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North Carolina hurricanes linked to rise in gastrointestinal illness in marginalized communities

Gail F. Harder — Mon, 07 Mar 2022 10:00:00 +0000

North Carolina ERs reported hundreds of visits for gastrointestinal illnesses such as diarrhea, vomiting and abdominal pain in the weeks during and after Hurricanes Florence in 2018 and Matthew in 2016. A new study published last month in the journal Science of the Total Environment found an 11% increase in emergency room visits during both storms, with the largest increase among elderly, black and Native American patients.

The study is one of the first to examine emergency department visits for gastrointestinal problems after hurricanes and to examine how visit rates vary between different demographic groups. It highlights the potential health effects of climate change as storms like Matthew and Florence become more frequent, as well as how these impacts are not shared equally.

“The issues we saw in terms of difference by race and ethnicity were concerning,” said Arbor Quist, lead study author and postdoctoral fellow at the University of Southern California. “We saw a greater increase among black and Native American patients, populations that have historically been pushed into less desirable, flood-prone lands.”

Heavy rains and flooding mobilize pathogens that can contaminate drinking water or sicken people exposed to floodwaters. The risk is highest for people with weakened immune systems or without access to health care.

Eastern North Carolina is one of the wettest regions in the state, and also among the poorest and most racially diverse. The inhabitants there have above average rates chronic diseases such as asthma, diabetes and cardiovascular disease.

The region is also home to the types of industrial facilities that researchers have identified as potential sources of contamination, including coal ash ponds and concentrated animal feed operations (CAFOs). North Carolina is the second-largest pork-producing state in the nation, and its pigs create more fecal waste each year than the state’s human population. During Hurricane Florence, the state estimates that at least 50 pig waste lagoons overflowed, contaminating the water with fecal bacteria like E. coli and salmonella.

“Black residents and Native American residents likely live near some of these sources of bacteria,” said Crystal Upperman, vice president of social performance and resilience at consultancy AECOM. “This is one more piece of evidence to show the negative impact people of color have in times of disaster.”

The study team used a public health surveillance system called NC DETECT, which tracks emergency room visits in North Carolina. By overlaying DETECT records of emergency room visits for gastrointestinal complications with maps of flood extent, researchers compared visit rates in flooded ZIP codes in the weeks following each storm to rates expected if storms n had not taken place.

“It’s a fantastic study,” said Julia Gohlke, associate professor of environmental health at Virginia Tech. “Compared to other studies that only use case reports after floods, this is definitely a step in the right direction.”

A wider range of diseases and regions

But these findings are not unique to North Carolina, and disasters can create and exacerbate a host of mental and physical health issues.

For example, a recent investigation highlighted the growing risk of Vibrio infection, a group of pathogens that includes flesh-eating bacteria, as warming water and intensifying storm surges help the bacteria thrive and move inland. In North Carolina, the state health department reported 14 Vibrio infections in the four months following Hurricane Florence, triple the number during the same period the previous year.

Gohlke has also been involved in similar work in Texas, using so-called syndromic surveillance systems like DETECT that collect data such as emergency room visits or Covid-19 cases to help officials monitor public health in time. real. These studies found significant increases in emergency room visits after Tropical Storm Imelda and Hurricane Harvey for various conditions, including intestinal problems, asthma and pregnancy complications.

“This really shows the power of using state-collected syndromic surveillance data to examine health outcomes associated with flooding,” Gohlke said. “When combined with environmental data such as flooding or rainfall, you can identify areas that are likely to be in need.”

However, even with the best data, linking acute medical problems to a particular disaster remains difficult. Quist said they could only offer “hypothetical pathways” for how flood-induced water contamination leads to gastrointestinal distress. The DETECT database does not specify the cause or severity of an ER visit.

“It’s hard to draw definitive conclusions,” Quist said. “Where were they exhibited? Have they been in contact with flood waters? Did they drink contaminated water? We just don’t know.

Previous studies have shown that few people with diarrheal disease seek medical care, and even fewer go to the emergency room. Quist thinks the Detect database is definitely missing post-hurricane disease reports, but she says that’s reason to believe their findings are, if anything, an understatement. real health risk. This is especially true in eastern North Carolina, where many residents are uninsured.

