Category Archives: Covid-19

The vast majority of Alabamians hospitalized with COVID-19, being cared for in ICUs and hooked to ventilators are unvaccinated. State hospitals on Sunday had a negative 92 ICU beds, and more than half of the beds occupied were COVID-19 patients.

Of the 2,713 people hospitalized with COVID-19 statewide on Sunday, 84 percent were unvaccinated, according to the Alabama Hospital Association.

At UAB Hospital in Birmingham on Friday, 134 of 149 COVID-19 patients were unvaccinated, or 89 percent. Of those patients who needed ICU care, 91 percent were unvaccinated, and the same percentage of the 49 COVID patients hooked to ventilators on Friday were unvaccinated.

State hospitals had a negative 92 ICU beds on Sunday, according to the Alabama Hospital Association, meaning there were 92 more patients needing ICU bed care than the states hospitals had formal ICU beds. While some hospitals had available ICU beds to care for the critically ill, others had patients awaiting that care. More than half of the states 1,618 ICU patients on Sunday had COVID-19.

East Alabama Health, which operates hospitals in Opelika and Valley, on Friday was just one COVID-19 patient shy of the hospital systems record, set in January. The two hospitals combined number of COVID-19 patients on ventilators reached a new high of 23 on Thursday. East Alabama Health on Friday had seven fewer ICU beds than patients needing those beds.

And the numbers would be even higher, but COVID has claimed the lives of 26 patients since August 1, the system said in a statement Friday.

Those 26 COVID-19 patients who died since Aug. 1 are just shy of the 28 patients who died of COVID at East Alabama Healths hospitals over the span of five months, from March 1 through July 31.

Of the 91 COVID-19 patients hospitalized at East Alabama Health hospitals on Friday, 80 percent were unvaccinated. of those patients on ventilators, 81 percent were unvaccinated.

We are doing everything we can to save every life that comes through our doors, and I mean everything, Dr. Meshia Wallace, a pulmonologist and critical care physician at East Alabama Health, said in a statement. Patients are on the ventilator, paralyzed, in a prone position, getting high doses of steroids, interleukin inhibitors, antivirals, dialysisas I said, were doing everything.

Seeing patients, including a new mom, fight for their lives on a ventilator is excruciating, Wallace said. Especially when its extremely clear now after eight months that the vaccines are safe and effective at keeping the vast majority of people out of the hospital and limiting critical care and deaths. This peak was very avoidable. Its sad to watch so many people suffer.

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Majority of Alabamians hospitalized with COVID-19, on ventilators, are unvaccinated - alreporter.com

COVID-19: New variant is here, but Fauci says not 'immediate threat'

A new COVID variant has emerged called mu, but Dr. Fauci says they are "keeping a very close eye on it."

Staff video, USA TODAY

Since classes began, the University of Texas has reported thousands of COVID-19 tests and a relatively small number of positivecases in the campus community.

UT welcomed an estimated 50,000 students to campus for fall classes starting Aug. 25, along with staff and faculty members. The university is holding nearly all classes in-person or in a hybrid format this fall, and it has reopened buildings such as the residence halls at full capacity.

UT reported an estimated 179 total active COVID-19 cases among students, staff and faculty as of Thursday. However, the university has not announced further requirements for community members to get tested, so the actual total number of cases remains unclear.

More: UT boosts graduate student funding by $11 million

Art Markman, the head of the academic working group for COVID-19 planning, said officials will have a better sense of student behavior and how the semester is going to look after another week, but things are looking pretty good so far. He said the university has not received a lot of reports of large indoor gatherings or of COVID-19 spread related to classroom activities.

The number of cases on campus is actually on the low to medium end of what the modeling team predicted. And I think that's in part because we did get a number of students who might have brought COVID-19 to campus ... to stay home a few extra days, Markman said. But obviously, we're going to continue to monitor.

A report by UT's COVID-19 Modeling Consortium published in August before classes started estimated that there would be between 187 and 236 UT students infected with COVID-19 during the first week of the semester.

Campus officials have implemented a number of precautions for the fall semester, including requiring students to submit a negative COVID-19 test resultbefore returning to classand allowing faculty members to temporarily reduce classroom density. UT spokeswoman Eliska Padilla said all students moving into the residence halls submitted proof of a negative test, and nearly 40,000 students reported negative test results to the university.

