Injured by a Vaccine? Here’s How to Report It

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3 simple strategies for stress relief

The last few months of any year, with deadlines and holidays, often create a harried pace. The beginning of a new year can give you a chance to exhale. But even if you experience a few serene days or weeks, tight shoulders and tension are never far off.

Family stress. Work stress. Daily life stress. Self-induced stress brought on by scrolling through the news. As it turns out, stress is almost impossible to avoid. So this year, instead of waiting for your most recent stressful patch to ebb, take a different approach. Teach yourself to stay grounded and calm — regardless of what’s going on around you.

Managing stress helps you stay healthier

It’s important to manage stress, because it’s not only emotionally taxing, but it’s also bad for your health. When you are under stress, the levels of a hormone called cortisol start to rise in your blood. Over time, chronic stress that results in higher than normal levels of cortisol can wreak havoc on your metabolism, spurring weight gain (particularly around your middle), and causing dangerous inflammation inside your body. It can affect your blood sugar levels, your blood pressure and heart, and even your memory.

Three simple strategies to counter stress

To lessen the effects of stress, try three simple strategies to help you reset.

Take a new approach. Much of life’s stress comes from how we view the various situations we encounter. For example, two people may take on the exact same task, but only one person may find it stressful. Some of this has to do with personality, but it also has to do with your inner narrative — how you frame things in your mind. Aim to change your perspective, and you can often reduce the number of stressors in your life.

Burn off tension. Physical activity can reduce cortisol levels, and help get you on a more even keel. But for many people, sticking to a daily exercise schedule is itself stressful, because they pick activities they don’t enjoy. Instead, choose to do something you love — gardening, taking nature walks, or yoga, which can slow the harmful effects of stress. Looking forward to the activity can keep you motivated, and help you destress and recharge.

Get organized. Ever spend 20 minutes looking for your car keys or trying to find a misplaced shoe? Disorganization and clutter can be stress inducing, and it’s unnecessary. Taking time to set up some systems, such as a set location for your keys, can help reduce these daily nuisances. In addition, plan ahead when it comes to other strategies that can help you manage your stress. Create a time for exercise, to plan healthy meals, and get on a regular schedule to ensure that you’re getting enough sleep. Also, if you know you’re going to be encountering a stressful period — the anniversary of a loved one’s death, an upcoming surgery, a financial challenge — think ahead of time about how you are going to manage it. Having a plan can help to reduce your level of stress, and prevent it from taking a toll on your health.

Whatever strategies you choose, be certain to take time to assess and revise your approach if it’s not working. Sometimes finding the right combination of stress busters can take time. If you are trying to reduce stress on your own and aren’t having any success, talk to your doctor. She or he might recommend a mental health specialist who can help.

The post 3 simple strategies for stress relief appeared first on Harvard Health Blog.

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Anxiety, Depression and Drinking During a Pandemic

MONDAY, Jan. 25, 2021 (HealthDay News) — People with anxiety and depression are more likely to step up their drinking during the COVID-19 pandemic than those without these mental health issues, an online survey revealed.

Alcohol use grew the most among young people, but older adults with anxiety and depression were about twice as likely to report increased drinking as older adults without those struggles, New York University researchers said.

“We expected that younger people and those with mental health issues would report drinking as a coping mechanism, but this is the first time we’re learning that mental health is associated with differences in alcohol use by age,” study author Yesim Tozan said in a university news release. She is an assistant professor of global health at NYU’s School of Global Public Health.

Lead author Ariadna Capasso, a doctoral student, said the increase in drinking, especially among people with mental health issues, is consistent with concerns that the pandemic may be triggering an epidemic of alcohol use.

Drinking to cope with stress and traumatic events is not unusual. After the 2001 World Trade Center attack, 25% of New Yorkers increased their alcohol use.

Likewise, COVID-19 has caused lots of stress, including isolation, disruption of routines, economic hardship, illness, fear of contagion.

For the study, the researchers conducted an online survey of people across the United States in March and April.

Of the more than 5,800 respondents who said they drink, 29% said they were drinking more during the pandemic. Nearly 20% said they were drinking less and 51% said their drinking habits hadn’t changed.

The survey found that people with depression were 64% more likely to drink more and people with anxiety were 41% more likely to do so.

