Long COVID Has Forced the U.S. to Take Chronic Fatigue Syndrome Seriously

Only a couple dozen doctors specialize in chronic fatigue syndrome (ME/CFS). Now their knowledge could be crucial to treating millions more patients. Kira Stoops lives in Bozeman, Montana—a beautiful mountain town where it sometimes feels like everyone regularly goes on 50-mile runs. Stoops, however, can’t walk around her own block on most days. To stand for more than a few minutes, she needs a wheeled walker.

She reacts so badly to most foods that her diet consists of just 12 ingredients. Her “brain fog” usually lifts for a mere two hours in the morning, during which she can sometimes work or, more rarely, see friends. Stoops has myalgic encephalomyelitis, or chronic fatigue syndrome (ME/CFS). “I’m considered a moderate patient on the mild side,” she told me.

ME/CFS involves a panoply of debilitating symptoms that affect many organ systems and that get worse with exertion. The Institute of Medicine estimates that it affects 836,000 to 2.5 million people in the U.S. alone, but is so misunderstood and stigmatized that about 90 percent of people who have it have never been diagnosed.

At best, most medical professionals know nothing about ME/CFS; at worst, they tell patients that their symptoms are psychosomatic, anxiety-induced, or simply signs of laziness. While ME/CFS patients, their caregivers, and the few doctors who treat them have spent years fighting for medical legitimacy, the coronavirus pandemic has now forced the issue.

A wide variety of infections can cause ME/CFS, and SARS-CoV-2, the coronavirus that causes COVID-19, is no different: Many cases of long COVID are effectively ME/CFS by another name. The exact number is hard to define, but past studies have shown that 5 to 27 percent of people infected by various pathogens, including Epstein-Barr virus and the original SARS, develop ME/CFS.

Even if that proportion is 10 times lower for SARS-CoV-2, the number of Americans with ME/CFS would still have doubled in the past three years. “We’re adding an immense volume of patients to an already dysfunctional and overburdened system,” Beth Pollack, a scientist at MIT who studies complex chronic illnesses, told me.

The U.S. has so few doctors who truly understand the disease and know how to treat it that when they convened in 2018 to create a formal coalition, there were only about a dozen, and the youngest was 60. Currently, the coalition’s website lists just 21 names, of whom at least three have retired and one is dead, Linda Tannenbaum, the CEO and president of the Open Medicine Foundation, told me.

These specialists are concentrated on the coasts; none work in the Midwest. American ME/CFS patients may outnumber the population of 15 individual states, but ME/CFS specialists couldn’t fill a Major League Baseball roster.

Stoops, who is 39, was formally diagnosed with ME/CFS only four years ago, and began receiving proper care from two of those specialists—Lucinda Bateman of the Bateman Horne Center and David Kaufman from the Center for Complex Diseases. Bateman told me that even before the pandemic, she could see fewer than 10 percent of the patients who asked for a consultation. “When I got into those practices, it was like I got into Harvard,” Stoops told me.

ME/CFS specialists, already overwhelmed with demand for their services, now have to decide how to best use and spread their knowledge, at a time when more patients and doctors than ever could benefit from it. Kaufman recently discharged many of the more stable ME/CFS patients in his care—Stoops among them—so that he could start seeing COVID long-haulers who “were just making the circuit of doctors and getting nowhere,” he told me.

“I can’t clone myself, and this was the only other way to” make room for new patients. Bateman, meanwhile, is feverishly focused on educating other clinicians. The hallmark symptom of ME/CFS—post-exertional malaise, or PEM—means even light physical or mental exertion can trigger major crashes that exacerbate every other symptom. Doctors who are unfamiliar with PEM, including many now running long-COVID clinics, can unwittingly hurt their patients by encouraging them to exercise.

Bateman is racing to spread that message, and better ways of treating patients, but that means she’ll have to reduce her clinic hours. These agonizing decisions mean that many existing ME/CFS patients are losing access to the best care they had found so far—what for Stoops meant “the difference between being stuck at home, miserable and in pain, and actually going out once or twice a day, seeing other humans, and breathing fresh air,” she told me.

But painful trade-offs might be necessary to finally drag American medicine to a place where it can treat these kinds of complex, oft-neglected conditions. Kaufman is 75 and Bateman is 64. Although both of them told me they’re not retiring anytime soon, they also won’t be practicing forever. To make full use of their expertise and create more doctors like them, the medical profession must face up to decades spent dismissing illnesses such as ME/CFS—an overdue reckoning incited by long COVID.

“It’s a disaster possibly wrapped up in a blessing,” Stoops told me. “The system is cracking and needs to crack.” Many ME/CFS specialists have a deep knowledge of the disease because they’ve experienced it firsthand. Jennifer Curtin, one of the youngest doctors in the field, has two family members with the disease, and had it herself for nine years. She improved enough to make it through medical school and residency training, which showed her that ME/CFS “just isn’t taught,” she told me. Most curricula don’t include it; most textbooks don’t mention it.

Even if doctors learn about ME/CFS, America’s health-care system makes it almost impossible for them to actually help patients. The insurance model pushes physicians toward shorter visits; 15 minutes might feel luxurious. “My average visit length is an hour, which doesn’t include the time I spend going over the patient’s 500 to 1,700 pages of records beforehand,” Curtin said. “It’s not a very scalable kind of care.” (She works with Kaufman at the Center for Complex Diseases, which bills patients directly.)

This also explains why the cohort of ME/CFS clinicians is aging out, with little young blood to refresh them. “Hospital systems want physicians to see lots of patients and they want them to follow the rules,” Kaufman said. “There’s less motivation for moving into areas of medicine that are more unknown and challenging.”

ME/CFS is certainly challenging, not least because it’s just “one face of a many-sided problem,” Jaime Seltzer, the director of scientific and medical outreach at the advocacy group MEAction, told me. The condition’s root causes can also lead to several distinct but interlocking illnesses, including mast cell activation syndrome, Ehlers-Danlos syndrome, fibromyalgia, dysautonomia (usually manifesting as POTS), and several autoimmune and gastrointestinal disorders.

“I’m still amazed at how often patients come in with Complaint No. 1, and then I find five to seven of the other things,” Kaufman said. These syndromes collectively afflict many organ systems, which can baffle doctors who’ve specialized in just one. Many of them disproportionately affect women, and are subject to medicine’s long-standing tendency to minimize or psychologize women’s pain, Pollack told me:

An average woman with Ehlers-Danlos syndrome typically spends 16 years getting a diagnosis, while a man needs only four. People with long COVID might have many of these conditions and not know about any—because their doctors don’t either. Like ME/CFS, they rarely feature in medical training, and it’s hard to “teach someone about all of them when they’ve never heard of any of them,” Seltzer said.

Specialists like Bateman and Kaufman matter because they understand not just ME/CFS but also the connected puzzle pieces. They can look at a patient’s full array of symptoms and prioritize the ones that are most urgent or foundational. They know how to test for conditions that can be invisible to standard medical techniques: “None of my tests came back abnormal until I saw an ME/CFS doctor, and then all my tests came back abnormal,” said Hannah Davis of the Patient-Led Research Collaborative, who has had long COVID since March 2020.

ME/CFS specialists also know how to help, in ways that are directly applicable to cases of long COVID with overlapping symptoms. ME/CFS has no cure but can be managed, often through “simple, inexpensive interventions that can be done through primary care,” Bateman told me. Over-the-counter antihistamines can help patients with inflammatory problems such as mast cell activation syndrome. Low doses of naltrexone, commonly used for addiction disorders, can help those with intense pain.

A simple but rarely administered test can show if patients have orthostatic intolerance—a blood-flow problem that worsens other symptoms when people stand or sit upright. Most important, teaching patients about pacing—carefully sensing and managing your energy levels—can prevent debilitating crashes. “We don’t go to an ME/CFS clinic and walk out in remission,” Stoops told me. “You go to become stabilized. The ship has 1,000 holes, and doctors can patch one before the next explodes, keeping the whole thing afloat.”

That’s why the prospect of losing specialists is so galling. Stoops understands why her doctors might choose to focus on education or newly diagnosed COVID long-haulers, but ME/CFS patients are “just so lost already, and to lose what little we have is a really big deal,” she said. Kaufman has offered to refer her to generalist physicians or talk to primary-care doctors on her behalf. But it won’t be the same: “Having one appointment with him is like six to eight appointments with other practitioners,” she said.

He educates her about ME/CFS; with other doctors, it’s often the other way round. “I’m going to have to work much harder to receive a similar level of care.” At least, she will for now. The ME/CFS specialists who are shifting their focus are hoping that they can use this moment of crisis to create more resources for everyone with these diseases. In a few years, Bateman hopes, “there will be 100 times more clinicians who are prepared to manage patients, and many more people with ME/CFS who have access to care.”

For someone who is diagnosed with ME/CFS today, the landscape already looks very different than it did just a decade ago. In 2015, the Institute of Medicine published a landmark report redefining the diagnostic criteria for the disease. In 2017, the CDC stopped recommending exercise therapy as a treatment. In 2021, Bateman and 20 other clinicians published a comprehensive guide to the condition in the journal of the Mayo Clinic.

