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153. Rethinking Airborne Pathogens: WHO Proposes New Terminology for Disease Spread
"Recently, the World Health Organization (WHO) initiated a paradigm shift in preventing pathogens from spreading through the air. If that phrasing seems non-scientific and does not use the jargon of “airborne pathogens” or “aerosolized pathogens”, it is by design... Too many healthcare experts believe that an “airborne” pathogen will only spread under certain circumstances or unusual conditions, such as during an aerosolizing procedure... Infection disease professionals must not only advocate but also act. A good first step is to carry a portable CO2 monitor to help evaluate indoor air quality at your health care workplace. One should advocate for continuous CO2 monitoring in your facility and make sure HEPA filtration is used with adequate ventilation." Infection Control Today. References May 15, 2024.  
152. Understanding the Impact of COVID-19 on Personality and Brain Function: A Grim Reality or a Wake-Up Call?
Opinion: A summary of studies on how COVID-19 may damage the brain's frontal lobes, alter personality traits and cognitive functions, and potentially reshape society's dynamics. A nightmare scenario would be if mankind were targeted by a pathogen that attacks our frontal lobes and changes our personalities, making us less likely to get along, reach a consensus, and understand others' points of view. Such a pathogen could bring an end to society as we know it. Unfortunately, the nightmare may be real and taking shape in SARS-CoV-2, the virus that causes COVID-19. References  Infection Control Today. April 30, 2024. 

151. COVID-19 Harmonization: Balancing Risks and Benefits of CDC's Latest Move
"The CDC's recent decision to align recommendations for respiratory viruses, particularly COVID-19, has garnered support from the public and infectious disease societies....the Infectious Diseases Society of America (IDSA) lends its backing to the CDC's harmonization efforts, concerns persist regarding the implications of this shift, especially considering the Omicron variant's unique characteristics and the ongoing challenges posed by COVID-19's multi-system impacts. Currently, IDSA is supporting the CDC in dropping the isolation time to 0 days for asymptomatic carriers. In view of protracted viral shedding in patients who have become symptom-free after infection (11% had positive cultures at 10 days) and a 40 to 50% rate of asymptomatic infections, some have concerns regarding this decision. COVID-19 is still ravaging our society, with over 200 deaths each week and over 20,000 individuals in the hospital each day. And the tolls of long COVID may be mounting, not decreasing. During the first week of February 2024, 6.8% of all adults are experiencing long COVID symptoms, up from 5.3% during the week of October 18 to 30, 2023. In Sweden, a country that had very few COVID-19 interventions, a major insurance company, If, reported that after the pandemic, 1 in 3 young adults are experiencing brain fog. A better prevention harmonization may well be with the measles and polio viruses." References Infection Control Today. Mar. 11, 2024. 
150. COVID-19 Realities: Beyond a Respiratory Virus, Addressing Optimism in Pandemic Management
The CDC needs to give an unambiguous message about the urgent need for COVID-19 vaccinations and not one minimizing the disease by green-lighting the safety of asymptomatic spreaders mingling in our community. 
We should not be minimizing COVID by comparing it to RSV and flu. Not all airborne viruses are primarily respiratory. There is disagreement with this contention in the scientific community as to whether SARS-CoV-2 should be considered a respiratory virus since it affects every organ system of the body, and COVID-19 may be more of a neurological and cardiovascular disease than respiratory. The United Kingdom's workforce has been crippled with chronic illnesses, with 2.8 million of UK’s citizens being inactive due to chronic illness. This figure has increased by 700,000 since the pandemic first started and corresponds to an equivalent decrease in workforce participation. We need to strengthen isolation requirements along with protecting the vulnerable. And we need to prepare for the next pandemic through increasing standards for ventilation and the use of N95 masks for all airborne pathogens. References Infection Control Today. Feb. 28, 2024. 

149.  CDC Sends Back Proposals to HICPAC on Pathogen Spread in Health Care for Revision
On January 23, 2023, the CDC announced it is sending back its 2023 proposals regarding the spread of dangerous pathogens in health care to the Healthcare Infection Control Practices Advisory Committee (HICPAC) for revision. Infection Control Today® (ICT®) has published 2 articles sounding the alarm regarding the potential harm these recommendations could potentially cause and the need to revise the 2023 proposed guidelines. The narrative that the use of N-95 masks, negative pressure rooms, and effective source control is too burdensome needs to be weighed against the Federal estimate of the cost of $9.6 million per life lost. But even more concerning is the newly posted preprint from Beijing China which describes a cell-cultured mutated SARS-CoV-2 related virus which has a 100% fatality rate in human ACE2-transgenic mice. Disease “X” may have been found, and we must be fully prepared for the next pandemic. References  Infection Control Today. Jan. 24, 2023.  
139.  COVID-19 vs Seasonal Influenza: A Comparative Analysis Reveals Alarming Trends
There were 2.87 times as many SARS-CoV-2 (5,572,366 cases) as seasonal influenza cases (1,772,602 cases and 5 times more new hospitalizations with COVID-19 than seasonal influenza. Importantly, the impact on society is not just determined by the case fatality or disability rate for those infected with a dangerous pathogen. Infectivity is also of utmost importance, especially for SARS-CoV-2, an immunoevasive mutating virus that all too commonly causes reinfections. The high rates of death and disability from SARS-CoV-2, compared to seasonal influenza, along with its increased infectivity, makes slowing viral spread and development of next-generation vaccines imperative. References  Infection Control Today. Jan. 2, 2023.   

138. How Artificial Intelligence Is Revolutionizing Diagnosis in Health Care
Diagnostic errors are a long-standing, pervasive problem. A recent study published in the British Medical Journal, Quality & Safety, estimates that in the United States, 795,000 patients suffer serious harm each year from diagnostic errors. The big 3 categories of diseases where these errors occurred were vascular events, infectious diseases, and cancers. There was an average medical error occurrence of 11% and a rate of patient harm of 4.4%. There is little doubt that AIs will be widely used to aid physicians in making diagnoses and nurses in making patient intake and triage decisions. Implementing AI promises to increase patient safety, accuracy, and efficiency. The latter, however, will mean fewer medical jobs for humans, but with the potential of patients having greater access to more affordable health care. References Infection Control Today. Dec. 22, 2023.  

137. CDC's HICPAC Update: Impact on COVID-19, Pathogen Control, and Immunocompromised Safety in Health care Settings
Recent CDC HICPAC revisions regarding SARS-CoV-2 control face criticism from the World Health Network and others due to alleged breaches in committee structure and erroneous infection control guidance, potentially impacting COVID-19 management and immunocompromised individuals in health care. As stated in an action letter sent to the CDC, for the  immunocompromised the status quo is unacceptable, and weakening current regulations will result in a “direct threat” to their safety and well-being and does not maintain accessible features for safe and adequate access to a facility. This concern was further underscored by the findings of the INFORM and EPOCH research initiatives. The CDC be “mindful of the provisions of the ADA and the impact recommendations will have regarding vulnerable individuals who both work in health care settings or are experiencing reduced access to healthcare because of unsafe healthcare environments.” References Infection Control Today. Nov. 8, 2023.  

136.  A Keynote Speaker's Journey: Strategies to Maximize Respiratory Safety During Air Travel Amid a Pandemic
A high-risk for severe COVID-19 keynote speaker, Kevin Kavanagh, MD, shares strategies for safe air travel during the COVID-19 pandemic, emphasizing mask usage, vaccinations, and air quality monitoring, with mixed observations throughout the journey. On the return, Logan airport had carbon dioxide levels consistently around 600 (549 to 690), making my wait much safer, but I kept my mask on. There was no downside to doing so. I flew on the exact same plane, and carbon dioxide levels were around 2000 ppm. Again, I stayed masked. When I landed, I hurried out of the airport with the stagnant and probably aerosol-ridden air, and then made it back home. The one thing that was very evident was the United States has a long way to go in providing clean indoor air. But for me, so far, so good, I have not developed a respiratory infection.  References  Infection Control Today. Oct. 16, 2023.

135.  How to Prepare For Possible “Tripledemic” of RSV, Influenza, and SARS-CoV-2 
The interaction between the respiratory viruses SARS-CoV-2, influenza, and RSV, poses ongoing challenges. Personal protective measures, testing, and vaccination are critical components of our strategy to mitigate the impact of these viruses. New research focuses on real-time SARS-CoV-2, RSV, and influenza detection. A proof-of-concept portable monitor has been developed to detect SARS-CoV-2 within 5 minutes.18 This technology could also be applied to RSV and influenza. Thus, we must not abandon public health and only rely on personal protection. This is a recipe which may force us to endure another tripledemic. Instead, we should prevent all respiratory illnesses to the highest degree possible, with strategies which are adopted and supported by society. References Infection Control Today. Sept. 25, 2023.  
134. Organized Disinformation Fanning the COVID-19 Flames of Vaccine Hesitancy
"Our pandemic response has undoubtedly been stymied, largely due to the divisive effects of organized disinformation. Many disseminators of disinformation downplay the idea of a multi-layer approach and proclaim that if you can still catch COVID-19 while wearing a mask, they do not work, ignoring that seldom is a single intervention 100% effective. Everything from treating a cold to cancer involves multilayer approaches, as does automobile and airline safety. Why should COVID-19 be any different? .... As COVID-19 cases and hospitalizations increase, do not fall prey to disinformation. It is wise to be vaccine-boosted, wear a mask in high-risk settings, and carry a CO2 monitor to determine safe indoor ventilation. These steps will help us all avoid the disabilities caused by long COVID and help to maintain the health of our families and the nation’s workforce." References Infection Control Today. Sept. 18, 2023. 

133. As COVID-19 Hospitalizations Increase Alarmingly, Workers and Patients Call for Better Standards
"After almost 4 years of COVID with over 10,000 patients currently hospitalized, a 22% increase over last week, one must ask, what has the CDC been doing? According to many people, the CDC has been trying to roll back our protections and ability to fight the spread of disease when experts are strongly advising those at high-risk to mask up in indoor settings." During an ongoing pandemic, credibility is of utmost importance. As one commentator stated, “We need consistent messaging to educate the public about the true dangers of COVID and being disabled by long COVID.” If the public cannot rely on the agency to communicate safe and effective recommendations on masking and ventilation, how then can they be expected to rely on the CDC’s advice on vaccine uptake? And if we minimize the dangers of SARS-CoV-2, how then can we expect the public to see the urgency in obtaining the updated booster? References Aug. 28, 2023. Infection Control Today.   

132.  Flying Blind as COVID-19 Rates Increase: The Eris Variant
Few people doubt COVID-19 will stay around, and it is starting to increase again in August 2023. Daily hospital admissions are on the rise, up over 70% from mid-June. Currently, there are 1500 COVID-19 admissions daily in the United States and projected to increase to over 1800 admissions by the end of August. The Walgreens COVID-19 test positivity rate is at 44.7%, the highest it has ever been. COVID-19 infections will not go away and will have a lasting impact on our resources. We must be able to accurately calculate and project the societal and workforce impact of COVID-19. We should have the data to calculate the percentage of the population disabled by COVID-19 and project this into the future. But at this point, we appear to still have our heads in the sand, hoping that if we do not measure and report the virus one day, like a miracle, will disappear. References Infection Control Today.  Aug. 17, 2023.

131.  One Step Forward, 2 Back: CDC's Proposals for Infection Control in Health Care Facilities
"During the CDC’s June 2023 Healthcare Infection Control Practices Advisory Committee (HICPAC) meeting, concerns were expressed regarding proposed updates to existing infection control guidance for health care facilities which would place patients, health care workers, and nursing home residents at risk.... The United States’ post-emergency infection control strategy involves scaling back data collection, weakening guidance, not effectively reporting health care worker or patient acquisitions, and not setting firm and effective standards for control. HICPAC/CDC is on the verge of weakening contact precautions (by adopting EBPs) and weakening airborne precautions, thereby ignoring decades of occupational health research." References  Infection Control Today. July 24, 2023.   

