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Lyme disease diagnoses have increased dramatically in the U.S. during the past 15 years, rising 357% in rural areas and 65% in urban areas, according to new data released by FAIR Health. The trends show that tick-borne illnesses are becoming a more common concern nationally, not just in the areas where Lyme disease has been found historically. “Lyme disease remains a growing public health concern,” Robin Gelburd, president of FAIR Health, said in a statement. FAIR Health is a national, independent nonprofit group that highlights health care information by looking at data from its collection of more than 36 billion private insurance claims records. “FAIR Health will continue to use its repository of claims data to provide actionable and relevant insights to healthcare stakeholders seeking to better understand the ongoing rise of Lyme disease cases,” Gelburd said. The 15-year analysis included private insurance claims from 2007 to 2021, which showed a 357% increase in Lyme disease diagnoses in rural areas and a 65% increase in urban areas. In the past 5 years, from 2016 to 2021, diagnoses rose 60% in rural areas and 19% in urban areas. The cases peaked in the summer months, when people spend more time outside in grassy areas, wooded areas, parks, and fields where ticks live. In June and July, Lyme disease diagnoses were more common in rural areas, but from November to April, diagnoses occurred more often in urban areas. Historically, Lyme disease cases have been a major problem in the Northeast and Upper Midwest, but the range has been growing in recent years. In 2017, the highest rates were in New Jersey, Connecticut, North Carolina, Rhode Island, and Vermont. North Carolina, which had the third-highest rate of diagnoses, was a surprise to researchers. But in 2021, North Carolina didn’t break the top five. New Jersey continued to have the highest proportion of Lyme disease diagnoses, followed by Vermont, Maine, Rhode Island, and Connecticut. With Maine coming in third on the list, researchers expressed concern about “a growing presence of the tick-borne illness in the state.” The data showed that Lyme disease can still affect patients long after treatment for the infection, also known as chronic Lyme disease. Although antibiotics can treat the illness, some patients develop long-term symptoms such as fatigue, mental dysfunction, and muscle and joint pain. The FAIR Health analysis found that diagnoses such as malaise, fatigue, and soft tissue-related issues were more common among Lyme disease patients. Most cases of Lyme disease are mild, and some people may not know they’re sick. But in more serious and untreated cases, the disease can spread to the heart, joints, nervous system, and major organs, which can lead to neurological problems that come up weeks or months after an infection. Severe complications can include meningitis, or inflammation of the brain, as well as temporary face paralysis and weakness in the limbs.
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Led by surges in the two hotspots and Eastern Europe, the average number of new daily cases has exceeded 800,000 for more than a week. Worldwide, the number of new coronavirus cases has shot upward since the beginning of March, more than doubling in two months. For the past two weeks, new global cases have exceeded their previous high point in early January. The average daily rate of new cases has now been above 800,000 for more than a week. The increase in cases is largely being driven by the uncontrolled outbreak in India, where new cases have risen sharply for the past month and show no signs of abating. A seven-day rolling average of new daily cases in the nation exceeded 357,000 on Thursday, a more than fivefold increase since April 1. India now accounts for more than 40 percent of the world’s new cases. The country’s death rate has followed the same dramatic curve, with more than 3,000 people now dying every day. Analysts say even those grim numbers may be undercounted. The second wave of the virus in India has been devastating. In hospitals in New Delhi, the capital, a shortage of medical oxygen has reached crisis levels, and cremation grounds are working around the clock as relatives and friends continue to bring more bodies to be burned. After enacting one of the world’s strictest lockdowns last March, which kept deaths relatively low, Indian officials relaxed restrictions. Some politicians even held crowded rallies in recent weeks as the country’s infection rate picked up. The surge has left hospitals overwhelmed. “People are angry because they are not getting ventilators and oxygen,” said Dr. Rakesh Kumar, a physician in the northern Indian state of Uttar Pradesh. “They are saying, ‘We are paying for the facilities; then why are our patients dying?’” Medical professionals in India face crushing conditions. “No hospital has shut down and no doctor