Tag Archives: Coronavirus pandemic

Health

Measles outbreak in central Ohio grows to more than 50 children, driven by ‘lack of vaccination’

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CNN
 — 

A measles outbreak in central Ohio is growing, sickening more than 50 children, with many of them needing hospitalization, according to data updated Tuesday by Columbus Public Health.

None of the children had been fully vaccinated against measles.

Since the start of the outbreak in November, at least 58 measles cases have been identified in Columbus and Franklin, Ross and Richland counties, and there have been 22 hospitalizations, according to Columbus Public Health.

Of those cases, 55 were in unvaccinated children. The other three were only partially vaccinated, meaning they received one dose of their MMR or measles, mumps and rubella vaccine when two are needed for a person to be considered fully vaccinated.

Experts recommend that children get the vaccine in two doses: the first between 12 months and 15 months of age, and a second between 4 and 6 years old. One dose is about 93% effective at preventing measles if you come into contact with the virus. Two doses are about 97% effective.

Nationwide, more than 90% of children in the US have been vaccinated against measles, mumps and rubella by age 2, according to the US Centers for Disease Control and Prevention.

“Measles can be very serious, especially for children under age 5,” Columbus Public Health spokesperson Kelli Newman wrote in an email Monday.

All of the Columbus cases have been in children: 12 in infants younger than 1, 28 in toddlers ages 1 to 2, 13 in children ages 3 to 5, and five in ages 6 to 17.

That corresponds to about 71% of cases being reported in 1- to 5-year-olds.

While the specifics of each hospitalized measles case can vary, “many children are hospitalized for dehydration,” Newman wrote. “Other serious complications also can include pneumonia and neurological conditions such as encephalitis. There’s no way of knowing which children will become so sick they have to be hospitalized. The safest way to protect children from measles is to make sure they are vaccinated with MMR.”

Some of the children visited a grocery store, a church and department stores in a mall while they were contagious, according to Columbus Public Health’s list of exposure sites.

Measles is a highly infectious disease that can spread through the air when an infected person coughs or sneezes or if someone comes into direct contact with or shares germs by touching contaminated objects or surfaces.

“Measles can be a severe illness and can commonly lead to complications which require hospitalization, especially in young children,” Dr. Matthew Washam, medical director of epidemiology and infection control at Nationwide Children’s in Columbus, wrote in an email Tuesday.

In the Ohio outbreak, the hospitalized children have been seen at Nationwide Children’s Hospital.

“Most children can usually recover at home with supportive care and can receive antibiotics for less severe complications, such as ear infections. Some children develop more severe complications, such as dehydration requiring intravenous fluids, pneumonia and/or croup which require respiratory support, or rarely more severe complications such as encephalitis,” Washam wrote.

“The mainstay of treatment for all children with measles is supportive care,” he added. “In the hospital, this can include intravenous fluids, antibiotics for secondary bacterial infections, and respiratory support amongst other supportive care measures. Some children with measles may also be treated with vitamin A given the association of lower vitamin A levels with more severe measles illness.”

The measles outbreak is “very concerning,” said Dr. Nora Colburn, an adult infectious diseases physician at The Ohio State University Wexner Medical Center in Columbus, who has been watching the outbreak closely along with her colleagues.

“What’s really driving this is unfortunately a lack of vaccination, which is just heartbreaking,” said Colburn, who also serves as the medical director of clinical epidemiology for the Richard M. Ross Heart Hospital at the OSU Wexner Medical Center.

“For measles, it is the most infectious disease we have,” she said. “And so it is very concerning as an infectious disease physician, as also a mother of a young child and as a community member.”

During the early days of the Covid-19 pandemic, while most people stayed home and some health-care facilities were closed, many children missed their routine immunizations, including the MMR vaccine – and they still may not have gotten all their recommended shots. That’s true around the world as well as in the US.

“The concern now is that we’ve had this global dip in vaccination coverage as a result of the pandemic, probably not actually from vaccine hesitancy or refusal but just there were a lot of kids that missed their checkups during the pandemic, and we really haven’t completely caught those kids up,” said Dr. Sean O’Leary, chair of the American Academy of Pediatrics’ Committee on Infectious Diseases and professor of pediatric infectious disease at the University of Colorado School of Medicine and Children’s Hospital Colorado.

“Measles is such a contagious disease that when you see those dips, we really worry about the potential for large outbreaks,” he said. “You need to really maintain a high vaccination coverage to keep measles from spreading.”

About 90% of unvaccinated people who are exposed to measles will become infected, according to Columbus Public Health, and about 1 in 5 people in the US who get measles will be hospitalized.

While the measles outbreak spreads across central Ohio, the United States has been battling a surge of respiratory illnesses, such as flu and RSV, or respiratory syncytial virus, and the ongoing Covid-19 pandemic.

Pediatric hospitals nationwide have been overwhelmed by this rise in respiratory infections and are bracing for the possibility of even more cases over the holiday season.

“I can’t even imagine if your hospital is already chock full and all of a sudden you’ve got to deal with measles, because measles is a really problematic infection-control situation, too. You need negative-pressure rooms, everyone has to wear N95 masks, and it’s incredibly contagious in a hospital,” O’Leary said.

“There’s a lot of risk particularly to immunocompromised patients that are also in children’s hospitals,” he said. “It’s a real problem.”

Nationwide Children’s Hospital confirmed to CNN in an email Tuesday that it has seen a surge in other respiratory illnesses, such as flu and RSV, but remains able to keep caring for patients.

“The current surge in respiratory illnesses such as the flu and RSV is being seen locally. While we are experiencing some visits and admissions related to measles, volumes are relatively low compared to flu and RSV. Measles poses a greater strain on resources related to public health efforts, including contact tracing, containment, education, and immunizations,” the hospital statement said. “While busy, our hospital remains able to continue to provide care for patients.”