UT also is encouraging community members to wear masksand isoffering incentives for people who upload proof of vaccination. Gov. Greg Abbott has prohibited agencies that receive public funding in Texas from instituting vaccine and mask requirements.

The university encourages all students in Austin who have not yet done so, to get tested through the UT Proactive Community Testing (PCT) Program. .... Just as we have seen throughout the pandemic, we expect our community will remain committed to good health and safety behaviors on our campus, Padilla said in a statement.

More: Wear a mask, get a cookie: UT professors can offer incentives for students to mask up

UT publishes the number of daily positive COVID-19 cases, proactive community tests, clinical tests and positivity rate among students, staff and faculty on a campus dashboard.The dashboard also lists the estimated active cases, which includes cases for 10 days after the onset of symptomsor 10 days after the test date if details about symptom onset are not available.

During the week that classes began, the university reported more than 10,000 weekly proactive community COVID-19 tests among the UT community, with a positivity rate of about 0.5% for students and 0.3% for faculty and staff. Lastweek, as ofFriday, the combined positivity rate for PCT tests in the last seven dayswas about 0.7% among students, faculty and staff, with55 positive tests out of 8,220.

While reported cases have been somewhatlow for the past two weeks even with increased testing, some UT students and faculty members said theyre still anxious about being on campus. They also said theyre concerned about the potential for more COVID-19 spread as the semester continues.

Stephennie Mulder, a UT associate professor in art history, said shes only teaching one small in-person class a week, but she worries about going home and infecting her unvaccinated daughter. She said she believes if UT mandated weekly testing of all students, it would help provide more data about the spread of COVID-19 in the campus community.

I feel very helpless, Mulder said. I'm a little bit less concerned for my own safety, because I'm vaccinated. If I'm wearing an N95 mask while teaching and I'm able to keep a distance from my students, the chance that I would bring that home to my daughter is relatively low, but it's possible.

Travis County COVID-19 vaccine tracker: 61% of people fully vaccinated

UT senior Apoorva Chintala said its been overwhelming and stressful for her to jump back into the routine of being back on campus with crowds of people and attending in-person classes for the past week and a half. She said, for her, the next few weeks will be critical to figuring out what's going to happen with COVID-19 the rest of the semester.

I hope more people get tested so that we can quarantine people that have COVID and minimize the spread, but it's not nearly enough, Chintala said. It's not the only thing we should be doing on campus to help stop the spread, because at that point people have already been around and spread out by the time they find out they're contagious.

Markman said the anxiety in the UT community is understandable, and he encourages people to engage in safe behavior. He said UT believes it has laid out a set of procedures that will keep people safe, but if there is evidence that that's not the case, the university will make changes.

We're doing a lot of daily testing right now, ... but we're not going to get exact numbers, Markman said. Generally speaking, if there's widespread illness on campus, we would see a lot more people coming in to get the clinical tests because they're symptomatic, and wed be seeing a much higher positivity rate on those tests.

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University of Texas sees relatively low COVID-19 numbers early in the semester - Austin American-Statesman

RIO DE JANEIRO Just a few weeks ago, Covid-19 was spreading with alarming ease across a cluster of nations in South America, overwhelming hospital systems and killing thousands of people daily.

Suddenly, the region that had been the epicenter of the pandemic is breathing a sigh of relief.

New infections have fallen sharply in nearly every nation in South America as vaccination rates have ramped up. The reprieve has been so sharp and fast, even as the Delta variant wreaks havoc elsewhere in the world, that experts cant quite explain it.

Brazil, Argentina, Chile, Peru, Colombia, Uruguay and Paraguay experienced dramatic surges of cases in the first months of the year, just as vaccines started to arrive in the region. Containment measures were uneven and largely lax because governments were desperate to jump-start languishing economies.

Now the situation has cooled across South America, said Carla Domingues, an epidemiologist who ran Brazils immunization program until 2019. Its a phenomenon we dont know how to explain.

There have been no new sweeping or large-scale containment measures in the region, although some countries have imposed strict border controls. A major factor in the recent drop in cases, experts say, is the speed with which the region ultimately managed to vaccinate people. Governments in South America have generally not faced the kind of apathy, politicization and conspiracy theories around vaccines that left much of the United States vulnerable to the highly contagious Delta variant.

In Brazil, which had a slow, chaotic vaccine rollout, nearly 64 percent of the population has received at least one dose of a vaccine, a rate that exceeds that of the United States. That led President Jair Bolsonaro, who had initially sowed doubts about vaccines, to brag last month.