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Another limitation of the research is that people move around, said Rachel Nobles, professor of marine science at the University of North Carolina. The DETECT database includes only North Carolina emergency departments and maps cases by patient billing address. If someone rides out the storm away from home and gets sick, they will be counted in the zip code where they live, not where they were exposed. If an evacuee is treated outside North Carolina, they are not counted at all.

Once a hurricane hits, it is also difficult to assess whether illness has been contracted from contaminated drinking water, contact with dirty floodwaters, or even food spoilage from a power outage.

Despite the shortcomings of available public health data, however, Nobles said the study is a “great first effort,” and evidence to date suggests that flooding does indeed cause acute illness, giving those affected by the storms and floods yet another thing to fear. .

Health departments need to invest in education to ensure residents understand the risks of water contamination, especially in communities that rely on well water, Quist said. Private wells are poorly regulated and rarely tested for the kinds of pathogens that make people sick. That’s a problem in a state where nearly a third of residents rely on household wells, she said.

Upperman also pointed to the need to address how governments regulate facilities like CAFO hogs with waste lagoons that can fail during floods. She said the environmental justice movement, which began in North Carolina, has always been focused on the inequitable location and impact of hazardous facilities.

North Carolina residents, however, should think beyond the impact of hurricanes and view water contamination as an ongoing and growing challenge, especially as climate change strains systems. water treatment and waste management with intensifying storms, Nobles said.

“While this document is very valuable for us to start thinking about public health and hurricane preparedness, we also need to think about people’s exposure under what we call ‘normal’ conditions,” he said. she declared. “We have to think about the deterioration of our water quality in general.”

Lea Campbell

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Leah Campbell is a Boston-based member of Inside Climate News. She is currently in MIT’s science writing graduate program, specializing in environmental and climate journalism. Previously, she worked as a research assistant at the University of North Carolina, studying flood survivor advocacy, risk mitigation planning, and hurricane recovery. She has also worked in the environmental nonprofit sector in California on citizen science projects and statewide policy regarding climate resilience and water quality. She is anything but a graduate in environmental planning and holds a BS in geology and geophysics from Yale University.

Peace Corps Plans to Resume Sending Volunteers Overseas | Health info

Gail F. Harder — Fri, 04 Mar 2022 01:08:00 +0000

By LISA RATHKE, Associated Press

The Peace Corps will resume sending volunteers overseas in mid-March after evacuating them from posts around the world two years ago due to the COVID-19 pandemic, the U.S. government program announced Thursday.

An initial group of new volunteers and those who were evacuated in March 2020 as the coronavirus began to spread across the world will travel to Zambia and the Dominican Republic this month, according to a Peace Corps statement.

The Peace Corps plans to return volunteers to their posts throughout the year, depending on the number of COVID-19 cases and the host nation’s hospital capacity and the Peace Corps’ ability to transport volunteers to locations. emergency medical evacuation centers. It is currently recruiting for 24 positions.

“Over the past two years, our main goal has been to return volunteers to over 60 countries who are eagerly awaiting their return. And, we have weathered the waves and variations of the COVID-19 situation in every position and redesigned Peace Corps systems, policies and procedures to align them with today’s reality,” said Carol Spahn, CEO of the Peace Corps.

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Besides their primary work on local issues, the volunteers will be involved in the COVID-19 response and recovery, the Peace Corps said.

In Zambia, volunteers will coordinate with local leaders and partner ministries to provide education on COVID-19 and promote access to vaccinations for communities, officials said. In the Dominican Republic, the focus will be on helping communities overcome issues exacerbated by the pandemic, such as rising school dropout rates, literacy skills and preparing young adults for work.

“I was absolutely thrilled. It’s been a dream of mine since I graduated high school,” said Campbell Martin, 23, of Sonoma, Calif., who applied last summer after graduating. from UCLA and is expected to begin serving in June as a primary teacher/trainer in The Gambia. He still needs medical and legal clearance.

