In this file:

 

·         Long-lasting COVID symptoms from lungs to limbs linger in coronavirus 'long haulers'

A growing number of people are suffering for months, but research is limited. Here are some of their stories.

 

·         Young, healthy adults with mild COVID-19 also take weeks to recover - CDC

… about a fifth of patients under 35 years reporting not returning to their usual state of health up to 21 days after testing positive…

 

·         Why COVID-19 is killing U.S. diabetes patients at alarming rates

… a new government study shows that nearly 40% of people who have died with COVID-19 had diabetes…

 

·         ‘You Do the Right Things, and Still You Get It’

A Texas family tried to ward off the virus. But as cases in the state soared and debates about masks and distancing raged, there was only so much they could control.

 

·         Pastor: 40 infected with coronavirus after church event

... some social distancing measures were in place during the services, which were held multiple times a day, and most members skipped the events out of concern for the virus. Those that attended sat with their own families. Masks were not required...

                                                           

·         How Do People Catch Covid-19? Here’s What Experts Say

The modus operandi is becoming clearer…

 

 

 

Long-lasting COVID symptoms from lungs to limbs linger in coronavirus 'long haulers'

A growing number of people are suffering for months, but research is limited. Here are some of their stories.

 

Jayne O'Donnell, and Khrysgiana Pineda, USA TODAY

Jul 25, 2020 

 

It's not all in their minds.

 

An unknown but growing number of the 4 million U.S. COVID-19 patients say they can't shake symptoms ranging from fatigue to serious respiratory or neurological problems, often for months after diagnosis. The ailments are all the more challenging because patients say they often face skeptical families, friends, employers and even doctors.

 

Research is limited on these so-called "long haulers." New York City's Mount Sinai hospital appears to have the first post-COVID treatment center in the U.S.

 

A study of 143 patients in Italy out this month in JAMA Network found 87% of patients who had recovered from COVID-19 reported at least one lingering symptom, notably fatigue and trouble breathing.

 

Natalie Lambert, an Indiana University associate research professor, analyzed at least 1,100 responses to a poll about post-COVID-19 symptoms in the 81,000-member Survivor Corps Facebook group. More than half of the patients reported at least one of six symptoms, including the now-common fatigue and breathing problems.

 

The list also includes two – inability to exercise or be active and difficulty concentrating – the Centers for Disease Control and Prevention hasn't yet cited in its list of COVID-19 symptoms.

 

Karyn Bishof appears to have most of them.

 

On Saturday, the Boca Raton, Florida resident hit Day 133 of suffering with a staggering list of symptoms that includes: cough, chronic fatigue, memory issues, vision impairment, chest heaviness, drastic heart rate and oxygen changes, sore throat, hair loss, heart palpitations, reflux, nausea, dizziness, vertigo, rapid hot flashes, joint paint, full body itchiness, tremors, mild fever, dry mouth, excessive thirst, overheating with no fever, rash, sleep apnea, chest pain and tinnitus.

 

She started her own poll in the Survivor Corps group in June to see how many other so-called COVID-19 "long haulers" there were. More than 1,500 people said they, too, were still suffering and more than half said the symptoms lasted more than three months.

 

Diana Berrent, who created Survivors Corps in March while isolating at home with COVID-19, estimates more than half of the Facebook group members who no longer test positive still experience COVID-19 symptoms.

 

Lambert said patients face even more skepticism with symptoms affecting the brain. Those include problems with memory, sleeping, irritability or sadness. Patients said their doctors often attribute sleeping problems to stress.

 

More than 40% of respondents in Bishof's poll reported their doctors hadn't listened to or believed them.

 

Dr. Maja Artandi is not one of them. 

 

"We definitely see prolonged symptoms, sometimes a lingering cough and the most serious cases have long term chest pains and still feel they can't breathe well," said Artandi, medical director of an outpatient COVID-19 clinic at Stanford University hospital. "It just causes all kinds of inflammation and takes awhile to heal."

 

Dr. George Abraham, chief of the department of medicine at St. Vincent Hospital in Worcester, Massachusetts, said the body's response to the virus's lingering inflammation will dictate how long it takes to resolve.

 

"The virus itself is a receptor that binds to the human body," said Dr. Makesh Madhavan, a fellow in the cardiology division at Columbia University Medical Center. Because the body has so many receptors, where the virus connects and inflames may depend on which organs already are compromised or factors still not understood, he said.

 

Patients with preexisting cardiac diseases, diabetes or coronary artery disease are always at higher risk, he added.