With each of these respiratory illnesses, it sometimes can be difficult to determine which infection a person has as the symptoms – such as fever, cough, and runny nose – can be similar.

“To have RSV, influenza, Covid at the same time as the holidays, and then now we have measles on top of it, which can have overlapping symptoms of fever and cough and fatigue, it can be really challenging to kind of sort out which infection is what,” Colburn said, adding that it is important for anyone with symptoms to stay home and get tested.

Measles symptoms may include fever, cough, runny nose, watery eyes and a rash of red spots. In rare cases, it may lead to pneumonia, encephalitis or death.

“Wearing your mask, especially in crowded areas, is really important, especially for our immunocompromised patients. I really worry about measles in adult patients who cannot get the MMR vaccines,” she said. “We can’t give it to severely immunocompromised patients or pregnant women. So it’s really important that everybody else gets vaccinated to cocoon those very vulnerable people and decrease the circulation of measles in our community.”

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Health

US children’s hospitals overwhelmed by RSV cases | Health News

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Los Angeles, California – “It feels like this endless, large-volume influx that keeps coming through our emergency department, or phone calls from outside hospitals who are also bursting at the seams,” Hui-wen Sato, an intensive care unit (ICU) nurse at a Los Angeles children’s hospital, said of a recent surge of RSV cases.

RSV, or respiratory syncytial virus, is a common virus that spreads mainly through direct contact or coughing. It usually causes mild symptoms but can be dangerous for young children and elderly people.

Across the United States, children’s hospitals are seeing a surge of RSV cases that are severely straining their capacity. As in the early days of the COVID-19 pandemic, some hospitals are building overflow tents to house more beds.

Sato, who has worked as a paediatric nurse for 12 years, said she has never seen such a high number of RSV cases, telling Al Jazeera that this year feels “exceptionally overwhelming”. Before the surge, her ICU was already under pressure due to staffing shortages. Nurses in the ICU can have a maximum of two patients, and while the unit physically has 24 beds, at times they have had to limit the number of filled beds to 20 because there aren’t enough staff.

Now, with the RSV surge, Sato said it’s a struggle to keep enough “wiggle room” for severe trauma patients coming through the emergency room. In the past, respiratory illness patients made up 50 to 60 percent of those admitted, but this year she estimated they make up about 70 percent.

Low morale, mental stress and illness have pushed droves of healthcare workers to quit since the pandemic began.

“There began this real steady departure of nurses from our hospital, but we’re hearing it happen everywhere,” Sato said. “The domino effect of the pandemic, nurses leaving, a [staffing] shortage and the biological reasons why there’s such a huge RSV surge is creating this perfect storm.”

COVID-19 isolation

Children’s hospitals and the American Academy of Pediatrics have called on the administration of US President Joe Biden to declare an emergency over RSV. But the administration has not yet done so, telling NBC News that “public health emergencies are determined based on nationwide data, science trends, and the insight of public health experts”.

On Sunday, the country’s top infectious disease expert, Dr Anthony Fauci, told CBS that children’s hospitals in some regions were being overwhelmed: “When the nurses and the paediatric associations are saying this is really critical, it is.”

The rise of the virus this fall may be connected to the lack of contact among children who were isolated during the pandemic, experts told Al Jazeera. Daniel Rauch, the chief of paediatric hospital medicine at Tufts Medicine, said preschoolers aged two to four are typically more resilient to RSV than infants, but this year it is making them sicker than usual.

“There’s a hypothesis that the kids getting it now, particularly that preschool age group, are the kids who didn’t get it last year and the year before in the pandemic, because they were isolated, and they weren’t around other sick kids, and they weren’t sharing those viruses,” Rauch told Al Jazeera.

A decline in paediatric hospital beds over the last 20 years is contributing to the current crisis, he said. US hospitals charge for the care they deliver, and in general, hospitals are paid more for an adult in a bed than for a child in a bed, because adults are more likely to need procedures that can be billed for, while children often only need supportive care, such as being placed on a ventilator or being given oxygen if they have a respiratory illness.

“A hospital that operates on a very thin margin has to decide: Are we going to take care of kids and potentially lose money on that? Or are we going to take care of adults and make more money for it – and that will support our care of everything else we do in the hospital? That’s unfortunately very simple math for a lot of hospital administrators,” Rauch said.

“We’ve lost this capacity over the last couple decades, and it’s because we don’t pay for paediatric care like we do for adult care,” he added. “And this is what happens when you don’t value caring for children.”

Vaccine development

One final, unexpected factor is also contributing to the bed shortage, experts say: the increasing mental health crisis among young people.

The pandemic has led to increased isolation and stress among children and teens, leading to higher rates of young people struggling with mental illnesses such as depression and substance use disorder – and those children can end up in ICUs if they attempt suicide, Rauch said.

“Five years ago, I could have handled this surge better because my beds weren’t filled with kids with behavioural health issues … There’s no psych beds for them. They’re just stuck in the hospitals,” he said. “So my capacity is actually much less than it seems, because I have all these kids with mental health issues that I can’t send anywhere else. It’s the storm of combined events that have made it very difficult to have access to inpatient care.”

While there is no vaccine for RSV, the US pharmaceutical company Pfizer has announced it will submit one for approval by the US Food and Drug Administration by the end of the year. The vaccine would be given to pregnant people who would then pass antibodies to their infants.

Janet Englund, a professor of paediatrics and an infectious disease specialist at Seattle Children’s Hospital, told Al Jazeera that her hospital was also contributing research towards the development of an RSV vaccine. “The vaccine may be available to elderly high-risk individuals by 2023 or 2024,” she said. Until then, Englund and other experts recommend wearing a mask or staying home when sick, in order to protect others and reduce strain on the healthcare system.

