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Infectious disease expert offers recommendations for holiday travel – Medical Xpress

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Dr. William Petri is vice chair for research in the UVA Department of Medicine and a chaired professor of infectious disease and international health. Credit: Dan Addison, University Communications

At this time last year, demand for holiday travel saw a steep decline, with train ticket sales down by 20% and the Transportation Security Administration reporting airport traffic as less than half of the numbers seen in 2019.

As the comes back on the horizon this year, it is clear that progress has been made. In late November of 2020, COVID vaccine shipments to the states were still a few weeks out. Fast-forward to today, and 445 million vaccines have been administered in the U.S. Almost 60% of the U.S. population is fully vaccinated, and an additional 31.5 million have received a booster.

With Thanksgiving now a week away and the rest of the holiday season to follow closely behind, UVA Today checked in with a UVA infectious diseases expert to understand what is expected heading into the gathering season. Dr. William Petri, vice chair for research in the UVA Department of Medicine and a chaired professor of infectious disease and , offered insights, comparisons and recommendations on how to proceed.

Q. Do health experts expect COVID cases to surge again this holiday season?

A. Yes, but I have invited my , who are all vaccinated, to travel home to see us! This is the opposite advice that I gave them last year at this time—which was the right decision then, as holiday travel last year resulted in the highest number of COVID-19 infections of the entire pandemic, peaking at 300,000 new cases in one day on Jan. 8.

Today, new infections, while declining or stable in Virginia, are beginning to creep up in the mountain states and northern U.S. It seems likely that we will see regional increases or surges in infections, but nothing like the nationwide problem last holiday season.

Q. Will case numbers be worse than anything we’ve seen previously?

A. No. Last year at this time, no one was vaccinated. Now 80% of Americans age 12 and older have received at least one vaccination. Vaccines are decreasing the chance of infection by six-fold, and of dying from COVID-19 by 12-fold. Now with 5- to 11-year-old children getting the vaccine, we are in a much, much better position, thus my invitation to my children to travel.

Q. Last winter, there were issues in differentiating COVID and the seasonal flu. Are there better methods in place this season to diagnose the two viruses separately?

A. Yes. I am caring for patients at the UVA Hospital this week, and we are testing everyone with cold- or flu-like symptoms for flu, COVID-19 and respiratory syncytial virus, since these can all have the same symptoms. It is worth mentioning here the importance of vaccination for flu for everyone 6 months of age and older, as this saves lives.

A side note is that this year there was no winter epidemic of influenza, an unprecedented event. It is thought that the record-low number of influenza cases was due to all of the efforts to mitigate COVID-19, including decreased travel, social distancing and mask-wearing, as well as a record number of influenza vaccinations. As we approach the 2022 flu season (generally from January to March of each year in the Northern Hemisphere), it is unknown how much flu we will have.

Q. Is it likely that hospitals will get pushed to near capacity again?

A. Not at a nationwide level. There however may be regions or localities where, due to low vaccination rates, a holiday surge is severe enough that this does occur.

The highest-risk group for hospitalization due to COVID-19, those 65 years of age and older, is fortunately also the most-vaccinated group, and this will go a long way to prevent demand exceeding capacity at hospitals. It is important to keep in mind that someone who is 80 years old is 700-fold more likely to die from COVID than someone who is 18 to 40 years old.

Q. Do five- to 11-year-olds still pose a health threat, since many will not receive their second dose until early- to mid-December?

A. No. One dose of the Pfizer vaccine in the 5- to 11-year- old age group is more than 90% effective at prevention of COVID-19 by one week after vaccination. This was shown in the phase 2/3 efficacy data submitted by Pfizer to the FDA for [emergency use authorization] approval on Oct. 26.

Q. Many Americans have been able to get booster shots of COVID vaccines this fall. Does this allow them to travel and visit family without much worry?

A. Yes. The booster shots for the COVID-19 vaccines have been shown to increase the levels of anti-spike neutralizing antibodies as much as 20-fold, thereby closing the gap on waning effectiveness of the primary vaccine series. Even without a booster, vaccinated individuals were 12-fold less likely to die from COVID-19 during the most recent delta variant surge. So, as we have all heard, and is true, vaccinated individuals can return to a near-pre-pandemic style of life!

