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Whitby harbour February 2020 by keithhull

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* A recent trip to Whitby allowed me to take yet another set of shots of its harbour walls . Not a new subject for me but then the light is never quite the same whenever you visit. It was very windy on that particular February afternoon and sand was really blowing about

Some of you will be surprised by the following comments. I was very impressed by the press conference held last night by PM Boris Johnson flanked by the UK’s chief medical officer, Chris Whitty, and the governments chief scientific adviser, Sir Patrick Vallance. Throughout it was serious and I thought level headed . Johnson avoided making any cheap political points and there was not boasting about how well we are doing. You got the sense that it was the scientists who were making the important decisions and they were doing this with rigour and thought . I am no expert on Epidemiology so I clearly have no idea if they are making the right decisions. Vallance and Whitty clarity and thoughtful answers to press questions made me believe that what they are saying is based on sound research and rational thinking not gut instinct . They are also involving behavioural scientists in the planning models. Politicians might like to believe they have all the answers and do not need experts but it is scientists and medical practitioners who will get us through this difficult situation . Hope none of my close friends read this , praising a Tory is a flogging offence

THANKS FOR YOUR VISITING BUT CAN I ASK YOU NOT TO FAVE AN IMAGE WITHOUT ALSO MAKING A COMMENT. MANY THANKS KEITH. ANYONE MAKING MULTIPLE FAVES WITHOUT COMMENTS WILL SIMPLY BE BLOCKED

School of Hammocks by Steven Sweeney

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This scene, looking skyward from the lobby of a convention center in Mérida, Yucatán, reminded me of a school of colorful manta rays swimming overhead. International Society of Veterinary Epidemiology & Economics, 2015

SPEAKING OF FOOLS by akahawkeyefan

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Kingsburg, Ca.

Are we lucky or what? Right here in my town we've got someone who knows more about diseases and epidemiology than all those folks who have devoted a lifetime to studying such.

Time for some vaca and chill by Qzxr Resident

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Though the evil virus is hanging over all our shoulders, we can still enjoy a good staycation! :D

Keeping away from the crazies that think the virus is a hoax, or that their rights are more important than their responsibilities towards other people's health... I have NO issues avoiding hanging out with those. I've not studied epidemiology for 7+ years at Uni, so I'll just keep following the advice of those that have.

Follow me ... please? :D ♥

Check out the event's flickr too! Gimme Gacha Flickr.

For a visual reference of the full inventory at Gachaland, check the official website and the official blog as well! :D

The things in the pic, available @ Gachaland untill the end of July 2020:

The eyes: {Demicorn} Glazed Eyes - 8 (for catwa, genus and omega)

The cup: *~*HopScotch*~* Summer Drink - Fruits Banana

The nails: .:: SO ::. Bento Nails Mesh Ballerina Long Maitreya (StunnerOriginals)

The bodysuit: AtaMe - CnK Skulls Bodysuit Maitryea

The watch: So Silly Interactive Fruity Watch

The flying pet: So Silly What A Germ Pet

The stool with my friend Squirrulz sitting on it: 12. *SS* WD [Stool] (Star Sugar)

♥

The painted trees and the cool Wicker Lounge is from an upcoming release by DRD (Deathrow Designs). More info on that, soon! I won that set at a give-away in DRD's discord server. They have plenty of those give-aways, so if you're not in the server, you're missing out! Like... seriously!

The squirrel is wearing: Ananas// Personal Space - Asteroids

My hair: {Limerence} Connie hair (available at Level Event till July 24th!)

The fence, grass and flowers: Heart - Flowering Path

My body: Maitreya Lara

My head: Catwa Catya

Extra close-up pictures:

The stool

The trees and wicker lounge

The wicker lounge

The cup, watch, bodysuit, and nails

The hair and eyes

The watch

The space helmet

Good News by wer macht denn sowas

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Gam-Covid-Vac Lyo is ready to go.

Congrats to Gamaleya Research Institute of Epidemiology and Microbiology

(picture above)

Sunday morning by Tatyana

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The kind of week when you are ready to pull your hair out one by one & then hit your head against the wall. No that’s actually past few months between front line work in N95, lack of oxygen & lightheadedness after work, school, worrying for the family who live in a Covid hotspot in Brooklyn, sore throat, headaches, sleepless nights ...

John Snow MD by Giles Johnson

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The father of epidemiology.

His theories on cholera were dismissed in Victorian times, and he was proved right. The parallels with this situation are uncanny. Please google this genius. We need a few more just now.

Palm Beach County Health Department, 800 Clematis Street, West Palm Beach, Florida, USA / Floors 5 by Urban Florida Photographer

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The Florida Department of Health (FDOH) was established by the Florida Legislature in 1996; however, public health has its roots in Florida dating back to 1888 with the creation of the Florida State Board of Health. In 2007, the first-ever State Surgeon General was established to spearhead the efforts of FDOH, thereby designating a health officer to oversee all matters of public health. The Surgeon General’s role is to be the state’s leading advocate for wellness and disease prevention.

FDOH is an executive branch agency, established in section 20.43, F.S. FDOH is led by a State Surgeon General, who serves as the State Health Officer and is directly appointed by Florida’s Governor, and confirmed by Florida’s Senate. FDOH has three deputy secretaries that oversee all of its business and programmatic operations.

FDOH is comprised of a state health office (central office) in Tallahassee, with statewide responsibilities; Florida’s 67 County Health Departments (CHDs); 22 Children’s Medical Services (CMS) area offices; 12 Medical Quality Assurance (MQA) regional offices; nine Disability Determinations regional offices; and three public health laboratories. Facilities for the 67 CHDs are provided through partnerships with local county governments. These 67 CHDs have a total of 255 sites throughout the state, providing a variety of services, and ranging from small to large in location size.

FDOH is accountable to the state legislature, the Executive Office of the Governor, all residents and visitors in the state, and the federal government. FDOH is responsive to priorities identified by the Governor and the legislature in determining services, associated funding, and delivery mechanisms. Annually, the state legislature passes a budget, approved by the Governor, and creates or amends laws that direct FDOH’s actions.

Florida Health represents the vision that health belongs to everyone and every group—not just a state agency. It takes individuals, families, communities, and partnerships with local and state-level policy makers and stakeholders to create a culture of health in Florida. While our agency is the spearhead for public health in the state, we are all stewards of health in Florida. Florida Health belongs to all of us.

Credit for the data above is given to the following website:

www.floridahealth.gov/about/index.html

Immersion by Mohammad Moniruzzaman

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Knoxville, TN, 2015.

Viewers in an exhibition by Lorrie Freddette. Lorrie's works are mostly connected to epidemiology of diseases. This particular piece was inspired by microscopic views of West Nile virus. Lorrie allows her viewers to go under the installation to give them an immersive experience.

This piece is called 'Implementation of Adaptation.'

Never Let Go... by Jeff Day

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A shell shocked homeless man cruises past brightly painted municipal platitudes downtown.

Re Covid-19 (in New York)

Homeless populations less than 65 years old have all-cause mortality 5-10 higher than the general population at baseline (Baggett et al, JAMA Intern Med, 2013). Living conditions, higher rates of comorbidities (including substance abuse and mental illness), difficulty for public health agencies to trace homeless individuals and limited connection with medical services are all likely challenges (Tsai and Wilson, Lancet Public Health, 2020) but data on the COVID-19 pandemic in the homeless remains limited.

covidprotocols.org/protocols/01-clinical-course-prognosis...

Plate: IMGP5056

Epidemiology by wilson hurst

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Changes effected

Factors affecting

Wind behavior

epidemiology by lorenzoo

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Série de 8 masques abandonnés devant 8 CHU de l'APHP

Minamata Bay by cortomaltese

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or of how much it matters to value humans more than industry . . .

I was making my return ride from Kagoshima in the South of Kyushu to Fukuoka on board of one of the very fast Shinkansen Japanese trains enjoying a beautiful sunset along the western coast.

Watching my localization on google map I realized in a few minutes the train would have been riding along the coast of Minamata Bay.

At once that name recalled to memory one of the first deseases I learnt while attending Epidemiology at the beginning of my Medicine studies, and I tried to take a picture of the place that had beeen the scenario where that discovery, and much more, took place

This is the best of a series of fast shots taken trhough the window of the very fast train.

This village has given its name to Minamata Disease, a severe and complex syndrome, mostly neurologic, that leads to insanity, paralysis, coma and death, caused by mercury poisoning.

The poisoning of the water of this beautiful Bay was caused by wastewater of a chemical plant (Chisso Corp.) that contained high quantity of ethylmercury. This highly toxic poison bioaccumulated (see how it happens) in the shellfish and fish of the bay and entered at last in the daily food assumption of the dwellers of these villages, that were mainly fishemen.

The first case of this dsease was described in Minamata in 1956 and deaths went on for 36 years. As of year 2001 the confirmed victims were 2265 (1784 deaths).

The activity of the chemical plant lasted from 1932 until 1968, 12 years after(!) the first case of Minamata Disease had been registered.

Finding the causative agent of the disease wasn't easy and Chisso was one of the biggest obstacles on the way.

The passage describing this investigation in Wikipedia is very interesting.

One of those not too rare severe incidents from which we all "should" learn how not to repeat the same mistakes . . .

Kumamoto Prefecture, Japan

notes // On Black // Interesthings // Japan as I saw it

Does it work? by DES Daughter

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Beware of the too-simple answer...

Hilda Bastian is Editor etc at PubMed Health, blogger at Scientific American.

Commenting on epidemiology with cartoons at Statistically funny.

" Leonard is so lucky! He's just asked a very complicated question and he's not getting an over-confident and misleading answer.

Granted, he was likely hoping for an easier one! But let's dive into it. "

Continue reading Does it work? Beware of the too-simple answer, by Hilda Bastian.

See more Comics - about Doctors - prescriptions drugs – the FDA - the Pharmaceutical Industry

Related:

While heavily marketed, the DES Drugs never worked, more the opposite...

like EDCs, they increase the risk of cancer and have transgenerational effects...

Coronavirus disease 2019...Passive antibodies... immune systems... antibody-dependent cellular cytotoxicity...Sex differences...Gendered impact of the pandemic and mortality rates are different for men and women. by Hughes Songe

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).[8] The disease was first identified in December 2019 in Wuhan, the capital of China's Hubei province, and has since spread globally, resulting in the ongoing 2019–20 coronavirus pandemic.[9][10] As of 26 April 2020, more than 2.89 million cases have been reported across 185 countries and territories, resulting in more than 203,000 deaths. More than 822,000 people have recovered.[7]

Common symptoms include fever, cough, fatigue, shortness of breath and loss of smell.[5][11][12] While the majority of cases result in mild symptoms, some progress to viral pneumonia, multi-organ failure, or cytokine storm.[13][9][14] More concerning symptoms include difficulty breathing, persistent chest pain, confusion, difficulty waking, and bluish skin.[5] The time from exposure to onset of symptoms is typically around five days but may range from two to fourteen days.[5][15]

The virus is primarily spread between people during close contact,[a] often via small droplets produced by coughing,[b] sneezing, or talking.[6][16][18] The droplets usually fall to the ground or onto surfaces rather than remaining in the air over long distances.[6][19][20] People may also become infected by touching a contaminated surface and then touching their face.[6][16] In experimental settings, the virus may survive on surfaces for up to 72 hours.[21][22][23] It is most contagious during the first three days after the onset of symptoms, although spread may be possible before symptoms appear and in later stages of the disease.[24] The standard method of diagnosis is by real-time reverse transcription polymerase chain reaction (rRT-PCR) from a nasopharyngeal swab.[25] Chest CT imaging may also be helpful for diagnosis in individuals where there is a high suspicion of infection based on symptoms and risk factors; however, guidelines do not recommend using it for routine screening.[26][27]

Recommended measures to prevent infection include frequent hand washing, maintaining physical distance from others (especially from those with symptoms), covering coughs, and keeping unwashed hands away from the face.[28][29] In addition, the use of a face covering is recommended for those who suspect they have the virus and their caregivers.[30][31] Recommendations for face covering use by the general public vary, with some authorities recommending against their use, some recommending their use, and others requiring their use.[32][31][33] Currently, there is not enough evidence for or against the use of masks (medical or other) in healthy individuals in the wider community.[6] Also masks purchased by the public may impact availability for health care providers.

Currently, there is no vaccine or specific antiviral treatment for COVID-19.[6] Management involves the treatment of symptoms, supportive care, isolation, and experimental measures.[34] The World Health Organization (WHO) declared the 2019–20 coronavirus outbreak a Public Health Emergency of International Concern (PHEIC)[35][36] on 30 January 2020 and a pandemic on 11 March 2020.[10] Local transmission of the disease has occurred in most countries across all six WHO regions.[37]

File:En.Wikipedia-VideoWiki-Coronavirus disease 2019.webm

Video summary (script)

Contents

1Signs and symptoms

2Cause

2.1Transmission

2.2Virology

3Pathophysiology

3.1Immunopathology

4Diagnosis

4.1Pathology

5Prevention

6Management

6.1Medications

6.2Protective equipment

6.3Mechanical ventilation

6.4Acute respiratory distress syndrome

6.5Experimental treatment

6.6Information technology

6.7Psychological support

7Prognosis

7.1Reinfection

8History

9Epidemiology

9.1Infection fatality rate

9.2Sex differences

10Society and culture

10.1Name

10.2Misinformation

10.3Protests

11Other animals

12Research

12.1Vaccine

12.2Medications

12.3Anti-cytokine storm

12.4Passive antibodies

13See also

14Notes

15References

16External links

16.1Health agencies

16.2Directories

16.3Medical journals

Signs and symptoms

Symptom[4]Range

Fever83–99%

Cough59–82%

Loss of Appetite40–84%

Fatigue44–70%

Shortness of breath31–40%

Coughing up sputum28–33%

Loss of smell15[38] to 30%[12][39]

Muscle aches and pains11–35%

Fever is the most common symptom, although some older people and those with other health problems experience fever later in the disease.[4][40] In one study, 44% of people had fever when they presented to the hospital, while 89% went on to develop fever at some point during their hospitalization.[4][41]

Other common symptoms include cough, loss of appetite, fatigue, shortness of breath, sputum production, and muscle and joint pains.[4][5][42][43] Symptoms such as nausea, vomiting and diarrhoea have been observed in varying percentages.[44][45][46] Less common symptoms include sneezing, runny nose, or sore throat.[47]

More serious symptoms include difficulty breathing, persistent chest pain or pressure, confusion, difficulty waking, and bluish face or lips. Immediate medical attention is advised if these symptoms are present.[5][48]

In some, the disease may progress to pneumonia, multi-organ failure, and death.[9][14] In those who develop severe symptoms, time from symptom onset to needing mechanical ventilation is typically eight days.[4] Some cases in China initially presented with only chest tightness and palpitations.[49]

Loss of smell was identified as a common symptom of COVID‑19 in March 2020,[12][39] although perhaps not as common as initially reported.[38] A decreased sense of smell and/or disturbances in taste have also been reported.[50] Estimates for loss of smell range from 15%[38] to 30%.[12][39]

As is common with infections, there is a delay between the moment a person is first infected and the time he or she develops symptoms. This is called the incubation period. The incubation period for COVID‑19 is typically five to six days but may range from two to 14 days,[51][52] although 97.5% of people who develop symptoms will do so within 11.5 days of infection.[53]

A minority of cases do not develop noticeable symptoms at any point in time.[54][55] These asymptomatic carriers tend not to get tested, and their role in transmission is not yet fully known.[56][57] However, preliminary evidence suggests they may contribute to the spread of the disease.[58][59] In March 2020, the Korea Centers for Disease Control and Prevention (KCDC) reported that 20% of confirmed cases remained asymptomatic during their hospital stay.[59][60]

A number of neurological symptoms has been reported including seizures, stroke, encephalitis and Guillain-Barre syndrome.[61] Cardiovascular related complications may include heart failure, irregular electrical activity, blood clots, and heart inflammation.[62]

Cause

See also: Severe acute respiratory syndrome coronavirus 2

Transmission

Cough/sneeze droplets visualised in dark background using Tyndall scattering

Respiratory droplets produced when a man is sneezing visualised using Tyndall scattering

File:COVID19 in numbers- R0, the case fatality rate and why we need to flatten the curve.webm

A video discussing the basic reproduction number and case fatality rate in the context of the pandemic

Some details about how the disease is spread are still being determined.[16][18] The WHO and the U.S. Centers for Disease Control and Prevention (CDC) say it is primarily spread during close contact and by small droplets produced when people cough, sneeze or talk;[6][16] with close contact being within approximately 1–2 m (3–7 ft).[6][63] Both sputum and saliva can carry large viral loads.[64] Loud talking releases more droplets than normal talking.[65] A study in Singapore found that an uncovered cough can lead to droplets travelling up to 4.5 metres (15 feet).[66] An article published in March 2020 argued that advice on droplet distance might be based on 1930s research which ignored the effects of warm moist exhaled air surrounding the droplets and that an uncovered cough or sneeze can travel up to 8.2 metres (27 feet).[17]

Respiratory droplets may also be produced while breathing out, including when talking. Though the virus is not generally airborne,[6][67] the National Academy of Sciences has suggested that bioaerosol transmission may be possible.[68] In one study cited, air collectors positioned in the hallway outside of people's rooms yielded samples positive for viral RNA but finding infectious virus has proven elusive.[68] The droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.[16] Some medical procedures such as intubation and cardiopulmonary resuscitation (CPR) may cause respiratory secretions to be aerosolised and thus result in an airborne spread.[67] Initial studies suggested a doubling time of the number of infected persons of 6–7 days and a basic reproduction number (R0 ) of 2.2–2.7, but a study published on April 7, 2020, calculated a much higher median R0 value of 5.7 in Wuhan.[69]

It may also spread when one touches a contaminated surface, known as fomite transmission, and then touches one's eyes, nose or mouth.[6] While there are concerns it may spread via faeces, this risk is believed to be low.[6][16]

The virus is most contagious when people are symptomatic; though spread is may be possible before symptoms emerge and from those who never develop symptoms.[6][70] A portion of individuals with coronavirus lack symptoms.[71] The European Centre for Disease Prevention and Control (ECDC) says while it is not entirely clear how easily the disease spreads, one person generally infects two or three others.[18]

The virus survives for hours to days on surfaces.[6][18] Specifically, the virus was found to be detectable for one day on cardboard, for up to three days on plastic (polypropylene) and stainless steel (AISI 304), and for up to four hours on 99% copper.[21][23] This, however, varies depending on the humidity and temperature.[72][73] Surfaces may be decontaminated with many solutions (with one minute of exposure to the product achieving a 4 or more log reduction (99.99% reduction)), including 78–95% ethanol (alcohol used in spirits), 70–100% 2-propanol (isopropyl alcohol), the combination of 45% 2-propanol with 30% 1-propanol, 0.21% sodium hypochlorite (bleach), 0.5% hydrogen peroxide, or 0.23–7.5% povidone-iodine. Soap and detergent are also effective if correctly used; soap products degrade the virus' fatty protective layer, deactivating it, as well as freeing them from the skin and other surfaces.[74] Other solutions, such as benzalkonium chloride and chlorhexidine gluconate (a surgical disinfectant), are less effective.[75]

In a Hong Kong study, saliva samples were taken a median of two days after the start of hospitalization. In five of six patients, the first sample showed the highest viral load, and the sixth patient showed the highest viral load on the second day tested.[64]

Virology

Main article: Severe acute respiratory syndrome coronavirus 2

Illustration of SARSr-CoV virion

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel severe acute respiratory syndrome coronavirus, first isolated from three people with pneumonia connected to the cluster of acute respiratory illness cases in Wuhan.[76] All features of the novel SARS-CoV-2 virus occur in related coronaviruses in nature.[77] Outside the human body, the virus is killed by household soap, which bursts its protective bubble.[26]

SARS-CoV-2 is closely related to the original SARS-CoV.[78] It is thought to have a zoonotic origin. Genetic analysis has revealed that the coronavirus genetically clusters with the genus Betacoronavirus, in subgenus Sarbecovirus (lineage B) together with two bat-derived strains. It is 96% identical at the whole genome level to other bat coronavirus samples (BatCov RaTG13).[47] In February 2020, Chinese researchers found that there is only one amino acid difference in the binding domain of the S protein between the coronaviruses from pangolins and those from humans; however, whole-genome comparison to date found that at most 92% of genetic material was shared between pangolin coronavirus and SARS-CoV-2, which is insufficient to prove pangolins to be the intermediate host.[79]

Pathophysiology

The lungs are the organs most affected by COVID‑19 because the virus accesses host cells via the enzyme angiotensin-converting enzyme 2 (ACE2), which is most abundant in type II alveolar cells of the lungs. The virus uses a special surface glycoprotein called a "spike" (peplomer) to connect to ACE2 and enter the host cell.[80] The density of ACE2 in each tissue correlates with the severity of the disease in that tissue and some have suggested that decreasing ACE2 activity might be protective,[81][82] though another view is that increasing ACE2 using angiotensin II receptor blocker medications could be protective and these hypotheses need to be tested.[83] As the alveolar disease progresses, respiratory failure might develop and death may follow.[82]