 

The lungs can nearly "drown in secretions" during the infection, which make them stiff.  It can take a long time for them to "start expanding and relaxing" again, said Abraham.

 

And just how long any of this takes is one of coronavirus' biggest unknowns.

 

"It’s only been about six months that COVID's been in the U.S. so the term 'long term' is relatively relative," Madavan said. 

 

"We have no idea if or when this will ever end" ...

 

"Doctors have told me this could last anywhere from six months to a year" ...

 

"I realized how much I wanted to live" ...

 

"I felt odd because I wasn't getting better" ...

 

"I try to focus on: what can I do to help myself?" ...

 

"Some days feel like I don’t have one ounce of energy left in my body" ...

 

"This is not how they said COVID would be." ...

 

"We can do this" ...

 

more, including table "Symptoms that linger with COVID-19 patients" 

https://www.usatoday.com/in-depth/news/health/2020/07/25/covid-19-long-haulers-fight-months-lingering-symptoms/5420534002/

 

 

Young, healthy adults with mild COVID-19 also take weeks to recover - CDC

 

Reporting by Vishwadha Chander in Bengaluru; Editing by Anil D'Silva, Reuters

via Thomson Reuters Foundation - 24 July 2020

 

 (Reuters) - Young, previously healthy adults can take weeks to fully recover from even a mild COVID-19 infection, with about a fifth of patients under 35 years reporting not returning to their usual state of health up to 21 days after testing positive, according to the Centers for Disease Control and Prevention (CDC).

 

A telephone survey across 13 states of symptomatic adults with mild COVID-19 found 35% had not returned to their usual state of health when interviewed two to three weeks after testing, the CDC reported in the Morbidity and Mortality Weekly Report on Friday.

 

Cough, fatigue and shortness of breath were among the symptoms reported while testing that persisted even weeks later, according to the report.

 

The findings indicate recovery can be prolonged even in young adults without chronic medical conditions, making a case for public health messaging to target populations that might not perceive COVID-19 as being a severe illness.

 

Between April 15 and June 25, telephone interviews were done with a random sample of people over 18 years of age who got themselves tested for COVID-19 at an outpatient visit, CDC said.

 

The interviews were done 14 to 21 days after the test date, and patients were asked about symptoms during testing, whether they had returned to their usual state of health, and if they suffer from a chronic medical condition.

 

Among 292 people interviewed, 274 reported experiencing one or more symptoms at the time of testing...

 

more

https://news.trust.org/item/20200724165404-ktkli

 

 

Why COVID-19 is killing U.S. diabetes patients at alarming rates

 

Chad Terhune, Deborah J. Nelson and Robin Respaut, Reuters

Jul 24, 2020

 

(Reuters) - Devon Brumfield could hear her father gasping for breath on the phone.

 

Darrell Cager Sr., 64, had diabetes. So his youngest daughter urged him to seek care. The next day, he collapsed and died in his New Orleans home.

 

The daughter soon learned the cause: acute respiratory distress from COVID-19. His death certificate noted diabetes as an underlying condition. Brumfield, who lives in Texas and also has type 2 diabetes, is “terrified” she could be next.

 

“I’m thinking, Lord, this could happen to me,” she said of her father’s death in late March.

 

She has good reason to fear. As U.S. outbreaks surge, a new government study shows that nearly 40% of people who have died with COVID-19 had diabetes.

 

Among deaths of those under 65, half had the chronic condition. The U.S. Centers for Disease Control and Prevention analyzed more than 10,000 deaths in 15 states and New York City from February to May.

 

Jonathan Wortham, a CDC epidemiologist who led the study, called the findings “extremely striking,” with serious implications for those with diabetes and their loved ones.

 

A separate Reuters survey of states found a similarly high rate of diabetes among people dying from COVID-19 in 12 states and the District of Columbia.

 

Ten states, including California, Arizona and Michigan, said they weren’t yet reporting diabetes and other underlying conditions, and the rest did not respond - rendering an incomplete picture for policymakers and clinicians struggling to protect those most at-risk.

 

America’s mortality rates from diabetes have been climbing since 2009 and exceed most other industrialized nations. Blacks and Latinos suffer from diabetes at higher rates than whites and have disproportionately suffered from COVID-19.

 

“Diabetes was already a slow-moving pandemic. Now COVID-19 has crashed through like a fast-moving wave,” said Elbert Huang, a professor of medicine and director of the University of Chicago’s Center for Chronic Disease Research and Policy.

 

Keeping diabetes under control - among the best defenses against COVID-19 - has become difficult as the pandemic disrupts medical care, exercise and healthy eating routines.

