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A third of COVID survivors suffer neurological or mental disorders -study

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The Daily Beast

On Mykonos, Greece’s Famed Party Island, ‘Everyone Is About to Explode’

Louisa Gouliamaki/AFP via Getty ImagesThe narrow, stone-paved alleys on the traditional village of Oia, in Santorini, are usually packed with tourists even this time of the year. The Greek island with the most famous sunset view in the world is always a top travel destination. But COVID-19 put the growing popularity of the Greek islands on hold in 2020 and even though the warm Mediterranean weather means the tourist season in Greece usually starts in early April and lasts until late October, the streets are relatively quiet.With vaccination continuing worldwide, though, and the convenience of rapid tests, Greece is opening up to international travelers May 14, after almost a year, and hopes to recapture its past success. And business owners on two of its most famous islands, Santorini and Mykonos, are expecting the reopening to go with a bang. Giorgos Dimitrokalis wakes up everyday looking at the magnificent view of the caldera, and although he was born and raised in Santorini, this view of the Aegean Sea never ceases to amaze him. But for the owner of KD Hotels and Resorts and vice president of the Santorini Hoteliers Association, it’s hard to be the only one to enjoy this view. “It feels like a completely different island. Unrecognizable. Last year we were joking that the locals had the chance to enjoy the island for themselves. I hope this summer, things will go back to as it was before the pandemic, because the island has really suffered.”Unlike other places in Greece, islands such as Santorini and Mykonos base the majority of their economy on tourism. In 2019, tourism was a little more than 20 percent of the country’s overall economy , according to the Institute of the Greek Tourism Confederation. It was the best year in a decade.And then, coronavirus came. A view of Oia on the island of Santorini, Greece. Alkis Konstantinidis “It was summer outside, but the people out in the streets were as many as if it was winter. There was not even a soul out there. It was surreal,” says Poly Linoxylaki, owner of the Sand Lily boutique at Imerovigli in Santorini.Desperate not to lose another year, the Greek minister of tourism, Harry Theoharis, announced recently that the government will reopen tourism in Greece from May 14.There are two types of tourists who visit Santorini, explains Dimitrokalis, who owns 10 hotels all around the island: “At the hotels that are close to the beach, we’ve seen a more increased interest so far this year. Our customers there stay for around seven days, are usually families, and most of them Europeans. At the more central hotels, like the ones at Caldera and Fyra, are usually travelers who come from overseas, such as Americans, Brazilians, Chinese, and Australians, and they usually stay for no longer than three days. They come to see the island, admire the sunset, and leave.”For Embark Beyond, a luxury travel advisory company based in New York, “Greece and Turkey may be the only European countries open this summer” for Americans, and because of that they suggest to their clients to “reserve now, before the flood gates open and it’s too late.”“What we’ve been told is that the international flights to Greece for tourism will be open from everywhere in the world on May 14. We are just waiting for the officials to tell us what the protocols for this year will be” says Dimitrokalis, who points out that Americans are among the biggest fans of the island.“Most tourists who visit Santorini are from the U.S. and Australia, and if they won’t be able to come for some reason, I will have a big trouble” says Linoxylaki, who sells clothes and accessories, mostly made by Greek designers. “These are my customers. They support small businesses like mine.”During this time of the year the reservations for summer would normally be at around 70-80 percent, but according to Dimitrokalis, today the number is down to 25-30 percent. “We hope that next month more people will be interested and we expect that by the end of the season we might be able to reach around 50 percent of 2019. We are putting our hopes in last-minute reservations to reach our goal,” he says.Most of the reservations are starting from mid-summer, but everyone is optimistic. “If the weather is good we expect to expand this year’s season, because we are already losing the first three months” says Dimitrokalis, and that is something Linoxylaki agrees, even though she has her doubts about the reopening: “We are hoping that September and October will be the peak of this season. But I must be honest, I personally don’t believe that we will be able to open up on May 14, as the government said.”Similar to Santorini, most of the Greek islands suffered their share too last year. Among them, Mykonos, the popular Cycladic island with the bright white houses and wild nightlife.When Kim Kardashian and her family traveled to Mykonos in 2013 to film the eighth season of Keeping Up with the Kardashians, Kim was pregnant with North and the island was full with paparazzi… and lots of tourists. Overview of the Chora of Mykonos at sunset. Demetrios Ioannou Today Iraklis Zisimopoulos, CEO of the Semeli Hospitality Group who hosted the