The CDC’s interviews with 350 people tested for COVID-19 at academic medical centers across the US is among the first in the country to examine exposures outside of group-living settings like prisons.
It reveals damning risk factors. Only 17 percent of people who tested positive and were able to work remotely amid the pandemic – the rest of those infected had to continue going to their places of work.
And, echoing the findings of previous studies, that those who got sick enough to be hospitalized were more likely to have lower incomes and to be Hispanic or black.
Public health officials have underlined the importance of not only testing, but contact tracing, to combatting the spread of coronavirus and lawmakers, eager to reopen their states, want to. know where people are getting sick. But a CDC study found that less than half of 350 covid-positive Americans knew they’d come into contact with someone with coronavirus (file)
So far, more than 2,683,000 Americans have caught coronavirus.
Test availability has improved dramatically in the US, with between 400,000 and 600,000 tests being run a day in June, compared to about 200,000 to 400,000 tests a day in May, according to tracking by 1point3acres.com.
But in the rush to test as many people as possible for coronavirus as quickly as possible, the second portion of the public health initiative to control the virus’s spread – contact tracing – may have fallen to the wayside.
States have struggled to hire contact tracers, who will be key to identifying groups that may be on the cusp of burgeoning outbreaks.
In the CDC’s report, contact tracing was done for all 350 positive patients.
Only 46 percent of those patients were aware of coming into contact with a COVID-19 patient.
Of those who knew they’d interacted with an infected person, 45 percent said their covid-positive contact was a family member.
More than a third of the patients reported having a co-worker sick with coronavirus.
Only 10 percent reported seeing a covid-positive friend, and 19 percent had contacts in other categories, consisting mostly of healthcare or long-term care facilities and a few who reported contact with neighbors, clients or inmates.
Perhaps surprisingly, coronavirus infection was not much more common among those who went to the grocery store once or more times a week compared to among those who shopped for food once or more a week.
About a third of the people who tested positive said they never went to the grocery store, 28 percent went out for groceries 34 percent, and 27 percent of them said. they went to the grocery store two to three times a week.
Only about two percent of those who tested positive went to the store on a daily basis.
The majority of people diagnosed with coronavirus and surveyed by phone (59 percent) had to go to work outside their homes every day during the two weeks prior to their positive tests.
Nineteen percent of people who were infected went to work two to three times a week, three percent went to their workplaces just once a week and 19 percent were employed but never had to work outside their homes.
Only 17 percent of people who tested positive were able to telework, and a quarter of people infected worked in healthcare settings.
‘A majority of COVID-19 patients reported working during the 2 weeks preceding illness, and few had the ability to telework, underscoring the need for enhanced measures to ensure workplace safety,’ the CDC authors wrote.
A disproportionate number of these people were black or Hispanic, and recent research suggests that the more frequently someone is exposed to coronavirus – vis a vis leaving their homes – the more likely they are to contract coronavirus and become more severely ill.
Across the country, Americans are returning to work. The CDC published a list of recommendations for businesses to limit the risk of viral spread in their stores, restaurants or offices, but these ‘considerations’ are unenforceable and it’s not clear if employers are acting on them.
During a Tuesday Senate hearing where infectious disease specialist Dr Anthony Fauci and CDC Dr Robert Redfield, Utah Senator Mitt Romney pressed the public health officials for ‘data on where people get infected,’ pleading that they tell Americans whether they can safely see one another outdoors.
The new report, published the same day, makes an effort to answer answer that question, but its findings also point to just how difficult it is pinpoint the exact time, place and person that led to a transmission.
‘Fewer than one half of patients were aware of recent close contact with someone with COVID-19, highlighting a need for increased screening, case investigation, contact tracing, and isolation of infected persons during periods of community transmission,’ the CDC authors wrote.
‘This finding suggests that ensuring social distancing and more widespread use of cloth face coverings are warranted.’
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Man, 18, reveals how loss of aunt from COVID-19 inspired him to train as 111 call-handler
Tonight’s episode of the Channel 4 show follows university student Ollie, from the West Midlands, as he tries to squeeze five weeks of 111 call handler training into just a fortnight.
Explaining the personal reason why he wants to volunteer, an emotional Ollie explains: ‘Throughout my fundamental growing years I’ve always wanted to be caring and give something back.’
‘I think what happened to auntie Kate made me realise that actually, how can you be more helpful to families who are going through this?’
Ollie, 18, from the West Midlands, reveals how the loss of his aunt from coronavirus inspired him to train as a 111-call assessor to help the NHS at this time of crisis in tonight’s episode of Channel 4’s Paramedics: Britain’s Lifesavers
The university student says that what happened to his auntie Kate (pictured), aged 56, made him want to help others
Ollie was meant to be doing his A-levels this summer, but they were cancelled due to the Covid-19 outbreak,
‘My auntie Kate had a cold a week or so before we went into lockdown and it all got pretty serious,’ he says.
