Monthly Archives: July 2021

NEW DELHIWith Indias hospitals under siege from a coronavirus wave in April, Mallik Manem found it nearly impossible to consult with a physician in the southern city of Hyderabad about care for his 81-year-old mother, who was sick with Covid-19. One harried doctor, Mr. Manem said, carved out five minutes to chat over the phone.

So the 55-year-old, who was himself ill with Covid-19, went online. Mr. Manem was able to consult with four doctors in the U.S. over video chats. One looked over lab results; another recommended breathing exercises.

It was just fantastic, said Mr. Manem, an Atlanta resident who was in India visiting family. Each doctor gave me at least 15 to 20 minutes of their time. His mother has since fully recovered.

The role of telemedicine has grown in many countries since the start of the pandemic. Often it has allowed people to consult with physicians without leaving their homes during lockdowns and avoid spreading or contracting the virus. In much of the developing world with weaker healthcare systems, and particularly in India during the recent surge, telemedicine has played a far more vital role.

Telemedicine has almost become a replacement for in-person care in many cases in India, said Vikram Kapur, a partner at Bain & Co. who leads its Asia-Pacific healthcare practice. Theres just not enough doctors and so many people needing care, he said.

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Doctors Online Provided Lifeline From Afar While Covid-19 Swept Through India - The Wall Street Journal

4:49 PM ET

Jeff PassanESPN

All-Star outfielder Aaron Judge was among six New York Yankees players who tested positive for COVID-19 on Thursday, forcing the postponement of their home game against the Boston Red Sox that was supposed to open Major League Baseball's second half and leaving other players on the American League All-Star team undergoing testing to ensure they didn't contract the virus, sources told ESPN.

In addition to Judge, third baseman Gio Urshela and catcher Kyle Higashioka were in the league's COVID-19 protocols after testing positive on rapid tests and awaiting confirmation from a test with greater accuracy, sources told ESPN's Buster Olney. Relievers Jonathan Loaisiga, Nestor Cortes Jr. and Wandy Peralta had confirmed positives and were placed on the COVID-19 injured list, Yankees general manager Brian Cashman said.

"It's a fluid situation that could spread," Cashman said. "It has spread to some degree."

While the rash of positives threw into flux the immediate future of a Yankees team still trying to determine how it will approach the July 30 trade deadline, Judge's inclusion rippled across the league, with players who participated in Tuesday's All-Star Game flying across the country to play a full slate of games Friday. Red Sox third baseman Rafael Devers told ESPN's Marly Rivera that the team's five All-Stars would undergo further testing on Thursday. Unvaccinated All-Stars were tested for COVID-19 while in Denver for the game, and all of the tests came back negative, sources said.

The Yankees, who are in fourth place in the American League East at 46-43, were hoping to put a dent in Boston's eight-game advantage. The Red Sox swept both three-game series against New York in the season's first half, and the teams were scheduled to play eight games over the next week and a half as the trade deadline approaches and the Yankees figure out whether to contend for a playoff spot, punt on the season or hold as is.

This is the second outbreak on the Yankees this year despite the team exceeding the 85% vaccination threshold that allows teams to enjoy relaxed protocols. In May, more than a half-dozen Yankees coaches, including pitching coach Matt Blake, third-base coach Phil Nevin and first-base coach Reggie Willits, tested positive. Nevin spent three weeks in the hospital but credited being vaccinated with saving him from a worse outcome.

"I guess the last year, year and a half, has in some ways kind of prepared you for this kind of stuff," manager Aaron Boone said. "Certainly disappointing and frustrating, and don't want to be sitting here talking about this, and desperately want us to go back to as normal as possible. But that's out of our control, too. And we just got to do the best with the circumstances and with the hand that we're dealt and try to make sure we're taking care of one eat one another as best we can, taking care of our players and staff as best we can. And hopefully get through this."

Among the six Yankees players currently with positive tests, the majority had received a COVID-19 vaccine and were asymptomatic, according to Cashman. Loaisiga went on the COVID-19 injured list Saturday, when the Yankees were in Houston, and did not travel home with the team Sunday.

"We're thankful that we're vaccinated in most cases, not all cases, but in most cases, so we're ultimately protected," Cashman said.

