Coronavirus
by texting SOS to 741741 or call the National Suicide Prevention Lifeline at 1-800-273-8255.
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NEW NEWS It’s
a Bad Time to Be a Booster Slacker
- 10/25/22 Video Index
6:33It's not the vaccine that is listening and watching your actions. It may be your cell phone. Genetics and covid deaths -
6/10/22
www.SorryAntiVaxxer.com
is a reposditory of stories of hundreds of
anti-vaxxers who have died of COVID. The purpose of
this site is educational. Except for a few
exceptions, everyone listed on this site was/is an
anti-vaxxer activist who helped spread COVID-19
misinformation on social media. Share to stop
others from making the same mistake. GET
VACCINATED!
Where is herd immunity? Dr. John Campbell -
10/15/21
Access
to Quality, Affordable Health Care Is More Important Than
Ever 4/27/20
Do Face Shields Protect Against COVID-19? A Mask and Shield Explainer Coronavirus Anxiety Has Skyrocketed, With 85% More Worried About Life Most
Hospitalized COVID Patients Not Fully Recovered 6 Months
Post-Discharge —
Fatigue, weakness are most common, Chinese study finds -
January 8, 2021 Be there for your students Systematic
Racism & Policing: Education & Action
during COVID-19 6/4/20 Steps to help prevent the spread of COVID-19 if you are sick (2 page PDF) What symptoms to be on
the lookout for and how to protect yourself from
coronavirus - 6:08 AM ET, Mon
3/2/20 Active Minds https://www.eachmindmatters.org/ask-the-expert/stayingconnected/ BLOG: Coping and Staying Emotionally Well During COVID-19 Social Distancing Another Covid
symptom: altered mental function The study looked at the records of more than 500 patients around Chicago. Those who experienced encephalopathy, the medical term for altered mental function, stayed in the hospital three times as long as patients without altered mental function. After they were discharged, only about one-third of those patients were able to handle everyday activities like cooking and paying bills. The study also found that patients who experienced altered mental function were more likely to be older and male, and were also more likely to have an underlying condition like cancer, chronic kidney disease or smoking. Some experts noted that President Trump was of the age and gender of patients who were more likely to develop encephalopathy. He also has a history of high cholesterol, which is thought to put patients at increased risk. But one of the study’s co-authors
urged caution in drawing inferences from the study to Mr.
Trump’s condition. “I think we should be careful
trying to ascribe a risk to an individual, based on this
retrospective study,” said Dr. Igor Koralnik, the
senior author of the study and chief of neuro-infectious
disease and global neurology at Northwestern Medicine.
“We need to know more about that individual’s
health records, which are not public.” CDC
Clarifies '15-Minute Rule' for Social Distancing That's the concern underlying new changes to the Centers for Disease Control and Prevention's definitions and guidance on social distancing during the pandemic, which will likely mean changes in some schools' approach to preventing or tracing coronavirus outbreaks and significantly more students being identified for quarantine. The CDC now defines a "close contact" of someone with COVID-19 as anyone who was within six feet of someone infected for a total of 15 minutes over the course of 24 hours. For example, if a student came into contact with a sick classmate three times during a school day, for five minutes each time, he would be asked to stay home and isolate himself for 14 days, while checking for fever, coughing, and other symptoms of COVID-19. Students and adults in schools would need to go into quarantine if they had close contact from two days before the infected person showed symptoms (or within two days of being tested, if the person had no symptoms) until the infected person started quarantine. Previously, a close contact was someone who was close to an infected person for 15 minutes continuously, a rule that has led to confusion in schools about how best to limit exposure. For example, the Iowa Department of Public Health's Medical Director Caitlin Pedati came out publically to discourage schools from using a so-called "COVID shuffle"—in which students are asked to get up and move around every 10-14 minutes to avoid students being close to one another for more than 15 minutes at a time. This kind of social distancing can be counterproductive, because while 15 minutes is considered a rule of thumb, the risk of becoming infected goes up with any exposure, and some research has suggested asking students to move around frequently in an indoor, poorly ventilated classroom could actually increase their risk of exposure to the virus. The CDC noted that students and
teachers should still be considered "close contacts" even if
they wear masks. While this wouldn't change contact tracing
and quarantine, separate research suggests that schools that
use preventative strategies—universal mask wearing,
six-foot social distancing, regular handwashing and
cleaning—have significantly lower risk of
infections. Oregon: Latest
updates on coronavirus - Last updated March 27 at 6:30
p.m. ET. Nine of the cases are in people ages 19 and younger, 32 are in 20- to 29-year-olds, 48 are in 30- to 39-year-olds, 81 are in 40- to 49-year-olds, 78 are in 50- to 59-year-olds, 84 are in 60- to 69-year-olds, 47 are in 70- to 70-year-olds, and 35 are in people older than 80. The age of one person was not available. At least 14 cases are linked to the Edward C. Allworth Veteran's Home in Lebanon, in Linn County, where half of those infected are over the age of 90, according to Oregon Live. The state has seen 12 deaths from the coronavirus. According to the Oregon Health Authority, the first individual was a 70-year-old man who died on Saturday (March 14) in Multnomah county. His was the first of two deaths in Multnomah County. The other deaths occured in Clackamas County (2), Lane County (1), Linn County (1), Marion County (3) and Washington County (3). On March 26, there were 362 available ICU beds and 684 available ventilators in Oregon, according to the Oregon Health Authority. A modeling study released Thursday (March 26) found that Oregon’s stay-at-home order may be enough to prevent the state’s healthcare system from becoming overwhelmed, as long as 9 out of 10 Oregonians follow the order, OregonLive reported. Oregon Live reported on Tuesday (March 24) that about 1 in 20 emergency room visits in the state are now related to COVID-19-like symptoms. While influenza case numbers are now dropping, visits to the ER for influenza-like symptoms (fever and sore throat or a cough), are on the rise, according to Oregon Health Authority data cited in the report. Oregon Governor Kate Brown issued a statewide stay-at-home order on Monday (March 23), prohibiting citizens from congregating in public or at businesses unless for essential activities such as grocery shopping. Some playgrounds and other outdoor recreation facilities, including campgrounds, will be closed, the Lebanon Express reported. Following the business closures, Oregon has seen a surge in unemployment claims. The state saw 23,000 new claims last week, OregonLive reported. Cases by county: (23 of 36 counties) Benton: 5 Gov. Brown declared a state of emergency in Oregon on March 8. On Thursday (March 11), Brown ordered all K-12 schools in the state to close through the end of March, a closure that was extended until April 28 on March 18. On Monday (March 16), the governor banned public gatherings of more than 25 people for at least a month and ordered restaurants and bars to end dine-in services. On Tuesday, the state restricted visitors to nursing homes and long-term care facilities, according to Oregon Public Broadcasting (OPB). The state's ski areas began closing on March 14, according to OPB. On Thursday (March 18), Oregon Governor Kate Brown warned that the state is "a couple days off" from running out of personal protective equipment for medical personnel, and called for citizens and businesses with stores of masks, gloves or gowns to donate them to the state via myoregon.gov. On Monday (March 23), a Portland man was arrested for allegedly stealing thousands of face masks meant for healthcare workers from a nonprofit, then posting them on Craigslist for sale, OregonLive reported. Other Coronavirus science and news Coronavirus
in the US: Map & cases Children are
not immune In the last two weeks of July, nearly 100,000 children in the United States tested positive for the coronavirus, according to data from the American Academy of Pediatrics and the Children’s Hospital Association. The speed and the scale of the infections — dozens of countries have not yet recorded 100,000 cases in total — further complicate the already daunting issue of reopening schools. In Georgia, Indiana and other states, some schools that reopened have already closed down again after new outbreaks emerged. Recent research suggests that children can carry at least as much of the virus in their noses and throats as adults do, even if they have only mild or moderate symptoms. That has prompted fears that students who become ill at school may spread the virus to their older relatives. But it’s not just older people who are at risk — in some rare cases, a child’s health can be severely affected. Nearly 600 young people in the U.S., from infants to 20 year olds, have developed an inflammatory syndrome linked to Covid-19, the Centers for Disease Control and Prevention reports. Most of the children required intensive care. “I fear that there has been this sense that kids just won’t get infected or don’t get infected in the same way as adults and that, therefore, they’re almost like a bubbled population,” Michael Osterholm, an infectious diseases expert at the University of Minnesota, told The Times in July. “There will be
transmission,” he said. “What we have to do is
accept that now and include that in our plans.” Suicide Mortality
and Coronavirus Disease 2019—A Perfect Storm? -
JAMA Psychiatry. Published online April 10, 2020. COVID-19 Public Health Interventions and Suicide Risk Secondary consequences of social distancing may increase the risk of suicide. It is important to consider changes in a variety of economic, psychosocial, and health-associated risk factors. Economic Stress There are fears that the combination of canceled public events, closed businesses, and shelter-in-place strategies will lead to a recession. Economic downturns are usually associated with higher suicide rates compared with periods of relative prosperity.2 Since the COVID-19 crisis, businesses have faced adversity and laying off employees. Schools have been closed for indeterminable periods, forcing some parents and guardians to take time off work. The stock market has experienced historic drops, resulting in significant changes in retirement funds. Existing research suggests that sustained economic stress could be associated with higher US suicide rates in the future. Social Isolation Leading theories of suicide emphasize the key role that social connections play in suicide prevention. Individuals experiencing suicidal ideation may lack connections to other people and often disconnect from others as suicide risk rises.3 Suicidal thoughts and behaviors are associated with social isolation and loneliness.3 Therefore, from a suicide prevention perspective, it is concerning that the most critical public health strategy for the COVID-19 crisis is social distancing. Furthermore, family and friends remain isolated from individuals who are hospitalized, even when their deaths are imminent. To the extent that these strategies increase social isolation and loneliness, they may increase suicide risk. Decreased Access to Community and Religious Support Many Americans attend various community or religious activities. Weekly attendance at religious services has been associated with a 5-fold lower suicide rate compared with those who do not attend.4 The effects of closing churches and community centers may further contribute to social isolation and hence suicide. Barriers to Mental Health Treatment Health care facilities are adding COVID-19 screening questions at entry points. At some facilities, children and other family members (without an appointment) are not permitted entry. Such actions may create barriers to mental health treatment (eg, canceled appointments associated with child restrictions while school is canceled). Information in the media may also imply that mental health services are not prioritized at this time (eg, portrayals of overwhelmed health care settings, canceled elective surgeries). Moreover, overcrowded emergency departments may negatively affect services for survivors of suicide attempts. Reduced access to mental health care could negatively affect patients with suicidal ideation. Illness and Medical Problems Exacerbated physical health problems could increase risk for some patients, especially among older adults, in whom health problems are associated with suicide. One patient illustrated the psychological toll of COVID-19 symptoms when he told his clinician, “'I feel like (you) sent me home to die.”5 Outcomes of National Anxiety It is possible that the 24/7 news coverage of these unprecedented events could serve as an additional stressor, especially for individuals with preexisting mental health problems. The outcomes of national anxiety on an individual’s depression, anxiety, and substance use deserve additional study. Health Care Professional Suicide Rates Many studies document elevated suicide rates among medical professionals.6 This at-risk group is now serving in the front lines of the battle against COVID-19. A national discussion is emerging about health care workers’ concerns about infection, exposure of family members, sick colleagues, shortages of necessary personal protective equipment, overwhelmed facilities, and work stress. This special population deserves support and prevention services. Firearm Sales Many news outlets have reported a surge in US gun sales as COVID-19 advances. Firearms are the most common method of suicide in the US, and firearm ownership or access and unsafe storage are associated with elevated suicide risk.7 In this context, issues of firearm safety for suicide prevention are increasingly relevant. Seasonal Variation in Rates In the northern hemisphere, suicide rates tend to peak in the late spring and early summer. The fact that this will probably coincide with peak COVID-19 prevention efforts is concerning and deserves additional study. Suicide Prevention Opportunities Despite challenges, there are opportunities to improve suicide prevention efforts in this unique time. Maintenance of some existing efforts is also possible. Physical Distance, Not Social Distance Despite its name, social distancing requires physical space between people, not social distance. Efforts can be made to stay connected and maintain meaningful relationships by telephone or video, especially among individuals with substantial risk factors for suicide. Social media solutions can be explored to facilitate these goals. Tele–Mental Health There is national momentum to increase the use of telehealth in response to COVID-19. Unfortunately, tele–mental health treatments for individuals with suicidal ideation have lagged far behind the telehealth field. Opportunities to increase the use of evidence-based treatments for individuals with suicidal thoughts have been noted for years, especially in rural settings, but fear of adverse events and lawsuits have paralyzed the field. Disparities in computer and high-speed internet access must also be addressed. Research, culture change, and potentially even legislative protections are needed to facilitate delivery of suicide prevention treatments to individuals who will otherwise receive nothing. Increase Access to Mental Health Care As COVID-19 precautions develop in health care settings, it is essential to consider the management of individuals with mental health crises. Screening and prevention procedures for COVID-19 that might reduce access to care (eg, canceled appointments, sending patients home) could include screening for mental health crises; clinical staff would be needed to some degree in settings that may currently relegate COVID-19 symptom screening to administrative staff. Also, rather than sending a patient with a child home, alternative treatment settings could be considered (eg, a private space outside). Distance-Based Suicide Prevention There are evidence-based suicide prevention interventions that were designed to be delivered remotely. For example, some brief contact interventions (telephone-based outreach) 8 and the Caring Letters intervention (in which letters are sent through the mail) 9 have reduced suicide rates in randomized clinical trials. Follow-up contact may be especially important for individuals who are positive for COVID-19 and have suicide risk factors. Media Reporting Because of suicide contagion, media reports on this topic should follow reporting guidelines and include the National Suicide Prevention Lifeline (1-800-273-8255) AND the Crisis Text Line (741741). Optimistic Considerations There may be a silver lining to the current situation. Suicide rates have declined in the period after past national disasters (eg, the September 11, 2001, terrorist attacks). One hypothesis is the so-called pulling-together effect, whereby individuals undergoing a shared experience might support one another, thus strengthening social connectedness. Recent advancements in technology (eg, video conferencing) might facilitate pulling together. Epidemics and pandemics may also alter one’s views on health and mortality, making life more precious, death more fearsome, and suicide less likely. Conclusions Concerns about negative secondary outcomes of COVID-19 prevention efforts should not be taken to imply that these public health actions should not be taken. However, implementation should include a comprehensive approach that considers multiple US public health priorities, including suicide prevention. There are opportunities to enhance suicide prevention services during this crisis. References 1. Drapeau CW?, McIntosh JL?. U.S.A. suicide: 2018 official final data. Published 2020. Accessed April 1, 2020. https://suicidology.org/wp-content/uploads/2020/02/2018datapgsv2_Final.pdf? 2.Oyesanya M?, Lopez-Morinigo J?, Dutta R?. Systematic review of suicide in economic recession. ? World J Psychiatry. 2015;5(2):243-254. doi:10.5498/wjp.v5.i2.243?PubMedGoogle ScholarCrossref 3. Van Orden KA?, Witte TK?, Cukrowicz KC?, Braithwaite SR?, Selby EA?, Joiner TE Jr?. The interpersonal theory of suicide. ? Psychol Rev. 2010;117(2):575-600. doi:10.1037/a0018697?PubMedGoogle ScholarCrossref 4. VanderWeele TJ?, Li S?, Tsai AC?, Kawachi I?. Association between religious service attendance and lower suicide rates among US women. ? JAMA Psychiatry. 2016;73(8):845-851. doi:10.1001/jamapsychiatry.2016.1243? ArticlePubMedGoogle ScholarCrossref 5. CBS News. Coronavirus patients describe symptoms. Published 2020. Accessed March 19, 2020. https://www.cbsnews.com/news/coronavirus-symptoms-fever-dry-cough-shortness-of-breath/ 6. Dutheil F?, Aubert C?, Pereira B?, et al. Suicide among physicians and health-care workers. ? PLoS One. 2019;14(12):e0226361. doi:10.1371/journal.pone.0226361PubMedGoogle Scholar 7. Mann JJ?, Michel CA?. Prevention of firearm suicide in the United States. ? Am J Psychiatry. 2016;173(10):969-979. doi:10.1176/appi.ajp.2016.16010069?PubMedGoogle ScholarCrossref 8. Fleischmann A?, Bertolote JM?, Wasserman D?, et al. Effectiveness of brief intervention and contact for suicide attempters. ? Bull World Health Organ. 2008;86(9):703-709. doi:10.2471/BLT.07.046995PubMedGoogle ScholarCrossref 9. Motto JA?, Bostrom AG?. A randomized controlled trial of postcrisis suicide prevention. ? Psychiatr Serv. 2001;52(6):828-833. doi:10.1176/appi.ps.52.6.828PubMedGoogle ScholarCrossref Source: jamanetwork.com/journals/jamapsychiatry/fullarticle/2764584 Getting the
