In The News

'Part of a New Normal': Covid Reinfections are Here to Stay

NBC News | By Akshay Syal, M.D. and Sara G. Miller

In 2020, Covid reinfections were considered rare.

In 2021, breakthrough infections in vaccinated individuals could occur, but again, the risk was low.

In 2022, that's no longer the case for either. As more immune-dodging coronavirus variants emerge, reinfections and breakthrough infections appear increasingly normal. 

The United States isn't currently tracking Covid reinfections. However, U.K. researchers have found that the risk of reinfection was eight times higher during the omicron wave than it was in last year's delta wave

“I would not be surprised if we see people get infected more than once per year,” Dr. Anthony Fauci, chief medical adviser to President Joe Biden, said in an interview with NBC News last week, though he added that he feels optimistic that it will eventually settle into becoming just a seasonal occurrence, like the flu. (Fauci, who has received two vaccine boosters, himself tested positive for Covid on Wednesday, saying he has mild symptoms.)

Of course, just because reinfections are possible, doesn’t mean people should give up on all efforts to prevent them; staying up-to-date on vaccinations and wearing masks indoors in places with high transmission still work to lower risk.

Here’s what we know so far about reinfections.

Can I be Reinfected if I’ve Already Had Covid, or Been Vaccinated or Boosted? 

To put it bluntly, yes. Experts are in agreement that reinfections are possible, even in people who have already been infected or those who are up-to-date on their vaccines.

“Reinfections, unfortunately, are not unusual for coronavirus,” said Akiko Iwasaki, a professor of immunobiology at Yale University. “It’s just the nature of this virus infection.”

The coronavirus that causes Covid is not unique — other types of coronaviruses that cause common colds can also reinfect, Fauci said. But those reinfections may occur every two or three years, because those viruses don’t change very much. 

That’s not the case for SARS-CoV-2, and particularly the rapidly evolving omicron subvariants, which are good at evading existing immunity. Combine that with the fact that people’s immunity naturally wanes over time, Iwasaki said, and “it’s not that surprising to see a lot of reinfections now.”

That’s especially true for people who were infected with the original omicron variant, dubbed BA.1, in the winter. The BA.4 and BA.5 subvariants — currently gaining a foothold in the U.S. — are quite different from BA.1, so “it’s no guarantee” that having a past omicron infection will protect you from subsequent subvariants, she said.

How Many Times Can I be Reinfected? 

It’s impossible to put an exact number on how many times a person can be reinfected, experts say.

With a high level of Covid currently spreading in the U.S., any of us have a good chance of being exposed to someone who is contagious — and becoming reinfected.

Whether a person is reinfected depends on the strength of the immune response when the person was exposed, as well as whether he or she has been recently vaccinated, said Dr. Julie McElrath, director of the vaccine and infectious disease division at the Fred Hutchinson Cancer Center in Seattle. Multiple exposures to the virus — which may not necessarily lead to symptoms — could have a silver lining, McElrath said.

Each time a person is exposed, the immune response matures and improves.

“We should consider reinfection as part of the new normal,” she said. “The hope is that with these multiple exposures continually improving antibody response will occur.”

Read Full Article for answers to the following questions:

  • How long does Covid immunity last after infection?
  • If reinfected, will symptoms be milder or worse?
  • Are certain people more vulnerable to reinfection?
  • Am I more likely to develop long Covid if I get reinfected?
 

How Home Health Providers Are Training Staff to Improve Patient Survey Scores

Home Health Care News | By Patrick Filbin
 
With a number of home health regulatory changes coming once the calendar flips to 2023, agencies are focusing on getting a head start adjusting their staff to changes.
 
Many leaders consider major regulatory shifts as an issue that needs to be dealt with from the top, down. But that’s not necessarily the case.
 
The Home Health Value-Based Purchasing (HHVBP) Model, for example, will be implemented on Jan. 1 of 2023.
 
That happens to be the same date when OASIS-E will finally be implemented as well.
 
Arming staff with the ability to deal with these changes is as important – if not more – than leaders’ ability to adapt themselves.
 
“Our staff has really emphasized that our ultimate goal with value-based purchasing is to continue to keep providing the best possible care for our patients,” Cheryl Foster, director of home health at North Kansas City Hospital, told Home Health Care News. “The biggest challenge, I think for a lot of people, is the cost of getting the staff and educating the staff on these changes.”
 
Foster has been in the home health industry for about 30 years and management for a majority of that time. North Kansas City Hospital’s home health arm has a patient census of about 350 and up to 85 full- and part-time employees.
 
The ultimate goal, of course, is for the home health division to continue to provide the best possible care for its patients under HHVBP.
 