The status of the New York-Boston game Friday at Yankee Stadium remains in flux, and as MLB conducts testing on close contacts and the Yankees scramble to mobilize players to fill out a roster that could be missing nearly a quarter of its regulars, MLB can choose to postpone that game as well.

"You don't want to take any chances," Red Sox manager Alex Cora said. "I think, from my end, playing [two games on Friday] doesn't make sense. Hopefully, we can play one. But the league will decide that."

This was the eighth COVID-19-related postponement this season but the first in nearly three months. Also delayed were a three-game series between the New York Mets and Washington Nationals on April 1-4 and Atlanta's game at the Nationals on April 5, two Minnesota Twins-Los Angeles Angels games on April 17-18 and a Twins-Oakland Athletics game on April 19.

There were 45 regular-season games postponed for virus-related reasons last year with two not made up.

New York was among the first major league teams to reach the 85% vaccination threshold to lessen coronavirus protocols such as dropping mask use in dugouts and bullpens.

MLB said in its last announcement on June 25 that 23 of its 30 teams had reached an 85% vaccination rate among Tier 1 individuals, such as players and on-field staff. The Red Sox were not among them.

New York players were taking early batting practice about 3 hours before the scheduled start Thursday when the Yankees asked media to leave the field while the team conducted COVID-19 testing. Boston, whose 55-36 record matched Houston for best in the AL, came onto the field to take batting practice as the postponement was announced.

The Associated Press contributed to this report.

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Sources - Aaron Judge among six New York Yankees to test positive for COVID-19 - ESPN

AUGUSTA, Maine (AP) The Maine Legislatures budget-writing committee voted along party lines on a plan for spending nearly $1 billion in federal COVID-19 relief funds that tracks closely with a plan laid out by the governor.

But Democratic Gov. Janet Mills urged the panel to negotiate a compromise that could gain the support of two-thirds majority of lawmakers to go into effect immediately, instead of 90 days after lawmakers adjourn.

If we allow three more months to pass simply because we couldnt find consensus, then that could mean the difference between a business surviving or failing, between a parent being able to afford child care so they can go back to work or not, between expanding broadband to rural communities or not, Mills said. The stakes are high. The implications are real.

The proposal includes money for economic recovery and job training; child care and education; and broadband, affordable housing and energy efficiency, among other things.

Rep. Sawin Millett, R-Waterford, his partys leading House committee member, said hes concerned about using one-time federal funds to create ongoing state spending, causing problems down the road.

Republicans proposed a similar alternative that includes more pandemic relief for businesses. One sticking point was that $20 million of $50 million in funding for building or renovating affordable housing must go to firms that have agreements with organized labor.

Senate Minority Leader Jeff Timberlake, R-Turner, said he hoped negotiations would continue over the weekend before lawmakers reconvene Monday.

But Sen. Cathy Breen, D-Falmouth, Senate chair of the budget committee, said any further changes will have to be made in the form of amendments once floor debate begins on the proposal.

___

Follow APs coverage of the pandemic at https://apnews.com/hub/coronavirus-pandemic.

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Panel approves spending of nearly $1B in COVID-19 relief - Associated Press

After a turbulent year that exacerbated and highlighted long-standing structural issues across the United States, the National Urban League, a civil rights advocacy organization, said in its annual "State of Black America" report released Thursday that COVID-19 has worsened racial issues in the country.

In partnership with the Brookings Institution, Johns Hopkins Center for Health Equity and Center for Policing Equity, the report analyzed the devastation in Black communities in the wake of the COVID-19 pandemic.

"Structural racism is not new to many of us. For centuries and even today, Black lives continue to be subject to laws, policies and practices that have created and sustained systematic oppression that impacts every facet of our lives," Tracie Keesee, co-founder and senior vice president of social justice initiatives at the Center for Policing Equity, said at a virtual event Thursday discussing the release of the report.

The report highlighted three main issues in the Black community right now, including economic injustice, racism in policing and health care inequality.

COVID-19 has proven flaws in the U.S. health care system, the report asserts. Black and brown victims are disproportionately dying from the virus, compared to other white populations, according to data from the Centers for Disease Control and Prevention. Black individuals are two times more likely to die from COVID-19 than people who are white, and Hispanics are 2.3 times more likely to die, according to CDC data.

A healthcare worker wheels a stretcher into the emergency room at Lenox Health Greenwich Village in New York, May 26, 2020.

