Category Archives: Covid-19

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

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

One in ten isnt good

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

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

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

Discover what doctors wish patients knew about healthy eating.

Data tells a bleak story

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

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

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

Why today is different

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

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

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

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

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

Learn more aboutAMA CME accreditation.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

It all comes down to the pancreas.

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

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

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

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

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

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

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

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

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

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

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

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

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

Unable to view the tables below?Click here.

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

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

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

Unable to view the tables below?Click here.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Chinese authorities say fighting COVID is vital to save lives.

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

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

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

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

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

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

Our Standards: The Thomson Reuters Trust Principles.

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

Scores of severely ill Covid-19 sufferers survived because they were given the NHSs highest form of intensive care in which an artificial lung breathes for them, a study has found.

Patients in the UK who underwent extracorporeal membrane oxygenation (ECMO) were more likely to survive than those who did not have the treatment, according to the research.

People whose breathing capacity had collapsed were more likely to stay alive if they had ECMO rather than only a spell on a mechanical ventilator.

That is the key finding of an analysis of 1,363 people treated for severe Covid using a ventilator in the UK in between March 2020 and February 2021. They included 243 who were taken by ambulance to either Guys and St Thomas or the Royal Brompton and Harefield hospital trust in London to try to save their lives using ECMO.

The other 1,120 were known as what doctors called perceived futility cases those it was deemed inappropriate to put on ECMO because they were considered too old and sick to survive Covid, and ECMO was thought unlikely to change their outcome. Doctors also had to consider who would benefit most from the limited availability of artificial life support, which is costly and labour-intensive, at the two specialist centres.

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The 243 were matched by computer analysis for their similarity of personal profile and symptoms with 206 of the 1,120 patients who did not receive ECMO to compare their outcomes.

The study, which has been published in the journal Intensive Care Medicine, found that 44% of the non-ECMO group died, while mortality was much lower among those who had the treatment at 26%.

During ECMO, blood is taken out of the unconscious patients body, put into an oxygenator, has oxygen added and carbon dioxide removed, and is then reinserted into the patient. The hope is that the extra oxygen will improve patients breathing enough to help them pull through.

ECMO had a substantial effect at saving lives in the UK. Lives were saved due to the significant effort on the part of NHS staff to ramp up ECMO provision to provide service for as many [patients] as possible, said Dr Luigi Camporota, a consultant in intensive care medicine at Guys and St Thomas who was one of the co-authors.

Our findings suggest that ECMO delivery at specialist SRF [severe respiratory failure] centres confers significant survival benefit, compared to matched patients who received conventional therapy in referring centres, he said.

NHS bosses believe ECMO saved several hundred lives during the pandemic.

Prof Stephen Powis, NHS Englands national medical director, said: This study is a testament to the incredible hard work of NHS staff over the last two years who have treated more than 700,000 Covid-19 patients in hospital including on ECMO machines, which have helped save hundreds of lives.

The survival from Covid thanks to ECMO seen in the study is higher than in other studies of its use conducted in other countries. However, the results are not directly comparable because of differences between them such as in the selection criteria for deciding which patients received ECMO and whether people were treated in a general hospital or specialist centre, such as the two hospital trusts in the capital.

In this study, 22.9% of the ECMO and 52.9% of the non-ECMO patients died during the first wave of Covid. Mortality rose in both during the second wave, which occurred during winter 2020-21, to 26.1% and 62.4% respectively.

This article was amended on 29 April 2022. Carbon dioxide is removed from the blood during ECMO, not added as an earlier version said.

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External blood oxygenation saved hundreds of Covid-19 sufferers study - The Guardian

NC rural hospital leaders talk about financial challenges

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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