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136. From "Behind the Mask," Infection Control Today's Podcast: Why Cutting Off Health Communications Puts Us All at Risk
"The closure of communications has impacted all committees, grant review boards, and publications,” Another ICTEAB member, Kevin Kavanagh, MD, wrote. “The purpose appears to be for a reset, hopefully for the assurance of accuracy and to make sure that the government functions are aligned with the current administration's priorities. As you well know, I have been critical of the CDC and many of its biases in decision-making. In my opinion, some of the appointments were political rather than based on scientific capabilities. For example, the [Healthcare Infection Control Practices Advisory Committee] not recommending respirators for all respiratory pathogens and not allowing the voluntary use of N95 masks by health care workers makes little sense to me. In the world of value-based purchasing, eliminating risk adjustment for minorities may help uncover poor performance of facilities and better allow remediation to take place.

Kavanagh continued, “Many will disagree with the administration's priorities, but elections have consequences, and the last one has our country headed in a different direction. However, these changes must be done strategically, ensuring no unintended consequences. For example, some communications relating to bacterial threats and the impending H5N1 pandemic need to be unimpeded for the sake of public safety. Many higher educational institutions are highly dependent on the grant money approved by study sections. We must be careful that the new course which will be taken is best for our nation.”
https://www.infectioncontroltoday.com/view/from-behind-mask-infection-control-today-s-podcast-why-cutting-off-health-communications-puts-us-all-at-risk  
  
135.  A win for healthcare workers and patients: The CDC returns HICPAC’s draft recommendations on infection control.
Fiona Lowenstein: Kavanagh and Thomason believe a lack of adequate protections for healthcare workers is contributing to staffing shortages. Employers claim “that the nursing shortage is preventing them from hiring,” ... Surveillance, tracking, data, and transparency have been “chronic problems” for the CDC since long before the pandemic, said Kevin Kavanagh, chairman of Health Watch USA — a patient advocacy, health care, and research integrity organization.
     His group has previously urged action for other infectious agents, including Candida auris, MRSA, C. diff, and CRE. Critics of HICPAC’s draft guidance have pointed out that the recommendations would increase the risk of infection for a wide range of pathogens beyond SARS-CoV-2, including influenza, RSV, measles, and Ebola. The (2023 draft HICPAC) recommendations would also do little to prepare healthcare centers for future airborne disease outbreaks.
     Kavanagh believes the CDC’s failures to better track and prevent the spread of these pathogens before 2020 contributed to a lack of preparedness when SARS-CoV-2 first emerged. “The strategic stockpile had dwindled,” he explained, referring to a shortage of personal protective equipment (PPE). “At one point there was an advisory that healthcare workers…could wear a bandana. That to me is a lack of preparation beyond comprehension.”...
     The CDC’s decision to return HICPAC’s draft reflects the power of push-back from health advocacy and labor groups. It also comes amidst an increase in some workplace protections around the country. Los Angeles County, Illinois, Berkshire Health System in Massachusetts, and New York City reinstated mask mandates for healthcare facilities this winter, as did New York’s Fire Department. Kavanagh called CDC’s decision to return HICPAC’s draft “important and impactful,” but warned that “much work still needs to be done.” Jan. 30, 2023. The Sick Times: https://thesicktimes.org/2024/01/30/a-win-for-healthcare-workers-and-patients-the-cdc-returns-hicpacs-draft-recommendations-on-infection-control/ 
 
134.  CDC Advisory Group Under Fire for Proposed Infection Control Guidelines
— Nurse union, occupational health experts, patients say weaker guidelines help only employers
"NNU and others say the proposed guidelines weaken existing infection control standards, privileging employer and hospital bottom lines over employee and patient safety. "The guidance that they're updating applies to every infectious disease in healthcare settings, from tuberculosis, to measles, to influenza, to MDROs [multidrug-resistant organisms], to COVID. All of it," said Thomason." ... A Murky Approval Process? "Kevin Kavanagh, MD, of Health Watch USA, a patient advocacy and research organization, and co-authors wrote in an article for Infection Control Today "the process of recommendation formulation is flawed and lacks transparency," citing HICPAC committee votes held before public comment and meeting presentations not publicly posted." Med Page Today. Aug. 25, 2023. https://www.medpagetoday.com/infectiousdisease/infectioncontrol/106030  
 
133. Health Watch USA's 17th Annual Conference: Exploring Long COVID's Impact on Patients, Workers, and Society
"Health Watch USA’s 17th annual conference/webinar, on November 1, 2023, 'Long COVID's Impact on Patients, Workers & Society,' will encompass a comprehensive exploration of long COVID across all age group Kevin Kavanagh, MD, MS, board chairman for Health Watch USA:
'Our society largely believes that all is well if one is not at risk for hospitalizations. Even policymakers are ignoring the ravages of long COVID. This webinar will highlight the personal and economic devastation produced by long COVID and the misinformation that is minimizing its risks in the eyes of the public.... But, frankly, the main message of the conference will be that we still must take this virus very seriously.' " Infection Control Today. Sept. 7, 2023. https://www.infectioncontroltoday.com/view/health-watch-usa-s-17th-annual-conference-exploring-long-covid-s-impact-patients-workers-society  
 
132 Biden taps former North Carolina health official Mandy Cohen as new director of CDC
Kevin Kavanagh, M.D., the president and founder of the patient advocacy organization, Health Watch USA and who has sometimes been critical of the agency’s handling of the COVID-19 pandemic, said that the change in CDC leadership “represents an opportunity for the CDC to head in a new direction. Currently a number of very important policies are being formulated. For example: At a minimum the use of N95 masks for all airborne pathogens needs to be recommended for healthcare staff and enhanced barrier precautions for nursing homes should only be undertaken in clinical trials.” Kavanagh also called for a strengthening of nursing home guidelines, and residents infected by a dangerous pathogen need to be separated from the rest of the facilities’ residents. “Advisory committees need to have greater transparency with public comments occurring before not after votes and in addition all meetings should be posted online for later viewing. Most importantly, frontline workers, patients, industrial hygienists, occupational scientists, aerosol scientists and worker unions need to have a voting seat at the table with equal representation as industry voices have.” Fierce Health Care. June 20, 2023  https://www.fiercehealthcare.com/payers/initial-response-bidens-appointment-mandy-cohen-new-cdc-director-positive  
   
131.  Long COVID described as a 'syndrome of syndromes' in NIH funded research
Kevin Kavanagh, M.D., president and founder of the patient advocacy organization Health Watch USA, told Fierce Healthcare in an email that of the symptoms researchers focused on, exertional malaise and brain fog would be the most debilitating. He added that “of interest is that individuals in the ‘uninfected’ study arm were found to be more likely to be vaccinated. The best defense against long COVID is vaccination and not becoming infected with SARS-CoV-2 in the first place and if you do, seek immediate medical attention to determine if you qualify for antiviral medications.” In the study, more than 20% of individuals who’ve had COVID were deemed to have long COVID because they exhibited these symptoms six months after the first time that they tested positive for the condition. However, a third of those individuals no longer suffered from long COVID at nine months. Kavanagh said “there is growing evidence that the symptoms are not necessarily the result of past viral damage but ongoing damage from an abnormal immune system or viral reservoirs.” Fierce Healthcare. May 30, 2023. https://www.fiercehealthcare.com/providers/long-covid-described-syndromes-syndromes-nih-funded-research  
 
130. Government stats show number of uninsured declined in 2022, though experts question methodology, conclusion
Kevin Kavanagh, M.D., founder and president of the patient advocacy organization Health Watch USA(sm), told Fierce Healthcare in an email that “healthcare marketplace plans will end the pandemic’s special enrollment period and will no longer maintain coverage if premiums cannot be paid. Unfortunately, I expect the rate of uninsured to increase in the United States as the PHE provisions are lost and those disabled with long COVID lose their employer’s private coverage but do not yet qualify for disability in Medicare.” Hispanic adults were most likely to lack health insurance coverage (27.6%) in 2022, followed by Black adults (13.3%), according to the NCHS report. Asian adults and white adults had the lowest percentage of uninsured, 7.1% and 7.4%, respectively. “Among white adults aged 18–64, the percentage who were uninsured decreased from 8.7% in 2021 to 7.4% in 2022,” the report states. “Among Hispanic and Black adults aged 18–64, the observed decreases in the percentage of uninsured from 2021 to 2022 were not significant.” Kavanagh said that Hispanic and Black patients are “also the racial groups which predominate in many of our frontline occupations and are at high risk for COVID-19. The ending of the PHE does not mean the ending of COVID. Adequate insurance coverage of minorities and economically disadvantaged populations is of utmost importance.” Fierce Healthcare. May 18, 2023. https://www.fiercehealthcare.com/payers/government-stats-show-number-uninsured-declined-though-experts-question-methodology  
  
129.  Horizon taps AI provider Solera Health in effort to offer more customized care to members
Kevin Kavanagh, M.D., founder and president of the patient advocacy organization Health Watch USA, said he worries about an AI arms race.
“Payers will use AI to evaluate office notes to determine level of payments and to make a coverage eligibility determination for ordered tests and procedures,” Kavanagh told Fierce Healthcare in an email. “On the provider end, Microsoft has announced Dragon Ambient eXperience which will produce a draft clinical note within seconds after a patient visit. The AI system will incorporate insights from unstructured data such as conversations."
"It is not a huge step to envision, the AI written clinical note will be optimized for reimbursement and that the AI will learn from previous claim denial and payments what data to incorporate," he added. Fierce Healthcare. May 4, 2023.
https://www.fiercehealthcare.com/payers/horizon-healthcare-services-taps-ai-provider-solera-health-effort-offer-more-customized-care   
  
128.  CDC seeks new weapons against antimicrobial resistance
"Kevin Kavanagh, M.D., founder and president of the patient advocacy organization Health Watch USA, applauds the CDC for investigating decolonization in more depth. “This new CDC strategy could represent a paradigm shift in how we approach the prevention of infectious diseases,” Kavanagh told Fierce Healthcare in an email. “Identifying carriers along with isolation and decolonization is key to the control of many pathogens. This includes MRSA, Candida auris and even COVID-19. In actuality, we should determine all the bacteria which are present in a patient’s microbiome, both on admission to healthcare facilities and nursing homes but also as part of a physical examination.” The identification of individuals carrying dangerous pathogens would be a good first step, said Kavanagh. “If decolonization fails, sequestering the patient or nursing home resident with others with compatible microbiomes may be an option,” Kavanagh said. “However, staff should continue contact precautions, so they do not become colonized and spread the pathogens to the community and their home.”" Fierce Healthcare.  Apr. 12, 2023. https://www.fiercehealthcare.com/payers/not-your-fathers-decolonization-approach-cdc-seeks-new-weapons-against-antimicrobial 
       
127.  Mpox Emergence: A Review of the 2022-2023 Outbreak
“The clinical and epidemiological presentation of mpox has changed,” Kevin Kavanagh, MD, a member of the Infection Control Today® Editorial Advisory Board, explains. “Although not typically considered a sexual disease, there is evidence that the virus can be present in semen early in the disease, possibly during an asymptomatic period. Although spread by this route has not been firmly established, epidemiological data and the clinical presentation of lesions support the contention that this can be a major route of spread. Initial outbreaks were associated with gay and bisexual men. In general, these communities had experience with the HIV epidemics and had high acceptance of public health measures, including vaccines. Working together with public health officials, the mpox pandemic was brought under control. Unfortunately, during the COVID-19 pandemic, the adoption of public health measures was not uniformly embraced throughout our society. The response and results achieved by the gay and bisexual communities to mpox should be emulated by others when dealing with COVID-19. Infection Control Today Feb. 23, 2023. https://www.infectioncontroltoday.com/view/mpox-emergence-review-2022-2023-outbreak   
    
126.  Study: Protection from prior COVID infection almost as good as vaccines
In addition, researchers equated a two-dose mRNA vaccine to prior infection and didn’t consider a booster, said Kevin Kavanagh, president and founder of patient advocacy group Health Watch USA, in an interview with Fierce Healthcare.
“I feel the meaning of the results of the study has been largely misinterpreted,” Kavanagh said. “Infection may give similar or greater immunity than a two-dose vaccine, but both are inadequate at this point,” he adds. Those results don't impress Kavanagh, he said. “If at the beginning of the pandemic, back in 2020, we announced that a vaccine would give protection for about 10 months, that it was only 36.1% effective in preventing infections with the tested BA.1 variant, and it would be expected to be less effective with the current circulating variants, few would view this as good news,” he said. Kavanagh said “preventing hospitalizations and deaths is important, but we now know that long COVID is also a grave concern, one which can occur in mild disease. Data from the CDC Household Pulse Survey indicates it is even more common in young and middle-aged adults than those above the age of 60. The results of the article underscore the necessity for both vaccinated and previously infected to receive a bivalent booster to optimize one’s immunity.” Fierce Healthcare. Feb. 22, 2023. https://www.fiercehealthcare.com/payers/study-argues-protection-prior-covid-infection-almost-good-vaccines  
    
125. Do masks really protect against COVID-19? Meta-analysis authors want to see more evidence
Kevin Kavanagh, M.D., the president and founder of the patient advocacy group Health Watch USA who’s been closely following and analyzing the pandemic from the beginning, cited The Conversation in his rebuttal of the Cochrane Library’s findings.
“Meta-analysis is a less than optimal methodology to apply to the issue of masking,” Kavanagh told Fierce Healthcare. “Almost all included studies varied widely in their methodology, since it is very hard to ethically have a non-masking control group.”
Kavanagh noted that in some of the studies in the meta-analysis, individuals wore masks only part of the time and COVID-19 spread throughout a building.
“Masks worn by an asymptomatic carrier also protect others, but this was not evaluated in most of the studies,” said Kavanagh. “Negative findings are not surprising in a meta-analysis with suboptimal research assumptions and which includes studies with widely varying methodologies.”
Kavanagh said that “surgical masks will not reliably stop an airborne pathogen.” (However,) Kavanagh said: “After all masking and public health measures stopped SARS-1 in its tracks in Toronto, I would view (the Cochrane meta-analysis' findings) with a large degree of skepticism.” Fierce Healthcare. Feb. 9, 2023.
https://www.fiercehealthcare.com/providers/do-masks-really-protect-against-covid-19-meta-analysis-authors-want-see-more-evidence  
  
124. How COVID-19 may have enhanced the status of preprint studies
Kevin Kavanagh, M.D., is the founder and president of the patient advocacy organization Health Watch USA. He’s also been keeping a close watch on COVID-19 throughout the pandemic, often using information from preprint studies. He was one of the first experts to sound the alarm about Delta’s lethality, and early on noted that COVID-19 doesn’t just affect the respiratory system, but other organs in the body as well.
Kavanagh argued that “by the time journal articles are formally reviewed and printed often the information will be outdated or lives lost in the delay.” However, Kavanagh echoes Krumholz in saying that preprint studies need to be handled with care, and the reader should be able to spot shoddy research.
“Both the history of the authors and institution is very important and of course you have to read the whole article, plus any comments which are posted on the preprint’s webpage,” Kavanagh told Fierce Healthcare. “Some journals have an open review process where anyone can make and post comments during the formal review process of the article. These steps should also be performed for articles that have been formally published, since peer review is largely a volunteer process and not an ironclad guarantee of quality.” Fierce Healthcare. Jan. 27, 2023. https://www.fiercehealthcare.com/providers/how-covid-19-may-have-enhanced-status-preprint-studies
   
