Researchers at the Centers for Disease Control and Prevention reported on Monday that a deadly, drug-resistant fungus emerging in the US is gaining ground faster and becoming more drug-resistant amid the COVID-19 pandemic.
yeast candida golden considered an “immediate threat” – the CDC’s highest level of concern – since it was first reported in the US in 2016. The yeast lurks in healthcare facilities and preys on vulnerable patients, causing invasive infections with a 30 to 60 percent fatality rate.
In 2019, before the start of the pandemic, 17 states and Washington DC reported a total of 476 clinical cases. But in 2020, eight additional states reported cases for the first time, with the total number of clinical cases in the country jumping 59 percent to 756. In 2021, 28 states were affected, and the number of clinical cases nearly doubled to 1,471. screenings also jumped amid the pandemic, tripling from 1,310 cases in 2020 to 4,041 cases in 2021. The data came out on Monday. in Annals of Internal Medicine.
“The rapid growth and geographic spread of cases is a cause for concern and highlights the need for continued surveillance, increased laboratory capacity, faster diagnostic tests, and adherence to proven infection prevention and control practices,” said CDC epidemiologist and study lead author Megan Lyman. says in the statement.
But its spread was not the only worrying aspect of yeast pandemic activity. He also became more drug resistant. Prior to the pandemic, six patients had developed infections resistant to the first-line antifungal drugs, echinocandins. But in 2021 alone, there were 19 such cases. Similarly, before the pandemic, there were only four reports of pandrug-resistant infections; that is, the fungus was resistant to all available drugs. In 2021, there were seven patients with pandrug-resistant infections.
Before the pandemic, cases of resistance and pan-resistance to echinocandins appeared to develop independently in patients on ongoing treatment, in other words, they were isolated cases that did not arise through human-to-human transmission. But there was evidence in the 2021 cases two flashes echinocandin-resistant and pan-resistant strains with human-to-human transmission.
“The timing of this has increased C. auris The prevalence and results of public health studies suggest that this may have been exacerbated by the pandemic-related strain on the healthcare system and public health systems,” Lyman and his colleagues concluded in the study.
CDC researchers suspect a shortage of personnel and personal protective equipment, as well as changes in patient movements and increased use of antimicrobials, may have contributed to the problem. They also suggested that while specific infection control measures were tightened up during the pandemic, others, such as environmental disinfection, may have been sidelined, which could exacerbate the spread. They called for renewed efforts to curb transmission. “C. auris remains a continuing health threat in the United States,” they wrote. An alarming surge during the pandemic “provides motivation to refocus on public health fundamentals to prevent disease and save lives.”
The world’s climate experts are clear: the planet will almost certainly warm much more than they had hoped, and there is only a slim path left to avert many horrific consequences for both humanity and the animal kingdom.
The UN Intergovernmental Panel on Climate Change has published its important summary climate report Monday is a decades-long attempt to unify scientists’ understanding of our changing world. The paper says the planet is likely to pass a dangerous and forewarned temperature threshold in the next decade. But it also keeps hope that the worst effects of climate change can be prevented.
Here are five key takeaways from the report:
1. Climate change has already damaged the planet.
The IPCC report speaks unambiguously about climate change. The planet has already warmed an average of 1.1 degrees Celsius above pre-industrial levels, changing ecosystems around the world. A warming world has affected food and water security, led to the extinction of hundreds of species, caused massive loss of life and led to irreversible retreat of glaciers and rising sea levels. Extreme weather events are becoming more intense and severe, with unnecessary damage and loss in some parts of the world.
Between 3.3 and 3.6 billion people are estimated to live in areas highly vulnerable to climate change, with many low-income countries in Africa, Asia and Central and South America being most affected.
2. Every warm-up counts.
Every region of the world is predicted to face increased climate hazards in the near future, the IPCC report says, threatening entire ecosystems and human society around the world. These threats include, but are not limited to, heat-related mortality, rising morbidity, flood risks, and loss of biodiversity.
These risks, however, increase with each increment of global warming and will accumulate and overlap as the planet warms.
“They are higher at 1.5°C global warming than they are currently, and even higher at 2°C,” the report says. “With further warming, the risks of climate change will become more complex and more difficult to manage.”
3. The impacts of climate change have been and will continue to be severe.
The food production network and fisheries around the world will experience a sharp drop in productivity, which will rise sharply in higher warming scenarios. The risk of heat and humidity to human health in a large swath along the equator will rise sharply, with some regions experiencing hundreds of days per year of severe temperatures in high-warming scenarios.
Many of these impacts, including sea level rise, are now inevitable. But the IPCC notes that if the world does not act, “the likelihood and consequences of abrupt and/or irreversible changes in the climate system, including changes caused by reaching tipping points, will increase.”