Q. What recommendations do you have for people as they travel and gather this holiday season?

A. One can enjoy indoor family gatherings safely if everyone has been vaccinated and everyone exercises common sense (i.e. does not attend if they have symptoms that could be COVID-19, such as a cough or cold).

Under-5-year-old children who cannot yet be vaccinated may pose a risk of asymptomatic transmission if they are exposed to the virus in settings such as day care or preschool. One approach would be to have them tested prior to the family gathering. This would be prudent if other family members are at increased risk (for example, grandparents due to their age, or someone with a serious underlying medical condition). Remember that the best way to protect under-5 children right now is to surround them with vaccinated family members.


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Islander living with HIV for 3 decades reflects on World AIDS Day – CBC.ca

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Troy Perrot-Sanderson has lived with human immunodeficiency virus for almost 30 years, but he’s only recently started talking about how he became infected. 

“It’s a very difficult thing for me to talk about,” said Perrot-Sanderson, in an interview tied to Dec. 1, which is World AIDS Day. “I’ve only really started dealing with it.” 

He said he was 21 years old when he was sexually assaulted, while he was living in Alberta. 

After the rape, Perrot-Sanderson said his life “spiralled” as he used drugs and alcohol to cope. 

He has just started to see a counsellor to help him deal with the trauma.

Perrot-Sanderson was a volunteer and later a staff member for AIDS P.E.I. He said his outlook on the disease has changed over the years and he feels much more optimistic now compared to when he was first diagnosed. (Submitted Troy Perrot-Sanderson)

HIV, human immunodeficiency virus, attacks the body’s immune system. If HIV is not treated, it can lead to acquired immunodeficiency syndrome, or AIDS.  

Perrot-Sanderson remembers that when he was first diagnosed, he thought his life was over. It took two decades after AIDS was first identified in the early 1980s to find an effective combination of drugs to treat it. In Canada alone, a 2017 report estimated, nearly 25,000 people had died of the disease by the end of 2016. 

“I just slowly prepared myself to die for a few years,” Perrot-Sanderson said. 

Advocate for others

He said he got more optimistic after he starting taking drugs to fight HIV. He volunteered and worked at AIDS PEI (later renamed PEERS Alliance) and was even acting executive director for a time. 

“We can take medication and live a pretty normal life,” he said.

PEERS Alliance recently relocated its office to downtown Charlottetown, and is planning an open house at 250 B Queen Street from 3 to 6 p.m. on Wednesday, Dec. 1. (Laura Meader/CBC)

Of today’s PEERS leader, he added: “I can’t thank them enough. They’re doing all kinds of amazing work in the community.” 

PEERS Alliance runs a number of education and outreach programs, working with a wide variety of people including gay and lesbian youth and adults; the trans community; and people who use drugs, who are susceptible to getting infected due to shared needles.

Still, as Perrot-Sanderson marks this World AIDS Day, he said it’s important to remember the people who have not survived, noting: “I have lost a lot of friends over the years.”

He worries there’s apathy around AIDS and HIV in 2021. 

“A lot of people just don’t talk about it or think about it any more,” he said. “We know how to protect ourselves now — we certainly know so much more, we know how to prevent this disease.”

Hopes for the future

Josie Baker is the executive director of PEERS Alliance, and hopes people will take part in an open house set up to mark World AIDS Day.

Baker noted that there is better access to testing now, with at-home kits available for use “in the comfort of someone’s own home.” 

Josie Baker of PEERS Alliance says she is looking forward to a day when there is no more stigma around HIV/AIDS. (Laura Meader/CBC)

Baker said non-nominal testing is also available, where each test is assigned a number instead of a name before going to the lab for analysis. That means people can be assured nobody at the lab will know who tested positive.   

There are still pressing issues that require lobbying, though, 40 years after the HIV crisis began. Baker said having an HIV care specialist on P.E.I. would help, since many have to go off-Island for specialized care. 