Sato says she constantly worries that she may admit one person too many, meaning she would have to deny a bed to an especially sick child. She also feels the moral distress of having to push her staff, “when all I want to do is support them – because as the charge nurse, I have to keep this flowing”.

She recommends that people wash their hands, postpone social gatherings if they feel sick, and wear masks.

“We’re not asking people to mask forever,” Sato said. “We’re just asking people to help the healthcare system stay afloat, and if they could just wear their masks through this winter, so that we don’t see a departure of burnt-out staff and see the whole system crumble.”

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Health

What to do if your child has a respiratory infection? Our medical analyst explains

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CNN
 — 

A common respiratory virus, respiratory syncytial virus, is surging in the United States, leading to some children’s hospitals being overwhelmed. The influenza virus is also on the rise, along with other viruses — such as adenovirus and rhinovirus — that cause the common cold.

At the same time, children are back at school and families are returning to many in-person activities, often without the mitigation measures applied during Covid-19, heightening the possibility for viral spread.

What kinds of respiratory infections can be treated at home — and with what treatments? Which symptoms should prompt a call to the doctor, or for parents and caregivers to bring their children to the hospital? When should children stay out of school? And what are the precautions families can take to reduce the spread of respiratory viruses?

To help us with these questions and more, I spoke with CNN Medical Analyst Dr. Leana Wen, an emergency physician, public health expert and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also author of “Lifelines: A Doctor’s Journey in the Fight for Public Health” and the mother of two young children.

CNN: Why are respiratory infections on the rise?

Dr. Leana Wen: They have always been common among children. Before Covid-19, it was the norm, especially during the fall and winter, for schoolkids to have runny noses and coughs.

Now, they may be increasing in part because mitigation measures taken during the pandemic — like social distancing, masking and avoiding large gatherings — resulted in fewer respiratory viruses being spread over the past two winters. As a result, a lot of kids don’t have the immunity they normally would.

My own kids have already had at least three bouts of respiratory illness each since they started back at kindergarten and preschool less than two months ago. Thankfully, they recovered well and did not get severely ill, but I certainly understand the worry and distress that parents and caregivers feel when our children are sick.

CNN: Which respiratory infections can be dealt with at home?

Wen: The vast majority of respiratory infections in children can be managed at home with fluids, fever-reducing medicines and rest. What’s causing the infection is generally not the key determining factor in whether a child needs hospital care — it’s how the child is doing.

Respiratory syncytial virus, also known as RSV, is concerning on a public health level because some hospitals are getting full with children who have it. Prior to the Covid-19 pandemic, the US Centers for Disease Control and Prevention estimated that virtually all children will get RSV before their second birthday — and that some 58,000 kids will end up being hospitalized for it every year. Clearly, RSV is a very serious infection among some children, and parents should know what to watch for to spot severe illness. But also keep in mind that the vast majority will have mild, cold-like symptoms and will not need to be hospitalized.

The same goes for other viruses. Influenza can cause very severe illness, as can Covid-19. However, most cases in children do not result in hospitalization, and symptoms can be managed at home. On the other hand, there are viruses that one typically associates with a mild cold, like adenovirus, that can cause some children to become very sick.

If you end up going to the emergency department, your child will probably get tested for Covid-19, influenza and RSV. Some pediatricians would do this too. If your child were hospitalized, they might get additional virus testing. But a lot of doctor’s offices wouldn’t provide such care because, again, the actual virus leading to the illness is less important in determining whether your child needs to be hospitalized than how your child is doing.

The exception is very young infants — generally those under 2 months of age — who are typically tested and monitored more.

CNN: What other risk factors should lead to parents watching for severe illness?

Wen: Newborns are very vulnerable. They have little immunity and not much physiological reserve, meaning that once they get sick they could become very ill very quickly. Premature babies are also at risk. Many of them have underdeveloped lungs. A baby born two months premature has a physiological age two months younger than a baby born at term on the same day.

There are other factors to consider, too, including for young kids who have significant heart and lung disease, or are severely immunocompromised. In all these situations, families should have a low threshold for calling their physician.

CNN: If a child is generally healthy and develops a fever, cough or runny nose, should parents and caregivers call the doctor? When should they rush to the hospital?

Wen: There are two major symptoms that should prompt concern in respiratory infections. The first is breathing difficulties. Look for struggled and fast breathing. For example, if your children are wheezing or grunting; if their nostrils are flaring; if they are belly breathing, meaning that the chest caves in during breathing and the belly goes out; or if their breathing rate is higher than normal.

The second is difficulty keeping hydrated. This is particularly a problem in babies. If they get stuffed noses, it can be hard for them to drink breastmilk and formula, and they could get dehydrated very quickly. If your child looks sleepy and isn’t drinking, or if your baby is having a decrease in the number of wet diapers, call your doctor sooner rather than later.

Ongoing issues — for example, a mild fever that’s been going for a few days — could probably wait for your pediatrician’s office hours.

I’d advise that you have a plan before your child gets sick. A lot of pediatricians have an on-call service where you can reach your doctor or another health care provider within an hour, even at night and on weekends. Know if this possibility exists and have that number easily available to call. If your pediatrician is not reachable after hours, you should know which hospital you’d bring your child to if they were to become seriously ill. Ideally, it’s a hospital close to you and that’s staffed with pediatric emergency medicine specialists.

If you can’t easily reach your doctor by phone in emergencies, have a low threshold to bring your child to the hospital, especially if you have a newborn or young baby. Breathing difficulties and inability to keep hydrated are good reasons to immediately go to the hospital.

