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2024-8-HW (Link to Article) A potential discovery of highly fatal SARS coronavirus?
"It’s time for a reality check. We must take this recent preprint seriously, and our government needs to take proactive measures to prepare for future pandemics. This entails implementing strategies such as source control through improved ventilation systems and the utilization of N95 masks or respirators. While considerable efforts have been made to emphasize individual responsibility in combating pandemics, the reality is that collective action led by public health authorities is indispensable. Relying solely on individual actions will not suffice to safeguard against future threats posed by dangerous pathogens."References Kevin MD. Mar. 23, 2024.

2024-7-HW (Link to Article) COVID denialism allows other infectious diseases to spread. We must make public health a priority.
"Falling vaccination rates are being driven by anti-science, and The Centers for Disease Control and Prevention only needs to look in the mirror to discover one of the driving forces. The anti-science rhetoric governmental institutions are spewing regarding COVID-19 is causing far reaching and enduring damage to public health, fueling conspiracy theorists and anti-vaxxers. Many in the mainstream public do not truly understand the intricate details of science, but they know when they are being gaslighted." We need to stop believing we live in a world of rainbows and unicorns. COVID-19 is currently filling over 22,000 hospital beds and resulting in more than 200 deaths each week. In addition, long COVID is ravaging our entire adult population with 6.8% afflicted with the disease, a number which appears to be increasing. Society must know the true downside and risks of spreading this virus and determine the number of chronic disability and premature deaths that we can tolerate...."References Courier Journal. Mar.13, 2024.

2024-6-HW (Link to Article) 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.

2024-5-HW (Link to Article) 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. 29, 2024.

2024-4-HW (Link to Article) Importing drugs from Canada is an old idea with new political direction .
"This is an extremely old Idea which I wrote about in my first Lexington Herald Leader Op Ed almost 20 years ago. The only difference is back then the idea was advocated by the left and anyone in opposition was obviously in the pockets of big pharma. Today, the political winds have reversed, and it is now being championed by the right. In 2004, I speculated that even with a 20% surplus, this strategy would only be expected to fill about 2% of the United States' needs. In today's post-pandemic environment with drug shortages and dependence on China for drug precursors, there is little hope of reimporting Canadian drugs. And why should Canada give their drugs to the United States when they have the political backbone to negotiate prices, and the strongest country in the world is trying to take the easy way out? And why would drug companies let this happen? Wouldn't they place export prohibitions in their contracts and limit sales commensurate with the country's needs? Little has changed since 2004, with the exception that the population of Canada appears to be growing faster than the United States'. But then this may be related to Canada's sound leadership taking decisive steps, such as negotiating drug prices for their citizens, rather than playing politics with their citizen's health and safety."References Lexington Herald Leader. Feb. 4, 2024.

2024-3-HW (Link to Article) 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, 2024.

2024-2-HW (Link to Article) Wake up! We are still in a pandemic and Vaccines are our best defense against long COVID.
"The chance of becoming severely sick from COVID when attending a January indoor function is far too great not to take preventative measures. And once you become sick, do not count on developing any long-term protective immunity to this rapidly changing, immune evasive virus. Infections also tear down not build immunity to other infections...We need to wake up as a society before we reach a point of no return, or before the damage to our frontal lobes from repeated viral infections reaches a point where we are unable to form a consensus and effectively respond to this pandemic...We need to wake up as a society before we reach a point of no return, or before the damage to our frontal lobes from repeated viral infections reaches a point where we are unable to form a consensus and effectively respond to this pandemic."References USA Today. Courier Journal. Jan. 8, 2024.

2024-1-HW (Link to Article) 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, 2024.


2023-30-HW (Link to Article) 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.

2023-29-HW (Link to Article) 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.

2023-28-HW (Link to Article) Commentary: Charleston airport needs to improve its air quality.
"Besides the concern about the spread of infectious disease - and not just COVID; I do not wish to spend thousands of dollars on a trip and be down for several days with even a cold - there is also the concern regarding cognition and worker performance. It should be noted that HEPA filters and UVC upper-room lighting do not lower carbon dioxide levels. Charleston International Airport needs to upgrade its indoor ventilation and heating and air conditioning systems. This requires more than just an upgrade of filters, because the increase in resistance to produce adequate airflow often requires new HVAC units, which may also require electrical upgrades. In addition, lowering the CO2 level by increasing the mix of outside air is imperative for both worker and traveler safety."References Post and Courier. Oct. 31, 2023.

2023-27-HW (Link to Article) 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.

2023-26-HW (Link to Article) 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."Infection Control Today. Sep. 25, 2023.

2023-25-HW (Link to Article) 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."Infection Control Today. Sep. 18, 2023.

2023-24-HW (Link to Article) COVID is closing Kentucky schools -- again. Embracing disinformation paralyzes our response. The myth that children do not have to worry about COVID, along with other respiratory diseases, is based on misinformation.
"Unfortunately, too many of our schools have unhealthy buildings with outdated HVAC systems. This will adversely impact our children's learning, along with placing them at risk for acquiring respiratory diseases (RSV, flu and even colds). I felt the spending of COVID funds on outdoor sports and running tracks, as opposed to improvements in indoor air quality and COVID mitigation strategies, exemplified Kentucky's embrace of disinformation and inability to safeguard the lives and well-being of our children. Let's make Kentucky the national leader in providing a safe educational environment for our children. The first and easiest steps will be to upgrade school ventilation and to respect parents who are masking their children."References Infection Control Today."Courier Journal. Sep. 6, 2023.    USA Today.  Sep. 6, 2023. https://www.usatoday.com/story/opinion/2023/09/06/kentucky-school-districts-close-covid-upgrade-buildings-ventilation/70765140007/ 

2023-23-HW (Link to Article) 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 Infection Control Today."Infection Control Today. Aug. 28, 2023.

2023-22-HW (Link to Article) 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."Infection Control Today. Aug. 17, 2023.

2023-21-HW (Link to Article) 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.

2023-20-HW (Link to Article) 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." ReferencesInfection Control Today. July 13, 2023.

2023-19-HW (Link to Article) Hospitals can't lose sight of infection control as COVID recedes
"Earlier this month, a news article from the United Kingdom reported that more than 2600 National Health Service staff have missed work due to Long COVID, some up to two years. The vast majority of those impacted were nurses. Two days later, the Journal of Infection Control and Hospital Epidemiology reported that 27.4% of Brazilian healthcare workers who were diagnosed with COVID-19 developed long COVID. The best defense against long COVID is to not get infected in the first place. Unless we commit to a reliable and robust measurement system of hospital-acquired infections, we will continue to have a stressed workforce and need to rely on data generated in other countries. If this does not occur, the United States will take a back seat in public health and healthcare safety and will lose its leadership position in the world. Fierce Healthcare." References Fierce Healthcare. June 23, 2023.

2023-18-HW (Link to Article) 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.

2023-17-HW (Link to Article)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.

2023-17-HW (Link to Article): Industry Voices - The case for hospitals to invest in cleaner air
"The American Society of Heating, Refrigeration, and Air-conditioning Engineers (ASHRAE) recommends an indoor CO2 level of 870 ppm or below. To achieve this, a minimum ventilation rate of 10 liters per second per person is needed. Lowering CO2 improves cognition: Higher CO2 levels can also cause drowsiness and affect concentration. Joseph Allen, et al., have demonstrated that compared to CO2 levels of 550 ppm, cognitive function was 15% lower at a level of 945 ppm and 50% lower at a level of 1400 ppm. For "strategy" (the ability to plan, sequence and prioritize actions) these scores were 16% and 78% lower, respectively. "On average, a 400 ppm increase in CO2 was associated with a 21% decrease in a typical participant's cognitive scores across all domains..." New draft ASHRAE recommendations released in May 2023 address "Control of Infectious Aerosols." Equivalent outdoor airflow in healthcare waiting rooms should be 60 liters per second per person (L/s/p), 45 L/s/p in common treatment areas and 90 L/s/p in healthcare patient rooms. Compared to the purchasing of N95 masks, the economic investment in clean air is much lower and should easily be offset by the advantages of maintaining a healthy workforce and increasing the safety of healthcare provided to patients." References  Fierce Healthcare. May 15, 2023.

2023-16-HW (Link to Article): 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. Infection Control Today. May 11, 2023." References  Infection Control Today. May 11, 2023.

2023-15-HW (Link to Article): 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." References  Infection Control Today. May 10, 2023.

2023-15-HW (Link to Article): 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.
     

2023-14-HW (Link to Article): Industry Voices - As healthcare's labor shortages worsen, masking remains critical
"Staffing shortages have created healthcare worker burnout and skyrocketed hiring prices. A vicious feedback loop ensued. N95 masks are one of the keys to the optimal maintenance of a healthy healthcare workforce and breaking this cycle. The expense of these masks pales in comparison to the expenses paid by hospitals to hire agency replacement workers. The benefits of high-quality masks extend far beyond SARS-CoV-2, since they will help prevent illnesses from other common airborne pathogens, decreasing sick leave and allowing the facility to maintain the provision of high-quality services." References  Fierce Healthcare. Apr. 7, 2023. 

2023-13-HW (Link to Article):  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. 4, 2023. 

2023-12-HW (Link to Article):  Industry Voices-Amid a return to normalcy, COVID remains a threat
"The Federal Reserve Board raising interest rates will not cure the bird flu, nor will it cure COVID. The infections have a lasting negative impact on our workforce, shackling our healthcare system with chronically sick long COVID patients with far too few healthcare staff to service them. Banks are collapsing; our economy is obviously not overheating. Our current economic strategy is like telling someone to run with a broken leg and work through the pain." References  Fierce Health Care. Mar. 27, 2023. 

2023-11-HW (Link to Article):  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 Infection." References  Infection Control Today. Mar. 21, 2023. 

2023-10-HW (Link to Article):  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.) Infection Control Today. March 3, 2023
." References  Infection Control Today. Mar. 3, 2023. 

2023-9-HW (Link to Article):  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. 

2023-8-HW (Link to Article):  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. 

2023-7-HW (Link to Article):  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. 