has retreated from the front lines,” one doctor wrote in a Facebook post. “We are fighting missiles with sticks but we are not leaving the fort.” The vaccine rollout in India has been too slow to stem the wave of cases, despite the country’s status as one of the world’s leading vaccine producers. Less than 2 percent of its residents are fully vaccinated, and less than 10 percent have received at least one dose. Other countries and regions are also seeing worrisome trends. Uruguay, currently experiencing the world’s highest cases per capita, is adding almost 3,000 cases per day — a staggering number in a country of just 3.5 million people. Indeed, much of South America is faring poorly: In addition to Uruguay, Paraguay, Brazil, Peru, Argentina and Colombia all rank among the top 20 nations in the world for Covid deaths per capita as of Thursday. Several factors have combined to fuel the outbreak in South America. In Brazil, the continent’s largest country, President Jair Bolsonaro’s dismissive attitude toward the threat posed by the virus has led to a monthslong crisis that has spilled over into neighboring nations. And early research has indicated that the P.1 variant, first identified in the Brazilian city of Manaus late last year, might be more transmissible and more deadly than earlier forms of the virus. Colombia’s second largest city, Medellín, is also among the places seeing severe outbreaks. Officials there largely managed to control the virus last year. But a second and third wave, in January and April, have devastated the city. Though officials added a thousand new intensive care units in the region in 2020, that preparation has not been enough. On a recent day, Dr. Andrés Aguirre, who leads Hospital Pablo Tobón Uribe, said that about 300 patients in Medellín and the surrounding area were waiting for space in an intensive care unit. And with vaccination moving slowly across the region, he said, he expected the situation to worsen: “The fourth peak and fifth peak will come.” Central and Eastern Europe account for half of the 20 nations with the highest Covid deaths per capita. Further east, a surge of cases in Turkey has led to a new lockdown that began on Thursday evening and is set to last three weeks. And in parts of western Europe, elevated case rates have reached a plateau or only very slowly begun to decline. New cases remain especially high in France, the Netherlands and Sweden. The region has been battered by a wave of new cases this spring amid the rise of the B.1.1.7 variant. In a news conference on Thursday, Dr. Tedros Ghebreyesus, the director general of the World Health Organization, expressed appreciation for the outpouring of international support India has received during its crisis, which has included cash and medical supplies from all over the world. “At the same time, we must remember that many other countries all over the world are still experiencing intense transmission,” Dr. Tedros said. After briefly discussing the state of the virus in Brazil, which has begun to see a decline in deaths from its worst days earlier this month, Dr. Tedros added: “The pandemic has taught us that no country can ever let down its guard.”
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The United States hit a record high number of confirmed daily coronavirus cases Friday, recording more than 83,000 new cases, according to data compiled by Johns Hopkins University. The number surpasses the previous record of more than 77,000 cases in mid-July. The U.S. also recorded 943 deaths due to COVID-19 on Friday. More than 8 million people in the U.S. have been infected with the virus, and more than 223,000 people have died from the disease since the pandemic began, according to Johns Hopkins University. More than 42 million cases have been reported worldwide. One day earlier, 71,671 new coronavirus cases were reported in the U.S. on Thursday. Cases have been rising sharply in the U.S. since mid-September, with new outbreaks picking up in several states. Hospitalizations have also been on the rise. The COVID Tracking Project reports 41,485 coronavirus patients were hospitalized as of Friday. The number is more than half of the highs recorded during the coronavirus surges in the spring and summer. Unlike past surges, where a few states drove up case numbers, the current high is being propelled by many states. Texas currently has the most recorded cases, followed by Illinois, Wisconsin and Florida. Despite the rise in cases, there has been some good news. Two peer-reviewed studies recently showed a drop in mortality among patients hospitalized with COVID-19, suggesting health care workers have gotten better at helping patients survive the disease. One study found that the mortality rate among hospitalized patients dropped from 25.6 percent to 7.6 percent. The mortality rate remains high compared with other diseases, and some continue to suffer complications long after recovering.