130. Opinion: Post Pandemic Strategies Are Inadequate To Assure Public Safety
Many COVID-19 experts place the odds at 20% in the next two years of experiencing an outbreak comparable to that caused by the Omicron variant. Unfortunately, SARS-CoV-2 is not the only disease on the rise. The lack of publicly available data regarding the incidence of MRSA, COVID-19, and other pathogens in the United States is concerning. This data should be readily and publicly available for community and facility-onset infections. For now, patients can only guard against exposure to aerosolized pathogens by wearing a well-fitted N95 mask in healthcare settings and using CO2 monitors to screen for adequate air ventilation. What is needed to control an organism is what is required to be implemented. The pathogen does not care where it is. The same interventions are needed in nursing homes as are needed in hospitals. And workers need to be protected from all, not some aerosolizing pathogens. No one wishes to be sick for days or weeks at a time. Just because it does not kill you is not an excuse to only provide a worker with a surgical mask or to not take necessary preventative strategies to limit airborne spread. References  Infection Control Today. July 13, 2023.   

129.  70% of COVID-19 Cases Transmitted By Children
COVID-19, schools, and children are sensitive topics. Some worry about transmission in schools, while others don't see it as a concern. Which is it? "One of the lessons of the COVID-19 pandemic is that schools can be opened safely if proper mitigation strategies are in place. However, during the pandemic, we witnessed a vicious cycle of concerned and loving parents wanting in-person learning for their children but justifying their position by asserting that COVID-19 in children was “not a thing.” This often led to mitigation strategies not being implemented and teachers being reluctant to return to school. Schools remained closed for a period much longer than would have been necessary. We must start planning for the next infectious disease surge and build an effective school infrastructure, including upgrading ventilation and upper room UV-C germicidal lighting." References Infection Control Today. June 5, 2023.  

128. Endemic SARS-CoV-2 Demonstrating Workforce/Health Consequences
The rate of unemployment, long COVID, and immune system issues are still causing problems globally. . Several countries are reporting workforce shortfalls. China is now short 41 million workers, and in the United Kingdom, for every 13 individuals working, one person is not working because of long-term sickness. The WHO is taking a leadership position, calling for a monovalent XBB booster that targets XBB.1.5 and XBB.1.16. Concerns of immune imprinting and the rapid waning of vaccine and infection-induced immunity make it clear that additional mitigation strategies are needed to mitigate transmission. Unspent COVID-19 funds are available, which should be used to expand infectious disease reporting, testing upgrade facility ventilation and air quality, and use upper room UV-C germicidal lighting. References Infection Control Today. May 22, 2023.  

127. The End of the COVID-19 Public Health Emergency?
Although the public health emergency for COVID-19 is officially over, infection rates, precautions, and safety measures for communities around the United States still need to be addressed. Even though the PHE has ended, numerous workplaces need to implement preventive strategies and upgrade their infrastructure. Adequate ventilation is still lacking in far too many venues, including our dilapidated school infrastructure. There is clearly a critical missed opportunity for engagement of electronic medical records to collect needed data for public health. It may be time to discontinue the Pandemic Health Emergency, but many have concerns regarding this action when the United States appears to be unprepared for another SARS-CoV-2 surge, let alone a new pandemic. As a nation, we can and must do better.  References  Infection Control Today.  May 11, 2023.  
126. Opinion: COVID-19 Expanded Reporting Systems Should Continue
One of the most concerning outcomes of the COVID-19 pandemic is that the CDC and other governmental agencies appear to be dismantling our newly expanded reporting systems rather than expanding and maintaining them for the next pandemic, a pandemic which many experts feel has a 15% to 20% chance of occurring in the next 2 years... We need not only to have a permanent system for monitoring the persistence and emergence of dangerous pathogens but also to determine the composition of patients’ microbiomes. Everyone should be tested every year and upon admission to acute and long-term care facilities. This would identify pathogens and provide new insights into diabetes, obesity, cancer, and even COVID-19 and long COVID... Control and prevention of infections are of paramount importance. We need to back away from blame. Regardless of who is at “fault” or even if any “fault” exists, if you need an internal prosthesis placed, you may not want to have this procedure in a hospital or a community with high rates of MRSA carriage or infections. Knowing and mitigating the actual numbers are important. Infection Control Today. References May 10, 2023.   

125.  COVID-19 Masking: Hundreds of Thousands of Russian Social Media Bots Have Tricked the Public
"Fake news and disinformation may significantly inhibit the adoption of masking by the public. The Washington Post reports that recently leaked national security documents indicate the Russians “boasted” that “less than 1%” of their sham social media profiles and bots have been caught. One of their propaganda campaigns spread the conspiracy theory that the United States was hiding the side effects of vaccines. A “network of hundreds of thousands of social media bots emulate(ed) users” and was intended to divide the West, and apparently was very successful. One could argue that this has led to a loss of confidence in public health authorities, adversely impacting adopting of COVID-19 mitigation strategies. As a hyper-traveling world society has emerged, dangerous pathogens spread almost instantaneously. The United States needs to adapt. As a first step, health care facilities should require universal masking to protect patients and staff." References Infection Control Today. Apr. 19, 2023.   

124. The Health of US Citizens Is Declining—But Why?
Some policymakers have blamed the infection increase on time-tested public health strategies, such as the few weeks of lockdowns 3 years ago. However, this phenomenon is also seen in Sweden, a country that implemented limited mandates and shunned masking. There is mounting research evidence that infection with SARS-CoV-2 causes immunological damage in at least a subset of patients, a subset which may progressively enlarge as reinfections occur. Unfortunately, many interventions have fallen by the wayside in the United States, explaining our marked decrease in life expectancy. We can declare the pandemic has ended, but the virus is an unrelenting adversary that does not respond to political pressure. References Infection Control Today. Apr. 5, 2023.  
123.  COVID-19: Study Suggests Long-term Damage to Immune System
NIH News Release: "...findings suggest that SARS-CoV-2 infection damages the CD8+ T cell response, an effect akin to that observed in earlier studies showing long-term damage to the immune system after infection with viruses such as hepatitis C or HIV." These findings mirror those reported by Jacob Files, PhD, et al who stated, “Overall, expression of these activation and exhaustion markers indicated more severe immune dysregulation of CD8+ T cells in the hospitalized group.” And they found that “CD8 T cell expression of exhaustion markers increased in nonhospitalized individuals over time….” We can choose to declare the pandemic over, but SARS-CoV-2 is deaf to these pronouncements. Hopefully, the dysfunction will be temporary and progressive in most individuals. However, just the possibility makes avoiding COVID-19 infections paramount, and we must keep our immunity as high as possible. References  Infection Control Today. March 21, 2023.

122. Addressing COVID-19 Misinformation: What the Experts Got Right—and Wrong
Information presented at this week's Congressional Committee needs a much deeper evaluation and consideration. The Cochrane Masking study may even vindicate the federal government's initial COVID-19 response.
Natural Immunity Is Superior to Vaccinated Immunity.
This is a self-fulfilling prophecy. Early on, it was stated that if the virus continued to spread, it would mutate, and the vaccine would become less effective. This has happened with the help of many individuals who discouraged adopting public health strategies.
Prior to the Delta variant, the vaccine had the edge; afterward, the vaccine’s efficacy diminished. However, neither type of immunity is adequate, and whether infected or vaccinated, your immunity will wane, and a booster is beneficial to obtain hybrid immunity.
Masks Prevent COVID-19 Transmission.
One of the main problems is that the study relies heavily on research evaluating the seasonal flu, a virus that is NOT felt to spread primarily by the airborne route. For the season flu, masking will not stop its major route of transmission. For SARS-CoV-2, which is airborne, cloth masks and even surgical masks will not provide optimal protection. Well-fitted N95 masks will provide the greatest protection.
School Closures Reduce COVID-19 Transmission
Abundant evidence exists that children can spread COVID-19. The Public Health Agency of Sweden Weekly Report #50 states: “(translated) among the environments for the public (excluding health care) was primary school, the environment from which the most outbreaks were reported in week 50…” (Total outbreaks 199, Nursery Schools 39, Elementary Schools 90, Grammar Schools 23, Workplace 39, High Schools were closed.) References Infection Control Today. March 3, 2023.
Read the full article for an expanded analysis and other areas of misinformation:   

121. How Soon Is Another Booster Needed? Durability of Vaccine-Induced Immunity
Specifically for older individuals and immunocompromised individuals, a year could be too long. "Is the (bivalent) booster worth taking? Yes, definitely. However, this differs from the booster or vaccine we need to navigate this pandemic. At the conclusion of the CDC Committee meeting, my primary impression was that we senior citizens might be viewed as expendable. Policy makers need to make the hard decisions that must be made to assure our safety during this pandemic. After looking at the data, I will consult my physician about receiving a booster on an accelerated schedule, possibly at 6 months. References Infection Control Today. Feb. 26, 2023.  

120. Is the Rise in RSV Infections Associated With Immune Debt or SARS-CoV-2 Immune Dysfunction?
Post-COVID-19 immune dysfunction is supported by epidemiological, clinical, and laboratory evidence. Attributing, with little to no evidence, that masking and lack of exposure is the primary driver of increases in bacterial and viral infections discourages critical interventions needed to stop the spread of disease. References  Infection Control Today. Feb. 24, 2023. 

119.  COVID-19 Immunity: Catching a Disease to Prevent a Disease?
I had to stop and read the Seattle Times news article "UW study: Catching COVID gives protection from its worst effects." The article’s first sentence states: "A past COVID-19 infection offers ‘durable,’ temporary protection against getting severely sick with the coronavirus." Can you please tell me what 'durable - temporary protection' is? Unfortunately, neither vaccination nor infection provides durable protection. Hybrid immunity is best, but becoming infected to achieve immunity is a perilous strategy. At 40 weeks, the study in question, reported that pooled data found only a 36.1% effectiveness against reinfection. This protection would be expected to be even less effective with the highly immune-invasive XBB.1.5 and BQ.1 variants. Herd immunity is not achievable and has not been achieved in Sweden, a country whose results have been discouraging. There is minimal downside to boosting your immunity to help avoid long COVID. Our goal as a nation must not be to become reinfected yearly; this is not a viable option. References Infection Control Today. Feb. 20, 2023.  
118.  FDA VRBPAC Meeting: Bivalent Vaccines, Natural Immunity, Imprinting and COVID-19 Hospitalization Rates
The FDA's Vaccines and Related Biological Products Advisory Committee laid out a simpler direction for SARS-CoV-2 development and deployment. In individuals without a previous infection, the better the original vaccination matches the current viral strain, the better the immunological response will match future viral sublineages and the less of an impact any potential imprinting will have. In addition, during a discussion regarding natural immunity, it was stated: “Major issue is, the concept was that if you had COVID-19 or had been vaccinated previously, you would just need one dose versus others who might have multiple doses.” Thus, the new vaccine strategy may bring natural immunity on par with initial vaccination, and require frequent updating of vaccines and boosters to minimize the impact, if any, of immune imprinting and maximize the immunological response to SARS-CoV-2. References Infection Control Today. Jan. 29, 2023.   

117. Bird Flu Warning: Its Spreading, Mutating, and Infecting Mammals
I’m starting to experience déjà Vu. Gain-of-Function experiments performed on a hazardous virus, viral spread from birds to mammals, spread between mammals, and mutations beginning to arise, which may be the first step in conferring the ability to transmit in humans. I do not want to go through this again, especially since our current pandemic is not under control. We need to aggressively contain the spread of bird flu and increase our genomic surveillance for this disease. References Infection Control Today. Jan. 23, 2023.   

116.  Immunodysfunction: A Cause of Stealth COVID-19 Illness and Death
The concept of immune dysfunction caused by COVID-19 is rapidly changing from a theoretical construct to a significant adverse outcome of COVID-19. One which may have the potential to collapse our health care system and impact patients long after they become COVID-19-negative. Along with heart disease, immune dysfunction and severe infections are becoming another cause of stealth COVID-19 deaths. The public needs a paradigm shift from believing that COVID-19 is a respiratory disease to understanding that COVID-19 impacts every organ of the body, causing delayed manifestations such as strokes, heart attacks, and infections which can present long after one becomes COVID-19-negative. References Infection Control Today. Jan. 17, 2023.  

