Saturday, September 4, 2021

Life with Chronic Conditions: How to Get What You Need “Long Covid” (PASC)

Updated July 2022

As defined by the American Medical Association (AMA) in 2021, PASC/Long Covid refers to those who are experiencing at least one persistent symptom up to six months after the initial infection has cleared. Symptoms include neurologic, cognitive, cardiopulmonary, constitutional, musculoskeletal, psychiatric and mobility impairments.

 

Worldwide, 49% of COVID-19 survivors reported persistent symptoms 4 months after diagnosis, estimates a meta-analysis of 31 studies published in The Journal of Infectious Diseases. University of Michigan researchers, who conducted a systematic review on Jul 5, 2021, also found the prevalence of long COVID at 1 month at 37%, while it was 25% at 2 months and 32% at 3 months. 

 

This post has been designed for those who are affected by Long Covid.


 If this is your first time visiting Healing Whole Blog, I’ve been blogging since 2009. Every Wednesday is “take a break,”  day and offers a variety of simple art activities, games and other ways to relax and reduce the stress that often accompanies dealing with chronic or serious health issues. There are now almost 450 activities archived at Take a Break Pinterest.  Many of these posts include multiple projects, so you can try something new every day of the year for several years.

 

Saturday’s post relate to issues that are common to those dealing with chronic conditions, with the third Saturday of the month being a Journal Watch. Lots of topics are covered, so use the search feature to find answers to some of your questions and concerns.

 

By way of introducing “how to get what you need,” keep in mind that you are more than a diagnosis. Fear, shame, vulnerability and powerlessness can be common emotions. It is easy to define yourself by what you can no longer do and how you appear. You might even feel that you have been robbed of everything that makes life worth living. Yet great things can be achieved by connecting with your inner self, identity, soul, spirit or whatever form you choose to call the core of who you are versus what you appear to be.  Well-being is achievable by being positive; engaged in life; and having a sense of purpose and strong connections with others.  While a “cure” is the direction you are moving towards, it is investing in the process that will help you heal. Check out the Well Being post to read more on this topic.



What you Might Need and How to Get it: Check List

The following checklist has been developed to help identify resources that might be helpful. It also provides a way to track what you are doing for yourself or those you are caring for. As you go through the checklist, you may find that you qualify for a service, but aren’t sure how to find them in your community.

Post COVID Care Centers [PCCC]: PCCCS have or are opening across the country - bringing together multidisciplinary teams from across a broad range of specialties - to address the issues of COVID-19 recovery - with comprehensive and coordinated treatment pathways. Check the Survivor Corps map to see what is close to you.  Many of these centers will require a referral from your medical provider and proof that you’ve had Covid. 

 

To assist you in finding resources in your community, you can contact:

Information and referral service helpline for your state: Find the helpline for your state

• The Independent Living Center for your State Call 713-520-0232

Eldercare Locator: Connects older Americans and their caregivers with sources of information on senior services. 1-800-677-1116 weekdays, 9:00 am-8:00 pm

State and Local Health Department Call 202-371-9090

Support Network: If you haven’t joined a support group, consider doing so on-line or in person. Finding friends and places that can support you emotionally, and where it is safe to talk about your health issues can make all the difference. Googling your state, city or town name with Covid may turn up a support group. Many hospitals and clinics that have started PASC clinics are offering support groups.  Facebook has become a good way for people to connect.

-       Covid-19 Support Group (Private for those with onset prior to April 1, 2020

-       Long Haul COVID Fighters - Round 2 (Onset of illness AFTER 04/01/20) 

-       Long Covid Support Group 

-       Long Haul COVID Fighters - Medical & Scientific Collaboration 

-       Young Covid Survivors (Under 35) 

 

Legal: Planning ahead is important for both you and your family’s future. You will need to have:

  a will;

• living will (advanced directives);

• durable power of attorney (makes financial & legal decisions for you if you are unable to do so);

• durable power of health attorney (makes health care decisions for you if you are unable to do  so);

• legal guardian (who would care for your child or other dependent adult if you were unable to do so).

 

It is best that you work with a lawyer in completing the necessary paper work. All states have Legal Aid offices, which can assist you. Check your phone book for Legal Aid office closest to you.

 

Case manager for medical issues. A case manager is someone who can help you monitor your care. You can learn more about medical case management from your doctor or clinic or the social work department where you receive your medical care.

 

Case manager for social needs. A case manager can help you with such issues as housing, transportation, finances and completing forms. Places which offer this type of case management include:

  Community Action Agencies: Call your state information referral network-211- for the Agency closes

• Independent Living Center

• Area Agency on Aging (sometimes called Council on Aging)

• The social work department at the hospital or clinic where you receive your care.

• Visiting Nurses Association

• Your place of worship

 

Note: Your case manager for social and medical needs can be the same person. If you are already enrolled in an Area Agency on Aging, or have Medicaid, you have a case manager.

 

Personal Health Notebook: It is important to keep a health notebook about the care you are receiving as it helps to monitor trends, allows you to share information with other providers, helps to reduce errors at medical appointments, when your chart may not be available, and can be a resource in making important health decisions. There are a variety of free on-line e-health tools you can use. Johns Hopkins offers a free printable notebook. Your smart phone will have a preloaded health app (it appears as a red heart). It’s a good idea to fill this out  and consider installing the free app My Medical

 

Share your data: This can shorten the path to new treatments. Patients Like Me, is world’s largest personalized health network and has published more than 100 research studies, has started a new page for people with Covid. Another option is Patient-Led Research Collaborative.

 

Use an Advocate to help you navigate the medical system and to support you.

