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Health

Why did so many Americans lie about following Covid guidelines?

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Nearly half of Americans acknowledged they weren’t truthful about their COVID-19 status or didn’t follow public health measures at the height of the pandemic in a new nationwide survey led in part by a team of University of Utah Health researchers.

Wanting to feel normal and exercise personal freedom were the most cited reasons for a list of behaviors that included lying about what precautions they were taking against spreading the virus, breaking quarantine rules, avoiding testing and failing to disclose they had COVID-19 when asked.

The findings “suggest that misrepresentation and non-adherence regarding COVID-19 public health measures constitute a serious public health challenge,” according to an article on the study published Monday in the Journal of the American Medical Association’s JAMA Network Open.

“This gave us a much better idea of what kind of behaviors people were engaging with and how prevalent it was. I think more importantly, we got a really good idea of the reasons why,” said Alistair Thorpe, the study’s co-first author and a postdoctoral researcher in the Department of Population Health Sciences at U Health.

Thorpe said the findings were more concerning than surprising.

Many of the behaviors people were asked if they had engaged in “can have very severe consequences,” he said, such as not being forthcoming about having COVID-19 when going to a doctor’s office, “a place where there’s potentially very vulnerable people who you’re exposing, without them knowing, to a very serious virus.”

The online survey of 1,733 participants, including six respondents who said they lived in Utah, was conducted in December 2021, when the highly transmissible omicron variant of COVID-19 that drove cases to record-breaking levels worldwide started sweeping through the country.

In Utah, the omicron surge led to reimposing mask mandates in Salt Lake and Summit counties, an effort that was quickly stopped by state lawmakers, while hospitals ended up being so overcrowded that patients had to be turned away.

But just under 42% of the Americans who participated in the survey reported misrepresentation or nonadherence for at least one of nine behaviors, most commonly telling someone they were spending time with that they were taking more measures against COVID-19 than they actually were.

Respondents who’d admitted they hadn’t been truthful with others and/or weren’t following the rules intended to protect the public were asked to answer yes or no to a long list of possible reasons for their behavior. The most popular choices were:

  • “I wanted my life to feel ‘normal’ (how I felt before the COVID-19 pandemic began).”
  • “I wanted to exercise my freedom to do what I want.”
  • “It’s no one else’s business.”
  • “I didn’t feel very sick.”
  • “I was following guidance from a public figure I trust (politicians, scientists, people on the news, celebrities).”

However, the survey also found “a substantial portion of participants” also agreed with these reasons:

  • “I didn’t think COVID-19 was real.”
  • “I didn’t think COVID-19 was a big deal.”
  • “I didn’t want someone to judge or think badly of me.”

A third of the participants had already had COVID-19, while the remaining participants who had not had the virus were split between the vaccinated and the unvaccinated. About 60% having sought a doctor’s advice for prevention or treatment.

While those younger than 60 — and those who expressed a greater distrust of science — were more likely to engage in misrepresentation or nonadherence behaviors, no association was found with political beliefs, party affiliation or religion.

“We don’t believe that these are simple behaviors, that people do one thing because of one reason,” Thorpe said. ”We really need to work to address them all, so it’s not the case, ‘Oh, if we change one thing, it will have the desired outcome.’ It’s a very complex behavioral process.”

A theme that emerged was “people wanting to maintain autonomy, that they felt it was no one else’s business, that they wanted to exercise personal freedom. The fact that these similar concepts were consistently prevalent across a number of reasons, that tells us something about how we can work better to communicate,” he said.

Making it easier to comply with public health measures can help people feel less resistant, Thorpe said. But he said public health officials also need to “figure out how you can talk to people about these concerns that they have in a way that can help them become more engaged with these measures” and see their collective benefit.

“That’s why this study is so important. We need to try and figure out who we’re not communicating as well with and how we can do better,” Thorpe said. The challenge during the COVID-19 pandemic is that “people have been asked to do things that they never even had to comprehend before in their lives. So it’s a challenge.”

Many people struggled to shift their perspective from viewing adherence to public health measures in terms of personal concerns to focusing more on how their actions could protect others. This “ties back to how a lot of these things have been really burdensome. You can have the best of intentions,” he said.

Thorpe said the pandemic placed people “under an extremely long period of uncertainty, stress in all aspects of your life — your social life, your financial life, your philosophies of life — those kind of situations, those extreme situations like we’ve seen here can make it difficult to engage in more proactive behavior.”

Besides Thorpe and others from the University of Utah, including Angela Fagerlin, senior author of the study and chair of the Department of Population Health Sciences, researchers from the Veterans Administration in Salt Lake City along with institutions in Connecticut, Colorado, Iowa and the American Heart Association also contributed to the study.

