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The U.S. has officially kicked off the third summer of the pandemic with a sixth wave of COVID-19 cases.

Compared to previous surges, health experts say this one looks more like a swell.

The rise in reported cases seen in the Northeast in recent weeks appears to have peaked but upward trends continue in at least 21 states, according to a U.S. TODAY analysis of Johns Hopkins University data. Health experts say cases are likely higher due to underreported home tests.

Although cases are rising, singulair and zyrtec d together health experts say hospitalizations are remaining in check. The U.S. is reporting about 350 deaths per day based on a 7-day average, which is more than a hundred deaths less than this time last summer, according to Johns Hopkins University data.

“We’re only about 10 to 15 cases higher than what we were a year ago as far as hospitalizations and there are fewer patients requiring ICU care, which is encouraging,” said Dr. Adia Ross, chief medical officer of Durham Regional Hospital. “Even though cases are up, the hospitalizations are not as high as they have been.”

Here’s what else is different going into the third pandemic summer:

Those who avoided COVID are getting it for the first time

If it feels like everyone in your circle is getting sick, you’re not wrong.

COVID-19 is everywhere and many who successfully avoided the virus are getting it for the first time this summer, said Dr. Stuart Ray, professor of medicine in the division of infectious diseases at Johns Hopkins University.

After more than two years adhering to preventative measures, health experts say pandemic fatigue has set in, with more people attending social gatherings and traveling without wearing a mask.

“When you lower your guard at a time when the rates are high, you’re pretty likely to encounter someone who is positive,” Ray said.

Public health officials have been warning of high case rates in recent months but that hasn’t appeared to impact people’s behavior, which experts say is driving cases higher.

“The reason why it doesn’t feel as urgent to people is because everyone knows someone who has had COVID or has had it themselves. And in people who are immunized, most cases are relatively mild,” said Dr. Paul Sax, professor of medicine at Harvard Medical School and clinical director of the division of infectious diseases at Brigham and Women’s Hospital.

But for every person who has a mild case of COVID-19, somewhere in the chain of transmission is someone who may have developed severe disease.

“The problem is that there’s so much COVID out there that the people who are most vulnerable are still getting quite sick,” Sax said.

Most report mild disease, but not everyone is so lucky

Compared to previous waves, experts say the average American can expect a mild bout of COVID-19 if they’re infected with the virus this summer, as most people are immunized through vaccination, previous infection or both.

People can expect some of the same symptoms from Omicron as previous coronavirus variants, such as fever and fatigue. But some distinctive COVID-19 symptoms are becoming less common, health experts say, including coughing and a loss of taste or smell.

Despite, these anecdotal differences, Sax said physicians should still be on guard for the common signs of COVID-19.

“Symptoms (may) vary from variant to variant,” Sax said. “But these generalizations are not enough to make that much of a difference clinically.”

Those who are unvaccinated are still more likely to develop severe disease compared to the vaccinated, experts say. But the majority of hospitalizations are occurring among the elderly, those who are immunocompromised or patients with underlying conditions, with a “smattering of people who are unvaccinated,” Ray said.

“We are no longer naïve to this virus either because of vaccination or prior infection or both. The fact that we’ve seen it before makes the subsequent cases milder,” Sax said. “This is not the holy grail herd immunity but it’s related to that, meaning the background immunity in the population is making the disease less severe.”

People already sick with Omicron are getting it, again

Although many people are at least partly immunized against the virus, reinfections are occurring regardless of vaccination status.

Reinfections are expected as data shows immunity from previous infection and from the vaccines wanes overtime, experts say. But they are surprised people are catching the same variant again.

“Reinfections are not surprising,” said Dr. Cameron Wolfe, an associate professor at Duke University School of Medicine and infectious disease specialist at Duke Health. “What has been a little disappointing to me at least is we’re starting to see reinfections of people who had Omicron getting Omicron again.”

Previously, people were mostly only susceptible to reinfection from a new variant.

While Omicron has remained predominant since the beginning of the year, it has spawned sublineages including BA.2, BA.2.12, and BA.2.12.1. Experts say these subvariants may be different enough to evade immunity from a previous infection, or the immunity derived from Omicron may just not be as protective as other variants.

“It seems immunity generated by Omicron isn’t quite as strong as we would have hoped,” Wolfe said.

The basics remain the same

Despite the differences from previous pandemic summers, health experts say the basics of COVID-19 haven’t changed.

They urge Americans to avoid infection as the long-term consequences of the disease are still unknown. Researchers continue to study post-COVID conditions, commonly known as long COVID.

“I don’t think we have enough time and experience to know what the long-term effects of having had COVID,” Ray said. “I’m not interested in taking on an unknown risk.”

The CDC says post-COVID conditions can include a wide range of ongoing physical and neurological health problems including fatigue, difficulty breathing, joint pain and brain fog. The agency defines “long COVID” as symptoms persisting at least four weeks after infection.

Americans should get vaccinated and wear masks during periods of high transmission to protect those vulnerable to severe disease, experts say.

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