Category Archives: Covid-19

ECMO is the highest level of life support beyond a ventilator, which pumps oxygen via a tube through the windpipe into the lungs. Instead, the ECMO process basically functions as a heart and lungs outside of the body routing the blood via tubing to a machine that oxygenates it, then pumps it back into the patient. Blake Farmer/Nashville Public Radio hide caption

ECMO is the highest level of life support beyond a ventilator, which pumps oxygen via a tube through the windpipe into the lungs. Instead, the ECMO process basically functions as a heart and lungs outside of the body routing the blood via tubing to a machine that oxygenates it, then pumps it back into the patient.

Hospital discharge day for Phoua Yang was more like a pep rally.

On her way rolling out of Centennial Medical Center in Nashville, she teared up as streamers and confetti rained down on her. Nurses chanted her name as they wheeled her out of the hospital for the first time since she arrived in February with COVID-19, barely able to breathe.

The 38-year-old mother is living proof of the power of ECMO a method of oxygenating a patient's blood outside the body, then pumping it back in. Her story helps explain why a shortage of trained staff who can run the machines that perform this extracorporeal membrane oxygenation has become such a pinch point as COVID-19 hospitalizations surge.

"One hundred forty six days is a long time," Yang says of the time she spent on the ECMO machine. "It's been like a forever journey with me."

For nearly five months, Yang had blood pumping out a hole in her neck and running through the rolling ECMO cart by her bed.

ECMO is the highest level of life support beyond a ventilator, which pumps oxygen via a tube through the windpipe, down into the lungs. The ECMO process, in contrast, basically functions as a heart and lungs outside the body.

The process, more often used before the pandemic for organ transplant candidates, is not a treatment. But it buys time for the lungs of patients who have COVID-19 to heal. Often they've been on a ventilator for a while. Even when it's working well, a ventilator can have its own side-effects after prolonged use including nerve damage or damage to the lung itself through the excessive air pressure.

Doctors often describe ECMO as a way to let the lungs "rest" especially useful when even ventilation isn't fully oxygenating a patient's blood.

Many more people could benefit from ECMO than are receiving it, which has made for a messy triaging of treatment that could escalate in the coming weeks as the delta variant surges across the South and in rural communities with low vaccination rates.

The ECMO logjam primarily stems from just how many people it takes to care for each patient. A one-on-one nurse is required, 24 hours a day. The staff shortages that many hospitals in hot zones are facing compound the problem.

Yang says she sometimes had four or five clinical staff members helping her when she needed to take a daily walk through the hospital halls to keep her muscles working. One person's job was just to make sure no hoses kinked as she moved, since the machine was literally keeping her alive.

Of all the patients treated in an ICU, those on ECMO require the most attention, says nurse Kristin Nguyen who works in the ICU at Vanderbilt University Medical Center.

"It's very labor-intensive," she tells us one morning, after a one-on-one shift with an ECMO patient who had already been in the ICU three weeks.

The Extracorporeal Life Support Association says the average ECMO patient with COVID-19 spends two weeks on the machine, though many physicians say their patients average a month or more.

"These patients take so long to recover, and they're eating up our hospital beds because they come in and they stay," Nguyen says. "And that's where we're getting in such a bind."

It's not that there aren't enough ECMO machines to go around or the high cost which is estimated at $5,000 a day or significantly more, depending on the hospital.

"There are plenty of ECMO machines it's people who know how to run it," says Dr. Robert Bartlett, a retired surgeon at the University of Michigan who helped pioneer the technology.

Every children's hospital has ECMO, where it's regularly used on newborns who are having trouble with their lungs. But Bartlett says prior to the pandemic, there was no point in training teams elsewhere to use ECMO when they might only use the technology a few times a year.

It's a fairly high risk intervention with little room for error. And it requires a round-the-clock team.

"We really don't think it should be that every little hospital has ECMO," Bartlett says.

Bartlett says his research team is working to make it so ECMO can be offered outside an ICU and possibly even send patients home with a wearable device. But that's years away.

Only the largest medical centers offer ECMO currently, and that's meant most hospitals in the south have been left waiting to transfer patients to a major medical center during the recent pandemic surge. But there's no formal way to make those transfers happen. And the larger hospitals have their own COVID patients eligible for ECMO who would be willing to try it.

"We have to make tough choices. That's really what it comes down to how sick are you, and what's the availability?" says Dr. Harshit Rao, chief clinical officer overseeing ICU doctors with physician services firm Envision. He works with ICUs in Dallas and Houston.

