Tag Archives: Pain

Science

Why redheads feel less pain, according to scientists

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They may be ginger — but their skin isn’t.

In a seemingly paradoxical study, US researchers found that redheads have a preternaturally high pain tolerance — wait for it — due to a mechanism that ups their susceptibility to sunburns.

The research found that the cells that determine skin color — called melanocytes — play a large role in deciding how people experience pain.
(iStock)

“These findings describe the mechanistic basis behind earlier evidence suggesting varied pain thresholds in different pigmentation backgrounds,” said Dr. David Fisher of the Massachusetts General Hospital in Massachusetts. He led the fiery study published in the journal Science Advances.

The research found that the cells that determine skin color — called melanocytes — play a large role in deciding how people experience pain.

IS IT COVID-19, ALLERGIES, OR POST-VACCINATION SYMPTOMS? HOW TO TELL THE DIFFERENCE

As fire-haired folks boast a faulty melanocyte, they can’t process enough dark pigment to tan, which has the added effect of elevating their threshold for hurt.

Not to worry, no Ron Weasleys were harmed in the name of science. An examination of red-furred mice revealed that their melanocytes functioned similarly to that of rust-headed humans.

Like all people, those with crimson curls — the rarest hair color — boast a melanocyte receptor called melanocortin 1, whose primary directive is determining when the body produces dark brown and black coloration, the Daily Mail reported.

However, in redheads, the receptor doesn’t function, which makes their pallid skin virtually unable to bronze as well as more vulnerable to sunburn.

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Fortunately, despite their increased sun sensitivity, these “vermillionhairs” are also less likely to feel the burn.

The aforementioned screwy receptors reduce the production of a chemical called POMC, causing lower levels of various hormones. This in turn, brings about equilibrium between pain-inhibiting and pain-enhancing receptors, boosting the function of the pain-dulling opioid sensors not manufactured by the skin color cells.

As a result, redheads have a higher pain tolerance than their blond and brunette brethren.

The goal of the research is not to confirm the “South Park” stereotype that gingers have freaky superpowers (even if they’re scientifically proven to smell sexier, among other special abilities).

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Rather, “understanding this mechanism provides validation of this earlier evidence and a valuable recognition for medical personnel when caring for patients whose pain sensitivities may vary,” said Dr. Fisher.

The Scut Farkuses of the world aren’t the only ones who can endure abnormal levels of abuse. A 2019 study found that women are the superior sex when it comes to processing agony that occurred in the past.

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Science

Pivotal Discovery Could Treat Epilepsy, Parkinson’s, Depression and Chronic Pain

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Artist’s rendering shows X-rays striking radioluminescent nanoparticles in the brain, which emit red light that triggers a sodium (Na+) and potassium (K+) ion influx and thereby activates brain neurons. Credit: Image by Zhaowei Chen/Argonne National Laboratory.

Scientists make pivotal discovery of method for wireless modulation of neurons with X-rays that could improve the lives of patients with brain disorders. The X-ray source only requires a machine like that found in a dentist’s office.

Many people worldwide suffer from movement-related brain disorders. Epilepsy accounts for more than 50 million; essential tremor, 40 million; and Parkinson’s disease, 10 million.

Relief for some brain disorder sufferers may one day be on the way in the form of a new treatment invented by researchers from the U.S. Department of Energy’s (DOE) Argonne National Laboratory and four universities. The treatment is based on breakthroughs in both optics and genetics. It would be applicable to not only movement-related brain disorders, but also chronic depression and pain.

“Our high precision noninvasive approach could become routine with the use of a small X-ray machine, the kind commonly found in every dental office.” — Elena Rozhkova, a nanoscientist in Argonne’s Center for Nanoscale Materials

This new treatment involves stimulation of neurons deep within the brain by means of injected nanoparticles that light up when exposed to X-rays (nanoscintillators) and would eliminate an invasive brain surgery currently in use. 

“Our high-precision noninvasive approach could become routine with the use of a small X-ray machine, the kind commonly found in every dental office,” said Elena Rozhkova, a lead author and a nanoscientist in Argonne’s Center for Nanoscale Materials (CNM), a DOE Office of Science User Facility.

Traditional deep brain stimulation requires an invasive neurosurgical procedure for disorders when conventional drug therapy is not an option. In the traditional procedure, approved by the U.S. Food and Drug Administration, surgeons implant a calibrated pulse generator under the skin (similar to a pacemaker). They then connect it with an insulated extension cord to electrodes inserted into a specific area of ​​the brain to stimulate the surrounding neurons and regulate abnormal impulses.

“The Spanish-American scientist José Manuel Rodríguez Delgado famously demonstrated deep brain stimulation in a bullring in the 1960s,” said Vassiliy Tsytsarev, a neurobiologist from the University of Maryland and a co-author of the study. ​“He brought a raging bull charging at him to a standstill by sending a radio signal to an implanted electrode.”

About 15 years ago, scientists introduced a revolutionary neuromodulation technology, ​“optogenetics,” which relies on genetic modification of specific neurons in the brain. These neurons create a light-sensitive ion channel in the brain and, thereby, fire in response to external laser light. This approach, however, requires very thin fiberoptic wires implanted in the brain and suffers from the limited penetration depth of the laser light through biological tissues.

The team’s alternative optogenetics approach uses nanoscintillators injected in the brain, bypassing implantable electrodes or fiberoptic wires. Instead of lasers, they substitute X-rays because of their greater ability to pass through biological tissue barriers.

“The injected nanoparticles absorb the X-ray energy and convert it into red light, which has significantly greater penetration depth than blue light,” said Zhaowei Chen, former CNM postdoctoral fellow.

“Thus, the nanoparticles serve as an internal light source that makes our method work without a wire or electrode,” added Rozhkova. Since the team’s approach can both stimulate and quell targeted small areas, Rozhkova noted, it has other applications than brain disorders. For example, it could be applicable to heart problems and other damaged muscles.    

One of the team’s keys to success was the collaboration between two of the world-class facilities at Argonne: CNM and Argonne’s Advanced Photon Source (APS), a DOE Office of Science User Facility. The work at these facilities began with the synthesis and multi-tool characterization of the nanoscintillators. In particular, the X-ray excited optical luminescence of the nanoparticle samples was determined at an APS beamline (20-BM). The results showed that the particles were extremely stable over months and upon repeated exposure to the high-intensity X-rays.

According to Zou Finfrock, a staff scientist at the APS 20-BM beamline and Canadian Light Source, ​“They kept glowing a beautiful orange-red light.”

Next, Argonne sent CNM-prepared nanoscintillators to the University of Maryland for tests in mice. The team at University of Maryland performed these tests over two months with a small portable X-ray machine. The results proved that the procedure worked as planned. Mice whose brains had been genetically modified to react to red light responded to the X-ray pulses with brain waves recorded on an electroencephalogram.