For any mainstream disease, such events—a report, a guideline revision, a review article—would be mundane. For ME/CFS, they felt momentous. And yet, “the current state of things is simply intolerable,” Julie Rehmeyer, a journalist with ME/CFS, told me. Solving the gargantuan challenge posed by complex chronic diseases demands seismic shifts in research funding, medical training, and public attitudes. “Achieving shifts like that takes something big,” Rehmeyer said. “Long COVID is big.”

COVID long-haulers have proved beyond any reasonable doubt that acute viral infections can leave people chronically ill. Many health-care workers, political-decision makers, and influencers either know someone with long COVID or have it themselves. Even if they still don’t know about ME/CFS, their heightened awareness of post-viral illnesses is already making a difference. Mary Dimmock’s son developed ME/CFS in 2011, and before the pandemic, one doctor in 10 might take him seriously.

“Now it’s the flip: Only one doctor out of 10 will be a real jerk,” Dimmock told me. “I attribute that to long COVID.” But being believed is the very least that ME/CFS patients deserve. They need therapeutics that target the root causes of the disease, which will require a clear understanding of those causes, which will require coordinated, well-funded research—three things ME/CFS has historically lacked.

But here, too, “long COVID is going to be a catalyst,” Amy Proal, the president of the Polybio Research Foundation, told me. She is leading the Long Covid Research Initiative—a group of scientists, including ME/CFS researchers, that will use state-of-the-art techniques to see exactly how the new coronavirus causes long COVID, and rapidly push potential treatments through clinical trials.

The National Institutes of Health has also committed $1.15 billion to long-COVID research, and while some advocates are concerned about how that money will be spent, Rehmeyer notes that the amount is still almost 80 times greater than the paltry $15 million spent on ME/CFS every year—less than any other disease in the NIH’s portfolio, relative to its societal burden. “Even if 90 percent is wasted, we’d be doing a lot better,” she said.

While they wait for better treatments, patients also need the medical community to heed the lessons that they and their clinicians have learned. For example, the American Academy for Family Physicians website still wrongly recommends exercise therapy and links ME/CFS to childhood abuse. “That group of doctors is very important to these patients,” Dimmock said, “so what does that say to them about what this disease is all about?”

Despite all evidence to the contrary, many clinicians and researchers still don’t see ME/CFS as a legitimate illness and are quick to dismiss any connection between it and long COVID. To ensure that both groups of patients get the best possible treatments, instead of advice that might harm them, ME/CFS specialists are working to disseminate their hard-won knowledge.

Bateman and her colleagues have been creating educational resources for clinicians and patients, continuing-medical-education courses, and an online lecture series. Jennifer Curtin has spent two years mapping all the decisions she makes when seeing a new patient, and is converting those into a tool that other clinicians can use. As part of her new start-up, called RTHM, she’s also trying to develop better ways of testing for ME/CFS and its related syndromes, of visualizing the hefty electronic health records that chronically ill patients accumulate, and of tracking the treatments they try and their effects.

“There are a lot of things that need to be fixed for this kind of care to be scalable,” Curtin told me. Had such shifts already occurred, the medical profession might have had more to offer COVID long-haulers beyond bewilderment and dismissal. But if the profession starts listening to the ME/CFS community now, it will stand the best chance of helping people being disabled by COVID, and of steeling itself against future epidemics.

Pathogens have been chronically disabling people for the longest time, and more pandemics are inevitable. The current one could and should be the last whose long-haulers are greeted with disbelief. New centers that cater to ME/CFS patients are already emerging. RTHM is currently focused on COVID long-haulers but will take on some of David Kaufman’s former patients in November, and will open its waiting list to the broader ME/CFS community in December.

(It is currently licensed to practice in just five states but expects to expand soon.) David Putrino, who leads a long-COVID rehabilitation clinic in Mount Sinai, is trying to raise funds for a new clinic that will treat both long COVID and ME/CFS. He credits ME/CFS patients with opening his eyes to the connection between long COVID and their condition.

Every ME/CFS patient I’ve talked with predicted long COVID’s arrival well before most doctors or even epidemiologists started catching up. They know more about complex chronic illnesses than many of the people now treating long COVID do. Despite having a condition that saps their energy, many have spent the past few years helping long-haulers navigate what for them was well-trodden terrain: “I did barely anything but work in 2020,” Seltzer told me.

Against the odds, they’ve survived. But the pandemic has created a catalytic opportunity for the odds to finally be tilted in their favor, “so that neither patients nor doctors of any complex chronic illness have to be heroes anymore,” Rehmeyer said.

By Ed Yong

Source: Long COVID Has Forced the U.S. to Take Chronic Fatigue Syndrome Seriously – The Atlantic

.

Related contents:

The Times: Chronic fatigue syndrome patient told: ‘You’re making it up’ The ME Association (Press Release)

11:33 Wed, 28 Sep
00:39 Wed, 28 Sep
14:35 Tue, 27 Sep
14:46 Tue, 20 Sep
11:44 Tue, 20 Sep
18:28 Wed, 14 Sep
14:46 Wed, 14 Sep
13:40 Wed, 07 Sep
New evidence affirms link between long COVID and chronic fatigue syndromeHere’s why the new COVID-19 booster could save your life Gavi, the Vaccine Alliance

23:51 Wed, 14 SepWhite House Monkeypox Covid
21:15 Thu, 15 SepMonkeypox Covid Joe Biden
10:54 Fri, 30 SepPhilippines Pandemic
14:47 Wed, 28 SepCovid Joe Biden Pandemic
21:52 Thu, 22 SepChristianity
Yesterday
10:54 Fri, 30 Sep
19:29 Sat, 24 Sep
15:30 Fri, 23 Sep
21:52 Thu, 22 Sep
09:47 Thu, 22 Sep
01:26 Wed, 21 Sep
10:32 Tue, 20 Sep
14:11 Mon, 19 Sep
15:22 Fri, 16 Sep
23:51 Wed, 14 Sep
04:12 Fri, 09 Sep
06:35 Wed, 07 Sep
04:33 Tue, 06 Sep
19:38 Sat, 03 Sep
00:17 Sat, 03 Sep
22:22 Fri, 02 Sep

.