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Researchers can't agree on topics such face mask, immunity and number of infections. Here's why. Although political leaders have closed borders in response to COVID-19, scientists are collaborating like never before. But the coronavirus (SARS-COV-2) is novel – and we don’t yet have all the facts about it. As a result, we may have to change our approach as new scientific data comes in. That doesn’t mean the science isn’t trustworthy – we will get the full picture over time. And there is already great research that can help inform political decisions. Here are three topics that scientists disagree on. Face masks The novel coronavirus spreads by droplets from coughs, sneezes and speaking. To halt the spread of the virus, face masks have become compulsory in many countries. But there has been much debate among scientists over the effectiveness of face masks on reducing the spread of COVID-19. A report from a multidisciplinary group convened by the Royal Society has come out in favour of the public wearing face masks. These documents, which have not been peer reviewed, argue that face coverings can contribute to reducing the transmission of COVID-19 if widely used in situations where physical distancing is not possible. One relatively small clinical study also showed that infected children who wore masks did not pass on the virus to family contacts. But the science is complex. Face masks won’t stop the wearer from inhaling small airborne particles of coronavirus, which can cause infection. A recent study reported that wearing a mask may also give a false sense of security, meaning wearers may ignore other important infection control measures. We also know that face masks can make us breathe more often and more deeply – potentiality spreading more contaminated air... Immunity Immunologists are working hard to determine what immunity to COVID-19 looks like. Much of the studies have focused on “neutralising antibodies”, produced by so-called B-cells, which bind to viral proteins and directly prevent infection. Studies have found that levels of neutralising antibodies remain high for a few weeks after infection, but then typically begin to wane. A peer-reviewed study from China showed that infected people had steep declines in levels of antibodies within two to three months of infection. This has created doubt over whether people get long-term protection against subsequent exposure to the virus. If this study turns out to be accurate – the result needs to be backed up by other studies – it could have implications for whether it is possible to produce vaccines with long-lasting immunity. While many scientists believe antibodies are the key to immunity, others argue that other immune cells called T-cells – produced when the body encounters the molecules that combat viruses, known as antigens – are involved too. These can become programmed to fight the same or similar viruses in the future. And studies suggest that T-cells are at work in many patients fighting COVID-19. People never infected may also harbour protective T-cells because they’ve been exposed to similar coronaviruses. A recent study from Karonliska Institute in Sweden, which has not yet been peer reviewed, found that many people who suffered mild or asymptomatic COVID-19 have T-cell-mediated immunity – even when antibodies can’t be detected. The authors believe this can prevent or limit reinfection, estimating that one-third of people with symptomless COVID-19 could have this kind of immunity. But it is not clear yet how it works and how long it lasts... Number of cases The reporting of coronavirus cases varies drastically around the world. Some regions are reporting that less than 1% of people have been infected, and others that over half the population has had COVID-19. One study, which has been peer reviewed, estimated that only 35% of symptomatic cases have been reported in the US, and that the figure is even lower for some other countries. When it comes to estimating true prevalence, scientists use just one of two main approaches. They either test a sample of people in a population for antibodies and directly report those numbers, or predict how the virus has affected a population using mathematical models. Such models have given very different estimates...
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GENEVA, Nov 23 (Reuters) - The World Health Organization (WHO) said on Tuesday there could be a further 700,000 deaths from COVID-19 in Europe by March, taking the total to above 2.2 million, as the world body urged people to get vaccinated. Total cumulative deaths from the respiratory disease in the 53 countries of the WHO's European region have already surpassed 1.5 million, it said, with the daily rate doubling from late September to 4,200 a day. The WHO's European region also includes Russia and other former Soviet republics as well as Turkey. "Cumulative reported deaths are projected to reach over 2.2 million by spring next year, based on current trends," it said, adding that COVID-19 is now the top regional cause of death. High or extreme stress on intensive care units is expected in 49 out of 53 countries by March 1, the WHO added. The Netherlands started transporting COVID-19 patients across the border to Germany on Tuesday as pressure rises on hospitals and infections jump to record levels. Austria began its fourth lockdown on Monday. Beyond prevention measures such as masks and hand-washing, the WHO's Regional Director for Europe, Hans Kluge, urged people to get primary vaccines doses and a booster "if offered". WHO officials have previously advised against COVID-19 vaccine boosters until more people around the world have received primary doses. "All of us have the opportunity and responsibility to help avert unnecessary tragedy and loss of life, and limit further disruption to society and businesses over this winter season," said Kluge. Reporting by Emma Farge Editing by Gareth Jones