Finally, the University of Maryland team sent the animal brains for characterization using X-ray fluorescence microscopy performed by Argonne scientists. This analysis was performed by Olga Antipova on the Microprobe beamline (2-ID-E) at APS and by Zhonghou Cai on the Hard X-ray Nanoprobe (26-ID) jointly operated by CNM and APS.

This multi-instrument arrangement made it possible to see tiny particles residing in the complex environment of the brain tissue with a super-resolution of dozens of nanometers. It also allowed visualizing neurons near and far from the injection site on a microscale. The results proved that the nanoscintillators are chemically and biologically stable. They do not wander from the injection site or degrade.

“Sample preparation is extremely important in these types of biological analysis,” said Antipova, a physicist in the X-ray Science Division (XSD) at the APS. Antipova was assisted by Qiaoling Jin and Xueli Liu, who prepared brain sections only a few micrometers thick with jeweler-like accuracy.

“There is an intense level of commercial interest in optogenetics for medical applications,” said Rozhkova. ​“Although still at the proof-of-concept stage, we predict our patent-pending wireless approach with small X-ray machines should have a bright future.”

Reference: “Wireless Optogenetic Modulation of Cortical Neurons Enabled by Radioluminescent Nanoparticles” by Zhaowei Chen, Vassiliy Tsytsarev, Y. Zou Finfrock, Olga A. Antipova, Zhonghou Cai, Hiroyuki Arakawa, Fritz W. Lischka, Bryan M. Hooks, Rosemarie Wilton, Dongyi Wang, Yi Liu, Brandon Gaitan, Yang Tao, Yu Chen, Reha S. Erzurumlu, Huanghao Yang and Elena A. Rozhkova, 24 February 2021, ACS Nano.
DOI: 10.1021/acsnano.0c10436

The related article ​“Wireless optogenetic modulation of cortical neurons enabled by radioluminescent nanoparticles” appeared in ACS Nano. In addition to Rozhkova, Chen, Finfrock, Antipova and Cai, another Argonne author is Rosemarie Wilton. University contributors include Vassiliy Tsytsarev, Dongyi Wang, Yi Liu, Brandon Gaitan, Yang Tao and Yu Chen from the University of Maryland, Department of Bioengineering; Hiroyuki Arakawa and Reha Erzurumlu from the University of Maryland School of Medicine; Fritz Lischka from the Uniformed Services University of the Health Sciences; Bryan Hooks from the University of Pittsburgh, Department of Neurobiology; and Huanghao Yang from Fuzhou University.

This research received support from the DOE Office of Science, National Institutes of Health and National Science Foundation.



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Health

Amid pandemic, ‘an international epidemic’ of childhood pain

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PARIS (AP) — By the time his parents rushed him to the hospital, 11-year-old Pablo was barely eating and had stopped drinking entirely. Weakened by months of self-privation, his heart had slowed to a crawl and his kidneys were faltering. Medics injected him with fluids and fed him through a tube — first steps toward stitching together yet another child coming apart amid the tumult of the coronavirus crisis.

For doctors who treat them, the pandemic’s impact on the mental health of children is increasingly alarming. The Paris pediatric hospital caring for Pablo has seen a doubling in the number of children and young teenagers requiring treatment after attempted suicides since September.

Doctors elsewhere report similar surges, with children — some as young as 8 — deliberately running into traffic, overdosing on pills and otherwise self-harming. In Japan, child and adolescent suicides hit record levels in 2020, according to the Education Ministry.

Pediatric psychiatrists say they’re also seeing children with coronavirus-related phobias, tics and eating disorders, obsessing about infection, scrubbing their hands raw, covering their bodies with disinfectant gel and terrified of getting sick from food.

Also increasingly common, doctors say, are children suffering panic attacks, heart palpitations and other symptoms of mental anguish, as well as chronic addictions to mobile devices and computer screens that have become their sitters, teachers and entertainers during lockdowns, curfews and school closures.

“There is no prototype for the child experiencing difficulties,” said Dr. Richard Delorme, who heads the psychiatric unit treating Pablo at the giant Robert Debré pediatric hospital, the busiest in France. “This concerns all of us.”

Pablo’s father, Jerome, is still trying to understand why his son gradually fell sick with a chronic eating disorder as the pandemic took hold, slowly starving himself until the only foods he would eat were small quantities of rice, tuna and cherry tomatoes.

Jerome suspects that disruptions last year to Pablo’s routines may have contributed to his illness. Because France was locked down, the boy had no in-school classes for months and couldn’t say goodbye to his friends and teacher at the end of the school year.

“It was very tough,” Jerome said. “This is a generation that has taken a beating.”

Sometimes, other factors pile on misery beyond the burden of the 2.6 million COVID-19 victims who have died in the world’s worst health crisis in a century.

Islamic State extremists who killed 130 people in gun and bomb attacks across Paris in 2015, including at a cafe on Pablo’s walk to school, also left a searing mark on his childhood. Pablo used to believe that the cafe’s dead customers were buried under the sidewalk where he trod.

When he was hospitalized at the end of February, Pablo had lost a third of his previous weight. His heart rate was so slow that medics struggled to find a pulse, and one of his kidneys was failing, said his father, who agreed to talk about his son’s illness on condition they not be identified by their surname.

“It is a real nightmare to have a child who is destroying himself,” the father said.

Pablo’s psychiatrist at the hospital, Dr. Coline Stordeur, says some of her other young patients with eating disorders, mostly aged 8 to 12, told her they began obsessing in lockdown about gaining weight because they couldn’t stay active. One boy compensated by running laps in his parents’ basement for hours each day, losing weight so precipitously that he had to be hospitalized.

Others told her they gradually restricted their diet: “No more sugar, then no more fat, and eventually no more of anything,” she said.

Some children try to keep their mental anguish to themselves, not wanting to further burden the adults in their lives who are perhaps mourning loved ones or jobs lost to the coronavirus. They “try to be children who are forgotten about, who don’t add to their parents’ problems,” Stordeur said.

Children also may lack the vocabulary of mental illness to voice their need for help and to make a connection between their difficulties and the pandemic.

“They don’t say, ‘Yes, I ended up here because of the coronavirus,’” Delorme said. “But what they tell you about is a chaotic world, of ‘Yes, I’m not doing my activities any more,’ ‘I’m no longer doing my music,’ ‘Going to school is hard in the mornings,’ ‘I am having difficulty waking up,’ ‘I am fed up with the mask.’”

Dr. David Greenhorn said the emergency department at the Bradford Royal Infirmary where he works in northern England used to treat one or two children per week for mental health emergencies, including suicide attempts. The average now is closer to one or two per day, sometimes involving children as young as 8, he said.

“This is an international epidemic, and we are not recognizing it,” Greenhorn said in a telephone interview. “In an 8-year-old’s life, a year is a really, really, really long time. They are fed up. They can’t see an end to it.”

At Robert Debré, the psychiatric unit typically used to see about 20 attempted suicide cases per month involving children aged 15 and under. Not only has that number now doubled in some months since September, but some children also seem ever-more determined to end their lives, Delorme said.

