User login
Bringing you the latest news, research and reviews, exclusive interviews, podcasts, quizzes, and more.
div[contains(@class, 'header__large-screen')]
div[contains(@class, 'read-next-article')]
div[contains(@class, 'nav-primary')]
nav[contains(@class, 'nav-primary')]
section[contains(@class, 'footer-nav-section-wrapper')]
footer[@id='footer']
div[contains(@class, 'main-prefix')]
section[contains(@class, 'nav-hidden')]
div[contains(@class, 'ce-card-content')]
nav[contains(@class, 'nav-ce-stack')]
Parent group warns of social media/eating disorders link
A parents’ advocacy group with more than 2.5 million members nationwide sent an advisory to its members on Jan. 11, warning that social media’s January onslaught of messages for dieting and weight loss may be particularly harmful to kids struggling with weight and body image.
The guidance from ParentsTogether noted that such messages can trigger eating disorders and body dysmorphia. But some are particularly dangerous.
A Wall Street Journal investigation recently found that TikTok is distributing videos of rapid-weight-loss competitions and ways to purge food.
According to the ParentsTogether advisory, the Wall Street Journal also found TikTok has sent thousands of videos to teen accounts with messages such as “how to eat only 300 calories a day” or ”how to hide not eating from parents.” The group says similar messages appear on other social media platforms children use daily.
The seasonal January barrage of ads comes on top of a pandemic trend of worsening eating disorder patterns in young people worldwide.
Amanda Kloer, an organizer of the campaign behind the advisory and mother of two teenagers, said in an interview: “We know that January is a particularly sensitive month for this because of the amount of ad spending the wellness industry does.
“We wanted parents to be aware that while these risks exist year round, if they have a kid who is at risk, who is struggling a bit, they should pay particular attention to what they’re seeing on social media in January.”
Ms. Kloer sets up accounts on different platforms to test the messages a teen might receive and says the algorithms ramp up the frequency and the severity of the content as interest by the user grows.
“It sends kids down an extremely dangerous rabbit hole,” she said.
Debra Katzman, MD, with the division of adolescent medicine, department of pediatrics, University of Toronto, wrote in the Journal of Adolescent Health: “The COVID-19 pandemic has had a severe impact on individuals with eating disorders. Since the onset of the COVID-19 pandemic, eating disorder experts from across the globe have observed a substantial increase in the number and severity of new and preexisting young people suffering with eating disorders compared to prior years.”
Contributors beyond social media include lockdowns that bring steady access to food, distancing from peers, anxiety over school closures, and lack of a steady routine.
Eleanor Benner, PsyD, with Children’s Hospital of Philadelphia, said in an interview that awareness is growing regarding the increase in eating disorders correlated with social media use.
Researchers and experts have acknowledged that social media use has increased and changed during the pandemic. Awareness is heightened as parents have been home with kids and noticing what kids are seeing online.
Dr. Benner, a psychologist for the eating disorder assessment and treatment program at CHOP, said platforms have made attempts to limit eating disorder content, but “the reality is that content producers can find ways around this, and unfortunately, we don’t know for whom exactly that content poses greatest risk of contributing to the onset of an eating disorder.”
The most important change for physicians and families to watch for is weight loss, Dr. Benner said.
“Weight loss or lack of weight in children and teenagers is not okay,” she said. “Kids and adolescents should be continually growing and gaining weight through their early 20s.”
Signs of trouble may include diet changes, rejections of favorite foods, and abnormal changes in physical activity, mood, and personality.
Dr. Benner said parents should feel empowered to share these changes with their pediatrician and request that the doctor not discuss weight in front of their children.
Parents should initiate conversations around what kids are seeing to help encourage critical questioning of social media content, Dr. Benner said.
“Parents can also promote body neutrality, the idea that bodies are neither good nor bad, that we don’t have to love our bodies, but acknowledge what they do for us and go about our lives without getting stuck on what they look or feel like,” she said.
Neutrality also extends to categorizing food, and Dr. Benner advised calling foods what they are – ice cream or broccoli, not “junk” or “healthy,” she said. “Food should not be a moral issue. Moralizing and labeling foods perpetuates diet culture and can contribute to shame and guilt around eating.”
ParentsTogether also called on social media platforms to:
- Remove extreme content and stop sending weight-loss material to kids’ accounts: Social media platforms should remove the most extreme and dangerous content such as promoting skin lightening, the group said.
- Create parental account settings. That way, parents can see what their kids see and initiate conversations about bodies and health.
- Feature diverse content creators. The group urges platforms to promote creators with diverse personal appearances and backgrounds and those who support body acceptance and self-love.
ParentsTogether had collected more than 2,700 signatures by Jan. 13 on an online petition asking Instagram and TikTok to “Stop pushing extreme weight loss and dieting on kids.”
Pinterest became the first major platform to prohibit all weight loss ads, according to its announcement in July 2021.
The platform announced, “It’s an expansion of our ad policies that have long prohibited body shaming and dangerous weight loss products or claims. We encourage others in the industry to do the same and acknowledge, once and for all, that there’s no such thing as one size fits all.”
Ms. Kloer and Dr. Benner report no relevant financial relationships.
A parents’ advocacy group with more than 2.5 million members nationwide sent an advisory to its members on Jan. 11, warning that social media’s January onslaught of messages for dieting and weight loss may be particularly harmful to kids struggling with weight and body image.
The guidance from ParentsTogether noted that such messages can trigger eating disorders and body dysmorphia. But some are particularly dangerous.
A Wall Street Journal investigation recently found that TikTok is distributing videos of rapid-weight-loss competitions and ways to purge food.
According to the ParentsTogether advisory, the Wall Street Journal also found TikTok has sent thousands of videos to teen accounts with messages such as “how to eat only 300 calories a day” or ”how to hide not eating from parents.” The group says similar messages appear on other social media platforms children use daily.
The seasonal January barrage of ads comes on top of a pandemic trend of worsening eating disorder patterns in young people worldwide.
Amanda Kloer, an organizer of the campaign behind the advisory and mother of two teenagers, said in an interview: “We know that January is a particularly sensitive month for this because of the amount of ad spending the wellness industry does.
“We wanted parents to be aware that while these risks exist year round, if they have a kid who is at risk, who is struggling a bit, they should pay particular attention to what they’re seeing on social media in January.”
Ms. Kloer sets up accounts on different platforms to test the messages a teen might receive and says the algorithms ramp up the frequency and the severity of the content as interest by the user grows.
“It sends kids down an extremely dangerous rabbit hole,” she said.
Debra Katzman, MD, with the division of adolescent medicine, department of pediatrics, University of Toronto, wrote in the Journal of Adolescent Health: “The COVID-19 pandemic has had a severe impact on individuals with eating disorders. Since the onset of the COVID-19 pandemic, eating disorder experts from across the globe have observed a substantial increase in the number and severity of new and preexisting young people suffering with eating disorders compared to prior years.”
Contributors beyond social media include lockdowns that bring steady access to food, distancing from peers, anxiety over school closures, and lack of a steady routine.
Eleanor Benner, PsyD, with Children’s Hospital of Philadelphia, said in an interview that awareness is growing regarding the increase in eating disorders correlated with social media use.
Researchers and experts have acknowledged that social media use has increased and changed during the pandemic. Awareness is heightened as parents have been home with kids and noticing what kids are seeing online.
Dr. Benner, a psychologist for the eating disorder assessment and treatment program at CHOP, said platforms have made attempts to limit eating disorder content, but “the reality is that content producers can find ways around this, and unfortunately, we don’t know for whom exactly that content poses greatest risk of contributing to the onset of an eating disorder.”
The most important change for physicians and families to watch for is weight loss, Dr. Benner said.
“Weight loss or lack of weight in children and teenagers is not okay,” she said. “Kids and adolescents should be continually growing and gaining weight through their early 20s.”
Signs of trouble may include diet changes, rejections of favorite foods, and abnormal changes in physical activity, mood, and personality.
Dr. Benner said parents should feel empowered to share these changes with their pediatrician and request that the doctor not discuss weight in front of their children.
Parents should initiate conversations around what kids are seeing to help encourage critical questioning of social media content, Dr. Benner said.
“Parents can also promote body neutrality, the idea that bodies are neither good nor bad, that we don’t have to love our bodies, but acknowledge what they do for us and go about our lives without getting stuck on what they look or feel like,” she said.
Neutrality also extends to categorizing food, and Dr. Benner advised calling foods what they are – ice cream or broccoli, not “junk” or “healthy,” she said. “Food should not be a moral issue. Moralizing and labeling foods perpetuates diet culture and can contribute to shame and guilt around eating.”
ParentsTogether also called on social media platforms to:
- Remove extreme content and stop sending weight-loss material to kids’ accounts: Social media platforms should remove the most extreme and dangerous content such as promoting skin lightening, the group said.
- Create parental account settings. That way, parents can see what their kids see and initiate conversations about bodies and health.
- Feature diverse content creators. The group urges platforms to promote creators with diverse personal appearances and backgrounds and those who support body acceptance and self-love.
ParentsTogether had collected more than 2,700 signatures by Jan. 13 on an online petition asking Instagram and TikTok to “Stop pushing extreme weight loss and dieting on kids.”
Pinterest became the first major platform to prohibit all weight loss ads, according to its announcement in July 2021.
The platform announced, “It’s an expansion of our ad policies that have long prohibited body shaming and dangerous weight loss products or claims. We encourage others in the industry to do the same and acknowledge, once and for all, that there’s no such thing as one size fits all.”
Ms. Kloer and Dr. Benner report no relevant financial relationships.
A parents’ advocacy group with more than 2.5 million members nationwide sent an advisory to its members on Jan. 11, warning that social media’s January onslaught of messages for dieting and weight loss may be particularly harmful to kids struggling with weight and body image.
The guidance from ParentsTogether noted that such messages can trigger eating disorders and body dysmorphia. But some are particularly dangerous.
A Wall Street Journal investigation recently found that TikTok is distributing videos of rapid-weight-loss competitions and ways to purge food.
According to the ParentsTogether advisory, the Wall Street Journal also found TikTok has sent thousands of videos to teen accounts with messages such as “how to eat only 300 calories a day” or ”how to hide not eating from parents.” The group says similar messages appear on other social media platforms children use daily.
The seasonal January barrage of ads comes on top of a pandemic trend of worsening eating disorder patterns in young people worldwide.
Amanda Kloer, an organizer of the campaign behind the advisory and mother of two teenagers, said in an interview: “We know that January is a particularly sensitive month for this because of the amount of ad spending the wellness industry does.
“We wanted parents to be aware that while these risks exist year round, if they have a kid who is at risk, who is struggling a bit, they should pay particular attention to what they’re seeing on social media in January.”
Ms. Kloer sets up accounts on different platforms to test the messages a teen might receive and says the algorithms ramp up the frequency and the severity of the content as interest by the user grows.
“It sends kids down an extremely dangerous rabbit hole,” she said.
Debra Katzman, MD, with the division of adolescent medicine, department of pediatrics, University of Toronto, wrote in the Journal of Adolescent Health: “The COVID-19 pandemic has had a severe impact on individuals with eating disorders. Since the onset of the COVID-19 pandemic, eating disorder experts from across the globe have observed a substantial increase in the number and severity of new and preexisting young people suffering with eating disorders compared to prior years.”
Contributors beyond social media include lockdowns that bring steady access to food, distancing from peers, anxiety over school closures, and lack of a steady routine.
Eleanor Benner, PsyD, with Children’s Hospital of Philadelphia, said in an interview that awareness is growing regarding the increase in eating disorders correlated with social media use.
Researchers and experts have acknowledged that social media use has increased and changed during the pandemic. Awareness is heightened as parents have been home with kids and noticing what kids are seeing online.
Dr. Benner, a psychologist for the eating disorder assessment and treatment program at CHOP, said platforms have made attempts to limit eating disorder content, but “the reality is that content producers can find ways around this, and unfortunately, we don’t know for whom exactly that content poses greatest risk of contributing to the onset of an eating disorder.”
The most important change for physicians and families to watch for is weight loss, Dr. Benner said.
“Weight loss or lack of weight in children and teenagers is not okay,” she said. “Kids and adolescents should be continually growing and gaining weight through their early 20s.”
Signs of trouble may include diet changes, rejections of favorite foods, and abnormal changes in physical activity, mood, and personality.
Dr. Benner said parents should feel empowered to share these changes with their pediatrician and request that the doctor not discuss weight in front of their children.
Parents should initiate conversations around what kids are seeing to help encourage critical questioning of social media content, Dr. Benner said.
“Parents can also promote body neutrality, the idea that bodies are neither good nor bad, that we don’t have to love our bodies, but acknowledge what they do for us and go about our lives without getting stuck on what they look or feel like,” she said.
Neutrality also extends to categorizing food, and Dr. Benner advised calling foods what they are – ice cream or broccoli, not “junk” or “healthy,” she said. “Food should not be a moral issue. Moralizing and labeling foods perpetuates diet culture and can contribute to shame and guilt around eating.”
ParentsTogether also called on social media platforms to:
- Remove extreme content and stop sending weight-loss material to kids’ accounts: Social media platforms should remove the most extreme and dangerous content such as promoting skin lightening, the group said.
- Create parental account settings. That way, parents can see what their kids see and initiate conversations about bodies and health.
- Feature diverse content creators. The group urges platforms to promote creators with diverse personal appearances and backgrounds and those who support body acceptance and self-love.
ParentsTogether had collected more than 2,700 signatures by Jan. 13 on an online petition asking Instagram and TikTok to “Stop pushing extreme weight loss and dieting on kids.”