“I want a career in the foreign service and I knew that Peace Corps was a wonderful step, not only to serve as a citizen of the world, but also Peace Corps – its mission, its intention – is something in which I believe very much. “, did he declare. “As COVID shut down the world, I also knew these opportunities would shut down for me until things started to reopen. Now that things have started, I’m just ecstatic about it.

The Peace Corps celebrates its 61st anniversary this week. Two years ago, it had 7,000 volunteers in 62 countries when they were evacuated and sent back to the United States.

Since those evacuations, the Peace Corps has called for volunteers to help with the national COVID-19 response and has developed a virtual service pilot program. Not before March 2020, the organization founded by President John F. Kennedy had to evacuate all of its volunteers at once.

More than 240,000 Americans have served as Peace Corps volunteers in numerous countries since the program’s inception in 1961. The goal is to help countries meet their development needs through a variety of programs – from the education in health and agriculture programs – while helping to promote a better understanding of Americans. Typical service lasts two years after a period of training.

Nunavut relaxes public health measures in 15 communities

Gail F. Harder — Tue, 15 Feb 2022 17:53:18 +0000

Fifteen Nunavut communities will be placed under less restrictive public health measures starting Monday as their number of COVID-19 cases decline.

Chief Public Health Officer Dr. Michael Patterson announced the changes Tuesday morning during a virtual COVID-19 press conference.

Sanitary measures are relaxed in Arviat, Baker Lake, Chesterfield Inlet, Clyde River, Gjoa Haven, Grise Fjord, Kimmirut, Kinngait, Kugluktuk, Naujaat, Pond Inlet, Qikiqtarjuaq, Sanirajak, Whale Cove and Igloolik.

In all but Igloolik, up to 50 people will be able to gather outside. Indoor gathering restrictions are changing so that 10 people plus household members can gather.

In Igloolik, those numbers are 25 for outdoor gatherings and five for indoor gatherings.

Other changes include increased capacity for restaurants, gymnasiums and other facilities.

Restrictions do not change in Arctic Bay, Cambridge Bay, Coral Harbour, Iqaluit, Kugaaruk, Pangnirtung, Rankin Inlet, Resolute Bay, Sanikiluaq and Taloyoak.

Nunavut had 352 confirmed cases of COVID-19 as of Tuesday. Patterson said about 90% of them are the Omicron variant, although Nunavut still sees cases of the Delta variant.

Rapid tests for essential services

Nunavut Premier PJ Akeeagok said the Department of Economic Development and Transportation has begun distributing rapid tests to essential businesses in Iqaluit and other communities. These include taxis, food retail workers and emergency home repair businesses, meat and fish services, cargo operators and airport cleaners.

“Over the next few weeks, as we receive faster access tests from the Government of Canada, we will expand distribution to all businesses that want it,” he said.

Patterson said it was important to maintain those services because outbreaks there would have a greater impact on communities than other services such as schools.

He noted that schools are the next priority after businesses.

Did you miss Tuesday’s update? Watch it here:

Appeal to correctional staff

Justice Minister David Akeeagok said the territory has openings for corrections staff at its facilities. Several facilities currently have cases of COVID-19 affecting staff.

“I would like to take this opportunity to appeal to anyone with correctional training,” he said.

At the Aaqqigiarvik Correctional Healing Center in Iqaluit, he said there are currently eight active cases of COVID-19, seven of which involve staff members.

Akeeagok said there were also two cases among staff at the Rankin Inlet Healing Center and the Women’s Correctional Center.

Should the school be in person? Academic and emotional concerns outweigh COVID-19 in parents’ opinion

Gail F. Harder — Fri, 04 Feb 2022 13:59:40 +0000

Students walk to class through the once crowded hallways of Brockton High School in Brockton, Massachusetts, in March 2021. (David L. Ryan/The Boston Globe via Getty Images)

Amid a wave of COVID-19 cases due to omicron variant, a slim majority of parents of K-12 students (53%) say schools in the United States should offer a mix of in-person and online instruction this winter, according to a new survey from Pew Research Center. Some 37% say K-12 schools should only provide in-person instruction, while just 9% say schools should be fully online.

