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The winter coronavirus surge is here; Orange County sinks deep into strictest purple tier – OCRegister

https://www.ocregister.com/2020/11/24/the-winter-coronavirus-surge-is-here-orange-county-sinks-deep-into-strictest-purple-tier/

The winter coronavirus surge is here; Orange County sinks deep into strictest purple tier - OCRegister

Orange County has an unwelcome visitor for the holidays: another coronavirus wave that may soon match the summer’s.

The county’s rate of new coronavirus cases has tripled over the past two weeks in a buildup that public health officials suspect is fueled by “COVID fatigue.” And it is happening at the confluence of flu season and end-of-year holidays.

Gov. Gavin Newsom already pulled a public health “emergency brake” in the state last week, putting Orange County and most others in California into the most-restrictive purple tier of the state’s monitoring system, which forces many business and public sectors – restaurants, gyms, houses of worship – to go outdoors-only once again.

But there was no slowing the slide into trouble territory: Orange County is now seeing about 17 new cases of the virus each day for every 100,000 residents – up from a rate of 10.8 last week and well above a rate of 5.6 two weeks ago.

The share of swab tests coming back positive – the testing positivity rate – also rose sharply to 6.8% in updated stats released by the state’s Department of Public Health on Tuesday, Nov. 24. Testing positivity was 4.6% last week.

On July 9, at the height of the summer surge, Orange County’s case rate peaked at about 27 cases per 100,000 residents and, within a week, testing positivity topped out at 12.7%.

“It’s just sort of the inevitable fall wave,” Andrew Noymer, an epidemiologist and professor of public health at UC Irvine, said. “On the county level it’s a little hard to call exactly where the peak will be.”

Tier assignments and metrics, which state officials had released each Tuesday since the four-tier system was introduced in late August, will be announced at least once a week going forward, officials said.

Most recently, Orange County has averaged 354 tests per day per 100,000 residents, beating the state average of 272 tests per 100,000.

The county hosts two testing “super-sites,” in Anaheim and Costa Mesa. Together the two are swabbing about 6,000 nostrils per day, said Tim Shirata, director of strategy at 360 Clinic, which operates the sites. Most patients get their swab test results back in two or three days, he said, and testing is free to everyone, whether or not they have health insurance.

Shirata said 360 Clinic is hiring up to 400 workers to meet growing testing demand – he’d especially like to hire people who might have been laid off in the local hospitality industry. The drive-thru line at the fairgrounds Tuesday morning took about 15 minutes to get through, he said.

“As you know there has been an uptick in coronavirus, and with the holidays coming up such as Thanksgiving and Christmas, we anticipate that there’s going to be a lot more testing,” Shirata said.

County leaders this week launched free, do-it-yourself saliva test kits, available to Anaheim and Santa Ana residents first – where hot spots of the virus are still being tamped down – in another push to make widespread testing faster and easier.

Dr. Clayton Chau, OC Health Care Agency director and county health officer, has said local drivers of recent new cases included Halloween parties, voting during the election and other reasons for people to gather, even in relatively small groups.

“We are truly in the midst of a surge here in California,” said Dr. Mark Ghaly, the state’s Health and Human Services secretary, during a news conference Tuesday. “The cases are concerning in part because they really foreshadow what the impact is going to be on our hospitals.”

Predictably, the sickest residents over the past month are ending up hospitalized; Ghaly said generally about 12% of COVID-19 patients need hospitalization two-to-three weeks after infection.

Coronavirus-related hospitalizations at Orange County’s 33 hospitals have tripled over the past month to 463 people by Tuesday.

“Statewide, I don’t believe we’ve ever seen as many hospital admissions … like we did in the past 24 hours, and I hope, but don’t expect, that it will be the highest we’ve ever had,” Ghaly said.

Orange County’s emergency rooms are better prepared for the expected flood of coronavirus patients than they were earlier in the pandemic, hospital officials have said, because they have proven surge plans and stockpiles of equipment.

Recent Health Care Agency reports have shown stable overall bed occupancy across the county’s hospitals, despite the increase in coronavirus patients, indicating that hospitals are adding and subtracting beds – and staff – as needed.

Nursing homes and other group living facilities, which were caught off guard early in the pandemic, also have adjusted to protect residents and have not seen a large uptick in cases compared to the summer.