Kardashian family and their crew almost a decade ago, looks back at those days with some nostalgia, but with confidence for the future. “I am sure that they will come back again; coronavirus won’t last forever. It might not be this year, but we see that the dynamic of Mykonos is not lost and we are sure that even better days will come” he says.Zisimopoulos is also the general secretary of the Mykonos Catering and Entertainment Association, as well as the president of the Association of Businesses and Professionals of Mykonos Town. “I have hotels, restaurants, bars, clubs, and everything is shut down,” he says with a bitter smile.Speaking to the Athens News Agency last September, Konstantinos Koukas, the mayor of the island, said that last season they reached only 30 percent of 2019, and as Zisimopoulos explains: “Last year was catastrophic, but we hope this year will be different. It definitely won’t be anywhere close to a normal season, but for sure it won’t be like 2020.”The most important role in shaping that will be the protocols under which tourists will be able to enter Greece. “So far we know that there are three options: 1) The people who have been already vaccinated, 2) Those who have tested negative the last 48 hours, and 3) Those who have already been sick and now have the antibodies” says Zisimopoulos, a doctor himself.When it comes to Mykonos though, people don’t travel to the island just for the nice view or to swim in the crystal clear blue sea. They go because they want to have fun and everyone has only one thing on mind… the nightlife!Mykonos is known worldwide as the “party island” of Greece and a land where you can openly be who you are. Anastasios Kapetanias contributed as much as anybody to this reputation. For the director and founder of XLSIOR Festival, the only gay music festival in Greece and among the top five in the world, last year was the first time that he had to cancel it, since it was first launched in 2009. But he has high hopes for this summer.“People are thirsty for fun” he says. “We receive lots of emails everyday from people begging us to do the festival this year. They tell us ‘we need to see our friends; we need to feel free again’. Everyone is about to explode; we can’t take it any more.”For the Greek government, nightlife isn’t a top priority and will be one of the last things to open, and under which terms is yet unknown. But for the local economy, this is a huge blow. XLSIOR alone brings to the island more than 30,000 people every summer from all around the world. “We have people coming from the U.S., Brazil, Spain, Israel, and most of them are people who come every year”, explains Kapetanias, who also cooperates with several local businesses like hotels, rent-a-cars, restaurants etc. to assist his clients.“Last August when the government decided to close all bars and clubs at midnight, all reservations stopped and many canceled,” says Zisimopoulos. The whole situation was completely surreal, as Kapetanias describes it: “People were all around the streets, looking for some villa parties to go and everyone was hiding as if we were in a war. This is not Mykonos.” One of the windmills overlooking the Chora of Mykonos. Demetrios Ioannou The Greek government decided to vaccinate all residents on small islands, with under 1,000 population, with some of the first COVID-free islands in Greece including Kastellorizo and Oinousses,Could a similar plan work for Mykonos, with around 10,000 people? Zisimopoulos is confident it would fix many of their problems: “If all the locals get vaccinated, whatever happens to the island, we will have a strong protective shield. In a normal season, we would have at least 10 reservations per day. Now the maximum is 2. The last 20 days we’ve seen some movement and we have some reservations from the U.K., Israel, and the U.S., where the vaccination goes faster. Most of those reservations are for July and August.”Kapetanias, on the other hand, suggests that a good idea for the reopening of live festivals like his could be the rapid tests. “They could go to a clinic on the island earlier on the same day, do the test and if it is negative they could come with the results and enter. We just need to be super organized, so the people will be completely safe.”And even though no one knows for sure how this summer nightlife will be like, the engines on the island are on and everyone is organizing, hoping they won’t have to cancel again. “Because of the situation we will be able to organize events in dreamy places, where other years it wasn’t possible. This year most of our events will be outdoors as well. Of course we will also be bringing the best DJs, musicians and dancers that we know our audience loves,” Kapetanias says about this year’s event, which has already been announced for August 18-25.“It will be a year in which we will get a big part of our life and vacations back, and because we have been deprived of so many things this past year, it will make us feel so much better. I really believe there is hope on the horizon,” says Zisimopoulos. Kapetanias concurs: “To be honest, what I want for this summer is to see happy people, who will be laughing, having fun, being safe and would want to come back again next year.”Read more at The Daily Beast.Get our top stories in your inbox every day. Sign up now!Daily Beast Membership: Beast Inside goes deeper on the stories that matter to you. Learn more.