coronavirus again The proof lay in the genome sequencing of the virus from both of the man’s infections, which researchers found to be significantly different. The second strain was one that had been circulating in Europe when he was there. The theoretical possibility of reinfection does not come as a surprise. “We expected that the immunity to the coronavirus might last less than a year because that’s how it is with common cold coronaviruses,” Apoorva Mandavilli, a Times science reporter, told us. The man experienced mild symptoms the first time he had Covid-19 but had none the second time — an encouraging sign, and very likely an indication that his immune system had been trained by the initial infection. If the research is buttressed by subsequent cases, it will underline the need for a comprehensive vaccine. “We can’t just get to herd immunity the natural way because only vaccines may be able to produce the kind of immune response that can prevent reinfection,” Apoorva said. Forget antibody tests. Many of the
current ones are inaccurate, some look for the wrong
antibodies and even the right antibodies can disappear,
experts at the Infectious Diseases Society of America have
advised. And because antibody tests can’t tell you if
you’re immune to subsequent infections, they’re
useless in deciding whether to ease up on mask-wearing and
other social-distancing precautions. Coronavirus Hits
Schools: Student, School Employee Among the Likely Infected
A 40-year-old man who had traveled to Europe on a trip with a Catholic high school in Pawtucket, R.I., has tested "presumptive positive" for the virus after returning from a trip to Italy, France, and Spain in mid-February, state health officials said. That case follows health officials announcing Friday night that a student in suburban Seattle and a school employee in suburban Portland, Ore., are among the new suspected coronavirus cases in the U.S. The cases, reported late Friday, concern health officials because in both instances, it's unclear how the two school-connected individuals contracted the virus. In both cases, neither individual had traveled to countries where there are outbreaks of the coronavirus or had contact with individuals who had done so. Those are worrisome signs that the coronavirus is spreading from "person-to-person" in the community. "It's concerning that this individual did not travel, since this individual acquired it in the community," Washington state health officer Dr. Kathy Lofy, said at a press conference announcing two new cases in the state, according to the Seattle Times. "We really believe now that the risk is increasing." Officials said that they got "presumptive" positive tests in both of the cases. Final results still must be confirmed by the federal Centers For Disease Control and Prevention. On Saturday afternoon, a person infected with coronavirus died, Washington state officials said. It is the first U.S. death from the virus. A second death from the virus, also in the state, came later in the weekend. The Washington state high school student, who attends Henry M. Jackson High School in the Everett school district north of Seattle, felt sick Monday and visited two clinics during the week. The student felt better and returned to school briefly Friday, but went home after the test showed the positive results, according to the Seattle Times. Students who had contact with the sick student are undergoing a 14-day quarantine and monitoring periods at their homes, the Everett school district said in an update on its website. The student's sibling attends a district middle school and was also being tested and quarantined, although they showed no symptoms of the disease, the district said. The district said it was taking the situation "very seriously," and that out of an abundance of caution it would close the school through March 2, for three days of "deep disinfecting." In Oregon, it was an employee of the Forest Hills Elementary School in the Lake Oswego School District, close to Portland, who had a "presumptive" positive test, health officials said late Friday. Lake Oswego officials are closing the 430-student K-5 school for "deep cleaning" through March 4, according to Oregon Live. The employee is being isolated at a local hospital while receiving treatment there. In a news conference Saturday, Lake Oswego Superintendent Lora de la Cruz said public health officials said it was not necessary to close other schools in the district. But she said all schools and buses would be cleaned and disinfected before students return to schools Monday morning The affected employee, de la Cruz said, "at this point, it appears that this person likely only had close contact with a few individuals." Who Has Authority to Close Schools in Public Health Crisis? Earlier this week, officials with the CDC said that Americans should be prepared for the inevitable spread of the coronavirus in the country and urged schools to prepare their responses to the likely outbreaks. So far, 65 cases of the coronavirus have been reported in the U.S., with the majority of those cases involving Americans who had contracted the disease abroad in areas that are affected by the outbreak. They recommended that the public contact their employers and school systems about their plans in the event of an outbreak. While school districts have been posting notices on their websites largely focused on preventative measures that parents, students, and staff can take to minimize the risks of contracting coronavirus, it's unclear whether they have concrete plans on how to keep a system running in the long term if they're required to shut down. And just who will ultimately make the
call about widespread school closures is an important issue
for district leaders to get clarity on. A 2008 research
paper that examined the legal and logistical issues
concluded that most states have multiple legal avenues for
ordering school closures. Mark Walsh has much more on that
here. Be there
for… your students Supporting your students so they can shine As educators, we support our students so they can achieve their goals. This often involves academic assistance that helps students be successful with learning. But what happens when the reason a student is struggling has more to do with mental health issues than academic issues? There are several things you can do to help, such as educating yourself about the warning signs to look out for, making adjustments to your teaching, or being prepared to approach students with helpful resources. Some helpful strategies Be open - Let students know they are welcome to come speak with you about their concerns, whether academic or personal. Be upfront - Address mental health early on. Share that you are there for your students and want to be a source of support. You want your students to succeed academically, and are obviously there if they need academic assistance, but you are also available should they be experiencing mental health difficulties. Add notes to your syllabi - Include the phone number for your campus’ Counseling and Psychological Services on the syllabus. Discuss taking care of one’s mental health as a priority. Your students need to hear their mental well-being is more important than any class. Suicide is a leading cause of death
among college students, Offer alternatives - Though it can be difficult and may require extra work on your part, students who need accommodations will be immensely grateful for your understanding and support. You can, for example, offer alternatives to assignments that may be difficult for students who are having mental health difficulties. For many students, asking for an alternative assignment is a difficult thing to do, so meet them with support and understanding. Examine what the purpose of the assignment or grade component is, and think creatively to suggest an alternative such as the following. Class participation vs. reading respnses - If the purpose of class participation is to show a student has completed the readings, offer the opportunity to do reading responses instead. Cold calling vs. pop quizzes - Cold-calling can be extremely anxiety-inducing for some students. Students have been known to drop a class if this is a policy due to fear of being called on. If the goal is to ensure students are prepared for class, try implementing pop quizzes. Public speaking vs. recording or narrated preentation - If a student is unable to do public speaking in class, offer to allow them to narrate their presentation and present the video in class. Or, have them film their presentation in front of a group of people of their choosing and show that video in class. Untreated mental health issues in the
college student population Educate yourself and your students Triggering content - Think about what you will be discussing and whether it may be potentially triggering to some students. Place a trigger warning before engaging in the topic so students can prepare themselves. Person-first language - When describing someone with a mental illness, use person-first language. This means saying “person with bipolar disorder” rather than “bipolar person” or “person with anorexia” instead of “anorexic.” Also, it is best practice to say “died by suicide” rather than “committed suicide.” The word “committed” connotes a crime. Warning signs - Educate yourself about the Signs and Symptoms of mental health problems. Look out for these symptoms in your students and address them early on if you have concerns. Available resources on campus -
Know what resources are available to your students and have
the information on hand. See the Crisis Information: Get
Help Now page if the student is in crisis. For other places
to find help, see the Referral Resources page. Do’s and
Don’ts When Protecting Yourself Against Coronavirus DO: Wash Your Hands Frequently The most important thing New Yorkers can do to protect themselves from COVID-19 and other person-to-person diseases is washing their hands. Spend at least 20 seconds thoroughly scrubbing your hands together with soap and water, the CDC advised. Wash your hands after going to the bathroom, before and after eating, and after blowing your nose, coughing or sneezing. If you are out and about and you don't have access to soap and water, use an alcohol-based hand sanitizer that has at least 60% alcohol, which will effectively kill the virus. Surgical Face Masks Don’t Protect Against Coronavirus Regular surgical face masks are not effective in protecting against the coronavirus. A more specialized face mask known as N95 respirators are thicker than surgical masks and...Read more DON'T: Stockpile Face Masks The CDC is not recommending anyone without symptoms to wear face masks. Surgical masks should be reserved for people who exhibit symptoms (to prevent them from spreading the virus through respiratory secretions such as saliva or mucus) and healthcare professionals who are taking care of sick people. Regular surgical face masks are not effective in protecting against the coronavirus, according to the CDC. A more specialized face mask known as N95 respirators are thicker than surgical masks and are fitted to a person’s face to keep out any viral particles. DO: Avoid Contact With Those Who Are Sick Symptoms of COVID-19 are similar to other respiratory diseases and they include fever, cough and shortness of breath. The CDC's recommendation to anyone with symptoms is to stay home and avoid contact with others. You should contact your healthcare provider if you develop symptoms, and have been in close contact (at least 6 feet) with a person known to have COVID-19 or if you have recently traveled from an area with widespread or ongoing community spread of the virus. Currently, the countries with health notices and ongoing transmission are China, Iran, Italy, South Korea and Japan. The CDC says you shouldn't share items such as dishes, cups, eating utensils, towels, or bedding with other people or pets in your home. If unavoidable, the items should be cleaned with soap and water. Surfaces such as counters, doorknobs, phones and keyboards should also be frequently cleaned. The only thing spreading faster than the panic regarding COVID-19 virus may be the myths surrounding it, including how it spreads and what can be done to prevent from...Read more DON'T: Avoid Going Into Chinese-Owned Businesses While COVID-19's epicenter is in Wuhan, China, the disease can make anyone sick regardless of their race or ethnicity, the CDC said. Local businesses in Chinatown and Flushing, Queens, say that they have seen a large drop off in their businesses since the virus started spreading but the fear that Chinese Americans are more likely to carry the virus is baseless. "Stigma hurts everyone by creating more fear or anger towards ordinary people instead of the disease that is causing the problem," the CDC said. DO: Store Supplies, Medicines and Keep Medical Records Handy If COVID-19 becomes more widespread, the Department of Homeland Security says you should stock up on medicine, supplies for you and your children. Pain relievers, cough and cold medicines, medicine for upset stomachs and even fluids that contain electrolytes are recommended. People with prescription medicines should also make sure they have enough regular supply. Having copies and electronic versions of your health records can also be useful in a pandemic, DHS says. If there's ever an interruption in the
supply chain, the DHS recommends having at least 2 weeks
worth nonperishable food and bottled water. What symptoms to
be on the lookout for and how to protect yourself from
coronavirus - 6:08 AM ET, Mon March 2, 2020 There are now 71 confirmed and presumptive positive cases of coronavirus in the United States. Here's what you should know to keep yourself safe: What are the symptoms Coronavirus makes people sick, usually with a mild to moderate upper respiratory tract illness, similar to a common cold. Its symptoms include a runny nose, cough, sore throat, headache and a fever that can last for a couple of days. For those with a weakened immune system, the elderly and the very young, there's a chance the virus could cause a lower, and much more serious, respiratory tract illness like a pneumonia or bronchitis. How does it spread Transmission between humans happens when someone comes into contact with an infected person's secretions, such as droplets in a cough. Depending on how virulent the virus is, a cough, sneeze or handshake could cause exposure. The virus can also be transmitted by coming into contact with something an infected person has touched and then touching your mouth, nose or eyes. Caregivers can sometimes be exposed by handling a patient's waste, according to the CDC. The virus appears to mainly spread from person to person. "People are thought to be most contagious when they are most symptomatic (the sickest)," the CDC says. "Some spread might be possible before people show symptoms; there have been reports of this occurring with ... coronavirus, but this is not thought to be the main way the virus spreads." How is it treated There is no specific antiviral treatment, but research is underway. Most of the time, symptoms will go away on their own and experts advise seeking care early. If symptoms feel worse than a standard cold, see your doctor. Doctors can relieve symptoms by prescribing a pain or fever medication. The CDC says a room humidifier or a hot shower can help with a sore throat or cough. People with coronavirus should receive supportive care to help relieve symptoms. In some severe cases, treatment includes care to support vital organ functions, the CDC says. People who think they may have been exposed to the virus should contact their healthcare provider immediately. How long is the incubation period Quarantine is usually set up for the incubation period -- the span of time during which people have developed illness after exposure. For coronavirus, the period of quarantine is 14 days from the last date of exposure, because 14 days is the longest incubation period seen for similar illnesses. How can you can prevent it The US National Institutes of Health is working on a vaccine but it will be months until clinical trials get underway and more than a year until it might become available. Meanwhile, you may be able to reduce your risk of infection by avoiding people who are sick. Cover your mouth and nose when you cough or sneeze, and disinfect the objects and surfaces you touch. Avoid touching your eyes, nose and mouth. Wash your hands often with soap and water for at least 20 seconds. Awareness is also key. If you are sick
and have reason to believe it may be coronavirus, you should
let a health care provider know and seek treatment
early. Veterans
- Know Your Risks To reach the Roseburg
VA, call (541) 440-1000 Talk of the new coronavirus (COVID-19) is everywhere. Here’s what you should know and do to keep yourself and your loved ones healthy. Know the symptoms The new virus causes respiratory illness in humans, usually 2–14 days after exposure. Illnesses have ranged from mild symptoms to severe, including fever, cough, and shortness of breath. The virus is thought to spread mainly from close contact with an affected person. It spreads in the air, like flu, and through droplets from sneezes and coughs. The droplets can stay suspended in the air and can land on surfaces that are touched by others. Understand your risk The Centers for Disease Control and Prevention (CDC) considers COVID-19 to be a serious public health threat, but individual risk is dependent upon exposure. For the general American public–those who are unlikely to be exposed to this virus at this time–the immediate health risk is low. Keep an eye on coronavirus, but remember the flu Symptoms of fever, cough and shortness of breath also happen to be symptoms of the common cold and flu. This year, at least 29 million flu cases have been reported with 280,000 hospitalizations and 16,000 deaths from flu. Flu activity most commonly peaks between December and February and can last until May. What’s important to remember is that anyone can get the flu. But you are more likely to become infected if you:
Take precautions to guard against infection
If you have symptoms of fever, cough, and shortness of breath, please call your local VA medical center and select the option to speak to a nurse before visiting the facility. Tell them about your symptoms and any recent travel. In addition to calling first, consider using VA’s telehealth and virtual care options. VA’s telehealth providers can evaluate your symptoms and provide a diagnosis and comprehensive care, so you do not have to leave your home or office. Get VA’s latest updates on the new coronavirus: www.publichealth.va.gov/n-coronavirus/index.asp __________________________________________________________________
PART TWO OF TWO PARTS TO THIS EMAIL CORRESPONDENCE: NEWS RELEASE From: VA Roseburg Healthcare System <veteranshealth@public.govdelivery.com> Sent: Monday, March 2, 2020 10:21 AM Subject: Roseburg VA Health Care System - Novel Coronavirus (COVID-19) Update for Veterans - March 3, 2020 Dear Veteran, The Novel Coronavirus Disease (COVID-19) is being highlighted every hour in the news. As the disease continues to spread, please be cautious at home and at work. While infection is unlikely, we all must be cognizant of disease prevention practices to avoid the spread of all types of infections, including the flu and the Coronavirus. The most current recommendations from the Department of Veterans Affairs and the Centers for Disease Control and Prevention follow: What precautions to take Currently, there is no vaccine to prevent the COVID-19 infection and no medication to treat it. CDC believes symptoms appear 2 to 14 days after exposure. Avoid exposure and avoid exposing others to an infection with these simple acts.
What to do if you have symptoms If you have both:
Call before visiting your local VA medical center to seek care or sign in to MyHealtheVet and send a Secure Message. VA telehealth options may be able to offer a prompt diagnosis and comprehensive care. What precautions to take when traveling The U.S. government
has imposed travel restrictions for all non-essential travel
to China. Additionally, U.S. citizens returning from the
region will undergo enhanced screening procedures.
Generally, foreign nationals (other than immediate family of
U.S. citizens, permanent residents and flight crew) who have
traveled in China within 14 days of their arrival, will be
denied entry into the U.S. If you have international travel
plans, review this specific guidance for travelers. People at High Risk
Who is at Higher Risk? Early information out of China, where COVID-19 first started, shows that some people are at higher risk of getting very sick from this illness. This includes:
If a COVID-19 outbreak happens in your community, it could last for a long time. (An outbreak is when a large number of people suddenly get sick.) Depending on how severe the outbreak is, public health officials may recommend community actions to reduce people’s risk of being exposed to COVID-19. These actions can slow the spread and reduce the impact of disease. If you are at higher risk for serious illness from COVID-19 because of your age or because you have a serious long-term health problem, it is extra important for you to take actions to reduce your risk of getting sick with the disease. Get Ready for COVID-19 Now Have supplies on handContact your healthcare provider to ask about obtaining extra necessary medications to have on hand in case there is an outbreak of COVID-19 in your community and you need to stay home for a prolonged period of time. Watch for symptoms and emergency warning signs Pay attention for potential COVID-19 symptoms including, fever, cough, and shortness of breath. If you feel like you are developing symptoms, call your doctor. *This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning. What to Do if You Get Sick Stay home and call your doctor What Others can do to Support Older Adults Community Support for Older Adults Community preparedness planning for COVID-19 should include older adults and people with disabilities, and the organizations that support them in their communities, to ensure their needs are taken into consideration.Many of these individuals live in the community, and many depend on services and supports provided in their homes or in the community to maintain their health and independence. Family and Caregiver Support Know what medications your loved one is taking and see if you can help them have extra on hand. Source: www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.html The
Suicide Squad’s James Gunn Responds To Idris
Elba’s Coronavirus Diagnosis Synopsis: Idris Elba's diagnosis is an
especially chilling one, as he
wasn't displaying any symptoms at the time of his
testing. This is no doubt
why officials are encouraging self-quarantine and
curfews, as COVID-19
can be undetectable for those carrying the
virus. Large groups are
no longer permitted around the country and
world. The past week has been a whirlwind in the global news cycle, as concerns over COVID-19 continue to grow. The pandemic has caused the entertainment world to come to a screeching halt, as movies are pushed back and film sets are suspended. What's more, a few high profile names have been diagnosed, including Tom Hanks and Rita Wilson. While that beloved couple was recently discharged from the hospital, Idris Elba also revealed that he was diagnosed with COVID-19. And now The Suicide Squad director James Gunn has broken his silence about this news. Principal photography for The Suicide Squad only recently ended, after a long shoot. Idris Elba has a mysterious role in the highly anticipated blockbuster, after originally being rumored to be replacing Will Smith as Deadshot. Elba recently posted a video revealing that he'd tested positive for COVID-19, encouraging the public to self-quarantine. James Gunn was recently asked about the actor's diagnosis, saying: "We just texted and he seems in good spirits. He’s a great guy and he’s in my prayers. I’m concerned for him, of course, but right now he’s not exhibiting symptoms which is good. But it goes to show us all we could be contracting it from someone without symptoms out there- of whom there are many, because we aren’t set up to properly test folks in the US. So socially distance yourself as much as possible!" Well, that was honest. It looks like James Gunn and Idris Elba are still in regular contact, despite principal photography for The Suicide Squad coming to an end. What's more, the 47 year-old actor seems to be in good spirits, as concern pours in from all over the world. James Gunn's update about Idris Elba comes from his personal Instagram page. The acclaimed filmmaker regularly uses social media to directly communicate with his legions of fans. The Gram became his primary outlet while filming The Suicide Squad, often doing informal Q&A's, and shutting down rumors along the way. And Gunn's most recent of these happened to include a question about Elba's health. For those who missed it, Idris Elba posted a video about his health status just yesterday, breaking the internet in the process. You can watch this address to the fans below, urging them to practice caution in the wake of the current global pandemic. Idris Elba Idris Elba's diagnosis is an especially chilling one, as he wasn't displaying any symptoms at the time of his testing or the entertainment world. Some studios are releasing movies to Video on Demand early, hoping to entertain and cash in as people are stuck in their homes. Idris Elba's diagnosis is an especially chilling one, as he wasn't displaying any symptoms at the time of his testing. This is no doubt why officials are encouraging self-quarantine and curfews, as COVID-19 can be undetectable for those carrying the virus. Large groups are no longer permitted around the country and world, which has created a unique landscape for the entertainment world. Some studios are releasing movies to Video on Demand early, hoping to entertain and cash in as people are stuck in their homes. The Suicide Squad is currently set to
arrive in theaters on August 6th, 2021. In the meantime,
check out our 2020
release list to plan your next
trip to the movies. Experts
seeing severe virus symptoms in young Fauci was responding to new data from the Centers for Disease Control and Prevention which, after studying more than 4,000 cases in the U.S., showed that about 40 percent of those who were hospitalized for the virus as of March 16 were between ages 20 and 54. Among the most critical cases, 12 percent of ICU admissions were among those ages 20 to 44 while 36 percent were for those between 45 and 64. About 80 percent of people in the U.S. who have died from COVID-19 were at or above the age of 65, with the highest percentage among those above the age of 85. Asked about the new numbers on CBS's "Face the Nation," Fauci said they highlighted "a very important critical issue that we're looking very closely at." "It looks like there is a big difference between that demography from China and what we're seeing in Europe," Fauci said. Data based on China's outbreak suggested that older people were more at risk. "Now, we have to look at the young people who are getting seriously ill from the European cohort and make sure that it isn't just driven by the fact that they have underlying conditions." "Because we know that underlying conditions, all bets are off no matter how young you are," Fauci added. "If you have an underlying, serious medical condition. You're going to potentially get into trouble. But if they don't have underlying conditions, that will be something we will have to really examine as to why we're seeing it here but we didn't see it in China. So we're going to look at that very closely." Speaking on CNN's "State of the Union," Rep. Alexandria Ocasio-Cortez, D-N.Y., said young people need to be taking the risks of the virus seriously. "I've been speaking about this for over a week now and if you are a young person in America today, you need to stay home," she said. "There was so much messaging about how coronavirus is only impacting older people and that younger people don't have to worry about it for their personal health. Well, let me tell you something, in the state of New York, about 55 percent of our cases are with folks 18 to 49." "And when you have that ... you are able to be directly impacted," she continued. "You're going to get your mom sick, you're going to get your grandparents sick. You're going to get people you care for sick if you are asymptomatic. So you may not think that you have it, and you very well might. And you especially might if you continue to go out and live life as usual." Fauci told "Face the Nation" that he does not expect the U.S.'s experience with the outbreak turn into Italy's, which has become one of the hardest-hit areas. "I mean obviously things are unpredictable, you can't make any definitive statement, but if you look at the dynamics of the outbreak in Italy, we don't know why they are suffering so terribly, but there is a possibility that many of us believe that early on they did not shutout the input of infections that originated in China and came to other parts of the world," Fauci said before touting the Trump administration's move to restrict travel from China, and then parts of Europe, earlier this year. "Again, I don't know why this is happening [in Italy] to such an extent," Fauci said. "But once you get so many of these spreads out, they spread exponentially and you can never keep up with this tsunami. And I think that's what our colleagues and unfortunately our dear friends in Italy are facing." Italy was "so
overwhelmed from the beginning," Fauci said, "that they
can't play catch up." Wiped
Out? Here Are 7 Things to Do If You Run Out of Toilet
Paper As people are stocking up to avoid going out during the coronavirus outbreak, there are several items that have been flying off the shelves. And one of the biggest offenders has definitely been toilet paper. A simple search for “#toiletpaper” on Twitter will pull up all sorts of photos of empty aisles at grocery stores, as well as a plethora of funny memes about what people are pretending to be using instead— everything from corn tortillas to giant leaves in their backyards, and even unmatched socks. But all jokes aside, finding a roll of toilet paper at the moment is not an easy feat. So what do you do if you run out of toilet paper and genuinely need some? Well, we are rounding up the best toilet paper alternatives. Parade.com chatted with some experts to bring you these ideas for how to replenish your supply and what else you can use instead. Toilet Paper Alternatives 1. Don’t panic. And certainly don’t call 9-1-1! Believe it or not, due to recent events, the Newport, Ore. police department has actually had to issue a Facebook statement to area residents saying that the police are not available to handle this “crisis” for civilians: The quote started out with: “It’s hard to believe that we even have to post this. Do not call 9-1-1 just because you ran out of toilet paper. You will survive without our assistance…” And, after talking about how you could use everything from corncobs to magazines as an alternative, they wrapped up the statement with: “Be resourceful. Be patient. There is a TP shortage. This too shall pass. Just don’t call 9-1-1. We cannot bring you toilet paper.” Toilet paper manufacturers are working as fast as they can and rest assured, if your store isn’t currently restocked, refills will be available in the near future. 2. Try different outlets for purchasing toilet paper. While grocery stores and major retailers like Target seem to be running low on toilet paper, know that it will eventually be restocked. Before rushing to the stores in the hopes of finding a spare package, Geoffrey Mount Varner, MD, an emergency medicine physician, says to save time—and keep yourself free from unnecessary person-to-person potential viral exposure—by browsing for it first on a store’s website. In lieu of your typical drugstore, some people have had luck finding toilet paper at less obvious places such as gas stations, 7-Elevens, Dollar General and even Bass Pro Shops. It can also be found on Amazon and eBay—just watch out for price gougers. 3. Ask your network If you’re having trouble locating a roll or two, ask others if they’ve had any luck. A lot of people, for instance, are posting on neighborhood forums like Nextdoor and sharing recommendations on where to find certain items during this time. “And you can always try asking a neighbor to borrow some,” says Varner. Some people that have admittedly gone a little wild with cleaning out Costco’s toilet paper reserves just might come to their senses and throw a few rolls your way. And if you are elderly or immunocompromised and running low on your supply, don’t be afraid to ask someone within your network to pick up some toilet paper refills for you. It’s being advised that people in this demographic stay at home and avoid crowds whenever possible, as to avoid coming into contact with potentially contaminated people. 4. Purchase a bidet It may be a foreign concept in the United States but many countries in Europe, South America and Asia are very familiar with bidets. In many homes, these bathtub-like fixtures are situated next to a toilet. After using the toilet, a person would then straddle the bidet bowl, turn on the water and cleanse themselves. After washing, you then pat dry with a towel and go on your merry way. These appliances are available at home improvement stores like Home Depot and Lowe’s and can even be ordered on Amazon. If you don’t have one of these fixtures installed in your home, and don’t want to purchase a whole new bathroom appliance, there are even ways in which you can add a bidet-like function to your existing toilet. TUSHY, for instance, makes bidets that you can attach to your toilet ($79), as well as a travel bidet ($29) for when on the go. And since the toilet paper hoarding has begun, bidet sales have absolutely skyrocketed. “TUSHY sales are 10x what they were since word spread of toilet paper shortages,” says company founder Miki Agrawal. “Last week, we had a few days where we sold over $500K a day, including a day where we hit $1M in sales.” The company proclaims: “bidets save money, trees, water and our butts.” They stress that using one is as simple as: 1) Do your doo 2) Turn the knob and spray your butt 3) Pat dry. TUSHY provides a tutorial on how the product works exactly here. Other companies such as Brondell offer their own versions like the Brondell White Bidet Attachment ($39.98 at Lowe’s. 5. Repurpose other types of paper If you are completely out of toilet paper, you can turn to other sources of paper products in your home to get the job done. Felice Gersh, MD, an OB/GYN and the founder/director of the Integrative Medical Practice of Irvine in California, says that “toilet seat covers, napkins, tissues and baby wipes” can all perform the same function. We’ve even seen suggestions of using coffee filters! The only issue is to take notice of what should and should not be flushed down the toilet. For instance, a toilet seat cover is flushable but the others on that list should be disposed of in a wastebasket so as not to cause any plumbing issues. (Remember: Parents still need baby wipes for their babies, so please buy only what you absolutely need.) 6. Use washable towels “Many societies in the world do not regularly use toilet paper,” explains Gersh, adding, “toilet paper is really a concern for Western societies.” If you don’t have any paper products at home, she says that you can take old towels and cut them into smaller sizes and use those to wipe. “Get hand towels or dish towels to dry the skin or to further wash the area more completely after a bowel movement. Then wash the towels in hot water, as diapers were for generations,” she offers. 7. Hop in the shower afterwards If all else fails and your toilet paper shortage becomes a serious concern, and you are out of other options, do your business and then rinse off in the shower afterwards. You can get out, towel dry off, and will find yourself cleaner than you ever were when simply wiping your backside with a piece of dry paper. Who knows —you may never go back to your old ways again! What to do lwith the
left-over toilet paper when this is all over.
