Children are being bullied at school for not brushing their teeth because their families cannot afford toothpaste amid the cost of living crisis, according to new research.

The findings revealed that one in three teachers have witnessed a child being bullied because of poor dental hygiene.

Teachers are being forced to step in and four in five teachers are now handing out toothbrushes and toothpaste to students as the cost of living crisis bites.

A survey of 260 secondary school teachers by hygiene poverty charity Beauty Banks and the British Dental Association (BDA) found that 83% of secondary teachers say they or their school has given students toothbrushes and toothpaste.

The research revealed that 25% of teachers said children miss school because of poor oral hygiene

(PA Wire)

The research also revealed that 81% of teachers said there are children in their school who don’t have regular access to oral hygiene supplies, with 40% saying this leads to children being socially excluded.

One Lewisham pastoral leader surveyed said children are still wearing Covid masks to hide their mouths, while 25% of teachers said children miss school because of poor oral hygiene.

The findings come as teachers across the country began the first of seven strikes last week in a dispute over pay, jobs and conditions.

Some teachers have been forced to work second jobs in order to “keep eating” and pay for essentials during the cost of living crisis, with one in 10 believed to have taken on another role alongside teaching.

Martin Lewis explains financial help available to ease childcare costs

The research revealed the extent of the impact of the cost of living crisis on schools, with half of teachers saying children had noticeable tooth decay, and 30% noting children in dental pain or suffering from halitosis.

BDA chair Eddie Crouch said: “This shocking survey underlines that deep health inequalities are set to widen. Yet while our children face an epidemic of decay, the government seems asleep at the wheel.”

Jo Jones, co-founder of Beauty Banks said: “We work with charities including food banks, family centres, domestic abuse centres, homeless shelters and universally - across the board - toothpaste is now our most requested item. Before the cost of living crisis, it wasn’t even in the top three.” 

Tooth decay is prevalent in children aged three to 11 according to data from the UK’s leading oral health charity, Dental Wellness Trust. 38% of children surveyed had untreated tooth decay.

Last year 16,959 children aged five to nine were admitted to hospital to have a tooth out, up from 9,429 in 2020-21.

The cost of living crisis has seen energy bills soar across the country due to an increase in wholesale gas prices.

 An increase in demand for gas across the whole world occurred after the coronavirus lockdowns in 2020, putting a strain on supplies.

Since then, the crisis has hit million of families across the UK.

Children are missing out on essential educational school trips due to the cost of living crisis, lack of funds and staffing issues.

Schools are also stepping in to help families struggling with washing their clothes and buying food as the cost of living continue to cripple millions across the country.

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The abrupt and profound loss of smell and taste are two unique symptoms of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. It has been observed that about 4% of patients who recover from COVID-19 show persistent signs of a distorted sense of smell or taste 6-12 months later.

In a new study posted to the medRxiv* preprint server, scientists in the United States assessed the extent of post-COVID-19 olfactory and gustatory dysfunction to gain deeper insights into the quality and severity of the symptoms over a year.

Study: Clinical Characteristics and Long-term Symptomology of Post-COVID-19 Olfactory and Gustatory Dysfunction. Image Credit: Shchus / ShutterstockStudy: Clinical Characteristics and Long-term Symptomology of Post-COVID-19 Olfactory and Gustatory Dysfunction. Image Credit: Shchus / Shutterstock

Background

Temporary disruptions in normal smell and taste are common in many chronic nasal inflammatory conditions and upper respiratory tract infections. However, the key distinguishing feature of COVID-19 is the sudden onset and severity of symptoms. Research has shown that up to 68% of patients report smell and taste disruptions, and about 55% recover within six months. 

An association between olfactory dysfunction and expression of the SARS-CoV2 receptor (ACE2) has been documented. However, the mechanisms underlying persistent smell and taste dysfunction remain unclear. The situation is made more complex by the fact that there is no neuronal distress or dysfunction. Some researchers have studied the mechanistic or neurological differences concerning the different SARS-CoV-2 strains, but sensory symptoms and severity in the major waves of the pandemic are yet to be analyzed.

About the Study

The main aim of the current study is to analyze the clinical characteristics of post-COVID gustatory and olfactory dysfunction. This could narrow down the predictors of persistent sensory dysfunction in patients with chronic symptomology or recovery over a year.

Adult patients with a history of COVID-19 and loss of smell or taste for more than 1 week were included in this study. A total of 426 patients enrolled in an online registry and were sent 8 study questionnaires at 4 points during a year. The questions were related to medication use, smoking history, and COVID-19 history. The terminology used for distortion of smell was dysosmia, and for distortion of taste was dysgeusia. 

Key Findings

Medical predispositions and threats, particularly nasal disease, was a key focus area of the study. This is because such conditions could make people more susceptible to sensory dysfunction after a SARS-CoV-2 infection. Chronic rhinosinusitis, nasal congestion, and environmental allergies showed significantly different frequencies across the major waves of the pandemic. However, recovery was associated only with environmental allergies, indicative of an overactive immune system capable of minimizing damage induced by COVID-19.

The participants confirmed that rinses, steroids (oral or intranasal), and nasal sprays were not able to provide temporary relief or recovery. This made it emotionally challenging and frustrating for them to cope with this condition and the slow progress. The patients also reported more significant mood disturbances, which could be due to the stigma around psychologically induced symptoms or the longevity of the symptoms.

Based on the data, the patients could fall into one of the four categories: dysosmia, dysgeusia, subjective dysosmia, and dysosmia/dysgeusia. Participants' self-reported symptoms were validated with clinical measures and compared with specific smells and tastes that could affect their daily lives. There were issues reported concerning smelling foul and dangerous odors, which is problematic for the quality and mental health. Regarding tastes, varied abilities to perceive flavors and subtle differences in food were noted.

Concluding Remarks

Lack of gender and racial/ethnical diversity was a fundamental limitation of the study, although the registry was provided in English and Spanish. It could be helpful to study the differences among patients infected at different time points within the pandemic. Future research could delve into this issue by comparing mechanistic data on post-COVID olfactory and gustatory dysfunction and clinical characteristics. 

Overall, COVID-19 is characterized by persistent gustatory and olfactory dysfunction, which occurs in conjunction with acute symptoms of infection but is not ameliorated by them. This study helped gain insights into the quality and severity of smell and taste dysfunction patients still experience post-infection. Despite being a self-reported data-driven study and unable to measure the smell and taste abilities of all participants, researchers noted a marked similarity among the recruited participants. 

The next goal would be to understand the mechanism underlying these clinical features in the current study and compare them with the registry data. This could be crucial to come up with prognosis trajectories for patients according to potential SARS-CoV-2 strain exposure and testing out novel targeted courses of treatment.

*Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

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The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has caused a significant amount of illness, mortality, and hospitalization globally. This ongoing pandemic has severely impacted the healthcare sectors, along with the global economy, which saw the greatest recession since the 1930s.

Study: Road networks to explore COVID-19 infection. Image Credit: Michael Smith ITWP/Shutterstock
Study: Road networks to explore COVID-19 infection. Image Credit: Michael Smith ITWP/Shutterstock

Background

In response to the pandemic, scientists have worked tirelessly to understand every little aspect of the novel coronavirus, SARS-CoV-2. They developed vaccines and therapeutics and gathered more knowledge about the mode of transmission to manage the pandemic. Similarly, governments implemented several strategies, such as national lockdowns, mandatory wearing of facemasks, and travel restrictions, to contain COVID-19.

Several models have been developed based on SARS-CoV-2 transmission data to effectively predict the future trend. For instance, an autoregressive integrated moving average (ARIMA) model was developed using data from 145 countries. This model predicted the COVID-19 spread pattern based on the population data. The ARIMA model demonstrated that SARS-CoV-2 transmission could be projected using variables such as humidity, culture, and climate.

The classical Susceptible-Infected-Recovery (SIR) model was modified with fuzzy parameters, such as recovery rate, infection rate, and death rate due to SARS-CoV-2 infection. Although classical statistical models could not incorporate important determining factors, machine learning models provided an effective alternative to understanding complicated datasets. The artificial neural network (ANN)-based model was developed to predict the SARS-CoV-2 transmission pattern. 

As stated above, most governments implemented restrictions on people’s mobility to protect individuals from contracting COVID-19. Not many studies have verified the impact of mobility restrictions in terms of costs and benefits. In addition, it is important to determine if the implementation of other factors, such as increasing awareness, economic support, education, and so forth, could collectively contain the pandemic.

About the study

A new study posted to the medRxiv* preprint server investigated how human mobility influenced SARS-CoV-2 transmission based on a network-based approach and panel regression methods. The authors particularly considered the suburban population’s characteristics, such as age, education, and income, for the analysis.

The current study included SARS-CoV-2 infection data for one hundred different suburbs of the Greater Sydney area of New South Wales, Australia. Two distinct periods were selected, i.e., during Delta variant circulation and during Omicron variant circulation, to determine infection statistics of the suburbs. Three moderating attributes, namely, age, education, and income, were considered to determine their impact on the relationship between the dependent and independent variables of the current study’s model.

Findings

This study was divided into two parts. In the first part, the authors investigated the impact of an individual’s mobility through the neighborhood on the COVID-19 case count. The neighborhood measure was associated with the number of shared roads to determine human movement across the suburbs.

Notably, several underlying factors changed in the two selected timeframes of the study, i.e., during the Delta and Omicron circulation. During the Delta outbreak, the lockdown was implemented, and people could move within a 5 km radius for essential items. In addition, some areas also had night-time curfews during this period. The vaccination coverage increased from approximately 26% to 43% in the area. 

In contrast, during the Omicron phase, no lockdowns were implemented. The only mandatory requirements were social distancing, wearing face masks, and business capacity capping. Double vaccination coverage increased from 77% to almost 79%. Unsurprisingly, people’s mobility within and across the suburbs during this phase was significantly more than in the Delta phase.

The Omicron variant is more infectious than the Delta strain; hence, it is crucial to determine how the neighborhood measure impacted the COVID-19 cases linked with the Delta and Omicron outbreaks. Although the fixed effect panel regression model provided a good prediction performance for the Delta variant (R-squared value of 85.66%), its performance suffered for the Omicron variant (R-squared value of 52.67%). 

The previous infection count had a significant positive influence on the present infection count for both Delta and Omicron variants. This model projected that the infection counts for a suburb during the Delta variant could be positively determined based on past infection counts and influx from surrounding suburbs (neighborhood measure). 

In the case of the Omicron variant, the regression model and the neighborhood measure needed to provide more insights because the R-square value was almost the same as the delta variant. In addition, the neighborhood measure revealed a negative impact on infection counts counter-intuitively.

In the second part of the study, researchers investigated how age, education, and income impacted the infection rate in the suburbs. They found that education did not have any moderating effect on the infection rate for both variants. In contrast, age and income significantly influenced the relationship between previous and present COVID-19 case counts.

Conclusions

The model captured the macro-movement during the lockdown and utilized it to predict infection rates during Delta and Omicron outbreaks. The impact of mobility on the infection rate was determined based on the road network between the neighboring suburbs that assisted in the influx and the corresponding risk of an increase in the number of cases from adjacent places.

*Important notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

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Ferry Efendi,1 Joni Haryanto,1 Eka Mishbahatul Mar’ah Has,1 Makhfudli Makhfudli,1 Retno Indarwati,1 Heri Kuswanto,2 Joni Wahyuhadi,3,4 Makhyan Jibril Al Farabi,4,5 Ken Hok Man Ho,6 Ika Adelia Susanti7

1Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia; 2Department of Statistics, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia; 3Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; 4Dr. Soetomo General Hospital, Surabaya, Indonesia; 5Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; 6Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong; 7Faculty of Health Science, Universitas dr. Soebandi, Jember, Indonesia

Introduction: Coronavirus disease 2019 (COVID-19) increases rapidly and causes mortality in all groups, including children. However, the predictive risk factors of mortality among children remain inconclusive. This study aimed to analyse the predictors related to mortality among children with COVID-19.
Methods: Secondary data analysis was conducted using provincial COVID-19 data from April 2020 to May 2021. We selected 6441 children under age 18 to be included in this study. Chi-square and binary logistic regression were used to evaluate the predictors of mortality in children with COVID-19.
Results: This study showed that the prevalence of children who died COVID-19 was 2.7%. Age, case definition, treatment status, severity of illness, and travel history had a significant relationship with survival status in children with COVID-19. As the increasing age, the risk of death with COVID-19 will decrease [AOR=0.94; CI 95%=0.91– 0.97]. Otherwise, suspected status [AOR=2.12; 95% CI=1.48– 3.04], hospitalization with ventilators [AOR=22.25; 95% CI=5.73– 86.42], severe illness [AOR=46.76; 95% CI=21.69– 100.80], and travel history [AOR=1.78; 95% CI=1.22– 2.60] were significantly related with an increased risk of death in children with COVID-19.
Discussion: Severe illness in children was the strongest predictor of mortality. Disease prevention and health promotion programs are the key to preventing hospitalizations in children and decreasing the mortality rate.