 

Organize Help: Lotsa Helping Hands  is a free private, web-based caregiving coordination service that allows family, friends, neighbors, and colleagues to create a community to assist a family caregiver with the daily tasks that become a challenge during times of medical crisis, caregiver exhaustion, or when caring for an elderly parent. If you are going to be needing help for any length of time, this is an excellent way to organize help and support. It’s the right answer to the common question, “What Can I do to help?”

 

Shared/Informed Decision Making: While decision making is part of life, at the moment, some of the decisions just feel over whelming because they can impact more than just you. Use the Decision Tools for the Time of Covid to help make choices and decisions for yourself and family.

 

Health Insurance Forms and Policies Help: Within your state’s Health Department, contact Division of Elderly and Adult Services; Office of Health Care Ombudsman; or Medicare Help. To find your state and local health department, check your local phone book, or go to www.astho.org or call 202-371-9090

 

Paying for Healthcare: If you are having difficulties paying for your health care contact your state or local health department. Most states have a number of programs to assist those who cannot afford health insurance, including Medicaid with special programs for children and low cost health insurance.

• If you are a veteran, there are a variety of programs to assist you. Call 1-877-222-VETS (8387)

• If you are disabled and/or 65 or older, you qualify for Medicare

• Many states have free clinics. To find out what is available in your community, check your phone directory or check the following website.

 

Paying for Medications: Drug companies offer a number of different programs to assist patients in obtaining necessary medication. Most states offer prescription programs for persons with low-income and Medicare has a special prescription program. Depending on where you received your care, many places will have samples and/or certificates for reduced costs for medications. Resources to consider:

-       Medicine Assistance Tool

-       Needy Meds 

-       Together Rx Access

-       Rx Assist 

-       Good RX

-       Tricare Senior Pharmacy For uniformed services beneficiaries 65 years of age or older. 

 

Non Medical needs: There are many indirect costs of living with a chronic condition, such as transportation, housing, childcare, home maker services etc. There are a wide array of community services that can be of help to you, and depending where you live, there may now be a service agency offering specific support for those affected by COVID.

 Places to consider:

• The Community Action Agency closest to you. Check your local phone book for listing or go to http://www.communityactionpartnership.com and look under Community Action Network

• Area Agencies on Aging, if you are 65 or older, provide case management and a variety of other services: Contact elder care hotline for you state, use Eldercare Navigator to find your state’s hotline

• Social services department of the hospital or clinic where you are receiving your care

• State Independent Living Center 713-520-0232 or www.ilru.org

• Civic organizations, such as Rotary, Lions club

• Many area schools and colleges offer student power to assist with yard work and home chores

 

Be aware that even if you qualify for a particular service, because of funding issues, the service may still not be available. It is important to develop a good support network to assist you. The Importance of Social Capital forthose Affected by Chronic Conditions

 

Disability Benefits: There are a variety of programs which you may be eligible for. They will involve filling out forms. Case managers, social workers and organizations like Area Agency on Aging or Community Action Agencies may be able to help you with this activity.  Use the Officeof Disability Employment Policy Covid Information to help you find resources.

 The Office for Civil Rights of the Department of Health and Human Services and the Civil Rights Division of the Department of Justice have joined together to provide Guidance on “Long COVID” as a Disability Under the ADA, Section 504, and Section 1557

Life settlements/viaticals/Reverse Mortgage If you have a life insurance policy, you can consider these options. Be cautious about such activities and check with a financial advisor before doing so.

 

-       Life Settlements allows policy owners to cash out of unwanted, unaffordable or obsolete life insurance policies insuring a senior over age 65.

 

-       Viatical Settlements enable someone facing a terminal illness to utilize the present day value of their life insurance policy to ease the financial burdens that can be caused by the high costs of medical care.

 

-       Reverse Mortgage, which is a loan against your home that you do not have to pay back for as long as you live there. For more information go to http://www.aarp.org/money/credit-loans-debt/reverse_mortgages/

 

End of Life Care

• Hospice Care is usually provided at home with the help of a visiting nurse and is usually time limited, six months or less. Talk to your care provider for a referral.

 

• Palliative Care provides focused care to improve overall quality of life. This approach offers relief from pain and other symptoms, such as fatigue, nausea, loss of appetite, shortness of breath, and/or anxiety. It is not time limited and can be provided at any stage of the illness. Usually such care is provided by a team. Ask about services at the treating hospital or talk to your care provider.

 

• Funeral Consumers Alliance: Non-profit organization, dedicated to protecting a consumer’s right to chose a meaningful, dignified affordable funeral. Check www.funerals.org for state program.

 

Work related: Consider the following:

• If you are no longer able to work, consider filing for disability.

• If you would like to return to work, but are afraid of losing benefits, contact your state’s Benefit’s to Work Program through your state’s independent living center or vocational rehabilitation program for assistance.

• If you would like to return to work, but are no longer able to do your old job, and/or you’ve never worked but would like to do so, contact your state’s vocational rehabilitation (VR) program. VR can help you find a job, keep a job as well as be train you for a new career.

 

COVID Related Resources

C19 Recovery Awareness: Provides support for those whose health has been affected by COVID-19, promote public awareness and education regarding lengthy COVID recovery, and advocate for the medical, mental health, and social interests of long haul COVID survivors.

BodyPolitic: Destigmatize issues facing the COVID-19 community and people with related chronic illnesses and disabilities by offering alternative narratives that get to the root of what it's like to live with a novel or chronic illness.