A wedding
dress? 20
of the worst epidemics and pandemics in history
3/20/20 Throughout the course of history, disease outbreaks have ravaged humanity, sometimes changing the course of history and, at times, signaling the end of entire civilizations. Here are 20 of the worst epidemics and pandemics, dating from prehistoric to modern times. 1. Prehistoric epidemic: Circa 3000 B.C. About 5,000 years ago, an epidemic wiped out a prehistoric village in China. The bodies of the dead were stuffed inside a house that was later burned down. No age group was spared, as the skeletons of juveniles, young adults and middle-age people were found inside the house. The archaeological site is now called "Hamin Mangha" and is one of the best-preserved prehistoric sites in northeastern China. Archaeological and anthropological study indicates that the epidemic happened quickly enough that there was no time for proper burials, and the site was not inhabited again. Before the discovery of Hamin Mangha, another prehistoric mass burial that dates to roughly the same time period was found at a site called Miaozigou, in northeastern China. Together, these discoveries suggest that an epidemic ravaged the entire region. 2. Plague of Athens: 430 B.C. Around 430 B.C., not long after a war between Athens and Sparta began, an epidemic ravaged the people of Athens and lasted for five years. Some estimates put the death toll as high as 100,000 people. The Greek historian Thucydides (460-400 B.C.) wrote that "people in good health were all of a sudden attacked by violent heats in the head, and redness and inflammation in the eyes, the inward parts, such as the throat or tongue, becoming bloody and emitting an unnatural and fetid breath" (translation by Richard Crawley from the book "The History of the Peloponnesian War," London Dent, 1914). What exactly this epidemic was has long been a source of debate among scientists; a number of diseases have been put forward as possibilities, including typhoid fever and Ebola. Many scholars believe that overcrowding caused by the war exacerbated the epidemic. Sparta's army was stronger, forcing the Athenians to take refuge behind a series of fortifications called the "long walls" that protected their city. Despite the epidemic, the war continued on, not ending until 404 B.C., when Athens was forced to capitulate to Sparta. 3. Antonine Plague: A.D. 165-180 When soldiers returned to the Roman Empire from campaigning, they brought back more than the spoils of victory. The Antonine Plague, which may have been smallpox, laid waste to the army and may have killed over 5 million people in the Roman empire, wrote April Pudsey, a senior lecturer in Roman History at Manchester Metropolitan University, in a paper published in the book "Disability in Antiquity," Routledge, 2017). Many historians believe that the epidemic was first brought into the Roman Empire by soldiers returning home after a war against Parthia. The epidemic contributed to the end of the Pax Romana (the Roman Peace), a period from 27 B.C. to A.D. 180, when Rome was at the height of its power. After A.D. 180, instability grew throughout the Roman Empire, as it experienced more civil wars and invasions by "barbarian" groups. Christianity became increasingly popular in the time after the plague occurred. 4. Plague of Cyprian: A.D. 250-271 Named after St. Cyprian, a bishop of Carthage (a city in Tunisia) who described the epidemic as signaling the end of the world, the Plague of Cyprian is estimated to have killed 5,000 people a day in Rome alone. In 2014, archaeologists in Luxor found what appears to be a mass burial site of plague victims. Their bodies were covered with a thick layer of lime (historically used as a disinfectant). Archaeologists found three kilns used to manufacture lime and the remains of plague victims burned in a giant bonfire. Experts aren't sure what disease caused the epidemic. "The bowels, relaxed into a constant flux, discharge the bodily strength [and] a fire originated in the marrow ferments into wounds of the fauces (an area of the mouth)," Cyprian wrote in Latin in a work called "De mortalitate" (translation by Philip Schaff from the book "Fathers of the Third Century: Hippolytus, Cyprian, Caius, Novatian, Appendix," Christian Classics Ethereal Library, 1885). 5. Plague of Justinian: A.D. 541-542 The Byzantine Empire was ravaged by the bubonic plague, which marked the start of its decline. The plague reoccurred periodically afterward. Some estimates suggest that up to 10% of the world's population died. The plague is named after the Byzantine Emperor Justinian (reigned A.D. 527-565). Under his reign, the Byzantine Empire reached its greatest extent, controlling territory that stretched from the Middle East to Western Europe. Justinian constructed a great cathedral known as Hagia Sophia ("Holy Wisdom") in Constantinople (modern-day Istanbul), the empire's capital. Justinian also got sick with the plague and survived; however, his empire gradually lost territory in the time after the plague struck. 6. The Black Death: 1346-1353 The Black Death traveled from Asia to Europe, leaving devastation in its wake. Some estimates suggest that it wiped out over half of Europe's population. It was caused by a strain of the bacterium Yersinia pestis that is likely extinct today and was spread by fleas on infected rodents. The bodies of victims were buried in mass graves. The plague changed the course of Europe's history. With so many dead, labor became harder to find, bringing about better pay for workers and the end of Europe's system of serfdom. Studies suggest that surviving workers had better access to meat and higher-quality bread. The lack of cheap labor may also have contributed to technological innovation. 7. Cocoliztli epidemic: 1545-1548 The infection that caused the cocoliztli epidemic was a form of viral hemorrhagic fever that killed 15 million inhabitants of Mexico and Central America. Among a population already weakened by extreme drought, the disease proved to be utterly catastrophic. "Cocoliztli" is the Aztec word for "pest." A recent study that examined DNA from the skeletons of victims found that they were infected with a subspecies of Salmonella known as S. paratyphi C, which causes enteric fever, a category of fever that includes typhoid. Enteric fever can cause high fever, dehydration and gastrointestinal problems and is still a major health threat today. 8. American Plagues: 16th century The American Plagues are a cluster of Eurasian diseases brought to the Americas by European explorers. These illnesses, including smallpox, contributed to the collapse of the Inca and Aztec civilizations. Some estimates suggest that 90% of the indigenous population in the Western Hemisphere was killed off. The diseases helped a Spanish force led by Hernán Cortés conquer the Aztec capital of Tenochtitlán in 1519 and another Spanish force led by Francisco Pizarro conquer the Incas in 1532. The Spanish took over the territories of both empires. In both cases, the Aztec and Incan armies had been ravaged by disease and were unable to withstand the Spanish forces. When citizens of Britain, France, Portugal and the Netherlands began exploring, conquering and settling the Western Hemisphere, they were also helped by the fact that disease had vastly reduced the size of any indigenous groups that opposed them. 9. Great Plague of London: 1665-1666 The Black Death's last major outbreak in Great Britain caused a mass exodus from London, led by King Charles II. The plague started in April 1665 and spread rapidly through the hot summer months. Fleas from plague-infected rodents were one of the main causes of transmission. By the time the plague ended, about 100,000 people, including 15% of the population of London, had died. But this was not the end of that city's suffering. On Sept. 2, 1666, the Great Fire of London started, lasting for four days and burning down a large portion of the city. 10. Great Plague of Marseille: 1720-1723 Historical records say that the Great Plague of Marseille started when a ship called Grand-Saint-Antoine docked in Marseille, France, carrying a cargo of goods from the eastern Mediterranean. Although the ship was quarantined, plague still got into the city, likely through fleas on plague-infected rodents. Plague spread quickly, and over the next three years, as many as 100,000 people may have died in Marseille and surrounding areas. It's estimated that up to 30% of the population of Marseille may have perished. 11. Russian plague: 1770-1772 In plague-ravaged Moscow, the terror of quarantined citizens erupted into violence. Riots spread through the city and culminated in the murder of Archbishop Ambrosius, who was encouraging crowds not to gather for worship. The empress of Russia, Catherine II (also called Catherine the Great), was so desperate to contain the plague and restore public order that she issued a hasty decree ordering that all factories be moved from Moscow. By the time the plague ended, as many as 100,000 people may have died. Even after the plague ended, Catherine struggled to restore order. In 1773, Yemelyan Pugachev, a man who claimed to be Peter III (Catherine's executed husband), led an insurrection that resulted in the deaths of thousands more. 12. Philadelphia yellow fever epidemic: 1793 When yellow fever seized Philadelphia, the United States' capital at the time, officials wrongly believed that slaves were immune. As a result, abolitionists called for people of African origin to be recruited to nurse the sick. The disease is carried and transmitted by mosquitoes, which experienced a population boom during the particularly hot and humid summer weather in Philadelphia that year. It wasn't until winter arrived — and the mosquitoes died out — that the epidemic finally stopped. By then, more than 5,000 people had died. 13. Flu pandemic: 1889-1890 In the modern industrial age, new transport links made it easier for influenza viruses to wreak havoc. In just a few months, the disease spanned the globe, killing 1 million people. It took just five weeks for the epidemic to reach peak mortality. The earliest cases were reported in Russia. The virus spread rapidly throughout St. Petersburg before it quickly made its way throughout Europe and the rest of the world, despite the fact that air travel didn't exist yet. 14. American polio epidemic: 1916 A polio epidemic that started in New York City caused 27,000 cases and 6,000 deaths in the United States. The disease mainly affects children and sometimes leaves survivors with permanent disabilities. Polio epidemics occurred sporadically in the United States until the Salk vaccine was developed in 1954. As the vaccine became widely available, cases in the United States declined. The last polio case in the United States was reported in 1979. Worldwide vaccination efforts have greatly reduced the disease, although it is not yet completely eradicated. 15. Spanish Flu: 1918-1920 An estimated 500 million people from the South Seas to the North Pole fell victim to Spanish Flu. One-fifth of those died, with some indigenous communities pushed to the brink of extinction. The flu's spread and lethality was enhanced by the cramped conditions of soldiers and poor wartime nutrition that many people were experiencing during World War I. Despite the name Spanish Flu, the disease likely did not start in Spain. Spain was a neutral nation during the war and did not enforce strict censorship of its press, which could therefore freely publish early accounts of the illness. As a result, people falsely believed the illness was specific to Spain, and the name Spanish Flu stuck. 16. Asian Flu: 1957-1958 The Asian Flu pandemic was another global showing for influenza. With its roots in China, the disease claimed more than 1 million lives. The virus that caused the pandemic was a blend of avian flu viruses. The Centers for Disease Control and Prevention notes that the disease spread rapidly and was reported in Singapore in February 1957, Hong Kong in April 1957, and the coastal cities of the United States in the summer of 1957. The total death toll was more than 1.1 million worldwide, with 116,000 deaths occurring in the United States. 17. AIDS pandemic and epidemic: 1981-present day AIDS has claimed an estimated 35 million lives since it was first identified. HIV, which is the virus that causes AIDS, likely developed from a chimpanzee virus that transferred to humans in West Africa in the 1920s. The virus made its way around the world, and AIDS was a pandemic by the late 20th century. Now, about 64% of the estimated 40 million living with human immunodeficiency virus (HIV) live in sub-Saharan Africa. For decades, the disease had no known cure, but medication developed in the 1990s now allows people with the disease to experience a normal life span with regular treatment. Even more encouraging, two people have been cured of HIV as of early 2020. 18. H1N1 Swine Flu pandemic: 2009-2010 The 2009 swine flu pandemic was caused by a new strain of H1N1 that originated in Mexico in the spring of 2009 before spreading to the rest of the world. In one year, the virus infected as many as 1.4 billion people across the globe and killed between 151,700 and 575,400 people, according to the CDC. The 2009 flu pandemic primarily affected children and young adults, and 80% of the deaths were in people younger than 65, the CDC reported. That was unusual, considering that most strains of flu viruses, including those that cause seasonal flu, cause the highest percentage of deaths in people ages 65 and older. But in the case of the swine flu, older people seemed to have already built up enough immunity to the group of viruses that H1N1 belongs to, so weren't affected as much. A vaccine for the H1N1 virus that caused the swine flu is now included in the annual flu vaccine. 19. West African Ebola epidemic: 2014-2023 Ebola ravaged West Africa between 2014 and 2016, with 28,600 reported cases and 11,325 deaths. The first case to be reported was in Guinea in December 2013, then the disease quickly spread to Liberia and Sierra Leone. The bulk of the cases and deaths occurred in those three countries. A smaller number of cases occurred in Nigeria, Mali, Senegal, the United States and Europe, the Centers for Disease Control and Prevention reported. There is no cure for Ebola, although efforts at finding a vaccine are ongoing. The first known cases of Ebola occurred in Sudan and the Democratic Republic of Congo in 1976, and the virus may have originated in bats. 20. Zika Virus epidemic: 2015-present day The impact of the recent Zika epidemic in South America and Central America won't be known for several years. In the meantime, scientists face a race against time to bring the virus under control. The Zika virus is usually spread through mosquitoes of the Aedes genus, although it can also be sexually transmitted in humans. While Zika is usually
not harmful to adults or children, it can attack infants who
are still in the womb and cause birth defects. The type of
mosquitoes that carry Zika flourish best in warm, humid
climates, making South America, Central America and parts of
the southern United States prime areas for the virus to
flourish. What
was the Black Death? 1346-1353 Less well known is that the plague continued to strike Europe, the Middle East and beyond for the next four centuries, returning every 10 to 20 years. The name "Black Death," Benedictow suggests, is actually a "misunderstanding, a mistranslation of the Latin expression 'atra mors,'" meaning at the same time "terrible" and "black." There is no discernible correlation between the grisly name and the symptoms experienced by victims. When did the Black Death start? The Black Death swept through the Middle East and Europe in the years 1346-1353 but it may have begun several decades earlier in the Qinghai Plateau of Central Asia. The period of recurring plague epidemics between the 14th and 18th centuries is known as the Second Plague Pandemic. The so-called First Pandemic occurred in the sixth through eighth centuries A.D. and the Third Pandemic lasted roughly between 1860-1960. The Black Death, Benedictow writes, was "the first disastrous wave of epidemics" of the Second Plague Pandemic. Few of the later outbreaks in the Second Plague Pandemic were as devastating, but they nonetheless continued to kill 10-20% of the population with each recurrence. How did the Black Death affect Europe? As surprising as it may seem to modern audiences, medieval and Early Modern people grew accustomed to the plague, and took this periodic loss of population in stride. Doctors and scientists worked to understand and treat plague better, especially in terms of preventing its arrival and spread in their communities. Many important developments in the history of medicine and health occurred against this backdrop of plague: the rebirth of dissection, the discovery of the circulation of blood and the development of public health measures. It is unclear why the Second Pandemic ended in Western Europe, while it continued to strike in Russia and the Ottoman Empire well into the 19th century. When did the Black Death end? The Great Plague of London in 1665 was the last major outbreak in England and plague also seems to have disappeared from Spanish and Germanic lands after the 17th century. The plague of Marseilles, France, in 1720-1721 is considered to be the last major plague outbreak in Western Europe. Some historians argue that public health had improved to such an extent as to halt the spread of plague, especially through the systematic and effective use of sanitary legislation. Others point to evolutionary changes in humans, rodents or in the bacterium itself, but none of these claims seem to be holding up to recent discoveries in plague genetics. What is clear, is that in the four