Marketing Programs To Buy:
.
10 Bold Actions In Positive Life & Work                https://jvz3.com/c/202927/383942/
3D Pal Toons                https://jvz6.com/c/202927/381689/
4brandcommercial        https://jvz1.com/c/202927/375487
7 Minutes Kit                    https://jvz8.com/c/202927/374505/
9 figure Success                        https://jvz8.com/c/202927/384653/
Ad Raven                       https://jvz4.com/c/202927/382796/
Ada leadz                           https://jvz8.com/c/202927/376381
ADA Web                        https://jvz3.com/c/202927/383751/
AdRaven                          https://jvz3.com/c/202927/382851/
Adsense Machine                  https://jvz2.com/c/202927/290487
Adtivate Agency                   https://jvz3.com/c/202927/383706/
AdvertSuite            https://jvz1.com/c/202927/335011/
AdzHero                      https://jvz2.com/c/202927/366972/
AffiliateMatic                 https://jvz3.com/c/202927/381148/
Agency Client Finder                        https://jvz3.com/c/202927/384619/
AgencyScale                          https://jvz4.com/c/202927/383111/
Agencyscale                      https://jvz1.com/c/202927/383113/
AIWA Commercial              https://jvz2.com/c/202927/365061
ALL-in-One HD Stock                   https://jvz4.com/c/202927/381560
Animaxime                   https://jvz2.com/c/202927/383307/
Appimize                            https://jvz8.com/c/202927/370227
Appoint B Agency                     https://jvz1.com/c/202927/384630/
Appointomatic               https://jvz6.com/c/202927/374258
Appowls                     https://jvz4.com/c/202927/381231/
Art Of Living                       https://jvz4.com/c/202927/382425/
Audiencetoolkit              https://jvz6.com/c/202927/302715
Aweber Crash Course                     https://jvz6.com/c/202927/383057/
Backlinkindexer           https://jvz6.com/c/202927/88118
BevTraders                               http://www.bevtraders.com/?ref=arminham
Big Audio Club                       https://jvz6.com/c/202927/380087/
BigAudio Club                   https://jvz2.com/c/202927/380877/
Boost Optimism                    https://jvz2.com/c/202927/380692/
BrandElevate                  https://jvzoo.com/c/202927/381812
BrandElevate                https://jvz4.com/c/202927/381807/
Bybit Crypto Trade                  https://www.bybit.com/en-US/invite?ref=ALEXP
CanvaKitz                     https://jvz4.com/c/202927/379051/
ChatterPal Commercial                 https://jvz8.com/c/202927/324615
Clientfinda                     https://jvz8.com/c/202927/370806
Clipsreel                             https://jvz3.com/c/202927/372682
Commission smasher          https://jvz3.com/c/202927/376879
Content Gorilla              https://jvz2.com/c/202927/330783
Content Tool Kit                     https://jvz3.com/c/202927/329145/
CourseAlly eLearning                      https://jvz4.com/c/202927/384759/
CourseReel                        https://jvz2.com/c/202927/355249
Courserious                       https://jvz8.com/c/202927/360397/
Coursova                         https://jvz1.com/c/202927/376527
Creaitecontentcreator          https://jvz1.com/c/202927/376986
Credit Repair                        https://jvz8.com/c/202927/377815/
Crypto Kit                     https://jvz8.com/c/202927/383809/
Crypto Rocket                     https://jvz6.com/c/202927/378113/
Crypto Underworld                           https://jvz8.com/c/202927/374345/
Dealcheck                                  https://dealcheck.io?fp_ref=armin16
Design beast               https://jvz6.com/c/202927/371547
Designa Suite License                  https://jvz2.com/c/202927/297271
Develop Self Empowerment                 https://jvz6.com/c/202927/383094/
DFY Content Club                 https://jvz6.com/c/202927/381337/
DFY Suite                    https://jvz3.com/c/202927/381194/
Diabetes Guide                       https://jvz2.com/c/202927/358870/
Diddly Pay’s DLCM                  https://jvz2.com/c/202927/315596
Diet fitness diabetes              https://jvz1.com/c/202927/286851
Domainname                  https://jvz6.com/c/202927/377005
Dominate Email             https://jvz4.com/c/202927/386980/
Dropshiply                   https://jvz3.com/c/202927/383483/
DUX Forex Signals                        https://jvz3.com/c/202927/128215/
EBook Agency                        https://jvz2.com/c/202927/384573/
Ejaculation Total                     https://jvz2.com/c/202927/75989/
Email Monetizer                     https://jvz2.com/c/202927/386337/
EngagerMate                         https://jvz8.com/c/202927/328172
EngageYard                     https://jvz2.com/c/202927/383051/
Extreme Adz                 https://jvz8.com/c/202927/379244/
Extreme Coupon                  https://jvz1.com/c/202927/216101/
EZ Local Appointmen                            https://jvz2.com/c/202927/385180/   t
Ezy                https://jvz1.com/c/202927/381935/
Ezy MultiStores               https://jvzoo.com/c/202927/381935
Facebook Cash Machine                 https://jvz4.com/c/202927/382333/
Facedrip                          https://jvz1.com/c/202927/376325/
FaceSwap                 https://jvz4.com/c/202927/381768/
Fade To Black                   https://jvz2.com/c/202927/344541
Fanpage                          https://jvz4.com/c/202927/144349
Fitness Nutrition                    https://jvz4.com/c/202927/353334/
Followup Builder                         https://jvz3.com/c/202927/386313/
Forex Atlatian                        https://jvz8.com/c/202927/25069/
Forex Blizz                             https://jvz8.com/c/202927/144577/
Forex Blue Stark                      https://jvz3.com/c/202927/47481/
Forex expert                   https://jvz1.com/c/202927/376877
Forex Hybrid Scalper                        https://jvz6.com/c/202927/95037/
Forex Joustar                     https://jvz8.com/c/202927/381617/
Forex Joustar                  https://jvz6.com/c/202927/381617/
Forex Mastery                    https://jvz2.com/c/202927/144621/
Forex Scouts                         https://jvz6.com/c/202927/132677/
forrk                                              https://jvz1.com/c/202927/373449
FusionMT4                             https://jvz2.com/c/202927/372523/
FX Goldminer                      https://jvz1.com/c/202927/381439/
Galactic                         https://jvz1.com/c/202927/188236/
Gaming job                    https://jvz2.com/c/202927/184902  s
Genesis Mining              https://www.genesis-mining.com/a/2535466
Givvy Mobile Lottery             https://givvy-numbers.app.link/qNDZMGGbhsb
Gluten free                              https://jvz4.com/c/202927/296191
GMB Magic                        https://jvz2.com/c/202927/377194
Graphic Alta           https://jvz2.com/c/202927/324492/
Heal Your Emptiness                         https://jvz6.com/c/202927/384848/
High Converting Emails                  https://jvz3.com/c/202927/386305/
HostLegends                       https://jvz4.com/c/202927/384755/
Hostley Domain Creator                        https://jvz1.com/c/202927/379223/
Human Synthesys Studio                      https://jvz8.com/c/202927/367353/
ImageX                      https://jvz6.com/c/202927/363237/
IMSyndicator                   https://jvz1.com/c/202927/370769
Inboxr                            https://jvz2.com/c/202927/312692
Insta Keyword                https://jvz6.com/c/202927/351606/
Instant Website                https://jvz2.com/c/202927/377557
InstantWebsiteBundle          https://jvz6.com/c/202927/377557
iTraffic X                          https://jvz2.com/c/202927/320466
keysearch                                    https://jvz3.com/c/202927/194909
Klippyo Kreators                         https://jvz8.com/c/202927/327447
KoinCart                            https://jvz2.com/c/202927/383555/
Leadvalet                         https://jvz3.com/c/202927/385580/
Levidio Royal Podcasting                        https://jvz6.com/c/202927/384025/
Linkable DFY                       https://jvz6.com/c/202927/385873/
Linkomatic                            https://jvz2.com/c/202927/380937/
LiteTrading                                 https://www.litefinance.com/?uid=929237543
Live Your Truth                       https://jvz6.com/c/202927/379020
Living An Intentional Life              https://jvzoo.com/c/202927/382455
Living an International Life                  https://jvz8.com/c/202927/382455/
Local Leader                   https://jvz4.com/c/202927/383751/
Local Sites                  https://jvz4.com/c/202927/380543/
LocalAgencyBox                 https://jvz2.com/c/202927/359468
LocalCentric                            https://jvz2.com/c/202927/379339/
MarketAll      https://jvz2.com/c/202927/386971/
Marketingblocks             https://jvz6.com/c/202927/374934
MarketPresso                  https://jvz2.com/c/202927/369837
Mat1 Simple Funnel                            https://jvz2.com/c/202927/380197/
Maxslides                         https://jvz8.com/c/202927/376842
Mech Forex Robot                           https://jvz6.com/c/202927/383447/
MediaCloudPro                 https://jvz2.com/c/202927/343635
Megasuite                         https://jvz3.com/c/202927/383953/
Mobi First                          https://jvz2.com/c/202927/353694/
Motion Kingdom Studio                    https://jvz4.com/c/202927/383177/
Movid Animation                     https://jvz6.com/c/202927/380385/
MT4Code System                  https://jvz2.com/c/202927/376925
My Passive Income                  https://jvz1.com/c/202927/384099/
MyMailIt                              https://jvz3.com/c/202927/292919
MyTrafficJacker               https://jvz2.com/c/202927/353558
Next Drive                      https://jvz4.com/c/202927/371095/
NichBox               https://jvz2.com/c/202927/370705/
Organic Life Guide                 https://jvz8.com/c/202927/366872/
Phemex              https://phemex.com/register-vt1?referralCode=D8HUS2
Photokit                           https://jvz4.com/c/202927/373207/
PicsAds                         https://jvz2.com/c/202927/385468/
PigMoney Metho                     https://jvz4.com/c/202927/377665/   d
PigMoneyMethod                        https://jvz2.com/c/202927/377665/
Pitchdeck                      https://jvz3.com/c/202927/347847/
Pixal                     https://jvz2.com/c/202927/378775/
PixaStudio      https://jvz1.com/c/202927/373089/
Pixivid                           https://jvz6.com/c/202927/385213/
PlanB Muscle Growth              https://jvz1.com/c/202927/36517/
PlayerNeos                 https://jvz2.com/c/202927/376962
Podcast Advantage                        https://jvz8.com/c/202927/379995/
Podcast Advantage              https://jvz1.com/c/202927/379995/
Podcast Masterclass               https://jvz3.com/c/202927/379998/
PodKastr                 https://jvz1.com/c/202927/369500/
Postradamus                              https://jvz6.com/c/202927/108695
Power Reviews                     https://jvz8.com/c/202927/384625/
Powrsuite                       https://jvz1.com/c/202927/376361
PR Rage                        https://jvz4.com/c/202927/343405
prime stocks                              https://jvz8.com/c/202927/369164  prime stocks
Profile mate                           https://jvz4.com/c/202927/358049
Promovidz                      https://jvz8.com/c/202927/375692/
Push Button Traffic         https://jvz2.com/c/202927/301402
QR Verse                      https://jvz3.com/c/202927/383865/
Quintex Capital                         https://quintexcapital.com/?ref=arminham
Quit Smoking                           https://jvz3.com/c/202927/359081/
QuizMatic          https://jvz6.com/c/202927/387116/
Reputor                 https://jvz8.com/c/202927/380159/
ReVideo                     https://jvzoo.com/c/202927/381761
ReviewReel                        https://jvz6.com/c/202927/382663/
Rewriter                      https://jvz4.com/c/202927/353373/
RSI SEO                              https://jvz6.com/c/202927/384381/
Scriptdio                       https://jvz4.com/c/202927/385387/
Seniors Income                        https://jvz2.com/c/202927/383888/
Senuke                                  https://jvz6.com/c/202927/279944
ShopABot                           https://jvz2.com/c/202927/291955
ShopFunnels                        https://jvz3.com/c/202927/384069/
SocialAgency360                 https://jvz1.com/c/202927/385357/
SociCake                       https://jvz2.com/c/202927/321987
Socifeed                          https://jvz6.com/c/202927/375706
SociJam                    https://jvz2.com/c/202927/309649
Soronity                                 https://jvz6.com/c/202927/368736
SqribbleEbook                 https://jvz6.com/c/202927/283867
Stackable Picture                        https://jvz1.com/c/202927/385046/
Steven Alvey’s                      https://jvz2.com/c/202927/351754
Stoodaio                                    https://jvz1.com/c/202927/372094
Storymate                         https://jvz3.com/c/202927/320972
StreamPilot                        https://jvz2.com/c/202927/385431/
Studioninja                       https://jvz1.com/c/202927/374965
Sunday Freebie                             https://jvz1.com/c/202927/267113/
Super backdrop                https://jvz8.com/c/202927/376524
Survai                      https://jvz8.com/c/202927/380933/
Syndranker                          https://jvz3.com/c/202927/378143/
Talkingfaces                    https://jvz3.com/c/202927/375550
The Internet Marketing                https://jvz2.com/c/202927/289944
Tonai Voice Content           https://jvz8.com/c/202927/383119/
Toon Video Maker                   https://jvz2.com/c/202927/357201
TrafficFor                https://jvz8.com/c/202927/381950/
TrafficForU                   https://jvz3.com/c/202927/381950/
Trendio                       https://jvz3.com/c/202927/381003/
TubePal                        https://jvz6.com/c/202927/379863/
Tubeserp                        https://jvz3.com/c/202927/370472
TubeTargeter                   https://jvz6.com/c/202927/377211
TuneMingo      https://jvz3.com/c/202927/386556/
TV Boss Fire                https://jvz6.com/c/202927/379480/
Ultrafunnels A.I                 https://jvz2.com/c/202927/381129/
VIADZ Ad Template                    https://jvz4.com/c/202927/379307/
Vidcentric                             https://jvz4.com/c/202927/376095
Viddeyo                                https://jvz6.com/c/202927/382326/
Videevolve                       https://jvz4.com/c/202927/381011/
Video Campaignor      https://jvz4.com/c/202927/387058/
Video Games                            https://jvz3.com/c/202927/184902/
VideoEnginePro                https://jvz2.com/c/202927/372916
VideoGameSuite                     https://jvz3.com/c/202927/366537/
VideoRobot Enterprise                https://jvz8.com/c/202927/291061
VidKreate                        https://jvz6.com/c/202927/386029/
VidMingo                           https://jvz6.com/c/202927/378359/
VidSnatcher                           https://jvz3.com/c/202927/342585
VidVoicer                      https://jvz1.com/c/202927/379983/
Vidzura                       https://jvz4.com/c/202927/385754/
Viral dash                            https://jvz6.com/c/202927/375959
Viral Quotes            https://jvz2.com/c/202927/386984/
VirtualReel                       https://jvz8.com/c/202927/376849
Vocalic                    https://jvz2.com/c/202927/383848/
VoiceBuddy                      https://jvz1.com/c/202927/342854
WebCop                         https://jvz4.com/c/202927/378683/
Webinarkit                       https://jvz3.com/c/202927/383937/
Webprimo                   https://jvz1.com/c/202927/379455/   Website Builder
WordPress Mastery                       https://jvz1.com/c/202927/386249/
WOW Backgrounds                      https://jvz3.com/c/202927/381615/
WowBackgraounds                       https://jvz2.com/c/202927/381556/
WP GDPR                                https://jvz8.com/c/202927/299907
WP Simulator                    https://jvz3.com/c/202927/46987/
Writer Arc           https://jvz1.com/c/202927/386602/
writing job                                  https://jvz8.com/c/202927/213027
XBrain Forex                           https://jvz3.com/c/202927/372305/
XFUNNELS                         https://jvz2.com/c/202927/310335
Xinemax                    https://jvz1.com/c/202927/381749/
YoDrive                    https://jvz2.com/c/202927/384700/
Your 3DPal                https://jvz2.com/c/202927/381685/
YTSuite                       https://jvzoo.com/c/202927/381179

