Health Welness

Virologist tackles monkeypox vaccine questions

Monkeypox isn’t going to be the next COVID-19. But with the outbreak having bloomed to thousands of infections, with cases in nearly every state, on Aug. 4, 2022, the U.S. declared monkeypox a national public health emergency. One reason health experts did not expect monkeypox to become so widespread is that the U.S. had previously approved two vaccines for the virus. Maureen Ferran, a virologist at Rochester Institute of Technology, has been keeping tabs on the two vaccines that can protect against monkeypox.

1. What are the available monkeypox vaccines?

Two vaccines are currently approved in the U.S. that can provide protection against monkeypox, the Jynneos vaccine – known as Imvamune/Imvanex in Europe – and ACAM2000, an older smallpox vaccine.

The Jynneos vaccine is produced by Bavarian Nordic, a small company in Denmark. The vaccine is for the prevention of smallpox and monkeypox disease in adults ages 18 and older who are at high risk for infection with either virus. It was approved in Europe in 2013 and by the U.S. Food and Drug Administration in 2019.

The Jynneos vaccine is given in two doses four weeks apart and contains a live vaccinia virus. Vaccinia normally infects cattle and is a type of poxvirus, a family of viruses that includes smallpox and monkeypox. The virus in this vaccine has been crippled – or attenuated – so that it is no longer able to replicate in cells.

This vaccine is good at protecting those who are at high risk for monkeypox from getting infected before exposure and can also lessen the severity of disease post-infection. It is effective against smallpox as well as monkeypox. Until the recent monkeypox outbreak, this vaccine was primarily given to health care workers or people who have had confirmed or suspected monkeypox exposure.

A circular mass of squiggly lines.

Both the Jynneos and ACAM2000 vaccines use the vaccinia virus, shown here, to produce immunity to smallpox and monkeypox.

CDC/ Cynthia Goldsmith

The ACAM2000 vaccine was approved by the FDA in 2007 for protection against smallpox disease. This vaccine is also based on vaccinia virus, however the version of the vaccinia virus in the ACAM2000 vaccine is able to replicate in a person’s cells. Because of this, the ACAM2000 vaccine can be associated with serious side effects. These can include severe skin infections as well as potentially life-threatening heart problems in vulnerable people. Another potential issue with the ACAM2000 vaccine is that it is more complicated to administer compared to a normal shot.

The U.S. government has over 200 million doses of ACAM2000 stockpiled in case of a biological weapon attack of smallpox. But despite the adequate supply of the vaccine, ACAM2000 is not being used to vaccinate against monkeypox because of the risk of serious adverse side effects. For now, only designated U.S. military personnel and laboratory researchers who work with certain poxviruses may receive this vaccine.

2. How effective are these vaccines?

According to the U.S. Centers for Disease Control, there is not yet any data available on the effectiveness of either vaccine in the current outbreak of monkeypox. But there is older data available from animal studies, clinical trials and studies in Africa.

A number of clinical trials done during the approval process for the Jynneos vaccine show that when given to a person, it triggers a strong antibody response on par with the ACAM2000 vaccine. An additional study done in nonhuman primates showed that vaccinated animals that were infected with monkeypox survived 80% to 100% of the time, compared with zero to 40% survival in unvaccinated animals.

Another use of the Jynneos vaccine is as a post-exposure prophylaxis, or PEP, meaning the vaccine can be effective even when given after exposure to the virus. Because the monkeypox virus incubates in a person’s body for six to 14 days, the body of someone who gets the Jynneos vaccine shortly after being exposed will produce antibodies that can help fight off infection and protect against a serious monkeypox case.

The ACAM2000 data is older and less precise but shows strong protection. Researchers tested the vaccine during an outbreak of monkeypox in central Africa in the 1980s. Although the study was small and didn’t directly test vaccine efficacy, the authors concluded that unvaccinated people faced an 85% higher risk of being infected than vaccinated people.

3. Does a smallpox vaccine protect against monkeypox?

According to the CDC, a previous smallpox vaccination does provide some protection against monkeypox, though that protection wanes over time. Experts advise that anyone who had the smallpox vaccine more than three years ago and is at increased risk for monkeypox get the monkeypox vaccine.

People lining up for monkeypox vaccines.

In California and New York City, demand for vaccines has been high among at-risk communities.

AP Photo/Marcio Jose Sanchez

4. Who should get vaccinated?

At the national level, anyone who has had close contact with an infected person, who has a weakened immune system or who had dermatitis or eczema is eligible for a Jynneos vaccine.

Some state and local governments are also making vaccines available to people in communities at higher risk for monkeypox. For example, New York City is allowing men who have sex with men and who have had multiple sexual partners in the past 14 days to get vaccinated.

5. What is the supply like for the Jynneos vaccine?

As of July 29, 2022, a little over 300,000 doses have been shipped to points of care or administered, with another 700,000 already allocated to states across the U.S. However, demand is far outpacing supply. Public health officials acknowledge that vaccine supply shortages have resulted in long lines and clinics having to close when they run out of vaccines. The issues have been magnified by technical problems with online booking systems, particularly in New York City.

To help boost supply, the U.S. has ordered nearly 7 million doses of the Jynneos vaccine, which are expected to arrive over the coming months.

6. What about just using one dose of Jynneos?

Although federal health officials advise against withholding the second dose, some places – including Washington, D.C., and New York City – are withholding the second dose until more become available. This strategy is being used in Britain and Canada as well to vaccinate as many people as possible at least one time.

A previous study reported that a single shot of the Jynneos vaccine protected monkeys infected with monkeypox and that this protection lasted for at least two years. If this holds up in the real world, it would support withholding second doses in favor of immunizing more Americans. This would be key as many health experts expect the virus to continue spreading, furthering increasing demand of the vaccine.The Conversation

Maureen Ferran, Associate Professor of Biology, Rochester Institute of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Biden Administration to declare monkeypox a public health emergency: report

President Joe Biden's administration is preparing to declare monkeypox a public health emergency, The Washington Post reported on Thursday.

"The declaration would come from Health and Human Services Secretary Xavier Becerra, who is expected to discuss the plan at an afternoon briefing, said two officials who spoke on the condition of anonymity because they were not authorized to comment," according to the Post. "The health secretary is planning a second declaration empowering federal officials to expedite medical countermeasures, such as potential treatments and vaccines, without going through full-fledged federal reviews. That would also allow for greater flexibility in how the current supply of vaccines is administered, the officials said."

The World Health Organization declared monkeypox a global health emergency – its most critical classification – on July 23rd. New York, California, Illinois, and other countries have also made similar proclamations.

