Fauci: Americans should be prepared for new COVID-19 restrictions


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White House chief medical adviser Dr. Anthony Fauci on Sunday warned about the potential for the reinstatement of COVID-19 restrictions in the U.S.

In an interview on the BBC’s “Sunday Morning,” Fauci said U.S. residents “need to be prepared for the possibility” of restrictions being put back into place.

FAUCI SAYS HE DOES NOT ANTICIPATE MAJOR COVID-19 SURGE IN US

Presenter Sophie Raworth asked if a new infectious COVID-19 variant could lead to future lockdowns mask mandates. 

“I don’t want to use the word ‘lockdowns.’ That has a charged element to it. But, I believe that we must keep our eye on the pattern of what we’re seeing with infections,” he said, noting that the U.S. is currently moving toward normalcy. 

“Having said that, we need to be prepared for the possibility that we would have another variant that would come along,” Fauci noted. “And then, if things change we do get a variant that does give us an uptick in cases hospitalization, we should be prepared flexible enough to pivot toward going back – at least temporarily – to a more rigid type of restrictions, such as requiring masks indoor.”

Dr. Anthony Fauci testifies before the Senate Health, Education, Labor Pensions Committee on Capitol Hill on Nov. 4, 2021.
(Chip Somodevilla/Getty Images)

Cases, hospitalizations deaths have fallen rapidly in the U.S. since the winter’s COVID-19 surge. 

Data from the Johns Hopkins Coronavirus Resource Center shows the U.S. reported 42,967 new cases 985 new deaths in the past day, whereas daily deaths in January exceeded 4,000. 

According to the Centers for Disease Control Prevention (CDC), the highly transmissible BA.2 omicron sub-variant that is spreading across the globe currently makes up 54.9% of cases. 

LONG COVID SYMPTOMS MAY DEPEND ON THE VARIANT A PERSON CONTRACTED

Fauci cautioned that the “same conditions” that appear to be driving the resurgence of cases in Europe are happening in the U.S. 

“It’s the greater transmissibility of the BA.2, it’s the relaxation of restriction, particularly in the context of indoor masking in congregate settings, also the fact that immunity, due to both vaccination as well as people who have been previously infected, tends to wane with SARS-CoV-2 – particularly with omicron,” he said. 

Last week, Fauci said he does not expect another major COVID-19 surge. 

“I would not be surprised at all, if we do see somewhat of an uptick,” Fauci told a Washington Post event. “I don’t really see, unless something changes dramatically, that there would be a major surge.”

With the administration now out of funds for a fourth COVID-19 vaccine dose, America’s pandemic future is murky. 

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On Tuesday, the Food Drug Administration (FDA) moved to authorize a second booster of the Moderna Pfizer-BioNTech COVID-19 vaccines for people ages 50 older. 

The CDC is expected to weigh in on the decision.

The Associated Press contributed to this report.



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Hackensack Meridian Health shows the benefits of telepsychiatry


Addressing the increasing need for behavioral health services is a nationwide challenge. With a shortage of physicians to address the growing need for care, a lack of providers who accept Medicaid, access issues due to transportation or office hour challenges, healthcare organizations are looking to technology to help bridge the gap.

“Without the utilization of telehealth, patients arriving at an emergency department often have long wait times before meeting with an available physician, creating a strain on social workers other members of the behavioral healthcare teams inside hospitals,” said Dr. Eric C. Alcera, network medical director/Hackensack Meridian Behavioral Health, chief medical officer at Preferred Behavioral Health Group, among other positions.

Expediting treatment time

“The implementation of a telepsychiatry program expedites the treatment time for a patient presenting in the emergency department in crisis,” he continued. “Utilizing a Chromebook HIPAA-compliant communications platform such as Zoom or Google Meets, team members can reach a Hackensack Meridian Health psychiatrist who can diagnose, prescribe provide recommendations on next steps for patients.”

The implementation of the telepsychiatry program has been a tremendous asset for the health system in getting patients in need of immediate behavioral health treatment access to a physician.