115.  Future Directions for Vaccine Development with considerations of immune imprinting and prevention of spread
"The commentary discusses the continued concerns about COVID-19 vaccine efficacy reduction and what he believes should be done to protect against the further spread." We need a warp speed on new vaccine development. Why this is not being done is one of the most significant failings of our pandemic response. Until we have a vaccine that stops spread, we need to use N95 masks, avoid crowded indoor venues, and markedly increase indoor ventilation and air sanitization (with upper room UV-C units). Because of immune imprinting, we need to consider the administration of a bivalent or monovalent BA.5 (or current variant) vaccine to COVID-19-naive individuals, especially young children, as opposed to the monovalent vaccine with the spike protein from the wild-type virus. Finally, we a new Warp Speed initiative designed to develop mucosal vaccines. Infection Control Today. References  Dec. 27, 2022.  
114.  COVID-19 and Traffic Accidents: Is a COVID-19 Personality Disorder Caused by Viral Damage to the Prefrontal Cortex?
A study from Canada suggests that not being vaccinated for COVID-19 could mean an individual is at higher risk for an automobile accident. What if it is from brain damage from contracting COVID-19? Right-wing media have ridiculed the American Journal of Medicine article. But this observation may be based in reality with a sound explanation. Suppose COVID-19 produces a lasting COVID-19 personality disorder due to anatomical damage of the orbitofrontal cortex created by SARS-CoV-2 infection. In that case, those segments of the population that shun public health interventions and aggressively seek to stop general health measures may be entering into a vicious cycle of decline. As repeated infections occur, damage to the brain increases, resulting in decreased emotional control and increased aggression. All of this makes it imperative that we slow the spread of this disease and have clear and consistent messaging regarding the risks of COVID-19 and what mitigation procedures can be implemented. References  Infection Control Today. Dec. 20, 2022.  

113.  COVID-19: How to Reduce Spread Without Vaccines and Monoclonal Treatments
With many of the new COVID-19 vaccines not as effective against the new variants, reducing their spread without pharmaceuticals is even more critical. Vaccines are losing their effectiveness. Although their ability to substantially prevent hospitalizations and death has remained intact, the degree of prevention with current variants cannot be determined until we are well into the COVID-19 wave. Now, more than ever, we need to take a layered approach and add non-pharmaceutical strategies to mitigate disease from and spread to SARS-CoV-2. Combined with the risks of long COVID-19, all of this means we need to reemphasize non-pharmaceutical strategies to reduce the spread of SARS-CoV-2. Three recent articles have placed renewed emphasis on ventilation, spread by fomites, and outdoor precautions. Dec. 13, 2022.  References  Infection Control Today.
112.  Sweden’s Pandemic Experiment: A Book Review
Currently, the United States’ rates of COVID-19 hospitalizations are increasing, and its response is muted, even paralyzed, with a lack of public consensus. Much of the public’s confusion can be traced back to Sweden’s “experience,” one which is shrouded in misinformation and the “massaging of data.” Of particular interest was the chapter dealing with “Children at the front line of the Covid-19 pandemic” by Johanna Hoog. This chapter delved into the push to keep schools open. The policy appeared to be based upon a misinterpretation of a World Health Organization study where a lack of analysis (“not possible to determine”) was reported by the lay press as strong evidence that children do not spread disease. In addition, there was inadequate testing and reporting of cases which masked the outbreaks that did occur. And finally, questions arose regarding how data was presented, data which appeared to mitigate the impact of SARS-CoV-2 on children. Infection Control Today. Dec. 12, 2022.  

111.  As Holidays Approach, COVID-19 Remains a Major Concern
As the festive holidays begin, even with vaccinations and boosters, COVID-19 still remains a concern for Long COVID and other severe long-term effects. Al Roker’s, cohost of the Today Show, recent hospitalization for blood clots in his leg, which embolized to his lungs, is a sobering illustration of the long-term risks imposed by even a mild case of COVID-19, along with the reason why those who survive the acute infection should not be considered recovered. Remember, many relatives are elderly and at a very high risk for severe COVID-19 and Long COVID. All who are able should receive the bivalent BA.5 booster. Right before family gatherings, perform a rapid antigen test on all attendees. Ask visiting relatives to follow safe practices (wearing masks and avoiding crowded indoor settings) several days before the holiday events. References Infection Control Today. Nov. 23, 2022 

110.  Nov. 8, 2022.  Respiratory Spread and the Flawed Concept of Immunological Debt: A New Understanding
The recent CDC discussion of potential redefinition of spread, uniform application of guidelines across different types of facilities and the recommended use of N95 masks to stop the spread of SARS-CoV-2, if adopted, could provide revolutionary and needed changes in our approach to infectious disease, along potentially transforming our approach to the SARS-CoV-2 pandemic.
Social media is filled with the discussion of “immunity debt” and a cause of the increase in RSV infections. I feel there is not a well-established scientific basis for this concept. One hypothesis to explain the increase in RSV hospitalizations is the possibility that SARS-CoV-2 causes a persistent immunological dysfunction in infected individuals. References Infection Control Today.  Nov. 8, 2022.   

109.  Nov. 1, 2022.  Is the Current Bivalent Booster the Correct One? Studies Suggest it Isn't
The United States may be on the precipice of a rude awakening regarding the persistence and devastation of COVID-19. A perfect storm is brewing with the convergence of 3 untoward outcomes: The bivalent booster may primarily elicit imprinted immunity, a deadly brew of a plethora of immune escape variants is forming, and our public has thrown safety to the wind with few—if any—masking or bothering to optimize their immunity. All of this is in the background of new and disturbing data regarding the dangers of long COVID-19.ReferencesInfection Control Today. Nov. 1, 2022.  
108.  Oct. 14, 2022  Have you recovered from COVID-19, or Just Survived?
A recent controlled study from the Institute of Health and Wellbeing and the Public Health of Scotland found that almost half of COVID-19 patients have persistent symptoms at 6 months; and that the percentage of patients with symptoms did not change over an 18 month period. The additive effects of Long COVID with repeat infections, combined with the long-term persistence of Long COVID systems, does not bode well for the United States’ workforce. N95 masks, vaccines, boosters and improvements in ventilation are keys to prevention. Currently, the Brookings Institute estimates that 2 to 4 million workers, or approximately 2% of the United States Workforce is not working because of Long COVID. Vaccines and boosters offer a degree of protection. The young have been observed to have a greater incidence of Long COVID than the elderly. This is not necessarily because they have a propensity to develop the disease, but because they are less likely to be vaccinated and boosted. Infection preventionists need to educate our population regarding the dangers of long COVID and repeated infections, encourage the wearing of N95 masks in indoor venues, monitor facility ventilation with CO2 levels as a surrogate for adequate ventilation, and have MERV-13 filters installed in central HVAC systems. Finally, to prevent the spread of highly infectious airborne pathogens, upper room germicidal UV-C lighting should be installed. References Infection Control Today. Oct. 14, 2022. 

107.  Sept. 2, 2022.  The Autumn COVID-19 Booster Is Here: Is it Safe and Effective?
On Sept. 1st the first autumn boosters will begin to be available, but individuals may be concerned about their efficacy and safety. Ample safety data and immunological response data indicates the reformulated boosters to the BA.4/5 Variant will provide an improvement in efficacy. The magnitude of this improvement is not known, and the mitigation of this augmentation due to “antigenic sin” is also not known. In the beginning of the pandemic, mRNA vaccines were heralded as a major breakthrough allowing rapid adaptation and distribution of a reformulated vaccine. To accomplish this feat in 2 months is just remarkable and validates the initial optimism for this technology. I feel a monovalent vaccine booster for BA.4/5 may have been better. However, the current authorized BA.4/5 bivalent booster promises to give much better protection to the BA.4/5 variant than the original booster. I will be first in line to receive the newly reformulated version. References  Infection Control Today. Sept. 2, 2022.

106.  Aug. 17, 2022.  Viewpoint: We Cannot Afford to Surrender to COVID-19 Now
Last week the Centers for Disease Control and Prevention (CDC) relaxed recommendations which neither control or prevent a rapidly evolving and disabling disease, COVID-19. However, we must maintain effective efforts to control the spread of the virus. Many of the relaxations appeared to be timed with the opening of schools, ignoring the high rate of COVID-19 related hospitalizations, national deaths hovering just under 500 per day, and the urgent need for a reformulated vaccine, whose delivery is expected in the fall of this year. References  Infection Control Today. Aug. 17, 2022.  

105. A Call for Action: The Triple Threat of Polio, Monkeypox, and SARS-CoV-2
The US is at substantial risk of having a reemergence of polio, the largest outbreak of monkeypox in the world and is enduring repeated surges of SARS-CoV-2 variants. Rapid and aggressive public health interventions are needed. If the resistance we have seen in attempting to stop SARS-CoV-2 becomes commonplace with other pathogens, we will be no better off dealing with disease than in the Middle Ages.
It is apparent we cannot simply vaccinate our way back to normal. We must also encourage the public to adopt public health strategies, including the wearing of N95 masks, avoiding close contact with strangers, and improved indoor ventilation. Now, more than ever, infection preventionists are needed to turn this tide around.  References  Infection Control Today.  Aug. 8, 2022.   

104.  The Public Ignores Warnings from Infection Preventionists, but at What Cost?
Preventing infections hides an infection’s true threat and firmly places IPs into the category of unsung heroes. The inability of some leaders to focus on preventing infections has placed our nation in peril, resulting in an ineffective COVID-19 response, fueled an exponential growth in monkeypox infections, along with a rise in antibiotic-resistant bacteria, and has allowed all but conquered diseases, such as polio, to start to reemerge. Scientists early on warned of exponential growth (of SARS-C0V-2), while politicians declared the epidemic gone, then under control. Only when the barn has burned down did elected officials become concerned about the once avoidable epidemic. References Infection Control Today. July 25, 2022.

103.  Long COVID-19 and New Variants: Sounding a Continuing Alarm.
It is easy to become complacent, but the SARS-CoV-2 pandemic is not over, and long COVID-19 and the new variants are causing rising concern. published in the New England Journal of Medicine which found that '…data show that the BA.2.12.1, BA.4, and BA.5 subvariants substantially escape neutralizing antibodies induced by both vaccination and infection.' In addition, the BA.4 and BA.5 variants may be the most infectious variants to date. Long COVID-19 has been found to occur in 30% of patients treated for COVID-19, and up to 70% have symptoms of brain fog, memory, or other cognitive problems. It also can have a profound impact on the heart and other organs. References
Infection Control Today. June 27, 2022.  

102. Viewpoint: Battling COVID-19 Disinformation
Much of the denial comes from a lack of understanding of the importance of infectivity and how it increases your chances of getting a severe infection. The best example of this is the high infectivity of the Omicron variant, which resulted in a large number of deaths and hospitalizations. Attending an event in the United States, your chances of dying of Omicron was greater than Delta, but once infected, the opposite is true. Advocating for herd immunity, downplaying the usefulness of masks; along with denying the severe impact of long-COVID and acute infections from SARS-CoV-2 makes little sense. One may choose to ignore disinformation, writing it off to a few uninformed individuals, but unfortunately, there are many. To make matters worse, disinformation can be highly organized, fanning flames that not only have the potential of placing health care workers in jeopardy but also weakening our nation. Hence, I would encourage all to engage in respectful conversations with those who spread disinformation to at least provide an opposing point of view. References  Infection Control Today.  June 17, 2022.   
Sympotoms of Monkeypox101.  Monkeypox: CDC Raises Travel Alert, But How Much Threat Is it Really?
Many are wondering should we be concerned about Monkeypox or is it just a disease of the week, soon to pass and be forgotten. Current data indicates the former. Cases in the United States have quickly risen, now at 25 confirmed cases and many more are expected to have occurred but not been detected. Worldwide, the number of confirmed and suspected cases has risen to nearly 1000, and spread is continuing. The virus is currently in 29 countries. Where this disease came from will probably be a mystery. Already, there are theories of biolabs and germ warfare circulating on social media. However, the history of this disease shows an increasing incidence in Africa, presumably from waning immunity. At this point, we must be vigilant but so far human-to-human spread of this virus appears to be related to risky behavior and very close physical contact. There are both vaccines and antiviral medications which are effective against Orthopoxviruses. In addition, epidemiological case tracking and public education are expected to bring this outbreak under control. References  Infection Control Today. June 6 2022.         
100.  A Pandemic Paradigm Shift in Our Understanding of Transmission
The bugs are winning, but only because we are letting them. Modern day epidemiology has divided the spread of respiratory diseases into categories of airborne and droplet transmission. We were not facing a dichotomy in methods of spread; we were facing a continuum. There is no doubt that infection preventionists have a herculean task before them. The first step must be to educate hospital administration regarding the resources required to reverse the increasing rates of antibiotic resistance and to improve infection prevention by implementing the knowledge learned during the pandemic. Only then will an optimal safe workplace be created and the safest possible care be provided to patients. References  Infection Control Today. May 25, 2022.
99.  AB.4 and BA.5 Variants, Pandemic Fatigue, and Waning Immunity: A Toxic Mix
With new variants emerging, cases rising and a more complete understanding of the dangers of long COVID-19, one can make a strong case for resuming public health measures intended to control spread and infections from this disease. Unfortunately, even in the face of waning immunity, few individuals in the United States are currently wearing masks, and many are continuing to engage in risky behavior. This may well be a toxic mix, and healthcare facilities, and infection preventionists need to prepare for another possible surge in cases.  References  Infection Control Today.  May 9, 2022.