Pinterest became the first major platform to prohibit all weight loss ads, according to its announcement in July 2021.
The platform announced, “It’s an expansion of our ad policies that have long prohibited body shaming and dangerous weight loss products or claims. We encourage others in the industry to do the same and acknowledge, once and for all, that there’s no such thing as one size fits all.”
Ms. Kloer and Dr. Benner report no relevant financial relationships.
Cardiac inflammation can be present after mild COVID infection
Myocardial inflammation is present in a small proportion of patients who have recovered from relatively mild cases of COVID-19 infection, a new study shows.
“Our findings suggest that even in patients who have had relatively mild cases of COVID-19, some will have inflammatory changes to the heart, and these changes can be present without any cardiac symptoms,” senior author, Paaladinesh Thavendiranathan, MD, University of Toronto, told this news organization.
“While our data suggest that this inflammation improves over time, and the outcomes seem positive, we don’t know if there will be any long-term consequences,” he added.
Noting that even a short period of inflammation in the heart may be associated with symptoms or arrhythmias in the longer term, Dr. Thavendiranathan said: “I would recommend that it is best to avoid getting the infection if there is any chance of heart inflammation.”
The study was published online in JAMA Cardiology on Jan. 12.
The authors explain that among patients hospitalized with COVID, early studies suggested that approximately one in four experience cardiovascular injury, defined as an elevation in troponin levels, which was associated with a 5- to 10-fold increase in the risk for death. But there is limited information on cardiac injury in patients who do not require hospitalization.
Although a broad range of abnormal myocardial tissue has been reported in several cardiac MRI studies of patients recovered from COVID infection, there is little understanding of persistent changes in myocardial metabolism in recovered patients, which is a potential concern, given that COVID-19 is associated with systemic inflammation during the acute illness, they say.
For the current study, the researchers examined myocardial inflammation measured using two different methods – cardiac MRI and fluorodeoxyglucose–positron emission tomography (FDG-PET) – in individuals who had recovered from COVID-19 infection and looked at how this related to changes in inflammatory blood markers.
Lead author Kate Hanneman, MD, also from the University of Toronto, explained that FDG-PET imaging is more sensitive than MRI in detecting active inflammation. “Inflammatory cells have a higher uptake of glucose, and FDG-PET imaging is used to look for metabolically active inflammatory tissue that takes up glucose. It gives complementary information to MRI. Cardiac MRI shows structural or functional changes, such as scarring or edema, whereas FDG-PET imaging directly measures metabolic activity related to inflammatory cells.”
The study involved 47 individuals, 51% female, with a mean age of 43 years, who had recently recovered from COVID-19 infection. Of these, the majority had had relatively mild COVID disease, with 85% not requiring hospitalization.
Cardiac imaging was performed a mean of 67 days after the diagnosis of COVID-19. At the time of imaging, 19 participants (40%) reported at least one cardiac symptom, including palpitations, chest pain, and shortness of breath.
Results showed that eight patients (17%) had focal FDG uptake on PET consistent with myocardial inflammation. Compared with those without FDG uptake, patients with focal FDG uptake had higher regional T2, T1, and extracellular volume (colocalizing with focal FDG uptake), higher prevalence of late gadolinium enhancement indicating fibrosis, lower left ventricular ejection fraction, worse global longitudinal and circumferential strain, and higher systemic inflammatory blood markers, including interleukin (IL)-6, IL- 8, an high-sensitivity C-reactive protein.
Of the 47 patients in the study, 13 had received at least one dose of a COVID-19 vaccine. There was no significant difference in the proportion of patients who were PET-positive among those who had received a COVID-19 vaccine and those who had not.
There was also no difference in inflammation in patients who had been hospitalized with COVID-19 and those who had managed their infection at home.
Among patients with focal FDG uptake, PET, MRI, and inflammatory blood markers improved at follow-up imaging performed a mean of 52 days after the first imaging. The authors say this suggests that these abnormalities were not related to pre-existing cardiovascular disease.
Of the eight patients with positive FDG-PET results, two did not show any MRI abnormalities. These two patients also had elevated inflammatory biomarkers. “PET is a more sensitive method of measuring cardiac inflammation, and our results show that these changes may not always translate into functional changes seen on MRI,” Dr. Thavendiranathan noted.
The only cardiac risk factor that was more common in participants with FDG uptake was hypertension. Although cardiac symptoms were nearly twice as common in participants with focal FDG uptake, this difference was not statistically significant.
“Given the growing number of survivors with similar symptoms, these interesting findings warrant further investigation,” the authors say.
Noting that FDG uptake correlated with elevations in systemic inflammatory biomarkers, the researchers suggest that “a more intense systemic inflammatory process may be contributing to cardiac inflammation and the consequential alteration to regional and global myocardial function in PET-positive participants.”
On repeat imaging 2 months later, all eight patients who showed FDG uptake showed improvement or resolution of inflammation without any treatment, although two patients still had some signs of inflammation. Blood biomarkers also improved on follow-up.
“This is encouraging information, but we need longer-term data to see if there are any long-term repercussions of this inflammation,” Dr. Hanneman said.
“Overall, the study findings suggest an imaging phenotype that is expected to have good prognosis. However, longer-term follow-up studies are required to understand the need for ongoing cardiac surveillance, relationship to cardiac symptoms, guidance for safe return to exercise and sports participation, and long-term cardiovascular disease risk,” the researchers state.
This study was funded by grants from the Joint Department of Medical Imaging Academic Incentive Fund, Peter Munk Cardiac Center Innovation Committee, and Ted Rogers Center for Heart Research. Dr. Hanneman reports personal fees from Sanofi Genzyme, Amicus, and Medscape outside the submitted work.
A version of this article first appeared on Medscape.com.
Myocardial inflammation is present in a small proportion of patients who have recovered from relatively mild cases of COVID-19 infection, a new study shows.
“Our findings suggest that even in patients who have had relatively mild cases of COVID-19, some will have inflammatory changes to the heart, and these changes can be present without any cardiac symptoms,” senior author, Paaladinesh Thavendiranathan, MD, University of Toronto, told this news organization.
“While our data suggest that this inflammation improves over time, and the outcomes seem positive, we don’t know if there will be any long-term consequences,” he added.
Noting that even a short period of inflammation in the heart may be associated with symptoms or arrhythmias in the longer term, Dr. Thavendiranathan said: “I would recommend that it is best to avoid getting the infection if there is any chance of heart inflammation.”
The study was published online in JAMA Cardiology on Jan. 12.
The authors explain that among patients hospitalized with COVID, early studies suggested that approximately one in four experience cardiovascular injury, defined as an elevation in troponin levels, which was associated with a 5- to 10-fold increase in the risk for death. But there is limited information on cardiac injury in patients who do not require hospitalization.
Although a broad range of abnormal myocardial tissue has been reported in several cardiac MRI studies of patients recovered from COVID infection, there is little understanding of persistent changes in myocardial metabolism in recovered patients, which is a potential concern, given that COVID-19 is associated with systemic inflammation during the acute illness, they say.
For the current study, the researchers examined myocardial inflammation measured using two different methods – cardiac MRI and fluorodeoxyglucose–positron emission tomography (FDG-PET) – in individuals who had recovered from COVID-19 infection and looked at how this related to changes in inflammatory blood markers.
Lead author Kate Hanneman, MD, also from the University of Toronto, explained that FDG-PET imaging is more sensitive than MRI in detecting active inflammation. “Inflammatory cells have a higher uptake of glucose, and FDG-PET imaging is used to look for metabolically active inflammatory tissue that takes up glucose. It gives complementary information to MRI. Cardiac MRI shows structural or functional changes, such as scarring or edema, whereas FDG-PET imaging directly measures metabolic activity related to inflammatory cells.”
The study involved 47 individuals, 51% female, with a mean age of 43 years, who had recently recovered from COVID-19 infection. Of these, the majority had had relatively mild COVID disease, with 85% not requiring hospitalization.
Cardiac imaging was performed a mean of 67 days after the diagnosis of COVID-19. At the time of imaging, 19 participants (40%) reported at least one cardiac symptom, including palpitations, chest pain, and shortness of breath.
Results showed that eight patients (17%) had focal FDG uptake on PET consistent with myocardial inflammation. Compared with those without FDG uptake, patients with focal FDG uptake had higher regional T2, T1, and extracellular volume (colocalizing with focal FDG uptake), higher prevalence of late gadolinium enhancement indicating fibrosis, lower left ventricular ejection fraction, worse global longitudinal and circumferential strain, and higher systemic inflammatory blood markers, including interleukin (IL)-6, IL- 8, an high-sensitivity C-reactive protein.
Of the 47 patients in the study, 13 had received at least one dose of a COVID-19 vaccine. There was no significant difference in the proportion of patients who were PET-positive among those who had received a COVID-19 vaccine and those who had not.
There was also no difference in inflammation in patients who had been hospitalized with COVID-19 and those who had managed their infection at home.
Among patients with focal FDG uptake, PET, MRI, and inflammatory blood markers improved at follow-up imaging performed a mean of 52 days after the first imaging. The authors say this suggests that these abnormalities were not related to pre-existing cardiovascular disease.
Of the eight patients with positive FDG-PET results, two did not show any MRI abnormalities. These two patients also had elevated inflammatory biomarkers. “PET is a more sensitive method of measuring cardiac inflammation, and our results show that these changes may not always translate into functional changes seen on MRI,” Dr. Thavendiranathan noted.
The only cardiac risk factor that was more common in participants with FDG uptake was hypertension. Although cardiac symptoms were nearly twice as common in participants with focal FDG uptake, this difference was not statistically significant.
“Given the growing number of survivors with similar symptoms, these interesting findings warrant further investigation,” the authors say.
Noting that FDG uptake correlated with elevations in systemic inflammatory biomarkers, the researchers suggest that “a more intense systemic inflammatory process may be contributing to cardiac inflammation and the consequential alteration to regional and global myocardial function in PET-positive participants.”
On repeat imaging 2 months later, all eight patients who showed FDG uptake showed improvement or resolution of inflammation without any treatment, although two patients still had some signs of inflammation. Blood biomarkers also improved on follow-up.
“This is encouraging information, but we need longer-term data to see if there are any long-term repercussions of this inflammation,” Dr. Hanneman said.
“Overall, the study findings suggest an imaging phenotype that is expected to have good prognosis. However, longer-term follow-up studies are required to understand the need for ongoing cardiac surveillance, relationship to cardiac symptoms, guidance for safe return to exercise and sports participation, and long-term cardiovascular disease risk,” the researchers state.
This study was funded by grants from the Joint Department of Medical Imaging Academic Incentive Fund, Peter Munk Cardiac Center Innovation Committee, and Ted Rogers Center for Heart Research. Dr. Hanneman reports personal fees from Sanofi Genzyme, Amicus, and Medscape outside the submitted work.
A version of this article first appeared on Medscape.com.
Myocardial inflammation is present in a small proportion of patients who have recovered from relatively mild cases of COVID-19 infection, a new study shows.
“Our findings suggest that even in patients who have had relatively mild cases of COVID-19, some will have inflammatory changes to the heart, and these changes can be present without any cardiac symptoms,” senior author, Paaladinesh Thavendiranathan, MD, University of Toronto, told this news organization.
“While our data suggest that this inflammation improves over time, and the outcomes seem positive, we don’t know if there will be any long-term consequences,” he added.
Noting that even a short period of inflammation in the heart may be associated with symptoms or arrhythmias in the longer term, Dr. Thavendiranathan said: “I would recommend that it is best to avoid getting the infection if there is any chance of heart inflammation.”
The study was published online in JAMA Cardiology on Jan. 12.
The authors explain that among patients hospitalized with COVID, early studies suggested that approximately one in four experience cardiovascular injury, defined as an elevation in troponin levels, which was associated with a 5- to 10-fold increase in the risk for death. But there is limited information on cardiac injury in patients who do not require hospitalization.
Although a broad range of abnormal myocardial tissue has been reported in several cardiac MRI studies of patients recovered from COVID infection, there is little understanding of persistent changes in myocardial metabolism in recovered patients, which is a potential concern, given that COVID-19 is associated with systemic inflammation during the acute illness, they say.
For the current study, the researchers examined myocardial inflammation measured using two different methods – cardiac MRI and fluorodeoxyglucose–positron emission tomography (FDG-PET) – in individuals who had recovered from COVID-19 infection and looked at how this related to changes in inflammatory blood markers.
Lead author Kate Hanneman, MD, also from the University of Toronto, explained that FDG-PET imaging is more sensitive than MRI in detecting active inflammation. “Inflammatory cells have a higher uptake of glucose, and FDG-PET imaging is used to look for metabolically active inflammatory tissue that takes up glucose. It gives complementary information to MRI. Cardiac MRI shows structural or functional changes, such as scarring or edema, whereas FDG-PET imaging directly measures metabolic activity related to inflammatory cells.”
The study involved 47 individuals, 51% female, with a mean age of 43 years, who had recently recovered from COVID-19 infection. Of these, the majority had had relatively mild COVID disease, with 85% not requiring hospitalization.
Cardiac imaging was performed a mean of 67 days after the diagnosis of COVID-19. At the time of imaging, 19 participants (40%) reported at least one cardiac symptom, including palpitations, chest pain, and shortness of breath.
Results showed that eight patients (17%) had focal FDG uptake on PET consistent with myocardial inflammation. Compared with those without FDG uptake, patients with focal FDG uptake had higher regional T2, T1, and extracellular volume (colocalizing with focal FDG uptake), higher prevalence of late gadolinium enhancement indicating fibrosis, lower left ventricular ejection fraction, worse global longitudinal and circumferential strain, and higher systemic inflammatory blood markers, including interleukin (IL)-6, IL- 8, an high-sensitivity C-reactive protein.