“We are very surprised by the intensity of the desire to die among children who may be 12 or 13 years old,” he said. “We sometimes have children of 9 who already want to die. And it’s not simply a provocation or a blackmail via suicide. It is a genuine wish to end their lives.”

“The levels of stress among children are truly massive,” he said. “The crisis affects all of us, from age 2 to 99.”

—-

AP writer Mari Yamaguchi in Tokyo contributed.

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Follow all of AP’s pandemic coverage at:

https://apnews.com/hub/coronavirus-pandemic

https://apnews.com/hub/coronavirus-vaccine

https://apnews.com/UnderstandingtheOutbreak

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Health

Coronavirus jab may help fight cancer, chronic pain… and even Alzheimer’s

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Joan Wakefield has barely been able to walk for the best part of six months. The 72-year-old from Stockport had a knee replacement in October and has since suffered infections in the scar tissue, causing agonising pain.

Then at the beginning of this month she received the first dose of AstraZeneca’s Covid-19 vaccine. ‘I woke up the next morning and the leg pain and stiffness was gone,’ she says.

‘I couldn’t believe it. I joked with my partner about whether the vaccine had anything to do with it. Previously, I couldn’t even bend my leg. Now I can extend it fully, and even put my shoes and socks on. I’m optimistic I’ll be able to return to work sooner, rather than later, now.’

It seems ludicrous – a vaccine designed to protect against one virus can, somehow, improve other totally unrelated elements of health.

But Joan Wakefield is far from alone.

A man receives his Covid-19 vaccinations at Lichfield Cathedral, Staffordshire earlier this week

Last month, Mail on Sunday GP Ellie Cannon wrote about the curious case of a man with Lyme disease who’d found his long-term fatigue had evaporated just days after having the Covid vaccine. Scores of you wrote in to tell similarly miraculous tales.

One has seen stubborn patches of eczema on her arms, legs and midriff mysteriously disappear within hours of having the jab. Another claimed that dizzying vertigo she’s battled for 25 years vanished four days after her shot.

What to read, watch and do 

READ

The Science Of Living: 219 Reasons To Rethink Your Daily Routine, by Dr Stuart Farrimond

Does exercising daily serve as many long-term benefits as we think? A scientist reveals the truth about the daily health hacks many of us live by.

DK, £15.99 

The Science Of Living: 219 Reasons To Rethink Your Daily Routine, by Dr Stuart Farrimond

WATCH 

Dispatches: One Doctor’s Story

A fly-on-the-wall look inside Covid wards, courtesy of Dr Saleyha Ahsan, who filmed her daily routine during the second wave. A moving and disturbing insight into the toll on NHS workers, revealing how close so many came to breaking point.

Tomorrow, 8pm, Channel 4

Dispatches: One Doctor’s Story

DO

Have a pottery party

Studies show that doing arts and crafts can reduce levels of anxiety – and sculpting pottery has been proven to be particularly calming.

sculpd.co.uk, £39 for a kit for two people. Larger kits are available.

Meanwhile, a woman wrote that her husband had enjoyed a full night’s sleep for the first time since his diagnosis of a sleep disorder 15 years ago. Even more bizarrely, some claimed to have been left in better health having contracted the virus itself. 

One 95-year-old care home resident was described by her daughter and being suddenly ‘alert and alive’ after having Covid last month.

‘Previously, mum was very frail, losing weight and her voice losing power. We were prepared for the end not to be far away,’ wrote Roz Ellis, from Ilford, Essex. 

‘Four weeks after recovering from Covid, her voice is stronger. She stands at the window for ten minutes and she’s put on 3 lb.’

Most readers guess the jab – or infection itself – caused the immune system to leap into action and attack other, niggling health problems. And they might well be right. Scientists have documented unexpected benefits of vaccines for decades – known medically as ‘non-specific effects’.

Studies in the 1970s and 1980s by Danish scientist Peter Aaby found mass measles vaccination in West African communities reduced the risk of child death by a third – but only four per cent of this decline was explained by more people surviving measles. 

Also in the 1970s, Russian scientists discovered vaccinating the population against polio reduced death from flu and other infections by up to 80 per cent.

More recently, Dutch and Greek researchers have reported astounding early results from trials looking at whether giving elderly people a vaccine for the bacterial infection tuberculosis – the BGC jab – could guard against other common infections that often land the frail and vulnerable in hospital.

Nearly twice as many infections were seen in the placebo group, compared to the vaccinated participants.

And the BCG vaccine is already used to treat bladder cancer patients with non-invasive tumours – it is administered directly into the bladder to help the immune system fight the cancer.

What’s more, bladder cancer patients who receive this therapy are less likely to develop Alzheimer’s, according to a recent Israeli study. But why?

Scientists are unsure as to the exact mechanism. Some indeed suggest vaccines can ‘train’ the immune system, strengthening it. 

But Professor Sheena Cruickshank, immunologist from the University of Manchester, doesn’t buy into this theory and insists there’s a different explanation.

She says: ‘The protection we see against other health problems in those who’ve had measles and BCG vaccines is a benefit of not having suffered those illnesses in younger years.

‘Suffering measles, tuberculosis or any other infections we vaccinate against can have long-term detrimental effects on our immune system.’

Studies show they weaken the response to threats and provoke systemic inflammation. Over time, this increases the risk of a host of diseases.

For those experiencing miraculous recoveries after the Covid-19 jab, Professor Sheena Cruickshank, immunologist from the University of Manchester, pictured, says the explanation lies with our emotional response to it

‘People vaccinated against these infections will in turn be less likely to suffer other diseases as a result.’

As for those experiencing miraculous recoveries after the Covid-19 jab, Prof Cruickshank says the explanation lies with our emotional response to it. ‘The pandemic has been hugely stressful, and we often underestimate the effect of stress on our immune system,’ she says.

Vax fact 

Vaccines prevent more than 2.5million deaths around the world every year, according to the World Health Organisation. 

She explains that increased stress hormones interfere with the ability of immune cells to target infections. She says: ‘This is why we tend to get bad colds or pick up bacterial infections when we’re stressed and run down.

‘It’s also this response that, in vulnerable people, leads to a flare-up in inflammatory conditions like eczema – because the immune system is going haywire.’

Dr Cruickshank suspects that the vaccine will come as a relief to many, immediately reducing stress levels. The beneficial effect on the immune system can be instant. It’s astonishing,’ she adds.

She also highlights that the type of vaccine used to prevent Covid-19 is markedly different to those used in previous studies.

‘The measles and tuberculosis jabs are all what’s called ‘live’ vaccines.

‘They involve injecting a minuscule amount of a weakened version of the virus or bacteria that causes the disease.

‘This helps the immune system recognise it when it sees it in larger doses, so it’s quicker to respond.

‘But all the Covid-19 vaccines work, not by injecting viral particles, but the genetic instructions that our immune cells need to create a small part of it.

‘It’s unlikely it’ll have any effect on immune cells they’re not specifically designed to target.’

Joan Wakefield has no doubt about the cure for her creaky knee. She writes: ‘As soon as I read about other people seeing miraculous effects from the vaccine, it all made sense.

