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Health

COVID-19’s Effects on Cognition – Neuroscience News

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Summary: Patterns of cognitive impairments suffered by those infected with COVID-19 were similar to those of healthy people who are sleep deprived. Additionally, worse symptoms of cognitive impairment in coronavirus patients were directly correlated with more severe infection.

Source: University of Western Ontario

A new long-term study led by neuroscientists at Western University shows short-term symptoms from COVID-19, like labored breathing, fever, and dry cough, may just be the proverbial tip of the iceberg.

The findings, published by Cell Reports Medicine, reveal short and possible long-term cognitive impairments among people who had COVID-19.

With a robust data set collected by participants using the Cambridge Brain Sciences online scientific investigation tool, principal investigators Adrian Owen and Conor Wild discovered significant impairments in reasoning, speed of thinking and verbal abilities in patients with confirmed cases of COVID-19, but no losses in memory functioning.

“The pattern of cognitive impairment in these COVID-19 patients resembles that of healthy study participants who are sleep-deprived,” said Owen, professor of cognitive neuroscience and imaging at Western’s Schulich School of Medicine & Dentistry.

In 2017, Owen and Wild conducted the world’s largest sleep study, with more than 40,000 people participating, using the same online scientific investigation tool.

For the COVID-19 brain study, Owen, Wild and their collaborators at Western, University of Cambridge, Sunnybrook Health Sciences Center, and University of Ottawa assessed nearly 500 people approximately three months after a confirmed diagnosis of COVID-19.

The participants’ COVID-19 experiences ranged from “very mild” to “ICU on ventilation.” The researchers found the severity of the cognitive impairments was directly related to the severity of the original infection.

“The worse the COVID-19 symptoms were for the patient, the worse the cognitive impairments were, as well,” said Wild, a Schulich School of Medicine & Dentistry research associate, noting significant impairments were also seen in those with mild infection.

Credit: University of Western Ontario

The researchers recruited thousands of participants for the study; however, since COVID-19 testing was so sparse in the early days of the pandemic (the study launched in June 2020), they were unable to confirm who had contracted COVID-19 versus those who just thought they might have it. As a result, Owen and Wild chose to focus on 478 individuals, who reported having had a medically confirmed case of COVID-19.

The study also found that the degree of cognitive impairment was not related to the amount of time that had elapsed between COVID-19 infection and the assessment, suggesting that they might be long-lasting.

The researchers found the severity of the cognitive impairments was directly related to the severity of the original infection. Image is in the public domain

“The impairments were not smaller for individuals who were up to three months post-infection, which suggests that these effects may not subside in the short term,” said Wild.

Mental health impact

The COVID-19 brain study participants presented significantly elevated levels of depression and anxiety, with 30 percent meeting the clinical criteria for one or the other, or both.

“These effects on mental health were not related to the severity of the original infection, or cognitive impairments, suggesting that they may be the result of living through the pandemic itself, rather than the result of COVID-19 infection,” said Dr. Richard Swartz from Sunnybrook Health Sciences Center.

The findings of this study are an important first step in a much larger research program emerging at Western, which includes researchers from Western Institute for Neuroscience (WIN), BrainsCAN, the Imaging Pathogens for Knowledge Translation (ImPaKT) Facility, and partners across campus studying the cognitive impairment, disease progression and mitigation, and social inequalities of long COVID.

About this cognition and COVID-19 research news

Author: Jeff Renaud
Source: University of Western Ontario
Contact: Jeff Renaud – University of Western Ontario
Image: The image is in the public domain

See also

Original Research: Open access.
“Disentangling the cognitive, physical, and mental health sequelae of COVID-19” by Conor J. Wild et al. Cell Reports Medicine

Abstract

Disentangling the cognitive, physical, and mental health sequelae of COVID-19

Highlights

  • Survivors of COVID-19 exhibit cognitive differences in specific domains
  • Speed of processing, verbal, and reasoning are affected, but not memory function
  • Performance in affected domains is linked to physical but not mental health
  • These effects are observed in mild and hospitalized cases of COVID-19

Summary

As COVID-19 cases exceed hundreds of millions globally, many survivors face cognitive challenges and prolonged symptoms.

However, important questions about the cognitive effects of COVID-19 remain unresolved. In this cross-sectional online study, 478 adult volunteers who self-reported a positive test for COVID-19 (mean = 30 days since most recent test) perform significantly worse than pre-pandemic norms on cognitive measures of processing speed, reasoning, verbal, and overall performance, but not short-term memory, suggesting domain-specific deficits. Cognitive differences are even observed in participants who did not require hospitalization.

Factor analysis of health- and COVID-related questionnaires reveals two clusters of symptoms—one that varies mostly with physical symptoms and illness severity, and one with mental health.

Cognitive performance is positively correlated with the global measure encompassing physical symptoms, but not the one that broadly describes mental health, suggesting that the subjective experience of “long COVID” relates to physical symptoms and cognitive deficits, especially executive dysfunction.