123. Providers jostle to lead way if FDA makes COVID vaccination a yearly jab
So why are children still getting the original monovalent version of the COVID-19 vaccine? That's a question Kevin Kavanagh, M.D., president and founder of patient advocacy organization Health Watch USA, told Fierce Healthcare he wants to see answered.
Kavanagh said he worries about imprinting, where exposure to the virus, whether it’s from a vaccine or infection, will determine the type of immune response to all future exposures. This creates a concern that those exposed only to the original variant, for instance through the monovalent vaccine, will not produce as strong a response and immune memory to new variants. “And this may also limit then the immune system’s learning about how to respond to the new infections when they’ve been imprinted with the original variant,” said Kavanagh. “The advantage of imprinting to the body is that it provides for a very rapid immunological response, but a response that may not perfectly match the virus that individuals are exposed to.” He expressed those concerns in a letter to VRBPAC ahead of the Thursday meeting. Fierce Healthcare. Jan. 26, 2023. https://www.fiercehealthcare.com/providers/and-then-there-were-1-fda-weights-battling-covid-similar-battling-flu-1-yearly-jab   
      
122.  268K people who died from COVID-19 in first 2 years of pandemic not included in official tally: study
Kevin Kavanagh, M.D., president and founder of patient advocacy organization Health Watch USA, told Fierce Healthcare that “the importance of having accurate data and the impact of COVID-19 for our country’s workforce and our healthcare system cannot be overstated.”
      Kavanagh adds that “our healthcare system may not be able to withstand the continued stresses of the pandemic, transforming it into a dysfunctional system not able to take care of heart attack or cancer patients during high rates of COVID-19. We thus should not choose to understate the actual numbers and mitigate the impact of the pandemic; this results in a lack of resources and inhibits our ability to effectively confront the pandemic.”
     Kavanagh said the “authors’ data and conclusions further build on a mountain of evidence of the dangers of the COVID-19 pandemic. Death certificate death numbers will greatly underestimate actual COVID-19 deaths. Many COVID-19 deaths are going uncounted and unnoticed since the public and policymakers seem fixated on just those resulting from acute respiratory disease.” 
    “(Delayed deaths from Long COVID) would almost double the total number of COVID-19 deaths,” said Kavanagh. “The vast majority of these additional deaths are in COVID-19 negative patients and are stealth deaths not reported to COVID fatality registries.” Fierce Healthcare. Jan. 24, 2023.
https://www.fiercehealthcare.com/providers/268176-people-who-died-covid-19-first-2-years-pandemic-not-included-official-tally-study   
 
121.  XBB COVID variant presents a unique threat: study
Kevin Kavanagh, M.D., is the president and founder of the patient advocacy organization Health Watch USA and has kept a close eye on COVID-19 throughout the pandemic. Kavanagh told Fierce Healthcare that “the most disturbing finding in the study is that this virus is a recombinant virus where two different genomes or genetic materials from viruses were recombined, as opposed to a chance mutation.” Kavanagh pointed out that the U.S. healthcare system currently deals with the tripledemic of influenza, respiratory syncytial virus (RSV) and COVID-19. Kavanagh said how, in the summer, Texas Children’s Hospital had to deal with about 25 cases where children had been infected by RSV and COVID-19 at the same time. “If viruses can start swapping genetic material, then the sky is the limit on the number of variants and the various characteristics which may be produced,” says Kavanagh. Kavanagh stressed that a virus created through recombination “can make huge leaps and bounds in changes in its characteristics in a very short period of time. The fact that this has been observed is even more concerning than this virus itself.” Fierce Healthcare. Dec. 28, 2022. https://www.fiercehealthcare.com/providers/xbb-covid-variant-presents-unique-threat-study 
   
Recombination between viral species is rare but can occur as outlined in a Proceedings of the National Academy of Sciences article entitled "Evidence that a plant virus switched hosts to infect a vertebrate and then recombined with a vertebrate-infecting virus."
https://www.pnas.org/doi/full/10.1073/pnas.96.14.8022  
  
The rampant spread of three different viruses at the same time with co-infections is very problematic. With viruses, rare events only have to happen once to have a profound impact on society.
     
120.  CDC tallies deaths from long COVID with new code
"The implementation of ICD–10 code U09.9 for cause-of-death coding and standardized guidance for certification of these deaths would facilitate more rapid ongoing surveillance of long COVID deaths”.... "Kevin Kavanagh, M.D., founder and president of the patient advocacy organization Health Watch USA, told Fierce Healthcare that “death certificates vastly underestimate the incidence of deaths. Unless there’s a checkbox or something on the certificate for the disease, it is unlikely that it’s going to pick up the underlying cause.” Kavanagh cites a study published in Nature in April 2021 in which deaths from long COVID among patients in Veterans Health Administration hospitals came to 0.839%, more than twice as many as what NCHS researchers found.Kavanagh adds that other studies have shown COVID affects almost every organ of the body. Some common diseases that individuals die from include heart disease, Alzheimer’s disease, lower respiratory disease, stroke and diabetes. “All of which are known effects of the virus,” says Kavanagh. “This virus affects the central nervous system, it causes brain fog, cognitive problems. It causes hypercoagulation of the blood, which can cause heart attacks. It’s well documented to increase the chances of having diabetes.”" Fierce HealthCare. Dec. 14, 2022. https://www.fiercehealthcare.com/payers/cdc-touts-code-long-covid-death-certificates 
 
119.  Experts urge polio vaccination to ward off any major resurgence
Kevin Kavanagh, M.D., president and founder of the patient advocacy organization Health Watch USA, agrees with Vasan, especially about the need for the healthcare system and society in general to champion polio vaccination. Vasan stresses the importance of a good public health system in the face of a polio outbreak. Kavanagh agrees with that as well, but with a caveat.
“The thing that is very hard about public health is when they’re successful, you don’t have disease,” Kavanagh told Fierce Healthcare. “And so many people believe, ‘Well, it wasn’t needed. We don’t need to get the vaccine.’ Unless people believe that public health is vital and it’s something that they need to incorporate into how they live their life plans (we will not be successful in mitigating outbreaks).”
Kavanagh said, “unfortunately there are too many loopholes or opt-outs for either religious beliefs or other reasons that allow too many people to go unvaccinated. When that occurs in a large community, then you’d have a number of individuals that are at high risk of getting polio because you no longer have herd immunity.”
Kavanagh points out that over 85% of the population needs to be vaccinated against polio before such herd immunity can take place. “Unfortunately, 70% of infections can be asymptomatic and those not vaccinated tend to have similar cultural views and encounter each other socially. Another 25% of polio infections are mild. Only one in 200 infections result in paralysis and of those 5% to 10% will die.”
Most patients who contract the polio virus do well, and most do not know they are infected. However, those who develop paralytic polio face a devastating life-altering disease.
“The polio vaccine is safe and highly effective, which is why everyone should become vaccinated,” said Kavanagh.   Fiercehealthcare Nov. 9, 2022. https://www.fiercehealthcare.com/providers/experts-urge-polio-vaccination-ward-any-major-resurgence   
  
118.  CDC advisory panel recommends adding COVID vaccine to kids' routine immunization schedule
Kevin Kavanagh, M.D., founder and president of the patient advocacy group Health Watch USA, told Fierce Healthcare that “this is a step in the right direction. Children can still get sick from this disease, and they commonly serve as a vector of transmission to both teachers and parents. In addition, this virus poses significant risks to children for long COVID, which we are just now starting to learn about.”  Fierce Healthcare. Oct. 20, 2022. https://www.fiercehealthcare.com/providers/cdc-advisory-panel-recommends-covid-vaccine-become-part-childs-vaccination-schedule  
  
117.  Highly evasive BQ.1.1 appears on CDC's COVID-19 variants charts for first time
Kavanagh said BQ.1.1 “appears to be doubling every week. Data from CDC appears delayed in being posted on this variant. Once it became apparent in the last few weeks that the variant is having a significant impact, the data were separated.”
As far as his patient advocacy concerns, Kavanagh added that “this underscores the importance of obtaining the bivalent BA.5 booster. For most individuals, the benefits of the booster far outweigh risks.” The take-up of the latest bivalent vaccine has been lackluster, with fewer than 5% of eligible Americans getting inoculated, according to the CDC. Kavanagh suggested that it might be time to reconfigure variant grouping methods. “With different lineages developing similar mutations and the myriad of concerning mutations which are having an impact on viral infectivity and severity, one may need to consider a different method of classification, such as using levels of variant mutations,” he said. “A Level 4 Variant would have 4 mutations of concern and a Level 6, six mutations. This may produce a more rapid flagging of variants of concern rather than waiting for data regarding the impact of specific lineages.” Fierce Healthcare Oct. 17, 2022. https://www.fiercehealthcare.com/providers/highly-evasive-bq11-appears-cdcs-covid-19-variants-charts-first-time   
   
116.  Health insurers can run, but they can’t hide: Tough long COVID coverage decisions on the horizon
Meanwhile, 14.9% of people 18 to 29 years old have experienced long COVID, and 16% of those 30 to 39 years old have had it, a point that’s too often overlooked, said Kevin Kavanagh, M.D., the president and founder of the patient advocacy organization Health Watch USA. “This underscores the reason why using deaths and hospitalizations to judge risks to the young is inappropriate because a major risk is long COVID,” Kavanagh tells Fierce Healthcare. “This also may well be true of younger children in school.” Long COVID puts health insurers in a tough spot because while there isn’t a test for individual patients “there are several biomarkers along with changes on MRI scans on patient populations which show that this is a true disease,” Kavanagh said. “One of the main effects of COVID-19 are the biological and anatomical changes it produces. They are associated with changes in memory and concentration, as well as somebody’s personality and their psychological well-being.” Fierce Healthcare. Oct. 10, 2022. 
https://www.fiercehealthcare.com/payers/health-insurers-can-run-they-cant-hide-tough-long-covid-coverage-decisions-way     
   
115. MRSA resurgence reflects how COVID diminished quality of care, says study
Kavanagh told Fierce Healthcare that the significance of the study’s findings “is that it indicates that we need to motivate facilities to support and maintain experienced healthcare staff and create safe working environments rather than normalizing bad outcomes through risk adjustment.” He added that “what the study shows is that the increase in MRSA may not be directly related to COVID-19 but to the delivered care which was hobbled in facilities by the COVID-19 pandemic.” The inevitable rejoinder that some experts and policymakers might make is: How are we going to pay for this? To which Kavanagh responds: “We can’t afford not to because the cost to society, patients and healthcare workers is too great. And unless facilities create a safe workplace, they’re not going to be able to overcome their staffing shortages which will impact their bottom line. They’ll be less profitable, and patients and staff will be injured.” Fierce Healthcare. Sept 30, 2021. https://www.fiercehealthcare.com/providers/mrsa-resurgence-reflects-how-covid-diminished-quality-care-says-study   
   
114.  New COVID-19 variant's spread draws concern from CDC
Kevin Kavanagh, M.D., the president and founder of the patient advocacy organization Health Watch USA, has been closely following the pandemic since it first emerged. “This variant is obviously outcompeting our current major variants, but it is too soon to say whether it will have a significant impact on the United States,” he told Fierce Healthcare. “Currently, regions of our country have different rates of vaccination and a different history of exposure to past variants. Thus, the impact seen in one region does not translate to another, and it is anyone’s guess if BF.7 rapid growth will continue.” Kavanagh says that the emergence of new COVID-19 variants “is continuing evidence that herd immunity is not possible. With the high mutation and infection rates of SARS-CoV-2 we will continue to see viral evolution designed to avoid both natural and vaccine immunity. As we adapt, so does the virus. We must keep our immunity as high as possible and do everything we can to avoid reinfections with the concomitant risk Long COVID that can occur even in the young with mild disease.” Fierce Healthcare. Sept 21, 2022. https://www.fiercehealthcare.com/payers/new-covid-19-variant-causes-concern    
  
113.  Biden declares the COVID-19 pandemic over as experts keep wary eye on potential fall surge. By Frank Diamond
Deborah Birx, M.D., who served in the Trump administration as the White House Coronavirus Response Coordinator, last Thursday addressed a conference hosted by the consumer advocacy organization Health Watch USA. She warned of COVID-19 surges coming in the fall (which officially arrives this Thursday). “This was just last week,” she said of a slide showing where COVID seems to be surging. “I call your attention to Kentucky, Tennessee, West Virginia, Northern Alabama, and Mississippi, and Northern Louisiana. You can see the surges. There’s a high potential for community spread. And this is just after schools have started.”  Nonetheless, Birx said, there’s plenty of reason to be optimistic about the battle against COVID. “We have 21st century tools and knowledge to keep every American safe from hospitalization and death,” Birx said.  Those include vaccination and testing, although she cautioned that that’s not enough to protect vulnerable family members. Other measures include proactive testing through surges and immediate administration of Paxlovid if the individual is at-risk for significant disease. She also urged the use of N95 masks for at-risk individuals and maintaining proper airflow in buildings.  Fierce Health Care.  Sep 19, 2022 https://www.fiercehealthcare.com/payers/biden-declares-covid-19-pandemic-over  
  
112.  Immunity Lessons From COVID-19: Natural Infection vs Vaccination
Several of those studies focusing heavily on natural and vaccination immunity were conducted by Laith Jamal Abu-Raddad, PhD. Speaking in an exclusive interview with Infection Control Today® (ICT®), Ab-Raddad discussed some of these studies about immunity, vaccination hesitancy, and his presentation titled, "Immune protection of COVID -19 vaccination and natural infection," at the "Frontline Worker Safety in the Age of COVID-19: A Global Perspective” a Health Watch USA Webinar on September 14, 2022. https://www.infectioncontroltoday.com/view/immunity-lessons-covid-19-natural-infection-vs-vaccination   
  
111.  Health plans will soon be footing the bill for COVID-19 shots, tests
“The loss of [governmental] financial support for vaccinations and testing can only be expected to fuel the pandemic,” Kevin Kavanagh, M.D., founder and president of the patient advocacy group Health Watch USA, said in an interview. “At this point, it is unclear to what extent this shortfall will be picked up by employers or private health insurance coverage. The final cost of the vaccine is also unknown, especially in view of the recent suit filed by Moderna over alleged patent infringement by Pfizer and BioNTech. However, for insurance companies, it is in their best interest to have patients vaccinated and avoid the costs associated with hospitalizations and long COVID. The same is true for private businesses whose workforce is placed at risk by this disease.”   Fierce Healthcare.  Aug. 29, 2022.
https://www.fiercehealthcare.com/payers/health-plans-prepare-cover-covid-19-vaccine-tests    
       
110. Monkeypox: Birx Says We Are Not Ready for a New Pandemic
Ambassador Deborah Birx, MD, told Infection Control Today® exclusively, “Every mistake that we made with COVID-19 in January and February of 2020, repeated in real time with monkeypox.” Infection Control Today.  Aug. 18, 2022. https://www.infectioncontroltoday.com/view/monkeypox-birx-says-we-are-not-ready-new-pandemic    
    
109.  Birx: Every New Infection, Loss Should be Considered a Failure of US Medical Infrastructure  
Ambassador Deborah Birx said in an exclusive interview with ICT® that there are “extraordinary structural barriers in the US to access” medical care. Individuals may have insurance, but they cannot access care. Ambassador Deborah Birx, MD, will be presenting about this topic, titled, “COVID-19 USA - Lessons and new tools to improve workplace safety “at the Frontline Worker Safety in the Age of COVID-19: A Global Perspective” a Health Watch USAs Webinar on September 14, 2022. Birx is a world-renowned medical expert and leader whose long career has focused on clinical and basic immunology, infectious disease, pandemic preparedness, vaccine research, and global health. Birx also served as a US Army Colonel and later, running some of the most high-profile and influential programs at the US Centers for Disease Control and Prevention (CDC) and US Department of State.  Infection Control Today.  Aug. 17, 2022.  https://www.infectioncontroltoday.com/view/birx-every-new-infection-loss-should-be-considered-failure-us-medical-infrastructure    
 