“Telepsychiatry has been an invaluable tool as we face an ever-growing behavioral health crisis.”

Dr. Eric C. Alcera, Hackensack Meridian Behavioral Healt

“As Hackensack Meridian Health continues to add additional psychiatrists to its network to increase the ability for patients to secure in-person appointments, telepsychiatry has been an invaluable tool as we face an ever-growing behavioral health crisis,” he noted.

When a patient presents to the emergency department in crisis, clinical behavioral healthcare teams immediately jump into action, treating stabilizing the patient if there are any medical needs before evaluating the patient to determine next steps behaviorally.

Calling the psychiatrist

“If it is decided that a patient needs further care beyond that of the social worker, the equipment is rolled to the bedside a licensed psychiatrist is called,” Alcera explained. “The psychiatrist, who is able to visually see interact with the patient, will then determine how best to proceed in their care treatment.”

Hackensack Meridian Health reports the program has been very successful. In the fourth quarter of 2019, there were 7,430 in-person psychiatry visits no telepsychiatry visits. By comparison, in the fourth quarter of 2020, there were 4,634 in-person psychiatry visits 5,221 telepsychiatry visits, accounting for 52.98% of visits.

In the fourth quarter of 2021, there were 4,024 in-person visits 6,726 telehealth visits, accounting for 62.57% of visits. And the numbers are continuing to grow, demonstrating the incredible need for impact of this program, Alcera said.

The FCC telehealth grant program awarded Hackensack Meridian Health, based in Edison, New Jersey, $973,055 for laptop computers, tablets, a telehealth platform remote monitoring equipment to provide behavioral health services in high-concentration COVID-19 hospitals, to ensure vulnerable elderly patients remain safe at home while receiving required medical treatment, to protect patients in skilled nursing facilities through consistent monitoring.

FCC funds for telehealth

“The FCC telehealth award funds have been used to implement the telepsychiatry program at our emergency departments to implement a remote patient monitoring system, called VitalConnect, which monitors patient vitals,” Alcera said.

“That program was rolled out at Hackensack Meridian Health nursing homes rehabilitation centers has been tremendously helpful, particularly throughout COVID,” he continued. “The amount of time it took to don doff PPE to get into patient rooms to check vitals meant patient care for another patient was impacted.”

By using the remote patch monitoring system, the nursing teams were able to have confidence in the stability of their patients – it helped to keep everyone safer, he added.

“The monitors are still used, particularly in the care of patients who may need to be monitored very closely, such as those recovering from open heart surgeries,” he concluded.

Twitter: @SiwickiHealthIT
Email the writer: [email protected]
Healthcare IT News is a HIMSS Media publication.





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Omicron BA.2 sub-variant now globally prevalent


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A sub-variant of the highly transmissible omicron version of coronavirus known as BA.2 is now dominant worldwide, prompting surges in many countries in Europe Asia raising concern over the potential for a new wave in the United States.

Below is a summary of what is known about BA.2.

LONG COVID SYMPTOMS MAY DEPEND ON THE VARIANT A PERSON CONTRACTED

MORE TRANSMISSIBLE

BA.2 now represents nearly 86% of all sequenced cases, according to the World Health Organization. It is even more transmissible than its highly contagious omicron siblings, BA.1 BA.1.1, however the evidence so far suggests that it is no more likely to cause severe disease.

As with the other variants in the omicron family, vaccines are less effective against BA.2 than against previous variants like alpha or the original strain of coronavirus, protection declines over time. However, according to UK Health Security Agency data, protection is restored by a booster jab, particularly for preventing hospitalization death. 

Policemen staff workers get tested for the coronavirus disease (COVID-19) at a makeshift nucleic acid testing centre inside barriers of an area under lockdown amid the coronavirus disease (COVID-19) pandemic, in Shanghai, China March 24, 2022.
( REUTERS/Aly Song)

GLOBAL PICTURE

The rise of BA.2 has been blamed for recent surges in China as well as record infections in European countries like Germany the UK. Yet some European countries are now seeing a slower uptick in new cases, or even a decline.