BA.5 Is Driving A Wave Of Covid Infections, But Not Deaths Here’s Why Experts Say We Should Still Be Cautious

The evasive BA.5 omicron variant is driving up Covid cases and hospitalizations as it spreads rapidly across the United States—but despite deaths remaining lower compared to earlier waves, experts tell Forbes there are still plenty of reasons to remain cautious and warn Americans against letting their guard down too soon.

While Covid-19 cases and hospitalizations have been on the rise in most states in recent weeks and jumped 20% nationwide over the past fortnight, deaths have risen only modestly and have hovered around 300-400 a day since April. Driving the new wave is BA.5, an omicron offshoot that has a “superpower to cause reinfection” and can evade immunity from vaccination and previous infection, even from other omicron variants, Dr. Peter Chin-Hong, an infectious disease expert at the University of California, San Francisco, told Forbes.

The disconnect reflects the fact that vaccines and past infections still provide strong protection against serious illness and death for BA.5 as well as there being more options available to treat early disease like Pfizer’s Paxlovid. Chin-Hong said there are still plenty of reasons to avoid infection, not least because Covid can still cause severe symptoms “even if you don’t end up in the hospital” and symptoms can “last for weeks.”

Infection also carries the risk of “long Covid”—lingering and sometimes debilitating symptoms that can persist for months or years—and early evidence suggests this is more likely the more times you get infected. Avoiding infection also helps safeguard people around you who may have less protection against serious disease like children, the elderly and those with weakened immune systems, Dr. Stuart Turville, a virologist at the University of New South Wales in Australia, told Forbes.

Increasingly transmissible variants of omicron have surged across the U.S. this year. BA.5, the most infectious form of the virus yet, rapidly spread and became the dominant variant in early July. It now accounts for an estimated 78% of cases, according to the Centers for Disease Control and Prevention and community transmission has spiked. Concerns over BA.5, as well as the related BA.4, prompted officials to direct vaccine makers to target the variants in updated shots and the Biden Administration announced new plans to tackle its spread.

Officials and experts say it is especially important to ensure strong protection against serious disease by keeping up-to-date on vaccinations, including booster shots. Despite the appeals of public health officials and being available for many months, booster uptake in the U.S. is poor. Fewer than half of fully vaccinated people have received their first booster dose and fewer than 30% of those who have and are eligible for a second have taken up the offer, according to CDC data.

More variants. It is inevitable that SARS-CoV-2, the virus that causes Covid-19, will evolve and spawn new variants over time. Another omicron offshoot, BA.2.75—inexplicably and successfully dubbed “Centaurus” by the internet—has already caught the eye of virologists. The variant is spreading rapidly in India, has been detected across Europe and North America and shows signs of evading immunity.

Little data is available and it’s not clear whether BA.2.75 causes more severe disease. It’s also not clear whether it would be able to take over from BA.5 “as the ruler of the roost,” Chin-Hong explained, as they haven’t had a chance to directly compete with each other as yet.”

A great deal. Data collection and surveillance is poor compared to earlier on in the pandemic. Individual testing is down, genomic surveillance is reduced and evidence suggests cases could be vastly higher than official figures state. Conversely, hospital figures are inflated and reflect routine testing upon admission, which catches many “incidental” infections from people seeking care for other problems.

There is a lot to be understood about the newer omicron variants as well, experts say. BA.5, as well as other more recent omicron offshoots like BA.4 and BA.2.75, are relatively new pathogens that are infecting or reinfecting large numbers of people in the community, Turville explained, which makes it hard to provide absolute and definitive answers. “As with most things with SARS CoV-2, it is a large bag of unknowns,” he added.

Turville told Forbes the decoupling of deaths from cases shows the longer term effects of vaccination and exposure to the virus. It’s a “maturing immunity to SARS-CoV-2 in general” which has taken off the “edge of disease severity,” he added.

While cases are growing—and likely undercounted—it’s worth noting that they are a long way from the earlier omicron peak in January. In July, there were around 100,000-120,000 cases reported on average compared to more than 800,000 in mid January.

I am a senior reporter for the Forbes breaking news team, covering health and science from the London office. Previously I worked as a reporter for a trade publication

Source: BA.5 Is Driving A Wave Of Covid Infections, But Not Deaths—Here’s Why Experts Say We Should Still Be Cautious

Critics by

So far there is no evidence that this variant causes more serious illness. And infectious disease experts say that even though new infections are on the rise, the impact of BA.5 is unlikely to be on the scale of the surge we saw last winter — in part because the country is better equipped to manage it.

The U.S. is averaging about 300 deaths a day, compared to 3,000 last winter. Dr. Anna Durbin, a professor at the Johns Hopkins University School of Medicine, says the combination of prior infections and vaccinations is still protective, and COVID-19 treatments are better.

“Most people have some underlying immunity that is helpful in fighting the virus,” she explains. “We have antivirals … And I think that because of that … we’re not seeing a rise in deaths. And that’s very reassuring. It tells me that even this virus, even BA.5, is not so divergent that it is escaping all arms of the immune system.”