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Health

Brazil variant can reinfect virus survivors; COVID-19 vaccine antibodies pass into breast milk

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The New York Times

The World Needs Syringes. He Jumped In to Make 5,900 Per Minute.

BALLABGARH, India — In late November, an urgent email popped up in the inbox of Hindustan Syringes & Medical Devices, one of the world’s largest syringe makers. It was from UNICEF, the United Nations agency for children, and it was desperately seeking syringes. Not just any would do. These syringes must be smaller than usual. They had to break if used a second time, to prevent spreading disease through accidental recycling. Most important, UNICEF needed them in vast quantities. Now. Sign up for The Morning newsletter from the New York Times “I thought, ‘No issues,’” said Rajiv Nath, the company’s managing director, who has sunk millions of dollars into preparing his syringe factories for the vaccination onslaught. “We could deliver it possibly faster than anybody else.” As countries jostle to secure enough vaccine doses to put an end to the COVID-19 outbreak, a second scramble is unfolding for syringes. Vaccines aren’t all that useful if health care professionals lack a way to inject them into people. Officials in the United States and the European Union have said they don’t have enough vaccine syringes. In January, Brazil restricted exports of syringes and needles when its vaccination effort fell short. Further complicating the rush, the syringes have to be the right type. Japan revealed last month that it might have to discard millions of doses of the Pfizer-BioNTech vaccine if it couldn’t secure enough special syringes that could draw out a sixth dose from its vials. In January, the Food and Drug Administration advised health care providers in the United States that they could extract more doses from the Pfizer vials after hospitals there discovered that some contained enough for a sixth — or even a seventh — person. “A lot of countries were caught flat-footed,” said Ingrid Katz, the associate director of the Harvard Global Health Institute. “It seems like a fundamental irony that countries around the world have not been fully prepared to get these types of syringes.” The world needs between 8 billion and 10 billion syringes for COVID-19 vaccinations alone, experts say. In previous years, only 5% to 10% of the estimated 16 billion syringes used worldwide were meant for vaccination and immunization, said Prashant Yadav, a senior fellow at the Center for Global Development, a think tank in Washington, and an expert on health care supply chains. Wealthier nations like the United States, Britain, France and Germany pumped billions of dollars of taxpayer money into developing the vaccines, but little public investment has gone to expand manufacturing for syringes, Yadav said. “I worry not just about the overall syringe manufacturing capacity but capacity for the specific types of syringes,” he said, “and whether syringes would already be in locations where they are needed.” Not all of the world’s syringes are suited to the task. To maximize the output from a vial of the Pfizer vaccine, for example, a syringe must carry an exact dose of 0.3 milliliters. The syringes also must have low dead space — the infinitesimal distance between the plunger and the needle after the dose is fully injected — to minimize waste. The industry has ramped up to meet demand. Becton Dickinson, which is based in New Jersey and a major syringe manufacturer, said it will spend $1.2 billion over four years to expand capacity in part to deal with pandemics. The United States is the world’s largest syringe supplier by sales, according to Fitch Solutions, a research firm. The United States and China are neck and neck in exports, with combined annual shipments worth $1.7 billion. While India is a small player globally, with only $32 million in exports in 2019, Nath of Hindustan Syringes sees a big opportunity. Each of his syringes sells for only three cents, but his total investment is considerable. He invested nearly $15 million to mass-produce specialty syringes, equal to roughly one-sixth of his annual sales, before purchase orders were even in sight. In May, he ordered new molds from suppliers in Italy, Germany and Japan to make a variety of barrels and plungers for his syringes. Nath added 500 workers to his production lines, which crank out more than 5,900 syringes per minute at factories spread over 11 acres in a dusty industrial district outside New Delhi. With Sundays and public holidays off, the company churns out nearly 2.5 billion a year, though it plans to scale up to 3 billion by July. Hindustan Syringes has a long history of supplying UNICEF immunization programs in some of the poorest countries, where syringe reuse is common and one of the main sources of deadly infections, including HIV and hepatitis. In late December, when the World Health Organization cleared Pfizer’s vaccine for emergency use, Robert Matthews, a UNICEF contract manager in Copenhagen, and his team needed to find a manufacturer that could produce millions of syringes. “We went, ‘Oh, dear!’” said Matthews, as they looked for a syringe that would meet WHO specifications and was compact for shipping. Hindustan Syringes’ product, he said, was the first. The company is set to begin shipping 3.2 million of those syringes soon, UNICEF said, provided they clear another quality check. Nath has sold 15 million syringes to the Japanese government, he said, and over 400 million to India for its COVID-19 inoculation drive, one of the largest in the world. More are in line, including UNICEF, for which he has offered to produce about 240 million more, and Brazil, he said. Inside the company’s Plant No. 6, machines coated in yellow paint hum as they squirt out plastic barrels and plungers. Other machines, from Bergamo, Italy, assemble each component, including needles, monitored by sensors and cameras. Workers in blue protective suits inspect trays full of syringes before unloading them into crates that they hand carry to a packaging area next door. To increase efficiency, Nath relies on a syringe design by Marc Koska, a British inventor of safety injections, and its ability to produce all of the components in-house. Hindustan Syringes makes its needles from stainless steel strips imported from Japan. The strips are curled into cylinders and welded at the seam, then stretched and cut into fine capillary tubes, which machines glue to plastic hubs. To make the jabs less painful, they are dipped in a silicone solution. The syringe business is a “bloodsucker,” Nath said, where upfront costs are astronomical and profits marginal. If demand for his syringes drops by even half in the next few years, he will lose almost all of the $15 million he invested. It’s clearly a frugal operation. The blue carpet in Nath’s office looks just as old as his desk or the glass chandelier by the stairs, fixtures his father put in place in 1984, before he handed over the company to Nath and his family. A family business is exactly how he likes it. No shareholders, no interference, no worries. In 1995, when Nath needed money to increase production and buy lots of new machines, he sought private capital for the first time. Had that been the case today, he said, he wouldn’t be able to follow his gut and produce his syringes at this enormous scale. “You have a good night’s sleep,” Nath said. “It’s better to be a big fish in a small pond.” This article originally appeared in The New York Times. © 2021 The New York Times Company

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Health

Recovery clinics offer coronavirus survivors hope

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  • Many COVID-19 long-haulers are still experiencing debilitating symptoms.
  • But new recovery clinics that are now opening up across the country are offering them hope.
  • Insider spoke to long-haulers and doctors running the programs to see how successful they’ve been.
  • Visit the Business section of Insider for more stories.

Amy Watson has had a chronic fever for 344 days. 

Almost a year after she was diagnosed with COVID-19, the schoolteacher from Portland, Oregon, is still suffering from ongoing symptoms. 

Apart from the fever, Watson told Insider that she is still experiencing chronic fatigue, “brain fog,” intense migraines, gastrointestinal issues, and severe body aches.

The 47-year-old, who had no underlying health condition before catching the virus, has also developed tachycardia and says every time she steps under the shower, her heart rate goes over 100 beats per minute.

“It’s really challenging. I don’t want people to have to know from personal experience what this is like,” Watson told Insider.

Watson is among a growing group of COVID’s longtime victims, or so-called “long-haulers,” whose bodies have been left debilitated by a virus about which little remains known. 

But now, post-recovery clinics specifically catered to long-haulers are opening up across the country and are offering people like Watson some much-needed hope.

Post-COVID clinics offer a “centralized” way to get long-haulers access to care

According to a CDC study published in the summer, around 1 in 3 people with COVID-19 will have symptoms that last longer than the typical two weeks. 

The symptoms, which can vary from an ongoing cough to scarred lungs, affect not only people who had to be hospitalized with COVID-19 but also those with milder cases. 

Post-COVID care centers aim to bring together a team of experts from a broad range of specialties to address all the wide-ranging issues long-haulers face, based on the disease’s latest understanding.

One of the first such clinics was the Mount Sinai Hospital in New York City. It has treated 1,500 people since it opened its doors in May. 