BA.2 has been called the “stealth variant” because it is slightly harder to track. A missing gene in BA.1 allowed it to be tracked by default through a common PCR test. BA.2 another sibling, BA.3, which is also increasing in prevalence but is currently at low levels, can only be found by genomic sequencing, which some countries do more of than others.

OMICRON SUB-VARIANT BA.2: HEALTH OFFICIALS CALL IT ‘VARIANT OF CONCERN’

REINFECTIONS

A key concern about BA.2 was whether it could re-infect people who had already had BA.1, particularly as a number of countries seemed to be experiencing “double peaks” in infection rates surprisingly close together. But data from both the UK Denmark have shown that while omicron can reinfect people who had other variants, such as delta, only a handful of BA.2 reinfections in people who had BA.1 have been found so far among tens of thousands of cases.

Scientists say a possible explanation for the recent rise in BA.2 could be that the global uptick happened at the same time that many countries lifted public health interventions.

“In some ways, it could just be that BA.2 was the variant that was circulating when all these people stopped wearing masks,” said Dr Andrew Pekosz, a virologist at the Johns Hopkins Bloomberg School of Public Health in Baltimore.

As such, other U.S. experts such as Eric Topol, director of the Scripps Research Translational Institute in La Jolla, California, said it was “a little too early” to call whether the U.S. too would see a significant BA.2 wave.

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But whatever the reason for BA.2’s rise, scientists said it was a reminder that the virus continues to cause harm, particularly among unvaccinated, under-vaccinated vulnerable populations.

“It is still a huge public health problem it is going to continue to be,” said Mark Woolhouse, an epidemiologist at the University of Edinburgh.



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Permanent daylight saving time may be harmful to our health, experts say


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The United States Senate recently unanimously passed a bipartisan bill known as the Sunshine Protection Act to make daylight saving time (DST) permanent, but the move may be more harmful to our health, according to a recent Wall Street Journal report. 

“Of the three choices—permanent daylight saving time, permanent standard time or where we are now, which is switching between the two—I think permanent DST is the worst solution,” said Dr. Phyllis Zee, director of the Center for Circadian Sleep Medicine at Northwestern University Feinberg School of Medicine.

WHAT IS ALOPECIA? JADA PINKETT SMITH JOKE SPARKS INTEREST IN THE AUTOIMMUNE DISORDER 

Our circadian rhythm, otherwise known as our “internal clocks,” are connected to the sun, but that is more in sync with permanent standard time, said Dr. Muhammad Adeel Rishi, pulmonologist sleep physician at Indiana University. 

Identify your triggers. Triggers vary by individual, but they may include certain people, places, things, foods (caffeine is often a culprit), activities, times of the year, or times of day. 
(iStock)

So when we advance our clocks one hour ahead, our internal clocks don’t adapt to the time difference, so daylight saving time is like “permanent social jet lag,” per the report. 

The paper noted too much evening light has also been associated with an increased risk of diabetes, high blood pressure, cancer, but these studies don’t prove less light in the morning causes the chronic medical problems, only that the medical issues are linked to it.

“It is the position of the AASM [American Academy of Sleep Medicine], that the U.S. should eliminate seasonal time changes in favor of a national, fixed, year-round time,” according to a position paper of the professional sleep society.

“Current evidence best supports the adoption of year-round standard time, which aligns best with human circadian biology provides distinct benefits for public health safety.” 

Electric Time technician Dan LaMoore puts a clock honto a 1000-lb., 12-foot diameter clock constructed for a resort in Vietnam, Tuesday, March 9, 2021, in Medfield, Mass. 

Electric Time technician Dan LaMoore puts a clock honto a 1000-lb., 12-foot diameter clock constructed for a resort in Vietnam, Tuesday, March 9, 2021, in Medfield, Mass. 
(AP Photo/Elise Amendola)

But “springing forward” does have some advantages that people enjoy, in part because the summer spring evenings have more daylight, which are good for business for some people’s social calendar, according to the report.