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DeSantis’ migrant flights to Martha’s Vineyard appear outside the scope of Florida transport program guidelines, state documents show

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CNN
 — 

A pair of flights carrying migrants from Texas to Martha’s Vineyard last month, orchestrated by Florida Gov. Ron DeSantis, may have exceeded the original scope of the state’s plan to transport undocumented individuals, according to records obtained by CNN.

The records show that in the months leading up to those flights, Florida had planned a narrower mission for a controversial new state program to transport migrants to other states. The goal, according to a callout to contractors and guidelines for the program, was to, “relocate out of the state of Florida foreign nationals who are not lawfully present in the United States.”

But that’s not what transpired. On September 14, two planes picked up 48 migrants in San Antonio – not Florida – and dropped them off in Martha’s Vineyard.

The documents, provided to CNN through a records request and released Friday evening by the Florida Department of Transportation and the governor’s office, offer new details about the stunt that thrust DeSantis even deeper into the middle of a national debate on immigration. From the White House to Florida, Massachusetts and beyond, the condemnation from Democrats was swift. So was the praise from Republicans for DeSantis, who only further bolstered his standing in his party as he considers running for President in 2024.

A Democratic state lawmaker is already suing the state and asking a judge to stop future flights, arguing the DeSantis administration was illegally spending taxpayer dollars. The budget act that created the $12 million program specified the money was set aside to relocate “unauthorized aliens from this state.”

The governor’s office did not immediately respond to a request for comment.

The records for the first time also directly tie a $615,000 state payment made to Vertol Systems Company for the September flights that sent migrants from San Antonio to Martha’s Vineyard. Previously, the payment to Vertol was disclosed by the state, but the governor’s office for weeks declined to confirm that the check was linked to the flights that landed in Massachusetts.

The Florida Department of Transportation, the agency tasked with executing the new migrant relocation program, received a price quote from Vertol CEO James Montgomerie on September 6 for “the first Project,” one document showed. Montgomerie identified that project as “the facilitation of the relocation of up to fifty individuals to the State of Massachusetts or other, proximate northeastern state.” The price, he said, was $615,000.

The next day, FDOT officials sent a letter asking for authorization for the $615,000 and the state made the payment within the next 24 hours, according to financial statements maintained on the Florida Chief Financial Officer’s website previously reported by CNN.

In communications with FDOT earlier during the summer, Montgomerie offered the state services that suggested a considerably less ambitious mission for the migrant relocation program.

On July 26, after a discussion with FDOT’s general counsel, Montgomerie gave the agency estimates for his company to charter flights that could carry four to 12 people from Crestview, Florida, to the Boston or Los Angeles areas, according to an email from the Vertol executive to FDOT.

“We are certainly willing to provide you with pricing information on specific ad-hoc requirements on a case by case basis,” Montgomerie wrote in the email.

The prices quoted for flights originating from Florida more closely aligned with FDOT’s guidelines for the program that it sent to prospective contractors and the agency’s request for quotes. In the three-page guidelines, FDOT stipulated the chosen company needed to ensure “that the Unauthorized Alien has voluntarily agreed to be relocated out of Florida.” The quotes also showed Montgomerie early on anticipated Vertol would be moving less people. Later, in September, his quotes evolved to include many more people on board.

Ultimately, the planes that left San Antonio briefly touched down in Crestview before eventually landing in Massachusetts.

At the time of the state’s request for contractors, DeSantis was publicly claiming that President Joe Biden could send buses of migrants from the US-Mexico border to Florida. But DeSantis acknowledged last month those buses never arrived, and his focus began to shift hundreds of miles away to Texas.

DeSantis has said the intention of executing the flights from Texas was to stop the flow of migrants at the source before they came to Florida.

“If you can do it at the source and divert to sanctuary jurisdictions, the chance they end up in Florida is much less,” DeSantis told reporters in September.

DeSantis has vowed to use “every penny” of the $12 million allocated to his administration for migrant transports. However, the state has not publicly taken credit for any transports since the two planes landed in Martha’s Vineyard.

State Sen. Jason Pizzo, the lawmaker now suing DeSantis, said the governor cannot choose to ignore the law when spending state money.

“You can’t even play by your own rules,” Pizzo told CNN last month when speaking of DeSantis. “This isn’t something that we passed 12 years ago. It was done four months ago at your request.”

DeSantis’ office previously said the lawsuit by Pizzo was an attempt at “15 minutes of fame.”

The state has paid Vertol $1.6 million so far through its migrant program, which is funded by interest earned on federal coronavirus relief money, according to the state budget documents. The initial payment of $615,000 was made by the FDOT on September 8, six days before the Martha’s Vineyard flight. Another payment for $950,000 followed on September 16, though it’s not clear what that payment went for.