During Tuesday’s news conference, Ghaly again asked Californians to celebrate Thanksgiving only with members of their own households and virtually with others.

A statewide travel advisory is still in effect, Ghaly said, with a strong recommendation that people arriving from other states and countries self-quarantine for two weeks and limit interactions with people they’re staying with.

“Make sure to drop off Thanksgiving meals to older loved ones and those with underlying (medical) conditions so they can stay home,” he said. “Remind yourselves, remind others around you, that these are the things we have to do to protect our families and friends, because we love them.”

As always, Ghaly said, wear a mask, wash hands frequently and avoid mixing with other households.

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COVID-19 will shorten American life expectancy, study shows – New York Post

https://nypost.com/2021/01/15/covid-19-will-shorten-american-life-expectancy-study-shows/

COVID-19 will shorten American life expectancy, study shows - New York Post

The coronavirus pandemic will shorten the life expectancy at birth for Americans by about a year due to the more than 336,000 deaths from the illness in the US in 2020, according to new research.

Researchers at the University of Southern California and Princeton project that life expectancy will be cut by 1.13 years, to 77.48 years, according to their study, which was published Thursday in the Proceedings of the National Academy of Sciences.

That is the lowest life expectancy estimated since 2003 — and marks the largest single-year decline in at least 40 years, according to Science Daily.

The longevity declines are likely even steeper among minority populations, the study found.

For blacks, the researchers project life expectancy would shorten by 2.10 years to 72.78 years, and for Latinos, by 3.05 years to 78.77 years, according to the research.

Among whites, the projected decline is 0.68 years to a life expectancy of 77.84 years — while overall, the gap in life expectancy between blacks and whites is projected to widen by 40 percent, from 3.6 to more than five years.

“Our study analyzes the effect of this exceptional number of deaths on life expectancy for the entire nation, as well as the consequences for marginalized groups,” said study author Theresa Andrasfay, a postdoctoral fellow at the USC Leonard Davis School of Gerontology.

“The COVID-19 pandemic’s disproportionate effect on the life expectancy of Black and Latino Americans likely has to do with their greater exposure through their workplace or extended family contacts, in addition to receiving poorer health care, leading to more infections and worse outcomes,” she added.

The coronavirus has apparently eliminated many of the gains made in narrowing the black-white life expectancy gap since 2006, Science Daily reported.

Medical personnel in Brooklyn move a deceased patient to a refrigerated truck being used as a makeshift morgue.
Medical personnel in Brooklyn move a deceased patient to a refrigerated truck being used as a makeshift morgue.
AFP via Getty Images

Latinos, who have experienced lower mortality than whites, would see their more than three-year survival advantage over whites reduced to less than one year.

“The huge decline in life expectancy for Latinos is especially shocking given that Latinos have lower rates than the white and black populations of most chronic conditions that are risk factors for COVID-19,” said study co-author Noreen Goldman, a professor of demography and public affairs at  Princeton.

 “The generally good health of Latinos prior to the pandemic, which should have protected them from COVID-19, has laid bare the risks associated with social and economic disadvantage,” she said.

The study estimated life expectancy at birth and at age 65 for 2020 for the total US population and by race and ethnicity.

The researchers used four scenarios of deaths — one in which the pandemic had not occurred and three others that include COVID-19 mortality projections by the Institute for Health Metrics and Evaluation, an independent global health research center at the University of Washington.

“The bigger reductions in life expectancy for the Black and Latino populations result in part from a disproportionate number of deaths at younger ages for these groups,” Goldman said.

“These findings underscore the need for protective behaviors and programs to reduce potential viral exposure among younger individuals who may not perceive themselves to be at high risk,” she added.

The projected pandemic-related drop in life expectancy is about 10 times as large as the declines seen in recent years.

During the 1918 influenza pandemic, life expectancy was reduced by an extraordinary seven to 12 years.