Of the 47 patients in the study, 13 had received at least one dose of a COVID-19 vaccine. There was no significant difference in the proportion of patients who were PET-positive among those who had received a COVID-19 vaccine and those who had not.
There was also no difference in inflammation in patients who had been hospitalized with COVID-19 and those who had managed their infection at home.
Among patients with focal FDG uptake, PET, MRI, and inflammatory blood markers improved at follow-up imaging performed a mean of 52 days after the first imaging. The authors say this suggests that these abnormalities were not related to pre-existing cardiovascular disease.
Of the eight patients with positive FDG-PET results, two did not show any MRI abnormalities. These two patients also had elevated inflammatory biomarkers. “PET is a more sensitive method of measuring cardiac inflammation, and our results show that these changes may not always translate into functional changes seen on MRI,” Dr. Thavendiranathan noted.
The only cardiac risk factor that was more common in participants with FDG uptake was hypertension. Although cardiac symptoms were nearly twice as common in participants with focal FDG uptake, this difference was not statistically significant.
“Given the growing number of survivors with similar symptoms, these interesting findings warrant further investigation,” the authors say.
Noting that FDG uptake correlated with elevations in systemic inflammatory biomarkers, the researchers suggest that “a more intense systemic inflammatory process may be contributing to cardiac inflammation and the consequential alteration to regional and global myocardial function in PET-positive participants.”
On repeat imaging 2 months later, all eight patients who showed FDG uptake showed improvement or resolution of inflammation without any treatment, although two patients still had some signs of inflammation. Blood biomarkers also improved on follow-up.
“This is encouraging information, but we need longer-term data to see if there are any long-term repercussions of this inflammation,” Dr. Hanneman said.
“Overall, the study findings suggest an imaging phenotype that is expected to have good prognosis. However, longer-term follow-up studies are required to understand the need for ongoing cardiac surveillance, relationship to cardiac symptoms, guidance for safe return to exercise and sports participation, and long-term cardiovascular disease risk,” the researchers state.
This study was funded by grants from the Joint Department of Medical Imaging Academic Incentive Fund, Peter Munk Cardiac Center Innovation Committee, and Ted Rogers Center for Heart Research. Dr. Hanneman reports personal fees from Sanofi Genzyme, Amicus, and Medscape outside the submitted work.
A version of this article first appeared on Medscape.com.
ACIP releases new dengue vaccine recommendations
The vaccine is only to be used for children aged 9-16 who live in endemic areas and who have evidence with a specific diagnostic test of prior dengue infection.
Dengue is a mosquito-borne virus found throughout the world, primarily in tropical or subtropical climates. Cases had steadily been increasing to 5.2 million in 2019, and the geographic distribution of cases is broadening with climate change and urbanization. About half of the world’s population is now at risk.
The dengue virus has four serotypes. The first infection may be mild or asymptomatic, but the second one can be life-threatening because of a phenomenon called antibody-dependent enhancement.
The lead author of the new recommendations is Gabriela Paz-Bailey, MD, PhD, division of vector-borne diseases, dengue branch, CDC. She told this news organization that, during the second infection, when there are “low levels of antibodies from that first infection, the antibodies help the virus get inside the cells. There the virus is not killed, and that results in increased viral load, and then that can result in more severe disease and the plasma leakage” syndrome, which can lead to shock, severe bleeding, and organ failure. The death rate for severe dengue is up to 13%.
Previous infection with Zika virus, common in the same areas where dengue is endemic, can also increase the risk for symptomatic and severe dengue for subsequent infections.
In the United States, Puerto Rico is the main focus of control efforts because 95% of domestic dengue cases originate there – almost 30,000 cases between 2010 and 2020, with 11,000 cases and 4,000 hospitalizations occurring in children between the ages of 10 and 19.
Because Aedes aegypti, the primary mosquito vector transmitting dengue, is resistant to all commonly used insecticides in Puerto Rico, preventive efforts have shifted from insecticides to vaccination.
Antibody tests prevaccination
The main concern with the Sanofi’s dengue vaccine is that it could act as an asymptomatic primary dengue infection, in effect priming the body for a severe reaction from antibody-dependent enhancement with a subsequent infection. That is why it’s critical that the vaccine only be given to children with evidence of prior disease.
Dr. Paz-Bailey said: “The CDC came up with recommendations of what the performance of the test used for prevaccination screening should be. And it was 98% specificity and 75% sensitivity. ... But no test by itself was found to have a specificity of 98%, and this is why we’re recommending the two-test algorithm,” in which two different assays are run off the same blood sample, drawn at a prevaccination visit.
If the child has evidence of prior dengue, they can proceed with vaccination to protect against recurrent infection. Dengvaxia is given as a series of three shots over 6 months. Vaccine efficacy is 82% – so not everyone is protected, and additionally, that protection declines over time.
There is concern that it will be difficult to achieve compliance with such a complex regimen. Dr. Paz-Bailey said, “But I think that the trust in vaccines that is highly prevalent for [Puerto] Rico and trusting the health care system, and sort of the importance that is assigned to dengue by providers and by parents because of previous outbreaks and previous experiences is going to help us.” She added, “I think that the COVID experience has been very revealing. And what we have learned is that Puerto Rico has a very strong health care system, a very strong network of vaccine providers. ... Coverage for COVID vaccine is higher than in other parts of the U.S.”
One of the interesting things about dengue is that the first infection can range from asymptomatic to life-threatening. The second infection is generally worse because of this antibody-dependent enhancement phenomenon. Eng Eong Ooi, MD, PhD, professor of microbiology and immunology, National University of Singapore, told this news organization, “After you have two infections, you seem to be protected quite well against the remaining two [serotypes]. The vaccine serves as another episode of infection in those who had prior dengue, so then any natural infections after the vaccination in the seropositive become like the outcome of a third or fourth infection.”
Vaccination alone will not solve dengue. Dr. Ooi said, “There’s not one method that would fully control dengue. You need both vaccines as well as control measures, whether it’s Wolbachia or something else. At the same time, I think we need antiviral drugs, because hitting this virus in just one part of its life cycle wouldn’t make a huge, lasting impact.” Dr. Ooi added that as “the spread of the virus and the population immunity drops, you’re actually now more vulnerable to dengue outbreaks when they do get introduced. So, suppressing transmission alone isn’t the answer. You also have to keep herd immunity levels high. So if we can reduce the virus transmission by controlling either mosquito population or transmission and at the same time vaccinate to keep the immunity levels high, then I think we have a chance of controlling dengue.”
Dr. Paz-Bailey concluded: “I do want to emphasize that we are excited about having these tools, because for years and years, we have had really limited options to prevent and control dengue. It’s an important addition to have the vaccine be approved to be used within the U.S., and it’s going to pave the road for future vaccines.”
Dr. Paz-Bailey and Dr. Ooi reported no relevant financial relationships.
A version of this article first appeared on Medscape.com.
The vaccine is only to be used for children aged 9-16 who live in endemic areas and who have evidence with a specific diagnostic test of prior dengue infection.
Dengue is a mosquito-borne virus found throughout the world, primarily in tropical or subtropical climates. Cases had steadily been increasing to 5.2 million in 2019, and the geographic distribution of cases is broadening with climate change and urbanization. About half of the world’s population is now at risk.
The dengue virus has four serotypes. The first infection may be mild or asymptomatic, but the second one can be life-threatening because of a phenomenon called antibody-dependent enhancement.
The lead author of the new recommendations is Gabriela Paz-Bailey, MD, PhD, division of vector-borne diseases, dengue branch, CDC. She told this news organization that, during the second infection, when there are “low levels of antibodies from that first infection, the antibodies help the virus get inside the cells. There the virus is not killed, and that results in increased viral load, and then that can result in more severe disease and the plasma leakage” syndrome, which can lead to shock, severe bleeding, and organ failure. The death rate for severe dengue is up to 13%.
Previous infection with Zika virus, common in the same areas where dengue is endemic, can also increase the risk for symptomatic and severe dengue for subsequent infections.
In the United States, Puerto Rico is the main focus of control efforts because 95% of domestic dengue cases originate there – almost 30,000 cases between 2010 and 2020, with 11,000 cases and 4,000 hospitalizations occurring in children between the ages of 10 and 19.
Because Aedes aegypti, the primary mosquito vector transmitting dengue, is resistant to all commonly used insecticides in Puerto Rico, preventive efforts have shifted from insecticides to vaccination.
Antibody tests prevaccination
The main concern with the Sanofi’s dengue vaccine is that it could act as an asymptomatic primary dengue infection, in effect priming the body for a severe reaction from antibody-dependent enhancement with a subsequent infection. That is why it’s critical that the vaccine only be given to children with evidence of prior disease.
Dr. Paz-Bailey said: “The CDC came up with recommendations of what the performance of the test used for prevaccination screening should be. And it was 98% specificity and 75% sensitivity. ... But no test by itself was found to have a specificity of 98%, and this is why we’re recommending the two-test algorithm,” in which two different assays are run off the same blood sample, drawn at a prevaccination visit.
If the child has evidence of prior dengue, they can proceed with vaccination to protect against recurrent infection. Dengvaxia is given as a series of three shots over 6 months. Vaccine efficacy is 82% – so not everyone is protected, and additionally, that protection declines over time.
There is concern that it will be difficult to achieve compliance with such a complex regimen. Dr. Paz-Bailey said, “But I think that the trust in vaccines that is highly prevalent for [Puerto] Rico and trusting the health care system, and sort of the importance that is assigned to dengue by providers and by parents because of previous outbreaks and previous experiences is going to help us.” She added, “I think that the COVID experience has been very revealing. And what we have learned is that Puerto Rico has a very strong health care system, a very strong network of vaccine providers. ... Coverage for COVID vaccine is higher than in other parts of the U.S.”
One of the interesting things about dengue is that the first infection can range from asymptomatic to life-threatening. The second infection is generally worse because of this antibody-dependent enhancement phenomenon. Eng Eong Ooi, MD, PhD, professor of microbiology and immunology, National University of Singapore, told this news organization, “After you have two infections, you seem to be protected quite well against the remaining two [serotypes]. The vaccine serves as another episode of infection in those who had prior dengue, so then any natural infections after the vaccination in the seropositive become like the outcome of a third or fourth infection.”
Vaccination alone will not solve dengue. Dr. Ooi said, “There’s not one method that would fully control dengue. You need both vaccines as well as control measures, whether it’s Wolbachia or something else. At the same time, I think we need antiviral drugs, because hitting this virus in just one part of its life cycle wouldn’t make a huge, lasting impact.” Dr. Ooi added that as “the spread of the virus and the population immunity drops, you’re actually now more vulnerable to dengue outbreaks when they do get introduced. So, suppressing transmission alone isn’t the answer. You also have to keep herd immunity levels high. So if we can reduce the virus transmission by controlling either mosquito population or transmission and at the same time vaccinate to keep the immunity levels high, then I think we have a chance of controlling dengue.”
Dr. Paz-Bailey concluded: “I do want to emphasize that we are excited about having these tools, because for years and years, we have had really limited options to prevent and control dengue. It’s an important addition to have the vaccine be approved to be used within the U.S., and it’s going to pave the road for future vaccines.”
Dr. Paz-Bailey and Dr. Ooi reported no relevant financial relationships.
A version of this article first appeared on Medscape.com.
The vaccine is only to be used for children aged 9-16 who live in endemic areas and who have evidence with a specific diagnostic test of prior dengue infection.
Dengue is a mosquito-borne virus found throughout the world, primarily in tropical or subtropical climates. Cases had steadily been increasing to 5.2 million in 2019, and the geographic distribution of cases is broadening with climate change and urbanization. About half of the world’s population is now at risk.
The dengue virus has four serotypes. The first infection may be mild or asymptomatic, but the second one can be life-threatening because of a phenomenon called antibody-dependent enhancement.
The lead author of the new recommendations is Gabriela Paz-Bailey, MD, PhD, division of vector-borne diseases, dengue branch, CDC. She told this news organization that, during the second infection, when there are “low levels of antibodies from that first infection, the antibodies help the virus get inside the cells. There the virus is not killed, and that results in increased viral load, and then that can result in more severe disease and the plasma leakage” syndrome, which can lead to shock, severe bleeding, and organ failure. The death rate for severe dengue is up to 13%.
Previous infection with Zika virus, common in the same areas where dengue is endemic, can also increase the risk for symptomatic and severe dengue for subsequent infections.
In the United States, Puerto Rico is the main focus of control efforts because 95% of domestic dengue cases originate there – almost 30,000 cases between 2010 and 2020, with 11,000 cases and 4,000 hospitalizations occurring in children between the ages of 10 and 19.
Because Aedes aegypti, the primary mosquito vector transmitting dengue, is resistant to all commonly used insecticides in Puerto Rico, preventive efforts have shifted from insecticides to vaccination.
Antibody tests prevaccination
The main concern with the Sanofi’s dengue vaccine is that it could act as an asymptomatic primary dengue infection, in effect priming the body for a severe reaction from antibody-dependent enhancement with a subsequent infection. That is why it’s critical that the vaccine only be given to children with evidence of prior disease.
Dr. Paz-Bailey said: “The CDC came up with recommendations of what the performance of the test used for prevaccination screening should be. And it was 98% specificity and 75% sensitivity. ... But no test by itself was found to have a specificity of 98%, and this is why we’re recommending the two-test algorithm,” in which two different assays are run off the same blood sample, drawn at a prevaccination visit.