Dr. Ruwanthi Titao, a cardiologist who works at the clinic, told Insider: “The purpose of the center was to fill this void of patients looking to seek care, who are feeling frustrated, worried, and concerned that they weren’t getting access to the proper care out in the community.

“And this was a nice, centralized way to get them access to care, to get their symptoms documented so that we can start recognizing patterns in terms of disease, and to then refer them to the appropriate specialist to get the proper therapy,” she added.

The entrance of Mount Sinai’s Post-Covid Care Clinic.

Mount Sinai Health System


Patients usually have a one-hour long intake appointment to review their medical history before looking at their current coronavirus-induced symptoms. 

“From that point, the post COVID office will make appropriate referrals. So that would be, for example, to cardiology, neurology, rehab medicine, or psychiatry,” Dr. Titano said. 

But treating people with multiple —and often severe — symptoms is challenging for a disease that still lacks long-term research.

Dr. Greg Vanichkachorn, the medical director of Mayo Clinic’s Covid Activity Rehabilitation Program (CARP) in Rochester, Minnesota, told Insider that his center is taking a “slow and steady” approach that is based on treatments used before the coronavirus pandemic.

“You know, this is is not the first coronavirus outbreak. We’ve had SARS and MERS, for example, and already have some research from that time that definitely shows that there was a post-viral syndrome similar to this as well,” he said.

“What we have stressed with our patients is helping them adapt and develop what’s called a ‘Paste’ therapy program, where they slowly, with hands-on help, engage in rehabilitation,” Dr. Vanichkachorn continued. “It’s all about the slow, consistent activity with small gains.”

The therapy often incorporates simple measures, such as encouraging patients to increase their fluid and salt intake or giving them compression socks to help with blood flow.

“And then if we really need to, we can also use medications to help with the symptoms either to bump up the blood pressure if we need to or help with things like rapid heart rate,” Dr. Vanichkachorn added.

Dr. Titano from Mount Sinai confirmed that her recovery clinic was taking a similar approach. 

“We’re fixers and healers, we want to have a clear diagnosis, and we want to fix this. But when there are flares of symptoms, or when there are relapses or setbacks, of course, we take it very much to heart,” Dr. Titano said.

But even though Dr. Titano admits that “it’s been a very arduous, slow process of improvement,” she remains hopeful. 

Mental health is a problem too

Clinics, like the one at Mount Sinai, are also giving patients access to social workers or therapists to work through their trauma.

Many long-haulers, especially those who were hospitalized, have been left with depression or, in some cases, post-traumatic stress disorder (PTSD).

This is the case for Heather-Elizabeth Brown, a 36-year-old corporate trainer from Detroit, Michigan, who had to be put on a ventilator in April after coronavirus-induced pneumonia caused her lungs to fail. 

Brown, who was in a coma for 31 days, said her experience was “traumatizing.”

Shortly after doctors had told her that a ventilator would be the only way they could save her life, Brown had to have a “FaceTime family meeting” to make her decision. Her mother had to take the call from the hospital parking lot.

“I remember I wrote my will on a napkin and put it in one of my boots and made sure to tell the nurses where it was just in case,” Brown said. “I just didn’t know at that time if I was going to come out alive.”



Heather-Elizabeth Brown in hospital.

Heather-Elizabeth Brown


“I have very strong faith. I trust God. But it’s one of those things that you don’t know. It was just a very big question mark,” she added.

Brown is currently doing therapy alongside a range of different treatments.

“I’m just lucky that a lot of my care is under one health system. So at least all of my records are in one place,” Brown said.

“But for people who may have other challenges or have different barriers to access, having one center that also provides mental health help is a phenomenal idea. It’s like a one-stop-shop,” she added. 

Long-haulers feel forgotten about

Schoolteacher Watson said that finding treatment for all of her conditions has been frustrating, and she very often feels dismissed by healthcare professionals.

The US is still grappling with tens of thousands of acute COVID-19 cases a day and many states are now turning their focus to administering the vaccines as swiftly as possible. This often means long-haulers are sidelined. 

“When we do go to our appointments, doctors tell us they don’t feel like our symptoms are severe enough and tell us they’re not going to waste their time on us. And that’s pretty disconcerting as a patient,” Watson continued.

This was part of the reason Watson started one of the largest Facebook support groups for long-haulers.



Amy Watson

Amy Watson


For Watson, having a program that is specifically tailored to long-haulers would be “life-changing.”

“I would personally love to go to one, but sadly there isn’t one in my area at the moment. But this is definitely something I am advocating for,” she said.

“People just need to understand that we’re growing a bit impatient. We would like to get better and get back to our lives and hopefully not have a significant portion of the population disabled by this disease,” she added.

Survivor Corps, a support and research organization, maintains a running list of post-COVID care centers in the United States, Canada, and the United Kingdom.

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Health

COVID death toll leaves survivors struggling to rebuild

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A new report finds that life expectancy in U.S. dropped a staggering one year during the first half of 2020 as the coronavirus pandemic caused its first wave of deaths. Minorities suffered the biggest impact­. (Feb 18)

AP Domestic

Day after day, Abby Adair Reinhard slumped out of her home office around dinnertime, her father’s abrupt COVID-19 death still fresh in her mind. Working to keep her flooring business afloat and worried about her mother’s health, she had little time for her three young kids.

“I would come out see my kids and think, ‘oh, good, at least they are all still alive,” she said. “And that’s horrible to admit.”

Reinhard’s father, who passed away in April, was among the first Americans to die of what at the time was a new virus sweeping the nation. Donald Adair, 76, had gone into the hospital after a fall and caught the virus from his hospital bed.

For agonizing hours, Reinhard, 42, and her three siblings listened to his labored breathing as he slowly weakened and died, one of about 1,500 Americans who passed away on April 6.