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Health

COVID-19’s 6th wave begins, with more seriously ill and more deaths

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Medical centers around the country, on the receiving end of the sixth Coronavirus wave, have reported an increase in patients needing to be hospitalized, those who are seriously ill and even in deaths.

Dr. Nadav Sorek, director of the infectious disease lab at the Samson Assuta Ashdod University Hospital said on Mondy that 25% of antigen tests for COVID-19 are positive now compared to only 10% in May. “The significance is twofold and worrying in light of the increase in the number of tests. In recent weeks, we have witnessed an increasing increase in positive tests from the total number of tests to detect and identify the Coronavirus, and if we take into account that the number of tests has increased at the same time, then the reality is even more complex.”

“If the criteria for being in another COVID-19 wave is an extreme increase in the number of positive tests, then we are in the midst of a wave.”

Dr. Nadav Sorek

The infectious disease expert added that “what mainly worries the healthcare system is an increase in infection among medical staffers, along with an increase in the number of critically ill patients as a result of an increase in the general patient rate. However, compared to the waves of the past and in light of the experience we have gained, vaccines and medications, most of our attention and concern is given to patients over the age of 60 who were infected along with suffering from chronic diseases.”

The Rabin Medical Center’s Beilinson Hospital reported on Monday that it now has 36 COVID-19 patients in its reopened ward, with six in serious condition.

Dr. Nadav Sorek (credit: COURTESY SAMSON ASSUTA ASHDOD MEDICAL CENTER)

Current COVID numbers

According to the Health Ministry, 11,438 tested positive for the virus on Sunday, 68,000 during the past seven days. A total of 53,828 have an active infection, most of them with the BA5 sub-type of the Omicron variant. A total of 285 are in serious condition and 56 in critical condition. Fifty are respirated and one is connected to an ECMO machine that takes over for the heart and lungs. A total of 10,940 people in Israel have died of COVID-19 in the last 2.5 years and 26 during the past week.

Over 825,000 people aged 60 and over have received a fourth vaccination, and 4.5 million Israelis have gotten three shots. Internal medicine departments at Ziv Medical Center in Safed are the most overburdened, with 123% capacity, followed by Hillel Jaffe with 121%.

Despite the rise in infectious and serious cases, the Health Ministry continues to recommend wearing face masks indoors, especially in crowded places but has not demanded wearing them except in medical institutions, apparently because “business as usual” in Israel and most people will refuse to comply, especially in the current hot weather. Mask-wearing in public transit, synagogues and event halls is minimal.



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Health

COVID-19’s Severe Impacts on the Brain – Even in People That Did Not Experience Serious Respiratory Symptoms

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CT brain scan.

Tracy Fischer, PhD, lead investigator and associate professor of microbiology and immunology at the Tulane National Primate Research Center. Credit: Tulane University, Paula Burch-Celentano

Tracy Fischer, PhD, lead investigator and associate professor of microbiology and immunology at the Tulane National Primate Research Center, has been studying brains for decades. Soon after the primate center launched its COVID-19 pilot program in the spring of 2020, she began studying the brain tissue of several subjects that had been infected.

Fischer’s initial findings documenting the extent of damage seen in the brain due to SARS-CoV-2 infection were so striking that she spent the next year further refining the study controls to ensure that the results were clearly attributable to the infection.

“Because the subjects didn’t experience significant respiratory symptoms, no one expected them to have the severity of disease that we found in the brain,” Fischer said. “But the findings were distinct and profound, and undeniably a result of the infection.”

The findings are also consistent with autopsy studies of people who have died of COVID-19, suggesting that nonhuman primates may serve as an appropriate model, or proxy, for how humans experience the disease.

Neurological complications are often among the first symptoms of SARS-CoV-2 infection and can be the most severe and persistent. They also affect people indiscriminately —all ages, with and without comorbidities, and with varying degrees of disease severity.

Fischer hopes that this and future studies that investigate how SARS-CoV-2 affects the brain will contribute to the understanding and treatment of patients suffering from the neurological consequences of COVID-19 and long COVID.

Reference: “Neuropathology and virus in brain of SARS-CoV-2 infected non-human primate” 1 April 2022, Nature Communications.
DOI: 10.1038/s41467-022-29440-z

The COVID-19 pilot research program at the Tulane National Primate Research Center was supported by funds made possible by the National Institutes of Health Office of Research Infrastructure Program, Tulane University and Fast Grants.



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Health

Clues to Covid-19’s Next Moves Come From Sewers

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BOSTON—At a sewage treatment plant on a sliver of land in Boston Harbor, trickles of wastewater are pumped into a plastic jug every 15 minutes. Samples from the jugs, analyzed at a lab in nearby Cambridge, Mass., are part of the growing effort to monitor the Covid-19 virus in wastewater across the U.S.