98.  Viewpoint: New UK Data Show BA.2 Variant Produces More Frequent Hospitalizations Than Omicron
New data is beginning to emerge for the BA.2 variant, and the results do not look good. Data from the United Kingdom show the BA.2 surge to be about half that of the Omicron surge. However, the number of hospitalizations are the same and those caused by BA.2 may eventually surpass Omicron. This evidence indicates that BA.2 is not only more infectious but also more virulent than the Omicron variant.  References  Infection Control Today.  Apr. 6, 2022.   Read Full Article:   
BA.2 Variant Cases and Hospiatlizations in the United Kindgm
97.  How Does the US Response to COVID-19 Compare With the Rest of the World?
Among high-income nations, the United States has one of the highest rates of COVID-19 excess deaths per capita. Despite the implementation of many strategies and high population adherence in Sweden, this country has one of the highest rates of COVID-19 excess deaths among Nordic Nations. Only Denmark is higher. The United States has not performed the worst during the pandemic, but it has performed below average among the worlds' nations. Even our completeness of reporting actual cases is below that of the United Kingdom and Southern South America Nations. This poor performance makes it imperative that we learn the lessons of this pandemic, reform our healthcare system, and improve messaging along with public acceptance of mitigation strategies. The United States can and must do better.  References  Infection Control Today. . Mar. 22, 2022.    

96.   Evidence Shows Students Need to Wear Masks in Schools Despite Disinformation
Multiple studies and reports show that masks in schools are effective, safe, and necessary because COVID-19 is not going away. Above all, as pointed out by the “Getting to and Sustaining the Next Normal” report, we need clear guidance on when school mitigation recommendations (“including masking, social distancing, quarantining, reduced class sizes, and outdoor learning”) are to be triggered to enable communities to provide the safest environment possible for the education of our children.  References  Infection Control Today. Mar. 14, 2022.  
95.  COVID-19 Brain Changes: New Evidence Details Long-Term Effects of Infection
A new study supports the conclusion that the “brain fog” reported by many who have recovered from mild COVID-19 infection is real and has an anatomical basis. The United States has all but declared victory and followed the United Kingdom’s example by rapidly relaxing public health strategies, including masking. The BA.2 (Stealth) variant could prove more infectious than Omicron (BA.1) and is ravaging Denmark and Hong Kong. This variant is also increasing in our country. A finding that, combined with the increased concerns over the impact of long COVID, dictates that a more careful approach to relaxation of mitigation strategies may be warranted.  References  Infection Control Today.  Mar. 9, 2021.   

94.  Preventing the Spread of COVID-19 While Keeping Kids in School: A Case Study
Amanda Mulcahy: Swampscott’s overall goal was to keep students and staff safe with significant consideration to minimize the disruption to learning for students and their families. This was accomplished with layers of mitigation strategies that were applied in the district. With every added layer, another barrier was created to protect both students and staff, keeping them safe in the district’s buildings and allowing the prioritization of in-person learning. Interventions included, attention to air filtration and circulation, use of masks, robust testing, case tracking and promotion of vaccinations. Infection Control Today.  Mar. 3, 2022.  
Health Watch USA Meeting Video Presentation  

93.  Mutated SARS-CoV-2 Detected in White-Tailed Deer in Ontario
Mounting evidence is supporting the spread of SARS-CoV-2 in animals. The latest report is from Ontario, Canada, and has added to the evidence that white-tailed deer can become infected with SARS-CoV-2. Above all, the report by Bradley Pickering et al underscores the importance of One Health, the idea that animals and mankind live in the same biosphere and you cannot optimally promote health in mankind without also addressing the health and spread of disease in animals. It is unlikely we can stop the emergence of future dangerous variants by vaccinating all of mankind. We must also address the health of animals and modify how we interact with domesticated and wild species. References  Infection Control Today.  Mar. 1, 2022.   

92.  Perspective: Relaxing Mask Guidance Must Be Done 'Carefully'
The Centers for Disease Control and Prevention (CDC) is expected to relax mask guidelines on indoor mask requirements Friday. Reports have indicated the new guidelines will be based, at least in part, on hospitalizations and hospital capacity. First, the metric for hospitalizations is a lagging indicator, and basing action on increasing hospitalizations will make our actions reactive and not proactive. Second, there are data that indicate we may not yet be in an endemic phase of the pandemic. During the month of February, deaths spiked in South Africa. In Denmark, a country whose cases are almost totally comprised of the BA.2 variant. Deaths are at an all-time high. For me, this is reason enough to continue masking.  References  Infection Control Today.  Feb. 25, 2022.       

91.  COVID-19 Boosters: New MMWR Report Explores Waning Immunity
The research found vaccine efficacy in the prevention of visits to urgent treatment centers and emergency rooms fell from 87% at 2 months, to 66% at 4 months, to 31% at ≥ 5 months. A WHO Variant of Concern, the Stealth Omicron (BA.2), may pose even new challenges and has been reported to be more severe and infectious than Omicron (BA.1). In addition, it is being initially reported that it may “largely” escape current vaccines and could be resistant to many monoclonal antibody products, including the GSK antibody, sotrovimab. However, a vaccination booster appears to restore immunity with a 74% protection against illness. References  Infection Control Today. Feb. 18, 2022.   
90.  Viewpoint: How to Improve U.S. Dismal COVID-19 Response
Former President Trump’s Presidential Federal Advisory Committee for COVID-19 needs to be reestablished under President Biden. The United States Senate HELP Committee will hold a hearing tomorrow to officially begin the process of formulating legislation to strengthen our pandemic preparation and response. All of the provisions focus on acronyms of the CDC, FDA, BARDA, ASPR, NIAID and the GAO. What is missing is OSHA and frontline worker protection, this includes infection preventionists.  References  Infection Control Today. Feb. 7, 2022.   

89.  Those Who Believe in Herd Immunity Cannot Do the Math
COVID-19 mutations are evading our immunity and at the same time our immunity is waning. Herd immunity to disease and the eradication of SARS-CoV-2 is no longer possible. According to the United Kingdom’s Imperial College COVID-19 response team, a two-dose vaccine (AstraZeneca and Pfizer) provides a vaccine effectiveness in the prevention of symptomatic disease between 0% and 20% with the Omicron Variant, and a previous infection gave a protection of 19%. However, unlike infections, you can safely receive a booster with an mRNA vaccine. Three-dose vaccinations provide a vaccine effectiveness for the prevention of symptomatic disease from Omicron of between 55% and 80%. Current data are placing the final nails in the coffin of herd immunity.  References  Infection Control Today.  Jan. 26, 2022.    

88. Viewpoint: COVID-19 Forever Cancels the Old Normal
Contrary to the “vaccinate and all will be well” narrative, “mild” does not mean just avoiding hospitalization, nor does surviving a COVID-19 acute illness means you have recovered. Vaccines are an important layer of armor but they, in themselves, will not stop COVID-19. Public health is focused on the community, not one’s own health. In public health, as vaccine efficacy falls, it is even more imperative that all who can, become vaccinated. We must slow down the spread of this virus. It is easy to advocate for personal freedom and act irresponsibly when someone else is funding your safety net.  References  Infection Control Today.  Jan. 24, 2022.   
87.  Animal Farms: COVID-19 Doesn’t Need Humans to Survive.
Animal infection sets the stage for an independent evolution of SARS-CoV-2 which, after an extended evolutionary period, can jump back to humans causing disease with an unpredictable infectivity and case fatality rate. This is what appears to have happened with the Omicron variant. In other words, we all need to start taking this virus more seriously and uniformly enact effective control measures. References  Infection Control Today. Jan. 20, 2022.   
86.  Viewpoint: Time to Consider Penalties for COVID-19 Unvaccinated
We may need to pivot to the strategy adopted by Singapore, to have voluntarily unvaccinated individuals pay at least a portion of their care. It is very easy to act irresponsibly when others are funding your safety net. SARS-CoV-2 is endemic, and we must adapt to live with it. This is based on observing that immunity from SARS-CoV-2, whether from vaccines or infections, is short lived, asymptomatic spread is frequent and the incubation time is very short, making identification of contacts problematic and vaccinations not having enough time to ward off disease. To cope with this pandemic, we need to decrease the spread of this virus. Executive action is needed for the formation of a National Public Health Service (possibly by fully implementing the Department of Veterans Affairs' 4th mission), along with the reappointment of a Coronavirus Task Force in the US. Building this pandemic response foundation is an overriding imperative. References  Infection Control Today.  Jan. 9, 2022.     
85. Even ‘Mild’ COVID-19 Can Make You the Sickest You’ve Ever Been
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. There are well over 12,000 Kentuckians have died of COVID-19. Even with Kentucky having some of the lowest in-network costs for COVID-19 hospital care in the nation, the total bill so far is just shy of 1 billion dollars ($990,040,866). This alone is an unsustainable amount, but it does not include the cost of outpatient care, mass testing, and chronic treatment for those afflicted with long-COVID-19. What is so infuriating is that the vast majority of individuals who are hospitalized are unvaccinated. It is imperative that they are uniformly adopted to suppress the spread of the virus in the community and prevent damage to our economy and the collapse of essential services. References  Infection Control Today. Jan. 4, 2022.   

84.  Viewpoint: Those Who Underestimate Omicron Aren’t Doing the Math
Infectivity causes more harm and deaths than lethality and in the case of Omicron more than makes up for its somewhat milder infections in immunologically naive individuals. Our best protection is to become fully vaccinated, including boosters, along with optimizing ventilation in buildings, wearing N95 masks and frequent testing. Schools might be able to be opened with a degree of safety, if these mitigation strategies are rigorously followed, but if not, both students and teachers will be at risk. In addition, it needs to be remembered that Omicron causes more severe disease in children than with other variants.  References  Infection Control Today.  Jan. 3, 2022.   

83.  Omicron More Infectious in Younger People, People of African Ethnicity, Study States
Omicron can significantly avoid immunity created by both prior infections and vaccines, and younger people and people of “African ethnicity” have higher rates of infection with Omicron than with Delta, says a new study. Many are looking at the total infections and see a much lower hospitalization rate, not realizing that there is a much larger number of cases and the expansion is largely due to reinfections and breakthrough infections which produce milder disease. The unvaccinated and those not previously infected are looking at a fate similar to Delta and those with waning immunity from vaccines or previous infections may endure a fate not that much better. The bottom line is if we ignore the pandemic, it is possible that with the high infectivity of Omicron the sheer number of cases may overwhelm the world’s health care systems. No one knows for sure. But what is known is that everyone needs to obtain a booster if they are 6 months after the second dose of an mRNA vaccine, and to become vaccinated even if they had a previous infection.  References  Infection Control Today.  Dec. 23, 2021.  
82. Countries Around the Globe Deluged by Delta, as Omicron Threat Grows
Even though Omicron may not have as high of a fatality rate, its infectivity being 3 times higher than the Delta variant creates grave risk to nations. Overstressed health care systems may collapse.
Strategies of travel bans, masking, testing, financial incentives, vaccinations and natural immunity were discussed. For example: Singapore requires mask-wearing outside of the home (indoors and outdoors) for people above the age of two. In Germany, a medical grade mask—surgical or N95—is required in indoor spaces. The US may need to follow the financial model of Singapore. Unlike Singapore, a substantial portion of the US population is not becoming vaccinated and/or is not following prevailing public health advice. If there is a safety net of 100% payment from public money, there is no tangible disincentive against promoting and/or engaging in dangerous behavior.  Infection Control Today.  References  Dec. 20, 2021.   