When asked what factors schools should consider when deciding whether to stay open for in-person instruction this winter, most parents of K-12 students said a lot should be given. attention to the possibility that students will fall behind academically (67%) or that their emotional well-being will be negatively affected (61%) if they do not attend school in person. Smaller shares cite parents who cannot work if their children are at home (52%), the risk of students or teachers contracting or spreading the coronavirus (43% and 39%, respectively) and the financial cost to school systems of following public health guidelines to keep schools open safely (26%).

This analysis explores parents’ views on the type of education K-12 schools in the United States should provide this winter and what factors parents consider important in deciding whether to keep schools open during the coronavirus pandemic. coronavirus continues. The analysis is based on a survey of 2,241 US parents of children in K-12 schools who live in their household. The data was collected as part of a larger survey of 10,237 adults from January 24-30, 2022. All of those who participated are members of the Pew Research Center’s American Trends Panel (ATP), a panel online survey recruited through random sampling of residential addresses. In this way, almost all American adults have a chance of being selected. The survey is weighted to be representative of the adult US population by gender, race, ethnicity, party affiliation, education and other categories. Learn more about the ATP methodology. Here are the questions used for this analysis, as well as the answers, and its methodology.

In July 2020, more K-12 parents said health risks for students (64%) and teachers (61%) should be considered more in decisions about reopening schools than they did not say the same about the possibility of students falling behind academically without individual instruction (54%). In February 2021 – when many schools that offered online instruction were deciding whether or not to reopen for in-person instruction – six in ten parents said academic considerations should be a major factor, while smaller proportions pointed to health risks for teachers (47%) or students (45%).

As has been the case throughout the pandemic, views on how schools should handle teaching vary widely across parties. Among parents of K-12 students, Republicans and those leaning Republican (55%) are much more likely than Democrats and Democrats (26%) to say schools should only provide a in-person instruction only this winter. A majority of Democratic parents (64%) — compared to 39% of Republican parents — say schools should offer a mix of in-person and online instruction.

Republican parents are more likely than Democratic parents to say that a lot of attention needs to be paid to the possibility of students falling behind academically or having their emotional well-being negatively affected without in-person instruction. Republicans are also more likely than Democrats to say parents unable to work while their kids are home should be a big factor in those decisions. In turn, a larger proportion of Democratic than Republican parents say the risk to teachers and students of contracting or spreading the coronavirus should be considered.

Opinions also vary across demographic groups. White parents (47%) are much more likely than nonwhite parents (25%) to say schools should only provide in-person instruction this winter, while nonwhite parents are about three times more likely than white parents say schools should be fully online (14% vs. 5%, respectively). (The non-white category includes parents who identify as Black, Asian, Hispanic, another race, or multiple races; these groups could not be analyzed separately due to sample size limitations.)

Some 46% of high-income parents and 43% of middle-income parents say schools should be in-person only, compared to 28% of low-income parents. Among low-income parents, 16% say schools should only offer online classes; only 7% of middle-income people and an even smaller share of high-income parents (2%) say the same.

These differences reflect, at least in part, factors that parents say should be considered in decisions to keep schools open this winter. Non-white parents are more likely than white parents to say health risks to students (56% vs. 33%, respectively) and teachers (50% vs. 31%) should be major factors. In contrast, white parents (66%) are more likely than non-white parents (54%) to cite concerns that students’ emotional well-being will be negatively affected if they do not attend school in person. . Similar proportions of white (69%) and non-white (65%) parents say academic concerns should be considered.

Low-income parents are more likely than middle- or high-income parents to say that students’ risk of contracting or spreading COVID-19 should be factored into these decisions; those with high incomes are most likely to cite concerns about academics and the emotional well-being of students if they are not attending school in person.

Most parents of K-12 students say their kids only get in-person instruction

While a majority of parents think K-12 schools should offer a mix of in-person and online instruction this winter, only 16% say that’s the type of education their kids are getting currently. About seven in ten (71%) say their children only receive in-person lessons, while only 5% say their children only receive online lessons. In October 2020, a plurality of K-12 parents (46%) said their children only received online lessons, while 20% said they only received in-person lessons and 23 % said there was a mix.