On Deer Island in Boston, readings from the system covering 2.4 million people have recently shown virus readings leveling off after a steep decline from this winter’s Omicron-driven rise. In some areas, levels of the virus may be edging higher.

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“The last few days have been a little worrisome,”

Larry Madoff,

medical director of the bureau of infectious disease and laboratory sciences at the Massachusetts Department of Public Health, said late last week. “It certainly bears careful watching.”

Wastewater sampling here and at hundreds of sites nationwide is once more drawing closer scrutiny from epidemiologists worried the spread of what appears to be a yet-more-contagious version of Omicron, known as BA.2, and rising cases in Europe could soon spoil the latest U.S. recovery. The number of wastewater sites indicating virus increases on a Centers for Disease Control and Prevention dashboard has risen in recent weeks, though the majority of sites still show declining levels.

In Boston and beyond, these systems during the Omicron wave helped quickly detect virus-concentration surges, declines and circulating variants, often before testing and case data. Health authorities believe it will become an increasingly important early-warning tool that can help guide public messaging and other responses, like marshaling resources to surging areas.

Massachusetts public health official Larry Madoff says, ‘The last few days have been a little worrisome.’

A view through the grates at the Deer Island treatment facility in Boston.

But the technique is also suffering some growing pains from a mix of technological, data-interpretation and logistical challenges as U.S. authorities try to build out a national system.

“We’re trying to figure out how you can take that data and turn it into public-health action and how that can be incorporated into a surveillance system,” said

Kelly Wroblewski,

director of infectious-disease programs at the Association of Public Health Laboratories. “It hasn’t quite matured yet.”

Researchers determined early in the pandemic they could track the new coronavirus through the sewers. The low-cost technique has speed and coverage benefits: People can shed virus in their waste before they feel sick enough to get tested. Many never get tests that generate results that can be tallied by public-health officials, especially now that people are self-testing more at home. States have also started closing testing sites and dialing back daily data reporting, making a passive data source like the sewers increasingly important.

“We are really relying more and more on wastewater as testing goes down,” said

Loren Hopkins,

chief environmental science officer with the Houston Health Department, which detected Omicron’s presence via wastewater before it confirmed a case in the city.

Wastewater samples can show an increase in Covid-19 virus levels before it shows up in the case data.

The CDC established a wastewater surveillance network in late 2020 and added wastewater data to its public Covid-19 dashboard in February. The system currently includes data from more than 700 sampling sites that cover roughly one-quarter of the U.S. population. The agency has a contract with a testing company to provide twice-weekly testing to more sites and is aiming to expand its network into all 50 states within the next few years.

Still, some places aren’t well-suited to wastewater monitoring. Roughly one in five households, concentrated in rural areas, use septic systems that don’t feed into sewers or wastewater treatment plants, federal officials estimate.

“We will have a challenge bringing wastewater surveillance to all communities, particularly those that are very rural,” said

Amy Kirby,

team lead on the National Wastewater Surveillance System at the CDC. “But we are hopeful that we can continue to get as many communities on board as possible.”

The CDC’s network has hit some challenges in its expansion. The well-established testing program on Boston’s Deer Island is working through some data-collection hurdles before it can submit numbers to the CDC, said

Steve Rhode,

a laboratory director for the Massachusetts Water Resources Authority.

Lab technicians analyze wastewater samples in Cambridge, Mass.



Photo:

ALLISON DINNER/REUTERS

Sewage samples from Boston and neighboring towns helped preview the Omicron surge.

Some states and facilities aren’t participating. The Wyoming Department of Health stopped its wastewater monitoring system in December after funding for the program ended. There hasn’t been a firm decision on future wastewater monitoring, a department spokeswoman said.

North Dakota monitors wastewater, but some lawmakers and citizens were opposed to reporting the data federally. The state declined to participate in the federal program, the state’s health department said.

Other states are aiming to build bigger programs. Louisiana has sampling sites in the New Orleans area transmitting data to the CDC. The state wants to build up to 100 sites including cities and places like prisons and nursing homes, said

Theresa Sokol,

Louisiana’s state epidemiologist.

What is an endemic and how will we know when Covid-19 becomes one? WSJ’s Daniela Hernandez breaks down how public-health experts assess when a virus like Covid-19 enters an endemic stage. Photo: Michael Nagle/Zuma Press

Comparing data from different sites can be difficult, water and public-health experts say. Facilities across the country often collect samples at different frequencies or use different analytical approaches. Local factors such as rainfall, the mix of industrial and residential developments and population surges in tourist areas can also affect readings. Some researchers have found workarounds, including measuring substances like other viruses consistently found in humans to normalize the data.

At low levels of virus, data gathered from wastewater can also be noisy, and the CDC’s current wastewater dashboard can show some confusing readings. It lists percent changes in virus concentrations at individual sites over 15-day periods, but not the virus levels themselves or the trends over time. This can lead to what look like huge increases—some recently topped 2 billion percent—likely in instances where there are changes from low virus levels, agency scientists say. The CDC is working on new ways to standardize and display its data, they say.