The virus also affects gastrointestinal organs as ACE2 is abundantly expressed in the glandular cells of gastric, duodenal and rectal epithelium[84] as well as endothelial cells and enterocytes of the small intestine.[85]

ACE2 is present in the brain, and there is growing evidence of neurological manifestations in people with COVID‑19. It is not certain if the virus can directly infect the brain by crossing the barriers that separate the circulation of the brain and the general circulation. Other coronaviruses are able to infect the brain via a synaptic route to the respiratory centre in the medulla, through mechanoreceptors like pulmonary stretch receptors and chemoreceptors (primarily central chemoreceptors) within the lungs.[medical citation needed] It is possible that dysfunction within the respiratory centre further worsens the ARDS seen in COVID‑19 patients. Common neurological presentations include a loss of smell, headaches, nausea, and vomiting. Encephalopathy has been noted to occur in some patients (and confirmed with imaging), with some reports of detection of the virus after cerebrospinal fluid assays although the presence of oligoclonal bands seems to be a common denominator in these patients.[86]

The virus can cause acute myocardial injury and chronic damage to the cardiovascular system.[87] An acute cardiac injury was found in 12% of infected people admitted to the hospital in Wuhan, China,[88] and is more frequent in severe disease.[89] Rates of cardiovascular symptoms are high, owing to the systemic inflammatory response and immune system disorders during disease progression, but acute myocardial injuries may also be related to ACE2 receptors in the heart.[87] ACE2 receptors are highly expressed in the heart and are involved in heart function.[87][90] A high incidence of thrombosis (31%) and venous thromboembolism (25%) have been found in ICU patients with COVID‑19 infections and may be related to poor prognosis.[91][92] Blood vessel dysfunction and clot formation (as suggested by high D-dimer levels) are thought to play a significant role in mortality, incidences of clots leading to pulmonary embolisms, and ischaemic events within the brain have been noted as complications leading to death in patients infected with SARS-CoV-2. Infection appears to set off a chain of vasoconstrictive responses within the body, constriction of blood vessels within the pulmonary circulation has also been posited as a mechanism in which oxygenation decreases alongside with the presentation of viral pneumonia.[93]

Another common cause of death is complications related to the kidneys[93]—SARS-CoV-2 directly infects kidney cells, as confirmed in post-mortem studies. Acute kidney injury is a common complication and cause of death; this is more significant in patients with already compromised kidney function, especially in people with pre-existing chronic conditions such as hypertension and diabetes which specifically cause nephropathy in the long run.[94]

Autopsies of people who died of COVID‑19 have found diffuse alveolar damage (DAD), and lymphocyte-containing inflammatory infiltrates within the lung.[95]

Immunopathology

Although SARS-COV-2 has a tropism for ACE2-expressing epithelial cells of the respiratory tract, patients with severe COVID‑19 have symptoms of systemic hyperinflammation. Clinical laboratory findings of elevated IL-2, IL-7, IL-6, granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon-γ inducible protein 10 (IP-10), monocyte chemoattractant protein 1 (MCP-1), macrophage inflammatory protein 1-α (MIP-1α), and tumour necrosis factor-α (TNF-α) indicative of cytokine release syndrome (CRS) suggest an underlying immunopathology.[96]

Additionally, people with COVID‑19 and acute respiratory distress syndrome (ARDS) have classical serum biomarkers of CRS, including elevated C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer, and ferritin.[97]

Systemic inflammation results in vasodilation, allowing inflammatory lymphocytic and monocytic infiltration of the lung and the heart. In particular, pathogenic GM-CSF-secreting T-cells were shown to correlate with the recruitment of inflammatory IL-6-secreting monocytes and severe lung pathology in COVID‑19 patients.[98] Lymphocytic infiltrates have also been reported at autopsy.[95]

Diagnosis

Main article: COVID-19 testing

Demonstration of a nasopharyngeal swab for COVID-19 testing

CDC rRT-PCR test kit for COVID-19[99]

The WHO has published several testing protocols for the disease.[100] The standard method of testing is real-time reverse transcription polymerase chain reaction (rRT-PCR).[101] The test is typically done on respiratory samples obtained by a nasopharyngeal swab; however, a nasal swab or sputum sample may also be used.[25][102] Results are generally available within a few hours to two days.[103][104] Blood tests can be used, but these require two blood samples taken two weeks apart, and the results have little immediate value.[105] Chinese scientists were able to isolate a strain of the coronavirus and publish the genetic sequence so laboratories across the world could independently develop polymerase chain reaction (PCR) tests to detect infection by the virus.[9][106][107] As of 4 April 2020, antibody tests (which may detect active infections and whether a person had been infected in the past) were in development, but not yet widely used.[108][109][110] The Chinese experience with testing has shown the accuracy is only 60 to 70%.[111] The FDA in the United States approved the first point-of-care test on 21 March 2020 for use at the end of that month.[112]

Diagnostic guidelines released by Zhongnan Hospital of Wuhan University suggested methods for detecting infections based upon clinical features and epidemiological risk. These involved identifying people who had at least two of the following symptoms in addition to a history of travel to Wuhan or contact with other infected people: fever, imaging features of pneumonia, normal or reduced white blood cell count, or reduced lymphocyte count.[113]

A study asked hospitalised COVID‑19 patients to cough into a sterile container, thus producing a saliva sample, and detected the virus in eleven of twelve patients using RT-PCR. This technique has the potential of being quicker than a swab and involving less risk to health care workers (collection at home or in the car).[64]

Along with laboratory testing, chest CT scans may be helpful to diagnose COVID-19 in individuals with a high clinical suspicion of infection but are not recommended for routine screening.[26][27] Bilateral multilobar ground-glass opacities with a peripheral, asymmetric, and posterior distribution are common in early infection.[26] Subpleural dominance, crazy paving (lobular septal thickening with variable alveolar filling), and consolidation may appear as the disease progresses.[26][114]

In late 2019, WHO assigned the emergency ICD-10 disease codes U07.1 for deaths from lab-confirmed SARS-CoV-2 infection and U07.2 for deaths from clinically or epidemiologically diagnosed COVID‑19 without lab-confirmed SARS-CoV-2 infection.[115]

Typical CT imaging findings

CT imaging of rapid progression stage

Pathology

Few data are available about microscopic lesions and the pathophysiology of COVID‑19.[116][117] The main pathological findings at autopsy are:

Macroscopy: pleurisy, pericarditis, lung consolidation and pulmonary oedema

Four types of severity of viral pneumonia can be observed:

minor pneumonia: minor serous exudation, minor fibrin exudation

mild pneumonia: pulmonary oedema, pneumocyte hyperplasia, large atypical pneumocytes, interstitial inflammation with lymphocytic infiltration and multinucleated giant cell formation

severe pneumonia: diffuse alveolar damage (DAD) with diffuse alveolar exudates. DAD is the cause of acute respiratory distress syndrome (ARDS) and severe hypoxemia.

healing pneumonia: organisation of exudates in alveolar cavities and pulmonary interstitial fibrosis

plasmocytosis in BAL[118]

Blood: disseminated intravascular coagulation (DIC);[119] leukoerythroblastic reaction[120]

Liver: microvesicular steatosis

Prevention

See also: 2019–20 coronavirus pandemic § Prevention, flatten the curve, and workplace hazard controls for COVID-19

Progressively stronger mitigation efforts to reduce the number of active cases at any given time—known as "flattening the curve"—allows healthcare services to better manage the same volume of patients.[121][122][123] Likewise, progressively greater increases in healthcare capacity—called raising the line—such as by increasing bed count, personnel, and equipment, helps to meet increased demand.[124]

Mitigation attempts that are inadequate in strictness or duration—such as premature relaxation of distancing rules or stay-at-home orders—can allow a resurgence after the initial surge and mitigation.[122][125]

Preventive measures to reduce the chances of infection include staying at home, avoiding crowded places, keeping distance from others, washing hands with soap and water often and for at least 20 seconds, practising good respiratory hygiene, and avoiding touching the eyes, nose, or mouth with unwashed hands.[126][127][128] The CDC recommends covering the mouth and nose with a tissue when coughing or sneezing and recommends using the inside of the elbow if no tissue is available.[126] Proper hand hygiene after any cough or sneeze is encouraged.[126] The CDC has recommended the use of cloth face coverings in public settings where other social distancing measures are difficult to maintain, in part to limit transmission by asymptomatic individuals.[129] The U.S. National Institutes of Health guidelines do not recommend any medication for prevention of COVID‑19, before or after exposure to the SARS-CoV-2 virus, outside of the setting of a clinical trial.[130]

Social distancing strategies aim to reduce contact of infected persons with large groups by closing schools and workplaces, restricting travel, and cancelling large public gatherings.[131] Distancing guidelines also include that people stay at least 6 feet (1.8 m) apart.[132] There is no medication known to be effective at preventing COVID‑19.[133] After the implementation of social distancing and stay-at-home orders, many regions have been able to sustain an effective transmission rate ("Rt") of less than one, meaning the disease is in remission in those areas.[134]

As a vaccine is not expected until 2021 at the earliest,[135] a key part of managing COVID‑19 is trying to decrease the epidemic peak, known as "flattening the curve".[122] This is done by slowing the infection rate to decrease the risk of health services being overwhelmed, allowing for better treatment of current cases, and delaying additional cases until effective treatments or a vaccine become available.[122][125]

According to the WHO, the use of masks is recommended only if a person is coughing or sneezing or when one is taking care of someone with a suspected infection.[136] For the European Centre for Disease Prevention and Control (ECDC) face masks "... could be considered especially when visiting busy closed spaces ..." but "... only as a complementary measure ..."[137] Several countries have recommended that healthy individuals wear face masks or cloth face coverings (like scarves or bandanas) at least in certain public settings, including China,[138] Hong Kong,[139] Spain,[140] Italy (Lombardy region),[141] and the United States.[129]

Those diagnosed with COVID‑19 or who believe they may be infected are advised by the CDC to stay home except to get medical care, call ahead before visiting a healthcare provider, wear a face mask before entering the healthcare provider's office and when in any room or vehicle with another person, cover coughs and sneezes with a tissue, regularly wash hands with soap and water and avoid sharing personal household items.[30][142] The CDC also recommends that individuals wash hands often with soap and water for at least 20 seconds, especially after going to the toilet or when hands are visibly dirty, before eating and after blowing one's nose, coughing or sneezing. It further recommends using an alcohol-based hand sanitiser with at least 60% alcohol, but only when soap and water are not readily available.[126]

For areas where commercial hand sanitisers are not readily available, the WHO provides two formulations for local production. In these formulations, the antimicrobial activity arises from ethanol or isopropanol. Hydrogen peroxide is used to help eliminate bacterial spores in the alcohol; it is "not an active substance for hand antisepsis". Glycerol is added as a humectant.[143]

Prevention efforts are multiplicative, with effects far beyond that of a single spread. Each avoided case leads to more avoided cases down the line, which in turn can stop the outbreak in its tracks.

File:COVID19 W ENG.ogv

Handwashing instructions

Management

People are managed with supportive care, which may include fluid therapy, oxygen support, and supporting other affected vital organs.[144][145][146] The CDC recommends that those who suspect they carry the virus wear a simple face mask.[30] Extracorporeal membrane oxygenation (ECMO) has been used to address the issue of respiratory failure, but its benefits are still under consideration.[41][147] Personal hygiene and a healthy lifestyle and diet have been recommended to improve immunity.[148] Supportive treatments may be useful in those with mild symptoms at the early stage of infection.[149]

The WHO, the Chinese National Health Commission, and the United States' National Institutes of Health have published recommendations for taking care of people who are hospitalised with COVID‑19.[130][150][151] Intensivists and pulmonologists in the U.S. have compiled treatment recommendations from various agencies into a free resource, the IBCC.[152][153]

Medications

See also: Coronavirus disease 2019 § Research

As of April 2020, there is no specific treatment for COVID‑19.[6][133] Research is, however, ongoing. For symptoms, some medical professionals recommend paracetamol (acetaminophen) over ibuprofen for first-line use.[154][155][156] The WHO and NIH do not oppose the use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen for symptoms,[130][157] and the FDA says currently there is no evidence that NSAIDs worsen COVID‑19 symptoms.[158]

While theoretical concerns have been raised about ACE inhibitors and angiotensin receptor blockers, as of 19 March 2020, these are not sufficient to justify stopping these medications.[130][159][160][161] Steroids, such as methylprednisolone, are not recommended unless the disease is complicated by acute respiratory distress syndrome.[162][163]

Medications to prevent blood clotting have been suggested for treatment,[91] and anticoagulant therapy with low molecular weight heparin appears to be associated with better outcomes in severe COVID‐19 showing signs of coagulopathy (elevated D-dimer).[164]

Protective equipment

See also[edit]

Anencephaly

Brain death

Botulism

Catatonia

Karolina Olsson

Locked-in syndrome

Process Oriented Coma Work, for an approach to working with residual consciousness in patients in comatose and persistent vegetative states

References[edit]

^ Laureys, Steven; Celesia, Gastone G; Cohadon, Francois; Lavrijsen, Jan; León-Carrión, José; Sannita, Walter G; Sazbon, Leon; Schmutzhard, Erich; von Wild, Klaus R (2010-11-01). "Unresponsive wakefulness syndrome: a new name for the vegetative state or apallic syndrome". BMC Medicine. 8: 68. doi:10.1186/1741-7015-8-68. ISSN 1741-7015. PMC 2987895. PMID 21040571.

^ Laureys S, Celesia GG, Cohadon F, Lavrijsen J, León-Carrión J, Sannita WG, Sazbon L, Schmutzhard E, von Wild KR, Zeman A, Dolce G (2010). "Unresponsive wakefulness syndrome: a new name for the vegetative state or apallic syndrome". BMC Med. 8: 68. doi:10.1186/1741-7015-8-68. PMC 2987895. PMID 21040571.

^ Jump up to: a b Royal College of Physicians 2013 Prolonged Disorders of Consciousness: National Clinical Guidelines, www.rcplondon.ac.uk/resources/prolonged-disorders-conscio...

^ Jennett, B (1999). "Should cases of permanent vegetative state still go to court?. Britain should follow other countries and keep the courts for cases of dispute". BMJ (Clinical Research Ed.). 319 (7213): 796–97. doi:10.1136/bmj.319.7213.796. PMC 1116645. PMID 10496803.

^ Royal College of Physicians 2013 Prolonged Disorders of Consciousness: National Clinical Guidelines

^ Jump up to: a b c Diagnosing The Permanent Vegetative State by Ronald Cranford, MD

^ PVS, The Multi-Society Task Force on (1994-05-26). "Medical Aspects of the Persistent Vegetative State". New England Journal of Medicine. 330 (21): 1499–1508. doi:10.1056/NEJM199405263302107. ISSN 0028-4793. PMID 7818633.

^ Jump up to: a b Wade, DT; Johnston, C (1999). "The permanent vegetative state: Practical guidance on diagnosis and management". BMJ (Clinical Research Ed.). 319 (7213): 841–4. doi:10.1136/bmj.319.7213.841. PMC 1116668. PMID 10496834.

^ Guidance on diagnosis and management: Report of a working party of the Royal College of Physicians. Royal College of Physicians: London. 1996.

^ Jump up to: a b c Bryan Jennett. The Vegetative State: Medical facts, ethical and legal dilemmas (PDF). University of Glasgow: Scotland. Retrieved 2007-11-09.

^ Post-coma unresponsiveness (Vegetative State): a clinical framework for diagnosis. National Health and Medical Research Council (NHMRC): Canberra. 2003. Archived from the original on 2006-08-20.

^ Jennett, B (2002). "Editorial: The vegetative state. The definition, diagnosis, prognosis and pathology of this state are discussed, together with the legal implications". British Medical Journal. 73 (4): 355–357. doi:10.1136/jnnp.73.4.355. PMC 1738081. PMID 12235296. Retrieved 2012-06-11.

^ "New Scientist". 2014-02-02. Archived from the original on 2017-07-11. Retrieved 2019-01-07.

^ Nell Boyce (July 8, 2000). "Is anyone in there?". New Scientist: 36.

^ Schapira, Anthony (December 18, 2006). Neurology and Clinical Neuroscience. Mosby. p. 126. ISBN 978-0323033541.

^ Mirsattari SM, Hammond RR, Sharpe MD, Leung FY, Young GB (April 2004). "Myoclonic status epilepticus following repeated oral ingestion of colloidal silver". Neurology. 62 (8): 1408–10. doi:10.1212/01.WNL.0000120671.73335.EC. PMID 15111684.

^ K Andrews; L Murphy; R Munday; C Littlewood (1996-07-06). "Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit". British Medical Journal. 313 (7048): 13–16. doi:10.1136/bmj.313.7048.13. PMC 2351462. PMID 8664760.

^ Giacino JT, et al. (2002). "Unknown title". Neurology. 58 (3): 349–353. doi:10.1212/wnl.58.3.349. PMID 11839831.

^ Owen AM, Coleman MR, Boly M, Davis MH, Laureys S, Pickard JD (2006-09-08). "Detecting awareness in the vegetative state". Science. 313 (5792): 1402. CiteSeerX 10.1.1.1022.2193. doi:10.1126/science.1130197. PMID 16959998.

^ "Vegetative patient 'communicates': A patient in a vegetative state can communicate just through using her thoughts, according to research". BBC News. September 7, 2006. Retrieved 2008-08-14.

^ Stein R (September 8, 2006). "Vegetative patient's brain active in test: Unprecedented experiment shows response to instructions to imagine playing tennis". San Francisco Chronicle. Retrieved 2007-09-26.

^ Willful Modulation of Brain Activity in Disorders of Consciousness at nejm.org

^ Jump up to: a b Richard Alleyne and Martin Beckford, Patients in 'vegetative' state can think and communicate,Telegraph (United Kingdom), Feb 4, 2010

^ Cruse Damian; et al. (2011). "Bedside detection of awareness in the vegetative state: a cohort study". The Lancet. 378 (9809): 2088–2094. CiteSeerX 10.1.1.368.3928. doi:10.1016/S0140-6736(11)61224-5. PMID 22078855.

^ Dolce, Giuliano; Sazbon, Leon (2002). The post-traumatic vegetative state. ISBN 9781588901163.

^ Georgiopoulos M, et al. (2010). "Vegetative state and minimally conscious state: a review of the therapeutic interventions". Stereotact Funct Neurosurg. 88 (4): 199–207. doi:10.1159/000314354. PMID 20460949.

^ Georgiopoulos, M; Katsakiori, P; Kefalopoulou, Z; Ellul, J; Chroni, E; Constantoyannis, C (2010). "Vegetative state and minimally conscious state: a review of the therapeutic interventions". Stereotactic and Functional Neurosurgery. 88 (4): 199–207. doi:10.1159/000314354. PMID 20460949.

^ Snyman, N; Egan, JR; London, K; Howman-Giles, R; Gill, D; Gillis, J; Scheinberg, A (2010). "Zolpidem for persistent vegetative state—a placebo-controlled trial in pediatrics". Neuropediatrics. 41 (5): 223–227. doi:10.1055/s-0030-1269893. PMID 21210338.

^ Whyte, J; Myers, R (2009). "Incidence of clinically significant responses to zolpidem among patients with disorders of consciousness: a preliminary placebo controlled trial". Am J Phys Med Rehabil. 88 (5): 410–418. doi:10.1097/PHM.0b013e3181a0e3a0. PMID 19620954.

^ Hirsch, Joy (2005-05-02). "Raising consciousness". The Journal of Clinical Investigation. 115 (5): 1102. doi:10.1172/JCI25320. PMC 1087197. PMID 15864333.

^ Ernst Kretschmer (1940). "Das apallische Syndrom". Neurol. Psychiat. 169: 576–579. doi:10.1007/BF02871384.

^ B Jennett; F Plum (1972). "Persistent vegetative state after brain damage: A syndrome in search of a name". The Lancet. 1 (7753): 734–737. doi:10.1016/S0140-6736(72)90242-5. PMID 4111204.

^ Appel on Betancourt v. Trinitas

^ Jump up to: a b c d Richard Alleyne and Martin Beckford, Patients in 'vegetative' state can think and communicate, Telegraph (United Kingdom), Feb 4, 2010

This article contains text from the NINDS public domain pages on TBI. [1] and [2].

External links[edit]

Sarà, M.; Sacco, S.; Cipolla, F.; Onorati, P.; Scoppetta, C; Albertini, G; Carolei, A (2007). "An unexpected recovery from permanent vegetative state". Brain Injury. 21 (1): 101–103. doi:10.1080/02699050601151761. PMID 17364525.

Canavero S, et al. (2009). "Recovery of consciousness following bifocal extradural cortical stimulation in a permanently vegetative patient". Journal of Neurology. 256 (5): 834–6. doi:10.1007/s00415-009-5019-4. PMID 19252808.