READ MORE: Why monkeypox is an emergency but not a reason to panic

"Federal leaders have spent weeks debating whether to declare monkeypox a public health emergency, and officials said that Thursday’s planned announcement is part of a broader push to contain the virus. The announcement follows the White House’s decision this week to name Robert J. Fenton Jr., a longtime official at the Federal Emergency Management Agency, as the coordinator of the national response to the virus," the Post noted.

The virulent pathogen – which is endemic to Africa – has been spreading throughout at least seventy countries since late spring, and health experts are still struggling to understand why. The outbreak was first identified in England.

As of today, more than 6,600 cases have been reported in the United States, and that figure – believed to be significantly undercounted due to a lack of testing – has been doubling roughly every eight days. Although the vast majority of infections are non-fatal, the disease can still cause a serious flu-like illness, pain, and scarring from blisters. Transmission occurs during close personal contact or from contaminated surfaces, including clothing.

Vaccine rollout, meanwhile, has been a challenge. Inoculations are limited in supply and have been primarily reserved for high-risk populations.

READ MORE: Marjorie Taylor Greene attacks gay men to sell monkeypox T-shirts

"Federal officials have identified about 1.6 million people as highest risk for monkeypox, but the U.S. has only received enough Jyennos doses to fully cover about 550,000 people," per the Post.

Despite the clear dangers to public health, officials have been split on whether declaring an emergency is a wise idea.

"Some Biden officials have previously argued that declaring an emergency for monkeypox would call attention to the growing outbreak and strengthen the nation’s overall response. For instance, the emergency declaration can be used to compel hospitals to report more data about their monkeypox patients, and enable the Food and Drug Administration to expedite medical countermeasures that might otherwise take months or years to undergo traditional regulatory reviews," the Post explained.

It added that "Becerra’s decision to declare monkeypox an emergency could raise political complications for the White House, which has faced calls from advocates to declare gun violence a public health emergency and climate change a national emergency. Democrats like Sen. Elizabeth Warren (D-Mass.) and reproductive health rights groups have also lobbied the administration to declare access to abortion a public health emergency in the wake of the Supreme Court’s recent ruling that overturned Roe v. Wade and led to new abortion restrictions around the nation."

READ MORE: 'They’re going to abuse those powers': DeSantis attacks states for declaring emergencies over monkeypox cases

Long COVID-19 may be caused by overactive immune systems | Opinion

Viruses that cause respiratory diseases like the flu and COVID-19 can lead to mild to severe symptoms within the first few weeks of infection. These symptoms typically resolve within a few more weeks, sometimes with the help of treatment if severe. However, some people go on to experience persistent symptoms that last several months to years. Why and how respiratory diseases can develop into chronic conditions like long COVID-19 are still unclear.

I am a doctoral student working in the Sun Lab at the University of Virginia. We study how the immune system sometimes goes awry after fighting off viral infections. We also develop ways to target the immune system to prevent further complications without weakening its ability to protect against future infections. Our recently published review of the research in this area found that it is becoming clearer that it might not be an active viral infection causing long COVID-19 and similar conditions, but an overactive immune system.

Long COVID-19 patients can experience persistent respiratory, cognitive and neurological symptoms.

The lungs in health and disease

Keeping your immune system dormant when there isn’t an active infection is essential for your lungs to be able to function optimally.

Your respiratory tract is in constant contact with your external environment, sampling around 5 to 8 liters (1.3 to 2 gallons) of air – and the toxins and microorganisms in it – every minute. Despite continuous exposure to potential pathogens and harmful substances, your body has evolved to keep the immune system dormant in the lungs. In fact, allergies and conditions such as asthma are byproducts of an overactive immune system. These excessive immune responses can cause your airways to constrict and make it difficult to breathe. Some severe cases may require treatment to suppress the immune system.

During an active infection, however, the immune system is absolutely essential. When viruses infect your respiratory tract, immune cells are recruited to your lungs to fight off the infection. Although these cells are crucial to eliminate the virus from your body, their activity often results in collateral damage to your lung tissue. After the virus is removed, your body dampens your immune system to give your lungs a chance to recover.

An overactive immune system, as in the case of asthma, can damage the lungs.

Over the past decade, researchers have identified a variety of specialized stem cells in the lungs that can help regenerate damaged tissue. These stem cells can turn into almost all the different types of cells in the lungs depending on the signals they receive from their surrounding environment. Recent studies have highlighted the prominent role the immune system plays in providing signals that facilitate lung recovery. But these signals can produce more than one effect. They can not only activate stem cells, but also perpetuate damaging inflammatory processes in the lung. Therefore, your body tightly regulates when, where and how strongly these signals are made in order to prevent further damage.

While the reasons are still unclear, some people are unable to turn off their immune system after infection and continue to produce tissue-damaging molecules long after the virus has been flushed out. This not only further damages the lungs, but also interferes with regeneration via the lung’s resident stem cells. This phenomenon can result in chronic disease, as seen in several respiratory viral infections including COVID-19, Middle East Respiratory Syndrome (MERS), respiratory syncytial virus (RSV) and the common cold.

The immune system’s role in chronic disease

In our review, my colleagues and I found that many different types of immune cells are involved in the development of chronic disease after respiratory viral infections, including long COVID-19.

Scientists so far have identified one particular type of immune cells, killer T cells, as potential contributors to chronic disease. Also known as cytotoxic or CD8+ T cells, they specialize in killing infected cells either by interacting directly with them or by producing damaging molecules called cytokines.

Killer T cells are essential to curbing the virus from spreading in the body during an active infection. But their persistence in the lungs after the infection has resolved is linked to extended reduced respiratory function. Moreover, animal studies have shown that removing killer T cells from the lungs after infection may improve lung function and tissue repair.

A legion of immune cells work together to remove invading pathogens.

Another type of immune cells called monocytes are also involved in fighting respiratory infections, serving among the first responders by producing virus- and tissue-damaging cytokines. Research has found that these cells also continue to accumulate in the lungs of long COVID-19 patients and promote a pro-inflammatory environment that can cause further damage.

Understanding the immunological mechanisms underlying long COVID-19 is the first step to addressing a quickly worsening public health problem. Identifying the subtle differences in how the same immune cells that protect you during an active infection can later become harmful could lead to earlier diagnosis of long COVID-19. Moreover, based on our findings, my team and I believe treatments that target the immune system could be an effective approach to manage long COVID-19 symptoms. We believe that this strategy may turn out to be useful not only for COVID-19, but also for other respiratory viral infections that lead to chronic disease as well.The Conversation

Harish Narasimhan, PhD Candidate in Immunology, University of Virginia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The war on drugs is a preview of life without reproductive freedom: columnist

Three days after the United States Supreme Court eliminated the constitutional right to abortion in its 6-3 reversal of Roe versus Wade and Casey versus Planned Parenthood on June 24th, 2022, the High Court issued rare unanimous 9-0 decisions in two cases – Ruan versus United States and Khan versus United States – that upheld overturned convictions of doctors that overprescribed narcotics as outlined in the Controlled Substances Act.