In Massachusetts, wastewater data are part of a broader picture health authorities are using to gauge trends, said Dr. Madoff of the state’s health department. But the sewage samples proved their particular value by previewing the Omicron surge and decline.

“It was clearly the first signal,” he said.

The Deer Island wastewater treatment plant is near the suburban community of Winthrop, Mass.

Write to Brianna Abbott at brianna.abbott@wsj.com and Jon Kamp at jon.kamp@wsj.com

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US

US coronavirus: It’s too soon to tell if Omicron’s spread will help end Covid-19’s pandemic phase, Fauci says, but he’s hopeful

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“When you talk about whether or not Omicron — because it’s as highly transmissible but apparently not as pathogenic, for example, as Delta — I would hope that that’s the case,” the director of the National Institute of Allergy and Infectious Diseases said Monday.

“But that would only be the case if we don’t get another variant that eludes the immune response to the prior variant,” Fauci told the Davos Agenda, a virtual event this week held by the World Economic Forum.

A disease that is endemic has a constant presence in a population but does not affect an alarmingly large number of people or disrupt society, as typically seen in a pandemic. Since Omicron is highly transmissible but less likely to cause as severe disease as some previous variants, it could mark a transition on the horizon to an endemic phase of the disease.

“We were fortunate” that Omicron did not share some of the same characteristics as Delta, Fauci said, “but the sheer volume of people who are getting infected overrides that rather less level of pathogenicity.”

“It is an open question as to whether or not Omicron is going to be the live virus vaccination that everyone is hoping for because you have such a great deal of variability with new variants emerging,” he said.

Early signs have suggested the latest Covid-19 wave in the United States is peaking — or at least plateauing — in parts of the Northeast. Still, cases of Covid-19 remain high due to Omicron’s high transmissibility. The daily average of recorded infections Monday was just over 680,000, according to Johns Hopkins University data, substantially higher than peaks of last winter’s surge.
Health care systems — some facing critical staffing shortages — have treated more Covid-19 patients in recent days than ever. At least 156,676 people in the US were hospitalized Monday with the virus, according to data from the Department of Health and Human Services.

Schools grapple with the Omicron surge

As cases and hospitalizations have spurred staffing shortages across the nation, some school districts — from Paterson, New Jersey, to Mobile, Alabama — have moved to virtual learning this week.

In Texas, all schools and offices in the Houston Independent School District will be closed Tuesday due to rising cases in the community, the school district announced on its website. Classes are expected to resume Wednesday.

The school district encouraged students and staff to take “this extra day to mitigate potential exposure.”

Meantime, a mandate to wear masks in schools is under fire in one new state. Citing “individual liberty” and the availability of vaccines for K-12 students, newly inaugurated Virginia Gov. Glenn Youngkin issued an executive order stating parents will get to decide if their child must wear a mask in class, a departure from his predecessor’s public health emergency order in August that masks were to be worn in schools.

Several districts in the Northern Virginia and metro Richmond area announced they will reject the latest order, set to begin January 24.

“Our layered prevention strategies have proven effective in keeping transmission rates low in our schools,” said Fairfax County Public Schools Superintendent Scott Brabrand in a letter to the school community.

“Universal mask use has proven effective in keeping Covid-19 transmission rates low in our schools and ensuring schools remain safe and open,” a statement from Arlington Public Schools said about its decision.

And an email from Henrico County Public Schools to parents and guardians reads, “Mask use is a vital component of the division’s layered prevention measures,” while noting the Centers for Disease Control and Prevention recommends masks in schools and that federal law requires masks on school buses.

Progress on future vaccines moves forward

To further get ahead of variants, new vaccines are under development.

Moderna should have data available on its Omicron-specific Covid-19 vaccine in March, company CEO Stephane Bancel said Monday.

“It should be in the clinic in the coming weeks. And we’re hoping in the March timeframe, we should be able to have data to share with regulators to figure out the next step forward,” he said in a panel conversation at Davos.

A combined Covid-19 and flu booster shot from Moderna could also be available in some countries by fall 2023, Bancel said, but he cautioned the goal date is a “best case scenario.”

Vaccine doses remain the most effective way to ward off severe Covid-19 complications, which remain a factor in the nation’s recovery as Americans continue to die from the virus. The average number of deaths has exceeded 1,600 daily over the last week, according to Johns Hopkins data.

Booster doses have successfully demonstrated the ability to raise a person’s antibody levels months after initial inoculations, helping to keep those at higher risk out of the hospital.

Early data out of Israel suggests a fourth dose of either the Pfizer/BioNTech or Moderna vaccines can elicit an increase in antibodies — more than what has been seen following a third dose — but it still might not be enough to protect against possible breakthrough infections caused by Omicron.