81. Omicron’s Mild Symptoms Can’t Mask Danger It Poses.
The high rate of infection of the Omicron variant, which is beginning to eclipse Delta infection in the United Kingdom, poses a grave risk to the US health care system. The US has a low rate of vaccination, a low rate of individuals obtaining boosters, and a relatively large segment of our population which is elderly or immunocompromised.
70% efficacy for Omicron hospitalizations with a two-dose mRNA vaccine Sound great. But this is South African data and they have just been recently vaccinated. Immunity may not have waned. Please obtain a booster.  References  Infection Control Today.  Dec. 14, 2021.    

80.  Omicron Proving to Be Nothing to Sneeze At
Only a small percentage of the Omicron variant of COVID-19 cases require hospitalization so far, but high infectivity may turn this small percentage into a large number of patients, which will further stress our health care system. In the United Kingdom, it has been observed that the Omicron variant causes less severe disease, but it risks overwhelming their health care system with 5 thousand admissions to the hospital each day. Omicron currently is responsible for 30% of all cases in London. References  Infection Control Today.  Dec. 11, 2021.   

79.  Viewpoint: What Doesn’t Kill You Mutates and Tries Again
The looming surge from the Omicron variant may well have a lower case-fatality-rate but its high infectivity will further strain our health care system and fill our hospitals. Hospital costs for complex cases (on the ventilator or in the ICU) ranges from $132,000 to $472,000. Co-Pays (without waivers) for privately and employer-insured patients average $3,800 per hospitalization. The looming surge from the Omicron variant may well have a lower case-fatality-rate but its high infectivity will further strain our health care system and fill our hospitals.  References Infection Control Today. Dec. 8, 2021.   
78.  COVID-19 Omicron May Be More Infectious, Deadlier Than Delta
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. In addition, antiviral medications will become of prime importance. Omicron appears to be much more transmissible than the Delta variant. It is already spreading around the globe and is reported to be increasing exponentially in regions where it has taken hold.The epicenter of the Omicron variant is in Gauteng Province, South Africa.As can be seen from the graph below, hospitalizations tripled in just 2 weeks.   References   Infection Control Today.  Nov. 29, 2021.    
77.  Smallpox Scare Offers Lessons About COVID-19 Vaccine Uptake
The recent story of finding previously unknown smallpox vials at the bottom of a deep freezer in Pennsylvania should serve as a reminder of the need for the strictest research precautions when handling dangerous pathogens and the dangers of any virus research program, especially gain of function research. Unfortunately, the vaccine hesitancy movement has placed us all at high risk for infectious disease. Those who are against mandatory vaccinations of frontline workers need to take a page from history and follow the lead of the Continental Army where an estimated 90% of the deaths were from infectious disease. After smallpox mandates were enacted in 1777, “the isolated infections that sprung up among Continental regulars during the southern campaign failed to incapacitate a single regiment.” With SARS-CoV-2 we are significantly weakening our nation by not abiding by public health advice and widely embracing vaccinations.   References  Infection Control Today.  Nov. 17, 2021.
76.  Confused Messaging About Boosters Might Cause 5th Wave of COVID
There is growing evidence that fully vaccinated should be defined as having 3 doses of an mRNA vaccine. The evidence is clear, and the path evident, we must expand our efforts to stop viral spread, including the upgrading of indoor ventilation along with the use of masks by all in public settings and expansion of home testing. But above all we need to offer boosters to all adults who are more than 5 to 6 months post receiving an mRNA vaccine. References Infection Control Today. Nov. 15, 2021.  

75. Natural Immunity vs. Super Immunity: Only a COVID-19 Vaccination Away
Many believe that super immunity can develop in those who have had SARS-CoV-2 infections and have become vaccinated. Meanwhile, fully vaccinated might mean getting 3 doses, not 2. The bottom line is that all need to be vaccinated, even those who have had previous infections. The definition of fully vaccinated for mRNA vaccines needs to be changed to 3 doses, making previous comparisons of infection versus 2 doses of a vaccine mute. In addition, those previously infected should also become vaccinated. How many doses and the exact vaccination schedule is still under investigation. But for now, those receiving 2 doses of an mRNA vaccine should obtain a booster and those with a previous infection should become “super-immune” with a vaccination.   References  Infection Control Today.  Nov. 2, 2021.    
 74.  COVID-19: Numbers Look Good, but Keep Guard Up

As of today, the outlook is very good and the pandemic is on a trajectory of burning out, but there are valid concerns which require that we continue our vigilance and public health strategies. In the United Kingdom, cases from the Delta variant spiked early on July 17, 2021, and then rapidly fell in half. Then cases rose with the Delta plus variant on October 28, 2021, reaching another peak almost as high as the one in July. This raised concerns that under certain conditions, the Delta plus variant can successfully compete with the Delta variant and cause another surge in the US.   References  Infection Control Today.  Oct. 27, 2021. 
73.  COVID-19 Boosters Need to be Encouraged
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. As of October 24, 2021, the United States has only 57% of its population fully vaccinated. It is behind 50 other countries, including Cuba, Sri Lanka, Curacao, Fiji, Mongolia, Bhutan, and Cambodia, let alone the European Nations. Thus, we must encourage and administer boosters, but at the same time it is of utmost importance that we decisively counter the anti-vaxxer movement in the United States and increase the primary vaccination rates in our country.   References  Infection Control Today.  Oct. 25, 2021.   

72.  Viewpoint: Here’s Why COVID-19 Is Much Worse Than Flu
Unlike influenza, SARS-CoV-2 uses ACE2 receptors to infiltrate cells. Similar to HIV, SARS-CoV-2 can silently spread throughout the host’s body and attack almost every organ. Thus, COVID-19 has a myriad of different presentations, all of which can result in severe and long-term sequelae.Just because COVID-19 is asymptomatic or does not produce “severe” pulmonary disease does not mean the patient does not have a serious infection.It is of utmost importance for public health officials to implement strategies to prevent the occurrence of long-term COVID-19 related disabilities and not just focus on acute pulmonary symptoms.  References  Infection Control Today.  Sept. 27, 2021.     
71.  Viewpoint: Politics, Bad Science Taints Decisions About COVID-19
Even if not hospitalized, COVID-19 often produces the most severe infection individuals will experience in their lifetimes and can produce lasting symptoms of fatigue, weakness, brain fog and cardiovascular damage. Walensky swiftly acted and in the evening reversed the committee’s decision. I feel this was a very wise decision which demonstrated proactive action and the ability to separate political rhetoric from science. These are not normal times; we need swift decisions which will often have to be based upon experience and the preponderance of evidence. As stated by John F. Kennedy “There are risks and costs to action. But they are far less than the long-range risks of comfortable inaction.”  References Infection Control Today. Sept. 24, 2021.   
70.  Viewpoint: On COVID Boosters, CDC Panel Must Recover Ball That FDA Panel Fumbled
Health care workers know all too well the lasting and debilitating effects of long COVID-19. They were one of the first to become vaccinated and are some of the first experiencing breakthrough infections. They are tired, burned out, and many are on the brink of collapse.
Initially, the FDA's concern appeared to be centered on having solid data which showed severe breakthrough infections were developing, especially in those who are biologically at high risk for disease. After the second vote, the concern was focusing on individuals having a high risk of exposure to COVID-19, regardless of the biological susceptibility of the individual. It would be more reasonable to either reconsider the initial proposal of offering boosters to all who are 16 years of age or older, or at least offering boosters to those who are 30 years of age or older, plus individuals who are at high risk for severe long COVID. Not including individuals with non-occupational exposure was unwise, since the proposal now may exclude caregivers of unvaccinated school age children, and places these caregivers at an unnecessary risk.  References  Infection Control Today.  Sept. 20, 2021.       

69.  FDA Panel Sidesteps Decision for Broad Distribution of Booster Shots   
Some medical experts say that in this case, inaction is also an action—either the US gives boosters or does not. That decision needs to be based on the best available evidence. Instead, there seems to be a desire to wait another 6 months for pristine randomized controlled studies. The logic of distinguishing between occupational and non-occupational high-risk exposure and why that makes a true difference was not evident. In addition, if exposure indeed is a major variable to obtaining a booster—shouldn’t the initial question about far-reaching availability of booster shots be readdressed?  References Infection Control Today.  Sept. 18, 2021.  
68.  Viewpoint: We’re Reopening Schools Too Quickly
The further away from an infected person you are, the less likely you are to contract the disease. But you are still not safe at 6 feet. The virus is airborne and can spread much further to the back of the classroom. There are those who advocate for herd immunity, but in reality, this is a fool’s dream. Teleschooling and hybrid programs may be a vital long-term strategy. They were not fully successful last year, but instead of discarding this strategy we should be developing improvements. It is apparent that the SARS-CoV-2 pandemic is an extremely difficult ever-changing problem. We must slow down the spread of this virus by adopting a layered approach so our pharmaceutical industry has time to catch up with development of therapeutics and next generation vaccines.   References  Infection Control Today.  Sept. 10, 2021.   

67.  Mu Variant Might Escape Immunity from Vaccines, Past Infection. 
After the Delta surge subsides, another surge is expected, possibly from the Mu variant. If Mu completely escapes immunity from vaccines and past infections, we must resort to stringent public health strategies. It is also becoming apparent we cannot vaccinate our way out of this pandemic. The vaccine’s effectiveness is waning, and the variants are becoming resistant making the wearing of masks, in a mask resistant population, an imperative. It was welcome news to finally have a clinical trial published by research from Stanford which demonstrated the effectiveness of surgical masks in curtailing COVID-19 infections.In those over 60, there was a decrease of 34.7%. Mask usage became even more important with a recent report in the CDC’s Morbidity and Morality Weekly Report (MMWR) demonstrating aerosolization in schools. A school outbreak was traced back to an unvaccinated, mildly symptomatic teacher who reportedly read unmasked to her 24 students who presumably were wearing masks.  References  Infection Control Today.  Sept. 6, 2021.   
66.  Viewpoint: Should US Adopt an Elimination Strategy Against COVID-19?
On July 29, 2021, Infection Control Today® sounded the alarm regarding vaccine breakthrough infections and waning immunity, citing Israeli data which found vaccine effectiveness in the prevention of all infections and symptomatic infections to be only 16% after 5 months from full vaccination.
In nursing homes, we need to administer boosters to residents who were fully vaccinated early in this pandemic. Nursing home residents are the most frail and highest risk members in our society.
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.   References  Infection Control Today.  Aug. 25, 2021.  

65.  Viewpoint: Expanding Booster Shots to US Adults Needed to Happen
In the Middle Ages a pandemic wiped out 50% of the world’s population. Presently we have a much higher population density, making us a feeding buffet for infectious disease…. If we do not follow the recommendations of modern science and public health, we are no better off than if we were living in the Middle Ages. "We do not have the luxury of waiting. Delta is here. In the case of delta, inaction is also an action, and an expedited decision is needed. Currently, the United States is discarding vaccines and these vaccines are known to be very safe. If we do not administer boosters to this high-risk population, we risk having a catastrophe on our hands.” The solution, if you have not already done so, get vaccinated. If you are vaccinated and are at risk of immunity waning, get a booster as soon as they are available.    References  Infection Control Today.  Aug. 18, 2021.   

64.  Take a Stand Now to Stop COVID-19 Variants
Herd immunity is no longer possible, the virus is mutating and likely has animal hosts. We must raise the bar on public health outcomes, not only focusing on deaths but also morbidity and long-hauler syndrome which can be all too common, even occurring with vaccine breakthrough infections. An emerging pattern is that each new wave which envelops a nation is caused by different variants of the virus. It also is apparent that each major wave is caused by a variant which possesses immune escape properties. Slowing down the replication and mutation of this virus is of utmost importance. We must plan and invest in long-term solutions. This virus might disappear, similar to the 1918 flu, or it could be present for decades. Consistent messaging and widespread embracement of vaccines along with public health measures are key to providing our pharmaceutical industry the necessary time to formulate new vaccines and therapeutics which can effectively treat and prevent infections.  References  Infection Control Today.  Aug 17, 2021    

63.  Messaging Muddle: Pushing Vaccination as COVID Vaccines’ Effectiveness Wanes
While not perfect, the mRNA vaccines do markedly reduce the chances of hospitalizations from critical disease and death.  This is a huge plus. Combining all of these reports shows that to control this pandemic we need to enact multiple layers of prevention including effective masking, vaccinations, upgrading ventilation systems and social distancing.  This virus is endemic.It is here to stay, and new variants are waiting in the wings to cause another surge with reinfections and breakthrough infections.  If we do this, we will be able to start to learn to live with this virus, we cannot simply wish it away.   References  Infection Control Today.  Aug. 12, 2021.     