‘She isolated at home and as the lockdown progressed she just got worse and worse. We used the 911 service to try and find out some advice and a decision was taken she needed to go into hospital. At this point, we still didn’t know she had coronavirus.
‘We thought it was just a bad chest infection that she was quite prone to. She sort of deteriorated along that week and then she slowly passed away in early April.’
Second year student Sam (pictured, with mum Kate and Paul), 21, hits the road ready to treat patients suffering from breathing difficulties, isolation related mental health issues and patients in care homes
Sam (pictured) admits that he doesn’t feel 100% safe working on the frontline – despite having full PPE
‘I think it’s really hit hard my mum because she just wanted to be able to give her sister a kiss good bye but of course, you’re not allowed to.’
Ollie goes on to explain that the family had the funeral this week and that it was ‘horrible’ because only ten people were allowed in.
‘There’s 13-14 of us in our immediate family, and only 10 of us were allowed in the crematorium and it was juts ten chairs stressed out and it was more than 2m apart,’ he says. ‘It’s just horrible to see your family broken up – half there and half outside.’
The programme features exclusive access to West Midlands Ambulance Service at the peak of the Covid-19 pandemic in April.
To deploy more ambulances onto the frontline, managers took the unprecedented step of asking university student paramedics to step forward and work on an ambulance with only a single qualified paramedic by their side.
Speaking of safety on the frontline, Sam says: ‘You can’t be too safe. You can’t be sure. It’s dangerous. It’s scary’
Sam (pictured) is one of the university student paramedics who stepped up in a bid to deploy more ambulances onto the frontline
Second year student Sam, 21, hits the road ready to treat patients suffering from breathing difficulties, isolation related mental health issues and patients in care homes.
During the episode, Sam can be seen on a call out alongside experienced paramedic Rich – and talks about his feelings of being on the frontline.
‘You can be rushing to put your masks and gloves on but you need to be sure your gloves are on properly and that the mask is fully covering your nose and mouth,’ he said.
‘Not making sure your PPE is right is what causes people to contract the virus and it’s those little mistakes that you end up taking home to your family and stuff and that’s a mistake we can’t really risk.’
And when asked by the cameraman whether he feels safe when he’s out there, Sam admits: ‘I’d say it/’s 50/50. I can’t say for sure, “Yes I feel safe.” The risk is always going to be there. You can’t be too safe. You can’t be sure. It’s dangerous. It’s scary.’
Paramedics: Britain’s Lifesavers, 9pm on Channel 4
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Coronavirus can damage the heart, study confirms
Coronavirus patients can suffer irreversible heart damage as a result of their battle with the disease, a study of hospital patients has found.
More than half of infected patients who had heart scans while in hospital with Covid-19 showed abnormal changes to their organ.
One in eight had signs of ‘severe dysfunction’ in their heart and doctors couldn’t find any other explanation except the coronavirus.
In the UK around one in four people admitted to hospital with Covid-19 die of it but even survivors may be left with long-term illness, this research suggests.
The study, done by the British Heart Foundation, adds to concerns that coronavirus can cause widespread damage to the vital organs and leaves some ‘long-haulers’ with health problems that will last for months and even years after the infection.
Long-term effects can include coughing, shortness of breath and reduced lung capcity, and there is also evidence the virus can affect the brain and kidneys. A lung doctor who helped treat Boris Johnson said the virus is ‘this generation’s polio’.
One British Heart Foundation researcher referred to Covid-19 as a ‘multi-system disease’ that can spread all round the body.
Scientists studied echocardiogram scans from hospital patients around the world and found abnormalities that could only have been caused by Covid-19, they said (stock image of heart scan)
Professor Mark Dweck, who is also a cardiologist at the University of Edinburgh, said: ‘Covid-19 is a complex, multisystem disease which can have profound effects on many parts of the body, including the heart.
‘Many doctors have been hesitant to order echocardiograms for patients with Covid-19 because it’s an added procedure which involves close contact with patients.
‘Our work shows that these scans are important – they improved the treatment for a third of patients who received them.’
The study looked at 1,216 patients in hospitals in 69 countries around the world who had been given heart scans.
Fifty-five per cent of them showed signs of damaging changes to their hearts which were affecting how well they pumped blood – and most of them had had healthy hearts before.
A further 13 per cent of the patients showed severe dysfunction in their heart, which likely raised their risk of death or of having permanent illness.
UK LAUNCHES STUDY OF COVID-19’S LONG-TERM EFFECTS
Scientists in the UK will investigate the long-term effects of Covid-19 in a scientific study which launches this month.
The Department of Health has announced that up to 10,000 people will be involved in a study to look at how people who catch the coronavirus fare long-term.
Growing evidence suggests that even people who only get mildly sick may suffer long-lasting health effects including lung damage.