‘I fully believe this is the case with me.’

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Business

Powell to Testify as Focus on Economic Pain Persists: Live Updates

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Credit…Al Drago for The New York Times

After it rocketed higher last year, the United States’ official unemployment rate has fallen to 6.3 percent. But top economic officials are increasingly citing a different figure, one that puts the jobless rate at a far higher 10 percent.

The higher figure includes people who have stopped looking for work, and the disparity between the official rate and the expanded statistic underlines the unusual nature of the pandemic shock and reinforces the idea that the economy remains far from a full recovery.

The reality that labor market weakness lingers, a year into the pandemic, could come up again as Jerome H. Powell, the Federal Reserve chair, testifies before Congress starting on Tuesday. Mr. Powell is set to speak before the Senate Banking Committee at 10 a.m. Tuesday, then before the House Financial Services Committee on Wednesday.

The Bureau of Labor Statistics tallies how many Americans are looking for work or are on temporary layoff midway through each month. That number, taken as a share of the civilian labor force, is reported as the official unemployment rate.

But economists have long worried that by relying on the headline rate, they ignore people they shouldn’t, including would-be employees who are not actively applying for jobs because they are discouraged or because they are waiting for the right opportunity.

Now, key policymakers are all but ditching the headline statistic, rather than just playing down its comprehensiveness. In an alternate unemployment figure, they’re adding back people who have left the job market since last February, along with those who are misclassified in the official report.

“We have an unemployment rate that, if properly measured in some sense, is really close to 10 percent,” Treasury Secretary Janet L. Yellen said on CNBC last week. And a week earlier, Mr. Powell cited a similar figure in a speech about lingering labor market damage.

“Published unemployment rates during Covid have dramatically understated the deterioration in the labor market,” Mr. Powell said recently. People dropped out of jobs rapidly when the economy closed, and with many restaurants, bars and hotels shut, there is nowhere for many workers who are trained in service work to apply.

Mr. Powell will be testifying as Democrats look to pass $1.9 trillion in new economic relief, an effort that has raised concerns in some quarters about the potential for higher inflation. Mr. Powell has said he and his colleagues do not expect inflation to move much higher persistently, and has typically pushed for additional government support to help the economy through the pandemic.

Rates on longer-term government bonds — which serve as benchmarks for things as varied as mortgages and credit-card debt — have been grinding higher and investors will also be watching carefully for any hints at how the Fed is interpreting that increase.

Credit…Eve Edelheit for The New York Times

The S&P 500 was set for a fourth straight of day losses on Tuesday. Stock futures indicated the index would fall 0.8 percent when the market opens, following European stock markets lower. Tech stocks have suffered some of the heaviest losses, and futures of the Nasdaq, a tech-heavy index, dropped 1.4 percent.

Stocks have dropped recently as a rise in U.S. inflation expectations and bond yields has raised concerns that the Federal Reserve will tighten its monetary policy sooner than expected, upending the easy-money policies that have helped bolster stocks during the pandemic.

The central bank’s policymakers have said they would look past a short-term rise inflation and keep supporting the economy, but investors will be listening for more details when Jerome H. Powell, the central bank chair, testifies before the Senate Banking Committee later on Tuesday and the House on Wednesday.

The official unemployment rate in the United States has fallen to 6.3 percent, but top economic officials are increasingly citing a figure that puts the jobless rate at 10 percent. The disparity reinforces the idea that the economy remains far from a full recovery.

  • Premarket trading indicates that tech stocks will continue their decline. On Monday, the information technology sector of the S&P 500, which includes Apple and Microsoft, dropped 2.3 percent, leading losses in the overall index. And the Nasdaq fell 2.8 percent.

  • Tesla shares dropped nearly 9 percent in premarket trading on Tuesday, after falling about 9 percent on Monday as Bitcoin prices also tumbled. Over the weekend, Elon Musk tweeted that prices of Bitcoin and Ether, the two largest cryptocurrencies, “do seem high.” A few weeks ago, the electric carmaker said it bought $1.5 billion in Bitcoin, sending prices of both soaring.

  • The Stoxx 600 Europe fell 1 percent, with tech stocks dropping the most.

  • The unemployment rate in Britain rose to 5.1 percent for the three months ending in December, 1.4 percentage points higher than it was a year earlier, official statistics showed on Tuesday. Job losses have fallen particularly hard on young people: The number of employees on company payrolls has declined by 726,000 in the past year, nearly three-fifths of these workers were under 25.

  • HSBC shares fell 1.8 percent in London after Europe’s largest bank said its pretax profit dropped 34 percent last year. It also announced plans to increase investments in Asia as it was “moving the heart of the business” there, including relocating some senior executives. The bank also said it would start paying dividends again.

Macy’s, the department store company that also owns Bloomingdale’s and Bluemercury, said on Tuesday that its net sales in 2020 tumbled 29 percent to $17.3 billion, highlighting the toll that the pandemic has taken on mall chains and apparel stores.

The retailer, which is based in New York, swung to a net loss of $3.9 billion for the year that ended Jan. 31, from a $564 million profit the prior year. But the company said it “anticipates 2021 as a recovery and rebuilding year,” particularly after a better than expected fourth quarter and holiday selling season, which was profitable even as sales dropped by 19 percent.

With its hundreds of stores, Macy’s is often viewed as a barometer for the health of department stores, malls and American consumers. Even before the pandemic hit, Macy’s was under strain. Last February, the company said that it planned to close about 125 of its least productive stores over three years and cut about 2,000 corporate and support function positions. Sales in 2019 had fallen to $24.6 billion from $25 billion a year earlier, though it was profitable at the time.

Credit…Brendan Mcdermid/Reuters

Less than a year after the pandemic thwarted an effort to sell Victoria’s Secret to the investment firm Sycamore Partners, the lingerie chain’s owner, L Brands, will again test private equity’s appetite for the business, according to the DealBook newsletter.

L Brands’ bankers at Goldman Sachs will begin formally pitching buyout firms about a potential takeover as soon as this week. L Brands said this month that it was weighing a sale or spinoff of Victoria’s Secret by August, as it focuses on its faster-growing Bath & Body Works division.

Victoria’s Secret had “substantially increased its valuation” and that L Brands was still evaluating all options for the business, Stuart Burgdoerfer, the chief financial officer of L Brands, said in a statement.

Victoria’s Secret has embarked on a turnaround effort since the Sycamore sale collapsed. A priority has been overhauling its brand, as younger customers shunned its overtly sexy products for alternatives focused on comfort and criticized its marketing as exclusionary.

Victoria’s Secret has overhauled its marketing, introducing a campaign last year that featured transgender, plus-size and older models. It is bringing back its much beloved swimwear brands to select stores.

The company has also changed up its management after former top executives were accused of misogyny and sexual harassment. New hires have included Martha Pease as chief marketing officer and Patti Cazzato as head of merchandising.