 

The high price of insulin has also forced some people to keep working - risking virus exposure - to afford the essential medicine. And as the country grapples with an economic crisis, millions of Americans have lost their jobs and their employer-sponsored health insurance.

 

Much of this could have been anticipated and addressed with a more comprehensive, national response, said A. Enrique Caballero, a Harvard Medical School endocrinologist and diabetes researcher.

 

Top health officials should have done more to emphasize the threat to people with diabetes and assuage their fears of hospital visits, he said, while also focusing more on helping patients manage their condition at home.

 

Policymakers had ample warning that COVID-19 posed a high risk for diabetes patients. In 2003, during the coronavirus outbreak known as SARS, or Severe Acute Respiratory Syndrome, more than 20% of people who died had diabetes...

 

‘ONE BIG PUZZLE’

 

Researchers have scrambled for months to unravel the connections between diabetes and the coronavirus, uncovering an array of vulnerabilities.

 

The virus targets the heart, lung and kidneys, organs already weakened in many diabetes patients. COVID-19 also kills more people who are elderly, obese or have high blood pressure, many of whom also have diabetes, studies show...

 

‘DIABETES BELT’ ...

 

‘UNDER CONTROL’ ...

 

WORKING FOR INSULIN ...

 

more

https://www.reuters.com/article/us-health-coronavirus-diabetes-insight/why-covid-19-is-killing-u-s-diabetes-patients-at-alarming-rates-idUSKCN24P1B4

 

 

‘You Do the Right Things, and Still You Get It’

A Texas family tried to ward off the virus. But as cases in the state soared and debates about masks and distancing raged, there was only so much they could control.

 

By Sheri Fink, The New York Times

July 26, 2020

 

HOUSTON — Elaine Roberts, a longtime bagger at a supermarket, tried to be so careful. She put on gloves and stopped riding the bus to work, instead relying on her father to drive her to keep their family safe. She wore masks — in space-themed fabrics stitched by her sister — as she stacked products on shelves, helped people to their cars and retrieved carts from the parking lot.

 

But many of the customers at the Randalls store in a Houston suburb did not wear them, she noticed, even as coronavirus cases in the state began rising in early June. Gov. Greg Abbott, who had pushed to reopen businesses in Texas, was refusing to make masks mandatory and for weeks had blocked local officials from enforcing any mask requirements. The grocery store only posted signs asking shoppers to wear them.

 

Ms. Roberts, 35, who has autism and lives with her parents, got sick first, sneezing and coughing. Then her father, Paul, and mother, Sheryl, who had been so cautious after the pandemic struck that their rare ventures out were mostly for bird-watching in a nearly empty park, were hospitalized with breathing problems.

 

Their cases were unusual: Sheryl Roberts, a sunny retired nurse, experienced severe psychiatric symptoms that made doctors fear she was suicidal, possibly an effect of the disease and medicines to treat it. She is recovering, but her husband is critically ill, on a ventilator, with failing kidneys and a mysterious paralysis that has afflicted about a dozen others at Houston Methodist Hospital.

 

While no one can be certain how Elaine Roberts was infected, her older sister, Sidra Roman, blamed grocery customers who she felt had put her family in danger.

 

“Wearing a piece of cloth, it’s a little uncomfortable,” she said. “It’s a lot less uncomfortable than ventilators, dialysis lines, all of those things that have had to happen to my father. And it’s not necessarily you that’s going to get sick and get hurt.”

 

“Whoever came to the grocery store and didn’t wear a mask,” she added, “doesn’t know this is going on.”

 

What happened to the Robertses is in many ways the story of Texas, one of the nation’s hot spots as coronavirus cases mount and deaths climb. For weeks, politicians were divided over keeping the economy open, citizens were polarized about wearing masks, doctors were warning that careless behavior could imperil others, and families were put at risk by their young.

 

Mr. Roberts, 67, is among the patients now packing intensive care units across Texas and other parts of the Sun Belt. The surge in virus cases here that took off in June first appeared to involve mostly younger adults, causing milder illnesses doctors believed would respond to new treatments. But the chain of infections that began with people under 40 — many who socialized at bars or parties without masks or distancing — moved to essential workers like Ms. Roberts, and then to their relatives.

 

“We thought this might be different, maybe with some of the things we’ve learned,” Dr. Pat Herlihy, chief of critical care at Baylor St. Luke’s Medical Center, said last week. But, he went on, “We’re right there now with super, super sick people.”