CNN: When should kids stay out of school?

Wen: That depends on the policies at your child’s school. Many schools ask that kids stay at home while they have fevers. They also shouldn’t be in attendance if they are throwing up. Some schools may also require Covid-19 testing to make sure that what’s causing the symptoms is not the coronavirus.

That said, it’s probably not reasonable to ask that kids stay home if they have any hint of the sniffles. That could mean kids miss many weeks of school during winter months. Parents and caregivers should assume there are kids who are infected with some respiratory pathogens in their child’s class at all times and take precautions accordingly. Some families may choose to mask. Others may go back to what they did pre-Covid, which is to stick with good hand hygiene and not being around vulnerable people when sick.

CNN: What types of precautions should parents and caregivers take?

Wen: Handwashing is a big one. Many of these respiratory pathogens travel through droplets: When someone sneezes or coughs, those droplets land on surfaces that someone else touches and then touch their nose or mouth. Encourage your kids to wash their hands frequently, and if they need to cough or sneeze, they should do so into their elbow or a tissue to reduce the spread of the droplets.

If a person in your household has a respiratory infection, it can be easily spread to other household members. You can reduce that risk by not sharing utensils or drinks with the person who is ill, and keeping the person who is sick away from vulnerable household members like newborns and the elderly. In general, families should also limit exposure for newborns and premature babies as much as possible.

There is no approved vaccine for RSV, but there is for the flu. Parents should get their kids the flu shot. They should get their kids vaccinated against Covid-19 if they haven’t already, and assess their own family circumstances to determine whether they should get their children aged 5 or older the new bivalent booster.

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Health

RSV: Behaviors that helped keep us safe from Covid are probably driving surge in RSV cases, scientists say

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CNN
 — 

The behaviors that helped keep us safe from Covid-19 over the past 2½ years – lockdowns, physical distancing, wearing masks, washing hands – are probably behind the “unprecedented” early surge in RSV infections this year, scientists say.

These factors may also have thrown other seasonal respiratory viruses out of whack around the globe.

“As long as we’ve had a record of RSV and other respiratory diseases in the United States, there have been these very regular patterns of outbreaks,” said Rachel Baker, an epidemiologist and assistant professor at Brown University.

“RSV pops up every year in the late autumn/wintertime and has these outbreaks mostly in young kids. Then it disappears again for the spring/summer months and pops up again the following winter,” Baker said. “It’s very regular and predictable” – until it isn’t.

Cases of RSV, or respiratory syncytial virus, in the United States started showing up in the spring and are now 60% higher than 2021’s peak week, a CNN analysis shows, and that’s probably an undercount.

Across the US, the number of flu cases has also been increasing a little earlier than usual. A handful of schools have seen large absences, and medical offices say they are seeing more people sick with other respiratory viruses at times that don’t fit the usual patterns.

There have been similar unusual patterns in respiratory infections such as adenovirus, parainfluenza and rhinovirus in other countries, too.

Scientists think unparalleled actions of the pandemic had unparalleled effects.

“The degree of societal changes that occurred with the Covid pandemic really is unprecedented in modern day,” said Dr. Kevin Messacar, an associate professor in the Department of Pediatrics at Children’s Hospital Colorado.

Like Covid-19, RSV and the flu spread through droplets released into the air when people cough or sneeze. The droplets also linger for hours on frequently touched surfaces like doorknobs and light switches.

So the people who washed hands and disinfected surfaces, who wore masks and kept their distance from others, did more than stop the spread of the coronavirus.

“Those interventions, while they were great at limiting the spread of Covid-19, they also did a really good job of limiting the spread of other respiratory diseases such as RSV and influenza,” Baker said.

There was a sudden dropoff in RSV cases and hospitalizations in the seasons of 2020 and 2021, studies have showed, as well as unusually tame flu seasons.

“It was really striking,” Baker said.

But as Covid-19 vaccines and treatments became available, more people started going back to school and work and interacting without masks. They also started sharing germs.

The pandemic behaviors created an “immunity gap” or “immunity debt” that makes more people in the US vulnerable to diseases like RSV.

Children build natural immunity to viruses when they’re exposed to them. Most kids catch RSV at some point before they turn 2, the US Centers for Disease Control and Prevention says. Newborns get some passive protection from their mothers, who pass along antibodies through breast milk.

But for a couple of years, there was little opportunity for children born during the pandemic or the people around them to catch RSV – or other viruses, for that matter. Their immunity waned or never formed at all. So when those little ones and their parents started to interact with others, they were more likely to get sick.

“Decreased exposure to endemic viruses created an immunity gap – a group of susceptible individuals who avoided infection and therefore lack pathogen-specific immunity to protect against future infection,” Messacar and Baker wrote this summer in a commentary published in the medical journal The Lancet.

They warned hospitals that they needed to remain flexible and prepared for unpredictable seasons of respiratory illnesses because of this gap.

“We knew it was inevitable that these diseases would come back,” Messacar told CNN.

The commentary warned about an influx of infections that would include older children who hadn’t been exposed to viruses as well as newborns whose moms weren’t able to pass along antibodies because they hadn’t been in contact with these germs.

“Now we’re seeing it’s spreading really well,” Baker said. “And it’s not just striking the kids that it would typically strike with that first birth cohort. It’s also creating infections in older kids.

“That’s how infectious diseases work,” she added. “Once you have more cases, they create more cases, and you get this spike.”

Baker and Messacar don’t think this early-season pattern with RSV is permanent, but it could take a while to return to its more predictable cycle.

“Now we’re in a little bit of a strange period, but I think in the next few years, we’ll start to see those regular outbreaks – well, depending on what happens with Covid,” Baker said. If the coronavirus gets bad enough that more lockdowns are necessary, it could once again throw off the seasonality of other viruses.