A few days after that second payment, reports of a similar flight plan from San Antonio to Delaware, Biden’s home state, sent officials there scrambling to prepare for migrant arrivals. The flights, though, never arrived.

The state did not provide a contract with Vertol in the records released Friday night. Nor do the documents offer further insight into why Vertol was chosen over two other companies that appeared to submit quotes to the state, according to records.

CNN has reached out to Montgomerie for further comment.

Vertol had an existing link to a DeSantis administration official prior to its work with the state. Lawrence Keefe, Florida’s “public safety czar” appointed by DeSantis to lead the state’s crackdown on illegal immigration, represented the aviation company from 2010 to 2017.

In its quoted price to the state, Vertol said it was providing “Project management, aircraft, crew, maintenance logistics, fuel, coordination and planning, route preparation, route services, landing fees, ground handling and logistics and other Project-related expenses,” according to the documents.

The request for quotes from the state also asked that potential contractors have “multilingual capability for Spanish.” The chosen contractor would also have to develop procedures for “confirming with Partner Agencies that the person to be transported is an Unauthorized Alien.” Pizzo and others have questioned whether the migrants are considered “unauthorized” by the federal government if they are legally seeking asylum.

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Health

You need to exercise over TWICE as much as guidelines recommend to maximize your lifespan

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Physical activity guidelines laid out by U.S. health officials – markers that a vast majority of Americans are not reaching – are still inadequate for a person who wants to maximize their lifespan, a new study finds.

Researchers from Harvard University, in Cambridge, Massachusetts, found that reaching guidelines set by the Department of Health and Human Services (HHS) in 2018 was likely not enough. For a person to limit their all-cause mortality risk as much as possible they would likely have to double or quadruple the requirements each week.

The HHS recommends for every American adult to get at least 2.5 hours of aerobic exercise each week – or only half of that if the activities are vigorous. 

Americans are largely failing to meet these guidelines already, though. The Centers for Disease Control and Prevention (CDC) revealed earlier this week that only around half of Americans are reaching the fitness marker.

Sedentary lifestyles have largely contributed to America’s issues with diet-related conditions. The CDC reports that more than 70 percent of Americans are overweight, and over 40 percent suffer from obesity. Just over ten percent have diabetes and heart disease remained the leading killer of people in the U.S. even through the COVID-19 pandemic.

Researchers found that reaching the basic aerobic fitness goals could reduce a person’s risk of all-cause mortality significantly, though reductions were more pronounced for those that managed to double – or even quadruple – those metrics

Hitting aerobic fitness goals each week was valuable at preventing death from heart disease in particular

Researchers, who published their findings Tuesday in Circulation, gathered data from 116,221 adults between 1988 and 2018. Data was from the Nurses’ Health Study and the Health Professionals Follow-Up Study.

Each one of the participants completed a questionnaire on their weekly and daily physical activity. They were then periodically followed up with up to 15 times to gauge their health, or if they had died at some point during the study period.

Just under 50,000 participants died at some point during the follow-up period. Those who had regularly met the two-and-a-half hour fitness goal reduced their rate of all-cause mortality by 19 percent.

Fitness is especially valuable against heart disease, as reaching goals could reduce death from that condition in particular 31 percent. Aerobic exercise alone cut risk of death from any other condition by 15 percent.

Those who are especially concerned about extending their life, or avoiding heart disease, should go even further with their exercise regimen, though.

The research team found that those who doubled HHS guidelines for weekly aerobic fitness reduced their risk of death by up to 29 percent.

If a person were to quadruple recommendations – meaning they reached a full ten hours of exercise each week – then they reduced risk of all-cause mortality by nearly 40 percent.

Hitting the ten hour marker is an ambitious goal, though, as that would require nearly 90 minutes of exercise each day. 

In America, reaching even the baseline 150 minute a week – around 20 minutes per day – has become a challenge for many.

A report published by the CDC Tuesday found that only 46.9 percent of American adults were reaching that marker.

Men were found to be the most likely to reach that marker. Adults aged 18 to 34 of either gender were the likeliest to reach exercise goals.

The CDC survey found that only 24% of American adults are reaching weekly exercise recommendations, and only around half are meeting one of the two requirements 

In both men and women, those aged 18 to 34 were most likely to reach exercise recommendations – with fitness rates decreasing in older age groups

The CDC survey also included HHS markers for strength exercise, which recommends a person perform activities that work-out muscles across their entire body on at least two days of every week. 

Combined, only 24 percent of adults were found to hit both goals. 

White men and women were both most likely to hit exercise goals when compared to other races – though the margin between white, Asian and black men was very slim – all falling just around 30 percent.

Only 23.5 percent of Hispanic men reached target exercise figures each week, the survey found.

The racial gap was much more pronounced among women. While 24.3 percent of white women hit designated markers, 18 percent or less of black, Hispanic or Asian women did.

