance. It was later expanded to other parts of the city, including sites chosen to monitor COVID-19 at local public school districts.

Karthikeyans team uses machines called autosamplers, which are placed inside a sewage system and programmed to collect small volumes of water over time. These machines slowly collect a set amount of water over the course of 24 hours, which is a more thorough method than grabbing that volume all at once since it captures waste from the entire day. Researchers will then typically take a small portion of the wastewater, dilute it with other chemicals to preserve genetic material in the sample and run COVID-19 PCR tests to determine whether the virus is present. They might also run tests to look for specific variants, like omicron. Karthikeyans team uses robots to automate these analysis steps and cut down on errors; other researchers have more human-driven processes.

UCSD now processes about 200 wastewater samples daily, Karthikeyan said. When signs of COVID-19 show up in the wastewater for a particular site, another automated system alerts residents or workers of that site that they should get a PCR test. These alerts help contain outbreaks on UCSDs campus while minimizing testing costs.

People who receive the alerts feel like they have a reason to get tested, Karthikeyan said. And we get 98 percent compliance when we send out these emails to students. Other colleges and universities have similarly used wastewater to drive targeted testing.

The San Diego wastewater surveillance network also directs COVID-19 precautions at the UCSD Health system, with tiered guidance based on wastewater data (and a couple of other metrics) telling workers when they need to mask, reduce their in-person work hours or take other precautions. In March, just one week after the health system started using this guidance, wastewater trends prompted a return to mandatory masking.

But many places dont have the same resources to set up wastewater surveillance or peg public health actions to data as San Diego does. When asked if he knew of other institutions using wastewater to guide their safety measures, UCSD Health chief medical officer Dr. Christopher Longhurst said no: I couldnt point you to one.

In recent months, scientists in California have expanded wastewater surveillance to more rural parts of the state, with support from the states Department of Public Health. This poses new challenges: Public health officials often arent used to looking at data from outside hospitals or health clinics, and there are many logistical hurdles to setting up sampling in new locations, combined with the complications of interpreting data from less populous areas, where wastewater surveillance is highly sensitive to changes in COVID-19 spread.

One document from Stanford Universitys Sewer Coronavirus Alert Network (SCAN) describes how the genetic material shed by someone with COVID-19 may change: over the course of their infection, from person to person and depending on measurement techniques, the weather, an influx of spring breakers, or even local business practices. For example, Modesto a city in Californias Central Valley had a lot of fruit cannery waste in its sewage. This industrial flow may have blocked the signal of the coronaviruss genetic material, impacting scientists ability to isolate it in PCR testing, said Colleen Naughton, an environmental engineering professor at the University of California, Merced, who works on wastewater monitoring in this region.

The Maine Center for Disease Control and Prevention has faced similar issues as it expands monitoring from Portland, the states major urban center, to more rural communities, said Michael Abbott, who leads wastewater screening at the agency.

One of Portlands wastewater treatment plants has been a long-running collection site for Biobot, a wastewater monitoring company based in Cambridge, Massachusetts. In Portland, a city of almost 70,000, it takes a really significant increase in COVID-19 prevalence for the virus levels in sewage to begin ticking up, Abbott said. So when the wastewater goes up, the trend is easy to interpret.

But in rural parts of the state, some of which started monitoring during the omicron surge, the data tends to bounce up and down more rather than following a fairly smooth curve, Abbott said. Small numbers of cases may have an outsized impact on wastewater levels, particularly when those cases represent outside tourists going into tiny towns, as is common in Maine.

As public health officials learn to navigate wastewater data, several states public health agencies told us they dont yet consider the system a reliable source for making policy decisions at least not in isolation. A recent report from The Rockefeller Foundation found that many local agencies, especially those serving rural areas, dont have the internal capacity to go all-in on wastewater data as they deal with budget cuts and burnout.

The Minnesota Department of Health is working to expand wastewater sampling, agency spokesperson Garry Bowman said in an email. But this expansion would take weeks or months to turn into useful data, long after Minnesotas PCR testing numbers have become wholly unreliable. And even if Minnesota does expand its wastewater monitoring to cover the whole state, the agency isnt sure if the federal government will keep up its funding, said Bowman.

It would be hard to tell these local wastewater challenges exist, though, looking at the CDCs wastewater dashboard. Highly publicized upon its addition to the agencys COVID Data Tracker in February, the dashboard only showed one metric until early April: colored dots representing an increase or decrease in coronavirus levels detected at each site over the past two weeks. There was no context about the viruss actual prevalence or how recent trends compare to longer time frames.