She adds that new booster shots specifically targeting omicron — which could roll out as soon as this fall — should also be helpful in preventing serious illness and deaths.

There are steps you can take to reduce your exposure to the virus, like masking up in crowded indoor spaces. Here’s how to step up your mask game.

Plus, children under the age of 5 are finally eligible to get vaccinated (and while many parents are hesitant, public health experts are encouraging them not to wait any longer). And adults ages 50 and older, as well as those over 12 with certain underlying conditions, can get a second booster shot.

And, if you already have plans to travel or attend gatherings this summer, check out these tips for protecting yourself outdoors, improving indoor airflow and what to do if you get sick while on vacation.

Related contents:

BA.5 variant now makes up 78% of active Covid-19 cases in the US Mail Online

20:08
19:59
19:55

More Remote Working Apps:

https://quintexcapital.com/?ref=arminham     Quintex Capital

https://www.genesis-mining.com/a/2535466   Genesis Mining

 http://www.bevtraders.com/?ref=arminham   BevTraders

https://www.litefinance.com/?uid=929237543  LiteTrading

https://alpariforex.org/fa/registration/?cpa_partner_id=13687690   Alpari Forex Trading

https://dealcheck.io?fp_ref=armin16   Dealcheck Real Estate Evaluator

https://jvz8.com/c/202927/369164  prime stocks

 https://jvz3.com/c/202927/361015  content gorilla

  https://jvz8.com/c/202927/366443  stock rush  

 https://jvz1.com/c/202927/373449  forrk   

https://jvz3.com/c/202927/194909  keysearch  

 https://jvz4.com/c/202927/296191  gluten free   

https://jvz1.com/c/202927/286851  diet fitness diabetes  

https://jvz8.com/c/202927/213027  writing job  

 https://jvz6.com/c/202927/108695  postradamus

https://jvz1.com/c/202927/372094  stoodaio

 https://jvz4.com/c/202927/358049  profile mate  

 https://jvz6.com/c/202927/279944  senuke  

 https://jvz8.com/c/202927/54245   asin   

https://jvz8.com/c/202927/370227  appimize

 https://jvz8.com/c/202927/376524  super backdrop

 https://jvz6.com/c/202927/302715  audiencetoolkit

 https://jvz1.com/c/202927/375487  4brandcommercial

https://jvz2.com/c/202927/375358  talkingfaces

 https://jvz6.com/c/202927/375706  socifeed

 https://jvz2.com/c/202927/184902  gaming jobs

 https://jvz6.com/c/202927/88118   backlinkindexer

 https://jvz1.com/c/202927/376361  powrsuite  

https://jvz3.com/c/202927/370472  tubeserp  

https://jvz4.com/c/202927/343405  PR Rage  

https://jvz6.com/c/202927/371547  design beast  

https://jvz3.com/c/202927/376879  commission smasher

 https://jvz2.com/c/202927/376925  MT4Code System

https://jvz6.com/c/202927/375959  viral dash

https://jvz1.com/c/202927/376527  coursova

 https://jvz4.com/c/202927/144349  fanpage

https://jvz1.com/c/202927/376877  forex expert  

https://jvz6.com/c/202927/374258  appointomatic

https://jvz2.com/c/202927/377003  woocommerce

https://jvz6.com/c/202927/377005  domainname

 https://jvz8.com/c/202927/376842  maxslides

https://jvz8.com/c/202927/376381  ada leadz

https://jvz2.com/c/202927/333637  eyeslick

https://jvz1.com/c/202927/376986  creaitecontentcreator

https://jvz4.com/c/202927/376095  vidcentric

https://jvz1.com/c/202927/374965  studioninja

https://jvz6.com/c/202927/374934  marketingblocks

https://jvz3.com/c/202927/372682  clipsreel  

https://jvz2.com/c/202927/372916  VideoEnginePro

https://jvz1.com/c/202927/144577  BarclaysForexExpert

https://jvz8.com/c/202927/370806  Clientfinda

https://jvz3.com/c/202927/375550  Talkingfaces

https://jvz1.com/c/202927/370769  IMSyndicator

https://jvz6.com/c/202927/283867  SqribbleEbook

https://jvz8.com/c/202927/376524  superbackdrop

https://jvz8.com/c/202927/376849  VirtualReel

https://jvz2.com/c/202927/369837  MarketPresso

https://jvz1.com/c/202927/342854  voiceBuddy

https://jvz6.com/c/202927/377211  tubeTargeter

https://jvz6.com/c/202927/377557  InstantWebsiteBundle

https://jvz6.com/c/202927/368736  soronity

https://jvz2.com/c/202927/337292  DFY Suite 3.0 Agency+ information

https://jvz8.com/c/202927/291061  VideoRobot Enterprise

https://jvz8.com/c/202927/327447  Klippyo Kreators

https://jvz8.com/c/202927/324615  ChatterPal Commercial

https://jvz8.com/c/202927/299907  WP GDPR Fix Elite Unltd Sites

https://jvz8.com/c/202927/328172  EngagerMate

https://jvz3.com/c/202927/342585  VidSnatcher Commercial

https://jvz3.com/c/202927/292919  myMailIt

https://jvz3.com/c/202927/320972  Storymate Luxury Edition

https://jvz2.com/c/202927/320466  iTraffic X – Platinum Edition

https://jvz2.com/c/202927/330783  Content Gorilla One-time

https://jvz2.com/c/202927/301402  Push Button Traffic 3.0 – Brand New

https://jvz2.com/c/202927/321987  SociCake Commercial

https://jvz2.com/c/202927/289944  The Internet Marketing

 https://jvz2.com/c/202927/297271  Designa Suite License

https://jvz2.com/c/202927/310335  XFUNNELS FE Commercial 

https://jvz2.com/c/202927/291955  ShopABot

https://jvz2.com/c/202927/312692  Inboxr

https://jvz2.com/c/202927/343635  MediaCloudPro 2.0 – Agency

 https://jvz2.com/c/202927/353558  MyTrafficJacker 2.0 Pro+

https://jvz2.com/c/202927/365061  AIWA Commercial

https://jvz2.com/c/202927/357201  Toon Video Maker Premium

https://jvz2.com/c/202927/351754  Steven Alvey’s Signature Series

https://jvz2.com/c/202927/344541  Fade To Black

https://jvz2.com/c/202927/290487  Adsense Machine

https://jvz2.com/c/202927/315596  Diddly Pay’s DLCM DFY Club

https://jvz2.com/c/202927/355249  CourseReel Professional

https://jvz2.com/c/202927/309649  SociJam System

https://jvz2.com/c/202927/263380  360Apps Certification

 https://jvz2.com/c/202927/359468  LocalAgencyBox

https://jvz2.com/c/202927/377557  Instant Website Bundle

https://jvz2.com/c/202927/377194  GMB Magic Content

https://jvz2.com/c/202927/376962  PlayerNeos VR

https://jvz8.com/c/202927/381812/  BrandElevate Bundle information

https://jvz4.com/c/202927/381807/ BrandElevate Ultimate

https://jvz2.com/c/202927/381556/ WowBackgraounds Plus

https://jvz4.com/c/202927/381689/  Your3DPal Ultimate

https://jvz2.com/c/202927/380877/  BigAudio Club Fast Pass

https://jvz3.com/c/202927/379998/ Podcast Masterclass

https://jvz3.com/c/202927/366537/  VideoGameSuite Exclusive

https://jvz8.com/c/202927/381148/ AffiliateMatic

https://jvzoo.com/c/202927/381179  YTSuite Advanced

https://jvz1.com/c/202927/381749/  Xinemax 2.0 Commercial

https://jvzoo.com/c/202927/382455  Living An Intentional Life

https://jvzoo.com/c/202927/381812  BrandElevate Bundle

https://jvzoo.com/c/202927/381935 Ezy MultiStores

https://jvz2.com/c/202927/381194/  DFY Suite 4.0 Agency

https://jvzoo.com/c/202927/381761  ReVideo

https://jvz4.com/c/202927/381976/  AppOwls Bundle

https://jvz8.com/c/202927/381950/  TrafficForU

https://jvz3.com/c/202927/381615/  WOW Backgrounds 2.0

https://jvz4.com/c/202927/381560   ALL-in-One HD Stock Bundle

https://jvz6.com/c/202927/382326/   Viddeyo Bundle

https://jvz8.com/c/202927/381617/  The Forex Joustar

https://jvz3.com/c/202927/383751/ ADA Web Accessibility Compliance 

https://jvz3.com/c/202927/383942/  10 Bold Actions In Positive Life & Work

https://jvz3.com/c/202927/383706/  Adtivate Agency

https://jvz1.com/c/202927/384099/   My Passive Income Blueprints

https://jvz3.com/c/202927/329145/  Content Tool Kit

https://jvz6.com/c/202927/382663/    ReviewReel

https://jvz3.com/c/202927/383940/    QR Verse Bundle

https://jvz4.com/c/202927/379307/    VIADZ Ad Template

https://jvz2.com/c/202927/383051/    EngageYard Ad Creator

https://jvz4.com/c/202927/381011/   Videevolve

https://jvz4.com/c/202927/383751/  Local Leader Bundle

https://jvz8.com/c/202927/383119/   Tonai Voice Content

https://jvz2.com/c/202927/383848/   Vocalic Commercial

https://jvz3.com/c/202927/383483/  Dropshiply Store Creator

How a Special Immune System Protects Our Grey Matter

In the past decade, however, scientists have discovered that the job of protecting the brain isn’t as straightforward as they thought. They’ve learnt that its fortifications have gateways and gaps, and that its borders are bustling with active immune cells.