Income played a large role as well, with those with a household income double the federal poverty line twice as likely to reach goals as those below the limit.

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World

How US government diet guidelines ignore the climate crisis | Environment

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To keep the climate habitable, most scientists agree that switching to renewable energy alone isn’t enough – Americans also need to change the way they eat. Environmental and public health advocates are pushing a new strategy to help get there: including climate breakdown in the official US dietary guidelines, which shape what goes into billions of meals eaten across the country every year.

Every five years, the Department of Agriculture and the Department of Health and Human Services jointly publish a new version of the guidelines. They form the basis for the public-facing eating guide MyPlate, formerly MyPyramid, as well as many government-backed meal programs, such as National School Lunch. Historically, these guidelines have narrowly focused on human nutrition, but some are now saying they should be expanded to incorporate climate considerations as well.

The current, 150-page edition for 2020-2025 doesn’t mention food’s role in the climate crisis at all. Climate groups say this is an abdication of responsibility, with Americans feeling the effects of a warming planet more than ever. The recently passed Inflation Reduction Act, the most significant climate legislation in US history, does very little to address the food system.

“Climate change poses a multitude of threats to human health and nutrition security. We cannot extricate these things from each other,” said Jessi Silverman, a senior policy associate for the Center for Science in the Public Interest. Her group and 39 others, including the Union of Concerned Scientists and the American Academy of Pediatrics, in May wrote a letter urging the government to include sustainability in the 2025-2030 dietary guidelines, which are now in development.

A sustainability component would encourage Americans to eat less meat and dairy, which have a significantly higher climate impact than nutritionally comparable plant-based foods. “It would be virtually impossible to even meet the two-degree [Celsius] limit in global temperature change without incorporating substantial reductions in beef intake,” said Mark Rifkin, senior food and agriculture policy specialist for the Center for Biological Diversity, another signatory to the letter.

A table showing USDA and Health and Human Services food guidelines compared to Climate experts’ recommendations. When it comes to protein, experts recommend swapping animal-based proteins with plant-based ones. As well as switching a cup of milk to a glass of water.

The current guidelines advise Americans to eat far more animal products than is sustainable, said Walter Willett, a professor at Harvard’s School of Public Health. The primary dietary chart recommends 26 ounces of protein from meat, poultry and eggs a week, compared with just 5 ounces from plant-based foods, although there are alternative charts that show how vegetarians can get the same nutrients without meat. They also “still basically say three servings of dairy a day, which is actually really radical because our current consumption is 1.6 servings a day”, he said. “To just recommend three servings of dairy and say nothing about the environmental consequences if people really did that is just completely irresponsible.”

Because most Americans are deficient in fiber and fruits and vegetables, not animal products, Rifkin, a dietitian, said climate-focused guidance would line up with what the public needs nutritionally. It would also help address other problems that stem from the meat-heavy US food system, he said, including risk of future pandemics, food security and pollution from concentrated animal feeding operations, which disproportionately affects communities of color.

A proposed list of questions released in April for the scientific panel that advises the guidelines didn’t include sustainability. That worries advocates, but they say it’s still early. Janet de Jesus, HHS’s staff lead on the guidelines, said sustainability could still be included. “We’re not saying that it’s not going to be in the dietary guidelines – we’re not saying that at all,” de Jesus said. “It’s a high priority for HHS leadership to address climate change.”

Countries including Germany, Brazil, Sweden and Qatar have addressed sustainability in their dietary guidelines, according to a UN Food and Agriculture Organization report. Canada’s Food Guide advises choosing plant-based foods more often for the environment. Germany has cut its per-capita meat consumption by 12% since 2011, Vox reported last month, and its minister of food and agriculture has recently prioritized a shift toward more plant-based eating.

Advocates say a change in the US dietary guidelines could have a similar influence. “The guidelines are much more impactful than I think a lot of people realize,” Silverman said. Federal food aid programs have to comply with the guidelines, shaping how millions of people eat. The National School Lunch and National School Breakfast, for instance, served more than 7bn meals a year to tens of millions of children before the Covid-19 pandemic. The guidelines also influence cafeteria food served in government buildings, hospitals and other institutions, and are used in nutrition education programs.

National School Lunch’s reach makes it “uniquely positioned to affect the dietary patterns of American children and adolescents and could aid in addressing the environmental impacts of food systems”, according to a recent paper in Communications Earth & Environment. Meat contributes disproportionately to school meals’ impact on the climate, as well as land and water use.

Because government programs and other large institutions serve so many meals, sustainability advocates in recent years have focused on trying to influence their food buying decisions. California earlier this year allocated $100m to help schools serve more plant-based meals.