Introduction

Coronavirus disease 2019 (COVID-19) poses a major risk of mortality worldwide.1 Since COVID-19 was declared a worldwide pandemic by the World Health Organization in March 2020, the number of reported cases, deaths, and affected countries has continuously increased.2 By June 2020, global reports of COVID-19 recorded 10 million cases and 503,862 deaths, with several countries categorized as having community transmission.3 At the same time, Indonesia also reported a total of 55,092 confirmed cases, the third country in Southeast Asia with the highest number of confirmed cases.3 Most provinces in the Java region reported an increase in cases and deaths.4 The East Java Province became the first province in Indonesia, with the highest number of cases reaching 11,823 by June 2020.5 The COVID-19-related fatality rate in East Java continues to increase, reaching 7.44%.6,7 Moreover, based on data from online hospital applications, the East Java Provincial Health Office announced that the bed occupation rate (BOR) in East Java reached more than 80% and was categorized as a red zone area.8 This fact requires special attention in overcoming the COVID-19 pandemic and reducing the number of confirmed cases and COVID-related deaths in East Java Province.9

The COVID-19 data update in East Java was conducted by the COVID-19 task force and reported through online systems such as websites, mass media, and government accounts.10,11 Although the trend of COVID-19 cases shows fluctuating data, the overall number cases in East Java have increased.6 Each region implements strict health protocols to manage the outbreak of a small number of cases to reduce the likelihood of a larger number of cases. Public health protection is provided through several strategies: health promotion, early detection, physical and social restrictions, coughing and sneezing etiquette, self-isolation, and quarantine.12 However, these efforts have not significantly reduced the number of COVID-19 cases in East Java.

Several studies have been conducted on COVID-19 to assess treatment-related risk factors and the clinical features of COVID-19 have become clearer in identifying the virus that causes COVID-19 and acute respiratory syndrome coronavirus 2 (SARS-CoV-2).13–16 The impact of COVID-19 on patients is clinically complex; outcomes may range from asymptomatic respiratory failure to death.17 In a pandemic, community resilience must be considered, especially for vulnerable groups.18 A previous study showed that the elderly were the most vulnerable population at risk, especially those with heart disease, respiratory disease, diabetes, or other autoimmune diseases.19 Although children appear to have milder symptoms and a better prognosis than adults,15,20,21 the number of cases in children is growing rapidly.22 It may also contribute to community transmission.23 Moreover, the potential harm caused by COVID-19 in children remains largely unknown, especially in neonates and infants.24 Previous studies have shown that several factors contribute to the fatality rate of children, such as those age ≥ 10 years, severe illness, poor oxygen ratio, and chronic underlying disease.25–27 Although several studies have analysed the predictors of mortality, most of the studies have focused on adults and the elderly, leading to difficulty in generalization. In this context, this study aimed to examine predictors of mortality among patients with COVID-19, especially in children.

Materials and Methods

Data Source

This study was a secondary data study using provincial COVID-19 data in Indonesia particularly in East Java province. The children dataset used for this study contains information about children aged less than 18 years and their health data related to COVID-19. East Java province COVID-19 platform pooled all of data from April 2020 to May 2021 through an online platform. The researcher applied for dataset access permission the East Java COVID-19 task force to obtain research data. The data were obtained from all health facilities in East Java that served all cities or regency within East Java province. Each health facilities were obliged to report all the cases to the data platform.

Subjects

This study involved paediatric patients with COVID-19 in East Java. The purposive sampling method was used to select a sample of 6441 children. The sampling technique allows selected respondents in population to be included in sampling due to certain criteria. The inclusion criteria in this study were children aged less than 18 years, either outpatient or inpatient. The definition of children following the guideline from the Government of Indonesia.28

Variables

The dependent variable in this study was survival status, namely, alive and dead. The time point started from the first-time admission to the health facilities until they discharged (dead or alive). Alive and dead is the current status when conducting data collection in May 2021 on health care status in outpatient and inpatient patients. Independent variables included sex, case definition, treatment status, severity of illness, travel history, and exposure to a person with a suspected/confirmed case of COVID-19. Sex was divided into two categories: male and female. In this study, the case definition category is divided into confirmed and suspected. Confirmed cases can be defined as positive cases of COVID-19 infection as evidenced by polymerase chain reaction (PCR) tests. Meanwhile, suspected cases were defined as cases that showed COVID-19-like symptoms with inconclusive results using PCR or any other type of testing.12 Treatment status was divided into three categories: non-hospitalized (isolation), hospitalized, and hospitalized with a ventilator. The severity of illness was divided into mild, medium, and severe based on reference to the Decree of the Minister of Health of the Republic of Indonesia. Mild symptoms include fever, cough, fatigue, anorexia, shortness of breath, myalgias, or other unspecified symptoms without evidence of viral pneumonia or without hypoxia. Moderate symptoms are characterized by the presence of clinical signs of pneumonia (fever, cough, shortness of breath, rapid breathing) without signs of severe pneumonia. Meanwhile, severe symptoms are characterized by clinical signs of pneumonia coupled with a respiratory rate > 30 x/minute or severe respiratory distress.29 Travelling history and exposure to a person with a suspected/confirmed case of COVID-19 was divided into two categories: yes and no.

Data Analysis

SPSS version 25 was used for data analysis in this study. The data that were obtained were analysed using chi-square and logistic regression to examine the determinants of survival status in children with COVID-19. To determine the strength of the relationship between the dependent and independent variables, it was assessed using an odds ratio and 95% confidence interval (CI) (p<0.05). We adjusted for any variables known to be associated with the independent variables. All the missing data were excluded from this analysis.

Ethical Approval

The datasets used in this study are available upon request after all individual-level identification variables were removed. It was not possible to identify the residence of any of the subjects. Therefore, ethical approval was not required for the study. This study confirmed that informed consent was obtained from all participants and performed according to the Declarations of Helsinki ethical principles for medical research involving human subjects.30

Results

Out of 6441 children, 3496 children with COVID-19 in East Java were male (54.3%) and categorized as having a suspected case of COVID-19 (65.4%). Based on treatment status, as of 60% children were hospitalized (60.0%) and a few were hospitalized with a ventilator (1.2%). Higher percentage of the children with COVID-19 had mild cases (86.4%), no travel history (58.8%) and were exposed to a person with a suspected/confirmed case of COVID-19 (63.2%) (Table 1). Table 1 also describes a bivariate analysis of the survival status of paediatric patients with COVID-19, with 177 children (2.7%) dead and 6246 children (97.3%) alive. From the analysis results, several factors related to mortality among children with COVID-19 including treatment, severity of illness, and travel history.

Table 1 Sociodemographic Data of Patients with COVID-19 (n=6441)

In a multivariate analysis using logistic regression, it was found that age, case definition, treatment status, severity of illness, and travel history had a significant relationship with survival status in children with COVID-19 in East Java. Based on the analysis results, as the child’s age increases, the risk of death will decrease by 0.94 times [AOR=0.94; 95% CI=0.91–0.97]. Children with a suspected case of COVID-19 have a higher risk of death than children with a confirmed case of COVID-19 [AOR=2.12; 95% CI=1.48–3.04]. Meanwhile, children hospitalized with ventilators had the highest risk of death, reaching 22 times that of isolated children [AOR=22.25; 95% CI=5.73–86.42]. The survival status of children with severe cases was 47 times more likely to die than those with mild cases [AOR=46.76; 95% CI=22.69–100.80]. The risk of death in children increased almost twice in children with a travel history compared to children without a history of travel [AOR=1.78; 95% CI=1.22–2.60] (Table 2).

Table 2 Multivariate Analysis of Survival Status in Children with COVID-19 (n=6441)

Discussion

The results showed several factors related to mortality among children with COVID-19 in East Java. As the child’s age increases, they are less likely to die of COVID-19. This result is in line with a previous study showing that the most significant proportion of severe and critical cases in children under one year of age was higher than that in older children, reaching 10.6%.31 The authors argue that the health facilities in East Java do not support the most significant number of critical cases in children under one year of age. This increases the risk of death in younger children than that in older children. At first, neonates and infants were not prioritized in the first wave of the pandemic. In 2020, the government focused on the elderly group, and the capacity for paediatric care was limited.32 This statement was also supported by data from online hospital applications that reported that the number of beds in the Neonatal Intensive Care Unit (NICU) and Paediatric Intensive Care Unit (PICU) in East Java were very limited in 2020.8 Furthermore, these results can be used as supporting data to identify indicators of mortality in high-risk patients with COVID-19, such as the risk associated with the child’s age.

Case definition was significantly related to the survival status in children with COVID-19. Children with suspected status have a 2.12 higher risk of death than children with confirmed status. This study is similar to previous research in which there were more suspected cases in children than confirmed cases, reaching 65.9%.33 A patients with a confirmed case of COVID-19 showed clinical signs and symptoms compared with patients with a suspected case.34 Patients with a confirmed case, by definition, may experience severe symptoms such as difficulty breathing, loss of speech/mobility, confusion, and chest pain.19 Based on this definition, the signs and symptoms and illness severity cause patients with confirmed cases of COVID-19 to have an increased risk of mortality. Although the clinical manifestations of children with COVID-19 are generally less severe than those of adults, they are more susceptible to infection.33 We also assume that children with confirmed status have rapid treatment and intervention compared with suspected cases. Thus, it can increase the risk of mortality among children with suspected cases.

Based on the results of this research, treatment factors were found to be significantly related to survival in children with COVID-19. Children who were hospitalized on a ventilator had 22 times higher risk of death than isolated children. This finding is consistent with studies conducted in Saudi Arabia showing that patients on mechanical ventilators (MVs) experience a high risk of death from COVID-19.35 Additionally, another study showed that the risk of death in patients admitted to the intensive care unit was high among hospitalized patients with COVID-19.36 Children and paediatric patients who required intensive care and those who died had different comorbidities with hydronephrosis, leukaemia, and intussusception.37 This demonstrated that comorbidities might be one of the factors contributing to the survival status of patients with COVID-19, but our data did not analyse this issue. The survival probability among patients with COVID-19 is also associated with the length of hospital stay (LOS), in which the first 14 days of hospitalization have a higher survival probability than patients treated for 30 days.35 Hospitalized children had a higher prevalence of symptoms, namely, fever, respiratory and gastrointestinal symptoms, and relatively lower haemoglobin and neutrophil levels.38 Based on this finding, we think this remains important to assess symptoms in children with COVID-19 to determine indications for hospitalization and ventilator use to increase survival probability.

The present study demonstrated that the survival status of children was associated with the severity of illness. Children with severe cases were 47 times more likely to die than those with mild cases. This study is in line with previous research conducted in China showing that the severity of illness in the nonsurvival group was higher than that in the survivor group.39 The mortality rate among patients with critical and severe cases increased to 17.6%. Decreases in arterial partial pressure of oxygen (PaO2) and the fraction of inspired oxygen (FiO2) were detected among nonsurviving patients with COVID-19, which mainly caused acute lung injury and death, especially in severely ill patients.39 Another study also showed that severe COVID-19 causes approximately 20% of hospitalizations and causes acute respiratory distress syndrome (ARDS) and viral sepsis.40 We suspect that although children have a risk of mild disease severity, infants and children with congenital (pre-existing) illnesses and various comorbidities, such as malignancy, could be a precipitating factor for increased disease severity, requiring ICU care, as described by previous studies.37,41 This illustrates the urgent need for an early warning system to monitor the progression of COVID-19 in children.

The last factor related to the risk of death in children was travel history. Children with a travel history were more likely to die than children without a travel history. This finding is consistent with a previous study showing that the major risk factors for COVID-19 in children were related to having close contact with family members with COVID-19, travel history, and living in endemic areas.37 A travel history is related to community mobility which has been believed to contribute to the increase of COVID-19 transmission.42 We also suspected that community mobility among children increases the risk of COVID-19 exposure, which increases children’s vulnerability to severe illness and death.

Limitations

Some limitations were identified in this study. First, the data were secondary and contained only certain variables. Therefore, researcher only select the available variables within the dataset. Second, the results of this study do not imply causality. Further the data were not reported the possibility of bias on the testing site and the cause of dead of the children. Despite these limitations, this study contributes to informing determinant factors of mortality among children with confirmed and suspected cases of COVID-19 in a specific population.

Conclusion

Mortality among children with COVID-19 was determined by several factors, including age, suspected status, hospitalization with ventilators, severe illness, and travel history. The key to reducing the risk of COVID-19-related mortality among children remains at the clinical and community levels. The promotion and prevention strategy should be deployed massively to reduce the risk of transmission at the community level. While at the clinical setting, resources should be utilized to prevent children getting severe condition. Therefore, initiatives to improve patient management like supportive care including provision of respiratory support, nutrition support, and family support at the clinical level should be implemented and prevention strategies within the community should also be improved. At the community level, health education through face-to-face or virtual can be implemented to give supportive care and monitor the health status of children.