With viruses like the flu, there are more variables involved, Messacar said.

There’s no vaccine to prevent RSV, but there is for flu, so if the flu shot is a good match for the strain in circulation and enough people get it, the country could avoid a spike in cases like it’s seeing now with RSV.

Scientists are working on an RSV vaccine, but it won’t come in time to help this season.

In the meantime, there are some things to do to limit the spread of RSV, and they’ll sound very familiar.

Wash your hands. Keep frequently used surfaces clean. Sneeze or cough into a tissue or into your elbow rather than your hands. Boost your immunity by getting plenty of sleep and eating a healthy diet. Wear a mask, especially when you’re sick. And most important, if you’re sick, stay home.

“These non-pharmaceutical interventions all work, clearly, and the more we can do to keep cases of any of these viruses down, the better,” Baker said.

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US

Test scores: US math and reading scores plummeted during the pandemic

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CNN
 — 

Fourth- and eighth-graders fell behind in reading and had the largest ever decline in math, according to a national educational assessment showing the devastating effect of the Covid-19 pandemic on America’s children.

The alarming findings are based on the National Assessment of Educational Progress reading and math exams, often called the “Nation’s Report Card” and conducted by the National Center for Education Statistics, a branch of the Education Department.

“If this is not a wake-up call for us to double down our efforts and improve education, even before it was – before the pandemic, then I don’t know what will,” US Secretary of Education Miguel Cardona told CNN’s Brianna Keilar during an appearance on “New Day” Monday.

He called on schools to ensure they are using funding from the Covid relief package passed in 2021 to boost student scores.

Cardona suggested widespread teacher shortages are a “symptom of decades of underinvestment” in schools and called on districts to pay teachers more competitively.

The first national assessment of student achievement in three years revealed the largest math score declines among fourth- and eighth-graders since the initial trial assessment in 1990, according to the Center’s Commissioner Peggy Carr. The tests were administered between January and March.

No state or large urban district showed improvements in math, the report said. Eighth-grade math scores sank in the more than 50 states and jurisdictions participating in the assessment. The last report card was issued in 2019, before the start of the pandemic in the US, where schools were shut down and teachers turned to online learning.

“Eighth grade is that gateway to more advanced mathematical course taking,” Carr told reporters before the report’s release. “This is what these students are missing. They’re missing these important skills that will prepare them eventually for (science, technology, engineering and math) level careers.”

The average math score of 236 for the fourth grade was 5 points lower than in 2019, and 8 points below the 2019 mark of 274 for the eighth grade. The reading score of 217 for the fourth grade was down 3 points this year – the same decline as the eighth grade score of 260 – compared to 2019.

The discouraging results come more than a month after the national assessment released results showing math and reading scores for 9-year-olds – typically fourth graders – fell between 2020 and 2022 by a level not seen in decades.

The Nation’s Report Card offers the first detailed look into how health crisis disruptions and virtual learning affected fourth- and eighth-graders across the country.

The report shows the pandemic affected all students but had a disproportionate impact on the most vulnerable, who fared the worst.

Scores on the eighth-grade math exams declined across most racial and ethnic groups as well as for lower, middle and high performing students. Fourth-grade math scores dropped for all racial and ethnic groups except native Hawaiian-Pacific Islanders.

The gaps between White students and Black and Hispanic students were larger in 2022 than three years ago, with greater score declines in math for Black and Hispanic students further widening those gaps.

“What we’re seeing is (lower performing) students … dropping even faster and we’re also seeing students who were not showing declines – students at the top, meaning students at the higher performing levels – they were holding steady before the pandemic or even improving,” Carr said. “Now all the students, regardless of their ability, are dropping. That is the point we need to be taking away from this report.”

The math exams reflected the performance of 116,200 fourth-graders in 5,780 schools, and 111,000 eighth-graders in 5,190 schools. The reading tests were given to 108,200 fourth-graders in 5,780 schools and 111,300 eighth-graders in 5,190 schools.

The declines are only partly attributable to the dynamics of schooling during the pandemic, when schools were shuttered and later turned to a mix of online and in-person classes in some cities.

“There’s nothing in this data that tells us that there is a measurable difference in the performance between states and districts based solely on how long schools were closed,” Carr said.

“And let’s not forget that remote learning looks very differently all across the United States. The quality – all of the factors that were associated with implementing remote learning – it is extremely complex.”

Declines in average math and reading scores in the fourth and eighth grades spanned the country – in the Northeast, Midwest, South and West, the report said.

“We’re not surprised to see that the math scores were going to take a bigger hit,” Carr said. “Math is just simply more sensitive to schooling. You really need good teachers to teach math. Reading, on the other hand, is something that parents and the community are more comfortable with helping students with.”

Carr said more analysis is needed to understand the role the pandemic played in the declines, along with other factors such as teacher shortages and bullying.

“This must be a wake-up call for the country that we have to make education a priority,” Beverly Perdue, former governor of North Carolina and chair of the National Assessment Governing Board which oversees the test, said in a statement.

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World

China’s economy is ‘in deep trouble’ as Xi heads to Communist Party congress

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Hong Kong
CNN Business
 — 

When Xi Jinping came to power a decade ago, China had just overtaken Japan to become the world’s second largest economy.

It has grown at a phenomenal pace since then. With an average annual growth rate of 6.7% since 2012, China has seen one of the fastest sustained expansions for a major economy in history. In 2021, its GDP hit nearly $18 trillion, constituting 18.4% of the global economy, according to the World Bank.

China’s rapid technological advances have also made it a strategic threat to the United States and its allies. It’s steadily pushing American rivals out of long-held leadership positions in sectors ranging from 5G technology to artificial intelligence.