108.  The 16th annual conference will highlight speakers from around the globe, offer continuing education credits, and will be held as a webinar on September 14, 2022.
“We are very pleased to have a number of world renown speakers ranging from Professor Lidia Morawska, one of Time Magazine's 100 most influential people in the world, regarding her work on the aerosolization of SARS-CoV-2; and Dr. Ziyad Al-Aly who had published a string of groundbreaking articles in Nature regarding the long-term effects of long COVID,” Kevin Kavanaugh, MD, MS, and the Board Chairman for Health Watch USA told Infection Control Today®. “The conference also will not be without examining the impact of lessons learned and a critical look at the United States' response by Dr. Deborah Birx and Sweden’s response by Dr. Nele Brusselaers. Other topics will include an examination of personnel protective equipment, including masks, surface disinfection, vaccines, and natural immunity. The event will conclude with presentations regarding the increasing incidence of workplace violence and a panel discussion on the inertia and barriers encountered in our health care system to correct many of the problems." Infection Control Today. Aug. 4, 2022. https://www.infectioncontroltoday.com/view/the-2022-health-watch-usa-conference-will-examine-frontline-work-safety-during-covid-19   
  
107.  J.D. Power: Mail-order pharmacies a growing threat to brick-and-mortar retailers
Kevin Kavanagh, M.D., founder of the patient advocacy group Health Watch USA, sees the benefit of more care being provided at pharmacies, noting that the COVID-fighting oral antiviral pill Paxlovid “can produce life-threatening drug interactions with a number of commonly prescribed medications, including cholesterol medications and anticoagulants. A pharmacist is the key healthcare professional to advise on the needed medication adjustments.” Kavanagh notes that not too many years ago, the only health service that a pharmacy might provide would be blood pressure readings. He predicts that “in the future, we will see treatments and testing for other common diseases spill over to the pharmacy and allied healthcare providers. A1C monitoring for diabetes and home testing for MRSA carriers are examples.” And while Amazon’s home delivery network represents a threat to any industry, even pharmacy, Kavanagh believes that many patients “will not want to wait for up to a day for their COVID-19 test and medication, and having a local healthcare provider who can readily consult with your physician when needed is a distinct advantage.”
Fierce Healthcare. Aug. 2, 2022. https://www.fiercehealthcare.com/retail/jd-power-mail-order-pharmacies-growing-threat-brick-and-mortar-retailers   
    
106.  Free At-Home COVID Tests on Way for Medicare Beneficiaries
Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board, said that while he’s happy about CMS’ plan, he also added that “when the problem was detected, most had a hard time believing it even existed. Why would Medicare not pay for home tests when private insurance did, and the elderly were the highest risk for COVID? This rule change will help with future variants, but the Omicron surge will likely have subsided before a Medicare recipient can obtain a free home test kit at a pharmacy.” In the meantime, Medicare beneficiaries can order 4 free at-home tests by going to covidtests.gov. Infection Control Today. Feb. 3, 2022.  https://www.infectioncontroltoday.com/view/free-at-home-covid-tests-on-way-for-medicare-beneficiaries    
   
105.  ‘Stealth Omicron’ Starting to Get Noticed, Setting Off Some Alarms
Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board, agrees. “With the large number of new mutations, I feel BA.2 should be viewed as a new variant,” says Kavanagh. “The variant appears to outcompete Omicron.”  Even if individuals infected with stealth Omicron turns out to have only “mild COVID-19”—a term Kavanagh has argued is a misnomer—if it nonetheless also turns out to be more infectious than original Omicron, that will cause even more disruptions to medical supply chains and add more burden to already overstressed health care systems.  “I feel we can all agree that the speed with which these new variants are developing is causing unsustainable stress on our society,” says Kavanagh. “We need to all implement public health strategies to slow down spread, which will also slow down the emergence of additional variants.” Infection Control Today.  Jan. 24, 2022. https://www.infectioncontroltoday.com/view/-stealth-omicron-starting-to-get-noticed-setting-off-some-alarms   
   
104.  COVID-19 Infecting White Tail Deer To Create Transmission Danger
This could be particularly problematic when it comes to trying to control COVID-19 spread and mutations, a point made by Kevin Kavanagh, MD, in a Q&A with Infection Control Today® (ICT®) last November. Talking about a study done by the US Department of Agriculture (DOA) on white-tail deer, Kavanagh—a member of ICT®’s Editorial Advisory Board—said that “the deer apparently live with COVID-19 quite well, but, yet rapidly spread it amongst the herds. And that’s actually very problematic, because if it finds a host that it doesn’t make sick, but yet it can mutate and change and then reinfect other animals and plus mankind, that is one of the worrisome scenarios that could take place.” Infection Control Today.  Jan. 17, 2022. https://www.infectioncontroltoday.com/view/covid-19-finds-home-in-deer-where-it-can-mutate-into-a-new-variant  
     
103.  U.S. Supreme Court Upholds Health Care Worker COVID-19 Vaccine Mandate
Kevin Kavanagh, MD, another ICT® EAB member, has long called for vaccine mandates for health care workers. In a Viewpoint in April 2021, Kavanagh wrote: “If you work in a health care facility, you need to be vaccinated against SARS-CoV-2. If you choose not to become vaccinated, then you should choose not to be working in a health care setting.”  Infection Control Today.  Jan. 14, 2022.
https://www.infectioncontroltoday.com/view/top-court-upholds-health-care-worker-covid-19-vaccine-mandate   
       
102.   What Infection Preventionists Must Do in Current Omicron Crisis
Kevin Kavanagh, MD, another ICT® EAB member, says that “it is even more imperative for us to up our mask protection with the highly infectious Omicron variant. A high-quality mask which fits well is required."
The best option is the N95, says Kavanagh.
"Even if not formally fit tested its performance can still be high, if worn properly. One study by MacIntyre CR, et al. even observed in a randomized controlled trial (published in Influenza and Other Respiratory Viruses) that ‘there was no significant difference in outcomes between the N95 arms with and without fit testing’ and ‘non‐fit‐tested N95 respirators were significantly more protective than medical masks against CRI (chronic respiratory illnesses).’”  Kavanagh says that all frontline workers and the public need to “be careful to make sure there is a good fit even if the mask is not formally fit tested. A mask placed over an N95 may hold the mask tighter to the face and assure an even tighter fit. This is important if the N95 is used repeatedly, and the elastic bands are beginning to stretch. Surgical masks will also offer some protection, but they are much harder to fit and require a second mask to hold them against the face.” Infection Control Today. Jan. 13, 2022. https://www.infectioncontroltoday.com/view/what-infection-preventionists-must-do-in-current-omicron-crisis   
   
101.  Cloth Masks Are Useless Against COVID-19 (Redux): Omicron Version
Kevin Kavanagh, MD, a member of ICT®’s Editorial Advisory Board, said at the time (April 2020) that while cloth masks might not keep someone from catching COVID-19, they may help prevent them from spreading it. In an article in May 2020 in ICT®, Kavanagh wrote that “when one exhales, coughs or sneezes, the particles are fairly directional and directed into the mask. One study estimated that cloth masks can stop up to 90% of droplets…. And over 100 countries now recommend the wearing of cloth masks by the public.” But what a difference a new COVID-19 variant can make. Kavanagh’s advice in 2020 had been tailored to the original variants of COVID-19, Alpha and Beta. When Delta appeared, Kavanagh altered his advice to fit the new reality. In a Q&A with ICT® in July 2021, Kavanagh said that “we need to be wearing respirators or N95s. Cloth masks, surgical masks with holes on the sides—those will not work.” Kavanagh has been ahead of the curve when it comes to predicting what the unpredictable SARS-CoV-2 might hit us with next.  Infection Control Today.  Jan. 12, 2022. https://www.infectioncontroltoday.com/view/cloth-masks-are-useless-against-covid-19-redux-omicron-version
  
100.  Delta, Omicron Coinfection Could Create a Super-Variant
Delta and Omicron coinfection is one of several concerns voiced by Paul Burton, MD, the chief medical officer at Moderna, to a panel of lawmakers in the United Kingdom.
Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board, wrote recently that “those who are not vaccinated or immunosuppressed are at risk for severe disease. Just these additional patients alone could easily collapse our overrun health care system. A transitory collapse has already happened in many regions of our nation during this pandemic which resulted in needed and sometimes urgent non-COVID-19 care to be delayed and sometimes unavailable.”  Infection Control Today.  Jan. 10, 2022.
https://www.infectioncontroltoday.com/view/delta-omicron-coinfection-could-create-a-super-variant    
   
99.  With few masks, will 2022 Kentucky legislative session be a COVID-19 super-spreader event?
Dr. Kevin Kavanagh, a retired Somerset physician, who follows COVID-19, called holding a legislative session without masks and regular testing "ill-advised." "Unfortunately, they are setting an example for their constituents," said Kavanagh, chairman of the patient advocacy group Health Watch USA. "I think we need to try to have everybody trying to follow public health advice and not spreading the virus." Dr. Kevin Kavanagh, a retired Somerset physician, who follows COVID-19, called holding a legislative session without masks and regular testing "ill-advised." "Unfortunately, they are setting an example for their constituents," said Kavanagh, chairman of the patient advocacy group Health Watch USA. "I think we need to try to have everybody trying to follow public health advice and not spreading the virus." Courier Journal.  Jan. 7, 2022.  https://www.courier-journal.com/story/news/politics/ky-general-assembly/2022/01/07/2022-kentucky-legislative-session-potential-covid-19-super-spreader/9103795002/   
    
98.  ‘Omicron the Pandemic Killer’ Idea Ignores Dangers of Long COVID
As noted by Kevin Kavanagh, MD, another member of ICT®’s EAB, a core difficulty in society’s attempt to guide COVID-19 from pandemic to endemic is that COVID is not just a respiratory virus. Kavanagh wrote in October that SARS-CoV-2 is similar to HIV because it can “silently spread throughout the host’s body and attack almost every organ.”  Kavanagh writes that “much of the abandonment of public health measures has been spurred by a massive disinformation campaign which has successfully convinced a relatively large portion of our population that as long as one lives through COVID-19 all will be well. The young and healthy have especially embraced this narrative.” It is a false narrative, Kavanagh warns, because “the premise that mild infections do not carry significant risks is false. In part this belief is driven by those who have not died from COVID-19 being counted as ‘recovered’ as opposed to ‘survived’. SARS-CoV-2 causes a system infection and is commonly detected in the heart and brain, exemplified by the loss of smell from brain tissue destruction and loss of cardiac function from myocarditis. Even those who develop ‘mild’ COVID-19 can develop long COVID-19 which in many cases lasts for a year or longer.”  Infection Control Today.  Jan. 4, 2022. 
https://www.infectioncontroltoday.com/view/-omicron-the-pandemic-killer-idea-ignores-dangers-of-long-covid   
      
97.  President Biden Vows Help for COVID-Swamped Hospitals
Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board calls Biden’s planned response to Omicron a “good start,” but says that the U.S. needs to be doing so much more than expanding hospital capacity, and testing.  “It is essential that we stress preventing infections,” says Kavanagh. “This includes ample N95 masks available for the public, social distancing, upgrading indoor ventilation and stressing the use of home delivery and curbside pickup.”  Kavanagh also cited an issue he’s focused on before: what he calls confused messaging about boosters. The Centers for Disease Control and Prevention has been inching its way toward saying that an individual will need 3 doses of a vaccine to be considered fully vaccinated, but hasn’t made that leap yet.  “It needs to be clearly stated that with waning of immunity, if you need a booster it is paramount you obtain one to give you protection against severe disease,” says Kavanagh. “Currently, if you become infected by Omicron there is a scarcity of effective monoclonal antibodies. We must develop the ability to rapidly produce and deploy monoclonal antibodies which are optimized for variants…. Remember approximately 3 percent of our population is immunocompromised and very susceptible to SARS-CoV-2.”  Infection Control Today.  Dec. 21, 2021.
https://www.infectioncontroltoday.com/view/president-biden-vows-help-for-covid-swamped-hospitals     
   
96.  COVID-19 spread on heels of tornadoes stirs fears of looming crisis
Dr. Kevin Kavanagh, a retired Somerset physician who follows COVID-19 infection, said testing is important to track the spread of COVID-19 in the area. But he said prevention is most important, especially in the area affected by tornadoes. "I think they need to concentrate on keeping them from being infected," said Kavanagh, chairman of the patient advocacy group Health Watch USA. "The virus is heartless, it is absolutely heartless. It does not care that these are stricken, frail individuals." Courier Journal.  Dec. 21, 2021.   https://www.courier-journal.com/story/news/local/2021/12/21/covid-spread-in-tornado-ravaged-kentucky-stirs-fears-looming-crisis/8969520002/   
   
95.  They’re Back: In Face of Omicron, Hand Hygiene, Social Distancing, Masking Needed
ICT® EAB member Kevin Kavanagh, MD, this week wrote just what that could mean in the US. “The US has a low rate of vaccination and obtaining boosters, and a relatively large segment of our population is elderly or immunocompromised,” Kavanagh wrote. “A 2-dose mRNA vaccine's immunity appears to rapidly wane and unlike South Africa, many in the US were fully vaccinated very early in the pandemic.” Kavanagh early on in the pandemic predicted that COVID-19 would become endemic for a lot of reasons, including the fact that it can infect animals and can jump from humans to animals and back to humans again in a different form. That seems to be the case with Omicron.
“Omicron did not mutate from Delta, it arose from a completely different evolutionary path,” Kavanagh wrote. “There is concern that Omicron arose in rodents, which were initially infected by humans, and then the virus jumped back into the human population. This etiology is supported by the plethora of different mutations, seven of which are associated with transmission between rodents.” Infection Control Today. Dec. 16, 2021.
https://www.infectioncontroltoday.com/view/they-re-back-in-face-of-omicron-hand-hygiene-social-distancing-masking-needed  
   
 94.  Prior COVID Infection Less Likely to Stop Omicron, Says Study
Omicron is three times more likely to reinfect people than Delta, according to a study out of South Africa where the latest iteration of COVID-19 first surfaced on November 25.
Citing a study by Alexis R. Demonbreun, et al., Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board, wrote last week that “as an initial goal in coping with COVID-19, we must prevent our health care system from being overrun. If the infectivity, lethality, and immune avoidance of the Omicron variant is confirmed, it will be of utmost importance that all who can, become vaccinated, including those who have had past COVID-19.”  Infection Control Today.  Dec. 5, 2021. 
https://www.infectioncontroltoday.com/view/prior-covid-infection-less-likely-to-stop-omicron-says-study   
   
93.  ‘You Dirty Rat’: Experts Posit That Omicron Hatched in Rodents
The number of mutations to the spike protein in Omicron suggest a very different evolutionary trail than had been seen in other iterations of COVID-19, say some experts. STAT talks to Robert Garry, PhD, a professor of microbiology and immunology at Tulane Medical School, who says that 7 SARS-CoV-2 mutations allow it infect mice and rats, and all 7 can be found in Omicron.
   