Data Sharing Statement

The datasets analysed during the current study available from the corresponding author on reasonable request.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Funding

This study was funded by Universitas Airlangga, Surabaya, Indonesia through “Hibah Riset Mandat Top Tier” (Top Tier Mandate Research Grant) grant number [768/UN3.15/PT/2021].

Disclosure

The authors report no conflicts of interest in this work.

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22. Ma H, Hu J, Tian J, et al. A single-center, retrospective study of COVID-19 features in children: a descriptive investigation. BMC Med. 2020;18(1):1–11. doi:10.1186/s12916-020-01596-9

23. World Health Organization. COVID-19 disease in children and adolescents. World Health Organization; 2021:1–10.

24. De Rose DU, Piersigilli F, Ronchetti MP, et al. Novel Coronavirus disease (COVID-19) in newborns and infants: what we know so far. Ital J Pediatr. 2020;46(1):56. doi:10.1186/s13052-020-0820-x

25. Dewi R, Kaswandani N, Karyanti MR, et al. Mortality in children with positive SARS-CoV-2 polymerase chain reaction test: lessons learned from a tertiary referral hospital in Indonesia. Int J Infect Dis. 2021;107:78–85. doi:10.1016/J.IJID.2021.04.019

26. Leoni MLG, Lombardelli L, Colombi D, et al. Prediction of 28-day mortality in critically ill patients with COVID-19: development and internal validation of a clinical prediction model. PLoS One. 2021;16(7):e0254550. doi:10.1371/journal.pone.0254550

27. Kim W, Han JM, Lee KE. Predictors of mortality in patients with COVID-19: a systematic review and meta-analysis. Korean J Clin Pharm. 2020;30(3):169–176. doi:10.24304/kjcp.2020.30.3.169

28. GoI. Undang-Undang Republik Indonesia Nomor 23 Tahun 2002 Tentang Perlindungan Anak. Sekretariat Negara; 2002.

29. Kepmenkes RI. Decree of the minister of health of the republic of Indonesia number HK.01.07/Menkes/5671/2021 concerning clinical management of corona virus disease 2019 (Covid-19) in Health Service Facilities (Keputusan Menteri Kesehatan Republik Indonesia Nomor HK. Tentang Managemen Klinis COVID-19 di Fasilitas Layanan Kesehatan; 2021.

30. WMA General Assembly. WMA declarations of Helsinki - ethical principles for medical research involving human subjects. Brazil: WMA General Assembly; 2013:1975.

31. Dong Y, Mo XI, Hu Y, et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics. 2020;145. doi:10.1542/peds.2020-0702

32. Kemenkes RI. Avoid the elderly from covid-19 (Hindarkan Lansia dari Covid-19). Pusat Analisis Determinan Kesehatan Kementerian Kesehatan Republik Indonesia 2020.

33. Dong Y, Mo X, Hu Y, et al. Epidemiology of COVID-19 among children in China. Pediatrics. 2020;145:6.

34. World Health Organization. Clinical Management of Severe Acute Respiratory Infection (‎‎SARI)‎‎ When COVID-19 Disease is Suspected: Interim Guidance, 13 March 2020. World Health Organization; 2020.

35. Khan AA, AlRuthia Y, Balkhi B, et al. Survival and estimation of direct medical costs of hospitalized COVID-19 patients in the Kingdom of Saudi Arabia. Int J Environ Res Public Health. 2020;17(20):7458. doi:10.3390/ijerph17207458

36. Abate SM, Checkol YA, Mantedafro B, Basu B. Prevalence and risk factors of mortality among hospitalized patients with COVID-19: a systematic review and meta-analysis. Bull World Heal Organ. 2020;2020:10.

37. Alsohime F, Temsah MH, Al-Nemri AM, Somily AM, Al-Subaie S. COVID-19 infection prevalence in pediatric population: etiology, clinical presentation, and outcome. J Infect Public Health. 2020;13:1791–1796. doi:10.1016/j.jiph.2020.10.008

38. Parcha V, Booker KS, Kalra R, et al. A retrospective cohort study of 12,306 pediatric COVID-19 patients in the United States. Sci Rep. 2021;11(1):1–10. doi:10.1038/s41598-021-89553-1

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Only 25 percent of people infected with COVID-19 have managed to recover fully after one month, while the majority of cases still suffer problems in respiratory, nerve, cardiovascular or endocrine systems after testing negative even though many have no symptoms, local experts said on Monday, citing a recent study.

Medical experts from the Shanghai International Medical Center collected and studied information of more than 2,000 post-COVID patients aged between 7 and 81 from different regions such as Shanghai, Beijing, Shenyang in Liaoning Province and Hebei Province. They conducted detailed artificial intelligence-based cell-level evaluation and analysis of 100 patients.

"Only 13.8 percent of patients have had complete recovery and 10.8 percent almost recovered. However, 75.4 percent of the people had problems in multiple systems, due to various reasons, like age, underlying diseases and the impact of the coronavirus," said Su Shan, who led the study.

Criteria for COVID-19 recovery

  • Body temperature returns to normal for at least three days.
  • All symptoms have disappeared or almost disappeared.
  • CT check confirms lung infection has greatly resolved.
  • Negative results of nucleic acid test in two consecutive days, or with a CT value over 35, or negative results of three antigen tests.
Full recovery evades majority of COVID-19 patients

Ti Gong

Su Shan from the Shanghai International Medical Center explains the AI-based cell-level study on 100 post-COVID patients.

"Moreover, 16.8 percent of asymptomatic or recovered patients were still found with viral vectors, which means they are still contagious. There is a risk of relapse if they have weak immunity," Su said.

"For people suffering post-COVID symptoms, their problems also vary, including headache, insomnia, poor memory, coughing, shortness of breath, abnormal heartbeat, body ache, fatigue and irregular menstruation."

Doctors said the first one to two months after COVID-19 infection is risky, especially for elderly people and those with underlying diseases.

"People should be on high alert and avoid severe exercises. Do not drink alcohol or smoke and maintain good habits like wearing masks and washing hands frequently. It is important to visit the hospital if suffering symptoms," she added.

On high alert for respiratory diseases

The Shanghai Health Promotion Center issued a notice on Monday, calling for awareness about respiratory diseases even though the pandemic is at a low level in the nation. With the end of the Spring Festival break, people are returning to their working post or schools. It is still important to do the following:

  • Wear masks in crowded indoor places and elevators.
  • Wash hands frequently.
  • Keep social distance.
  • Visit doctors if suffering symptoms.

"People with post-COVID symptoms can visit COVID-19 rehabilitation clinics at community health centers and hospitals for professional diagnosis and treatment," the center added.

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Key messages

High levels of community transmission and the co-circulation of respiratory viruses, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza, respiratory syncytial virus (RSV) and others can increase pressure on healthcare systems. These co-circulating viruses pose a challenge for the management of large numbers of patients with respiratory viral infections and have a tendency to cause outbreaks in healthcare settings. These outbreaks often result in severe consequences for hospitalised patients with comorbidities and other risk factors for severe disease and death.

Maintaining and strengthening appropriate infection prevention and control (IPC) practices mitigates the spread of respiratory virus in healthcare facilities, especially during peak periods of hospital admission. Timely implementation of multi-layered interventions is the key to preventing further strain on hospital personnel and other resources. Such interventions should be based on a holistic approach, addressing risks from transmission of all respiratory viruses and not just SARS-CoV-2.

In healthcare facilities, the mainstay of IPC comprises administrative measures (such as triage and placement of patients), standard precautions (especially hand hygiene), appropriate use of personal protective equipment (PPE) and environmental measures (such as cleaning and ventilation).

Testing for the early detection of COVID-19, influenza and RSV cases facilitates both the management of patient admissions and appropriate room and bed allocation in accordance with IPC recommendations.

Universal screening, by testing all patients for SARS-CoV-2 on admission to the hospital irrespective of symptoms to reduce the risk of onward transmission from asymptomatic patients, has limited additional benefit. It may be considered during periods of high community transmission of SARS-CoV-2, in particular by targeting high-risk vulnerable groups (e.g. patients admitted to oncology, transplantation units, etc.) or in the event of emerging viruses with high impact (e.g. emerging SARS-CoV-2 variants with high morbidity and mortality).

Ideally, patients with confirmed respiratory viral infection, or probable respiratory viral infection with confirmatory test results pending, should be placed in a single room. If the number of cases exceeds the single-room capacity, patients with the same viral infection can be placed in the same room (cohorting). Patients with co-infections involving two (or more) respiratory viruses, immunocompromised patients, patients with pronounced symptoms and those requiring bedside procedures associated with a high risk of transmission should be prioritised for placement in single rooms.

During periods of high community transmission of respiratory viruses such as SARS-CoV-2, influenza and RSV, in addition to appropriate hand and respiratory hygiene, staff, visitors and patients in both primary and secondary healthcare settings should be advised to wear medical face masks (universal masking) in common areas of the hospital, patient rooms and other areas where patient care is provided.

Alternatively, during periods of high community transmission, healthcare workers in contact with patients should wear a medical face mask during all routine patient care (targeted clinical masking). Universal and targeted clinical masking can be discontinued when the period of high community transmission is over.

Decisions on implementation of universal or targeted clinical masking should take into account the expected benefit, as well as the burden on resources, staff, patients and visitors.

Healthcare facilities should ensure that PPE is available and appropriately used to safeguard staff providing patient care.

A risk assessment should be conducted to support appropriate selection of PPE. It is recommended that healthcare workers interacting with patients who have viral respiratory infections, without close proximity or long exposure to the patient, should wear a medical face mask, as a minimum. For prolonged contact in close proximity to the patient, including the performance of high-risk procedures, a well-fitted respirator (see ‘Definitions’) and eye protection are recommended. Gloves and a long-sleeve gown are recommended when there is a risk of exposure to body fluids and in settings where there is a high risk of exposure to respiratory viruses, such as when performing procedures with a high risk of transmission (also referred to as ‘aerosol-generating procedures’ - AGPs). If gloves and gowns are used, these should always be changed after contact with each individual patient.

In hospital rooms, it is recommended that floors should be cleaned regularly and that frequently-touched surfaces are disinfected using hospital disinfectants active against viruses. Ventilation is a key environmental measure for the prevention of respiratory viral infections in healthcare and other settings. The minimum number of air exchanges per hour, in accordance with national or hospital regulations, should be always ensured.

The decision to discontinue transmission-based precautions should be based on the time since symptom onset, the resolution of symptoms and other factors, such as the severity of disease, possible immunodeficiency and microbiological test results.

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N

ext week marks the last chance adults aged 49 and younger who have not yet received a full set of coronavirus vaccines can take up the offer of a booster.

The NHS has said Sunday February 12 will be the last day that people aged 16 to 49 can attend a vaccination site for a booster dose.

After this date, the booster jabs will only be offered to people considered to be at risk of serious illness, as recommended by the Joint Committee on Vaccination and Immunisation (JCVI).

The JCVI has also advised that the offer of initial vaccinations to healthy five to 49-year-olds should be withdrawn in 2023 in favour of a more targeted approach, but the Government has not yet made any announcement about future policy.

It has already advised that there should be another autumn vaccination campaign later this year, as well as a potential spring campaign for the most vulnerable.

There are 2,800 sites open across the country next week, with 391,000 appointments available before the programme scales down.

So far 15,000 people have booked a Covid vaccine for next week, the NHS said, after 17.3 million people had a booster jab over the winter.

Overall, 144.5 million coronavirus vaccine doses have been delivered across Britain since the start of the pandemic.

Health and Social Care Secretary Steve Barclay and the NHS director of vaccinations and screening, Steve Russell, urged people to take the final opportunity to get the booster jab.

Mr Russell said: “There is just one week left of the autumn booster campaign and so if you are eligible for a booster but have yet to take up your latest dose, please do so before the end of next week.

“Whether you have had previous doses or a bout of Covid, we know that a booster is the best way to maintain protection against serious illness from Covid for yourself and your loved ones, so please do make the most of the offer while it is available and give yourself both protection and peace of mind for the year ahead.”

Mr Barclay added: “Our hardworking NHS staff and volunteers have done an incredible job getting jabs into arms, and they’re on hand to top up your immunity and keep you and your loved ones protected.”

Coronavirus infections in the UK have dropped for a fourth week in a row, and are at a level last seen at the start of last autumn.

Infections are not falling across all age groups, with increases in England among primary and secondary school children and for 35 to 49-year-olds.

The recent drop in coronavirus patients in hospital has also come to a halt, as health experts said there were “concerning” signs the number may be starting to rise.

A total of 941,800 people in private households in the UK were likely to have had Covid-19 in the week ending January 24, down 15% from 1.1 million the previous week, according to the Office for National Statistics.

This is the lowest UK total since the week ending September 14 2022.

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As COVID-19 began to rip through California, hospitals were deluged with sickened patients. Medical staff struggled to manage the onslaught.

Amid the new threat of the coronavirus, an old one was also quietly on the rise: More people have suffered severe sepsis in California hospitals in recent years — including a troubling surge in patients who got sepsis inside the hospital itself, state data show.