Until recently, some economists were predicting that China would become the world’s biggest economy by 2030, unseating the United States. Now, the situation looks much less promising.

As Xi prepares for his second decade in power, he faces mounting economic challenges, including an unhappy middle-class. If he is not able to bring the economy back on track, China faces slowing innovation and productivity, along with rising social discontent.

“For 30 years, China was on a path that gave people great hope,” said Doug Guthrie, the director of China Initiatives at Arizona State University’s Thunderbird School of Global Management, adding that the country is “in deep trouble right now.”

While Xi is one of the most powerful leaders China and its ruling Communist Party have seen, some experts say that he can’t claim credit for the country’s astonishing progress.

“Xi’s leadership is not causal for China’s economic rise,” said Sonja Opper, a professor at Bocconi University in Italy who studies China’s economy. “Xi was able to capitalize on an ongoing entrepreneurial movement and rapid development of a private [sector] economy prior leaders had unleashed,” she added.

Rather, in recent years, Xi’s policies have caused some massive headaches in China.

A sweeping crackdown by Beijing on the country’s private sector, that began in late 2020, and its unwavering commitment to a zero-Covid policy, have hit the economy and job market hard.

“If anything, Xi’s leadership may have dampened some of the country’s growth dynamic,” Opper said.

More than $1 trillion has been wiped off the market value of Alibaba and Tencent — the crown jewels of China’s tech industry — over the last two years. Sales growth in the sector has slowed, and

tens of thousands of employees have been laid off, leading to record youth unemployment.

The property sector has also been bludgeoned, hitting some of the country’s biggest home developers. The collapse in real estate — which accounts for as much as 30% of GDP — has triggered widespread and rare dissent among the middle class.

Thousands of angry homebuyers refused to pay their mortgages on stalled projects, fueling fears of systemic financial risks and forcing authorities to pressure banks and developers to defuse the unrest. That wasn’t the only demonstration of discontent this year.

In July, Chinese authorities violently dispersed a peaceful protest by hundreds of depositors, who were demanding their life savings back from rural banks that had frozen millions of dollars worth of deposits. The banking scandal not only threatened the livelihoods of hundreds of thousands of customers but also highlighted the deteriorating financial health of China’s smaller banks.

“Many middle-class people are disappointed in the recent economic performance and disillusioned with Xi’s rule,” said David Dollar, a senior fellow in the John L. Thornton China Center at the Brookings Institution.

According to analysts, the vulnerabilities in the financial system are a result of the country’s unfettered debt-fuelled expansion in the previous decade, and the model needs to change.

“China’s growth during Xi’s decade in power is attributable mainly to the general economic approach adopted by his predecessors, which focused on rapid expansion through investment, manufacturing, and trade,” said Neil Thomas, a senior analyst for China and Northeast Asia at Eurasia Group.

“But this model had reached a point of significantly diminishing returns and was increasing economic inequality, financial debt, and environmental damage,” he said.

While Xi is trying to change that model, he is not going about it the right way, experts said, and is risking the future of China’s businesses with tighter state controls.

The 69-year old leader launched his crackdown to rein in the “disorderly” private businesses that were growing too powerful. He also wants to redistribute wealth in the society, under his “common prosperity” goal.

Xi hopes for a “new normal,” where consumption and services become more important drivers of expansion than investments and exports.

But, so far, these measures have pushed the Chinese economy into one of its worst economic crises in four decades.

The International Monetary Fund recently cut its forecast for China’s growth to 3.2% this year, representing a sharp slowdown from 8.1% in 2021. That would be the country’s second lowest growth rate in 46 years, better only than 2020 when the initial coronavirus outbreak pummeled the economy.

Under Xi, China has not only become more insular, but has also seen the fraying of US-China relations. His refusal to condemn Moscow’s invasion of Ukraine, and China’s recent aggression towards Taiwan, could alienate the country even further from Washington and its allies.

Analysts say the current problems don’t yet pose a major threat to Xi’s rule. He is expected to secure an unprecedented third term in power at the Communist Party Congress that begins on Sunday. Priorities presented at the congress will also set China’s trajectory for the next five years or even longer.

“It would likely take an economic catastrophe on the scale of the Great Depression to create levels of social discontent and popular protest that might pose a threat to Communist Party rule,” said Thomas from Eurasia Group.

“Moreover, growth is not the only source of legitimacy and support for the Communist Party, and Xi has increasingly burnished the Communist Party’s nationalist credentials to appeal to patriotism as well as pocketbooks,” he added.

But to get China back to high growth and innovation, Xi may have to bring back market-oriented reforms.

“If he was smart, he would liberalize things quickly in his third term,” said Guthrie.

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Health

Second COVID booster effective at preventing hospitalizations and deaths in nursing home residents: study

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A new study published this week found that the second COVID-19 booster that was made available to U.S. adults older than 50 this year was highly effective at protecting nursing home residents from hospitalizations and deaths, though its ability to prevent infections was not as potent.

The analysis, published in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report, compared nursing home residents who received a second original mRNA booster dose to those who did not get the additional shot.

According to the study, the second shot was 90 percent effective at preventing coronavirus-related deaths and 74 percent effective at preventing severe cases that led to either hospitalizations or deaths.

The shot was about 26 percent effective at preventing infection, however. This study looked at cases between March 29 and July 25. It was within this period that the BA.5 omicron subvariant grew to become dominant in the U.S.

By the end of July, BA.5 was accounting for four out of five coronavirus cases, and experts had noted its ability to evade protection from immunization and prior infection.