High-income parents are the most likely to say their children only receive in-person instruction: 84% say this in the new survey, compared to 77% of those with middle incomes and an even lower proportion of those with low incomes ( 58%). %). About one in ten low-income parents (9%) say their children only receive online lessons, while 23% say their children receive both in-person and online lessons. Only 3% of middle-income K-12 parents and 2% of high-income parents say their children only receive online lessons, while about one in ten in each group say they receive a mix.

Note: The following are the questions used for this analysis, together with the answers, and its methodology.

UW unlikely to return to online format this semester, says UHS leadership The Badger Herald

Gail F. Harder — Tue, 01 Feb 2022 05:05:00 +0000

University Health Services is working with University of Wisconsin Health to encourage the UW and Madison community to get vaccinated as Omicron cases increase and students return to in-person classes.

In 2021, the Wisconsin Department of Health Services designated UW Health the “regional distribution center” for vaccine distribution as Pfizer vaccine doses became more available that year. In partnership with Wisconsin DHS, UW Health is responsible for distributing the Pfizer vaccine to health systems and care facilities in the region.

UW-Health is an “excellent” candidate as a distribution center for Pfizer vaccines because of its unique ability to refrigerate, store and deliver them, said UHS Associate Vice Chancellor Jake Baggott.

Baggott said this relationship between UW and UHS health is mutually beneficial.

“We’re all part of the same community and we work closely together,” Baggott said.

In an emailed statement to the Badger Herald, UW spokeswoman Meredith McGlone said students can provide information on COVID-19-related issues to the COVID-19 Student Advisory Council.

The advisory board consists of 12 students and meets approximately every three weeks. According to McGlone, some left the group, leaving it at six members. Student Affairs has reached out to Madison Student Associates to seek board nominations, McGlone said.

Individuals interested in serving on the advisory board can contact [email protected] or ASM shared governance [email protected]

Students Seek Inclusiveness, Shared Governance, and Accessibility in Next UW ChancellorThe University of Wisconsin Chancellor’s Research and Screen Committee held a public listening session Monday afternoon to provide a Read…

So far, UW has not considered a threshold for COVID-19 cases that would pivot it to teaching online, McGlone said. In addition, UHS is confident the university will operate in-person throughout the spring semester, according to Baggott.

“Our protocols helped us have a safe and successful campus operation last fall, and we are confident that we will continue to be able to do so throughout the spring,” Baggott said.

UHS intended to expedite the authorization of large-scale community vaccines by sharing and communicating with community distributors, Baggott said.

As UW enters its fifth semester in response to the COVID-19 pandemic, Baggott said growing familiarity with COVID-19 response protocols has allowed for a greater diversity of vaccination options and information, driving more students off campus for their recall. UHS does not offer Moderna boosters and recommends students visit off-campus sites for a third dose of Moderna.

Students can be vaccinated on campus or off campus and must document their booster vaccination on their MyUHS Account. Baggott said many students who are boosted don’t document their status, restricting a full understanding of the booster’s effectiveness in the community.

“We have documentation to show that there are very strong numbers [of booster shots]Baggott said. “But we know there’s a lot more out there.”

Doctor’s Briefing Weekly Coronavirus Summary | Health

Gail F. Harder — Fri, 28 Jan 2022 21:28:48 +0000

Here’s what the editors of Physician’s Briefing have picked as the most important COVID-19 developments for you and your practice for the week of January 24-28, 2022. This roundup includes the latest research news from studies from journals and other reliable sources that are likely to affect clinical practice.

Three doses of mRNA vaccine protecting against Delta, Omicron

FRIDAY, Jan. 28, 2022 (HealthDay News) — Receiving three doses of a COVID-19 mRNA vaccine is associated with protection against delta and omicron compared to not being vaccinated and receiving of two doses, according to a study published online on January 28, 2022. 21 in the Journal of the American Medical Association.