If the child has evidence of prior dengue, they can proceed with vaccination to protect against recurrent infection. Dengvaxia is given as a series of three shots over 6 months. Vaccine efficacy is 82% – so not everyone is protected, and additionally, that protection declines over time.
There is concern that it will be difficult to achieve compliance with such a complex regimen. Dr. Paz-Bailey said, “But I think that the trust in vaccines that is highly prevalent for [Puerto] Rico and trusting the health care system, and sort of the importance that is assigned to dengue by providers and by parents because of previous outbreaks and previous experiences is going to help us.” She added, “I think that the COVID experience has been very revealing. And what we have learned is that Puerto Rico has a very strong health care system, a very strong network of vaccine providers. ... Coverage for COVID vaccine is higher than in other parts of the U.S.”
One of the interesting things about dengue is that the first infection can range from asymptomatic to life-threatening. The second infection is generally worse because of this antibody-dependent enhancement phenomenon. Eng Eong Ooi, MD, PhD, professor of microbiology and immunology, National University of Singapore, told this news organization, “After you have two infections, you seem to be protected quite well against the remaining two [serotypes]. The vaccine serves as another episode of infection in those who had prior dengue, so then any natural infections after the vaccination in the seropositive become like the outcome of a third or fourth infection.”
Vaccination alone will not solve dengue. Dr. Ooi said, “There’s not one method that would fully control dengue. You need both vaccines as well as control measures, whether it’s Wolbachia or something else. At the same time, I think we need antiviral drugs, because hitting this virus in just one part of its life cycle wouldn’t make a huge, lasting impact.” Dr. Ooi added that as “the spread of the virus and the population immunity drops, you’re actually now more vulnerable to dengue outbreaks when they do get introduced. So, suppressing transmission alone isn’t the answer. You also have to keep herd immunity levels high. So if we can reduce the virus transmission by controlling either mosquito population or transmission and at the same time vaccinate to keep the immunity levels high, then I think we have a chance of controlling dengue.”
Dr. Paz-Bailey concluded: “I do want to emphasize that we are excited about having these tools, because for years and years, we have had really limited options to prevent and control dengue. It’s an important addition to have the vaccine be approved to be used within the U.S., and it’s going to pave the road for future vaccines.”
Dr. Paz-Bailey and Dr. Ooi reported no relevant financial relationships.
A version of this article first appeared on Medscape.com.
FROM MMWR RECOMMENDATIONS AND REPORTS
Pregnancy diet linked to risk of obesity in child
A new study suggests that a healthy diet initiated by women before conception could lower the risk of obesity in the offspring.
Childhood obesity is a major public health concern in the United Kingdom, with nearly a quarter of children under 5 and more than a third of children starting secondary school being overweight or obese. Furthermore, childhood obesity is likely to persist in adulthood and have long-term health consequences.
Researchers at the University of Southampton (England) analyzed dietary data of 2,963 mother-child dyads identified from the U.K. Southampton Women’s Survey. Using the dietary data, each mother-child dyad was assigned combined diet quality score, based on which they were categorized into 5 groups: poor, poor-medium, medium, medium-better and best. Childhood adiposity was evaluated using dual-energy x-ray absorptiometry (DXA) and body mass index (BMI) z-scores.
The findings, published in the International Journal of Obesity, showed that mother-offspring diet quality trajectories were stable from preconception in mothers to age 8-9 years in the offspring. A poorer diet quality trajectory was linked to higher prepregnancy maternal BMI, lower maternal age at birth, lower educational levels, smoking, and multiparity.
After adjusting for confounders, a 1-category reduction in the dietary trajectory was associated with higher DXA percentage body fat (standard deviation, 0.08; 95% confidence interval, 0.01-0.15) and BMI z-score (SD, 0.08; 95% CI, 0.00-0.16) in the offspring aged 8-9 years.
Lead author Sarah Crozier, PhD, University of Southampton, said: “This research shows the importance of intervening at the earliest possible stage in a child’s life, in pregnancy or even before conception, to enable us to tackle it.” The authors believe that the preconception period serves as a crucial window to introduce favorable changes in the maternal dietary quality.
The research was funded by grants from the Medical Research Council, Project EarlyNutrition, and the European Union’s Seventh Framework and Horizon 2020 programs. The study also received support from National Institute for Health Research Southampton Biomedical Research Centre, the University of Southampton and University Hospital Southampton NHS Foundation Trust. The authors reported no competing interests.
A version of this article first appeared on Medscape UK.
A new study suggests that a healthy diet initiated by women before conception could lower the risk of obesity in the offspring.
Childhood obesity is a major public health concern in the United Kingdom, with nearly a quarter of children under 5 and more than a third of children starting secondary school being overweight or obese. Furthermore, childhood obesity is likely to persist in adulthood and have long-term health consequences.
Researchers at the University of Southampton (England) analyzed dietary data of 2,963 mother-child dyads identified from the U.K. Southampton Women’s Survey. Using the dietary data, each mother-child dyad was assigned combined diet quality score, based on which they were categorized into 5 groups: poor, poor-medium, medium, medium-better and best. Childhood adiposity was evaluated using dual-energy x-ray absorptiometry (DXA) and body mass index (BMI) z-scores.
The findings, published in the International Journal of Obesity, showed that mother-offspring diet quality trajectories were stable from preconception in mothers to age 8-9 years in the offspring. A poorer diet quality trajectory was linked to higher prepregnancy maternal BMI, lower maternal age at birth, lower educational levels, smoking, and multiparity.
After adjusting for confounders, a 1-category reduction in the dietary trajectory was associated with higher DXA percentage body fat (standard deviation, 0.08; 95% confidence interval, 0.01-0.15) and BMI z-score (SD, 0.08; 95% CI, 0.00-0.16) in the offspring aged 8-9 years.
Lead author Sarah Crozier, PhD, University of Southampton, said: “This research shows the importance of intervening at the earliest possible stage in a child’s life, in pregnancy or even before conception, to enable us to tackle it.” The authors believe that the preconception period serves as a crucial window to introduce favorable changes in the maternal dietary quality.
The research was funded by grants from the Medical Research Council, Project EarlyNutrition, and the European Union’s Seventh Framework and Horizon 2020 programs. The study also received support from National Institute for Health Research Southampton Biomedical Research Centre, the University of Southampton and University Hospital Southampton NHS Foundation Trust. The authors reported no competing interests.
A version of this article first appeared on Medscape UK.
A new study suggests that a healthy diet initiated by women before conception could lower the risk of obesity in the offspring.
Childhood obesity is a major public health concern in the United Kingdom, with nearly a quarter of children under 5 and more than a third of children starting secondary school being overweight or obese. Furthermore, childhood obesity is likely to persist in adulthood and have long-term health consequences.
Researchers at the University of Southampton (England) analyzed dietary data of 2,963 mother-child dyads identified from the U.K. Southampton Women’s Survey. Using the dietary data, each mother-child dyad was assigned combined diet quality score, based on which they were categorized into 5 groups: poor, poor-medium, medium, medium-better and best. Childhood adiposity was evaluated using dual-energy x-ray absorptiometry (DXA) and body mass index (BMI) z-scores.
The findings, published in the International Journal of Obesity, showed that mother-offspring diet quality trajectories were stable from preconception in mothers to age 8-9 years in the offspring. A poorer diet quality trajectory was linked to higher prepregnancy maternal BMI, lower maternal age at birth, lower educational levels, smoking, and multiparity.
After adjusting for confounders, a 1-category reduction in the dietary trajectory was associated with higher DXA percentage body fat (standard deviation, 0.08; 95% confidence interval, 0.01-0.15) and BMI z-score (SD, 0.08; 95% CI, 0.00-0.16) in the offspring aged 8-9 years.
Lead author Sarah Crozier, PhD, University of Southampton, said: “This research shows the importance of intervening at the earliest possible stage in a child’s life, in pregnancy or even before conception, to enable us to tackle it.” The authors believe that the preconception period serves as a crucial window to introduce favorable changes in the maternal dietary quality.
The research was funded by grants from the Medical Research Council, Project EarlyNutrition, and the European Union’s Seventh Framework and Horizon 2020 programs. The study also received support from National Institute for Health Research Southampton Biomedical Research Centre, the University of Southampton and University Hospital Southampton NHS Foundation Trust. The authors reported no competing interests.
A version of this article first appeared on Medscape UK.
FROM THE INTERNATIONAL JOURNAL OF OBESITY
CDC to update mask recommendations as Omicron spreads
Director Rochelle Walensky, MD, said on Jan. 12.
“We are preparing an update to the info on our mask website to best reflect the options that are available to people and the different levels of protection different masks provide, and we want to provide Americans the best and most updated information to choose what mask is going to be right for them,” she said at a White House news briefing.
While the higher-quality masks provide better protection, they can be uncomfortable to wear, expensive, and harder to find. That’s why Dr. Walensky added an important caveat.
“Any mask is better than no mask, and we do encourage all Americans to wear a well-fitting mask to protect themselves and prevent the spread of COVID-19. That recommendation is not going to change,” she said.
“Most importantly, the best mask that you wear is the one you will wear and the one you can keep on all day long and tolerate in public indoor settings.”
Meanwhile, the World Health Organization was more focused on vaccines.
WHO officials stressed on Jan. 12 that global vaccine distribution is first priority in defeating the highly contagious Omicron variant, as well as other variants that may evolve.
The WHO’s Technical Advisory Group on COVID-19 Vaccine Composition – a group of experts assessing how COVID-19 vaccines perform against Omicron and other emerging variants – says there is an “urgent need” for broader access to vaccines, along with reviewing and updating current vaccines as needed to ensure protection.
The WHO also disputed the idea that COVID-19 could become endemic in one largely vaccinated nation, while the rest of the world remains unprotected.
“It is up to us how this pandemic unfolds,” Maria Van Kerkhove, PhD, the WHO’s technical lead on COVID-19 response, said at a news briefing.
The WHO has a goal of vaccinating 70% of the population of every country by the middle of the year.
But right now, 90 countries have yet to reach 40% vaccination rates, and 36 of those countries have less than 10% of their populations vaccinated, according to WHO Director General Tedros Adhanom Ghebreyesus, PhD.
A staggering 85% of the African population has not received a first dose.
But progress is being made, Dr. Ghebreyesus said at the briefing.
The WHO said there were over 15 million COVID-19 cases reported last week – the most ever in a single week – and this is likely an underestimate.
The Omicron variant, first identified in South Africa 2 months ago and now found on all seven continents, is “rapidly replacing Delta in almost all countries,” Dr. Ghebreyesus said.
Dr. Walensky said this week’s U.S. daily average COVID-19 case count was 751,000, an increase of 47% from last week. The average daily hospital admissions this week is 19,800, an increase of 33%. Deaths are up 40%, reaching 1,600 per day.
But she also reported new data that supports other research showing Omicron may produce less severe disease. Kaiser Permanente Southern California released a study on Jan. 11 showing that, compared with Delta infections, Omicron was associated with a 53% reduction in hospitalizations, a 74% reduction in intensive care unit admissions, and a 91% lower risk of death.
In the study, no patients with Omicron required mechanical ventilation. The strain now accounts for 98% of cases nationwide.
But Dr. Walensky warned the lower disease severity is not enough to make up for the sheer number of cases that continue to overwhelm hospital systems.
“While we are seeing early evidence that Omicron is less severe than Delta and that those infected are less likely to require hospitalization, it’s important to note that Omicron continues to be much more transmissible than Delta,” she said. “The sudden rise in cases due to Omicron is resulting in unprecedented daily case counts, sickness, absenteeism, and strains on our health care system.”
A version of this article first appeared on WebMD.com.
Director Rochelle Walensky, MD, said on Jan. 12.
“We are preparing an update to the info on our mask website to best reflect the options that are available to people and the different levels of protection different masks provide, and we want to provide Americans the best and most updated information to choose what mask is going to be right for them,” she said at a White House news briefing.
While the higher-quality masks provide better protection, they can be uncomfortable to wear, expensive, and harder to find. That’s why Dr. Walensky added an important caveat.
“Any mask is better than no mask, and we do encourage all Americans to wear a well-fitting mask to protect themselves and prevent the spread of COVID-19. That recommendation is not going to change,” she said.
“Most importantly, the best mask that you wear is the one you will wear and the one you can keep on all day long and tolerate in public indoor settings.”
Meanwhile, the World Health Organization was more focused on vaccines.
WHO officials stressed on Jan. 12 that global vaccine distribution is first priority in defeating the highly contagious Omicron variant, as well as other variants that may evolve.
The WHO’s Technical Advisory Group on COVID-19 Vaccine Composition – a group of experts assessing how COVID-19 vaccines perform against Omicron and other emerging variants – says there is an “urgent need” for broader access to vaccines, along with reviewing and updating current vaccines as needed to ensure protection.
The WHO also disputed the idea that COVID-19 could become endemic in one largely vaccinated nation, while the rest of the world remains unprotected.
“It is up to us how this pandemic unfolds,” Maria Van Kerkhove, PhD, the WHO’s technical lead on COVID-19 response, said at a news briefing.
The WHO has a goal of vaccinating 70% of the population of every country by the middle of the year.
But right now, 90 countries have yet to reach 40% vaccination rates, and 36 of those countries have less than 10% of their populations vaccinated, according to WHO Director General Tedros Adhanom Ghebreyesus, PhD.
A staggering 85% of the African population has not received a first dose.
But progress is being made, Dr. Ghebreyesus said at the briefing.