62.  Get Vaccinated Even If You’ve Gotten COVID-19, Study Suggests
A CDC investigation shows 2.3 times the number of reinfections with natural immunity compared to breakthrough infections in those who are vaccinated.  Public Health England (PHE) briefing includes updated hospitalization data for Delta, which shows that in the period since the last update on July 19, "1467 people were hospitalised with cases of Delta confirmed by sequencing or genotyping." Of these, 808 (55.1%) were unvaccinated, while 512 (34.9%) had received both doses of a vaccine. This supports the Health Ministry of Israel’s data which shows waning of vaccine protection in those who are over 60 years of age and are more than 5 months post vaccination. As Infection Control Today® reported, 8.6% of breakthrough infections in this group of elderly patients have resulted in hospitalization and 2% have resulted in death.   References   Infection Control Today. Aug 8, 2021.   

61.  Lambda Variant, COVID-19 Animal Hosts Present Deadly Mix
Data collected by Britain’s Scientific Advisory Group for Emergencies, Japanese researchers, and the US Department of Agriculture paint a picture of a growing challenge. Taken together, the report from SAGE, the viruses’ establishment of an animal host and the news regarding the lambda variant is an extremely deadly mix. We need to come together as a society so we can slow down the spread of this virus so viral recombination will not occur, and genetic drift slows. In addition, we need to formulate strategies to prevent the spread from animal hosts to mankind. Above all, we need to learn how to live with this virus so our pharmaceutical giants can develop and manufacture vaccines faster than the virus can mutate.  References  Infection Control Today.  Aug. 5, 2021.   

60.  COVID-19 Booster Shots for Older Americans Might be Needed
Overall, the vaccines are still very effective in preventing hospitalizations and deaths, with the exception of those over 60 who have been fully vaccinated before the end of January 2021. Most of the infections in Israel are caused by the Delta variant. Overall if there was a breakthrough infection: 8.6% hospitalized and 2% died. However, the test positivity rate appears to be low, about 0.3%, indicating that vaccines afford protection against infection. Those who are not vaccinated need to become vaccinated and, similar to Israel, those over the age of 60 who were fully vaccinated before January of this year, should be considered for a booster.   Infection Control Today.    References   Infection Control Today.  Aug. 2, 2021.    

59.  Latest Data Point to a Need for COVID-19 Booster Shots
Overall, The Israeli data found that after 2 doses of the vaccine the effectiveness in the prevention of infection with the Delta variant was 39% and the prevention of symptomatic disease was 41%. However, the main observation is that once immunity takes hold, the infections by the alpha variant (in May—middle graph) almost disappeared. But in late June and July, the Delta variant emerged and markedly decreased the vaccine’s ability to prevent breakthrough infections. Surprisingly, as indicated by anecdotal reports, the young are not spared. The Israeli data need to be confirmed. A good first step would be for the CDC to release its data on reinfections so all can evaluate it.   References   Infection Control Today.  July 29, 2021.   

58. Viewpoint: CDC Continues to Bumble COVID-19 Response
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. Needless-to-say, early recognition of aerosolization would require the use of N-95 masks and make upgrading ventilation systems an imperative. Others are starting to follow former Surgeon General Jerome Adams’ advice. On July 19, 2021, the American Academy of Pediatrics recommended that all children over the age of 2, regardless of vaccination status, wear masks in schools this fall.  References  Infection Control Today. July 20, 2021.   

Kentucky Health News:


  57.  Stage May be Set for Next COVID-19 Surge
Beating back infection is a numbers game: viruses against antibodies. 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 immune system.
As we are on the beginnings of another COVID-19 surge, many are starting to question whether we can vaccinate our way out of this pandemic. Can we vaccinate our way into herd immunity? Possibly not, because 3 barriers are shedding doubt on accomplishing this goal.  References  Infection Control Today.  July 13, 2021.   

56.  We Might Ignore the Delta Variant, but It’s Not Ignoring the U.S.
"It has been two weeks since Infection Control Today® sounded the alarm that the Delta variant (B1617.2, Double Mutation Indian Variant) was spreading rapidly in the United States. On June 15, the Centers for Disease Control and Prevention (CDC) issued a warning regarding the variant and declared it a “variant of concern.” As Australia and Singapore have adopted a zero tolerance to COVID-19, closing down sectors of the country with even 2 or 3 cases, we have adopted a wait-and-see policy, largely ignoring the potential dangers posed by these new variants. And there is now a Delta Plus variant (AY.1 & AY.2) which has emerged in India which is more resistant to monoclonal antibodies, including antibody cocktails and has also entered the United States. For now, I would strongly advise every person (even those who have had COVID-19) to be fully vaccinated to boost one’s immunity to the highest possible level and wear masks when indoors in poorly ventilated buildings. It is far too soon to be fully reopening our society."  References  Infection Control Today.  June 21, 2021.

55.  Not Quite Over Yet: COVID-19 Variants on Rise in the U.S.
As the United States emerges from the COVID-19 pandemic, nobody really wants to hear (and few media outlets report) that the rapid emergence of immune escape COVID-19 variants pose a clear and present danger of a setback. Over three weeks, the percentage of genomic testing which was comprised of the Indian Double Mutation Variant, or Delta Variant, jumped from 1% to 7% in the U.S. The data was derived from, a website operated by Scripps Research and funded by the NIC, the Centers for Disease Control and Prevention (CDC) and National Center for Data for Health.  References  Infection Control Today.  June 7, 2021. 
54.  Viewpoint: CDC Might Help COVID-19 Make a Comeback in U.S.
The day before the publication of the modeling study’s dire warning, the CDC abruptly removed mask and physical distancing requirements for those who are vaccinated. Unfortunately, this will probably also result in many unvaccinated individuals unmasking.
Those of you who advocate reopening at the peril of those who are vaccine hesitant—letting nature decide the fate of the ill-informed—need to remember that survival is not the same as recovery. Let’s not be cavalier in our approach to a return to a new normal. Let’s be smart and cautious. Continued masking and social distancing for a few months, possibly just a few weeks, is a small price to pay to assure the safety of our nation.  References  Infection Control Today.  May 18, 2021.  

53.  COVID-19 Model Says 905,289 Died of the Disease in U.S.
Infection preventionists need to stress the importance of aerosolization with increased recommendations for N-95 masks and we all need to realize that a prerequisite of reopening a business, school or public venue should be safe ventilation. Nowhere is safe inside a poorly ventilated building. The six-foot rule does not apply. Infection preventionists need to stress the importance of aerosolization with increased recommendations for N-95 masks and we all need to realize that a prerequisite of reopening a business, school or public venue should be safe ventilation with an increased number of complete air exchanges along with air sanitization.  References  Infection Control Today.  MAY 8, 2021.

52.  Infection Preventionists Must Ward Off a COVID Comeback
What happens in India, or anywhere else in the world, doesn't stay there. The longer COVID-19 hangs around, the more chance it has of mutating into a variant that the vaccines won't stop. Policymakers have falsely equated outdoor safety, produced by the rapid dissipation of aerosols, with safety from droplets and have ill-advised not wearing masks at some outdoor events. This may be effective in suppressing community spread, but it will not afford adequate protection for the individual.  References   Infection Control Today.  May 4, 2021.   

51.  Viewpoint: Health Care Professionals—Get Vaccinated or Get Out
In the last 2 months COVID-19 cases have not fallen. They are hovering above 60,000 per day (7 day moving average). Some have wondered why doubling the number of vaccinated Americans has not budged the numbers. There are two reasons: variants and vaccine hesitancy.Thus, even with the E484K variants, vaccination appears to provide substantial protection against severe COVID-19. However, for the most part, severe is defined as dying or being hospitalized. This is a very low bar to set for community health. I personally know too many of my friends who have had “mild” COVID and are now suffering from chronic dyspnea and heart disease, such as arrhythmias.
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.  Apr. 22, 2021. References  

50.  COVID-19 Variants Make Road to Normal a Bit Rocky
Infection preventionists (IPs) are now faced with delivering a difficult message. It is much easier to advocate for vaccinations which prevent disease, than it is for vaccinations which lessen the severity of disease or reduces your chances of becoming infected.
Thus, both natural (post-infection) and vaccine immunity appear to provide excellent protection against COVID-19. At least for the original strain or wild-type of the virus.
One must ask, why are some sounding the alarm? Fauci recently has stated that the COVID-19 case rate has creeped up from around 30,000 to 40,000 cases per day to 60,000 cases per day. And he warns we do not want to declare victory prematurely because of the viral variants.  Variants which are of special concern contain one of two new spike protein mutations which can evade immunity. Thus, both natural and vaccine immunity appear to provide excellent protection against COVID-19. At least for the original strain or wild-type of the virus.  Infection Control Today.  Apr. 8, 2021.  References 

49.  Viewpoint: South African Variant Could Spur a New U.S. Surge
If one does the math, if a third of our population is vaccinated, which means they may be protected from severe illness but can become infected and spread the virus, it places those not vaccinated at grave risk. If these variants are more infectious and deadlier than last year’s, D614G, then we may be headed for another major surge. Those offering reassurance based on the upcoming warm weather have forgotten last year’s lessons and the major summer surges. The best advice is to get vaccinated and follow strict public health advice. Infection Control Today. Mar. 19, 2021.  References  

48.  Possible New Variant Causes Outbreak in Highly Vaccinated Nursing Home - Argues Against CMS's New Guidance.
As I have stated repeatedly, if we keep spreading around SARS-CoV-2, it may well mutate into a variant which evades the vaccines for coronavirus disease 2019 (COVID-19). According what recently went on in a Kentucky nursing home, the virus may well have done just that. According to WKYT: “The governor says a COVID-19 outbreak has been reported at a nursing home in eastern Kentucky. There are 41 cases reported, including five residents that have been hospitalized. Dr. Steven Stack says 30% of vaccinated individuals are symptomatic and 83% of the unvaccinated at the nursing home are showing symptoms.” It is reported that one vaccinated resident is hospitalized (1 in 71) with COVID-19, compared to 4 unvaccinated residents that are hospitalized (4 in 13). According to “85 percent of residents and 48 percent of staff opted to get a coronavirus vaccine.”  Infection Control Today.  Mar. 17, 2021.  References   

47.  Viewpoint: Nursing Home Guidance Endangers Elderly
Our elderly in nursing homes have been at grave risk for contracting coronavirus disease 2019 (COVID-19). Yesterday the Centers for Medicare and Medicaid Services (CMS) released revised nursing home guidelines for visitation recommendations. They are designed to provide relief to the grave psychological toll COVID-19 has inflicted through long-term isolation and separation of residents from loved ones. But one has to ask, are they safe? I have grave concerns.... Regardless of what we deeply desire to take place, or are able to mandate or recommend, the virus will spread relentlessly. It is an uncaring soulless machine which is evolutionarily programmed to inflict a devastating toll as it efficiently spreads and evolves throughout our communities. Enacting these recommendations at this time is reckless and places nursing home residents at undue risk.Our loved ones deserve better.   Infection Control Today.  March. 11, 2021.  References    

46.   Rush to Reopen Buys COVID-19 More Time
There needs to be a shift from droplet precaution standards to airborne spread standards and we need to invest in the safety of our frontline workers. Quite simply, this virus is aerosolized, meaning it is airborne. I really thought this had been decided last July when a letter was sent to the World Health Organization (WHO) by 329 top scientists from 33 countries. But although agencies responded by recognizing airborne spread in some of their statements and webpages, their recommendations on controlling spread and reopening of businesses and schools largely did not. Most importantly, the CDC needs to articulate firm and harmonized advisements which are consistent across all materials, recommendations and webpages. Until this happens, there will not be a demand for N95 masks and air sanitization units. Manufacturing will not gear up production and pathogens will continue to spread. We need to enact these reforms not only for COVID-19 and the next pandemic, but for other endemic dangerous pathogens. Our children deserve better than the status quo.  Infection Control Today.  Mar. 4, 2021.  References   
45.  Viewpoint: CDC’s School Reopening Plan Gets an ‘F’
The argument that preventative strategies need to be tailored to the needs and resources of local communities, along with a one-size-does-not-fit-all approach, may placate political pressures, but the virus does not care. You need to do what you need to do to control the disease. It needs to be clearly stated what needs to be done and if a community cannot comply and wants to open schools, then the parents need to be informed of the increased risks to students. Recommendations should not be changed to reassure families of a degree of safety which does not exist.....Frequent, (three times a week) screening of our athletes has been key to the opening of professional sports. Our students deserve the same safety precautions as professional athletes. Infection Control Today. Feb. 15, 2021.  References 
44.  Beginning of the End? Some Hopeful COVID Developments
The good news? The fact that 3 different viruses with 3 different lineages came up with the same mutation to evade natural immunity and the vaccines. And initial reports are that it only partially evades the vaccines. And one needs to ask, why did these viruses not come up with different mutations? After all they do not plan the mutations, they evolve by random chance. Maybe the answer is that this random amino acid combination is possibly the last major mutation the virus can produce without changing its ability to enter the cells or its infectivity. Infection Control Today.  Feb. 3, 2021. 