Reddit /r/COVID -19 Positive

• Resources for People with Long Covid 

COVID-19 and “Alternative” Treatments: What You Need To Know 

Wednesday, September 1, 2021

Take a Break: Sun print


The weather is starting to shift in VT, with the nights now in the 50s. With Labor Day weekend in a few days, and schools starting, there is time to squeeze in one more sun project. This time it's making sun prints. 


You’ll need 100% white or light colored cotton fabric. Some acrylic paints, leaves and other items that suitable for leaving a “print” and a sunny day. Check out Acrylic Paint Sun Prints  for step by step instructions and/or watch the video below. 


 


 Don't have paints or fabric? You can make interesting sun prints with construction paper. Take leaves or other items, lay on the construction paper, and leave in the sun. It's a good idea to cover with glass (use glass from a picture frame) so items don't blow away. I've been able to do this in a very spot in my house in the dead of winter, so the last of summer sun should yield some good results.

 

Not interested in today’s activities, try the Take a Break Pinterest Board.

Saturday, August 28, 2021

Life with Chronic Disease: Mix and Match Covid Vaccines/Masking/Flu shot


A number of people have asked about the upcoming booster shots and whether “mixing and matching” (M&M) will be approved along with the possibility of  a J & J booster.

 

The one thing we can count on, be it Covid or anything else, is that things change as we learn more. Therefore, this post is accurate as of 8/28/21.

 

In response to supply challenges, a number of countries including England, Germany, Thailand and Canada are mixing and matching, with one of the more common strategies being AstraZeneca (AZ) followed by one of the mRNAs (Pfizer or Moderna). While AZ is not approved in the USA, J & J is a similar vaccine, though designed as a “one and done shot” vs the two shot AZ protocol. 

 

AZ and J&J  use “viral vector technology,” which has been around since the 1970s. Viral vector vaccines use a modified, harmless version of a different virus as a vector, or carrier, to deliver immunity instructions to cells in the body. The body then follows those instructions to build an immune response to the intended virus (in this case, SARS-CoV-2, which causes COVID-19.) The virus vector being used in J&J and AZ vaccines is an adenovirus, a common type of virus that typically causes mild cold symptoms when it infects someone.

 

As we’ve seen with the mRNAs, research findings on effectiveness are pretty similar, so it would seem the AZ research is relevant to the potential for a J&J mix and match.

 

mRNAS can Mix & Match:  With the approval of a third dose of an mRNA, regulators have stated that if a recipient’s original shot is not available, they can be vaccinated with the other one. E.g. If your first two shots were Moderna, your third can be Pfizer and vice versa

 

M&M Research to date looks good: A good review of the current situation appears in Nature which summed up findings as follows: Mixing COVID-19 vaccines is emerging as a good way to get people the protection they need when faced with safety concerns and unpredictable supplies…The lingering possibility of rare side effects is one reason some researchers recommend that people stick to the standard two shots of a single vaccine for now…But as new variants of SARS-CoV-2 emerge, the results of mix-and-match trials could provide policymakers with the data they need to switch to more protective combinations.

 

Countries already M&Ming it: While the World Health Organization said on July 12 that the M&M approach was a dangerous trend since there was little data about the health impact, as of Aug. 16, Reuters named a list of the countries that have decided and/or are considering M&M-Cambodia; Denmark; Germany; Indonesia; Russia; Turkey; UK and the US.

 

So where does that leave J&J folks? Some providers are referring to this as a “supplemental dose,” and San Francisco General Hospital made the decision, in conjunction with the San Francisco’s Dept. of Public Health, to offer an mRNA to those J&J recipients that want it. Note that the most recent research on J&J The New England of Medicine, shows that it’s offering lasting protection and works against Delta. It appears that people had stable and broader antibodies at 8 months after immunization than they essentially did at 8 weeks.

 

Johnson & Johnson Booster Shot: A booster dose of Johnson & Johnson's COVID-19 vaccine prompted a big spike in antibodies among clinical trial participants, when taken six to eight months after the first dose, the company announced on Wednesday (Aug.25). 

 

Breakthrough Data: The breakthrough data is interesting. Healthline recently published data on how well the vaccines have worked against the Delta variant, suggesting efficacy rates of more than 67 percent for the J&J vaccine, 72 to 95 percent for the Moderna vaccine, and 42 to 96 percent for the Pfizer-BioNTech vaccine.

 

COVID-19 Vaccines 66% Effective Against Delta Variant: Vaccine effectiveness against COVID-19 infection dropped from about 91% to 66% once the Delta variant became the dominant strain in the U.S., according to a new study published Tuesday by the CDC. The decline points to the highly contagious nature of the Delta variant and underscores the importance of vaccination to prevent severe disease, hospitalization and death, the study authors wrote. The latest update is part of an ongoing study that follows health care workers, first responders and essential workers who undergo weekly testing in eight locations across six states. The weekly testing helps researchers to better track the rates of people who develop mild or no symptoms and may be less likely to get tested overall.

 

US Plans COVID-19 Booster Shots at 6 Months Instead of 8: U.S. health regulators could approve a third COVID-19 shot for adults beginning at least six months after full vaccination, instead of the previously announced eight-month gap, the Wall Street Journal reported on Wednesday. Approval of boosters for three COVID-19 shots being administered in the United States, including J&J is expected in mid-September, the report said.

 

 So why a booster If Delta would be the parting shot of Covid that would be lovely, but it isn’t and we will be dealing with Covid for many years to come. Note, the 1918 flu virus H1N1 is still with us. Ultimately, the boosters are being put in play to better protect against the variants stacking up to take their turn at whacking the humans.