There is no formal process for prioritizing patients, though a national nonprofit has started a registry. And there's limited data on which factors make some patients who have COVID-19more likely to benefit from ECMO than others.

ECMO has been used in the United States throughout the pandemic. But there wasn't as much of a shortage early on when the people dying from COVID-19 tended to be older. ECMO is rarely used for anyone elderly or with health conditions that would keep them from seeing much benefit.

Even before the pandemic, there was intense debate about whether ECMO was just an expensive "bridge to nowhere" for most patients. Currently, the survival rate for COVID-19 patients on ECMO is roughly 50% a figure that has been dropping as more families of sicker patients have been pushing for life-support.

But the calculation is different for the younger people who make up this summer's wave of largely unvaccinated COVID-19 patients in ICUs. So there's more demand for ECMO.

"I think it's 100% directed at the fact that they're younger patients," says Dr. Mani Daneshmand, who leads the transplant and ECMO programs at Emory University Hospital.

Even as big as Emory is, the Atlanta hospital is turning down multiple requests a day to transfer COVID-19 patients who need ECMO, Daneshmand says. And calls are coming in from all over the Southeast.

"When you have a 30-year-old or 40-year-old or someone who has just become a parent, you're going to call. We've gotten calls for 18-year-olds," he says. "There are a lot of people who are very young who are needing a lot of support, and a lot of them are dying."

Even for younger people, who tend to have better chances on ECMO, many are debilitated afterward.

Laura Lyons was a comedian with a day job in New York City before the pandemic. Though just 31 years old when she came down with COVID-19, she nearly died. ECMO, she says, saved her life. But she may never be the same.

"I was running around New York City a year and half ago, and now I'm in a wheelchair," she says. "My doctors have told me I'll be on oxygen forever, and I'm just choosing not to accept that. I just don't see my life attached to a cord."

Lyons now lives at her parents' house in central Massachusetts, and spends most days doing physical therapy. Her struggle to regain her strength continues, but she's alive.

Since it's kind of the wild west to even get someone an ECMO bed, some families have made their desperation public, as their loved one waits on a ventilator.

As soon as Toby Plumlee's wife was put on a ventilator in August, he started pressing her doctors about ECMO. She was in a north Georgia community hospital, and the family searched for help at bigger hospitals looking 500 miles in every direction.

"But the more you research, the more you read, the more you talk to the hospital, the more you start to see what a shortage it really is," he says. "You get to the point, the only thing you can do is pray for your loved one that they're going to survive."

Plumlee says his wife made it to sixth in line at a hospital 200 miles away Centennial Medical Center where Phoua Yang was finishing her 146-day ECMO marathon.

Yang left with a miracle. Plumlee and their children were left in mourning. His wife died before ever getting ECMO a few days after turning 40.

This story was produced as part of NPR's partnership with Kaiser Health News and Nashville Public Radio.

Read the original:

Too Few Hospitals In COVID Hotspots Are Equipped To Offer ECMO : Shots - Health News - NPR

Kentucky saw its fourth highest number of new coronavirus cases Friday and again set new records for Covid-19 hospitalizations, intensive-care-unit and ventilator use, prompting Gov. Andy Beshear to call this "one of the most dangerous times we've had in this pandemic."

"I hope I can convey how real this is," Beshear said in a Facebook post. "I hope that we'll see more people out there wearing masks when they're in public, but indoors. Folks, it is a scary time -- definitely if you are unvaccinated, but if you are vaccinated too. Please get your shot of hope; put on your mask. We need everybody's help to stop this."

The state reported 5,111 new cases Friday, with 1,547, or 30 percent, in people 18 and under. The seven-day average is 4,282, a new high.

The share of Kentuckians testing positive for the virus dropped for the third straight day, to 13.17%. Beshear said Thursday that the drops are likely due to more testing.

Kentucky's infection rate is third in the nation,accordingtoThe New York Times. Only Tennessee and South Carolina have higher rates. The Times reports that Kentucky's daily average number of cases has risen 34% in the last two weeks.

The state says its daily rate of new cases over the last seven days is 89.89 per 100,000 residents. Counties with double that rate areOwsley, 262.1; Perry, 226.8; Leslie, 224.2; Bell, 219.5; Clay, 211; Whitley, 195.4; Russell, 183.3; and Breathitt, 179.8.