Daily deaths from the infection are now roughly twice that, and now nearly 500,000 have died, many of them alone in hospital beds following anguished, labored phone calls to family members.

Ten months after her father’s death, Reinhard and her family in Rochester, New York, are still struggling with their loss— and the loss of the community she once thought she could count on. While most people lift up her family, there are still some who unleash stabbing pain as they ask, “how old was he? Did he have underlying health conditions?”

Each question feels like an insult.

“It’s like, how does that even matter?” Reinhard said, anger rising in her voice. “Does that make it OK that he died? He’s dead. He shouldn’t be dead.”

Across the country, the virus has reshaped daily life, from the low-paid workers forced to remain on the job so they can feed their families and keep their healthcare, to the middle-class families who’ve suddenly had to home-school their children, cancel vacations and skip Thanksgiving dinners with loved ones.

Tens of millions of families face eviction, and as many as 10 million remain unemployed as restaurants limp along, hair salons operate under heavy restrictions and small businesses remain shuttered, many permanently. The virus has hit poor and marginalized communities the hardest: Coronavirus deaths for people of color are 1.2 to 3.6 times higher than for white Americans.

Like most families, Reinhard’s has battled through school closures and mask mandates, each day weighing personal safety against some semblance of normality. The kids went back to virtual school in early September under the supervision of a daily sitter, and twice a week Reinhard’s mom, a retired teacher, comes in to help with their schoolwork.

The routine helps. But very little is normal.

Anxiety. Nightmares. The ever-present smell of hand sanitizer. Fingernails jammed into the side of her thumb. Rushing past unmasked people at the dentist’s office. Five extra pounds from all the extra desserts.

Even photos of her smiling family shared on Facebook feel misleading, she said.

“I feel like I’ve been going through this process of healing with a wound that keeps getting ripped open again,” she said. “Being OK with not being OK was a big step for me. I know that I’m not my best self.”

Compounding her anguish, her kids are missing out on a normal childhood. Day after day, they sit at home with little outside interaction, their isolation the price her family pays to help slow the pandemic’s spread. Reinhard acknowledges that many Americans have chosen to ignore public health recommendations, which means they’re living far more normal lives.

Doing the right thing hurts, she said.

“My youngest, the other day, she said, ‘I don’t have a best friend. I don’t have friends,'” Reinhard said. “They haven’t played with other children since March. I know other families have, but we’ve chosen not to do that. And that’s a big deal. A year in the life of a young kid is such an eternity.”

The days follow a grindingly familiar pattern: The kids do online school while Reinhard runs from her home office her flooring company, which has expanded to provide facility virus-disinfection services. Reinhard gave up her office at company HQ so the workers who have to go in have safe places to sit.

She journals and occasionally writes, including a pre-election poem about the power of voting. She trades texts with her siblings, all of them still stunned by their father’s death. In a rare treat, she and her husband, Josh, celebrated their 10-year wedding anniversary in August by renewing their vows and eating dinner alone on an outside patio. 

For a few years before his death, Reinhard and her father were not as close as she would have wanted. She had worked to mend that in the months before his unexpected passing. She’s thankful every day for making that effort.

“If I hadn’t done that, I would be living with so much more pain and regret now that he’s gone,” she said. “Recently I’ve been working on forgiving myself and others every chance I get. I’ve been angry with those who haven’t taken COVID seriously, and I’ve been mad at myself for struggling with anxiety. When I can forgive, it frees up space inside of me.”

Reinhard knows her family has it better than many. They’ve got a roof over their head, and their business is getting through. They can afford to put food on the table, and even manage to celebrate holidays by pretending they’ve traveled to Las Vegas, putting up a fake skyline and posing for photos.

“From a tactical perspective, I don’t get out much. The real visceral sense I could lose my other parent heightens our need to be cautious,” she said. “I appreciate the small things more now, too. It’s cliche but true, and it’s important that I keep that going post-COVID.”

That’s why her encounters with COVID-deniers still stop her cold. Even after all the deaths, the hospitalizations, the trauma of seeing family members and loved ones vanish, people still act as if the virus is some sort of hoax, or a political maneuver. Her brother, Tom, even posted their dad’s death certificate on Facebook showing his cause of death: respiratory failure caused by COVID-19. 

“I don’t advocate for living in fear, but I do advocate caring for other people,” Reinhard said. “To have people in my life, who know what we went through, to not take it seriously? For a lot of others, it wasn’t until they lost somebody that is was real, and if they haven’t lost anyone, well, it still isn’t.”

Reinhard’s mom got vaccinated in early February, raising her hopes that the nation’s doctors and scientists are turning the tide. She’s not sure when life will return to normal in Rochester, but she’s hopeful things will be safer by the fall, when her kids might go back to in-person classes.

She thinks a lot about how the pandemic has exposed some uncomfortable truths about how we live our lives. For her part, she’s thankful for the opportunity to grow closer to family, but is wondering what the long-term impacts will be on communities following the bitter disputes about safety and wearing masks.

“I think core to the identity of our nation is this idea of rugged individualism. That worked well for us for two centuries. But now we are all so connected— what’s good for the group is also good for the individual,” she said. “For us, staying safe is about keeping Grammy safe.”

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Uttarakhand glacier disaster: Details emerge of terrifying moments before avalanche struck as search for survivors continues

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Rana was lucky. He saw the disaster unfold from above in the village of Raini, where he was building a new railroad for the Hyderabad-based Rithwik Railway Company. But several of his co-workers below were unable to see the danger down the road.

Those from the higher vantage point screamed to warn them.

“The five or six people who heard them ran. Some people were saved,” Rana said.