The lingerie market is in demand. A recent investment valued Rihanna’s Savage x Fenty brand at $1 billion, for example. For prospective buyers, Victoria’s Secret remains a well-known label with a sizable market share.

Still, potential acquirers may have one lingering concern: the continuing investigations and shareholder lawsuits about the ties between L Brands’ chairman, Les Wexner, and Jeffrey Epstein.

Sapna Maheshwari contributed reporting.

On the second day of the DealBook DC Policy Project, we will hear from more policymakers and business leaders about the challenges for the coronavirus vaccine rollout, the future of financial regulation and the outlook for bipartisanship in polarized times.

Here is the lineup (all times Eastern):

12:30 P.M. – 1 P.M.

Karen Lynch took over CVS Health this month as the pharmacy chain takes center stage in efforts to fight the pandemic. It is working with the government to distribute the coronavirus vaccine in its stores, as well as in nursing homes and assisted-living facilities. To aid in those efforts, the company hired 15,000 employees at the end of last year, staffing up to deal with what President Biden has called “gigantic” logistical hurdles to the vaccine rollout.

2:30 P.M. – 3 P.M.

At the center of the recent meme-stock frenzy was the online brokerage firm Robinhood, which has attracted millions of users with commission-free trades but drew outrage among its users when it halted trading in GameStop and other stocks at the height of the mania.

Vlad Tenev, Robinhood’s chief executive, is fresh from facing hours of hostile questioning at a congressional hearing last week about his company’s business practices. Joining him to discuss what regulators should now do — if anything — is Jay Clayton, the veteran Wall Street lawyer who led the Securities and Exchange Commission during the Trump administration. From the beginning of his tenure, Mr. Clayton said that his mission was protecting “the long-term interests of the Main Street investor.”

5:30 P.M. – 6 P.M.

Senator Mitt Romney, Republican of Utah, crossed party lines to vote to convict President Donald J. Trump on articles of impeachment, twice. He is also drafting a bill with Senator Tom Cotton, Republican of Arkansas, that would raise the minimum wage while forbidding businesses to hire undocumented immigrants. This is typical of Mr. Romney’s approach, speaking to concerns on both sides of the aisle in an era of stark partisan divisions.

Credit…Jerome Favre/EPA, via Shutterstock

HSBC is deepening its focus on Asia as it looks to unload some of its troubled Western operations, the bank said on Tuesday.

Noel Quinn, the chief executive, said the bank would invest $6 billion to expand its wealth management and wholesale banking business in Hong Kong, China and Singapore over the next five years. He also said he was considering relocating some of the bank’s top executives to Hong Kong because it would be “important to be closer to growth opportunities.”

Underscoring the turn toward Asia, the bank, which is based in London, also said it was considering the sale of its U.S. retail banking network and was in talks with potential buyers for its French consumer banking unit.

HSBC, which derives more than half of its revenue from China, has come under increasing political pressure from China and Britain over its business operations in Hong Kong, the former British colony. Pro-Beijing lawmakers in the city have publicly pressured it to embrace the Communist Party’s firmer grip on Hong Kong. When some executives have pledged support to Beijing, British members of Parliament have hammered the bank.

The political focus on HSBC is unlikely to ease and any future public statement about plans to move top executives to Hong Kong could prompt further criticism from British lawmakers.

“We haven’t firmed up our plans yet,” Mr. Quinn said on a call with reporters. “But the majority of executives will remain in London.”

HSBC, which reported its profit before tax in 2020 fell by 34 percent to $8.8 billion compared with a year earlier, blamed the pandemic for its financial performance.

Credit…Richa Naidu/Reuters

The company that makes the aluminum cans used by LaCroix, White Claw and other beverage giants is spinning off that business in a deal that values the new company at $8.5 billion, the company announced Tuesday.

The deal by the Ardagh Group, which is based in Luxembourg, would be in the form of a merger with a special-purpose acquisition vehicle, or SPAC, backed by an affiliate of the Gores Group, a private equity firm based in California.

It is a bet on the continued growth of the can business, as companies increasingly weigh the environmental consequences of their products. Nestlé announced the sale of its water business for $4.3 billion this month, in part a move to shift away from water packaged in plastic. Aluminum cans are far easier to recycle than plastic bottles.

Ardagh will retain a roughly 80 percent stake in the company after the deal. Investors are contributing a $600 million private placement, while Gores is putting in $525 million in cash. The new company, Ardagh Metal Packaging, will issue $2.65 billion of new debt. Those proceeds will go to Ardagh.

The deal, involving an already-public company carving off a unit with the backing of a SPAC, is the latest twist on a SPAC transaction. The Gores Group’s experience in SPACs was part of its appeal to Ardagh as a buyer, said Ardagh’s chair, Paul Coulson.

The Gores SPAC, named Gores Holdings V, is the seventh such deal the group has done. “You don’t really want to be going to a surgeon and have him perform his first surgery,” Mr. Coulson said.

Ardagh generates more half its roughly $7 billion in annual sales from making cans for beverage companies. This past year, sales by the unit grew 2 percent, fueled by beverage sales and environmental awareness, while earnings before interest tax depreciation and amortization grew 8 percent. Ardagh will keep its glass packaging business.

For beverage companies, cans have become an increasingly important tool for branding, providing colorful and sleek packaging.

When Ardagh acquired its canning operation in 2016 for $3 billion, it did most of its business with legacy brands like large soda and beer companies. It has since worked with younger and faster-growing seltzer-based brands like White Claw, LaCroix and Truly Hard Seltzer to help charge its growth. To prepare for further expected expansion in the United States, it bought a factory in Huron, Ohio.

Globally, the company is considering growth in Europe and Brazil, where beer sales remain strong as consumers are increasingly shifting from tap to cans.

Credit…Anastasiia Sapon for The New York Times

Nearly a month into the second run of the Paycheck Protection Program, $126 billion in emergency aid has been distributed by banks, which make the government-backed loans, to nearly 1.7 million small businesses.

But a thicket of errors and technology glitches has slowed the relief effort and vexed borrowers and lenders alike, Stacy Cowley reports for The New York Times.

Some are run-of-the-mill challenges magnified by the immense demand for loans, which has overwhelmed customer service representatives. But many stem from new data checks added by the Small Business Administration to combat fraud and eliminate unqualified applicants.

Instead of approving applications from banks immediately, the S.B.A. has held them for a day or two to verify some of the information. That has caused — or exposed — a cascade of problems. Formatting applications in ways that will pass the agency’s automated vetting has been a challenge for some lenders, and many have had to revise their technology systems almost daily to keep up with adjustments to the agency’s system. False red flags, which can require time-consuming human intervention to fix, remain a persistent problem.

Numerated, a technology company that processes loans for more than 100 lenders, still has around 10 percent of its applications snarled in error codes, down from a peak of more than 25 percent, said Dan O’Malley, the company’s chief executive.

Nearly 5 percent of the 5.2 million loans made last year had “anomalies,” the agency revealed last month, ranging from minor mistakes like typos to major ones like ineligibility. Even tiny mistakes can spiral into bureaucratic disasters.