The 9,527 nursing home residents who were included in the study had received their booster within 60 days when they were followed up on by researchers. In order to be eligible, participants had to have stayed in a nursing home for more than 100 days, spent less than 10 outside of the facility and received three prior vaccine doses, with the last dose received more than 120 days beforehand.

Nearly 200 nursing homes from 19 states were included in the study.

Nursing homes have been disproportionately impacted by the coronavirus throughout the pandemic. Roughly three out of four COVID-19 deaths have been among those over the age of 65. When the delta variant spread throughout the U.S. last year, coronavirus deaths rose at a faster rate in nursing homes than in the rest of the country.

“These findings suggest that among nursing home residents, second mRNA COVID-19 vaccine booster doses provided additional protection over first booster doses against severe COVID-19 outcomes during a time of emerging Omicron variants,” researchers wrote.

“Facilities should continue to ensure that nursing home residents remain up to date with COVID-19 vaccination, including bivalent vaccine booster doses, to prevent severe COVID-19 outcomes.”

White House COVID-19 response coordinator Ashish Jha hailed the study’s findings.

“This is why we’re so focused on ensuring folks, particularly the high risk, get the latest vaccine,” Jha tweeted.

If they have not been recently vaccinated once more or infected with the virus, many of the participants in this study would now be eligible to receive the bivalent omicron-specific COVID-19 booster. The updated shot was authorized at the end of August.

The White House has strongly encouraged eligible individuals to get the bivalent booster, hoping to avoid another surge in coronavirus cases in the fall and winter. The dose has been followed by some uncertainty, as it was approved before a full human study was completed, with both Pfizer and Moderna submitting animal data, as is done for annual flu shots.

Pfizer and Moderna have recently submitted applications seeking authorization from the Food and Drug Administration to administer their shots in younger populations. Pfizer’s bivalent booster is authorized for children as young as 12, while Moderna’s is currently only authorized for adults.

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US

Biden to host French President Macron at White House for first state visit

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CNN
 — 

President Joe Biden will host his first state visit at the White House for French President Emmanuel Macron on December 1, the White House confirmed, marking the return of a tradition not seen since before the Covid-19 pandemic.

“We’d like to announce that President Joe Biden and first lady Dr. Biden will host President Emmanuel Macron and Mrs. Brigitte Macron of France for a state visit to the United States on December 1st, 2022. This will be the first state visit of the Biden-Harris administration,” White House press secretary Karine Jean-Pierre said during Monday’s press briefing.

The state visit, which will include a state dinner, “will underscore the deep and enduring relationship between the United States and France – our oldest ally,” Jean-Pierre said.

“Our close relationship with France is founded on our shared democratic values, economic ties and defense and security cooperation. The leaders will discuss our continued close partnership on shared global challenges and areas of bilateral interest,” she added.

Biden is holding his first state dinner more than halfway through his term in office – later than previous US presidents. Jean-Pierre acknowledged Monday that “Covid certainly has delayed many of the in-person events a president traditionally hosts at the White House,” but highlighted previous White House visits by world leaders earlier in Biden’s term.

The tradition of the White House state visit – which is typically a multi-day affair that entails formal ceremonies, meetings and a glitzy black tie dinner – has been dwindling.

The Trumps welcomed the Macrons for their administration’s first state dinner in 2018. Their second and final state visit took place in 2019, when the White House hosted then-Australian Prime Minister Scott Morrison. The Trumps were also slated to host the King and Queen of Spain in 2020 – an event that was postponed indefinitely due to the pandemic.

Macron and Biden have spoken to one another several times since Biden took office in January 2021. Most recently, they met last week in New York as world leaders gathered for the United Nations General Assembly. The two discussed the ongoing war in Ukraine, Iran, the Indo-Pacific and challenges posed by China, according to the White House.

Biden and Macron held their first formal meeting in June 2021 during the G7 Summit in England, walking away having relayed that they were on the same page. Macron heaped praise on Biden as being “part of the club” following a more fraught relationship with former US President Donald Trump.

Macron, now in his second term, has emerged as the leading voice to advocate for the European Union. Since the warm G7 meeting, a number of global challenges have emerged, setting Macron up to distinguish himself on the world stage.

A failed deal for France to produce nuclear-powered submarines for Australia caused a major international rift.

In September 2021, the French government recalled its ambassadors to the US and Australia for consultation in response to an announced national security partnership that would provide the US-produced submarines to Australia – abandoning a $90 billion existing deal with France to provide their submarines to the country.

Later that fall, Biden admitted that his administration was “clumsy” in its handling of the deal, saying he was “under the impression that France had been informed long before that the deal was not going through.” And earlier this summer, France’s defense minister said the country aimed to rebuild its relationship with Australia.

Western leaders, including Biden and Macron, have broadly united in their opposition to combat Russia’s ongoing war on Ukraine.

France has also been a key player in negotiations to curb Iran’s nuclear program.

Pressed on Monday whether the decision to host France was about mending ties following some rifts earlier in Biden’s term, Jean-Pierre responded, “We deeply value our relationship with France. … We work closely with France on the full range of global challenges, as you all know, including the war in Ukraine. It is for these reasons that the President and first lady thought it was important to welcome this close and valued partner to the White House for their first state visit.”

This story has been updated with additional reporting.

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Health

Your sore throat can determine if you have contracted Covid-19. Here’s how to understand

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On similar tracks, the common symptom of common cold – sore throat- can also determine of you have contracted the coronavirus or not. 

In a recent media briefing World Health Organization (WHO) chief Tedros Adhanom Ghebreyesus spoke of a new sub-variant of the highly transmissible Omicron variant of Covid-19 that has now been detected in India.

Omicron sub-variants BA.4, BA.5 may fuel into a new Covid infection surge, a top health official in India said on 8 July.