centuries between the Black Death and the disappearance of
plague from Europe, doctors worked tirelessly to explain,
contain and treat this terrifying disease. Spanish
flu of 1918: The deadliest pandemic in history -
3/14/20 Estimates vary on the exact number of deaths caused by the disease, but it is thought to have infected a third of the world's population and killed at least 50 million people, making it the deadliest pandemic in modern history. Although at the time it gained the nickname "Spanish flu," it's unlikely that the virus originated in Spain. What caused the Spanish flu? The outbreak began in 1918, during the final months of World War I, and historians now believe that the conflict may have been partly responsible for spreading the virus. On the Western Front, soldiers living in cramped, dirty and damp conditions became ill. This was a direct result of weakened immune systems from malnourishment. Their illnesses, which were known as "la grippe," were infectious, and spread among the ranks. Within around three days of becoming ill, many soldiers would start to feel better, but not all would make it. During the summer of 1918, as troops began to return home on leave, they brought with them the undetected virus that had made them ill. The virus spread across cities, towns and villages in the soldiers' home countries. Many of those infected, both soldiers and civilians, did not recover rapidly. The virus was hardest on young adults between the ages of 20 and 30 who had previously been healthy. In 2014, a new theory about the origins of the virus suggested that it first emerged in China, National Geographic reported. Previously undiscovered records linked the flu to the transportation of Chinese laborers, the Chinese Labour Corps, across Canada in 1917 and 1918. The laborers were mostly farm workers from remote parts of rural China, according to Mark Humphries' book "The Last Plague" (University of Toronto Press, 2013). They spent six days in sealed train containers as they were transported across the country before continuing to France. There, they were required to dig trenches, unload trains, lay tracks, build roads and repair damaged tanks. In all, over 90,000 workers were mobilized to the Western Front. Humphries explains that in one count of 25,000 Chinese laborers in 1918, some 3,000 ended their Canadian journey in medical quarantine. At the time, because of racial stereotypes, their illness was blamed on "Chinese laziness" and Canadian doctors did not take the workers' symptoms seriously. By the time the laborers arrived in northern France in early 1918, many were sick, and hundreds were soon dying. Why was it called the Spanish flu? Spain was one of the earliest countries where the epidemic was identified, but historians believe this was likely a result of wartime censorship. Spain was a neutral nation during the war and did not enforce strict censorship of its press, which could therefore freely publish early accounts of the illness. As a result, people falsely believed the illness was specific to Spain, and the name "Spanish flu" stuck. Even in late Spring 1918, a Spanish news service sent word to Reuters' London office informing the news agency that "a strange form of disease of epidemic character has appeared in Madrid. The epidemic is of a mild nature, no deaths having been reported," according to Henry Davies' book "The Spanish Flu," (Henry Holt & Co., 2000). Within two weeks of the report, more than 100,000 people had become infected with the flu. The illness struck the king of Spain, Alfonso XIII, along with leading politicians. Between 30% and 40% of people who worked or lived in confined areas, such as schools, barracks and government buildings, became infected. Service on the Madrid tram system had to be reduced, and the telegraph service was disturbed, in both cases because there were not enough healthy employees available to work. Medical supplies and services couldn't keep up with demand. The term "Spanish influenza" rapidly took hold in Britain. According to Niall Johnson's book "Britain and the 1918-19 Influenza Pandemic" (Routledge, 2006), the British press blamed the flu epidemic in Spain on the Spanish weather: "… the dry, windy Spanish spring is an unpleasant and unhealthy season," read one article in The Times. It was suggested that microbe-laden dust was being spread by the high winds in Spain, meaning that Britain's wet climate might stop the flu from spreading there. What were the symptoms of the flu? Initial symptoms of the illness included a sore head and tiredness, followed by a dry, hacking cough; a loss of appetite; stomach problems; and then, on the second day, excessive sweating. Next, the illness could affect the respiratory organs, and pneumonia could develop. Humphries explains that pneumonia, or other respiratory complications brought about by the flu, were often the main causes of death. This explains why it is difficult to determine exact numbers killed by the flu, as the listed cause of death was often something other than the flu. By the summer of 1918, the virus was quickly spreading to other countries in mainland Europe. Vienna and Budapest, Hungary, were suffering, and parts of Germany and France were similarly affected. Many children in Berlin schools were reported ill and absent from school, and absences in armament factories reduced production. By June 25, 1918, the flu epidemic in Spain had reached Britain. In July, the epidemic was hitting the London textile trade hard, with one factory having 80 out of 400 workers go home sick in one evening alone, according to "The Spanish Influenza Pandemic of 1918-1919: New Perspectives" (Routledge, 2003). In London, reports on government workers absent due to the flu range from 25% to 50% of the workforce. The epidemic had rapidly become a pandemic, making its way around the world. In August 1918, six Canadian sailors died on the St. Lawrence River. In the same month, cases were reported among the Swedish army, then in the country's civilian population and also among South Africa's laboring population. By September, the flu had reached the U.S. through Boston harbor. What advice were people given? Doctors were at a loss as to what to recommend to their patients; many physicians urged people to avoid crowded places or simply other people. Others suggested remedies included eating cinnamon, drinking wine or even drinking Oxo's meat drink (beef broth). Doctors also told people to keep their mouths and noses covered in public. At one point, the use of aspirin was blamed for causing the pandemic, when it might actually have helped those infected. On June 28, 1918, a public notice appeared in the British papers advising people of the symptoms of the flu; however, it turned out this was actually an advertisement for Formamints, a tablet made and sold by a vitamin company. Even as people were dying, there was money to be made by advertising fake "cures." The advert stated that the mints were the "best means of preventing the infective processes" and that everyone, including children, should suck four or five of these tablets a day until they felt better. Americans were offered similar advice about how to avoid getting infected. They were advised not to shake hands with others, to stay indoors, to avoid touching library books and to wear masks. Schools and theaters closed, and the New York City Department of Health strictly enforced a Sanitary Code amendment that made spitting in the streets illegal, according to a review published in the journal Public Health Reports. World War I resulted in a shortage of doctors in some areas, and many of the physicians who were left became ill themselves. Schools and other buildings became makeshift hospitals, and medical students had to take the place of doctors in some instances. How many people died? By the spring of 1919, the numbers of deaths from the Spanish flu were decreasing. Countries were left devastated in the wake of the outbreak, as medical professionals had been unable to halt the spread of the disease. The pandemic echoed what had happened 500 years earlier, when the Black Death wreaked chaos around the world. Nancy Bristow's book "American Pandemic: The Lost Worlds of the 1918 Influenza Epidemic" (Oxford University Press, 2016) explains that the virus affected as many as 500 million people around the world. At the time, this represented a third of the global population. As many as 50 million people died from the virus, though the true figure is thought to be even higher. Bristow estimates that the virus infected as much as 25% of the U.S. population, and among members of the U.S. Navy, this number reached up to 40%, possibly due to the conditions of serving at sea. The flu had killed 200,000 Americans by the end of October 1918, and Bristow claims that the pandemic killed over 675,000 Americans in total. The impact on the population was so severe that in 1918, American life expectancy was reduced by 12 years. Bodies piled up to such an extent that cemeteries were overwhelmed and families had to dig graves for their relatives. The deaths created a shortage of farmworkers, which affected the late summer harvest. As in Britain, a lack of staff and resources put other services, such as waste collection, under pressure. The pandemic spread to Asia, Africa, South America and the South Pacific. In India, the mortality rate reached 50 deaths per 1,000 people — a shocking figure. How does this compare to seasonal flu? The Spanish flu remains the most deadly flu pandemic to date by a long shot, having killed an estimated 1% to 3% of the world's population. The most recent comparable flu pandemic occurred in 2009 to 2010, after a new form of the H1N1 influenza strain appeared. The disease was named the "swine flu" because the virus that causes it is similar to one found in pigs (not because the virus came from pigs). The swine flu caused respiratory illnesses that killed an estimated 151,700-575,400 people worldwide in the first year, according to the Centers for Disease Prevention and Control. That was about 0.001% to 0.007% of the world's population, so this pandemic was much less impactful than the 1918 Spanish flu pandemic. About 80% of the deaths caused by swine flu occurred in people younger than 65, which was unusual. Typically, 70% to 90% of deaths caused by seasonal influenza are in people older than 65. A vaccine for the influenza strain
that causes swine flu is now included in annual flu
vaccines. People still die from the flu every year, but the
numbers are far lower, on average, compared to those for the
swine flu or Spanish flu pandemics. Annual epidemics of
seasonal flu result in about 3 million to 5 million cases of
severe illness and about 290,000 to 650,000 deaths,
according to the World Health Organization. AIDS
pandemic and epidemic: 1981-present day For decades, the
disease had no known cure, but medication developed in the
1990s now allows people with the disease to experience a
normal life span with regular treatment. Even more
encouraging, two people have been cured of HIV as of early
2020. Psychosocial
Impact of SARS In addition to SARS patients themselves, an estimated 50% of family members of SARS patients had psychological problems, including feelings of depression or stigmatization (5). They had difficulties sleeping, and some children who had lost parents cried continuously. Some children also felt embarrassed to be a member of a SARS family (6). The spouse of one healthcare worker who died from SARS attempted suicide at her workplace (7). The loss of parents who were SARS patients also impaired the growth of their children (7). A study conducted in China (8) reported that negative SARS-related information increased persons' perception of their risk and led to irrational nervousness or fear. Although data from systematic studies of SARS do not exist, evidence suggests that this disease has psychosocial consequences for SARS patients, their families, and society. While biomedical scientists must continue their efforts to clarify the genetic makeup of the SARS coronavirus, look for new medications, and develop vaccines (9–13), the social and psychological aspects of SARS should not be overlooked. Since nearly all resources are devoted to biomedical research and medical treatment, psychosocial problems of SARS patients and their families are largely ignored. Our review of the literature using the ISI Web of Knowledge on January 17, 2004, substantiated this observation. To date, no systematic study examining psychosocial consequences of SARS has been published in scientific journals. A systematic exploration of how SARS negatively affects patients' mental health is needed so that appropriate interventions may be implemented at individual, family, and societal levels. Footnotes Suggested citation for this article: Tsang HWH, Scudds RJ, Chan EYL. Psychosocial impact of SARS [letter]. Emerg Infect Dis [serial on the Internet]. 2004 Jul [date cited]. http://dx.doi.org/10.3201/eid1007.040090 References 1. World Health Organization Summary table of SARS cases by country, 1 November 2002 – 7 August 2003. [2003 Nov 11]. Available from: http://www.who.int/csr/sars/country/en/country2003_8_15.pdf 2. Fifteen percent of the SARS recovered cases needed psychological counseling [in Chinese]. MingPao. 2003. Jul 12 [cited 2003 Aug 17]. Available from: http://hk.news.yahoo.com/030711/12/sx83.html 3. Orthopedic examination on all rehab cases. Victims complained on improper medications [in Chinese]. MingPao. 2003. Oct 10 [cited 2003 Oct 17]. Available from: http://hk.news.yahoo.com/031009/12/uox2.html 4. SARS recovered medical practitioner jump due to economic difficulties [in Chinese]. MingPao. 2003. Oct 6 [cited 2003 Oct 17]. Available from: http://hk.news.yahoo.com/031005/12/ulsp.html 5. Expert blamed the Social Welfare Department on the negligence of the psychological support for the SARS family [in Chinese]. MingPao. 2003. Jun 5 [cited 2003 Oct 17]. Available from: http://hk.news.yahoo.com/030604/12/s5wt.html 6. Children from SARS family are spiritually weak [in Chinese]. MingPao. 2003. Aug 4 [cited 2003 Oct 17]. Available from: http://hk.news.yahoo.com/030803/12/tcwg.html 7. Spouse of SARS victims commit suicide after the announcement of the Report of the HA Review panel on the SARS outbreak [in Chinese]. MingPao. 2003. Oct 5 [cited 2003 Oct 17]. Available from: http://hk.news.yahoo.com/031004/12/uldf.html 8. Shi K, Lu JF, Fan HX, Jia JM, Song ZL, Li WD, et al. Rationality of 17 cities' public perception of SARS and predictive model of psychological behavior. Chin Sci Bull. 2003;48:1297–303 10.1360/03wc0304 [CrossRef] [Google Scholar] 9. Antonio GE, Wong KT, Hui DS WuA, Lee N, Yuen EH. Thin-section CT in patients with severe acute respiratory syndrome following hospital discharge: preliminary experience. Radiology. 2003;228:810–5 10.1148/radiol.2283030726 [PubMed] [CrossRef] [Google Scholar] 10. Chiang CH, Chen HM, Shih JF, Su WJ, Perng RP Management of hospital-acquired severe acute respiratory syndrome with different disease spectrum. J Chin Med Assoc. 2003;66:328–38 [PubMed] [Google Scholar] 11. Cyranoski D Critics slam treatment for SARS as ineffective and perhaps dangerous. Nature. 2003;423:4 10.1038/423004a [PubMed] [CrossRef] [Google Scholar] 12. Koren G, King S, Knowles S, Phillips E Ribavirin in the treatment of SARS: a new trick for an old drug? CMAJ. 2003;168:1289–92 [PMC free article] [PubMed] [Google Scholar] 13. Yang M, Hon KL, Li K,
Fok TF, Li CK The effect of SARS coronavirus on blood
system: its clinical findings and the pathophysiologic
hypothesis. Zhongguo Shi Yan Xue Ye Xue Za Zhi.