Kentucky Health News.  Feb. 3, 2021. 

43.  Problem: COVID-19 Hospital-Acquired Infections
HSJ analyzed England’s National Health Service Data regarding hospital-acquired SARS-CoV-2 infections. SARS-CoV-2 is the virus that causes COVID-19 and unfortunately HSJ found that hospital-acquired infections (HAIs) are not uncommon, estimated to cause almost 1 in 4 hospital COVID-19 cases. We need to have mandatory reporting of worker and patient acquisition of SARS-CoV-2 and the development of COVID-19 with metrics to provide us the most accurate estimate of cases so we can effectively plan and allocate resources.  Infection Control Today.  Jan. 20, 2021.  References  

42.  As Vaccine Rollout Stalls, Move Monoclonal Antibodies Into COVID Fight
As of January 16, 2021, only 39.4% of the 31.2 million allocated vaccine doses have been placed in arms. The original goal was to vaccinate 20 million citizens by the end of 2020. Until vaccines become widely available, it is imperative that those at high risk for severe COVID-19 be offered monoclonal antibody therapy. So far, the use of monoclonal antibodies has not been a priority in the United States’ COVID-19 response, and the medication has largely gone unused, with 80% of the 600,000 doses still “sitting on shelves.” Monoclonal antibodies need to be given within 3 days of diagnosis and to those who are at high risk for severe COVID-19. To locate a facility, the Dept. of Health and Human Services has posted a medication locator at:  Then click on the "Find Infusion Locations" screen button.  Infection Control Today.  Jan. 17, 2021.    References

41.  COVID-19 Variants Make Infection Prevention Harder
Infection preventionists need to spread the message and articulate the uncertainties of this new variant of COVID-19. They need to emphasize that it is just not the old who are at risk and employ stricter containment measures....  Many health departments are understaffed. In one Kentucky Public Health District, staffing has been cut almost in half over the last decade. Our stressed healthcare system has an inadequate infrastructure to administer the initial vaccine dose, let alone doubling the effort to administer the second dose. Infection Control Today. Jan. 4, 2021.  References  

40.  Vaccines Should Work Against New COVID-19 Strain
We must treat this strain with the respect it deserves, but we must not panic. There is no doubt that increased infectivity equates with increases in deaths, but it does not mean the vaccines will not work. It is imperative that we follow public health advice. Just remember what happened to the snow leopards in the Louisville Zoo, they are exceptionally good at enforcing social distancing, but not so good at wearing masks. They caught COVID-19. Thus, you must do both. And be steadfast, since we have to slow down the spread of SARS-CoV-2, so the viruses natural production laboratory does not outstrip the capacity of our pharmaceutical giants. Infection Control Today.  Dec. 22, 2020.  References
39.  Viewpoint: Monitoring Systems Track COVID Vaccine Reactions
V-Safe and VAERS are 2 monitoring systems for patients who are given a COVID-19 vaccine. Infection preventionists can play a vital role in educating about the strengths and drawbacks of each. However, questions remain. We do not know how long immunity will last, if those vaccinated can become infectious as an asymptomatic carrier, or how the vaccine affects special populations such as those who are pregnant, very young or immunosuppressed.  Infection Control Today. Dec. 15, 2020.  
38.  COVID-19 Vaccine? Hurry Up and Wait
At last, the vaccines are here! Or are they? There appears to be a shortfall, not enough to initially vaccinate even all of the frontline healthcare workers and nursing home residents against coronavirus disease 2019 (COVID-19). By some estimates only about 20% of the expected doses will be available by year’s end. Shortages can more easily be corrected, than the combating of anti-vaxxer misinformation. However recent polls have been reassuring, with those willing to take the COVID-19 vaccine increasing to 63%. Infection preventionists are an important component of this effort and need to actively articulate to both patients and on social media the need to be vaccinated and to follow public health advice. Infection Control Today.  Dec. 10, 2020.  References
37. Healthcare Workers Hit by COVID Need Workers Comp  
"Kevin Kavanagh, MD. In a wide-ranging discussion, Kavanagh—a member of Infection Control Today®’s Editorial Advisory Board—says that the nation isn’t doing nearly enough to help those on the frontlines battling the coronavirus disease 2019 (COVID-19) pandemic. Kavanagh says that “these frontline healthcare workers are putting their lives at risk, and also the lives of their families and loved ones. And they need to be given support; at least proper protective equipment. In my opinion, they should get presumptive workers comp, if they start to develop problems. This is a significant problem.” The public isn’t taking the disease seriously enough and leaders are not leading."  Infection Control Today.  Nov. 17, 2020.  

36.  Viewpoint: Healthcare Workers Not Being Protected from COVID
Faced with greater than three times the number of cases as the last surge, along with exponential growth with no end in sight, there is little hope healthcare workers can safely treat patients without a drastic change in policy and a more productive and secure supply line.  Infection Control Today. Nov. 16, 2020.   References  
35.  Viewpoint: Quackery Might Stall Progress Against COVID-19
The worst-case scenario is that if an effective and safe COVID-19 vaccine is found, a large segment of our population will elect to use hydroxychloroquine or another ineffective treatment instead, allowing the virus to continue to thrive, and devastate our nation. As a nation, we can easily defeat this virus, but it requires us to trust modern science and embrace a national strategy coordinated by public health officials and our federal government. Let’s not embrace attitudes and views of the 1800’s.  Infection Control Today.  Nov. 7, 2020.    References

34.  COVID Vaccine: What Infection Preventionists Need to Know
Kevin Kavanagh, MD: "Infection preventionists will need to make sure that they still have access to adequate PPE, even if the vaccine comes out [and they] really need to look at the experimental group that was used for the EUA."   And believe me, if I was a frontline healthcare worker at my age, a vaccine would really have to have a lot of complications and concerns before I would not get it. Now that's just a personal view. Because if it adds any armor to protect me from a highly infectious disease that's very prevalent in our community, that has a high rate of fatality, and even a higher rate of chronic disability, I would opt for that vaccine. 
33.  FDA Panel Reviews Many Challenges Facing a COVID Vaccine  -- Vaccines: Safety & Efficacy

The overall cost for society is far too high for a flawed and relaxed vaccine approval process. If the vaccine has low effectivity and primarily prevents mild disease, it will offer little protection to society and may cause inconceivable harm. To paraphrase Peter Luri, MD, MPH, from the Center for Science in Public Interest—The benefits of a minimally effective vaccine can be negated if the public relaxes wearing masks and social distancing. But even worse, if the vaccine is ineffective, it will further fuel the antivaccine movement for decades to come.  Infection Control Today.  Oct. 25, 2020.      References 

32.  Viewpoint: The “Not So” Great Barrington Declaration
Recently, an international group of scientists signed a declaration advocating for achieving herd immunity from coronavirus disease 2019 (COVID-19) by opening communities and business, while protecting the vulnerable with "focused protection." The Declaration states: "A comprehensive and detailed list of measures, including approaches to multi-generational households, can be implemented, and is well within the scope and capability of public health professionals." But to be honest, I’m not sure how this can be done.
Currently, the United States is undergoing a third peak of infections on our first wave and the metrics, of cases and test positivity rates are increasing.
For infection preventionists and frontline healthcare workers, the Great Barrington Declaration places their lives and livelihood at risk. A field hospital has been activated in Wisconsin and the state is at risk of running out of hospital beds and trained staff.  Infection Control Today.  Oct. 15, 2020.    References
31.  Q&A: Are Infection Preventionists Being Misinformed?
Kevin Kavanagh, MD: “Many of the infection preventionists over the last six months now have more experience than many of the policymakers up in DC, because they’ve lived it firsthand. And they’ve seen how COVID-19 can spread. And they’re starting to develop a good idea of how to stop it.” “There have been a number of statements from the CDC or at least with the CDC label on it, which have been disturbing,” Kavanagh tells ICT®. Some of those disturbing statements can be attributed to the fact that the CDC and the rest of the world didn’t quite know what it was dealing with, but not all of them. Kavanagh worries that political pressure may be at work. One of the ways infection preventionists (IPs) can educate themselves is to look at what’s being done in other countries, and read the comments under pre-print studies. Also, experience counts, and IPs have now had months of dealing with the coronavirus.  Infection Control Today.  Oct. 9, 2020.  
30.  School Daze: COVID-19 Spreads Fear, Confusion:
"Opening schools should depend upon low rates of viral spread in the community, widespread testing, rigorous following of public health guidelines, and upgrading the physical infrastructure of our buildings. Our schools are anything but healthy buildings.18 Concerns have existed for decades regarding both the air quality and the crowded conditions our children are exposed to. COVID-19 should be viewed as an opportunity for transformation, allowing us to build a better school system with smaller class sizes for better education and implement strategies to prevent the spread of all infectious diseases"  Infection Control Today Oct 2020. (Page 28)
5f2ddf41a688625d1f8afd54dcb8e87d7cb5cbfa.pdf   References
29.  Trick or Treat … or COVID-19? Yes it is Airborne
Traditional trick or treating is viewed as a high-risk-activity by the CDC. Of course, we all knew Halloween would be problematic. An important caveat for Halloween is not to use your Halloween mask to prevent the spread of coronavirus. It will offer very little protection. These recommendations contain many important lessons both for Halloween and how we should be living our lives in general. And Yes it is Airborne.  Infection Control Today.  Sept. 28, 2020.      References
28.  Eli Lilly Neutralizing Antibodies: Breakthrough for COVID-19 Treatment?
Eli Lilly announced preliminary results to their SARS-CoV-2 neutralizing antibody product, LY-CoV555, which was reported to have spectacular results with a 72% decrease in hospitalizations or ER visits when mildly or moderately symptomatic patients are given the drug within 3 days of diagnosis.
As observed in the Eli Lilly study, those newly diagnosed patients who are obese or have advanced age are the most likely to become hospitalized, and I feel initially this innovative product should be targeted toward these high-risk patients.  Infection Control Today.  Sept. 17, 2020.    Download Original Article    References

Updated Oct. 8, 2020.  Downloaded Article  (The article was updated again on Nov. 10 by ICT Editorial Board Staff)
27.  Taking Aim at Antibiotic-Resistant Bacteria During COVID - A review of the Fall 2020 PACCARB Meeting.
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. Infection Control Today.  Sept. 16, 2020.    References
26.  Is COVID-19 Primarily a Heart and Vascular Diseases?
Thus, the once thought asymptomatic patients who luckily dodged a bullet and were spared from the ravages of the disease, may indeed be truly sick. A significant portion of them may develop myocarditis along with vascular vasodilation with resultant hypoxemia. This pathological process could easily be more significant than the pulmonary effects of the virus, since it is present in both symptomatic and asymptomatic patients. And could explain the debilitating symptoms of fatigue and mental fog which “long-haulers” are experiencing, many of which had a mild initial illness. Infection Control Today.  Sept. 8, 2020.    References
25.  Viewpoint: Infection Preventionist Guide to Dealing with COVID Misinformation
"It is imperative that infection preventionists engage and combat this messaging on social media and wherever it occurs. To not do so, allows misinformation to fan the pandemic, placing all of our lives at risk."
After one leave retorts to the misinformation, "you will notice that you have numerous exchanges with one individual. That this individual has left a junkyard full of highly complex and intwined web of misinformation. Yet for all of this work, when you go to the troll’s home page, it will most likely be blank. This tells you may be dealing with a professional. If the troll responded to you throughout the entire day, he may well be on a payroll." Sept. 7, 2020.  Infection Control Today.    References
24.  Q&A: Flu Data Show Potency of Anti-COVID Tactics Like Masking, Hand Hygiene
Wear a mask, good hand hygiene, follow social distancing guidelines: The strategies just mentioned might snuff out COVID-19 in the long term, says Kavanagh, if everybody follows them. “But when you look at the flu, which isn’t as infectious, you would expect it to just annihilate that type of a pandemic and organism and that’s what we’re seeing in the Southern Hemisphere,” says Kavanagh. “Now, that of course is contingent that we follow this guidance, which as you know, is anywhere but universally accepted by the American public.”  Aug. 18, 2020.  Infection Control Today. 
23.  The 2020 Flu: Dud or Devastation, It is Up To You
"This year we have to do more than just rely on the flu vaccine. Avoiding the flu plus COVID-19 catastrophe is contingent on the US widely embracing public health guidance of wearing masks, meticulous hand hygiene and social distancing."  "If one looks at the data from the CDC, the flu became almost nonexistent in the United States by the end of March, with a very steep drop-off in cases. The World Health Organization (WHO) data from the Southern Hemisphere is even more surprising. Summer is their peak Flu season. But unlike previous years no viral specimens were submitted to the WHO from many countries during the Summer months."  Infection Control Today.  Aug. 18, 2020.    References

22.  Infection Preventionists Might be Needed in Schools
Similar to our healthcare system as a whole, COVID-19 is shedding a light on deficiencies and the dearth of personal safeguards in our schools. Let us not forget, schools are a nidus for spreading the flu and other diseases. Opening schools should depend upon low rates of viral spread in the community, widespread testing, rigorous following of public health guidelines and upgrading the physical infrastructure of our buildings. COVID-19 should be viewed as an opportunity for transformation, allowing us to build a better school system with smaller class sizes for better education and implement strategies to prevent the spread of all infectious diseases.  Infection Control Today.  Aug. 10, 2020.