Canavero S (editor) (2009). Textbook of therapeutic cortical stimulation. New York: Nova Science. ISBN 9781606925379.

Canavero S, Massa-Micon B, Cauda F, Montanaro E (May 2009). "Bifocal extradural cortical stimulation-induced recovery of consciousness in the permanent post-traumatic vegetative state". J Neurol. 256 (5): 834–6. doi:10.1007/s00415-009-5019-4. PMID 19252808.

Connolly, Kate. "Car crash victim trapped in a coma for 23 years was conscious", The Guardian, November 23, 2009.

Machado, Calixto, et al. "A Cuban Perspective on Management of Persistent Vegetative State". MEDICC Review 2012;14(1):44–48.

en.wikipedia.org/wiki/Persistent_vegetative_state

Abstract by Minn Thu

Me & Epidemiology.

A little light summer reading... by Thad Zajdowicz

18 10

Well, for me it is!

Day 188 of my 365 Project

20220121 by Guy M Wong

www.msn.com/en-us/news/us/has-the-omicron-wave-peaked-in-...

Has the omicron wave peaked in the U.S.?

Covid-19 cases are finally falling in the United States, welcome news after nearly two months of skyrocketing case counts driven by the highly infectious omicron variant.

“Nationally, the case numbers are coming down, which I consider an optimistic trend,” Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said at a White House Covid briefing Friday.

But the falling numbers don’t mean Americans are out of the woods.

That’s because, as cases fall, a huge number of people will still be infected: As many people who got sick as cases soared to their peak will get infected on the downward slope, said Dr. Jonathan Li, an infectious disease physician at Brigham and Women’s Hospital in Boston.

“It’s a great sign that the slope is going down but case rates remain very high,” he said.

Friday, the seven-day average of cases in the U.S. was 743,913 cases, down 7 percent from the week before, according to NBC News data. Deaths, however, rose slightly, from an average of 1,979 on Jan. 14 to 2,131 on Friday.

According to Katriona Shea, a professor of biology at Pennsylvania State University and a member of the coordination team for the Covid-19 Scenario Modeling Hub, a group of institutions that pool multiple models to create pandemic projections, cases and hospitalizations are expected to peak before the end of January in most states.

Cases are already falling in parts of the Northeast, Walensky said. “We are starting to see steep declines in areas that were first peaking, so areas of the Northeast — New York, Rhode Island, Connecticut — are really starting to come down.”

Shea said that cases in the rest of the country and deaths, which lag behind cases, are expected to trail shortly after.

The big dropoff in cases in large states like New York can make the nationwide average look lower, even though cases are still rising in many states, but she expects all states to hit their peaks soon after Northeastern states.

Even so, people should not see this as a time to ease up on precautions, she said.

“People think that if the peak is at the end of January, then we’re done. But a lot of damage can be done on the other side of that peak,” Shea said.

The omicron variant now accounts for nearly 100 percent of new Covid cases in the nation, CDC data show. Although early evidence suggests this strain of the virus is less likely to cause severe disease than its predecessors, many more people are being infected than ever before, so the number of people dying will still be significant, she said.

People also shouldn’t expect a smooth decline.

“It wouldn’t be surprising if we saw a few more bumps in the road, temporary bounce backs that don’t get back at the level of the peaks we’re seeing now, but are still brief periods of increase on this general trend of a decline,” said Justin Lessler, a professor of epidemiology at the University of North Carolina Gillings School of Public Health in Chapel Hill.

These brief spikes will likely be driven by lags in reporting and behavior changes, such as traveling more over holiday weekends, he said.

According to Li, although much of the decline is driven by immunity and fewer hosts for the variant to infect, behavior changes also play a vital role. If these behavior changes such as wearing masks ease up, it could blunt the speed of the decline, he said.

The latest Covid-19 Scenario Modeling Hub predictions, published Thursday, projected that by April, cases could drop to the lows seen in June 2021, before the delta wave hit.

What the models cannot predict, however, is how the virus may evolve.

“All it takes is one new variant,” Shea said. “There was no indication of omicron and there were other variants that did not take off. Omicron made a huge change and it’s definitely possible it could happen again.”

www.msn.com/en-us/news/us/covid-hospitalizations-plateau-...

COVID hospitalizations plateau in some parts of the US, while a crisis remains in others

COVID-19 cases have sharply risen again across the US and around the world, with the new Omicron variant accounting for most new cases. The winter surge has prompted many experts and officials to reemphasize the importance of masking indoors and social distancing, in addition to getting vaccinated, including booster shots.

Below, we’re gathering all the latest news and updates on coronavirus in New England and beyond.

New Zealand will move to tighter Covid-19 restrictions at the end of the day after evidence shows that omicron is circulating in the community.

The move to the “red” settings will include more mask wearing, gathering limits and increased distancing requirements at hospitality outlets, Prime Minister Jacinda Ardern said at a news conference Sunday in Wellington. Businesses will remain open and people can travel. Red isn’t a lockdown, she said.

“The goal at red is to slow the spread of the virus,” she said. “We have significant capacity in the system to attempt to stamp out outbreaks.”

Nine Covid cases reported previously in the South Island city of Nelson have been confirmed as omicron, which has triggered the response, Ardern explained. The cases in a single family had attended a wedding in Auckland where one guest has also tested positive, and an Air New Zealand worker on their flight is also infected.

For students in surge, a ‘new normal’ and plenty of worries

Massachusetts — still faced with record-setting COVID-19 caseloads, nearly two years into the pandemic — the 17-year-old begins each day with a high-stakes calculation: How to get to her first class on time, alongside 1,500 other students, while limiting her risk of exposure to the virus?

If she enters Worcester Technical High School too early, she will have to wait in the cafeteria with hundreds of other students, some unmasked as they eat breakfast, until the 7:10 a.m. bell that releases the crowd into the hallways. But if she waits too long to avoid the rush, she risks being tardy to class, even if she sprints upstairs to her fourth-floor classroom.

It is the first of dozens of decisions she must make as she navigates a pandemic-era school day during the Omicron surge, a routine she agreed to document this month for the Globe to help shed light on the experience of thousands of Massachusetts students. Since December, more than 100,000 positive cases of the virus have been reported among the state’s 911,000 students.

Omicron spreads to rural Alabama

New infections are climbing steeply in rural Alabama, even though the omicron surge appears to have leveled off in urban areas like Birmingham, Mobile and Montgomery, al.com reported.

Alabama is the second-least vaccinated state in the U.S., with less than 48% of people fully vaccinated, compared with the U.S. average of almost 63%. Hardest hit in the omicron wave are counties with the lowest vaccination rates, al.com reported. The state hit a record on Thursday of 46% of tests positive for Covid-19.

Tom Cruise’s next ‘Mission: Impossible’ films are delayed over COVID

One of the biggest movies slated for 2022 — “Mission: Impossible 7″ starring Tom Cruise — is being pushed into next year in the latest blow to struggling cinemas.

The film, which had already been postponed before, will shift from September to July 2023, according to a statement from ViacomCBS Inc.’s Paramount Pictures. Although filming wrapped last year, editing and other post-production chores have been delayed by the surge of the omicron variant.

The next picture in the series, “Mission: Impossible 8,” is also moving, from July 2023 to June 2024.

What to know about cruise travel while Omicron spreads

It’s not the most carefree time to go on a cruise.

The Centers for Disease Control and Prevention recently warned all travelers, even those who are vaccinated, to avoid cruise ships. Infections are soaring during the omicron surge, with ships reporting 14,803 coronavirus cases onboard between Dec. 30 and Jan. 12. That number was below 200 in early December. Passengers and crew have told horror stories about being stuck in isolation for days, with only lukewarm room service and in-room TV to pass the time.

There is a fresh level of uncertainty to sailing now: Several cruise lines have canceled trips in the near future and longer term, and ports have been turning ships away.

Despite the CDC’s advice, travelers will still book cruises as long as they’re allowed. Here are answers to 10 common questions they may be asking at this stage of the omicron wave.

Omicron wave leaves US food banks scrambling for volunteers

Food banks across the country are experiencing a critical shortage of volunteers as the omicron variant frightens people away from their usual shifts, and companies and schools that regularly supply large groups of volunteers are canceling their participation over virus fears.

The end result in many cases has been a serious increase in spending by the food banks at a time when they are already dealing with higher food costs due to inflation and supply chain issues.

Vaccine passport protests in Europe draw thousands of people

Thousands of people gathered in European capitals Saturday to protest vaccine passports and other requirements governments have imposed in hopes of ending the coronavirus pandemic.

Demonstrations took place in Athens, Helsinki, London, Paris and Stockholm.

Marches in Paris drew hundreds of demonstrators protesting the introduction from Monday of a new COVID-19 pass. It will severely restrict the lives of those who refuse to get vaccinated by banning them from domestic flights, sports events, bars, cinemas and other leisure venues. French media reported that demonstrators also marched by the hundreds in other cities.

In Sweden, where vaccine certificates are required to attend indoor events with more than 50 people, some 3,000 demonstrators marched though central Stockholm and assembled in a main square for a protest organized by the Frihetsrorelsen - or Freedom Movement.

Omicron nears US peak even as some regions still face struggle

The omicron variant is starting to loosen its grip on the U.S. Northeast, but experts warn that it will take more time for the latest wave of Covid-19 to recede nationwide.

The strain’s fast surge and swift descent in one of the most populous parts of the U.S. echoes its trajectory in areas of Europe and South Africa, where infections skyrocketed only to come back down nearly as quickly. That’s raised hopes that while omicron has at times seemed like a replay of the worst days of the early pandemic, it will soon ebb.

However, the shape of the omicron wave may look different in various parts of the U.S., depending on vaccination rates and hospital capacity in those areas. While omicron has been milder than other variants, it has strained health-care providers across the country, and infections in children have been higher this time around.

Little evidence that COVID spreads by contact with overseas mail, China says

Chinese officials say experts have seen little to suggest that Covid-19 is spreading via non-frozen goods after a recent infection of the omicron variant in Beijing was said to be traced to overseas mail.

Experts have insufficient evidence so far on non-frozen imported goods transmitting Covid-19 to people in China, according to He Qinghua, an official with the National Health Commission, at a press conference on Saturday. Earlier this week, the Beijing Municipal Health Commission said a positive case sometimes handled international mail at work and authorities couldn’t rule out the possibility of the person getting infected through such an instance.

Further studies need to be carried out, He said. Global studies and virus control practices show the coronavirus mainly spreads through close human-to-human contact, he said.

“Humans contracting the virus via tainted goods is not the main spreading channel, but we cannot rule out such a possibility,” he added.

In the Beijing instance, samples taken from a package and some documents inside international mail received by the person tested positive for the virus.

Airlines in Europe say they are flying near-empty planes as Omicron derails travel. They say EU rules mean they can’t stop

As the Omicron variant derails travel plans around the world, airlines say strict European Union regulations are forcing them to fly near-empty flights — unnecessary and environmentally harmful flights that they argue they need to fly to save their long-term takeoff and landing slots at European airports.

Airlines must use a certain percentage of their designated slots at airports to hold on to them. But low demand during the pandemic has led airlines to fly near empty flights, often known as ghost flights, to meet the requirements. Lufthansa, a large German airline, has said it canceled 33,000 trips, or 10 percent of its winter flights, because of low demand but still anticipates needing to fly 18,000 “poorly booked” flights to secure its slots.

China’s success taming virus could make exit strategy harder

The sweeping “zero-tolerance” strategy that China has used to keep COVID-19 case numbers low and its economy functioning may, paradoxically, make it harder for the country to exit the pandemic.

Most experts say the coronavirus around the world isn’t going away and believe it could eventually become, like the flu, a persistent but generally manageable threat if enough people gain immunity through infections and vaccines.

The Fugees are the latest artists to cancel shows over the pandemic

Pandemic woes continue to disrupt the attempts of artists to resume live performances. Months after delaying their 25th anniversary reunion tour to early this year, The Fugees announced Friday that the tour would be canceled altogether, saying the pandemic made performing safely too difficult. On Thursday, Adele postponed her Las Vegas residency only a day before its debut.

In a post on Instagram, Lauryn Hill, Wyclef Jean, and Pras Michel, who were promoting the anniversary of their Grammy Award-winning album “The Score,” said they were putting safety first.

“We want to make sure we keep our fans and ourselves healthy and safe,” the post read.

The group said that “now it may not currently be our time for revisiting this past work,” adding that it remained hopeful that “if opportunity, public safety and scheduling allow,” a future reunion tour might be possible.

Jan. 21, 2022

Passenger from Ireland charged with assault on Delta flight to New York

A belligerent Delta Air Lines passenger who refused to wear a mask during a recent eight-hour flight from Dublin to New York has been charged with assaulting and intimidating a member of the crew — one of several who tried to get him under control — as he terrorized everyone aboard throughout the trip.

Shane McInerney, 29, a Galway, Ireland, resident, threw tantrums and stubbornly went maskless on the Jan. 7 international flight despite being asked “dozens of times” by crew members to put one on, court documents say.

He also created chaos in other ways throughout the trip — including mooning people as he was escorted back to his seat, throwing a drink can at the head of another passenger, and kicking the seat of the person in front of him, according to a criminal complaint filed in federal court in Brooklyn.

Two hours into the flight, the captain, on a break, spoke to McInerney, who took off his cap twice, put it on the captain’s head, then allegedly held his fist to the captain’s face and said: “Don’t touch me.”

As the plane was landing, when passengers and crew members were seated and wearing seat belts, McInerney defiantly stood in the aisle and refused to sit, officials said.

McInerney was charged with assaulting and intimidating a crew member on Delta Flight 45. He was released on a $20,000 bond when he appeared before a judge a week ago. His case was unsealed on Friday.

NFL ends daily COVID-19 testing for all players

The NFL is curtailing daily testing of all players, vaccinated or unvaccinated, for COVID-19.

In a memo sent to the 32 clubs and obtained by The Associated Press, the league said Friday that medical experts from the NFL and the players’ union agreed to the change. Those doctors have seen enough evidence of a decrease in positive tests in the last month to feel comfortable with dropping daily tests.

Last month, weekly testing for vaccinated players and personnel was stopped, but anyone who reported symptoms of COVID-19 or was part of targeted surveillance still was subjected to testing.

“Following consultation with our jointly retained infectious disease experts, the NFL and NFL Players Association have updated the NFL-NFLPA COVID-19 protocols to eliminate the distinction between vaccinated and unvaccinated players to determine testing cadence,” the memo said. “Effective immediately, all players and tiered staff will be subject to strategic and targeted testing.”

The league will continue symptom-based testing and screening for symptoms.

White House official says US is moving toward a time when ‘COVID won’t be a constant crisis’

The official in charge of President Biden’s coronavirus response team expressed optimism Friday about the future of the pandemic, saying the nation is “moving toward a time when COVID won’t disrupt our daily lives, where COVID won’t be a constant crisis but something we protect against and treat.”

The official, Jeff Zients, made the remark at a White House news conference as the national coronavirus caseload was on a slight downward trajectory, largely because of declines in major cities in the hard-hit Northeast. That trend also prompted Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, to sound an upbeat note.

Latin America, Asia latest to get hit with Omicron surge

In Costa Rica, officials are encouraging those infected with the coronavirus to skip voting in upcoming national elections. On the other side of the world, Beijing is locking down residential communities as the country anxiously awaits the start of the Winter Olympics on Feb. 4.

In Latin America and Asia, where the omicron variant is making its latest appearance, some countries are imposing such restrictions while others are loath to place new limits on populations already exhausted by previous constraints.

Omicron quickly swept through the places it first hit, such as South Africa, the U.K. and the United States, pushing daily cases far higher than at any time during the pandemic.

The Americas reported nearly 7.2 million new COVID infections and more than 15,000 COVID-related deaths over the past week, the Pan American Health Organization said Wednesday. Coronavirus infections across the Americas almost doubled between Jan. 1 and Jan. 8, from 3.4 million cases to 6.1 million, PAHO said.

Infections are accelerating in Bolivia, Brazil, Colombia and Peru, and hospitalizations are rising in Argentina, Paraguay and Uruguay, said PAHO Director Carissa Etienne. The Caribbean islands are experiencing their steepest increase in COVID-19 cases since the start of the pandemic, Etienne noted.

Mass. Nurses Association calls on Baker to declare state of emergency

The Massachusetts Nurses Association has called for Governor Charlie Baker to declare a state of emergency through the end of March and establish new protections for health care workers who are exhausted by the crushing demands of the pandemic, according to a letter from the group.

Union President Katie Murphy, a registered nurse, warned in the letter Thursday that the state’s health care system is nearing a breaking point and said Baker should reinstate the provisions of his March 10, 2020, emergency declaration, made one day before the COVID-19 outbreak was declared a pandemic by the World Health Organization.

COVID hospitalizations plateau in some parts of the US, while a crisis remains in others

Fewer people in the United States are being admitted to hospitals with the coronavirus than a week ago, suggesting that the record-breaking surge in hospitalizations driven by the omicron variant could soon decline, following recent case trends. But the country remains far from the end of the omicron wave, and in many areas it could be weeks before the strain on hospitals subsides.

The number of people hospitalized with the virus nationwide and those sick enough to require intensive care remain at or near record levels. In much of the West, in parts of the Midwest and in more rural areas of the country, where omicron surges have hit later, cases and hospitalizations are still growing significantly.

FDA authorizes antiviral drug remdesivir as an outpatient therapy for people with COVID-19

Federal regulators Friday authorized the antiviral drug remdesivir for covid-19 outpatients at high risk of being hospitalized, providing a new treatment option for doctors struggling with shortages of effective drugs to counter the coronavirus.

The Food and Drug Administration said the intravenous treatment, which had been limited to patients in the hospital, could be administered to outpatients with mild-to-moderate illness.

Remdesivir, manufactured by Gilead Sciences, was among the first coronavirus treatments authorized in 2020. The drug received full agency approval later that year for people 12 and older. Treatment of younger children is permitted under an emergency use authorization, but Friday’s expansion to outpatients includes both age groups.

Arizona sues Biden to keep school anti-mask rules

Arizona Gov. Doug Ducey sued the Biden administration on Friday over its demand that the state stop sending millions in federal COVID-19 relief money to schools that don’t have mask requirements or that close due to COVID-19 outbreaks.

The lawsuit filed in federal court in Phoenix comes a week after the U.S. Treasury Department demanded that Ducey either restructure the $163 million program to eliminate restrictions it says undermine public health recommendations or face a repayment demand. The Treasury Department also wants changes to a $10 million program Ducey created that gives private school tuition money to parents if their children’s schools have mask mandates.

Rio de Janeiro delays Carnival parades as Omicron spreads

The world-famous Carnival festivities in Rio de Janeiro will be held in late April rather than the final weekend of February, as the number of coronavirus cases in Brazil spikes and the omicron variant spreads across the country.

“The decision was made respecting for the current situation of the COVID-19 pandemic in Brazil and the need, at this time, to preserve lives and join forces to drive vaccination throughout the country,” said a statement issued Friday jointly by the cities of Rio and Sao Paulo, which also delayed the start of its Carnival parades until April 21.

Earlier in the afternoon, Rio’s Mayor Eduardo Paes and his Sao Paulo counterpart Ricardo Nunes held a video call along with their respective health secretaries and each city’s league of samba schools that put on the parade, according to the statement.

Mass. reports 86,450 breakthrough COVID-19 cases, raising total to 6.8 percent of fully vaccinated people

Massachusetts on Friday reported 86,450 more COVID-19 cases among fully vaccinated people since last week, bringing the total since the beginning of the vaccination campaign to 348,510 cases, or 6.8 percent of all fully vaccinated people.

The data, which is typically released on Tuesdays, was reported on Friday after delays due to network connectivity issues, the Massachusetts Department of Public Health said.

Preteens may be vaccinated without parents under California bill

California would allow children age 12 and up to be vaccinated without their parents’ consent under a proposal introduced Friday by a state senator who said youngsters “deserve the right to protect themselves” against infectious disease.

Currently in California, minors ages 12 to 17 cannot be vaccinated without permission from their parents or guardians, unless the vaccine is specifically to prevent a sexually transmitted disease. Parental consent laws for vaccinations vary by state and region and a few places such as Philadelphia, San Francisco allow minors to consent to their own COVID-19 vaccines.

Wiener’s bill would lift the parental requirement for that age group for any vaccine that has been approved by the U.S. Food and Drug Administration and Centers for Disease Control and Prevention. If the bill passes, California would allow the youngest age of any state to be vaccinated without parental permission.

That includes immunizations against the coronavirus, but Wiener said vaccine hesitancy and misinformation has also deterred vaccinations against measles and other contagious diseases that can then spread among youths whose parents won’t agree to have them vaccinated.

“You have parents who are blocking their kids from getting the vaccines or ... they may not be anti-vaccine but they just aren’t prioritizing it,” Wiener told reporters at a news conference at San Francisco’s Everett Middle School. “Those kids deserve the right to protect themselves.”