And even though the percentage of Black and white people who are vaccine hesitant or refusing to get the vaccine are roughly the same, vaccinate rates are much lower among Black populations. The report states that disparities in COVID-19 vaccination rates indicate inequities in vaccine distribution and access for Black populations.

The group's research also found that Black people are more likely than whites to live more than 10 miles from a vaccine facility.

Poor access to health care is just one result of structural racism, the report states. Economic inequality is another, which was also worsened by COVID-19.

The typical African American household had less than 15% of the median wealth of a typical white household, and Black workers face significant pay gaps in the workforce, according to data from the Federal Reserve Bank.

And during the COVID-19 pandemic, almost 17% of Black households lacked basic financial services, compared to only 3% of white households, according to the Brookings Institution.

A nurse wearing personal protective equipment (PPE) attends to a patient in a Covid-19 intensive care unit (ICU) at Martin Luther King Jr. Community Hospital on Jan. 6, 2021 in Los Angeles.

Experts at the National Urban League said the existing inequalities can be fixed by closing the racial wealth gap, reparations and more.

"We need to look at wage suppression, and wage in equity as a racial issue in and of itself," Jennifer Jones Austin, the CEO and executive director of the Federation of Protestant Welfare Agencies, said Thursday on the panel discussing the report. "Why can't we increase wages at the federal level? It is because this nation has determined that there will always be an underclass. And disproportionately that underclass represents Black and brown Americans."

Police brutality and violence have also been a consequence of structural racism, according to the report.

Even as the racial reckoning took over the country following the death of George Floyd, killings of Black people at the hands of police continued, including Daunte Wright, Ma'Khia Bryant and others.

Black people are not only more likely to be killed by police, but according to the Center for Policing Equity, Black people were also about 6.5 times more likely to be stopped while driving and 20 times more likely to be searched than their white counterparts.

To solve this, the National Urban League recommended reenvisioning public safety and what its structure and function in communities looks like.

A dose of Covid-19 vaccine is administered in Odessa, Texas, May 27, 2021.

The organization also recommended holding officers accountable for misconduct, changing divisive policing policies, requiring transparency, reporting and data collection and improving training standards.

Not much has improved since last year's "State of Black America" report, experts on the panel said, but with the data and knowledge that has been gathered this year on structural racism and how it impacts people of color, some community leaders have hope.

"Dismantling structural racism -- identifying and repairing the cracks in our national foundation -- will result in more resilient and dynamic institutions that expand opportunity for everyone," Marc Morial, president and CEO of the National Urban League, said in the report. "As the pandemic becomes more of a memory, we are challenged to keep the same energy and finish what we started."

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COVID-19 heightened racial issues in the US: Report - ABC News

The West Virginia Department of Health and Human Resources (DHHR) reports as of July 15, 2021, there have been 3,060,485 total confirmatory laboratory results received for COVID-19, with 164,843 total cases and 2,917 deaths.

DHHR has confirmed the death of a 69-year old male from Preston County. We offer our deepest sympathy as both the family and our state grieve another loss due to COVID-19, said Bill J. Crouch, DHHR Cabinet Secretary. Lets continue taking every precaution we can to stop the spread of this disease, including scheduling a COVID-19 vaccination for yourself and all eligible family members.

CASES PER COUNTY: Barbour (1,517), Berkeley (12,915), Boone (2,186), Braxton (1,023), Brooke (2,252), Cabell (8,938), Calhoun (399), Clay (544), Doddridge (647), Fayette (3,565), Gilmer (890), Grant (1,319), Greenbrier (2,913), Hampshire (1,935), Hancock (2,847), Hardy (1,588), Harrison (6,232), Jackson (2,271), Jefferson (4,812), Kanawha (15,547), Lewis (1,313), Lincoln (1,609), Logan (3,310), Marion (4,673), Marshall (3,542), Mason (2,074), McDowell (1,639), Mercer (5,223), Mineral (2,999), Mingo (2,779), Monongalia (9,416), Monroe (1,226), Morgan (1,246), Nicholas (1,916), Ohio (4,320), Pendleton (726), Pleasants (959), Pocahontas (682), Preston (2,965), Putnam (5,374), Raleigh (7,113), Randolph (2,864), Ritchie (765), Roane (667), Summers (866), Taylor (1,293), Tucker (548), Tyler (751), Upshur (1,988), Wayne (3,188), Webster (565), Wetzel (1,400), Wirt (466), Wood (7,967), Wyoming (2,071).

