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Growing number of Californians are dying at home

Opinion: Paxlovid side effects make drug hard to swallow

In a Chronicle op-ed, Bay Area journalist Debbie Cohen argues that the side effects of Paxlovid may be too much to bear for some. While she acknowledges that the antiviral drug from Pfizer is the most effective tool available to reduce the risk of severe COVID-19 infection, its strong metallic aftertaste made it difficult for her to complete the entire course of treatment, which requires taking three pills, twice daily over five days. “No matter how many cough drops I sucked on or sticks of gum I chewed, I could not shake the rancid, metallic-tasting dumpster fire that has seemingly taken up permanent residence in my mouth,” she said. Cohen added she is hopeful about a new antiviral pill called V116, which was found to be as effective as Paxlovid at curbing mild to moderate COVID among people at high risk but with far fewer side effects, according to a study published in the New England Journal of Medicine. Read more about Cohen’s Paxlovid misadventure.

Growing number of Californians are dying at home

The COVID-19 pandemic has bumped up the proportion of Californians who are dying at home rather than in a hospital or nursing home, accelerating a slow but steady rise that dates back at least two decades, according to a new report from Kaiser Health News. The rise in at-home deaths started in 2020, the first year of the pandemic, and the rate has continued to climb, outlasting lockdowns at hospitals and nursing homes that might help explain the initial shift. Nearly 40% of deaths in California during the first 10 months of 2022 took place at home, up from about 36% for all of 2019, according to death certificate data from the California Department of Public Health.

By comparison, U.S. Centers for Disease Control and Prevention data shows that about 26% of Californians died at home in 1999, the earliest year for which data on at-home deaths is accessible in the agency’s public database.The trend is amplified among California residents with serious chronic conditions. About 55% of Californians who died from cancer did so at home during the first 10 months of 2022, compared with 50% in 2019 and 44% in 1999. About 43% of Californians who died from Alzheimer’s in the first 10 months of 2022 did so at home, compared with 34% in 2019 and nearly 16% in 1999. Nationwide, the share of deaths occurring at home also jumped in 2020, to 33%, then rose to nearly 34% in 2021. Nationwide data for 2022 is not yet available.

More Americans say they are experiencing long COVID

For the first time since June, the proportion of American adults who say they are currently experiencing symptoms associated with long COVID has increased, based on new data from the U.S. Census Bureau published Wednesday by the Centers for Disease Control and Prevention. In January, the percentage of all U.S. adults experiencing post-COVID conditions — defined as adults who have had COVID, had long-term symptoms, and were still experiencing symptoms — rose to 5.9% after steadily declining from 7.5% in June to 5.8% in December. The percentage of respondents to the agencies’ experimental House Pulse Survey online who said they were experiencing activity limitations due to long COVID has also stopped declining, remaining at 4.8% for the second consecutive month. It is estimated that 53.8% of all American adults have had COVID-19 at least once as of January up from 40.3% in early June. But the agency notes that “the percentage of adults who said they ever had COVID based on the Household Pulse Survey is lower than other estimates based on seroprevalence studies.”

CDC plans to revise how deaths are counted

In its ongoing effort to wind down from the pandemic, the U.S. Centers for Disease Control and Prevention is developing a new national standard for classifying COVID-19-associated deaths. The change could see the number of reported fatalities linked to the virus reduce by 10%-20% in future tallies.  The Colorado Department of Public Health is among the first regional agencies to update its data visualizations to align with the Council of State and Territorial Epidemiologists’ Revised COVID-19-associated Death Classification Guidance — which is the new national standard for classifying COVID-19-associated deaths jointly with state health departments and the CDC.

The updated definition primarily relies on death certificate data and more closely aligns with “deaths due to COVID” data to better reflect deaths that are attributable to COVID-19, “especially during periods of high COVID rates when a significant proportion of people who die might incidentally test positive for the virus.” According to the guidance, which the CDC is expected to adopt this year, for a death to count as being caused by COVID, the “death certificate must indicate COVID-19 or an equivalent term as an immediate, underlying, or contributing cause of death, OR a case investigation determines COVID-19 was a cause of death,” and the death must occur within one year of a COVID-19 infection. Earlier this month, public health officials in Los Angeles County said the change could see a reduction in reported COVID-19 deaths going forward. Barbara Ferrer, the Los Angeles agency’s director, told a media briefing, “It’s very hard to go back in time, so I’m not going to but the deaths that we’re counting right now, those designations might change if there is a reclassification but we won’t know until we see the exact language… we might see a shift maybe it’s 10 to 20%.