In an editorial in Tuesday's New York Times, addiction and public policy columnist Maia Szalavitz contemplated why the Court's rulings in Ruan and Khan do not cover medically necessary abortion.

"Physicians across the country are struggling to balance the conflicting imperatives of their calling to care with their institutional duty to avoid legal liability, all to the detriment of their patients," Szalavitz wrote. "Medicine is hard to govern with the blunt instrument of criminal law. Human biological processes, including pregnancy, are enormously variable. In many cases, determining the precise moment when someone’s life or health is so threatened that abortion would be legal under a particular law is not an ethically answerable scientific question. And so doctors turn to lawyers, often with no medical experience, to protect themselves from prison."

READ MORE: Mike Pence stumps for 'unborn' personhood

Szalavitz's argument, which is predicated on the underlying principle of the war on drugs that prohibition reduces harm, is that law enforcement's power grab over personal medical choices does exactly the opposite.

"Physicians who prescribe controlled substances like opioids carry a similar burden" to adhering to abortion restrictions that are frequently unscientific and prohibitively vague," Szalavits noted. "They can face decades in prison if prosecutors target them for overprescribing. Although there are cases of bad actors who prescribed opioids for profit, even legitimate physicians may fear being targeted by law enforcement, and research shows that the threat of legal action has a broad chilling effect on the way doctors provide care. The war on drugs shows that when medicine is criminalized and politicized, harm to patients and doctors increases, while the activities that the laws are intended to curb continue or even increase."

The decades-long crusade against substance use and stigmatization of addition "doesn’t allow for nuances that are part and parcel of medicine, such as the fact that some people need large doses of opioids because the enzymes that metabolize drugs vary widely because of genetics and other factors," Szalavits continued, stressing that "criminalization invites suspicion, framing patients as liars. Health care providers, often unconsciously, can become contemptuous of those whose cases may bring legal scrutiny, corroding care."

With Roe gone, patients seeking to terminate – often regardless of the reason, even if the pregnancy is non-viable – "are suspected of having illegal abortions," Szalavitz explained. "Already women say the laws in their state are preventing them from receiving the care they need, including for miscarriages."

READ MORE: How the 'unprecedented' Supreme Court leak made efforts to lobby conservatives on Roe 'all but impossible': report

The statistics are staggering.

"At least 1,700 women were prosecuted from 1973 to 2020 for stillbirths, miscarriages or exposing their fetus to some actual or perceived risk of harm, including, in many cases, for allegations of drug use during pregnancy. Consequences included lengthy prison sentences and child custody loss, even when there was no proof that the substances caused damage. Many were reported to the police by medical professionals; those targeted were overwhelmingly poor and disproportionately Black," Szalavitz pointed out. But the nightmare does not end there.

"Loopholes in medical privacy laws — often justified by drug enforcement — mean that hospitals have discretion to share records without patient consent. Only 19 states ban warrantless searches of prescription drug monitoring databases, and at the federal level, the Drug Enforcement Administration claims that it should be able to search these databases without a warrant in any state," Szalavitz said. "Almost half of the states define drug use during pregnancy as child abuse, which triggers mandatory reporting to child welfare agencies and can also result in criminal charges. It’s not too difficult to see how similar data could be used to target women seeking abortions or doctors helping with their care."

The consequences of criminalizing abortion have already arrived en mass.

"Physicians are already taking extreme measures to protect themselves from abortion prosecutions, such as ending women’s prescriptions for an immune disorder treatment, methotrexate, because if they get pregnant, it can cause miscarriage," Szalavitz remarked. "The Texas Medical Association recently asked state regulators to act, saying that several hospitals are turning away patients with pregnancy complications for fear of violating the state’s abortion ban. Women who are miscarrying have been left to wait until they have severe bleeding before help is offered. As with the drug war, legal fear is driving doctors to prioritize themselves over their patients’ health."

The Supreme Court "sided with physicians" in Ruan and Khan, having determined that "doctors can’t be convicted as dealers," Szalavitz emphasized. She then rhetorically asked why "this intent requirement would not pertain to abortion cases as well."

Szalavitz's answer is that both target the same fundamental liberty: choice.

"It is already obvious that prosecuting physicians hasn’t ended the overdose crisis. Instead, it scared many into defensive medicine and drove people with addiction and even some pain patients to far more deadly street drugs. Last year, the United States had its highest rate of overdose death, with the majority lost to opioids," Szalavitz concluded. "As with the drug war, criminalizing abortion will increase harm while failing to stop the behavior it is intended to reduce."

READ MORE: Haunted by the ghosts of settled law | Opinion

Florida newspaper blasts Ron DeSantis for 'cruel, barbaric' delay of COVID-19 vaccines for children

While former President Donald Trump and former White House Press Secretary Sarah Huckabee Sanders have described COVID-19 vaccines as a triumph of the MAGA movement —Sanders calls them the “Trump vaccine” — countless other MAGA Republicans have been strident anti-vaxxers. Florida Gov. Ron DeSantis, who is running for reelection in the 2022 midterms and appears likely to run for president in 2024, hasn’t been shy about pandering to MAGA anti-vaxxers — and in a scathing editorial published on June 20, the South Florida Sun Sentinel’s lambasts him for doing so at the “expense” of children’s wellbeing.

“The quip ‘often wrong, never in doubt’ fits Gov. Ron DeSantis like a glove,” the Sun Sentinel’s editorial board writes. “He takes it to extremes by doubling down, at the expense of our children, on his cultivated political appeal to the anti-vaxxer element of right-wing America. It’s an absolute disgrace for Florida to be the only one of 50 states that did not preorder Pfizer and Moderna coronavirus vaccines for children ages six months to five years, once it became apparent that federal regulators would approve and recommend them.”

The Sun Sentinel’s editorial board continues, “The preorder deadline passed a week ago, June 14. Florida delayed the availability of shots to children whose parents want them. President Joe Biden, to his credit, moved swiftly to circumvent that obstacle.”

Who would you vote for in 2024 - Biden or DeSantis?

The Sun Sentinel’s editorial board is equally critical of Florida Surgeon General Joseph Ladapo — who has also pandered to anti-vaxxers — and argues that when DeSantis missed the deadline, he did so on purpose “based on…. Ladapo’s earlier refusal to recommend COVID vaccinations for healthy children.”

“To hear DeSantis tell it, he’s right and 49 other states are wrong,” the Sun Sentinel’s editorial board writes. “Never in doubt, he doubled down again Monday. ‘We are not going to have any programs where we’re trying to jab six-month-old babies,’ he said at a barbecue restaurant in Callahan near Jacksonville, adding that the vaccines will not be available at any county health departments.”