In December, Israel started trialing a fourth dose of the coronavirus vaccines for healthy participants ahead of a roll out of the additional booster shot to at-risk populations — marking the first study of its kind among healthy people getting a fourth dose.

“I think that the decision to allow the fourth vaccine to vulnerable populations is probably correct,” Dr. Gili-Regev Yochay, director of Infection Prevention Control Unit at the Sheba Medical Center, said Monday of the data. “It may give a little bit of benefit but probably not enough to support the decision to give it to all of the population, I would say.”

CNN’s Jacqueline Howard, John Bonifield, Virginia Langmaid, Dan Merica, Eva McKend, Ryan Nobles, Livvy Doherty, Carma Hassan and Alex Medeiros contributed to this report.

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Technology

Are COVID-19’s big waves over? Experts are split

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Experts are split on whether the waning delta surge will be the last major COVID-19 wave to strike the U.S., as Americans grow eager for the pandemic to end after 19 months. 

The vaccination rate and decreasing cases in most states have provided a ray of hope that the pandemic could be winding down after its final large wave, some experts say. 

But other public health experts caution the unpredictability of the virus suggests another surge could still happen as the country braces for winter — which led to skyrocketing cases, deaths and hospitalizations last year.

Nicholas Reich, a professor of biostatistics at the University of Massachusetts Amherst, said declaring there won’t be another major wave after delta “feels like” a “premature” and “bold” statement.

“Is there a chance? Sure, but I feel like if there’s one thing we’ve learned from this, it’s that there’s a lot more sort of uncertainty and randomness … in COVID then we’ve given it credit for so far,” he said.

Some experts, including Reich, pointed out that factors such as the potential development of variants and the unknown endurance of immunity after infection and vaccination could spark larger-scale rises in COVID-19 cases after the country has seen a national decline. 

The downturn in cases comes after the delta strain fueled a spike, reaching a seven-day average of more than 175,000 daily cases in mid-September. But on Thursday, that average dropped below 100,000 for the first time since Aug. 4, according to data from The New York Times. 

Overall, 39 states have seen their seven-day averages of COVID-19 cases fall within the past two weeks. Despite these drops in cases, COVID-19 is not eliminated and “many hundreds of thousands of people are still gonna get infected” as the pandemic continues, Reich said. 

While COVID-19 numbers are moving “in the right direction,” some areas of the country, including Alaska and West Virginia, are still “very much in the midst of the delta wave,” said Leana Wen, an emergency physician and public health professor at George Washington University.

“I’m very concerned about people becoming complacent because they think that the delta wave is passing us,” she said. “We have seen this happen before, where there is a rise in the number of cases, then a decline, and then people let down their guard. And as a result, we plateau at a very high level of cases. That’s unacceptable.”

The approaching winter season also makes it difficult to forecast future COVID-19 trends, as coronaviruses can more easily spread in colder weather and in indoor spaces. Last winter, the U.S. saw its highest surge of cases, hospitalizations and deaths amid holiday gatherings held before vaccines became widely available.

Christopher Murray, the director of the Institute for Health Metrics and Evaluation at the University of Washington, said he expects cases to increase in the winter after bottoming out in October, but that it is likely to be lower than the delta surge.  

“I think some people will be surprised that it doesn’t just keep going away, and … that doesn’t seem very likely,” he said. 

Wen of George Washington University said having just 56.2 percent of the total U.S. population fully vaccinated and fewer restrictions than last year leaves it uncertain that the delta wave could be the U.S.’s final major COVID-19 surge.

“I don’t know how we could possibly say that considering we don’t know what’s going to come our way,” Wen said.

“I’m not sure how we can know for certain that the level of protection we have nailed through vaccination is sufficient,” she said, adding she’s hopeful the end is “on the horizon” with children’s vaccines, oral treatment and more testing. 

Others, including former Food and Drug Administration (FDA) commissioner Scott Gottlieb, took a more optimistic stance, anticipating that cases won’t rise to the summer delta levels again. 

“Barring something unexpected, I’m of the opinion that this is the last major wave of infection,” Gottlieb told The New York Times this week.

Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security, told MSNBC on Friday that any rise in winter cases will likely be “more decoupled from hospitalizations and deaths” due to the increased immunity due to vaccines and infections.

“Many more people have been vaccinated, so many more people have natural immunity from this big delta wave and unfortunately so many people have died that we probably won’t see peaks that are anything like we saw in the past, especially when it comes to what matters which is hospitalization, serious disease and death,” he said.

“I think delta was hopefully the worst that this virus can throw at us,” he added.

David Dowdy, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, said he thinks it’s “unlikely” that the U.S. will endure another COVID-19 wave “to the level” of the summer delta and previous winter surges. 

With the vaccination level rising and a “fair amount” of the unvaccinated getting infected, Americans’ immunity is “higher now than it’s ever been,” he said.

The emergence of a new variant could potentially threaten that immunity if the strain evades the vaccines. But Dowdy said he doesn’t expect that in the short-term, as delta has reigned as the dominant variant worldwide for months without another strain usurping it. 