San Diego first major city in state to sunset emergency declaration

The San Diego City Council on Tuesday voted to end the city’s COVID-19 emergency declaration and drop a city employee vaccine mandate at the end of February. The move aligns with California’s decision to lift a statewide order next month. 

 The council also decided to sunset a vaccine mandate for city employees, which was adopted in November 2021, according to KPBS. It noted that 91% of city employees have complied with the requirement.  “We find ourselves in this improved state because, by and large, San Diegans did their part in the fight against the pandemic by getting vaccinated and following public health guidance,” the statement said. 

Asian restaurants lost $7.4 billion in 1 year due to pandemic stigma, study finds

Anti-Asian sentiment during the COVID-19 pandemic caused substantial financial losses for both Chinese and non-Chinese Asian restaurants, according to a study by researchers from Boston College, the University of Michigan and Microsoft Research. Multiple data points show that consumer discrimination led to an 18.4% decrease in traffic compared to comparable non-Asian restaurants, with an estimated $7.42 billion in lost revenue in 2020 alone. Negative attitudes were fed by the racist rhetoric of then-President Donald Trump, who regularly blamed the virus outbreak on China and referred to it as the “kung flu.”

“Areas with more Trump support saw a larger relative drop in Chinese restaurant traffic than those with lower Trump support, and that Trump voters were more likely to misidentify Asian restaurants compared with non-Trump voters,” according to the authors of the study published in the journal Nature Human Behaviour on Thursday. Other kinds of Asian restaurants that were not Chinese suffered from the consumers not knowing them apart from Chinese establishments. 

“Although our results focus on consumer discrimination against Asian restaurants in the wake of the pandemic, these findings have relevance in a much broader context,” the authors wrote. “Restaurants are a bellwether for broader anti-minority-group sentiment and its impact on small businesses owing to their ubiquity and easy association with an ethnic group. Other small businesses, such as dental offices, lawyers, doctors, and accountants, are also easily affiliated with an ethnic group due to typical naming conventions, and our conclusions on how restaurant avoidance is not explained by consumer health safety concerns have substantial implications for consumer discrimination against these businesses as well.”

Mississippi doctor who opposes vaccine mandate enters gubernatorial GOP primary

A Mississippi doctor who leads a group of physicians opposed to COVID-19 vaccine mandates has filed paperwork to challenge Mississippi Gov. Tate Reeves in the state’s Republican primary. Dr. John Witcher is the only Republican so far challenging Reeves in the primary. He’s best known for founding a group of doctors against requiring COVID-19 vaccines. Witcher has said he was fired from a Mississippi hospital in 2021 after switching patients’ COVID-19 medication to ivermectin, an anti-parasite drug that is not authorized by the FDA to use for the coronavirus and which research shows doesn’t work.

A representative for Baptist Memorial Hospital in Yazoo City told the Biloxi Sun Herald that Witcher practiced at the facility as an independent physician and was never an employee. According to a Mississippi State Board of Medical Licensure document, the doctor was suspended in 2010 from practicing medicine at another Mississippi hospital after a regulatory commission found he was “an immediate threat to the public by reason of alcohol or other substance abuse.”

Once-a-year vaccine plan is flawed, say WHO officials

Officials from the World Health Organization cast doubt on plans by U.S. health officials to make COVID-19 vaccinations more like the annual flu shot. “For the time being, COVID hasn’t really come down to the usual seasonal seasonality that we see for other viruses,” Joachim Hombach, executive secretary of the WHO strategic advisory group of experts on immunization, told a  media briefing on Tuesday. “The virus is still fairly unstable so it is a bit of anticipation if we end up in a seasonal pattern as we have it for instance for influenza.” He said that the U.S. Food and Drug Administration’s proposal to allow most adults and children to get a once-a-year shot to protect against the mutating virus might work at some point but warned “you basically have to find the sweet spot between waning immunity and the benefit and the effort of providing an additional vaccination.” That would vary for each individual.

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