The results varied by age: Respondents under age 40 were the most likely to report drinking more (40%), compared with 40- to 59-year-olds (30%) and those over 60 (20%).

The researchers said they support increasing mental health services during the pandemic through telehealth. They also suggested actively reaching out to people with mental health problems.

“Lessons we’ve learned from previous disasters show us that intervening early for unhealthy substance use is critical and could help lessen the pandemic’s impact on mental health,” said senior author Ralph DiClemente, chairman of NYU’s Department of Social and Behavioral Sciences.

The findings were recently published online in the journal Preventive Medicine.

More information

For more about coping with stress and the pandemic, visit the U.S. Centers for Disease Control and Prevention.

SOURCE: New York University, news release, Jan. 18, 2021

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More contagious U.K. COVID strain is also deadlier, Boris Johnson warns

BARCELONA — It was a bad end to a bad COVID week in Europe. On Friday evening, British Prime Minister Boris Johnson announced that researchers had found “some evidence” that the recently discovered U.K. variant of the coronavirus, which was already known to be more contagious than the original strain and has prompted an alarming surge of cases and a lockdown in that country, “may be associated with a higher degree of mortality.” A 30 percent higher mortality, added his government lead scientific adviser, Patrick Vallance, in revealing the assessment by that country’s New and Emerging Respiratory Virus Threats Advisory Group. He added there is still “a lot of uncertainty” about exactly how lethal the variant is.

Responding to the news, Yahoo News Medical Contributor Dr. Kavita Patel explained that “10 different studies with models show that the [U.K.] variant has a higher risk of death compared to the non-U.K. variants,” but underscored that “these are studies and models, not necessarily clinical trials.” She added that if the U.K. strain is in fact more deadly, it becomes “more urgent to get vaccines out as soon as possible” and that epidemiologists need to more clearly “understand the spread of the variant here in the U.S.”

The variant, which is believed to be as much as 70 percent more transmissible than the predominant strain in the U.S., has been identified in at least 20 states among Americans with no recent history of foreign travel, indicating it is spreading rapidly. The CDC says it could become the dominant strain in the U.S. by March.

The U.K. report hit Spain particularly hard, as new cases there have been spiking since the holiday season ended, with Friday’s announcement of 44,357 new cases breaking all previous daily records. Only the U.S. and Brazil are reporting higher numbers of new cases. At least 5 percent of the cases in this Spanish “third wave” are believed to be the U.K. variant, which the Spanish government’s chief scientific COVID adviser, Fernando Simón, believes will be the dominant strain in Spain within a few weeks.

Boris Johnson
British Prime Minister Boris Johnson. (Leon Neal/Pool/AFP via Getty Images)

The dramatic spike was initially believed to be a reflection of the extended holiday season in Spain, which stretches from Dec. 24 to Jan. 6, during which some restrictions, such as curfews and travel between regions, were eased. However, with hospitalizations hitting new highs, epidemiologists realized that the U.K. variant, which first showed up in Spain a month ago, was evident in increasing numbers, and appears to be fueling the rising cases, particularly in the country’s south.

Thus far, the Spanish national government — which has mandated mask wearing in all public places, including on the streets, curtailed hours of restaurant operations and imposed a nationwide 10 p.m. curfew in October — is denying requests from Spain’s regions to set the curfew to 8 p.m. or to impose a full lockdown.

In fact, in the land where tourism is an economic driver, Spanish authorities have recently announced they hope Spain’s tourism will be back on track by late summer, by which time the prime minister believes at least 70 percent of Spaniards will have been vaccinated, a process that started last month.

Patel stressed that “despite this sobering news, we still believe vaccines can work against these variants and be incredibly important, especially for those at high risk for dying from COVID.” But as vaccines may need to be tweaked to address the British and other new variants, Americans “need to triple down on our public health efforts” such as donning masks and social distancing.


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UK doctors seek review of 12-week gap between vaccine doses

A medical staff member prepares the Pfizer-BioNTech COVID-19 vaccine at Tudor Ranch in Mecca, Calif., Thursday, Jan. 21, 2021. (AP Photo/Jae C. Hong)

A major British doctors’ group is says the U.K. government should “urgently review” it’s decision to give people a second dose of the Pfizer-BioNTech coronavirus vaccine up to 12 weeks after the first, rather than the shorter gap recommended by the manufacturer and the World Health Organization.