4. The warmer the world, the more animal species are at serious risk.
Without adaptation, climate change will cause serious and irreversible damage to the world. The risk of species loss is high at 1.5 degrees Celsius warming, but at higher levels of warming, entire sectors of the planet will face potentially dangerous temperature conditions for vast swaths of biodiversity.
Climatologist Katherine Hayhow notesthese risks will be keenly felt by ocean species that are already suffering (such as the Great Barrier Reef) and animals that live in already warm tropical zones.
5. There is a window for action, but it is small and getting smaller.
The extent to which future generations will experience a warmer world depends on decisions made now or in the very near future, the IPCC report warns.
Limiting warming to 1.5°C or 2°C requires “rapid, deep and in most cases immediate reductions in greenhouse gas emissions.” So far, the world has not aspired to anything close to this, and current policies will result in global warming levels much higher than scientists hope.
This will require the world to rapidly wind down and wind down oil and gas projects and invest trillions annually in clean energy and climate change mitigation measures, three to six times more than the planet’s governments and businesses are already spending.
“The 1.5°C limit is achievable,” UN Secretary-General António Guterres said on Monday. “But it will make a quantum leap in the fight against climate change.”
In December 2021, Surgeon General Vivek Murthy issued a rare warning that mental health issues were causing “devastating consequences” among young people. His announcement came after suicide rates among young Americans aged 10 to 19 jumped 40 percent from 2001 to 2019, and emergency room visits for self-harm rose 88 percent.
Lately, Dr. Murthy has used his position to draw attention to the issue, as has the doctor. C. Everett Koop, who was Surgeon General in the 1980s, famously spoke about the dangers of smoking. Dr. Murthy was on an audition tour of sorts, talking to students, medical professionals and community groups across the country.
He recently spoke to The New York Times about the growing tension in his attention to this issue. This conversation has been edited for clarity and brevity.
You have described mental health as “the defining public health crisis of our time.” Why?
I think of mental health as the fuel that allows us to speak to our communities, our friends, our family and our lives. And when that fuel tank runs out, it jeopardizes our ability to be who we can be in our best moments and show up at work or school.
Other generations have faced mental health issues. Has something changed today?
There is something worse. It’s not just about better detection; yes, there is a greater willingness to talk about their mental health, and this has contributed to the increase in messages. But the number of hospitalizations has increased, the number of suicides has increased, these are real things. Something is driving more pain and despair.
Tips for parents to help their struggling teens
Maps 1 of 6
Are you worried about your teenager? If you’re worried that your teen may have depression or suicidal thoughts, there are a few things you can do to help them. Dr. Christine Moutier, Chief Medical Officer of the American Foundation for Suicide Prevention, suggests the following steps:
Look for change. Pay attention to changes in your teen’s sleep and eating habits, as well as any problems he or she may have in school, such as poor grades. Watch for angry outbursts, mood swings, and loss of interest in activities they used to enjoy. Also follow their posts on social networks.
Keep lines of communication open. If you notice something out of the ordinary, start a conversation. But your child may not want to talk. In this case, offer to help him or her find a trusted person to share your concerns with.
Look for professional support. A child expressing suicidal thoughts may benefit from mental health evaluation and treatment. You can start by talking to your child’s pediatrician or mental health professional.
In an emergency: If you have an immediate concern for your child’s safety, don’t leave him or her alone. Call the emergency suicide prevention service. Lock up any potentially dangerous items. Children actively attempting to harm themselves should be taken to the nearest emergency room.
You cited a number of reasons, including the stigma that keeps young people from seeking help and the lack of resources for treatment. What other reasons do you see?
There are factors that cause mental health crises that we must address if we are truly to get to the root of the problem. These include a growing crisis of loneliness and isolation; the fact that bullying occurs not only offline, but also online; the fact that our children are surrounded by an information environment that comes to them 24/7 and often causes fear and anxiety.
This is also due to the fact that young people, when they think about the future, see the serious threats that we face today, such as violence, racism and climate change, but they do not see effective solutions.
By information environment, do you mean social networks?
Young people, especially in early adolescence, are in a sensitive phase of development. Their brain develops, their relationships with others develop, their personality and self-esteem develop as well. And right now, when I talk to young people on the road, they keep telling me three things about social media: they say it makes them feel worse; it makes them feel worse about their friendship; and can’t get away.
This is not surprising, in part because these platforms were designed to maximize the amount of time people spend on them, not necessarily to maximize how well you have that time or how much support you have in developing healthy relationships. Not only do teens spend many hours on social media every day, but they also take that time away from sleep, exercise, face-to-face interactions, schoolwork, and other activities that can bring them joy.