Kevin Kavanagh, MD, a member of Infection Control Today®’s (ICT®’s) Editorial Advisory Board, has sounded the alarm for months about the dangers posed by the fact that COVID-19 can jump from humans, to animals, and them back again (or vice versa), and pick up more mutations along the way. Kavanagh most recently noted this possibility in a Q&A with ICT® on November 22. In that interview, Kavanagh said that “deer apparently live with COVID-19 quite well, but, yet rapidly spread it amongst the herds. And that’s actually very problematic, because if it finds a host that it doesn’t make sick, but yet it can mutate and change and then reinfect other animals and plus mankind, that is one of the worrisome scenarios that could take place.” Kavanagh has thought that the idea is plausible for some time. Back in January 2021, Kavanagh noted that the reason we’ll need to learn to deal with endemic COVID-19, and not something that can be completely eradicated with a vaccine—such as smallpox—is that SARS-CoV-2 can jump from humans to animals and back again. “The problem is, if you have animal hosts, if your immunity drops––and it will over a couple of years––they’ll just reinfect you,” Kavanagh said in a Q&A with ICT®. “The idea of going out getting infected and the virus will go away, that’s not going to happen. It’ll get better, infections will drop dramatically, [and] we can return to a more normal life. But I think right now, it’s going to be pretty much endemic either in animals or in ourselves.”
Kavanagh again cited the danger posed by animal hosts in an article that he wrote for ICT® in August, when concern arose over that the more lethal Lambda variant, which displayed earmarks of potentially evading antibodies produced by vaccines or prior infections, and might be able to shove aside the dominant Delta variant. (That didn’t happen.) In that article, among other things, Kavanagh cited a study by the United States Department of Agriculture that showed that 40% of 385 samples taken from white tail deer were positive for SARS-CoV-2. Kavanagh noted that white tail deer are abundant near urban settings and that “this is very problematic; control may involve special handling and precautions when around deer, or even possible culling.”   Infection Control Today.  Dec. 3, 2021.
https://www.infectioncontroltoday.com/view/-you-dirty-rat-experts-posit-that-omicron-hatched-in-rodents     
   
82.  As Omicron Spreads, CDC Says Adults 18 and Older Should Get a Booster
Still, the COVID-19 pandemic and its aftermath—an aftermath that might extend for decades, if fears about long COVID pan out—raises a host of ethical questions, as Kevin Kavanagh, MD, and another member of ICT®’s EAB, put it in a recent interview. Kavanagh said that “one person with COVID-19 can spend months in the ICU, which would prevent 10 or 20, non-COVID-19 cases from going to the ICU, whether it’s for a coronary bypass, or just angioplasty, or getting a cancer procedure. You have 10 or 20 times the number of patients that can’t get care for other serious illnesses.”  Infection Control Today.  Dec. 1, 2021.  https://www.infectioncontroltoday.com/view/as-omicron-spreads-cdc-says-adults-18-and-older-should-get-a-booster
  
91.  Vaccines That Target Omicron Reportedly in the Works
The current vaccine will not be effective enough against Omicron. “I think it’s going to be a material drop,” Stéphane Bancel (CEO of Moderna) tells the Financial Times. “I just don’t know how much because we need to wait for the data. But all the scientists I’ve talked to . . . are like, ‘This is not going to be good.’”
As Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board (EAB) wrote yesterday, some 30 mutations in Omicron are on the spike protein. Vaccines strengthen that protein to enable the body to fight off the virus. Making the formula for a new vaccine is a relatively easy and speedy process thanks to mRNA technology. No more long periods of culturing in petri dishes in laboratories; a computer can print out the new formula.
“I’ve been told they can design a new vaccine in three days,” Kavanagh told ICT® in a Q&A on July 27. “And that’s great news, but you can’t make 300 million doses and get them in arms that quickly, especially when you have half of the country being anti-vaxxers and not wanting to take the vaccine.” Full vaccine development & testing may take approximately 3 months.
As Kavanagh, Linda Spaulding, RN-BC, CIC, CHEC, CHOP, and another member of ICT®’s EAB, and other experts have expressed to ICT®, the speed with which COVID-19 attacks continues to catch the health care system off guard.   Infection Control Today.  Nov. 30, 2021.   https://www.infectioncontroltoday.com/view/vaccines-that-target-omicron-reportedly-in-the-works  
  
90.  Enter Omicrom: New COVID-19 Variant Spreads Alarm
Although not much has been disclosed about Omicrom so far, its appearance made the WHO label it a variant of concern and caused a cascade of travel restrictions around the world.
Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board, says that “although there is scant data being shared with the public to draw definitive conclusions, the swift actions taken by governments throughout the world indicate an extremely high level of concern.”
Kavanagh says that while scientists strive to find out more about Omicrom, “initial reports are that it is more transmissible, possibly more lethal and is highly mutated having a plethora of different immunity escape mechanisms.”
Kavanagh also points to the reaction to the variant by the WHO, the US, and other nations.
“It is evident by actions, that world governments have grave concerns,” says Kavanagh. “The World Health Organization has just classified this variant as a ‘variant of concern’, only the fifth time it has done so….
What made the Delta variant so deadly was its infectiousness. Omicrom, says Kavanagh, “appears to be spreading fast and has been already found in Hong Kong, Belgium and Israel. Travel restrictions have been imposed by the United Kingdom, European Union along with Japan and Singapore have ordered travel bans on travelers from southern Africa,” says Kavanagh.  Infection Control Today.  Nov. 26, 2021.
https://www.infectioncontroltoday.com/view/enter-omicrom-new-covid-19-variant-spreads-alarm   
  
89.  FDA Could Approve COVID-19 Boosters for All Adults Today
For some experts—such as Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board—the approval of booster shots seems like a no-brainer. On October 25, in an ICT® article headlined “COVID-19 Boosters Need to Be Encouraged,” Kavanagh wrote that “the disagreement over who should get a booster is not one of interpreting science, but one over the goals of giving boosters. As with most other infectious diseases, many feel the goal should be the prevention of disease and spread of disease, not just hospitalizations and deaths. The term ‘mild COVID-19’ is an oxymoron. The devastating long-term effects of long COVID, along with future emergence of cardiovascular disease in those with minimal initial symptoms, reminds us that all SARS-CoV-2 infections may pose grave dangers to those who contract the virus.”
The question for Kavanagh and other experts isn’t whether the FDA and CDC will approve booster shots for all adults, but whether that goes far enough. Kavanagh, too, has been looking at “what other countries are doing.” In an ICT® article headlined “Confused Messaging About Boosters Might Cause 5th Wave of COVID,” that was posted on the ICT® website on Monday, he notes that “because of waning immunity Israel started offering boosters to those over 60 years of age on July 30, 2021, and then extending this to all adults over 50 a few weeks later. By August 28, 2021 children as young as 12 were being encouraged to obtain boosters.”
As Kavanagh notes, in terms of vaccination rates, this puts the US “behind 50 other countries, including Cuba, Sri Lanka, Curacao, Fiji, Mongolia, Bhutan, and Cambodia, let alone the European Nations. This is very concerning with the looming AY.4.2 variant and the high rates of infections this variant is causing in the United Kingdom.”  Infection Control Today.  Nov. 18, 2021.     https://www.infectioncontroltoday.com/view/fda-could-approve-covid-19-boosters-for-all-adults-today  
  
88. Gov. Andy Beshear authorizes COVID-19 booster shots for all Kentucky adults
Dr. Kevin Kavanagh, a retired Somerset physician who monitors and writes about COVID-19, said expanding access to booster shots is important with studies showing waning immunity and increasing breakthrough infections among vaccinated individuals. "I think that's a very wise idea," said Kavanagh, chairman of the patient advocacy group Health Watch USA. "Right now, immunity is waning. Everyone who's vaccinated needs to get a booster." Also, Kavanagh said everyone not vaccinated should get vaccinated immediately, even if they've already had COVID-19. Simply having had COVID-19 doesn't ensure immunity and having the infection carries the risks of what's known as "long COVID" — debilitating, lasting effects from the virus including fatigue, headaches, memory loss and other health problems. "Even those mildly affected can develop lasting symptoms of COVID," Kavanagh said. Without broader vaccination against COVID-19, including booster shots, Kentucky and other states are at risk of yet another outbreak of infection similar the one that struck in July, as the delta variant continues to circulate, he said. "Unless the rate of people who get boosters increases, I think we'll be in for another surge in cases," Kavanagh said.  Courier Journal.  Nov. 17, 2021.   https://www.courier-journal.com/story/news/local/2021/11/17/beshear-authorizes-covid-vaccine-booster-shots-all-kentucky-adults/8653861002/   
     
 87. ‘Son’ of Delta Variant on Scientists’ Radar   
The UK Health Security Agency says that as of September 27, about 6% of sequencing tests in the UK tested positive for the Delta descendant—AY.4.2—which some scientists estimate may be 10% more infectious than original Delta.
AY.4.2 certainly concerns Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board. “There is no doubt that while we celebrate and throw caution to the wind, with Delta infections rapidly decreasing in many areas of the United States, quietly and unseen SARS-CoV-2 is desperately trying to mutate in order to wreak further havoc,” says Kavanagh. “It is like watching a science fiction horror movie. I cannot tell you how it is going to end.”  Infection Control Today.  Oct. 20, 2021.
https://www.infectioncontroltoday.com/view/-son-of-delta-variant-on-scientists-radar  
  
86.  As COVID-19 infection, hospitalization, and mortality rates head downward, pediatric SARS-CoV-2 rates rise, and nursing homes can again become disaster zones. And remember: Winter is coming.
COVID-19 will be with us always, as more and more medical experts conclude that it’s endemic, a point that Kevin Kavanagh, MD, a member of Infection Control Today®’s (ICT®’s) Editorial Advisory Board (EAB), has been making for well over a year. And herd immunity doesn’t seem likely either, what with a constantly mutating virus, something that Kavanagh asserted back in April 2020. Kavanagh said told ICT® in January that “one of the things that’s really frustrated me with this epidemic and pandemic is that people are totally focused on dying…. But in actuality, the disabilities are much, much more concerning because that is even affecting the young people.” Infection Control Today. Oct. 13, 2021.
https://www.infectioncontroltoday.com/view/the-young-the-old-and-covid-19   
  
85.  More Data Assert Vaccination Reduces COVID-19 Spread
University of Oxford investigators used contact tracing to conclude that vaccinated individuals are less likely to spread COVID-19 even if they become reinfected. Kevin Kavanagh, MD, a member of Infection Control Today® ‘s (ICT®’s) Editorial Advisory Board says that the study shows that boosters need to be offered to offset the waning effectiveness of vaccines. “Stopping the spread of disease is a high priority not only to prevent severe acute illness and long COVID but also to prevent viral mutations,” says Kavanagh. “Vaccines appear to be a vital strategy in lowering the R0 of SARS-CoV-2 below 1.0 and should be used in combination with surgical or N95 masks, social distancing, testing, contact tracing and improvements in building ventilation.” Infection Control Today. Oct. 5, 2021. https://www.infectioncontroltoday.com/view/more-data-assert-vaccination-reduces-covid-19-spread    
  
84.  Study Boosts Importance of COVID-19 Booster Shots
Kevin Kavanagh, MD, a member of Infection Control Today® ‘s (ICT®’s) Editorial Advisory Board says that the Pfizer/BioNtech Lancet study “confirms the need to administer boosters to all with waning immunity. Stopping the spread of disease is a high priority not only to prevent severe acute illness and long COVID but also to prevent viral mutations. Vaccines appear to be a vital strategy in lowering the R0 of SARS-CoV-2 below 1.0 and should be used in combination with surgical or N95 masks, social distancing, testing, contact tracing and improvements in building ventilation.” Intection Control Today. Oct. 5, 2021. https://www.infectioncontroltoday.com/view/how-infection-preventionists-can-battle-misinformation   
     
 83.  Long COVID-19 Spreads Wide Toxic Net That Includes Kids
One of those experts is Kevin Kavanagh, MD, a member of Infection Control Today®’s (ICT®’s) Editorial Advisory Board who, in a Viewpoint published Monday, forcefully described the differences between COVID-19 and the flu. “Unlike influenza, SARS-CoV-2 uses ACE2 receptors to infiltrate cells,” Kavanagh wrote. “Similar to HIV, SARS-CoV-2 can silently spread throughout the host’s body and attack almost every organ.”
Kavanagh warned that COVID-19 “is affecting kids and kids can be affected long term. The idea of focusing on deaths is absolutely ludicrous. I know patient after patient and my friends also have been affected. They are developing long COVID. And I’m talking about arrhythmias, chronic coughs. One has her hair falling out two to three months after the infection. It is not good. This is causing heart disease, myocarditis, vasculitis in a number of patients.”
He added: “I need to ask you this. Do you really want to have our children as the guinea pigs to find out what the Delta variant’s going to do? Because let’s face it, we are confronted with a more contagious, a more lethal virus that’s more apt to affect the young.”  Infection Control Today.  Sept. 30., 2021. 
https://www.infectioncontroltoday.com/view/long-covid-19-spreads-wide-toxic-net-that-includes-kids    
    
82.  Beginning of the End? Some Experts Predict COVID-19 Will Recede
Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board, says that “many were talking” about the chart above, but not everybody had the same interpretation. “The graph appears to be an old model which was entirely not correct,” Kavanagh tells ICT®. “It predicted that COVID-19 would be gone by this August. This did not happen. Instead, we got Delta. Predicting the future of COVID-19 is like predicting the stock market. Unfortunately you have two unknowns; one is future human behavior and the other is viral mutations. The wide range of future projections from IHME illustrates this dilemma.”
Kavanagh also warns about comparing COVID-19’s behavior to that of the flu. He told ICT® in a Q&A in early August that “this is not the flu. You see countries that have had mass graves. I mean, how many times have you seen mass graves from the flu? You just don’t see it.” Kavanagh has also argued that vaccinations must be seen as just one layer to the type of mitigation that will help the world return to pre-COVID-19 normal. He says social distancing, isolation precautions, lockdowns, hand hygiene and, especially, masking must be included.  Infection Control Today.  Sept. 23, 2021.
https://www.infectioncontroltoday.com/view/beginning-of-the-end-some-experts-predict-covid-19-will-recede
 
81.  Kentucky lawmakers offer conspiracy theories, debunked claims during COVID special session
Kavanagh noted few lawmakers are wearing masks during the current legislative session even though public health guidelines recommend them for indoor spaces. "This is a very dangerous message to send during this surge," he said. Kavanagh said Tate's reliance on VAERS is misplaced.
"Just in Kentucky, we've had almost 8,000 deaths from COVID-19," he said. "I know of many people who have lost loved ones. I don't know anybody who died from the vaccine." Courier Journal. Sept. 9, 2021.
https://www.courier-journal.com/story/news/politics/ky-legislature/2021/09/09/kentucky-lawmakers-covid-special-session-spout-conspiracy-theories/5768699001/  
 
80.  COVID-19 Is a Disease of Unvaccinated: What Does That Mean for Schools?
Kevin Kavanagh, MD, another member of ICT®’s EAB, recently asked if the US should adopt an elimination strategy for COVID-19. “In Beijing the total cases in an outbreak were reported to be less than 10. China used over 100 million tests to eradicate what would be classified as a very small outbreak by US standards,” Kavanagh wrote. He added that the US “may need to pivot as a nation to an elimination strategy and break the cycle of repeated waves of deaths and disabilities caused by emerging variants.”
An article written by Kavanagh posted to ICT®’s website yesterday looks at the same MMWR study that Popescu looked at. Kavanagh notes that the COVID-19 virus infected two of the four children in the row at the very back of the classroom. The virus is aerosolized and that stopping the spread would have required a social distancing of more than 6 feet, never mind the 3 feet that schools now maintain between students.
“There were also another 8 cases identified in parents and siblings demonstrating that children at school can be significant vectors for spreading COVID-19,” Kavanagh wrote. “The students also wore masks, illustrating that masking as a sole intervention is inadequate. Masks need to be upgraded to well-fitted medical grade, KN95 or N95 masks, along with testing of all students and staff twice weekly, and better school ventilation. Even with these strategies the virus may still be expected to cause outbreaks, necessitating the need for smaller class sizes, podding, hybrid classes and teleschooling.”
Kavanagh circles back to elimination strategy.
“After the Delta surge subsides, another surge is expected, possibly from the mu variant,” Kavanagh wrote. “If mu completely escapes immunity from vaccines and past infections, we must resort to stringent public health strategies. Eventually, the United States may need to adopt an elimination strategy, sacrificing short-term for long-term societal benefits. But whatever strategy is adopted, all Americans must embrace public health measures, or we will not be successful in viral mutations and the pandemic.” Infection Control Today. Sept. 7, 2021.
https://www.infectioncontroltoday.com/view/ovid-19-is-a-disease-of-unvaccinated-what-does-that-mean-for-schools-    
  