This isn’t the first time the environment has been at issue in the nation’s dietary guidelines. In 2015, the government-appointed panel of nutrition experts that advised the 2015-2020 guidelines addressed sustainability in its scientific report. “In general, a dietary pattern that is higher in plant-based foods, such as vegetables, fruits, whole grains, legumes, nuts, and seeds, and lower in animal-based foods is more health promoting and is associated with lesser environmental impact,” the panel wrote.

But after outcry from the meat industry and Republican lawmakers, the recommendation to eat more plants was dropped from the final guidelines. In an interview with the Wall Street Journal at the time, the USDA secretary, Tom Vilsack, said sustainability was outside the purview of the dietary guidelines and compared the scientific committee to his granddaughter who “colors outside of the lines”.

“It’s really condescending stuff,” said Bob Martin, of the Johns Hopkins Center for a Livable Future, about Vilsack’s comments. “The people involved in this were highly qualified.”

Agribusiness has a long history of influence over the dietary guidelines, and it will undoubtedly be a factor this time around, too. The meat and dairy industries spent $49.5m on political contributions in 2020, and another $15.9m lobbying the federal government.

Food industry groups also routinely report lobbying on federal nutrition policy. The National Cattlemen’s Beef Association between 2014 and 2016 spent more than $303,000 lobbying to keep beef in the dietary guidelines, according to federal lobbying records. Several industry groups, including the North American Meat Institute, the International Dairy Foods Association and the National Turkey Federation, have already weighed in on the process for the 2025-2030 guidance. “[W]hile an important topic, sustainability is outside the scope of the Dietary Guidelines,” the National Pork Producers Council wrote in a public comment in May.

Even though environmental advocates face an uphill battle, a lot has changed since the failed 2015 effort to incorporate sustainability, said Jessi Silverman of the Center for Science in the Public Interest. “I think the public pressure to have concrete policies to address climate change has grown a lot in the years since then.”

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Health

Lack of ‘high quality’ clinical guidelines for monkeypox may be hurting treatment efforts, researchers say  – The Hill

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Story at a glance

  • A team of researchers mainly from the University of Oxford looked at 14 clinical guidelines for monkeypox and found that most of them were “low quality.” 
  • Researchers said the guidelines lacked sufficient detail on the virus and contradictory treatment recommendations.
  • The lack of standardization of these clinical guidelines could be hurting global efforts to treat people with the disease.  

A lack of up-to-date clinical guidelines on monkeypox may be impacting health care workers’ ability to administer effective and safe treatment in those infected, according to researchers.  

U.K.-based researchers looked at the existing clinical guidelines available for the disease and found that they often lack sufficient detail, are contradictory in their recommendations and fail to include impacts of the illness on different groups including children.  

The findings of the analysis were published earlier this week in the journal BMI Global Health.  

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Monkeypox is a viral disease that belongs to the same family as smallpox that can show up as a rash made up of small and painful blisters. Symptoms of the illness can also include fever, chills, fatigue, muscle aches, cough, neck pain and swollen lymph nodes.  

There has been an outbreak of the rare disease this summer with the U.S. Centers for Disease Control and Prevention confirming 14,115 cases of the virus across the country as of Thursday.  

Before the 2022 outbreak, the disease had been mainly reported in people living in about a dozen central and western African countries, according to the CDC.  

Now, a worldwide jump in cases has prompted the World Health Organization to declare the spike a public health emergency.  

In their analysis, researchers parsed through six major research databases with relevant information on monkeypox published up to October of last year and other “grey literature” like policy documents, newsletters and reports in multiple languages published until this May. They found a total of 14 relevant clinical guidelines, most of which were “low quality” and only covered a range of topics.  

Only five out of the 14 clinical guidelines gave any guidance on how to care for children infected with the virus and only three had any advice on how to treat pregnant women or people living with HIV who had contracted the disease, according to the analysis findings.  

Monkeypox treatment guidance was mostly limited to advice on antiviral medication and was not consistent, researchers added. Out of the guidelines reviewed, seven recommended that patients with monkeypox be given cidofovir, and out of those seven only four noted that the medication be only administered to treat severe infections.  

Only four clinical guidelines recommended tecovirimat and one advised giving the sick brincidofovir.  

Currently, the WHO recommends that health care professionals use tecovirimat to treat monkeypox patients instead of cidofovir.  

None of the clinical guidelines reviewed contained details on optimal doses, timing or length of treatment and only one had any recommendations on supportive care and treatment complications, according to the findings.  

Every one of the 14 guidelines encouraged vaccination as post-exposure prophylaxis but not all of them had up to date information on the newer generation of vaccines.  

Guidelines are key tools for clinicians and are especially important for emerging infectious diseases that health care workers might be less familiar with, according to Louise Sigfrid, who works at the ISARIC Global Support Center, Pandemic Sciences Institute at the University of Oxford and is one of the lead researchers in the analysis.  