2003;11:217–21 [PubMed] [Google
Scholar] The
impact of epidemic outbreak: The case of severe acute
respiratory syndrome (SARS) and suicide among older adults
in Hong Kong Background: Previous studies revealed that there was a significant increase in suicide deaths among those aged 65 and over in 2003. The peak coincided with the majority of SARS cases being reported in April 2003. Aims: In this paper we examine the mechanism of how the SARS outbreak resulted in a higher completed suicide rate especially among older adults in Hong Kong. Methods: We used Qualitative data analysis to uncover the association between the occurrence of SARS and older adult suicide. Furthermore, we used a qualitative study based on the Coroner Court reports to provide empirical evidence about the relationship between SARS and the excessive number of suicide deaths among the elderly. Results: SARS-related older adult suicide victims were more likely to be afraid of contracting the disease and had fears of disconnection. The suicide motives among SARS-related suicide deaths were more closely associated with stress over fears of being a burden to their families during the negative impact of the epidemic. Social disengagement, mental stress, and anxiety at the time of the SARS epidemic among a certain group of older adults resulted in an exceptionally high rate of suicide deaths. Conclusions: We recommend that
the mental and psychological well-being of the community, in
particular older adults, be taken into careful account when
developing epidemic control measures to combat the future
outbreak of diseases in the community. In addition, it is
important to alert family members to vulnerable individuals
who are at potential risk because of their illnesses or
anxieties. 2009
H1N1 Pandemic (H1N1pdm09 virus) April 2009-April
2010 The 2009 H1N1 Pandemic: A New Flu Virus Emerges The (H1N1)pdm09 virus was very
different from H1N1 viruses that were circulating at the
time of the pandemic. Few young people had any existing
immunity (as detected by antibody response) to the
(H1N1)pdm09 virus, but nearly one-third of people over 60
years old had antibodies against this virus, likely from
exposure to an older H1N1 virus earlier in their lives.
Since the (H1N1)pdm09 virus was very different from
circulating H1N1 viruses, vaccination with seasonal flu
vaccines offered little cross-protection against (H1N1)pdm09
virus infection. While a monovalent
(H1N1)pdm09 vaccine was
produced, it was not available in large quantities until
late November—after the peak of illness during the
second wave had come and gone in the United States. From
April 12, 2009 to April 10, 2010, CDC estimated there were
60.8 million cases (range: 43.3-89.3 million), 274,304
hospitalizations (range: 195,086-402,719), and 12,469 deaths
(range: 8868-18,306) in the United States due to the
(H1N1)pdm09 virus. Disease Burden
of the H1N1pdm09 Flu Virus, 2009-2023 Additionally, CDC estimated that 151,700-575,400 people worldwide died from (H1N1)pdm09 virus infection during the first year the virus circulated.** Globally, 80 percent of (H1N1)pdm09 virus-related deaths were estimated to have occurred in people younger than 65 years of age. This differs greatly from typical seasonal influenza epidemics, during which about 70 percent to 90 percent of deaths are estimated to occur in people 65 years and older. Though the 2009 flu pandemic primarily affected children and young and middle-aged adults, the impact of the (H1N1)pdm09 virus on the global population during the first year was less severe than that of previous pandemics. Estimates of pandemic influenza mortality ranged from 0.03 percent of the world’s population during the 1968 H3N2 pandemic to 1 percent to 3 percent of the world’s population during the 1918 H1N1 pandemic. It is estimated that 0.001 percent to 0.007 percent of the world’s population died of respiratory complications associated with (H1N1)pdm09 virus infection during the first 12 months the virus circulated. The United States mounted a complex,
multi-faceted and long-term response to the pandemic,
summarized in The
2009 H1N1 Pandemic: Summary Highlights, April 2009-April
2010. On August 10, 2010, WHO
declared an end to the global 2009 H1N1 influenza pandemic.
However, (H1N1)pdm09 virus continues to circulate as a
seasonal flu virus, and cause illness, hospitalization, and
deaths worldwide every year. Coronavirus symptoms start slow, and worsen quickly, doctors say - Mar 24th 2020
As the novel coronavirus spreads, doctors are seeing a pattern in the way their patients are responding to the disease. People who get sick tend to first suffer minor ailments, like headaches, light coughs, and a slight fever for around a week. But it's usually only at the end of the second week that they will either start improving, or suddenly decline, and for those who do get worse, it can quickly escalate to a trip to the emergency room. For those who end up in the intensive care unit (ICU), there is a similar kind of delay in the way patients display symptoms and relapse after receiving treatments Michelle N. Gong, the director of critical care research at Montefiore Medical Center, said in a Q&A with the Journal of the American Medical Association on Monday that COVID-19 patients have often seemed to be "doing okay, but at the five- to seven-day mark they got worse and then developed respiratory arrest in its true form." It's a quick onset, she said, "that can be very abrupt." Many people who get the coronavirus feel fine for a week, then 'crash' Critical care physician Dr. Joshua Denson told NBC News that, based on the 15-20 patients with coronavirus he has treated, he would describe the first phase of illness as "a slow burn." Infectious disease specialist Dr. Christopher Ohl also told NBC that he's seen patients saying they think they're getting better, and "then within 20 to 24 hours, they've got fevers, severe fatigue, worsening cough and shortness of breath. Then they get hospitalized." The CDC warns there is plenty of evidence, both published by researchers and anecdotal, that many patients see a "clinical deterioration during the second week of illness." A study published in The Lancet in January found more than half of patients developed shortness of breath after already being ill for a week. "It's known as the second-week crash," Donald G. McNeil Jr, a science and health reporter for The New York Times, said on The Daily podcast. "And some people crash even after they thought they were starting to get better." Patients in hospital seem to get better before they get worse A respiratory therapist told ProPublica that his "patients will be on minimal support, on a little bit of oxygen, and then all of a sudden, they go into complete respiratory arrest, shut down and can't breathe at all." This sudden decline is most likely to happen for the most at-risk patients; the elderly and those with pre-existing health conditions. With COVID-19 patients, unlike people with pneumonia or acute respiratory distress syndrome (ARDS), a disease where fluid builds up in the lungs, respiratory failure does not occur within the first few days of hospitalization. Gong added that there is a very high proportion of cardiac arrest in coronavirus patients, which may have to do with underlying conditions. "But, again, it's sudden, it's not yet predictable as to who will get it and who will not," she said. Gong warned doctors not to use chloroquine, an immunosuppressive drug that can fight malaria, on their coronavirus patients. She understands that physicians may be desperate for a cure, but says it can cause more harm than good when used on coronavirus patients, given the medical establishment still doesn't know how it will react with coronavirus. Plus it could deprive patients who need the drug of their medicine. "I still feel like we
haven't seen the full extent," one internal medicine doctor
previously
told Business Insider.