The U.K., which has Europe’s deadliest coronavirus outbreak, adopted the policy in order to give as many people as possible a first dose of vaccine quickly. So far almost 5.5 million people have received a shot of either a vaccine made by U.S. drugmaker Pfizer and Germany’s BioNTech or one developed by U.K.-Swedish pharmaceutical giant AstraZeneca and Oxford University.

AstraZeneca has said it believes a first dose of its vaccine offers protection after 12 weeks, but Pfizer says it has not tested the efficacy of its jab after such a long gap.

The British Medical Association on Saturday urged England’s chief medical officer to “urgently review the U.K.’s current position of second doses after 12 weeks.”

In a statement, the association said there was “growing concern from the medical profession regarding the delay of the second dose of the Pfizer-BioNTech vaccine as Britain’s strategy has become increasingly isolated from many other countries.”

“No other nation has adopted the U.K.’s approach,” Dr. Chaand Nagpaul, chairman of the BMA council, told the BBC.

UK doctors seek review of 12-week gap between vaccine doses
Britain’s Prime Minister Boris Johnson speaks during a coronavirus press conference at 10 Downing Street in London, Friday Jan. 22, 2021. Johnson announced that the new variant of COVID-19, which was first discovered in the south of England, may be linked with a possible increase in the mortality rate. (Leon Neal/Pool via AP)

He said the WHO had recommended that the second Pfizer vaccine shot could be given up to six weeks after the first but only “in exceptional circumstances.”

“I do understand the trade-off and the rationale, but if that was the right thing to do then we would see other nations following suit,” Nagpaul said.

Yvonne Doyle, medical director of Public Health England, defended the decision as “a reasonable scientific balance on the basis of both supply and also protecting the most people.”

Researchers in Britain have begun collecting blood samples from newly vaccinated people in order to study how many antibodies they are producing at different intervals, from 3 weeks to 24 months, to get an answer to the question of what timing is best for the shots.

The doctors’ concerns came a day after government medical advisers said there was evidence that a new variant of the virus first identified in southeast England carries a greater risk of death than the original strain.

  • UK doctors seek review of 12-week gap between vaccine doses
    Resident Margaret Keating, 88, receives the Pfizer BioNTech COVID-19 vaccine at the Abercorn House Care Home in Hamilton, Scotland, Monday Dec. 14, 2020. (Russell Cheyne/PA via AP)
  • UK doctors seek review of 12-week gap between vaccine doses
    A pharmacist prepares a syringe of the Pfizer-BioNTech COVID-19 vaccine Friday, Jan. 8, 2021, at Queen Anne Healthcare, a skilled nursing and rehabilitation facility in Seattle. Pfizer has committed to supply up to 40 million doses of its COVID-19 vaccine this year to a World Health Organization-backed effort to get affordable vaccines to 92 poor and middle-income countries. The deal announced Friday, Jan. 22 will supply the shots to the program known as COVAX. (AP Photo/Ted S. Warren)
  • UK doctors seek review of 12-week gap between vaccine doses
    A health worker prepares the Pfizer-BioNTech vaccine inside Salisbury Cathedral in Salisbury, England, Wednesday, Jan. 20, 2021. Salisbury Cathedral opened its doors for the second time as a venue for the Sarum South Primary Care Network COVID-19 Local Vaccination Service. (AP Photo/Frank Augstein)
  • UK doctors seek review of 12-week gap between vaccine doses
    People sit and relax after receiving their Pfizer-BioNTech vaccination at Salisbury Cathedral in Salisbury, England, Wednesday, Jan. 20, 2021. Salisbury Cathedral opened its doors for the second time as a venue for the Sarum South Primary Care Network COVID-19 Local Vaccination Service. (AP Photo/Frank Augstein)
  • UK doctors seek review of 12-week gap between vaccine doses
    Britain’s Prime Minister Boris Johnson speaks during a coronavirus press conference at 10 Downing Street in London, Friday Jan. 22, 2021. Johnson announced that the new variant of COVID-19, which was first discovered in the south of England, may be linked with an increase in the mortality rate. (Leon Neal/Pool via AP)

Chief Scientific Adviser Patrick Vallance said Friday “that there is evidence that there is an increased risk for those who have the new variant,” which is also more transmissible than the original virus. He said the new strain might be about 30% more deadly, but stressed that “the evidence is not yet strong” and more research is needed.