The rest are among the nearly 200 people still missing after part of a glacier collapsed on Sunday in the northern Indian state of Uttarakhand, causing a massive avalanche that tore through a mountain gorge and crashed through a dam.

Authorities were able to save a handful of individuals immediately after the disaster, and another 126 people from the nearby Niti Valley were rescued by helicopter.

Three days after the tragedy, the search for survivors continues. So far, the bodies of 32 people have been found — and as the clock keeps ticking, hope is dimming for those still unaccounted for.

A handful of villages in the remote region, where roads are few and far between, are now cut off from the outside world, including Rana’s home of Pan, where his wife is stuck.

It’s not exactly clear what caused the piece of the glacier to fall off, triggering the avalanche. Indian Home Minister Amit Shah told parliament a landslide triggered a “snow avalanche” that spread across 14 square kilometers (5 square miles), causing flash floods.

Manish Mehta, a senior scientist at Wadia Institute of Himalayan Geology, who is inspecting the site with four colleagues, said preliminary evidence shows a “huge rock slide” near the glacier may be to blame for triggering the avalanche. The scale of the ensuing flash flood was unprecedented, he added, and could affect “more than 100 square kilometers (38 square miles).”

Dr. Dan Shugar, a professor with the University of Calgary’s Department of Geoscience, said in a tweet Tuesday that analysis “suggested a landslide that took out part of a hanging glacier.”

“The glacier that we think collapsed is a very steep, hanging glacier. It is not a typical valley glacier, with low gradient/slope, that sometimes have lakes at the terminus,” Shugar said, adding that the landslide likely contained both bedrock and glacier ice. “It descended a steep slope and likely disintegrated when it hit the valley floor.”

Authorities described Sunday’s landslide as a freak event, yet the ecologically sensitive Himalayan region is prone to flash floods and landslides. Himalayan glaciers are also vulnerable to rising global temperatures because of man-made climate change.

As the ice melts, glaciers become unstable and start to retreat. A 2019 study found Himalayan glaciers are melting twice as fast as last century, losing almost half a meter (1.6 feet) of ice each year.

Others have pointed to construction along the state’s rivers, which in recent years have seen an increasing number of hydroelectric dams, projects and infrastructure connecting them, such as roads and new developments.

Dozens of workers building a series of underground tunnels for a new power plant near the dam were trapped by the avalanche Sunday, including Virendra Kumar Gautam. That day, at about 11 a.m., he and his team heard shouts from outside the tunnel, telling them to evacuate.

He ordered his team to move. After traveling about 50 meters (164 feet), Gautam recalled, “suddenly a flood entered, glacier and water entered in full force.”

Gautam and the others climbed emergency ladders built into the walls. Their section of the tunnel was only about 4.5 meters (14.5 feet) tall, but water quickly reached about 3.5 meters high (11.5 feet).

“I kept helping people climb up and telling them that they would survive and shouldn’t worry, everything will be fine,” he said.

Gautam was right. The water level suddenly reduced, he said, becoming shallow enough for the group to pass and climb about 350 meters (1,150 feet) up the emergency ladders to the surface.

Gautam said it took his team about 90 minutes, but eventually they made it to safety.

Others were not so lucky, however. There are still people trapped in the tunnels, and authorities say those inside may not have survived unless the debris somehow blocked the water and left enough air in the tunnels for the men to breathe.

Vidhyadhar Maletha, an employee at Prithak company overseeing rescue efforts, said the four side tunnels and the main tunnel have all been filled with debris.

He said they have cleaned out about 90 meters (295 feet) of debris, and the height of the tunnel has dropped by 25 to 30 meters (82 to 98 feet). But mud and boulders are still blocking the way.

“There is too much debris,” Maletha said.

CNN’s Helen Regan, Esha Mitra, Manveena Suri, Swati Gupta, Radina Gigova and Vedika Sud contributed to this report

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Health

COVID-19 steals smell, taste. Some survivors may never regain them.

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Dozens of clinics that have cropped up around the U.S. to address a puzzling and troubling aspect of COVID-19: aftereffects that linger for some people weeks and months after the infection itself has subsided. (Jan. 19)

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Edelmira Rivera was lying on her bed with her husband and 16-month-old son selecting a movie when she heard a loud bang outside their home in Waco, Texas.

Then her sister screamed, “Fire!”

“I dropped everything and just grabbed my son and his blanket,” said Rivera, 22. “I could not smell anything. I was so shocked to see the fire at the front door.”

Rivera tested positive for COVID-19 and lost her sense of smell on Jan. 14. Early the next morning, a fire broke out on the other side of her bedroom wall, less than a foot from where she was lying. But Rivera couldn’t smell it, nor could the family of four who was staying with them.

Her sister, Bianca Rivera, 19, smelled something burning from the other side of the house, initially thinking her sister had burned popcorn in the kitchen. When she smelled burning plastic, Rivera walked out of her room and saw smoke in the hallway, quickly ushering seven people and three dogs out of the home before fire consumed it.

Like Rivera, millions of people worldwide have suffered changes to their sense of smell or taste after contracting COVID-19. In most cases, the symptoms usually only last a few weeks.

But a year into the pandemic, researchers still aren’t sure when some COVID-19 survivors may get their senses back – if ever – and many are struggling with the long-term safety, hygiene and psychiatric implications of the loss.

“As the pandemic has rolled on, we’ve gotten a better idea about the long-term, chronic effects of COVID on smell and taste,” said Dr. Jay Piccirillo, an ENT and professor at the Washington University School of Medicine who studies the topic. “The things we’ve learned suggest that most people recover smell and taste, but not all.”