21.  New Study: Hydroxychloroquine Works in Monkeys, Not Humans
Thus, at this point, there is no compelling evidence to recommend the use of hydroxychloroquine for clinical use and several large organizations have suspended research involving this drug. There has been an enormous amount of valuable scientific resources which have been devoted to answering this scientific, now political, issue. These resources would have been better spent on more promising treatment modalities, such as studying Camostat mesilate or nafamostat mesylate therapy for COVID-19, a compound which has been shown to block TMPRSS2 .  Infection Control Today.  Aug. 3, 2020.   
20.  National Reporting System for All Dangerous Pathogens Needed
After decades of reluctance to implement a national reporting system, when COVID-19 came along we witnessed almost overnight the formulation of case definitions and comprehensive national reporting from all healthcare facilities.  A dangerous pathogen is a dangerous pathogen; we should not discriminate on our approach to COVID-19. The nursing home reporting policies for COVID-19 need to be adopted systemwide for all dangerous pathogens and our infrastructure permanently enhanced.  One may think that enhancement is a forgone conclusion. But we did not learn these lessons from the 1918 Spanish flu or from the Ebola, severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS) outbreaks. Six months or 6 years after this epidemic our resolve may wane. IPs need to document their experiences and keep telling their stories so our memories of this horrific ordeal do not fade.  Infection Control Today.  July 20, 2020.  
19.  Viewpoint: Despite Happy Talk, We’re Far From Out of the COVID Woods
COVID-19 cases in many states have risen and the false narrative is that this is because of increased testing. But the rise in cases far outstrips the rise in testing... the young are not shielded from the viruses’ devastating effects. We need to take this pandemic seriously, the public needs to wear masks and practice social distancing. As stated by Avindra Nath, MD, the senior investigator at the Section of Infections of the Nervous System at National Institutes of Health: “It’s quite possible some will never get their health back." Infection Control Today.  June 22, 2020. 

18.  COVID-19 Experience Suggests Need for National Reporting System for Dangerous Pathogens
It is of utmost importance to screen healthcare staff and patients for dangerous pathogens along with the establishment of a national tracking system. The nursing home reporting policies for COVID-19 need to be adopted system wide for all dangerous pathogens and our infrastructure permanently enhanced.  One may think that enhancement is a forgone conclusion. But we did not learn these lessons from the 1918 Spanish flu or from the Ebola, SARS or MERS outbreaks. Six months or six years after this epidemic our resolve may wane. IPs need to document their experiences and keep telling their stories so our memories of this horrific ordeal do not fade.  Infection Control Today.  June 8, 2020.     
17.  Reopening After COVID-19 Needs to be Done Carefully
Kevin Kavanagh, MD, the board chairman of the patient advocacy group Health Watch USAsm, talks to Infection Control Today about the perils of reopening too quickly and the value of cloth masks. "What worries me the most about reopening is that people are going to say, 'Oh, it's over with' and not do any sort of protection, whether it's social distancing, wearing masks, not gathering in crowds. I really think that people will think, 'Well, we got this beat.'"  Infection Control Today.  May 28, 2020.   
16.  Why the Public Should Wear Masks During the COVID-19 Pandemic
Initially, the public was advised not to wear masks. However, this was before the importance of asymptomatic transmission was known. Recent studies have also underscored the growing importance of person-to-person transmission through the air. Guidance changed. It is now recommended for the public to wear cotton masks. This guidance is not intended to protect the wearer, but to help prevent the wearer from spreading the virus to others if they are an unknown asymptomatic carrier.   Infection Control Today.  May 27, 2020. 
15.  When COVID-19 Knocks on Nursing Homes’ Doors, Systemic Problems Welcome It.
"Despite nursing homes becoming a nidus of multi-drug resistant organisms (MDROs), the regulations for staffing infection preventionists (IPs) at nursing homes are far too lax. Nursing homes should have a full-time IP. Presently the regulations only specify a part-time IP without a specific required time commitment. In view of the large number of nursing home residents and the high drug-resistant carriage rate, a full-time position is certainly needed."  Infection Control Today.  May 7, 2020.    
14.  Viewpoint: COVID-19 Modeling: Lies, Damn Lies and Statistics.
We have now received our fourth projection on deaths. I'm not sure if it will be right or wrong, but the others have proven to not be correct, so I'm not hopeful for this one. That is actually good news because the last projection doubles the number of expected deaths to 134,475 by Aug 4, 2020."   Infection Control Today.  May 6, 2020.
13.  Viewpoint: Have You Heard About the Herd? It’s a COVID-19 Fallacy.

"Strategies of social distancing, not gathering in large crowds, wearing masks and protecting those at increased risk are required to manage this epidemic. Returning to life as usual with the dependence on herd immunity in a non-vaccinated population to control spread is almost certainly a false narrative."  Infection Control Today.  April 29, 2020.  
12.  Kevin Kavanagh & Lindsay Calderon. Lessons of the Hydroxychloroquine Debacle: Solid COVID-19 Research Matters.
"In the new reality of making decisions with limited and incomplete data, it is important that decision makers and scientists are free from biases.  Biases can be financial and even geopolitical pressure created by the huge trade war and divisive rhetoric between the United States and China. In a time of great national fear and stress, we must be careful in both reporting and interpreting messaging, including the results of unconfirmed research. Let’s not repeat the mistakes of HCQ for unproven benefits, since these are powerful drugs which may also cause harm."
Infection Control Today.  April 26, 2020.   
11 .   Viewpoint: CDC's Changing Guidance Underscores How COVID-19 Keeps Winning.
"Needless to say, additional PPE is desperately needed, hopefully both increased manufacturing and sterilization techniques will relieve the shortage. In addition, the strategy adopted by New York State to designate some facilities to exclusively treat COVID-19 patients and others for non-COVID-19 patients to help improve patient safety should be adopted in other areas of the nation.   We must make protecting our frontline healthcare workers and patients a priority. Rapid testing will go a long way in assuring the safety of patients by identifying asymptomatic carriers in healthcare workers and staff."  Infection Control Today.  April 15, 2020.   

10.  Viewpoint: As COVID-19 Spreads, Where's All the Money Hospitals Have Made?
"There is no excuse for running a system which is lean on hospital rooms, supplies and staff. Net-profits and assets are desirable, but not at the expense of public safety. Hospital staff are being asked to see patients under draconian conditions and at the same time they do not have an adequate economic and healthcare safety net. Healthcare workers do not need paid sick leave, they need adequate PPE and worker's compensation benefits, if they become infected. IPs are placing both themselves and their families' lives at grave risk under the crisis management CDC infectious disease recommendations. That is the very least we can do for them."   Infection Control Today(redacted version).  April 10, 2020:

9.  Authorities are split on what to do if a person is already on ACE Inhibitors and ARBs
Many in the United States have advocated to stay the course, until more information is known.  Switching medications may be difficult at best.  At the least, until this controversy can be resolved, if you are on one of these medications one should perform strict social distancing and protect yourself from contracting COVID-19.  Staying safe at home is best and follow strict recommendations when contacting the public.   Infection Control Today.  April 7, 2020.
Health Watch USAsm Summary of Recommendations Regarding ACE Inhibitors and ARBs with COVID-19.
8.  Churches Could be the Deadliest Places in the COVID-19 Pandemic.  
One may ask: Why am I calling out churches? The answer is asymptomatic spread and aerosolization of the virus from singing.   Infection Control Today.  April 3, 2020.   
7.  As COVID-19 Knocks on Nursing Homes' Doors, Full-Time Infection Preventionists Needed More Than Ever. "Despite nursing homes becoming a nidus of multi-drug resistant organisms (MDROs), the regulations for staffing infection preventionists (IPs) at nursing homes are far too lax. Nursing homes should have a full-time IP. Presently the regulations only specify a part-time IP without a specific required time commitment. In view of the large number of nursing home residents and the high drug-resistant carriage rate, a full time position is certainly needed." Infection Control Today. March 27, 2020.  Download PDF of Article  
6.  Evidence Continues to Link ACE Inhibitors to Severe COVID-19 Symptoms
There is mounting consensus that ACE inhibitors may be a primary driver of the severe symptoms. The concerns were originally raised in the Lancet. ACE inhibitors up regulate (increase) the ACE2 receptor. This is the receptor the COVID-19 virus uses to attack the lungs.  Infection Control Today.  March 26, 2020.    
Health Watch USAsm Summary of Recommendations Regarding ACE Inhibitors and ARBs with COVID-19.
5.  COVID-19: We'll Know We've Won the War Against COVID-19 When...
"Judging when we have won the war against the coronavirus is not simple. The good news is that we have the technology and know-how to confront and substantially mitigate these epidemics. What we have lacked is the willpower to implement this knowledge. If we are unable to rapidly transform our system and correct these flagrant deficiencies, then the worse projections from the Imperial College projections of 2.2 million United States citizen fatalities may come to pass" Infection Control Today. Mar. 20, 2020 (Online).      
4. COVID-19: IPs, Other Healthcare Workers at Greater Jeopardy Than Thought.
"Of extreme concern, of the 3711 Diamond Princess cruise ship passengers, 634 tested positive for SARS-CoV-2 (the virus which causes COVID-19) and of these 17.9% were asymptomatic and presumably could spread the virus." Infection Control Today. Mar. 17, 2020 (Online).   
3. Viewpoint: US Woefully Unprepared for COVID-19 Pandemic.
"A news commentator made the alarmist statement that we may get to the point where the national guard is escorting patients to a high school gym for placement on ventilators. This is of course a ridiculously misinformed statement since we do not have enough ventilators."
Infection Control Today. Mar. 11, 2020 (Online).  
2. We’re Losing the Fight Against COVID-19 So Far.
"We seem to be at risk of entering into a blame game and "politicizing" the problems. Our response to this contagion shows severe flaws in our healthcare delivery system. As one government official stated, "We have for whatever reason and there are many good ones, designed a system based on very lean staffing practices based on just-in-time supply chains and purchasing." Infection Control Today. Mar. 9, 2020 (Online).     
1. Infection Preventionists, Hospital Administrators Will Be on Frontlines of Coming COVID-19 Epidemic. "Preparation for the impending epidemic of the COVID-19 coronavirus is of utmost importance and will place a tremendous strain on our healthcare system that will require coordination between the IPs, administrators and the hospital's board. This impending epidemic underscores the importance of the work that the CDC is undertaking by using surveillance and quarantine strategies to delay entry and slow the spread of this pathogen." Infection Control Today. Feb. 27, 2020.  
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This webpage is for guidance only, always consult your healthcare provider and the CDC Website for information before making decisions relating to the coronavirus.