All but three counties remain in the red zone, for counties with more than 25 daily cases per 100,000 residents, considered a high level of transmission. They are Woodford, Trigg and Carlisle counties.

Kentucky hospitals reported 2,365 Covid-19 patients; 661 in intensive care, and 425 on mechanical ventilation.

All but two of the state's hospital readiness regions are using more than 90% of their staffed intensive-care beds, with the Lake Cumberland region and the western region that includes Owensboro and Hopkinsville at 100% capacity.

The state reported 24 more Covid-19 deaths Friday, bringing the death toll to 7,845.

Hazard ARH Regional Medical Center's morgue reached capacity on Wednesday night,accordingto a hospital news release posted on the hospital'sFacebookpage.Engle-Bowling Funeral Homein Hazard is providing additional morgue space as families make their funeral arrangements.

"This morgue capacity issue is a tragic consequence of this pandemic that could easily be prevented if more people would choose to be vaccinated against Covid-19 and take other precautions to help protect themselves and limit the spread of the virus to others by wearing a mask while indoors and social distancing," Dr. Maria Braman, ARH chief medical officer, said in a news release.

Vaccination rates have inched up in Kentucky, showing a 9% increase in the last seven days, with an average of 14,642 doses per day administered,accordingtoThe Washington Post.

The percentage of Kentuckians 18 and older who have received at least one dose of a vaccine is 69% and 57% of the total population has received at least one dose.

Other pandemic news Friday:

We are making critical coverage of the coronavirus available for free. Please consider subscribing so we can continue to bring you the latest news and information on this developing story.

Read more:

Beshear calls it 'a scary time' because Covid-19 case average and hospital numbers hit new high; many intensive-care units full - Times Tribune of...

BAINBRIDGE, Ga. A Georgia couple who were well-known business owners in their small community died on the same day of COVID-19.

Edwin (66) and Linda (58) McCullers both died at Memorial Hospital in Bainbridge on Aug. 28.

[DOWNLOAD: Free WSB-TV News app for alerts as news breaks]

Edwin McCullers was the owner of Flint River Outfitters, which sells hunting, fishing and other outdoor equipment. The business was closed until further notice after his death. Linda McCullers owned a hair salon.

The couple contracted the virus in mid-August.

They were both of the Methodist faith.

TRENDING STORIES:

There were dozens of tributes to the couple on social media.

Edwin and his dear wife Linda McCullers were two of the hardest working people I ever knew, one friend wrote on Facebook. They built several highly successful businesses over the years, but they always took the time to personally attend to each customer.

[SIGN UP: WSB-TV Daily Headlines Newsletter]

The family encouraged everyone to wear masks in their joint obituary. Their funeral service will be private.

Bainbridge is a close-knit community that is home to around 13,000 people. It is the county seat of Decatur County and the hometown of UGA head football coach Kirby Smart.

A total of 66 people in Decatur County have died of COVID-19 since the start of the pandemic.

2021 Cox Media Group

Read the original:

South Georgia couple who were business owners die of COVID-19 on the same day - WSB Atlanta

FRANKFORT, Ky. -- Democratic Gov. Andy Beshear announced Saturday that he's calling Kentucky's Republican-led legislature into a special session to shape pandemic policies as the state struggles with a record surge of COVID-19 cases and hospitalizations.

The return of lawmakers to the state Capitol starts Tuesday and marks a dramatic power shift in coronavirus-related policymaking in the Bluegrass State following a landmark court ruling. Since the pandemic hit Kentucky, the governor mostly acted unilaterally in setting statewide virus policies, but the state Supreme Court shifted those decisions to the legislature.

Now, that burden will fall in large part on the General Assembly," Beshear said Saturday. "It will have to carry much of that weight to confront unpopular choices and to make decisions that balance many things, including the lives and the possible deaths of our citizens.

Beshear had sole authority to call a special session and set the agenda. At a news conference Saturday, he outlined pandemic issues he wants lawmakers to consider, including policies on mask-wearing and school schedules amid growing school closures due to virus outbreaks. But GOP House and Senate supermajorities will decide what measures ultimately pass.

Beshear told reporters Saturday he's had good conversations with top GOP lawmakers and that draft legislation was exchanged.

Republican House Speaker David Osborne said the proposals offered by lawmakers were the culmination of 18 months of research, discussion and input from groups and individuals directly engaged in responding to this pandemic.