 

Can I get my flu shot and booster at the same time? The Morbidity & Mortality Weekly Report has just released updated flu vaccine recommendations for 2021–2022. COVID-19 vaccines may be given with flu vaccines. Everyone 6 months and older should get a flu vaccine this fall. That noted, if you had a reaction to the Covid vaccine and/or flu vaccines, discuss with your provider as it may be best for you to get them at different times.

 

Masking does work: Because of the highly transmission and the volume of virus in the nose and throat, masks make a lot of sense. In spite of raging Governors and parents shouting down pediatricians about how masks don’t work (they learned that from Dr. Facebook), the research is showing that they do save lives. Check out Masks Save Lives:Here’s What You Need to Know. 

 

The University of Texas Covid-19 Modeling Consortium is projecting nearly 100,000 more Covid 19 deaths between now and Dec. 1. However, this number could be cut in half if nearly everyone wore a mask in public spaces.

 

 

 

 

 

Wednesday, August 25, 2021

Take a Break: Watch the Para Olympics


It’s now a lot easier to watch the Para Olympics than in previous years. If you’ve never seen wheelchair basketball, it’s one of the fastest most amazing sports to watch. Definitely check it out.

 

If you need a dose of inspiration about making the impossible possible, watch these athletes.

 

 

 

Last night I saw parts of the opening ceremony and was blown away. Here is just a glimpse.

 

 

NBC is carrying the games on various channels. Click here to check out how to watch and stream on NBC.  Don’t have NBC, check out Tom’s Guide to learn how to watch for free.

 

 

Not interested in today’s activities, try the Take a Break Pinterest Board.

 

 

Saturday, August 21, 2021

Journal Watch August 2021


COVID

3rd Dose for Moderately or Severely Immunocompromised: Anyone who is moderately or severely immunocompromised, and has received the Pfizer or Moderna Covid vaccine, should receive a third dose. Those qualifying for this shot, distribution which begins the latter part of this week in many states, will need to meet one of the following criteria: Receiving active cancer treatment for tumors or cancers of the blood; organ transplant recipient and taking meds to suppress immune system; received a stem cell transplant in the last two years; taking medications to suppress immune function; moderate or severe primary immunodeficiency (such as DiGeorge Syndrome, Wiskott-Aldrich syndrome; advanced or untreated HIV infection; active treatment with high dose corticosteroids. If you are unsure if you qualify, contact your medical provider.

 

The US Dept. of Health and Human Services have rolled out a plan for a third dose of the Modern/Pfizer Vaccines: On Wed., HHS stated, "Based on our latest assessment, the current protection against severe disease, hospitalization, and death could diminish in the months ahead, especially among those who are at higher risk or were vaccinated during the earlier phases of the vaccination rollout.” Pending FDA and CDC's Advisory Committee on Immunization Practices (ACIP), the roll out will begin the week of Sept. 20. The booster should be scheduled 8 months after the second dose. If your second dose was March 22, the third dose should be given around Nov. 22.

 

Why People Being Treated for Cancer Really Need a Second COVID-19 Vaccine Dose: A study released from the Leukemia and Lymphoma Society (LLS) shows that while the vaccines are safe, about 1 in 4 people with blood cancer fail to produce detectable antibodies after vaccination. Meanwhile, another new studyTrusted Source from Israel cancer researchers published in JAMA Oncology shows that people with solid tumor cancer in active treatment had a “pronounced lag” in antibody production after receiving the first Pfizer-BioNTech COVID-19 vaccine. But the rate increased substantially after receiving the second dose

 

Pfizer Vaccine Protection Wanes After 6 Months: Study: The July 28 preprint report of the study, which has not been peer reviewed, suggests a gradual "declining trend in vaccine efficacy" over 6 months after a two-dose regimen of the Pfizer vaccine. The study included more than 45,000 people worldwide. The study found that overall effectiveness fell from 96% to 84%. A third booster dose of the Pfizer vaccine increases neutralizing antibody levels against the Delta variant by more than five times compared to levels after a second dose in people aged 18 to 55 years, new data from Pfizer show. The immune response to the third dose appears even more robust ― more than 11 times higher than the response to second shot ― among people aged 65 to 85 years.

 

Third Pfizer Dose 86% Effective in Over 60s: A third dose of Pfizer/BioNTech's COVID-19 vaccine was found to be 86% effective in people aged over 60, an Israeli healthcare provider reported, citing initial results from a study of thousands of members.

 

Atypical COVID Symptoms Common in Older Adults: New research provides more evidence that older adults with COVID-19 often present with atypical symptoms, including functional decline and altered mental status, and pinpoints demographic and clinical factors associated with atypical presentation. Those most at risk are adults age 75 and older, women, Blacks and non-Hispanics, those with a higher comorbidity index and those who have dementia and/or diabetes, according to the Journal of Gerontology report. 

 

CDC Calls for Masks in Schools, Hard-Hit Areas, Even if Vaccinated: The Centers for Disease Control and Prevention (CDC) once again is recommending that some Americans wear masks indoors. The agency called for masks in K-12 school settings and in areas of the United States experiencing high or substantial SARS-CoV-2 transmission, even for the fully vaccinated. The move reverses a controversial announcement the agency made in May 2021 that fully vaccinated Americans could skip wearing a mask in most settings. The Delta variant as well as new evidence of transmission from breakthrough cases are largely driving these changes. https://www.medscape.com/viewarticle/955488

 

Risks of the Delta Variant for Vaccinated vs. Unvaccinated People: A new CDC reportTrusted Source shows that since July 26, there have been only 6,587 reports of breakthrough infections that resulted in hospitalization or death among 163 million fully vaccinated people — a percentage of 0.01 percent or less.