The WHO said there were over 15 million COVID-19 cases reported last week – the most ever in a single week – and this is likely an underestimate.
The Omicron variant, first identified in South Africa 2 months ago and now found on all seven continents, is “rapidly replacing Delta in almost all countries,” Dr. Ghebreyesus said.
Dr. Walensky said this week’s U.S. daily average COVID-19 case count was 751,000, an increase of 47% from last week. The average daily hospital admissions this week is 19,800, an increase of 33%. Deaths are up 40%, reaching 1,600 per day.
But she also reported new data that supports other research showing Omicron may produce less severe disease. Kaiser Permanente Southern California released a study on Jan. 11 showing that, compared with Delta infections, Omicron was associated with a 53% reduction in hospitalizations, a 74% reduction in intensive care unit admissions, and a 91% lower risk of death.
In the study, no patients with Omicron required mechanical ventilation. The strain now accounts for 98% of cases nationwide.
But Dr. Walensky warned the lower disease severity is not enough to make up for the sheer number of cases that continue to overwhelm hospital systems.
“While we are seeing early evidence that Omicron is less severe than Delta and that those infected are less likely to require hospitalization, it’s important to note that Omicron continues to be much more transmissible than Delta,” she said. “The sudden rise in cases due to Omicron is resulting in unprecedented daily case counts, sickness, absenteeism, and strains on our health care system.”
A version of this article first appeared on WebMD.com.
Director Rochelle Walensky, MD, said on Jan. 12.
“We are preparing an update to the info on our mask website to best reflect the options that are available to people and the different levels of protection different masks provide, and we want to provide Americans the best and most updated information to choose what mask is going to be right for them,” she said at a White House news briefing.
While the higher-quality masks provide better protection, they can be uncomfortable to wear, expensive, and harder to find. That’s why Dr. Walensky added an important caveat.
“Any mask is better than no mask, and we do encourage all Americans to wear a well-fitting mask to protect themselves and prevent the spread of COVID-19. That recommendation is not going to change,” she said.
“Most importantly, the best mask that you wear is the one you will wear and the one you can keep on all day long and tolerate in public indoor settings.”
Meanwhile, the World Health Organization was more focused on vaccines.
WHO officials stressed on Jan. 12 that global vaccine distribution is first priority in defeating the highly contagious Omicron variant, as well as other variants that may evolve.
The WHO’s Technical Advisory Group on COVID-19 Vaccine Composition – a group of experts assessing how COVID-19 vaccines perform against Omicron and other emerging variants – says there is an “urgent need” for broader access to vaccines, along with reviewing and updating current vaccines as needed to ensure protection.
The WHO also disputed the idea that COVID-19 could become endemic in one largely vaccinated nation, while the rest of the world remains unprotected.
“It is up to us how this pandemic unfolds,” Maria Van Kerkhove, PhD, the WHO’s technical lead on COVID-19 response, said at a news briefing.
The WHO has a goal of vaccinating 70% of the population of every country by the middle of the year.
But right now, 90 countries have yet to reach 40% vaccination rates, and 36 of those countries have less than 10% of their populations vaccinated, according to WHO Director General Tedros Adhanom Ghebreyesus, PhD.
A staggering 85% of the African population has not received a first dose.
But progress is being made, Dr. Ghebreyesus said at the briefing.
The WHO said there were over 15 million COVID-19 cases reported last week – the most ever in a single week – and this is likely an underestimate.
The Omicron variant, first identified in South Africa 2 months ago and now found on all seven continents, is “rapidly replacing Delta in almost all countries,” Dr. Ghebreyesus said.
Dr. Walensky said this week’s U.S. daily average COVID-19 case count was 751,000, an increase of 47% from last week. The average daily hospital admissions this week is 19,800, an increase of 33%. Deaths are up 40%, reaching 1,600 per day.
But she also reported new data that supports other research showing Omicron may produce less severe disease. Kaiser Permanente Southern California released a study on Jan. 11 showing that, compared with Delta infections, Omicron was associated with a 53% reduction in hospitalizations, a 74% reduction in intensive care unit admissions, and a 91% lower risk of death.
In the study, no patients with Omicron required mechanical ventilation. The strain now accounts for 98% of cases nationwide.
But Dr. Walensky warned the lower disease severity is not enough to make up for the sheer number of cases that continue to overwhelm hospital systems.
“While we are seeing early evidence that Omicron is less severe than Delta and that those infected are less likely to require hospitalization, it’s important to note that Omicron continues to be much more transmissible than Delta,” she said. “The sudden rise in cases due to Omicron is resulting in unprecedented daily case counts, sickness, absenteeism, and strains on our health care system.”
A version of this article first appeared on WebMD.com.
Urine for a new vaccine alternative
Urine for a new vaccine alternative
Yep, you read that right: Another vaccine alternative. Urine sounds disgusting, but you’ve got to admit, it’s resourceful at least.
Christopher Key, the leader of a group of antivaxxers known as the “Vaccine Police,” is now claiming that you should do “urine therapy,” when means drinking your own pee to ward off COVID-19. According to My. Key, “tons and tons of research” shows the benefits of drinking urine to fight COVID-19, the Guardian reported.
He doesn’t seem like the best source of information, especially since he’s been arrested in the past for refusing to wear a mask in a store. Not wanting to wear a mask in a store doesn’t seem like much, but he also believes that those who administer the COVID-19 vaccine should be “executed” and he tried to impersonate a law official toattempt to arrest a Democratic governor for vaccine mandates.
The overwhelming amount of COVID-19 misinformation has been stressful, yet sometimes laugh-worthy. Urine is not the first “cure” and probably won’t be the last. If you heard something works in a sketchy group on Facebook, it’s probably safe to assume that it absolutely does not. Please don’t recycle your urine.
Vaccine or beer? You must now choose
As the COVID-19 pandemic drags on toward its third year, the large subset of the population who refuse to get vaccinated has proved nearly intractable. Governments have tried numerous incentives to boost vaccination rates, ranging from free beer to million dollar lotteries. Needless to say, beyond their ability to generate LOTME stories, these incentives have been less than effective.
As the frankly unfairly contagious Omicron variant makes it way through the world, our friends in the Great White North have decided enough is enough. If the carrot doesn’t work, the people of Quebec are going to get the stick. Starting on Jan. 18, vaccination cards will be required to enter stores that sell alcohol or cannabis, better known as the things that have gotten us all through this pandemic.
And you know what? Cutting off the booze supply seems to be working. Christian Dubé, Quebec’s health minister, said that the number of vaccination appointments had quadrupled in the new year, rising from 1,500 per day to 6,000 per day, according to the CTV News report. Now, those aren’t massive numbers, but this is big empty Canada we’re talking about, and the unvaccinated make up about 10% of Quebec’s population, so 6,000 a day is quite impressive.
Mr. Dubé added that additional nonessential businesses could be added to the restriction list in the coming weeks, but we’re not sure it’ll be necessary. Those middle-aged soccer moms will do anything to secure their daily merlot. Also, alcohol and cannabis nonessential? The LOTME staff is appalled and offended at this insinuation.
All I need is the polyester that I breathe
When you do laundry, you’re probably thinking more of how to get that ketchup stain out of your white shirt than the effect it has on the environment. Well, research shows it actually has some significance.
That significance comes in the form of microfibers, which are released from natural fabrics such as cotton and from synthetic fabrics such as polyester, which are also considered to be microplastics.
The microfibers that get released in the water when we wash clothes are filtered out eventually, but the dryer is the real culprit, according to a study in Environmental Science & Technology Letters. We’re talking a discharge of up to 120 million microfiber fragments directly into the air annually from just one dryer!
Dryers, they found, emitted between 1.4-40 times more microfibers than did washing machines in previous studies. And polyester fabrics produced more fragments when load sizes increased, while fragment production from cotton fabrics remained constant.
Recent findings suggest that inhaling these microfibers can cause lung inflammation, increase cancer risk, and induce asthma attacks. The authors of the current study suggested additional filtration should be done on dryer vents to reduce the amount of pollutants emitted into the air.
Who would have thought just drying your sheets could be such a dangerous act?
It’s always in the last place you look
At least a million times every morning in this country, a million children yell something like this as they get ready for school: “Mom, have you seen my ...?”
Well, thanks to Defector.com, now we know what Mom should yell back: “Look in your weird cousin Mortimer!”
We will explain ... again.
When they’re not dealing with COVID-19, the folks who work in emergency departments spend a lot of their time removing things that are stuck in people’s bodily orifices. The U.S. Consumer Product Safety Commission even keeps track of them.
So if you’re looking for the number 8 button from the TV remote, or maybe a bullet, check Mortimer’s nose. Maybe you’re missing a lollipop, a hairpin, or some espresso beans. Mortimer’s friend Beulah might have put them in her ear.
Has an earbud gone missing? Another friend of Mortimer’s went to the ED with something stuck in his throat and said that he had a “pill in one hand and his earbud in the other hand, got distracted and took the earbud instead.” Yes, that is an actual quote (via Defector) from the CPSC database.
What about that old saying that someone’s lost his marbles? Well, the ED found one of Mortimer’s marbles ... in his penis. Also a spork, and a bread twist tie, and a chopstick. No, not all at the same time. As for Beulah, a barbell and a Spider-Man action figure somehow found their way – not at the same time, thank goodness – into her vagina.
And have you ever heard someone say that they’re “not going to stand for this”? Mortimer has, so he sat down ... on a light bulb, and a rolling pin, and a billiard ball. Yup, the ED had to remove these items from his rectum.
But not all at the same time, thank goodness.
Urine for a new vaccine alternative
Yep, you read that right: Another vaccine alternative. Urine sounds disgusting, but you’ve got to admit, it’s resourceful at least.
Christopher Key, the leader of a group of antivaxxers known as the “Vaccine Police,” is now claiming that you should do “urine therapy,” when means drinking your own pee to ward off COVID-19. According to My. Key, “tons and tons of research” shows the benefits of drinking urine to fight COVID-19, the Guardian reported.
He doesn’t seem like the best source of information, especially since he’s been arrested in the past for refusing to wear a mask in a store. Not wanting to wear a mask in a store doesn’t seem like much, but he also believes that those who administer the COVID-19 vaccine should be “executed” and he tried to impersonate a law official toattempt to arrest a Democratic governor for vaccine mandates.
The overwhelming amount of COVID-19 misinformation has been stressful, yet sometimes laugh-worthy. Urine is not the first “cure” and probably won’t be the last. If you heard something works in a sketchy group on Facebook, it’s probably safe to assume that it absolutely does not. Please don’t recycle your urine.
Vaccine or beer? You must now choose
As the COVID-19 pandemic drags on toward its third year, the large subset of the population who refuse to get vaccinated has proved nearly intractable. Governments have tried numerous incentives to boost vaccination rates, ranging from free beer to million dollar lotteries. Needless to say, beyond their ability to generate LOTME stories, these incentives have been less than effective.
As the frankly unfairly contagious Omicron variant makes it way through the world, our friends in the Great White North have decided enough is enough. If the carrot doesn’t work, the people of Quebec are going to get the stick. Starting on Jan. 18, vaccination cards will be required to enter stores that sell alcohol or cannabis, better known as the things that have gotten us all through this pandemic.
And you know what? Cutting off the booze supply seems to be working. Christian Dubé, Quebec’s health minister, said that the number of vaccination appointments had quadrupled in the new year, rising from 1,500 per day to 6,000 per day, according to the CTV News report. Now, those aren’t massive numbers, but this is big empty Canada we’re talking about, and the unvaccinated make up about 10% of Quebec’s population, so 6,000 a day is quite impressive.
Mr. Dubé added that additional nonessential businesses could be added to the restriction list in the coming weeks, but we’re not sure it’ll be necessary. Those middle-aged soccer moms will do anything to secure their daily merlot. Also, alcohol and cannabis nonessential? The LOTME staff is appalled and offended at this insinuation.
All I need is the polyester that I breathe
When you do laundry, you’re probably thinking more of how to get that ketchup stain out of your white shirt than the effect it has on the environment. Well, research shows it actually has some significance.
That significance comes in the form of microfibers, which are released from natural fabrics such as cotton and from synthetic fabrics such as polyester, which are also considered to be microplastics.
The microfibers that get released in the water when we wash clothes are filtered out eventually, but the dryer is the real culprit, according to a study in Environmental Science & Technology Letters. We’re talking a discharge of up to 120 million microfiber fragments directly into the air annually from just one dryer!
Dryers, they found, emitted between 1.4-40 times more microfibers than did washing machines in previous studies. And polyester fabrics produced more fragments when load sizes increased, while fragment production from cotton fabrics remained constant.
Recent findings suggest that inhaling these microfibers can cause lung inflammation, increase cancer risk, and induce asthma attacks. The authors of the current study suggested additional filtration should be done on dryer vents to reduce the amount of pollutants emitted into the air.
Who would have thought just drying your sheets could be such a dangerous act?
It’s always in the last place you look
At least a million times every morning in this country, a million children yell something like this as they get ready for school: “Mom, have you seen my ...?”
Well, thanks to Defector.com, now we know what Mom should yell back: “Look in your weird cousin Mortimer!”
We will explain ... again.
When they’re not dealing with COVID-19, the folks who work in emergency departments spend a lot of their time removing things that are stuck in people’s bodily orifices. The U.S. Consumer Product Safety Commission even keeps track of them.
So if you’re looking for the number 8 button from the TV remote, or maybe a bullet, check Mortimer’s nose. Maybe you’re missing a lollipop, a hairpin, or some espresso beans. Mortimer’s friend Beulah might have put them in her ear.