While we are not yet in agreement regarding the specific language of the legislation we will consider, we are continuing discussions and have agreed it is in the best interests of our commonwealth to move forward with the call, Osborne said in a statement.

Lawmakers will be asked to extend the pandemic-related state of emergency until mid-January, when the legislature would be back in regular session, Beshear said. They will be asked to review his virus-related executive orders and other actions by his administration, the governor said.

On the issue of masks, the governor said his call will ask them to determine my ability to require masking in certain situations, depending on where the pandemic goes and how bad any area is.

Beshear ordered statewide mask mandates to confront previous virus surges and said Saturday he sees that authority as absolutely necessary to tackle the delta variant. Acknowledging the issue will be contentious, he suggested a more targeted approach.

If they wont consider providing that authority in general, my hope is that they will consider a threshold to where they will provide me that authority," the governor said.

Beshear also asked lawmakers to provide more school scheduling flexibility as many districts have had to pause in-person learning because of virus outbreaks. Several ideas are being considered, he said, including allowing local school leaders to use a more tailored approach when shifting to remote learning, allowing them to apply it to a single school or even a classroom rather than the entire district. That idea was discussed at a recent legislative committee hearing.

Key GOP lawmakers have signaled their preference for policies favoring local decision-making over statewide mandates to combat COVID-19.

Lawmakers also will be asked to appropriate leftover federal pandemic aid to further the fight against the coronavirus, the governor said. The funding would support pandemic mitigation and prevention efforts, including testing and vaccine distribution.

More than 7,840 Kentuckians have died from COVID-19, include 69 deaths announced on Thursday and Friday. The delta variant has put record numbers of virus patients in Kentucky hospitals, including in intensive care units and on ventilators. The state reported Friday that nearly 90% of ICU beds statewide were occupied.

The delta variant is spreading at a rate never seen before, impacting businesses, shuttering schools and worse causing severe illness and death, Beshear said Saturday.

We need as many tools as possible to fight this deadly surge in order to save lives, keep our children in school and keep our economy churning, he added.

Various emergency measures issued by Beshear are set to expire as a result of the court decision issued two weeks ago. Lawmakers will decide whether to extend, alter or discontinue each emergency order, while putting their own stamp on the state's response to COVID-19.

Throughout the pandemic, Republican lawmakers watched from the sidelines as Beshear waged an aggressive response that included statewide mask mandates and strict limits on gatherings. Republicans criticized the governor for what they viewed as overly broad and stringent restrictions, most of which were lifted in June.

The state Supreme Court recently shifted those virus-related decisions to the legislature. The court cleared the way for new laws to limit the governors emergency powers, which he used to impose virus restrictions. The justices said a lower court wrongly blocked the GOP-backed measures.

See the rest here:

Kentucky governor calls special session on handling COVID-19 - ABC News

Workers load empty oxygen cylinders onto a supply truck for refilling, at the Medical College and Hospital, amid the spread of the coronavirus disease (COVID-19), in Kolkata, India, May 5, 2021. REUTERS/Rupak De Chowdhuri

BENGALURU, Sept 6 (Reuters) - India aims to ramp up its medical oxygen production capacity to 15,000 tonnes per day before a potential third wave of coronavirus infections that is expected to hit the country as soon as mid-September, an industry executive said.

The target implies a 50% jump from the maximum output of almost 10,000 tonnes reached earlier this year during the peak of the second COVID-19 wave, when hospitals ran short of the gas and relatives of patients had to search out oxygen cylinders.

Linde India (LIND.NS) supplied nearly one-third of the total oxygen demand during the peak.

Moloy Banerjee, head of Linde South Asia, said that while the government is targeting 15,000 tonnes of medical oxygen per day, Linde and other manufacturers were hoping to hit production of at least 13,500 tonnes per day ahead of the third wave.

As of Monday, India's total COVID-19 cases had reached 33.03 million, with the death toll at 440,752, according to health ministry data.

While demand for medical oxygen in India has considerably reduced since the peak, reaching near pre-COVID levels, gas companies along with the government are gearing up for a scenario where the third wave could be worse than the previous one.

The New Delhi government said last month it will increase oxygen production by setting up new manufacturing units or expanding the production capacity of existing units for uninterrupted oxygen supply during a health crisis.

Shares of Linde India rose to record levels in the days following the Delhi government's notification and have more than doubled for the year as of Monday's closing price.