She also said being HIV-positive still carries a stigma on P.E.I. and elsewhere, and people should be able to access care and live in their communities free of judgment. 

“That would be my hope: to end the stigma,” said Baker. 

Perrot-Sanderson agrees, saying stigma often prevents people from seeking medical help. 

“People ignore it and don’t protect themselves,” he said.

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Singapore tests out ‘smart bandage’ for remote recovery

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Researchers in Singapore have developed a smart bandage to enable patients to have chronic wounds monitored remotely via an app on a mobile device, potentially saving them visits to the doctor.

A research team at the National University of Singapore has created a wearable sensor attached to a transparent bandage to track progress in healing, using information like temperature, bacteria type, and levels of pH and inflammation.

“Traditionally when someone has a wound or ulcer, if it’s infected, the only way to examine it is through looking at the wound itself, through visual inspection,” said Chwee Teck Lim, lead researcher at the university’s department of biomedical engineering.

“If the clinician wants to have further information then they will obtain the wound fluid and send to the lab for further testing,” he said.

“So what we’re trying to do is use our smart bandage to cut the number of hours or days to just a few minutes.”

The “VeCare” technology will enable patients to convalesce more at home and visit a doctor only if necessary.

The bandage is being tested on patients with chronic venous ulcers, or leg ulcers caused by circulation problems in veins.

Data collection by researchers on the wounds has so far been effective, according to Lim, who said the smart bandage could potentially be used for other wounds, like diabetic foot ulcers.

(This story refiles to correct to cut extraneous word in the first paragraph)

 

(Reporting by Ying Shan Lee; Writing by Masako Iijima; Editing by Martin Petty, William Maclean)

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Courts block two Biden administration COVID vaccine mandates

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The Biden administration was blocked on Tuesday from enforcing two mandates requiring millions of American workers to get vaccinated against COVID-19, a key part of its strategy for controlling the spread of the coronavirus.

U.S. District Judge Terry Doughty in Monroe, Louisiana, temporarily blocked the Centers for Medicare & Medicaid Services (CMS) from enforcing its vaccine mandate for healthcare workers until the court can resolve legal challenges.

Doughty’s ruling applied nationwide, except in 10 states where the CMS was already prevented from enforcing the rule due to a prior order from a federal judge in St. Louis.

Doughty said the CMS lacked the authority to issue a vaccine mandate that would require more than 2 million unvaccinated healthcare workers to get a coronavirus shot.

“There is no question that mandating a vaccine to 10.3 million healthcare workers is something that should be done by Congress, not a government agency,” wrote Doughty.

Separately, U.S. District Judge Gregory Van Tatenhove in Frankfort, Kentucky, blocked the administration from enforcing a regulation that new government contracts must include clauses requiring that contractors’ employees get vaccinated.

The contractor ruling applied in the three states that had filed the lawsuit, Kentucky, Ohio and Tennessee, one of at least 13 legal challenges nationwide against the regulation. It appears to be the first ruling against the contractor vaccine mandate.

The White House declined to comment.

The legal setbacks for President Joe Biden’s vaccine policy come as concerns that the Omicron coronavirus variant could trigger a new wave of infections and curtail travel and economic activity across the globe.

Biden unveiled regulations in September to increase the U.S. adult vaccination rate beyond the current 71% as a way of fighting the pandemic, which has killed more than 750,000 Americans and weighed on the economy.

Republican state attorneys general, conservative groups and trade organizations have sued to stop the regulations.

Tuesday’s rulings add to a string of court losses for the Biden administration over its COVID-19 policies.

The most sweeping regulation, a workplace vaccine-or-testing mandate for businesses with at least 100 employees, was temporarily blocked by a federal appeals court in early November.

In August, the U.S. Supreme Court ended the administration’s pandemic-related federal moratorium on residential evictions.

(Reporting by Tom Hals in Wilmington, Delaware; Additional reporting by Nandita Bose in Washington; Editing by Jonathan Oatis and Peter Cooney)

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