A large body of evidence now shows that the brain and the immune system are tightly intertwined. Scientists already knew that the brain had its own resident immune cells, called microglia; recent discoveries are painting more-detailed pictures of their functions and revealing the characteristics of the other immune warriors housed in the regions around the brain. Some of these cells come from elsewhere in the body; others are produced locally, in the bone marrow of the skull.

By studying these immune cells and mapping out how they interact with the brain, researchers are discovering that they play an important part in both healthy and diseased or damaged brains. Interest in the field has exploded: there were fewer than 2,000 papers per year on the subject in 2010, swelling to more than 10,000 per year in 2021, and researchers have made several major findings in the past few years.

No longer do scientists consider the brain to be a special, sealed-off zone. “This whole idea of immune privilege is quite outdated now,” says Kiavash Movahedi, a neuroimmunologist at the Free University of Brussels (VUB). Although the brain is still seen as immunologically unique — its barriers prevent immune cells from coming and going at will — it’s clear that the brain and immune system constantly interact, he adds (see ‘The brain’s immune defences’).

This shift in attitude is widespread in the community, says Leonardo Tonelli, chief of the neuroendocrinology and neuroimmunology programme at the US National Institute of Mental Health in Bethesda, Maryland. In his experience, almost every neuroscientist who reviews grant proposals for the agency accepts the connection, he says, although many still need to catch up with the latest discoveries in neuroimmunology, which have started to reveal the underlying mechanisms.

The rush to understand how the brain and immune system knit together has prompted a wealth of questions, says Tony Wyss-Coray, a neuroimmunologist at Stanford University in California. “How important is this in normal brain function or disease? That is a very hard question to answer.”

Privileged space

More than two decades ago, when neuroimmunologist Michal Schwartz had just set up her laboratory at the Weizmann Institute of Science in Rehovot,  she couldn’t stop asking herself an unpopular question: could it really be true that the brain is completely cut off from immune protection? “It was completely axiomatic that the brain cannot tolerate any immune activity — everyone thought that if you have any immune activation, this was a sign of pathology,” she says. “But it didn’t make sense that tissue that is so indispensable, like the brain, cannot enjoy the benefit of being assisted by the immune system.”

The idea that the brain was off limits to the immune system took root decades earlier. In the 1920s, the Japanese scientist Y. Shirai reported that when tumour cells were implanted in a rat’s body, the immune response destroyed them, but when placed in the brain, they survived — indicating a feeble or absent immune response. Similar findings followed in the 1940s.

Most scientists also thought that the brain lacked a system for ferrying immune molecules in and out — the lymphatic drainage system that exists elsewhere in the body — even though such a system was first described in the brain more than two centuries ago. The prevailing view, then, was that the brain and the immune system lived largely separate lives. The two were thought to collide only under hostile circumstances: when immune cells went rogue, attacking the body’s own cells in diseases such as multiple sclerosis.

So when, in the late 1990s, Schwartz and her team reported that after an acute injury to the central nervous system, two types of immune cells, macrophages and T cells, protected neurons from damage and supported their recovery, many scientists were sceptical. “Everyone told me, you’re absolutely wrong,” Schwartz recalls.

Since those early experiments, Schwartz’s team and others have amassed a large body of evidence showing that immune cells do, indeed, have a significant role in the brain, even in the absence of autoimmune disease. Researchers have shown, for example, that in mice engineered to lack an immune system, neurodegenerative diseases such as motor neuron disease (amyotrophic lateral sclerosis) and Alzheimer’s disease seemed to progress more rapidly, whereas restoring the immune system slowed their progression. Scientists have also revealed a potential role for microglia in Alzheimer’s disease.

More recently, scientists have shown that immune cells at the brain’s edges are active in neurodegenerative diseases. After examining the cerebrospinal fluid of people with Alzheimer’s, Wyss-Coray and his colleagues found evidence of a rise in numbers of T cells in the brain’s fluid-filled borders5. The expansion of these immune-cell populations suggests that they might have a role in the disease, Wyss-Coray says.

But whether immune cells hurt or help the brain is an open question. In their studies of Alzheimer’s and other neurodegenerative disorders, Wyss-Coray and his colleagues suggest that the immune system could be damaging neurons by releasing molecules that boost inflammation and trigger cell death. Others have suggested that T cells and other immune cells could instead be protective. For example, Schwartz’s group has reported6 that in mouse models of Alzheimer’s, boosting the immune response leads to a clearance of amyloid plaques — a pathological hallmark of the disease — and improves cognitive performance.

Busy borders

It’s now becoming clear that the brain’s margins are immunologically diverse: almost any type of immune cell in the body can also be found in the area surrounding the brain. The meninges — the fluid-filled membranes that wrap the brain — are an “immunological wonderland”, says Movahedi, whose work focuses on macrophages in the brain’s borders. “There’s so much happening out there.”

Some residents are exclusive to the frontiers. In 2021, Jonathan Kipnis, a neuroimmunologist at Washington University in St. Louis, Missouri, and his colleagues reported7 that there is a local source of immune cells: the bone marrow of the skull.

When they explored how the bone marrow mobilizes these cells, Kipnis and his colleagues demonstrated8 that, in response to an injury to the central nervous system or in the presence of a pathogen, signals carried in the cerebrospinal fluid were delivered to the skull bone marrow, prompting it to produce and release these cells (see ‘Private protectors’).

What role these locally produced immune cells have remains to be seen, but Kipnis’s group thinks that they might have a gentler role than immune cells from elsewhere in the body, regulating the immune response rather than being primed to fight. Kipnis says that this distinction, if true, has implications for treatment. In diseases such as multiple sclerosis, he says, symptoms could perhaps be improved by preventing immune cells from other parts of the body from coming in. By contrast, with a brain tumour, he adds, “you want the fighters”.

His team has also detected a network of channels that snake and branch over the surface of the brain, and which swarm with immune cells, forming the brain’s own lymphatic system9. These vessels, which sit in the outermost part of the meninges, give immune cells a vantage point near the brain from where they can monitor any signs of infection or injury.

In sickness and in health

As evidence builds for the involvement of immune cells during brain injury and disease, researchers have been exploring their function in healthy brains. “I think the most exciting part of neuroimmunology is that it’s relevant to so many different disorders and conditions and to normal physiology,” says Beth Stevens, a neuroscientist at Boston Children’s Hospital in Massachusetts.

Many groups, including Stevens’s, have found microglia to be important to the brain’s development. These cells are involved in pruning neuronal connections, and studies suggest that problems in the pruning process might contribute to neurodevelopmental conditions.

Border immune cells, too, have been shown to be essential in healthy brains. Kipnis, Schwartz and their colleagues, for example, have shown that mice that lack some of these cells display problems in learning and social behaviour10. Others reported11 in 2020 that mice that develop without a specific population of T cells in both the brain and the rest of the body have defective microglia. Their microglia struggle to prune neuronal connections during development, leading to excessive numbers of synapses and abnormal behaviour. The authors propose that during this crucial period, T cells migrate into the brain and help microglia to mature.

One big mystery is how exactly immune cells — particularly those around the borders — talk to the brain. Although there is some evidence that they might occasionally cross into the organ, most studies so far suggest that these cells communicate by sending in molecular messengers known as cytokines. These, in turn, influence behaviour.

Researchers have been studying how cytokines affect behaviour for decades, finding, for example, that cytokines sent out by immune cells during infection can initiate ‘sickness behaviours’ such as increased sleep12. They have also shown in animal models that alterations in cytokines — induced by depleting them throughout the body or knocking out specific cytokine receptors on neurons — can lead to alterations in memory, learning and social behaviours13. How cytokines travel into the brain and exert their effects remains an area of active study.

Cytokines might also be a link between the immune system and neurodevelopmental conditions such as autism. When Gloria Choi, a neuroimmunologist at the Massachusetts Institute of Technology in Cambridge, and her colleagues boosted cytokine levels in pregnant mice, they saw brain changes and autism-like behaviours in the offspring14.

Although these insights are tantalizing, much of the work on how immune cells, especially those in the borders, operate in the brain is still in its infancy. “We are very far away from understanding what’s happening in healthy brains,” Kipnis says.

A two-way street

Communication between the immune system and the brain also seems to go in the other direction: the brain can direct the immune system.

Some of these insights are decades old. In the 1970s, scientists conditioned rats to become immunosuppressed when they tasted saccharin, an artificial sweetener, by pairing it with an immunosuppressive drug for several days15.

In more recent work, Asya Rolls, a neuroimmunologist at Technion — Israel Institute of Technology in Haifa, and her team explored the link between emotion, immunity and cancer in mice. They reported16 in 2018 that activating neurons in the ventral tegmental area, a brain region involved in positive emotions and motivation, boosted the immune response and, in turn, slowed tumour growth.