The Sun Sentinel’s editorial board continues, “Parents will still have the option, but Florida’s refusal to preorder may delay availability of the vaccines through pediatricians’ offices, children’s hospitals and pharmacies. Parents can go to Vaccines.gov, a federal government website, to find nearby locations offering child vaccines. Hospitals have depended on the state’s supply network to vaccinate older children.”

The Sun Sentinel slams DeSantis for playing politics at the cost of children’s health.

“Biden’s COVID-19 coordinator, Dr. Ashish Jha, said Friday, (June 17) it had already begun shipping vaccines ‘to children’s hospitals and pediatricians in every state in the country except Florida,’” the Sun Sentinel’s editorial board writes. “He called Florida’s delay ‘unconscionable.’ We call it cruel, barbaric — and totally political.”

Animosity is growing between ‘traditional animal agriculture’ and providers of vegan products: report

In recent years, the demand for plant-based “meats” has grown — and brought with it some heated debates between proponents of planted-based “meats” and proponents of actual meats. Journalist Laura Reiley takes a look at that rivalry in an article published by the Washington Post on Valentine’s Day 2022.

In an advertising campaign, the San Francisco-company Eat Just has been claiming that men who avoid meat consumption are less likely to suffer from erectile dysfunction as they age — a claim that meat proponents vehemently disagree with.

“This Valentine’s weekend blitz is the latest sign of the increasingly vitriolic rhetoric between plant-based food companies and mainstream meat industries, one that could even be considered below the belt,” Reiley explains. “The alternative egg company Eat Just uses the ads to direct people to its campaign’s website, which claims men who eat a healthy plant-based diet are less at risk for erectile dysfunction, citing research.”

Reiley adds, “Erectile dysfunction tends to go with age. But it can also commonly occur in men with high blood pressure, a history of heart disease or diabetes. These health problems have, in turn, been linked to higher red meat consumption. But there is by no means universal consensus on this. And the National Cattlemen’s Beef Association has declared the campaign as having ‘no basis in fact.’”

Proponents of “traditional animal agriculture,” Reiley notes, vehemently object to companies using the words “meat” or “milk” to sell vegan products — which, they argue, is false advertising since they aren’t really selling either “meat” or “milk.”

Danielle Beck, senior executive director of government affairs for the National Cattlemen’s Beef Association, was highly critical of Eat Just’s recent advertising campaign — telling the Post, “This marketing campaign has no basis in fact, to the point that it’s comical. We respect consumers’ ability to do their own research and make choices about what they put on their plate, and it’s sad when others choose deception over fact. America’s beef producers will continue to be transparent as we share the overwhelming body of scientific evidence that supports beef’s continued role in a balanced diet.”

Sports dietician Leslie Bonci told the Post that a diet that has high planet consumption is beneficial. But she attributes erectile dysfunction to things other than meat consumption, and she doesn’t believe that the animosity between companies that offer vegan products and the meat industry is helpful to consumers.

“A plate is more than macronutrients,” Bonci told the Post.

Regret can be all-consuming. A neurobehavioral scientist explains how people can overcome it

J. Kim Penberthy, University of Virginia

A friend of mine – we will call him “Jay” – was working for IBM in New York City in the early ‘90s. He was a computer programmer and made a good salary. Occasionally, competitors and startups approached Jay to join their companies. He had an offer from an interesting but small organization in Seattle, but the salary was paltry and most of the offer package was in company shares. After consulting with friends and his parents, Jay declined the offer and stayed with IBM. He has regretted it ever since. That small company was Microsoft.

Regret is a very real reaction to a disappointing event in your life, a choice you made that can’t be changed, something you said that you can’t take back. It’s one of those feelings you can’t seem to shake, a heavy and intrusive negative emotion that can last for minutes, days, years or even a lifetime. Imaging studies reveal that feelings of regret show increased activity in an area of the brain called the medial orbitofrontal cortex.

Dealing with regret is even more difficult because of the other negative emotions connected to it: remorse, sorrow and helplessness. Regret can increase our stress, negatively affect physical health and throw off the balance of hormone and immune systems. Regret is not only unpleasant. It is unhealthy.

As a licensed clinical psychologist at the University of Virginia School of Medicine, I conduct research on stressful emotions. Through this work, I help patients overcome regret, move on with their lives and grow. And that is the good news: Regret can be overcome through interventions like therapy and evidence-based strategies.

A 'sense of stuckness’

There are basically two ways to experience regret: One is what researchers refer to as the action path and the other is the inaction path. That is, we can regret the things we did – or we can regret the things we did not do.

Research suggests that action-related regrets, although painful, spur people to learn from their mistakes and move on. But regret related to the inaction path – the things undone, the opportunities lost – is harder to fix. This kind of regret is more likely to lead to depression, anxiety, a sense of “stuckness” and a feeling of longing over not knowing what could have been.

As with other negative emotions, it doesn’t work to avoid, deny or try to squash regret. In the long run, these tactics only increase negative feelings and prolong the time you suffer with them. Rather than stay stuck, people can manage these emotions in four steps: First, accept the fact that you are feeling them; determine why you are feeling them; allow yourself to learn from them; and finally, release them and move forward.

You can help release these feelings of regret by practicing self-compassion. This means reminding yourself that you are human, you are doing the best you can, and you can learn from past decisions and grow. Showing this compassion to yourself can help you accept and move past the regret.

Accepting that you have feelings of regret does not mean that you like these feelings. It just means you know they are there. It also helps to identify the specific emotion you’re feeling. Instead of telling yourself, “I feel bad,” say “This is me, feeling regret.” Simple as it sounds, the semantic difference has a big emotional impact.

Accept, acknowledge and forgive yourself

Acknowledging your thoughts and feelings can bring relief from strong negative emotions. In Jay’s case, he could remind himself that he had no crystal ball. Instead, he made the best decision he could, given the information he had at the time, and given the same circumstances, most of his contemporaries would have made the same decision.

This method of noticing and then restructuring your thoughts is sometimes called cognitive reappraisal. Seeing the situation in a different way may help reduce regret and help you make future decisions.

Forgiving yourself for actions taken or not taken is a powerful step toward overcoming regret. This has been formalized into a commonly used cognitive psychological model called REACH, which asks people to recall the hurt (face it), empathize (be kind and compassionate), altruistically offer forgiveness (to oneself), commit publicly (share it) and then hold on to that forgiveness and stay true to the decision. Research shows that six hours of work with a trained professional using this model can have a positive impact.

Author and journalist Kathryn Schulz reflects on the value of learning to embrace and make peace with regret.

More knowledge = less regret

At first, Jay pushed away his feelings of regret. He continued to struggle with thoughts of what he missed. He did not change until he approached and explored his feelings of regret, first with a friend and ultimately with a therapist.