If a site measures virus not detected (meaning no COVID-19) for three weeks in a row, and then measures a fairly low level of COVID-19, the CDC dashboard would show a 100 percent increase, said Zuzana Bohrerova, an environmental scientist at Ohio State University who works on Ohios monitoring program. A red dot on the dashboard might be a serious warning, or it might be unimportant the CDCs original presentation made it difficult to tell.

I think they were trying to be simpler, Naughton said of the CDC dashboard. They didnt want to release all the concentration data, since they thought thats difficult for people to understand.

On April 8, the agency updated this dashboard, adding new metrics and the option to click into a specific site for a chart showing wastewater trends at that location. The updates were intended to help users better understand changes in virus levels at different sites, CDC spokesperson Brian Katzowitz said. Wastewater experts who talked to me on Twitter said they were glad to see the CDC adjusting its data visualization. Still, theres room for other improvements that would make the data more easily understandable, Katzowitz said.

Even if thousands of new wastewater collection sites are added to the U.S.s network in the coming weeks, it will take serious investment in data analysis and communication for the country to actually use these numbers in predicting new surges. Expanding wastewater sampling can take weeks or months before the effort begins to produce usable data and it costs a lot money agencies aren't sure the federal government will continue to provide.

Despite its challenges, experts say that wastewater monitoring has potential beyond COVID-19 for other respiratory viruses, antimicrobial resistance, and even identifying entirely new viruses. But without continued federal support, we wont even be able to get useful COVID-19 surveillance at a time that its deeply needed.

This story was published in partnership with the Documenting COVID-19 project, which is supported by Columbia Universitys Brown Institute for Media Innovation and MuckRock. The project collects and shares government documents related to the COVID-19 pandemic and works on investigative journalism projects with partner newsrooms.

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The National Fight Against COVID-19 Isnt Ready To Go To The Sewers - FiveThirtyEight

For two years you didnt see friends like you used to. You missed your colleagues from work, even the barista on the way there.

You were lonely. We all were.

Heres what neuroscientists think was happening your brain.

The human brain, having evolved to seek safety in numbers, registers loneliness as a threat. The centers that monitor for danger, including the amygdala, go into overdrive, triggering a release of fight or flight stress hormones. Your heart rate rises, your blood pressure and blood sugar level increase to provide energy in case you need it. Your body produces extra inflammatory cells to repair tissue damage and prevent infection, and fewer antibodies to fight viruses. Subconsciously, you start to view other people more as potential threats sources of rejection or apathy and less as friends, remedies for your loneliness.

And in a cruel twist, your protective measures to isolate you from the coronavirus may actually make you less resistant to it, or less responsive to the vaccine, because you have fewer antibodies to fight it.

New York City, where one million people live alone, was for two years an experiment in loneliness: nine million people siloed with smartphones and 24/7 home delivery, cut off from the places where they used to gather. Therapists were booked up, even as tens of thousands of New Yorkers were grieving for a best friend, a spouse, a partner, a parent.

For Julie Anderson, a documentary filmmaker, it sets in every day at 5 p.m. the hour when she would be thinking of dinner with friends, evening plans, now shrunk to watching television alone. Stephen Lipman, a fine artist in the Bronx, feels it in the idle hours once a cherished time to work on his art, now drained of ideas or motivation. Eduardo Lazo, whose wife died of pancreatic cancer early in the pandemic, feels it every minute, as the end of the world they made together.

Who doesnt see suicide as an option at that juncture of life? he said. But Im religious, and that would terminate any chance I have of being with my wife or my loved ones when Im dead. I cant jeopardize that possibility.

Robin Solod, who lives alone on Manhattans Upper East Side, thought she was an unlikely candidate for loneliness.

I was too busy schmoozing, she said of her life before the pandemic. Chicken soup at the Mansion Diner. We would go to Zabars on the West Side every week, get a bagel, sit, schmooze. Who was home? I never was home. Then all of a sudden, everything comes to a halt.

As some pandemic restrictions now finally lift, and New York returns to some semblance of normal, one unknown is the lasting effects of two years of prolonged isolation and the loneliness that came with it. Some people cut off nearly all physical interaction, others were more social, but few got through the various lockdowns and spikes without some sense of loss for the human connections they were missing.