Sepsis happens when the body tries to fight off an infection and ends up jeopardizing itself. Chemicals and proteins released by the body to combat an infection can injure healthy cells as well as infected ones and cause inflammation, leaky blood vessels and blood clots, according to the National Institutes of Health.

It is a perilous condition that can end up damaging tissues and triggering organ failure. Across the country, sepsis kills more people annually than breast cancer, HIV/AIDS and opioid overdoses combined, said Dr. Kedar Mate, president and chief executive of the Institute for Healthcare Improvement.

“Sepsis is a leading cause of death in hospitals. It’s been true for a long time — and it’s become even more true during the pandemic,” Mate said.

The bulk of sepsis cases begin outside hospitals, but people are also at risk of getting sepsis while hospitalized for other illnesses or medical procedures. And that danger grew during the pandemic, according to state data: In California, the number of “hospital-acquired” cases of severe sepsis rose more than 46% between 2019 and 2021.

Experts say the pandemic exacerbated a persistent threat for patients, faulting both the dangers of the coronavirus itself and the stresses that hospitals have faced during the pandemic. The rise in sepsis in California came as hospital-acquired infections increased across the country — a problem that worsened during surges in COVID-19 hospitalizations, researchers have found.

“This setback can and must be temporary,” said Lindsey Lastinger, a health scientist in the Centers for Disease Control and Prevention’s Division of Healthcare Quality Promotion.

Physicians describe sepsis as hard to spot and easy to treat in its earliest stages, but harder to treat by the time it becomes evident. It can show up in a range of ways, and detecting it is complicated by the fact that its symptoms — which can include confusion, shortness of breath, clammy skin and fever — are not unique to sepsis.

There’s no “gold standard test to say that you have sepsis or not,” said Dr. Santhi Kumar, interim chief of pulmonology, critical care and sleep medicine at Keck Medicine of USC. “It’s a constellation of symptoms.”

Christopher Lin, 28, endured excruciating pain and a broiling fever of 102.9 degrees at home before heading to the Kaiser Permanente Los Angeles Medical Center. It was October 2020, and the hospital looked “surreal,” Lin said, with a tent set up outside and chairs spaced sparsely in the waiting room.

His fever raised concerns about COVID-19, but Lin tested negative. At one point at the emergency department his blood pressure abruptly dropped, Lin said, and “it felt like my soul had left my body.”

Lin, who suffered sepsis in connection with a bacterial infection, isn’t sure where he first got infected. Days before he went to the hospital, he had undergone a quick procedure at urgent care to drain a painful abscess on his chest, and got the gauze changed by a nurse the following day, he said. Such outpatient procedures aren’t included in state data on hospital-acquired sepsis.

Someone with sepsis might have a high temperature or a low one, a heart rate that has sped or slowed, a breathing rate that is high or low.

It can result from bacteria, fungal infections, viruses or even parasites — “and the challenge is that when someone walks into the emergency department with a fever, we don’t know which of those four things they have,” said Dr. Karin Molander, an emergency medicine physician and past board chair of Sepsis Alliance. Treatment can vary depending on what is driving the infection that spurred sepsis, but antibiotics are common because many cases are tied to bacterial infections.

The pandemic piled on the risks: A coronavirus infection can itself lead to sepsis, and the virus also ushered more elderly and medically vulnerable people into hospitals who are at higher risk for the dangerous condition, experts said. Nearly 40% of severe sepsis patients who died in California hospitals in 2021 were diagnosed with COVID-19, according to state data. Some COVID-19 patients were hospitalized for weeks at a time, ramping up their risk of other complications that can lead to sepsis.

“The longer you’re in the hospital, the more things happen to you,” said Dr. Maita Kuvhenguhwa, an attending physician in infectious disease at MLK Community Healthcare. “You’re immobilized, so you have a risk of developing pressure ulcers” — not just on the backside, but potentially on the face under an oxygen device — “and the wound can get infected.”

“Lines, tubes, being here a long time — all put them at risk for infection,” Kuvhenguhwa said.

Experts said the pandemic may have also pulled away attention from other kinds of infection control, as staff were strained and hospital routines were disrupted. California, which is unusual nationwide in mandating minimum ratios for nurse staffing, allowed some hospitals to relax those requirements amid the pandemic.

Nurses juggling more patients might not check and clean patients’ mouths as often to help prevent bacterial infections, Kumar said. Mate said that hospitalized patients might not get their catheters changed as often amid staff shortages, which can increase the risk of urinary tract infections.

Hospitals might have brought in traveling nurses to help plug the gaps, but “if they don’t know the same systems, it’s going to be harder for them to follow the same processes” to deter infections, said Catherine Cohen, a policy researcher with the Rand Corp.

Armando Nahum, one of the founding members of Patients for Patient Safety U.S., said that pandemic restrictions on hospital visitors may have also worsened the problem, preventing family members from being able to spot that a relative was acting unusually and raise concerns.

Molander echoed that point, saying that it’s important for patients to have someone who knows them well and might be able to alert doctors, “My mom has dementia, but she’s normally very talkative.”

Sepsis has been a long-standing battle for hospitals: One-third of people who die in U.S. hospitals had sepsis during their hospitalization, according to research cited by the CDC. But Mate argued that sepsis deaths can be reduced significantly “with the right actions that we know how to take.”

In Pennsylvania and New Jersey, Jefferson Health began rolling out a new effort to combat sepsis in the fall of 2021, just before the initial Omicron wave began to hit hospitals.

Its system includes predictive modeling that uses information from electronic medical records to alert clinicians that someone might be suffering from sepsis. It also set up a “standardized workflow” for sepsis patients so that crucial steps such as prescribing antibiotics happen as quickly as possible, hospital officials said.

The goal was to lessen the mental burden on doctors and nurses pulled in many directions, said Dr. Patricia Henwood, its chief clinical officer. “Clinicians across the country are strained, and we don’t necessarily need better clinicians — we need better systems,” she said.

Jefferson Health credits the new system with helping to reduce deaths from severe sepsis by 15% in a year.

In New York state, uproar over the death of 12-year-old Rory Staunton led to new requirements for hospitals to adopt protocols to rapidly identify and treat sepsis and report data to the state. State officials said the effort saved more than 16,000 lives between 2015 and 2019, and researchers found greater reductions in sepsis deaths in New York than in states without such requirements.

If your child gets sick, he said, “you shouldn’t have to wonder if the hospital on the right has sepsis protocols and the one on the left doesn’t,” said Ciaran Staunton, who co-founded the organization End Sepsis after the death of his son. His group welcomed the news when federal agencies were recently directed to develop “hospital quality measures” for sepsis.

Such a move could face opposition. Robert Imhoff, president and chief executive of the Hospital Quality Institute — an affiliate of the California Hospital Assn. — contended that expanding the kind of requirements in effect in New York was unnecessary.

“I don’t think hospitals need to be mandated to provide safe, quality care,” Imhoff said.

State data show that severe sepsis — including cases originating both outside and inside hospitals — has been on the rise in California over the last decade, but Molander said the long-term increase may be tied to changes in reporting requirements that led to more cases being tracked. California has yet to release new data on severe sepsis acquired in hospitals last year, and is not expected to do so until this fall.

For Lin, surviving sepsis left him determined to make sure that the word gets out about sepsis — and not just in English. In the hospital, he had struggled to explain what was happening to his mother, who speaks Cantonese. After recovering, Lin worked with local officials to get materials from Sepsis Alliance translated into Chinese.

“I can’t imagine if it were my parents in the hospital,” he said, “going through what I was going through.”

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Biofourmis and Beacon Health System have partnered for an in-home monitoring program specifically meant for patients with complex chronic diseases, including chronic obstructive pulmonary disease (COPD), during their post-discharge period.

Patient-reported data will be automatically collected, analyzed, and presented in a continuously updated dashboard visible to clinicians. This remote monitoring program aims to reduce hospital readmissions, improve clinical outcomes, and expand care access.

Patients with congestive heart failure are also eligible to be enrolled in the program in the first year, which will be launched across Elkhart General Hospital and Memorial Hospital, two of Beacon’s largest hospitals. Based on early results, the program is expected to expand to larger patient populations with other health conditions.

“With the Biofourmis solution, our patients with congestive heart failure or COPD can be discharged home safely and will be monitored more closely to prevent the need for readmission,” Sam El-Dalati, MD, chief clinical officer at Beacon, said in a press release.

Recommended Reading

COPD breathing worse at night | COPD News Today | surveys illustration

Estimated 16 million people live with COPD in US

COPD is a chronic inflammatory disease of the lungs characterized by air flow blockage associated with long-term exposure to lung irritants, mainly cigarette smoke. It is estimated that 16 million Americans are living with COPD, a disease that leads to more than 650,000 hospitalizations per year. Statistics also indicate that 20% of patients diagnosed with COPD end up being readmitted to the hospital within 30 days of being discharged.

The remote patient monitoring program includes Biovitals, a Biofourmis advanced analytics platform, along with patient-facing digital tools, a clinician dashboard with a mobile interface, medical devices and equipment, logistics, and clinical services.

With the Biovitals Analytics Engine, patients are evaluated based on their own clinical baseline data. This helps Beacon providers to evaluate each patient’s trajectory on the dashboard, where they are notified of any significant changes.

The platform’s goal is to simplify healthcare and improve patient health, by providing in-home access to hospital-level services, virtual provider networks for remote care, and innovative clinical trials. This may help to prevent hospital readmissions and accelerate therapy development.

“The solution will enable us to remotely monitor patients’ conditions, respond to symptoms, assist with medications and even conduct telehealth visits. Together, these tools will help us ensure these patients transition to home safely following their hospitalizations,” said John Bruinsma, manager of care coordination at Beacon.

Beacon providers will receive remote support from Biofourmis’ multidisciplinary care team, which includes qualified physicians, nurses, care navigators, and respiratory technicians, who will assist with patient monitoring and interventions, mainly overnight and on weekends.

Recommended Reading

quality of life | COPD News Today | air pollution | aerial view of industrial smokestacks

“Leading, innovative health systems like Beacon understand that preventing readmissions and improving outcomes for patients with complex chronic conditions requires next-generation monitoring, patient education and proactive clinical interventions,” said Maulik Majmudar, MD, chief medical officer and co-founder of Biofourmis.

“Biofourmis is supporting Beacon’s important initiative by delivering a continuously updated view of each patient’s health along with actionable care insights and a skilled clinical team to yield better outcomes while expanding access to care by allowing patients to remain at home,” Majmudar said.

Over the next months, Beacon physicians and teams from several fields of specialty will work together to plan, develop, and launch the program. The monitoring program is being supported by funding Beacon obtained from the Coronavirus Aid, Relief, and Economic Security Act, which is part of the COVID-19 Telehealth Program.

Beacon is the largest local non-profit health system across northern Indiana and southwest lower Michigan, with 146 care sites, including eight hospitals with 1,240 beds, across seven counties. It has nearly 8,000 associates and more than 1,175 physicians and other providers who care for more than 4,000 patients a day.

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Company Logo

Company Logo

Global Disposable Protective Clothing Market

Global Disposable Protective Clothing Market

Global Disposable Protective Clothing Market

Dublin, Feb. 01, 2023 (GLOBE NEWSWIRE) -- The "Disposable Protective Clothing Market: Global Industry Trends, Share, Size, Growth, Opportunity and Forecast 2022-2027" report has been added to ResearchAndMarkets.com's offering.

The global disposable protective clothing market size reached US$ 3.32 Billion in 2021. Looking forward, the publisher expects the market to reach US$ 5.51 Billion by 2027, exhibiting a CAGR of 8.81% during 2021-2027.

Keeping in mind the uncertainties of COVID-19, we are continuously tracking and evaluating the direct as well as the indirect influence of the pandemic on different end use industries. These insights are included in the report as a major market contributor.

Disposable protective clothing refers to a personal protective equipment (PPE) product, which is designed and fabricated for protecting personnel from hazardous working environments and contaminants.

It includes lab coats, ballistic vests, and head, eye, body and breathing protection gears, which assists frontline workers and operators in obstructing the entry of physical, chemical, airborne, heat and biohazard matters.

This, in turn, aids in ensuring a higher rate of cleanliness, maintaining hygiene, and providing optimal safety to the workers at affordable prices.

Apart from this, disposable protective clothing is versatile, sustainable, and lightweight in nature, on account of which it is extensively used in different applications. At present, it is commercially available in polyethene, polyester, and polypropylene material types.

Disposable Protective Clothing Market Trends:

The rising need for effective respiratory and protective clothing across the healthcare sector for mitigating the spread of hospital acquired infections (HAIs) is primarily driving the disposable protective clothing market.

The product is also gaining huge popularity owing to the coronavirus disease (COVID-19) pandemic, which has intensified their adoption in the medical and food service industries to prevent the spread of the virus and meet the health and safety measures.

Additionally, the increasing instances of manual industrial accidents and injuries caused due to handling hazardous chemicals in the oil and gas and manufacturing sectors has prompted governments of different nations to undertake favorable initiatives for ensuring the safety of point of entries (POEs) and employers or employee at workplaces, which, in turn, is supporting the market growth.