[Over 140,000 readers rely on The Conversation’s newsletters to understand the world. Sign up today.]

Eventually, he accepted the pain of not knowing what might have happened, but also reminded himself of his rationale at the time, which was actually quite reasonable. He demonstrated compassion towards himself, and spoke to himself kindly, the way he would when talking to a loved one or close friend. Practicing this self-compassion allowed him to build resilience, move on from the negative emotions and ultimately forgive himself.

On making future decisions, Jay recognized the importance of obtaining as much information about opportunities as possible. He challenged himself to learn about the big players in the field. Doing so allowed him to overcome his regret and move forward. New opportunities came along. Jay, currently employed by another giant computer engineering company, is doing quite well for himself, and has been able to move beyond the regret of his past decision.The Conversation

J. Kim Penberthy, Professor of Psychiatry and Neurobehavioral Sciences, University of Virginia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Here are the risk factors that determine whether you’re more or less likely to develop cognitive decline

Mark Dallas, University of Reading

About two in ten people over the age of 65 have mild cognitive impairment – a noticeable change in their memory, problem-solving abilities or attention. This is caused, in part, by the same brain changes that occur in dementia. While mild cognitive impairment often has little effect on a person’s way of living, 5-10% of people with it will develop dementia.

Why some people with mild cognitive impairment develop dementia while others don’t has long been a mystery. But a recent study from Columbia University has identified several factors that determine whether a person is more or less likely to develop mild cognitive impairment. These findings might give us a clue about who might be more likely to develop dementia.

The researchers looked at 2,903 people aged 65 or over and tracked their brain function for nine years. Cognitive impairment was diagnosed by looking at whether participants struggled with a memory task, if they reported difficulty performing certain daily tasks (such as using the phone) and hadn’t been diagnosed with dementia.

At the start of the study, all participants had normal brain function. At the six-year follow-up, 1,805 participants had normal cognitive function, 752 had mild cognitive impairment, and 301 had dementia. The researchers then followed up with the cognitively impaired group for another three years.

As some participants were “lost to follow-up”, the researchers were only able to look at 480 people from the original mild cognitive impairment group. While 142 still had mild cognitive impairment, they found that 62 people from this group now had dementia. The researchers also found that 276 people no longer met the criteria for mild cognitive impairment – showing us that mild cognitive impairment does not always lead to dementia and it isn’t necessarily permanent.

Let’s first look at the factors linked to a lower risk of developing mild cognitive impairment.

Education

The time a person spent in education was one factor that decreased a person’s risk of mild cognitive impairment. People who had an average of 11.5 years in education were 5% less likely to develop mild cognitive impairment compared with those with only ten years in education. The study did not differentiate between the type of education (such as school or higher education).

One theory for this link is because a longer time in education is linked to higher socioeconomic status – which may mean a person has better access to a healthier lifestyle and better healthcare.

Another theory is that education helps the brain build more neurons and connections, which helps the brain maintain good function. This may help the brain compensate for any changes that may happen as a result of mild cognitive impairment, such as memory loss.

Leisure activities

People who were more physically active or social had a slightly lower risk of developing mild cognitive impairment.

To measure how social or active participants were, they filled out a questionnaire about the activities they did and how often they did them, such as walking or going to the movies. Researchers then gave participants a score out of 13. The higher the score, the more active the participant was. Those who didn’t have mild cognitive impairment scored 7.5 on average, while those who had mild cognitive impairment scored slightly lower at 7.4. People with dementia scored 5.8.

Previous studies have also shown that moderate-intensity activity (such as swimming) during mid-life or late-life can reduce the risk of mild cognitive impairment. The protective effect of exercise could be explained by beneficial structural changes that happen in our brains as a result of exercise. Growing evidence also shows us that being social can help maintain brain health and lower the risk of premature death.

Income

People who had an income greater than US$36,000 (£27,264) a year had a 20% lower chance of developing mild cognitive impairment compared with those who made less than US$9,000 a year.

Income is probably linked to a lower risk of cognitive impairment for similar reasons as education, since people with a higher income are more likely to be able to afford better healthcare and afford a better diet and lifestyle. They may also live in areas where environmental factors – such as pollution – have less effect on them. This is important, as growing evidence shows pollution may also be linked to conditions such as Alzheimer’s and Parkinson’s disease.

Greater risk

The Columbia University researchers also identified several factors that were associated with a greater risk of developing mild cognitive impairment. They include:

Genetics

The presence of the AP0E E4 allele (one of two or more versions of a gene) was found to increase the risk of developing mild cognitive impairment by 18%. This finding chimes with previous evidence which also shows that this allele can increase the risk of dementia.

People with AP0E E4 are around three times more likely to develop Alzheimer’s disease than those with a different variant of the AP0E gene. It’s thought this is because this variant makes people more likely to accumulate toxic protein deposits in the brain – a hallmark of Alzheimer’s disease. Researchers also think this gene only causes harm in older age.

Underlying health conditions

People with one or more chronic health conditions, such as heart disease, depression or diabetes, have a 9% greater risk of developing mild cognitive impairment, the Columbia University researchers found.

The increased burden of having several health conditions might mean a person engages less in their usual daily activities or social life. Both of these can accelerate a decline in brain health. Other conditions, such as heart disease, are also known to increase the risk of cognitive decline.

This study reminds us that mild cognitive impairment isn’t necessarily a prelude to dementia. In fact, some participants in the study who had mild cognitive impairment ended up returning to normal brain function. It’s not entirely certain why, but it could be down to lifestyle changes after diagnosis (such as exercising more) which may have improved outcomes. While it could also be the case that some participants were misdiagnosed at the beginning of the study, this is unlikely given the wide range of tools they used to confirm their diagnoses.

Our brains are dynamic and keeping them active throughout our lives is important to maintaining good brain function. While there are some risk factors – such as our genes – that we can’t change, keeping active and following a healthy lifestyle may be one way to lower our risk of mild cognitive impairment and dementia.The Conversation

Mark Dallas, Associate Professor in Cellular Neuroscience, University of Reading

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The US was not prepared for a pandemic – and the failures of neoliberalism explain why

by Elanah Uretsky, Brandeis University

It's unclear when the pandemic will come to an end. What may be an even more important question is whether the U.S. will be prepared for the next one. The past year and a half suggests that the answer may be no.

As a medical anthropologist who has spent the past 20 years studying how the Chinese government reacts to infectious disease, my research can provide insight into how countries, including the U.S., can better prepare for disease outbreaks.

Researchers agree that a good response starts with a strong public health system. But this is something that has been sidelined by the United States' neoliberal system, which places more value on free markets and deregulation than public welfare.

Neoliberalism promotes a free market accessible to the wealthy few, making essential services less free for everyone else.