For Ms. Solod, who believed people are my air, the last blow came when she had to part with her loyal companion, a rescue Shih Tzu named Annie. Ms. Solod, 67, has health problems that keep her in a wheelchair, and she relied on volunteers from a nonprofit organization called PAWS NY to walk her dog. But when the pandemic started, the volunteers stopped coming.

Now Annie lives out in Long Island, and its so lonely without her, she said. I never didnt have a dog. The environment that Ive always lived in has been my dog, the park, the people with dogs in the building. That was the connection. Everything has changed.

Loneliness, as defined by mental health professionals, is a gap between the level of connectedness that you want and what you have. It is not the same as social isolation, which is codified in the social sciences as a measure of a persons contacts. Loneliness is a subjective feeling. People can have a lot of contact and still be lonely, or be perfectly content by themselves.

For many New Yorkers, the pandemic brought too much contact with others in crowded apartments, workplaces or subways. But the contacts were not necessarily fulfilling or desired and maybe seemed dangerous. This, too, is a condition for loneliness.

In small doses, loneliness is like hunger or thirst, a healthy signal that you are missing something and to seek out what you need. But prolonged over time, loneliness can be damaging not just to mental health, but also to physical health.

Even before the pandemic, the United States surgeon general, Vivek Murthy, said the country was experiencing an epidemic of loneliness, driven by the accelerated pace of life and the spread of technology into all of our social interactions. With this acceleration, he said, efficiency and convenience have edged out the time-consuming messiness of real relationships.

The result is a public health crisis on the scale of the opioid epidemic or obesity, Dr. Murthy said. In a 2018 study by the Kaiser Family Foundation, one in five Americans said they always or often felt lonely or socially isolated.

The pandemic only exacerbated these feelings. In a recent citywide survey by New Yorks health department, 57 percent of people said they felt lonely some or most of the time, and two-thirds said they felt socially isolated in the prior month.

Loneliness, Dr. Murthy said, has real consequences to our health and well-being.

Being lonely, like other forms of stress, increases the risk of emotional disorders like depression, anxiety and substance abuse. Less obviously, it also puts people at greater risk of physical ailments that seem unrelated, like heart disease, cancer, stroke, hypertension, dementia and premature death. In lab experiments, lonely people who were exposed to a cold virus were more likely to develop symptoms than people who were not lonely.

An often-cited meta-analysis by Julianne Holt-Lunstad of Brigham Young University compared the risk effects of loneliness, isolation and weak social networks to smoking 15 cigarettes a day.

The general public recognizes how loneliness might influence our levels of distress, our emotional or mental health, Dr. Holt-Lunstad said. But we probably dont recognize the robust evidence of the effects on our physical health.

Nor do we recognize the economic cost.

Social isolation and loneliness are associated with an additional $6.7 billion in Medicare spending and cost employers more than $154 billion annually in stress-related absenteeism, plus more in job turnover, according to studies by AARP and the insurance giant Cigna.

Yet the culture has moved slowly to address the epidemic, Dr. Murthy said, treating loneliness as an unpleasant feeling rather than a public health crisis. There are more adults struggling with loneliness than have diabetes, he said. Yet think about the discrepancy in the attention that we give to these two conditions.

Ms. Solod, before the pandemic, was not concerned about any of this. She lived alone, which did put her at higher risk of isolation, but she had always immersed herself among people. A million friends, she said.

She had run an electrolysis business, cut hair at Bergdorf Goodman and had a real estate license. Shed even worked as a hostess at Chippendales.

I was beyond dynamic, she said.

But New York can chip away at ones social network. Friends get buried in work, move away, find lovers, change dog parks. Men are more likely to be socially isolated, but women are more likely to be lonely.

For people over 60, like Ms. Solod, who are one of the highest-risk groups, the isolation often begins with their health.

Six years ago, Ms. Solod began treatment for lung cancer, then multiple myeloma. Suddenly her life revolved around medical treatments, not socializing, and she needed a wheelchair to get around.

Yet she was still enjoying the city with friends or with her mother, who lived nearby. I could hear my mothers voice: Dont stay home, she said. Then a year before the pandemic her mother died. That was a connection she could not replace, a role no one else could step into. She still had lots of social contacts, but she was missing a meaningful connection that she needed. The name for that gap is loneliness.

The worst was the Jewish holidays, she said, when all her losses seemed to pile up. I once had a life. I had a husband, I had a mom, neighbors and friends and relatives. That ceases to exist in the same way when the focal point of the mother is gone, that central person. When thats gone, nothing can bring back the holidays.