There is also the experience that many people have on social media, being exposed to malicious content and being immersed in a culture where they constantly compare themselves to other people’s profiles and posts, which often makes them feel worse. This is despite the fact that what you see on social media isn’t always an accurate reflection of what’s going on.
These platforms also allow young people to connect and explore different ideas. How do you assess the tension between information overload and freedom of exploration and expression?
The life of people today is much more difficult than 20 years ago, and even more so 100 years ago. I don’t think we should go back 100 years. But the more choices you have, the more important the core values that guide you in your definition of success become. At such moments, we must ask ourselves: what values guide us as a society?
What is the relationship between values and mental health?
Values are the filter we use to help us make decisions when we are faced with a choice. But our values also determine what we strive for in life.
Young people tell me they feel involved in a hustle culture. They told me that they felt they were being asked to pursue certain goals—get a job with a beautiful position, make a lot of money, become famous, gain power. And many of them not only said they were tired, but they were not sure that this would bring them happiness. This is where we need to pause and ask ourselves: Are we pushing our children towards something that will actually lead them to happiness and fulfillment?
The formal end of the pandemic on May 11 marks neither victory nor peace: it is the cessation of hostilities with a dangerous virus that is still with us.
To uphold such an uneasy truth, Americans will have to stay protected enough to prevent a viral enemy of humanity from staging a breach on our shaky deal.
Providing such a guarantee, in turn, assumes that all scientists and public health officials agree on what it means to be “sufficiently protected” and that they can tell if people meet this indicator.
On both counts, the country’s readiness to monitor this truce is insufficient.
The problem is that no one has a clear idea of the extent of American immunity to the virus that causes COVID-19. And behind that lies a more fundamental problem: scientists and public health officials are still undecided on what it means to be immune, or have not accepted a common yardstick to measure it.
Path from the pandemic
This is the fifth part of a series of stories about emerging from the COVID-19 pandemic and how life in the United States will change after it.
“We always have to make decisions without this data,” Dr. Haley Goosea Stanford doctor of infectious diseases who advises the Food and Drug Administration on vaccine policy, said in a recent public meeting called by the agency.
There are encouraging trends. The number of hospitalizations for COVID-19 has fallen sharply, and weekly deaths from COVID-19 have fallen by 90% from the most recent peak just over a year ago.
But it’s just a “snapshot in time,” said Dr. Cody MeisnerPediatric Infectious Diseases Physician at Dartmouth University, who is on the FDA Vaccine Advisory Panel.The ability of the pandemic virus to deliver surprises has scientists wishing they understood COVID-19 immunity well enough to anticipate its next move.
Scientists have one indicator of immunity, confirmed by decades of research – the count of antibodies. This is easy and inexpensive to do with available laboratory tests.
Counting the immune proteins produced after a vaccination or infection is one way to assess how quickly a person can block or cure an infection. The more antibodies, the more reliable their protection.
To get an idea of a country’s immunity as a whole, scientists are measuring coronavirus antibodies in large groups of people, such as patients who have been bled for routine laboratory tests or volunteers who donate blood to blood banks. Thesis seroprevalence studies showed that by June 2022, 94% of American adults — and about the same children – have been vaccinated, infected, or both.
For a while, officials hoped that high antibody levels would drive the virus out of circulation entirely. It has been argued that once enough Americans are vaccinated, the antibodies will block so many infections that the coronavirus will simply die out for lack of new victims to infect.
But as the pandemic progressed, hopes of achieving this state of “herd immunity” collapsed.
All virus-specific antibodies “break down” over time, leaving behind a template that can be produced when needed. But this renewal process takes time, and the Delta and Omicron variants have proven to be able to establish infections before the body’s defenses are ready.
Over time, it became clear that antibodies alone did not tell the whole story of American immunity. People who have been vaccinated or previously infected have contracted COVID-19. But they didn’t get very sick and didn’t die at nearly the same rate as people who weren’t immune. There was clearly some other process at work here.
This invisible mechanism was what scientists call cellular immunity, and T cells are its foot soldiers.
Dr. Dan H Barusha Harvard immunologist, calls T-cells the “unsung heroes” of the immune system. They do the actual job of hunting down and destroying cells that have been invaded and taken over by the coronavirus.
Cellular immunity is believed to prevent the most devastating effects of COVID-19. Even in those whose weakened immune systems have caused an anemic antibody response to vaccination, cellular immunity may kick hard and protect from death.