“I think anyone who says that they can predict the future of this pandemic is probably lying to you,” Dowdy said. “But I think we have a lot of reasons to be optimistic that we will not see another massive wave the way that we have seen so far.”

 



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Health

How COVID-19’s death toll and social impact compares to past U.S. pandemics

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William Brangham:

Throughout this pandemic, it’s been hard to keep perspective on the true scale of the losses caused by COVID-19.

On the Washington Mall right now, artist Suzanne Brennan Firstenberg has planted an ocean of white flags, one for each life lost to the virus.

Another metric is a comparison to the past, and, this week, the U.S. matched the death toll from another terrible virus, the 1918 influenza pandemic.

For some perspective on then and now, I’m joined by Dr. Jeremy Brown. He wrote the book “Influenza: The Hundred Year Hunt to Cure the Deadliest Disease in History.” And he is currently director of Office of Emergency Care Research at the National Institutes of Health.

Dr. Brown, very good to see you again.

We have now hit his awful bar in the U.S., where we have lost as many people to COVID as we lost to the influenza pandemic. But there are meaningful differences between the two, right?

Dr. Jeremy Brown, National Institutes of Health: Yes, indeed.

It is indeed awful to be speaking at this terrible milestone, 675,000 deaths, the same number as the people who died in the U.S. in the 1918 pandemic.

But we must also recall that this pandemic is still far less deadly than that terrible one in 1918. The population in the U.S. in 1918 was around 100 million. Today, it’s around 320 million. So, if we put these numbers into proportion, then those 675,000 deaths 103 years ago, relatively speaking, would be the equivalent of some two million deaths today.

We are nowhere near that number, thankfully. But, still, today’s numbers are still a reminder of just how deadly COVID is.

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Business

India’s Economic Figures Belie Covid-19’s Toll

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NEW DELHI — The coronavirus continues to batter India’s damaged economy, putting growing pressure on Prime Minister Narendra Modi to nurture a nascent recovery and get the country back to work.

The coronavirus, which has struck in two waves, has killed hundreds of thousands of people and at times has brought cities to a halt. Infections and deaths have eased, and the country is returning to work. Economists predict that growth could surge in the second half of the year on paper.

Still, the damage could take years to undo. Economic output was 9.2 percent lower for the April-through-June period this year than what it was for the same period in 2019, according to India Ratings, a credit ratings agency.

The coronavirus has essentially robbed India of much of the momentum it needed to provide jobs for its young and fast-growing work force. It has also exacerbated longer-term problems that were already dragging down growth, such as high debt, a lack of competitiveness with other countries and policy missteps.

Economists are particularly concerned about the slow rate of vaccinations and the possibility of a third wave of the coronavirus, which could prove to be disastrous for any economic recovery.

“Vaccination progress remains slow,” with just 11 percent of the population fully inoculated so far, Priyanka Kishore, the head of India and Southeast Asia at Oxford Economics, said in a research briefing last week. The firm lowered its growth rate for 2021 to 8.8 percent, from 9.1 percent.

Even growth of 8.8 percent would be a strong number in better times. Compared with the prior year, India’s economy grew 20.1 percent April through June, according to estimates released Tuesday evening by the Ministry of Statistics and Program Implementation.

But those comparisons benefit from comparison with India’s dismal performance last year. The economy shrank 7.3 percent last year, when the government shut down the economy to stop a first wave of the coronavirus. That led to big job losses, now among the biggest hurdles holding back growth, experts say.

Real household incomes have fallen further this year, said Mahesh Vyas, the chief executive of the Center for Monitoring Indian Economy. “Till this is not repaired,” he said, “the Indian economy can’t bounce back.”

At least 3.2 million Indians lost stable, well-paying salaried jobs in July alone, Mr. Vyas estimated. Small traders and daily wage laborers suffered bigger job losses during the lockdowns than others, though they were able to go back to work once the restrictions were lifted, Mr. Vyas said in a report this month.

“Salaried jobs are not similarly elastic,” he said. “It is difficult to retrieve a lost salaried job.”

About 10 million people have lost such jobs since the beginning of the pandemic, Mr. Vyas said.

Mr. Modi’s government moved this month to rekindle the economy by selling stakes worth close to $81 billion in state-owned assets like airports, railway stations and stadiums. But economists largely see the policy as a move to generate cash in the short term. It remains to be seen if it will lead to more investment, they say.

“The whole idea is that the government will borrow this money from the domestic market,” said Devendra Kumar Pant, the chief economist at India Ratings. “But what happens if this project goes to a domestic player and he is having to borrow in the domestic market? Your credit demand domestically won’t change.”

Dr. Pant added that questions remained about how willing private players would be to maintain those assets long term and how the monetization policy would ultimately affect prices for consumers.

“In India, things will decay for the worse rather than improve,” he said, adding that the costs to users of highways and other infrastructure could go up.