As US neoliberalism evolved, public health devolved

Neoliberal economic policies became popular in the 1980s during the Reagan and Thatcher eras. This new approach aimed to make government leaner and more efficient through measures like market deregulation, privatization and reduction of government provision of public services like health and education – resources that do not necessarily lend themselves to market production.

While neoliberal governments still work to promote the health, welfare and security of their citizens, they place the responsibility of providing those services in the hands of private entities like health insurance companies and nongovernmental organizations. This gives the government space to focus on economic performance.

But placing responsibility for a public good into the hands of a private corporation turns that good into a commodity that people need to buy, rather than a service publicly available to all.

Spending on health care in the U.S., including on hospitals, medications and private insurance, has more than tripled in the past 60 years. But the public health system that helps the nation prepare for the unexpected has been neglected.

U.S. spending on the local health departments that help to avert epidemic outbreaks and protect the health of populations fell by 18% between 2010 and 2021. Two and a half cents of every medical dollar goes toward public health, a figure that has fallen from 1930 levels of 3.3 cents of every dollar. This has allowed the U.S. to manage health risks like chronic diseases that threaten individual's health. But it leaves the nation inadequately prepared for population-level major health threats that have a much bigger effect on the economy and society.

Public health cuts left the U.S with a skeletal workforce to manage the pandemic. Because of this, responsibility fell to individuals. For example, without mandatory workplace COVID-19 safety guidelines, essential workers faced daily exposure to the coronavirus with insufficient to no protective gear and sanitizing supplies. They had to protect both their own health and the health of their families when they returned home, a difficult task without proper resources and support.

And this was not unique to the U.S. There were similar COVID-19 outcomes in other neoliberal countries like the U.K. and India that had shifted priorities away from public health.

How Asian nations learned their lessons

The story was different in many Asian nations where people enjoy the same types of individual liberties as those who live in neoliberal societies. The difference is a collectivist type of mindset that guides these societies and encourages people and government to take responsibility for one another. In her book Flexible Citizenship, anthropologist Aihwa Ong argues that this leads to a societal model where citizens can be independent and self-reliant while also able to rely on a state that supports the collective. Countries like Taiwan and South Korea may have been better prepared to respond to the pandemic because most people are accustomed to protecting themselves and their communities.

Like China, these countries also learned from their recent experience with a pandemic. In 2003, China and much of Asia were caught off guard with the emergence of SARS. Like the U.S., China's public health system had taken a backseat to investment in market reforms for over 20 years. As a result, it couldn't accurately track individual cases of infections.

Following the end of the SARS outbreak, however, the Chinese government improved training for public health professionals and developed one of the most sophisticated disease surveillance systems in the world. This allowed China to respond more quickly to the 2009 H1N1 pandemic and late 2019 COVID-19 outbreaks, once it was able to get past the initial bureaucratic and political hurdles that prevented local doctors and government officials from sounding the alarm.

Some have attributed this swift action to China's authoritarian form of government that allows for greater control over individual lives. But prioritizing public health is not new to China. This became official practice as early as 1910 when it adopted the methods of quarantine, surveillance and masking to respond to an outbreak of pneumonic plague.

Could this work in the US?

Much like SARS did with China, COVID-19 has exposed huge holes in the American public health infrastructure.

Take for example contact tracing. SARS taught China and other affected countries the importance of a robust system to identify and track people who may have been exposed to the COVID-19 virus. The Chinese government sent more than 1,800 teams of scientific investigators to Wuhan to trace the virus, which helped their efforts to quickly bring the virus under control.

In the U.S., on the other hand, poorly funded and thinly staffed public health departments struggled to test and notify people who had been in direct contact with infected individuals. This crippled the U.S.'s ability to prevent the spread of COVID-19.

In my home state of Massachusetts, the local government teamed up with the global health organization Partners in Health to start a contact tracing operation. But even then, people were left to fend for themselves. This became all the more evident as people scrambled for vaccines after their initial approval, through Facebook groups and informal volunteer networks that worked to help people secure appointments. Those who had resources learned how to take advantage of the system while others were overlooked.

This is typical of a U.S. health care system that is consumer-oriented and market-based. Americans are often convinced that the solution to a health problem must be technical and costly. The focus was placed on developing vaccines and therapeutics, which are essential for ending the pandemic, while ignoring lower-cost solutions.

But masking and social distancing – non-pharmaceutical interventions that have long been known to save lives during disease outbreaks – fell by the wayside. Uptake of these simple interventions is dependent on strong and coordinated public health messaging.

As seen in several Asian nations like Taiwan and South Korea, a well-thought-out plan for public health communication is key to a unified response. Without clear, coordinated directions from a public health system, it becomes difficult to prevent the spread of an outbreak.

What it takes to be prepared

Anthropologist Andrew Lakoff describes preparedness as more than just having the tools. It's also about knowing how and when to use them, and keeping the public properly informed.

Such preparedness can only happen in a coordinated fashion organized by national leadership. But the U.S. has seen little of this over the past year and a half, leaving pandemic response up to individuals. In an era where emergent viruses are an increasing threat to health and welfare, the individualism of neoliberal policies is not enough. While neoliberalism can be good for an economy, it's not so good for health.The Conversation

Elanah Uretsky, Associate Professor of International and Global Studies, Brandeis University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

'Misinformation and disinformation' have caused COVID-19 infections to 'soar' in Alaska: Emergency room doctor

At least 75% of U.S.-based adults, according to the Centers for Disease Control and Prevention, have been either partially or fully vaccinated for COVID-19. But in Alaska, the Mayo Clinic reports, the number is only 59% — which is the type of figure that frustrates President Joe Biden and his top White House medical expert, Dr. Anthony Fauci. It's also the type of figure that frustrates Dr. Anne Zink, Alaska's chief medical officer and an emergency room physician. Zink, in an op-ed published by the Washington Post on October 27, cites "misinformation and disinformation" about vaccines as a key factor in the unnecessary suffering she is witnessing in her state.

"Alaska has fared comparatively well overall during the pandemic," Zink explains, "but this fall, the infection rate soared. Surgeries were postponed, patient transfers were delayed, and nursing ratios were stretched as hospitals ran out of staffed beds and almost ran out of oxygen. Our hospitals were like seaside rocks slowly being drowned by a rising tide of COVID-19 patients."

Zink recalls that when COVID-19 vaccines first became available in the U.S., Alaska "led the nation with high vaccination rates."

"Eventually, as occurred in many other rural states, our vaccination effort stalled," Zink laments. "Hesitancy and misinformation made many people underestimate the risk of COVID-19 infections and overestimate the risk from the coronavirus vaccines…. With little natural immunity from previous COVID-19 surges, relatively low vaccination rates and a population weary of mitigation measures — and with temperatures falling and indoor gatherings increasing — Alaska was overrun by the Delta variant."

