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Thursday, September 30, 2021

CDC issues urgent health advisory for pregnant women to get vaccinated - KCRA Sacramento

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  1. CDC issues urgent health advisory for pregnant women to get vaccinated  KCRA Sacramento
  2. Breaking down the CDC's recommendation for pregnant women and COVID-19 vaccine l GMA  Good Morning America
  3. Can I get COVID and the flu at the same time?  NJ.com
  4. Unvaccinated CA surgical tech says she's being placed on unpaid leave despite medical exemption  ABC7 News Bay Area
  5. Doctor treating pregnant Covid patients warns this could be 'just another lull before another potential surge'  CNBC
  6. View Full Coverage on Google News


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CDC issues urgent health advisory for pregnant women to get vaccinated - KCRA Sacramento
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Mark Cuban defends Mavericks' COVID policy as preseason gets ready to start - Fox Business

The Dallas Mavericks will require fans who enter the American Airlines Center for home games to have proof of being fully vaccinated against the coronavirus or a negative COVID-19 test within 48 hours of the game.

The Mavericks are following the Oklahoma City Thunder, New York Knicks, Brooklyn Nets and Golden State Warriors, which will have similar policies. The Thunder and Mavericks are the only teams that adopted the policy without a local mandate with which to comply.

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The Mavs are one of the teams who have the policy in place without a local mandate. (REUTERS/Borut Zivulovic / Reuters Photos)

The announcement came into the inboxes of Mavericks season-ticket holders, according to 105.3 The Fan in Dallas. Additionally, fans will be required to wear masks throughout the arena except when they’re eating or drinking. Children under 12 years old who are not seated within 15 feet of the court will not need to comply with the requirements, but anyone over the age of 2 still has to wear a mask.

Mavericks team owner Mark Cuban explained the decision to D Magazine.

"We wanted to keep our customers and employees as safe as we can. There are no absolutes with COVID. But based on the data we have, we felt that was the best decision. As the data and science evolves, we will re-evaluate our decisions as often as we think it helps," Cuban said.

Dallas, Texas, USA; Dallas Mavericks owner Mark Cuban shoots before the game against the Los Angeles Lakers at American Airlines Center. (Kevin Jairaj-USA TODAY Sports / Reuters Photos)

MICHAEL JORDAN'S UNDERWEAR SELLS FOR BIG PRICE AT AUCTION

Cuban also answered criticism of the policy on Twitter.

Mavericks fans are hoping a new coach and a roster loaded with talent, including Luka Doncic and Kristaps Porzingis, will get them back to the NBA Finals.

Luka Doncic is one of the biggest stars in the NBA. (AP Photo/LM Otero / AP Newsroom)

The Mavericks have a preseason home game on Oct. 6.

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Dallas was bounced from the first round of the playoffs in each of the last two seasons. Jason Kidd was hired to replace Rick Carlisle as head coach for this season.

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Tucker: Draconian COVID policies in Australia may be coming to the United States - Fox News

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One thing about Americans: they love Australia. Most Americans have never been there. It’s an awfully long way away. But when Americans think of Australia, they imagine a freer, tougher version of themselves. Steve Irwin, Crocodile Dundee, that kind of thing. So there’s a huge reserve of affection in the United States for Australia, its culture, and its people. It’s also possible most Americans, us included, have not updated our assumptions about Australia in a while. The modern reality is a little different from what we imagine.

Case and point: In June of 2019, federal police in Sydney, Australia raided the offices of the state broadcaster, ABC. They weren’t at all unclear about why they were raiding the offices. They said it out loud. Just days before the raid, ABC broadcast allegations from a whistleblower that embarrassed Australia's government. This whistleblower said that Australia's military leaders had killed civilians in Afghanistan, including children, and had lied about it. ABC broadcast that story. 

It wasn’t a crime to broadcast the story, and Australia’s federal police didn’t pretend it was. Instead, they served ABC with a warrant that authorized them, the police, to cover up the evidence of the military's misconduct. The warrant, and we're quoting, allowed police to "add, copy, delete, or alter" any material they wanted to alter on the broadcaster's computers. 

That’s not the kind of thing that happens in a free country, to put it mildly. And yet, Australia's military and police forces never suffered any consequences for doing it; In fact, many Australians supported it. They rewarded their military with hundreds of millions of dollars in new spending -- most of that money was intended to keep Australians safe from the malign influence of "Chinese authoritarianism," even though that seemed a lot like Chinese authoritarianism itself.  

MEDIA STOPS COVERING FL COVID DATA BECAUSE DESANTIS' DOWNTREND THREATENS LOCKDOWN POLITICS: SEXTON, TRAVIS

Two years later, what does Australia look like? It looks a lot like China did at the beginning of the pandemic. We showed you those images from China at the time -- the people being welded inside their apartments to starve, the guys in hazmat suits forcing people in quarantine boxes and driving away to some unknown destination. At the time, our public health officials, including Tony Fauci, told us nothing like that could ever happen in our country or in the west. But that was wrong because those things are now happening in Australia. This is what happens in Australia if you try to leave your apartment:

REPORTER: Anthony Karam knows he’s COVID positive when he steps into this public lift. Already breaking so many rules, he doesn’t bother to cover his mouth as he sneezes and splutters. The 27-year-old is still infectious but has gone missing from his Wentworth Point apartment, the warrant now issued for his arrest. 

HEALTH MINISTER BRAD HASSARD: This 27-year-old chap who apparently has expressed the view that he doesn’t care less whether he spreads the virus is one example of the worst of the worst.

So a national manhunt for a man who sneezed in an elevator. That’s the state of play in modern-day Australia. Not everyone in the country is on board with this, but since Australians were completely disarmed by their government several years ago, there’s precisely nothing they can do about it, so it’s accelerating. Look at what’s happening now. They’re being crushed. The scene in Melbourne (the second-most populous city in Australia) over the past month was chaos.

Is the government cracking down on Islamic extremists, dangerous revolutionaries in their midst? No. Just ordinary Australians complaining, demonstrating peacefully against the lockdowns, beaten by police.

You've seen a lot of footage from Australia that shows the chaos, but something that's not immediately obvious from the American vantage is this is not all of Australia. The whole country is not locked down. In Australia, most of the lockdowns are in the eastern part of the country, that’s where the capital of the country is and where the federal government has the most control. Western Australia, home to most of the country's national resources, isn't locked down at all. 50,000 fans just crowded inside a stadium for a rugby match in Perth, the capital of Western Australia; no one beat them with nightsticks or hosed by the police. The rugby match was not a super-spreader event. Western Australia has virtually no COVID cases.