At least she still had her dog.

Then the pandemic hit.

Turhan Canli, professor of integrative neuroscience at the State University of New York at Stony Brook, wondered whether there was a gene that turned on or off when a person was lonely. Past researchers had shown that loneliness, like other forms of stress, was associated with depression, inflammation, cognitive decline and heart disease. But how? What pathways were opened or closed when people were lonely, what genes activated or deactivated? From the Rush University Memory and Aging Project in Chicago, he was able to get tissues from the brains of older adults who in their final years had answered questions about their levels of loneliness.

His analysis provided an insight into the physical, cellular nature of loneliness. He found distinct differences between the brains of lonely or non-lonely people. Some genes that promote the proliferation of cancerous cells were more activated in lonely people, while genes that regulate inflammation were turned off.

We found hundreds of genes that would be differently expressed depending on how lonely these people felt, he said. These genes were associated with cancer, inflammation, heart disease, as well as cognitive function.

He cautioned that, as with many studies of loneliness, his did not prove that loneliness caused these differences in gene expression; it might simply have been more prevalent in people who had them.

Ms. Anderson, the documentary filmmaker, described nights in her apartment when she felt so oppressively lonely that she would not answer her telephone, even though the conversation might improve her mood. Youd think I would pick up the phone and call people, she said. I feel that the loneliness feels so heavy, that if I call someone Im going to be so down that they dont want to talk to me. Its exactly what I should do. I just dont feel like it.

For Ms. Solod, who had been struggling before Covid, the pandemic brought several new levels of loneliness. There was the abrupt end to casual encounters with neighbors, merchants, the waitstaff at her favorite diner or deli. There were the friends who used to visit, but were suddenly just voices on the telephone. And there was the dog.

In December of 2021, she was hospitalized for two weeks in the Covid unit at Memorial Sloan Kettering Cancer Center, so she could receive treatment for cancer and the coronavirus. Since that experience, she said, Im terrified.

So even as she saw neighbors return to some social activity, she remained extremely cautious. Sometimes shed take her wheelchair into her building lobby to watch the dogs, then go back upstairs, missing her own dog. And always, she said, she was conscious of how many people had died.

I speak to my friends all the time, she said. They call me. But its very different, that type of connection. You dont have the same emotions, the same feelings, as when you see someone in person. And also, when you can hug someone, its very different.

The pandemic has underscored just how important even casual connections are for emotional well-being, said Anne Marie Albano, director of the Columbia University Clinic for Anxiety and Related Disorders. Even the little things like making room for someone to sit down next to you on the subway, or someone doing that for you those kinds of things are not happening, Dr. Albano said. And that makes an individual who is prone to feel alone feel that more intensely.

Even as case numbers in New York have remained well below their peak, Ms. Solods loneliness has not eased. If anything, she said, seeing people about their business, without masks, has made her feel even more isolated.

So many people I know say, Oh, dont worry, and they start quoting the mayor and talk about the kids in school. But even putting the cancer and my illness aside, I would say Im still very frightened of the virus. I dont want to have to go back to that world of isolation.

During the Iranian New Year in late March, an Iranian friend brought her food, for which she was grateful. But then people dont like to stay, she said. Its almost like weve been ingrained in running out. Its a quick hello, and see you later. In my world, no ones really staying.

Even if life returns to the way it was before the pandemic, it is unclear how far the loneliness of the last two years will lift, or what scars it might leave behind. According to Stephanie Cacioppo, an assistant professor of psychiatry and behavioral neuroscience at the University of Chicago, loneliness, like other forms of stress, may leave lasting damage.

One early indicator is life on the college campus, Dr. Cacioppo said. Now that students are back, we are hearing so much loneliness and isolation tied to disappointment. College is not what kids expected it to be. So social isolation was reduced, but a form of loneliness has lingered, in the gap between the social life people want and what they have.

A paradox: People are more connected now than ever through phones, social media, Zoom and such yet loneliness continues to rise. Among the most digitally connected, teenagers and young adults, loneliness nearly doubled in prevalence between 2012 and 2018, coinciding with the explosion in social media use.

Four years ago, the British government appointed a minister of loneliness to address growing concerns among the public. One town set up Happy to Chat benches, with signs reading Sit here if you dont mind someone stopping to say hello. The model has proved popular and spread around England and to Canada and Poland.

In the United States, the health care system has focused on social isolation in older adults but been slower to address loneliness as a broad public health problem.