The UK’s Scientific Advisory Group for Emergencies (SAGE) has warned that Covid-19 patients could be left with ‘extreme tiredness and shortness of breath for several months’.
The study, led by researchers and doctors in Leicester, will look at how people’s mental health is affected by illness and whether factors like sex or ethnicity affect how well someone recovers from Covid-19.
Patients in the study, which will receive £8.4million in funding, will have medical scans, blood tests and lung samples so experts can look at how they are affected.
It comes as the NHS has announced it’s launched a long-term recovery service called ‘Your Covid Recovery’, which will offer online advice to the public and more specialised physio and mental health support to some patients from this summer.
Chief Medical Officer, Professor Chris Whitty, said: ‘As well as the immediate health impacts of the virus it is also important to look at the longer-term impacts on health, which may be significant.
‘We have rightly focused on mortality, and what the UK can do straight away to protect lives, but we should also look at how Covid-19 impacts on the health of people after they have recovered from the immediate disease.’
Doctors and researchers in other studies have found that the virus can cause blood clots to form in the lungs and other vital organs.
Clots can be severely damaging and even fatal if they travel to their heart, brain and lungs.
Coronavirus is thought to damage the heart and circulation system by triggering harmful internal swelling, called inflammation, which puts extra strain on the body.
The study was only done on patients who had their hearts scanned, meaning it is not clear how coronavirus affects the hearts of people who aren’t critically ill.
Heart scans are only generally given to people who doctors already suspect have a heart problem, so the proportion of those with serious issues is particularly high in this group.
Professor Dweck added: ‘Damage to the heart is known to occur in severe flu, but we were surprised to see so many patients with damage to their heart with Covid-19 and so many patients with severe dysfunction.
‘We now need to understand the exact mechanism of this damage, whether it is reversible and what the long-term consequences of Covid-19 infection are on the heart.’
Professor Dweck and his colleagues said more coronavirus patients should have their hearts scanned so doctors can pick up on problems and treat them.
Because the scans – called echocardiograms – involve physical contact with a patient they are generally not done unless doctors suspect something is wrong.
But of the patients in the study, one in three had their treatment changed because of what medics picked up on the scans.
They were given heart failure drugs, for example, or had their fluid intake controlled more strictly. These changes in treatment may have saved lives, the scientists said.
People with heart disease are at a higher risk of dying if they catch the coronavirus than other people, data has shown – and research like this may shine a light on why.
If people’s hearts are already damaged, they may have less capacity to cope with and recover from further damage that the coronavirus can cause.
Dr Sonya Babu-Narayan, associate medical director at the BHF, added: ‘Severe Covid-19 illness can result in damage to the heart and circulatory system.
‘We urgently need to understand more about why this is happening so we can provide appropriate care – both short and long term.
‘This global study – carried out at the height of the pandemic – shows that we must be on the lookout for heart complications in people with Covid-19 so that we can adapt their treatment, if needed.’
The long-term effects of the virus are increasingly coming to light now that the virus has been around for months and millions of people have recovered.
The UK’s Department of Health has now launched a study into how people get affected in the long run amid concerns they might suffer from breathing problems and mental health issues.
In March, one doctor who helped treat Prime Minister Boris Johnson when he was intensive care with the virus, likened the illness to polio.
Professor Nicholas Hart, a lung doctor at St Thomas’ Hospital, said on Twitter: ‘Covid-19 is this generation’s polio. Patients have mild, moderate and severe illness.
‘Large numbers of patients will have physical, cognitive and psychological disability post critical illness that will require long-term management.
‘We must plan ahead.’
The BHF study was published in the European Heart Journal – Cardiovascular Imaging.
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DR ELLIE CANNON: Just what is a healthy level of cholesterol these days?
I read in The Mail on Sunday that having very high HDL cholesterol is a worry, especially for middle-aged women like me.
My total cholesterol is 5.3 – and I have an HDL of 2.3. The ratio calculator online tells me this is healthy, but now I read that 2.3 is very high.
Also, could my high HDL be the reason for having a lipoma, and should I have it removed?
Our understanding about cholesterol has evolved over the past 20 years. Once, we were just concerned with total cholesterol, but now we are focused much more on sub-types of cholesterol, and how they contribute to increased risk of a heart attack.
Risk is a nuanced thing and many factors are at play – blood pressure, whether you’re overweight or smoke, your age and family history, as well as other illnesses you may suffer from, all contribute. Cholesterol isn’t the be-all-and-end-all but if you do have high overall cholesterol, and also raised levels of a sub-type called LDL cholesterol, sometimes called ‘bad’ cholesterol, you might be advised to take statins, which will lower it. HDL cholesterol was once thought to protect the heart, which is why it’s often called ‘good cholesterol’. And although it still does, it seems very high levels, above 1.4, are associated with a raised heart-attack risk.