Mass. reports 13,935 confirmed COVID-19 cases and 102 deaths

Massachusetts on Friday reported 13,935 new confirmed coronavirus cases and said 29,322 vaccinations, including booster shots, had been administered. The Department of Public Health also reported 102 new confirmed deaths.

Why you should take COVID-19 precautions even as Omicron declines

Recent news on the Omicron-fueled coronavirus surge has been encouraging. Massachusetts cases are dropping from stratospheric heights. Coronavirus traces in Boston-area waste water, considered a harbinger of future cases, are plummeting. And some experts are predicting a lull ahead — or even the beginning of the end of the pandemic.

But don’t get too excited, experts say, emphasizing that it’s crucial for people to take precautions even as cases fall, both to protect themselves and to ensure that the steep case declines continue.

US judge blocks Biden’s vaccine mandate for federal workers

A federal judge in Texas issued a preliminary injunction Friday blocking the White House from requiring federal workers to be vaccinated against the coronavirus, although the ruling came months after the White House said that 95% of federal workers were already in compliance.

The Justice Department said it would appeal the ruling.

What can Google search trends for COVID-19 symptoms tell us about the direction of the pandemic?

In what may be another encouraging sign that the surge of the Omicron variant is subsiding in Massachusetts and around the country, the volume of Google search trends for COVID-19 symptoms is declining.

Data provided by Google on trends in searches for COVID-19 symptoms showed that after rising through most of December, the number of searches for symptoms like fever, chills, and cough began to drop in the last days of 2021 in the United States and Massachusetts.

The decline in search volume for certain COVID symptoms appears to align with data from the state’s Department of Public Health that show COVID-19 cases are declining in the state. According to state data, the seven-day average of new cases is 30 percent lower than when it peaked last week. And in the United States, the seven-day average of daily cases is beginning to tick downwards after appearing to reach a peak a few days ago, according to data from the Centers for Disease Control and Prevention.

Having trouble ordering free COVID-19 rapid tests? Here’s what to do.

The government website where you can order free COVID-19 tests is up and running, and every American home is eligible to receive four at-home tests. It’s a very simple process — except when it’s not.

If you haven’t ordered your free rapid tests, visit www.covidtests.gov, click on the blue “Order Free At-Home Tests” button, and it will take you to a page on the US Postal Service’s website where you fill out your name and address. No payment is necessary, so you don’t need a credit card or health insurance information. Tests are supposed to start being mailed out the week of Jan. 24, and orders should ship within 7-12 days of placing the order, according to the website.

Changing Course: American Air tweaks meals to boost masking

American Airlines and its flight attendants agreed to change the carrier’s onboard food service to maximize the amount of time that passengers keep their face masks on.

Effective Jan. 26, the first three courses of meals in first class will be served at once, rather than separately, on some cross-country flights and routes to Europe, Asia and South America. In coach on those flights, beverages will be offered only with meal service, according to a memo sent to flight attendants Friday.

On domestic trips of 1,500 miles or more, a second beverage service will be made on-request.

The Association of Professional Flight Attendants proposed the new standards, which are temporary, to help reduce contact between flight attendants and passengers while travelers face coverings are off. Federal rules meant to limit spread of the new coronavirus require passengers to wear masks during flights unless they are eating or drinking.

Mass. employers added 222,000 jobs last year

Massachusetts employers added 20,100 jobs in December, according to data released on Friday, wrapping up a year in which they struggled to fill open positions.

Employment in the state increased by more than 222,000 jobs in 2021 but remains about 155,000 below the pre-pandemic level of February 2020. Hiring has been restrained by COVID-19 disruptions and the reluctance of many residents to jump back into the labor force.

Somerville health panel rejects indoor business vaccine mandate

Somerville’s Board of Health on Thursday voted 2-1 to reject a proposed COVID-19 vaccination requirement for indoor businesses such as restaurants, gyms, clubs, and theaters.

“I don’t feel like I’m ready to sign on to this mandate for this virus at this time,” said Dr. Brian Green, chair of the health board, during the panel’s meeting prior to the vote. “Because what we know about Omicron is that this is not going to have any effect of decreasing transmissibility in the restaurants and gyms.”

Green, however, suggested he could support such a mandate under different circumstances.

Almost a quarter of Bulgarians testing positive for COVID, country responds

Health authorities stepped up anti-infection measures in Bulgaria’s capital, Sofia, and other major cities in response to a surge in new coronavirus cases driven by the highly contagious Omicron variant.

Schools are limiting in-person classes, requiring students in all grades except first through fourth to switch to distance learning. The precautions also ban mass events and require restaurants and bars to operate at half of their customer capacity. All catering and entertainment establishments have to close no later than 10 p.m., and visitors need valid health certificates to be admitted.

Bulgaria, which has the lowest COVID-19 vaccination rate in the European Union and a population of 6.5 million, reported on Friday 8,932 new virus cases and 87 deaths. The country’s test positivity rate for the virus increased to about 24 percent.

Booster shots improve protection against Omicron, CDC studies show

Three studies released Friday offered more evidence that COVID-19 vaccines are standing up to the Omicron variant, at least among people who received booster shots.

They are the first large US studies to look at vaccine protection against Omicron, health officials said.

The papers echo previous research — including studies in Germany, South Africa and the UK — indicating available vaccines are less effective against Omicron than earlier versions of the coronavirus, but also that boosters significantly improve protection.

Firefighters union pushes back against vaccination mandate for Boston’s workforce

In the latest instance of resistance to Boston’s COVID-19 vaccination mandate for its city workforce, the influential firefighters union is pushing back against the new requirement with a planned news conference that will detail its objections at Florian Hall on Friday.

The Boston Firefighters Local 718 has invited its members “to stand in opposition to Mayor [Michelle] Wu’s anti-labor actions.”

“Her blatant disregard for the collective bargaining process by unilaterally revising a memorandum of agreement with an effective testing option cannot go unchecked,” read a message from the union to its members.

COVID boosters should start with most vulnerable, says WHO

The World Health Organization says that coronavirus vaccine boosters should now now be offered to people, starting with the most vulnerable, in a move away from its previous insistence that boosters were unnecessary for healthy adults and an acknowledgment that the vaccine supply is improving globally.

At a press briefing on Friday, the U.N. health agency said it was now recommending booster doses of the Pfizer-BioNTech vaccine, beginning in the highest-priority groups, about four to six months after receiving the first two doses, in line with guidance from dozens of countries that embarked upon booster programs months ago.

6 Czech players test positive before Olympic training camp

Six players on the Czech Republic’s Olympic hockey team have tested positive for the coronavirus, national team coach Filip Pešán said Friday.

The six players, all unnamed, are among a group of 12 that came from the Russia-based KHL.

“It’s a complicated situation and it’s changing every hour,” Pešán said, adding none of the positive players had any symptoms.

Those who tested negative will stay in a bubble in a hotel near the team’s training facility in Prague while the positive individuals will isolate at home and join the team later, depending on negative tests.

The Czechs have named a preliminary 24-man squad for the Beijing Olympics. Anticipating possible positive coronavirus tests, Pešán has 30 substitutes available to step in.

Former Boston Bruins center David Krejci will lead the hockey team in Beijing, where the NHL won’t participate. The 35-year-old Krejci left Boston in July after 14 NHL seasons to continue his career at home in the Czech Republic.

The first part of the team is set to fly to Beijing on Thursday.

Adele postpones Las Vegas residency, citing pandemic impact

Adele has postponed a 24-date Las Vegas residency hours before it was to start, citing delivery delays and coronavirus illness in her crew.

The chart-topping British singer said she was “gutted” and promised to reschedule the shows.

In a video message posted on social media, a tearful Adele said: “I’m so sorry but my show ain’t ready.”

“We’ve tried absolutely everything that we can to pull it together in time and for it to be good enough for you but we’ve been absolutely destroyed by delivery delays and COVID,” she said, adding that “half my team are down with” the virus.

Adele had been due to perform 24 shows at Caesars Palace Hotel starting Friday following the release of her fourth album, “30.”

In a tweet, Caesars Palace said it understood fans’ disappointment but added: “Creating a show of this magnitude is incredibly complex. We fully support Adele and are confident the show she unveils at The Colosseum at Caesars Palace will be extraordinary.”

Australia records deadliest day of pandemic with 80 deaths

Australia on Friday reported its deadliest day of the pandemic with 80 coronavirus fatalities, as an outbreak of the Omicron variant continued to take a toll.

But Dominic Perrottet, premier of the most populous state, New South Wales, said a slight decrease in hospitalizations gave him some hope about the strain the outbreak is putting on the health system.

The previous record of 78 deaths was set on Tuesday. There have been just under 3,000 coronavirus deaths in Australia since the pandemic began.

New South Wales, home to Sydney, reported a record 46 deaths. They included a baby who died from COVID-19 in December, one of several historical cases that were investigated.

China mandates 3-day Olympic torch relay amid virus concerns

China is limiting the torch relay for the Winter Olympic Games to just three days amid coronavirus worries, organizers said Friday.

The flame will be displayed only in enclosed venues that are deemed “safe and controllable,” according to officials speaking at a news conference.

No public transit routes would be disturbed and normal life would continue for the 20 million residents of the capital, where a handful of new COVID-19 cases have been recorded over recent days.

Beijing’s Deputy Sports Director Yang Haibin said safety was the “top priority,” with the pandemic, venue preparations and the possibility of forest fires in Beijing’s cold, dry climate all factored in.

The relay will run Feb. 2-4, taking in the three competition areas of downtown Beijing, the suburb of Yanqing, and Zhangjiakou in the neighboring province of Hebei.

The Games have already been impacted on a scale similar to that experienced by Tokyo during last year’s Summer Olympics.

Preteens may be vaxed without parents under California bill

California would allow children age 12 and up to be vaccinated without their parents’ consent, the youngest age of any state, under a proposal late Thursday by a state senator.

Alabama allows such decisions at age 14, Oregon at 15, Rhode Island, and South Carolina at 16, according to Senator Scott Wiener, a Democrat from San Francisco who is proposing the change. Only Washington, D.C., has a lower limit, at age 11.

Wiener argued that California already allows those 12 and up to consent to the Hepatitis B and Human Papillomavirus (HPV) vaccines, and to treatment for sexually transmitted infections, substance abuse, and mental health disorders.

“Giving young people the autonomy to receive life-saving vaccines, regardless of their parents’ beliefs or work schedules, is essential for their physical and mental health,” he said. “It’s unconscionable for teens to be blocked from the vaccine because a parent either refuses or cannot take their child to a vaccination site.”

Currently in California, minors ages 12 to 17 cannot be vaccinated without permission from their parents or guardian, unless the vaccine is specifically to prevent a sexually transmitted disease.

Wiener’s bill would lift the parental requirement for that age group for any vaccine that has been approved by the US Food and Drug Administration and Centers for Disease Control and Prevention.

Austria takes big step toward COVID vaccine mandate for adults

Austria’s lower house of Parliament voted Thursday to make COVID-19 vaccines mandatory for almost everyone 18 and older, putting the nation on the path to be the first in Europe with such a wide-reaching mandate.

The law would take effect Feb. 1. The bill must still pass in the upper house and be signed by the president, Alexander Van der Bellen, but both are considered formalities at this point.

While Austria’s bill is the first of its kind, other European nations are pushing large segments of their populations to get vaccinated. Italy has made vaccines mandatory for those older than 50, with fines for those who do not comply, and Greece has mandated vaccines for those 60 and older. Other European countries have made vaccine passports compulsory for certain activities.

Under the Austrian law, people who are pregnant or cannot be vaccinated for medical reasons and those who have recently recovered from COVID-19 will be exempt.

Once the law goes into effect, all households will be notified. The government said it would begin routine checks of vaccination status in mid-March, including during traffic checks.

Once the vaccine checks begin, people who can’t immediately produce proof of vaccination will be reported to authorities and can be fined up to 600 euros ($685). If people contest their fine, it can increase to 3,600 euros (about $4,000).

The law is set to last until 2024. Austria’s current rate of vaccination is 75%, similar to that of France and of Italy, and new cases are averaging 17,846 a day, according to a New York Times database.

Texas Attorney General Ken Paxton, opponent of vaccine and mask mandates, tests positive for coronavirus

Texas Attorney General Ken Paxton, R, who has challenged the Biden administration’s efforts to mandate vaccines, reportedly tested positive for the coronavirus, his office confirmed.

“He remains working diligently for the people of Texas from home,” spokesman Alejandro Garcia said in a statement.

Paxton’s office did not answer questions about whether he was vaccinated or when he was infected.

Social media posts showed him attending a rally for former president Donald Trump over the weekend.

The attorney general, whom Trump endorsed, filed a lawsuit this month to challenge the Biden administration’s vaccine mandate efforts.

Paxton has staunchly opposed attempts by President Biden to make coronavirus vaccines compulsory for health-care workers in facilities that receive Medicare and Medicaid funds, for troops in the Texas National Guard, and for staff members at Head Start programs. He has also fought requirements for parents, teachers, and children to wear masks at schools.

Jan. 20, 2022

About 1.5 percent of Beijing Olympics arrivals have COVID

About 1.5% of athletes and others entering Beijing for the Winter Olympics are testing positive for Covid, with all of the infections caught within five days of arrival, according to the International Olympics Committee’s Covid-19 support team. There have been no signs of transmission within the closed-loop bubble established by the organizers, and just 0.02% of those screened inside the area have tested positive.

The results show that early identification of infections and mitigation measures designed to stop their transmission is an effective alternative to quarantine requirements, the organizers said.

Japan eyes more quasi-emergency measures, Yomiuri says

Japan’s government may expand a state of quasi-emergency to eight more prefectures, covering 24 of the country’s 47 regions in total, the Yomiuri newspaper reported without attribution. The expansion would include Osaka and its vicinity.

An official decision on the measure, which allows local governments to place restrictions on businesses, will be made as early as Jan. 25, the newspaper said. It also reported that the government is looking to extend existing measures in three prefectures -- Okinawa, Hiroshima, Yamaguchi -- by two weeks.

San Francisco coronavirus cases fall rapidly

San Francisco’s infections are falling rapidly from a peak a week and half ago, the city’s department of health said Thursday. The seven-day average of cases dropped to about 1,705 per day as of Jan. 12 from 2,164 on Jan. 9, while hospitalizations are also expected to peak in the next few days at a level that’s within the health system’s capacity.

Mayor London Breed said the city’s response to the omicron-fueled surge demonstrates it can handle large outbreaks while keeping schools and the economy open.

“We know that this virus will be with us for the foreseeable future, but we have the tools in place and the experience managing Covid to not let it completely upend our lives,” she said in a statement.

Mass. reports dip in new public school coronavirus cases with 28,151 among students and 4,758 among staff

For the first time since early December, coronavirus cases among both students and staff in Massachusetts public school have decreased, according to data released Thursday.

State education leaders reported 28,151 new cases among public school students and 4,758 among staff members for the week that ended Wednesday.

The 32,909 total cases were 15,505 fewer, or about 32 percent less, than those reported last week. The decrease in school cases comes as data shows that cases statewide have peaked after an Omicron-fueled surge.

14,384 confirmed cases and 86 deaths. See today’s COVID-19 data from Mass.

Massachusetts on Thursday reported 14,384 new confirmed coronavirus cases and said 31,190 vaccinations, including booster shots, had been administered. The Department of Public Health also reported 86 new confirmed deaths.

The state also reported that 3,144 patients were hospitalized for COVID-19. The seven-day percent positivity was 15.03 percent.

Nearly half of COVID-19 hospitalizations in Massachusetts are ‘incidental’ cases, new state data show

New state data show 51 percent of COVID hospitalizations in Massachusetts on Tuesday were patients who were seriously ill from the virus, while 49 percent of patients were admitted for other reasons but happened to test positive upon admission.

The state launched its new method of reporting primary vs. incidental COVID-19 hospitalizations on Thursday, reporting that on Jan. 18, 1,624 people were in the hospital primarily because they were seriously sick with the virus while 1,563 patients had tested positive for COVID-19 while being hospitalized for other reasons.

Some experts predict a lull but say COVID could have more tricks up its sleeve

The surge fueled by the Omicron variant will likely fade in the weeks ahead in the United States, experts say, and encouraging case declines have already emerged in Massachusetts and other states in the Northeast.

But what comes after that? Some experts are expecting a lull in the pandemic followed by a decline in the severity of future waves. But many also warn that it’s hard to predict where the pandemic will go next — and a new variant could throw everything into doubt.

COVID-19 cases have peaked in Massachusetts

The latest wave of COVID-19 in Massachusetts has crested, with the number of new cases dropping precipitously since last week, prompting even the most wary prognosticators to see a flicker at the end of the tunnel.

The data indicate Massachusetts is headed toward a respite, and the United States also will see cases decline, said Dr. Jacob Lemieux, an infectious disease specialist at Massachusetts General Hospital. But he cautioned that “every expectation with this virus comes with a caveat because it’s always making us look silly.”

Biden’s team says it’s on alert for Omicron disruptions in China

The Biden administration is monitoring real-time data obtained from businesses operating in China to determine whether outbreaks of the Omicron variant of coronavirus pose a risk to US supply chains, an administration official said.

It’s too early to tell whether there will be any impact on the American economy from the variant’s spread in China or from aggressive efforts by officials there to stamp it out, the official said.

The official asked not to be identified discussing the administration’s efforts because the data is not public.

Free rapid tests are about to roll out in the US. In other countries, they’re already part of daily life.

The US government is just beginning to roll out free antigen home tests. A website for ordering launched this week, with the first batches - four per household - scheduled for delivery later this month. But while up to now home tests have been expensive and hard to find in much of America, in other countries - Britain, Singapore and India among them - rapid self-tests have been widely accessible for some time. And people have incorporated them into their everyday lives.

Whereas the Biden administration announced it is buying 1 billion rapid tests, Britain’s National Health Service has already distributed 1.7 billion free home tests (in a country of 67 million) over the past nine months. With packs of seven available by home delivery and at pharmacies, people have boxes in their kitchen, next to the daily bread, ready to go.

Coronavirus levels in Boston-area waste water continue to plunge

In another encouraging sign that Omicron may be loosening its grip on the state, the amount of coronavirus detected in Eastern Massachusetts waste water has continued its dizzying decline in recent days, according to data released Thursday by the Massachusetts Water Resources Authority.

The numbers have dropped to less than a quarter of their Omicron-fueled peaks early this month, though they are remain higher than they were during last winter’s surge.

Plane heading to London returns to Miami over maskless passenger

An American Airlines flight to London returned to Miami after a passenger refused to follow the federal requirement to wear a face mask, according to the airline.

The airline called Miami police, and officers escorted a woman off the plane at Miami International Airport Wednesday evening without incident. A spokesperson for the Miami-Dade Police Department said American Airlines staff dealt “administratively” with the passenger.

The Cambridge startup tracking COVID in America’s wastewater

When talking with Mariana Matus and Newsha Ghaeli about poop, it can veer into the philosophical.

“The behavior of a city is imprinted in its sewage,” Ghaeli said. “It’s like the fingerprints of our health.”

Their company, Biobot Analytics, has met the pandemic moment. What started as a research idea at MIT, focusing on how wastewater data can help mitigate the spread of disease, has turned into something bigger. Now, it’s a fast-growing startup — with over 65 employees and millions in funding — that has contracted with over 700 towns, across every state in the country, to study their sewage and help policy makers predict how bad the coronavirus could get in their communities.

NBC will not send announcers to Beijing for Winter Olympics

NBC will not be sending its announcers and most hosts to the Beijing Olympics due to continued concerns about rising COVID-19 cases worldwide and China’s strict policy about those who test positive.

It will be the second straight Games for which the broadcast teams will work mostly out of NBC Sports headquarters in Stamford, Connecticut, rather than the host city.

MBTA patron refuses to wear mask, hits Transit police officer in face, officials say

A 29-year-old Sturbridge man was arrested Tuesday for allegedly striking a Transit police officer after refusing to don a mask to ride the T at North Station, officials said.

In a statement, MBTA Transit Police identified the man as Rutul Jaiswal.

Police were called to the North Station Commuter Rail around 9:45 a.m. because Jaiswal had allegedly refused “to wear a mask while attempting to travel on the MBTA,” the release said.

36 percent lower risk of hospitalization from Omicron found in Denmark

The risk of ending up hospitalized after a COVID-19 infection is 36 percent lower for people who were exposed to the Omicron than the Delta variant, according to a new study from health authorities in Denmark.

The study in the Nordic nation, which has one of the world’s most ambitious programs for testing and variant screening, showed that 0.6 percent of those infected with the new variant were admitted to hospital, compared with 1.5 percent of those who tested positive for Delta.

US jobless claims rise to 286,000, highest since October

The number of Americans applying for unemployment benefits rose to the highest level in three months as the fast-spreading Omicron variant disrupted the job market.

Jobless claims rose for the third straight week — by 55,000 to 286,000, highest since mid-October, the Labor Department reported Thursday. The four-week average of claims, which smooths out weekly volatility, rose by 20,000 to 231,000, highest since late November.