"It's like leaning over the edge of a cliff." Age
is not the only risk for severe coronavirus disease And as cases skyrocket in the U.S. and Europe, it’s becoming more clear that how healthy you were before the pandemic began plays a key role in how you fare regardless of how old you are. The majority of people who get COVID-19 have mild or moderate symptoms. But “majority” doesn't mean “all," and that raises an important question: Who should worry most that they'll be among the seriously ill? While it will be months before scientists have enough data to say for sure who is most at risk and why, preliminary numbers from early cases around the world are starting to offer hints. Not just the old who get sick Senior citizens undoubtedly are the hardest hit by COVID-19. In China, 80% of deaths were among people in their 60s or older, and that general trend is playing out elsewhere. The graying of the population means some countries face particular risk. Italy has the world’s second oldest population after Japan. While death rates fluctuate wildly early in an outbreak, Italy has reported more than 80% of deaths so far were among those 70 or older. But, “the idea that this is purely a disease that causes death in older people we need to be very, very careful with,” Dr. Mike Ryan, the World Health Organization’s emergencies chief, warned. As much as 10% to 15% of people under 50 have moderate to severe infection, he said Friday. Even if they survive, the middle-aged can spend weeks in the hospital. In France, more than half of the first 300 people admitted to intensive care units were under 60. “Young people are not invincible,” WHO's Maria Van Kerkhove added, saying more information is needed about the disease in all age groups. Italy reported that a quarter of its cases so far were among people ages 19 to 50. In Spain, a third are under age 44. In the U.S., the Centers for Disease Control and Prevention’s first snapshot of cases found 29% were ages 20 to 44. Then there’s the puzzle of children, who have made up a small fraction of the world’s case counts to date. But while most appear only mildly ill, in the journal Pediatrics researchers traced 2,100 infected children in China and noted one death, a 14-year-old, and that nearly 6% were seriously ill. Another question is what role kids have in spreading the virus: “There is an urgent need for further investigation of the role children have in the chain of transmission,” researchers at Canada’s Dalhousie University wrote in The Lancet Infectious Diseases. The riskiest health conditions Put aside age: Underlying health plays a big role. In China, 40% of people who required critical care had other chronic health problems. And there, deaths were highest among people who had heart disease, diabetes or chronic lung diseases before they got COVID-19. Preexisting health problems also can increase risk of infection, such as people who have weak immune systems including from cancer treatment. Other countries now are seeing how pre-pandemic health plays a role, and more such threats are likely to be discovered. Italy reported that of the first nine people younger than 40 who died of COVID-19, seven were confirmed to have “grave pathologies” such as heart disease. The more health problems, the worse they fare. Italy also reports about half of people who died with COVID-19 had three or more underlying conditions, while just 2% of deaths were in people with no preexisting ailments. Heart disease is a very broad term, but so far it looks like those most at risk have significant cardiovascular diseases such as congestive heart failure or severely stiffened and clogged arteries, said Dr. Trish Perl, infectious disease chief at UT Southwestern Medical Center. Any sort of infection tends to make diabetes harder to control, but it’s not clear why diabetics appear to be at particular risk with COVID-19. Risks in the less healthy may have something to do with how they hold up if their immune systems overreact to the virus. Patients who die often seemed to have been improving after a week or so only to suddenly deteriorate — experiencing organ-damaging inflammation. As for preexisting lung problems, “this is really happening in people who have less lung capacity,” Perl said, because of diseases such as COPD -- chronic obstructive pulmonary disease -- or cystic fibrosis. Asthma also is on the worry list. No one really knows about the risk from very mild asthma, although even routine respiratory infections often leave patients using their inhalers more often and they’ll need monitoring with COVID-19, she said. What about a prior bout of pneumonia? Unless it was severe enough to put you on a ventilator, that alone shouldn’t have caused any significant lingering damage, she said. The gender mystery Perhaps the gender imbalance shouldn’t be a surprise: During previous outbreaks of SARS and MERS -- cousins to COVID-19 -- scientists noticed men seemed more susceptible than women. This time around, slightly more than half the COVID-19 deaths in China were among men. Other parts of Asia saw similar numbers. Then Europe, too, spotted what Dr. Deborah Birx, the White House coronavirus coordinator, labeled a concerning trend. In Italy, where men so far make up 58% of infections, male deaths are outpacing female deaths and the increased risk starts at age 50, according to a report from Italy’s COVID-19 surveillance group. The U.S. CDC hasn’t yet released details. But one report about the first nearly 200 British patients admitted to critical care found about two-thirds were male. (Editor: Possibly because men are generally exposed to more people in an average day versus at-home moms?) One suspect: Globally, men are more likely to have smoked more heavily and for longer periods than women. The European Center for Disease Prevention and Control is urging research into smoking’s connection to COVID-19. Hormones may play a role, too. In
2017, University of Iowa researchers infected mice with SARS
and, just like had happened in people, males were more
likely to die. Estrogen seemed protective — when their
ovaries were removed, deaths among female mice jumped, the
team reported in the Journal of Immunology. Scientists
Compare Novel Coronavirus with SARS and MERS Viruses “It’s very helpful to know what the genome looks like and what the proteins look like,” says Rachel Roper, a biologist at East Carolina University who was part of the team that first analyzed and sequenced the SARS coronavirus genome in 2003 and did not participate in this study. “It gives us some idea about what protein differences may be that are allowing this virus to be so virulent and transmissible in humans.” We’re all wondering where this virus came from, and we can see from the new sequence and the sequences that we’ve already had for coronaviruses that it’s likely to be a recombinant of a number of different coronaviruses that are known.—Rachel Roper, East Carolina University As of January 20, there were 14 genome sequences for 2019-nCoV that had been released by six different labs. Each is available to researchers through either the National Center for Biotechnology Information’s Genbank or the Global Initiative on Sharing All Influenza Data (GISAID). While some research teams have done preliminary phylogenetic analysis and annotation, this report is one of the first in-depth looks at these genomes. Taijiao Jiang, a computational biologist at the Chinese Academy of Medical Sciences & Peking Union Medical College, and colleagues wanted to gain “insights into the molecular mechanisms underlying the functionality and pathogenesis of this novel virus,” he tells The Scientist in an email. They annotated three genomes of 2019-nCoV, which were sequenced from samples collected on December 30 and January 1 by the National Institute for Viral Disease Control and Prevention, part of the Chinese CDC and are available through GISAID.. Then they compared them to bat SARS-like coronaviruses, human SARS coronaviruses, and human Middle East respiratory syndrome coronaviruses (MERS-CoV). The authors found that there were only five nucleotide differences—in a total genome of about 29,800 nucleotides—among the three 2019-nCoV genomes. They also identified 14 open reading frames, predicted to encode 27 proteins, including four structural and eight accessory proteins. Previous coronavirus research indicates that accessory proteins may mediate the host response to the virus, which can affect pathogenicity, and may make up part of the viral particle. Because the researchers identified just five nucleotide differences among the genomes, it’s unlikely that there are any significant changes between the viruses that affect their pathogenicity or transmissibility, “but really all it takes is one change,” says Anthony Fehr, a biologist at the University of Kansas who studies the replication and pathogenesis of coronaviruses and was not involved in the work. Whether these nucleotide differences mean anything functionally for the viruses will be something look at in the future, he adds. Jiang and colleagues noted differences in the amino acid sequences of SARS-CoV and 2019-nCoV. For instance, one SARS-CoV accessory protein, known as 8a, is absent in the new virus. Other accessory proteins varied in length. In 2019-nCoV, 8b is 37 amino acids longer than in SARS-CoV while 3b is shorter by 132 amino acids. “The structural proteins are very highly conserved between all coronaviruses, whereas accessory proteins are generally unique to each specific group of coronaviruses,” explains Fehr. The amino acid sequences show “the connection of this virus to the SARS-like coronaviruses and a little bit more distant relationship to SARS coronavirus.” The researchers determined that 2019-nCoV is most closely related to bat SARS-like coronaviruses, from which SARS-CoV evolved, and more distantly related to MERS coronaviruses. Still, they did not find a single bat SARS-like coronavirus in which all the proteins were most similar to those of the new coronavirus. Instead, some 2019-nCoV proteins are more similar to those of bat SARS-like coronaviruses, while accessory proteins 3a and 8b are most similar to the SARS-CoVs. Our “analysis of genome data of 2019-nCoV together with other coronaviruses clearly shows that, although this novel virus has high sequence similarity to SARS virus, they belong to distinct phylogenetic branches and were both derived from SARS-like virus isolated in bat,” writes Jiang in an email to The Scientist. In the paper, the authors acknowledge that, given the limited knowledge of 2019-nCoV, it is difficult to infer the functional significance of the 380 amino acid substitutions they found between 2019-nCoV and the SARS and SARS-like CoVs. According to Jiang, this question, as well as figuring out how the novel coronavirus has mutated and adapted over its short history in humans, will be the focus of future research. “We’re all wondering where this virus came from, and we can see from the new sequence and the sequences that we’ve already had for coronaviruses that it’s likely to be a recombinant of a number of different coronaviruses that are known,” says Roper. She adds that this finding could help researchers understand how coronaviruses can jump into humans—2019-nCoV is the third to do so in the last 17 years. “This may continue, so the more we know about these the better.” “The authors talk about it
transmitting finally to humans, but we don’t know that
this is its final jump. It could transmit to cats or dogs
and then circulate back to humans,” says Roper.
“We were able to control and stop SARS because it
didn’t get into any other animals. . . . Hopefully it
won’t happen, but we shouldn’t assume that
it’s just going to stop with us.” Fact
checking Trump's claim about suicides if the economic
shutdown continues Trump wants US open for business by Easter ABC News’ Tom Llamas responds to President Donald Trump's push forward to restart the economy as state governments want to keep restrictions in place. As some in President Donald Trump's inner circle push for loosening social distancing guidelines amid economic fallout from the novel coronavirus outbreak, he has predicted "tremendous death" and "suicide by the thousands" if the country isn't "opened for business" in a matter of weeks. While public health officials warn that dropping social guidelines to boost the economy could quickly overload hospital systems, costing more money and more lives, the president has claimed several times this week that the number of suicides specifically would "definitely" be greater than the death toll from the virus itself as he pointed to people returning to work as a remedy. "You're going to lose more people by putting a country into a massive recession or depression." Trump said Tuesday in a Fox News town hall. "You're going to lose people. You're going to have suicides by the thousands." One night before, at a coronavirus task force briefing, the president said, "I'm talking about where people suffer massive depression, where people commit suicide, where tremendous death happens… I mean, definitely would be in far greater numbers than the numbers that we're talking about with regard to the virus." A scientific report released March 16, 2020 by an epidemic modeling group at Imperial College London, found that without action by the government and individuals to slow the spread of COVID-19, as many as 2.2 million people in the U.S. could die -- not accounting for the negative effects of health care systems being overwhelmed. There's no way to predict the exact impact of an unprecedented pandemic, but experts also say that there's no evidence to suggest that the suicide rate will rise dramatically because people are stressed from losing their jobs or that the death toll would surpass potential coronavirus deaths. According to the Centers for Disease Control and Prevention, suicide mortalities have gone up every year since 1999, but it's still "selective" for the president to latch onto that, says Richard Dunn, associate professor of Agricultural and Resource Economics at University of Connecticut who has studied the connection between markets and depression. "The general fact that President Trump cited is, in fact, true that when economies contract suicides do go up," Dunn said, acknowledging how the financial crisis of the early 2000s triggered more suicides, "but that is not the only cause of death that responds to economic downturn." "If you were to look across all the current causes of death in a recession, you would see that the number of deaths actually declines. Heart deaths from heart disease fall. Deaths from motor vehicle accidents crashes fall," Dunn added. "One of the few activities that we have left to us in many parts of the country is to go out for a walk, so physical activity tends to go up." "So we actually see overall that there are fewer deaths in economic downturn -- but suicide is the one major cause of death that does not follow that pattern," Dunn said. While the global reported death toll for COVID-19 is nearly 20,000 people at this time, the CDC reports that 47,173 Americans died by suicide in 2017 alone (Editor: that number is 48,344 in 2018) and the number is on track to grow in coming years -- but experts still caution pairing the mortality rate to that of the current pandemic. Timothy Classen, an associate professor of economics and associate dean at the Quinlan School of Business at Loyola University, notes that in the years since the Great Recession, unemployment numbers have recovered from roughly 10% to 4% -- yet suicides mortalities have continued to increase. "That contradicts the notion that as unemployment increases, that's going to increase suicide rates," Classen said. Classen also notes that while "of course" one individual's suicide has consequences to others, it does not transmit itself like a virus, adding to the difficulty in predicting either death toll, albeit comparing them through sound science. The direct payments to individuals and extended unemployment benefits in the $2 trillion economic relief package Congress is close to approving, which also includes suspension of loan payments, could reduce a lot of the financial stress. When it comes to next steps, former Trump administration homeland security adviser -- and now ABC News Contributor -- Tom Bossert cautions that allowing the disease to spread without making an effort to mitigate would still take a "devastating" toll on the country. "I think everybody shares his [President Trump's] frustration and his hope -- but what he needs to do is avoid second waves and reinfections," Bossert said. "At this stage we've paid a very heavy cost in our economy and in our lives. To lose the benefit of it at this point by not sticking to our guns would be a really devastating decision." The National Suicide Prevention
Lifeline is 1-800-273-8255 or text SOS to 741741 Medusa's