 

Massachusetts outbreak demonstrates Delta variant's transmissibility: A series of large public events in a Massachusetts town in July 2021 has been linked to 469 new COVID-19 cases. Three-quarters of these cases were in fully vaccinated people. The vast majority of infections were with the Delta variant of the virus.  Fully vaccinated individuals who contracted the virus appeared to be just as infectious as those who had not been fully vaccinated. As a result, the Centers for Disease Control and Prevention (CDC) now recommend wearing masks in indoor public settings in areas with substantial or high transmission. CDCTrusted Source

 

Breakthrough COVID-19 More Likely Months After Vaccination: People who received their second dose of the Pfizer/BioNTech vaccine five or more months ago are more likely to test positive for COVID-19 than people who were fully vaccinated less than five months ago, new data suggest. Researchers at an Israeli HMO studied nearly 34,000 fully vaccinated adults who were tested to see if they had a breakthrough case of COVID-19. Overall, 1.8% tested positive. Among patients older than 60, the odds of a positive test were almost three times higher when at least 146 days had passed since the second dose. Very few patients had required hospitalization. medRxiv 

 

Vaccination May Cut Risk of COVID Reinfection in Half: A new study published today in the CDC's Morbidity and Mortality Weekly Report shows people who have recovered from COVID-19 but haven't been vaccinated have more than double the risk of testing positive for the virus again, compared with someone who was vaccinated after an initial infection. They found that those who were unvaccinated had more than double the risk of being reinfected during the Delta wave. Partial vaccination appeared to have no significant impact on the risk of reinfection Among those who were reinfected, 20% were fully vaccinated, while 34% of those who did not get reinfected were fully vaccinated.

 

Injectable Monoclonal Antibodies Prevent COVID-19 in Trial: A combination of two monoclonal antibodies given as a subcutaneous injection prevented COVID-19 in patients at a high risk of infection due to household exposure, according to results of a randomized, double-blind, placebo-controlled clinical trial published online August 4 in the New England Journal of Medicine.

 

Moderna Says Boosters May be Needed after 6 months: Moderna says neutralizing antibodies generated by its COVID-19 vaccine against three variants of the virus that causes the disease waned substantially 6 months after the second dose. The new data was presented in an earnings call to investors and is based on a small study that hasn't yet been published in medical literature. 

 

Delta Won’t Be the Last Variant: How Will the Coronivirus Evolve New  from the New Yorker

 

World-first COVID vaccine booster randomized clinical trial in transplant patients proves third shot is very effective. New England Journal of Medicine.

 

US Pediatric Hospitals in Peril as Delta Hits Children: Over the course of the pandemic, COVID-19 has been a less serious illness for children than it has been for adults, and that continues to be true. But with the arrival of Delta, the risk for kids is rising, and that's creating a perilous situation for hospitals across the United States that treat them.  Roughly 1800 kids were hospitalized with COVID-19 in the United States last week, a 500% increase in the rate of COVID-19 hospitalizations for children since early July, according to data from the Centers for Disease Control and Prevention.

 

Youngest Kids More Likely to Spread SARS-CoV-2 to Family: Young children are more likely than their older siblings to transmit SARS-CoV-2 in their households, according to an analysis of public health records in Ontario, Canada – a finding that upends the common belief that children play a minimal role in Covid-19 spread. The study by researchers from Public Health Ontario, published online  in JAMA Pediatrics, found that teenagers (14- to 17-year-olds) were more likely than their younger siblings to bring the virus into the household, while infants and toddlers (up to age 3) were about 43% more likely than the older teens to spread it to others in the home.

 

As Vaccines Wane, Immune System Still Has Weapons Against Delta: More recent studies — but not all — show waning effectiveness of the mRNA vaccines to prevent SARS-CoV-2 infection, especially with high levels of the Delta variant going around. At the same time, the vaccines continue to offer robust protection against severe COVID-19 outcomes. Medscape 

 

Tachycardia Syndrome May Be a Distinct Marker for Long COVID: Tachycardia is commonly reported in patients with post-acute COVID-19 syndrome (PACS), also known as long COVID, authors report in a new article. The researchers say tachycardia syndrome should be considered a distinct phenotype. The study was published online August 11 in The American Journal of Medicine.

 

Lambda Variant Shows Vaccine Resistance: The Lambda variant of the coronavirus, first identified in Peru and now spreading in South America, is highly infectious and more resistant to vaccines than the original version of the virus the emerged from Wuhan, China, Japanese researchers have found.  bioRxiv,

 

COVID-19 an Independent Driver for Heart Attack and Stroke: The risk for acute MI and ischemic stroke increased by roughly eightfold and sixfold, respectively, in the first week following onset of COVID-19 when day 0 (exposure day) was included in the analysis. Even when day 0 was excluded (reducing the risk for bias), the risk for acute MI and stroke was increased by roughly threefold. The study was published online July 29 in The Lancet.