A million new survivors with chronically diminished senses?

In the coming year, there will be at least a million new cases of people in the U.S. with chronically diminished senses of smell or taste due to COVID-19, Piccirillo predicts.

Studies suggest up to 80% of people who have COVID-19 symptoms experience smell or taste dysfunction, with a significant association between the two senses. Some experience reduced ability to smell or taste. Some have a complete loss. And some experience distorted senses, where certain tastes and smells change or become unpleasant – an increasingly common outcome, called “parosmia.”

Dr. Evan Reiter, an ENT and professor at Virginia Commonwealth University who studies the issue, said he’s seeing similar rates of patients reporting dysfunction with smell as with taste.

Fact check: Burnt oranges, brown sugar won’t restore senses lost to COVID-19

“In general, anytime you’re eating something, it hits the taste buds in your mouth, and you’re smelling the vapors in your food at the same time, so you brain puts it all together to determine how you perceive the taste of food,” Reiter said.

Most people regain their senses within a few weeks, but approximately 5-10% will continue to have symptoms after six months, Piccirillo said. At that point, they may not ever return, he said.

Scientists have known since the early days of the pandemic that smell-taste disturbance is associated with milder cases of COVID-19, and with cases in younger people. A study published earlier this month in the Journal of Internal Medicine reinforced the conclusions.

Sniffing out COVID-19: Ohio State study proposes using hard candy to test for symptoms

Among more than 2,500 COVID-19 patients at 18 European hospitals in the study, more than 74% self-reported a distorted sense of smell and 46% a distorted sense of taste. The vast majority of both categories were younger patients and those with milder cases.

The good news is that more than half of the patients with smell distortions saw their symptoms disappear within a month, rising to 95% of patients by six months, according to the study. For those remaining 5%, the future remains unclear.

Dr. Pam Dalton, a researcher at the Monell Chemical Senses Center in Philadelphia, said patients should not give up hope. Some people who have lost their sense of smell due to rhinoviruses, which cause common colds, have regained the sense after several years, she said.

“There is evidence from other viruses that may disrupt the system in different ways that recovery can occur after six months,” Dalton said. “There isn’t a cut-off beyond which all hope should be abandoned.”

‘It can be depressing and upsetting’

Loss of smell or taste can have a severe impact on quality of life and make it harder to identify dangers in the environment, such as gas leaks or spoiled food, experts say. For professions that rely on the senses, loss of smell or taste can be career-ending. It can alter relationships, degrade mental health and result in severe weight loss or gain.

New York City resident Lyss Stern, 46, said she’s gained 30 pounds since she lost her senses of smell and taste in late March, when she had a mild case of COVID-19 for six weeks. She’s too fatigued to exercise, and she eats a lot of carbs because she likes the way they feel in her mouth.

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Stern said she has identified a dozen foods that she can still taste, and she goes to the same pickle shop every week to stock up on a variety of flavors. Last month, Stern smelled an orange again for the first time and started crying. And a few weeks ago, she got a whiff of a cookie when she walked past a bakery.

“It can be depressing and upsetting,” Stern said. “Everything to me just tastes gross. But I’m not going to let that get me down – now or ever. I’m here. So many people didn’t survive this beast.”

Stern said her family is in the process of moving apartments, and she plans to set up smoke and gas detectors in the new home right away. “It’s very scary,” Stern said. “If there’s a leak, I can’t smell it.”

Many patients who lose their sense of smell or taste also struggle with social anxiety and hygiene concerns, experts said. Piccirillo said parents often report wishing they knew when their child’s diaper needed to be changed – and when they may unknowingly be subjecting friends or family to a foul smell.

“People will report never wearing an item of clothing more than once because they’re afraid it might smell of their body odor and they can’t detect it. And the same thing goes with a lot of different social interactions,” Dalton said.

Gail Pav, 53, of Long Beach, Mississippi, has to ask her husband to taste-test their meals and let her know when there’s something smelly in the trash can. She had a mild case of COVID-19 in September – a stuffy nose for a few days, but never a fever. Ever since, her senses have been off.

“This week, the coffee was tasting funny. I’ve been having some really weird smells going on, like fuel. It’s so weird,” said Pav, who still wears perfume every day. “I’ve got a new grandbaby, and I just want to be able to smell Stella.”

For some COVID-19 survivors, the loss of smell or taste can be “crippling,” Piccirillo said. “With all the quality of life problems (during the pandemic), to now be isolated by sense of smell, or worse, distortion – it’s very sad,” he said.

Dr. Simone Wildes, an infectious disease physician at South Shore Health in Massachusetts, said it’s frustrating that there are “no specific therapies or more supportive advice” that she can give to patients. Many of her patients with loss of smell or taste have turned to online support groups.

With increasing reports of more transmissible coronavirus variants, Wildes said she’s worried greater spread may result in more cases with loss of smell or taste.

“It does not have to be deadly for you to end up with something very distressing in your life,” Wildes said. “For some people it’s temporary, but for some, it may be permanent.”

A ‘tidal wave’ of trial participants

Research into how the coronavirus disrupts senses of taste and smell is ongoing. In July, dozens of researchers published a paper suggesting the coronavirus changes the sense of smell in patients not by directly infecting smell-detecting neurons but by affecting the function of supporting cells.

Now, researchers are beginning to look at human autopsy data to assess the initial theory, said Dr. Sandeep Robert Datta, a professor of neurobiology at Harvard Medical School and one of the study co-authors. Data available so far is “broadly consistent” with the hypothesis, Datta said, but he’s keeping an open mind.