In line with this, ongoing technological advancements, along with strategic collaborations between key players for introducing advanced disposable coveralls manufactured from microporous films, is acting as another growth-inducing factor. These materials assist in providing an excellent barrier against viruses, protozoans, and parasites, due to which it is extensively used for disease prevention purposes.

Competitive Landscape:

The competitive landscape of the industry has also been examined along with the profiles of the key players being 3M Company, Ansell Ltd., Asatex AG, Derekduck Industry Corp., Dragerwerk AG & Co. KGaA, DuPont de Nemours Inc., Honeywell International Inc., International Enviroguard, Kimberly-Clark Worldwide Inc. (Kimberly-Clark Corporation), Lakeland Industries Inc., Thermo Fisher Scientific and Uvex Winter Holding Gmbh & Co. Kg.

Key Questions Answered in This Report:

  • How has the global disposable protective clothing market performed so far and how will it perform in the coming years?

  • What has been the impact of COVID-19 on the global disposable protective clothing market?

  • What are the key regional markets?

  • What is the breakup of the market based on the material type?

  • What is the breakup of the market based on the application?

  • What is the breakup of the market based on the end use industry?

  • What are the various stages in the value chain of the industry?

  • What are the key driving factors and challenges in the industry?

  • What is the structure of the global disposable protective clothing market and who are the key players?

  • What is the degree of competition in the industry?

Report Attribute

Details

No. of Pages

121

Forecast Period

2021 - 2027

Estimated Market Value (USD) in 2021

$3.32 Billion

Forecasted Market Value (USD) by 2027

$5.51 Billion

Compound Annual Growth Rate

8.8%

Regions Covered

Global

Key Topics Covered:

1 Preface

2 Scope and Methodology

3 Executive Summary

4 Introduction
4.1 Overview
4.2 Key Industry Trends

5 Global Disposable Protective Clothing Market
5.1 Market Overview
5.2 Market Performance
5.3 Impact of COVID-19
5.4 Market Forecast

6 Market Breakup by Material Type
6.1 Polyethylene
6.1.1 Market Trends
6.1.2 Market Forecast
6.2 Polypropylene
6.2.1 Market Trends
6.2.2 Market Forecast
6.3 Polyester
6.3.1 Market Trends
6.3.2 Market Forecast
6.4 Others
6.4.1 Market Trends
6.4.2 Market Forecast

7 Market Breakup by Application
7.1 Thermal
7.1.1 Market Trends
7.1.2 Market Forecast
7.2 Mechanical
7.2.1 Market Trends
7.2.2 Market Forecast
7.3 Chemical
7.3.1 Market Trends
7.3.2 Market Forecast
7.4 Radiation
7.4.1 Market Trends
7.4.2 Market Forecast
7.5 Others
7.5.1 Market Trends
7.5.2 Market Forecast

8 Market Breakup by End Use Industry
8.1 Manufacturing
8.1.1 Market Trends
8.1.2 Market Forecast
8.2 Oil and Gas
8.2.1 Market Trends
8.2.2 Market Forecast
8.3 Healthcare
8.3.1 Market Trends
8.3.2 Market Forecast
8.4 Defense
8.4.1 Market Trends
8.4.2 Market Forecast
8.5 Others
8.5.1 Market Trends
8.5.2 Market Forecast

9 Market Breakup by Region

10 SWOT Analysis

11 Value Chain Analysis

12 Porters Five Forces Analysis

13 Price Analysis

14 Competitive Landscape
14.1 Market Structure
14.2 Key Players
14.3 Profiles of Key Players
14.3.1 3M Company
14.3.1.1 Company Overview
14.3.1.2 Product Portfolio
14.3.1.3 Financials
14.3.1.4 SWOT Analysis
14.3.2 Ansell Ltd.
14.3.2.1 Company Overview
14.3.2.2 Product Portfolio
14.3.2.3 Financials
14.3.2.4 SWOT Analysis
14.3.3 Asatex AG
14.3.3.1 Company Overview
14.3.3.2 Product Portfolio
14.3.4 Derekduck Industry Corp.
14.3.4.1 Company Overview
14.3.4.2 Product Portfolio
14.3.5 Dragerwerk AG & Co. KGaA
14.3.5.1 Company Overview
14.3.5.2 Product Portfolio
14.3.5.3 Financials
14.3.5.4 SWOT Analysis
14.3.6 DuPont de Nemours Inc.
14.3.6.1 Company Overview
14.3.6.2 Product Portfolio
14.3.6.3 Financials
14.3.6.4 SWOT Analysis
14.3.7 Honeywell International Inc.
14.3.7.1 Company Overview
14.3.7.2 Product Portfolio
14.3.7.3 Financials
14.3.7.4 SWOT Analysis
14.3.8 International Enviroguard
14.3.8.1 Company Overview
14.3.8.2 Product Portfolio
14.3.9 Kimberly-Clark Worldwide Inc. (Kimberly-Clark Corporation)
14.3.9.1 Company Overview
14.3.9.2 Product Portfolio
14.3.10 Lakeland Industries Inc.
14.3.10.1 Company Overview
14.3.10.2 Product Portfolio
14.3.10.3 Financials
14.3.11 Thermo Fisher Scientific
14.3.11.1 Company Overview
14.3.11.2 Product Portfolio
14.3.11.3 Financials
14.3.11.4 SWOT Analysis
14.3.12 Uvex Winter Holding Gmbh & Co. Kg
14.3.12.1 Company Overview
14.3.12.2 Product Portfolio

For more information about this report visit www.researchandmarkets.com/r/7mbkz5

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Consumer Medicine Information (CMI) summary

The full CMI on the next page has more details. If you are worried about receiving this vaccine,
speak to your doctor or pharmacist.

 

This vaccine is new or being used differently. Please report side effects. See the
full CMI for further details.

Why am I being given COMIRNATY Original/Omicron BA.4-5?

COMIRNATY Original/Omicron BA.4-5 is a vaccine given as a booster dose to prevent
coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus
2 (SARS-CoV-2) in individuals 12 years of age and older. COMIRNATY Original/Omicron
BA.4-5 contains the active ingredients tozinameran and famtozinameran. For more information,
see Section 1. Why am I being given COMIRNATY Original/Omicron BA.4-5? in the full CMI.

What should I know before I am given COMIRNATY Original/Omicron BA.4-5?

You should not be given COMIRNATY Original/Omicron BA.4-5 if you have had an allergic
reaction to any of the ingredients in the vaccine. See list at the end of the CMI.
Check with your doctor if you have had: a severe allergic reaction or breathing problems
after any other vaccine or after being given COMIRNATY in the past; fainted following
any needle injection; a severe illness or infection with high fever; a weakened immune
system or are on a medicine that affects your immune system; a bleeding disorder,
bruise easily or are on a blood thinning medicine. As with any vaccine, COMIRNATY
Original/Omicron BA.4-5 may not fully protect all those who receive it, and it is
not known how long you will be protected. Talk to your doctor if you have any other
medical conditions, take any other medicines, or are pregnant or plan to become pregnant
or are breastfeeding. This vaccine should not be given to children under 12 years.
For more information, see Section 2. What should I know before I am given COMIRNATY Original/Omicron BA.4-5? in the full CMI.

What if I am taking other medicines?

Tell your doctor or pharmacist if you are taking any other medicines, including any
medicines, vitamins or supplements that you buy without a prescription. Tell your
doctor or pharmacist if you have recently received any other vaccine. For more information,
see Section 3. What if I am taking other medicines? in the full CMI.

How will I be given COMIRNATY Original/Omicron BA.4-5?

COMIRNATY Original/Omicron BA.4-5 will be given as an injection into the muscle of
your upper arm by a doctor, nurse or pharmacist. You will be given one dose at least
3 months after the primary course. A doctor, nurse or pharmacist will observe you
for at least 15 minutes after being given the vaccine. COMIRNATY Original/Omicron
BA.4-5 is only given as booster doses. For primary vaccination, ask your doctor or
pharmacist. For more information, see Section 4. How will I be given COMIRNATY Original/Omicron BA.4-5? in the full CMI.

What should I know while being given COMIRNATY Original/Omicron BA.4-5?

Things you should know

An initial dose of COMIRNATY Original/Omicron BA.4-5 may be given as a booster at
least 3 months after the primary vaccination for people 12 years of age and older.

COMIRNATY Original/Omicron BA.4-5 may also be given to individuals 12 years of age
and older at least 3 months after a previous booster dose of any COVID 19 vaccine.

Driving or using machines

Be careful before you drive or use any machines or tools until you know how the vaccine
affects you. Some of the side effects of the vaccine may temporarily affect your ability
to drive or use machines.

Are there any side effects?

Very common side effects of COMIRNATY Original/Omicron BA.4-5 include pain/swelling
at injection site, tiredness, headache, muscle pain, chills, joint pain and fever.
For more information, including what to do if you have any side effects, see Section
6. Are there any side effects? in the full CMI.
This vaccine is subject to additional monitoring. This will allow quick identification
of new safety information. You can help by reporting any side effects you may get.
You can report side effects to your doctor, or directly at www.tga.gov.au/reporting-problems .

Active ingredients:
tozinameran and famtozinameran

This vaccine has provisional approval in Australia as a booster dose to prevent COVID-19 disease caused by SARS-CoV-2 virus
in individuals 12 years of age and older. This approval has been granted on the basis
of short term safety and efficacy data. Evidence of longer term efficacy and safety
from ongoing clinical trials and vaccination in the community continues to be gathered
and assessed.

Consumer Medicine Information (CMI)

This leaflet provides important information about using COMIRNATY Original/Omicron
BA.4-5. You should also speak to your doctor or pharmacist if you would like further information
or if you have any concerns or questions about receiving COMIRNATY Original/Omicron
BA.4-5.

Where to find information in this leaflet:

Why am I being given COMIRNATY Original/Omicron BA.4-5?

COMIRNATY Original/Omicron BA.4-5 contains the active ingredients tozinameran and
famtozinameran.
COMIRNATY Original/Omicron BA.4-5 is an mRNA (messenger ribonucleic acid) vaccine.

COMIRNATY Original/Omicron BA.4-5 is a vaccine given as a booster dose to prevent
COVID-19 disease caused by SARS-CoV-2 virus in individuals 12 years of age and older.

COMIRNATY Original/Omicron BA.4-5 is only given as booster doses. For primary vaccination,
ask your doctor or pharmacist.

COMIRNATY Original/Omicron BA.4-5 works by triggering your immune system to produce
antibodies and blood cells that work against the virus, to protect against COVID-19
disease.

What should I know before I am given COMIRNATY Original/Omicron BA.4-5?

Warnings

COMIRNATY Original/Omicron BA.4-5 should not be given:

1. if you are allergic to tozinameran, famtozinameran or any of the ingredients listed
at the end of this leaflet.

Check with your doctor if you have:

had a severe allergic reaction or breathing problems after any other vaccine or after
being given COMIRNATY in the past.

fainted following any needle injection.

a severe illness or infection with high fever. However, you can have your vaccination
if you have a mild fever or upper airway infection like a cold.

a weakened immune system, such as due to HIV infection or are on a medicine that affects
your immune system.

a bleeding disorder, bruise easily or are on a blood thinning medicine.

During treatment, you may be at risk of developing certain side effects. It is important
you understand these risks and how to monitor for them. See additional information
under Section 6. Are there any side effects?

Very rare cases of myocarditis (inflammation of the heart muscle) and pericarditis
(inflammation of the lining outside the heart) have been reported after vaccination
with COMIRNATY. The cases have mostly occurred within two weeks following vaccination,
more often after the second vaccination, and more often occurred in younger men. Following
vaccination, you should be alert to signs of myocarditis and pericarditis, such as
breathlessness, palpitations and chest pain, and seek immediate medical attention
should these occur.

You may develop a temporary, stress-related response associated with the process of
receiving your injection. This may include dizziness, fainting, sweating, increased
heart rate and/or anxiety. If you start to feel faint at any time during the process
of receiving your injection, let your doctor, nurse or pharmacist know and take actions
to avoid falling and injuring yourself, such as sitting or lying down.

As with any vaccine, COMIRNATY Original/Omicron BA.4-5 may not fully protect all those
who receive it, and it is not known how long you will be protected.

Pregnancy and breastfeeding

If you are pregnant or breast-feeding, think you may be pregnant or are planning to
have a baby, ask your doctor or pharmacist for advice before you receive this vaccine.

Children and adolescents

COMIRNATY Original/Omicron BA.4-5 should not be given to children under 12 years.

What if I am taking other medicines?

Tell your doctor or pharmacist if you are taking, have recently taken or might take
any other medicines, including any medicines, vitamins or supplements that you buy
without a prescription from your pharmacy, supermarket or health food shop.

Tell your doctor or pharmacist if you have recently received any other vaccine.

Check with your doctor or pharmacist if you are not sure about what medicines, vitamins
or supplements you are taking and if these affect, or are affected by, COMIRNATY

Original/Omicron BA.4-5.