2023-6-HW (Link to Article):  Who gets better COVID protection? CEOs or the frontline workers they employ? Opinion
"What does the capitalistic business magazine, Forbes, and the World Socialist Web Site have in common? Answer: Both are pointing out the glaring double standard in COVID-19 precautions given to business CEOs and world business leaders at the DAVOS World Economic Forum, compared to those given to frontline workers which many of them employ. With the dangers of delayed heart disease, memory and disorders cognition, along with post-COVID immune dysfunction, we are dealing with a dangerous pathogen and I have repeatedly given the advice for business owners to upgrade their airflow, patrons to use portable CO2 monitors to estimate air quality and to test before gatherings. If it is good enough for billionaires and Fortune 500 CEOs it is good enough for me." References  Courier Journal. Jan. 30, 2023. 

2023-5-HW (Link to Article):  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. 

2023-4-HW (Link to Article):  Bird Flu Warning: Its Spreading, Mutating, and Infecting Mammals
"I'm starting to experience deja 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. 

2023-3-HW (Link to Article):  Immunodysfunction: A Cause of Stealth COVID-19 Illness and Death
 (Recent editorial and additional references regarding immune dysfunction post COVID-19) 
"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. 

2023-2-HW (Link to Article):  Despite misinformation, we can do more to protect against Covid, RSV and flu | Opinion (Recent editorial and additional references regarding immune dysfunction post COVID-19)  
"Much of the current COVID-19 misinformation has its genesis from the newly concocted explanation of "Immune Debt." Mounting evidence indicates this is not the case. A more concerning process may be taking place. In Africa and Southeast Asia, masks and social mitigation measures have been used for decades to blunt the epidemics of SARS, MERS, and Ebola without any observed ill effects. The other more ominous possibility is "immune theft" resulting from an immunodysfunction caused by previous COVID-19 infections. A non-peer reviewed preprint recently reported that children who contracted RSV were twice as likely to have had a previous COVID-19 infection than those who did not develop an RSV infection. Common sense measures need to be taken during this winter surge. And The United States also had a large RSV spike last year. Thus, the "Immune Debt" explanation does not fit. For patrons, high-quality N95 masks should be worn when one enters indoor venues. For business, to the extent possible, make available curbside pickup and online purchasing options." References  Lexington Herald Leader, Jan. 6, 2023. 

2023-1-HW (Link to Article):  Why 'herd immunity' is as outdated as 'the earth is flat' when it comes to COVID: Opinion 
"This concept was formulated before science knew what viruses and mutations were. In actuality, many biological systems are highly dynamic and constantly adapting. With the exception of smallpox, no pathogen has ever been eradicated from the earth and with smallpox, eradication was achieved with a highly effective long-lasting vaccine. Our goal must be to decrease pathogen spread. We need to embrace vaccinations, the use of N95 masks in crowded venues, along with home delivery, curbside pickup and outside dining. Indoor air quality must be improved to the point where it is safer indoors than it is outdoors." References  Courier Journal, Jan. 4, 2023. 


2022-46-HW (Link to Article):  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." References  Infection Control Today, Dec. 27, 2022. 

2022-45-HW (Link to Article):  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.  

2022-44-HW (Link to Article):  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." References  Infection Control Today, Dec. 13, 2022.  

2022-43-HW (Link to Article):  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.  

2022-42-HW (Link to Article):  There is no such thing as 'herd immunity.' Why the ongoing dangers of COVID-19 are real
"We all need to recognize the dangers of COVID-19 and the risks it imposes to our long-term health and our country’s workforce. Long COVID occurs in approximately 30% to 35% of cases. It commonly occurs with even mild disease and with reinfections. Thus, testing, masking, avoiding indoor crowded settings along with keeping vaccinations and boosters up to date are the best strategies we have to stay safe during times of high viral spread. Above all, we need to have clear and comprehensive public health messaging. We must be willing to make a few compromises in the way we live, for the safety of others and ourselves. " References   Courier Journal, Nov. 29, 2022.  

2022-41-HW (Link to Article):  As Holidays Approach, COVID-19 Remains a Major Concern
"With the upcoming holidays and family gatherings along with the public largely ignoring masking, testing and vaccinations, we may well be in for a holiday surge of COVID-19; adding to the increasing cases in RSV and seasonal flu. Masking, testing and vaccinations to flu and COVID are in themselves good steps, but taken together will give the best possible protection. Everyone should be tested immediately before the event, which some research has shown can decrease spread by 40%. Second, ask those attending a family gathering to not enter high risk settings and to wear an N95 mask in public a week before the event." References   Infection Control Today, Nov. 23, 2022.  

2022-40-HW (Link to Article):  These holidays, we still need to think about COVID
"With the upcoming holidays and family gatherings along with the public largely ignoring masking, testing and vaccinations, we may well be in for a holiday surge of COVID-19; adding to the increasing cases in RSV and seasonal flu. Masking, testing and vaccinations to flu and COVID are in themselves good steps, but taken together will give the best possible protection. Everyone should be tested immediately before the event, which some research has shown can decrease spread by 40%. Second, ask those attending a family gathering to not enter high risk settings and to wear an N95 mask in public a week before the event." References   Download OpEd PDF  Lexington Hearald Leader, Nov. 21, 2022.  

2022-39-HW (Link to Article):  Opinion: With only 28% of Kentuckians boosted against COVID-19, variants could pose a big health risk
"Cases of COVID-19 are surging in Europe, there is not just one variant of concern but what appears to be a "soup" of highly infectious variants. In the United States these include the BA.5, BA.4.6, BA.2.75, BF.7, BQ.1 and BQ. 1.1 and in Southeast Asia, the XBB variant. Variant "soup" is highly problematic, since it just takes one variant that is able to evade your immunological history to cause an acute infection. "the original sin of the COVID-19 response is the failure to recognize airborne transmission as the dominant mode of transmission." Industry needs to upgrade indoor ventilation and ideally install germicidal UV-C lighting." ReferencesDownload OpEd PDF  Kentucky Gazette, Nov. 16, 2022.  

2022-38-HW (Link to Article):  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.  

2022-37-HW (Link to Article):  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.  Infection Control Today." References Infection Control Today, Nov.  1, 2022.  

2022-36-HW (Link to Article):  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.  

2022-35-HW (Link to Article):  COVID-19 Risk Adjustment, Driving Transformation or Normalizing Deviance? It is Our Choice.
"During the COVID-19 pandemic, the U.S. healthcare system neared collapse, in large part due to lean staffing and meager stockpiles of supplies. However, instead of transformation, it appears policymakers have assumed that facilities can do little to prevent safety lapses in the presence of COVID-19, and the Centers for Medicare and Medicaid (CMS) have decided to "risk" adjust quality metrics used in financial incentives. Risk adjustment should only be applied when effective strategies do not exist to prevent the occurrence of adverse outcomes. The question remains: Are we going to meet the challenge, build the needed infrastructure and strengthen our healthcare system to adapt to the new normal, or are we going to normalize deviance with continued lean staffing and just-in-time supply chains? I would choose the former and use financial incentives to drive the change." References On Health, BMC, Sept. 28, 2022.  

2022-34-HW (Link to Article):  How a new phase of fighting COVID requires the public to pay: Opinion.
"Due to lack of congressional funding, the Biden administration announced plans to curtail the funding of COVID-19 tests, treatments and vaccines shifting the financing and burden of the epidemic onto the public and private market. Along with Kentucky's recent devastating natural disasters, curtailing federal payment on vaccines, tests and treatments is another stressor which risks the health and well-being of Kentuckians. As calls for a national public healthcare system are becoming louder, this is a step in the opposite direction. The best advice is to take advantage of the vaccines, ordering of tests and the bivalent BA.5 booster which will be available in early September before federal coverage for all is suspended." References Courier Journal.  Sept. 2, 2022.  

2022-33-HW (Link to Article):  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.  

2022-32-HW (Link to Article):  We're facing a triple threat of COVID, monkeypox and polio. Let's take them seriously.
"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 Lexington Herald Leader.  Aug. 17, 2022.  

2022-31-HW (Link to Article):  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.  

2022-30-HW (Link to Article):  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.  

2022-29-HW (Link to Article):  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.  

2022-28-HW (Link to Article):  How patient risks of harm in the hospital have increased during the pandemic: Opinion.
"Facilities appear to be responding by trying to water down regulations and to lessen the efficiency and impact of quality monitoring. And we received from the CDC were watered-down regulations, with not having specific recommendations to increase ventilation, admission COVID testing at the "discretion of the facility" and the encouragement, but not mandating, the use of N95 masks. All of the above has resulted in many staff not feeling safe, worsening the chronic nursing staff shortage. The CDC must set the highest standards for the world to emulate, not standards that are pliable for our profit-driven health care systems." References Courier Journal. July 11 2022.  

2022-27-HW (Link to Article):  Kentuckians are convinced that COVID is over, but they are wrong.
"Herd immunity" may help end a surge, but the virus quickly adapts and strikes again. As new variants continue to rapidly emerge, the guidance actually becomes simpler: All immunity is waning, and one needs to keep your immunity as strong as possible. This means to stay up to date with your vaccinations and boosters, even if you have had a previous infection. We all need to wear high-quality N95 masks during times of high viral spread. I am not sure how to motivate Kentucky's population to do so. At the very least we need to use our vote to express political feelings, and our love for our neighbors to dictate how we act in public." References Lexington Herald Leader. June 29, 2022.  

2022-26-HW (Link to Article):  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.  

2022-25-HW (Link to Article):  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.  

2022-24-HW (Link to Article):  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.  

2022-23-HW (Link to Article):  Does COVID make you dumber? Here's how you lose IQ points when you're infected 
"Last night I awoke during a nightmare. We were in a COVID-19 cognitive feedback loop, where repeated infections were causing a progressive loss of intelligence which was making us more likely to undertake risky behavior. Sort of like the planet of the apes, but instead of the apes getting smarter, we were getting dumber. This apocalyptic thinking was spurred by a New York Times report detailing healthy individuals enduring multiple infections because of waning natural and vaccine immunity. And cognitive loss with COVID-19 is a real concern."  References Courier Journal.  May 31, 2022.  

2022-22-HW (Link to Article):  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.  

2022-21-HW (Link to Article):  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.  

2022-20-HW (Link to Article):  We may not have to wear masks, but COVID is still lurking out there
"Masks have again entered the public spotlight with a Florida federal judge ruling prohibiting the CDC from issuing mask mandates regarding public transportation. Mid-flight passengers cheered, oblivious to the fact that the virus could care less. Currently, we are witnessing the emergence of a new and even more infectious variant in central New York, BA.2.12.1. Now is not the time to be promoting spread around the country with maskless airline travelers. Dosage counts. If a single virus penetrates a mask, it is unlikely to cause an infection, but if someone is exposed to 1000s of viruses, that is another story." References Lexington Herald Leader.  Apr. 29, 2022.  