In her op-ed, Zink describes the unvaccinated COVID-19 patients she is seeing — for example, a man who was "struggling to breathe, blue and scared, with oxygen levels not usually compatible with life" after choosing "not to be vaccinated because he feared side effects and misunderstood the risk of COVID."

"My patient, who remains hospitalized, was suffering not just because of the virus, but also, because of the deadly combination of misinformation and disinformation in a broken health-care system, in a country of broken trust," Zink writes. "As both an emergency physician and Alaska's chief medical officer, after 22 months of fighting this pandemic, I found myself exhausted as I sat there with him, humbled by this virus and acutely aware of how much work we have yet to do."

How anti-vaxxers are finding 'clever workarounds' to Instagram’s anti-misinformation algorithms: report

No matter how high the COVID-19 death count climbs — Johns Hopkins University in Baltimore, as of October 4, reports more than 4.8 million deaths worldwide, including 701,000 in the United States — many anti-vaxxers continue to falsely claim that COVID-19 vaccines are more dangerous than COVID-19 itself, sometimes using social media to make their claims. Journalist Kiera Butler, in an article published by Mother Jones on October 4, examines the presence of anti-vaxxers on Instagram. And she notes the ways in which they are trying to get around Instagram's anti-misinformation policies.

Anti-vaxxers, Butler explains, won't necessarily post misinformation on Instagram itself, but they will provide links to anti-vaxxer websites. Butler cites Instagram user Janny Organically as an example.

"If the content in these links were posted on Instagram itself," Butler observes, "they could trip the platform's misinformation algorithms because they contain factually incorrect statements. The vaccine guide link, for example, suggests that vaccines cause autism, which isn't true. If the algorithm picked up on this, the account could be suspended or even banned. But Janny Organically and a host of other Instagram users have figured out a clever workaround: They've found sites that allow you to curate a list of links under one tidy and unassuming URL."

Instagram's moderators may have gotten wise to what Janny Organically was up to — perhaps because of Butler's reporting.

Butler linked to Janny Organically's Instagram page from her Mother Jones article, but that link now says, "Sorry, this page isn't available. The link you followed may be broken, or the page may have been removed."

Butler explains, "I counted dozens of popular anti-vaccine Instagram accounts that use link lists, including a chiropractor in San Diego with 33,000 followers, an essential-oils-peddling homeschool mom in Tennessee with 101,000 followers, and an Australian podcaster with 80,000 followers. Some organizations use them, too: A powerful anti-vaccine advocacy group called Freedom Keepers United uses a Campsite link on its Instagram account, which has more than 66,000 followers. Another anti-vaccine group, Moms for Liberty, uses Linktree in several of its local chapters."

Scathing memo offers blueprint for attacking 'extremist' Republicans on COVID-19: report

During the 2020 election, many Democrats hammered Republicans relentlessly over their failure to take the COVID-19 pandemic seriously — and according to a Democratic Congressional Campaign Committee memo that CNN has obtained a copy of, Democrats also plan to make COVID-19 a major issue in the 2022 midterms.

Some non-Trumpian GOP governors have been quite proactive in their response to the pandemic, including Maryland's Larry Hogan, Massachusetts' Charlie Baker and Vermont's Phil Scott. Yet countless other Republicans have downplayed the pandemic's severity, opposed social distancing measures and discouraged the use of protective mask mandates.

CNN's Melanie Zanona reports, "The House Democrats' campaign arm is amplifying their warnings that the GOP's dangerous rhetoric and misinformation about COVID-19 is threatening to harm public health and thwart economic progress — a preview of how Democrats on the campaign trail plan to address a crisis that is still consuming both the country and Joe Biden's presidency. In a new memo that began circulating on Thursday, the Democratic Congressional Campaign Committee writes that House Republicans have 'lied about (Covid's) impact,' 'dangerously rejected medical guidance to wear masks and social distance,' and 'encouraged Americans to consume horse and cattle dewormer in lieu of the proven COVID-19 vaccine,' according to a copy of the memo obtained by CNN."

The DCCC memo, according to Zanona, specifically mentions far-right Republicans such as Rep. Marjorie Taylor Greene of Georgia, Rep. Louis Gohmert of Texas and Rep. Madison Cawthorn of North Carolina. And it lays out a Republican/Democrat contrast with COVID-19, saying, "Biden and House Democrats have rushed to get Americans back to work and crush the COVID-19 virus and rebuild our economy with the American Rescue Plan. We've added 4.5 million new jobs since January 2021, returning the nation's economy to pre-pandemic levels and put more than 374 million shots in arms. But House Republicans are threatening our economic progress by doubling down on their deadly lies."

From a health standpoint, the DCCC memo argues, putting Republicans back in control of Congress would be a huge mistake.

The memo reads, "House Republicans' Extremist Ringleaders Kevin McCarthy and Tom Emmer have a moronic proposal for the American people; hand them control of Congress next November and usher in their clan of dangerous extremists. The American people simply can't afford to give extremist House Republicans control of Congress."

DCCC Chairman Sean Patrick Maloney, during an interview with CNN, also offered a sneak preview of what Democratic messaging on COVID-19 will look like in the 2022 midterms. The New York congressman told CNN, "From Day One of this pandemic, Republicans have rejected reality and embraced political extremism by lying about the effectiveness of vaccines, mask wearing and social distancing. Even as school children fill up ICU beds across the country, they've taken to social media and conservative media outlets to whip up dangerous conspiracies, including peddling horse dewormer as a COVID treatment."

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Kristi Noem still brags about defying public health advice — but an expert just showed why it was a disaster

South Dakota and Vermont are not only two very different states politically — they are also two states that have had very different COVID-19 outcomes. And Dr. Ashish Jha, a dean at the Brown University School of Public Health who is often featured as a medical expert on MSNBC, lays out some reasons for those outcomes in an op-ed published by the Washington Post this week.

South Dakota is a deep red state with a Republican governor, Kristi Noem, who is a far-right supporter of former President Donald Trump and has been highly critical of COVID-19 restrictions and social distancing measures. Even now, she still brags about her refusal to comply with basic public health precautions:

Vermont, in contrast, is a blue state that has a Republican governor, Phil Scott, who leans conservative economically but is far from a Trump loyalist. Although Scott has policy differences with Vermont's Sen. Bernie Sanders, a self-described "democratic socialist," he crossed party lines in the 2020 presidential election and voted for now-President Joe Biden — not Trump. And Scott has never been a coronavirus denier.

Jha explains, "Let's start with some basics. Vermont and South Dakota share several important similarities. Both have relatively White, older and rural populations. They have comparable median incomes. Both states have Republican governors, challenging the simplistic notion that COVID risk is a partisan phenomenon."