A surge in COVID-19 cases has set back what had been a strong comeback from last year’s short but devastating coronavirus recession. Jobless claims, a proxy for layoffs, had fallen mostly steadily for about a year and late last year dipped below the pre-pandemic average of around 220,000 a week.

‘It’s been a desperate call’: Substitute teachers in high demand as districts grapple with teaching shortages

With Massachusetts school districts facing debilitating teacher shortages due to COVID-19, substitutes are among the staff members sorely needed but in scant supply. In an attempt to keep classrooms covered, school systems across the region are desperately trying to find anyone to fill in as the most recent surge of the virus pummels the teaching population.

As incentives, districts like Woburn and Brockton recently announced pay hikes to recruit more substitutes. Since the onset of the pandemic, both Boston and Cambridge have waived the requirement for substitute teachers to have a bachelor’s degree; Cambridge now requires at least one year of professional experience working with students, said spokesperson Sujata Wycoff, and Boston requires unlicensed candidates to pass an online course, according to the current job listing.

New Mexico is short on substitute teachers. The governor asked the National Guard and state employees for help

As school districts across the country scramble to find substitute teachers to fill in for instructors out sick with COVID, New Mexico is tapping into unconventional resources for help: the National Guard and state employees.

The initiative, which Governor Michelle Lujan Grisham, D, said is the first in the nation, encourages government workers and National Guard members to volunteer to become licensed substitute teachers, Lujan Grisham announced Wednesday.

“Our schools are a critical source of stability for kids — we know they learn better in the classroom and thrive among their peers,” Lujan Grisham said in a news release. " . . . The state stands ready to help keep kids in the classroom, parents able to go to work, and teachers able to fully focus on the critical work they do every single day.”

Government employees and National Guard members who volunteer will be placed on administrative leave or active duty status and receive their normal salaries.

Employers across various industries are reeling from staff shortages as the Omicron variant spreads throughout the country. Hospitals, grocery stores, and airlines are all struggling to keep up with demands as employees call out because they are sick or need to quarantine after being exposed to the virus.

Staff shortages at schools have been a primary concern for government officials, who worry about how a third year of instability will impact students. Some school districts have taken creative steps to keep students in classrooms and operations running. Superintendents in Texas and Michigan have asked parents to volunteer as substitutes. In Vermont, school board members have filled in as custodial workers, and in Georgia, a school principal has been helping out in the cafeteria. In Delaware, a charter school offered to pay parents $700 to take their children to school and pick them up at the end of the day.

Dutch artists protest COVID lockdown of cultural venues by hosting approved haircuts at shut-down museums

Some of the Netherlands’ most celebrated museums, concert halls, and art centers opened their doors Wednesday to host hairdressers, nail artists, and fitness instructors, in playful protest against what they see as inconsistencies in the country’s coronavirus protocols.

Dutch Prime Minister Mark Rutte said last week that businesses such as beauty salons and fitness centers would be allowed to resume operations after a strict lockdown that was imposed in mid-December. But cultural venues such as theaters and galleries would remain shut for at least another week, he said.

That proved a step too far for performance artists Sanne Wallis de Vries and Diederik Ebbinge, who organized the Hair Salon Theater initiative to bring hairdressers and nail artists to still-shuttered cultural venues on Wednesday.

The Dutch cultural sector has been flexible and adaptive, the organizers said in a statement, but believed that the “dire situation” facing the arts should be highlighted. They asked for a plan for reopening the sector and noted that few infections had been linked to arts groups over the pandemic, suggesting that it was possible to resume cultural life carefully.

The Van Gogh Museum in Amsterdam was among the several dozen cultural venues that partnered with the Hair Salon Theater initiative. Customers who reserved seats ahead of time were able to get $38 haircuts or $34 Van Gogh-themed manicures while sitting amid the impressionist master’s portraits. (Masking and social distancing were mandatory.)

New Zealand says it won’t use lockdowns when Omicron spreads

New Zealand is among the few remaining countries to have avoided any outbreaks of the Omicron variant — but Prime Minister Jacinda Ardern said Thursday an outbreak was inevitable and the nation would tighten restrictions as soon as one was detected.

But she also said that New Zealand would not impose the lockdowns that it has used previously, including for the Delta variant.

“This stage of the pandemic is different to what we have dealt with before. Omicron is more transmissible,” Ardern said. “That is going to make it harder to keep it out, but it will also make it more challenging to control once it arrives. But just like before, when COVID changes, we change.”

Ardern said that within 24 to 48 hours of Omicron being detected in the community, the nation would move into its “red” setting. That would allow businesses to remain open and domestic travel to continue, but would require schoolchildren to wear masks and limit crowds to 100 people.

Why are men more likely to die of COVID? It’s complicated

It’s one of the most well-known takeaways of the pandemic: Men die of COVID-19 more often than women do.

Early on, some scientists suspected the reason was primarily biological, and that sex-based treatments for men — like estrogen injections or androgen blockers — could help reduce their risk of dying.

But a new study analyzing sex differences in COVID-19 deaths over time in the United States suggests that the picture is much more complicated.

While men overall died at a higher rate than women, the trends varied widely over time and by state, the study found. That suggests that social factors — like job types, behavioral patterns, and underlying health issues — played a big role in the apparent sex differences, researchers said.

NBC will not send announcers to Beijing for Winter Games

It will be the second straight Games for which the broadcast teams will work mostly out of NBC Sports headquarters in Stamford, Connecticut, rather than the host city.

“Something significant has changed virtually every day for the last three months, forcing us to adjust our plan numerous times. And I expect that to continue as well as the challenge of doing the Olympics,” said Molly Solomon, the head of NBC’s Olympics production unit.

Video: Houston hospital turns to virtual ICUs to fight Covid surge (CNBC)

“With COVID’s changing conditions and China’s zero-tolerance policy, it’s just added a layer of complexity to all of this, so we need to make sure we can provide the same quality experience to the American viewers. That’s why we are split between the two cities.”

NBC Sports spokesman Greg Hughes said in a phone interview the network no longer plans to send announcing teams for Alpine skiing, figure skating, and snowboarding to China. Those had been among the handful of announcers expected to travel, but NBC’s plans changed over the past couple of weeks.

“Our plans will continue to evolve based on the conditions, and we’re going to stay flexible as we move through this,” Hughes said.

NBC Olympics president Gary Zenkel is one of 250 people the network already has in Beijing. Most of those are technical staff.

US hospitals brace as deadlines loom from a vaccine mandate

Health care workers in two dozen states must be fully vaccinated against the coronavirus by March 15 after a Supreme Court decision last week, a ruling that has left some already understaffed hospital systems bracing to possibly lose workers just as the highly contagious Omicron variant is inundating them with patients.

The new guidance was issued Friday by the Centers for Medicare & Medicaid Services after the court upheld President Biden’s vaccine mandate for health care workers. It will affect about 10 million people at about 76,000 health care facilities participating in the Medicaid and Medicare program, including hospitals and long-term care facilities.

Experts say mandates are effective in persuading more people to become vaccinated, which they say is essential to helping prevent the spread of the virus. And Biden has continued to push for more vaccinations and testing, reiterating that schools should remain open and the time for lockdowns was over.

“We’re moving toward a time when COVID-19 won’t disrupt our daily lives,” Biden said at a news conference Wednesday. He called a recent Supreme Court decision to block a vaccination-or-testing mandate for large private employers “a mistake.”

The CDC’s guidance Friday meant that health care workers in 24 states where vaccine mandates were not yet in effect must receive at least one shot of a coronavirus vaccine within 30 days and must be fully vaccinated by March 15, a spokesperson for the Centers for Medicare & Medicaid Services said.

The states affected are Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Utah, West Virginia and Wyoming. For these states, the federal vaccine requirement had been blocked by a lower court.

The guidance does not yet apply to Texas, where a preliminary injunction still prevents such requirements.

The Supreme Court’s decision does not affect timelines already in place for the other 25 states, Washington, D.C., and U.S. territories, where health care workers must by fully vaccinated by Feb. 28, according to the Centers for Medicare & Medicaid Services.

New Jersey mandates booster shots for hospital, nursing home, and prison employees

Employees of New Jersey hospitals, nursing homes, prisons, and jails will be required to be fully vaccinated against the coronavirus — with a booster — or risk losing their jobs, Governor Philip D. Murphy announced on Wednesday.

Workers at most medical facilities in the state were already required to be vaccinated by Feb. 28 under President Biden’s mandate for health care workers at entities receiving federal money, which recently withstood a Supreme Court challenge.

But Murphy’s requirement goes further, mandating health care workers to get booster shots as well, and it represents a significant shift for the state’s prison and jail system, where staffing levels are already strained and vaccination is well below the statewide rate.

Murphy, a Democrat who was sworn in to a second term on Tuesday, had given workers the option to satisfy the state’s earlier vaccination requirement by getting regularly tested for the coronavirus.

“Testing out will no longer be an option,” Murphy said outside a testing site in South Jersey. “We are no longer going to look past those who continue to put their colleagues, and, perhaps, I think, even more importantly, those who are their responsibility, in danger of COVID. That has to stop.”

USA Contiguous COVID-19 infections 1/22/2020 - 3/26/2020 by Chuck Sutherland

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Brompton Cemetery: Dr John Snow by Peter Denton

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Dr John Snow (1813-58), who is buried here in Brompton Cemetery, west London, was one of the founders of modern epidemiology and early germ theory, and we have much to thank him for.

Following a severe outbreak of cholera in Soho, London, which killed more than 600 people in 1854, Dr Snow established that the disease was caused by contaminated drinking water rather than particles in the air. He even identified the specific public water pump concerned and had it shut down.

His findings brought about fundamental changes in the water and waste systems of London, which led to similar changes in other cities, and a significant improvement in general public health around the world.

Very unfortunately, in 1858 Dr Snow (who was also a leading anaesthetist) suffered a stroke at the age of 45, and he died six days later.

The inscription on his memorial reads: 'In remembrance of his great labours in science and of the excellence of his private life and character this monument (with the assent of Mr William Snow) has been erected over his grave by his professional brethren and friends'.

Population Architecture Using Genomics and Epidemiology (PAGE) by National Human Genome Research Institute (NHGRI)

Through NHGRI's Population Architecture Using Genomics and Epidemiology (PAGE) program, five research teams in 2013 have received new four-year awards to study the genomics of disease susceptibility in ethnically diverse populations. Credit: Jonathan Bailey, NHGRI.

Best 7 ways to protect your joints by Yoga Sensing

Learn the best ways to take care of your bones.

Bones are held by different types of joints and every single one of them play a special part to keep the body function. So it is important to keep them safe and healthy. Here are the best 7 ways to protect your joints.

7 Ways to Protect Your Joints in Yoga

View image | gettyimages.com

Yoga is a safe and healthy way to improve muscle strength, endurance, flexibility and balance. The American Academy of Orthopaedic Surgeons (AAOS) supports yoga as a safe form of exercise as long as do you do yoga based on your own individual flexibility and level. A recent review in the American Journal of Epidemiology of over 300 yoga studies concluded that yoga was just as safe as traditional care for health problems and other forms exercise.

Injuries from yoga are uncommon, and most do not require medical attention. One recent study found that less than one percent of people get injuries from yoga that cause them to stop doing yoga.

Some of the most common injuries in yoga are muscle or joint problems, though most problems are mild. Yoga can even be a safe and helpful form of exercise for people with joint issues like rheumatoid arthritis, as long as you know how to modify postures with the help of your yoga teacher.

Here are seven tips to help keep your joints healthy and safe in yoga:

1. Protect your wrists: Spread your hands wide and evenly when your hands bear weight, such as in Downward Facing Dog Pose.

Beginners in yoga often tent their hands in Downward Facing Dog Pose, but this actually makes it more difficult on your hands and wrists. Make sure that your hands are spread wide and ground all corners of your palm on your mat. Your hands should be pressed down firmly enough that someone would not be able to pluck your fingers off the mat.

Dr. David Wei of Orthopaedic & Neurosurgery Specialists in Greenwich, CT, an orthopedic hand surgeon who specializes in injuries of the hand, wrist, and elbow, explains:

Many poses in yoga, such as the Downward Facing Dog require a fair amount of wrist extension, while simultaneously putting direct pressure on the palm of the hand. This can exacerbate existing wrist problems, as well as pre-existing carpal tunnel syndrome.

To help prevent this, make sure you press down evenly throughout the entire surface area of your hand in contact with your mat, so this decreases the weight or pressure at any one point. This also makes it safer for your hands and wrists. Or, try modifying the pose by using your forearms instead (Dolphin Pose modification).

View image | gettyimages.com

Protect your shoulders:

Externally rotate your shoulders in Downward Facing Dog Pose to strengthen your external rotator cuff muscles.

In Downward Facing Dog Pose, make sure your hands are shoulders width apart and that your elbows are not sticking out towards the sides-- this places weight unevenly on the inner parts of your hand. Instead, externally rotate your shoulders so that your elbows creases face forward, which allows weight to be more evenly distributed between all your fingers on your hand. This also activates your external rotators of your shoulders to help strengthen your rotator cuff and helps prevent future rotator cuff injury.

View image | gettyimages.com

Release tension in your shoulders: Melt your shoulders away from your ears. Chronic tension can lead to your shoulders creeping up towards your ears. Check your shoulders in poses like Warrior I, Warrior II Pose or Upward Facing Dog Pose to make sure that your shoulders are not hunched or shrugged. Draw your shoulder blades down and towards each other to release tension in your shoulder and neck muscles.

View image | gettyimages.com

Protect your elbows:

Tuck your elbows in towards your ribs when lowering down from High Plank/ Push-Up to Low Plank/ Push-Up Pose. Don't let your elbows buckle outwards. If this does not feel comfortable, try lowering your knees during Low Plank Pose to build your core strength and support your elbows.

When you jump back from Standing Half Forward Bend to Low Plank Pose, make sure your elbows are bent when landing in order to lessen the impact on your elbow joint. Avoid landing on a fully extended elbow (i.e., don't jump back and land in High Plank Pose).

4. Protect your knee:

When your front knee is bent in standing poses like Warrior I, Warrior II, or High Crescent Lunge Pose, your knee should be vertically in line with your ankle so that it forms a 90 degree angle. It's also very important that your knee is not leaning in toward your ankle.

Dr. David Wei explains why it's important to protect your knee in this pose:

When your knee is in the valgus, or knock-kneed, position, then your or anterior cruciate ligament or ACL in your knee is more vulnerable and at risk of injury.

View image | gettyimages.com

If certain poses cause knee pain when your knee is pressing on the mat, use a rolled blanket or folded towel to cushion the knee, like in Low Lunge Pose.

View image | gettyimages.com

In positions like Tree Pose, avoid pressing directly on your knee with your other foot. Instead, place your foot along either your thigh or your shin rather than directly onto your knee.

View image | gettyimages.com

Protect your hips:

In hip-opener postures, support your hips with blocks and modifications, particularly if you have tight hips or prior hip injuries.

In Lizard Pose, place blocks under your hands or forearms to help you avoid sinking too deeply into your hips.

In Half Pigeon Pose, place blocks underneath the thigh of your back leg and your bottom/pelvis to support your hips if they are not able to reach the ground.

In Reclined Bound Angle Pose, if your knees don't reach the ground, add blocks (or cushions) beneath both bent knees in order to avoid straining your hips.

6. Protect your neck: Avoid flexing or extending your neck too far forwards or backwards.

In many postures such as Mountain Pose, Triangle Pose, or Extended Side Angle Pose, keep your neck as a natural extension of your spine. (Some forms of yoga such as Forrest Yoga offer more relaxed neck positions to release neck tension.)

Release neck tension by shaking your head "yes" and "no" in Standing Forward Bend.

View image | gettyimages.com

In postures like Cobra Pose or Upward Facing Dog Pose, do not overly extend your neck backwards. People often crank their neck too far backwards in these poses in order to try to achieve what they believe is the ideal curved shape of the pose. However, your gaze should actually be straight ahead--not at the ceiling-- so that your neck is a natural extension of your spine so that your neck is not compressed.

View image | gettyimages.com

Other poses where your neck is flexed towards your chest, like Shoulder Stand Pose and Plow Pose, can be particularly hard on your neck. Support your neck with a rolled towel or blanket underneath your neck in shoulder stand. Or try modifying the posture by doing supported Shoulder Stand Pose with a block underneath your sacrum or Legs up the wall Pose. Both poses are inversions that keep your torso and neck supported on the mat in a neutral position.

Dr. David Wei notes:

People with medical conditions like rheumatoid arthritis should avoid postures where your neck are flexed or extended away from the spine given the risk of neck instability.

7. Protect your jaw joint: When you are in difficult yoga poses, notice if you are clenching your jaw tightly (this is common!). Chronic stress can cause you to clench your jaw joint and lead to problems like teeth-grinding and pain in the jaw joint. Loosen your jaw by opening and letting it relax, or flutter your lips to make noise in forward folding poses like Standing Forward Bend or Wide-Legged Forward Bend.

Most importantly, throughout your yoga practice, be compassionate to yourself and aware of your needs. If you feel pain, then stop, modify or skip the pose. Remind yourself to let go of pride or perfection-- this can help prevent injuries since ego can drive you past the point of what is safe or comfortable.

Finally, let your teacher know ahead of time of any specific medical issues or pre-existing injuries. If you have specific joint injuries or medical problems that affect your joints, discuss doing yoga first with your physician and then work with your yoga teacher to tailor poses for your body.

By Marlynn Wei www.yogasensing.com/yoga/best-7-ways-to-protect-your-joints/

An evening walk in Brompton Cemetery by Ian Wood

The much restored grave of John Snow M.D.

John Snow (15 March 1813 – 16 June 1858) was an English physician and a leader in the development of anaesthesia and medical hygiene. He is considered one of the founders of modern epidemiology, in part because of his work in tracing the source of a cholera outbreak in Soho, London, in 1854, which he curtailed by removing the handle of a water pump. Snow's findings inspired the adoption of anaesthesia as well as fundamental changes in the water and waste systems of London, which led to similar changes in other cities, and a significant improvement in general public health around the world.

Snow was born on 15 March 1813 in York, England, the first of nine children born to William and Frances Snow in their North Street home, and was baptised at All Saints' Church, North Street, York. His father was a labourer who worked at a local coal yard, by the Ouse, constantly replenished from the Yorkshire coalfield by barges, but later was a farmer in a small village to the north of York.

The neighbourhood was one of the poorest in the city, and was frequently in danger of flooding because of its proximity to the River Ouse. Growing up, Snow experienced unsanitary conditions and contamination in his hometown. Most of the streets were unsanitary and the river was contaminated by runoff water from market squares, cemeteries and sewage

From a young age, Snow demonstrated an aptitude for mathematics. In 1827, when he was 14, he obtained a medical apprenticeship with William Hardcastle in the area of Newcastle-upon-Tyne. In 1832, during his time as a surgeon-apothecary apprentice, he encountered a cholera epidemic for the first time in Killingworth, a coal-mining village. Snow treated many victims of the disease and thus gained experience. Eventually he adjusted to teetotalism and led a life characterized by abstinence, signing an abstinence pledge in 1835. Snow was also a vegetarian and tried to only drink distilled water that was “pure”. Between 1832 and 1835 Snow worked as an assistant to a colliery surgeon, first in Burnopfield, County Durham, and then in Pateley Bridge, West Riding of Yorkshire. In October 1836 he enrolled at the Hunterian school of medicine on Great Windmill Street, London.

In the 1830s, Snow's colleague at the Newcastle Infirmary was surgeon Thomas Michael Greenhow. The surgeons worked together conducting research on England's cholera epidemics, both continuing to do so for many years.

In 1837, Snow began working at the Westminster Hospital. Admitted as a member of the Royal College of Surgeons of England on 2 May 1838, he graduated from the University of London in December 1844 and was admitted to the Royal College of Physicians in 1850. Snow was a founding member of the Epidemiological Society of London which was formed in May 1850 in response to the cholera outbreak of 1849. By 1856, Snow and Greenhow's nephew, Dr. E.H. Greenhow were some of a handful of esteemed medical men of the society who held discussions on this "dreadful scourge, the cholera".

After finishing his medical studies in the University of London, he earned his MD in 1844. Snow set up his practice at 54 Frith Street in Soho as a surgeon and general practitioner. John Snow contributed to a wide range of medical concerns including anaesthesiology. He was a member of the Westminster Medical Society, an organisation dedicated to clinical and scientific demonstrations. Snow gained prestige and recognition all the while being able to experiment and pursue many of his scientific ideas. He was a speaker multiple times at the society's meetings and he also wrote and published articles. He was especially interested in patients with respiratory diseases and tested his hypothesis through animal studies. In 1841, he wrote, On Asphyxiation, and on the Resuscitation of Still-Born Children, which is an article that discusses his discoveries on the physiology of neonatal respiration, oxygen consumption and the effects of body temperature change.

In 1857, Snow made an early and often overlooked contribution to epidemiology in a pamphlet, On the adulteration of bread as a cause of rickets.