Brazil has one of the best performances on vaccination globally, he said in a Twitter post.

In Chile and Uruguay, more than 70 percent of the population has been fully vaccinated.

As cases have dropped, schools in much of the region have resumed in-person classes. Airports are becoming busier as more people have started traveling for work and leisure.

Sept. 6, 2021, 12:36 p.m. ET

The drop in caseloads led the United Nations this past week to provide a more optimistic projection of economic growth in the region. It now expects economies in Latin America and the Caribbean to grow by 5.9 percent this year, a slight increase from its 5.2 estimate in July.

Weve managed to delay major circulation of the Delta variant and move forward with the biggest vaccination campaign in our history, Carla Vizzotti, Argentinas health minister, said last week.

In Argentina, more than 61 percent of the population has received at least one dose of a vaccine.

Chrystina Barros, a health care expert at the Federal University of Rio de Janeiro, said she worries that falling caseloads will lead people to become complacent about wearing masks and avoiding crowds while the epidemic remains a threat.

UnderstandVaccine and Mask Mandates in the U.S.

There is a serious risk of putting the very effectiveness of the vaccine at risk, she said. The cooling of the pandemic cannot inspire people to relax in relation to the crisis.

Jairo Mndez Rico, a viral diseases expert advising the World Health Organization, said the Delta variant may have been slow to gain traction in South America because so many people in the region have natural immunity from having had the virus. But he said the variant could still lead to new surges.

Its not easy to explain, he said. Its too early to say what is happening.

Despite the uncertainty, governments in South America are moving to reopen borders in coming months. President Alberto Fernndez of Argentina said in late July that the path to normalcy was in sight.

We deserve another life, a life in which we enjoy music, painting, sculptures, movies, theater, he said. A life in which we can laugh without a face mask, where we can hug those we love.

Jennifer Mac Donnell, a cosmetologist in Buenos Aires, is days away from a mid-September wedding a milestone that has felt uncertain for much of the year.

We feared we were going to be forced to cancel it, the 39-year-old said. Now were much more calm, cases are down, most of our friends are vaccinated and everyone is just focused on having a good time.

Daniel Politi reported from Buenos Aires, and Flvia Milhorance from Rio de Janeiro.

Read more:

Covid Ravaged South America. Then Came a Sharp Drop in Infections. - The New York Times

SIOUX FALLS, S.D. (KELO) According to the CDC, the nation has seen an increase in pregnant people getting infected with the coronavirus. And doctors say the virus can lead to severe illness, which is why they are urging pregnant people to get vaccinated.

Throughout the last year and a half, Dr. Kimberlee McKay with Avera Medical Group has had to see multiple pregnant patients become severely sick and, in some cases, give birth early because of complications from a COVID-19 diagnosis.

Last year, the worst I ever felt was when we had a pregnant mom who we were getting ready to C-section and she needed to be intubated, McKay, the clinical vice president of the Ob/Gyn Service Line at Avera Medical Group, said. And before we intubated her, in order to deliver her baby and then take her to the ICU, I just looked over the top of the C-section curtain and I said, Im going to take really good care of you, and she just looked me straight in the eye and she said, please, let me wake up to see my baby.'

And now she says it seems patients are getting even sicker with the Delta variant spreading.

If your risk as a young person who is not pregnant is 0.8 percent chance of being admitted to the ICU, a pregnant womans, they say, is 22 times higher.

Most of them are unvaccinated and so when they come in its just with the full blown disease, McKay said. Whats hard is that, when mom cant breathe, what youll see is changes in the babys heart rate. And when mom is having trouble oxygenating, the baby, of course, is going to have trouble.

McKay says COVID-19 also targets blood vessels, which is what the placenta is primarily made of.

And so, even in mild cases of the disease, were seeing a good number of these patients, probably 25 to 30 percent, who go on to develop things like preeclampsia and have other maternal sicknesses that necessitate an early delivery.

Other risks include miscarriage and stillbirth.

And, of course, any time that a baby needs to be delivered early, there are acute needs, meaning more care thats needed right then and also long-term health effects for the baby.

Thats why doctors are urging pregnant patients to get vaccinated against COVID-19. Dr. Elizabeth Miller is an Ob/Gyn with Sanford Health; shes also a mom.