How will I be given COMIRNATY Original/Omicron BA.4-5?

COMIRNATY Original/Omicron BA.4-5 will be given as an injection into the muscle of
your upper arm by a doctor, nurse or pharmacist.

An initial dose of COMIRNATY Original/Omicron BA.4-5 may be given as a booster at
least 3 months after the primary vaccination for people 12 years of age and older.

A doctor, nurse or pharmacist will observe you for at least 15 minutes after being
given COMIRNATY Original/Omicron BA.4-5.

COMIRNATY Original/Omicron BA.4-5 is only given as booster doses. For primary vaccination,
ask your doctor or pharmacist.

What should I know while being given COMIRNATY Original/Omicron BA.4-5?

Things you should know

An initial dose of COMIRNATY Original/Omicron BA.4-5 may be given as a booster at
least 3 months after the primary vaccination for people 12 years of age and older.

COMIRNATY Original/Omicron BA.4-5 may also be given to individuals 12 years of age
and older at least 3 months after a previous booster dose of any COVID 19 vaccine.

Driving or using machines

Be careful before you drive or use any machines or tools until you know how COMIRNATY
Original/Omicron BA.4-5 affects you.

Some of the side effects of COMIRNATY Original/Omicron BA.4-5 may temporarily affect
your ability to drive or use machines.

Storage of the vaccine

A doctor, nurse or pharmacist will prepare the injection for you before you are given
it.

Getting rid of any unwanted vaccine

A doctor, nurse or pharmacist will dispose of any unused vaccine.

Are there any side effects?

All medicines can have side effects. If you do experience any side effects, most of
them are minor and temporary. However, some side effects may need medical attention.

See the information below and, if you need to, ask your doctor or pharmacist if you
have any further questions about side effects.

Other side effects (frequency unknown)

Tell your doctor or pharmacist if you notice anything else that may be making you
feel unwell.

Other side effects not listed here may occur in some people.

Reporting side effects

After you have received medical advice for any side effects you experience, you can
report side effects to the Therapeutic Goods Administration online at www.tga.gov.au/reporting-problems . By reporting side effects, you can help provide more information on the safety of
this vaccine.

Product details

What COMIRNATY Original/Omicron BA.4-5 contains

Active ingredients

(main ingredients)

Tozinameran

Famtozinameran

Other ingredients

(inactive ingredients)

((4-hydroxybutyl)azanediyl) bis(hexane-6,1-diyl)bis(2-hexyldecanoate) (ALC-0315)

2-[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide (ALC-0159)

Distearoylphosphatidylcholine (DSPC)

Cholesterol

Sucrose

Trometamol

Trometamol hydrochloride

Water for injections

Do not receive this vaccine if you are allergic to any of these ingredients.

What COMIRNATY Original/Omicron BA.4-5 looks like

COMIRNATY Original/Omicron BA.4-5 is a white to off-white suspension.

COMIRNATY Original/Omicron BA.4-5 is provided in packs of 10 and 195 in multidose
clear glass vials with grey flip-off caps. Each dose is 0.3 mL and each vial contains
6 doses of vaccine (2.25 mL fill).

AUST R 400874.

Not all presentations may be available.

Who distributes COMIRNATY Original/Omicron BA.4-5

Pfizer Australia Pty Ltd

Sydney NSW

Toll Free Number: 1800 675 229

COMIRNATY® is a registered trademark of BioNTech SE. Used under license.

This leaflet was prepared in January 2023.

© Copyright

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COVID-19 is a potentially serious disease that can cause severe illness in some individuals. Therefore, people living with HIV, particularly those who are older or have lower CD4 counts, should take extra precautions to protect themselves from contracting SARS-CoV-2, the virus that causes the disease.

HIV destroys white blood cells that help fight infections. People with HIV, particularly those without appropriate strategies to control the virus, have an increased risk of developing all types of infections and serious illnesses if they contract SARS-CoV-2.

Scientists are still learning about the interaction between HIV and COVID-19. The current data suggest that coronavirus affects people with HIV differently. While not everyone will develop severe illness, the risk factors vary greatly, especially for people with coexisting conditions.

Continue reading to find out more about the relationship between COVID-19 and HIV.

If someone with HIV has yet to achieve viral suppression through antiretroviral treatment (ART), they may have a weakened immune system. This can mean an increased risk of developing opportunistic infections due to the following germs:

  • bacteria
  • parasites
  • fungi
  • viruses

Opportunistic infections occur when germs take advantage of issues with a person’s immune system, grow in numbers, and cause symptoms. Although opportunistic infections include viral infections, there is no clinical evidence that people with HIV are more likely to develop COVID-19 than those without HIV.

However, individuals with HIV are more likely to develop a severe, life threatening condition if they contract SARS-CoV-2. The risk is 38% greater than in people without HIV. This is the case with certain populations only, with the Centers for Disease Control and Prevention (CDC) highlighting that severe COVID-19 illness for those with HIV is more likely if they:

  • are older
  • have lower CD4 cell counts
  • have an ineffective HIV treatment regimen

COVID-19 symptoms are similar in people with or without HIV. They can include:

  • cough
  • fever
  • chills
  • breathing problems
  • fatigue
  • muscle aches
  • headache
  • loss of taste
  • loss of smell
  • sore throat
  • congestion or runny nose
  • nausea
  • vomiting

Coughing and fever are the most common symptoms of COVID-19.

People with HIV may have longer periods of fever, and it takes longer for the lungs to recover from the effects of COVID-19. This may be due to a delayed SARS-CoV-2-specific antibody response by the body’s immune system, which can slow the lung healing process.

The best way for people with HIV to protect themselves from COVID-19 is to practice preventive measures. These can include:

  • maintaining good hygiene, for example, handwashing regularly and thoroughly
  • avoiding large gatherings
  • wearing a cloth face mask while in public spaces
  • staying away from individuals with suspected or confirmed COVID-19

People should also stay up to date with COVID-19 vaccines. Experts recommend vaccines for everyone with HIV, regardless of their CD4 count or viral load. The number of necessary doses can depend on a person’s age and the vaccine type.

Are vaccine boosters necessary?

Everyone, including people with HIV, should receive a booster shot if they are eligible. The CDC recommends that everyone over the age of 5 years get one updated (bivalent) booster if it is more than 2 months since their last dose.

COVID-19 vaccines are safe for people living with HIV. There is no evidence that they interfere with ART or preexposure prophylaxis to prevent HIV.

If someone with HIV tests positive for COVID-19 or experiences any related symptoms, they should contact a doctor as soon as possible. They may be eligible for COVID-19 treatment or preventive medicines that can reduce the risk of severe illness.

Treatment must begin within the first few days of infection to be effective. It is important to note that some treatments can interfere with ART. However, doctors know of no interactions between ART and COVID-19 prevention medication, such as Evusheld.

People should also contact their doctor if they have had exposure to someone with COVID-19 or develop other symptoms related to their HIV.

Individuals with HIV need to remain up to date on all treatments, vaccinations, and preventive measures.

HIV affects the immune system and increases a person’s risk of infections. As yet, there is no clinical evidence that people with HIV have an increased risk of developing COVID-19 compared with those without HIV. However, they are more at risk of becoming seriously ill if they contract the virus.

Therefore, people with HIV must take extra precautions against COVID-19. These include regular handwashing, avoiding large gatherings, and wearing a face mask in public spaces. In addition, vaccines are available and recommended for everyone with HIV, regardless of their CD4 count or viral load.

If someone with HIV tests positive for COVID-19, they should contact a healthcare professional as soon as possible for treatment or preventive medication if eligible.

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click to enlarge Scientists are looking at what factors may play a role in making winter a sickening season. - Photo: Pixabay

Photo: Pixabay

Scientists are looking at what factors may play a role in making winter a sickening season.


When bitter winds blew and temperatures dropped, my grandmother would urge me to come inside. “You’ll catch your death of cold out there,” she’d say.

Sure, freezing to death is possible in frigid temperatures. But doctors and other health experts have long stressed that being cold won’t give you a cold. Still, winter is undisputedly cold-and-flu season. It’s also a period when COVID-19 spreads more.

But if the chill doesn’t matter, why does the spread of so many respiratory viruses peak during the season?

“I’ve spent the past 13 years looking into this question,” says Linsey Marr, a civil and environmental engineer at Virginia Tech in Blacksburg who studies viruses in the air. “The deeper we go, the more I realize we don’t know [and] the more there is to figure out.”

She and I are not alone.

“That wintertime seasonality has puzzled people for a very long time; thousands of years, to be honest,” says Jeffrey Shaman, an infectious diseases researcher who directs the Climate and Health Program at the Columbia University Mailman School of Public Health.

There is some evidence that winter’s shorter days may make people more susceptible to infection, he says. Less sunlight means people make less vitamin D, which is required for some immune responses. But that’s just one piece of the puzzle.

Scientists are also looking at what other factors may play a role in making winter a sickening season.

Illness may spread more inside

My grandma’s well-intentioned urging to come in from the cold may have instead increased the risk that I’d get sick.

Colds, influenza and respiratory syncytial virus, or RSV, are all illnesses that are more prevalent at certain times of year when people spend more time inside. That includes winter in temperate climates, where there are distinct seasons, and rainy seasons in tropical zones. COVID-19 also spreads more indoors than outside.

Those diseases are caused by viruses that are transmitted primarily through breathing in small droplets known as aerosols. That’s a change in thinking. Many scientists thought until very recently that such viruses were spread mainly by touching contaminated surfaces.

“When you’re outdoors, you’re in the ultimate well-ventilated space,” says David Fisman, an epidemiologist at the University of Toronto Dalla Lana School of Public Health. Viruses exhaled outside are diluted quickly with clean air.

But inside, aerosols and the viruses they contain can build up. “When you’re in a poorly ventilated space, the air you breathe in is often air that other people have breathed out,” he says.

Since viruses come along with that exhaled breath, “it makes a lot of sense that proximity to individuals who might be contagious would facilitate transmission,” Shaman says.

But there is more to the story, says Benjamin Bleier, a specialist for sinus and nasal disorders at Harvard Medical School.

“In modern society, we’re indoors all year round,” he says. To drive the seasonal pattern we see year after year, something else must be going on too to make people more susceptible to infection and increase the amount of virus circulating, he says.

Drier air can give some viruses a boost

Some viruses thrive in winter. But the reason why may not be so much about temperature, but humidity.

“There are some viruses that like it warm and wet and some viruses like it dry and cold,” says Donald Milton, an aerobiologist at the University of Maryland School of Public Health in College Park. For instance, rhinoviruses — one of the many types of viruses that cause colds — survive better when it is humid. Cases of rhinovirus infection typically peak in early fall, he says.

Marr and other researchers have found that viruses that surge in the winter, including influenza viruses and SARS-CoV-2 — the coronavirus that causes COVID-19 — survive best when the relative humidity in the air falls below about 40 percent.

Viruses aren’t usually floating around naked, Marr says. They are encased in droplets of fluid, such as saliva. Those droplets also have bits of mucus, proteins, salt and other substances in them. Those other components may determine if the virus survives drying.

When the humidity is higher, droplets dry slowly. Such slow drying kills viruses such as influenza A and SARS-CoV-2, Marr and colleagues reported July 27 in a preprint at bioRxiv.org. During slow drying, salt and other things that may harm the virus become more concentrated, although researchers still don’t fully understand what’s happening at the molecular scale to inactivate the virus.

But flash drying in parched air preserves those viruses. “If the air is very dry, the water quickly evaporates. Everything is dried down, and it’s almost like things are frozen in place,” Marr says.

How humidity affects airborne droplets

At low humidity levels, airborne droplets, or aerosols, dry quickly (left), preserving viruses under a feathery crystalline lattice, as this microscope image shows. At intermediate humidity levels, crystals form inside liquid droplets (middle), but those crystals may inactivate viruses, not preserve them. At high humidity levels (right), aerosols remain liquid, allowing viruses to survive better than at midlevel humidity.

click to enlarge At high humidity levels, aerosols remain liquid, allowing viruses to survive better than at midlevel humidity. - Photo: Janie French/Lakdawala Lab/Univ. of Pittsburg School of Medicine

Photo: Janie French/Lakdawala Lab/Univ. of Pittsburg School of Medicine

At high humidity levels, aerosols remain liquid, allowing viruses to survive better than at midlevel humidity.

Dryer, smaller aerosols are also more buoyant and may hang in the air longer, increasing the chance that someone will breathe them in, Fisman says.

What’s more, dry air can tear down some of people’s defenses against viruses. Studies in animals suggest that dry air can trigger death of some cells lining the airways. That could leave cracks where viruses can invade.

Mucus in the airways can trap viruses and help protect against infection. But breathing cold, dry air can also slow the system that usually moves mucus out of the body. That may give viruses time to break out of the mucus trap and invade cells, Fisman says.

Cold may harm our ability to fight off viruses

Being cold may not give you a cold, but it could make you more susceptible to catching one.