Credit…Leah Millis/Reuters

Wally Adeyemo, President Biden’s nominee for deputy Treasury Secretary, plans to emphasize the importance of rebuilding the United States’ alliances to combat China’s unfair trade practices and halt foreign interference in the country’s democratic institutions at his confirmation hearing on Tuesday, according to a copy of his prepared remarks, which were reviewed by The New York Times.

His remarks highlight the importance that the Biden administration is placing on multilateralism as it seeks to undo many of the economic policies put in place by former President Donald J. Trump.

Mr. Adeyemo will tell members of the Senate Finance Committee that Treasury Secretary Janet L. Yellen has asked him to focus on national security matters at the department. If confirmed, he will be a pivotal player in the country’s economic diplomacy efforts.

“We must reclaim America’s credibility as a global leader, advocating for economic fairness and democratic values,” Mr. Adeyemo will say.

Mr. Adeyemo is expected to be introduced at the hearing by Senator Elizabeth Warren, the progressive Democrat from Massachusetts. Ms. Warren, who established the Consumer Financial Protection Bureau before joining the Senate, worked with Mr. Adeyemo, who served as her first chief of staff.

Mr. Adeyemo will discuss the nexus between economic and national security, arguing that “Made in America” policies will make the country more competitive around the world. If confirmed, he is expected to conduct a broad review of Treasury’s sanctions program, which the Trump administration used aggressively, but often haphazardly, against Iran, North Korea, Venezuela and other countries.

“Treasury’s tools must play a role in responding to authoritarian governments that seek to subvert our democratic institutions; combating unfair economic practices in China and elsewhere; and detecting and eliminating terrorist organizations that seek to do us harm,” Mr. Adeyemo, a former Obama administration official, will say.

Born in Nigeria, Mr. Adeyemo emigrated with his parents to the United States when he was a baby and settled in Southern California outside Los Angeles. At the hearing, he will also talk about his working-class upbringing and the need to ensure that low-income communities and communities of color, which have been hit hardest by the pandemic, receive relief.

Credit…Kate Munsch/Reuters

Adam Neumann, the flamboyant co-founder of WeWork, and SoftBank, the Japanese conglomerate that rescued the co-working company in 2019, have in recent weeks made significant headway toward settling their drawn-out legal dispute, according to two people with knowledge of the matter. That battle has stalled SoftBank’s efforts to take WeWork public.

As part of its multibillion-dollar bailout of WeWork, SoftBank offered to pay $3 billion for stock owned by Mr. Neumann and other shareholders. Several months later, after the coronavirus pandemic had emptied WeWork’s locations, SoftBank withdrew the offer. Mr. Neumann then sued SoftBank for breach of contract.

SoftBank was already a big investor in WeWork when it withdrew plans for an initial public offering in 2019. Now, SoftBank has plans to combine WeWork with a publicly traded special-purpose acquisition company, a type of deal that has recently become a popular way of quickly bringing private companies public. The legal dispute between Mr. Neumann and SoftBank is a threat to such a deal because it leaves unresolved the question of how much control SoftBank has over WeWork.

The settlement talks, which were reported earlier by The Wall Street Journal, could still fall apart, the two people said. Under the terms being discussed, SoftBank would buy half the number of shares that it had originally agreed to, one of the people said. As a result, it would pay $1.5 billion, not $3 billion. Mr. Neumann would get nearly $500 million instead of almost $1 billion, but he would retain more of his shares.

Under Mr. Neumann, WeWork grew at a breakneck pace and was using up so much cash that it was close to bankruptcy before SoftBank stepped in. Under the management team SoftBank installed, WeWork has tried to cut costs by slowing its growth and negotiating deals with the landlords it rents space from.

Credit…Angela Weiss/Agence France-Presse — Getty Images

Movie theaters in New York City will be permitted to open for the first time in nearly a year on March 5, Gov. Andrew M. Cuomo announced at a news conference on Monday.

The theaters will only be permitted to operate at 25 percent of their maximum capacity, with no more than 50 people per screening. Masks will be mandatory, and theaters must assign seating to patrons to guarantee proper social distancing. Tests for the virus will not be required.

Movie theaters were permitted to open with similar limits in the rest of the state in late October, but New York City was excluded out of concern that the city’s density would hasten the spread of the virus there.

The virus has battered the movie theater industry. In October, the owner of Regal Cinemas, the second-largest cinema chain in the United States, temporarily closed its theaters as Hollywood studios kept postponing releases and cautious audiences were hesitant to return to screenings. AMC Entertainment, the world’s largest movie theater chain, has increasingly edged toward bankruptcy.

The economic effects of the pandemic have been particularly felt in New York City, one of the biggest movie markets in the United States. Theaters in the city closed in mid-March, as the region was becoming an epicenter of the pandemic in the country.

While other indoor businesses, including restaurants, bowling alleys and museums, had been allowed to open in the city, Mr. Cuomo had kept movie theaters closed out of concern that people would be sitting indoors in poorly ventilated theaters for hours, risking the further spread of the virus.

Theaters that open will be required to have enhanced air filtration systems. Public health experts say when considering indoor gatherings, the quality of ventilation is key because the virus is known to spread more easily indoors.

Mr. Cuomo’s announcement was applauded by the National Association of Theater Owners.

“New York City is a major market for moviegoing in the U.S.; reopening there gives confidence to film distributors in setting and holding their theatrical release dates, and is an important step in the recovery of the entire industry,” the association said in a statement.

In a statement, AMC’s chief executive, Adam Aron, said the company would open all 13 of its New York City theaters on March 5.

The move came just days after Mr. Cuomo said that indoor family entertainment centers and places of amusement could reopen statewide, at 25 percent maximum capacity, on March 26. Outdoor amusement parks will be allowed to open with a 33 percent capacity limit in April.

The governor also said that the state was working on guidelines to allow pool and billiards halls to reopen after the state lost a lawsuit from pool hall operators. Those establishments will be allowed to reopen at 50 percent capacity with masks required, he said.

Cases in New York remain high despite climbing down from their January peak. Over the last seven days, the state averaged 38 cases per 100,000 residents each day, as of Sunday. That is the second-highest rate per capita of new cases in the last week in the country, after South Carolina.

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Brain fog, pain, fatigue, nausea, dizziness: Almost one-third of people with ‘mild’ COVID-19 still battle symptoms months later, study finds

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It’s been almost a year since Michael Reagan, 50, came down with COVID-19.

“I woke up first thing in the morning and I felt really hot and out of breath,” he said, recalling the morning of March 22, 2020. “I went into the bathroom trying to catch my breath, and I immediately coughed up blood into the sink. … I ended up in the hospital that day and tested positive for COVID.”

Reagan said he spent two months in and out of the hospital last spring, with acute COVID-19.

US data shows a big decline in new COVID-19 cases. Here’s why it could be deceptive

But for as hard as that was, what he’s been through since could be considered just as bad, if not worse: His current symptoms include constant pain in his chest, painful nerve pain in his hands and legs, seizures, tremors, and the loss of vision in one eye.