 

Here’s How Well COVID-19 Vaccines Work Against the Delta Variant: Data so far suggests efficacy rates of more than 67 percent for the J&J vaccine, 72 to 95 percent for the Moderna vaccine, and 42 to 96 percent for the Pfizer-BioNTech vaccine. Healthline 

 

COVID-19, Alzheimer’sDisease, and Memory Loss: What We Know: Researchers are learning more about how COVID-19 may impact memory.  In one study, 1 in 10 patients have been reporting memory problems after mild cases of COVID-19 that did not require hospitalization, even 8 months after disease. People who have recovered from COVID-19 but presented with cognitive decline are more likely to be in poorer physical health and have low O2 saturation in their blood. COVID-19 may heighten the risk of developing Alzheimer’s, and COVID-19 can cause an increase in blood-based molecular biomarkers for Alzheimer’s disease. Healthline 

 

No significant benefit of convalescent plasma for COVID-19 outpatients with early symptoms, study shows The final results of the Clinical Trial of COVID-19 Convalescent Plasma in Outpatients (C3PO) demonstrate that COVID-19 convalescent plasma did not prevent disease progression in a high-risk group of outpatients with COVID-19, when administered within the first week of their symptoms. The trial was stopped in February 2021 due to lack of efficacy based on a planned interim analysis. NEJM 

 

Long-HaulCOVID-19 May Affect Two of Three With Mild, Moderate Disease: The majority of individuals who experience mild or moderate COVID-19 infection have persistent symptoms more than 30 days after diagnosis, according to a study published online Aug. 4 in PLOS ONE. The researchers found that the prevalence of PASC at 30 days postinfection was 68.7 percent. The median number of symptoms was three, with the most commonly reported symptoms including fatigue (37.5 percent), shortness of breath (37.5 percent), brain fog (30.8 percent), and stress/anxiety (30.8 percent). Among a subset of 157 participants with follow-up ≥60 days, PASC prevalence was 77.1 percent.

 

 


PAIN        

'Where does it hurt?' predicts chronic pain outcomes, study shows: Pain distribution as reported on a body map, on its own, can be used to assign patients to distinct subgroups that are associated with differences in pain intensity, pain quality, pain impact and clinically-relevant three-month outcomes, according to a new study. PLOS ONE


 Reducing opioids for pain patients linked to higher rates of overdose and mental health crisis: A new study found a 68% increase in overdose events and a doubling of mental health crises among patients who were on stable opioid therapy but had their doses tapered.  JAMA 

 

Widespread pain linked to heightened dementia and stroke risk: Widespread pain is linked to a heightened risk of all types of dementia, including Alzheimer’s disease, and stroke, finds research published online in the journal Regional Anesthesia & Pain Medicine. And this association is independent of potentially influential factors, such as age, general health, and lifestyle, the findings indicate.

 

Study confirms safety of stem cell therapy for chronic knee pain

A study released in STEM CELLS Translational Medicine has confirmed the safety of a novel type of cellular therapy for knee pain caused by osteoarthritis.

 

New app helps relieve back pain: Researchers tested new app called selfBACK.

using a randomized controlled trial that included 461 patients with back pain from Norway and Denmark — and it works. JAMA Internal Medicine

 

Chronic pain might impact how the brain processes emotions: A new study shows that people with chronic pain have an imbalance of neurotransmitters in the part of the brain responsible for regulating emotions. This imbalance could be making it harder for them to keep negative emotions in check – and the researchers think persistent pain might be triggering the chemical disruption.The findings were  published  in the European Journal of Pain.

 


COMPLEMENTARY & ALTERNATIVE MEDICINE

Alternative medicine is widespread among people with MS: A new survey of more than 1,000 people with multiple sclerosis finds that an overwhelming majority use complementary and alternative medicine, with many using cannabis. 81% used dietary supplements such as vitamins, minerals and herbs, up from 65% in the same survey conducted almost two decades ago. 39% used mind-body therapies such as mindfulness and massage, up from 14% in the earlier survey.  81% used exercise to help manage their symptoms - an increase from 67% in 2001. Multiple Sclerosis and Related Disorders.

 

Second-hand marijuana smoke exposure associated with respiratory infections in children: Children whose parents regularly smoke or vape marijuana may experience viral respiratory infections, such as the common cold, more frequently than those whose parents do not smoke, according to a new study.  Pediatric Research

 

Having a good listener improves your brain health: Researchers find having someone to listen to you when you need to talk is associated with greater cognitive resilience. New study shows social interaction in adulthood can stave off cognitive decline despite brain aging. JAMA Network Open

 

Acupuncture improves symptoms of chronic prostatitis/chronic pelvic pain syndrome compared to sham treatment : A multicenter randomized trial showed that 20 sessions of acupuncture over 8 weeks resulted in greater improvement in symptoms of moderate to severe chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) compared with sham therapy. Treatment effects endured over 24 weeks follow up. The findings are published in Annals of Internal Medicine 

 


FDA ACTION

• Approved new indication for Xywav for idiopathic hypersomnia (IH) in adults

• Approved Nexviazyme (avalglucosidase alfa-ngpt) for intravenous infusion to treat patients 1 year of age and older with late-onset Pompe disease.

• Approved Semglee, the first interchangeable biosimilar insulin product, indicated to improve glycemic control in adults and pediatric patients with Type 1 diabetes mellitus and in adults with Type 2 diabetes mellitus.

 

 


PREVENTION: Exercise

Want to Increase Your Physical Activity? Fitness Trackers May Be the Best Way: Researchers say people living with diabetes, heart disease, and obesity can increase their physical activity levels by using fitness trackers. Trackers can provide accountability and help people at all levels motivate themselves. Researchers advise that trackers can provide accountability and help people at all levels motivate themselves. Findings are from an analysisTrusted Source published in JAMA Network Open.

 

Sleep apnea: Exercise and cutting TV time reduce risk: Obstructive sleep apnea (OSA) is a sleep disorder that affects 10–20% of the adult population in the United States. OSA is associated with an increased risk of certain chronic diseases. A new study concludes that being more active and spending less time watching television are linked to a lower risk of developing OSA. European Respiratory JournalTrusted Source.