"There have been discussions with the Delhi government since the second wave of COVID-19. We are still reviewing the policy and trying to see if it is workable for Linde," Banerjee added.

The company has not entered any formal agreement with the government.

Linde has also been in touch with the governments of Andhra Pradesh and Madhya Pradesh states to support setting up of additional oxygen storage capacities and manufacturing units.

Reporting by Shivani Singh in Bengaluru; Editing by Angus MacSwan

Our Standards: The Thomson Reuters Trust Principles.

Continued here:

India plans 50% increase in oxygen production before third COVID-19 wave - Reuters India

This obituary is part of We Will Remember, a series about those weve lost to the coronavirus.

Her daughter encouraged her to get testedeven though she had been fully vaccinated since February. Thats when Suzanne Martha Madigan found out she waspositive for COVID-19.

Madigan, 74, died May 16 at Ascension St. John Hospital in Detroit as a result ofcomplications from the illness.

The Warren resident was born in Detroit and grew up in St. Clair Shores, where she graduated from Lakeview High School. Madigan received a bachelors degree from Michigan State University and a masters degreein education from Wayne State University. She taught in the Grosse Pointe Public School System for 26 years.

Madigan met her husband, John, to whom she was married for more than 40 years, while at Michigan State University.They had five children and 13 grandchildren. He died in 2013.

After the death of her husband, Madigan spent a lot of time with her family and often found herself running from one event to the next, according todaughter Kelly Salamango.Her activities included spending time at her cottage off Lake St. Clair, attending grandchildrens sporting events, going out for dinner with her sisters and babysitting her grandchildren.

Madigan, known to many as Susy,loved flowers and spent lots of time tending to her meticulous garden.

In May 2019, Madigan was struck by a car in a parking lot after visiting her brother Duke, who had just undergonesurgery. She ended up breaking both of her wrists and femur and had to undergo surgery.

She spent the next few months in a rehab facility learning to walk again while her brother was in another rehab facility doing the same thing after his surgery, Salamango said. The joke between the two of them was who would get out first and get to go to their cottage.

Duke died in September2020. Salamango noted:Duke and Susy would talk every day (let's be honest multiple times a day) and were inseparable.

In April,Madigan, who was fully vaccinated, thought she had a sinus infection, so she had a telehealth appointment with her doctor. Her doctor agreed her symptoms suggesteda sinus infection, so he called in a prescription. Just to be safe, Salamango urged her mother to get tested for COVID-19. Theresults came back positive.

The next week, Madiganhad mild symptoms, was overly tired and didnt have much energy. Herson Matt took her to the hospital to be monitored becauseher oxygen levels were low. She was put on oxygen, and after her oxygen levels droppedagain, she was put on a ventilator.

Madigans family members relied on the hospital staff to give them updates two times a day and had Zoom calls becauseshe was unable to have visitors. Even though she was unable to respond, it was important for her family to let her know they were there with her, Salamango noted. Her mother diedMay 16.

It's surreal that she has gone through so much the last few years. We thought she was more protected from the virus since she was fully vaccinated and was very cautious if she had to go out, Salamango said. Yet the virus was just too powerful. We do find comfort in knowing she's reunited with our dad, her brother Duke, and her parents and other sister Nancy, who have all passed before her.

Madigan leaves to cherish her memory children Matthew (Shannon), Patrick (Rosanna), Timothy (Jennifer), Michael (Amber), and Kelly (Jason) Salamango; grandchildren Brady, Jack, Katie, Aubrey, Liam, Molly, Haley, Lacey, Lachlan, Stella, Miles, Quinn and Finnegan; and many family members and friends.

If you have a family member or close friend who has died from COVID-19 and you would like to share their story, please visit our memorial wall and select Share a story.

Brendel Hightower is an assistant editorat the Detroit Free Press.Contact her at bhightower@freepress.com.

View original post here:

Retired teacher from Warren died of COVID-19 several months after being vaccinated - Detroit Free Press

The report was published online Sept. 1 in the journal BMJ .

It's not surprising that the risk to teachers is not higher than other groups, said Douglas Harris, Schlieder Foundation Chair in public education at Tulane University in New Orleans, and director of the Education Research Alliance for New Orleans.

In schools where masks and social distancing are mandated, the risk of spreading COVID-19 is cut dramatically, he said.

"I think, for the most part, schools are handling it in a sensible way and I think, for the most part, it's sensible keeping the kids in school when it's safe," Harris said.