Ugly Head Again: From SARS to MERS-CoV In Arabi and colleagues’ case series, all patients had comorbid illness that may have increased susceptibility to infection. Similar to SARS, MERS-CoV affects middle-aged persons and spares children. However, preexisting chronic illness is more common in patients with severe MERS-CoV–associated pneumonia than in those with SARS: Rates of diabetes, renal disease, and heart disease are 68%, 49%, and 28%, respectively, in patients with MERS versus 24%, 2.6%, and 10%, respectively, among those with SARS (3). Carefully designed case–control studies are essential to determine the exposures that lead to infection. Such studies could identify potential preventive strategies and, when coupled with translational studies of genetic and other biological factors, could further define the key factors modulating disease severity. Of note in Arabi and colleagues’ report (and similar to SARS) is the nosocomial transmission among close contacts, with 33% of the cases associated with health care. Other reports from Jordan (4), the United Kingdom (5), and the Al-Hasa province of Saudi Arabia (6) implicated health care transmission in an even greater proportion of cases. In the Al-Hasa report, epidemiologic analysis suggested that 91% of reported cases resulted from transmission in health care facilities. Genomic analysis subsequently identified close phylogenetic clustering of MERS-CoV isolates consistent with human-to-human transmission (7). Although the investigations of Arabi and colleagues and others (4, 5) have found a relatively low risk for MERS-CoV infection and illness in exposed health care personnel, 30 of the first 161 reported MERS-CoV case patients were health care providers and new cases continue to occur in this population (8). Analysis to date suggests that MERS-CoV does not yet have pandemic potential. A model based on published data used the rate of MERS-CoV introduction into the population in the Jordan and Al-Hasa outbreaks to calculate the basic reproductive number (R0)—that is, the number of secondary cases per index case in a fully susceptible population (9). For MERS-CoV, R0 is estimated to be between 0.60 (95% CI, 0.42 to 0.80) and 0.69 (CI, 0.50 to 0.92). At first blush, this is comforting: Prepandemic SARS virus had an R0 of 0.8. However, we must keep in mind both the rapid evolution that occurred with SARS and that it emerged in a much more densely populated region. Given the right environment and a crowded part of the world, MERS-CoV might propagate more readily. As with SARS, we are indebted to international collaboration and a ProMED post that alerted the world to a new virus on 15 September 2012. Early recognition allowed the World Health Organization and other public health authorities to enhance surveillance and develop mitigation strategies. To date, all cases have been directly or indirectly linked to travel to or residence in countries in the Arabian Peninsula. How long will this last, given minimal data on specific exposure risks for infection and persistent health care transmission? The question remains of whether MERS-CoV infection is occurring due to repeated introductions from an animal reservoir with subsequent limited transmission in humans or from sustained human-to-human transmission, with most cases being subclinical disease in patients without underlying medical conditions. Camels and bats have been implicated as potential reservoirs, but most case patients have not been exposed to these animals and the search for the source of human exposure continues (10, 11). As reported cases of MERS-CoV increase, we must not lose sight of the most important lesson of SARS: the value of transparency in reporting and of effective international collaboration in public health and research. Does health care transmission continue because of failure to adhere to infection control practices or despite practices previously believed to be adequate to control the transmission of infection? The concentration of vulnerable patients, the frequent movement of patients, and the many daily contacts make health care facilities the perfect breeding ground for MERS-CoV transmission. This, in combination with known imperfect adherence to routine infection prevention practices, suggests that early recognition of possible MERS-CoV infection is critical. Intensive surveillance for cases combined with the use of standard, contact, and droplet precautions for persons with suspected or confirmed disease aborted the Al-Hasa outbreak (6). Because we know little about how the virus is transmitted, it is not surprising that the Centers for Disease Control and Prevention and the World Health Organization disagree on the need for airborne isolation. Data are unavailable to discount either approach. Arabi and colleagues provide a stark reminder of lessons learned from SARS. Infection with MERS-CoV causes respiratory failure with extrapulmonary organ dysfunction for which there is no effective treatment. Mortality remains high. Health care–associated MERS-CoV transmission to patients, workers, and visitors remains significant but is underplayed. Focus on the health care setting may prevent continued human-to-human transmission among at-risk patients. We applaud these brave authors for providing independent data and enhancing the scientific collaborations that MERS-CoV has created. Globalization and emerging viruses combine to demand new levels of scientific transparency and collaboration to effectively protect populations, a change we must all strive to achieve. References 1. CauchemezS, FraserC, Van KerkhoveMD, DonnellyCA, RileyS, RambautA, et alMiddle East respiratory syndrome coronavirus: quantification of the extent of the epidemic, surveillance biases, and transmissibility.Lancet Infect Dis 20141450-6 2. ArabiYM, ArifiAA, BalkhyHH, NajmH, AldawoodAS, GhabashiA, et alClinical course and outcomes of critically ill patients with Middle East respiratory syndrome coronavirus infection.Ann Intern Med 2014160389-97 3. AssiriA, Al-TawfiqJA, Al-RabeeahAA, Al-RabiahFA, Al-HajjarS, Al-BarrakA, et alEpidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study.Lancet Infect Dis 201313752-61 4. HijawiB, AbdallatM, SayaydehA, AlqasrawiS, HaddadinA, JaarourN, et alNovel coronavirus infections in Jordan, April 2012: epidemiological findings from a retrospective investigation.East Mediterr Health J201319 Suppl 1S12-8 5. Health Protection Agency (HPA) UK Novel Coronavirus Investigation TeamEvidence of person-to-person transmission within a family cluster of novel coronavirus infections, United Kingdom, February 2013.Euro Surveill 20131820427 6. AssiriA, McGeerA, PerlTM, PriceCS, Al RabeeahAA, CummingsDA, et alKSA MERS-CoV Investigation TeamHospital outbreak of Middle East respiratory syndrome coronavirus.N Engl J Med2013369407-16 7. CottenM, WatsonSJ, KellamP, Al-RabeeahAA, MakhdoomHQ, AssiriA, et alTransmission and evolution of the Middle East respiratory syndrome coronavirus in Saudi Arabia: a descriptive genomic study.Lancet 20133821993-2002 8. The WHO MERS-CoV Research GroupState of knowledge and data gaps of Middle East respiratory syndrome coronavirus (MERS-CoV) in humans.PLoS Curr 20135 9. BrebanR, RiouJ, FontanetA. Interhuman transmissibility of Middle East respiratory syndrome coronavirus: estimation of pandemic risk.Lancet2013382694-9 10. ReuskenC, AbabnehM, RajV, MeyerB, EljarahA, AbutarbushS, et alMiddle East respiratory syndrome coronavirus (MERS-CoV) serology in major livestock species in an affected region in Jordan, June to September 2013.Euro Surveill 201318 11. PereraRA,
WangP, GomaaMR, El-SheshenyR, KandeilA, BagatoO, et
alSeroepidemiology for MERS coronavirus using
microneutralisation and pseudoparticle virus neutralisation
assays reveal a high prevalence of antibody in dromedary
camels in Egypt, June 2013.Euro Surveill 201318pii=20574 Some
things you can do for Curry County Businesses
These are just a few ideas. We know
you have others. Let us know the ways you’re giving
back to those around you. Send us a message gordonclay@aol.com COVID-19
Messaging Guidance Public Messengers
Specific Messengers American Indian/Alaska Native Communities
Construction
Entertainment Industry (Content Creators, Producers, Talent)
Faith Communities
Family Members with Children
Family Members of Older Adults
Health Care Providers/Clinicians
Law Enforcement/Public Safety
Recommendations for Reporting on Suicide Sport
Workplaces (Employees and Employers) Veterans, Service Members, and Their Families
Additional COVID-19 Mental Health Support
If you or someone you know is in
crisis, please call 800-273-TALK (8255) or text 'SOS' to
741741. Coronavirus Hits
Schools: Student, School Employee Among the Likely
Infected - February 29, 2020 A 40-year-old man who had traveled to Europe on a trip with a Catholic high school in Pawtucket, R.I., has tested "presumptive positive" for the virus after returning from a trip to Italy, France, and Spain in mid-February, state health officials said. That case follows health officials announcing Friday night that a student in suburban Seattle and a school employee in suburban Portland, Ore., are among the new suspected coronavirus cases in the U.S. The cases, reported late Friday, concern health officials because in both instances, it's unclear how the two school-connected individuals contracted the virus. In both cases, neither individual had traveled to countries where there are outbreaks of the coronavirus or had contact with individuals who had done so. Those are worrisome signs that the coronavirus is spreading from "person-to-person" in the community. "It's concerning that this individual did not travel, since this individual acquired it in the community," Washington state health officer Dr. Kathy Lofy, said at a press conference announcing two new cases in the state, according to the Seattle Times. "We really believe now that the risk is increasing." Officials said that they got "presumptive" positive tests in both of the cases. Final results still must be confirmed by the federal Centers For Disease Control and Prevention. On Saturday afternoon, a person infected with coronavirus died, Washington state officials said. It is the first U.S. death from the virus. A second death from the virus, also in the state, came later in the weekend. The Washington state high school student, who attends Henry M. Jackson High School in the Everett school district north of Seattle, felt sick Monday and visited two clinics during the week. The student felt better and returned to school briefly Friday, but went home after the test showed the positive results, according to the Seattle Times. Students who had contact with the sick student are undergoing a 14-day quarantine and monitoring periods at their homes, the Everett school district said in an update on its website. The student's sibling attends a district middle school and was also being tested and quarantined, although they showed no symptoms of the disease, the district said. The district said it was taking the situation "very seriously," and that out of an abundance of caution it would close the school through March 2, for three days of "deep disinfecting." In Oregon, it was an employee of the Forest Hills Elementary School in the Lake Oswego School District, close to Portland, who had a "presumptive" positive test, health officials said late Friday. Lake Oswego officials are closing the 430-student K-5 school for "deep cleaning" through March 4, according to Oregon Live. The employee is being isolated at a local hospital while receiving treatment there. In a news conference Saturday, Lake Oswego Superintendent Lora de la Cruz said public health officials said it was not necessary to close other schools in the district. But she said all schools and buses would be cleaned and disinfected before students return to schools Monday morning The affected employee, de la Cruz said, "at this point, it appears that this person likely only had close contact with a few individuals." Who Has Authority to Close Schools in Public Health Crisis? Earlier this week, officials with the CDC said that Americans should be prepared for the inevitable spread of the coronavirus in the country and urged schools to prepare their responses to the likely outbreaks. So far, 65 cases of the coronavirus have been reported in the U.S., with the majority of those cases involving Americans who had contracted the disease abroad in areas that are affected by the outbreak. They recommended that the public contact their employers and school systems about their plans in the event of an outbreak. While school districts have been posting notices on their websites largely focused on preventative measures that parents, students, and staff can take to minimize the risks of contracting coronavirus, it's unclear whether they have concrete plans on how to keep a system running in the long term if they're required to shut down. And just who will ultimately make the
call about widespread school closures is an important issue
for district leaders to get clarity on. A 2008 research
paper that examined the legal and logistical issues
concluded that most states have multiple legal avenues for
ordering school closures. Mark Walsh has much more on that
here. Staying
Connected, Emerging Stronger - A letter from Tricycle
Magazine's editor James Shaneen, Summer 2020 There are significant differences between then and now, but it’s impossible for many of us not to view what’s happening through the lens of that past: now as then, communities of care have emerged to tend to the sick despite national leadership that is by turns incompetent and indifferent to the point of cruelty. Without proper equipment or sufficient support, teams of medical workers risk their own health to care for the sick, just as, in the early days of AIDS, friends, family, and even strangers gathered, as they cannot now, at unknown risk to themselves to comfort the ill. Whereas the AIDS pandemic took its toll over years, the current crisis has unfolded with astonishing swiftness, and I can’t even guess where we’ll be by the time this issue is delivered. And so I’ve been asking myself, what can a quarterly magazine offer at a time like this, when it will necessarily miss a moment that demands an immediate response? In the current pandemic, the very same Buddhist teachings that grounded me after years of loss help ground me today. In moments of panic or fear it is so easy to lose touch with the sources of wisdom we each need to draw upon for guidance and direction. So while a quarterly magazine cannot respond nimbly to rapidly changing events, it can keep us connected to the enduring values of care and compassion that do not change, values that sustain us over the long run. As Masha Gessen wrote recently in the New Yorker, The real question, though, is: How do we handle this as a society, as communities? What are the opportunities for mutual aid and care, even amid calls for social distancing? What is the response that creates, on the other side of this epidemic, not a collection of atomized individuals who survived a plague but a polity whose members helped one another live? For me, and, I hope, for our readership, the Buddhist emphasis on wisdom and compassion will guide our response and bring us together. On March 10, the Tricycle staff began working remotely. At the center of the pandemic, in New York City, we had little choice. And although years ago I griped often about the Internet’s contributing to greater social isolation, I’m deeply grateful for the connection it affords us at a time when the best we can do to help is to remain physically isolated from one another. While the magazine can help ground us
in teachings that stand the test of time, it is in their
online presentation that they find more time-sensitive
expression. To that end, we have begun offering a series of
free livestream teachings to the public; short practices for
relief and resilience; and a free workshop for turning
obstacles into opportunities. As we go to press, well over
20,000 people have registered for them, and we are immensely
pleased that these offerings seem to speak to a real need
for practical guidance in a time of great suffering.
I’d like to think that when all is said and done,
we—all of us in the Tricycle community—can say
that we stayed connected to the true spirit of the
teachings. If we can do this, we as a community will emerge
stronger for it. I have seen it before, in the community of
care that emerged during another pandemic nearly four
decades ago. What
Can We Learn From the Pandemic? 12/114/20 Sitting here today in the middle of the rising tide of this pandemic, and on the verge of the arrival of vaccines that may finally help us stem the course of this disease, I'm reminded of how far we've come, and how far we truly have to go. Again and again, the things we've seen, the things we've learned, and the things we haven't learned tell us how far we have to go to make our healthcare system just and equitable. Right now, there's lots of talk on social media about who should get vaccinated first, how we ensure it is distributed to do the most benefit, to save the most lives, and there are certainly valid arguments to be had on multiple sides. Vaccinating healthcare workers, frontline employees, essential personnel in critical jobs, as well as targeting our most high-risk patients, certainly makes sense as we try to decide who to start with. Maybe there is something to be said for vaccinating the most vulnerable first, those we know to be at high risk, those who have been so often left behind by the inequities built into our outmoded system. I've heard some argue that healthcare providers have the "luxury" of PPE while in exposure situations -- something most people do not have -- and so maybe doctors, nurses, respiratory therapists, and all the rest should wait till later. And I worry that those who refuse to wear masks and practice social distancing and other basics of public health may refuse the vaccines, to the detriment of their own loved ones and communities, potentially worsening things for everyone. Some just don't trust the science, some are skeptical of the system as a whole, and some will never change. But if we've learned nothing else, I think we have to find a way to make sure that everyone is valued, that everyone who could possibly need and want these vaccines has the unfettered opportunity to receive them. If it turns out we need these vaccines every year, like a flu shot, we need to ensure that we distribute them equally across our population, throughout our communities, and help make sure that no one gets left behind. If things get bad over the next few months, and we return to harsher and harsher restrictions on life, we need to rapidly develop models to care for patients at home, either through video visits and telehealth, or finding other safe ways to reach them in their communities. We need to embrace contact tracing, supporting people who cannot go to work and those who must, paying people to quarantine and checking on them, bringing them food at home, paying their rent and utilities. That is what a just society must do. We need to build safe models of getting to work, being together, going to school, traveling, becoming normal once again. We need to rise up with one voice and say that healthcare is a universal right, that no one in this great country of ours should suffer for lack of access, lack of medication, fear, or misinformation. By creating opportunities for improved health, we can work with other sectors of our society to improve education, housing, safe water supplies, food, and access to jobs that will raise everyone up. I will continue to write and vent about how we've let our healthcare system become a bloated behemoth that far too often interferes with the health of our patients -- interference through the bureaucracy and regulations and the special interests of those profiting off healthcare. We need to continue to take every opportunity we can to return the control of healthcare to those on the frontlines, who really do know what's best for our patients, while simultaneously preventing fraud, and engaging our patients in their healthcare as much as we possibly can. Heading into the holiday season, and as this terrible year comes to an end, I can only hope once again that we continue to chisel away, wear away, blast away, and demand nothing less than the best for our patients and all of the people who work so hard day to day to make this healthcare system what it should be. Whether it's better data, a more flexible and responsive electronic medical record, access to broadband in the community, fair pricing of medications, or care that is blinded to people's insurance status, there's so much more that needs to be done. And we'll never stop asking for
it. What
are ‘underlying conditions’? These conditions include: cardiovascular disease (hypertension), chronic liver and lung disease, chronic renal disease, being a current or former smoker, diabetes mellitus, immunocompromised condition, neurologic and neurodevelopmental conditions, obesity and other chronic diseases.? Having type 2 diabetes increases your risk of severe illness from COVID-19. Based on what we know at this time, having type 1 or gestational diabetes might increase your risk of severe illness from COVID-19. Check out the graphic below to learn more about diabetes and COVID-19.?For more information on underlying conditions, see the Centers for Disease Control and Prevention (CDC) webpage. high blood sugars affect immune system
and diabetes-related health problems like heart or kidney
disease can make it harder to recover from COVID-19 Why it's
important to be vaccinated and boosted even though you can
still get COVID-19 The latest data from the Centers for Disease Control and Prevention show people age 12 and older who received no vaccinations were 20 times more likely to die from COVID-19 and 7 times more likely to be hospitalized compared to those who received primary series and booster vaccine doses. Additionally, recent studies have
found potential connections between COVID-19 and diabetes,
heart disease and cognitive decline. Studies also suggest
COVID-19 vaccines reduce the risk of long-term health
complications. Read
on for more. FULL
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