Has an earbud gone missing? Another friend of Mortimer’s went to the ED with something stuck in his throat and said that he had a “pill in one hand and his earbud in the other hand, got distracted and took the earbud instead.” Yes, that is an actual quote (via Defector) from the CPSC database.
What about that old saying that someone’s lost his marbles? Well, the ED found one of Mortimer’s marbles ... in his penis. Also a spork, and a bread twist tie, and a chopstick. No, not all at the same time. As for Beulah, a barbell and a Spider-Man action figure somehow found their way – not at the same time, thank goodness – into her vagina.
And have you ever heard someone say that they’re “not going to stand for this”? Mortimer has, so he sat down ... on a light bulb, and a rolling pin, and a billiard ball. Yup, the ED had to remove these items from his rectum.
But not all at the same time, thank goodness.
Urine for a new vaccine alternative
Yep, you read that right: Another vaccine alternative. Urine sounds disgusting, but you’ve got to admit, it’s resourceful at least.
Christopher Key, the leader of a group of antivaxxers known as the “Vaccine Police,” is now claiming that you should do “urine therapy,” when means drinking your own pee to ward off COVID-19. According to My. Key, “tons and tons of research” shows the benefits of drinking urine to fight COVID-19, the Guardian reported.
He doesn’t seem like the best source of information, especially since he’s been arrested in the past for refusing to wear a mask in a store. Not wanting to wear a mask in a store doesn’t seem like much, but he also believes that those who administer the COVID-19 vaccine should be “executed” and he tried to impersonate a law official toattempt to arrest a Democratic governor for vaccine mandates.
The overwhelming amount of COVID-19 misinformation has been stressful, yet sometimes laugh-worthy. Urine is not the first “cure” and probably won’t be the last. If you heard something works in a sketchy group on Facebook, it’s probably safe to assume that it absolutely does not. Please don’t recycle your urine.
Vaccine or beer? You must now choose
As the COVID-19 pandemic drags on toward its third year, the large subset of the population who refuse to get vaccinated has proved nearly intractable. Governments have tried numerous incentives to boost vaccination rates, ranging from free beer to million dollar lotteries. Needless to say, beyond their ability to generate LOTME stories, these incentives have been less than effective.
As the frankly unfairly contagious Omicron variant makes it way through the world, our friends in the Great White North have decided enough is enough. If the carrot doesn’t work, the people of Quebec are going to get the stick. Starting on Jan. 18, vaccination cards will be required to enter stores that sell alcohol or cannabis, better known as the things that have gotten us all through this pandemic.
And you know what? Cutting off the booze supply seems to be working. Christian Dubé, Quebec’s health minister, said that the number of vaccination appointments had quadrupled in the new year, rising from 1,500 per day to 6,000 per day, according to the CTV News report. Now, those aren’t massive numbers, but this is big empty Canada we’re talking about, and the unvaccinated make up about 10% of Quebec’s population, so 6,000 a day is quite impressive.
Mr. Dubé added that additional nonessential businesses could be added to the restriction list in the coming weeks, but we’re not sure it’ll be necessary. Those middle-aged soccer moms will do anything to secure their daily merlot. Also, alcohol and cannabis nonessential? The LOTME staff is appalled and offended at this insinuation.
All I need is the polyester that I breathe
When you do laundry, you’re probably thinking more of how to get that ketchup stain out of your white shirt than the effect it has on the environment. Well, research shows it actually has some significance.
That significance comes in the form of microfibers, which are released from natural fabrics such as cotton and from synthetic fabrics such as polyester, which are also considered to be microplastics.
The microfibers that get released in the water when we wash clothes are filtered out eventually, but the dryer is the real culprit, according to a study in Environmental Science & Technology Letters. We’re talking a discharge of up to 120 million microfiber fragments directly into the air annually from just one dryer!
Dryers, they found, emitted between 1.4-40 times more microfibers than did washing machines in previous studies. And polyester fabrics produced more fragments when load sizes increased, while fragment production from cotton fabrics remained constant.
Recent findings suggest that inhaling these microfibers can cause lung inflammation, increase cancer risk, and induce asthma attacks. The authors of the current study suggested additional filtration should be done on dryer vents to reduce the amount of pollutants emitted into the air.
Who would have thought just drying your sheets could be such a dangerous act?
It’s always in the last place you look
At least a million times every morning in this country, a million children yell something like this as they get ready for school: “Mom, have you seen my ...?”
Well, thanks to Defector.com, now we know what Mom should yell back: “Look in your weird cousin Mortimer!”
We will explain ... again.
When they’re not dealing with COVID-19, the folks who work in emergency departments spend a lot of their time removing things that are stuck in people’s bodily orifices. The U.S. Consumer Product Safety Commission even keeps track of them.
So if you’re looking for the number 8 button from the TV remote, or maybe a bullet, check Mortimer’s nose. Maybe you’re missing a lollipop, a hairpin, or some espresso beans. Mortimer’s friend Beulah might have put them in her ear.
Has an earbud gone missing? Another friend of Mortimer’s went to the ED with something stuck in his throat and said that he had a “pill in one hand and his earbud in the other hand, got distracted and took the earbud instead.” Yes, that is an actual quote (via Defector) from the CPSC database.
What about that old saying that someone’s lost his marbles? Well, the ED found one of Mortimer’s marbles ... in his penis. Also a spork, and a bread twist tie, and a chopstick. No, not all at the same time. As for Beulah, a barbell and a Spider-Man action figure somehow found their way – not at the same time, thank goodness – into her vagina.
And have you ever heard someone say that they’re “not going to stand for this”? Mortimer has, so he sat down ... on a light bulb, and a rolling pin, and a billiard ball. Yup, the ED had to remove these items from his rectum.
But not all at the same time, thank goodness.
The limits of education
For more than a decade, studies on the dubious value of education in the face of vaccine refusal and hesitancy have been accumulating. But, too often, the research has been ignored by folks who believe that they can teach the “misinformed” into dropping their resistance. Among some circles education ranks right up there with apple pie and motherhood as one of the pillars of Americana. Those wedded to the education mantra may acknowledge that teaching and preaching hasn’t worked well in the past. But, they may claim it’s because we haven’t done enough of it or hit the right buttons. The notion that if we can just share the facts with the uninformed everything will be fine is a myth that obviously is going to die slowly.
In a recent op-ed piece in the New York Times two physicians at Harvard Medical School reported on their study of about three-quarters of a million children who were eligible to receive HPV vaccines (2021 Dec 21. “Facts alone aren’t going to win over the unvaccinated. This might,” Anupam B. Jena and Christopher M. Worsham). The researchers found that children whose mothers had been diagnosed with cervical cancer were no more likely to be immunized than those children whose mothers had not had the disease. Who could be better informed about risks and hazards of contracting HPV than women with cervical cancer? If the facts won’t motivate, where does that leave us?
Those of you born before 1960 may remember or at least have heard about a television show called “Truth or Consequences.” It was a silly farce of a game show which has no bearing on our nation’s crisis of widespread vaccine refusal. However, buried in its title is the answer. If the truth isn’t convincing the resistors, then the obvious choice is consequences.
I hope that you have discovered that same strategy when counseling parents of misbehaving children. Talk is cheap and often ineffective. Explaining the error of his ways to a child who probably already knows what he is doing wrong is a waste of everyone’s time and unpleasant for those within earshot. At some point, sooner better than later, it’s time to say there is going to be a consequence for this misbehavior – going home from the playground, spending a few minutes in time-out, removing a privilege, etc. If consequences are chosen well and instituted with a minimum of idle threats, they work.
And, we are beginning to see it work in the face of pandemic shot refusal. Here in Maine the governor mandated that all health care workers be vaccinated. There was plenty of gnashing of teeth and threats of mass job walk offs. And, there were a few hospital workers who quit, but in the end it worked.
The trick is choosing consequences that have some teeth and make sense. Clearly, some folks who have read about the consequences of not getting vaccinated and may have even lost family members to the disease don’t see those losses as significant consequences for whatever reason. The threat of losing a job is likely to get their attention.
Threats must be carried out even though they may be disruptive in the short term. The good thing about well-crafted mandates is that they can be a win-win for everyone. The vaccine resisters don’t need to admit they were wrong. “Those shots are B.S., but the governor made me do it.” The problem is finding leaders who understand that education has its limits and who have the courage to create and administer the consequences.
Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine, for nearly 40 years. He has authored several books on behavioral pediatrics, including “How to Say No to Your Toddler.” Other than a Littman stethoscope he accepted as a first-year medical student in 1966, Dr. Wilkoff reports having nothing to disclose. Email him at [email protected].
For more than a decade, studies on the dubious value of education in the face of vaccine refusal and hesitancy have been accumulating. But, too often, the research has been ignored by folks who believe that they can teach the “misinformed” into dropping their resistance. Among some circles education ranks right up there with apple pie and motherhood as one of the pillars of Americana. Those wedded to the education mantra may acknowledge that teaching and preaching hasn’t worked well in the past. But, they may claim it’s because we haven’t done enough of it or hit the right buttons. The notion that if we can just share the facts with the uninformed everything will be fine is a myth that obviously is going to die slowly.
In a recent op-ed piece in the New York Times two physicians at Harvard Medical School reported on their study of about three-quarters of a million children who were eligible to receive HPV vaccines (2021 Dec 21. “Facts alone aren’t going to win over the unvaccinated. This might,” Anupam B. Jena and Christopher M. Worsham). The researchers found that children whose mothers had been diagnosed with cervical cancer were no more likely to be immunized than those children whose mothers had not had the disease. Who could be better informed about risks and hazards of contracting HPV than women with cervical cancer? If the facts won’t motivate, where does that leave us?
Those of you born before 1960 may remember or at least have heard about a television show called “Truth or Consequences.” It was a silly farce of a game show which has no bearing on our nation’s crisis of widespread vaccine refusal. However, buried in its title is the answer. If the truth isn’t convincing the resistors, then the obvious choice is consequences.
I hope that you have discovered that same strategy when counseling parents of misbehaving children. Talk is cheap and often ineffective. Explaining the error of his ways to a child who probably already knows what he is doing wrong is a waste of everyone’s time and unpleasant for those within earshot. At some point, sooner better than later, it’s time to say there is going to be a consequence for this misbehavior – going home from the playground, spending a few minutes in time-out, removing a privilege, etc. If consequences are chosen well and instituted with a minimum of idle threats, they work.
And, we are beginning to see it work in the face of pandemic shot refusal. Here in Maine the governor mandated that all health care workers be vaccinated. There was plenty of gnashing of teeth and threats of mass job walk offs. And, there were a few hospital workers who quit, but in the end it worked.
The trick is choosing consequences that have some teeth and make sense. Clearly, some folks who have read about the consequences of not getting vaccinated and may have even lost family members to the disease don’t see those losses as significant consequences for whatever reason. The threat of losing a job is likely to get their attention.
Threats must be carried out even though they may be disruptive in the short term. The good thing about well-crafted mandates is that they can be a win-win for everyone. The vaccine resisters don’t need to admit they were wrong. “Those shots are B.S., but the governor made me do it.” The problem is finding leaders who understand that education has its limits and who have the courage to create and administer the consequences.
Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine, for nearly 40 years. He has authored several books on behavioral pediatrics, including “How to Say No to Your Toddler.” Other than a Littman stethoscope he accepted as a first-year medical student in 1966, Dr. Wilkoff reports having nothing to disclose. Email him at [email protected].
For more than a decade, studies on the dubious value of education in the face of vaccine refusal and hesitancy have been accumulating. But, too often, the research has been ignored by folks who believe that they can teach the “misinformed” into dropping their resistance. Among some circles education ranks right up there with apple pie and motherhood as one of the pillars of Americana. Those wedded to the education mantra may acknowledge that teaching and preaching hasn’t worked well in the past. But, they may claim it’s because we haven’t done enough of it or hit the right buttons. The notion that if we can just share the facts with the uninformed everything will be fine is a myth that obviously is going to die slowly.
In a recent op-ed piece in the New York Times two physicians at Harvard Medical School reported on their study of about three-quarters of a million children who were eligible to receive HPV vaccines (2021 Dec 21. “Facts alone aren’t going to win over the unvaccinated. This might,” Anupam B. Jena and Christopher M. Worsham). The researchers found that children whose mothers had been diagnosed with cervical cancer were no more likely to be immunized than those children whose mothers had not had the disease. Who could be better informed about risks and hazards of contracting HPV than women with cervical cancer? If the facts won’t motivate, where does that leave us?
Those of you born before 1960 may remember or at least have heard about a television show called “Truth or Consequences.” It was a silly farce of a game show which has no bearing on our nation’s crisis of widespread vaccine refusal. However, buried in its title is the answer. If the truth isn’t convincing the resistors, then the obvious choice is consequences.
I hope that you have discovered that same strategy when counseling parents of misbehaving children. Talk is cheap and often ineffective. Explaining the error of his ways to a child who probably already knows what he is doing wrong is a waste of everyone’s time and unpleasant for those within earshot. At some point, sooner better than later, it’s time to say there is going to be a consequence for this misbehavior – going home from the playground, spending a few minutes in time-out, removing a privilege, etc. If consequences are chosen well and instituted with a minimum of idle threats, they work.
And, we are beginning to see it work in the face of pandemic shot refusal. Here in Maine the governor mandated that all health care workers be vaccinated. There was plenty of gnashing of teeth and threats of mass job walk offs. And, there were a few hospital workers who quit, but in the end it worked.