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Will Vaccines Work Against the New Coronavirus Variants?

By Dennis Thompson HealthDay Reporter

FRIDAY, Jan. 22, 2021 (HealthDay News)

Everyone has heard the scary reports about the new, more infectious coronavirus variants that are circulating in countries around the world, but scientists aren’t pushing the panic button at this point.

Why? Because the new COVID-19 vaccines should still work on these viral interlopers.

Luckily, the new variants still rely on the coronavirus’ “spike protein” to infect cells, and the two COVID vaccines now on the U.S. market specifically target the spike protein to prevent transmission, explained Dr. Kathryn Edwards, scientific director of the Vanderbilt University Vaccine Research Program in Nashville.

“The spike is really critical. It’s really what is needed to interact with the cell,” Edwards said. “So, I think it would be hard to circumvent the spike in terms of function.”

New COVID variants out of Britain, South Africa and Brazil appear to be more infectious, possibly because the spike protein has mutated to make transmission between people easier, said Dr. Mirella Salvatore, an infectious disease expert and assistant professor at Weill Cornell Medicine in New York City.

“The spike protein is needed to bind to the cell, to allow the virus to enter,” Salvatore explained. “If there are a lot of these mutations, maybe this binding is stronger and the virus can enter more easily. This is a possibility why this virus seems to transmit more easily.”

But the Pfizer and Moderna vaccines are designed to not only target the spike protein, but to promote the creation of antibodies that will attack it in several different ways, Salvatore said.

Therefore, it’s not likely that a mutation would be able to evade the complex immune response created by a vaccine, even if the mutation makes the spike protein more effective at infecting unvaccinated people, the experts said.

“It’s not one single antibody, so if there is a mutation that changed a little bit of the structure of the spike protein, then there would be a lot of other substantial antibodies that would be able to stop the virus from attacking the cell and entering the cell,” Salvatore noted.

Edwards and Salvatore spoke Thursday during a briefing hosted by the Infectious Diseases Society of America, of which they are both fellows.

There was a bit of bad news delivered during the briefing: The new Brazilian and South African variants do appear to be capable of reinfecting people who’ve had COVID before, the experts said.

For example, a Brazilian health care worker fell ill from both the original COVID-19 virus and, months later, again from what turned out to be a new mutation of the virus, Edwards said.

However, the man did not suffer severe illness either time, so it’s possible that his body didn’t mount a strong enough immune response during the first infection to protect him against the second, Edwards said.

“The height of the antibody response may be somewhat proportional to how sick you are in the beginning. Maybe if the patient had been vaccinated or maybe had a more severe disease, he would have had a higher antibody count that would have protected him,” Edwards said.

The heightened transmissibility of the new strains and their potential to evade the natural immunity caused by infection has raised concerns about a new wave of coronavirus in the United States, said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

“I am extremely worried about the U.K. variant,” Osterholm said during a HD Live! interview this week. “I think over the course of the next six to 12 weeks we could see the darkest days of this pandemic in this country, with that variant being responsible for greatly increased transmission.”

The new variants haven’t proven more lethal than the original COVID strain, Salvatore said, but increased infection could increase the number of people who die from the coronavirus.

Public health and infectious disease experts will need to continue to track new variants of COVID and decipher their genetics, just in case a new mutation causes a severe decline in vaccine effectiveness, the experts said.

But if that happens, it likely will be easy to change up the lab-created messenger RNA vaccines to maintain their effectiveness against new mutations, Edwards said.

“That is an advantage of the mRNA vaccines,” Edwards said, noting that public health officials already change the flu vaccine every year to maintain its effectiveness against the much more mutation-prone influenza virus.

“That process is done so efficiently by the [U.S. Food and Drug Administration] and other regulators that the ability to change is something we do every year,” Edwards said. “I think as we are going forward, we are using influenza as the model.”

More information

The U.S. Centers for Disease Control and Prevention has more about COVID-19 variants.

SOURCES: Kathryn Edwards, MD, scientific director, Vanderbilt University Vaccine Research Program, Nashville, Tenn.; Mirella Salvatore, MD, assistant professor, Weill Cornell Medicine, New York City; Michael Osterholm, PhD, MPH, director, Center for Infectious Disease Research and Policy, University of Minnesota, Minneapolis; Infectious Diseases Society of America, media briefing, Jan. 21, 2021

Copyright © 2020 HealthDay. All rights reserved.