Sigfrid noted that some of her colleagues in London that treated monkeypox patients early in the U.K.’s outbreak this spring reported struggling to know how to diagnose and treat patients due to limited guidelines.  

“The main aim of the clinical national guidelines is to benefit patient care,” Sigfrid told Changing America. “It’s also to standardize care. To make sure that all patients in all settings have access to evidence-based care and that clinicians have access to evidence-based treatments.”  

Standardizing clinical guidelines also serves an important purpose when it comes to developing vaccines for diseases like monkeypox, Sigfrid added. Without them, clinical research for treatments can be weakened and hamper randomized control trials.  

“As rare diseases are emerging…what we have also seen when we are trying to implement rapidly is that clinicians in different sites will use different treatments,” said Sigfrid.  

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Published on Aug. 19, 2022



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Health

Clinical Management Guidelines Lacking for Monkeypox | Madison.com Health, Sports Health & Fitness

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FRIDAY, Aug. 19, 2022 (HealthDay News) — There is a lack of evidence-based clinical management guidelines for monkeypox (MPX), according to a review published online Aug. 16 in BMJ Global Health.

Eika Webb, M.B.B.S., from Liverpool School of Tropical Medicine in the United Kingdom, and colleagues conducted a systematic review and identified MPX guidelines providing treatment and supportive care recommendations. A total of 14 guidelines were included, from 2,026 records screened.

The researchers found that most guidelines were of low quality (median score, 2 out of 7), lacked detail, and covered only a narrow range of topics. Most of the guidelines focused on adults; five, three, and three provided some advice for children, pregnant women, and people living with HIV, respectively. Treatment guidance was mainly limited to antiviral advice; cidofovir was advised in seven guidelines (four for severe MPX only), while four and one guidelines advised tecovirimat and brincidofovir, respectively. Recommendations on supportive care and treatment of complications were provided in only one guideline. Vaccination was recommended as postexposure prophylaxis (PEP) in all guidelines. Vaccinia immune globulin was advised as PEP for severe cases in people with immunosuppression in three guidelines.

“Urgent investments into research to identify optimal treatment and prophylaxis strategies are needed for the whole population, in any setting, to benefit patient care and outcomes,” the authors write.

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World

Experts question CDC guidelines on isolation after testing positive for COVID as Biden continues to work remotely

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President Joe Biden is expected to continue to work from his office Tuesday as he isolates for at least five days in accordance with Centers for Disease Control and Prevention guidelines for people who test positive for COVID.

The President tested positive again on Monday in a ‘rebound’ case, a rare outcome of the antiviral Paxlovid with which he was treated last week.

Don’t miss: Paxlovid has been given to Biden and millions of Americans infected with COVID-19. In the U.K., it sits on the shelf.

Experts are concerned, however, that the CDC’s guidelines on isolation are confusing and do not reflect the changing nature of the virus some two-and-a-half years into the pandemic, the Washington Post reported.

The CDC recommends a timeline of five days of isolation, but does not insist on a negative test that would prove that a patient is no longer shedding virus and unlikely to infect another person. Yet new research shows that people often remain infectious for longer than five days, meaning it’s vital that when ending isolation, they continue to wear a well-fitting mask around others at home or in indoor spaces through day 10, the paper reported.

“Given that a substantial portion of people do have a rapid positive test after 5 days, I think an updated recommendation should include people having a negative rapid test before coming out of isolation for COVID,” Tom Inglesby, director of the Johns Hopkins Center for Health Security, and the Biden administration’s senior adviser on testing from December until April told the Washington Post.

The CDC is expected to unveil new recommendations in the coming weeks after an internal review, according to the Post, citing three officials and advisers who spoke on the condition of anonymity. However, a draft of the update does not include a test requirement before ending isolation, they said.

Read also: Campus COVID-19 vaccine mandates had the biggest impact on colleges with low-income students. Here’s why they were so effective.

The daily average for new U.S. cases remains close to 130,000 a day, but not all data are being captured as many people are testing at home. The average stood at 121,313 on Monday, according to a New York Times tracker, down 4% from two weeks ago.

The daily average for hospitalizations rose to 43,653 up 5% in two weeks. The daily average for deaths is up 4% to 446.

Coronavirus Update: MarketWatch’s daily roundup has been curating and reporting all the latest developments every weekday since the coronavirus pandemic began

Other COVID-19 news you should know about:

•Japan is considering altering its COVID-19 reporting protocols, including a change in how it collects case numbers, in a bid to lessen the burden on hospitals as they strain under a new wave that has spread across the country, The Japan Times reported, citing government sources. Medical facilities and public health centers currently cooperate to report the total COVID-19 cases to the government, but the change may limit the reporting of cases to designated establishments. With the prevalent omicron variant having less risk of causing severe illness compared with previous strains, some government officials have questioned the need to report every case. The government is expected to start formal discussions after the seventh wave of the pandemic dies down.