 

The same is likely to befall hospitals in other areas where cases are rising; Houston was among the cities at the leading edge of the summer wave, and critical illnesses often lag new infections by weeks...

 

more

https://www.nytimes.com/2020/07/26/us/coronavirus-family-houston-masks.html

 

Pastor: 40 infected with coronavirus after church event

An Alabama pastor says more than 40 people have been infected with the coronavirus after attending a multi-day revival event at his Baptist church

 

By The Associated Press

via ABC News - July 27, 2020

 

STRAWBERRY, Ala. -- More than 40 people were infected with the coronavirus after attending a multi-day revival event at a north Alabama Baptist church, according to the congregation's pastor.

 

“The whole church has got it, just about,” Al.com quoted pastor Daryl Ross of Warrior Creek Missionary Baptist Church in Marshall County as saying.

 

The pastor says the churchgoers, including himself, tested positive after the congregation held a series of religious services featuring a guest pastor over the course of several days last week.

 

Ross said the services were shut down by Friday after learning that one of the members who attended had tested positive for the virus. The member presented no symptoms, but got tested when several of his coworkers received positive tests, according to the pastor.

 

Over the weekend, dozens more fell ill, Ross said, adding: “I’ve got church members sick everywhere."

 

“We knew what we were getting into,” he said. “We knew the possibilities."

 

Ross said only two members’ cases were serious, and as of Sunday, nobody had been hospitalized, though many had reported having fevers, headaches and respiratory issues.

 

He said some social distancing measures were in place during the services, which were held multiple times a day, and most members skipped the events out of concern for the virus. Those that attended sat with their own families. Masks were not required, the newspaper reported...

 

more

https://abcnews.go.com/Health/wireStory/pastor-40-infected-coronavirus-church-event-72006518

 

  

How Do People Catch Covid-19? Here’s What Experts Say

 

By Jason Gale and Ari Altstedter, Bloomberg

July 25, 2020

 

The modus operandi is becoming clearer. For the most part, SARS-CoV-2, the coronavirus that causes Covid-19, spreads by close personal contact via tiny particles emitted when an infected person coughs, sneezes, speaks, sings -- or even just breathes normally. These can infect another person by falling into an eye, nose or mouth, by being inhaled or getting stuck on a hand and transferred to one of these entry sites. Here’s an explanation of the established route of contagion and other pathways under investigation.

 

Respiratory Droplets

 

These spatters of virus-laden liquid of varying sizes, expelled from an infected person in a turbulent gas cloud, are thought to be the main route.

 

The warm, moist atmosphere within the gas cloud delays evaporation, while airflow helps propel the payload of pathogen-bearing droplets further than if they were outside a cloud. A cough can disperse virus particles 4-to-5 meters (13-16 feet) and a sneeze can project them as far as 8 meters away, depending on humidity and temperature. Infection could occur if the droplets drift into the nose, mouth or eye of someone nearby.

 

Droplets can contaminate surfaces when they settle, creating what’s called a “fomite.” Although less likely, transmission could occur when a hand touches a fomite, such as a doorknob or utensil, and then comes in contact with the mouth, nose or eyes.

 

Patients may harbor potentially infectious SARS-CoV-2 virus in their saliva, stool, and urine as long as 15 days after falling ill, researchers in South Korea showed in a study of five patients in July. Spending at least 15 minutes in close contact (being within 1.8 meters) with an infected person, and spending even briefer periods with someone who is coughing or sneezing, are associated with higher risk for transmission.

 

The virus can be highly stable in favorable environments, lingering for weeks in near-freezing temperatures. At room temperature, it can survive as long as 24 hours on cardboard, 48 hours on stainless steel, and 72 hours on plastic, one study found. Standard disinfection kills it though.

 

Public health authorities recommend people wash their hands frequently, avoid close contact for prolonged periods with those outside their household, and forgo shaking hands, hugging and kissing for now. For households with a suspected or confirmed case of infection, doctors suggest keeping that person separated from others as much as possible and cleaning and disinfecting “high-touch surfaces” in common areas -- such as switches, tables and remotes -- daily. Where members of the public are crowded together, such as on buses and subways, numerous health authorities across the world are telling people to cover their faces. If medical masks are in short supply, many suggest using home-made versions.

 

Tiny Aerosolized Particles ...

 

Food or Water ...

 

Animals ...

 

Fecal-to-Oral ...

 

Mother-to-Child ...

 

The Reference Shelf ...

 

more, including links 

https://www.bloomberg.com/news/articles/2020-02-21/how-the-novel-coronavirus-can-maybe-infect-you-quicktake