Free pop-up COVID-19 testing is available today in Barbour, Berkeley, Hampshire, Jefferson, Lewis, Lincoln, and Mingo counties.

Barbour County

9:00 AM 11:00 AM, Barbour County Health Department, 109 Wabash Avenue, Philippi, WV

Berkeley County

10:00 AM 5:00 PM, 891 Auto Parts Place, Martinsburg, WV

Hampshire County

10:00 AM 5:00 PM, Hampshire County Health Department, 16189 Northwestern Turnpike, Augusta, WV

Jefferson County

10:00 AM 6:00 PM, Hollywood Casino, 750 Hollywood Drive, Charles Town, WV

Lewis County

Lincoln County

Mingo County

10:00 AM 2:00 PM, Seven Eleven, 11 West Second Avenue, Williamson, WV

11:00 AM 4:00 PM, Larry Joe Harless Community Center, 202 Larry Joe Harless Drive, Gilbert, WV

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COVID-19 Daily Update 7-15-2021 - West Virginia Department of Health and Human Resources

PROVIDENCE, R.I. (AP) Rhode Island is shutting down six state-run COVID-19 testing sites that since September have exclusively served school and child care students and staff.

The sites will not be needed as testing will be available on-site at schools in the fall, and because testing is now more accessible in traditional health care settings, the state Department of Health said in a statement Thursday.

The sites will end operations on July 31.

They are at the Stop & Shop in Bristol; the Stop & Shop in Cranston; the YMCA in Lincoln; the Manton Avenue Stop & Shop in Providence; Fidelity Investments in Smithfield; and the Walmart in Westerly.

The states plan for full in-person learning for the fall includes on-site testing, with school districts able to design and resource their plans. Options will include symptomatic testing, outbreak testing, and asymptomatic testing.

The sites were opened in September to support the return to in-person learning and child care.

Five school and child care testing sites will remain open.

Original post:

Rhode Island to close 6 school COVID-19 testing sites - Associated Press

GENEVA/NEW YORK, 15July 2021 --- 23 million children missed out on basic vaccines through routine immunization services in 2020 3.7 million more than in 2019 - according to official data published today by WHO and UNICEF. This latest set of comprehensive worldwide childhood immunization figures, the first official figures to reflect global service disruptions due to COVID-19, show a majority of countries last year experienced drops in childhood vaccination rates.

Concerningly, most of these up to 17 million children likely did not receive a single vaccine during the year, widening already immense inequities in vaccine access. Most of these children live in communities affected by conflict, in under-served remote places, or in informal or slum settings where they face multiple deprivations including limited access to basic health and key social services.

Even as countries clamour to get their hands on COVID-19 vaccines, we have gone backwards on other vaccinations, leaving children at risk from devastating but preventable diseases like measles, polio or meningitis, said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. Multiple disease outbreaks would be catastrophic for communities and health systems already battling COVID-19, making it more urgent than ever to invest in childhood vaccination and ensure every child is reached.

In all regions, rising numbers of children miss vital first vaccine doses in 2020; millions more miss later vaccines

Disruptions in immunization services were widespread in 2020, with the WHO Southeast Asian and Eastern Mediterranean Regions most affected. As access to health services and immunization outreach were curtailed, the number of children not receiving even their very first vaccinations increased in all regions. As compared with 2019, 3.5 million more children missed their first dose of diphtheria, tetanus and pertussis vaccine (DTP-1) while 3 million more children missed their first measles dose.

This evidence should be a clear warning the COVID-19 pandemic and related disruptions cost us valuable ground we cannot afford to lose and the consequences will be paid in the lives and wellbeing of the most vulnerable, said Henrietta Fore, UNICEF Executive Director. Even before the pandemic, there were worrying signs that we were beginning to lose ground in the fight to immunize children against preventable child illness, including with the widespread measles outbreaks two years ago. The pandemic has made a bad situation worse. With the equitable distribution of COVID-19 vaccines at the forefront of everyones minds, we must remember that vaccine distribution has always been inequitable, but it does not have to be.