“Never before in recent medical history have there been so many people who have lost their sense of smell or lost taste for this period of time,” Datta said. “We need to make a serious basic science effort to help physicians deal with the patients who are flooding their offices.”

Other researchers are looking into whether the coronavirus attacks the taste system independently of the smell system.

Are patients losing taste as a direct result of smell loss? Or are they also losing chemical sensitivity in their mouths? Valentina Parma, a researcher at Temple University who studies the senses of smell and taste, said that, for now, “the jury is still out” on what mechanism is affecting taste in patients with COVID-19.

The science behind smell loss: Why do so many COVID-19 patients lose their sense of smell? Scientists now know.

Treatment options for people with loss or distortion of smell or taste are limited, experts said. There’s some research on steroid and vitamin treatments. There’s also a long-used technique called olfactory training, where patients who have lost their sense of smell sniff various essential oils for a brief time each day for several weeks.

“For those patients who have (distortions of smell), we think it’s some sort of miswiring. When they see coffee, they small oranges,” Piccirillo said. “Through olfactory training, you can maybe rewire them. That’s the hypothesis.”

Piccirillo and his team are conducting an olfactory training trial with COVID-19 patients. The training traditionally features four scents: rose, lemon, clove and eucalyptus. For his trial, Piccirillo is allowing one group of participants to select their preferred scents to test if the approach is more effective with scents that are important to people.

“The No. 1 scent people want to train on? Smoke,” Piccirillo said. “It’s makes them so scared they can’t smell smoke or natural gas.”

Piccirillo and his team have seen a “tidal wave” of study participants. They’re also starting a clinical trial looking at the drug theophylline, a common asthma medicine.

Both Reiter and Dalton are working with their teams to track the recoveries of COVID-19 patients who have lost their sense of smell. Dalton’s team is also developing a smell screening test to identify people who may have COVID-19. They’re deploying the tests to drive-up clinics, as well as to Yale University, where some students are taking the smell test in addition to twice-weekly molecular tests.

“It’s really discouraging with so many people now suffering or who will be suffering,” Piccirillo said. “Any way you slice it, this is a big problem, and presents a real challenge to the scientific community to start finding some effective treatment options for people.”

Bianca Rivera, who got her family and friends out of the house fire, still doesn’t know why she never contracted COVID-19, even after extended exposure to her family and friends when they moved into hotel rooms together after the blaze.

Her sister, Edelmira, regained her sense of smell a few days after the fire, which is under investigation. The family is planning to rebuild their home and install smoke detectors.

“Losing all my shoes, clothes – none of that matters to me. It can be replaced. Not having a home for my son … I’m grateful that I still have him. I’m still alive to see him grow,” she said.

Rivera said she was initially “skeptical” about COVID-19.

“I thought it was a hoax. I thought it was fake. But actually going through it and losing my smell, it’s scary,” she said. “So take it as a reminder to take care of your home, and to take care of yourself.”

Follow breaking news reporter Grace Hauck on Twitter at @grace_hauck.

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World

China mine rescue: Survivors to remain trapped at least two more weeks

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image captionDrilling into the mine is extremely difficult

Chinese rescue teams say it might be more than two weeks until they can save a group of miners trapped hundreds of metres underground.

They have been trapped since an explosion closed the entrance tunnel to the Hushan gold mine in Shandong province on 10 January.

Authorities made contact with 11 surviving miners a week after the blast, but one has since died.

Rescuers have drilled small holes to supply food and medicine to the men.

The cause of the explosion that sealed the mine entrance is still not known.

The fate of another 11 miners trapped by the blast is unclear – authorities have been unable to communicate with them despite lowering food and messages into other areas of the mine.

The group discovered alive told rescuers they had established communication with a lone miner about 100m below them, but had since lost touch with him.

How will the rescue work?

Currently, rescue operations are trying to widen a narrow shaft to make it big enough to lift the miners out.

However, drilling is proving difficult as it needs to get through particularly hard granite and the miners are trapped far from the surface. Rescuers face an added problem in that the mine is waterlogged and there’s the risk the chamber where the miners are stuck could flood.

“The obstacles are just too huge, which means we need a least another 15 days or even more to reach the miners,” Gong Haitao, deputy head of the local publicity department, said.

The debris standing in the way weighs about 70 tons, he added.

How did they get trapped?

The entry into the mine was severely damaged and communication was cut off by the so-far unexplained explosion.

For a week, there was no sign of life. Then, last Sunday, rescuers felt a pull on one of the ropes they were lowering into small shafts leading down into the dark.

A paper note was then sent up on a rope from a group of 12 surviving miners – 11 trapped in one place and a 12th trapped further below.

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Since then, the contact with the 12th miner has been lost, while one of the group of 11, who had fallen into a coma after sustaining a head wound in the explosion, was on Thursday confirmed dead.

image copyrightGetty Images
image captionRescuers have opened a communication channel with the trapped miners via a thin tunnel

Mining accidents are not uncommon in China, where the industry safety regulations can be poorly enforced. In December last year, 23 miners died after a carbon monoxide leak at a coal mine.

In September, 16 workers were killed at another mine on the outskirts of Chongqing, also due to carbon monoxide. In December 2019, an explosion at a coal mine in Guizhou province, south-west China, killed at least 14 people.

How are the miners doing?

The group of 10 known survivors are trapped in the dark some 600m (2,000ft) underground. They are in regular contact with the rescue teams.

A communication line has been established and food and medicine can be lowered to them through a narrow shaft.

While they’ve been receiving porridge and nutritional liquids, the miners a few days ago asked for a traditional meal of sausages.

Eight of them are thought to be doing well, while two are in poor health.

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media captionA wall of rock and mud slides into a flooded pit in Myanmar

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