79.  Gain-of-Disfunction? Research Method Comes Under Fire
“Gain-of-function research on viral pathogens is one of the most dangerous academic endeavors which can be undertaken by mankind,” says Kavanagh. “Just the gain-of-function research on avian influenza has the potential of wiping out large percentages of the world’s population. It is hard to imagine a benefit which justifies the risk, but when one is identified such research should only be undertaken with an assumption that a lab accident may occur. There must be a viable plan which has a very high probability of success for containment of any escaped pathogen and the identification and quarantining of exposed personnel, without a risk of spreading to the general population.”
Such a “viable plan” that Kavanagh refers to seems to have been in place when investigators with Osaka University in Japan recently created the pseudo-virus Delta 4+ in making the case that future mutations in the Delta variant could help it to evade antibodies in COVID-19 vaccines. Kavanagh says that the Osaka University research “is an example of gain-of-function research using a pseudo-virus which is extremely beneficial.”
In this example, gain-of-function research may have helped sound the alarm, Kavanagh adds. “The research reported that the Delta virus is one mutation away from fully escaping the vaccine.” Infection Control Today. Aug. 30, 2021. https://www.infectioncontroltoday.com/view/gain-of-disfunction-research-method-comes-under-fire   
    
78.  Can Kentucky medical professionals lose their licenses if they spread disputed COVID claims?
"At a minimum, I feel that the medical licensure board should make a public statement on standards they think physicians should follow," said Dr. Kevin Kavanagh, a retired Somerset physician and author of a Courier Journal opinion piece calling some of Paul's vaccine claims "reprehensible."  Courier Journal.  Aug. 30, 2021. 
https://www.courier-journal.com/story/news/local/2021/08/30/what-happens-kentucky-doctors-who-make-disputed-covid-19-claims/5572479001/     
 
77.  Future Delta Variant Mutations Seem to Elude Vaccine Antibodies
Although the data are preliminary, Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board, says that the findings warrant attention. “This report is an example of gain of function research using a pseudo-virus which is extremely beneficial,” Kavanagh tells ICT®. “The research reported that the Delta virus is one mutation away from fully escaping the vaccine. It is possible that those infected with the Delta variant may have a degree of immunity, but those vaccinated or who had COVID-19 with a previous variant will be at high risk for a significant reinfection.”  Infection Control Today.  Aug. 27, 2021. 
https://www.infectioncontroltoday.com/view/delta-variant-mutations-seem-to-elude-vaccine-antibodies    
   
76.  Vaccines Not as Effective Against Delta Variant, say CDC Data
Kevin Kavanagh, MD, a member of Infection Control Today®s (ICT®)’s Editorial Advisory Board, made the same argument on July 27 in ICT® in a Q&A headlined “Everybody Needs to be Vaccinated and Wear a Mask.” Kavanagh said that “I am convinced this virus is about one or two iterations away from completely avoiding the vaccine. And remember, we have the lambda variant and the kappa variant which are sitting out there in the wings, waiting for immunity to drop and possibly cause another wave.”  Infection Control Today.  Aug. 25, 2021.
https://www.infectioncontroltoday.com/view/vaccines-not-as-effective-against-delta-variant-says-cdc-data    
 
75.  Why Wait 8 Months for a COVID-19 Booster Shot?
As ICT® reported, Israel—which launched its booster shot program in the beginning of August—is offering booster shots to people 60 and older who’d had their second dose of vaccine 5 months prior.
Kevin Kavanagh, MD, a member of ICT®’s Editorial Advisory Board analyzed and translated the data by the Ministry of Health Israel and about 3 weeks before the US announced its booster shot plan wrote that the US should begin a similar program immediately.
Kavanagh said in an email to ICT® that “with the Israel data email ICT® published showing that individuals greater than 60 years old and 5 months out from full vaccination plus the recent New York Times data showing that between 12% to 25% of hospitalizations are breakthrough infections, one must ask the question: Why wait 8 months for boosters? This underscores the importance of using the vaccine as a layer of armor and not a panacea. Those vaccinated at the same time need to wear N95 masks and avoid indoor settings.”  Infection Control Today.  Aug. 20, 2021. 
https://www.infectioncontroltoday.com/view/why-wait-8-months-for-a-covid-19-booster-shot-    
  
74.  COVID-19 Boosters Shots for US Adults Coming in September
Kevin Kavanagh, MD, a member of ICT®’s Editorial Advisory Board writes in an email to ICT® that the move “comes as a surprise to many since just a few weeks ago people were being assured that breakthrough infections are ‘extremely rare’, less than 1% in all reporting states. Why the 180-degree pivot? The answer is delta and data provided from the Ministry of Health Israel (MHI). The MHI reported that there was only a 16% Pfizer vaccine effectiveness in preventing symptomatic infections after 5 months post vaccination. And in the group of patients who are over age 60 and more than 5 months since vaccination, a breakthrough infection is associated with a 8.6% incidence of hospitalization and a 2% incidence of death.”   Infection Control Today.  Aug. 18, 2021.
https://www.infectioncontroltoday.com/view/covid-19-boosters-shots-for-us-adults-in-the-works   
    
73.  COVID-19 Booster Shots Alone Might Not Stop Delta and Other Variants
Booster shots alone won't turn away the pandemic. The way back to our normal lives involves a multi-pronged approach to infection prevention.
But that won’t be enough, Kavanagh argues in an article scheduled to be printed in an upcoming issue of ICT®.
“SARS-CoV-2 has continued to evolve,” Kavanagh writes. “It has now become evident that with each emerging variant, the virus has appeared to progressively become more infective. Variants which increase viral load may also increase transmissibility and the opportunity to mutate, along with overwhelming a host’s immune system and becoming more virulent.” And there seems to be wave after wave of variants.
Kavanagh adds that “to make matters worse, SARS-CoV-2 is infecting a number of animals, including cats, large cats, dogs and gorillas. Most recently, concern has been raised that it may have found an animal host in white tail deer, with SARS-CoV-2 antibodies identified in 40% of surveyed animals.”
Kavanagh has always said that COVID-19 vaccines alone are not a panacea in stopping the pandemic. And although booster shots are crucially important, one should also not rely on booster shots alone, either.
There must be a multi-pronged approach to COVID-19 if we have any hope of returning to our pre-COVID normal lives, Kavanagh writes in his article. That includes:

1)  Upgrade recommendations for mask usage and to use N95 or KN95 masks whenever possible.
2)  Everyone who can needs to become vaccinated. Similar to Israel, we should fast track approval for mRNA boosters to those who are at higher risk, including those who are immunosuppressed and over the age of 60 and 5 months out from vaccination.
3)  Upgrade building ventilation systems to increase air exchanges and air sanitization.
4)  Expand testing capabilities to be able to test frontline workers and school children at least twice a week, and other workers at least once a week.
5)  Limiting sizes of gatherings, including podding in schools and plans for permanent hybrid instruction to limit class sizes.
6)  Businesses, including restaurants, need to offer online ordering along with curbside pickup and when possible, home delivery.

Everyone needs to be vaccinated. Mandatory vaccines should be required in many settings, including health care. Vaccine passports or green cards are being implemented in Israel and France and need to be implemented in the United States.  Infection Control Today.  Aug. 17, 2021. 
https://www.infectioncontroltoday.com/view/covid-19-booster-shots-alone-might-not-stop-delta-and-other-variants   
  
72.  2-Dose COVID-19 Vaccines Work Against Delta Variant, Says Study
Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board, notes that “the data from the United Kingdom which reports that the Pfizer mRNA vaccine is 88% effective against symptomatic infections appears to be in stark contrast to the 41% effectiveness reported by the Ministry of Health in Israel. The difference can be explained by waning of immunity over time and the vaccine dosage schedule in the two countries.”
Israel was one of the first countries to administer vaccines to their population and has a dosage schedule similar to the US. The UK, on the other hand, spaced the 2 doses apart by up to 3 months, says Kavanagh.
“Thus, most in Israel completed their vaccination schedule far ahead of those in the United Kingdom,” says Kavanagh. “Israel is currently administering boosters to those above the age of 60 and more than 5 months since vaccination. The United Kingdom is planning to start booster shots in September.”  Infection Control Today.  Aug. 12, 2021. 
https://www.infectioncontroltoday.com/view/-dose-covid-19-vaccines-work-against-delta-variant-says-study   
   
71.  Put COVID-19 to the Test
ICT® EAB member Kevin Kavanagh, MD, asserts that “as we are learning more about the Delta variant and how it can evade immunity, causing breakthrough infections, we realize that expanding our testing activities is imperative. In Germany, everyone in schools and industry are tested twice weekly.”
Kavanagh also points out that in the United Kingdom, people who live where the Delta variant is spreading are encouraged to get tested twice a week, and China tests every citizen in Wuhan.
“We need to do much more testing, and we also need to monitor the accuracy of our tests on each of the new variants,” says Kavanagh.   Infection Control Today. Aug. 10, 2021.
https://www.infectioncontroltoday.com/view/put-covid-19-to-the-test   
      
 70.  CDC study of Kentuckians disputes Rand Paul, Thomas Massie claims about COVID-19 immunity
"Paul, a Bowling Green physician, has been especially outspoken on the subject. In a May opinion piece in The Courier Journal, he blasted "petty tyrants in government" for pushing vaccines and arguing there are no studies showing "any benefit at all" to vaccination for those who have had COVID-19.
.... But retired Somerset physican Kevin Kavanagh, who sharply criticized some of Paul's claims about the vaccine as "reprehensible" in a Courier-Journal opinion article, said in an email Monday that vaccines are even more essential amid the spread of the delta variant. "With the emergence of new variants, reinfections can and are occurring," said Kavanagh, chairman of the patient advocacy group Health Watch USA. "No one wants to become repeatedly infected with a deadly virus." "  Courier Journal.  Aug. 9, 2021.  
https://www.courier-journal.com/story/news/politics/2021/08/09/cdc-study-disputes-rand-paul-thomas-massie-covid-immunity-claims/5536638001/    
      
69.  Some Experts See a Peak, Steep Decline of Delta Variant Coming
As experts have been telling ICT® for months now, we control our destiny. Kevin Kavanagh, MD, another member of ICT®’s EAB member, puts it this way: “I am convinced this virus is about one or two iterations away from completely avoiding the vaccine. And remember, we have the lambda variant and the kappa variant which are sitting out there in the wings, waiting for immunity to drop and possibly cause another wave.” Other experts echo Kavanagh’s “we the people” approach to getting back to some semblance of our pre-pandemic lives. Infection Control Today. Aug. 6, 2021.
https://www.infectioncontroltoday.com/view/some-experts-see-a-peak-steep-decline-of-delta-variant-coming  
  
68.  As US Reaches Vaccine Milestone, Question of COVID Booster Shots Persist
Israel announced last week that it will be the first country to offer COVID-19 vaccine booster shots to citizens 60 and older, and that effort officially began last Sunday. As Infection Control Today® (ICT®) reported Monday, booster shots for older Americans might be something the United States will soon undertake.
Kevin Kavanagh, MD, a member of ICT®’s Editorial Advisory Board, said this morning that “Israel was one of the first countries to vaccinate a majority of its citizens. They used a dosage schedule similar to the United States. Recent data from the Ministry of Health in Israel has shown that immunity is waning in those over 60 years of age who have received their second dose of the vaccine 5 months ago.”
Regarding booster shots, Kavanagh says that “in the United States our most vulnerable, along with nursing home residents, were given vaccinations early on in the pandemic. They are at risk of breakthrough infections with significant morbidity and mortality. Similar to the policy in other countries, I feel that the United States needs to administer boosters to our most vulnerable, before we see a repeat of last year's devastation in nursing homes caused by the Delta variant.”  Infection Control Today.  Aug. 4, 2021. 
https://www.infectioncontroltoday.com/view/s-us-reaches-vaccine-milestone-question-of-covid-booster-shots-persist   
  
67.  CDC: 74% of COVID-19 Cases in Cluster Happened Among Vaccinated
Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board urged early this week in a Q&A with ICT® that, as the headline to the article put it: “Everybody Needs to be Vaccinated and Wear a Mask.”
About the MMWR study, Kavanagh said that “this outbreak makes the Israeli data which we reported on Wednesday look overly optimistic. In the Cape Cod outbreak, the vaccine appears to have had little efficacy in the prevention of infections or symptomatic disease. The data that we have today indicates the vaccines are highly effective in preventing hospitalization, severe disease and death. But it needs to be remembered that even those with mild infections can develop long COVID. A small study out of Israel which studied health care workers who had a vaccine breakthrough infection found 19% had symptoms greater than 6 weeks.”
Five people were hospitalized, and 4 of them had been fully vaccinated. Kavanagh pointed out that “the Delta variant is much more infectious, producing 1000 times more virions than the wild type of virus. And the viral load of individuals with breakthrough infections was the same as those who are not vaccinated. This outbreak occurred in a highly vaccinated area. We all need, regardless of where you live, you need to wear medical grade masks (preferably N95s) and become vaccinated.”  Infection Control Today.  July 30. 2021. 
https://www.infectioncontroltoday.com/view/cdc-74-of-covid-19-cases-in-cluster-happened-among-vaccinated   
      
66.  Centers for Disease Control releases new mask guidance. Here's what it means for Kentucky   
Dr. Kevin Kavanagh, a retired Somerset physician and chairman of Health Watch USA, a non-profit patient advocacy organization, said the CDC should have acted sooner to try to mitigate the spread of the Delta variant by recommending masks in most indoor settings. "They're leading from behind," he said. "I think our state of Kentucky needs to get its own policy. We need to do what is required to protect our citizens."
Kavanagh said masks should be worn in indoor settings where people are exposed to others outside their households. While vaccinated individuals are less likely to experience symptoms or serious illness, they could still spread it to others, he said.
And the longer the virus circulates, the more likely it is to mutate into even more dangerous forms that could evade the vaccine.
"We're in grave danger," he said. "This virus is out to win."  Courier Journal.  July 27, 2021.   https://www.courier-journal.com/story/news/local/2021/07/27/amid-covid-delta-variant-surge-cdc-issues-new-masking-advice/5386431001/  
 
65.  CDC Expected to Tighten Masking Rules for Fully Vaccinated
One of the experts who challenged the CDC’s guidelines is Kevin Kavanagh, MD, a member of the ICT®’s Editorial Advisory Board who just last week in an opinion piece implored the agency to take a different approach to COVID-19.
“We need to have a paradigm shift in the way we view this virus, planning and implementing strategies to allow us to live with an endemic pathogen,” Kavanagh wrote. And in a Q&A posted to ICT®’s website this morning with a headline—“Everybody Needs to be Vaccinated and Wear a Mask”—that may prove to be prescient, Kavanagh said that he’s “convinced this virus is about one or two iterations away from completely avoiding the vaccine. And remember, we have the lambda variant and the kappa variant which are sitting out there in the wings, waiting for immunity to drop and possibly cause another wave.”
But, as Kavanagh said, it’s the Delta variant that’s really changed the nature of the battle against COVID-19. The CDC relaxed masking guidelines for the fully vaccinated based on data taken from previous iterations of the coronavirus. Kavanagh said that his biggest concern is that “everybody’s in the mindset that this pandemic is over with. We don’t need to do anything else. And if you’re vaccinated, you have a get-out-of-jail card, and you can go on with your life as if it was normal. And with this Delta variant, nothing could be further from the truth. I feel it is imperative that everyone, even those vaccinated, start wearing masks and start following public health strategies, which were followed over the surge of the winter holidays. I can’t stress that more.” Infectin control Today.  July 27, 2021.
https://www.infectioncontroltoday.com/view/cdc-expected-to-tighten-masking-rules-for-fully-vaccinated   
  