• President Joe Biden is set to name top officials from the Federal Emergency Management Agency and the Centers for Disease Control and Prevention to serve as the White House coordinators to combat the growing monkeypox outbreak, the Associated Press reported, as the illness replaces COVID in headlines. Biden will announce Tuesday that he has tapped Robert Fenton, who helped lead FEMA’s mass vaccination effort for COVID-19 as the agency’s acting administrator when Biden first took office, as the White House coordinator. Dr. Demetre Daskalakis of the CDC will be named his deputy. Daskalakis, the director of the agency’s HIV prevention division and a national expert on issues affecting the LGBTQ community, previously helped lead New York City’s COVID-19 response. Separately, California Gov. Gavin Newsom declared a state of emergency to speed efforts to combat the monkeypox outbreak, becoming the second state in three days to take the step, after New York.

The continuing spread of monkeypox has prompted the World Health Organization to declare a global health emergency. WSJ’s Denise Roland explains what you need to know about the outbreak. Photo: Kena Betancur/AFP/Getty Images

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is dropping its face-mask mandate for employees at “most locations,” The Verge reported, citing an internal email from the company’s COVID response team that it obtained. “Don’t hesitate to continue wearing a face mask if you feel more comfortable doing so,” the email reads. “Also, please respect every individual’s decision to wear a mask or not.” The move comes amid a surge in the highly transmissible BA.5 variant of COVID-19. Earlier this week, the Bay Area transit system BART brought back its mask mandate.

• The number of companies filing for voluntary liquidation in England and Wales hit a record in the second quarter after COVID support programs were removed, Reuters reported. Total company insolvencies surged by 81% compared with the April-June period last year, the bulk of them creditors’ voluntary liquidations (CVLs) which were the highest since records began in 1960, the government’s Insolvency Service said. Total company insolvencies were 13% higher than in the January-March quarter.

President Joe Biden posted a video clip to Twitter on Saturday afternoon after he tested positive for COVID-19 on Saturday morning in what his physician called a rebound case. Photo: AP Photo/Susan Walsh

Here’s what the numbers say

The global tally of confirmed cases of COVID-19 topped 578.5 million on Monday, while the death toll rose above 6.40 million, according to data aggregated by Johns Hopkins University.

The U.S. leads the world with 91.5 million cases and 1,030,554 fatalities.

The Centers for Disease Control and Prevention’s tracker shows that 223.2 million people living in the U.S. are fully vaccinated, equal to 67.2% of the total population. But just 107.9 million have had a booster, equal to 48.3% of the vaccinated population, and just 19.9 million of the people 50 years old and over who are eligible for a second booster have had one, equal to 30.9% of those who had a first booster.

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Health

At last, medical guidelines address care for adults with Down syndrome

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In the 1960s, the life span of a person with Down syndrome was just 10 years.

Today, those life spans have stretched to 60 years. But until recently, no guidelines existed for treating the special health problems many adults with Down syndrome face.

Now, a guide for families and caretakers breaks down a new set of advice on caring for the medical needs of adults with the chromosomal abnormality.

It was developed by the Global Down Syndrome Foundation (GLOBAL), a leading nonprofit and advocacy organization focused on improving the health of people with the condition. The foundation worked with the clinical directors of eight of the largest Down syndrome medical centers as well as other experts, in consultation with adults with Down syndrome, their family members and other advocates.

For people with Down syndrome, a longer life, but under a cloud

The family publication distills the guidelines that were first published for physicians in a peer-reviewed article in JAMA.

Recommendations touch on the nine most common types of health problems faced by adults with Down syndrome: behavioral issues, dementia, diabetes, cardiovascular disease, obesity, instability of the bones at the base of the skull and neck, osteoporosis, thyroid issues and celiac disease.

How long covid could change the way we think about disability

The guidelines reflect the importance of tailoring treatment for patients and avoiding misdiagnoses. Some risk factors are unclear, and some treatments can be dangerous. The foundation says several of the questions posed by the medical authors had no published research evidence — which officials said was proof of the disparities faced by people with Down syndrome.

Though it is the most common chromosomal disorder in the United States, affecting about 1 in every 700 babies born, Down syndrome research has historically been underfunded compared with other major genetic conditions. But that is changing because of self-advocacy and the efforts of parents, caretakers, physicians and others. Today, more research is being undertaken. Discrimination and disparities still exist, however. And some medical providers still rely on inaccurate or outdated information about the condition.

Want to take a look at the new guidelines? Visit bit.ly/DownGuidelines to download the free guide.