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MEXICO CITY (AP) — Mexico on Saturday topped 1 million registered coronavirus cases and nearly 100,000 test-confirmed deaths, though officials agree the number is probably much higher. How did Mexico get here? By marching resolutely, even defiantly, against many internationally accepted practices in pandemic management, from face mask wearing, to lockdowns, testing and contact tracing. What is more, officials in Mexico claim science is on their side. Assistant Health Secretary Hugo López-Gatell says any wider testing would be “a waste of time, effort and money.” Face masks, López-Gatell says, “are an auxiliary measure to prevent spreading the virus. They do not protect us, but they are useful for protecting other people.” President Andres Manuel López Obrador almost never wears a mask, and López-Gatell only occasionally does. Except science does not appear to be on their side. International experts have recommended mass testing, and say face masks protect both the wearer and other people. “They say there is no evidence. No, excuse me, there is evidence,” said former health secretary Dr. José Narro. “In May, we already began to have empirical evidence and well-documented scientific studies began to appear stressing the importance of face masks and the need for testing.” “What I can say is the (government) strategy did not have the necessary flexibility to adjust to the increasing amount of knowledge” about the disease, Narro said. In part that has been a hallmark of López Obrador’s administration: never back down, never change course, and if challenged, double down. His main promise to Mexicans is that there would be enough hospital beds for everyone who needs one, and his government has largely fulfilled that basic promise — even if Mexicans are so afraid of those hospitals they often wait until the last moment to go for treatment, at which point, doctors say, it’s often too late. That fear was not unfounded; early in the pandemic, three-quarters of patients intubated and put on ventilators in Mexico’s largest hospital network died. That resistance was what Mexico City human resources manager Lorena Salas felt when her 76-year-old father, Jaime Salas Osuna, began to show signs of what could be COVID-19. “The idea was mainly to stay at home, no? Thinking of going to the hospital was not an option, we were terrified that there he would surely be infected,” said Salas. Instead, she sped down to the resort city of Acapulco, where her father lived, and when she arrived, she found him thin, sweating and confused. “At that moment the delivery service arrived with the oxygen meter, and his oxygen saturation was 77,” she recalled. (A normal reading is 93 to 98). “At that moment I felt like a bucket of cold water had fallen on me. We just looked at each other. I said ‘Dad, do you have COVID?” Salas drove him to Mexico City; he didn’t want to be intubated, but doctors explained they had to. He underwent two operations, two intubations and struggled for 13 days before he died on Oct. 20. To its credit, that is one of the few areas where the government’s public message has changed: where officials once urged people with the disease to stay home as long as possible, they now advise those over 60 or with risk factors like diabetes or obesity to seek treatment immediately...
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Spain saw one of the most draconian Covid-19 lockdowns in Europe, but two months after it was lifted, the virus is spreading faster than in any neighbouring nation. It now has Europe's fastest-rising caseload, with 142 positive cases per 100,000 inhabitants over the past two weeks. By the time the state of emergency ended on 21 June, Spain was registering 100 to 150 cases per day. That number has risen to more than 3,000. But the number of deaths over the past week stood at 122 on Thursday, a far cry from the 950 registered on 2 April alone, the blackest day in Europe's deadliest per capita coronavirus epidemic. Most of the transmission is now between young people, and around three-quarters of positives are in patients who show no symptoms. Spain's government admits the numbers are "not what we want to see", but points to key differences compared to the spring. Only around 3% of current cases require hospital treatment, less than 0.5% need intensive care and the current death rate is as low as 0.3%. "Mortality is very low, as is the hospitalisation rate. Something has changed big time, although the rise is still worrying," says Ildefonso Hernández, a professor in public health from Miguel Hernández University in Alicante. "As long as cases are rising, we have to think that a second wave is on the way. We don't have much time to react before September's return to routines." Spain's tourism season has ended up as little more than a damp squib, as most countries moved to blacklist this key destination within weeks of the country opening up at the end of June. That means beach areas have so far avoided the highest rates of infection, although Catalonia's infection rate is slightly above the national average on 145 cases per 100,000 inhabitants. Healthcare is a competence of Spain's 17 regions, and some are looking much better prepared than others. At the good end of the scale, the northern region of Asturias has an infection rate of 32, while Aragón in the north-east is topping 500. Aragón's capital, Zaragoza, has become a hotspot for community transmission over recent weeks, but the problems began in the early summer when thousands of seasonal workers, many of them wandering migrants, began to travel to orchards in the region. Growers and packing companies have been criticised for not providing accommodation for migrant workers, leading them to travel between shelters and fields or subsist in insanitary shanties. "Everything happening in Aragón is very much connected to outbreaks among the seasonal fruit-pickers. There should have been more anticipation of the problems that could arise due to the accommodation situation of these workers," explains Juan González Armengol, president of the Spanish Society of Emergency Medicine (Semes). Worst of all, more than 55 care homes for the elderly in Aragón have registered cases since the end of the state of emergency..
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