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Book review of Keep Sharp: Build a Better Brain at Any Age by Sanjay Gupta – The Washington Post

https://www.washingtonpost.com/outlook/advice-for-keeping-your-brain-at-its-best/2021/01/13/34a84816-451f-11eb-a277-49a6d1f9dff1_story.html

Book review of Keep Sharp: Build a Better Brain at Any Age by Sanjay Gupta - The Washington Post

Yet Gupta, who is CNN’s chief medical correspondent and a practicing neurosurgeon in Atlanta, is quick to tell readers that fear of dementia should not be the reason to read the book, which was published collaboratively with AARP. Instead, he writes, “it should be the knowledge that you can build a better brain at any age.”

“Keep Sharp” is largely a self-help book, but Gupta devotes the first 100 pages or so to the science of the brain (“what makes you you,” as he aptly puts it) and dementia.

At the outset, he takes care to distinguish between dementia, which is a broad condition of functional impairment from cognitive decline, and the specific form of dementia known as Alzheimer’s disease, which accounts for more than half the cases of dementia.

Gupta explores a number of explanations for “ways the brain begins to break.” Genetics are a possible factor, as are blood flow abnormalities in the brain, neurotoxins and metabolic disorders. As for the “amyloid cascade hypothesis” for Alzheimer’s disease, which dates back to 1907, when Aloysius Alzheimer first identified “senile plaques” in a woman’s brain during an autopsy, Gupta writes that scientists increasingly believe that the plaques aren’t the cause of Alzheimer’s disease but a consequence of it.

Gupta does some interesting myth busting. For instance, he assures us that dementia is not necessarily an inevitable consequence of old age, that older people can in fact learn new things, and that doing the daily crossword puzzle is fine but flexes only a portion of your brain.

The book’s main thrust is prevention. Put simply, Gupta writes, “clean living can slash your risk of developing a serious mind-destroying disorder, including Alzheimer’s disease, even if you carry genetic risk factors.” Because dementia takes root decades before it is diagnosed, the earlier you start your prevention regimen, the better. To that end, Gupta lays out a 12-week “sharp brain” program, consisting of exercise, healthful eating, a bedtime routine, sound sleep, relaxation, intentional socializing, yoga, even a gratitude journal. Similar advice has been dispensed in numerous other books, and packaging it as a 12-week program sounds attractive. Yet while all of Gupta’s recommendations are good general tips, the jury is still out on whether doing any of this will actually sharpen your brain, much less stave off dementia.

Gupta presents himself as a model, and as such he’s asking a lot of his readers. Somehow, he finds time every day to exercise for an hour and to meditate. He avoids red meat, seldom snacks and has dabbled in fasting, which has been shown in animal models to boost memory.

Still, the book’s exhortations are difficult to ignore. After reading Part 2 (“How Not to Lose Your Mind”), this reader, for one, headed straight to the bathroom and threw out all the Benadryl in the medicine cabinet, brushed and flossed, Googled “turmeric recipes,” ordered a bottle of L-serine, then scaled a couple of San Francisco hills.

Gupta’s ghostwriter is Kristin Loberg, an experienced hand at collaborating on health books, particularly those of the self-help variety. The writing is largely lucid and succinct, but repetitive in places. The reader is reminded multiple times that the seeds of dementia are planted decades before symptoms appear. Read that frightening fact once, and you’re put on notice. By the fifth time it feels like unnecessary bludgeoning.

Snappy acronyms are a time-honored tradition in the self-help genre. But Gupta’s S.H.A.R.P. dietary protocol is just plain silly. The connections between a letter and its action item are less than obvious — the “A” stands for “Add more Omega-3’s” to your diet. (For the record, a number of recent studies have cast doubt on the benefits of omega-3s.) Then there’s “P,” for “Plan meals ahead.” Your grandmother could have told you this.

The most recent scientific study cited in the book is from late 2019, well before the coronavirus pandemic hit. While the most recent dementia studies might be too new to include, it’s a shame the book doesn’t note the widespread concern over the lasting neurological effects on those who have gotten sick from the coronavirus. Of those who have recovered from covid-19, roughly 1 in 3 have had lingering neurological problems, according to Stat, a publication covering health news. Gupta has reported at length on covid-19 for CNN, but no mention of the pandemic appears in the book. That’s too bad because this signal event is unlikely to vanish from anyone’s memory, short-term or otherwise.