Normally, the immune system has a trick for warding off viruses, Bleier and colleagues recently discovered. Cells in the nose and elsewhere in the body are studded with surface proteins that can detect viruses. When one of these sensor proteins sees a virus coming, it signals the cell to release tiny bubbles called extracellular vesicles.

The bubbles work as a diversionary tactic, a bit like chaff being released from a military jet trying to avoid a heat-seeking missile, Bleier says. Viruses may go after the vesicles instead of infecting cells.

If a virus docks with one of the bubbles, it’s in for a surprise: Inside the vesicles are virus-killing bits of RNA called microRNAs. One of those microRNAs known as miR-17 could kill two types of rhinoviruses and a cold-causing coronavirus, the team reported Dec. 6 in the Journal of Allergy and Clinical Immunology.

How cold weather affects the immune system

The immune system has a diversionary tactic to keep viruses from infecting cells in the nose: When viruses (black and gray spheres) are detected, nasal cells release bubbles called extracellular vesicles (blue circles). These bubbles are studded with proteins (red, blue and black shapes on blue circles) that are normally found on the surface of nasal cells. Viruses may go after the bubbles instead of infecting cells. When temperatures in the nose drop below body temperature (right), cells release fewer bubbles, making it easier for viruses to find and infect nasal cells.

click to enlarge When temperatures in the nose drop below body temperature, it's easier for viruses to find and infect nasal cells. - Photo: D. Huang et al/Journal of Allergy and Clinical Immunology 2022; Adapted by E. Otwell

Photo: D. Huang et al/Journal of Allergy and Clinical Immunology 2022; Adapted by E. Otwell

When temperatures in the nose drop below body temperature, it's easier for viruses to find and infect nasal cells.

Researchers measured bubbles released from human nasal cells grown in lab dishes at 37° Celsius, our typical body temperature. Then the scientists lowered the thermostat to 32° C. Cells released about 42 percent fewer vesicles at the cooler temperature, the team found. What’s more, those vesicles carried fewer weapons. Vesicles can pack in about 24 percent more microRNA at body temperature than when it is cooler.

Three tips to bolster our immune system

I asked the experts what people can do to protect themselves from viruses in the winter. Some said using a humidifier might help raise moisture levels enough to slow the drying of virus-laden droplets, killing the viruses.

“Any increase in humidity should be beneficial,” says Shaman. “You get a lot of bang for your buck if you go from very dry to dry.”

But Milton doesn’t think it’s a good idea to pump a lot of moisture into a house when it is cold outside. “That humidity is going to find all of the cold spaces in your house and condense there,” creating a breeding ground for mold and rot, he says.

Instead, he advocates turning on kitchen and bathroom exhaust fans to increase ventilation and using HEPA filters or Corsi-Rosenthal boxes to filter unwanted viruses out of the air.

Bleier suggests wearing a mask. Not only can masks filter out viruses, but “our work suggests these masks have a second mechanism of action,” he says. “They keep a cushion of warm [moist] air in front of our noses, which could help bolster the immune system.”

This commentary was originally published in Science News and republished here with permission.

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SEOUL, South Korea (AP) — Russia’s embassy in North Korea says the country has eased stringent epidemic controls in capital Pyongyang that were placed during the past five days to slow the spread of respiratory illnesses.

North Korea has not officially acknowledged a lockdown in Pyongyang or a re-emergence of COVID-19 after leader Kim Jong Un declared a widely disputed victory over the coronavirus in August, but the Russian embassy’s Facebook posts have provided...

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SEOUL, South Korea (AP) — Russia’s embassy in North Korea says the country has eased stringent epidemic controls in capital Pyongyang that were placed during the past five days to slow the spread of respiratory illnesses.

North Korea has not officially acknowledged a lockdown in Pyongyang or a re-emergence of COVID-19 after leader Kim Jong Un declared a widely disputed victory over the coronavirus in August, but the Russian embassy’s Facebook posts have provided rare glimpses into the secretive country’s infectious disease controls.

The embassy posted a notice Monday issued by North Korea’s Foreign Ministry informing foreign diplomats that the “intensified anti-epidemic period” imposed in Pyongyang since Wednesday was lifted as of Monday.

Last week, the embassy said that North Korean health authorities required diplomatic missions to keep their employees indoors and also measure their temperatures four times a day and report the results to a hospital in Pyongyang. It said the North Korean measures were in response to an increase in “flu and other respiratory diseases,” but it didn’t mention the spread of COVID-19 or restrictions imposed on regular citizens.

Shortly before that post, NK News, a North Korea-focused news website, cited a North Korean government notice to report that health officials had imposed a five-day lockdown in Pyongyang in an effort to stem the spread of respiratory illnesses.

North Korea’s state media didn’t mention any preventive measures specifically tied to COVID-19 as it tightened restrictions in Pyongyang last week. But on Wednesday, the state-run Korean Central News Agency said North Korean health workers have “redoubled” their efforts to prevent the spread of infectious diseases and firmly maintain an “anti-epidemic atmosphere” throughout society to cope with the “daily-worsening world health crisis.”

“(Health workers) are directing primary efforts to consolidating the anti-epidemic barrier and intensifying the medical examination and disinfection to prevent the outbreak and spread of viral respiratory diseases including influenza,” the agency said. “They also make it a daily routine to measure temperatures and sterilize hands of the people in crowded places and ensure the accuracy of medical examination.”

Getting a read of North Korea’s virus situation is difficult as the country has been tightly shut since early 2020, with officials imposing strict border controls, banning tourists and aid workers and jetting out diplomats while scrambling to shield their poor health care system.

North Korea’s admission of a COVID-19 outbreak in May last year came after it spent 2 ½ years rejecting outside offers of vaccines and other help while steadfastly claiming that its socialist system was protecting its population from an “evil” virus that had killed millions elsewhere.

South Korea’s Unification Ministry, which handles inter-Korean affairs, said the number of foreign missions that are currently active in North Korea would be 10 or less, a list that includes the missions of China, Vietnam and Cuba along with the Russian embassy.

North Korean state media in recent weeks have stressed vigilance against a possible re-emergence of COVID-19. The official Rodong Sinmun newspaper, which previously described the anti-virus campaign as the “No. 1 priority” in national affairs, called for North Koreans to maintain a “sense of high crisis” Monday as COVID-19 continues to spread in neighboring countries.

Some analysts say North Korea could be taking preventive measures as it prepares to stage huge public events in Pyongyang — possibly as early as next week — to glorify Kim’s authoritarian leadership and the expansion of his nuclear weapons and missiles program.

Recent commercial satellite images indicated preparations for a massive military parade in Pyongyang, likely for the 75th founding anniversary of the Korean People’s Army that falls on Feb. 8 — an occasion Kim could potentially use to showcase his growing collection of nuclear-capable missiles.

Satellite images taken Friday indicated continuing parade practices at a training site in southeast Pyongyang despite the reported lockdown, according to 38 North, a website specializing in North Korea studies. But no activities were seen at Kim Il Sung Square in the central part of the city where the country usually hosts military parades, the report said.

Some outside experts linked North Korea’s 2022 COVID-19 outbreak to a massive military parade in April, where Kim vowed to accelerate the development of nuclear weapons and threatened to use them if provoked.

North Korea maintains it has had no confirmed COVID-19 cases since Aug. 10, when Kim used a major political conference to declare the country has eradicated the coronavirus, just three months after the country acknowledged an omicron outbreak.

While Kim claimed that the country’s purported success against the virus would be recognized as a global health miracle, experts believe North Korea has manipulated disclosures on its outbreak to help him maintain absolute control.

From May to August, North Korea reported about 4.8 million “fever cases” across its population of 26 million but only identified a fraction of them as COVID-19. Experts say the country’s official death toll of 74 is abnormally small, considering the country’s lack of public health tools.

North Korea has dubiously insisted that rival South Korea was responsible for its COVID-19 outbreak, saying that the virus was transported by anti-Pyongyang propaganda leaflets and other materials flown across the border by balloons launched by South Korean civilian activists. South Korea has dismissed such claims as unscientific and “ridiculous.”

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In a recent article published in Emerging Infectious Diseases, researchers examined the prevalence and predictors of long coronavirus disease (COVID) in a sample representing a Washington, DC University in the United States of America (USA).

Study: Postacute Sequelae of SARS-CoV-2 in University Setting. Image Credit: Ground Picture/Shutterstock
Study: Postacute Sequelae of SARS-CoV-2 in University Setting. Image Credit: Ground Picture/Shutterstock

Background

Studies have shown that one in three Americans experience long COVID or post-acute sequelae of COVID (PASC). They have persistent symptoms from 28 days to six months after acute SARS-CoV-2 infection. Patients with asymptomatic COVID-19 can also experience long COVID, and its symptoms fluctuate or relapse in many cases.

In addition, long COVID symptoms vary by sex, age, and initial disease severity. For instance, younger patients and women have reported more headaches, and anxiety/depression, while older patients experience cognitive deficits and breathing problems more often. Men tend to suffer more from pain in the muscles or joints.

A post-COVID-19 condition occurs in individuals usually three months from the onset of COVID-19 with symptoms that last for at least two months and cannot be explained by an alternative diagnosis.”

World Health Organization (WHO) working group

Long COVID could potentially be the 'next national health disaster.’ Yet, there is a  lack of studies investigating long COVID symptoms and predictors on a college campus. It is a unique population that is primarily young and healthy, and complications of long COVID could be detrimental to their academic learning and quality of life.

About the study

In the present study, researchers conducted this study between July 2021 and March 2022, i.e., over 18 months, in students, faculty, and staff of George Washington University. The study population comprised 1,338 COVID-19 cases, which the team followed up after 30 days of the initial COVID-19-positive test using electronic surveys with queries about long COVID.

They merged this data with the COVID-19 case investigation data compiled by the University Campus COVID-19 Support Team (CCST). They completed case investigations within 24 to 48 hours after a university member received a COVID-19-positive test result.

The team designed the long COVID survey as a telephone interview, and they recorded all survey responses on REDCap, an online application. It enquired about questions related to long COVID symptoms and its changes during pre- to post-isolation periods. They also provided additional resources to assist participants in filling out the survey in ~15–20 minutes.

Study findings

The study examined the prevalence of long COVID on a university campus, with primarily young and healthy adults, as 75.2% of participants had no preexisting health issues. The average age of the study participants was 23 years, and they had an average of four long COVID symptoms. Around 63% of these participants were female, and non-Hispanic White comprised 55.7% of the respondents. Only 26.6% of these respondents were staff members, while 73.4% were students.

Irrespective of initial symptoms, 36% of the COVID-19-affected study participants self-reported experiencing symptoms congruous with long COVID, with 92% having symptoms affecting their upper respiratory tract (e.g., cough & congestion). The other 51.2%, 51.1%, and 44.9% of the participants experienced headache, fatigue, and fever, respectively. Notably, each extra symptom self-reported during the initial infection increased the odds of reporting long COVID symptoms.

Further, the study results pointed out that non-recipients of COVID-19 vaccines and boosters were at higher risk for experiencing long COVID symptoms. In the study population, 29.9% had received the primary vaccination series when testing COVID-19-positive, while 41.5% had also received a booster vaccine. The study highlighted that it is crucial to adhere to published recommendations for receiving COVID-19 vaccines besides the need for routine short- and long-term follow-up of individuals testing COVID-19-positive.

Conclusions

The study findings could help universities strengthen the infrastructure and services devised to support the campus population experiencing long COVID-related health issues. Further, the university administration could also make referrals to enroll their affected population in rehabilitation services. It would help them restore their overall health to engage in classes and work with new enthusiasm. Universities may even adopt preventive measures, e.g., extended pandemic leave, given the long-term effects of PASC.

In this regard, future research should follow up with long COVID patients for five to 10 years after the first infection to gather in-depth insight into its effect(s) on young and healthy populations. Furthermore, research examining the COVID-19 vaccine booster(s) effects on PASC could also be vital.

To conclude, a better understanding of the long-term consequences of long COVID could help universities better support the staff members and students dealing with the condition in universities.

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Image Source: BruceBlaus – CC BY-SA 4.0

I need to vent, because we need better ventilation.

The World Health Organization now recommends masking “for anyone in a crowded, enclosed, or poorly ventilated space.”  But few of us know the quality of ventilation in our spaces.

Those who can afford it might use a portable CO2 monitor as a proxy for this, since the more people are exhaling in a poorly ventilated space, the higher the CO2 level rises, and the more of the air you breathe has already been in someone else’s lungs. For the same reason, some nations have instituted requirements for public CO2 monitoring. In Belgium, for instance, anything over 900 requires remediation.

Last week, I took a CO2 monitor to a dentist’s office.  When I arrived at 7am, the reading was in the 700s.  Two hours later,  the level had risen to over 1000.  That’s a lot of unventilated exhalation from me and other patients in the open-plan space.  No telling how high it climbed later in the day.