Then, in 2021, her group pinpointed neurons in the insular cortex — a part of the brain involved in processing emotion and bodily sensations, among other things — that were active during inflammation in the colon, a condition also known as colitis.

By activating these neurons artificially, the researchers were able to reawaken the intestinal immune response17. Just as Pavlov’s dogs learnt to associate the sound of a bell with food, causing the animals to salivate any time they heard the noise, these rodents’ neurons had captured a ‘memory’ of the immunological response that could be rebooted. “This showed that there is very intense crosstalk between neurons and immune cells,” says Movahedi, who wasn’t involved with this work.

Rolls suspects that organisms evolved such immunological ‘memories’ because they are advantageous, gearing up the immune system in situations when the body might meet pathogens. She adds that in certain cases, they can instead be maladaptive — when the body anticipates an infection and mounts an unnecessary immune response, causing collateral damage. This pathway might help to explain how psychological states can influence the immune response, providing a potential mechanism for many psychosomatic disorders, according to Rolls.

It could also inspire therapies. Rolls and her team found that blocking the activity of those inflammation-associated neurons lessened inflammation in mice with colitis. Her group hopes to translate these findings to humans, and is examining whether inhibiting activity using non-invasive brain stimulation can help to alleviate symptoms in people with Crohn’s disease and psoriasis — disorders that are mediated by the immune system. This work is in the early phases, Rolls says, “but it’ll be really cool if it works”.

Other groups are exploring how the brain controls the immune system. Choi’s team is tracing out the specific neurons and circuits that modulate the immune response. One day, she hopes to be able to generate a comprehensive map of the interactions between the brain and immune system, outlining the cells, circuits and molecular messengers responsible for the communication in both directions — and connecting those to behavioural or physiological readouts.

One of the biggest challenges now is to tease apart which populations of cells are involved in these myriad functions. To tackle it, some researchers have been probing how these cells differ at the molecular level, by sequencing genes in single cells. This has revealed a subset of microglia associated with neurodegenerative disease, for example. Understanding how these microglia function differently from their healthy counterparts will be useful in developing treatments, Stevens says. They could also be used as markers to track the progression of a disease or the efficacy of therapies, she adds.

Researchers have already begun using these insights into the immune ecosystem in and around the brain. Schwartz’s team, for example, is rejuvenating the immune system in the hope of fighting Alzheimer’s disease. This work has opened up new avenues for therapeutics, particularly for neurodegenerative conditions, Schwartz says. “It’s an exciting time in the history of brain research.”

By: Diana Kwon

Source: Guardians of the brain: how a special immune system protects our grey matter

More contents:

Diabetes Fast Facts

Here’s a look at diabetes, a disease that affects millions of people around the world. Diabetes is characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. The disease can lead to serious complications such as blindness, kidney damage, cardiovascular disease, limb amputations and premature death.

Facts

People with diabetes or certain other underlying medical conditions are more likely to become severely ill if infected with Covid-19, according to the CDC. Worldwide, the number of people living with the potentially fatal disease has quadrupled since 1980, to around 422 million, according to the World Health Organization (WHO).

37.3 million people in the United States have diabetes, about 11.3% of the population. 8.5 million (23%) of adults with diabetes are undiagnosed. Diabetes was the eighth leading cause of death in the United States in 2020, according to provisional data from the National Vital Statistics System.

There are several types of diabetes: Type 1, Type 2 and gestational diabetes. Prediabetes occurs when blood glucose levels are higher than normal but not yet high enough to be diagnosed as diabetes. Before developing Type 2 diabetes, people almost always have prediabetes. Research has shown that some long-term damage to the body may occur during prediabetes.

Type 1 diabetes develops when the body’s immune system destroys pancreatic beta cells, the only cells in the body that make insulin. This form of diabetes usually strikes children and young adults. Only 5-10% of people with diabetes have Type 1. Risk factors for Type 1 diabetes may be autoimmune, genetic or environmental. There is no known way to prevent Type 1 diabetes.

Type 2 diabetes occurs when the body does not produce enough insulin or the cells do not use insulin properly. Type 2 diabetes is the most common form of diabetes and in adults, it accounts for about 90% to 95% of all diagnosed cases of diabetes. It is associated with older age, obesity, family history, physical inactivity and race/ethnicity.

It is more common in African Americans, Latino Americans, American Indians, Asian Americans, Native Hawaiians and other Pacific Islanders. Type 2 diabetes in children and adolescents, although still rare, is being diagnosed more frequently.

Gestational diabetes is a form of glucose intolerance diagnosed during pregnancy. It affects about 4% of all pregnant women. A diagnosis of gestational diabetes doesn’t mean that a woman had diabetes before she conceived, or that she will have diabetes after giving birth.

Other types of diabetes result from genetic conditions, surgery, medications, infections and other illnesses. Such types of diabetes account for 1% to 5% of all diagnosed cases.

Possible Symptoms

Frequent urination
Excessive thirst
Unexplained weight loss
Extreme hunger
Sudden changes in vision
Numbness in hands or feet
Tiredness
Dry skin
Slow healing wounds
Frequent infections

Complications

Adults with diabetes have heart disease death rates about two to four times higher than adults without diabetes. The risk for stroke is two to four times higher among people with diabetes. People with diabetes are at high risk for high blood pressure.

Diabetes is the leading cause of new cases of blindness among adults aged 20-74 years. Diabetes is the leading cause of kidney failure. Between 60% and 70% of people with diabetes have mild to severe forms of nervous system damage or neuropathy.

US Diabetes Statistics

1.4 million new cases are diagnosed every year in the United States.

In 2019, about 96 million people aged 18 or older had prediabetes.

About 286,000 people under 20 years old have diabetes.

$327 billion – Cost to treat diabetes in the US in 2017.

Timeline

1921 – Insulin is discovered by Drs. Frederick Banting and Charles Best.

November 16, 2012 – The CDC releases a report showing that 18 states had a 100% or more increase in the prevalence of diabetes from 1995 to 2010. Forty-two states saw an increase of at least 50%.

January 17, 2014 – For the first time, US surgeon general’s report on the health consequences of smoking includes data that indicates smoking can cause diabetes, as well as erectile dysfunction, rheumatoid arthritis, macular degeneration, ectopic pregnancies and impaired immune function. Smokers have a 30% to 40% increased risk of developing Type 2 diabetes compared with nonsmokers.

May 4, 2015 – A study published in the Journal of Clinical Investigation detects a possible connection between diabetes and Alzheimer’s disease.

September 28, 2016 – The Food and Drug Administration approves a so-called artificial pancreas. The first-of-its-kind device, the size of a cell phone, monitors and treats patients with type 1 diabetes, also known as juvenile diabetes.

September 28, 2017 – The FDA approves the “first-ever continuous blood sugar monitoring device” that doesn’t require patients to prick their fingers for blood samples.

December 2, 2019 – An estimated 18% of adolescents ages 12 to 18 and 24% of young adults ages 19 to 34 in the United States have prediabetes, according to a JAMA Pediatrics study covering 2005-2016.

May 15, 2022 – In its biannual Diabetes Report Card, the CDC notes a decrease in newly diagnosed cases of diabetes after almost two decades of continual increases. In 2019, the number of newly diagnosed US adults decreased from a high of 9.3 per 1,000 in 2009 to 5.9 per 1,000 adults.

By:

Source: Diabetes Fast Facts – CNN

More contents:

Brain Surgeon: if You Have Tinnitus (Ear Ringing) Do This…

How Long Does $1 Million Last After 60? Fisher Investments

The Days Of Shingles Are Over. See Why Metal Roofing Is So…

Doctors Can’t Explain Why This Fruit May Cut Your Blood Sugar By… Gluco Shield Pro