55.  Can Providers be Blamed for Losing Patience with Vaccine Hesitant?   
EAB member Kevin Kavanagh, MD, has written extensively for ICT® about that dangers posed by COVID-19. Kavanagh points out that compassion fatigue can always pounce because poor decisions made by patients necessitates much of health care treatment.
“Vaccination rates are not only low with the public but also with health care workers,” Kavanagh points out. “All need to realize that the public looks up to health care workers for guidance and many have cited the example of unvaccinated workers as influencing their decision.”
Kavanagh adds that people need to keep in mind that many health care workers are suffering from post-traumatic stress, as ICT® reported in its May cover story.Kavanagh adds that people need to keep in mind that many health care workers are suffering from post-traumatic stress, as ICT® reported in its May cover story.
“Ideally, counseling and time off of work is desperately needed,” says Kavanagh. “Unfortunately, this is not possible and we will be soon facing a health care worker shortage. The solution is for everyone who can, to become vaccinated and we all need to adopt strict public health strategies. And for all to support, however possible, our frontline workers.”
https://www.infectioncontroltoday.com/view/can-providers-be-blamed-for-losing-patience-with-vaccine-hesitant-  
     
54 .  Lambda Variant of COVID-19 Might Be Resistant to Vaccines
Kevin Kavanagh, MD, a member of ICT®’s Editorial Advisory Board, argues that the emergence of the lambda variant underscores the need to consider vaccines just 1 layer of protection against COVID-19 infection, and that they should be combined with masks and goggles.
“It needs to be remembered that a high-quality mask or respirator can decrease viral exposure up to sixfold, making them an important adjunct to vaccines with reduced efficacy,” Kavanagh tells ICT®. “Our goal needs to be to prevent both death and long-term disability.”
Slow the spread and the mutations of COVID-19, Kavanagh urges. And though there may be very few cases of the lambda variant in the U.S., it still “underscores the need for travel restrictions, including quarantining of returning [travelers], regardless of vaccination status,” says Kavanagh. “We also need to pivot away from our current two-tiered advisories regarding vaccinated and unvaccinated individuals. With the lambda and Delta variants we all should become vaccinated plus follow public health advice.”
https://www.infectioncontroltoday.com/view/lambda-variant-of-covid-19-might-be-resistant-to-vaccines  
  
53. COVID-19 Isn’t Done with Us Yet, Medical Experts Warn
Kevin Kavanagh, MD, a member of Infection Control Today®’s (ICT®) Editorial Advisory Board, worries that the unvaccinated put others at risk, if not of death from COVID-19, but from long COVID. Kavanagh worries that far from being a return to pre-COVID normal, when the pandemic finally recedes it will leave a destructive overload of disabilities behind.
“We need to have as much diligence in preventing chronic disability in the young as we do in preventing deaths in the elderly,” Kavanagh tells ICT®. Kavanagh’s concern dovetails with those of the author of a study in Circulation in April with the ominous title: “Avoiding the Coming Tsunami of Common, Chronic Disease: What the Lessons of the COVID-19 Pandemic Can Teach Us.”  Infection Control Today.  July 20, 2021.
https://www.infectioncontroltoday.com/view/covid-19-isn-t-done-with-us-yet-medical-experts-warn   
  
 52.  COVID-19 Case Counts Surge in 46 States
Medical experts have been warning for weeks that this could happen. Kevin Kavanagh, MD, a member of Infection Control Today®’s (ICT®) Editorial Advisory Board, pointed out just yesterday that the stage has been set for another COVID-19 surge. “Beating back infection is a numbers game: viruses against antibodies,” Kavanagh wrote. “If the virus changes its armor so the antibodies cannot attach, it develops an advantage. However, it can also produce viruses which are more efficient at attaching to and invading cells, or simply just produce a lot more viruses, overwhelming the system.”
Kavanagh has also mentioned the dangers posed by long COVID-19, and how the young are not immune to that problem. “One of the things that’s really frustrated me with this epidemic and pandemic is that people are totally focused on dying…. But in actuality, the disabilities are much, much more concerning because that is even affecting the young people.”  Infection Control Today.  July 14, 2021.
https://www.infectioncontroltoday.com/view/covid-19-case-counts-surge-in-46-states 
     
51.  Infectious Disease Organizations: Health Care Workers Must be Vaccinated
Back in April, Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board, wrote in an opinion piece in ICT® that health care workers who refuse to get the COVID-19 vaccine put vulnerable patients at risk, an act Kavanagh described as “reprehensible.”  Kavanagh wrote that “if you work in a health care facility, you need to be vaccinated against SARS-CoV-2. If you choose not to become vaccinated, then you should choose not to be working in a health care setting.”  Infection Control Today.  July 13, 2021.
https://www.infectioncontroltoday.com/view/infectious-disease-organizations-health-care-workers-must-be-vaccinated
 
50.  It’s Not Over: As Delta Variant Preys on the Unvaccinated, Long COVID Settles In
Then there’s the risk posed by long COVID. Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board, told ICT® in a Q&A in January that “one of the things that’s really frustrated me with this epidemic and pandemic is that people are totally focused on dying…. But in actuality, the disabilities are much, much more concerning because that is even affecting the young people.” Other health care experts have begun to echo Kavanagh’s concerns.  Infection Control Today.  June 25, 2021. 
https://www.infectioncontroltoday.com/view/it-s-not-over-as-delta-variant-preys-on-the-unvaccinated-long-covid-settles-in   
  
49.  Kentucky COVID-19 restrictions end Friday, signaling hope and a return to normalcy for many
Dr. Kevin Kavanagh, a retired Somerset physician and chairman of Health Watch USA, a non-profit patient advocacy organization.
Kavanagh is particularly concerned about the spread of variants, or mutations, of COVID-19, that tend to spread among unvaccinated populations and are more contagious and possibly, more dangerous.
A variant from the explosion of cases in India, known as the Delta variant, has surfaced in the United States in increasing numbers, but because of limited testing and analysis, it's not clear how widespread it is, he said.
"We don’t know where the Indian variant is or isn’t," he said. "We are flying blind and if you're flying blind, I tend not to want to get on the plane."
Kavanagh thinks officials should go more slowly in easing requirements such as mask-wearing until a greater percentage of the population is vaccinated.
"They are exceedingly safe vaccines that are highly effective," he said.  Courier journal.  June 11, 2021.
https://www.courier-journal.com/story/news/local/2021/06/11/kentucky-mask-mandate-expected-to-end-signaling-hope/7604229002/  
  
48.  As Delta Variant Rises, Hospital Suspends 178 Employees for Not Getting Vaccinated Against COVID-19
Contacted this morning by ICT®, Kavanagh expressed concern with how the CDC’s going about informing the public about the COVID-19 variants. “The CDC's government webpage on variants still lags behind the CDC/NIH funded Scripps research site of outbreak.info,” Kavanagh said. “Even today the Delta Variant was not included in the CDC Website Table Listing Variants of Concern and state specific data on this variant is absent. The latest data which you can obtain by a mouse over on the bar graph lists the prevalence of the Delta Variant as 2.5%. This is much less than the data in the NPR story of over 6% and less than the outbreak.info listing of 19%”
There’s little doubt as to which side of the Houston Methodist Hospital debate Kavanagh comes down on. The headline for an article published on the ICT® website on April 22 sums it up: “Viewpoint: Health Care Professionals—Get Vaccinated or Get Out.” In it, Kavanagh wrote that “if you work in a health care facility, you need to be vaccinated against SARS-CoV-2. If you choose not to become vaccinated, then you should choose not to be working in a health care setting.”  Infection Control Today.  June 9, 2021.
https://www.infectioncontroltoday.com/view/as-delta-variant-rises-hospital-suspends-178-employees-for-not-getting-covid-vaccinated  
    
47.  Memorial Day Musings in the Shadow of COVID-19
As Kevin Kavanagh, MD, a member of Infection Control Today®’s (ICT®) Editorial Advisory Board (EAB) put it, we still don’t know the actual number of health care workers who’ve died from COVID-19 because “no one is truly counting. The reporting of their deaths is voluntary.”
As Kavanagh has pointed out, surviving COVID-19 should not be the sole benchmark. Of the health care workers who’ve gotten mild to moderate COVID-19, between 10% and 30% can be expected to have long-term symptoms. “In addition, the reported deaths would mainly represent those who died in the acute phase of the illness,” Kavanagh says. “It has recently been reported that 8 deaths per 1000 of non-hospitalized cases of COVID-19 can occur between 30 to 180 days after diagnosis. These cases died from detrimental effects on multiple organs and may not have been counted as COVID-19 deaths. All of these frontline workers have given their lives and livelihood for our safety and need to be remembered during this Memorial Day.”  Infection Control Today.  May 31, 2021.
https://www.infectioncontroltoday.com/view/memorial-day-musings-in-the-shadow-of-covid-19   
 
46.  CDC Study Might Nudge Vaccine Hesitant Health Care Workers
As Kevin Kavanagh, MD, a member of ICT®’s Editorial Advisory Board (EAB) put it recently: “It’s hard to convince a patient to become vaccinated when they were just escorted to the room with a nurse who did not have the vaccine.”  Infection Control Today.  May 18, 2021.
https://www.infectioncontroltoday.com/view/cdc-study-might-nudge-vaccine-hesitant-health-care-workers  
 
45.  Wuhan Lab Leak Called Viable Possibility for COVID-19 Pandemic
Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board, says that “the assertion that the virus was purposefully released is probably not valid since the epicenter of the epidemic was in a highly populated portion of China and the country did not have a workable vaccine.”
“There appears to be little doubt that, like the rest of the world, the Wuhan lab was experimenting on coronaviruses,” says Kavanagh. “On May 11 of this year Senator Rand Paul questioned the White House regarding 'gain of function' research, research which would be expected to make the viruses more dangerous and more transmissible. This research was also mentioned in a Presidential Fact Sheet: Activity at the Wuhan Institute of Virology from the Trump Administration which apparently has not yet been refuted by the Biden Administration.”
Kavanagh says that “this subject of research in the Wuhan Lab has been almost taboo in the mainstream media. However, the construction of man-made (pseudo) virus is presently an exact science, with single amino acid substitutions possible. Similar to vaccine production, you just need to be able to input the genetic code you desire and a vaccine or pseudo-virus can be made.”
What Kavanagh refers to what he describes as a “chilling article” by authors affiliated with China's National Institutes for Food and Drug Control (NIFDC) and WHO Collaborating Center for Standardization and Evaluation of Biologicals.  “This article describes a plethora of single amino acid substitutions in the spike protein from 106 pseudo-virus which resulted in ‘ten mutations such as N234Q, L452R, A475V, and V483A was markedly resistant to some mAbs’ and that ‘the dominant D614G itself and combined with other mutations are more infectious.’” The D614G variant was the dominant variant in the United States in 2020.      Infection Control Today. May 18 2021.  https://www.infectioncontroltoday.com/view/lab-leak-called-viable-possibility-for-covid-19-pandemic    

• Watkins M. Rand Paul and Anthony Fauci argue over theories about COVID-19's origin. Courier Journal. May 11, 2021. https://www.courier-journal.com/story/news/politics/rand-paul/2021/05/11/rand-paul-anthony-fauci-argue-over-conspiracy-covid-19-s-origin/5037451001/

• Fact Sheet: Activity at the Wuhan Institute of Virology
  U.S Dept of State. Jan 15, 2021. https://2017-2021.state.gov/fact-sheet-activity-at-the-wuhan-institute-of-virology/index.html

• Rogin J. Opinion: The Biden administration confirms some but not all of Trump’s Wuhan lab claims. The Washington Post. Mar. 9, 2021. https://www.washingtonpost.com/opinions/2021/03/09/biden-administration-confirms-some-trump-wuhan-lab-claims/

• Li Q, Wu J, Nie J, et al. The Impact of Mutations in SARS-CoV-2 Spike on Viral Infectivity and Antigenicity. Cell. July 17, 2021. https://www.cell.com/cell/fulltext/S0092-8674(20)30877-1

    
44.  Seemingly Mixed Messages About Indian COVID-19 Variant Given br /> As Infection Control Today® has been reporting, the CDC has been criticized for doling out information during the COVID-19 pandemic that has often been contradictory, when it’s not been out and out wrong. Last October in a Q&A, Kevin Kavanagh, MD, a member of ICT®’s Editorial Advisory Board, said that “there have been a number of statements from the CDC or at least with the CDC label on it, which have been disturbing.” Infection Control Today. May 12, 2021
https://www.infectioncontroltoday.com/view/seemingly-mixed-messages-about-indian-covid-19-variant-given
   
43.  CDC Relaxes Mask-Wearing Guidelines for Fully Vaccinated Individuals
Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board, recently wrote that the wearing of masks should continue until herd immunity is reached.
When contacted about the CDC announcement, Kavanagh told ICT® in an email exchange that people should approach the changed guidance with caution.
“We still have over half of our population not fully vaccinated and one cannot tell who is and who is not vaccinated,” Kavanagh said. “And because of aerosolization of the virus, how close you are to someone will not gauge indoor safety. Airflow and sanitization is of utmost importance.” Infection Control Today. May 13, 2021.
https://www.infectioncontroltoday.com/view/cdc-relaxing-mask-wearing-guidelines-ap-reports  
    
42.  Kentucky nursing home with deadly COVID-19 variant outbreak identified as Rowan facility
Dr. Kevin Kavanagh, a retired Somerset physician and chairman of Health Watch USA, a non-profit patient advocacy organization, said the impact of the virus could worsen for those who are vaccinated as more variants of COVID-19 develop and spread. Genome sequencing identified the strain as an "R.1" variant, or mutation, of COVID-19 that bore some similarities to variants identified in other countries but was not identical. The report said the mutation had not been previously identified in Kentucky. Kavanagh said the vaccine should be mandatory for staff who work at nursing homes. "No one has the right to inflict a devastating disease on a frail, elderly person who has entrusted their life to them," he said.  Courier Journal.  May. 4, 2021.
https://www.courier-journal.com/story/news/local/2021/05/04/kentucky-nursing-home-deadly-covid-19-variant-outbreak-morehead-site/4935105001/  
 
41.  Louisville health officials worried about post-Kentucky Derby spike in COVID-19 cases
Dr. Kevin Kavanagh, a retired Somerset physician and chairman of Health Watch USA, a non-profit patient advocacy organization, said he is concerned about the potential for the Derby and related events, such as parties or crowds at bars, to increase the spread of COVID-19. He said he was particularly concerned about images from the weekend of people crowded together both inside and outdoors. “It’s just a set-up for a super-spreader event,” Kavanagh said. “If you get close to someone with COVID-19, even outdoors, you have a risk of getting infected.” Moreover, the continuing spread of variants, or mutations of the virus — largely among unvaccinated people — increases the risk of catching a new, more contagious and possibly more dangerous form of COVID-19. “I know that’s doom and gloom,” he said. “We’ll just have to wait a couple of weeks and see what happens.” Courier Journal. May 4, 2021.
https://www.courier-journal.com/story/news/local/2021/05/04/louisville-health-officials-worry-over-possible-post-kentucky-derby-covid-19-spike/7003404002/   
      