 

Combination of muscle strengthening and aerobic exercises can reduce cancer mortality: Regular muscle strengthening exercises associated with aerobic activities can reduce cancer mortality, according to a systematic review of epidemiological studies. Workouts with squats, rowing, planks, weight training and so on can reduce the probability of dying from cancer by 14%. When these exercises are combined with aerobic activities, the benefit is even greater, potentially reducing mortality by 28%. International Journal of Behavioral Nutrition and Physical Activity

 

People with stroke who walk 30 minutes per day may have 54% lower risk of death : A new study shows that people who walk or garden at least three to four hours per week, or bike at least two to three hours per week, or the equivalent after having a stroke may have a 54% lower risk of death from any cause. he study found the most benefit for younger stroke survivors. When people under the age of 75 exercised at least that amount, their risk of death was reduced by 80%. Neurology

 

Cancer patients discharged from hospital sooner following preparation for surgery: The approach termed “prehabilitation” includes exercise, nutrition and psychological and social interventions to optimise both physical and mental health before surgery. Researchers found that prehabilitation interventions of between one and four weeks reduced cancer patients’ stay in hospital by 1.8 days compared with standard care. Annals of Surgery

 

Physical activity associated with better cognition in breast cancer patients: Moderate to vigorous exercise may be important in addressing ‘chemo brain’ 

 

Regular exercise, even in polluted areas, can lower risk of death: Regular exercise, even performed in areas with air pollution, can reduce the risk of death from natural causes, according to new research in CMAJ (Canadian Medical Association Journal

 


PREVENTION: Vitamins/Supplements

Growing evidence of vitamin K benefits for heart health: New research has found that people who eat a diet rich in vitamin K have up to a 34 percent lower risk of atherosclerosis-related cardiovascular disease (conditions affecting the heart or blood vessels). Vitamin K1 comes primarily from green leafy vegetables and vegetable oils while vitamin K2 is found in meat, eggs and fermented foods such as cheese. Journal of the American Heart Association

 

Vitamin D may protect against young-onset colorectal cancer: Consuming higher amounts of Vitamin D -- mainly from dietary sources -- may help protect against developing young-onset colorectal cancer or precancerous colon polyps, according to the first study to show such an association. Gastroenterology 

 

Vitamin D reduces the need for opioids in palliative cancer: Patients with vitamin D deficiency who received vitamin D supplements had a reduced need for pain relief and lower levels of fatigue in palliative cancer treatment, a randomized and placebo-controlled study shows. Cancers 

 

Vitamin D supplements ineffective treatment for painful IBS symptoms: New research from University of Sheffield reveals vitamin D supplementation does not improve painful IBS symptoms. Scientists nonetheless noted a high prevalence of poor vitamin D status in people with IBS, so the authors still recommend testing and remedy to support overall health. The definitive study is the largest to provide evidence on effect of vitamin D on IBS symptoms. European Journal of Nutrition

 


PREVENTION: Diet/Nutrition

Iron Deficiency Increasing in U.S. Diets: A new studyTrusted Source published in the Journal of Nutrition reports an increase in iron deficiency in the US. The main reason is high crop yields per acre that are reducing the amount of iron in foods that people and animals eat. Nutritionists recommend people eat more foods with higher iron levels, and foods that help the body absorb iron.

 

Cutting Out 200 Calories a Day and Exercising Can Help You Stay Heart Healthy: A new study has found that older adults with obesity who combined aerobic exercise with a moderate reduction in calories had greater improvements in cardiovascular health than adults who opted for exercise only, or exercise with a more restrictive diet. Circulation

 

Diabetes: Do low glycemic index diets work? A recent analysis, which appears in BMJTrusted Source, suggests that eating a diet of low GI foods may help people with diabetes, particularly type 2, maintain better average blood sugar levels and improve other health parameters.

 

More evidence that a plant-based diet protects heart health: Two recent observational studies looked at the cardiovascular health of people who incorporated more plant-based foods into their diets. One study followed participants for 32 years and found that people with more plant-based diets had lower rates of heart disease. Journal of the American Heart Association. The other study focused on women’s health and learned that women in the postmenopausal stage of life with more plant-centered diets also had a reduced risk of heart issues. Journal of the American Heart Association

 

Moderate drinking may be safe for people with cardiovascular disease: A new study finds that moderate consumption of alcohol may reduce the risk of recurring cardiovascular events. It says people with cardiovascular disease who drink may experience a reduced risk of heart attack, stroke, angina, or death from cardiovascular causes if they consume 7–8 alcoholic drinks per week. People who consumed 6 ounces (oz) of alcohol per day lowered their risk by 50% compared to people with CVD who do not drink. BMC Medicine,

 

The Sick-Quitter Effect: How Alcohol Can Seem Cardioprotective When it Isn’t.: Ever since 60 Minutes ran their story on the French Paradox, people are fixated on the idea that red wine can lower your risk of having a heart attack even if everything else in your life is going wrong. You can smoke and eat unhealthy food, but somehow red wine will fix all that. It won't, of course, and for one very simple reason: The French Paradox, like most medical paradoxes, is a statistical anomaly and is most certainly not true. Medscape

 

New-AF Risk May Not Rise With Light Drinking, May Fall With Wine: A large cohort study saw a familiar J-shaped curve detailing risk for new atrial fibrillation (AF), in which the risk rose steadily with greater number of drinks per week, except at the lowest levels of alcohol intake. There, the curve turned the other way. Light drinkers overall showed no higher AF risk than nondrinkers, and the risk was lowest at any degree of alcohol intake up to 56 g per week. On closer analysis of risk patterns, the type of alcoholic beverage mattered. Modest weekly intake of red wine, at least one serving but no more than seven, may have actually protected against new AF compared with zero intake. published July 27 in JACC: Clinical Electrophysiology.