During the second wave in May, Mr. Modi resisted calls by many epidemiologists, including Dr. Anthony Fauci, the director of the U.S. National Institute of Allergy and Infectious Diseases, to reinstitute a nationwide lockdown.

The lockdowns in 2021 were nowhere near as severe as the nationwide curbs last year, which pushed millions of people out of cities and into rural areas, often on foot because rail and other transportation had been suspended.

Throughout the second wave, core infrastructure projects across the country, which employ millions of domestic migrant workers, were exempted from restrictions. More than 15,000 miles of Indian highway projects, along with rail and city metro improvements, continued.

On Tuesday, Dr. Pant said India’s growth estimates of 20.1 percent for the April-through-June period were nothing but an “illusion.” Growth contracted so sharply around the same period last year, by a record 24 percent, that even double-digit gains this year would leave the economy behind where it was two years ago.

Economists say India needs to spend, even splurge, to unlock the full potential of its huge low-skilled work force. “There is a need for very simple primary health facilities, primary services to deliver nutrition to children,” Mr. Vyas said. “All these are highly labor intensive jobs, and these are government services largely.”

One of the reasons Indian governments typically have not spent in those areas, Mr. Vyas said, is that it has been considered “not a sexy thing to do.” Another is the governments’ “dogmatic fixation” with keeping fiscal deficits in control, he said. The government simply can’t rely on private sector alone for creating jobs, Mr. Vyas said.

The “only solution,” he said, is for the government to spend and spur private investment. “You have a de-motivated private sector because there isn’t enough demand. That’s what’s holding India back.”

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Health

UNMC doctor shows difference between COVID-19′s Delta variant in vaccinated, unvaccinated people

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LINCOLN, Neb. (KOLN) – Doctors and the CDC report that the Delta variant of COVID-19 spreads as easily as chickenpox, but what exactly does that look like when it’s transmitted from person to person?

Dr. James Lawler sees patients at Nebraska Medicine on a daily basis. He explained in simple terms, if someone is infected with the COVID-19 Delta variant, it attaches to cells in our respiratory system, lining our airways and our lungs. Dr. Lawler said the variant then “hijacks” the cell, causing it to spread to others quickly.

“What happens is it releases its RNA,” Dr. Lawler said while in front of a big screen of 3-D animations. “The cell then uses its ribosome to turn that RNA into virus protein.”

He went on to explain how these steps lead to infection, “The virus is essentially hijacking the cell to turn it into a virus factory. This is making thousands and thousands of copies of viruses in the golgi apparatus and turns into new virus particles and variants, and then, they come out of this cell and go on to infect other cells.”

What if someone is fully vaccinated? Doctors said the Delta variant gets access into the cell through spiked proteins, “As long as this spiked protein is open, it’s essentially the lock to fit that key, and it can gain entry.”

After two doses of the vaccine, doctors said people develop higher levels of protection than unvaccinated people, leading to smaller chances of ending up in the hospital and the ICU.

“When those antibodies bind, they prevent the spiked protein from being able to gain entry into the cell.” Dr. Lawler said, “So, that lock and key mechanism is blocked.”

The UNMC demonstrations showed lungs from a patient’s CT scan. This person recovered from COVID-19 but was left with permanent severe lung damage.

“This person is never going to have normal pulmonary function again,” Dr. Lawler said.

That’s why once again, doctors urged everyone eligible to get the vaccine.

UNMC doctors expect the Delta variant to spread quickly in the next three to four weeks.

“If we open schools without kids with face masks and other interventions, those layers of Swiss cheese and how you block virus propagation in a community, we’re just going to be throwing gasoline on a fire at that point, and we’re going to see much higher rates of transmission.”

Dr. Lawler said the combination of hospitals seeing an unusual rise in kids of early infections of the flu and RSV cases and the start of school in less than two weeks, not requiring everyone to be masked up is a concern and said we may soon see a strain on the healthcare system for children alone.

Copyright 2021 KOLN. All rights reserved.

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Health

Covid-19’s obesity link, ‘neanderthal thinking,’ and skipping the line. What you need to know about Covid-19 this Thursday.

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The research found that by the end of 2020, global coronavirus death tolls were more than 10 times higher in nations where over half the adults are overweight, compared to those where fewer than half are overweight.

Using mortality data from Johns Hopkins University (JHU) and the World Health Organization (WHO), the team discovered that of 2.5 million Covid-19 deaths reported by the end of February, 2.2 million were in countries where more than half the population is overweight. Mortality rates also increased along with countries’ prevalence of obesity. The researchers also noted that the link persisted even after adjusting for age and national wealth.

The findings follow hundreds of worldwide studies, which also confirmed the increased need for medical care for Covid-19 patients who are overweight, the report notes. A study in China found overweight people had 84% increased odds for developing a severe form of the disease. Another US study found obese people were more than twice as likely to need hospitalization and more than six times as likely to die, or need mechanically assisted breathing, after developing Covid-19.