“Since then it has been a roller coaster,” he said, with ups and downs, new symptoms, a whole series of doctors, medications and tests.

“I realized that I have a lot of damage from COVID and it’s changed my life completely,” he said. He has not been able to return to anything near the active life he enjoyed before.

Unlike Reagan, when 34-year-old Stephanie Condra got sick with COVID-19 last summer, she didn’t have to be hospitalized. Her symptoms were comparatively mild: fatigue, shortness of breath, stomach pain and cramping, and a low-grade fever.

Medical imaging shows how COVID attacks the body, new study finds

But, after it appeared she had recovered from her acute illness, Condra says she began developing a wide array of health problems that that waxed and waned but did not clear up: terrible sinus pain, nausea and loss of appetite, bone-crushing fatigue, dizziness, a burning sensation in her chest, a dry cough, brain fog, confusion, concentration issues and problems with word retrieval.

“My symptoms are constantly evolving. I get the same symptoms again and again, and it’s like one will kind of disappear and then others will come up,” she explained.

While Condra said she started getting better at the beginning of 2021, she describes her progress as slow and halting. “I’m really only able to function for maybe, tops, like four hours during a day,” she said.

More than a year into the pandemic, what has become abundantly clear is that SARS-CoV-2 — the virus that causes COVID-19 — is a tricky virus: Some people aren’t aware they’re infected at all, while others are hospitalized and some die. And a growing group of people get sick and then never fully recover. In support groups, they sometimes refer to themselves as long-haulers; their condition is alternately called long COVID, continued COVID, post-COVID syndrome or post-acute COVID syndrome.

What we’re learning

Nobody is sure what percentage of people who’ve been infected with SARS-CoV-2 go on to develop post-COVID syndrome.

A new research letter published Friday in the journal JAMA Network Open is shedding new light on the condition. Researchers from the University of Washington followed 177 people with laboratory-confirmed SARS-CoV-2 infection for up to nine months — the longest follow-up to date. Notably, this group included 150 outpatients, who had “mild” disease and were not hospitalized.

They found that 30% of respondents reported persistent symptoms. The most common were fatigue and loss of smell or taste. More than 30% of respondents reported worse quality of life compared to before getting sick. And 14 participants (8%) — including 9 people who had not been hospitalized — reported having trouble performing at least one usual activity, such as daily chores.

US life expectancy drops 1 year during COVID pandemic, most since World War II

The researchers wrote that with 57.8 million cases worldwide, “even a small incidence of long-term debility could have enormous health and economic consequences.” There are now more than 110 million cases worldwide, according to the latest data compiled by Johns Hopkins University.

A much larger study, published in early January in The Lancet, found that of 1,733 coronavirus patients treated in the Chinese city of Wuhan, 76% were still experiencing at least one symptom six months after their symptoms began. But this group was made up entirely of hospitalized patients.

Treatment is a long and winding road

The Center for Post-COVID Care at Mount Sinai Health System, in New York City, was the first of its kind to open back up in May. So far, the center has seen more than 1600 patients — including Reagan and Condra — and there’s a months-long wait to get an appointment.

“It’s very hard to predict who will get these symptoms,” Dr. Zijian Chen, the medical director, told me when I interviewed him last summer. “The patients we’re seeing at the center are, you know, of all races. They span in age from the 20s to 70s and 80s. You have patients who are both male and female, of equal distribution.”

He said having mild illness or being healthy to begin with, is no protection from having persistent symptoms.

“I would presume that if … you had a pre-existing condition, that the infection with the virus can worsen that condition. But again, we’re also seeing patients who are previously healthy, had somewhat relatively mild illness,” Chen said.

Age, he said, isn’t a predictor either.

Another baffling aspect of post-COVID syndrome is the vast and seemingly random array of health issues that some patients face.

Dr. Christian Sandrock is a professor of medicine in pulmonary critical care and infectious diseases at UC Davis School of Medicine, in Sacramento, California. As director of critical care, he is one of the doctors who assesses patients at UC Davis’ Post-COVID-19 Clinic. It was the first such center in the region to open its doors, back in October.

“When we look at the long-term symptoms … the big things we see are fatigue, lethargy and sleep disturbance, and that makes up probably more than half of what we see. Loss of taste and smell is a very specific one that we will see. Shortness of breath is a very specific one, and chest pain as well,” he said. Many patients have multiple symptoms, and the symptoms can come and go.

Sandrock categorizes the symptoms into several buckets. Problems such as chest pain, shortness of breath and heart inflammation fall into the cardiovascular category. Chest pain and shortness of breath could, depending on the underlying cause, fall into the respiratory category, as does decreased exercise tolerance and pulmonary function abnormalities. He puts rashes, hair loss and even tooth loss into the dermatologic category. Fatigue, brain fog and not feeling like oneself belong to the constitutional category. The neurological category comprises loss of smell and taste, sleep dysregulation, altered cognition and memory impairment. Depression, anxiety and mood changes, he explained, all fall into the psychiatric category.

As for what is causing those symptoms, Sandrock points to several culprits. Some might be caused by the complications of an extended hospital or ICU stay, which is known to be hard on the body and have lasting effects. Some could be triggered by microvascular disease — damage to the capillaries, which Sandrock says is behind many symptoms, from chest pain to “COVID toes” to fatigue and even brain fog. Some symptoms could be set off by an autoimmune response triggered by high levels of inflammation, such as joint and body aches, sleep disturbances, depression and fatigue. And some could be as a direct infection by the virus, such as loss of smell and/or taste, according to Sandrock.

Treatment, Sandrock said, is very much individualized and depends on the symptoms and the underlying cause of those symptoms.

“Treatment needs to be customized,” he said. “We have to really spend our time seeing what our patients need. Some of them — they really just have chest pain, shortness of breath and low oxygen levels, and in that case we can manage that. Another person may have a lot of brain fog, difficulty concentrating and sleep disturbances — that’s a whole host of other things we then need to do.”

It can involve referral to other experts within the clinic, medications and rehabilitation. Medications such as immune-modulators, anti-inflammatories, anti-depressants, beta-blockers and/or steroids, he said. Rehab, such as cognitive, pulmonary and/or cardiac rehab. Sleep studies to root out the cause of any sleep disturbance.

But there is one constant. “The only treatment I’ve seen that’s consistent is a lot of what we would call supportive care. So that really involves better living and higher quality living, for lack of a better term. But that means you really need sleep. Sleep is going to matter a lot,” Sandrock said, noting that stress reduction, meditation and yoga are also part of the mix.

He said patients need to adjust their life to a less stressful and slower pace to allow the body to heal. “So, we want people to really be patient with themselves, know that it’s going to take a lot of time as they work through it. So that, I think, is key,” he said.

Dr. Dayna McCarthy, a team member at Mount Sinai’s Center for Post-COVID Care, agrees patients have to adjust their expectations of themselves and slow down.