When it comes to COVID-19, according to Jha, "South Dakota has infection numbers almost as low as Vermont, the most vaccinated state in the nation."

"Over the past two months," Jha observes, "the rates of infection in Vermont and South Dakota have appeared remarkably similar. Both states have seen steep declines in cases, making both states near the best in terms of infections per population. But this is where the similarity ends. While nearly 75% of Vermonters have had at least one vaccine shot, putting the state near the threshold for herd immunity, only half of South Dakotans have had at least one shot. South Dakota's substantial population immunity instead comes in large part from prior infections, particularly during the fall."

COVID-19 infection rates and COVID-19 mortality rates, however, are two different things. The pandemic, according to Jha, has been deadlier in South Dakota — where Noem encouraged the crowded Sturgis Motorcycle Rally in August 2020.

"Unsurprisingly, these states experienced stunningly different outcomes," Jha notes. "Adjusted for population, nearly six times as many people died in South Dakota from COVID-19 as in Vermont: 230 per 100,000 in South Dakota compared to just 40 per 100,000 in Vermont. In real numbers, while about 250 Vermont residents died from the disease, more than 2000 South Dakotans died. And as of today, Vermont has a lower unemployment rate, suggesting that there need not be any trade-off between public health and the economy."

In 2021, according to Jha, Vermont's approach has been "keeping public health measures in place to keep infections low and then, building up population immunity through excellent vaccination campaigns."

"Embracing a policy of 'personal responsibility,' South Dakota did little to protect its residents, leading to the deaths of more than 2000 South Dakotans and the suffering of tens of thousands more," Jha stresses. "To avoid more unnecessary outbreaks, we need to learn from states that have successfully weathered the pandemic, follow the science and keep vaccinating Americans."

People with dementia are twice as likely to contract COVID-19: study

Recently, scientists have discovered peculiar connections between neurological conditions and COVID-19 risk. We know that there is a heightened risk of dying of COVID-19 complications for those with schizophrenia. Now, this week comes a new study which finds that people with dementia are twice as likely to contract COVID-19 as those without the deadly cognitive disease.

The study, which was mainly written by researchers from Case Western University and published on Tuesday in Alzheimer's & Dementia: The Journal of the Alzheimer's Association, analyzed electronic health record data for nearly 62 million Americans adults.

"Currently, there is little if any quantitative analysis of the risks and outcomes for COVID‐19 in individuals with [Alzheimer's disease] or dementia in the United States," the authors explained.

But what accounts for the connection between contracting COVID-19 and dementia? The answer may lie in the relationship between the brain and the body.

Indeed, researchers hypothesized that, because individuals with Alzheimer's disease and dementia experience damage to the blood-brain barrier, they may be more susceptible to COVID-19 — just as they are to other diseases. In addition, they speculated that patients with dementia might struggle to follow public health guidelines to prevent transmission such as wearing masks, washing hands and social distancing.

Researchers also wanted to test whether patients with dementia who were infected with COVID-19 were at a higher risk of dying, noting that "SARS‐CoV2 has also been shown to affect the brain directly with reports of encephalitis, thrombotic events, and brain invasion."

The researchers found that patients with dementia were both more likely to develop COVID-19 and were more likely to suffer severe adverse effects after being infected with the novel coronavirus. Although only 25% of the overall number of patients studied in the article were hospitalized due to COVID-19, 59% of those with dementia had to be hospitalized. Similarly, although only 5% of the overall number of patients died as a result of COVID-19, that number quadrupled to 20% among those who had dementia.

The authors also noted a racial disparity. Among black patients with dementia who contracted COVID-19, a staggering 73% had to be hospitalized and 23% ultimately passed away, compared to 53% of white patients with dementia and COVID-19 being hospitalized and 19% of white patients dying.

This is the second recent study to draw attention to the vulnerability of mentally ill individuals to COVID-19. As alluded to, earlier this month a study published in the journal JAMA Psychiatry found that individuals on the schizophrenia spectrum were almost three times as likely to die after being diagnosed with COVID-19.

"In the first month and a half after COVID diagnosis, patients with schizophrenia as compared to patients without psychiatric disorders were roughly two-and-a-half times more likely to die," Mark Olfson, a professor of psychiatry at Columbia University, told Salon by email about the study. "An increased mortality risk was not found for patients with mood or anxiety, two common less severe conditions."

Experts also anticipate that there will be lingering psychological trauma caused by the pandemic, with the lockdowns and fear of death altering human behavior long after the plague itself has passed.

"This will take generations to get past," Dr. David Reiss, psychiatrist in private practice and expert in mental fitness evaluations, told Salon last month. "And that's because at every stage of development, things have been disrupted."

Giuliani's Health Care Lies Come Back to Haunt Him

This post, written by Amanda Terkel, originally appeared on Think Progress

New Hampshire for Health Care, which "represents more than 60,000 residents who consider health care a top priority in the 2008 election," has called on Giuliani to pull down his misleading ad on prostate cancer statistics. In the ad, Giuliani claims that his "chance of surviving prostate cancer" was 82 percent in the United States, and just 44 percent "under socialized medicine" in England.

Giuliani's campaign confirmed that it took the statistics from a summer 2007 article entitled "The Ugly Truth About Canadian Health Care." The piece by David Gratzer appeared in the right-wing quarterly magazine City Journal, an arm of the conservative Manhattan Institute.

Gratzer told reporters that "he based his figures on a study by the Commonwealth Fund, a nonprofit group that researches health care policy." But according to the Concord Monitor today, the Commonwealth Fund disputes Giuliani and Gratzer's use of its figures:
But the Commonwealth Fund said the figures didn't come from its reports. They can't accurately be calculated from the seven-year-old report Gratzer references, said Dr. Stephen Schoenbaum, executive vice president for programs at the Commonwealth Fund.
"The figures that they're working on (are) not correctly derived," he said. "They're also old numbers. The numbers are possibly changing."
The Commonwealth Fund report relied upon by Gratzer is from 2000, and contains a chart on prostate cancer "incidence and mortality rates":

Click for larger version
(click for larger version)

Senate Passes SCHIP Again, Bush to Screw Over Sick Kids...Again

This post, written by Joe Sudbay, originally appeared on AMERICABlog

They must be all excited at the Bush White House tonight. Bush gets to pull out his veto pen again. And, one more time, he gets to screw sick kids. The Senate passed the children's health insurance bill tonight:
The Senate passed a new bill Thursday expanding a popular children's health insurance program, despite the lingering threat of a veto from President Bush.
The bill -- which boosts the number of low-income children covered by the State Children's Health Insurance Program -- was recently passed by the House, but without the veto-proof margin it received in the Senate.
Bush vetoed the first SCHIP bill and is expected to veto this one.