Table 1: Countries with the greatest increase in children not receiving a first dose of diphtheria-tetanus-pertussis combined vaccine (DTP-1)

2019

2020

India

1'403'000

3'038'000

Pakistan

567'000

968'000

Indonesia

472'000

797'000

Philippines

450'000

557'000

Mexico

348000

454'000

Mozambique

97'000

186'000

Angola

399'000

482'000

United Republic of Tanzania

183'000

249'000

Argentina

97'000

156'000

Venezuela (Bolivarian Republic of)

75'000

134'000

Mali

136'000

193'000

The data shows that middle-income countries now account for an increasing share of unprotected children that is, children missing out on at least some vaccine doses. India is experiencing a particularly large drop, with DTP-3 coverage falling from 91 per centto 85 per cent.

Fuelled by funding shortfalls, vaccine misinformation, instability and other factors, a troubling picture is also emerging in WHOs Region of the Americas, where vaccination coverage continues to fall. Just 82 per centof children are fully vaccinated with DTP, down from 91 per centin 2016.

Countries risk resurgence of measles, other vaccine-preventable diseases

Even prior to the COVID-19 pandemic, global childhood vaccination rates against diphtheria, tetanus, pertussis, measles and polio had stalled for several years at around 86 per cent. This rate is well below the 95 per centrecommended by WHO to protect against measles often the first disease to resurge when children are not reached with vaccines - and insufficient to stop other vaccine-preventable diseases.

With many resources and personnel diverted to support the COVID-19 response, there have been significant disruptions to immunization service provision in many parts of the world. In some countries, clinics have been closed or hours reduced, while people may have been reluctant to seek healthcare because of fear of transmission or have experienced challenges reaching services due to lockdown measures and transportation disruptions.

These are alarming numbers, suggesting the pandemic is unravelling years of progress in routine immunization and exposing millions of children to deadly, preventable diseases, said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. This is a wake-up call we cannot allow a legacy of COVID-19 to be the resurgence of measles, polio and other killers. We all need to work together to help countries both defeat COVID-19, by ensuring global, equitable access to vaccines, and get routine immunization programmes back on track. The future health and wellbeing of millions of children and their communities across the globe depends on it.

Concerns are not just for outbreak-prone diseases. Already at low rates, vaccinations against human papillomavirus (HPV) - which protect girls against cervical cancer later in life - have been highly affected by school closures. As a result, across countries that have introduced HPV vaccine to date, approximately 1.6 million more girls missed out in 2020. Globally only 13 per cent ofgirls were vaccinated against HPV, falling from 15 per centin 2019.

Agencies call for urgent recovery and investment in routine immunization

As countries work to recover lost ground due to COVID-19 related disruptions, UNICEF, WHO and partners like Gavi, the Vaccine Alliance are supporting efforts to strengthen immunization systems by:

The agencies are working with countries and partners to deliver the ambitious targets of the global Immunization Agenda 2030, which aims to achieve 90% coverage for essential childhood vaccines; halve the number of entirely unvaccinated, or zero dose children, and increase the uptake of newer lifesaving vaccines such as rotavirus or pneumococcus in low and middle-income countries.

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Notes for editors:

About the data

Based on country-reported data, the official WHO and UNICEF estimates of national immunization coverage (WUENIC) provide the worlds largest data-set on immunization trends for vaccinations against 13 diseases given through regular health systems - normally at clinics or community centres or health worker visits. For 2020, data were provided from 160 countries.

Globally, the vaccination rate for three doses of diphtheria-tetanus and pertussis (DTP-3) vaccine fell from around 86 per centin 2019 to 83 per cent in 2020, meaning 22.7 million children missed out, and for measles first dose, from 86 to 84 per cent, meaning 22.3 million children missed out. Vaccination rates for measles second dose were at 71 per cent(from 70 per cent in 2019). To control measles, 95 per cent uptake of two vaccine doses is required; countries that cannot reach that level rely on periodic nationwide vaccination campaigns to fill the gap.

In addition to routine immunization disruptions, there are currently 57 postponed mass vaccination campaigns in 44 countries*, for measles, polio, yellow fever and other diseases, affecting millions more people.

New modelling also shows significant declines in DTP, measles vaccination coverage

New modelling, also published today in The Lancet by researchers at the Washington-based Institute for Health Metrics and Evaluation (IHME), similarly shows that childhood vaccination declined globally in 2020 due to COVID-19 disruptions. The IHME-led modelling is based on country-reported administrative data for DTP and measles vaccines, supplemented by reports on electronic medical records and human movement data captured through anonymized tracking of mobile phones.