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Why a Covid-19 vaccine will not stop the coronavirus pandemic right away

It was in 2009, when the H1N1 “swine” flu broke out in April, right at the end of the regular flu season.

“That was very challenging,” Shah, who heads the Harris County, Texas, health department, told CNN.

“There were a lot of moving pieces. It took several weeks to months to not just organize but to implement and to do safely and effectively. And that was a mild pandemic.”

This is not a mild pandemic. And while vaccine manufacturers, public health experts and the federal government are all confident one or more of the coronavirus vaccines being tested now will be shown to work safely by the end of the year, the US and the world will still be a long way from ending the pandemic.

“I feel cautiously optimistic that we will have a vaccine by the end of this calendar year, as we get into early 2021,” Dr. Anthony Fauci, who, as director of the National Institute of Allergy and Infectious Diseases, is helping lead the medical battle against the virus, told CNN’s Wolf Blitzer Friday.

“But it’s not going to be turning a switch off and turning the switch on. It’s going to be gradual,” Fauci added.

“Having” a vaccine does not mean having a vaccine approved, distributed and into the arms of more than 300 million Americans.

First, any vaccine must either be approved or authorized by the US Food and Drug Administration. That’s a process that under normal circumstances can take months or years. While the FDA has promised a speedier process for a Covid-19 vaccine, it must still go through a committee known as the Vaccines and Related Biological Products Advisory Committee, or VRBAC.

The FDA will almost certainly allow a shortcut process known as emergency use authorization, or EUA, but the agency has said it will require an “EUA-plus” that adds at least some layers of scrutiny.

“It’s unlikely that a Covid-19 vaccine will receive full approval and broad distribution right away. Instead, the FDA will probably authorize vaccines for use in targeted groups of people at high risk from Covid and most likely to benefit from the vaccine,” Dr. Mark McClellan and Dr. Scott Gottlieb, both former FDA commissioners, wrote in a commentary in the Wall Street Journal Monday. “All this means that at least initially, Covid vaccines won’t provide the sort of herd immunity that can help extinguish an epidemic.”

That will take time — likely well into next year, even if a vaccine were to be authorized in January, most experts who spoke to CNN predicted.

“People can’t be lulled into a false sense of security by knowing the vaccine is coming,” Dr. Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officers, told CNN.

Although manufacturers are already making vaccine doses, it takes time. And the US will likely need more than 600 million doses of vaccine — enough for everyone to get two doses of the vaccine.

A new vaccine, and a plan for getting it out

“Let’s say … at the end of the year, there will be millions and tens of millions of doses available,” Fauci said in the CNN interview Friday.

“It won’t be until we get into 2021 that you’ll have hundreds of millions of doses, and just the logistics constraints in vaccinating large numbers of people — it’s going to take months to get enough people vaccinated to have an umbrella of immunity over the community.”

The US just is not ready for a mass vaccination campaign like the one needed to bring coronavirus under control, public health experts agreed.

Pfizer proposes expanding Covid-19 vaccine trial to include more diversity as race for a vaccine continues

“I don’t think it’s going to be seamless,” said Plescia.

The biggest mass vaccination program the US undertakes every year is the annual influenza vaccine. Only about half of Americans get a flu vaccine, and manufacturers make and distribute fewer than 150 million doses of it.

Yet it takes a full year from start to finish to formulate, make and distribute flu vaccines every influenza season.

“We start planning for flu vaccines in January or February,” Michael Einhorn, the president of Dealmed, an independent medical supply distributor covering New York, New Jersey, Connecticut and Pennsylvania. Flu vaccines generally become available in August — seven to eight months later.

And that’s with a vaccine made using familiar technology, and dispensed in ways that people are familiar with — in pediatricians’ offices, at pharmacies, in grocery stores and at clinics.

“You have a playbook for influenza,” Shah said. “This is not the same.”

Here's how Trump could bigfoot the FDA and get a vaccine out ahead of the science

Any coronavirus vaccines will involve new technology and a whole new process for distribution, administration and then for payment.