Yet there are interventions that can help, Dr. Cacioppo said.

For years people thought the best thing you could do for a lonely person is to give them support, she said. Actually, we found that its about receiving and also giving back. So the best thing you can do for someone who is lonely is not to give them help but ask them for help. So you give them a sense of worth and a chance to be altruistic. Even if were getting the best care, we still feel lonely if we cant give something back. The care is extremely valuable but its not enough.

She also suggested a regular practice of gratitude and altruism, both of which counter a mind-set of seeing others as threats.

But real remedies to the problem of loneliness, Dr. Murthy stressed, must address not just the lonely people but the culture making them lonely.

We ask people to exercise and eat a healthy diet and take their medications, he said. But if we truly want to be healthy, happy and fulfilled as a society, we have to restructure our lives around people. Right now our lives are centered around work.

From the surgeon general of the United States, this is a moonshot call, to reverse cultural patterns that are decades in the making and that profit some of the nations biggest businesses.

Robert Putnam, in his 2000 book Bowling Alone: The Collapse and Revival of American Community, charted a steady erosion of social ties dating back to 1950.

Hannah Arendt called widespread loneliness an underlying condition for totalitarianism.

Dr. Murthys moonshot called for a complete shift in societal priorities. But the alternative, he said, is literally killing people. Connected people live longer, happier, healthier lives. So a shift is in order, starting in our homes and workplaces.

We have this powerful force for enhancing health and well-being, in their relationships, he said. But how often do we invest in that?

For Robin Solod, alone in her East Side apartment, this is a need she came to recognize the hard way.

Shed always been too busy running around to think about how much she depended on her connections with people, and how fragile those could be, she said. But when you take that away, whats left? What do you replace it with?

She answered her own question. Without the connection to other people, she said, you have bupkis.

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Covid-19 Mask Mandates and Travel News: Live Updates - The New York Times

ASHWAUBENON -One of the first orders of business for the new Brown County Board will be reviewing the county's response to the COVID-19 pandemic.

County Board member Megan BorchardtofGreen Bay has asked the county's Human Services Department for a report on successesand opportunities for improvementinhow Brown County responded to the public health needs of county residents. The goal, supervisors said, was to continue doing what the county had done well, whileimprovingwhere improvements were needed.

"We know there is a plan of action, and it continues to be updated," Borchardt said. County health officials said they plan further updates to the plan later this spring.

Human Services Committee members in March discussed a number of successes in the county's response, including areas where the county's response had started slowly but had grown into a strength. In other areas, officials said, Brown County's response later became a best practice adopted by a number of counties.

At the same time, Human Services meeting minutes from March show that the committeeacknowledged that Brown County struggled, especially early in its response,in involving some community partners sooner. For example, some people, including a member of the county Board of Health, complained that it took several calls before they got an answer about where help from speakers fluent inlanguages other than English wasneeded.

Also, some believed there were timeswhere the county should have realizedit needed to ask earlier for other types of assistance. For example, a COVID-19 testing clinic catering to Spanish speakers, and people with limited access to transportation, opened at CASA Alba Melanie in downtown Green Bay in May2020 a day after the county opened a clinicat the Resch Expo construction site in Ashwaubenon, that was geared towardpeople able to drive to the facility.

Health & Human Services officials didn't return a call seeking an interview.

County Board members said they expect the report on the pandemic response to be discussed at their May board meeting.

Also Tuesday:

Supervisors agreed to accept $5 million in federal transportation funding for environmental andengineering/design work for the Southern Bridge project that would funnel some traffic south of De Pere. The board also agreed to allocate $600,000 in county money, and $600,000 from the city of De Pere, as the local share.

The board accepted $103,000 in grant money for the Child Support Department; funding, which must be spent by June 30, will pay for department overtime, new office printersand new furniture.

The board elected Dave Kaster of Bellevuevice-chairman over Borchardt. KastersucceedsTom Sieber, who did not seek reelection to the board. Patrick Buckley remains chairman of the County Board.

More:Brown County coronavirus cases zoom past 1,400, as people continue to ignore preventive measures

More: COVID-19: Here's where you can get tested in Green Bay, Brown County

More: Updated: Where to get COVID-19 vaccinations in Brown County

Contact Doug Schneider at (920) 431-8333, or DSchneid@gannett.com. Follow him on Twitter at @PGDougSchneider.

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Brown County Board looks to build on COVID-19 response, acknowledges there's room for improvement - Green Bay Press Gazette