Both analyses show that countries and the broader health community must ensure that new waves of COVID-19 and the massive rollout of COVID 19 vaccines dont derail routine immunization and that catch-up activities continue to be enhanced.

*Correction: This figure was corrected from57 postponed mass vaccination campaigns in 66 countries.

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COVID-19 pandemic leads to major backsliding on childhood vaccinations, new WHO - UNICEF

What GAO Found

State and local government revenues from individual, corporate, and sales taxes declined about $61 billion in the second quarter of 2020 compared to the second quarter in 2019 and rebounded in the third and fourth quarters of 2020. State and local government expenditures remained largely flat throughout 2020 as state and local governments increased expenditures in some areas but limited spending in other areas.

State and Local Government Revenues, First Quarter 2019 through Fourth Quarter 2020

Among the eight states GAO selected, those highly reliant on tax revenues from the energy and tourism and leisure sectors were particularly vulnerable to the economic effects of the pandemic. Other states saw varying levels of revenue declines based on factors such as the duration of business shutdowns. Some selected states revised their revenue forecasts downward as the pandemic progressed and some states' revenue declines were not as severe as initially projected by the revised revenue forecasts.

Most selected states increased public health and safety expenditures and cut spending in other areas. Six states took actions aimed at reducing spending, including hiring freezes or furloughs. Half of the selected states used reserve funds to help balance their budgets. Officials from most states reported that their proposed budgets did not include tax or fee increases.

Five of the eight selected states used the federal assistance they received, including Coronavirus Relief Funds (CRF), to help bolster their states' capacity to implement federal programs. In particular, states used CRF to help manage the increased demand for services due to COVID-19, such as administering unemployment insurance benefits.

The COVID-19 pandemic and related policies had a rapid and severe effect on the U.S. economy, including state and local governments. To limit social contact and slow the spread of the pandemic, nearly all states implemented policies that limited certain economic activities. Relief laws, including the CARES Act, provided appropriations to state and local governments to address the public health and economic threats posed by the pandemic.

The CARES Act includes a provision for GAO to report on COVID-19 pandemic oversight efforts. This report examines (1) changes in revenues and expenditures for the state and local government sector since the onset of the pandemic, (2) changes in revenues and expenditures for selected states, (3) actions selected states took to address changes in revenues and expenditures, and (4) factors that affected the selected states' capacity to implement federal programs.

To conduct this work, GAO analyzed state and local government revenue and expenditure data from the U.S. Census Bureau and the Bureau of Economic Analysis's National Income and Product Accounts. GAO analyzed state budget and other relevant documents and interviewed budget officials in eight states that represented a range of factors, including number of COVID-19 cases, revenue sources, and geographic region. GAO also interviewed organizations that represent state and local governments and experts that provide financial and credit risk information to state and local governments.

For more information, contact Michelle Sager at (202) 512-6806 or SagerM@gao.gov.

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State and Local Governments: Fiscal Conditions During the COVID-19 Pandemic in Selected States - Government Accountability Office

As training camps across the NFL are set to open up in less than two weeks, some teams may be looking at a competitive disadvantage due to their vaccination rates. According to Tom Pelissero of the NFL Network, two teams remain under 50% vaccinated. This is improved from four clubs being under that threshold, which Rob Maaddi of the Associated Pressnoted in a report released on Thursday. The Los Angeles Chargers, Washington Football Team, Indianapolis Colts, and Arizona Cardinals were said to be the teams with the four lowest COVID-19 vaccination rates in the league as of Thursday, per the AP's source, who spoke on condition of anonymity, but it's unclear which two still remain under 50%.

Meanwhile, the NFL Network adds that 13 teams are over the 85% vaccinated threshold and 73.8% of players have at least one shot. The AP adds that thePittsburgh Steelers, Miami Dolphins, Carolina Panthers and Denver Broncos are among with teams with the highest vaccination rates.

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Maaddi notes that teams are required to have a method of easily identifying vaccinated individuals (Ex. credentials, color-coded wristbands, etc.). While fully vaccinated players face relaxed protocols this season, unvaccinated players will be required to undergo daily testing, wear masks and practice social distancing. Other restrictions include not being allowed to eat meals with teammates, participate in media or marketing activities while traveling, using the sauna or steam room and being confined to the team hotel while traveling. Vaccinated players have no such restrictions.

These vaccination numbers come in particular focus as we not only creep toward the start of the NFL's regular season but as the COVID-19 pandemic continues to be a thorn in the side of professional sports in the United States. The Red Sox-Yankees game scheduled for Thursday to begin the second half of the MLB season was postponed due to an outbreak within New York's clubhouse. Team USA basketball's exhibition with Australia was canceled due to health and safety concerns after star guard Bradley Beal was sent home and will no longer participate in the Olympics.

The APreports that the NFL does not plan to postpone games this season, so naturally, teams with fewer players vaccinated do open themselves up to playing under less-than-ideal conditions. There was arguably no greater example of that in 2020 than when the Broncos' entire quarterback room was ineligible to play in Week 12 due to COVID-19, thrusting wide receiver Kendall Hinton in as the team's starting quarterback. If teams want to avoid a similar scenario and have a fully equipped squad heading into a game on a weekly basis, having a high vaccination rate is paramount.

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Two NFL teams remain under the 50 percent COVID-19 vaccination threshold, per report - CBS Sports

The U.S. fell short of its goal of giving at least one dose of the COVID-19 vaccine to 70 percent of adults by July 4, but not by much. About two-thirds of everyone above the age of 18 had gotten a shot when the holiday arrived, with coverage among seniors surpassing even that benchmark. That leaves kidsmostly unvaccinatedas the Americans most exposed to the pandemic this summer, while the Delta variant spreads. Its said that COVID-19 may soon be a disease of the young. If thats whats coming, then its effects on children must be better understood.

This month, The New England Journal of Medicine published new treatment guidelines for the occasionally fatal, COVID-related condition known as multisystem inflammatory syndrome in children (MIS-C). When kids first started showing signs of MIS-C in early 2020rash or conjunctivitis; low blood pressure; diarrhea or vomiting; etc.doctors guessed it was an inflammatory disease that occurs most often in toddlers called Kawasaki disease. Now most experts believe its a separate condition, affecting kids at an average age of 8. No more than a few hundred children in the U.S. have died from COVID-19 during the pandemiccompared with more than half a million deaths overallbut more than 4,000 have developed MIS-C, and we still dont have foolproof ways to cure it. But a handful of scientists think theyve found important clues about what drives MIS-C. The disease, they say, may have something to do with a dangerous condition most commonly associated with tampon use.

That condition, called toxic shock syndrome, was also quite mysterious when it first appeared, in a group of kids in the late 1970s. Within a few years, it was clear that women who used high-absorbency tampons were also falling ill, with symptoms very much like those now seen in MIS-C: They had kidney failure, diarrhea, and skin rashes; a few went into shock and died. (Indeed, one of the early sufferers, like the early MIS-C patients, was initially and incorrectly thought to have Kawasaki disease.) Doctors soon realized that the tampon-induced sickness was caused by a buildup of toxins from certain strains of Staphylococcus or Streptococcus bacteria. In people who do not yet have immunity to those strains, the toxins somehow bypass the immune systems usual processes for developing a targeted response to a pathogen. That sets off a widespread, confused, nonspecific immune reaction.

Read: Doctors are puzzled by heart inflammation in the young and vaccinated

The toxins that caused the immune system to run amok were called superantigens in 1989. (More than two dozen types have now been discovered in tampon-related bacteria, rabies, Ebola, and other pathogens.) What makes them super is their ability to short-circuit T-cell receptors. Under normal circumstances, a foreign substance provokes an immune reaction when a piece of it, called an antigen, binds to the nook in the middle of a T-cell receptor. That prompts the body to make antibodies tailored to the antigens specific shape. But superantigens manage to grab on and connect to the T cells outside the nook. That still triggers an immune response, but it isnt one thats custom-made for the infection. What does a superantigen do? It comes on from the side, says Moshe Arditi, a pediatric-infectious-disease doctor at Cedars-Sinai Medical Center, in L.A. That's why its able to bind to many, many, many, many cells20 to 30 percent of your T cells that suddenly could be bound by the superantigen andboomactivated like crazy.