And while anyone can walk into, say, a pharmacy, get a flu shot and leave without ever thinking about it again, coronavirus vaccines will involve a whole lot more trouble and paperwork. People will probably need at least two doses about a month apart. Someone will have to track and follow up on that.

“We have to be able to see who has been vaccinated and who has not been,” Dr. Ngozi Ezike, director of the Illinois Department of Public Health, told a public hearing about vaccine distribution organized by the National Academies of Science, Engineering and Medicine.

Paperwork and red tape

“To have two doses means that you provide the initial dose and we will need to bring the person back for a second dose a month later,” Dr. Jinlene Chan, acting deputy secretary of public health for the state of Maryland, told CNN.

And it’s very likely that vaccines made by several different companies will be in use by next year.

9 vaccine makers sign safety pledge in race for Covid-19 vaccine

“We have to make sure that we give the person the same vaccine for their second dose that they got for their first dose,” Chan said.

No vaccination program can start until there are plans in place to manage this.

Plus, the coronavirus vaccine or vaccines will still be experimental, so every person who gets one will need to be tracked to make sure there are no adverse reactions.

There is no plan yet for any of this.

“We have gotten very little information on how this is going to roll out,” said Harris County’s Shah. “That makes it even more difficult to plan.”

One big potential stumbling block is what’s known as the cold chain. The two vaccines furthest along in development both must be kept frozen. Moderna’s vaccine must be kept at -4 degrees Fahrenheit (-20 degrees Celsius), while Pfizer’s must be kept at -94 F (-70 C). While -4 isn’t much colder than the optimal home freezer’s setting of 0 degrees F, -94 is more of a challenge.

“Throughout — from every single point the vaccine has to traverse — we have to maintain it at that temperature. Otherwise, there is a risk of some degradation and the vaccine possibly becoming less effective,” Chan said. “We need to make sure that there is some capability to store it appropriately until it is ready to use.”

There's a legitimate way to end coronavirus vaccine trials early, Fauci says

Otherwise, a thawed batch could mean hundreds or even thousands of people get a dud vaccine.

This can be a challenge, said Dr. Carlos del Rio, a vaccine expert at Emory University. “We simply don’t have freezers that can reach minus 70 degrees in most clinics,” he told the National Academies meeting.

To reach enough people, any mass vaccination effort will have to go beyond clinics, hospitals and pharmacies. “You are going to have to get out to communities. You are going to have to get out to places of work,” Del Rio said. That makes keeping the vaccines cold enough more of a challenge.

Plescia said Pfizer has a plan to help keep its vaccine cold. “Pfizer is going to have special boxes they ship the vaccines in, packed with dry ice,” he said. “Once you get the box, it’ll keep the stuff at negative 80 degrees for 10 days.”

But it’s not clear, Plescia said, if the boxes could be opened and a few doses of vaccine taken out safely. “Even if these boxes work very well, it is still going to add a whole level of challenge,” he said.

Taking the mass out of mass vaccination

Past mass vaccination efforts have been just that — mass. But coronavirus is a respiratory disease, and the last thing anyone should be doing is lining people up or packing them into, say, school gyms to get vaccinated, Chan noted.

Past vaccine disasters show why rushing a coronavirus vaccine now would be 'colossally stupid'

“With mass vaccination clinics, it involves bringing large groups of people into a site and vaccinating as many people as possible,” Chan said. “How do we do that in a way that reduces the risk of transmitting the very disease that we trying to vaccinate against?”

Illinois’ Ezike said some of the experience with test sites may help. “We had these strike teams,” she said. “We have been able to convert a lot of different sites into sites where people can drive up. Can you do a vaccination through the [car] window?” she asked.

But to accommodate that, cities and states will have to get busy soon. “We are going to need additional providers,” she told the NASEM meeting. “We need mass vaccination clinics and sites. So we really want to recruit lots and lots of essential partners,” she added — especially for the communities that are hardest hit by the pandemic, including meat-packing facilities and remote rural areas.

Experts call for independent commission separate from FDA to review Covid-19 vaccines

That means changes in policies and legislation — another potentially time-consuming process. Medical practice is legislated by states, not by the federal government. “We know that we’ll need some expanded scope of practice for different professional groups,” she said. For instance, states may want to enable dentists, dental hygienists and even medical school students and veterinarians to vaccinate people.