41.  CDC cites COVID-19 outbreak at Kentucky nursing home in urging more staff to be vaccinated
"Still, Dr. Kevin Kavanagh, a retired Somerset physician and and chairman of Health Watch USA, a non-profit patient advocacy organization, said it may be a luxury society can't afford as variants of COVID-19 spread that are considered more contagious and may be more deadly. "You shouldn't be allowed to advocate for your civil rights at the expense of elderly patients," he said. And as variants spread among largely unvaccinated people, so does the threat of another surge of COVID-19, he said. "I think we're going to be in for a huge rebound of the virus if people don't get vaccinated," he said."  Courier Journal.  Apr. 22, 2021.
https://www.courier-journal.com/story/news/local/2021/04/22/cdc-cites-kentucky-nursing-home-covid-19-outbreak-vaccination-push/7332528002/  
    
40.  Ky. pauses use of one-dose coronavirus vaccine over rare side effects; Beshear worries federal advice will have negative impact
"Dr. Kevin Kavanaugh, an infection-control activist who leads the Somerset-based watchdog group Health Watch USA, said we need "to be very careful that the enemy of the good is not better."
Kavanaugh first noted that these severe episodes have occurred in less than one in a million people and then said to his knowledge the J&J vaccine was the only one so far that had been field tested in people with the South African variant and found to be effective. "So all things combined, personally I would still be willing to take the Johnson and Johnson vaccine," he said."  Kentucky Health News.  Apr. 13, 2021.
https://kyhealthnews.blogspot.com/2021/04/ky-pauses-use-of-one-dose-coronavirus.html   
    
39.  The Kentucky Derby 2021 and COVID-19: Is it safe to attend? Health experts weigh in
"I think we should be focusing on following good public health advice instead of opening up more," said Dr. Kevin Kavanagh, a retired Somerset physician and chairman of Health Watch USA, a non-profit patient advocacy organization.
Kevin Kavanagh is a retired physician from Somerset, Kentucky, and chairman of Health Watch USA. ​​​​​​​
"We're almost there, almost there to the end," Kavanagh said. "What we don't want to have happen is to spread the virus and have a mutation that can evade the vaccines totally. Then we're in big trouble."  Courier Jounral.  Apr. 6, 2021.
https://www.courier-journal.com/story/entertainment/events/kentucky-derby/2021/04/01/kentucky-derby-2021-safety-amid-covid-19/7004531002/
  
38.  'No unknown soldiers': How Kentucky missed over 600 deaths from COVID-19
"A disease like COVID affects every organ of the body," said Dr. Kevin Kavanagh, a retired physician from Somerset and chairman of Health Watch USA. "A lot of COVID patients die from heart attacks."
https://www.courier-journal.com/story/news/local/2021/03/25/covid-19-deaths-audit-finds-662-more-kentucky-cases/6973083002/  
 
37.  Ungar L. For Spring Season, Young Athletes Get Back in the Game Despite Covid Risk
Dr. Kevin Kavanagh, an infection control expert in Kentucky who runs the national patient safety group Health Watch USA, said contact sports are “very problematic,” especially those played indoors. He said heavy breathing during exertion could raise the risk of covid even if students wear cloth masks. Ideally, he said, indoor contact sports should not be played until after the pandemic.   “These are not professional athletes,” Kavanagh said. “They’re children.” Ungar L. Kaiser Health News. Mar. 16, 2021.
https://khn.org/news/article/young-athletes-return-to-team-sports-despite-covid-risk-spring-season/   
  
36.  Diamond F. Possible New COVID Variant Causes Outbreak in Highly Vaccinated Nursing Home.
Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board, wrote in a viewpoint that CMS’ relaxing of the restrictions on visiting was a mistake. Kavangh wrote that “this recommendation appears to assume that herd immunity is reached at 70%. This figure appears to be even a low community estimate for obtaining herd immunity. And certainly, will not be true for spread which occurs in an indoor setting with poor ventilation and high resident contact; let alone that which is needed for to achieve herd immunity with the new variants.”  Infection Control Today. Mar. 16, 2021.  https://www.infectioncontroltoday.com/view/covid-variant-spreads-among-kentucky-nursing-home-residents   
 
35.  Medicare-Certified Long-Term Care Visitation Update:  New Guidance
Dr. Kevin Kavanagh, a retired Somerset physician who heads Health Watch USA, which focuses on infection control, objected to the new government guidelines.
     He told Kentucky Health News that he had many concerns, including rules that allow visitation to continue as soon as one round of testing is completed and reveals no cases after a new case is identified. "That doesn't work," he said. "You've got a long incubation period and we saw that in the Rose Garden" event Sept. 26 for new Supreme Court Justice Amy Coney Barrett, which led to several Covid-19 cases.
     Kavanagh also objected to the part of the federal guidance that will allow visitation in certain units of a home that have tested negative for the virus, while closing other units that still have active cases. Because the virus is aerosolized, he said, it can spread through the home's ventilation system to other units.
     "That's kind of like smoking in the back of an airplane," he said. "This thing's aerosolized. That doesn't work."
     He added, "These are our highest risk individuals. . . . This virus is relentless, it does not care. And we cannot set up the elderly in an unsafe situation, especially when vaccines are available. If people want to visit the elderly, they should get vaccinated."
     He expanded on his concerns in an op-ed for Infection Control Today titled, "Nursing Home Guidance Endangers Elderly."   Kentucky Health News.  Mar. 11, 2021. 
https://kyhealthnews.blogspot.com/2021/03/medicare-certified-nursing-homes-will.html   
    
34.  People Vaccinated Against COVID-19 Can Mingle Maskless Again
Kevin Kavanagh, MD, said: “Relaxation of adivsements will come as a welcome relief. All are weary of living under public health restrictions. Obtaining both doses for the Pfizer/BioNTech and Moderna vaccines is essential, since this is what will give protection to the variants. The Johnson & Johnson vaccine is single dosage and even with this, its clinical trials demonstrate excellent protection against severe disease caused by the South African variant. The duration of vaccine induced immunity is a concern, especially for effectiveness against the South African and Brazilian variants. Thus, even if you become fully vaccinated, a booster may still be advised in the future.”   Infection Control Today. Mar. 8, 2021.
https://www.infectioncontroltoday.com/view/people-vaccinated-against-covid-19-can-mingle-maskless-again
   
33.  Montana health director nominee once faced criticism over Kentucky's hepatitis A outbreak
Dr. Kevin Kavanagh, a retired Kentucky physician who runs the national watchdog group Health Watch USA, is among those who said Meier and his team needed to do more early on to curb the hepatitis outbreak as it made its way into Appalachia. Kavanagh said Meier’s handling of the outbreak provides a window into how he might handle the COVID crisis in Montana.  “But it could be a learning opportunity if failed strategies are corrected,” Kavanagh said. “The biggest question is: What did he learn in Kentucky?” Courier Journal.  Feb. 27, 2012. 
https://www.courier-journal.com/story/news/politics/2021/02/27/montana-health-director-nominee-adam-meier-led-during-kentucky-hepatitis-outbreak/6850713002/  
  
https://www.usatoday.com/story/news/2021/03/01/looking-kentuckys-past-understand-montana-health-nominees-future/6873126002/  
 
32.  Leaked video more comical than incendiary, but coach's conduct raises coronavirus concerns
“When you have two individuals indoors without cloth masks, that is a set up for transmission, which can be a disaster for the individuals in close contact,” said Dr. Kevin Kavanagh, board chairman of Health Watch USA. “When they are public figures, it sets a bad example and may encourage other Kentuckians to do the same.”  “I don’t know what that means,” Kavanagh said. “Testing is not a for-sure guarantee that you won’t get transmission. Even vaccination is not for sure, especially with the new variants.  “One needs to do both masking and social distancing and when you’re indoors there’s a possibility neither will be effective because this virus can aerosolize.”  Americans grow increasingly susceptible to COVID-19 fatigue, tempted to cut corners and resume life as we once knew it. As vaccines are distributed and immunity increases, Kavanagh says, “I’m very worried that as a society we’re declaring victory and letting our guard down.”  Courier Journal.  Feb. 21, 2021. 
https://www.courier-journal.com/story/sports/college/louisville/
2021/02/21/sullivan-macks-conduct-after-
louisville-win-raises-covid-19-concerns/4533748001/  

31.  Legislators tell Beshear they’ll talk with him after votes to override vetoes; he says ‘See you in court,’ warns of fourth surge in cases 
"In an opinion piece for the Courier Journal, Dr. Kevin Kavanagh, a retired Somerset physician and the chairman of Health Watch USA, walks through the dangers of the coronavirus variant that originated in the United Kingdom, noting that it may be 70% more infectious, 30% more lethal and more likely to infect children. He adds that the Brazil and the South Africa variants “are even more concerning.” That said, he said there is hope in President Biden’s seven-point plan that aims to create a standardized pandemic approach. He also writes that “For many, the virus is becoming a litmus test for reliable news sources,” noting that “unreliable sources rarely if ever correct reporting errors, which have led to the deaths of hundreds of thousands of Americans.”"  Kentucky Health News.  Feb. 2, 2021.   http://ci.uky.edu/kentuckyhealthnews/2021/02/02/
legislators-tell-beshear-theyll-talk-with-him-after-votes-to-override-vetoes-he-says-see-you-in-court-warns-of-fourth-surge-in-cases/     

30.  Goodbye to January 2021, COVID-19’s Worst Month (So Far)
There’s a strain of COVID that emerged in South Africa—E484K—that has experts even more concerned, because it seems as if the vaccines are less effective against that strain. Modern technology allows us to create a new vaccine or booster shot in a matter of weeks, if that’s in fact what’s needed. We don’t have to culture them anymore. But as Kevin Kavanagh, MD, and a member of Infection Control Today®’s Editorial Advisory Board, tells ICT®, the main goal at this point is to stop the spread of the new variants because if they take hold there’s this problem: You have to, in Kavanagh’s words, revaccinate the entire world. “And if we keep having these variants coming about every six months, because we’re spreading this virus like wildfire, it’s going to be very problematic.   Infection Control Today.  Feb. 1, 2021.  https://www.infectioncontroltoday.com/view/goodbye-to-january-2021-covid-19-s-worst-month-so-far-
 
29.  B.1.1.7 Cornavirus Strain Now Said to Be More Deadly and Contagious
Kevin Kavanagh, MD, a member of Infection Control Today®'s Editorial Advisory Board said that "initial reports that the UK Variant is not more lethal than our current strain and that its increase in transmissibility was possibly due to an increase in viral production by the patient did not make sense. Since, increased viral load should produce a more severe disease in the patient. I was thus hoping for another mechanism, but it now looks like this strain may be more lethal after all and to make matters worse, it may have an increased propensity to infect children and young adults."   Kavanagh argues that now is the time for the CDC to be proactive in its outreach to other countries. "The new emerging coronavirus strains underscore the necessity of not only having increased vigilance on our shores and the need to expand our genomic surveillance in the United States, but also to reactivate and expand the CDC's foreign support services and personnel. Similar to Ebola we need to stop these new biological threats in the countries they emerge in, rather than let them spread around the globe and into the United States." Infection Control Today.  Jan. 22, 2021. 
https://www.infectioncontroltoday.com/view/p-1-1-7-now-said-to-be-more-deadly-and-contagious   
 
28.  Pfizer COVID Vaccine Days Away From Approval
"Kevin Kavanagh, MD, points out in an article on ICT®’s website that “the Pfizer/BioNTech vaccine is in short supply. The lion’s share of the doses are not expected to be delivered to the United States until late June or July, 2021. Moderna appears to have more available vaccines but the exact delivery dates are unknown.” "  Infection Control Today.  Dec. 11, 2020. 
https://www.infectioncontroltoday.com/view/fda-panel-meets-today-on-covid-19-vaccine-approval  
  
27.  COVID Unleashes the ‘Lurking Scourge’ Candida Auris
"Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board, says that drug resistant C. Auris is a dangerous pathogen, it first came to attention back in 2015. “Presently, it is known to be highly infectious and can cause dangerous co-infections,” says Kavanagh.”C. Auris co-infections do occur in COVID-19 patients and if present the case-fatality-rate is 60%"  Infection Control Today.  Nov. 11, 2020.  https://www.infectioncontroltoday.com/view/covid-unleashes-the-lurking-scourge-candida-auris      
 
26.  Experts say COVID-19 vaccine will come with challenges and cautions after distribution
"Even after a vaccine is approved for the novel coronavirus and is widely distributed, it will still be important to follow public-health recommendations to thwart the spread of the virus, including basic hand hygiene, social distancing and wearing a mask.
All that said, Kavanagh said if you are at high risk for COVID-19 or a frontline worker, it may be in your best interests to get the vaccine, after weighing the risks and benefits. As for the rest of the population, the months-long wait for universal distribution will give time for more research, he said: “By that time, there’ll be a lot more safety data, and data on the vaccine’s effectiveness.”  "  Ky Forward.  Nov. 3, 2020.  
https://www.kyforward.com/experts-say-covid-19-vaccine-will-come-with-challenges-and-cautions-after-distribution/ 
 
25.  CDC Launches $180M Anti-infection Program for Healthcare Workers
Kevin Kavanagh, MD, another member of ICT®’s Editorial Advisory Board, says that “this efficient and highly accessible training is desperately needed as many states are making final plans for the opening of satellite hospitals and potentially assigning desperately needed staff with minimal experience in infectious disease. In addition, tracking and mandatory reporting of healthcare worker acquisitions and infections with dangerous pathogens such as COVID-19 is of utmost importance.  Infection Control Today.  Oct. 28, 2020. 
https://www.infectioncontroltoday.com/view/cdc-launches-180m-anti-infection-program-for-healthcare-workers
  
24.  To 'celebrate' or not to celebrate Halloween; that is the question
Dr. Kevin Kavanagh, a retired Somerset physician who heads Health Watch USA, which focuses on infection control, reminded Kentuckians on the Jack Pattie Show on Lexington's WVLK that just because an activity is outdoors doesn't mean it's safe. He noted that the Centers for Disease Control and Prevention has declared traditional trick-or-treating, in which treats are handed to children who go door to door, a high-risk activity.
Don't think that wearing a Halloween mask, is going to protect you from the coronavirus, Kavanagh said. "If screaming will likely occur, greater distancing is advised," he said. "The greater the distance, the lower the risk of spreading a respiratory virus.”
The CDC also advises against wearing both a regular mask and a costume mask: "Do not wear a costume mask over a cloth mask because it can be dangerous if the costume mask makes it hard to breathe. Instead, consider using a Halloween-themed cloth mask."  Kentucky Health News.  Oct. 26, 2020. 
http://kyhealthnews.blogspot.com/2020/10/to-celebrate-or-not-to-celebrate.html  
   
23.  Healthcare-Acquired Infections Not Reported Enough
"One of the problems with controlling HAIs has to do with the growth of antibiotic resistant pathogens.  Kevin Kavanagh, MD, a member of the Infection Control Today®'s Editorial Advisory Board, noted in an article that 500 people in the United States die each day from antibiotic resistant organisms. As mentioned, the data collected for the ID Week study are pre-COVID.
Kavanagh wrote that preliminary data revealed that "patients with COVID-19 were more likely to contract healthcare-acquired infections (HAIs), possibly due to longer hospital stays. The most common MDRO infecting patients with COVID-19 was methicillin-resistant Staphylococcus aureus (MRSA), followed closely by extended spectrum beta-lactamases (ESBL)-producing organisms. MRSA caused just under half of the COVID-19 hospital-acquired antibiotic resistant infections."  " Infection Control Today. Oct. 23, 2020.
https://www.infectioncontroltoday.com/view/healthcare-acquired-infections-not-reported-enough
    