 

Switching from Western diet to a balanced diet may reduce skin, joint inflammation: Diet rich in sugar and fat leads to disruption in the gut's microbial culture and contributes to inflammatory skin diseases such as psoriasis. Research shows that switching to a more balanced diet restores the gut's health and suppresses inflammation. Journal of Investigative Dermatology

 


PREVENTION

Second-hand marijuana smoke exposure associated with respiratory infections in children: Children whose parents regularly smoke or vape marijuana may experience viral respiratory infections, such as the common cold, more frequently than those whose parents do not smoke, according to a new study. Pediatric Research

 

Lyme disease heightens risk of mental disorders, suicidality: A new study reports that patients hospitalized with Lyme disease had a 28 percent higher rate of mental disorders and were twice as likely to attempt suicide. Physicians and patients should be aware of the potential for psychiatric symptoms post-Lyme infection, particularly during the first year after diagnosis. American Journal of Psychiatry

 

High BMI causes depression – and both physical and social factors play a role: A largescale new study provides further evidence that being overweight causes depression and lowers wellbeing and indicates both social and physical factors may play a role in the effect. With one in four adults estimated to be obese in the UK, and growing numbers of children affected, obesity is a global health challenge. While the dangers of being obese on physical health is well known, researchers are now discovering that being overweight can also have a significant impact on mental health. Human Molecular Genetics 


Examining correlation between occupational noise, heart disease: Hearing conservation programs and policies aim to protect workers from noise-induced hearing loss, but it remains unclear whether stress reactions caused by noise exposure might also lead to other negative health outcomes. Researchers now describe how data from the Canadian Health Measures Survey do not support an association between loud noise exposure and changes in biomarkers for cardiovascular disease or outcomes. The Journal of the Acoustical Society of America

 


TREATMENT

Two types of blood pressure meds prevent heart events equally, but side effects differ: In an analysis of almost 3 million patients taking a single high blood pressure medication for the first time, angiotensin receptor blockers (ARBs) were as good as angiotensin-converting enzyme (ACE) inhibitors at preventing cardiovascular events linked to hypertension, including heart attack, stroke and heart failure. 51 possible side effects and safety concerns were examined: The patients taking ARBs were found to be significantly less likely to develop tissue swelling, cough, pancreas inflammation and bleeding in the digestive tract. Hypertension

 

No more finger pricks: A continuous glucose monitor benefits patients with diabetes in more ways than one: A 15-center study of 175 patients with poorly controlled type 2 diabetes found that continuous glucose monitoring, compared to blood glucose meter monitoring, or finger pricking, significantly decreased their hemoglobin A1C over eight months. JAMA

Switching drugs may not help with antibiotic resistance: In a new study, researchers have shown that antibiotic cycling — which involves doctors switching between antibiotics to overcome antibiotic resistance — may be an ineffective and unsustainable strategy. However, in their study, which appears in The Lancet Microbe, the researchers did find that some subpopulations of bacteria may be appropriate for antibiotic cycling, in limited cases.

Diabetes drugs reduce the risk of Alzheimer’s: People taking certain drugs to lower blood sugar for type 2 diabetes had less amyloid in the brain, a biomarker of Alzheimer’s disease, when compared to both people with type 2 diabetes not taking the drugs and people without diabetes. People taking these drugs, called dipeptidyl peptidase-4 inhibitors, showed slower cognitive decline than people in the other two groups. Neurology 

 

Common weight-loss drug successfully targets fat that can endanger heart health: Researchers have announced successful results of a clinical trial for a commonly prescribed weight-loss drug called liraglutide. In adults who are overweight or have obesity combined with high cardiovascular risk, once-daily liraglutide combined with lifestyle interventions significantly lowered two types of fat that have been associated with risk to heart health: visceral fat and ectopic fat. The Lancet Diabetes & Endocrinology

 

Patients report long-term favorable effects of weight loss surgery in their daily lives: A new study shows that over the course of five years, patients who had bariatric and metabolic surgery to treat uncontrolled type 2 diabetes reported greater physical health, more energy, less body pain, and less negative effects of diabetes in their daily lives, compared with patients who had medical therapy alone for their diabetes. Annals of Surgery

 

Sequential-combinatorial regimens can make treatment more effective for people with aggressive cancers: A new preclinical study suggests that treating people who have aggressive cancers, including melanoma, pancreatic and colorectal cancers, with immune checkpoint inhibitors, quickly followed with mutation-targeted therapy, can help overcome treatment resistance and help people live longer.  Cancer Cell

 

OTHER

When Does Your Metabolism Significantly Decline? It’s Later Than You Think: Many of us think of metabolism as peaking during teenage years when people can “eat anything” without gaining weight and then seeing a slowdown in the metabolic system in midlife in the 30s and 40s as it becomes difficult to keep weight off.  But now, new research finds these long-held ideas about metabolism and age might be incorrect. But research from Duke University has found new information about when this process actually starts and when we can actually blame age for an expanding waistline. Metabolism rates don’t significantly decline until a person reaches their late 50s to 60s.

 

Philips CPAP Machines Are Being Recalled, What to Know: Philips Respironics recalled several sleep apnea machines over concerns that people could be inhaling cancer-causing chemicals through a type of foam that’s embedded in the devices.  The foam is used to reduce the sounds and vibrations emitted by the devices. According to Philips, the foam may break down into small particles. These can then be inhaled and lead to short-term and long-term health issues.  The recallTrusted Source, includes BiPAP and CPAP machines