GLOBAL Medical Care Guidelines for Adults with Down Syndrome

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Science

Dress to impress: US Space Force releases new grooming and uniform guidelines

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The U.S. Space Force aims to make sure its gallant Guardians are turned out in high style with impeccable grooming standards to match their impressive official outfits and insignias.

The Space Force has delivered a revamped grooming and uniform policy that will ensure that America’s sixth military branch has a distinctive style, identity and culture.

As announced in a press release (opens in new tab) last week, the Space Force now requires that all Guardians in active service represent a unifying theme in their appearance. The new updates were devised with the help of input from Guardians across the entire chain of command, Space Force officials said.

Related: The Space Force’s prototype dress uniforms look like something out of science fiction

The U.S. Space Force recently updated its uniform requirements for Guardians. (Image credit: U.S. Space Force)

“Guardians have been waiting a long time for this policy to drop, and I couldn’t be happier to get it out there and start getting this stuff on the shelves,” Space Force Chief Master Sgt. Roger Towberman said in the press release.

“I appreciate their connection, which brought us these ideas, and the character they’ve shown waiting patiently for us to work through the policy process,” Towberman said. “It’s time to space it up!”

The policy outlines new decorative items that Guardians can choose to display on their interim service dress uniforms, temporary togs that will be used until new Space Force dress uniforms arrive.  

The new uniform choices and accoutrements include: an enlisted rank insignia;
a hexagonal nametag; a hexagonal U.S. lapel insignia for enlisted Guardians; distinctive service hat badges for officers and enlisted personnel; and Space Force “Delta, Globe and Orbit” buttons.

Insignia used by the U.S. Space Force. (Image credit: U.S. Space Force)

According to the press release, the new grooming guidelines include:

  • Adjusting mustache restrictions to the outer corners of the mouth in a horizontal line, rather than vertical, “and no more than ¼ inch [0.6 centimeters] from the end of the corner of the horizontal plane.”
  • Increasing color options for nail polish and lipstick colors to “allow maximum variations for all female skin tones.” 
  • Allowing men “to wear inconspicuous concealer/foundation to cover up scars/blemishes.”
  • Expanding the tattoo policy to match those of the Space Force’s sister services. Neck and hand tattoos are explicitly allowed.

The new grooming and uniform updates result from negotiations and suggestions presented at the Space Force’s first-ever uniform board, which was held last year. They’re intended to spruce up the temporary formal outfit and nurture an immediate identification with the space-centric agency as Guardians.

With these new updated dress and grooming codes, the Space Force is obviously well aware of appearances and intends for its Guardians to stand out in a military crowd on Earth and beyond. Semper Supra!

Follow us on Twitter @Spacedotcom (opens in new tab) or on Facebook (opens in new tab).  



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Health

CDC publishes guidelines on monkeypox vaccine

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The CDC on Friday published recommendations by its group of independent experts on a smallpox vaccine that limit its use to only people who work closely with viruses such as monkeypox. (Tami Chappell, Reuters)

Estimated read time: 2-3 minutes

WASHINGTON — The U.S. Centers for Disease Control and Prevention on Friday published recommendations by its group of independent experts on a smallpox vaccine that limit its use to only people who work closely with viruses such as monkeypox.

The Jynneos vaccine, made by Bavarian Nordic, will be available for certain health care workers and laboratory personnel at a time when monkeypox infections has spread in Europe, the United States and beyond.

The vaccine was approved in the United States in 2019 to prevent smallpox and monkeypox in high-risk adults aged 18 and older.

CDC officials earlier this week said they were in the process of releasing some doses of the Jynneos vaccine for people in contact with known monkeypox patients.

Officials said there were over 100 million doses of an older smallpox vaccine called ACAM2000, made by Emergent BioSolutions, which has significant side effects.

Monkeypox is a mild viral infection that is endemic in certain parts of Africa, but the recent outbreak in countries where the virus doesn’t usually spread has raised concerns.

So far, there are about 300 confirmed or suspected cases in around 20 countries where the virus was not previously circulating. The Salt Lake County Health Department two confirmed cases of monkeypox in Utah on Wednesday. The World Health Organization has called for quick action from countries to contain the monkeypox spread.

The CDC said its experts’ recommendations are meant for clinical laboratory personnel performing diagnostic tests for orthopoxviruses such as smallpox and monkeypox, laboratory people doing research on the viruses and health care workers who administer the ACAM2000 vaccine or care for patients infected with orthopoxviruses.

The publication of the vote by the CDC’s Advisory Committee on Immunization Practices, which took place in November last year, formalizes the recommendations.

Both ACAM2000 and Jynneos are available for prevention of orthopoxvirus infections among at-risk people, the CDC said on Friday.

Contributing: Amruta Khandekar

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