“That needs to really be our focus,” she said. ”We’re going to look at the different things that roll into value-based purchasing, but the reason we’re looking at them is because we want to provide better care for our patients and better outcomes.”
 
However, reaching that goal will prove difficult for several reasons.
  
Read Full Article

 

Regulators Taking Aim at Hospice PE Backers

Hospice News | By Jim Parker

Private equity firms are pouring investment dollars into hospices at a record pace. Meanwhile, legislators and regulators as far up as the White House are taking aim at those firms.

Despite a cool down in the hospice mergers and acquisitions market during the first quarter of 2022, private equity firms have stayed aggressive on deals. About 30% to 50% of home health and hospice transactions in 2021 involved private equity, according to the M&A advisory firm The Braff Group.

With this growing influence comes renewed scrutiny about their impact on patient care, federal policymakers have indicated. Even President Joe Biden called out PE investors during his State of the Union address this year.

“As Wall Street firms take over more nursing homes, quality in those homes has gone down and costs have gone up. That ends on my watch,” Biden said. “Medicare is going to set higher standards for nursing homes and make sure your loved ones get the care they deserve and expect.”

Though the president’s remarks focused on nursing homes, investors throughout the health care continuum should take note. A number of agencies and some lawmakers have also started to step up oversight of these firms.

The U.S. Securities and Exchange Commission (SEC) in January proposed amendments to reporting requirements for advisors to large hedge funds and private equity funds.

If made final, the new rules would require these individuals to file reports within one business day of events that could indicate potential harm to investors or signal broader financial risks.

Current SEC rules mandate that these advisors report their private equity assets under management when they meet or exceed $2 billion. The proposal would reduce that threshold to $1.5 billion and would require firms to provide more information used for risk assessment and regulatory enforcement.

Another key finance regulator, the U.S. Federal Trade Commission, is also sharpening its gaze on private equity, based on recent actions and statements from the commission’s leaders.

Stakeholders have raised similar antirust questions about PE firms that invest in health care, as well as perceived lack of oversight.

“Private equity firms operate under the public and regulatory radar. Most private equity acquisitions in health care are not reportable to antitrust or financial regulatory authorities under current law,” a report from the American Antitrust Institute recently stated. “And, even where transactions are reportable, the complex structure of private equity funds obscures the competitive impact of those deals. As a result, private equity companies operate in health care without any effective oversight.”

Read Full Article

 

COVID-19 Updates

What to Know About the Newest, Most Contagious Omicron Subvariants

It only took about a month for BA.2.12.1, an Omicron subvariant, to cause most of the new COVID-19 cases in the U.S. since scientists first spotted it in the country. But even newer iterations of the Omicron variant are spreading rapidly through the U.S. and are poised to outcompete past versions of the virus, reinfect millions of Americans, and extend the country’s current COVID-19 surge.

Read more @ Time

Omicron Less Likely to Cause Long COVID, Data Suggest

The SARS-CoV-2 Omicron variant may pose less risk for long COVID than the Delta variant, U.K. researchers reported.

About 4.5% of people who became infected with SARS-CoV-2 when Omicron was the dominant strain experienced long COVID symptoms, compared with 10.8% who became infected during the Delta period, reported Claire Steves, PhD, of King's College London in England, and co-authors.

Overall odds of long COVID were about 20% to 50% less during the Omicron era -- defined as December 2021 to February 2022 in this study -- depending on age and time since vaccination, the researchers wrote in a letter to The Lancet.

Read more @ MedPage Today

FDA Panel Unanimously Backs Moderna's COVID Vax for Kids and Teens

A committee of independent vaccine experts recommended that the FDA grant an emergency use authorization (EUA) for the two-dose Moderna COVID-19 vaccine for kids ages 6 to 17 years.

The Vaccines and Related Biological Products Advisory Committee (VRBPAC) voted 22-0, agreeing unanimously that the benefits of vaccination outweigh the risks in two age groups: kids ages 6 to 11 years and teens ages 12 to 17. They recommended two 50-mcg doses for the younger kids and two 100-mcg doses for teens.

Read more @ MedPage Today

 
 

Citing a Disastrous Pandemic Response, an Expert Panel Will Call for an Overhaul of the U.S. Public Health System

A bipartisan panel of health experts will call on Tuesday for an overhaul of the American public health system that would greatly expand the role of the federal government, giving Washington the authority to set minimum health standards and coordinate a patchwork of nearly 3,000 state, local and tribal agencies.

The recommendations flow from what the panel, the Commonwealth Fund Commission on a National Public Health System, described as the inadequacies and inequities of the United States’ response to the coronavirus pandemic, which has killed more than one million Americans.

Read more @ NY Times

 
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