The trick is choosing consequences that have some teeth and make sense. Clearly, some folks who have read about the consequences of not getting vaccinated and may have even lost family members to the disease don’t see those losses as significant consequences for whatever reason. The threat of losing a job is likely to get their attention.
Threats must be carried out even though they may be disruptive in the short term. The good thing about well-crafted mandates is that they can be a win-win for everyone. The vaccine resisters don’t need to admit they were wrong. “Those shots are B.S., but the governor made me do it.” The problem is finding leaders who understand that education has its limits and who have the courage to create and administer the consequences.
Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine, for nearly 40 years. He has authored several books on behavioral pediatrics, including “How to Say No to Your Toddler.” Other than a Littman stethoscope he accepted as a first-year medical student in 1966, Dr. Wilkoff reports having nothing to disclose. Email him at [email protected].
What is the diagnosis?
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that is becoming more recognized in children. It has a variable presentation, most commonly presenting as painful, recurrent cysts, abscesses, nodules, and/or pustules in classic locations with associated scarring and sinus tract formation.
The majority of patients present with bilateral lesions found most commonly in the axillae and inguinal folds.1 There are myriad other potential sites of involvement including the inframammary folds, inner thighs, buttocks, and groin.1 Diagnosis is made based on history and physical exam. There is a standard severity classification scheme called the Hurley score, which stratifies disease severity based on the presence of sinus tracts and extent of disease.1 HS is associated with comorbid conditions such as obesity, overweight, acne, and inflammatory bowel and joint disease.2 This painful, persistent condition is well documented to have a negative impact on quality of life in adult patients, and similar impairment has been found in pediatric patients.3,4
HS may be increasing in pediatric and adolescent patients, with recent studies showing onset coinciding most commonly with the onset of puberty.1,2 There is often a period of several years between symptom onset and diagnosis.1 A recent editorial highlighted the disparities that exist in HS, with disease more common in Black children and limited information about disease prevalence in Hispanic children.5
What’s the treatment plan?
HS is a difficult disease to treat, with few patients achieving remission and a significant proportion of patients with treatment-refractory disease.1 There are limited studies of HS treatment in pediatric patients. Topical and systemic antibiotic therapy are mainstays of HS treatment, with tetracyclines and a combination of clindamycin plus rifampin commonly used in adults and children alike. Topical therapies including topical antibiotics and antibacterial solutions are frequently used as adjunctive therapy.6 Adalimumab, a tumor necrosis factor receptor blocker, has been Food and Drug Administration approved for HS for ages 12 and up and is currently the only FDA-approved medication for HS in pediatric patients. Our patient was started on 100 mg doxycycline twice daily, with short-dose topical corticosteroids for symptom management of the most inflamed lesions.
What’s on the differential?
Acne conglobata
Acne conglobata is an uncommon, severe variant of acne vulgaris which arise in patients with a history of acne vulgaris and presents with comedones, cysts, abscesses, and scarring with possible drainage of pus. Lesions can present diffusely on the face, back, and body, including in the axillae, groin, and buttocks, and as such can be confused with HS.7
However, in contrast with HS, patients with acne conglobata will also develop disease in non–apocrine gland–bearing skin. This patient’s lack of preceding acne and restriction of lesions to the axillae, inguinal folds, and buttocks makes acne conglobata less likely.
Epidermal inclusion cyst
Epidermal inclusion cyst (EIC) is a common cutaneous cyst, presenting as a well-circumscribed nodule(s) with a central punctum. If not excised, lesions can sometimes become infected and painful.8 In contrast with HS, EIC presents only uncommonly as multiple lesions arising in different areas, and spontaneous drainage is uncommon. Our patient’s development of multiple draining lesions makes this diagnosis unlikely.
Furunculosis
Furunculosis is a common bacterial infection of the skin, presenting with inflammatory nodules or pustules centered around the hair follicle. Lesions may commonly present at sites of skin trauma and are found most frequently on the extremities.9 Though furunculosis lesions may drain pus and can coalesce to form larger “carbuncles,” our patient’s presence of significant scarring and lack of extremity involvement makes HS more likely.
Recurrent MRSA abscesses
Methicillin-resistant Staphylococcus aureus skin and soft-tissue infections are not uncommon in the pediatric population, with presentation of infection ranging from cellulitis to fluid-containing abscesses.10 Recurrent abscesses may be seen in MRSA infection, however in this patient the presence of draining, scarring lesions in multiple locations typical for HS over time is more consistent with a diagnosis of HS.
Dr. Eichenfield is vice chair of the department of dermatology and professor of dermatology and pediatrics at the University of California, San Diego, and Rady Children’s Hospital, San Diego. Ms. Appiah is a pediatric dermatology research associate in the division of pediatric and adolescent dermatology at the University of California, San Diego, and Rady Children’s Hospital. Dr. Eichenfield and Ms. Appiah have no relevant financial disclosures.
References
1. Liy-Wong C et al. JAMA Dermatol. 2021;157(4):385-91.
2. Choi E et al. J Am Acad Dermatol. 2022;86(1):140-7.
3. Machado MO et al. JAMA Dermatol. 2019;155(8):939-45.
4. McAndrew R et al. J Am Acad Dermatol. 2021;84(3):829-30.
5. Kirby JS and Zaenglein AL. JAMA Dermatol. 2021;157(4):379-80.
6. Alikhan A et al. J Am Acad Dermatol. 2019;81(1):91-101.
7. Greydanus DE et al. Dis Mon. 2021;67(4):101103.
8. Weir CB, St. Hilaire NJ. Epidermal Inclusion Cyst, in “StatPearls.” Treasure Island, Fla: StatPearls Publishing, 2021.
9. Atanaskova N and Tomecki KJ. Dermatol Clin. 2010;28(3):479-87.
10. Papastefan ST et al. J Surg Res. 2019;242:70-7.
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that is becoming more recognized in children. It has a variable presentation, most commonly presenting as painful, recurrent cysts, abscesses, nodules, and/or pustules in classic locations with associated scarring and sinus tract formation.
The majority of patients present with bilateral lesions found most commonly in the axillae and inguinal folds.1 There are myriad other potential sites of involvement including the inframammary folds, inner thighs, buttocks, and groin.1 Diagnosis is made based on history and physical exam. There is a standard severity classification scheme called the Hurley score, which stratifies disease severity based on the presence of sinus tracts and extent of disease.1 HS is associated with comorbid conditions such as obesity, overweight, acne, and inflammatory bowel and joint disease.2 This painful, persistent condition is well documented to have a negative impact on quality of life in adult patients, and similar impairment has been found in pediatric patients.3,4
HS may be increasing in pediatric and adolescent patients, with recent studies showing onset coinciding most commonly with the onset of puberty.1,2 There is often a period of several years between symptom onset and diagnosis.1 A recent editorial highlighted the disparities that exist in HS, with disease more common in Black children and limited information about disease prevalence in Hispanic children.5
What’s the treatment plan?
HS is a difficult disease to treat, with few patients achieving remission and a significant proportion of patients with treatment-refractory disease.1 There are limited studies of HS treatment in pediatric patients. Topical and systemic antibiotic therapy are mainstays of HS treatment, with tetracyclines and a combination of clindamycin plus rifampin commonly used in adults and children alike. Topical therapies including topical antibiotics and antibacterial solutions are frequently used as adjunctive therapy.6 Adalimumab, a tumor necrosis factor receptor blocker, has been Food and Drug Administration approved for HS for ages 12 and up and is currently the only FDA-approved medication for HS in pediatric patients. Our patient was started on 100 mg doxycycline twice daily, with short-dose topical corticosteroids for symptom management of the most inflamed lesions.
What’s on the differential?
Acne conglobata
Acne conglobata is an uncommon, severe variant of acne vulgaris which arise in patients with a history of acne vulgaris and presents with comedones, cysts, abscesses, and scarring with possible drainage of pus. Lesions can present diffusely on the face, back, and body, including in the axillae, groin, and buttocks, and as such can be confused with HS.7
However, in contrast with HS, patients with acne conglobata will also develop disease in non–apocrine gland–bearing skin. This patient’s lack of preceding acne and restriction of lesions to the axillae, inguinal folds, and buttocks makes acne conglobata less likely.
Epidermal inclusion cyst
Epidermal inclusion cyst (EIC) is a common cutaneous cyst, presenting as a well-circumscribed nodule(s) with a central punctum. If not excised, lesions can sometimes become infected and painful.8 In contrast with HS, EIC presents only uncommonly as multiple lesions arising in different areas, and spontaneous drainage is uncommon. Our patient’s development of multiple draining lesions makes this diagnosis unlikely.
Furunculosis
Furunculosis is a common bacterial infection of the skin, presenting with inflammatory nodules or pustules centered around the hair follicle. Lesions may commonly present at sites of skin trauma and are found most frequently on the extremities.9 Though furunculosis lesions may drain pus and can coalesce to form larger “carbuncles,” our patient’s presence of significant scarring and lack of extremity involvement makes HS more likely.
Recurrent MRSA abscesses
Methicillin-resistant Staphylococcus aureus skin and soft-tissue infections are not uncommon in the pediatric population, with presentation of infection ranging from cellulitis to fluid-containing abscesses.10 Recurrent abscesses may be seen in MRSA infection, however in this patient the presence of draining, scarring lesions in multiple locations typical for HS over time is more consistent with a diagnosis of HS.
Dr. Eichenfield is vice chair of the department of dermatology and professor of dermatology and pediatrics at the University of California, San Diego, and Rady Children’s Hospital, San Diego. Ms. Appiah is a pediatric dermatology research associate in the division of pediatric and adolescent dermatology at the University of California, San Diego, and Rady Children’s Hospital. Dr. Eichenfield and Ms. Appiah have no relevant financial disclosures.
References
1. Liy-Wong C et al. JAMA Dermatol. 2021;157(4):385-91.
2. Choi E et al. J Am Acad Dermatol. 2022;86(1):140-7.
3. Machado MO et al. JAMA Dermatol. 2019;155(8):939-45.
4. McAndrew R et al. J Am Acad Dermatol. 2021;84(3):829-30.
5. Kirby JS and Zaenglein AL. JAMA Dermatol. 2021;157(4):379-80.
6. Alikhan A et al. J Am Acad Dermatol. 2019;81(1):91-101.
7. Greydanus DE et al. Dis Mon. 2021;67(4):101103.
8. Weir CB, St. Hilaire NJ. Epidermal Inclusion Cyst, in “StatPearls.” Treasure Island, Fla: StatPearls Publishing, 2021.
9. Atanaskova N and Tomecki KJ. Dermatol Clin. 2010;28(3):479-87.
10. Papastefan ST et al. J Surg Res. 2019;242:70-7.
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that is becoming more recognized in children. It has a variable presentation, most commonly presenting as painful, recurrent cysts, abscesses, nodules, and/or pustules in classic locations with associated scarring and sinus tract formation.
The majority of patients present with bilateral lesions found most commonly in the axillae and inguinal folds.1 There are myriad other potential sites of involvement including the inframammary folds, inner thighs, buttocks, and groin.1 Diagnosis is made based on history and physical exam. There is a standard severity classification scheme called the Hurley score, which stratifies disease severity based on the presence of sinus tracts and extent of disease.1 HS is associated with comorbid conditions such as obesity, overweight, acne, and inflammatory bowel and joint disease.2 This painful, persistent condition is well documented to have a negative impact on quality of life in adult patients, and similar impairment has been found in pediatric patients.3,4
HS may be increasing in pediatric and adolescent patients, with recent studies showing onset coinciding most commonly with the onset of puberty.1,2 There is often a period of several years between symptom onset and diagnosis.1 A recent editorial highlighted the disparities that exist in HS, with disease more common in Black children and limited information about disease prevalence in Hispanic children.5
What’s the treatment plan?
HS is a difficult disease to treat, with few patients achieving remission and a significant proportion of patients with treatment-refractory disease.1 There are limited studies of HS treatment in pediatric patients. Topical and systemic antibiotic therapy are mainstays of HS treatment, with tetracyclines and a combination of clindamycin plus rifampin commonly used in adults and children alike. Topical therapies including topical antibiotics and antibacterial solutions are frequently used as adjunctive therapy.6 Adalimumab, a tumor necrosis factor receptor blocker, has been Food and Drug Administration approved for HS for ages 12 and up and is currently the only FDA-approved medication for HS in pediatric patients. Our patient was started on 100 mg doxycycline twice daily, with short-dose topical corticosteroids for symptom management of the most inflamed lesions.
What’s on the differential?
Acne conglobata
Acne conglobata is an uncommon, severe variant of acne vulgaris which arise in patients with a history of acne vulgaris and presents with comedones, cysts, abscesses, and scarring with possible drainage of pus. Lesions can present diffusely on the face, back, and body, including in the axillae, groin, and buttocks, and as such can be confused with HS.7
However, in contrast with HS, patients with acne conglobata will also develop disease in non–apocrine gland–bearing skin. This patient’s lack of preceding acne and restriction of lesions to the axillae, inguinal folds, and buttocks makes acne conglobata less likely.
Epidermal inclusion cyst
Epidermal inclusion cyst (EIC) is a common cutaneous cyst, presenting as a well-circumscribed nodule(s) with a central punctum. If not excised, lesions can sometimes become infected and painful.8 In contrast with HS, EIC presents only uncommonly as multiple lesions arising in different areas, and spontaneous drainage is uncommon. Our patient’s development of multiple draining lesions makes this diagnosis unlikely.