2022-19-HW (Link to Article):  What the US must learn from its handling of the COVID-19 pandemic: Opinion
"As stated by researchers in Nature: "This Swedish laissez-faire strategy has had a large human cost for the Swedish society". emails revealed: "they (State Epidemiologists) at least speculated on the use of children to acquire herd immunity," but at the same time were publicly stating children "played a negligible role" in spreading the disease and did not become ill. And the elderly fared even worse, where many were given morphine instead of needed and available oxygen, "effectively ending their lives." Reuters described a European Union document that found that "Russian media... deployed a "significant disinformation campaign" against the West to worsen the impact of the coronavirus, generate panic and sow distrust..." As a nation, we need a Federal Government which does not sugarcoat the facts of the pandemic and a public that gathers its information from a multitude of historically reliable national and international sources." References Courier Journal.  Apr. 7, 2022.  

2022-18-HW (Link to Article):  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.  
 BA.2 Variant Cases and Hospiatlizations in the United Kindgm
  

2022-17-HW (Link to Article):  As another variant emerges in Europe, it's too soon to let down guard against COVID
"It seems most of the nation has declared the pandemic all but over. In Kentucky, as of March 22, NYTs data showed the 14 day case average was down by 25%. However, Eastern Kentucky is telling a different story. In the United Kingdom, this resurgence started approximately two weeks after COVID-19 restrictions were lifted. The BA2 Variant is highly infectious, possibly as much as measles. Predicting severity of illness is difficult, since the vast majority of individuals have varying immunity to the virus. However, Long COVID can occur in 10% to 30% of cases. Complaints regarding cognitive function occur in approximately 70% of patients with long COVID. We must respect others, some of whom we wear a mask to protect, but above all, get vaccinated along with obtaining boosters when indicated." References Lexington Herald Leader.  Mar. 22, 2022.

2022-16-HW (Link to Article):  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.

2022-15-HW (Link to Article):  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.

2022-14-HW (Link to Article):  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, 2022.

2022-13-HW (Link to Article):  Kentucky COVID-19 bills are based on campaign talking points, not reality: Opinion
"The toll of this pandemic has been enormous. Kentucky has had well over 13,000 deaths from COVID-19 and FAIR Health estimates, as calculated by insurance company allowables, Kentucky has spent over $1 billion on COVID-19 hospital treatment alone, not counting outpatient or chronic rehabilitation costs. Let's quit getting our information from social media sites. This is like reading the emails in your spam folder. ...for the safety of all Kentuckians, we need to have clear, accurate messaging." References Infection Control Today.  Mar. 3, 2022.

2022-12-HW (Link to Article):  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.

2022-11-HW (Link to Article):  Perspective: Relaxing Mask Guidance Must Be Done 'Carefully'
"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.

2022-10-HW (Link to Article):  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. Infection Control Today. Feb. 25, 2022". References Infection Control Today. Feb. 25, 2022.

2022-09-HW (Link to Article):  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. 12, 2022.

2022-08-HW (Link to Article):  Disinformation is still hurting in Kentucky’s battle against COVID-19.
"Immunity elicited by boosters markedly diminishes after 6 months, but vaccines are our best bridge until antiviral therapeutics become widely available and also to keep our facilities from being overrun. Pfizer and Moderna are both reformulating a vaccine for the Omicron variant and plan to have it available before Summer. For now, let's just take one month at a time and use the tools which are available to us. The disinformation which some are spewing is nothing short of parroting the propaganda playbook of our communists’ adversaries. It is dividing and weakening our country. We as a country must do better". References Lexington Herald Leader. Feb. 11, 2022.

2022-07-HW (Link to Article):  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 preventionsts". References Infection Control Today. Feb. 7, 2022.

2022-06-HW (Link to Article):  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.." Infection Control Today. References Infection Control Today. Jan. 26, 2022.

2022-05-HW (Link to Article):  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." Infection Control Today. References Infection Control Today. Jan. 24, 2022.

2022-04-HW (Link to Article):  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." Infection Control Today. References Infection Control Today. Jan. 20, 2022.

2022-03-HW (Link to Article):  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."  Infection Control Today. References Infection Control Today. Jan. 9, 2022.

2022-02-HW (Link to Article):  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.

2022-01-HW (Link to Article):  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.


2021-65-HW (Link to Article):  Why the Biden administration needs to take decisive action on COVID-19 | Opinion.
"We are now enduring our fifth wave caused by a new variant "Omicron," having immune escape properties and by some estimates over three times as infectious as the Delta Variant. We can expect continued surges in the future caused by a variety of different variants. Herd immunity and returning to "Normal" is no longer an option. As a country, we need to rally around a transformative plan which will take our country in a new direction. To this end, reenactment of the Coronavirus Task Force along with creation of a National Public Health System would be the first steps to accomplish this imperative. The United States Department of Veterans Affairs' fourth mission of responding to health emergencies in the United States, may be able to serve as a foundation to build a national public health System." References Courier Journal.  Dec. 27, 2021.

2021-64-HW (Link to Article):  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.

2021-63-HW (Link to Article):  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 mas--surgical or N9--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."
References Infection Control Today.  Dec. 20, 2021.

2021-62-HW (Link to Article):  Kentucky's nursing shortage not about supply but retention in tough working conditions.
"I am not surprised that Kentucky is facing a nursing crisis with a projected need of an additional 16,000 nurses by 2024. This is a problem of retention not production of nurses. A problem which has been decades in the making. If we wish to maintain a viable healthcare system, rather than a crippled understaffed delivery system which triages care, we need to slow down the spread of COVID-19. We need to curtail spending COVID-19 relief funds on quasi-related projects and focus on changing our society to live with this endemic virus. This means investing in proper infrastructure including improvements in building ventilation, the provision of high-quality protective gear and the frequent testing for all employees. For me, I religiously follow a no-mask, no tip rule." References Lexington Herald Leader.  Dec. 16, 2021.    

2021-61-HW (Link to Article):  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.   

2021-60-HW (Link to Article):  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.   

2021-59-HW (Link to Article):  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.   

2021-58-HW (Link to Article):  Why we must listen to science and get vaccinated to beat COVID-19 | Opinion.  
"I am not sure why our citizens continue to listen to those who have stated the pandemic was a hoax and medical personnel were diagnosing cases for money. Some of these same leaders also predicted the attainment of herd immunity after each COVID-19 surge.
Many around the world are envious of the COVID-19 resources available in the United States and perplexed why we do not fully utilize them. For the safety of our loved ones, let’s become vaccinated, wear masks and utilize home testing. All of these modalities are inexpensive and readily available."
 References Courier JournalDec. 1, 2021.   

2021-57-HW (Link to Article):  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 TodayNov. 29, 2021.   

2021-56-HW (Link to Article):  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.   

2021-55-HW (Link to Article):  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.   

2021-54-HW (Link to Article):  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 TodayNov. 2, 2021.   

2021-53-HW (Link to Article):  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.   

2021-52-HW (Link to Article):  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 TodayOct. 25, 2021.   

2021-51-HW (Link to Article):  Your ‘right’ not to vaccinate delayed my cancer treatment.  
"Over the past few weeks my writing was placed on hiatus, since I was finally able to obtain needed cancer surgery. The surgery had been previously delayed because a bunch of misguided souls were exercising their 'right' to not become vaccinated. And then exercised their right to receive protracted medical care by filling regional ICU’s and hospitals; denying prompt medical treatment to many with serious illnesses.
And some of those so-called libertarians who advocate freedom from Government actually want to use the Government to shackle the free market by
prohibiting employers from implementing worker and patron safety measures. The era of Authoritarian Libertarianism, justified by pseudoscience, has been
born. In health care, exposing the most vulnerable to a dangerous pathogen is unconscionable. I would state, the health care vaccine mandate has been 100% effective, because it eliminated patient exposure to individuals, who did not care enough about those who have entrusted their lives to them, to become vaccinated."
 References Courier Journal.  Oct. 23, 2021.   

2021-50-HW (Link to Article):  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 TodaySept. 27, 2021.   

2021-49-HW (Link to Article):  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.   

2021-48-HW (Link to Article):  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 TodaySept. 20, 2021.   

2021-47-HW (Link to Article):  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.   

2021-46-HW (Link to Article):  Kentucky's failure to unite against COVID-19 is like 'making a pact with the devil'.  
"Natural immunity does not work well with Ebola and rabies. Those who will point out that Ebola and rabies are animal viruses and are more dangerous because they do not depend upon mankind for survival need to remember SARS-CoV-2 is also an animal virus and has multiple animal hosts. SARS-CoV-2 will not miraculously disappear. In the short term, it is unlikely to become less severe. This virus has gotten meaner with each iteration. It does not need us, so it does not have to play nice.
We need to create the safest school and workplace environments possible. Kentuckians not coming together to fight this virus with all their might is nothing more than making a pact with the devil."
 References Courier Journal.  Sept. 17, 2021.   

2021-45-HW (Link to Article):  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 TodaySept. 10, 2021.   

2021-44-HW (Link to Article):  The only way for us to fight COVID-19 is with a 'layered' approach. Here's what you can do.  
"Vaccines are a vital layer of armor but as a recent Israeli study has illustrated not a COVID-19 cure in themselves. As stated in a previous opinion column, vaccine immunity is starting to wane, necessitating the implementation of added interventions and plans for administering boosters. We must plan to live with the continued waves of this virus by implementing layered approaches, including keeping current with vaccinations and boosters, frequent testing (twice weekly) of all frontline workers and students in schools, wearing high-quality, well-fitted masks, preferably a KN95 or N95 mask, and enacting strategies to combat an airborne virus, including upgrading of indoor sanitization and complete air exchanges. But of utmost importance, we cannot solely be centered on protecting ourselves. We must also protect others in the community and drive down community spread. Remember, we are all members of the same community so protecting others, will also protect ourselves." References Courier Journal.  Sept. 8, 2021.   

2021-43-HW (Link to Article):  Mu Variant Might Escape Immunity from Vaccines, Past Infections.  
"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.   