Ghebreyesus also talked about the global sudden surge in coronavirus cases. “Globally reported cases have increased nearly 30 per cent over the past two weeks. Four out of six of the WHO subregions saw cases increase in the last week,” he said. “In Europe and America, BA.4 and BA.5 are driving waves. In countries like India a new sub-lineage of BA.2.75 has also been detected, which we’re following,” he added.

The SARs-CoV-2 virus is a respiratory illness just like a common cold or influenza. It can impact both the upper and the lower respiratory tract giving light to several symptoms.

Sore throat for symptom

With the oncoming monsoon season after a difficult phase of prolonged heat wave, the season change has caused viral fever with cough and cold in many. 

At such a time, sore throat is very common among patients and recently experts believe the duration of your symptom could reveal whether you have Covid-19 or not. 

However, there are no evidence to support that the sore throat and a Covid-19 are throat are any different. 

What happens during sore throat?

Sore throat is one of the most common symptoms that arises with respiratory infections. Other than that, fever, cough, runny nose, and sneezing are some of the other most commonly reported symptoms in people infected with Covid or common cold/flu.

If you develop a sore throat due to Covid-19, you may experience pain, scratchiness, thickness in your throat, especially while swallowing something. There could be a dry, irritating feeling which could be an outcome of inflammation in the back of your throat.

How to differentiate between Covid and non Covid sore throat?

The best way to differentiate between COVID and common cold/flu is by looking at the severity of the disease and how fast the viruses travel. Covid-19 seems to spread more easily than the flu or the common cold and takes more time when it comes to recovery.

According to the data collected by the UK’s ZOE Covid Symptom Study app, while a sore throat is a less well-known symptom of Covid, it is an early sign of the disease and common among children and adults aged 65 and above.

Besides being “relatively mild”, experts in charge of the app suggest that sore throat from Covid lasts no more than five days.

Anyone suffering from sore throat for over five days should get themselves tested for some other illness, as per the experts.

Reportedly, a Covid sore throat “usually” appears in the first week of illness and can improve “quite quickly”.

“It feels worse on the first day of infection but gets better on each following day,” researchers at ZOE explain.

While sore throat is a commonly reported symptom of COVID-19, it is not the only one. According to the ZOE Covid app, 69% of users have reported headache, making it a leading symptom.

Other signs and symptoms of Covid-19

A person should take a Covid-19 test if they are suffering from the illnesses listed below

– Fever or chills

– Cough

– Fatigue

– Muscle or body aches

– New loss of taste or smell

– Shortness of breath or difficulty breathing

– Congestion or runny nose

– Gastrointestinal issues like nausea, vomiting, loss of appetite, diarrhea

Remedies for Covid sore throat

One must drink plenty of warm water and stay hydrated. You can also mix a spoonful of honey to soothe the irritation and inflammation in the throat.

Gargling with saltwater is also read to be a soothing practice. You can also do such on throat lozenges, which helps keep your throat moist.

Make sure you get enough rest so that your body’s immune system is recharged and can combat infections efficiently.

In case the home remedies fail, you can take over-the-counter medications prescribed by your doctors to ease your pain.

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Health

LA COVID Hospitalizations Rise, Prompting Mother’s Day Warning – NBC Los Angeles

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The number of COVID-positive patients in Los Angeles County hospitals has risen by 19 people to 258, according to the latest state data out Saturday.

The number of those patients being treated in intensive care was 33, down from 36 on Friday.

Those numbers come one day after local health officials reported more than 3,200 new infections, while warning again of the disproportionate impact the pandemic has had on Black and Latino/a residents.

The county reported 3,270 new infections Friday, lifting its overall total throughout the pandemic to 2,888,408. Six more virus-related fatalities were also reported, raising the death toll to 31,991, according to the Los Angeles Department of Public Health.

The average daily rate of people testing positive for the virus was 2.3% on Friday, roughly the same as Thursday.

The department does not report COVID data on weekends.

The health department warned Friday that throughout the pandemic, Black and Latino/a residents have faced a higher impact in terms of infections and deaths than white and Asian residents. Lower-income areas have also been more heavily affected.

The discrepancies point to long-standing differences in level of care and access to care, officials said.

Health officials noted that during the four COVID surges the county has faced, Black and Brown residents have had case rates between two and four times higher than white residents. Hospitalization rates were three to four times higher during the recent winter surge, and death rates were two to three times higher in that same period.

COVID vaccinations didn’t fully rectify discrepancies between wealthy and lower-income areas. According to the county, fully vaccinated residents in high-poverty areas were still twice as likely to get infected and wind up hospitalized than fully vaccinated residents in wealthier communities.

Unvaccinated residents in high-poverty areas, meanwhile, are 12 times more likely to die from the virus than unvaccinated residents in wealthier areas.

County officials attributed the differences to factors such as frequency of exposures, overall community conditions and general health status of residents in the various areas.

Health officials have also said that the majority of people who die of COVID complications have underlying conditions, mainly hypertension, diabetes and heart disease.

“As LA County continues in this different phase of the pandemic, Public Health’s goal has not changed, and we will work with partners to reduce serious illness and deaths from COVID-19,” Public Health Director Barbara Ferrer said in a statement. “It is simply not appropriate to tolerate disproportionality that results in higher rates of illness, death and long-term disability among some residents and workers when there are collective prevention strategies that can mitigate spread and serious illness.”

Ferrer also urged people to exercise caution during Sunday’s Mother’s Day activities.

“Given that the virus is spreading at a high rate, Public Health asks all those gathering to celebrate and honor their moms and grandmoms this weekend to keep each other safe by testing before gathering, staying outside as much as possible, and wearing masks when indoors,” she said in a statement Saturday. “We wish everyone a joyous Mother’s Day.”

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