 POLITICO REPORTER SCOLDS GOLD STAR FAMILY OF MARINE KILLED FROM KABUL ATTACK FOR NOT WEARING MASKS IN CAPITOL

How did that happen? How does Western Australia not lockdown but remain virtually COVID-free? Simple. By controlling its borders. Western Australia didn't allow thousands of people to stream in from anywhere they wanted to in the world. They’re not Texas. They didn’t care about protecting their borders. They’re not worried about being called racist. It seemed common sense, and it worked. 

And here's the really revealing thing. Australia's federal government is angry that Western Australia has closed its borders. They want that part of the country to open its borders. Why might that be? According to ABC News, Australia's government is, "arguing that [Western Australia's] internal border restrictions are a drag on the national economy." 

That’s interesting because the problem with Australia's economy does not come from Western Australia closing its borders. It comes from the lockdowns. Those are the biggest drag on the national economy ever conceived in Australia. So are those police SWAT teams beating people for going outside. 

COVID mandates are a far greater threat to Australia’s economy and its social fabric than COVID itself. The Queensland health minister, in eastern Australia, explaining that outdoor mask mandates are necessary because of two new COVID cases. Not two thousand, but two:

QUEENSLAND HEALTH MINISTER YVETTE D'ATH: What these two cases mean is that we will be extending immediately the directive in relation to mask-wearing to the Gold Coast. 

We want to pause for a moment to give you a sense of the scope of the pandemic in Australia: To date, COVID has caused 1,300 "recorded deaths" in the entire country. Australia has 25 million people. That 1,300 figure includes people who "died with probable COVID," whatever that means. 

In Alberta, Canada, the health minister just announced that anyone who stays home from any illness will be counted by the Canadian government as a COVID patient. Then she pretended she didn't say that because it’s obviously insane, but it’s on video, so we know she did.

In Australia, the government has adopted a similar standard -- anyone who leaves home is apparently being counted as a COVID patient. A man in Melbourne on Sunday made the mistake of walking outside a block from his home:

WOMAN: He lives a block away! 

POLICE OFFICER: He has no reason to be here. He has no valid reason to be out today.  He wasn’t wearing a face mask. 

WOMAN: He has a face mask in his pocket. He was just smoking a cigarette. He just came to get lunch with me. 

MAN: And the reason I didn’t have a mask on was I was having a cigarette. I have two masks in my pocket. What do you want me to do?

Here’s the interesting thing – apart from that’s obvious authoritarianism, it’s terrifying that could happen in a civilized English-speaking country, Australia of all places – notice the police didn’t ask the man if he’s been vaccinated. You think that’d be the first question they’d ask. Vaccination works, doesn’t it? That’s why it’s mandatory, right? 

REP. CHIP ROY INTRODUCES LEGISLATION TO BLOCK FINES FOR BIDEN'S VACCINE MANDATE

That's an important point because publicly, Australia's leaders are still pretending vaccination status matters. In New South Wales -- again, Eastern Australia -- one official promised that the unvaccinated will be allowed to retain their freedoms:

DEPUTY PREMIER OF NEW SOUTH WALES JOHN BARILARO: The message to the unvaccinated is that you will not achieve any further freedom unless you get vaccinated and finally my message to south wales … There will be individuals in South Wales who choose not to be vaccinated who will lose their freedoms on the 11th of October.

No more freedom if you don’t get the vax, but, they will arrest you for being outside smoking a cigarette a block from your home without a mask, and not even ask you whether they’ve been vaccinated. So if vaccination status is that important as a health matter, wouldn’t that be the first question you ask? But they didn’t even bother. 

Meanwhile, in the same state -- New South Wales -- Australian officials are telling people that whether they're vaccinated or not, they can't go to church:

PASTOR: In the name of Jesus, lockdowns are over, in the cities of New South Wales. 

REPORTER: It’s unclear what passage this pastor is preaching from, but it’s not the public health order. His church the Christ Embassy in Blacktown is in lockdown, hard lockdown. … There was no QR code on the door. Costing the organization 5,000 dollars. Each of these thirty adult worshipers fined a thousand dollars. 

POLICE OFFICER: Whether it’s a soccer match, whether it’s a church service, it doesn’t matter. You cannot gather as they did at Blacktown.

Oh, so you have to get vaccinated to get any of your freedoms, but even if you are vaccinated, you’re not allowed to go to church. So what is the point of vaccination? Why did the federal government in Australia lock everyone down if there’s no actual way to stop the lockdowns. And more to the point, why do they want open borders in Western Australia if closing the borders has actually kept the population safe. 

COVID CASES SPIKE IN AUSTRALIAN STATE OF VICTORIA, GOVERNMENT BLAMES PEOPLE WATCHING SPORTS AT HOME

They want open borders there for the same reason they want them here. In New South Wales, one official -- the health officer -- made it explicit:

DR. KERRY CHANT: We will be looking at what contact tracing looks like in the new world order. Yes, it will be pubs and clubs and other things if we have a positive case there.

The new world order. She said it out loud. This is a really interesting story, what’s happening in Australia, and what it means for the rest of the Anglosphere, very much including us. And maybe that’s why globally, most media organizations have refused to cover it. That comment barely got any coverage at all. In fact, all the footage we just quoted is mostly being ignored in the United States. 

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Why? It’s possible what’s happening in Australia might be instructive to us in the United States. In just two years, Australia's police went from raiding newsrooms to beating people in the street. Maybe the lesson is: Things can change very quickly. One moment, the English-speaking world is mocking China for being dystopian and autocratic. 

The next moment, they’re aping China and hunting people down who are two blocks from their home and smoking a cigarette. 

This article is adapted from Tucker Carlson's opening commentary on the Sept. 30, 2021 edition of "Tucker Carlson Tonight."

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Dolores rescheduling homecoming events after virus spike - The Journal

The Dolores school district reported a spike in COVID-19 cases this week.

The district saw an upward trend in COVID-19 cases this week, particularly in the secondary school

Dolores School District RE-4A had a surge in COVID-19 cases this week, and postponed its homecoming events, according to Superintendent Reece Blincoe.