Of course, vaccination is the key to beating the pandemic, he added.

"I think in the U.S., there's an ongoing debate about whether vaccines can be mandated. That's the elephant in the room. I think that that almost has to happen if we're really going to get back to normal," Harris said.

Harris believes that school systems should mandate COVID-19 vaccinations for teachers and all students, including young children once a vaccine has been approved.

"We already do that for, for children, they're already required to get vaccinated for other things," he said. "It's hard to see why you wouldn't require it. In this case and really that is the only way we get back to normal, this could go on for years."

As more adults are vaccinated, the virus will attack mostly the unvaccinated, especially children, Harris said.

But everything should be done to minimize the spread of the virus and keep schools open, he said.

"There are health consequences to closing schools," Harris said. "We tend to focus on the immediate effect of schools opening and spreading the virus, which is clearly important and probably the first consideration, but when you close the schools you create a new set of problems, mental illness and child abuse, and all sorts of economic side effects."

More information

For more on COVID-19 and schools, see the U.S. Centers for Disease Control and Prevention.

SOURCES: David McAllister, MD, MPH, professor, clinical epidemiology and medical informatics, Institute of Health and Wellbeing, University of Glasgow, Scotland; Douglas Harris, PhD, professor, economics, and Schlieder Foundation Chair, public education, Tulane University, New Orleans, and director, Education Research Alliance for New Orleans; BMJ , Sept. 1, 2021, online

See more here:

Teachers Have No Higher Risk of Severe COVID-19 - WebMD

Stay Safe Reopening Plan

As we welcome customers and staff back to city buildings, we have created a Stay Safe Reopening Plan to guide our efforts. Read reopening plan hereVersion OptionsCovid-19 (Coronavirus) InformationHeadlineStay Safe Reopening PlanStay Safe Reopening PlanStay Safe Reopening PlanStay Safe Reopening PlanStay Safe Reopening PlanStay Safe Reopening PlanStay Safe Reopening PlanStay Safe Reopening Plan.

This 5-stage plan provides a general framework and guidelines for all city services and departments, in accordance with guidance provided by the State of Washington. This plan is the basis for how the City will continue to:

Provide services and programs, and continue field operations Conduct public events and meetings Manage the timeline for reopening facilities Implement staffing schedules Apply CDC recommendations and maintain sanitation and janitorial services

Reopened July 1, 10 a.m. to 3 p.m., Monday - Friday

City Hall Redmond Community Center at Marymoor Village Public Safety Building Fire Stations

Due to recent increases in COVID-19 cases, face coverings are now required inside city facilities regardless of vaccination status.

Redmond Pool is reopened

Reopening later this year Bytes Caf for senior programming Old Firehouse Teen Center

The City will continue to follow Washington States guidelines for the suspension of the in-person requirement for the Open Public Meetings Act until the suspension is lifted (anticipated June 30) after which time:

Council meetings have resumed in Council Chambers as of Tuesday, July 6, 2021 and are running hybrid, in-person and virtual. The City follows Washington State guidelines for open public meetings. Watch Council Meetings View Council meeting dates, agendas and materials

Parks and Recreation have outlined the "Play Safe, Stay Safe" plan to reopen park amenities, facilities and activities.

Read more:

COVID-19 Resources & City Reopening Plan | Redmond, WA

All around the world, there seem to be signs that immunity to SARS-CoV-2, the coronavirus that causes the disease COVID-19, doesn't last very long after you're vaccinated.

Israel is now having one of the world's worst COVID-19 surges about five months after vaccinating a majority of its population. And in the U.S., health officials are recommending a booster shot eight months after the original vaccine course.

So, how long does immunity last after two doses of the vaccine? Six months or so? And at that point, how much protection is left over?

It all depends on which type of immunity you're talking about, says immunologist Ali Ellebedy at Washington University in St. Louis. Six months after your vaccine, your body may be more ready to fight off the coronavirus than you might think.

"If you were vaccinated six months ago, your immune system has been training for six months you are better ready to fight a COVID-19 infection," says Ellebedy.

A series of new studies, including two led by Ellebedy, suggests that mRNA vaccines like those from Pfizer-BioNTech and Moderna trigger the immune system to establish long-term protection against severe COVID-19 protection that likely will last several years or even longer, Ellebedy says.

To understand what he's talking about, let's say you received the second Moderna or Pfizer vaccine six months ago. Right away, your immune system got to work and began making antibodies.