2021-42-HW (Link to Article):  How the CDC's missteps left Americans vulnerable to COVID-19's delta variant.  
"Unfortunately, the hospitalization of Jesse Jackson, who was fully vaccinated, and the death of former Kentucky legislator Brent Yonts from COVID-19 are not outliers. It is in line with the Israeli data on vaccine effectiveness and is the culmination of a long string of failures by the Centers for Disease Control and Prevention in generating timely data and promptly informing the public regarding the risks of COVID-19.
The continued narrative that breakthrough vaccine infections are uncommon is not true. When they do occur, certain groups are at risk of hospitalizations and deaths. As immunity wanes, we all will enter this category. Thus, we will need to receive a booster. For now, wear a medical grade, KN95, or a well-fitted N95 mask, avoid indoor settings and above all keep current with your COVID-19 vaccinations."
 References Infection Control Today.  Aug. 26, 2021.   

2021-41-HW (Link to Article):  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.   

2021-40-HW (Link to Article):  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.   

2021-39-HW (Link to Article):  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.   

2021-38-HW (Link to Article):  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.   

2021-37-HW (Link to Article):  COVID-19 is ravaging our unprotected children. Opening schools now is dangerous.  
"Currently, we are confronting a variant that is more than twice as infectious as last year’s wild-type virus; it is more deadly and has an increased propensity to infect children. Kentucky’s community spread is extremely high with a test positivity rate of over 10%. To open schools at this time and expect our children to be safe is dangerous cult thinking. Unfortunately, we have done nothing to prepare for continued waves of COVID-19. We have squandered coronavirus funds and just hoped the virus will go away. However, at this point, stopping SARS-CoV-2 will also require a marked change in the way we live, along with a massive infrastructure investment and a sustained commitment to the safety and welfare of others."  References   Courier Jounral.  Aug. 10, 2021.   

 2021-36-HW (Link to Article):  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.   

2021-35-HW (Link to Article):  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.   

2021-34-HW (Link to Article):  The delta variant is the biggest public health threat we have faced. Here's how to beat it.  
"We cannot solely vaccinate our way out of this. We must also implement stringent public health strategies to slow down the spread and mutation of this virus, including universal access to N-95 masks and upgrading building ventilation. In that way, our pharmaceutical development and production can catch up with the emerging variants. The new mRNA vaccines are a medical miracle, and we can develop a new vaccine within weeks. The challenge is in producing and distributing hundreds of millions of doses and placing them into arms. With the VA’s large infrastructure and fourth mission mandate, it is the obvious vehicle to implement a nationwide public health care system."  References   Courier Journal.  Aug. 4, 2021.   

2021-33-HW (Link to Article):  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."  References Infection Control Today Aug. 2, 2021.   

2021-32-HW (Link to Article):  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.   

2021-31-HW (Link to Article):  Viewpoint: CDC Continues to Bungle 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:  https://ci.uky.edu/kentuckyhealthnews/2021/07/26/somerset-doctor-says-spread-strength-of-delta-variant-mean-its-too-late-to-vax-it-or-mask-it-both-needed-in-high-spread-areas/   

2021-30-HW (Link to Article):  Why we need a worldwide perspective about wearing masks, especially when traveling.  
"For many, they appear to be stuck in the stage of denial and anger. And one of the manifestations of this is the anger being displayed on air travel; most confrontations are over the use of masks.
There should be little question that one of the highest risk settings for acquiring COVID-19 are crowded transportation hubs and vehicles, especially where passengers can come in contact with international travelers.  Several countries, such as Australia and Singapore, have practically closed their borders to travelers. As long as the United States’ borders remain relatively open and we are dealing with highly contagious variants, the least we can do is to require travelers to wear masks."
 References Courier Journal.  July 19, 2021.   

2021-29-HW (Link to Article):  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.   

2021-28-HW (Link to Article):  We can't will away COVID-19, and the delta variant is spreading rapidly. Get vaccinated.  
"Watching our nation's Fourth of July celebration one could only conclude that we have decided to will COVID-19 away and ignore its presence. Many do not want to trust science and argue over the validity and meaning of the data, but determining what will happen is actually quite easy. Just look at the United Kingdom. Currently, the U.K. is spiking cases and Boris Johnson predicted there could be 50,000 cases by July 19, Both Gov. Andy Beshear and Sen. Mitch McConnell agree that everyone who can should become vaccinated. And when those two agree on something, one should listen."  References Courier Journal.  July 8, 2021.   

2021-27-HW (Link to Article): 
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.   

2021-26-HW (Link to Article):  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 Outbreak.info, 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.   

2021-25-HW (Link to Article):  With COVID-19 variants lurking, we must prepare for the worst.
"We do not have an available booster for the next variant. One of the problems is that there are several different ones and unlike the flu, last year’s virus did not go away. Comparing the length of protection an infection with SARS or MERS affords is not applicable to COVID-19 with the immune escape variants. The evolutionary success of mutations is dependent upon increasing transmissibility or allowing the virus to escape immunity. SARS-CoV-2 (the virus which causes COVID-19) is doing both. In the case of the United States, we (need to) expand genomic testing of immune escape variants to early on detect community spread, and for all to receive vaccines to the wild type virus to boost their immunity to a level which will prevent disease, hopefully even mild to moderate disease, by the immune escape variants. We have the knowledge to avoid another devastation by this virus. Simply become vaccinated." References Courier Journal.  June 3, 2021.   

2021-24-HW (Link to Article):  Rand Paul's statement about the COVID vaccine can be summed up in one word: Reprehensible.
"The recent statement by Sen. Rand Paul that he does not plan to be vaccinated until more citizens become reinfected with COVID-19 and are “dying in large numbers or being hospitalized or getting very sick” was nothing short of reprehensible. As a leader, he should have the foresight to ward off catastrophes, not react to them after they have already happened. We all should be out of this pandemic by now and returning to a more normal life. Case rates are plummeting in the nation, but only slowly falling in Kentucky. In many respects, the COVID-19 pandemic has ended, and what we are faced with is a massive pandemic of misinformation, being largely ignited by foreign adversaries and whose flames are being fanned by some of our own leaders." References Infection Control Today.  May 25, 2021.   

2021-23-HW (Link to Article):  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.   

2021-22-HW (Link to Article):  Why the COVID-19 6-foot rule isn't enough and how to return to a more normal life.
"The 6-foot rule no longer applies; the virus is airborne. In poorly ventilated buildings, 60 feet is as safe as 6 feet away. These aerosols can be produced by talking, shouting and singing.
We need to reopen the state smartly. As a prerequisite, all public venues should be required to meet safe ventilation standards for airborne contagions. The public needs to embrace vaccinations and we need to be prepared for other waves of new variants. Hopefully, if we can lower the case rate in our state and manage small outbreaks with rapid and effective case tracking, only then will we be able to return to a more normal life."
 References Courier Journal.  May 13, 2021.   

2021-21-HW (Link to Article):  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.   

2021-20-HW (Link to Article):  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.   

2021-19-HW (Link to Article):  COVID-19: Here are the four most common myths and how to keep yourself and others safe.

  • Myth 1: Any type of masks will work. With these highly infectious variants, this is no longer true.

  • Myth 2: You are safe indoors, if you wear a mask plus are 6 feet away from someone.

  • Myth 3: If you survive, you recover and only the old do not survive. Too many do not worry about COVID-19, citing the extremely low chances of them dying of the acute illness.

  • Myth 4: If you are vaccinated you do not need to wear a mask; if you have to wear a mask then vaccines do not work.

During this pandemic we must all weigh the risks and benefits to ourselves regarding public health advice. Almost all activities have risks. But in our decision of how we engage in activities, even those that are necessary such as seeking medical care, we should not place others or our community at an undue risk of acquiring COVID-19. And above all get vaccinated.  References Courier Journal.  Apr. 29, 2021.   

2021-18-HW (Link to Article):  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."
 References Infection Control Today.  Apr. 22, 2021.   

2021-17-HW (Link to Article):  With young people and sports, COVID-19 must be our main opponent.
"With the looming new variants, our society needs to have a paradigm shift in thinking; we must respect the dangers of nature and this ever-evolving natural predator. Businesses need to markedly upgrade ventilation systems; we all need to obtain the vaccine (which is highly effective against the wild-type and current UK variant); and we need to obtain the booster for the “EeK” variants once it is available. Until then we must stop spreading the virus, making it more likely that the more dangerous variants will take hold in our communities and even worse, increases the likelihood a totally vaccine-evading mutation will emerge."References 
Courier Journal.  Apr. 15, 2021.   

2021-16-HW (Link to Article):  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."
References  Infection Control Today.  Apr. 8, 2021.   

2021-15-HW (Link to Article):  What stands in the way of ending COVID-19? Only variants and anti-vaxxers.
"And these roadblocks are highly related. Those who do not become vaccinated, will spread the virus and promote emergence of variants. Ironically, the same group of individuals who are against vaccinations also tend to not want to wear masks. Herd immunity will not protect them since, they tend to meet and clump together which will spread the virus. There is now more than six months of safety data with COVID-19 vaccines and so far, the benefit has been great and severe reactions extremely rare. If you are afraid of the vaccine but for the safety of others receive it anyway, then you are displaying the compassion and bravery that our nation was built upon. We all need to become vaccinated to achieve herd immunity and return our society to a new and better normal."References  Courier Journal. Mar. 25, 2021.   

2021-14-HW (Link to Article):  'We are so close.' Let's not play Russian roulette with our nursing homes and COVID.
"We are so close to stopping this virus from spreading, so let's not play Russian roulette with our grandparents and with others who are at high risk for severe COVID-19 infections. We have already lost over 500,000 souls to COVID-19 and we are on the verge of stopping this pandemic. Let's undertake strict public health strategies for just a few more weeks and allow our race with vaccinations win out over the spread of variants." References Lexington Herald Leader.  Mar. 20, 2021.   

2021-13-HW (Link to Article):  Possible New Variant Causes Outbreak in Highly Vaccinated Nursing Home - Argues Against CMS's New Guidance.
"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 Infection Control Today.  Mar. 19, 2021.   

2021-12-HW (Link to Article):  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 Kentucky.com "85 percent of residents and 48 percent of staff opted to get a coronavirus vaccine." References Infection Control Today.  Mar. 17, 2021.   

2021-11-HW (Link to Article):  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." References Infection Control Today.  Mar. 11, 2021.   