And that requires some other levels of legislation so that providers can get paid for their time. Changes to health insurance laws may be necessary, including billing codes that provide for a system under which people get vaccinated for no charge.

Because rollout will not be immediate, people will be vaccinated in groups. The National Academies is considering this, as is the US Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP). They, along with private advocacy groups, have already released their own draft blueprints that in general put health care workers, first responders and the most vulnerable at the front of the line. But that’s another layer of management for governments to take on.

Many states have old and unwieldy systems for managing all of this, and Ezike said the needed upgrades may take time.

Immunity takes time

Adding to the timeline is simple biology. The Pfizer and Modern vaccines, at least, will have to be given in two doses, a month apart. After that, it takes about two weeks for immunity to build. That makes for six weeks from the time someone first gets vaccinated to when they can feel safe from infection.

US could see a 'very deadly December' with tens of thousands of coronavirus death to come, computer model predicts

On top of all of this, many Americans are fearful of vaccines — especially a new one and especially a new vaccine rolled out in a time of intense politicization of the process.

“There’s general vaccination mistrust and then there’s government mistrust,” Ezike noted.

The current atmosphere over mask use has not helped, added Harris County’s Shah.

“We have made it a political fight,” he said.

“When you make it political in nature, not driven by health and medical considerations, ultimately people will take sides.”

Unless a majority of the population gets vaccinated, the virus will continue its spread. Most estimates suggest that 60% to 70% of the population must be immune to provide enough herd immunity to interrupt the spread of the virus. Polls indicate that only about half of Americans feel confident right now about being vaccinated.

And if vaccines are less than fully effective, that may mean even more of the population needs to be vaccinated to have an effect on spread.

Then there are the unknowns.

“Testing has not been seamless at all. There are going to be some glitches,” Plescia said.

“I think there is a good chance there is going to be a vaccine that works and gets us out of this, but it is hard to believe that it is going to go really smoothly, given all the things that could happen.”

Shah is ready for unpleasant surprises. “This is a super slick virus that has broken every rule in the book,” he said.

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Getting rescued by helicopter has risks. This gadget could make it safer.

The litter stabilization system, in this configuration, consists of two units, one at each end of the rescue basket. (Scott C Childress / U.S. Army/)

When Caleb Carr was 15, he was taking part in a search-and-rescue training expedition in Oregon, and an adult on the trip suffered a heart attack. A helicopter from the state’s National Guard arrived to try to airlift the man out, but the operation encountered a problem when trying to lower the rescue litter. “The basket kept swinging back and forth,” he recalls. “[It] couldn’t make it through the trees.”

The traditional method for stabilizing a litter or basket as a helicopter lowers it to the ground is through a tagline, which people down below grab to guide the payload. Taglines, Carr says, “were virtually impossible [to use that day], especially from a dense tree canopy.”

Since the patient required CPR, it wasn’t possible to move him. Ultimately, the airborne evacuation attempt failed. They declared “time of death,” Carr remembers.

That event occurred in 2009, and now Carr is CEO of Vita Inclinata, which has developed a high-tech replacement for taglines. It’s a contraption that includes electric thrusters that can autonomously stabilize a litter that’s dangling from a helicopter.

It may sound like an esoteric problem, but a rapidly-spinning litter beneath a helicopter with a 74-year-old evacuee in it made news in 2019 in a video that will make you gasp. That spinning was attributed to the interaction between the air coming off the helicopter’s rotors (known as wash) and the basket below.

The new system works independently from the aircraft itself. To understand how it functions, picture a litter hanging from a single line beneath a rescue helicopter. The system consists of two units, one at each end of the litter. Each box-like unit has two battery-powered thrusters—one thruster (technically, a fan inside a duct) points in one direction, and another, in the other direction. Since there are two boxes, that adds up to a total of four thrusters, positioned near the four corners of the litter, with the two units connected by a data line. Each box has sensors on board—accelerometer, gyroscope, and magnetometer—and computing equipment. The sensors figure out what’s going on with the load, detecting if it is spinning or not, and instructions zip to the ducted fans to stabilize it.

“A hundred times per second, we’re computing what the best action is for these thrusters to take to stop the spin, or swing, or any type of motion,” says Derek Sikora, the CTO at Vita Inclinata. Imagine the litter is spinning rapidly. “When you kick us on, we’re going to stop that in a matter of three seconds or less—in that case you just kick on the opposing fans.”