These antibodies are a bit like archers outside the moat of a castle. They set up in the lining of your nose and throat, ready to shoot down (aka neutralize) any SARS-CoV-2 particles that try to enter the moat (aka your nasal tissue).

These antibodies can prevent an infection, says bioimmunologist Deepta Bhattacharya at the University of Arizona. They stop the virus from entering cells and setting up shop. They are the body's front-line defense.

But right after vaccination, this initial round of antibodies has a few problems. The antibodies are a bit wimpy. They're not that well trained at killing SARS-CoV-2, and they're not very durable, Bhattacharya says.

About a month after the second mRNA shot, the number of antibodies in the blood reaches its peak level and then starts to decline. The antibodies themselves degrade and the cells that make them die, a study published in the journal Nature reported in June.

This happens with every vaccine, whether it's for COVID-19, the flu or measles, Bhattacharya says. "In every single immune response, there is a sharp rise in antibodies, a period of sharp decline, and then it starts to settle into a more stable nadir."

The media has largely focused on this decline of antibodies as the cause of "waning immunity." And it's true, Bhattacharya says, that this decline in antibodies, combined with the high potency of the delta variant, which began dominating many countries this year, is likely increasing the rate of infection in fully vaccinated people.

"If you get a big dose of delta, as the variant often gives, the virus can slip past the initial wall of antibodies," he says. "So I think we may be seeing some signs of that. But the [level of breakthrough infections] is probably not as dramatic as I think it's being made out to be."

Why? Because the media has largely overlooked several key facts about the antibodies present eight months after the vaccine. For starters, they're more powerful than the original ones triggered by the vaccine, Bhattacharya says.

While the first round of archers (antibodies) was out guarding the moat of your castle (respiratory tract), the immune system wasn't just sitting around idly, hoping those soldiers would be enough. Instead, it was busy training better archers and a whole bunch of foot soldiers too.

After your second shot, the immune system sets up a training center in the lymph nodes to teach special cells how to make more powerful antibodies, the Nature paper from June reported.

"The quality of the antibody improves over time. It takes far fewer of those new antibodies to protect you," Bhattacharya says. "So I think that worrying about antibody decline is not something that's productive," he adds.

At the same time, the cells that make these souped-up antibodies become souped up themselves, he adds. In the training center, they learn how to make a huge amount of the highly powerful antibodies.

"These cells are remarkable," Bhattacharya says. "They're estimated to spit out something like 10,000 antibody molecules per second." So you don't need many of these cells to protect you against a future infection.

"We've done some back-of-the-envelope calculations to figure out how many of these cells are needed to protect a mouse from a lethal infection. It's three," Bhattacharya says. "Of course, we're bigger than mice. But you get the sense that it doesn't take many to offer good protection."

On top of that, these cells learn something remarkable in the training center: how to persist. "They're essentially given the gift of eternity," says immunologist Ellebedy.

He and his colleagues have found that by about six months after vaccination, these antibody-producing cells go into the bone marrow, where they can live for decades, perhaps even a lifetime, studies have found, and continue to produce antibodies the entire time. In one 2008 study, researchers identified antibodies that could neutralize the 1918 flu in the blood of people who were exposed to the virus 90 years earlier.

"We looked in the bone marrow and have seen these cells in people previously infected with SARS-CoV-2," Ellebedy says. "Now we are finishing research that shows these cells appear in the bone marrow after vaccination as well."

Called long-lived plasma cells, these cells will likely pump out antibodies into the blood for decades, Ellebedy says, giving people some sustained, long-term protection against SARS-CoV-2. (There is a caveat: If the virus changes too much, these antibodies won't be as effective.)

"The antibodies are maintained at very low levels, but they're the first line of defense against an infection," Ellebedy says. "If you're taken by surprise by SARS-CoV-2, these antibodies will slow down the replication of the virus" until reinforcements come along.

And reinforcements will likely come!

On top of training up better archers (antibodies) and factories to create them (plasma cells), the immune system has also been training up the equivalent of foot soldiers, several studies have found. These foot soldiers are called memory B cells and memory T cells, and they largely serve as a surveillance system, looking for other cells infected with SARS-CoV-2.

"They're patrolling all over," Ellebedy says, checking to see if a cell has SARS-CoV-2 hiding in it. "It's almost like going through the neighborhood, house by house, and just making sure it's clean."