The uber-rich know that COVID-19 is not a cold ([*]) and that we need better ventilation to avoid catching it. You can tell they know this because they are providing good ventilation for their own spaces.  The hashtag #DavosSafe emerged after the discovery of the situation of at the 2023 meeting of the World Economic Forum, laid out in their three-page “Guidance on Health Measures.”   Participants were required to have a negative PCR test, without which their badges would be deactivated and their entry denied, and rapid tests were provided and encouraged.  In addition, they had high-quality ventilation systems, HEPA filters, and perhaps upper-room Ultraviolet germicidal irradiation (UVGI). The prevalence of sweaters in photos of the event also suggests a lot of open windows.  In addition, the Forum provided high-quality masks and required masking of those working there (as “servants“), though not for those badged participants in the meetings. Given the other precautions, universal masking would be less crucial, though it appears that many attendees did wear masks, which of course also helps keep any infectious exhalations out of the shared air.

The need for cleaner air is not news.  We’ve known for years that SARS-Cov-2 is airborne, and reporters have for years been pointing to the handy historical analogy of cholera in nineteenth-century London, where John Snow fathered the field of epidemiology by figuring out that the danger came from human waste in the drinking water. (@NeoliberalSnow on twitter is his satiric incarnation, “Ineffectively addressing preventable disease through deregulation and individualism.”). It wasn’t vaccines or treatment that reduced the disease’s toll: it was better sewer management through public works.  Still, I need to vent, and you need to vent.

Ventilation is about moving air: bringing fresh air into an enclosed area to replace stagnant or noxious air, or removing pollutants from the air (OED I.3), introducing new ideas or therapeutically expressing negative feelings (OED I.5.b), debating or bringing public awareness to a subject (OED II.7.a).   We need to push into the air our anger about what Beatrice Adler-Bolton and Arnie Vierkant have characterized as the state’s “extractive abandonment” of the population.  We need to bring greater public awareness to the issue, and debate how to make happen the solutions we know are materially possible.  And we need to physically clear the air.

So yeah, I have some negative feelings about the fact that US life expectancy has continued to decline precipitouslyand we still do not have universal health care.  I have some righteous indignation about the fact that although the President has stopped thinking about the pandemic he says is over, those around him continue to protect him from contagion with measures not extended to the plebs.  I have some ire about the injustice that while we can’t breathe (because of cops, climate, or covid), the rich are breathing easy.

In the US, the private school attended by the offspring of CDC Director Rochelle Walensky and White House Coronavirus Response Coordinator Ashish Jha has also had ventilation upgrades.   There are likely many other such cases of improved air quality for me (“me” of the governing and Professional Managerial Class) and not for thee (me, workers and lumpenfolk), but of course they are not widely advertised, not generally ventilated.

The rest of us have plenty of toxic things in our indoor air.  All that cooking with gas has generously given us NO2, benzene, and fine particulate matter, the last of which is also amply supplied by diesel fuel and the wildfires kindled by climate change.  Homes, schools, offices, and other spaces also offer mold, lead, radon, pesticides, PCBs, and other nastiness. Most of them can kill you, though SARS-Cov-2 might kill you faster than most of the others.

Last year, the White House held a “summit” on improving indoor air quality and launched a “challenge”  asking organizations to voluntarily improve indoor air quality, and calling attention to funds that school districts might (or might not) use to upgrade ventilation and filtration of air.

The summit ended up recommending that spaces achieve 4-6 changes of air per hour (ACH).  That is likely to be an improvement for many places, but inadequate to protect us from the ambient danger of unchecked SARS-Cov-2.  For places occupied by people with airborne infections –which, given the widespread dropping of mitigation measures in the race to pretend the pandemic is over, can now mean pretty much anywhere–the CDC recommends 6-12 ACH, and some studies suggest 12 ACH is minimal.

Clearly, big stockholders and CEOs want to keep the economy going.  They’ve funded campaigns to minimize the dangers of the disease and move the public back to pre-pandemic spending.   And it’s paid off for them in another enormous wealth transfer upward. They presumably also want to avoid panic and organized mass labor actions. But there’s money to be made in the new markets created by privatization.  And of course they don’t care about the social murder of the poor, or we in the US wouldn’t have the lethal  health care system we already live (and die) with. The plan to end the emergency declaration and move the public response to the private market has generated some public ire about the projected cost of vaccines, but the market for indoor air quality firms is looking great!

To be sure, the quality of the “solutions” we might be sold for cleaner air will likely continue to be left to the market, as well.  Early in the pandemic, organizations that tried to do the right thing by cleaning the air sometimes ended up being sold products that were ineffective and possibly dangerous, as suggested by the current lawsuit against GPS(Global Plasma Solutions).  That company, in turn, has sued whistleblower scientist Marwa Zaatari.   The EPA cautions against devices that produce ozone.

Even effective and safe technologies can raise legal problems.  One dining house at Harvard installed UVGIdevices, but, because their presence in one space implied the need for them elsewhere, they presumably opened the university to charges of negligence in not installing them campuswide, and so they were removed.

Meanwhile, we can  organize to oppose the end of the pandemic declaration and demand mandatory improvements in indoor air quality.  We can build safe and reliable Corsi-Rosenthal boxes (or just box fans with HEPA filters) and share them.  We can wear masks to protect ourselves and each other. We can take action to make sure our schoolsand workplaces have cleaner air.  And we can vent!

Notes.

[*] For anyone who has not heard the news, COVID-19 is a vascular disease that compromises the immune system; it increases the risk of heart,  brain, kidney, and other damage; repeat infections increase those risks; vaccination offers only partial protection; deaths are undercounted; and long covid affects 20-50% of those infected. Harms have, of course, especially affected those already vulnerable: racialized  communities, health-care and other front-line workers, poor people, those with disabilities, and so on. And the more it spreads, the more it mutates,  and the longer the pandemic lasts.

 



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Eleanor holding her rucksack, with visible air filter on the frontMatt Alexander/PA Wire

Eleanor hopes her rucksack will help people to "breathe better"

Eleanor is 12 years old, and has just created a solar-powered rucksack that filters polluted air.

She was inspired by her mum - who has asthma - to create something to help people breathe outside.

The rucksack was entered into the competition 'backpacks to the future' - and won!

Eleanor says the design is all about keeping her friends and family safe when out and about.

The 'breathe better backpack'

Eleanor facing away from camera, wearing rucksack. London background.Matt Alexander/PA Wire

The rucksack is designed to reduce the impact of air pollution

After Eleanor entered her rucksack in for the 'backpacks to the future' competition, she won, and was presented with her own special design.

The rucksack has a cool blue design - Eleanor's choice - and you can see the special air filter which sits in the front small pocket.

"My generation is really aware of pollution and we have lessons on it at school along with diseases spreading, and this is another reason I designed this, because it is getting much worse" she says.

Eleanor lives on a busy main road, and says she can taste the petrol when cars drive past. Through creating the rucksack, she wanted to make something that would make her daily walk safer not just for her, but her friends and family.

If just a few people start using it, it could be really good for the planet

Eleanor

Super-powered by solar

Blue rucksack with bubble pattern and air filter in front pocket section. Logo reads "Hype."Matt Alexander/PA Wire

Check out Eleanor's design - she said the blue colour and the bubbles are inspired by the breathing idea

The rucksack's impressive design doesn't just stop at air-filtering - it's also powered by green energy!

To make the filter work, the rucksack uses solar power and a dynamo. The dynamo converts mechanical energy into electric energy, which powers the bag.

Eleanor says that environmental activist Greta Thunberg is a big inspiration for her.

Eleanor's inspiration

Woman holding inhalerAnastassiya Bezhekeneva

Some of the symptoms of asthma can be relieved with an inhaler. Lots of people with asthma carry one around with them, or have one to use if they become unwell

As well as being aware of the air pollution she experiences when she walks to school, Eleanor also wanted to help her mum and her friends.

Her mum has asthma, and so do some of her friends, and during the coronavirus lockdown Eleanor became more aware of the worried they had about going outside.

She says they already have an air filter in their home to help with her mum's condition. She hopes these rucksacks will be useful not just for people with asthma like her mum, but also to help prevent future pandemics, by reducing how much people can become infected through the air.

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The first confirmed case of COVID-19, the disease caused by the novel coronavirus, was reported in Wuhan, China in December 2019. The patient, a 55-year-old man, was a resident of the city and worked at a seafood market, which was later identified as a "wet market" that sold live animals in addition to seafood.

The man initially sought medical treatment on December 1st for a fever, cough, and difficulty breathing. He was hospitalized and diagnosed with a viral pneumonia of unknown cause. As more cases of similar pneumonia began to surface in Wuhan, Chinese health officials began to suspect a new virus and identified the novel coronavirus as the cause of the outbreak.

The man's case was officially confirmed as the first case of COVID-19 on December 31st, 2019. He was discharged from the hospital on January 3rd, 2020, after recovering from the disease.

This case was the beginning of a pandemic that would eventually spread to every corner of the globe, leading to widespread illness and death, as well as significant disruptions to daily life and the global economy. The World Health Organization declared COVID-19 a pandemic on March 11th, 2020, and as of January 2021, more than 100 million cases have been confirmed worldwide.

The outbreak in Wuhan was traced back to the wet market where the first patient worked, and it was believed that the virus had jumped from an animal host to humans, possibly through contact with bats. The market was quickly closed, and strict measures were put in place to contain the spread of the virus.

The first patient's case serves as a reminder of the importance of swift and decisive action in the face of a potential pandemic. It also highlights the need for ongoing surveillance and research to better understand and respond to emerging infectious diseases.

As the first confirmed case of COVID-19, the 55-year-old patient from Wuhan played a significant role in the early identification and response to the outbreak. His case led to the rapid detection and isolation of additional cases, and ultimately the implementation of strict measures to contain the spread of the virus.

However, it is important to note that the first patient was not the first person to be infected with the virus. It is believed that the virus had been circulating in the community for several weeks, if not months, before it was identified. In fact, it is thought that the first cases of COVID-19 may have occurred as early as November 2019.

Additionally, the seafood market where the first patient worked was not the only source of the outbreak in Wuhan. The virus was also found to have spread through other means, including person-to-person transmission in the community.

The first patient's case also brought attention to the potential dangers of wet markets and the need for better regulation and oversight of these types of markets to prevent the spread of infectious diseases. It also led to increased scrutiny of the Chinese government's initial response to the outbreak, with accusations of a lack of transparency and delays in sharing information with the international community.

In conclusion, the first confirmed case of COVID-19 served as a crucial catalyst in the early detection and response to the pandemic. The patient's case and the outbreak in Wuhan highlighted the importance of swift action, ongoing surveillance, and international cooperation in managing a global health crisis.

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Many people who contract COVID-19 make a full recovery weeks after infection. But for those who don’t, the side effects can last months and even years. Last year it was reported that around two million Britons were living with post-Covid syndrome - more commonly known as long Covid.

She said: “Apart from the well-known symptoms such as fatigue, breathlessness, and brain fog, long Covid symptoms can also include pins and needles, dizziness, joint pain, tinnitus, earache, heart palpitations, skin rashes, as well as changes to smell and taste and loss of appetite and nausea.

“Some studies have also reported hair loss, headaches/migraines, muscle pains and coughing as long Covid symptoms.

“Changes in your menstrual cycle, diarrhoea and stomach pain are others.

“All of these symptoms can be debilitating and affect your daily life especially if you have multiple symptoms, and it can take weeks or months, or sometimes years to recover.”

DON'T MISS

Healthily ran a survey of 1,000 women with long Covid in 2022 in order to establish the prevalence of certain symptoms.

Of these women almost half (49 percent) said they experienced low sex drive as a result, and 60 percent said they were suffering from “disrupted” sleep.

The most common symptom was fatigue, which was reported by 76 percent of participants.

While 74.5 percent said it affected their periods, with this rising to 86.5 percent for women aged between 25 and 40.

READ MORE: Three drinks that can help you fall asleep and boost sleep quality - expert

Low mood and brain fog were also common symptoms, experienced by 66 and 50 percent respectively.

Worryingly though, half said they felt their problems were “not taken seriously” and 48 percent said this extended to medical professionals.

A further 65 percent said they were not offered any tests for long Covid.

Professor Baker warned that there is no one-size-fits all treatment for long Covid, but specific symptoms can be addressed by different treatments and therapies.

“For example, people with long COVID breathing problems can do specific breathing exercises or see a specialist lung physiotherapist for therapy,” she said.

“Those with brain fog may have to stick to an easy-to-follow daily routine, use memory aids, do brain exercises and ask family and friends for support.

“Often there is a sense of loss of control from coronavirus, so find ways you may regain control.”

If you think you have long Covid it is worth seeing your GP.



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WILMINGTON, Del. (AP) — Delaware Gov. John Carney has tested positive for COVID-19, the governor's office announced on Saturday.

Carney tested positive late Friday using an at-home antigen test after experiencing mild symptoms, according to a news release.

Carney, 66, said he's “feeling fine” and is isolating himself — following U.S. Centers for Disease Control and Prevention guidelines — and will work from home.

This marks Carney's second publicly announced bout with coronavirus in the past several months. He tested positive last May.

Carney is in second term as governor and thus barred by term limits from seeking reelection in 2024.

Copyright 2023 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed without permission.

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