Furunculosis
Furunculosis is a common bacterial infection of the skin, presenting with inflammatory nodules or pustules centered around the hair follicle. Lesions may commonly present at sites of skin trauma and are found most frequently on the extremities.9 Though furunculosis lesions may drain pus and can coalesce to form larger “carbuncles,” our patient’s presence of significant scarring and lack of extremity involvement makes HS more likely.
Recurrent MRSA abscesses
Methicillin-resistant Staphylococcus aureus skin and soft-tissue infections are not uncommon in the pediatric population, with presentation of infection ranging from cellulitis to fluid-containing abscesses.10 Recurrent abscesses may be seen in MRSA infection, however in this patient the presence of draining, scarring lesions in multiple locations typical for HS over time is more consistent with a diagnosis of HS.
Dr. Eichenfield is vice chair of the department of dermatology and professor of dermatology and pediatrics at the University of California, San Diego, and Rady Children’s Hospital, San Diego. Ms. Appiah is a pediatric dermatology research associate in the division of pediatric and adolescent dermatology at the University of California, San Diego, and Rady Children’s Hospital. Dr. Eichenfield and Ms. Appiah have no relevant financial disclosures.
References
1. Liy-Wong C et al. JAMA Dermatol. 2021;157(4):385-91.
2. Choi E et al. J Am Acad Dermatol. 2022;86(1):140-7.
3. Machado MO et al. JAMA Dermatol. 2019;155(8):939-45.
4. McAndrew R et al. J Am Acad Dermatol. 2021;84(3):829-30.
5. Kirby JS and Zaenglein AL. JAMA Dermatol. 2021;157(4):379-80.
6. Alikhan A et al. J Am Acad Dermatol. 2019;81(1):91-101.
7. Greydanus DE et al. Dis Mon. 2021;67(4):101103.
8. Weir CB, St. Hilaire NJ. Epidermal Inclusion Cyst, in “StatPearls.” Treasure Island, Fla: StatPearls Publishing, 2021.
9. Atanaskova N and Tomecki KJ. Dermatol Clin. 2010;28(3):479-87.
10. Papastefan ST et al. J Surg Res. 2019;242:70-7.
Common cold could protect against COVID-19, study says
, according to a small study published Jan. 10 in Nature Communications.
Previous studies have shown that T cells created from other coronaviruses can recognize SARS-CoV-2, the virus that causes COVID-19. In the new study, researchers at Imperial College London found that the presence of these T cells at the time of COVID-19 exposure could reduce the chance of getting infected.
The findings could provide a blueprint for a second-generation, universal vaccine to prevent infection from COVID-19 variants, including Omicron and ones that crop up later.
“Being exposed to SARS-CoV-2 virus doesn’t always result in infection, and we’ve been keen to understand why,” Rhia Kundu, PhD, the lead study author from Imperial’s National Heart and Lung Institute, said in a statement.
People with higher levels of T cells from the common cold were less likely to become infected with COVID-19, the researchers found.
“While this is an important discovery, it is only one form of protection, and I would stress that no one should rely on this alone,” Dr. Kundu said. “Instead, the best way to protect yourself against COVID-19 is to be fully vaccinated, including getting your booster dose.”
For the study, Dr. Kundu and colleagues analyzed blood samples from 52 people who lived with someone with confirmed COVID-19 in September 2020. Among the 26 people who didn’t contract COVID-19, there were “significantly higher levels” of preexisting T cells from common cold coronaviruses, as compared with the 26 people who did become infected.
The T cells researched in the study are considered “cross-reactive” and can recognize the proteins of SARS-CoV-2. They offer protection by targeting proteins inside the SARS-CoV-2 virus, rather than the spike proteins on the surface that allow the virus to invade cells.
The current COVID-19 vaccines target the spike proteins, which are more likely to mutate than internal proteins, the researchers wrote. The Omicron variant, for instance, has numerous mutations on spike proteins that may allow it to evade vaccines.
The data suggest that the next step of COVID-19 vaccine development could focus on internal proteins, the researchers said, which could provide lasting protection because T-cell responses persist longer than antibody responses that fade within a few months of vaccination.
“New vaccines that include these conserved, internal proteins would therefore induce broadly protective T-cell responses that should protect against current and future SARS-CoV-2 variants,” Ajit Lalvani, MD, the senior study author and director of Imperial’s respiratory infections health protection research unit, said in the statement.
But more research is needed, the authors said, noting that the study had a small sample size and lacked ethnic diversity, which puts limits on the research.
A version of this article first appeared on WebMD.com
, according to a small study published Jan. 10 in Nature Communications.
Previous studies have shown that T cells created from other coronaviruses can recognize SARS-CoV-2, the virus that causes COVID-19. In the new study, researchers at Imperial College London found that the presence of these T cells at the time of COVID-19 exposure could reduce the chance of getting infected.
The findings could provide a blueprint for a second-generation, universal vaccine to prevent infection from COVID-19 variants, including Omicron and ones that crop up later.
“Being exposed to SARS-CoV-2 virus doesn’t always result in infection, and we’ve been keen to understand why,” Rhia Kundu, PhD, the lead study author from Imperial’s National Heart and Lung Institute, said in a statement.
People with higher levels of T cells from the common cold were less likely to become infected with COVID-19, the researchers found.
“While this is an important discovery, it is only one form of protection, and I would stress that no one should rely on this alone,” Dr. Kundu said. “Instead, the best way to protect yourself against COVID-19 is to be fully vaccinated, including getting your booster dose.”
For the study, Dr. Kundu and colleagues analyzed blood samples from 52 people who lived with someone with confirmed COVID-19 in September 2020. Among the 26 people who didn’t contract COVID-19, there were “significantly higher levels” of preexisting T cells from common cold coronaviruses, as compared with the 26 people who did become infected.
The T cells researched in the study are considered “cross-reactive” and can recognize the proteins of SARS-CoV-2. They offer protection by targeting proteins inside the SARS-CoV-2 virus, rather than the spike proteins on the surface that allow the virus to invade cells.
The current COVID-19 vaccines target the spike proteins, which are more likely to mutate than internal proteins, the researchers wrote. The Omicron variant, for instance, has numerous mutations on spike proteins that may allow it to evade vaccines.
The data suggest that the next step of COVID-19 vaccine development could focus on internal proteins, the researchers said, which could provide lasting protection because T-cell responses persist longer than antibody responses that fade within a few months of vaccination.
“New vaccines that include these conserved, internal proteins would therefore induce broadly protective T-cell responses that should protect against current and future SARS-CoV-2 variants,” Ajit Lalvani, MD, the senior study author and director of Imperial’s respiratory infections health protection research unit, said in the statement.
But more research is needed, the authors said, noting that the study had a small sample size and lacked ethnic diversity, which puts limits on the research.
A version of this article first appeared on WebMD.com
, according to a small study published Jan. 10 in Nature Communications.
Previous studies have shown that T cells created from other coronaviruses can recognize SARS-CoV-2, the virus that causes COVID-19. In the new study, researchers at Imperial College London found that the presence of these T cells at the time of COVID-19 exposure could reduce the chance of getting infected.
The findings could provide a blueprint for a second-generation, universal vaccine to prevent infection from COVID-19 variants, including Omicron and ones that crop up later.
“Being exposed to SARS-CoV-2 virus doesn’t always result in infection, and we’ve been keen to understand why,” Rhia Kundu, PhD, the lead study author from Imperial’s National Heart and Lung Institute, said in a statement.
People with higher levels of T cells from the common cold were less likely to become infected with COVID-19, the researchers found.
“While this is an important discovery, it is only one form of protection, and I would stress that no one should rely on this alone,” Dr. Kundu said. “Instead, the best way to protect yourself against COVID-19 is to be fully vaccinated, including getting your booster dose.”
For the study, Dr. Kundu and colleagues analyzed blood samples from 52 people who lived with someone with confirmed COVID-19 in September 2020. Among the 26 people who didn’t contract COVID-19, there were “significantly higher levels” of preexisting T cells from common cold coronaviruses, as compared with the 26 people who did become infected.
The T cells researched in the study are considered “cross-reactive” and can recognize the proteins of SARS-CoV-2. They offer protection by targeting proteins inside the SARS-CoV-2 virus, rather than the spike proteins on the surface that allow the virus to invade cells.
The current COVID-19 vaccines target the spike proteins, which are more likely to mutate than internal proteins, the researchers wrote. The Omicron variant, for instance, has numerous mutations on spike proteins that may allow it to evade vaccines.
The data suggest that the next step of COVID-19 vaccine development could focus on internal proteins, the researchers said, which could provide lasting protection because T-cell responses persist longer than antibody responses that fade within a few months of vaccination.
“New vaccines that include these conserved, internal proteins would therefore induce broadly protective T-cell responses that should protect against current and future SARS-CoV-2 variants,” Ajit Lalvani, MD, the senior study author and director of Imperial’s respiratory infections health protection research unit, said in the statement.
But more research is needed, the authors said, noting that the study had a small sample size and lacked ethnic diversity, which puts limits on the research.
A version of this article first appeared on WebMD.com
Ranking seven COVID-19 antigen tests by ease of use: Report
Some COVID-19 rapid antigen home test kits are much easier to use than others, according to an analysis by ECRI, an independent, nonprofit patient safety organization.
None of the tests were rated as “excellent” in terms of usability and some had “noteworthy” usability concerns, the company said.
If a test is hard to use, “chances are that you may miss a step or not follow the right order, or contaminate the testing area and that can definitely influence the accuracy of the test and lead to a wrong test result,” Marcus Schabacker, MD, PhD, president and CEO of ECRI, told this news organization.
To gauge usability, ECRI used the “industry-standard” system usability scale (SUS), which rates products on a scale of 0 to 100 with 100 being the easiest to use.
More than 30 points separated the top and bottom tests analyzed. The top performer was On/Go, followed by CareStart and Flowflex.
ECRI analysts found that some tests require particularly fine motor skills or have instructions with extremely small font size that may make it hard for older adults or people with complex health conditions to use the tests correctly.
“If you have a tremor from Parkinson’s, for example, or anything which won’t allow you to handle small items, you will have difficulties to do that test by yourself. That is the No. 1 concern we have,” Dr. Schabacker said.
“The second concern is readability, as all of these tests have relatively small instructions. One of them actually has doesn’t even have instructions – you have to download an app,” he noted.
Given demand and supply issues, Dr. Schabacker acknowledged that consumers might not have a choice in which test to use and may have to rely on whatever is available.
These tests are a “hot commodity right now,” he said. “If you have a choice, people should use the ones which are easiest to use, which is the On/Go, the CareStart, or the Flowflex.”
A version of this article first appeared on Medscape.com.
Some COVID-19 rapid antigen home test kits are much easier to use than others, according to an analysis by ECRI, an independent, nonprofit patient safety organization.
None of the tests were rated as “excellent” in terms of usability and some had “noteworthy” usability concerns, the company said.
If a test is hard to use, “chances are that you may miss a step or not follow the right order, or contaminate the testing area and that can definitely influence the accuracy of the test and lead to a wrong test result,” Marcus Schabacker, MD, PhD, president and CEO of ECRI, told this news organization.
To gauge usability, ECRI used the “industry-standard” system usability scale (SUS), which rates products on a scale of 0 to 100 with 100 being the easiest to use.
More than 30 points separated the top and bottom tests analyzed. The top performer was On/Go, followed by CareStart and Flowflex.
ECRI analysts found that some tests require particularly fine motor skills or have instructions with extremely small font size that may make it hard for older adults or people with complex health conditions to use the tests correctly.
“If you have a tremor from Parkinson’s, for example, or anything which won’t allow you to handle small items, you will have difficulties to do that test by yourself. That is the No. 1 concern we have,” Dr. Schabacker said.
“The second concern is readability, as all of these tests have relatively small instructions. One of them actually has doesn’t even have instructions – you have to download an app,” he noted.
Given demand and supply issues, Dr. Schabacker acknowledged that consumers might not have a choice in which test to use and may have to rely on whatever is available.
These tests are a “hot commodity right now,” he said. “If you have a choice, people should use the ones which are easiest to use, which is the On/Go, the CareStart, or the Flowflex.”
A version of this article first appeared on Medscape.com.
Some COVID-19 rapid antigen home test kits are much easier to use than others, according to an analysis by ECRI, an independent, nonprofit patient safety organization.
None of the tests were rated as “excellent” in terms of usability and some had “noteworthy” usability concerns, the company said.
If a test is hard to use, “chances are that you may miss a step or not follow the right order, or contaminate the testing area and that can definitely influence the accuracy of the test and lead to a wrong test result,” Marcus Schabacker, MD, PhD, president and CEO of ECRI, told this news organization.
To gauge usability, ECRI used the “industry-standard” system usability scale (SUS), which rates products on a scale of 0 to 100 with 100 being the easiest to use.
More than 30 points separated the top and bottom tests analyzed. The top performer was On/Go, followed by CareStart and Flowflex.
ECRI analysts found that some tests require particularly fine motor skills or have instructions with extremely small font size that may make it hard for older adults or people with complex health conditions to use the tests correctly.
“If you have a tremor from Parkinson’s, for example, or anything which won’t allow you to handle small items, you will have difficulties to do that test by yourself. That is the No. 1 concern we have,” Dr. Schabacker said.
“The second concern is readability, as all of these tests have relatively small instructions. One of them actually has doesn’t even have instructions – you have to download an app,” he noted.
Given demand and supply issues, Dr. Schabacker acknowledged that consumers might not have a choice in which test to use and may have to rely on whatever is available.
These tests are a “hot commodity right now,” he said. “If you have a choice, people should use the ones which are easiest to use, which is the On/Go, the CareStart, or the Flowflex.”
A version of this article first appeared on Medscape.com.