Keep Sharp

Build a
Better Brain
at Any Age

Simon & Schuster.
318 pp. $28

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Many scientists citing two scandalous COVID-19 papers ignore their retractions – Science Magazine

https://www.sciencemag.org/news/2021/01/many-scientists-citing-two-scandalous-covid-19-papers-ignore-their-retractions

Many scientists citing two scandalous COVID-19 papers ignore their retractions - Science Magazine
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Many scientists citing two scandalous COVID-19 papers ignore their retractions - Science Magazine

E. Petersen/Science

This story was supported by the Science Fund for Investigative Reporting. Please help Science pursue ambitious journalism projects.

In June 2020, in the biggest research scandal of the pandemic so far, two of the most important medical journals each retracted a high-profile study of COVID-19 patients. Thousands of news articles, tweets, and scholarly commentaries highlighted the scandal, yet many researchers apparently failed to notice. In an examination of the most recent 200 academic articles published in 2020 that cite those papers, Science found that more than half—including many in leading journals—used the disgraced papers to support scientific findings and failed to note the retractions.

COVID-19 “is such a hot topic that publishers are willing to publish without proper vetting,” even in the face of retractions that made global headlines, says Elizabeth Suelzer, a reference librarian at the Medical College of Wisconsin who has written about problematic citations to a retracted 1998 study in The Lancet falsely linking vaccination to autism.

Both of the retracted COVID-19 papers, one in The New England Journal of Medicine (NEJM) and the other in The Lancet, were based on what appeared to be a huge database of patient records compiled from hospitals worldwide by Surgisphere, a small company operated by vascular surgeon Sapan Desai, who was a co-author on each article. The 22 May 2020 Lancet paper ostensibly showed that hydroxychloroquine, an antimalarial drug promoted by President Donald Trump and others, could harm rather than help COVID-19 patients. Its publication led to a temporary halt in a major clinical trial and inflamed an already-divisive debate over the drug, which has proved to be no help against COVID-19. The 1 May NEJM article corroborated other evidence that people already taking certain blood pressure medicines did not face a greater risk of death if they developed COVID-19.

Questions soon arose about the validity, and even existence, of the Surgisphere database, however, and the retractions followed on 4 June. But of the 200 papers examined by Science—all published after the retractions—105 inappropriately cited one of the disgraced studies. In several cases it was a primary source for a meta-analysis combining multiple studies to draw overarching conclusions. In most, the studies were cited as scientific support or context. Science also found a handful of articles that uncritically cited an influential April preprint based on the same Surgisphere data set, which described the antiparasitic drug ivermectin as beneficial in critical COVID-19 cases. (There is no standard way to retract preprints, however.)

Ivan Oransky, co-founder of the website Retraction Watch, says such blunders occur because “people are either willfully or negligently not checking references.” Many authors copy and paste lists of apparently relevant citations from similar papers without actually reading them, he says. “It’s frightening. It’s terrible, but common.”

Many of the tainted citations appeared in papers published by little-known journals, but at least a dozen found their way into major publications. For example, three articles in PLOS ONE, the prominent open-access journal, cited the retracted papers in discussions of pandemic conditions in Europe. A 28 December paper in the Proceedings of the National Academy of Sciences (PNAS)—one of the most influential journals—discussed the risks and benefits of drugs to treat COVID-19 and noted the Lancet retraction in its citations, yet the text merely noted the paper’s hydroxychloroquine findings as “controversial.”

Editors at those two publications said they would correct the references and take steps to prevent such problems in the future. Renee Hoch, a PLOS ONE editor and publication ethics manager, wrote in an email that the publication relies on authors and its outside, volunteer editors to check citations, and she was caught by surprise when contacted by Science. “We are currently following up on this issue with high priority in light of the implications for public health and ongoing COVID-19 research,” she wrote.

Hoch added that reliance on retracted work, “either directly or in the form of supporting references,” can be harmful. “[W]here the retracted work has clinical implications, this can result in direct risks to patients.”

In a written response to questions about the citation of the Lancet paper, May Berenbaum, editor-in-chief of PNAS, said, “The authors really should have either removed the citation, added more text about why they included it, or cited the retraction notice itself.” Given that no editor or reviewer caught the problem, she said, “I plan to discuss with the staff incorporating such screening into manuscript processing.” A co-author of the paper, biostatistician Clelia Di Serio of Vita-Salute San Raffaele University, later said the reference to the Lancet paper would be expunged.