2021-10-HW (Link to Article):  The COVID-19 pandemic has shown the dangers of distorting science for political ends.
"On Feb. 15, 12 prominent scientists, sent a letter to the White House and CDC pointing out that current policies appear to be minimizing the importance of aerosolization and are not providing adequate protection of frontline workers. And we are still following advisements designed for stop-gap measures in an acute crisis, such as resterilization of N95 masks. I am not sure if I am most disturbed by the deficiencies discussed in the letter or that these scientists are now out of the key inner circle, having to resort to sending a letter. We must break this downward spiral in our society by not distorting science for political ends and by giving the truth to the public. Only then will we have the knowledge and willingness to invest the needed resources to address this and future pandemics." References 
Courier Journal.  Mar. 4, 2021  

2021-9-HW (Link to Article):  Schools can be reopened safely amid COVID, but only if we take overdue steps.
"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." References 
Infection Control Today. Mar. 4, 2021.   

2021-8-HW (Link to Article):  Schools can be reopened safely amid COVID, but only if we take overdue steps.
"Political debate is one thing, but spinning science and placing our children at risk is unacceptable. Statements that research shows "schools are safer than the community" or that we should take the "default position of opening schools" are being grossly misinterpreted. "Safer" is not "Safe." It depends upon the rate of community transmission, and "default" means to do something if there is not a reason to otherwise not do it.... Instead, we need to focus on transformation and making the needed investments in our society to effectively eliminate this virus and then to snuff out outbreaks. And this includes schools. Smaller class sizes and healthier buildings are something we should have done long ago, regardless of the COVID-19 pandemic. School-age children have always been known to have an increased risk of transmitting infections from school and all these transmissions are potentially preventable." References 
Courier Journal. Feb. 19, 2021.   

2021-7-HW (Link to Article):  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." References  Infection Control Today. Feb. 15, 2021.   

2021-6-HW (Link to Article):  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.  http://kyhealthnews.blogspot.com/2021/02/as-virus-mutations-pop-up-around-world.html 

2021-5-HW (Link to Article):  Dangerous COVID-19 variants lurk, but there are signs of hope.
"We are fighting not only a deadly virus, but an inability of our nation to unite to confront this deadly adversary, being kept apart by "fake news" and an alternate reality being inflamed by a misplaced trust in false idols. Even more formidable strains of the virus already exist. The P1 in Brazil and the 501Y.V2 in South Africa are even more concerning. They may evade monoclonal antibodies, make the vaccines less effective and cause reinfections. We all need to receive vaccinations when vaccines become available. We now have many months of safety data which should capture the vast majority of adverse events. So far, both vaccines have been found to be effective and very safe, certainly safer than developing COVID-19. Some recall the Tuskegee experiments and are concerned, but this is much different. With this virus, our only choice is to get the vaccine or be an experimental "control." I for one will choose the vaccine." References Courier Journal. Jan. 29, 2021.   

2021-4-HW (Link to Article):  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." References Infection Control Today. Jan. 20, 2021.   

2021-3-HW (Link to Article):  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: https://combatcovid.hhs.gov/  Then click on the "Find Infusion Locations" screen button." References  Infection Control Today. Jan. 17, 2021.   

2021-2-HW (Link to Article):  With the coronavirus mutating and vaccinations behind schedule, here's what we must do now.
 "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." References USA Today. Jan. 9, 2021.   

Courier Journal:  https://www.courier-journal.com/story/opinion/2021/01/08/with-coronavirus-vaccinations-behind-schedule-heres-what-us-must-do/6557584002/  

 Yahoo News:   https://news.yahoo.com/coronavirus-mutating-vaccinations-behind-schedule-120015673.html  

Kaiser Healthcare News Morning Briefing:  https://khn.org/morning-breakout/viewpoints-bring-back-science-trump-took-away-from-advisory-committees-create-a-real-vaccination-plan/ 

2021-1-HW (Link to Article):  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." References Infection Control Today. Jan. 4, 2021.   


2020-51-HW (Link to Article):  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." References Infection Control Today. Dec. 22, 2020.   

2020-50-HW (Link to Article):  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.   

2020-49-HW (Link to Article):  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."  References  Infection Control Today. Dec. 10, 2020.   

2020-48-HW (Link to Article):  In Battling COVID-19, Government Needs to Engage, Not Fight With Religious Communities.
"Public health strategists should realize these rulings set a template for a unified national strategy that is not perverted by economic or political interests. New York City, the genesis of the Supreme Court Case, closed schools and allowed bars and restaurants to remain open, which made little sense. And many in Kentucky question the wisdom of closing schools with sporting events remaining open. All of this is creating unnecessary public confusion, eroding faith in our public health institutions and most importantly ineffectively controlling the spread of COVID-19."  References  Courier Journal. Dec. 4, 2020.   

2020-47-HW (Link to Article):  We can see a light at the end of the COVID tunnel, but we still have to be diligent.
"We can now see a light at the end of the tunnel but let's not brick up the end. We must slow down the transmission of this virus, so nature's lab does not outpace our pharmaceutical giants. If a safe and effective vaccine is available, please take the vaccine and encourage others to receive it. And wear a mask along with social distancing." References  Lexington Herald Leader. Nov. 20, 2020.   

2020-46-HW (Link to Article):  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."  References  Infection Control Today. Nov. 15, 2020.   

2020-45-HW (Link to Article):  Distortion of Science to Inhibit the Adoption of Infectious Disease Strategies.
"Distortion of science for political and economic ends has prevented the allocation of needed resources to stop the spread of dangerous pathogens. This places all of society as a whole at risk, but exacting an insufferable toll of death and disability on our front-line healthcare workers, along with our most vulnerable populations. COVID-19 has demonstrated how dangerous this scenario has become.
Whether one deals with MRSA or COVID-19, screening and decolonization or self-isolation of healthcare workers is of utmost importance. Their health, the health of their families along with their patients depend upon it." 
References Biomed Central. Nov. 13, 2020.   

2020-44-HW (Link to Article):  Will the COVID-19 Pandemic Transform Health Care ?
"Many lessons have been learned from COVID-19. We have learned that case definitions can be rapidly created and a reporting system which comprises all types of healthcare facilities can be implemented. The same needs to be done for other dangerous pathogens, including the CDC's Urgent and Serious Threats, and strategies need to be standardized across all types of facilities. SARS-CoV-2 does not vary its lethality or infectivity based upon the facility type or region of the country." References Biomed Central. Nov. 11, 2020. 

2020-43-HW (Link to Article):  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." References Infection Control Today.  Nov. 6, 2020. 

2020-42-HW (Link to Article):  To successfully deal with COVID-19, we need to transform our way of life 
"It is imperative that we need to take our head out of the sand and unite as a nation. Successfully dealing and living with viruses is the new norm. We need to adapt and need to invest in our infrastructure and transform our society. New Zealand, Australia, Taiwan, China and South Korea have done this, so can the United States."  References  Courier Journal. Nov. 5, 2020. 

2020-41-HW (Link to Article):  FDA Panel Reviews Many Challenges Facing a COVID Vaccine
"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." References  Infection Control Today.  October 25, 2020. 

2020-40-HW (Link to Article):  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." References
Infection Control Today. October 15, 2020.   

2020-39-HW (Link to Article):  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. October, 2020.

2020-38-HW (Link to Article):  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.   Oct. 8, 2020 Article Update

2020-37-HW (Link to Article):  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.  

2020-36-HW (Link to Article):  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. 15, 2020.  

2020-35-HW (Link to Article):  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.  

2020-34-HW (Link to Article):  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." Infection Control Today. Sept. 7, 2020.  

2020-33-HW (Link to Article):  Our nation needs to learn how to live safely with the coronavirus.
As our society continues to live in a way that defies public health logic, one can only conclude the infectivity and lethality of this virus is being severely underappreciated by our leaders. An underappreciation exemplified by Kentucky Sen. Rand Paul's recent push for a policy of opening all schools and having only those at risk wear masks.  We need to approach this pandemic not with third-world nation strategies but by expanding rapid testing and case identification, along with transforming our infrastructure and society to allow us to safely live with this virus.  References Courier Journal.  Aug. 26, 2020.  

2020-32-HW (Link to Article):  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.  

2020-31-HW (Link to Article):  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.  

2020-30-HW (Link to Article):  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.  

2020-29-HW (Link to Article):  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 frequency of an outbreak should not be used to deter a policy that an outbreak of a dangerous contagious pathogen should be publicly reported in real time. The nursing home reporting policies for COVID-19 need to be adopted systemwide for all dangerous pathogens and our infrastructure permanently enhanced."  Infection Control Today. July 20, 2020.  

2020-28-HW (Link to Article):  On COVID-19, the U.S. is turning into a dangerous cult of bad information.
"Some of us formed into online cliques and developed a Jonestown cult mentality in our approach to American life. Added to the toxic mix, foreign agitation placed us on the precipice of one of the greatest ordeals which our society may endure, COVID-19. A study from Carnegie Mellon University found almost half the tweets regarding the coronavirus are likely bots with a playbook similar to Chinese and Russian disinformation campaigns. Reuters reported similar findings, describing a European Union document which concluded Russia implemented an online misinformation campaign, in multiple languages, which was making the EU's response to the epidemic difficult." References Lexington Hearld Leader. July 8, 2020.  

2020-27-HW (Link to Article):  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.  

2020-26-HW (Link to Article):  If we don't come together as a nation, the coronavirus will win the battle
"Currently, society is struggling on two fronts, both for social justice and at the same time to control a raging epidemic. The epidemic of COVID-19 may be with us for a long time. And those who try to minimize it are doing so by placing front-line workers and economically disadvantaged populations at risk.  We are opening our economy, but we need to do so safely, and we need to learn to live with this virus. That means wearing masks in public and in stores, social distancing and protecting, not fighting others.  While we fight for social justice, it is imperative that at the same time we need to slow the spread of this virus, so our technology and vaccine development can catch up." References
Courier Journal. June 16, 2020.  

2020-25-HW (Link to Article):  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.  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 6, 2020.  

2020-24-HW (Link to Article):  Reopening After COVID-19 Needs to be Done Carefully (Interview).
"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.  

2020-23-HW (Link to Article):  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. 

2020-22-HW (Link to Article):  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. 

2020-21-HW (Link to Article):  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.  Infection Control Today. May 6, 2020. 

2020-20-HW (Link to Article):  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. 