So one of the things that I share with my patients to help them feel confident about getting the vaccine is that I got the vaccine when I was fifteen weeks pregnant with my son, Miller said. And it was one of the first times that I felt hopeful in this pandemic, knowing that I was more protected and that my son would be born with protection as well.

Dr. Miller says 150,000 pregnant people have received the vaccine nationally. She says the vaccine is safe for expecting parents, but it also provides extra safety for the baby.

And also, when moms get the vaccine in pregnancy, it passes antibodies through the placenta to baby and can help protect babies against COVID when theyre born, Miller said. Babies cant get the vaccine so this is one of the best ways that moms can protect their babies too.

Getting vaccinated in pregnancy is one of the best ways that you can help keep you and your baby safe.

Doctors also urge parents who are breastfeeding to get the vaccine, as antibodies can also pass into breast milk.

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The increased risks of COVID-19 in pregnancy and why doctors are urging the vaccine - KELOLAND.com

Despite being founded just last June, Belgian biotech ExeVir is making serious headway in the race to develop effective antibodies against Covid-19. The companys llama-derived antibody, XVR011, is currently being trialled in healthy individuals and hospitalised Covid-19 patients and the data so far looks promising.

The antibodies were originally extracted from a llama named Winter, who is now being left to his own devices at a private animal park in Belgium as the antibodies can be synthesised in a lab. The small, llama-derived nanobodies have demonstrated strong neutralising activity against Covid-19 and all of its variants of concern. ExeVir, which was spun out from the Flanders Institute for Biotechnology, has moved its lead candidate from laboratory tests to human clinical trials at an impressive pace, and beyond the current pandemic, the firm is hoping to build a broader platform for the treatment of infectious diseases of all kinds, both viral and bacterial.

Pharmaceutical Technology speaks to ExeVir CEO Torsten Mumenbrauer about the companys research and why XVR011 has the edge over other Covid-neutralising antibody programmes.

Darcy Jimenez: How did research into this therapeutic candidate begin, and why were llama-derived antibodies chosen?

Torsten Mummenbrauer: The technology as such is pretty old. It had been invented at the University of Brussels almost 20 years ago, then the Flanders Institute for Biotechnology (VIB) in Ghent took it on board and continue to develop the technology.

The big benefit of the technology is the small size of the nanobodies, and the resulting advantages. In our special case, we have a very specific epitope on the spike protein, which is targeted by our lead candidate. And because the molecule is so much smaller than human antibodies, it can bind in this small groove or niche, and that makes it special. Its applicable for any use thats why we believe its a platform technology which can be used broadly in infectious disease development.

The fact that the nanobody is that much smaller also makes it applicable for different presentation in humans so you can consider inhaled versions, we will develop a subcutaneous version, and you can fuse it to the Fc receptor to make it look like a human antibody. Thats what we have done with our lead molecule, specifically to stabilise it. When its fused to an Fc, its roughly only half of the size of a human antibody, so if you put a certain amount per dose in your therapeutic approach, you have roughly double the number of molecules in the patient.

Then you can think about future variations or design changes. The FDA advised, for Covid-19 products, to go for a combination product thats what we see with the Regeneron product, which is a combination of two [monoclonal antibodies], and Lillys as well. In our case, we could simply fuse two different nanobodies to one molecule or on one Fc and mimic the combination approach, but keep all the advantages of the technology.

DJ: What have studies shown so far about the antibodys efficacy against Covid-19?

TM: We started off against the wild type, the Wuhan strain, of course, and we showed efficacy in picomolar range in the hamster model. We have done the same experiment against Alpha, Beta, Gamma and Delta variants, and we see no change. We have very much the same potency against all variants which are [circulating] so far. We are looking at the variants of interest, and well follow up and test these as well.

The key importance here is the epitope of your binder. If this epitope starts to mutate, then that allows the virus to escape. And this is what happens on the antibodies from Regeneron, which were originally derived from plasma from convalescent patients. They are all binding to the outer part of the RBD (receptor binding domain), and this is where you find the mutation hotspots of the virus.

We are on a side niche, and we are not impacted by any of these mutations; we have a crystal structure, and we can clearly show that these mutation hotspots are in other areas of the virus. We have shown on sequencing data that our epitope is very highly conserved over the SARS-COV virus family.

An interesting aspect is that originally, our llama Winter had been immunised against SARS-COV-1 already four or five years ago thats the reason why the company could be that fast. The library against SARS-COV-1 existed already in February last year, when the SARS-COV-2 sequence was published. So we immediately did a screen, and we found 100% cross-reactive binders, and that resulted in our lead candidate. Thats probably another reason why we have this highly conserved and very stable epitope, because its conserved on the whole virus family.