Sikora says that the system can be operated from either on board the aircraft or from the ground, using a controller on which someone would just “click ‘stabilize.’” The algorithm and thrusters take it from there.

The setup has another trick: power up two fans on the same side, and it can push the litter through the air, one way or the other, so that it can swing towards a cliff or building to pick someone up. They can “fly a load off-axis, outside the circumference of the rotor blades,” Carr says. “That opens the door for really a whole dynamic shift in the use of helicopters when it comes to rescue operations.”

Every aviation system comes with tradeoffs, and in this case, the system weighs 35 pounds, slightly reducing the load a helicopter basket could carry. And any technology that needs electricity and other components is going to be more complex than something that doesn’t, and complexity can create problems even as it solves them. In this case, their “competition is a rope,” Carr says. Ropes don’t need to be recharged, nor do they need software, but then again, algorithms and thrusters can perform tricks that a rope, or tagline, cannot.

The company is a contender to supply its stabilization system to the Army. The most recent National Defense Authorization Bill includes a $5.5 million appropriation for load stability systems that the military could spend on this gadget if they choose to.

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The Ultimate Guide to Intermittent Fasting

Intermittent fasting is one of the most popular weight loss methods, and for good reason—it works! Many studies have shown that it has powerful effects for your body and brain, and it may even help you to live longer. Intermittent fasting is not actually a diet but rather described as an eating pattern. It’s an approach where you go a certain period of time during the day without eating (water and black coffee are allowed during this period). Typically this is a 16-hour window, followed by an 8-hour feeding window (a period of 8 hours where you consume all your calories for the day).

There are many variations to these alternating eating and fasting windows. Some examples are two days of a full 24-hour fast (not recommended, especially if your goal is building or maintaining muscle), 18-hour fast with a 6-hour eating window or a 20-hour fast with a 4-hour eating window.

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Soaring COVID-19 Deaths Darken Biden’s Inauguration

Current hospitalizations are always the most stable indicator of the pandemic’s progress, and after peaking at 132,474 on January 6, they have declined more than 6 percent—meaning that 8,654 fewer people are in the hospital now, compared with two weeks ago. Hospitalizations have declined, too, in every region for at least the past week or so. Still, they are more than twice as high as the spring and summer peaks combined, both of which stopped just short of 60,000. And if the current peak follows the path of the previous two, the decline will be slow; the spring and summer peaks took about a month to build from the previous low, and then about two months to subside to the next low.

Across the country, though, regional cases per million have been declining, with a substantial drop in the Midwest since late November and recent, short-term declines in the other three U.S. regions. Deaths, a lagging indicator, may be reaching a plateau in all regions as a result; there are the first hints of it in the seven-day average—ever-so-slight changes in momentum visible at the edge of the graphs below.

Much of what happens next will depend on conditions in some of the country’s largest states— California, where the seven-day average of hospitalizations peaked at 22,703 on January 12; Arizona, which has the highest per capita hospitalization rate in the country and has of late had the worst outbreak in the world; Texas, where hospitalizations and deaths are well above prior peaks and climbing; and Florida, where hospitalizations and deaths may be peaking after a steady rise going back to late fall. New York may be hitting a second peak or plateau of hospitalizations, at a seven-day average just under 9,000, about half of its awful spring peak. New cases and hospitalizations are climbing in Virginia, which is at about twice its previous hospitalizations peak, in May. North Carolina’s seven-day average of hospitalizations has been climbing continuously since early November.

But at the state level, peaks are not necessarily followed by an immediate decline. Missouri has had a seven-day average of hospitalizations between 2,500 and 2,800 since late November. New Jersey has remained between 3,600 and 3,700 since December 16. Even assuming that we are at a peak, unwinding the damage will take long enough as it is—at least a couple of months, if the previous lower peaks are any indication.

The Biden administration inherits a mess, and now the B.1.1.7 variant of the virus, which may be 50 to 70 percent more transmissible, has been found in many states, suggesting that it’s widespread. But the administration also has the tools to clean this mess up. It has promised new, seemingly more aggressive action. The vaccine is rolling out, at an estimated rate of nearly 777,000 doses administered a day. We may still hope that this will be the worst point of the pandemic—the peak of this horrifying wave—and that from here the numbers will drop slowly but inexorably down.

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