2020-19-HW (Link to Article):  Healthcare system's basic infrastructure left it unprepared for COVID-19. 
"Hospitals are receiving massive bailouts based upon their Medicare billings. However, this will primarily shunt money to large healthcare systems as opposed to frontline hospitals. Similar, to everyday citizens' stimulus checks, hospital bailouts should be based upon need. Non-profits with high net assets should not receive as much funds as frontline hospitals with negative assets. If for-profit facilities or private equity firms receive a bailout, it should be paid back with interest or the Government should acquire an equity position in the company. And all of this should be predicated on not furloughing workers." References  Lexington Herald Leader. April 27, 2020.  

2020-18-HW (Link to Article):  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.17 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 17, 2020. 

2020-17-HW (Link to Article):  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." Infection Control Today. April 15, 2020. 

2020-16-HW (Link to Article):  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." References Infection Control Today. April 7, 2020.   Med Page Today.  April 20, 2020.  Hospital Financial Filings    Related Radio Segment     

2020-15-HW (Link to Article):  Viewpoint: What To Do About ACE Inhibitors During COVID-19 Pandemic 
"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.      

2020-14-HW (Link to Article):  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.      

2020-13-HW (Link to Article):  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.      

2020-12-HW (Link to Article):  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.      

2020-11-HW (Link to Article):  The United States has squandered resources it needs to fight coronavirus
"The United States is on the verge of being ravaged by an invader which we have far too little resources to confront. New estimates from the United Kingdom are predicting 2.2 million deaths in the United States from an unmitigated coronavirus (COVID-19) epidemic.  In Italy, there are reports of those over 80 not being placed on ventilators. In addition, critical care survivors, including the young, may well develop pulmonary fibrosis, a disabling chronic lung disease." References Lexington Herald Leader.   Mar. 24, 2020 (Online).

2020-10-HW (Link to Article):  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).

2020-09-HW (Link to Article):  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).

2020-08-HW (Link to Article):  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).  

2020-07-HW (Link to Article):  Viewpoint: 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).

2020-06-HW (Link to Article):  The Untimely Reporting of Drug-Resistant Outbreaks in the United States.   Over the course of the last few decades, the United States has fallen into the dark abyss of secrecy: if truth is inconvenient, just cover it up and don't disclose it. The United States needs to implement mandatory real-time public reporting of the CDC's dangerous biological threats. References  The Center For Disease Dynamics, Economics & Policy.   Mar. 3, 2020 (Online).

2020-05-HW (Link to Article):  Coronavirus is the biggest challenge our healthcare system has faced. Is Kentucky prepared?"In January, I concluded an OpEd with an alarmist statement: 'The epidemic of antibiotic resistant organisms may be the final solution to global warming.'  We are currently on the precipice of a massive pandemic from the coronavirus (COVID-19). Initial data from China has documented massive economic disruption with a 25 percent drop in carbon emissions.  A sobering observation, but of even more concern when one considers the United States does not have the authoritarian structure and a culture of population control which exists in the Chinese government. According to the CDC, the unknown is when, not if, the epidemic will hit the United States and "severe disruption" of everyday life may occur.  Lexington Herald Leader.   Feb. 27, 2020 (Online).

2020-04-HW (Link to Article):  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.

2020-03-HW (Link to Article):  As a doctor, I put patient well-being above my personal feelings. Don't pass SB 90.  
"Medicine is difficult and diverse, and we are destined to encounter conflicts in the management of some patients. We may have strong feelings about them, but we try our best to help because we are doctors and we don't turn away. Kentucky Senate Bill 90 deserves a swift and merciful death." References Lexington Herald Leader.  Feb. 25, 2020 (Online).   

2020-02-HW (Link to Article): A Conversation With Kevin Kavanagh, MD: Infection Preventionists Are Underutilized and Underappreciated (Expanded and Updated). 
"At 100% compliance, recent research looking at glove and gown acquisitions of methicillin-resistant Staphylococcus aureus (MRSA) indicates that gloves alone stop almost two-thirds of MRSA acquisitions, making hand hygiene a cornerstone of infection control. However, two-thirds control may not be adequate to prevent spread, and in the case of drug-resistant dangerous pathogens, hand hygiene should be viewed as a backup measure, since these pathogens should not be on a healthcare worker's hands in the first place." Infection Control Today.   Jan. 21, 2020.

2020-1-HW (Link to Article): Amid disgrace of U.S. nursing homes lurks epidemic of drug-resistant bacteria. 
"A recent study in California found that over 50 percent of nursing home residents harbor dangerous antibiotic resistant bacteria. Unfortunately, there are few regulations which safeguard the health and well-being of either the facility's residents or the nursing home's staff. It needs to be remembered that these resistant bacteria do not care about policy and politics, they are out to win. And unless we decisively act, the prophetic tragedy predicted by several commentators in a La Times OpEd may come true. The epidemic of antibiotic resistant organisms may be the final solution to global warming."  Lexington Herald Leader.   Jan. 16, 2020.


2019-10-HW (Link to Article): A Conversation With Kevin Kavanagh, MD: Infection Preventionists Are Underutilized and Underappreciated.
"The CDC estimates (at a minimum) that 35,000 individuals die each year from resistant organisms with another 12,800 patients dying from C. difficile. This does not count the long-term disability many of the survivors will endure. The United Kingdom's Wellcome Trust report estimated that by 2050 antibiotic resistance will have a cumulative cost to the world of $100 trillion dollars and 10 million lives will be lost each year."  Infection Control Today.   Dec. 15, 2019.

2019-9-HW (Link to Article): Healthcare may not be a right but it is a necessity for society.
"Almost everyone is worried about healthcare. Kentuckians are pushing for reforms on a state level, but state administrations have limited ability to transform our system, since so much of the framework is mandated and fixed in stone by either federal law or federal dollars. Thus, lets promote a healthy Kentucky. If universal healthcare is not a right, it is a necessity, not just for the individual but for Kentucky's society as a whole."  Lexington Herald Leader.  Nov. 15, 2019.

2019-8-HW (Link to Article): Data for Action, Not Complacency, is Needed to Stop Dangerous Pathogens. 
"Economic and political forces in the United States are impeding the adoption of these important infection control tenets. But, as the toll of drug resistance on American citizens mounts, denials will become harder to make, and political policy may well merge with science. Hopefully, not too late..."   The Center For Disease Dynamics, Economics & Policy  July 22, 2019.

2019-7-HW (Link to Article): From plague to parrot fever, history shows inequity of medical care. Don�t let it continue.  In the 1980s many of us witnessed the near lack of concern and urgency in the AIDs epidemic because it was initially perceived that it affected only a small minority group whom many disliked and who were easy to discriminate against.  Lexington Herald Leader July 8, 2019.

2019-6-HW (Link to Article): The changing narrative of MRSA infection control in the United States. 
But of utmost importance, we need to protect our healthcare workers who may well be acting as reservoirs to spread these pathogens to patients and their familiesBiomed Central.  June 19, 2019.

2019-5-HW (Link to Article): Collective ignorance and government timidity are public health threats. 
I am a firm believer that we must learn from history or be doomed to repeat it. Unfortunately, the United States and many other nations appear not to have learned this lesson with regard to public health and are heading down a dangerous path.  Los Angeles Times.  May 16, 2019.

Kaiser Healthcare News

2019-4-HW (Link to Letter): Bevin's misery for his nine children is not necessarily over. 
They are now at risk for shingles in later life. Shingles results from reactivation of the chickenpox virus. The misery can last from weeks to even years in people who develop complications.  Lexington Herald Leader.  Publication Online Mar. 29, 2019.

2019-3-HW (Link to Article):  News on hospital infections in Kentucky, nationally is not good. What needs to change?
"Instead of mathematically massaging the numbers lets institute additional interventions which other institutions have used successfully."  Lexington Herald Leader.  Publication Online Mar. 8, 2019.

2019-2-HW (Link to Article):  Patients now have more information about hospital prices, but will need patience to sort it out
"Posting of the hospital's sticker prices in an accessible understandable format is a social responsibility that all hospitals should willingly undertake."  Lexington Herald Leader.  Publication Online Feb. 25, 2019.

2019-1-HW (Link to Article):  Arguments for medical review panels unjustified
"We the people -- we the patients -- deserve health policy shaped by facts, not rhetoric reflecting fears and fantasies. Let's work together to solve real problems within health care in Kentucky. Melissa Clarkson is a member of Health Watch USAsm and an assistant professor of biomedical informatics at the University of Kentucky."  Lexington Herald Leader.  Publication Online Jan. 4, 2019.   Print Jan. 7, 2019.


2018-5-HW (Link to Article):  Patients have few remedies for spiraling health-care costs, but here are a few tips.  
"It is fair to say that all of us have had experience with skyrocketing health-care costs and are astonished that this situation is allowed to continue. Policymakers seem to have an insurmountable inertia. The conclusion: the United States spends almost twice as much on health-care than other developed nations but has similar health-care utilization. Although, commonly blamed, this is not the patient's fault."  Lexington Herald Leader.  Publication Online Nov. 27, 2018.   Print Dec. 3, 2018.

2018-4-HW (Link to Article):  Politics is Protecting Pathogens, Not Patients.  
"The current United States government is still relying on the widely held misconception that the health-care industry is in a competitive market and will improve its quality because of market pressures.  At the same time, access to health-care quality information -- essential to consumers' choice -- is under attack."  Lexington Herald Leader.  Sept. 21, 2018.  

KY Hospital Rankings2018-3-HW (Link to Article):  How to choose a hospital (spoiler: it's not getting any easier).  
"Even in Kentucky's leading hospitals, infections rates are alarming, which makes it even harder for patients to be smart consumers."  Lexington Herald Leader.  June. 1, 2018.  

2018-2-HW (Link to Article):  'Roseanne' reflects how much opioid use is now engrained.  
"I know from studying the science and personal experience that prescription narcotics are not an effective treatment for chronic pain.  Yet, narcotic usage has become rampant and even trivialized as a laugh line on the "Roseanne" reboot .."  Lexington Herald Leader.  April. 13, 2018.