We of course are looking into the sequencing database available for all virus isolates worldwide, and there you can see the mutation hotspots coming. In our binding area there is extremely limited mutation frequency, so it seems that this highly conserved epitope is important for the viability of the virus itself, and thats probably the reason why its so stable.

DJ: Dosing of Phase I trial participants began last month, and hospitalised Covid-19 patients were also dosed recently. Are you confident about the antibody being studied in a hospital setting?

TM: We decided a while ago to silence our Fc component, and Ive mentioned that weve fused the Fc of the antibody to the nanobody thats specifically for safety reasons. Its one of our key differentiators compared to other antibodies, where you have the concern of antibody-derived enhancement of the disease, because of the activation of the immune system through the antibody. Our Fc is silenced, so we just neutralise the virus and we do not activate the immune system.

Were extremely confident about [the study], and we strongly believe that the early-stage, mild-to-moderate hospitalised patients have the highest medical need, because there you want to avoid progression of the disease and ICU, of course.

To add on to that, the first cohort in Phase I healthy subjects have been completely dosed without any severe side effects. There is a bit of redness at the infusion site, which is normal for antibodies, and the same [was found] for the first hospital patient who has been dosed.

DJ: Developing a promising candidate to help combat the pandemic is an impressive feat for a company that was founded only last year. What else is ExeVir working on that youre particularly excited about?

TM: This is our lead candidate; we were focusing very much over the last year on the lead, otherwise it wasnt going to happen. We were always thinking, if you want to make a difference in a disease like Covid-19, in a crisis, you need to be extremely fast. And so that has to be the focus, but we definitely see this as a platform technology to fight infectious diseases, and there we split that into two parts.

One is the future of pandemic preparedness: I strongly believe that people have realised that vaccines, in the case of a pandemic outbreak, are an important component of a response, but it also requires therapeutics. If you want to ringfence a local outbreak, a therapeutic is much more efficacious. You dont need to wait for onset of immunity, you can use antibodies in prophylactic and therapeutic settings, and I think we have proven with the pre-immunisation of the llama that you can be very fast with this technology.

We definitely want to be part of pandemic preparedness of the future, but thats not where you can really build the commercial future of a company in my view, because you dont know if or when your pre-developed product might be required. So we are also working on a pipeline for infectious diseases with high medical need, and we are in the last step, I would say, of the process to come up with a shortlist of candidates. It will target infectious diseases with the highest medical need and hospitalisation relevance, so the technology can be used against bacterial diseases as well as viral. There is an ongoing programme on universal flu at VIB, which is very exciting for us, so there will be definitely a strong pipeline path for the next year beyond Covid-19.

We are really proud to demonstrate with [XVR011] that you can bring a molecule from early R&D and preclinical to a patient within a year. And for a small company, under all the circumstances of the pandemic, we believe thats a really cool achievement.

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ExeVir Q&A: the llama-derived antibody that could fight Covid-19 - Pharmaceutical Technology

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

HAMILTON A Butler County judge sided with a local hospital and reversed a previous court order forcing it to honor a prescription of ivermectin, which infectious disease experts have warned against as a COVID-19 treatment, for a patient who has spent weeks in the ICU with the disease.

After two days of testimony and arguments, Common Pleas Judge Michael Oster issued an order Monday siding with West Chester Hospital. He said the hospital bears no duty to honor a prescription written for Jeffrey Smith, 51, for ivermectin, a drug used as a dewormer in horses and an anti-parasitic in humans.

The drug has surged in popularity as a COVID-19 treatment, egged on by conservative politicians and media figures, despite adverse warnings from the Centers for Disease Control, the Food and Drug Administration, the American Medical Association, the drugs manufacturer and others.

This Court is not determining if ivermectin will ever be effective and useful as a treatment for COVID-19, Oster said.

However, based upon the evidence, it has not been shown to be effective at this juncture. The studies that tend to give support to ivermectin have had inconsistent results, limitations to the studies, were open label studies, were of low quality or low certainty, included small sample sizes, various dosing regiments, or have been so riddled with issues that the study was withdrawn.

Julie Smith brought the lawsuit on behalf of her husband, Jeffrey Smith, who tested positive for COVID-19 and was admitted to the ICU July 15, where he remains today. He has been sedated, intubated and on a ventilator since Aug. 1.