Snow's interest in anaesthesia and breathing was evident from 1841 and beginning in 1843, he experimented with ether to see its effects on respiration. Only a year after ether was introduced to Britain, in 1847, he published a short work titled, On the Inhalation of the Vapor of Ether, which served as a guide for its use. At the same time, he worked on various papers that reported his clinical experience with anaesthesia, noting reactions, procedures and experiments. Within two years of ether being introduced, Snow was the most accomplished anaesthetist in Britain. London's principal surgeons suddenly wanted his assistance.

As well as ether, John Snow studied chloroform, which was introduced in 1847 by James Young Simpson, a Scottish obstetrician. He realised that chloroform was much more potent and required more attention and precision when administering it. Snow first realised this with Hannah Greener, a 15-year-old patient who died on 28 January 1848 after a surgical procedure that required the cutting of her toenail. She was administered chloroform by covering her face with a cloth dipped in the substance. However, she quickly lost pulse and died. After investigating her death and a couple of deaths that followed, he realized that chloroform had to be administered carefully and published his findings in a letter to The Lancet.

John Snow was one of the first physicians to study and calculate dosages for the use of ether and chloroform as surgical anaesthetics, allowing patients to undergo surgical and obstetric procedures without the distress and pain they would otherwise experience. He designed the apparatus to safely administer ether to the patients and also designed a mask to administer chloroform.[17] Snow published an article on ether in 1847 entitled On the Inhalation of the Vapor of Ether. A longer version entitled On Chloroform and Other Anaesthetics and Their Action and Administration was published posthumously in 1858.

Although he thoroughly worked with ether as an anaesthetic, he never attempted to patent it; instead, he continued to work and publish written works on his observations and research.

Snow's work and findings were related to both anaesthesia and the practice of childbirth. His experience with obstetric patients was extensive and used different substances including ether, amylene and chloroform to treat his patients. However, chloroform was the easiest drug to administer. He treated 77 obstetric patients with chloroform. He would apply the chloroform at the second stage of labour and controlled the amount without completely putting the patients to sleep. Once the patient was delivering the baby, they would only feel the first half of the contraction and be on the border of unconsciousness, but not fully there. Regarding administration of the anaesthetic, Snow believed that it would be safer if another person that was not the surgeon applied it.

The use of chloroform as an anaesthetic for childbirth was seen as unethical by many physicians and even the Church of England. However, on 7 April 1853, Queen Victoria asked John Snow to administer chloroform during the delivery of her eighth child, Leopold. He then repeated the procedure for the delivery of her daughter Beatrice in 1857. This led to wider acceptance of obstetrical anaesthesia.

Snow was a skeptic of the then-dominant miasma theory that stated that diseases such as cholera and bubonic plague were caused by pollution or a noxious form of "bad air". The germ theory of disease had not yet been developed, so Snow did not understand the mechanism by which the disease was transmitted. His observation of the evidence led him to discount the theory of foul air. He first published his theory in an 1849 essay, On the Mode of Communication of Cholera, followed by a more detailed treatise in 1855 incorporating the results of his investigation of the role of the water supply in the Soho epidemic of 1854.

By talking to local residents (with the help of Henry Whitehead), he identified the source of the outbreak as the public water pump on Broad Street (now Broadwick Street). Although Snow's chemical and microscope examination of a water sample from the Broad Street pump did not conclusively prove its danger, his studies of the pattern of the disease were convincing enough to persuade the local council to disable the well pump by removing its handle (force rod). This action has been commonly credited as ending the outbreak, but Snow observed that the epidemic may have already been in rapid decline:

There is no doubt that the mortality was much diminished, as I said before, by the flight of the population, which commenced soon after the outbreak; but the attacks had so far diminished before the use of the water was stopped, that it is impossible to decide whether the well still contained the cholera poison in an active state, or whether, from some cause, the water had become free from it.

Snow later used a dot map to illustrate the cluster of cholera cases around the pump. He also used statistics to illustrate the connection between the quality of the water source and cholera cases. He showed that homes supplied by the Southwark and Vauxhall Waterworks Company, which was taking water from sewage-polluted sections of the Thames, had a cholera rate fourteen times that of those supplied by Lambeth Waterworks Company, which obtained water from the upriver, cleaner Seething Wells. Snow's study was a major event in the history of public health and geography. It is regarded as the founding event of the science of epidemiology.

Snow wrote:

On proceeding to the spot, I found that nearly all the deaths had taken place within a short distance of the [Broad Street] pump. There were only ten deaths in houses situated decidedly nearer to another street-pump. In five of these cases the families of the deceased persons informed me that they always sent to the pump in Broad Street, as they preferred the water to that of the pumps which were nearer. In three other cases, the deceased were children who went to school near the pump in Broad Street...

With regard to the deaths occurring in the locality belonging to the pump, there were 61 instances in which I was informed that the deceased persons used to drink the pump water from Broad Street, either constantly or occasionally...

I had an interview with the Board of Guardians of St James's parish, on the evening of the 7th inst [7 September], and represented the above circumstances to them. In consequence of what I said, the handle of the pump was removed on the following day.

— John Snow, letter to the editor of the Medical Times and Gazette

Researchers later discovered that this public well had been dug only 3 feet (0.9 m) from an old cesspit, which had begun to leak faecal bacteria. The cloth nappy of a baby, who had contracted cholera from another source, had been washed into this cesspit. Its opening was originally under a nearby house, which had been rebuilt farther away after a fire. The city had widened the street and the cesspit was lost. It was common at the time to have a cesspit under most homes. Most families tried to have their raw sewage collected and dumped in the Thames to prevent their cesspit from filling faster than the sewage could decompose into the soil.

Thomas Shapter had conducted similar studies and used a point-based map for the study of cholera in Exeter, seven years before John Snow, although this did not identify the water supply problem that was later held responsible.

After the cholera epidemic had subsided, government officials replaced the Broad Street pump handle. They had responded only to the urgent threat posed to the population, and afterward they rejected Snow's theory. To accept his proposal would have meant indirectly accepting the fecal-oral route of disease transmission, which was too unpleasant for most of the public to contemplate.

It wasn't until 1866 that William Farr, one of Snow's chief opponents, realised the validity of his diagnosis when investigating another outbreak of cholera at Bromley by Bow and issued immediate orders that unboiled water was not to be drunk.

Farr denied Snow's explanation of how exactly the contaminated water spread cholera, although he did accept that water had a role in the spread of the illness. In fact, some of the statistical data that Farr collected helped promote John Snow's views.

Public health officials recognise the political struggles in which reformers have often become entangled. During the Annual Pumphandle Lecture in England, members of the John Snow Society remove and replace a pump handle to symbolise the continuing challenges for advances in public health.

Snow became a vegetarian at the age of 17 and was a teetotaller. He embraced an ovo-lacto vegetarian diet by supplementing his vegetables with dairy products and eggs. On this diet he excelled at swimming. He later became a vegan. In the mid-1840s, his health deteriorated and he suffered a renal disorder which he attributed to his vegan diet so he took up meat-eating and drinking wine. He continued drinking pure water (via boiling) throughout his adult life. He never married.

In 1830, Snow became a member of the temperance movement. In 1845, he became a member of York Temperance Society. After his health declined it was only about 1845 that he consumed a little wine to aid digestion.

Snow lived at 18 Sackville Street, London, from 1852 to his death in 1858.

Snow suffered a stroke while working in his London office on 10 June 1858. He was 45 years old at the time. He never recovered, dying six days later on 16 June 1858.

Cambridge postgraduate by Sir Cam

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A Roadmap for Biosecurity by Milken Institute

Nita Madhav

Head of Epidemiology & Global Risk Analytics, Ginkgo Bioworks

Mariana Matus

CEO and Co-Founder, Biobot Analytics

Robert Nelsen

Co-Founder and Managing Director, Arch Venture Partners

Raj Panjabi

Special Assistant to the President and Senior Director for Global Health Security and Biodefense, National Security Council, The White House

Peter Sands

Executive Director, The Global

Fund to Fight AIDS, Tuberculosis and Malaria

Yong-Bee Lim

Deputy Director of The Converging Risks Lab, Council on Strategic Risks

Meet Dartmouth's New Faculty for 2016–17 by Dartmouth College

Anne Hoen, Geisel

Assistant Professor of Epidemiology, Assistant Professor of Biomedical Data Science

(Photo by Eli Burakian '00)

Read more about our new faculty.

Stay connected to Dartmouth:

Facebook | Twitter | YouTube | Google+ | Instagram

Postgraduate Anwesha by Sir Cam

Anwesha Lahiri from India is studying for an Master’s in Epidemiology at Trinity Hall, University of Cambridge.

2015-2016 MCD Listy Handayani 6 by TEPHINET Secretariat

FETP Fellow: Listy Handayani

Country: Indonesia

Project: Maternal Determinant of Low Birth Weight in Temanggung District, Central of Java Province, 2015

Maternal and Child Health Mini-Grant

VWBPE 16 - Virtual Epidemiology in Open Sim by lorraine mockford

LV touring the Broad Street simulation with the developers, walking in the footsteps of John Snow.

A Roadmap for Biosecurity by Milken Institute

Nita Madhav

Head of Epidemiology & Global Risk Analytics, Ginkgo Bioworks

Mariana Matus

CEO and Co-Founder, Biobot Analytics

Robert Nelsen

Co-Founder and Managing Director, Arch Venture Partners

Raj Panjabi

Special Assistant to the President and Senior Director for Global Health Security and Biodefense, National Security Council, The White House

Peter Sands

Executive Director, The Global

Fund to Fight AIDS, Tuberculosis and Malaria

Yong-Bee Lim

Deputy Director of The Converging Risks Lab, Council on Strategic Risks

Dr. John Snow by Nasir

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John Snow (15 March 1813 – 16 June 1858) was an English physician and a leader in the adoption of anaesthesia and medical hygiene. He is considered to be one of the fathers of modern epidemiology, because of his work in tracing the source of a cholera outbreak in England, in 1854.

Below, John Snow's letter to the editor of the Medical Times and Gazette, which explains the famous map behind him, which he use to pinpoint the cause of the outbreak, the water-pump and the pump-handle in this painting

The result of the inquiry, then, is, that there has been no particular outbreak or prevalence of cholera in this part of London except among the persons who were in the habit of drinking the water of the above-mentioned pump wellI had an interview with the Board of Guardians of St James's parish, on the evening of the 7th inst [Sept 7], and represented the above circumstances to them. In consequence of what I said, the handle of the pump was removed on the following day.

Acrylic on small stretched canvas

From this photo

Ticking Time-bomb. by deanspic

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I recently attended a medical meeting discussing the rising incidence of Lyme Disease in Ontario. It was hosted by the KFLA Public Health Department in Kingston Ontario. A panel of experts presented the provincial and local epidemiology of Lyme disease, the biology and spread of the deer tick, as well as current diagnostic and treatment guidelines.

I live in what is now considered an endemic area for Lyme Disease. In other words the local deer tick population is well established in the St. Lawrence Valley and there is a significant biologic reservoir of the bacteria, Borrelia burgdorferi, that can infect people (and dogs) when bitten by the tick. It is just as bad here as it is in highly endemic areas of the US Northeast (like Lyme Connecticut, where the disease was first discovered back in the 70's). Unfortunately many cases of Lyme disease go unrecognized here in Ontario because most people and Doctors know so little about it. Hopefully that's about to change with the efforts of Public Health.

www.standard-freeholder.com/PrintArticle.aspx?e=2564062

www.rogerstv.com/page.aspx?sid=4011&rid=17&lid=23...

www.ontla.on.ca/library/repository/mon/2000/10298292.htm

www.health.gov.on.ca/en/ms/lyme/

www.cdc.gov/ncidod/dvbid/lyme/resources/handbook.pdf

cid.oxfordjournals.org/content/43/9/1089.full

emergency.cdc.gov/coca/calls/2012/callinfo_030612.asp

www.cihr-irsc.gc.ca/e/49713.html

NYC COVID-19 lockdowns walking 9th Ave Hells Kitchen November 13th 2020 by RyanReporting

NYC COVID-19 lockdowns walking 9th Ave Hells Kitchen November 13th 2020

Walking from Times Square w42nd Street to West 36th Street

Stile's Farmers Market

476 9th Ave,

New York, NY 10018

ANDREW M. CUOMO, Governor of the State of New York

Executive Order 202.3, as extended, and Sections 105 and 106 of the Alcoholic Beverage Control Law, to the extent necessary to require that:

All businesses that are licensed by the State Liquor Authority under sections 63 and 79 of the Alcoholic Beverage Control Law (“liquor stores” and “wine stores”) shall cease all off premises sales and close at or before 10:00PM, and shall not reopen before existing county opening hours permit.

All businesses that are licensed by the State Liquor Authority for on premises service of alcoholic beverages, shall cease all on premises service and consumption of food and beverages (including alcoholic beverages), inside or outside, at or before 10:00PM and shall not reopen before the later of any stipulated opening hours or existing county opening hours permit; further, to-go and delivery service of food, and non-alcoholic beverages only, may continue at such business licensed for on premises service until the earlier of any stipulated closing hours or existing county closing hours permit.

This provision shall be subject to reasonable limitations and procedures set by the Chairman of the State Liquor Authority and/or any relevant Department of Health guidance.

All restaurants, irrespective of whether such restaurant is licensed by the State Liquor Authority, shall cease in-person dining at 10:00PM, but may continue curbside takeout and delivery service after 10:00PM so long as otherwise permitted, and may reopen no earlier than 5:00AM.

Any gym or fitness center shall cease operation and close to the public at 10:00PM, and cannot reopen until 5:00AM.

The directive contained in Executive Order 202.45, as extended, which amended the directives in Executive Order 202.42, 202.38, and 202.10, that limited all non-essential gatherings to allow gatherings of 50 of fewer individuals for any lawful purpose or reason, is hereby modified only insofar as to further limit non-essential private residential gatherings to 10 or fewer individuals for any lawful purpose or reason, provided that social distancing, face covering, and cleaning and disinfection protocols required by the Department of Health are adhered to.

All suspensions, modifications, and directives issues pursuant to this Executive Order are effective at 10:00PM on Friday, November 13, 2020.

#CoronavirusDisease #Coronavirus #COVID-19 #COVID19 #COVID #SARS-CoV-2 #SARSCoV2 #PublicHealth #Epidemiology #COVIDNYC #NewYorkHistory #HistoryofNewYork #NYCHistory #History #2020 #NY2020 #NYC2020 #NewYork2020 #NewYorkCity2020 #ANDREWMCUOMO #ANDREWCUOMO #CUOMO #GovernorCuomo #BilldeBlasio #MayordeBlasio #Lockdown #Shutdown #NewYorkOnPause #NYonPause #CovidLockdown #CovidShutdown #IndoorDining #HellsKitchen #HellsKitchenNYC #HKNY #NY #NYC #NYNY #NewYork #NewYorkCity #NewYorkNewYork #NYS #NewYorkState #restaurants #Lockdown #Shutdown #TimesSquareNYC #42ndSt #42ndStreet #PortAuthorityBusTerminal #NYPizza #NYCPizza

Laboratory of Epidemiology & Public Health, New Haven, USA by Iqbal Aalam

5 2

Paul Rudolph's Crawford Manor can be seen in the bacground.

Archive trawl of 1967 slides continues.

Building identification welcome. As far as I can make out it is Laboratory of Epidemiology & Public Health, 1963 by Douglas Orr, Philip Johnson and Zion & Breen.

Looking at recent Google Maps, Crawford Manor will now be hidden behind a huge building.

A Roadmap for Biosecurity by Milken Institute

Nita Madhav

Head of Epidemiology & Global Risk Analytics, Ginkgo Bioworks

Mariana Matus

CEO and Co-Founder, Biobot Analytics

Robert Nelsen

Co-Founder and Managing Director, Arch Venture Partners

Raj Panjabi

Special Assistant to the President and Senior Director for Global Health Security and Biodefense, National Security Council, The White House

Peter Sands

Executive Director, The Global

Fund to Fight AIDS, Tuberculosis and Malaria

Yong-Bee Lim

Deputy Director of The Converging Risks Lab, Council on Strategic Risks

Grave of John Snow M.D. by Ian Wood

4 1

John Snow (15 March 1813 – 16 June 1858) was an English physician and a leader in the adoption of anesthesia and medical hygiene. He is considered one of the fathers of modern epidemiology, in part because of his work in tracing the source of a cholera outbreak in Soho, London, in 1854. His findings inspired fundamental changes in the water and waste systems of London, which led to similar changes in other cities, and a significant improvement in general public health around the world.

Snow was born 15 March 1813 in York, England. He was the first of nine children born to William and Frances Snow in their North Street home. His neighbourhood was one of the poorest in the city and was always in danger of flooding because of its proximity to the River Ouse. His father was a labourer who may have worked at a local coal yard, by the Ouse, probably constantly replenished from the Yorkshire coalfield by barges, but later was a farmer in a small village to the north of York. Snow was baptised at All Saints' Church, North Street, York

Snow studied in York until the age of 14, when he was apprenticed to William Hardcastle, a surgeon in Newcastle upon Tyne. It was there, in 1831, that he first encountered cholera, which entered Newcastle via the seaport of Sunderland and devastated the town. Between 1833 and 1836 Snow worked as an assistant to a colliery surgeon, first in Burnopfield, County Durham, and then in Pateley Bridge, West Riding of Yorkshire. In October 1836 he enrolled at the Hunterian school of medicine on Great Windmill Street, London.

In 1837 Snow began working at the Westminster Hospital. Admitted as a member of the Royal College of Surgeons of England on 2 May 1838, he graduated from the University of London in December 1844 and was admitted to the Royal College of Physicians in 1850. In 1850 he was also one of the founding members of the Epidemiological Society of London, formed in response to the cholera outbreak of 1849.

In 1857 Snow made an early and often overlooked contribution to epidemiology in a pamphlet, On the adulteration of bread as a cause of rickets

John Snow was one of the first physicians to study and calculate dosages for the use of ether and chloroform as surgical anaesthetics, allowing patients to undergo surgical and obstetric procedures without the distress and pain they would otherwise experience. He designed the apparatus to safely administer ether to the patients and also designed a mask to administer chloroform. He personally administered chloroform to Queen Victoria when she gave birth to the last two of her nine children, Leopold in 1853 and Beatrice in 1857, leading to wider public acceptance of obstetric anaesthesia. Snow published an article on ether in 1847 entitled On the Inhalation of the Vapor of Ether. A longer version entitled On Chloroform and Other Anaesthetics and Their Action and Administration was published posthumously in 1858.

Snow was a skeptic of the then-dominant miasma theory that stated that diseases such as cholera and bubonic plague were caused by pollution or a noxious form of "bad air". The germ theory of disease had not yet been developed, so Snow did not understand the mechanism by which the disease was transmitted. His observation of the evidence led him to discount the theory of foul air. He first publicised his theory in an 1849 essay, On the Mode of Communication of Cholera, followed by a more detailed treatise in 1855 incorporating the results of his investigation of the role of the water supply in the Soho epidemic of 1854.

By talking to local residents (with the help of Reverend Henry Whitehead), he identified the source of the outbreak as the public water pump on Broad Street (now Broadwick Street). Although Snow's chemical and microscope examination of a water sample from the Broad Street pump did not conclusively prove its danger, his studies of the pattern of the disease were convincing enough to persuade the local council to disable the well pump by removing its handle. This action has been commonly credited as ending the outbreak, but Snow observed that the epidemic may have already been in rapid decline:

Snow later used a dot map to illustrate the cluster of cholera cases around the pump. He also used statistics to illustrate the connection between the quality of the water source and cholera cases. He showed that the Southwark and Vauxhall Waterworks Company was taking water from sewage-polluted sections of the Thames and delivering the water to homes, leading to an increased incidence of cholera. Snow's study was a major event in the history of public health and geography. It is regarded as the founding event of the science of epidemiology.

Snow wrote:

— John Snow, letter to the editor of the Medical Times and Gazette

Researchers later discovered that this public well had been dug only 3 feet (0.9 m) from an old cesspit, which had begun to leak fecal bacteria. The cloth nappy of a baby, who had contracted cholera from another source, had been washed into this cesspit. Its opening was originally under a nearby house, which had been rebuilt farther away after a fire. The city had widened the street and the cesspit was lost. It was common at the time to have a cesspit under most homes. Most families tried to have their raw sewage collected and dumped in the Thames to prevent their cesspit from filling faster than the sewage could decompose into the soil.

Thomas Shapter had conducted similar studies and used a point-based map for the study of cholera in Exeter, Devon years before John Snow, although this did not identify the water supply problem that was later held responsible.

After the cholera epidemic had subsided, government officials replaced the Broad Street pump handle. They had responded only to the urgent threat posed to the population, and afterward they rejected Snow's theory. To accept his proposal would have meant indirectly accepting the oral-fecal method of transmission of disease, which was too unpleasant for most of the public to contemplate.[14]

It wasn't until 1866 that William Farr, one of Snow's chief opponents, realized the validity of his diagnosis when investigating another outbreak of cholera at Bromley by Bow and issued immediate orders that unboiled water was not to be drunk.