2018-1-HW (Link to Article):  Survival tips in the age of drug-resistant bacteria.  
"There is a war going on, reminiscent of a zombie apocalypse. The insidious agent is spread easily between people, a bite is not required. It does not turn its captors into mindless killing drones but instead, when they least expect it, they are slowly eaten from the inside out. The apocalypse is called drug-resistant bacteria and, so far, modern medicine is failing miserably at stopping it."  Lexington Herald Leader.  Dec. 29, 2017. (Print Publication: Jan. 13, 2018)


2017-5-HW (Link to Article):   Kentucky doctor says Medicare-style plan could curb costs, empower consumers (Print Title:  "The fix: Revive competition to cut health costs").  
"The answer to healthcare reform is simple, you must lower health care costs. Either instill true provider competition or give more power to the purchasers with a variation of a single-payer system. In our present political climate, a pragmatic solution may be Medicare-Advantage-For-All."  Lexington Herald Leader.  Oct. 20, 2017.

2017-4-HW (Link to Article):   Shoddy research, deadly results.  
"(The problem of Conflicts of interest) is of paramount importance. Research is the foundation for treatment protocols and health policy. A murky fog has descended over what works and what does not."  Lexington Herald Leader.  July. 30, 2017.    

2017-3-HW (Link to Article):   The incidence of MRSA infections in the United States: is a more comprehensive tracking system needed?  
"If MRSA is being spread by the hands of healthcare workers, then their hands must at one time have become contaminated with MRSA and there must have been a failure of containment and control, which should be viewed as our frontline intervention. "  BioMed Central.  On Health.  Mar. 10, 2017.    

2017-2-HW (Link to Article):   Hospitals, doctors must come clean when patients are harmed.  
"There is room for improvement in patient safety in every facility, even in higher-functioning ones. As stated by Jim Conway, past senior vice president of Institute for Healthcare Improvement, 'In the gap between excellence and perfection, there is suffering, harm, tragedy and death.' " References  Lexington Herald Leader.  Mar. 5, 2017.    

2017-1-HW (Link to Article):   Choosing a hospital? Read this first.  So how did the hospitals do? In the Lexington region, they overall have improved. References Lexington Herald Leader.  Feb. 2, 2017.

Coverage by Kentucky Health News  http://kyhealthnews.blogspot.com/2017/02/comparing-rankings-that-compare-ky.html


2016-4-HW (Link to Article):   Drug industry's quest for profits yields superbugs.  
The next bailout: Big Pharma  now asking for tax dollars to fund new antibiotics. References Lexington Herald Leader.  Sep. 24, 2016.  

2016-3-HW (Link to Article):    US Health Reform Now Needs Reforming  
We spent $24,691 for each family on healthcare--almost half of the average family income of $54,000.  References  Lexington Herald Leader.  Aug. 20, 2016.  

2016-2-HW (Link to Article):    Non-profit hospitals an oxymoron (Healthcare Rendition)  
Kentucky Hospital Charges and Those In the Nation are Far Too High.  References  Lexington Herald Leader.  May 20, 2016.  

2016-1-HW (Link to Article):    Buyer beware: no return, redo in hospital care  
Kentucky Hospital Rankings by Major Hospital Ranking Organizations, Including CMS (Medicare) References  Lexington Herald Leader.  Jan. 16, 2016.   
Download Expanded Ranking Table       


2015-6-HW (Link to Article):    Needed: Greater Surveillance, New Norms in the Fight Against Antibiotic Resistance 
The 21st Century Cures Act needs to assure effective antibiotic stewardship and Antibiotic Resistant Organism Surveillance  Center for Disease Dynamics, Economics and Policy.  Oct. 8, 2015.     

2015-5-HW (Link to Article):    Without more monitoring, medical devices will keep harming patients 
We all need to encourage Congress to amend the 21st Century Cures Act to assure effective pre-market testing and post-market monitoring of medical devices.  Lexington Herald Leader.  Aug. 14, 2015.     

2015-4-HW (Link to Article):  hospitals should act as Ky. falls on key infection ranking.
One of the most prevalent superbugs is MRSA which causes the deadly staph infection. Until recently, Kentucky had one of the highest rates of staph bloodstream infections in the nation. New data from the Centers for Disease Control's National Healthcare Safety Network show that our MRSA bloodstream infection rate has worsened; Kentucky is now dead last among the 50 states in controlling this deadly disease.  Lexington Herald Leader.  June 18, 2015.     

2015-3-HW (Link to Article):  Single-payer health care may emerge as best option.
Returning to a free-market system will be more difficult than just saying "repeal Obamacare." Six difficult changes would have to be made to create a free market.  Lexington Herald Leader.  May 16, 2015.     

2015-2-HW (Link to Article):  Health-care non-profits may not be what they seem.
Profits soar Yet cost is the often repeated excuse for not doing more to control infections.  Lexington Herald Leader.  Mar. 27, 2015.     

2015-1-HW (Link to Article):  Legislative panel must support more hospital reporting of infection outbreaks
Lexington Herald Leader.  Jan. 13, 2015.    


2014-7-HW (Link to Article):  How Ebola reveals scary gaps in U.S. health care
Lexington Herald Leader.  Oct. 12, 2014.
  

2014-6-HW (Link to Article):  Beshear moving to protect Kentuckians from health-care associated infections
Lexington Herald Leader.  Sept. 15, 2014.   

Kentucky Hospital Rankings

2014-5-HW (Link to Article):  Use Hospital Rankings to Help Stay Out of Harm's Way
Lexington Herald Leader.  Aug. 10, 2014.    Download Complete Expanded Table

2014-4-HW (Link to Article):  VA lesson: defend and deny bad health policy.  
References  Lexington Herald Leader.  Jun. 22, 2014.   More on Full Disclosure - Steve Kraman

2014-3-HW (Link to Article):  Overuse of antibiotics aids attacks of deadly bacteria.  
Lexington Herald Leader.  Mar. 13, 2014.

Healthcare Paradox2014-2-HW (Link to Article):  Book Review - The American Health Paradox.  
Louisville Courier Journal.  Mar. 13, 2014.

2014-1-HW (Link to Article):  Mandate reporting of Ky. health-care related infections.  
Lexington Herald Leader.  Mar. 13, 2014.


2013-8-HW (Link to Article):  Surcharge on smokers under Ky. health reform is unfair, shortsighted.  
Lexington Herald Leader.  Sep. 5, 2013.

Pricing smokers out of health care is bad policy. Lexington Herald Leader Editorial Board:  Kentucky's 40 percent surcharge is short-term gain for long-term pain  Sep. 8, 2013. http://www.kentucky.com/opinion/editorials/article44443032.html   

State health-insurance exchange plans to make smokers pay 40 percent more for coverage; varied interests object...   Burchett M.  The Lazer.  Sep. 9, 2013.
 http://www.thelevisalazer.com/news/local-news/8110-many-smokers-could-not-afford-health-insurance-at-all-

2013-7-HW (Link to Article):  Disclosure key to curbing medical errors; UK board should demand it.  
UK board responsible for hospital safety.  Lexington Herald Leader.  Aug 11, 2013. 

2013-6-HW (Link to Article):   Better monitoring needed in a post-antibiotic era.  Lexington Herald Leader.  July 11, 2013.  The case is made for public reporting of Healthcare Associated Infections and for Engagement of the Health Department.

2013-5-HW (Link to Article):   Tough Diagnosis: Hospital Rankings.  Lexington Herald Leader.  May 12, 2013.  An Op-Ed which describes the various hospital rating systems and give Kentucky Hospital Ratings.  Download PDF of how Kentucky Hospitals do on these rating systems. 

2013-4-HW (Link to Article):  Costs soar when doctors work for hospitals.  Lexington Herald Leader.  April 22, 2013.  The case is made to reduce hospital facility fees.  View Op Ed      View Op-Ed References   

See Shortened Version of the Published in Op-Ed in US News & World Report  
View Op Ed

2013-3-HW (Link to Article):  'Book Review - Bad Pharma'  Courier Journal, Louisville, Ky.   Feb 23, 2013.   Details of Drug Company Tactics.    
View Book Review References

    

2013-2-HW (Link to Article):   More scrutiny on spread of infections; health care industry resists surveillance.  Lexington Herald Leader.  Feb. 11, 2013.   Healthcare Industry Resists Surveillance.   View Op-Ed References

2013-1-HW (Link to Article):  Hospital Facility Fees Raise Out-of-Pocket Costs for Medicare Patients.  US News & World Report.  Jan 11, 2013.  The case is made to reduce hospital facility fees.  View Op Ed    View Op-Ed References  

Opposing Op-Ed from American Hospital Association:  View Op-Ed 


2012-11-HW (Link to Article)  Consumers must scrutinize details of hospital rankings.  Herald Leader Lexington, Ky,  Nov. 7, 2012.  The Quality Measures used in different hospital ranking systems.   View Op-Ed References   

2012-10-HW (Link to Article)  The Changing Role of the Physician.  American College of Surgeons Surgical News,  Oct. 23, 2012.   Changing healthcare governance, fiduciary responsibility and the driving forces behind integration.   View Op-Ed References 

2012-9- HW (Link to Article)  Assessing Changes in Reform.   Courier Journal,  Aug 27, 2012.   Healthcare Consolidation, Integration and Oligopolies are increasing healthcare costs.     View Op-Ed References   View Op-Ed Text

Rooted in the Mountains, Reaching to the World2012-8- HW (Link to Article)  'Book Review:  Rooted in the Mountains, Reaching to the World'.   Courier Journal,  Aug 17, 2012.   The book is more about adventures involving horses shod with ice nails and the forging of swollen streams; about the power and courage of humanity to overcome obstacles, to instill hope.  

Appalachian Health and Well-Being2012-7- HW (Link to Article)  'Book Review:  Appalachian Health and Well-Being'.   Courier Journal,  July 14, 2012.   Healthy living challenge for Appalachia.  
  

2012-6-HW (Link to Article)  'Patients dissatisfied with unnecessary, expensive care'.  Herald Leader, Lexington, Ky,  June 25, 2012.  There is a wide variation in the recommended medical care which is received by patients.    View Op-Ed References

My Father 2012-5-HW (Link to Article)    'Book Review:  My Father'.   Courier Journal, Louisville,   Jun. 16, 2012.  "One of the most disturbing chapters details the legislative hearings and ill-motivated national politics that have prevented an effective national response, spurring the birth of the consumer advocacy movement to combat hospital-acquired infections."  
 