The district quarantined more than 60 students this week, he said – about 30 of them in the sixth grade alone. Over 20 students tested positive for the virus, and two additional elementary school students tested positive Thursday, he said.

The situation began to improve Thursday, though, as some students and staff returned to school, Blincoe said.

“We were able to pull this together,” he said.

The only homecoming event that proceeded on schedule was the high school volleyball game Thursday against Mancos, according to the district’s website.

The Colorado Department of Public Health and Environment has not yet recorded the cases on its outbreak map.

CDPHE updated its definition of an “outbreak” for most settings June 1. In locations like schools, workplaces, events and dorms, an outbreak occurs when there are five or more confirmed or probable cases, with at least one case having a positive molecular amplification test or antigen test.

Blincoe said the spike began at the end of last week, and climbed this week.

“We literally went from zero,” he said.

On Wednesday, the secondary school entered “Yellow Status” – the third tier of the district’s five-category “Infectious Disease Safety Protocols.” The rubric was created over the course of a few school board meetings, and breaks down different health procedures by number of cases in the district. It may be adjusted at some point if needed by the district’s designated Wellness Committee, Blincoe said.

In yellow status, all staff are required to wear masks, but they are still optional for students. No visitors are allowed on campus. For this protocol to go into effect, 3% to 5% of students on one campus must become infected. This is equivalent to 13 to 21 secondary students, 10 to 15 elementary students or three to five preschool students.

Currently, the preschool and elementary school are following “Blue Status” — which is in effect when 1.5 to 3% of students on one campus are infected. This means anywhere from six to 13 secondary students, five to 10 elementary students or one to three preschool students are infected. In blue status, masks are optional – except for food handlers – and visitors are limited.

“We’re trying to be careful and safe and follow precautions,” Blincoe said.

He said that while the district does its best, it is unable to make everyone happy. Some parents contact him to oppose mask-wearing, and others contact him to support stricter virus regulations, he said.

“I hear it from both sides,” he said.

The high school is planning to reschedule its homecoming football game for Oct. 15, with dates for the other events to follow.

"We’re going to try to do our best to bring everything back,“ Blincoe said.

He said a group of seniors emailed him and secondary school principal Justin Schmitt asking about the possibility of holding the homecoming events.

Blincoe said he was touched, finding their ability to express themselves mature.

“I took it to heart,” he said.

He wants them to feel seen.

“We’re trying to keep you in school, we want these events too,” he said.

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Dolores rescheduling homecoming events after virus spike - The Journal
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West Nile virus cases in Maricopa County: what areas get fogged the most? - AZFamily

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West Nile virus cases in Maricopa County: what areas get fogged the most?  AZFamily

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West Nile virus cases in Maricopa County: what areas get fogged the most? - AZFamily
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Feinstein introduces bill to require vaccinations or tests for domestic air travel | TheHill - The Hill

Sen. Dianne FeinsteinDianne Emiel FeinsteinCongress's role in the AUKUS nuclear-powered submarine deal No. 2 Senate Democrat: Raising debt limit under reconciliation a 'non-starter' Federal watchdog calls on Congress, Energy Dept. to overhaul nuclear waste storage process MORE (D-Calif.) introduced a bill on Wednesday that would require travelers to be fully vaccinated against COVID-19 or test negative before domestic travel.

The U.S. Air Travel Public Safety Act would require the Department of Health and Human Services and the Federal Aviation Administration to develop standards for airlines to verify that a person has either been vaccinated, tested negative for COVID-19 or has fully recovered from a coronavirus infection to be able to fly.

In a statement, Feinstein said the U.S. cannot go through a surge in coronavirus infections this holiday season like the surge that occurred during the 2020 winter season.

“Ensuring that air travelers protect themselves and their destination communities from this disease is critical to prevent the next surge, particularly if we confront new, more virulent variants of COVID-19,” Feinstein said. 

“It only makes sense that we also ensure the millions of airline passengers that crisscross our country aren’t contributing to further transmission, especially as young children remain ineligible to be vaccinated,” she continued.

As the U.S. deals with a wave of coronavirus infections fueled by the delta variant, some experts warn that another surge in the winter is likely.

The Centers for Disease Control and Prevention currently requires air passengers from a foreign country to test negative for COVID-19 or have recovered from COVID-19. 

Last week, the Biden administration said that all foreign visitors must show that they are vaccinated against COVID-19 before boarding a plane headed to the U.S. Visitors would also have to provide a negative test within 72 hours before flying.

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Media stops covering FL COVID data because DeSantis' downtrend threatens lockdown politics: Sexton, Travis - Fox News

As the mainstream media and Democrats seem to have abruptly halted or at least slackened their barrage of criticism toward Florida Republican Gov. Ron DeSantis, questions arise as to the reasons behind the sudden silence, co-host Buck Sexton discussed Thursday on "The Clay Travis and Buck Sexton Show."

For more than a year, DeSantis and the Sunshine State were a favorite bugaboo of the left and prominent members of the mainstream media whenever the topic of coronavirus mitigation came up.

On "The Clay Travis and Buck Sexton Show," host Buck Sexton noted that essentially in the time since then, little has been said by the pundits about DeSantis or Florida.

"Why is it that you are not hearing about the Florida COVID caseload so much anymore?" he asked. "We were here talking to you about it in July because the media was convinced Ron DeSantis… ‘doesn't care about old people or children dying of COVID’ – [saying] horrible things."

Sexton further remarked that conservatives had latched onto the media's nonstop derision of DeSantis by satirically blaming him for coronavirus spikes in places like Hawaii and the Northeast.

"We knew it was absurd," said Sexton. "[T]hey were scoring cheap political points, when we all know there is a seasonality to the virus."

In Hawaii, Democratic Gov. David Ige implemented the Safe Travels Program, which required travelers from the mainland to submit negative results from a coronavirus test from approved vendors a short time before traveling to the Aloha State, in addition to a mask mandate. As of mid-June, Ige announced restrictions will gradually be lifted as vaccination rates increase.

As of May, there had been 55 reported arrests of people violating Safe Travels quarantine provisions, according to the Honolulu Star-Advertiser.

In New York, Gov. Kathy Hochul recently said the NYS National Guard will replace health care workers who will be fired for violating the state's vaccine mandate, while Mayor Bill de Blasio of New York City began enforcing an order mandating people show their vaccine cards in order to enter restaurants, shops or theaters.

Co-host Clay Travis later added that Florida has become "so threatening to the Blue Checkmark Brigade [on Twitter] and to the Anthony Faucis of the world [and] the Biden administration."

"[Florida] didn't implement a mask mandate, didn't do COVID passports and the cases still went down," said Travis, after Sexton referenced a 50% decline in COVID cases across the Sunshine State in the past 2 weeks.

"Florida has proven how much the Fauciites are filled with ‘Emperors who have No Clothes’," Travis remarked.

The hosts noted that Australia is one case where the populace has no "test case" like Florida to point to stop the liberal government there from implementing sweeping socioeconomic controls, including on simple freedom of movement, enforced by police and the military.

But, in the U.S., DeSantis has been essentially ruining Democrats and media rhetoric because his state has fared much better than they expected as they routinely admonished his lack of blanket restrictions.

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Sexton pointed to a new video from an activist group called "Remove Ron", which interposed the storyline of "The Purge" over video of people flying in an airplane and entering the ostensibly menacing Florida airspace – dubbing it "Your FlorEver Purge."

He called it "one of the most unintentionally hilarious and powerful-for-the-person-being-attacked political ads" he or Travis had seen.

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Utah may have 'summited' peak of COVID-19 surge, Cox says as state reports 1704 cases - KSL.com

Gov. Spencer Cox speaks at his monthly news conference at PBS Utah in Salt Lake City on Thursday. (Trent Nelson)

SALT LAKE CITY — Utah Gov. Spencer Cox said Thursday the state appears to be headed toward the "other side" after several weeks of a COVID-19 surge.

"Over the last 14 days, our positive tests are down about 20% in the state, and so there are good indicators that we have summited the peak of the delta variant," Cox said during his monthly PBS news conference.

"That's welcome news, obviously, for our hospitals and our front-line workers who have just been slammed over the past few weeks," he said.

Meanwhile on Thursday, the Utah Department of Health reported 1,704 new coronavirus cases and 12 deaths.

The rolling seven-day average for positive tests is now 1,355 per day, and the percent positivity rate of those tested is 14.2%.

Hospitalizations are also starting to decrease, Cox noted, and fatalities should soon begin decreasing.

On Thursday, 566 patients were hospitalized with the novel coronavirus in Utah, an increase of nearly 100 compared to the count reported the previous day. It's unclear if the count reported by the state health department of 471 patients hospitalized was accurate or represented a data error, as some of Utah's largest hospital systems said Wednesday they have not seen a large decrease in patients.

At the same time, testing for the coronavirus has been in high demand for the past several weeks, leading to long waits at many testing sites. "Quite frankly, we fell short of expectations of meeting this demand," Cox said.

Intermountain Healthcare, which previously during the pandemic administered about half of the state's tests daily, needed to reduce those efforts as hospitals became more busy.

Cox said the Utah Department of Health has aimed to improve its testing efforts by hiring more staff and expanding mobile sites and site hours. Now, wait times for most are no more than 20 minutes, and less than five minutes for most, according to the governor.

Cox also announced the state employee insurance company PEHP will soon begin offering financial incentives to employees and their family members who receive the coronavirus vaccine. Company officials believe the savings in hospitalizations will pay for the cost of the incentives.

New test-to-travel program

On Monday, the state will launch a pilot test-to-travel program ahead of the holidays to allow those traveling to other states or countries to receive the tests they need for free with a quick turnaround time, Cox said.

"Many locations across the globe are putting more and more testing restrictions on travelers, even for vaccinated travelers, they're requiring tests … and we want to make it as easy as possible for Utahns," he added.

The testing site at the Utah Department of Health Cannon Building, 288 N. 1460 West in Salt Lake City, will have a line specifically for travelers with a selection of tests required by many locations for traveler entry.

Travelers will need to know which test is required by their destination. The tests will be free to Utahns but available for a fee to nonresidents.

Rapid antigen tests, which yield results in 15 minutes, rapid PCR tests that offer results in less than 24 hours, and traditional PCR tests that take more than 24 hours to process will all be available, Cox said.

He said the state will work with other countries to make sure they recognize the tests offered at the center.


Utah Gov. Spencer Cox provided a COVID-19 pandemic update during his monthly PBS news conference Thursday morning. Watch the replay of the event below.


Latest Utah data

School-age children accounted for 360 of the 1,704 new cases confirmed Thursday — 179 cases were ages 5-10; 65 were ages 11-13, and 116 were 14-17, health officials with the Utah Department of Health said in a daily update.

Since Wednesday's report, 5,739 more residents received a vaccine dose, bringing total doses given in Utah to 3,471,701.

In the last 28 days, unvaccinated residents have seen 5.6 times greater risk of dying from COVID-19, 7.6 times greater risk of being hospitalized,and 6.5 times greater risk of testing positive for COVID-19 than vaccinated people, according to the state health department.

Since Feb. 1, people who are unvaccinated are at 4.0 times greater risk of dying from COVID-19, 4.9 times greater risk of being hospitalized, and 4.2 times greater risk of testing positive for the disease than vaccinated people.

Of the cases reported Thursday, 349 were confirmed as "breakthrough" cases, meaning they had been fully vaccinated more than two weeks ago. The state also confirmed 16 new breakthrough hospitalizations and two breakthrough deaths, according to the data.

State health officials and doctors have noted receiving the vaccine does not mean someone will not contract the coronavirus, but in most cases it is protective against serious illness. The vaccine also does not cause a person to get COVID-19.

Since vaccines became available to the public early this year, the state has confirmed 17,978 breakthrough cases, 918 breakthrough hospitalizations and 122 breakthrough deaths.

The latest deaths:

  • A Davis County man, between the ages of 65 and 84, who was hospitalized when he died.
  • An Emery County man, 45-64, not hospitalized.
  • A Millard County man, 65-84, not hospitalized.
  • A Salt Lake County man, older than 85, not hospitalized.
  • A Sanpete County resident, sex unknown, older than 85, not hospitalized.
  • A Summit County woman, 65-84, hospitalized.
  • A Utah County man, 45-64, not hospitalized.
  • A Utah County man, 65-84, long-term care facility resident.
  • A Utah County man, older than 85, hospitalized.
  • Two Washington County men, 65-84, not hospitalized.
  • A Weber County man, 65-84, hospitalized.

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Covid Is killing rural Americans at twice the rate of people in urban areas - NBC News

Rural Americans are dying of Covid at more than twice the rate of their urban counterparts — a divide that health experts say is likely to widen as access to medical care shrinks for a population that tends to be older, sicker, heavier, poorer and less vaccinated.

While the initial surge of Covid-19 deaths skipped over much of rural America, where roughly 15 percent of Americans live, nonmetropolitan mortality rates quickly started to outpace those of metropolitan areas as the virus spread nationwide before vaccinations became available, according to data from the Rural Policy Research Institute.

Since the pandemic began, about 1 in 434 rural Americans have died from Covid, compared with roughly 1 in 513 urban Americans, the institute’s data shows. And though vaccines have reduced overall Covid death rates since the winter peak, rural mortality rates are now more than double that of urban ones — and accelerating quickly.

In rural northeastern Texas, Titus Regional Medical Center CEO Terry Scoggin is grappling with a 39 percent vaccination rate in his community. Eleven patients died of Covid in the first half of September at his hospital in Mount Pleasant, population 16,000. Typically, three or four nonhospice patients die there in a whole month.

“We don’t see death like that,” Scoggin said. “You usually don’t see your friends and neighbors die.”

For full coverage of the coronavirus pandemic

Part of the problem is that Covid incidence rates in September were roughly 54 percent higher in rural areas than elsewhere, said Fred Ullrich, a University of Iowa College of Public Health research analyst who co-wrote the institute’s report. He said the analysis compared the rates between nonmetropolitan, or rural, areas and metropolitan, or urban, areas. In 39 states, he added, rural counties had higher rates of Covid than their urban counterparts.

“There is a national disconnect between perception and reality when it comes to Covid in rural America,” said Alan Morgan, head of the National Rural Health Association. “We’ve turned many rural communities into kill boxes. And there's no movement towards addressing what we're seeing in many of these communities, either among the public, or among governing officials.”

Still, the high incidence of cases and low vaccination rates don’t fully capture why mortality rates are so much higher in rural areas than elsewhere. Academics and officials alike describe rural Americans’ greater rates of poor health and their limited options for medical care as a deadly combination. The pressures of the pandemic have compounded the problem by deepening staffing shortages at hospitals, creating a cycle of worsening access to care.

It's the latest example of the deadly coronavirus wreaking more havoc in some communities than others. Covid has also killed Native American, Black or Hispanic people at disproportionately high rates.

Vaccinations are the most effective way to prevent Covid infections from turning deadly. Roughly 41 percent of rural America was vaccinated as of Sept. 23, compared with about 53 percent of urban America, according to an analysis by The Daily Yonder, a newsroom covering rural America. Limited supplies and low access made shots hard to get in the far-flung regions at first, but officials and academics now blame vaccine hesitancy, misinformation and politics for the low vaccination rates.

In hard-hit southwestern Missouri, for example, 26 percent of Newton County’s residents were fully vaccinated as of Sept. 27. The health department has held raffles and vaccine clinics, advertised in the local newspaper, and even driven the vaccine to those lacking transportation in remote areas, according to department administrator Larry Bergner. But he said interest in the shots typically increases only after someone dies or gets seriously ill within a hesitant person’s social circle.

People attend a county fair in Rolla, Mo., a city that has seen a spike in Covid infections, on Aug. 6.Spencer Platt / Getty Images file

Additionally, the overload of Covid patients in hospitals has undermined a basic tenet of rural health care infrastructure: the ability to transfer patients out of rural hospitals to higher levels of specialty care at regional or urban health centers.

“We literally have email Listservs of rural chief nursing officers or rural CEOs sending up an SOS to the group, saying, ‘We’ve called 60 or 70 hospitals and can’t get this heart attack or stroke patient or surgical patient out and they’re going to get septic and die if it goes on much longer,’” said John Henderson, president and CEO of the Texas Organization of Rural & Community Hospitals.

Morgan said he can’t count how many people have talked to him about the transfer problem.

“It’s crazy, just crazy. It’s unacceptable,” Morgan said. “From what I’m seeing, that mortality gap is accelerating.”

Access to medical care has long bedeviled swaths of rural America — since 2005, 181 rural hospitals have closed. A 2020 KHN analysis found that more than half of U.S. counties, many of them largely rural, don’t have a hospital with intensive care unit beds.

Pre-pandemic, rural Americans had 20 percent higher overall death rates than those who live in urban areas, due to their lower rates of insurance, higher rates of poverty and more limited access to health care, according to the Centers for Disease Control and Prevention’s 2019 National Center for Health Statistics.

In southeastern Missouri’s Ripley County, the local hospital closed in 2018. As of Sept. 27, only 24 percent of residents were fully vaccinated against Covid. Due to a recent crush of cases, Covid patients are getting sent home from emergency rooms in surrounding counties if they’re not “severely bad,” the health department's director, Tammy Cosgrove, said.

Relentless cycle of burnout

The nursing shortage hitting the country is particularly dire in rural areas, which have less money than large hospitals to pay the exorbitant fees travel nursing agencies are demanding. And as nursing temp agencies offer hospital staffers more cash to join their teams, many rural nurses are jumping ship. One of Scoggin’s nurses told him she had to take a travel job — she could pay off all her debt in three months with that kind of money.

And then there’s the burnout of working over a year and a half through the pandemic. Audrey Snyder, the immediate past president of the Rural Nurse Organization, said she’s lost count of how many nurses have told her they’re quitting. Those resignations feed into a relentless cycle: As travel nurse companies attract more nurses, the nurses left behind shouldering their work become more burned out — and eventually quit. While this is true at hospitals of all types, the effects in hard-to-staff rural hospitals can be especially dire.

Rural health officials fear the staffing shortages could be exacerbated by health care vaccination mandates promised by President Joe Biden, which they say could cause a wave of resignations the hospitals cannot afford. About half of Scoggin’s staff, for example, is unvaccinated.

Snyder warned that nursing shortages and their high associated costs will become unsustainable for rural hospitals operating on razor-thin margins. She predicted a new wave of rural hospital closures will further drive up the dire mortality numbers.

Staffing shortages already limit how many beds hospitals can use, Scoggin said. He estimated most hospitals in Texas, including his own, are operating at roughly two-thirds of their bed capacity. His emergency room is so swamped, he’s had to send a few patients home to be monitored daily by an ambulance team.

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HPV: Virus affects 90% of population, and most are unaware - The Jerusalem Post

It might surprise you to know that the papilloma virus will affect almost every one of us. HPV, as it’s commonly known, won’t affect most of the people infected with it, but some will have a higher risk of developing various cancers. Two experts from Hillel Yaffe Medical Center in Hadera discuss the virus and its effects, the vaccine and how each of us can manage it. Read the comprehensive advice here.

HPV has been in the headlines in recent years and awareness of it has grown, especially in light of the vaccine that is now administered to young teens. 
The vaccine aims to significantly reduce cases of cervical cancer that the virus can cause, and protect against genital warts. We asked Prof. Ilan Baruchim, director of the Department of Gynecology and Gyno-Oncology, and Dr. Tomer Bar-Noy, a senior physician in the Gynecology-Oncology unit at Hillel Yaffe, to explain all aspects of HPV.

What is human papillomavirus (HPV) and how dangerous is it?

HPV is a group of over 200 species of viruses belonging to the Papillomaviridae  family. Some varieties, like the HPV6 and HPV11 strains are low risk and can cause conical warts - so-called "condyloma.”
This is a problem that is primarily aesthetic and not dangerous or linked to cancer. Warts are transmitted through sex via direct contact with a partner who has active or dormant condyloma. In some cases only individual warts are seen, but widespread infection can also occur.  Warts can be present in the vulva, vagina, cervix, anus and/or penis. Treating the warts depends on the location and areas affected.
If there’s a limited number of warts or a limited infected area, usually the treatment is topical, like ointments or gels.
In the case of more advanced cases with widespread warts, the proposed treatment will usually include using a laser or freezing with cold nitrogen that will “burn” off the warts, or surgical removal in cases where there is no adequate response to the various treatments, explained Dr. Bar Noy.  
He added that these methods aim to destroy the condyloma lesions while trying to preserve the surrounding healthy tissue.
Another part of the same family of viruses, about 15 strains, are considered high-risk, mainly the strains HPV16 and HPV18, which can actually lead to the development of cervical cancer, and at a lesser but significant rate, also cases of vaginal and anal cancer and malignancies in the mouth and the throat. 
Even in these cases the strains are transmitted by sexual contact.

How contagious  is HPV? 

"It should be noted that the rate of infection with the papilloma virus is very high, and in fact more than 90% of men and about 80% of women will be infected during their lifetime.  According to the Centers for Disease Control and Prevention in the United States about 50% of new cases of infection occur each year among young people aged 2-15. But Prof. Baruchim said that the good news is that in most cases the body's immune system can defeat the virus and eliminate it.
In a small proportion of cases (about 5%) in which the immune system won’t eliminate the virus, it will remain in the cells of the cervix or vagina for a long time, and then it’s called asymptomatic.
Usually at this stage there will be no signs of HPV in the body, so most of those infected with it may be unaware that they have been infected. If it’s one of the strains that is a high risk factor and it stays in the body, it may develop into pre-malignant cells first and later malignant cells. The process of developing from infection to a malignant tumor may take between 10 and 15 years, the professor added.
In Israel, every year, about 5,000 women develop a precancerous condition and about 200 new patients are diagnosed with cervical cancer. The average age is 40. 
There is difficulty in predicting which of these cases will “persist” and become a premalignant or malignant condition. Yet, various risk factors are known to affect the chance of the disease progressing to a malignant condition, including the strain of the virus, duration of infection, smoking, chlamydia infection, dietary factors, use of hormonal birth control and more.
(Credit: Ingimage)(Credit: Ingimage)

How to deal with papillomavirus

The only safe way to avoid infection is to abstain from any form of sex. However, in recent years we have witnessed a revolution in the field with the advent of the HPV virus vaccine. 
This vaccine is considered a scientific breakthrough that allows for the initial prevention of pre-malignancy of cervical cancer and even prevention of condyloma. This synthetic vaccine is injected into a muscle in two or three doses over a period of six months. 
The vaccine consists of treated parts of the virus and is therefore effective in producing antibodies, but won’t cause infection or disease. The vaccine is approved in most countries worldwide and is included in 58 different countries as part of the recommended vaccination routine for boys and girls.
Today there are three vaccines that protect against different strains. One is against the two high risk strains mentioned, the other is against these two strains and against HPV6 and HPV11, which don’t cause cervical cancer but are responsible for most cases of condyloma. 
Both of these vaccines provide close to 70% protection against precancerous tumors and cancers of the cervix. The third (newer) vaccine protects against nine strains of HPV that are mainly involved in cervical cancer, and provides protection of close to 90%.


At what age can you get vaccinated against the papilloma virus?

In Israel, the vaccine has been included in the health basket since 2013 and is given to eighth-grade boys and girls free of charge in order to protect adolescents from infection before the start of sexual intercourse, as the effectiveness of the vaccine decreases significantly after exposure to the virus. In addition, it’s been verified that vaccination at younger ages leads to a better, more effective immune response.
Sexually active women can also be vaccinated even if they have had a pap smear that showed infection or conical warts, as the vaccine may prevent conditions caused by the virus strains to which they haven’t yet been exposed. One can be vaccinated until age 45, although in Israel the health basket subsidizes the vaccine until the age of 18 (for girls and boys) and up to the age of 26 for men at increased risk.
Most supplementary health insurance programs subsidize vaccines for men and women over the age of 26, and from the age of 27 to 45 you can consult a doctor to assess risk factors and the need to receive the vaccine.

 
How safe and effective is the vaccine?

Despite several press reports of unusual side effects, the vaccine's safety profile is high and the World Health Organization has determined that the vaccine is safe and effective, and the known and side effects after testing are local only and include redness, pain and swelling at the injection site. More rare side effects can include fever, headache, nausea, dizziness and even fainting. During pregnancy, studies show that receiving the vaccine won’t harm the fetus, but the information about it is considered partial, so at present, it isn’t recommended for a pregnant woman to receive a vaccine until after pregnancy.
It should be noted that resistance to vaccines isn’t new and some people avoid vaccinating their children with any vaccine, and rely on theories and opinions which cause unnecessary anxieties and fears, the experts clarify.


Are there other ways to reduce the risk of exposure to the virus?

Using a condom, which doesn’t completely protect exposed areas, does help reduce infection. It;s important to use it throughout vaginal intercourse, and also during anal and/or oral intercourse. Of course, a healthy lifestyle strengthens the immune system such as adherence to a healthy diet, not smoking or using drugs,   and exercise, improves protection against viruses and infections .Also remember that the vaccine doesn’t provide complete protection against the risk of contracting the virus that causes cervical cancer or premalignant conditions, so periodic screening should continue, emphasizes Dr. Bar-Noy.
The Israeli Society for Cervical Colposcopy and Pathology recommends a routine scan of all women to prevent cervical cancer. It is recommended to perform a Pap test from age 25 once every 3 years. 
The Pap is a good screening test, but its sensitivity as a single test amounts to only 50 percent reliability. HPV strains can now also be tested from the age of 25 once every 3 or 5 years. The test is performed by taking a vaginal or cervical surface and sending it for PCR where the results will provide information on whether there is a carrier of the virus and if so which strains are present. If an incorrect finding is obtained in the Pap or the test is positive for high-risk strains, further investigation or close follow-up is required, depending on the results, states Prof. Baruchim.
In conclusion, HPV is very common  and there is a high probability that most of us will "meet" it during our lives. Also, this virus can cause warts (condyloma) and there is even a risk that the cervical cells will be transformed into pre-malignant and even malignant conditions if infection with high risk strains occurs. Today there are many ways to diagnose, treat and most importantly - prevent by vaccination. Therefore, be aware of the virus, its various strains, the screening and diagnostic tests and of course - coping and prevention. It’s possible that in the not-so-distant future, through immunization and prevention, we will be able to eradicate the severe disease, cervical cancer.

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It's flu vaccine time, even if you've had your COVID shots - ABC News

But with U.S. schools and businesses reopened, international travel resuming and far less masking this fall, flu could make a comeback. The big question is whether it will trickle in or roar back and put extra pressure on hospitals already struggling with COVID-19 surges.

Yet after 18 months of little influenza exposure, “we probably as a population don’t have as much immunity against this virus as we typically might,” Webby said. “It makes absolute sense to go on out and get that vaccine and at least prepare for something that, you know, could be quite severe.”

Here are some things to know:

Q: Who should get a flu vaccine?

A: The Centers for Disease Control and Prevention says just about everybody needs an annual flu vaccination, starting with 6-month-old babies. Influenza is most dangerous for adults over age 65, young children, pregnant women and people with certain health conditions, such as heart or lung disease.

Q: Why do I need one this year, since flu hasn’t been a threat during the pandemic?

A: COVID-19 restrictions including masking and staying home — especially for children, who are flu’s biggest spreaders — clearly had a side benefit of tamping down influenza and other respiratory bugs. But as soon as masks started to come off, the U.S. experienced an unusual summer surge of children hospitalized with a different virus, named RSV, that usually strikes in the winter. That’s a worrying sign of what to expect if flu returns.

Q: What’s the forecast for flu this winter?

A: Flu is notoriously difficult to predict. But there’s a little more circulating in some countries this fall than last, including a recent uptick in China, said Webby, who directs a World Health Organization flu center. And people may be a little more vulnerable: Before the pandemic, 15% to 30% of the population was exposed to flu each year, a missing bump in immunity, he said.

“If flu does at least get a foothold in, it’s going to have more opportunity of spreading this season,” he said.

Q: When should I get a flu vaccine?

A: Now. The CDC encourages people to get their vaccine by the end of October. Doctors' offices, retail pharmacies and local health departments have millions of doses in hand. And most Americans with health insurance can get it with no co-pay.

Q: I already got a COVID-19 vaccine. Do I really need a flu shot, too?

A: COVID-19 vaccines prevent the coronavirus and flu vaccines prevent influenza. They don’t overlap. But you can catch both viruses at the same time, or one after the other.

“Avoid the double whammy” and get both vaccines, advised the American College of Emergency Physicians. For now, COVID-19 vaccines are available for anyone 12 and older.

Flu vaccines aren’t as powerful as vaccines against some other diseases but if people do get influenza anyway, they tend to have a much milder illness.

Q: Can I get a flu vaccine and a COVID-19 vaccine at the same visit?

A: Yes, the CDC says it’s fine to pair a flu vaccine with either a primary COVID-19 shot or a booster dose.

Q: What’s the best flu vaccine to get?

A: Flu constantly evolves, and each year’s vaccine is made to fight the strains that international experts deem most likely to circulate. This year all the flu vaccines offered in the U.S. offer protection against all four of those strains. Options include traditional shots or a nasal spray vaccine. There also are shots specifically designed to rev up seniors’ age-weakened immune systems, either with a higher dose or an added immune booster. There are also options for people allergic to eggs, which are used to make some flu shots.

Q: How much flu vaccine is available?

A: The CDC expects vaccine manufacturers to deliver 188 million to 200 million doses. Nearly 194 million doses were distributed last winter, a record.

———

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

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  1. Kaiser doctor explains why pregnant women should get the COVID-19 vaccine, not skip medical visits  KCRA Sacramento
  2. CDC Issues Urgent Recommendation For Pregnant Women To Get Vaccinated  TODAY
  3. Banner Health concerned about resources ahead of flu season in Arizona  KTAR.com
  4. For the first time since June, the number of projected Covid-19 deaths in the US is decreasing  CNN
  5. Health expert: This year's flu season is expected to be worse than last year's  ABC15 Arizona
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Melbourne cases hit record despite two months of lockdown - Reuters

  • Home parties to watch sports event behind spike in cases
  • 98% cases in Sydney and Melbourne out of Australia's 2,400
  • Federal govt to wind down emergency business payments

SYDNEY, Sept 30 (Reuters) - Melbourne's COVID-19 cases surged to record levels on Thursday with officials blaming illegal home gatherings to watch a key sporting event for the spike as a hard lockdown to combat the spread of the Delta variant neared two months.

Authorities in Victoria, home to Melbourne, estimated nearly a third of Thursday's 1,438 new infections could be traced back to home parties last weekend to watch the Australian Rules Football Grand Final on television.

"Many of these cases were completely avoidable ... I'm not trying to blame anyone, I'm simply trying to explain because a lot of people will be scratching their heads - how could it have gone up by so much, so fast," state Premier Daniel Andrews said during a media briefing.

Officials admitted Thursday's numbers, a 50% jump to Wednesday's 950 cases, is a "major setback" in managing the flare-up, as they race to vaccinate the state's 5.5 million adult population.

Half of the state's population above 16 have received their first dose, below the national average of 53%, as officials halved the intervals between Pfizer (PFE.N) shots in state-run vaccine hubs to three weeks after supplies rose.

Australia's largest cities, Sydney and Melbourne, and the capital Canberra are in a weeks-long lockdown to combat a third wave of infections fuelled by the fast-moving Delta variant. Authorities have ditched a COVID-zero strategy and are looking at higher vaccination as their exit strategy from lockdowns.

A total of 941 new cases were reported in New South Wales on Thursday, the majority in state capital Sydney, while Queensland recorded six and the Australian Capital Territory 31 infections.

EASING FINANCIAL SUPPORT

A woman wearing a protective face mask walks along a deserted city bridge during morning commute hours on the first day of a lockdown as the state of Victoria looks to curb the spread of a coronavirus disease (COVID-19) outbreak in Melbourne, Australia, July 16, 2021. REUTERS/Sandra Sanders

The record cases in Victoria come as the federal government on Thursday decided to phase out its emergency financial support for businesses impacted by the lockdowns, in line with its plan to end support to virus-impacted employees. read more

Federal Treasurer Josh Frydenberg said the temporary payments will stop once 80% of the adult population in states and territories becomes fully vaccinated.

But Victoria's businesses will receive a fresh A$2.27 billion ($1.65 billion) support from the federal government through the next six weeks at which point the state should hit that dosage target, from around 50% now.

"We can't eliminate the virus, we need to learn to live with it in a COVID-safe way", Frydenberg said in a statement.

The federal government decision to wind down support payments, shared equally between states and Canberra, will put pressure on virus-free states to keep their economies open and avoid lockdowns to fight future outbreaks.

Prime Minister Scott Morrison has been pressing all states and territories to begin living with the virus once full inoculations reach 70%-80% but Queensland and Western Australia, largely COVID-free, flagged they may delay their reopening.

Despite the latest Delta outbreaks, total cases in Australia stand at around 105,000 and deaths at 1,291, well below other comparable nations. Eleven new deaths were recorded in the country.

($1 = 1.3778 Australian dollars)

Reporting by Renju Jose; additional reporting by Sonali Paul in Melbourne; Editing by Himani Sarkar

Our Standards: The Thomson Reuters Trust Principles.

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Aladdin Cases Thwart Broadway; Threats to Teachers: Virus Update - Bloomberg

The Walt Disney Co. musical Aladdin on Broadway was temporarily canceled a day after its reopening as some of the company members tested positive for Covid-19.

Escalating threats to U.S. teachers and school board members over campus mask mandates and quarantines are raising alarm among national K-12 groups. Idaho doctors see an alarming trend -- maternal deaths, stillbirths and sicker babies -- in a state where hospitalizations keep setting records, health care is rationed and vaccination rates are low, the Idaho Statesman newspaper reported.

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It's flu vaccine time, even if you've had your COVID shots - Yahoo News

Amid all the focus on COVID-19 vaccinations, U.S. health experts have another plea: Don’t skip your flu shot.

Flu cases have dropped to historically low levels during the pandemic. The U.S. and Europe experienced hardly any flu last winter, and the Southern Hemisphere just ended its second flu season of the coronavirus pandemic with little to report.

But with U.S. schools and businesses reopened, international travel resuming and far less masking this fall, flu could make a comeback. The big question is whether it will trickle in or roar back and put extra pressure on hospitals already struggling with COVID-19 surges.

“People are sick to death of hearing about having to roll on out and get vaccines of any sort,” said flu specialist Richard Webby of St. Jude Children’s Research Hospital in Memphis. 

Yet after 18 months of little influenza exposure, “we probably as a population don’t have as much immunity against this virus as we typically might,” Webby said. “It makes absolute sense to go on out and get that vaccine and at least prepare for something that, you know, could be quite severe.”

Here are some things to know:

Q: Who should get a flu vaccine?

A: The Centers for Disease Control and Prevention says just about everybody needs an annual flu vaccination, starting with 6-month-old babies. Influenza is most dangerous for adults over age 65, young children, pregnant women and people with certain health conditions, such as heart or lung disease.

Q: Why do I need one this year, since flu hasn’t been a threat during the pandemic?

A: COVID-19 restrictions including masking and staying home — especially for children, who are flu’s biggest spreaders — clearly had a side benefit of tamping down influenza and other respiratory bugs. But as soon as masks started to come off, the U.S. experienced an unusual summer surge of children hospitalized with a different virus, named RSV, that usually strikes in the winter. That’s a worrying sign of what to expect if flu returns.

Q: What’s the forecast for flu this winter?

A: Flu is notoriously difficult to predict. But there’s a little more circulating in some countries this fall than last, including a recent uptick in China, said Webby, who directs a World Health Organization flu center. And people may be a little more vulnerable: Before the pandemic, 15% to 30% of the population was exposed to flu each year, a missing bump in immunity, he said.

“If flu does at least get a foothold in, it’s going to have more opportunity of spreading this season,” he said.

Q: When should I get a flu vaccine?

A: Now. The CDC encourages people to get their vaccine by the end of October. Doctors' offices, retail pharmacies and local health departments have millions of doses in hand. And most Americans with health insurance can get it with no co-pay.

Q: I already got a COVID-19 vaccine. Do I really need a flu shot, too?

A: COVID-19 vaccines prevent the coronavirus and flu vaccines prevent influenza. They don’t overlap. But you can catch both viruses at the same time, or one after the other.

“Avoid the double whammy” and get both vaccines, advised the American College of Emergency Physicians. For now, COVID-19 vaccines are available for anyone 12 and older.

Flu vaccines aren’t as powerful as vaccines against some other diseases but if people do get influenza anyway, they tend to have a much milder illness.

Q: Can I get a flu vaccine and a COVID-19 vaccine at the same visit?

A: Yes, the CDC says it’s fine to pair a flu vaccine with either a primary COVID-19 shot or a booster dose. 

Q: What’s the best flu vaccine to get?

A: Flu constantly evolves, and each year’s vaccine is made to fight the strains that international experts deem most likely to circulate. This year all the flu vaccines offered in the U.S. offer protection against all four of those strains. Options include traditional shots or a nasal spray vaccine. There also are shots specifically designed to rev up seniors’ age-weakened immune systems, either with a higher dose or an added immune booster. There are also options for people allergic to eggs, which are used to make some flu shots.

Q: How much flu vaccine is available?

A: The CDC expects vaccine manufacturers to deliver 188 million to 200 million doses. Nearly 194 million doses were distributed last winter, a record.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

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