“Day after day of eating at the wrong time, being active at the wrong time, sleeping at the wrong time, build up” can lead to long-term negative health consequences, says Dr. Erin Flynn-Evans, circadian researcher consultant to the AASM’s public safety committee.

A recent sleep study, which randomized 20 healthy people to sleep in dim light versus moderate lighting, showed a single night of light exposure increased insulin resistance the heart rates of the participants the following day compared to those who slept in an environment with dim light, according to the Proceedings of the National Academy of Sciences of the United States of America. 

LONG COVID SYMPTOMS MAY DEPEND ON THE VARIANT A PERSON CONTRACTED 

One of the biggest objections to permanent DST is because the winter sun rises later, schoolchildren often will be walking to school in the dark, the Journal noted.

For example in certain parts of Indiana where the sun doesn’t rise after 9 a.m., Rishi warned: “You’re basically putting these kids two hours off from their circadian biology.” 

UNITED STATES - MAY 26: Sen. Marco Rubio, R-Fla., walks to the Senate subway after a vote in the U.S. Capitol on Wednesday, May 26, 2021. 

UNITED STATES – MAY 26: Sen. Marco Rubio, R-Fla., walks to the Senate subway after a vote in the U.S. Capitol on Wednesday, May 26, 2021. 
(Photo by Bill Clark/CQ-Roll Call, Inc via Getty Images)

The United States government has been unsuccessful at least three times to make DST permanent, with the most recent attempt in 1974 when the country was on DST for one year before it went back to the status quo, per the Journal.

Congress adopted daylight saving time originally as a wartime measure, but the bill is now headed to the House of Representatives, they are being cautious on whether it will have enough support to pass, according to The Hill. 

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“Different members have articulated a different perspective. We’ll have to come to some consensus. We were unexpectedly sent this bill by the Senate. Now, we’re trying to absorb it,” Rep. Hakeem Jeffries (N.Y.), head of the House Democratic Caucus, told the Hill.



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‘American Diagnosis’: ‘Water Warriors’ Tap Diné Resilience to Increase Access on Navajo Land



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The transcript for this segment is being processed. We’re working to post it four to five days after the episode airs.


Episode 6:

In 2020, during the first wave of the coronavirus pandemic, Zoel Zohnnie was feeling restless. Growing up on the Navajo Nation, he said, the importance of caring for family community was instilled at an early age. So Zohnnie wanted to find a way to help members of his tribe. One need in particular stood out: water.

American Indian Alaska Native households are 3.7 times as likely to lack complete plumbing as households whose members do not identify as Indigenous or Black, according to a 2019 mapping report on plumbing poverty in the United States. 

(Oona Tempest / KHN)

“Climate change excessive water use is exacerbating these struggles,” explained George McGraw, CEO of DigDeep. “Much of the western United States has been in severe drought for years. Many rivers wells on or near the Navajo lhave dried up. As groundwater recedes, people are forced to seek water from unsafe sources.”

To answer that need, Zohnnie began hauling water to people who were without, he founded Water Warriors United. In this episode, listeners come along for the ride as he ― his truck ― make one herculean trek across snow-covered roads in New Mexico.  

Episode 6 is an exploration of the root causes behind the Navajo Nation’s water accessibility challenges a story about the water rights that some communities have effectively lost.

Voices from the episode:

  • Dr. Ernestine Chaco, emergency medicine physician lawyer Twitter
  • Brianna Johnson, community health representative with the Naschitti Chapter, Navajo Nation
  • George McGraw, CEO of DigDeep — LinkedIn, Instagram, Twitter
  • Jeanette Wolfley, assistant professor of law at the University of New Mexico — LinkedIn
  • Zoel Zohnnie, founder of Collective Medicine actor — TikTok

Season 4 of “American Diagnosis” is a co-production of KHN Just Human Productions.

Our Editorial Advisory Board includes Jourdan Bennett-BegayeAlastair Bitsóí, and Bryan Pollard.

To hear all KHN podcasts, click here.

Listen follow “American Diagnosis” on Apple Podcasts, Spotify, Google, or Stitcher.

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