Obama reconnects with kid who touched his hair in iconic photo

 Weight Loss After 60 Comes Down To This Daily Habit

New “Lung Cleaning” Device Is Going Viral In United 

More Remote Working Apps:

https://quintexcapital.com/?ref=arminham     Quintex Capital

https://www.genesis-mining.com/a/2535466   Genesis Mining

 http://www.bevtraders.com/?ref=arminham   BevTraders

https://www.litefinance.com/?uid=929237543  LiteTrading

https://jvz8.com/c/202927/369164  prime stocks

  https://jvz3.com/c/202927/361015  content gorilla

  https://jvz8.com/c/202927/366443  stock rush  

 https://jvz1.com/c/202927/373449  forrk   

https://jvz3.com/c/202927/194909  keysearch  

 https://jvz4.com/c/202927/296191  gluten free   

https://jvz1.com/c/202927/286851  diet fitness diabetes  

https://jvz8.com/c/202927/213027  writing job  

 https://jvz6.com/c/202927/108695  postradamus

https://jvz1.com/c/202927/372094  stoodaio

 https://jvz4.com/c/202927/358049  profile mate  

 https://jvz6.com/c/202927/279944  senuke  

 https://jvz8.com/c/202927/54245   asin   

https://jvz8.com/c/202927/370227  appimize

 https://jvz8.com/c/202927/376524  super backdrop

 https://jvz6.com/c/202927/302715  audiencetoolkit

 https://jvz1.com/c/202927/375487  4brandcommercial

https://jvz2.com/c/202927/375358  talkingfaces

 https://jvz6.com/c/202927/375706  socifeed

 https://jvz2.com/c/202927/184902  gaming jobs

 https://jvz6.com/c/202927/88118   backlink indexer

https://jvz3.com/c/202927/370472  tubeserp  

https://jvz4.com/c/202927/343405  PR Rage  

https://jvz6.com/c/202927/371547  design beast  

https://jvz3.com/c/202927/376879  commission smasher

 https://jvz2.com/c/202927/376925  MT4Code System

https://jvz6.com/c/202927/375959  viral dash

https://jvz1.com/c/202927/376527  coursova

 https://jvz4.com/c/202927/144349  fanpage

https://jvz1.com/c/202927/376877  forex expert  

https://jvz6.com/c/202927/374258  appointomatic

https://jvz2.com/c/202927/377003  woocommerce

https://jvz6.com/c/202927/377005  domainname

 https://jvz8.com/c/202927/376842  maxslides

https://jvz8.com/c/202927/376381  ada leadz

https://jvz2.com/c/202927/333637  eyeslick

https://jvz1.com/c/202927/376986  creaitecontentcreator

https://jvz4.com/c/202927/376095  vidcentric

https://jvz1.com/c/202927/374965  studioninja

https://jvz6.com/c/202927/374934  marketingblocks https://jvz3.com/c/202927/372682  clipsreel  

https://jvz2.com/c/202927/372916  VideoEnginePro

https://jvz1.com/c/202927/144577  BarclaysForexExpert

https://jvz8.com/c/202927/370806  Clientfinda

https://jvz3.com/c/202927/375550  Talkingfaces

https://jvz1.com/c/202927/370769  IMSyndicator

https://jvz6.com/c/202927/283867  SqribbleEbook

https://jvz8.com/c/202927/376524  superbackdrop

https://jvz8.com/c/202927/376849  VirtualReel

https://jvz2.com/c/202927/369837  MarketPresso

https://jvz1.com/c/202927/342854  voiceBuddy

https://jvz6.com/c/202927/377211  tubeTargeter

https://jvz6.com/c/202927/377557  InstantWebsiteBundle

https://jvz6.com/c/202927/368736  soronity

https://jvz2.com/c/202927/337292  DFY Suite 3.0 Agency+ information

https://jvz8.com/c/202927/291061  VideoRobot Enterprise

https://jvz8.com/c/202927/327447  Klippyo Kreators

https://jvz8.com/c/202927/324615  ChatterPal Commercial

https://jvz8.com/c/202927/299907  WP GDPR Fix Elite Unltd Sites

https://jvz8.com/c/202927/328172  EngagerMate

https://jvz3.com/c/202927/342585  VidSnatcher Commercial

https://jvz3.com/c/202927/292919  myMailIt

https://jvz3.com/c/202927/320972  Storymate Luxury Edition

https://jvz2.com/c/202927/320466  iTraffic X – Platinum Edition

https://jvz2.com/c/202927/330783  Content Gorilla One-time

https://jvz2.com/c/202927/301402  Push Button Traffic 3.0 – Brand New

https://jvz2.com/c/202927/321987  SociCake Commercial

https://jvz2.com/c/202927/289944  The Internet Marketing

 https://jvz2.com/c/202927/297271  Designa Suite License

https://jvz2.com/c/202927/310335  XFUNNELS FE Commercial 

https://jvz2.com/c/202927/291955  ShopABot

https://jvz2.com/c/202927/312692  Inboxr

https://jvz2.com/c/202927/343635  MediaCloudPro 2.0 – Agency

 https://jvz2.com/c/202927/353558  MyTrafficJacker 2.0 Pro+

https://jvz2.com/c/202927/365061  AIWA Commercial

https://jvz2.com/c/202927/357201  Toon Video Maker Premium

https://jvz2.com/c/202927/351754  Steven Alvey’s Signature Series

https://jvz2.com/c/202927/344541  Fade To Black

https://jvz2.com/c/202927/290487  Adsense Machine

https://jvz2.com/c/202927/315596  Diddly Pay’s DLCM DFY Club

https://jvz2.com/c/202927/355249  CourseReel Professional

https://jvz2.com/c/202927/309649  SociJam System

https://jvz2.com/c/202927/263380  360Apps Certification

 https://jvz2.com/c/202927/359468  LocalAgencyBox

https://jvz2.com/c/202927/377557  Instant Website Bundle

https://jvz2.com/c/202927/377194  GMB Magic Content

https://jvz2.com/c/202927/376962  PlayerNeos VR

Why Some People Get COVID More Than Once


Although the federal government does not collect data on COVID reinfections, and nor do health authorities in WA and Queensland, Victoria recorded almost 10,000 reinfections between late December 2021 and late March 2022. This compares with just 108 known reinfections in Victoria during the previous two years. NSW plans to release state reinfection data soon.

As the Omicron sub-variant BA.2 continues to fuel more infections, the spectre of repeat infections is well and truly upon us. Current vaccines were designed to protect against the original strain of SARS-CoV-2, and while the shots are crucial in shielding us from severe illness and death, they are less effective in preventing infection by newer variants.

 Unfortunately, natural immunity gained from a Delta infection also won’t stop us getting infected with Omicron. We learnt this with the rise of Omicron in South Africa late last year, when a population with relatively high natural immunity from previous coronavirus infections still fell victim to the merciless Omicron wave.

Reinfections have become something of a hallmark of Omicron. Since the rise of this highly transmissible strain, the number of people reinfected with coronavirus has spiked, in a pattern that is unique to the strain. Imperial College London researchers estimate a reinfection with Omicron is 5.4 times greater than with the Delta variant.

A letter published in The New England Journal of Medicine indicated that a previous COVID-19 infection was 90 per cent effective at preventing an infection with the Alpha, Beta or Delta variants, but only 56 per cent effective against Omicron.

In England, where Omicron has driven a spike in reinfections, provisional data from the UK Health Security Agency shows 10.7 per cent of all positive COVID-19 cases were reinfections in the last week of March.

The data shows that the number of weekly reinfections jumped from 20,000 to 50,000 in just one month, with reinfections occurring across all age groups, despite high vaccination levels. (A reinfection was counted when someone tested positive on two tests taken more than 90 days apart.)

Waning immunity is playing a part, along with the easing of restrictions. But the potent variable here is the rise of the BA.2 variant of Omicron, which is rapidly becoming the dominant strain globally.

A non-peer reviewed Swedish study suggests Omicron BA.2 could be more contagious than the original BA.1 strain due to its higher viral loads in the nose and throat. (The first case of a new recombinant variant combining BA.1 and BA.2, known as XE, was detected in New South Wales on April 9. Watch this space.)

The good news as far as reinfections go, is that catching the same variant twice is fairly unlikely. So if you got sick with Omicron BA.1, you’re probably in the clear when it comes to catching BA.2.

A more likely scenario is being reinfected after having Delta or an earlier strain. You’re more likely again to get infected if you’ve had no prior COVID infection at all, and that likelihood increases further if you’re unvaccinated.

While reinfection is no fun, the plus side is that it gives you excellent immunity when coupled with vaccination. The combination triggers a broader range of antibody and white cell responses in your system, meaning you are less likely to suffer serious illness on reinfection.

A preprint study from Qatar confirms that the best defence against Omicron BA.1 or BA.2 infections is a prior infection plus two vaccinations and a booster shot. This reduces the risk of infection by 77 per cent, compared with 52 per cent if you got three doses but had no prior infection, the study found.

Senior research fellow at the Kirby Institute’s infection analytics program Dr Deborah Cromer says COVID-19 may follow the trajectory of other respiratory viruses, such as the flu, when it comes to reinfection.

“People will get the flu once, but that doesn’t mean they won’t get the flu again,” she says. “They probably won’t get the flu twice in one season, but obviously, there are people who do. And if you’ve had the flu vaccine, it doesn’t mean you won’t get the flu, but your symptoms will probably be less severe.

“I think what we’re talking about is a respiratory virus that will keep changing, but if people’s immunity levels keep being maintained at a high level, then it should hopefully not be too severe.”

That’s pretty much how the 1918 Spanish flu petered out. The first couple of years of that pandemic were the worst in terms of severe sickness and death, but as the virus changed and spread over the following decades, it continued to infect people but was far less dangerous.

The key problem in Australia, though, is a lack of good data. As more people rely on rapid-antigen tests, there are fewer samples available for sequencing. ANU infectious diseases physician Peter Collignon says we need systematic surveillance to monitor infections and genomic sequencing to better understand how reinfections will impact us.

“Instead of having a one in 1000 chance of dying, is there one in 10,000 if you’re reinfected? What’s your chance of getting into hospital? And how is it proportionate to your socio-economic condition and your age? We need that sort of data to be able to plan for the future.”

Timna Jacks

By: Timna Jacks

Source: Why some people get COVID more than once

.

More contents:

 

%d bloggers like this: