Category Archives: Covid-19

Experts recommend regulatory policies to improve long-term care in the wake of COVID-19.

Nursing homes and other long-term care facilities have been devastated by the COVID-19 pandemic. Nearly one-third of coronavirus deaths in the United States have been residents and employees of these facilities. As of May 2021, confirmed cases in these facilities have reached over one million. The leading explanation for these high rates is that residents advanced age and comorbidities make them particularly at risk for severe illness and death from the virus. This risk is compounded by the communal nature of long-term facilities, which increases the likelihood of residents and staff spreading COVID-19. Still, some experts argue that regulatory failures and chronic underfunding are partly to blame for such tragic outcomes in one of Americas most vulnerable populations.

Although the challenges of the COVID-19 pandemic are new, the crisis in long-term care is not. Long-term care facilities have a long history of low-quality care. In 1986, a study by the Institute of Medicine found that nursing home residents were routinely given inadequate care, neglected, or abused. In response, Congress passed the Nursing Home Reform Act, which set new care standards, upgraded staffing requirements, and established an enforcement mechanism for noncompliant facilities. Today, states enforce these standards through unannounced surveys conducted every 9 to 15 months, with variable penalties depending on the severity of the violation.

Most nursing home quality measures have improved over time under this law, but the majority of facilities still fall short of federal standards. In recent years, over 90 percent of nursing homes have received at least one citation per year for violating federal regulations. The pandemic only exposed and amplified these issues. Numerous nursing home residents have reported instances of severe neglect during lockdowns, including extreme weight loss and untreated bedsores.

Neglect for long-term care is also visible in its patchwork funding regime. The majority of long-term care is paid for by Medicaid, which only becomes available once individuals have exhausted their personal assets. Medicaid funding for long-term care also varies dramatically by state and is frequently under threat of budget cuts, especially during economic downturns. For individuals who look to private insurance to cover costs, they often find prohibitively high premiums. Fewer than 1 in 30 Americans own a long-term care insurance plan. Medicare, the primary insurer of Americans over 65 years old, does not cover long-term care beyond 100 days.

As a result of this patchwork system, nursing homes are chronically underfunded. The majority of nursing homes in the U.S. operate at a net loss, and hundreds of nursing homes have been forced to close in recent years. Thin or negative profit margins prompt facilities to cut corners in care quality and staffing levels, perpetuating low quality care. During the pandemic, increased costs have placed nursing homes on the brink of collapse, prompting billions of dollars of federal aid.

Today, approximately 12 million people in the U.S. need long-term care. By 2050, that number is expected to more than double. The challenges of the pandemic present a unique opportunity for policymakers to evaluate how the long-term care system is failing, so as to better prepare for increased demand going forward.

In this weeks Saturday Seminar, scholars explore how regulatory failures contributed to COVID-19 outbreaks in nursing homes and provide potential avenues for reform.

The Saturday Seminar is a weekly feature that aims to put into written form the kind of content that would be conveyed in a live seminar involving regulatory experts. Each week,The Regulatory Reviewpublishes a brief overview of a selected regulatory topic and then distills recent research and scholarly writing on that topic.

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Long-Term Care After COVID-19 - The Regulatory Review

Despite the progress that's been made to prevent the spread of COVID-19, more people are finding themselves re-infected, regardless of vaccination status.

CORPUS CHRISTI, Texas Although precautions and vaccinations are in place, more people are finding themselves re-infected, regardless of vaccination status.

Pulmonologist Dr. Salim Surani said people taking precautions, like wearing a mask, is a good thing.

Dr. Surani told 3NEWS, "even as of yesterday, if you look at it, we had more than 100,000 people who had an infection. Even in Nueces County, it's almost 175 people who were infected, many of those were reinfection."

The challenge with the number of reinfection cases is that these can be an underestimation, because people have the option of at-home testing.

"I think people are recognizing that there is a higher incidence of infection, and a lot of the folks who have already received the vaccine, or they've had COVID in the past, they're getting the infection again," Dr. Surani shared.

The vaccine is doing its job to prevent serious illness and hospitalizations, but the vaccine immunity wears off after a certain amount of time. That may be the reason why people are seeing more reinfections lately. Boosters, along with vaccinations, are crucial.

"I think we have to go beyond that," Dr. Surani said. "We have to have a constant state of vigilance. In other words, if you see an increased number of cases in your community, then you need to make sure that you avoid large public gatherings."

Social distancing and hand washing are practices that we've been doing for the past few years. These precautions work hand-in-hand with vaccinations and boosters, like the vaccinations that were recently approved for those six-months and up.

"If you look at the bigger states like California and New York, they have more than 200 cases of reinfection," Dr. Surani said. "So the reinfection is going to happen, depending on your community prevalence or incidence of the disease. The higher number of cases that are in the community, the more chances you may get infected."

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COVID-19 reinfections are on the rise in Nueces County - KIIITV.com

Over a year after the US authorized its first vaccines, COVID cases continue to pile up, leaving many vaccinated people wondering: Do I need a vaccine upgrade? People who are fully vaccinated and boosted have been testing positive in huge numbers, particularly since the omicron-triggered wave started its relentless burn across the United States in December. Vaccines that once caused experts to declare COVID-19 a pandemic of the unvaccinated dont protect as well against illness, even as they continued to protect against the most severe disease. Breakthrough infections are so common that the near-miraculous protection the vaccine promised a year ago feels very far away.

Part of the problem is that the virus that the vaccines target the first version of the coronavirus that started spreading in early 2020 doesnt exist anymore. Now, regulators, researchers, and vaccine companies are turning to the next phase of the vaccine development process: finding a way to protect against the virus thats spreading now and finding a way to protect people against future variations of the virus.

On June 28th, an FDA committee will meet to discuss whether and how future booster doses of vaccines might specifically target emerging variants of the virus. Like the seasonal flu shot, the next vaccines may at some point protect against whatever version of the virus is going to be circulating in a particular year. At the same time, other scientists are looking into ways of making the protection from any booster shot last longer. Longer-term, COVID-19 vaccines might be very different from current shots, using different technology and protecting against viruses that dont even exist yet. Some might not be shots but nasal sprays, which might be able to prevent even mild infections.

Preventing severe disease was the original goal, and I understand that. At the beginning of the pandemic, that made sense, said Akiko Iwasaki, a professor of immunobiology at Yale University School of Medicine. But now we understand the virus better and the fact that the variants are here I think we need to shift our thinking.

The first step for the future of COVID-19 vaccines is to play catch-up with the recent past. After over two years, the version of the virus that was first detected in Wuhan, China, has been replaced by its more contagious and immune-evading variants. Several vaccine manufacturers have already started testing vaccines tailored to the omicron variant. An early analysis of Modernas omicron-specific shot showed that it generated more antibodies against the omicron virus than the original vaccine, the company announced earlier this month. The vaccine is bivalent its made to protect against both the original flavor coronavirus and omicron.

Moderna says its booster may be available by late summer in some markets, wrote Elise Meyer, senior director of communications at Moderna, in an email to The Verge.

Pfizer and BioNTech are also running a clinical trial to update their shots against omicron, examining standard booster shots of the original vaccine, a version targeting only omicron, and a bivalent shot like Modernas. At a press briefing in April, Pfizer CEO Albert Bourla said an omicron shot might be available in the fall.

Novavax, whose vaccine might be approved soon in the US, is working on its own omicron booster. Its clinical trial testing both omicron-targeted shot and a bivalent vaccine started on May 31st. The vaccine, which has been under review by the FDA since January, seems to have less severe side effects than the other vaccines, making it potentially ideal to use as a non-disruptive booster.

But its still unclear if the omicron shots will work much better than the original vaccine against omicron and other variants. In one study on mice, the original vaccine actually worked quite well, at least in the short-term, said Larissa Thackray, an associate professor of infectious disease at the Washington University School of Medicine in St. Louis.

If omicron-specific vaccines dont have a major benefit over the existing vaccines, they could be a hard sell to be authorized by the FDA. Yet despite the uncertainty, Thackray said she thinks an omicron booster is overdue. A vaccine targeting a current or at least recent variant makes more sense than one targeting a much different virus the original strain of SARS-CoV-2, which doesnt exist anymore.

At some point, omicron might not be circulating anymore either. Its already evolved into several sublineages, and the virus will only keep evolving. Figuring out a way to continuously update the shots is one way to keep on top of it. But other researchers are working on universal vaccines which could theoretically protect against any new form of the virus.

Vaccines like this take advantage of the immune systems ability to respond to the parts of viruses that stay the same as they evolve, said David Martinez, an immunologist at the University of North Carolina at Chapel Hill and an author of a 2021 study examining a proposed universal coronavirus vaccine.

Martinez and other researchers made their vaccine by combining genetic material from a handful of different coronaviruses. Their goal was to make a shot that could generate an immune response against current and future variants, as well as other coronaviruses that could cause another pandemic. Its still preliminary that particular universal vaccine has only been tested in animals but its a first step toward broad protection.

This kind of vaccine might still work even if the virus substantially changes, said Martinez. But it will be a long time before we know if this is true its likely that this kind of vaccine will take years for scientists to develop, test, and get approved, he said.

Universal vaccines arent the only next-gen products in development. Researchers are also working on vaccines that arent shots at all theyre nasal sprays.

Intranasal vaccines could protect against the virus right where it enters the body, said Iwasaki, the immunobiologist at Yale University School of Medicine.

It makes sense to establish immune defense right at these mucosal sites, she said, referring to the inside of the nose. It can prevent the infection of these tissues altogether. Without infection, people wouldnt transmit the virus, and theyd be protected from long COVID.

There is one intranasal vaccine given now FluMist but it uses a weak version of the live flu virus, which is not safe for immunocompromised people. Iwasaki and her colleagues are working on a strategy to get around that issue: using a nasal spray containing a version of the COVID-19 virus spike protein as a booster after an initial mRNA shot. Because its used as a booster, the spray doesnt need to contain a live virus to trigger a strong enough immune response immunity from the initial shot is enough to drive a strong response to the protein in the spray.

So far, the technique is experimental and only has been tested in mice. But Iwasaki co-founded a company, Xanadu Bio, to make these vaccines, though she says they are still raising money to start clinical trials and working on testing the vaccine in nonhuman primates. And Xanadu is far from the only one looking at nasal spray vaccines. There are more than a dozen clinical trials of intranasal vaccines already in progress in the US and globally.

There are still a lot of challenges ahead before the next set of COVID-19 vaccines are available to the public. Theres still a lot experts dont know about the current vaccines like why they lose their efficacy over time, regardless of new variants, says Deepta Bhattacharya, a professor of immunobiology at the University of Arizona College of Medicine. He says it can be hard to know exactly what it is about a vaccine that makes it work well for a long time.

When youre comparing one vaccine to another, theres a lot of things that are different, he said. And so trying to extract which of those differences are really important is almost as much guesswork as it is science.

There are also practical limitations. The FDA meeting next week to discuss vaccinating against COVID-19 variants could have a big impact on the direction that future vaccine development will take. Funding, both for new research and to make shots available to people for free, will also probably be an issue. Unless Congress can agree on more pandemic funding, free future vaccines might be limited to only the most vulnerable people.

Despite everything, Bhattacharya is optimistic about the future of COVID-19 vaccines. Research seems to show that combining and refining the next-generation vaccine techniques like intranasal, vaccine-targeted, and universal vaccines could have great success, he said.

I think the science is there for sure to have better vaccines in the coming years, he said.

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Where's the next generation of COVID-19 shots? - The Verge

People queue for COVID-19 testing in Macau, China, June 20, 2022. REUTERS/John Mak

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HONG KONG, June 27 (Reuters) - Macau launched a third round of mandatory COVID-19 testing for its more than 600,000 residents on Monday, in a push to curb a rise in infections in the world's biggest gambling hub.

Authorities in Macau have locked down multiple buildings and put more than 5,000 people in quarantine in the past few days, the city's government said. Health authorities said 38 new COVID cases were recorded on Sunday, taking the total number of infections to 299 in the latest outbreak.

Two rounds of COVID tests were conducted in Macau in the past week. The latest round is expected to end on Tuesday.

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Authorities have asked people to remain at home as much as possible with most of the city effectively closed, including bars, hair salons and outdoor parks. Only takeaway is allowed from dining facilities. read more

Casinos, while mostly deserted, are allowed to stay open, the city's government said, in a move to protect local jobs.

The stringent measures come after the Chinese special administrative region has been largely COVID-free since an outbreak in October 2021. It has not previously had to deal with the highly transmissible Omicron variant.

Macau adheres to China's "zero COVID" policy which aims to eradicate all outbreaks, at just about any cost, running counter to a global trend of trying to co-exist with the virus.

Macau's cases are still far below daily infections in other places, including neighbouring Hong Kong where cases have jumped to close to 2,000 a day this month.

Hong Kong's outbreak this year saw more than 1 million confirmed infections, and more than 9,000 deaths, swamping hospitals and public services. Officials there are looking to ease some restrictions.

Macau only has one public hospital with its services already stretched on a daily basis. The territory's swift plan to test its population comes as it keeps open the border with mainland China, with many residents living and working in the adjoining city of Zhuhai.

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Reporting by Farah Master; Editing by Himani Sarkar

Our Standards: The Thomson Reuters Trust Principles.

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Casino hub Macau launches third round of COVID testing as infections rise - Reuters

WELLINGTON, New Zealand (AP) All Blacks head coach Ian Foster, assistant John Plumtree and two leading players have tested positive for COVID-19, severely disrupting the teams preparation for Saturdays first rugby test against Ireland.

Foster and Plumtree are isolating at home and midfielders Jack Goodhue and David Havili havent joined the team in Auckland where the test will be played in front of a sellout crowd at Eden Park.

Goodhue and Havili both had strong chances of being named in the New Zealand lineup for the first test of a three-test series.

Assistant coaches Scott McLeod and Brad Mooar will take charge of the team in the lead-up to the match while Crusaders center Braydon Ennor has joined the squad to provide midfield cover.

Foster said he is confident the test preparation will be in good hands.

Weve had a plan for this happening and its a great opportunity for the wider coaching group and the senior players who will be highly motivated to step up, he said. We have learned how to cope with the unexpected like everyone has over the past couple of years. I will still be working alongside the coaches and team via Zoom and I have huge faith in the coaching group and the players.

The All Blacks have numerous midfield options with Rieko Ioane and Quinn Tupaea now likely to fill those roles.

Saturdays test is an important one for the All Blacks, who hadnt lost to Ireland for 111 years before doing so at Soldier Field, Chicago in November 2016. They have now lost three of their last five tests against Ireland, including the most recent at Dublin last year.

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NZ coach, 2 players have COVID-19 ahead of 1st Ireland test - The Associated Press - en Espaol

Dear Doctors: I get why people are totally over dealing with COVID-19, but I dont have that luxury. Im 31 years old, and I thought I was lucky when my case of COVID-19 only felt like a bad cold. But its been six months now, and Im still sick. Have we learned anything new about what causes long COVID-19?

Dear Reader: As most of us probably know by now, long COVID-19 refers to the long-lasting health problems that affect a sizable number of those who have been ill with COVID-19.

The official name for the syndrome is post-acute sequelae of SARS-CoV-2 infection, or PASC. It consists of a shifting constellation of a wide range of symptoms. These include fever, headache, chronic cough, shortness of breath, a racing or disordered heartbeat, stomach pain, gastroenteritis, changes to menstrual cycle, dizziness, brain fog, insomnia, changes to mood and persistent fatigue or exhaustion. Symptoms last for weeks, and often for many months, after the initial illness has passed.

When long COVID-19 first emerged, it appeared to occur mainly in those who experienced severe illness. We now know that anyone who becomes infected with SARS-CoV-2, which is the name of the coronavirus that causes COVID-19, can go on to develop the syndrome.

Data from several new studies into long COVID-19 have just been released. While there has not yet been a definitive breakthrough regarding the cause, the results of the research continue to chip away at this baffling illness.

One study, conducted by the Centers for Disease Control and Prevention, found that long COVID-19 occurs in about 20% of adult COVID-19 survivors under the age of 65, and up to one-fourth of those over the age of 65. In the older group, risk of developing long COVID-19 increased with age.

For some long COVID-19 patients, like yourself, symptoms of the initial disease never fully resolve. In others, who have recovered from their illness, symptoms return, sometimes as long as six months later. Another study found that having been vaccinated produced a mild protective effect against long COVID-19 but did not eliminate the risk of developing the disease.

Research conducted by the National Institutes of Health looked into whether the syndrome might be caused by lingering fragments of virus, whose presence could trigger the immune system to fight the disease all over again. Unfortunately for those hoping for a definitive answer to the mystery of what causes long COVID, the study did not find evidence of that.

Now researchers are looking to the intense immune response that occurs in some individuals as a potential factor in the cause of lingering disease. It is possible that, after revving up to such a high level, the immune system never fully settles back down. Meanwhile, a seasonal pattern of COVID-19 infections has emerged. As with the flu, the disease is always present. But epidemiologists, including colleagues here at UCLA, have begun referring to COVID-19 as a seasonal illness, with surges occurring in summer and winter.

We know were repeating ourselves here, but we urge our readers to please remain vigilant in protecting themselves and their loved ones from infection.

Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.

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Ask the Doctors | There are no definitive answers on long COVID-19 - Eureka Times-Standard

Introduction

In his State of the Union address earlier this year, President Joe Biden spoke of a new moment where the coronavirus will be more manageable and the need for masks less frequent. States have moved toward this transition as positive cases, hospitalization, and deaths began to drop. In the first week of March, governors inMississippi, Texas,Alabama, Arizona, West Virginia and Connecticut announced significant loosening of statewide pandemic restrictions like mask mandates and indoor capacity limits. These states joined several others in loosening statewide coronavirus restrictions much earlier in the year.

As we transition toward directly battling COVID-19 to the next phase in the process, we must note that living with the virus means something much different for those struggling with the symptoms of long COVID-19. Long COVID-19 is associated with chronic symptoms like fatigue, cognitive problems, and respiratory challenges that can linger for months after the initial coronavirus infection has passed. Long-haulers, or people who experience prolonged symptoms more than three or four weeks after infection could need several months to recover.

It is important to recognize that experiencing longer-term challenges with COVID is rather pervasive and affects not only those with severe cases, but those with relatively mild symptoms as well as Americans who are generally healthy, not just those with underlying conditions. In fact, our colleagues here at Brookings have estimated that 31 million working-age Americansmore than one in sevenmay have experienced, or be experiencing, lingering COVID-19 symptoms.

The persistence of these symptoms and their ability to limit major life activities creates new considerations for immediate and long-term policy solutions. The COVID-19 pandemic increases the need to protect vulnerable communities based on current knowledge and predictions of the extension of disparate health conditions.

Similar to all other health outcomes associated with the pandemic, there are significant racial inequalities associated with long COVID-19 as vast inequalities in underlying conditions make the severity of longer-term cases more pronounced for racial and ethnic minorities. This blog post summarizes a few considerations about the racial differences among COVID-19 patients with longer-term symptoms and identifies policy solutions to help address these challenges.

The glaring racial inequalities in COVID-19 outcomes have been well documented by Brookings and a wide range of other scholars and think tanks. It is clear that Native Americans, African Americans, and Latinos have all experienced higher rates of coronavirus infection, hospitalization and casualties throughout the pandemic.

However, our knowledge of how race impacts long-term challenges with COVID-19 is unfortunately pretty limited. A key report focused on the State of Black America and COVID-19 has identified that Black Americans have not been sufficiently included in long COVID-19 trials, treatment programs and registries. There is unfortunately limited research on other racial and ethnic minorities as well.

It has now become clear that access to a primary care physician and adequate health care coverage as well as appropriate disability coverage will be crucial to the ways in which Americans navigate long COVID-19.

First, primary care doctors will be key to patients with long COVID-19, as many patients require comprehensive assessment to exclude serious complications that might be associated with their symptoms. A primary care clinician who knows the patient and his or her life circumstances is in an optimal position to coordinate and personalize the recovery plan and understand the barriers the patient may face along the way. Ideally patients with difficult cases would have access to holistic clinical intervention and followup.

Unfortunately, there is a significant gap in access to a primary care physicians for Americans from diverse backgrounds. TheAfrican American Research Collaborative/Commonwealth Fund American COVID-19 Vaccine Pollis an extensive, diverse national survey with measures of access to primary care physician. According to the survey, 82% of white Americans reporting having a primary care doctor while only 74% of Black, 69% of Latino, and 72% of Native Americans have access to a doctor they see regularly for care.

Second, people with long COVID-19 will need adequate health coverage to manage both the financial and health components of care management. Unfortunately, racial inequalities in access to health insurance are vast, particularly for Latinos. This is a direct consequence of the several jobs held by people of color lacking sufficient healthcare benefits. Additionally, states in which Medicaid has not been expanded complicate the way in which people of color are able to manage long COVID-19.

It is important to note that long COVID-19, particularly in vulnerable groups, may be complicated by other longterm conditions, notably diabetes, hypertension, ischemic heart disease, and chronic mental health conditions.[1] Racial and ethnic minorities are more likely to experience all of these conditions which strongly suggests that we should anticipate more complex and challenging cases for all non-white groups.

One of the other health issues associated with long-haulers is insomnia, a condition that can last months and possibly longer among Americans with long-term challenges due to COVID-19. Like most chronic health conditions, challenges with insomnia are greater among racial and ethnic minorities already, particularly for those who have high levels of perceived discrimination. Given the correlation between lack of quality sleep and a wide range of other health conditions, this may generate even greater racial inequalities in health outcomes down the line. The challenges with sleeping are likely to be exasperated by a host of underlying forces that impact sleep, including sub-par housing conditions.

The long-term effects of COVID-19 have not been realized. Our health systems and structures and the policies that regulate them will need major overhauling to be flexible enough to manage the impending social and health implications of long COVID-19. In closing, while we all enjoy the ability to feel more comfortable with expanded social interaction, and the ability to not have to wear our masks as often when we leave our homes, we must recognize that those struggling with the symptoms of long COVID-19 are far from being able to return to normalcy.

Finally, people suffering from the persistence of symptoms are eligible for disability services according to the Department of Health and Human Services. The physical impairment due to long COVID-19 can affect walking, standing, speaking, breathing, and many other physical functions that may limit ones role in their ability to manage daily activities with their families, and in their current jobs. Because long COVID-19 can be experienced by youth and young adults, there is additional guidance on how primary, secondary, and post-secondary schools should evaluate, assess, and make academic adjustments for those in school and higher education settings.

In this post we identify the gaping racial inequalities not only associated with long COVID-19 cases, but in the resources needed to properly manage a lingering case. In future posts we will summarize the policy solutions needed to help address the challenges raised in this blog, as well as the economic consequences associated with long COVID-19 for communities of color who are already being squeezed by inflation and a slower recovery from the economic downturn.

[1] See for example: https://pubmed.ncbi.nlm.nih.gov/32419765/

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Living with COVID-19 will not be easy for many Americans suffering from long COVID-19, particularly those from diverse communities - Brookings...

The West Virginia Department of Health and Human Resources (DHHR) reports as of June 22, 2022, there are currently 1,882 active COVID-19 cases statewide. There have been no deaths reported since the last report, with a total of 7,018 deaths attributed to COVID-19.

CURRENT ACTIVE CASES PER COUNTY: Barbour (18), Berkeley (109), Boone (24), Braxton (10), Brooke (18), Cabell (89), Calhoun (15), Clay (5), Doddridge (1), Fayette (37), Gilmer (12), Grant (21), Greenbrier (39), Hampshire (8), Hancock (23), Hardy (21), Harrison (91), Jackson (16), Jefferson (81), Kanawha (148), Lewis (31), Lincoln (14), Logan (36), Marion (87), Marshall (37), Mason (41), McDowell (28), Mercer (78), Mineral (31), Mingo (15), Monongalia (113), Monroe (26), Morgan (10), Nicholas (24), Ohio (29), Pendleton (2), Pleasants (7), Pocahontas (5), Preston (16), Putnam (57), Raleigh (90), Randolph (18), Ritchie (6), Roane (53), Summers (14), Taylor (16), Tucker (3), Tyler (5), Upshur (30), Wayne (22), Webster (8), Wetzel (24), Wirt (5), Wood (82), Wyoming (33). To find the cumulative cases per county, please visit coronavirus.wv.gov and look on the Cumulative Summary tab which is sortable by county.

West Virginians ages 6 months and older are recommended to get vaccinated against the virus that causes COVID-19. Those 5 years and older should receive a booster shot when due. Second booster shots for those age 50 and over who are 4 months or greater from their first booster are recommended, as well as for younger individuals over 12 years old with serious and chronic health conditions that lead to being considered moderately to severely immunocompromised.

Visit the WV COVID-19 Vaccination Due Date Calculator, a free, online tool that helps individuals figure out when they may be due for a COVID-19 shot, making it easier to stay up-to-date on COVID-19 vaccination. To learn more about COVID-19 vaccines, or to find a vaccine site near you, visit vaccinate.wv.gov or call 1-833-734-0965.

To locate COVID-19 testing near you, please visit https://dhhr.wv.gov/COVID-19/pages/testing.aspx.

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COVID-19 Daily Update 6-22-2022 - West Virginia Department of Health and Human Resources

Asst. Prof. Huanhuan Joyce Chen of Pritzker Molecular Engineering led a new study showing that the type of macrophages present in a persons body might determine how likely they are to develop severe inflammation in response to COVID-19. Credit: Photo by John Zich

University of Chicago Pritzker School of Molecular Engineering researchers point to macrophages.

When a virus makes its way into a persons body, one of the immune systems first responders is a set of pathogen-removal cells called macrophages. But macrophages are diverse; they dont all target viruses in the same way.

Scientists at the University of Chicagos Pritzker School of Molecular Engineering have discovered that the type of macrophages present in a persons body might determine how likely they are to develop severe inflammation in response to COVID-19. Their study was published recently in the journal Nature Communications.

Clinicians know that COVID-19 can cause a spectrum of disease severity from mild to severe symptoms. Why some people, and not others, develop very severe disease has been a mystery, said Asst. Prof. Huanhuan Joyce Chen, who led the research with Qizhou Lian of the University of Hong Kong. This is the first time anyone has linked the variation in symptoms to macrophages.

Studying the cellular and molecular effects of the SARS-CoV-2 virus has been challenging for researchers who usually turn to model organisms to mimic human diseases, because mice, rats, and many other animals dont develop the same COVID-19 symptoms as people. Thats why, shortly after the COVID-19 pandemic began, Joyce Chen Lab harnessed human stem cells to study the virus.

The new findings from the Joyce Chen Lab could inform the prevention or treatment of severe COVID-19 in the most at-risk patients. Above, Asst. Prof. Chen works with postdoctoral researchers Abhimanyu Thakur (left) and Kui Zhang (right). Credit: Photo by John Zich

As reported previously in Nature, Chen and her colleagues grew stem cells into functioning mini-lungs and colonscalled lung and colon organoidsto probe the effects of SARS-CoV-2 on those organs and screen drugs to treat the virus.

In the new study, the researchers first analyzed lung biopsies from COVID-19 patients and discovered that they had especially high levels of macrophages. To better understand the role of macrophages during a COVID-19 infection, Chens team developed an approach that could exploit the same line of human stem cells to become both lung cells and macrophages simultaneously. The fact that they arose from the same initial stem cells was important to prevent the immune cells from attacking the lung cells.

This model system provides a perfect way to decode, step by step, how these three componentsthe immune system, the lungs, and the virusinteract, said Chen.

When Chens lab infected the stem cell-derived lungs and macrophages with SARS-CoV-2, they found that not all macrophages responded in the same way. One subset, dubbed M2 macrophages, eliminate the virus by physically engulfing virus and virus-infected cells in a process known as phagocytosis, while releasing anti-inflammatory molecules.

M1 macrophages behaved in an opposite way: these cells released a plethora of inflammatory chemical signals that not only fight SARS-CoV-2, but cause a more widespread immune response. These same inflammatory factors have been shown to be present in the blood of people with severe COVID-19 symptoms.

Asst. Prof. Chen, here working with graduate student Jingwen Xu, examined the effects of SARS-CoV-2 on lung and colon organoids in a previous study. Credit: Photo by John Zich

Our results suggest that people who already have M1 macrophages activated in the lungs when infected with COVID-19 might be more likely to develop very severe inflammation from the virus, said Chen.