There is also encouraging evidence that this cellular immunity is long lasting. Scientists have confirmed a strong T-cell response one year after infection with SARS-CoV-2 and at least six months after vaccination. Moreover, patients infected with the SARS-CoV coronavirus, a close relative of the pandemic virus that caused death in 2003. Acute respiratory disease – have signs of T-cell immunity 17 years later.
All this was done by a vaccine expert at the University of Pennsylvania. Dr. Paul Offit question the value of booster shots as a means of keeping Americans protected from COVID-19.
Evidence has accumulated that most Americans’ immunity now depends more on T cells than on maintaining antibody levels, Ofit said. As a result, the US government’s strategy for repeated vaccine boosters probably isn’t needed for everyone except those with weakened immune systems, he added.
Offit acknowledged that each shot raised antibody levels. But it’s not clear if these extra antibodies reduce the chance of getting seriously ill or dying, which by now should be the definition of “protected,” he said.
Meisner goes further.
“This virus is like the wind – it cannot be stopped,” he said. “It will continue to mutate and become more contagious. But as long as we can protect against severe illness at this stage of the pandemic, I can live with it.”
At a recent meeting convened by the FDA to review future vaccination strategies, Ofit, Meisner and others urged the agency to be clear about what vaccines are for and how it will evaluate them.
“We need to define what we want from this vaccine,” Offit said at the meeting. If it’s a defense against serious illness and death, “T-cells are important.”
Unfortunately, the state of human cellular immunity is more difficult to capture and quantify. There are tests that measure these immune cells, but they are not cheap or easy to perform.
The inhabitants of the cellular immune system are very diverse, whose functions change with time and circumstances. Key details of how this complex system responds to the coronavirus are still eluding scientists, Meisner said.
“We don’t know which of these T cells are integral to protecting against a respiratory virus,” he said. “So it’s not easy to look at T cells and ask if we have enough to protect us.”
There are tests that fix cellular immunity, but their implementation is very expensive. Most of them require a large volume of human blood, special chemicals and complex manipulations to produce results. Many require highly skilled lab technicians or extensive computing resources to produce useful data.
As a result, they are used sparingly in the treatment of patients. And they have never been used to test general populations.
If a lab test could measure cellular immunity as easily as antibodies, “it would spread like wildfire because everyone is looking for it,” Meisner said.
Such a test could not only assess whether a person needed a second shot; widely used, it could encourage a return to public health measures such as social distancing and mask-wearing. If T-cell protection falls in populations, it could even alert vaccine manufacturers that they need to re-formulate vaccines to better match the circulating strain.
One such test could be the start.
In August, the European Medicines Agency blessed commercial analysis this offers scientists and public health officials an easy way to measure T-cell immunity.
The advertised use of the test is to give immunocompromised patients an indication of whether they are at high risk of becoming seriously ill or dying if they contract the coronavirus. But public health officials in Spain have used it to assess the immunity of Madrid residents after most received the vaccine and multiple waves of COVID-19 swept through the city.
For 40 consecutive days, the phlebotomists collected 100 blood samples per day. Samples were processed each night by a single lab technician operating a PCR machine, a standard fixture in virtually any commercial testing lab. The results provide a yes/no answer to the question of whether there is a cellular immune response to SARS. -Virus CoV-2.
“Even my 12-year-old son can pass the test,” he said. Jordi Ochando, an immunologist at the Icahn School of Medicine at Mount Sinai in New York City, who oversaw the Madrid study. He added that results can be accessed within a day of blood collection and instantly uploaded for analysis, sharing and storage.
Ochando quickly got the answer: on average, 10 months after vaccination, 90.2% of the population tested still showed a cellular immune response to the pandemic virus.
The test was developed by a British biotechnology company. Harris, far from exhaustive. It does not count T cells or examine their strength or diversity, as some lab tests do. And instead of detecting the response of the cellular immune system, it looks for the genetic signal that brings out such activation.
But it is simple and cheap to use. In Europe, the cost per person is “on par with a standard PCR test” for COVID-19, Hyris founder and CEO said. Stefano Lo Priore.
“His A method – the only scalable method we have right now – to quantify cellular immunity,” said Ernesto GuccioneMount Sinai immunology researcher who helped develop the test and has a patent pending.
According to Lo Priore, such a test could make it possible to measure cellular immunity in residents of a boarding school, nursing home or city. The results could help officials decide whether to lift or reinstate public health measures, such as mandatory indoor masks, or determine when more shots should be given.
Over time, this test could be used along with other tests to learn more about how T cells protect and for how long, Guccione said. It must pass FDA review before it can be sold in the United States, a process the company is currently preparing for.
Guccione and Ochando set their sights on measuring T-cell immunity in New York City, which has repeatedly been the epicenter of the pandemic in the United States.