The authors of the World Obesity Forum report have called for people living with obesity to be prioritized for coronavirus testing and vaccination. “Covid-19 is not the first respiratory viral infection exacerbated by overweight. Data from the last two decades on the impact of MERS, H1N1 influenza and other influenza-related infections show worse outcomes linked to excess bodyweight,” the study added. “An overweight population is an unhealthy population, and a pandemic waiting to happen.”

YOU ASKED. WE ANSWERED

Q: How many cases caused by Covid-19 variants are there in the US?

A: At least 2,581 cases of coronavirus variants first spotted in the UK, South Africa and Brazil have been reported in the US, according to data updated Tuesday by the US Centers for Disease Control and Prevention (CDC).

The vast majority of these infections, 2,506, are caused by the more contagious strain known as B.1.1.7, which was originally detected in the UK. In addition, 65 cases have been reported of a variant initially seen in South Africa, called B.1.351. Lastly, 10 cases of the P.1 variant first found in Brazil have been discovered in five states.

Send your questions here. Are you a health care worker fighting Covid-19? Message us on WhatsApp about the challenges you’re facing: +1 347-322-0415.

WHAT’S IMPORTANT TODAY

‘Neanderthal thinking.’ Biden slams Texas and Mississippi for lifting restrictions

US President Joe Biden sharply criticized states such as Texas and Mississippi for lifting Covid-19 restrictions and mask mandates against pleas from the CDC and other top public health officials, accusing those in power of “Neanderthal thinking.

“I think it’s a big mistake. Look, I hope everybody’s realized by now, these masks make a difference. We are on the cusp of being able to fundamentally change the nature of this disease because of the way in which we’re able to get vaccines in people’s arms,” Biden said when asked about the decisions by the Republican governors of Texas and Mississippi to relax restrictions.

Russian vaccine expands its reach in Latin America while Cuba goes its own way

Russia’s Sputnik V shot has seen rising popularity across Latin America as more countries announce shipments and deals to purchase the Covid-19 vaccine. Nine Latin American countries have approved its use. The shot is cheaper and can be stored at higher temperatures than the Pfizer vaccine, which has made it appealing to Latin American countries with less-developed economies and infrastructures.
Meanwhile, Cuba is making its own vaccines. Starting in March, two of the island’s four homegrown vaccine candidates will begin their third and final trials, the Cuban government has announced. For much of 2020, Cuba was able to keep the spread of the pandemic under control but a bungled reopening to international travelers in December led to a surge in cases.

Spanish princesses’ vaccinations abroad spark controversy at home

Two Spanish princesses, who got vaccinated against Covid-19 in the United Arab Emirates much earlier than they would have back in Spain, have sparked outrage for skipping the vaccine line. Several Spanish ministers on Wednesday publicly criticized the two princesses, Elena and Cristina, who were inoculated while visiting their father, Spain’s former King Juan Carlos, in Abu Dhabi, where he’s living.

In response to media reports about the vaccination, Princess Elena said in a statement they took the shot with the aim of a getting a health passport so that they could visit their father regularly. A royal household spokesman noted that while they are sisters of Spain’s King Felipe, the princesses have not had any official duties as members of the royal family since at least 2014.

ON OUR RADAR

  • As Covid-19 cases continue to slide, California may soon allow fans to attend Major League Baseball games.
  • While vaccines will be available for all US adults by the end of May, teenagers will still have to wait until the fall, Dr. Anthony Fauci says.
  • The B.1.1.7 coronavirus variant first seen in the UK is more contagious than older circulating versions of the virus and it’s likely to drive a large new surge of infections, research suggests.
  • A global fake Covid-19 vaccine distribution network has been dismantled in South Africa and China.
  • The US is still holding firm to the strategy of administering two doses of the Moderna and Pfizer/BioNTech Covid-19 vaccines a few weeks apart.

TOP TIP

Rock and Roll Hall of Famer John Oates and his wife Aimee are reviving the Oates Song Fest 7908 to fundraise for Feeding America, the nation’s largest hunger-relief organization.

The economic fallout of the Covid-19 pandemic is driving up food insecurity across the US. Feeding America estimates that one in six Americans could face food insecurity as a result of the pandemic.

The virtual star-studded fundraiser will stream on Nugs.tv on March 20 at 8 p.m. ET. Oates and YouTube sensation Saxsquatch will host the event. Find out more here.

TODAY’S PODCAST

“The reality is that when you’re out of sight, you’re really out of mind. And a lot of remote workers feel like they miss out on a lot of these opportunities because they’re not getting access to the projects and opportunities that would help get them promoted.” — Andrew Hewitt, senior analyst at Forrester

The coronavirus has fundamentally changed the American workplace, but which changes can we expect to stick around permanently? Hewitt, a remote work expert, shares his predictions for the post-pandemic future of office work. Listen now.

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