These foot soldiers can't prevent an infection from initially occurring, but they can quickly stop one once it occurs, says immunologist Jennifer Gommerman at the University of Toronto. "Because of the vaccine-generated 'memory' of the SARS-CoV-2 spike protein, you get a very brisk cellular immune response."

OK. So now we've got all the information to understand what's going on with the COVID-19 vaccine and immune durability.

About six months after the shots, the antibodies in the blood have fallen as expected. They're also a bit less effective against the delta variant. "Together, that means there are more symptomatic infections as we go further out from the vaccination rollout," Gommerman says.

But in vaccinated people, these infections will most likely be mild or moderate because the immune system isn't starting from scratch. In fact, it's the opposite. It has been training cells and antibodies for months.

"You still have all this immunity inside of your body that will then say, 'OK, we've had a breach, and it's time to bring in the cellular immunity and respond to this threat,' " Gommerman says. "And because of vaccination, you have cells that can do that really quickly."

And so, overall, you'll be less sick than if you weren't vaccinated and be much less likely to end up in the hospital, she says.

"That's really what the vaccines were designed to do to teach the immune system to deal with this invader if an infection does occur," Gommerman says. "And the vaccines do that remarkably well."

Go here to see the original:

How Long Does Immunity To COVID-19 Last? : Goats and Soda - NPR

PORTSMOUTH, Va. (WAVY) From the terrorist attacks of Sept. 11, 2001, to the destructive waters of Superstorm Sandy, to real estate scams in Queens, Debbie Cohen for eight years covered the stories big and small in her hometown of New York City.

Cohen decided it was time for a career change.

She moved to Virginia Beach in 2017 and enrolled in graduate school at Regent University. In the School of Government, she earned two masters degrees: one has an emphasis in health care policy, the other in national security affairs and cyber security.

Hampton Roads is a long way from living in the Big Apple, but Cohen enjoyed the family atmosphere at Regent University, swimming off the Oceanfront, kayaking at First Landing State Park, and long walks along the Atlantic Ocean.

The pandemic slowed down her efforts to find a job in her new field, but she did secure some temporary positions that allowed her to work from home.

Earlier this year, she considered getting the potentially life-saving coronavirus vaccine but decided against it because of her history of allergies. Another complication: she was struck by a car while walking in a parking lot along Indian River Road.

Three weeks ago, Cohen, a friend, and his wife contracted the coronavirus. Cohen and the wife survived but the man was killed by COVID-19.

Cohen spent two weeks at Sentara Princess Anne Hospital where she was treated with the drug Remdesivir. Last week, she was transferred to Consulate Health Norfolk, where she is seen by a doctor three times a week and is visited by a nurse four to five times a week. She said she has COVID-pneumonia, which has left her too weak to even walk. She remains on oxygen, steroids, and antibiotics.

10 On Your Side first introduced Cohen to the public last week when she cried out for help when, in sweltering temperatures, the air conditioning system failed in part of the Consulate Health Care building at 3900 Llewellyn Avenue in Norfolk. Technicians and city officials responded and the problem was corrected, according to the city.

Last week, Cohen said she felt as if COVID-19 is killing her. This week, that fear persists.

This COVID is real, it really takes you down, said Cohen in a recorded Zoom interview.

In the interview, Cohen fluffed up her long blonde locks and proceeded to explain how it feels to suffer from pleurisy, which is an inflammation of the membranes that surround the lungs.

I still feel like I cant breathe Im dying from COVID I know everybody is praying for me churches, friends family, and school. It cuts off your breathing and you try to catch your breath and take a breath, but its impossible, she said.

She has advice for the vaccine-hesitant: Dont do what I did.

Im going to take the vaccine and Im advising everyone this is not a hoax. Help our children help your grandchildren, implored Cohen.

She is also frustrated with how the pandemic has been politicized and the proliferation of conspiracy theories.

I want to tell everybody this is not a government conspiracy. The vaccine does not have chips in it or fetal tissue, said Cohen. It doesnt matter if you are a liberal, a Libertarian, Republican, or a Democrat, it [the virus] doesnt discriminate.

Cohen is waiting for more details on her prognosis for the lung disorder. Until then, she is leaning on loved ones, including a Regent University professor, who have offered prayers.

Get the free WAVY News App, available for download in the App Store and Google Play, to stay up to date with all your local news, weather and sports, live newscasts and other live events.

See the original post:

Former journalist recovering from COVID-19 in Norfolk: It is not a hoax - WAVY.com