Arditi has been studying Kawasaki disease for years, but when cases of MIS-C began to be described last year, he suspected they had more in common with toxic shock syndrome. So Arditi reached out to the computational biologist Ivet Bahar, of the University of Pittsburgh School of Medicine, among other scientists, to help investigate. Bahars lab found a resemblance between the SARS-CoV-2 spike protein, which allows the pandemic virus to infect human cells, and the Staphylococcus superantigen toxin. The results appeared in September in the Proceedings of the National Academy of Sciences. This level of similarity, both in sequence and structure with the bacterial toxin, tells us for sure that this segment of spike has the same behavior, Bahar told me.

Still, the scientists continued to gather evidence in support of this idea. In spring, Arditi, Bahar, and other colleagues reported that children with MIS-C, like people with toxic shock syndrome, have increased numbers of T cells with a receptor that binds to superantigens. Around the same time, scientists in France reached a similar conclusion, likening the unusual T-cell pattern in MIS-C to that of toxic shock syndrome.

Read: Why kids might be key to reaching herd immunity

If its true that a protein from the virus that causes COVID-19 is a superantigen, then you might expect to see something akin to toxic shock syndrome among a larger segment of those who are infected, as opposed to just in kids. In fact, there is an adult version of MIS-C, known as MIS-A (the incidence of this condition is not known, however). Its also possible that long COVID in adults, as well as other suspected autoimmune features of the disease, is related to superantigens, says Michel Goldman, an immunologist at the French-speaking Free University of Brussels.

However, not every MIS-C researcher is convinced that the spike protein itself causes a superantigen-like illness. I don't buy that its driven by SARS-CoV-2 directly, says Carrie Lucas, an immunologist at the Yale University School of Medicine who has studied the pediatric disease. Lucas notes that toxic shock syndrome tends to come on in a matter of days following a bacterial infection, whereas MIS-C often manifests several weeks after a child has contracted the coronavirus. Also, affected children usually show only mild symptoms during their initial encounter with the pathogen. To Lucas, those two factors suggest that another mechanism is in play. Perhaps the body creates a molecule in response to the coronavirus infection, and this molecule, in turn, behaves as a superantigen.

Another unusual finding about MIS-C could explain its delayed onset, though. Lael Yonker, a pediatric pulmonologist at Massachusetts General Hospital, and her collaborators found some evidence suggestingbut not definitively provingthat the condition originates, weeks after infection, in a childs gut. Its been well established that the coronavirus, or at least bits of it, can be detected for some time post-exposure in peoples stool samples. But samples from kids with MIS-C also show elevated levels of a protein called zonulin, which is normally found in the gut lining and makes the intestine more permeable when its released. If children with MIS-C have leaky guts, that could explain their prolonged gastrointestinal symptoms. It might also tell us why infected kids who develop MIS-C (as opposed to infected kids who dont) end up with spike protein from the coronavirus circulating in their blood.

Read: The tampon: a history

Yonker and her colleagues wanted to see if they could prevent this damage to the gut, so they tried giving a toddler with MIS-C an experimental medicine for celiac disease that goes after zonulin. He was very ill, Yonker says. He was being treated with the standard treatments like steroids and his symptoms kept coming back. The toddler got better: Spike levels in his blood dropped by 90 percent and his fever lessened. One case cant demonstrate a connection between the drug and the response, so the scientists are now launching a formal study of the celiac drug, called larazotide, for MIS-C.

Meanwhile, Arditi and his colleagues have reported that, in laboratory testing, a monoclonal antibody drug developed as a potential (but still experimental) treatment for patients with toxic shock syndrome also attached to the suspected superantigen portion of SARS-CoV-2 and blocked the virus from infecting cells. The team has patented the new use of the experimental toxic-shock drug for COVID-19 and is waiting to see if there is interest from industry in moving it forward in development.

The approval of those drugs for COVID-19, or MIS-C patients specifically, is a very distant prospect. For now, the fact that SARS-CoV-2 might function as a superantigen in children (as well as some adults) underscores a risk that may be growing. Youngsters who are not yet immunized against COVID-19 would be the most important beneficiaries of a better understanding of this link. The global sweep of newer, more infectious, variants means we need to remain vigilant, says Diana Berrent, the founder of the patient advocacy group Survivor Corps. With no child under 12 vaccinated, and the general trend towards abandonment of masking, testing, and isolation, we are putting our children in an unnecessarily vulnerable position.

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Clues About MIS-C and COVID-19 in Kids - The Atlantic