Our understanding about cholesterol has evolved over the past 20 years. Once, we were just concerned with total cholesterol, but now we are focused much more on sub-types of cholesterol, and how they contribute to increased risk of a heart attack
This is based on new research and it’s not fully understood, but it is worth talking to your GP, showing them the article you mention. They might want to recalculate your risk, based on the new evidence.
Medication can’t lower HDL but there may be other steps worth taking, such as statins to lower LDL, tackling blood pressure, and lifestyle changes.
A lipoma is a benign, soft lump on the skin composed of fat – and this is unrelated to cholesterol. They are usually harmless, so doctors do not advise removing them unless they are unsightly or causing pain.
Life has left me utterly miserable. My GP suggested antidepressants but I don’t want to take them. Can you help?
It is not surprising that any of us would be feeling miserable right now. Not only has day-to-day life changed immeasurably, but the immense trauma, loss and uncertainty we have experienced nationally and individually since the start of the pandemic has, understandably, left huge emotional toll.
More from Dr Ellie Cannon for The Mail on Sunday…
Doctors are increasingly concerned about rising numbers of patients with symptoms of anxiety and depression – and those who actually make it as far as calling a doctor are probably just the tip of the iceberg.
It is vital that anyone feeling persistently low gets a proper assessment, so a diagnosis can be made. Depression is different to sadness or misery, and involves symptoms of mood or sadness but also changes in appetite, sleep, and thoughts. These things have an impact on daily life, work and relationships.
A GP can carry out initial consultation via video calls or phone.
Or you can cut out the middle man and refer yourself directly to a specialist in your area who offers psychological therapies.
If you search online for ‘IAPT services’ – IAPT stands for improving access to psychological therapies – the top hit should be the nhs.uk web page that allows you to refer.
Mental health treatment can involve medicine, but also psychotherapy and lifestyle changes. If medicine is not a choice for you, look at the two other options.
Free, NHS online therapy sessions for many areas of the country are available via iesohealth.com.
Doctors are increasingly concerned about rising numbers of patients with symptoms of anxiety and depression
There are some incredibly helpful mental health apps that I routinely recommend to patients. These are available to look at on the NHS apps library and are targeted to specific issues – for example Big White Wall for stress and anxiety, or Silvercloud which is an eight-week course for depression. Lifestyle measures sound simple but shouldn’t be underestimated. Walking daily, pushing yourself to exercise or finding a hobby, yoga or just conversations with a friend can have a tremendous impact on mood and feelings, even when the mental health problem is quite significant.
I am 76, and relatively fit, and until February was going to the gym up to three times a week. But then my hip starting hurting. A lot. An X-ray showed nothing wrong. What could it be?
Anyone aged over 76 will have some arthritis in the hips and knees, which may or may not show up on an X-ray. Other common hip pain comes from bursitis which is swelling from the fluid around the hip – known as trochanteric bursitis.
Your GP can arrange access to physiotherapy which is helpful for bursitis and can be sought at the moment remotely. Bursitis of the hip can be part of greater trochanteric pain syndrome, when the top of the thigh bone becomes irritated.
Avoid sitting cross-legged and do not sleep on the affected side, and it might improve matters.
I told Boris Johnson to be a mask model… now he is
I was on the news again last week talking about my favourite subject, masks – and the fact that leading politicians, despite telling us we should wear them, seem not to want to practise what they preach.
Boris Johnson, Matt Hancock and Rishi Sunak had all been seen over the past fortnight out and about meeting the public, sometimes in close contact, not once wearing a mask. It wasn’t a good look, I argued. They need to be role models, as mask-wearing is a huge culture change for us Britons. Well, it seemed Boris was listening as on Friday he appeared, right, for the first time wearing a face covering. I hope the Cabinet follow his lead.
In other news, people have been asking where I get my cloth face coverings. They’re from the charity Binti, at bintiperiod.org. I might buy one for Boris.
Boris Johnson, Matt Hancock and Rishi Sunak had all been seen over the past fortnight out and about meeting the public, sometimes in close contact, not once wearing a mask. It wasn’t a good look, I argued, but now the PM has a been spotted with a mask
Has that mole changed? Get it checked now
I’ve been asked whether skin clinics are closed, by people worried about changes to a mole and have stressed that they should make a GP appointment without delay.
We are working differently, but are very much open, as are dermatology units. Most GP appointments will start on the phone and then, for a skin problem, we will either want to see photos or use a video consultation. If your GP is concerned, you can be referred. Many dermatology clinics are open for face- to-face appointments but it may be possible to have a more than adequate consultation remotely.
Signs of melanoma skin cancer include changes in shape, size or texture of a mole. One that looks very different to others around it can be a concern.
You are also more at risk over the age of 65, if you have fair skin and freckles, or if you have a member of your family with melanoma.
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