Farr denied Snow's explanation of how exactly the contaminated water spread cholera, although he did accept that water had a role in the spread of the illness. In fact, some of Farr's statistical data that he collected helped promote John Snow's views.

n 1830 Snow became a member of the Temperance Movement, and lived for a decade or so as a vegetarian and teetotaler. In the mid-1840s his health deteriorated, and he returned to meat-eating and drinking wine. He continued drinking pure water (via boiling) throughout his adult life. He never married.

Snow lived at 18 Sackville Street, London, from 1852 to his death in 1858.

Snow suffered a stroke while working in his London office on 10 June 1858. He was 45 years old at the time. He never recovered, dying on 16 June 1858.

Brompton Cemetery

Problems of Birth Defects by DES Daughter

From Hippocrates to Thalidomide and After,

original papers with commentaries by T.V.N. Persaud.

A collection of 57 papers and commentaries, arranged in eight sections, discuss the historical aspects, epidemiology, mechanisms, genetics, etiology, prenatal diagnosis, management, and social aspects of birth defects.

Paperback: 399 pages

Publisher: University Park Press (1977).

More DES DiEthylStilbestrol Resources

* DES studies on cancers and screening.

* DES studies on epigenetics and transgenerational effects.

* DES studies on fertility and pregnancy.

* DES studies on gender identity and psychological health.

* DES studies on in-utero exposure to DES and side-effects.

* DES studies on the genital tract.

* Papers on DES lawsuits.

* DES videos and posts tagged DES, the DES-exposed, DES victims.

Ask About: Big Data for Public Health by World Economic Forum

Emily Banks, Professor of Epidemiology and Public Health, Australian National University, Australia at the Annual Meeting 2017 of the World Economic Forum in Davos, January 17, 2017

Prostate…Calcifications appear as brightly echogenic foci that may or may not show posterior shadowing ……Prostatic calcifications are a common finding after the age of 500 by Hughes Songe

Epidemiology

They are rare in children, infrequent below age 40, and common in those over 50. Their number and size increase with age 8. Reported prevalence range is very wide and can range between 7-70%11.

Clinical presentation

Prostatic calcifications are most often an incidental and asymptomatic finding, but they have been associated with symptoms such as dysuria, hematuria, obstruction, or pelvic/perineal pain. Occasionally calcifications can be passed via the urethra 1,2.

Pathology

One of the key mechanisms for development of prostate calcifications is thought to be calcification of the corpora amylacea and simple precipitation of prostatic secretions 9.

Etiology

Prostatic calcification may be either primary (idiopathic) or secondary to 2,6 :

diabetes mellitus

infections - e.g. tuberculosis or bacterial prostatitis

benign prostatic hypertrophy - calcification occurs in 10%

prostate cancer

radiation therapy

iatrogenic - urethral stents or surgery

Associations

chronic pelvic pain syndrome 4,5

voiding dysfunction: rarely reported with large extrinsic calculi 11

large prostatic volume 10

ADVERTISEMENT: Supporters see fewer/no ads

Radiographic features

Prostate calcifications are most often bilateral and found in the posterior and lateral lobes although unilateral calcification can also be seen.

Plain radiograph

Variable appearance from fine granules to irregular lumps and can range in size from 1 to 40 mm. If there is significant prostatic hypertrophy the calcifications can project well above the pubic symphysis 1,2.

Ultrasound

Calcifications appear as brightly echogenic foci that may or may not show posterior shadowing 3.

Calcifications appear as hyperattenuating foci of variable thickness 3.

MRI

Often difficult to visualize on MRI, the typical appearance is a small signal void, similar to calcifications elsewhere in the body. Gradient echo sequences, such as SWI may be better to identify calcifications.

radiopaedia.org/articles/prostatic-calcification

The prostate is both an accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation. It is found only in some mammals. It differs between species anatomically, chemically, and physiologically. Anatomically, the prostate is found below the bladder, with the urethra passing through it. It is described in gross anatomy as consisting of lobes, and in microanatomy by zone. It is surrounded by an elastic, fibromuscular capsule and contains glandular tissue as well as connective tissue.

The prostate glands produce and contain fluid that forms part of semen, the substance that is emitted during ejaculation as part of the male sexual response. This prostatic fluid is slightly alkaline, milky or white in appearance. The alkalinity of semen helps neutralize the acidity of the vaginal tract, prolonging the lifespan of sperm. The prostatic fluid is expelled in the first part of ejaculate, together with most of the sperm, because of the action of smooth muscle tissue within the prostate. In comparison with the few spermatozoa expelled together with mainly seminal vesicular fluid, those in prostatic fluid have better motility, longer survival, and better protection of genetic material.

Disorders of the prostate include enlargement, inflammation, infection, and cancer. The word prostate comes from Ancient Greek προστάτης, prostátēs, meaning "one who stands before", "protector", "guardian", with the term originally used to describe the seminal vesicles.

en.wikipedia.org/wiki/Prostate

orbe doré by postbear eater of worlds

3 6

algerian polymath ∋vitruc, though born into poverty, rose in influence and power through his revisioning of janissarian tactics, demonstrating uncommon military brilliance and innovation. initially forced because of his age (estimated to be 13 at his first foray) to filter his instructions through a "ghost", an older, mildly disabled war veteran, his identity was discovered upon investigation of the death of said ghost. still a very young man (14 or 15; sources differ), he was challenged by pasha to prove his competence in developing strategy for a pending battle. ∋vitruc agreed, making a request that no opposing soldiers be killed unnecessarily, and that all armaments and gear obtained from the defeated be given him to study. upon the rout of the enemy battalion (again, sources differ alarmingly here, showing much personal bias among historians), ∋vitruc was awarded his prize, along with two captured soldiers, now his servants.

these servants, whom he'd personally selected, were reputed to become his advisors and reporters of the mysterious scientific innovations of foreign lands. though the empire was powerful, suspicion of great weaponry possessed by the enemy haunted the upper classes, and ∋vitruc's youthful intelligence was given unprecedented freedom to spend and explore. retiring with his servants to a remote valley some distance from oran, he spent some time refining (and re-refining) his own astonishingly accurate (and lethal) modifications to the arquebus, eventually earning the undying gratitude of the pasha for more than tripling the range of the firearm. as a result, the empire went unchallenged with any seriousness for many years.

his true reasons for retiring to the privacy of the countryside, however, were only revealed upon the eve of what has been recorded as his death (in or around 1623), but was really what more modern biographers now call his grand escape. algeria began to suffer from the effects of plague in 1620, and though he felt safe in his sheltered valley, ∋vitruc realised that terrible disease could strike at any time (his theories on epidemiology, though noted here, will have to wait to be discussed). none of his drawings survive (disputed; no paper record exists), but he was rumoured to have been fascinated by the constellations and from a very early age built odd devices (described as witches' clouds) that clearly must have been balloon prototypes. cave drawings estimated to be from his era (and in a valley not far from oran) show odd craft in the sky, in both day and night - historians again squabble here, as the drawings are crude and ∋vitruc was widely known to be a meticulous and exemplary artist. some agreement can be established that it was his servants who did the scribbling while he worked, and he possibly took his paperwork with him.

unsatisfied with paper aircraft, ∋vitruc began working with metal constructs he believed would fly through the air and carry weaponry, people and any and all matter of goods. documents survive in algiers, written by his detractors (and those who politically opposed his funders) that mock his impossible dream of levitating rocks, metals and minerals. ∋vitruc's legend and value as a miltary innovator protected him, though, and only the most polite needling of his dreams seems to have been allowed. some more serious criticism came in the form of questioning his use of valuable materials (notably silver and gold), which he was reputed to be experimenting with and destroying in vast amounts. there is evidence that at least two attempts were made by brigands to steal from him, but his weaponry was very greatly feared and respected (and his location secret and remote), so it's doubtful any dent in his resources was made.

the golden orb, shown above, is one of the few remaining devices he developed. with plague threatening his land (one of the servants is said to have become quite ill or died in 1622), ∋vitruc boarded his experimental metal craft and is said to have floated or flown away over the mediterranean sea. his surviving servant, when questioned, was barely believed, and he indicated that ∋vitruc had packed all of his remaining machines, along with some food, before departing. envoys of the pasha delivered the news, and in a fury, believing ∋vitruc had simply stolen all the wealth allowed him (not more than a few ounces of gold and silver remained), the story of his death was summarily spread.

the orb, once in the possession of the musée des arts et métiers (museum of arts and crafts) in paris, france, was lost and presumed stolen in 1804. a daguerreotype (dated 1850) of an unnamed man standing beside it surfaced in 1948, but no location could be determined. its existence on the grey market is, however, an open secret, and though algerian nationalists have made strong claims that the orb be repatriated, other pressing matters have consistently stifled the issue.

shown here is the orb attached sideways to a support structure, for no reason other than the whim of the current owner (and perhaps a slight attempt to disguise it, as it is on somewhat open display). the mechanical works are unfortunately not shown and may be missing entirely, though i was not allowed to touch, approach or examine the orb. photographing it was forbidden for the few years i knew of its location, until just recently, and i was required to both obscure all background details and surrender the memory card of my camera after downloading and editing this one shot. for obvious reasons, i cannot geolocate the orb on any map.

Laboratory of Epidemiology & Public Health, New Haven, USA by Iqbal Aalam

A Roadmap for Biosecurity by Milken Institute

Nita Madhav

Head of Epidemiology & Global Risk Analytics, Ginkgo Bioworks

Mariana Matus

CEO and Co-Founder, Biobot Analytics

Robert Nelsen

Co-Founder and Managing Director, Arch Venture Partners

Social Epidemiology: Public Health and Social Movements by Milken Institute

Richard Ditizio, President, Milken Institute

John Feinblatt, President, Everytown for Gun Safety

Robin Koval, CEO and President, Truth Initiative

Jesse Milan Jr., President and CEO, AIDS United

IMGP4199 -1fwlcon by citatus

Tombstone of William Harding Le Riche (March 21, 1916 - December 31, 2010), a professor of epidemiology at the University of Toronto, and his wife. Mount Pleasant Cemetery, Toronto, Canada. Summer afternoon, 2021. Pentax K1 II.

From en.wikipedia.org/wiki/William_Harding_le_Riche

William Harding le Riche FRCPC (21 March 1916 – 31 December 2010) was a South African–born Canadian epidemiologist. He was Professor of Epidemiology (emeritus) at University of Toronto.

Le Riche was born in Dewetsdorp, Orange Free State, Republic of South Africa and first studied at the University of the Witwatersrand in Johannesburg, where he gained a Bachelor of Science (B.Sc.) in 1936. He died in Toronto, Ontario, Canada.

Education

He was educated at University of the Witwatersrand.B.Sc. 1936, MB.ChB. 1943, MD 1949. He received a Carnegie Research Grant, Bureau for Education and Social Research, Pretoria 1937-1939. Harvard University (Rockefeller fellowship) M.P.H. (cum laude) 1949-50. He had an internship at Zulu McCord Hospital, Durban 1944.

Employment

Appointed by Union Health Department to Health Centre Service firstly at Pholela, Natal and later (1945) established first Health Centre for Whites and Eurafricans at Knysna, South Africa. 1945-1949.

Epidemiologist Union (Fed) Health Department, South Africa 1950-1952

Consultant in Epidemiology, Department of National Health and Welfare, Ottawa (worked on background report of Canadian Sickness Survey 1952-1954.

Research Medical Officer, Physicians Service Inc. Toronto, Ontario 1954-1957

Department of Public Health, School of Hygiene, University of Toronto 1959

Professor and Head of Department of Epidemiology, University of Toronto, 1962-1975.

Professor of Epidemiology, Department of Preventive Medicine, 1975–1982

Professor Emeritus from 1982

In reference to his higher qualifications, the MD was by thesis: Studies in Health, Growth and Nutrition. The FRCPC was in the area of Medical Science 1973. The F.A.C.P. was in Preventive Medicine

His research interests were wide. In 1936 he and Dr G. Schepers took the famous paleontologist, Doctor Robert Broom, to the Sterkfontein caves, near Johannesburg, South Africa, where Broom made important discoveries of hominid fossils, Australopithecus africanus.

Professional positions and appointments

In his University teaching he saw epidemiology as a broad comprehensive subject studying the determinants of disease. From this point of view epidemiology includes the basic medical sciences, microbiology, environmental chemistry and clinical medicine. However, by 1975, in the English speaking academic world, epidemiology had become a narrow statistical subject, involved mainly with analysis and past epidemic surveys and clinical trials. The Department of Epidemiology and Biometrics grew and M.Sc. and Ph.D. Programs were developed.

Between 1950 and 1980 the pundits were claiming antibiotics would solve the problems of most infectious disease. The fact that bacteria develop resistance to medicaments was not considered. In 1973 le Riche and Dr. Michael Lenczner raised the importance of infectious and tropical disease imported into Canada by travellers, immigrants and refugees. Governments were not interested in these situations.

By 1981 it became clear that AIDS (acquired immune deficiency syndrome) was a serious infectious disease.

In 1953 he received a part-time commission in the Canadian Armed Forces, serving in the 23rd Field Ambulance, under Lieut. Col. David Thompson in Ottawa. In 1968 he became a member of the Defence Research Board and for many years he was Consultant on preventive medicine to the Defence Medical Council. Outside the University he served on many committees including those of the Ontario Medical Association and the Canadian Medical Association.

During 1966-72 he was on the Metropolitan Toronto Hospital Planning Council under the chairmanship of Dr. H. Hoyle Campbell, plastic surgeon, who with Dr. Shouldice, pioneered outpatient surgery in Toronto. Some of the excellent recommendations of the Council were carried out in 1998 and 1999. For many years he served as the Medical Research Council Associate Committee on Hospital Infections, Chairman Professor E.G.D. Murray. As a result of this association the book on "The Control of Infections in Hospitals" was published in 1966. Other committees were the Professional Education Committee of the American Public Health Association, Examiners Committee, Public Health and Preventive Medicine, Royal College of Physicians and Surgeons of Canada, Nursing Research Committee, Ontario Council of Health Care 1969, Physicians Services Inc. Research Grants Committee, Second International Conference on Agriculture, University of Reading, England, Committee, Canadian Cancer Research Foundation, Committee on Acupuncture, Ontario Council of Health, Report on Reorganization of the City of Toronto Health Department. He was Chairman of the Canadian Society for Tropical Medicine and International Health 1976-1978.

He was a member of the Committee on Preventive Medicine, Medical Council of Canada.

In the University he was on the Planning Strategy Committee, Planning and Priorities Subcommittee, and many others. Research on Medical Care included surveys on the work of Medical Officers of Health in Ontario, and the work of Optometrists and Ophthalmologists in Ontario.

For a few weeks he was visiting professor, Wayne County Medical School, Detroit and Distinguished Lecturer at Dalhousie Medical School.

In 1956 he first appeared with Dr. Arthur Kelly, Canadian Medical Association on a television program. This was the beginning of a 25-year career in radio, television and the daily press, which covered many aspects of health care, nutrition and communicable diseases, and medical politics. He became a good communicator, and public speaker. His academic interests were nutrition, infections, populations, and environmental destruction. He was a Fellow of the American Public Health Association and Fellow of the Royal Society of Tropical Medicine. For 18 years he was on the part-time staff of the Department of Family Practice and Extended Care at Sunnybrook Hospital. He was awarded the Defries medal and granted Honorary Membership of the Canadian Public Health Association. He became a Life Member of the Ontario Medical Association and was granted Senior Membership of The Canadian Medical Association.

Personal

Le Riche married Margaret Cardross Grant on 11 December 1943. They had five children. His hobbies, at various time of his life included camping, photography, and he rode regularly until the age of 70. He was interested in music, opera and live theatre, and attended St. Timothy's Anglican Church, Toronto, Ontario.

The Department of Physician Assistant Studies, Class of 2012 Research Poster Presentation by Hofstra University

Upon completion of their courses in Epidemiology, Evidence Based Medicine, and Research Design and Analysis, the students completed a thesis based upon a clinically relevant topic for their Master of Science degree.

Students had the opportunity to partner with healthcare organizations, hospitals, and research institutes across Long Island and New York City where they conducted qualitative and quantitative research on pressing public health issues. Topics included smoking, obesity, health literacy, preventive health screening, sexual health, asthma, aging, and even driving safety. Some students evaluated novel health promotion interventions aimed to increase access to healthy foods, promote sexual self-efficacy and safety, disease self-management, and physical activity among patients at risk for diabetes and hypertension. Each student’s presentation marks the culmination of intense individual or team research and reflects the mastery of methodology and foundational knowledge. It is the program’s objective to promote the integrity of evidence based research and its application to the clinical decision-making process.

The Department of Physician Assistant Studies, Class of 2012 Research Poster Presentation by Hofstra University

MPH Reunion and 25th Anniversary Reception by Vanderbilt MPH Program

Friday, October 7, 2022

On October 7, the Vanderbilt MPH Program celebrated its 25th anniversary and the Global Health track’s 10th anniversary!

Alumni, students, faculty, and staff were invited to connect with classmates, friends, mentors, and colleagues and celebrate 25 years of Vanderbilt’s Master of Public Health Program and 10 years of the program’s Global Health track. Attendees toasted to the MPH Program’s first alumni award recipients, too!

Photo by Terry Wyatt, www.terrywyattphotography.com

Nashville, TN

This image is taken from United States Naval Medical Bulletin Vol. 8, Nos. 1-4, 1914 by Medical Heritage Library, Inc.

Go to the Book with image in the Internet Archive

Title: United States Naval Medical Bulletin Vol. 8, Nos. 1-4, 1914

Creator: U.S. Navy. Bureau of Medicine and Surgery

Publisher:

Sponsor:

Contributor:

Date: 1914

Language: eng

Table of Contents

Number 1

Preface v

Special articles:

The application of psychiatry to certain military problems, by W. A.

White, M. D 1

Schistosomiasis on the Yangtze River, with report of cases, by R. H.

Laning, assistant surgeon, United States Navy 16

A brief discussion of matters pertaining to health and sanitation,

observed on the summer practice cruise of 1913 for midshipmen of the third

class, by J. L. Neilson, surgeon, United States Navy 36

Technique of neosalvarsan administration, and a brief outline of the

treatment for syphilis used at the United States Naval Hospital, Norfolk, Va., by

W. Chambers, passed assistant surgeon, United States Navy 45

Some notes on the disposal of wastes, by A. Farenholt, surgeon, United States

Navy 47

The medical department on expeditionary duty, by R. E. Hoyt, surgeon, United

States Navy 51

A new brigade medical outfit, by T. W. Richards, surgeon, United States

Navy 62

Early diagnosis of cerebrospinal meningitis; report of 10 cases, by G.

F. Cottle, passed assistant surgeon, United States Navy 65

Comments on mistakes made with the Nomenclature, 1913, Abstract of patients

(Form F), and the Statistical report (Form K), by C. E. Alexander, pharmacist,

United States Navy 70

Classification of the United States Navy Nomenclature, 1913, by C. E. Alexander,

pharmacist, United States Navy 75

On the methods employed for the detection and determination of

disturbances in the sense of equilibrium of flyers. Translated by H. G. Beyer,

medical director, United States Navy, retired 87

United States Naval Medical School laboratories:

Additions to the pathological collection 107

Additions to the helminthological collection 107

Suggested devices:

A portable air sampling apparatus for use aboard ship, by E. W. Brown, passed

assistant surgeon, United States Navy 109

A new design for a sanitary pail 111

Clinical notes:

A case of paresis, with apparent remission, following neosalvarsan, by R.

F. Sheehan, passed assistant surgeon, United States Navy 113

Case reports from Guam, by E. O. J. Eytinge, passed assistant surgeon, United

States Navy 116

Stab wound of ascending colon; suture; recovery, by H. C. Curl,

surgeon, United States Navy 123

Perforation of a duodenal ulcer, by H. F. Strine, surgeon, United

States Navy 124

Two cases of bone surgery, by R. Spear, surgeon, United States Navy 125

Editorial comment:

Brig. Gen. George II. Torney, Surgeon General United States Army 127

Medical ethics in the Navy 127

Medical officers in civil practice 128

Progress in medical sciences:

General medicine. —Some anatomic and physiologic principles concerning

pyloric ulcer. By H. C. Curl. Low-priced clinical thermometers; a warning. By.

L. W. Johnson. The value of X-ray examinations in the

diagnosis of ulcer of the stomach and duodenum. The primary cause of

rheumatoid arthritis. Strychnine in heart failure. On the treatment of

leukaemia with benzol. By A. W. Dunbar and G. B. Crow 131

Surgery. — Surgical aspects of furuncles and carbuncles. Iodine

idiosyncrasy. By L. W. Johnson. Rectus transplantation for deficiency of

internal oblique muscle in certain cases of inguinal hernia. The technic of

nephro- pyelo- and ureterolithotomy. Recurrence of inguinal hernia. By H. C.