“We’re like rubber bands. We just want to kind of snap back to the way that we were before. So, I think that has been one of the biggest challenges. But if people are not able to do that, and they keep pushing, that is when the symptoms just do not get better,” she said.

Improvements are hard-won and extremely slow. “Day to day it’s really hard to measure those improvements. As these symptoms wax and wane, the improvement is very stuttering. You know, three steps forward, two steps back,” said Sandrock, noting that he measures improvements in terms of months.

McCarthy, who calls the process “glacially slow,” says patients do get better with supportive care and time. “But a lot of it falls on the patient and having to understand and come to terms with the fact that their life needs to change for them to get better,” she said. “And when you’re young and healthy and you’re used to being in kind of fifth gear — you’re ‘full steam ahead’ and now we’re telling you, you really have to kind of shift back and shift down to allow your body what it needs to recuperate and recover. (It’s) a very difficult thing for patients to process and embrace,” she said.

More research is needed

Both Sandrock and McCarthy say much more research is needed to better understand post-COVID syndrome, including who gets it and best treatment practices. But they’re optimistic about the future, now that the condition has been recognized and “science is getting behind it,” as McCarthy put it.

“So, people are coming together both in systems, and then systems coming together nationally, and then internationally. So, there’s been this mass collaboration of scientists and health care professionals that are looking for answers. And that takes time. But I’m very happy to report that,” she said.

Sandrock said he was excited to learn that the National Institutes of Health recently announced it would be offering research grants as part of its “Post-Acute Sequelae of SARS-CoV-2 Infection (PASC)” initiative.

Biden says life may be back to normal by Christmas 2021

As for Michael Reagan and Stephanie Condra, they’re carrying on as best they can.

“Every day I make the conscious decision to be optimistic and to be positive. I can’t always control what circumstances life throws at me, but I can control how I carry myself. If I carry myself with grace and dignity that I’m going to be OK,” Reagan said. “I have a very supportive family. I have a supportive partner. I have job (and) coworkers that understand. I have excellent doctors. So, I try to look at things I am grateful for.”

Said Condra, “I really had to relinquish my sense of control in not knowing when this is going to end for me. But really being grateful for the improvements that are happening, and at least (getting) back some level of having a quality of life and being able to take advantage of the days, the weeks where I am feeling better … but it’s mind-blowing that it’s been so long.”



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Diabetes symptoms: Sign in your legs of high blood sugar – the ‘pain’ you shouldn’t ignore

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Diabetes is a common condition that affects around five million people in the UK. But a lot of people may not even know that they have diabetes. You could be at risk if you develop a subtle pain in your legs.

Diabetes is a life-long condition, and 90 percent of all cases are caused by type 2 diabetes.

Type 2 diabetes is where the body struggles to produce enough of the hormone insulin.

Insulin helps the body to convert sugar in the blood into useable energy.

But if your body isn’t getting enough insulin, the amount of sugar in your blood starts to rise, which can lead to diabetes.

READ MORE: Type 2 diabetes symptoms – ‘dark adaption’ could be a warning sign

“Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes,” said the Mayo Clinic.

“High blood sugar can injure nerves throughout your body. Diabetic neuropathy most often damages nerves in your legs and feet.

“Depending on the affected nerves, diabetic neuropathy symptoms can range from pain and numbness in your legs and feet to problems with your digestive system, urinary tract, blood vessels and heart.

“Some people have mild symptoms. But for others, diabetic neuropathy can be quite painful and disabling.”

Meanwhile, other common symptoms of diabetes include passing more urine than normal, and feeling unusually tired.

Some people also find that they’re always feeling thirsty, despite drinking plenty of fluids.

Speak to a doctor if you’re worried about the signs of diabetes.

Diagnosing the condition early could help to lower your risk of diabetes complications, including strokes or heart disease.



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Pain relief medications like Tylenol and Advil are ‘perfectly fine’ for COVID-19 vaccine aftereffects, experts say

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Avoid pain relief medications just before getting the COVID-19 vaccine, but they are “perfectly fine” to take after, experts say.

Headache, fever, body aches and chills: While these are completely normal side effects of the COVID-19 vaccine – and a good sign your immune system is working – they can be unpleasant.

To minimize the discomfort, some Americans may turn to pain relievers such as acetaminophen or ibuprofen. Others worry those medications could blunt the effectiveness of the vaccine.

Studies on the subject are sparse and inconsistent, but the Centers for Disease Control and Prevention and the World Health Organization recommend against the preventive use of pain relievers, though they allow them if symptoms develop after.

In a study published in the peer-reviewed Journal of Virology, researchers found nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can reduce the production of antibodies and affect other aspects of the immune response to SARS-CoV-2, the virus that causes COVID-19.

Researchers said the study’s results raised the possibility that pain relievers such as ibuprofen could alter the immune response to the COVID-19 vaccine.

Dr. Colleen Kelley, an associate professor of medicine at Emory University School of Medicine, who was not affiliated with the study, speculates that an altered response could be caused by reducing inflammation triggered by the immune system.

“The immune system generates a response through controlled inflammation. (Pain relievers) can reduce the production of inflammatory mediators,” she said. “So, this is the potential mechanism for a reduced immune response to vaccination if you take these medications.”

But Dr. Marian Michaels, a member of the University of Pittsburgh Medical Center’s COVID-19 vaccine advisory committee, says studies have shown the immune system responds differently to the COVID-19 vaccine than it does to natural infection.

“We believe that the (immune) response to the vaccine is actually a better response than the wild-type virus with COVID-19,” said Michaels, who is also a pediatric infectious disease physician at UPMC Children’s Hospital of Pittsburgh. “For that very reason, even for someone who has had the infection in the past … we recommend that people still receive the vaccine.”

‘This is fantastic’: Mass vaccination clinics to play key role in ending COVID-19 pandemic

One 2016 study from Duke University looked at the effectiveness of various vaccines among children and found those who took pain relievers before getting their regularly scheduled shots had fewer antibodies than those who didn’t.

But the few studies that exist on pain relievers and vaccines are not robust enough to draw conclusions, experts say, as the children in the 2016 study who took pain relievers and showed fewer antibodies still had a sufficient immune response to provide protection.

There’s no data that shows a reduced immune response if the medications are taken after getting the vaccine to treat side effects, Kelley added.

‘Actively looking at it’: Will travelers need a negative COVID-19 test to board flights within the US? The CDC says it’s under consideration

“It’s perfectly fine to take NSAIDs or Tylenol if you are feeling unwell after vaccination,” Kelley said. “The symptoms you are experiencing indicate that your immune system is functioning normally and that the immune response is ongoing.”

Michaels notes that study participants were not prohibited to take pain relievers in either the Pfizer-BioNTech and Moderna COVID-19 trials and efficacy rates were still over 95%.

“While I don’t have the exact numbers of people in the research study … I’m sure a number of them took acetaminophen or ibuprofen because 70% had mild (side effects to the vaccine),” she said. “And yet, there was still an immunologic response.”

Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

This article originally appeared on USA TODAY: COVID vaccine: OK to take Tylenol, Advil for side effects after shot

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