22.  Measuring Effects of Flu, COVID Co-Infections
"Kevin Kavanagh, MD, another member of ICT®'s Editorial Advisory Board, said in a Q&A back in August that those methods used against COVID seem to be particularly effective against the flu. The rates of flu in the Southern Hemisphere and in even back in March in the United States "just plummeted."   "It's a very steep slope,” Kavanagh said in August. “And so one would ask, ‘Why did that happen?’ Well, it happened because of the use of masks, hand hygiene, and social distancing. These same public health initiatives and strategies which are very effective on COVID-19 are even more effective with the flu."  " Infection Control Today. Oct. 21, 2020.
https://www.infectioncontroltoday.com/view/measuring-effects-of-flu-covid-co-infections
  
21.  AHRQ Process Cuts Down on Antibiotic Overprescribing
"In the November issue of Infection Control Today®, Kevin Kavanagh, MD, writes about how COVID-19 has complicated the tracking of antibiotic resistant bacteria. Patients afflicted with COVID-19 have an increased susceptibility to antibiotic resistant infections both from prolonged hospitalizations and the use of immunocompromising agents such as dexamethasone,” writes Kavanagh, who is a member of ICT®'s Editorial Advisory Board. Kavanagh points out that patients with COVID-19 have longer hospital stays than patients with flu-like symptoms who have not been infected by the coronavirus. He also writes that COVID patients are much more likely to be hit by a healthcare-acquired infection, than non-COVID patients.
Kavanagh writes that preliminary data by the US Centers for Disease Control and Prevention "found that during the pandemic, total hospitalizations in the United States decreased by approximately 25%. However, inpatient antibiotic usage did not markedly change. The most common types of antibiotics prescribed were ceftriaxone for presumptive community acquired pneumonia, which increased by 22% in April and then fell during the summer, and azithromycin, possibly used in conjunction with hydroxychloroquine, the rate of which increased by 55% in April and then also fell. It was evident to me that in both cases the usage pattern represents changes in both diagnostic ability and treatment recommendations."  " Infection Control Today. Oct. 21, 2020.  https://www.infectioncontroltoday.com/view/ahrq-process-cuts-down-on-antibiotic-overprescribing
  
20.  Experts Forcefully Push Back on Barrington Declaration
"Kavanagh, MD, a member of Infection Control Today®'s Editorial Advisory Board in his rebuttal to the Declaration.   Kavanagh wrote that “for infection preventionists and frontline healthcare workers, the Great Barrington Declaration places their lives and livelihood at risk." " Infection Control Today. Oct. 20, 2020.  https://www.infectioncontroltoday.com/view/experts-forcefully-push-back-on-barrington-declaration  

19.  Smoke Gets in Your Eyes: How COVID Spreads Indoors
"While reiterating that SARS-CoV-2 most commonly spreads through close contact (less than 6 feet, and for about 15 minutes) with a symptomatic or asymptomatic carrier, the CDC now suggests that the coronavirus is even more contagious than previously thought."
Well, yesterday the CDC again put the guidance on its website, acknowledging that aerosolized particles of the coronavirus can spread further than six feet and linger for a long time, particularly in poorly ventilated areas.
This might not come as a surprise to many experts who’ve been closely monitoring COVID-19. Certainly not to Kevin Kavanagh, MD, a member of Infection Control Today®’s Editorial Advisory Board and a frequent contributor to ICT®. Kavanagh recently pointed out that the CDC in fact has already acknowledged that the coronavirus can be aerosolized when it released recommendations on how people should approach the upcoming holidays.  Infection Control Today.  Oct. 6, 2020. 
https://www.infectioncontroltoday.com/view/smoke-gets-in-your-eyes-how-covid-spreads-indoors
   
18.  President Trump, First Lady Melania Trump Test Positive for COVID
"Kevin Kavanagh, MD, is a member of Infection Control Today®’s Editorial Advisory Board. Kavanagh tells ICT®: “This is a testament to how easily this virus can spread. President Trump was in a testing bubble and relied at his rallies on social distancing. However, these rallies would be defined as a high-risk activity, since even outdoors—and not all were—loud vocalizations can aerosolized the virus. In an aerosolized form, the virus can travel much farther than 6 feet, live for up to 16 hours and defeat the protections afforded by a cotton mask. If one does not wear a mask, then the activity is at an even higher risk.” Infection Control Today. Oct. 3, 2020. https://www.infectioncontroltoday.com/view/president-trump-first-lady-melania-trump-have-covid-19  
 
17.  Somerset-area legislators decry Beshear's restrictions at Chamber meeting with little use of masks or social distancing 
The lawmakers from the Somerset area spoke to "a packed house" that included "a whole host of the community’s business and political leaders," reported Chris Harris of the Somerset Commonwealth Journal. The newspaper's editor, Jeff Neal, told Kentucky Health News that "There wasn’t a whole lot of social distancing, and since they were eating, there were not a lot of masks being used."
The event concerned Dr. Kevin Kavanagh, a retired Somerset physician who heads Health Watch USA, which focuses on infection control in health care.
"Events like this are very problematic," Kavanagh told Kentucky Health News. "They usually have many cases or none. With the number of individuals present and the prevalence of the virus in Pulaski County, the odds are nothing will happen, but if the virus was present at the event it can be catastrophic. . . . "
http://kyhealthnews.blogspot.com/2020/08/somerset-area-legislators-decry.html  
 
16.  Kentucky Derby 2020: Why health experts say they agree with Churchill Down's decision
“Dr. Kevin Kavanagh, a retired Somerset physician who also had warned against allowing fans at the event, praised Friday's decision.
"It sends a very strong message to the community and Kentucky about how serious this pandemic really is," said Kavanagh, chairman of the patient advocacy group Health Watch USA.
Kavanagh said earlier this week that holding the event largely outdoors would have helped. But it still wouldn't account for people entering the racetrack through the building, passing through hallways, placing bets, buying food and drink, using restrooms or otherwise moving about, Kavanagh said.
And any cheering or shouting tends to "aerosolize" the virus and increase chances of spread, he said.
Though most people who contract the virus don't experience the severe and sometimes fatal symptoms associated with it, that doesn't mean it's not a risk to mingle in a crowd, he said. Even people who appear to have recovered from a less serious case of COVID-19 may be at risk for lasting heart, lung or kidney damage.
“This is one dangerous virus that we don’t know much about," Kavanagh said. "This lackadaisical attitude that you can go out and get infected and everything will be fine if you’re at low risk is just plain magical thinking.””  Yetter D.  Courier Jounal.  Aug. 22, 2020.   https://www.courier-journal.com/story/news/2020/08/21/health-experts-say-cancelling-fans-good-call-for-kentucky-derby/3400329001/
     
15.  Beshear says Kentucky Derby can safely host fans despite COVID-19. Not everyone agrees  
"Any large gathering of people carries risks," said Dr. Kevin Kavanagh, a retired physician from Somerset, Kentucky, and chairman of the patient advocacy group Health Watch USA. "That risk is lessened outdoors with social distancing and by the wearing masks."
However, Kavanagh said in an email that shouting, which often happens during the Derby, can cause the virus to "aerosolize" and "defeat the safety of a cloth mask" while causing droplets to "travel much further than 6 feet." "In addition, getting into and out of the stands and use of restrooms is problematic," Kavanagh said.   Yetter D.  Courier Jounal.  Aug. 12, 2020.    https://www.courier-journal.com/story/entertainment/events/kentucky-derby/2020/08/12/kentucky-derby-2020-beshear-says-race-safe-amid-covid-19/3353837001/ 
 
14.  As COVID-19 spread, the feds relaxed rules, and hospitals tried to contain the outbreak. Other infections may have risen 
"Patients need to be repositioned every two hours to prevent ulcers on the skin, said physician Kevin Kavanagh, founder of patient advocacy group Health Watch USA. Doing so will show staff when patients have soiled their beds, he said.   Daily bathing is necessary to prevent hospital infections, given "the dangerous pathogens and compromised patients," Kavanagh said, but bathing takes so many workers that short-staffed facilities too often don't do it."    Odonell J.  USA Today. Aug. 5, 2020.  https://www.usatoday.com/story/news/2020/08/05/some-hospital-infections-up-feds-waived-safety-oversight-reporting/5537817002/ 
 
13.  Once seemingly insulated, Kentucky's Appalachian counties scramble to stop COVID-19 outbreak 
Dr. Kevin Kavanagh, a retired physician and infectious-control advocate in Somerset who runs a patient-safety group called Health Watch USA, said tracing remains a crucial measure, though it gets less effective as cases grow and lab results in some areas take more than a week.   Courier Journal.  July 31, 2020.    https://www.courier-journal.com/story/news/local/2020/07/31/covid-19-appalachia-tiny-health-departments-struggle-outbreak/5526869002/  
 
12. Hospitals must treat infection control as a priority, not a profit center. 
"We have gone far too long with not making the proper investments,” warned Kevin Kavanagh, the physician founder of Health Watch USA, in a recent commentary in Infection Control Today. “I fear that, as a society, we may well have to pay the price for this neglect."  STAT. July 1, 2020.  https://www.statnews.com/2020/07/01/hospitals-must-treat-infection-control-as-a-priority-not-a-profit-center/   
 
11.  26,000 COVID-19 Deaths in Nursing Homes Might Spur Federal-State Blame Game
 “Infection control in nursing homes has been almost non-existent for years along with effective regulations to serve as guidance,” Kavanagh said. “We are also concerned with a reactionary program of inspections based on non-specific regulations.”  Kavanagh would like to see a sustained program of oversight using detailed metrics designed to drive a high-quality outcome.  Infection Control Today.  June 2, 2020.
https://www.infectioncontroltoday.com/covid-19/26000-covid-19-deaths-nursing-homes-might-spur-federal-state-blame-game
 
10.  As obesity's link to COVID-19 grows, one family that lost 24-year-old daughter diets together
"Along with making mechanical ventilation harder, being severely overweight can make it harder to breath, reducing the patient's own ventilation, said Dr. Kevin Kavanagh, a Kentucky physician and founder of the patient advocacy group Health Watch USA."  USA Today.  May 23, 2020.
https://www.usatoday.com/story/news/
2020/05/23/obesity-makes-covid-19-risk-larger-hospitals-challenges-much-harder/5221600002/
 
9.  Mask or no mask? Why Kentucky's new requirement to battle COVID-19 is causing such a fuss
Getting people to wear them is "absolutely key," in part because modeling suggests that getting most of the public to wear masks is what makes them effective, said Dr. Kevin Kavanagh, head of the patient safety group Health Watch USA.   It's also critical to making consumers, especially older Kentuckians, feel safe to return to stores and help revive the economy, he said.  Courier Journal. May 15, 2020. 
https://www.courier-journal.com/story/news/2020/05/15/coronavirus-masks-how-kentuckys-first-week-went-requiring-masks/5192238002/
    
8.  Rich hospitals, poor safety plans leading up to coronavirus: Should rules change for them now?
"As many hospitals cut staff and more than 9,200 health care workers have been diagnosed with COVID-19, Dr. Kevin Kavanagh, founder of the patient safety group Health Watch USA, said the government shouldn't bail them out after they “put us all at risk.” He calls it "a step in the right direction" that rural hospitals and those with the most COVID-19 patients were getting money Friday, but said "non-profit facilities with net assets in the billions should have to first leverage these assets before receiving public funds." "   USA TOday.  May 10, 2020.   https://www.usatoday.com/story/news/health
/2020/05/10/coronavirus-should-rich-hospitals-bankroll-better-pandemic-plans/3048437001/ 
 
7.  Nelson D.  Blood-pressure drugs are in the crosshairs of COVID-19 research.  Reuters News Service.  April 23, 2020.  https://uk.reuters.com/article/us-health-conoravirus-blood-pressure-ins-idUKKCN2251GQ   
New York Times: https://www.nytimes.com/reuters/2020/04/23/us
/23reuters-health-conoravirus-blood-pressure-insight.html 
"Dr Kevin Kavanagh, founder of Health Watch USA, a patient advocacy organization, questioned whether scientists who are funded by the drug industry should be advising clinicians, given the high stakes.
"You need to consider stepping back, and let others without a conflict of interest try to make a call," Kavanagh said."  His organization recommends that doctors temporarily avoid putting new patients on the drugs and warn those currently on them to take extreme precautions to avoid virus exposure.
 
6.  Morgan-Besecker T.  Patient advocate: State needs more aggressive action to confront COVID-19 deaths.  The Citizens' Voice. April 22, 2020.  https://www.citizensvoice.com/news/patient-advocate-state-needs-more-aggressive-action-to-confront-covid-19-deaths-1.2620809  
"Kevin Kavanagh, director of Health Watch USA, a patient advocacy group, said efforts to halt the virus from entering facilities fell short with catastrophic outcomes.   "You try to wall off the home from the outside. Once COVID-19 gets into the nursing home environment ... it tends to ravage residents and it does not stop," Kavanagh said.  Many homes tried to halt the spread by isolating residents to a specific floor. Kavanagh said the government must consider taking it a step further and designate one facility to house infected patients."
 
5.  Sullivan T: Louisville area preacher defies ban on mass gatherings, plans to hold Sunday service.  Courier Journal.  April 4, 2020.  https://www.courier-journal.com/story/news/2020/04/04/preaching-gospel-defying-government/2943503001/ 
"Dr. Kevin Kavanagh, the Somerset-based founder of Health Watch USA, argues that church services pose specific and inordinate dangers during a pandemic.   "One of the cruelest characteristics of the coronavirus epidemic is that it strikes fear in the hearts and minds of many causing them to ask for comfort and protection from the God they believe in," Kavanagh wrote in an essay published Friday in Infection Control Today.“And at the same time this virus has made a church service one of the most deadliest places to be in. The combination of singing in close quarters and decreased ventilation is nothing short of a petri dish (or cell plate) for viral growth."" 
   
4. Jacobes A. Fink S.  How Prepared Is the U.S. for a Coronavirus Outbreak? New York Times.  Feb. 29, 2020.  https://www.nytimes.com/2020/02/29/health/coronavirus-preparation-united-states.html    
"Dr. Kevin Kavanagh, who has studied infection control practices in health care settings, said such facilities might eventually have to limit visitors, or even keep residents under quarantine as a preventive measure. "Nursing homes will be extremely vulnerable to this epidemic, and it will be difficult to implement hygiene practices to prevent the spread," he said."
  
3.  Kenning C. Why the coronavirus couldn't have come at a worse time for reeling Appalachian Kentucky. Courier Journal. March 21. 2020. https://www.courier-journal.com/story/news/2020/03/21/coronavirus-comes-terrible-time-reeling-appalachian-kentucky/2878214001/  
 
2. Terrie Morgan-Besecker. NEPA grocery store begins taking customers' temps. The Citizens' Voice. Mar. 24, 2020. https://www.citizensvoice.com/news/nepa-grocery-store-begins-taking-customers-temps-1.2610547  
 
1.  Healy J, Richtel M, Baker M. Nursing Homes Becoming Islands of Isolation Amid 'Shocking' Mortality Rate. New York Times. March 10, 2020. https://www.nytimes.com/2020/03/10/us/coronavirus-nursing-homes-washington-seattle.html
"Dr. Kevin Kavanagh, an expert in infection control who has been critical of lax practices at nursing homes, lauded the new guidance that restricts social visits. This extreme level of quarantine is sometimes known as "reverse isolation” and was used to effect during the Spanish Flu epidemic, Dr. Kavanagh said. 'As evidenced by the Life Care Center in Kirkland, once the virus starts to spread in the facility it ravages its residents,” he said. He said that “the importance is in delay.""