Some journal editors noted extenuating factors. In Stroke, a leading medical journal, a December article about ischemic stroke in COVID-19 patients referenced the NEJM paper without mentioning the retraction. Stroke Editor-in-Chief Ralph Sacco wrote in an email that the retraction occurred after the article was initially received. However, a revision of the article was resubmitted months after the event, according to the paper itself. Sacco said he would issue no correction because the retraction “is not material to the findings.”

A 16 December paper on SARS-CoV-2 genetics in Nature Communications, another high-profile journal, also cited the NEJM article without reference to the retraction. Elisa De Ranieri, the journal’s editor-in-chief, told Science her journal does not routinely check for “retractions or other postpublication updates.” A lead author of the paper, biomathematician Maik Pietzner at the University of Cambridge, said that although the paper was submitted after the retractions occurred, it was written beforehand, and “the current pandemic requires immediate response.” However, the paper was published 4 months after its submission.

Suelzer says inappropriate citations of retracted articles are hard to excuse. Retraction Watch publishes a free retraction database that has been integrated into a number of automated services to check citations, including scite.ai, Zotero, and RedacTek. The failure to use such tools “is a disservice to the readers and researchers,” Suelzer says. “They are pretty low bars.”

Yet Oransky estimates that in biomedicine, up to 90% of citations to retracted papers don’t mention their fall from grace. “Half the time [as seen with the Surgisphere papers] is an improvement. That’s what’s shocking about it.”

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Natural immunity after Covid-19 could last at least 5 months – Vox.com

https://www.vox.com/22230667/covid-immunity-natural-infection-symptoms-asymptomatic

Natural immunity after Covid-19 could last at least 5 months - Vox.com

For the nearly 100 million people around the world who’ve been infected with the coronavirus, new science offers some comfort: Reinfections appear to be rare, and you may be protected from Covid-19 for at least five months.

The study, the largest of its kind, followed more than 20,000 health workers in the UK, regularly testing them for infection and antibodies. Between June and November, the researchers — from Public Health England (PHE) — found 44 potential reinfections out of the 6,614 participants who had tested positive for antibodies or had a previous positive PCR or antibody test when they joined the study. (The full results aren’t yet published, but PHE told Vox a preprint would soon be shared online.) Meanwhile, of the 14,000-plus people who had tested negative for the virus at the start of the study, there were 409 new infections.

Only two of the 44 potential reinfections were designated “probable” and the rest were considered “possible,” “based on the amount of confirmatory evidence available,” the health agency press release said. According to the BMJ, 15 people — or 34 percent — had symptoms.

So if all 44 reinfections are real, that translates to an 83 percent lower risk of reinfection compared to health workers who never had the virus. If only two are confirmed, that rate of protection goes up to 99 percent. Either way, it means natural immunity provides a similar level of protection as the approved Covid-19 vaccines.

As with the vaccines, it’s not yet clear how long immunity after an infection lasts. Antibodies may fade after five months or last much longer, something the researchers behind the ongoing study, which will run for a total of 12 months, plan to investigate.

“This [new] study does provide some comfort that naturally acquired antibodies are pretty effective in preventing reinfections,” Akiko Iwasaki, an immunobiologist at Yale University, told Vox. The findings also square with another paper on health workers, published in the New England Journal of Medicine in December: Researchers found people who had Covid-19 antibodies were better protected from the virus for six months than people who did not.

That said, Iwasaki said, “You can also interpret these data to mean that protection against reinfection is not complete — especially for people who had Covid during the first wave, say in March-April 2020.”

People who had the virus may still be able to pass it on if reinfected

The good news for individuals who have had Covid-19 also comes with a warning about the risk they can still pose to other people. While antibodies might protect against a second case of Covid-19 in most people, “early evidence from the next stage of the study suggests that some of these individuals carry high levels of virus and could continue to transmit the virus to others,” PHE warned in the press release.

“We now know that most of those who have had the virus, and developed antibodies, are protected from reinfection, but this is not total,” Susan Hopkins, a senior medical adviser at PHE and the study lead, said in a statement, “and we do not yet know how long protection lasts.”