Elderly people and those with certain conditions like hypertension or diabetesalready known to be prone to more severe COVID-19 symptomsmay have higher levels of the M1 macrophages, she added.

Her team went on to show that antibodiessimilar to those already used clinically to treat COVID-19helped M2 macrophages clear the SARS-CoV-2 virus. More work is needed to show whether the observations hold true in humans, but the findings could help inform the prevention or treatment of severe COVID-19 in the most at-risk patients. And Chen is already thinking ahead to her next experiments with the stem cell-derived organoids.

This model system is useful for decoding the molecular mechanisms behind not only COVID-19, but other infectious diseases, said Chen.

In the future, her group hopes to make more complex mini-organs that include not only lung and immune cells, but blood vessels, nerves, and other supporting cell types.

Reference: Differential effects of macrophage subtypes on SARS-CoV-2 infection in a human pluripotent stem cell-derived model by Qizhou Lian, Kui Zhang, Zhao Zhang, Fuyu Duan, Liyan Guo, Weiren Luo, Bobo Wing-Yee Mok, Abhimanyu Thakur, Xiaoshan Ke, Pedram Motallebnejad, Vlad Nicolaescu, Jonathan Chen, Chui Yan Ma, Xiaoya Zhou, Shuo Han, Teng Han, Wei Zhang, Adrian Y. Tan, Tuo Zhang, Xing Wang, Dong Xu, Jenny Xiang, Aimin Xu, Can Liao, Fang-Ping Huang, Ya-Wen Chen, Jie Na, Glenn Randall, Hung-fat Tse, Zhiwei Chen, Yin Chen and Huanhuan Joyce Chen, 19 April 2022, Nature Communications.DOI: 10.1038/s41467-022-29731-5

Funding: National Institute of Health, Cancer Research Foundation Young Investigator Award, Janet D. Rowley Discovery Fund, Hong Kong Health and Medical Research Fund, Guangzhou Women and Childrens Medical Centre, Shenzhen Science and Technology Program, Tsinghua University Spring Breeze Fund, the National Key R&D Program of China and the National Natural Science Grant of China.

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Hunting for the Immune Cells That Lead to Severe COVID-19 - SciTechDaily

People, wearing protective face masks, walk below the arcades of the Rue de Rivoli in Paris, France, February 11, 2022. REUTERS/Sarah Meyssonnier

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PARIS, June 22 (Reuters) - France is facing a new wave of COVID-19 infections fuelled by new variants of the disease, French vaccination chief Alain Fischer said on Wednesday, as daily new cases reached an almost two-month peak the day before at more than 95,000.

Speaking on France 2 television, he said there was no doubt there was once again an upsurge of the pandemic in the country, adding he was personally in favour of reinstating mandatory face mask wearing on public transport.

"The question is: 'what intensity does this wave have?'" Fischer said.

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Other European countries, especially Portugal, are also seeing an increase, due two new Omicron subvariants BA.4 and BA.5, which, according to the European Centre for Disease Prevention and Control, are likely to become dominant in the region. read more

The variants do not appear to carry a higher risk of severe disease than other forms of Omicron but as they are somewhat more infectious than the latter, it could lead to an increase in hospitalisations and deaths, the ECDC said. read more

There is traditionally a two-week delay between cases and hospitalisation trends and then a similar delay regarding COVID-deaths.

New infections have been steadily rising since the end of May in France, with the seven-day moving average of daily new cases almost tripling between the May 27 figure of 17,705 and Tuesday's 50,402.

That total is nonetheless still seven times lower than the 366,179 record reached at the start of the year.

The number of people hospitalised for the disease fell to a six-month low of 13,876 on Saturday but it has increased by 458 over the last three days, at 14,334, an almost three-week high.

France's COVID death toll rose by 56 over 24 hours on Tuesday, to reach 149,162.

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Reporting by Myriam Rivet and Benoit Van Overstraeten; Editing by William Maclean

Our Standards: The Thomson Reuters Trust Principles.

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France is facing a new COVID-19 wave - French vaccination chief - Reuters