Battle Over Healthcare2012-4-HW (Link to Article)   'Book Review:  The Battle Over Healthcare'.   Courier Journal, Louisville,   May. 19, 2012.    As stated by the Chinese philosopher Lao Tzu, �If you do not change direction, you may end up where you are heading.� Unless we change, we are headed for a health care system that few can afford and few will want.

2012-3-HW (Link to Article)  'A tale of two cows: Why we have a cow map and not a healthcare acquired infection map.   Center for Disease Dynamics, Economics and Policy,   Mar. 13, 2012.  A parody comparing the availability of data between agriculture and healthcare.  View Op-Ed References

Coverage by William Heisel's Antidote: Spotting MRSA & Other Superbugs

Coverage by William Heisel's Antidote: Better Definitions and Better Data

2012-2-HW (Link to Article)  'More doctors controlled by hospitals mean restricted care.   Herald Leader, Lexington, KY,   Mar. 1, 2012.  Healthcare Integration, Medicare Expenditures and the Shrinking Role of Physicians in Healthcare.  View Op-Ed References

See Letter to Editor by Cameron S. Schaeffer, M.D.    http://www.kentucky.com/2012/03/16/2112586/letters-to-editor-march-16.html

2012-1-HW (Link to Article)  'Hospital Infections are Underreported.  Courier Journal, Louisville, KY,  Jan. 31, 2012.  The case is made for Public Reporting and Full Disclosure of Adverse Events and Not to Charge Patients for These Events.   View Op-Ed References   Link to Article Text



2011-9-HW (Link to Article)  'Don't Tell' Culture a Plague Health Care.  Herald Leader, Lexington, KY,  Dec. 5, 2011.  The case is made for Full Disclosure of Medical Errors.   View Op-Ed References

2011-8-HW (Link to Article)  One in Seven Hospitalizations Results in Harm:  Hospital performance tied to Board Engagement.  Medical News,  Nov. 2011.  View Op-Ed References

2011-7-HW (Link to Article)   Outpatient Antibiotic Utilization Highest in West Virginia and Kentucky  The Center for Disease Dynamics, Economics & Policy.  Washington, DC,  Nov. 17, 2011.  Quoted by Charleston Daily Mail 

2011-6-HW (Link to Article)   Investigate staffing, infection rates at UK hospital  Herald Leader.  Lexington, KY,  Sep. 4, 2011.   

2011-5-HW (Link to Article)   Public, patients have right to know hospitals' infection rates  Herald leader. Lexington, KY,   July 11, 2011.   The case is presented for patients right to know hospital infection rates.

2011-4-HW (Link to Article Text)   Tracking of Hospital Acquired Infections   Courier Journal, Louisville, KY,  Apr. 20, 2011   Norton Healthcare System's Award from the NQF is Outstanding.  Other Kentucky hospitals should follow its example.   Link to Archived Abstract    Link to Article Text

2011-3-HW (Link to Article)  UK Wrong To Downplay Loss of Nursing Honor  Herald Leader, Lexington, KY,  Mar. 21, 2011   It is important for hospitals to achieve the Magnet Recognition and to participate in the Leapfrog Group Survey.

2011-2-HW (Link to Article Text)  Revising Health Care Reform  Courier Journal, Louisville, KY,  Jan. 21, 2011   The healthcare system still has significant problems with increasing insurance premiums.   
 View Op-Ed References    Link to Archived Abstract
  Link to Article Text

2011-1-HW (Link to Article)  State Reporting on Hospital Infections - Lax, Dangerous    Lexington Herald Leader, Lexington, KY, Jan. 21, 2011   As other states are issuing infection reports to the public.  Kentuckians are endangered by the lack of reporting and inhibited health department oversight.  View Op-Ed References



2010-5-HW (Link to Article Text)  Health Care Strom Brewing   Courier Journal, Louisville, KY,  Dec. 8, 2010   The healthcare system is still in crisis, checks and balances on quality and costs have been weakened.  
View Op-Ed References     Link to Archived Abstract    Link to Article Text

2010-4-HW (PDF)  Hospital Acquired Infections Reporting and Kentucky's HAI Health Plan    Lexington Herald Leader, Lexington, KY,  July. 25, 2010   The State of Kentucky Needs to require hospitals to report all Hospital Acquired Infections.  

2010-3-HW (Link to Article)  Kentucky Should Award CONs so All Hospital Systems in The State Benefit, Not Just One  Medical News - The Business of Healthcare, Louisville, KY,  March. 12, 2010  The certificate of need should be abolished or placed up for bid so all facilities can benefit.

2010-2- HW (Link to Article Text)  Fight Hospital-Acquired Infections  Courier Journal, Louisville, KY,  Jan. 12, 2010   The healthcare industry can and needs to do more to prevent healthcare acquired infections.   
Link to Archived Abstract    Link to Article Text

2010-1-HW (PDF)  Poor Way to Decide Who Gets Hospitals   Lexington Herald Leader, Lexington, KY,  Jan. 11, 2010   The Certificate of Need is adversely affecting the health of residents of Jessamine County and is running up healthcare costs.   



2009-3-HW (PDF)  Keep Public Reporting in Reform Plan - Lexington Herald Leader, Lexington, KY,  Oct. 4, 2009   Public reporting of healthcare acquired infections is now supported by major national medical organizations.

2009-2-HW (PDF)   Stop Hospital Borne Infections  Courier Journal, Louisville, KY, July 9, 2009   Public reporting of healthcare acquired infections is now in the process of implementation in 27 states.    View CJ Editor's Comment on HAI

2009-1-HW (PDF) Kentucky's Certificate of Need Process Needs Overhauling- Courier Journal, Louisville, KY, January 5 2009  Kentucky's CON process for acute care facilities is frozen with decronian regulations making it impossible to build additional facilities.  The State not petitioners, should decide where CONs are needed; they should place them nationally up for bid. 



2008-3-HW (PDF) Hospitals Reckless to Leave Floors Short of Nurses- Lexington Herald Leader, Lexington Kentucky, May 28, 2008  Low levels of hospital staff has been reported by nurses and lack of facility cleanliness and responsiveness by patients.  Medicare is no longer paying for preventable adverse patient outcomes, Medicaid should follow suit.

2008-2-HW (PDF) The Case for Surveillance for MRSA - Lexington Herald Leader, Lexington Kentucky, March 21, 2008  One could argue that Medicare patient admissions in the State of Kentucky would develop 2,500 hospital acquired infections and at risk of losing between $80,000,000 to $131,000,000 in revenue.

2008-1-HW (PDF) Mandatory Reporting of MRSA and HAIs - Lexington Herald Leader, Lexington Kentucky, Feb. 4, 2008  HAIs are more common than any other reportable disease and deaths exceed several of the causes listed in the top 10 causes of death in the US vital statistics.



2007-7-HW (PDF) Health Care Crisis Unites Disparate Groups, Interests - Lexington Herald Leader, Lexington Kentucky, Oct. 15, 2007  Problems in Kentucky's health care system are discussed in a statewide conference.

2007-6-HW (PDF) Too Much to Expect From Too Few Nurses - Lexington Herald Leader, Lexington Kentucky, April 16, 2007  Frontline Caregivers get little support in protecting patients.

2007-5-HW (PDF) The CON Steals Jessamine's Health Care Access - Jessamine Journal, Nicholasville Kentucky, April 12, 2007  As long as hospitals exist in Lexington, the CON is preventing Jessamine County from building a hospital.

2007-4-HW (PDF) The Fletcher Administration & Oakwood, a Sordid Affair - Lexington Herald Leader, Lexington Kentucky, Feb 26, 2007  Reason for outrage, scrutiny -- Fletcher aides, donors hurt Oakwood, State.

2007-4-BG (PDF) CON Law Shrinks Health-Cares Iron Triangle - Bluegrass Institute, Kentucky, Jan 8, 2007 The CON fails to lower prices or improve quality or access.

2007-3-HW (PDF)  Give Public Info About Health Care Facilities - Lexington Herald Leader, Lexington Kentucky Jan 29, 2007 A call to increase the transparency of health care quality.

2007-2-HW (PDF)  Medical Tourism or Creative Destruction - Courier Journal Online, Jan 18, 2007 Foreign countries are competing and trying to attract patients from the United States.

2007-1-BG (PDF)  Prognosis for Ailing Health Care System Will Improve Only With Competition, Transparency - Bluegrass Institute, Kentucky, Jan 8, 2007  The high cost and low quality of the United States healthcare system

2007-1-HW (PDF)  Quality Not Rising With Cost of Health Care - Herald Leader, Lexington KY, Jan 2, 2007  The high cost and low quality of the US healthcare system



2006-8-HW (PDF)  Certificate of Need Unneeded - Herald Leader, Lexington KY, November 13, 2006  

2006-45-BG (PDF)  Eliminate CON, Embrace Competition - Bluegrass Institute, Kentucky, OCT 23, 2006

2006-7-HW (PDF) State Blocking Medical Competition - Herald Leader, Lexington KY, July 31, 2006

2006-6-HW (PDF)  Health Care in Crisis: What is Wrong With Frankfort? - Jessamine Journal, Nicholasville KY July 27, 2006

2006-5-HW (PDF)  Frankfort Didn't Tell Whole Story on CON Details - Commonwealth Journal, Somerset KY July 5, 2006

2006-4-HW (PDF) Certificate of Monopoly - Courier Journal, Louisville KY, June 22, 2006

2006-3-HW (PDF)  Second Hospital Now Out of Reach ? - Commonwealth Journal, Somerset KY, April 26, 2006

2006-2-HW (PDF)  Nursing Shortage Argument Doesn't Hold Water - Commonwealth Journal, Somerset KY, January 8, 2006

2006-1-HW (PDF)  Kentucky's New Healthcare Plan - Courier Journal, Louisville KY January 3, 2006



2005-3-HW (PDF)  Let Consumer Demand Ensure Adequate Nursing Staff  - Herald Leader, Lexington KY November 21, 2005

2005-2-HW (PDF)  Health Savings Accounts a Possible Solution for the Kentucky Health Care Crisis - Herald Leader, Lexington, KY February 26, 2005


2005-1-HW (PDF)  Marriage of Managed Care, Medicaid Can Be Saved - Herald Leader, Lexington, KY January 24, 2005



2004-1-HW (PDF)  RX For High Drug Costs - Herald Leader, Lexington, KY October 21, 2004


MRSA PictureThe picture on the right is a photomicrograph of
Methicillin-resistant Staphylococcus Aureus (MRSA).