In other words, even if you’ve had Covid-19, while you’re unlikely to get really sick again anytime soon, you should still consider yourself a potential risk of spreading it to others if you catch the virus again and may be asymptomatic. That means continuing to take precautions — like mask-wearing and social distancing, Iwasaki added. And it’s one reason why immunologists have said people who’ve already been infected with the virus should still plan to get the vaccine when their turn comes.

There’s also still a lot we don’t know about immunity after Covid-19: How exactly does it compare to immunity after vaccination? How will the new coronavirus variants affect it?

Who is most likely to have a lasting immune response? We do have some evidence that different individuals mount different antibody responses after Covid-19 infections. And it’s possible factors like gender and disease severity influence the strength of a person’s immune response.

For now, though, the research suggests that survivors of the virus might just help us get to herd immunity faster — if their immunity lasts long enough. But given the virus has only been known to humans for a little over a year, it may take a while to authoritatively answer the question.

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Post-COVID lungs worse than the worst smokers lungs, surgeon says – CBS News

https://www.cbsnews.com/news/covid-lungs-scarring-smokers-lungs/

Post-COVID lungs worse than the worst smokers lungs, surgeon says - CBS News

A Texas trauma surgeon says it’s rare that X-rays from any of her COVID-19 patients come back without dense scarring. Dr. Brittany Bankhead-Kendall tweeted, “Post-COVID lungs look worse than any type of terrible smoker’s lung we’ve ever seen. And they collapse. And they clot off. And the shortness of breath lingers on… & on… & on.”

“Everyone’s just so worried about the mortality thing and that’s terrible and it’s awful,” she told CBS Dallas-Fort Worth. “But man, for all the survivors and the people who have tested positive this is — it’s going to be a problem.”

Bankhead-Kendall, an assistant professor of surgery with Texas Tech University, in Lubbock, has treated thousands of patients since the pandemic began in March.

texas-tech-university-trauma-surgeon-dr-brittany-bankhead-kendall.jpg
Lubbock, Texas trauma surgeon Dr. Brittany Bankhead-Kendall.

CBS Dallas


She says patients who’ve had COVID-19 symptoms show a severe chest X-ray every time, and those who were asymptomatic show a severe chest X-ray 70% to 80% of the time.

“There are still people who say ‘I’m fine. I don’t have any issues,’ and you pull up their chest X-ray and they absolutely have a bad chest X-ray,” she said.

In X-ray photos of a normal lung, a smoker’s lung and a COVID-19 lung that Bankhead-Kendall shared with CBS Dallas, the healthy lungs are clean with a lot of black, which is mainly air. In the smoker’s lung, white lines are indicative of scarring and congestion, while the COVID lung is filled with white.

“You’ll either see a lot of that white, dense scarring or you’ll see it throughout the entire lung. Even if you’re not feeling problems now, the fact that that’s on your chest X-ray — it sure is indicative of you possibly having problems later on,” she said.

normal-smokers-covid-chest-x-rays.jpg
X-rays of a normal lung, a smoker’s lung and a COVID patient’s lung. 

Dr. Brittany Bankhead-Kendall via CBS Dallas


Dr. Amesh Adalja, an infectious disease expert and senior scholar at Johns Hopkins University Bloomberg School of Public Health, told CBSN that some patients with severe COVID-19 could feel the impact for years to come.

“When someone recovers from pneumonia, whether it’s a bacterial pneumonia or a viral pneumonia, it’s going to take some time for their chest X-rays to improve. Chest X-rays lag your clinical improvement. So you may be better, but your chest X-ray still looks bad,” he said. “And we know that people with COVID-19 can get severe pneumonia, and some of that pneumonia will lead to damage to the lungs that will take time to heal. And some of it may be permanent.”

He said the potential long-term health consequences are another reason people should take warnings about the disease seriously. 

“It’s not something you can blow off. This isn’t something you want to have. Because even if you survive, you still may be left with some severe complications that make it very hard for you to go back to your baseline functioning.”

Bankhead-Kendall said it’s important that if you’re experiencing shortness of breath after your COVID-19 goes away, you stay in touch with your primary care doctor.

She also points out, “There is no long-term implication of a vaccine that could ever be as bad as the long-term implications of COVID.”

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