Curl and R. A. Warner 138

Hygiene and sanitation. —Ozone: Its bactericidal, physiologic and

deodorizing action. The alleged purification of air by the ozone machine. By E.

W. Brown. The prevention of dental caries. Gun-running operations in the

Persian Gulf in 1909 and 1910. The croton bug (Ectobia germanica) as a factor

in bacterial dissemination. Fumigation of vessels for the destruction of rats.

Improved moist chamber for mosquito breeding. The necessity for international

reforms in the sanitation of crew spaces on

merchant vessels. By C. N. Fiske and R. C. Ransdell 143

Tropical medicine. —The transmissibility of the lepra bacillus by the

bite of the bedbug. By L. W. Johnson. A note on a case of loa loa. Cases of

syphilitic pyrexia simulating tropical fevers. Verruga peruviana, oroya fever

and uta. Ankylostomiasis in Nyasaland. Experimental entamoebic dysentery. By E.

R. Stitt ... 148

Pathology, bacteriology, and animal parasitology. —The relation of the spleen

to the blood destruction and regeneration and to hemolytic jaundice: 6, The

blood picture at various periods after splenectomy. The presence of tubercle

bacilli in the feces. By A. B. Clifford and G. F. Clark 157

Chemistry and pharmacy. —Detection of bile pigments in urine. Value of the

guaiacum test for bloodstains. New reagent for the detection of traces of

blood. Estimation of urea. Estimation of uric acid in urine. By E. W. Brown and

O. G. Ruge 158

Eye, ear, nose, and throat. —Probable deleterious effect of salvarsan

on the eye. Effect of salvarsan on the eye. Fate of patients with

parenchymatous keratitis due to hereditary lues. Trachoma, prevalence of, in

the United States. The exploratory needle puncture of the maxillary antrum in

100 tuberculous individuals. Auterobic organisms associated with acute

rhinitis. Toxicity of human tonsils. By E. J. Grow and G. B. Trible 160

Miscellaneous. —Yearbook of the medical association of

Frankfurt-am-Main. By R. C. Ransdell 163

Reports and letters:

Notes on the Clinical Congress of Surgeons. By G. F. Cottle, passed

assistant surgeon, United States Navy 167

Number 2

Preface v

Special articles:

Report of the fourteenth annual meeting of the American Roentgen Ray Society,

by J. R. Phelps, passed assistant surgeon, United States Navy. 171

Typhoid perforation; five operations with three recoveries, by G. G.

Holladay, assistant surgeon, Medic al Reserve Corps, United States Navy 238

A satisfactory method for easily obtaining material from syphilitic

lesions, by E. R. Stitt, medical inspector, United States Navy 242

An epidemic of measles and mumps in Guam, by C. P. Kindleberger, surgeon,

United States Navy 243

The feeble-minded from a military standpoint, by A. R. Schier, acting assistant

surgeon, United States Navy 247

The Towne-Lambert elimination treatment of drug addictions, by W. M. Kerr,

passed assistant surgeon, United States Navy 258

Medical experiences in the Amazonian Tropics, by C. C. Ammerman, assistant

surgeon, Medical Reserve Corps, United States Navy 270

United States Naval Medical School laboratories:

Additions to the pathological collection 281

Additions to the helminthologieal collection 281

Suggested devices:

An easy method for obtaining blood cultures and for preparing blood

agar, by E. R. Stitt, medical inspector, and G. F. Clark, passed assistant surgeon,

United States Navy 283

Humidity regulating device on a modern battleship, by R. C. Ransdell, passed

assistant surgeon, United States Navy 284

Clinical notes:

Lateral sinus thrombosis, report of case, by G. F. Cottle, passed

assistant surgeon. United States Navy 287

Twenty-two cases of poisoning by the seeds of Jatropha curcai, by J. A.

Randall, passed assistant surgeon, United States Navy 290

Shellac bolus in the stomach in fatal case of poisoning by weed

alcohol, by H. F. Hull and O. J. Mink, passed assistant surgeons, United States

Navy 291

A case of pneumonia complicated by gangrenous endocarditis, by G. B. Crow,

passed assistant surgeon, United States Navy 292

Progress in medical sciences:

General medicine. —On progressive paralysis in the imperial navy during

the years 1901-1911. By H. G. Beyer. An etiological study of Hodgkin's disease.

The etiology and vaccine treatment of Hodgkin's dis

ease. Coryncbacterium hodgkini in lymphatic leukemia and Hodgkin's disease.

Autointoxication and subinfection. Studies of syphilis. The treatment of the

pneumonias. Whooping cough: Etiolcgy, diagnosis, and vaccine treatment. A new

and logical treatment for alcoholism. Intraspinous injection of salvarsanized

serum in the treatment of syphilis of the nervous system, including tabes and

paresis. On the infective nature of certain cases of splenomegaly and Banti's

disease. The etiology and vaccine treatment of Hodgkin's disease. Cultural

results in Hodgkin's disease. By A. W. Dunbar and G. B. Crow 295

Surgery- Interesting cases of gunshot injury treated at Hankow during

the revolution of 1911 and 1912 in China. The fool's paradise stage in

appendicitis. By L. W. Johnson. The present status of bismuth paste treatment

of suppurative sinuses and empyema. The inguinal route operation for femoral

hernia; with supplementary note on Cooper's ligament. By R. Spear and R. A.

Warner 307

Hygiene and sanitation. — A contribution to the chemistry of

ventilation. The use of ozone in ventilation. By E. \V. Brown. Pulmonary

tuberculosis in the royal navy, with special reference to its detection and

prevention. An investigation into the keeping properties of condensed milks at

the temperature of tropical climates. By C. N. Fiske and R. C. Ransdell 313

Tropical medicine. —Seven days fever of the Indian ports. By L. W.

Johnson. Intestinal schistosomiasis in the Sudan. Disease carriers in our army

in India. Origin and present status of the emetin treatment of amebic

dysentery. The culture of leishmania from the finger blood of a case of Indian

kala-azar. By E. R. Stitt 315

Pathology, bacteriology, and animal parasitology. —The isolation of

typhoid bacilli from feces by means of brilliant green in fluid medium. By C.

N. Fiske. An efficient and convenient stain for use in the eeneral examination

of blood films. By 0. B. Crow. A contribution to the epidemiology of

poliomyelitis. A contribution to the pathology of epidemic poliomyelitis. A

note on the etiology of epidemic

oliomyelitis. Transmutations within the streptococcus-pneumococcus

group. The etiology of acute rheumatism, articular and muscular. By A. B.

Clifford and G. F. Clark 320

Chemistry and pharmacy.— Centrifugal method for estimating albumin in

urine. Detection of albumin in urine. New indican reaction A report on the

chemistry, technology, and pharmacology of and the legislation pertaining to

methyl alcohol. By E. W. Brown and O. O. Ruge. . 325

Eye, ear, nose, and throat. —The use of local anesthesia in

exenteration of the orbit. Salvarsan in

ophthalmic practice. The effect of salvarsan on the eye. Total blindness

from the toxic action of wood alcohol, with recovery of vision under negative

galvanism. Furunculosis of the external auditory canal; the use of alcohol as a

valuable aid in treatment. Local treatment of Vincent's angina with salvarsan.

Perforated ear drum may be responsible for sudden death in water. The indications

for operating in acute mastoiditis. Turbinotomy. Why is nasal catarrh so

prevalent in the United States? By E. J. Grow and G. B. Trible 330

Miscellaneous. — The organization and work of the hospital ship Re d’

Italia. ByG. B. Trible 333

Reports and letters:

Correspondence concerning the article "Some aspects of the

prophylaxis of typhoid fever by injection of killed cultures," by Surg. C.

S. Butler, United States Navy, which appeared in the Bulletin, October, 1913

339

Malaria on the U. S. S. Tacoma from February, 1913, to February, 1914.

by I. S. K. Reeves, passed assistant surgeon, United States Navy 344

Extracts from annual sanitary reports for 1913 345

Number 3

Preface vii

Special articles:

Economy and waste in naval hospitals, by E. M. Shipp, surgeon, and P.

J. Waldner, chief pharmacist, United States Navy 357

The new method of physical training in the United States Navy, by J. A.

Murphy, surgeon, United States Navy 368

A study of the etiology of gangosa in Guam, by C. P. Kindleberger,

surgeon, United States Navy 381

Unreliability of Wassermann tests using unheated serum, by E. R. Stitt,

medical inspector, and G. F. Clark, passed assistant surgeon, United States

Navy 410

Laboratory note on antigens, by G. F. Clark, pasted assistant surgeon,

United States Navy 411

Prevention of mouth infection, by Joseph Head, M. D., D. D. S 411

The Medical Department at general quarters and preparations for battle,

by A. Farenholt, surgeon, United States Navy 421

A bacteriological index for dirt in milk, by J. J. Kinyoun, assistant

surgeon, Medical Reserve Corps, United States Navy 435

Brief description of proposed plan of a fleet hospital ship, based upon

the type auxiliary hull, by E. M. Blackwell, surgeon, United States Navy.. 442

The diagnostic value of the cutaneous tuberculin test in recruiting, by

E. M. Brown, passed assistant surgeon, United States Navy, retired 448

United States Naval Medical School laboratories:

Additions to the pathological collection 453

Suggested devices:

A sanitary mess table for hospitals, by F. M. Bogan, surgeon, United

States Navy 455

A suggested improvement of the Navy scuttle butt, by E. M. Blackwell,

surgeon, United States Navy 455

Clinical notes:

Malaria cured by neosalvarsan, by F. M. Bogan, surgeon, United States

Navy 457

A case of rupture of the bladder with fracture of the pelvis, by H. F.

Strine, surgeon, and M. E. Higgins, passed assistant surgeon, United States

Navy. 458

Clinical observations on the use of succinimid of mercury, by T. W.

Reed, passed assistant surgeon, United States Navy 459

Points in the post-mortem ligation of the lingual artery, by O. J.

Mink, passed assistant surgeon, United States Navy 462

Notes on the wounded at Vera Cruz, by H. F. Strine, surgeon, and M. E.

Higgins, passed assistant surgeon. United States Navy 464

Case reports from the Naval Hospital, Portsmouth, N. H., by F. M.

Bogan, surgeon, United States Navy 469

Progress in medical sciences:

General medicine. —The mouth in the etiology and symptomatology of

general systemic disturbances. Statistique m£dicale de la marine, 1909. By L.

W. Johnson. Antityphoid inoculation. Vaccines from the standpoint of the

physician. The treatment of sciatica. Chronic gastric ulcer and its relation to

gastric carcinoma. The nonprotein nitrogenous constituents of the blood in

chronic vascular nephritis

(arteriosclero-iis) as influenced by the level of protein metabolism.

The influence of diet on hepatic necrosis and toxicity of chloroform. The

rational treatment of tetanus. The comparative value of cardiac remedies. By A.

W. Dunbar and G. B. Crow

Psychiatry. —Abderhalden's method. Precis de psychiatric Constitutional

immorality. Nine years' experience with manic-depressive insanity. The pupil

and its reflexes in insanity. By R. F. Sheehan.

Surgery. —On the occurrence of traumatic dislocations (luxationen) in

the Imperial German Navy during the last 20 years. By H. G. Beyer. The wounding

effects of the Turkish sharp-pointed bullet. By T. W. Richards. Intestinal

obstruction: formation and absorption of toxin. By G. B. Crow

Hygiene and sanitation. —Relation of oysters to the transmission of

infectious diseases. The proper diet in the Tropics, with some pertinent remarks

on the use of alcohol. By E. W. Brown. Report of committee

upon period of isolation and exclusion from school in cases of

communicable disease. Resultats d'une enquete relative a la morbidity venerienne

dans la division navale d'Extreme-Orient et aux moyens susceptibles de la

restreindre. Ship's hygiene in the middle of the seventeenth century- Progress in

ship's hygiene during the nineteenth century. The origin of some of the

streptococci found in milk. On the further perfecting of mosquito spraying. By

C. N. Fiske and R. C. Ransdell

Tropical medicine. — Le transport, colloidal de medicaments dans le cholera.

By T. W. Richards. Cholera in the Turkish Army. A supposed case of yellow fever

in Jamaica. By L. W. Johnson. Note on a new geographic locality for balantidiosis.

Brief note on Toxoplasma pyroqenes. Note on certain protozoalike bodies in a

case of protracted fever with splenomegaly. The emetine and other treatment of

amebic dysentery and hepatitis, including liver abscess. A study of epidemic dysentery

in the Fiji Islands. By E. R. Stitt

Pathology, bacteriology, and animal parasitology. — The best method of staining

Treponema pallidum. By C. N. Fiske. Bacteriological methods of meat analysis.

By R. C. Ransdell. Primary tissue lesions in the heart produced by Spirochete

pallida. Ten tests by which a physician may determine when p patient is cured

of gonorrhea. Diagnostic value of percutaneous tuberculin test (Moro). Some

causes of failure of vaccine therapy. A method of increasing the accuracy and

delicacy of the Wassermann reaction: By A. B. Clifford and G. F. Clark

Chemistry and pharmacy. —Quantitative test of pancreatic function. A comparison

of various preservatives of urine. A clinical method for the rapid estimation

of the quantity of dextrose in urine. By E. W. Brown and O. G. Ruge

Eye, ear, nose, and throat. —Intraocular pressure. Strauma as an

important factor in diseases of the eye. Carbonic cauterization "in the

treatment of granular ophthalmia. Ocular and other complications of syphilis treated

by salvarsan. Some notes on hay fever. A radiographic study of the mastoid. Ear

complications during typhoid fever. Su di un caso di piccola sanguisuga

cavallina nel bronco destro e su 7 casi di grosse sanguisughe cavalline in

laringe in trachea e rino-faringe. By E. J. Grow and G. B. Trible

Reports and letters:

American medico-psychological association, by R. F. Sheehan, passed assistant

surgeon, United States Navy 517

Report of 11 cases of asphyxiation from coal gas, by L. C. Whiteside,

passed assistant surgeon, United States Navy 522

Extracts from annual sanitary reports for 1913 — United States Naval

Academy, Annapolis, Md., by A. M. D. McCormick, medical director, United States

Navy 523

U. S. S. Arkansas, by W. B. Grove, surgeon, United States Navy 524

Marine barracks, Camp Elliott, Canal Zone, Panama, by B. H. Dorsey, passed

assistant surgeon, United States Navy 525

U. S. S. Cincinnati, by J. B. Mears, passed assistant surgeon. United States

Navy 526

U. S. S. Florida, by M. S. Elliott, surgeon, United States Navy 527

Naval training station, Great Lakes, Ill., by J. S. Taylor, surgeon, United

States Navy 527

Naval station, Guam, by C. P. Kindleberger, surgeon, United States Navy

528

Naval Hospital, Las Animas, Colo., by G. H. Barber, medical inspector, United

States Navy 532

U. S. S. Nebraska, by E. H. H. Old, passed assistant surgeon, United States

Navy 533

U. S. S. North Dakota, by J. C. Pryor, surgeon, United States Navy. .

534

Navy yard, Olongapo, P. L, by J. S. Woodward, passed assistant surgeon,

United States Navy 536

U. S. S. San Francisco, by T. W. Reed, passed assistant surgeon, United

States Navy 537

U. S. S. Saratoga, by H. R. Hermesch, assistant surgeon, United States Navy

538

U. S. S. Scorpion, by E. P. Huff, passed assistant surgeon, United States

Navy 538

U. S. S. West Virginia, by O. J. Mink, passed assistant surgeon, United

States Navy 539

Number 4

Preface V

Special articles:

Some prevailing ideas regarding the treatment of tuberculosis, by

Passed Asst. Surg. G. B. Crow 541

The Training School for the Hospital Corps of the Navy, by Surg. F. E. McCullough

and Passed Asst. Surg. J. B. Kaufman 555

Khaki dye for white uniforms, by Passed Asst. Surg. W. E. Eaton 561

Some facts and some fancies regarding the unity of yaws and syphilis,

by Surg. C. S. Butler 561

Quinine prophylaxis of malaria, by Passed Asst. Surg. L. W. McGuire 571

The nervous system and naval warfare, translated by Surg. T. W.

Richards. 576

Measles, by Surg. G. F. Freeman 586

Smallpox and vaccination, by Passed Asst. Surg. T. W. Raison 589

Rabies; methods of diagnosis and immunization, by Passed Asst. Surg. F.

X. Koltes 597

Syphilis aboard ship, by Passed Asst. Surg. G. F. Cottle 605

Systematic recording and treatment of syphilis, by Surg. A. M.

Fauntleroy and Passed Asst. Surg. E. H. H. Old 620

Organization and station bills of the U. S. naval hospital ship Solace,

by Surg. W. M. Garton 624

United States Naval Medical School laboratories:

Additions to the pathological collection 647

Additions to the helminthological collection 647

Clinical notes:

Succinimid of mercury in pyorrhea alveolaris, by Acting Asst. Dental Surg.

P. G. White 649

A case of pityriasis rosea, by Surg. R. E. Ledbetter 651

Emetin in the treatment of amebic abscess of the liver, by Surg. H. F. Strine

and Passed Asst. Surg. L. Sheldon, jr 653

Salvarsan in a case of amebic dysentery, by Passed Asst. Surg. O. J.

Mink. . 653

Laceration of the subclavian artery and complete severing of brachial plexus,

by Surg. H. C. Curl and Passed Asst. Surg. C. B. Camerer 654

Malarial infection complicating splenectomy, by Surg. H. F. Strine 655

A case of gastric hemorrhage; operative interference impossible, by

Passed Arst. Surg. G. E. Robertson 656

Operation for strangulated hernia, by Passed Asst. Surg. W. S. Pugh 657

A case of bronchiectasis with hypertrophic pulmonary osteoarthropathy,

by Passed Asst. Surg. L. C. Whiteside 658

Editorial comment:

Systematic recording and treatment of syphilis 665

Progress in medical sciences:

General medicine. —A note of three cases of enteric fever inoculated

during the incubation period. By T. W. Richards. The modern treatment of

chancroids. The treatment of burns. By W. E. Eaton. Experiments on the curative

value of the intraspinal administration of tetanus antitoxin. Hexamethylenamin.

Hexamethylenamin as an internal

antiseptic in other fluids of the body than urine. Lumbar puncture as a special

procedure for controlling headache in the course of infectious diseases.

Cardiospasm. Acromion auscultation; a new and delicate test in the early

diagnosis of incipient pulmonary tuberculosis.

Diabetes mellitus and its differentiation from alimentary glycosuria.

The complement fixation test in typhoid fever; its comparison with the

agglutination test and blood culture method. By C. B. Crow.. 671

Mental and nervous diseases. —A voice sign in chorea. By G. B. Crow.

Wassermann reaction and its application to neurology. Epilepsy: a theory of

causation founded upon the clinical manifestations and the therapeutic and

pathological data. Salvarsanized serum (Swift-Ellis treatment) in syphilitic diseases

of the central nervous system. Mental manifestations in tumors of the brain.

Some of the broader issues of the psycho-analytic n movement. Mental disease

and defect in United States troops. By R. Sheehan 6S1

Surgery. — Infiltration anesthesia. War surgery. Tenoplasty; tendon transplantation;

tendon substitution; neuroplasty. Carcinoma of the male breast. Visceral

pleureotomy for chronic empyema. By A. M. Fauntleroy and E. H. H. Old 6S8

Hygiene and sanitation. — Further experiences with the Berkefold filter

in the purifying of lead-contaminated water. By T. W. Richards. Experiments in

the destruction of fly larvae in horse manure. By A. B. Clifford. Investigation

relative to the life cycle, brooding, and tome practical moans of reducing the

multiplication of flies in camp. By W. E. Eaton, Humidity and heat stroke;

further observations on an analysis of

50 cases. By C. N. Fiske 693

Tropical medicine. — The treatment of aneylostoma anemia. Latent dysentery

or dysentery carriers. Naphthalone for the destruction of mosquitoes. Emetin in

amebic dysentery. By E. R. Stitt 704

Pathology, bacteriology, and animal parasitology. —Meningitis by

injection of pyogenic microbes in the peripheral nerves. The growth of pathogenic

intestinal bacteria in bread. Present status of the complement fixation test in

the diagnosis of gonorrheal infections. Practical application of the luetin

test. By A. B. Clifford and G. F. Clark 707

Eye, ear, nose, and throat. — Misting of eyeglasses. By E. L. Sleeth.

The treatment of ocular syphilis by salvarsan and neo salvarsan. The moving

picture and the eye. Treatment of various forms of ocular syphilis with

salvarsan. Rapid, painless, and bloodless method for removing the inferior

turbinate. Hemorrhage from the superior petrosal sinus. The frequency of

laryngeal tuberculosis in Massachusetts.

Intrinsic cancer of larynx. Treatment of hematoma of the auricle. By E.

J. Grow and G. B. Trible 709

Reports and letters:

Care of wounded at Mazatlan and at Villa Union, by Medical Inspector S.

G. Evans 713

Medico-military reports of the occupation of Vera Cruz 715

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