The hospital refused to honor the prescription, prompting the lawsuit. On Aug. 23, another judge wrote an order demanding the hospital administer the ivermectin as prescribed. Mondays order nixes the August order.

Julie Smith testified that neither she nor her husband were vaccinated against COVID-19. She said it was experimental, so she didnt trust it.

We didnt feel confident it had been out long enough, she said during a hearing Thursday.

She later connected with Dr. Fred Wagshul, a founding physician of the Front Line COVID-19 Critical Care Alliance, a nonprofit that touts ivermectin as a wonder drug. Wagshul is a licensed physician but is not board certified within any specialty and hasnt worked in a hospital for 10 years, according to his testimony.

He prescribed Jeffrey Smith 21 days worth of ivermectin without reviewing Jeffrey Smiths clinical information or talking to any of his treating physicians. He said the pharmaceutical industry and U.S. government have smeared ivermectin and censored its allegedly undeniable beneficial value.

However, when asked if it had benefitted Smith, he hedged.

I honestly dont know, but the rule of thumb is, when something is working, you dont stop it, he said.

Several witnesses for the hospital cast doubt on Wagshuls testimony and credibility as a physician. Dr. Ferhan Asghar, a surgeon and chief of staff at the hospital, said a physician who is not board certified would never be admitted to practice at West Chester, per hospital policy. He said it was also a concern that a physician would issue such a controversial prescription without seeing the patient or reviewing his information.

Dr. Jaime Robertson is an infectious disease physician who sits on a committee at UC Health, which staffs West Chester Hospital, to review available evidence to guide treatment for COVID-19 patients. He said the evidence doesnt necessarily conclude ivermectin doesnt work; instead, he said ivermectin bears risks just like any treatment but theres no conclusive evidence to show enough benefit exists to outweigh that risk.

I think the problem here is there are conflicting outcomes in public health literature, he said.

Dr. Daniel Tanase, Jeffrey Smiths treating physician, disputed any notion that the ivermectin demonstrably helped his patient, and said theres not enough evidence to support the use of ivermectin on COVID-19 patients.

We follow science and we follow what the guidelines are, he said. So yes, I dont think ivermectin is what he needs at this time.

On Aug. 26, the CDC issued a health alert warning of a five-fold increase of calls to poison control centers regarding ivermectin exposure compared to a pre-pandemic baseline. These included exposures related to topical and veterinary formulations of the drug.

Clinical effects of ivermectin overdose include gastrointestinal symptoms such as nausea, vomiting, and diarrhea, the CDC states. Overdoses are associated with hypotension and neurologic effects such as decreased consciousness, confusion, hallucinations, seizures, coma, and death. Ivermectin may potentiate the effects of other drugs that cause central nervous system depression such as benzodiazepines and barbiturates.

Several other federal authorities have issued similar warnings. Even Merck, which manufactures the drug, issued a statement in February affirming its position that theres no scientific basis for a potential therapeutic effect against COVID-19 from ivermectin. The company also noted a concerning lack of safety data in the majority of studies.

Areview of available literature conducted in August by the journal Nature found theres no certainty in the available data on potential benefits of ivermectin.

Ohio Hospital Association President Mike Abrams said in a statement before Oster issued his order stating there is insufficient data to support ivermectin as a treatment for COVID-19. He called the initial order concerning in regards to forcing a hospital to use a drug unapproved for use.

OHA believes it is an extraordinarily dangerous precedent for judges to practice medicine and order unproven medical treatments over the objections of highly-trained clinicians and against all standards established by the medical community, Baker said.

Bill Paiobeis, an attorney for West Chester Hospital, declined comment Monday, citing the potential for an appeal.

Ralph Lorigo, an attorney representing Smith, said he won the lawsuit in a way. He said Jeffrey Smith obtained 13-days worth of ivermectin, and the hospital has since told Julie Smith that theyre ready to begin to ween him off the ventilator.

Julie has won this case; I dont care what this judge says, Lorigo said in an interview. We are believers hes going to survive because of ivermectin.

He said hes not planning any appeal as one would effectively be moot.

This is a man who has been helped by the medication, and this is a judge who just doesnt get it right, Lorigo said.

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

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

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

The couple contracted the virus in mid-August.

They were both of the Methodist faith.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Other pandemic news Friday:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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