- Healthcare worker burnout trend backed up by new data: The COVID-19 pandemic has exacerbated a growing burnout crisis among healthcare workers in the U.S., as many articles and scientific papers have explored in the last couple of years. Two studies from the past week add more data to back up the trend. CDC researchers shared the results of a survey of about 2,000 workers, finding that workers were more likely to report poor mental health and burnout in 2022 than in 2018, while harassment and a lack of support at work contributed to increased burnout. Another research group (at the University of North Carolina at Greensboro and Washington University in St. Louis) also surveyed healthcare workers and found that many experienced food insecurity and financial challenges; workers with worse employer benefits were more likely to increase these challenges.
- Viral load not necessarily associated with symptoms: This paper is a rare, relatively recent update on how COVID-19 symptoms connect to viral load, or the amount of virus that a patient has in their respiratory tract. The higher a patient’s viral load, the more likely they are to infect others, making this an important metric for contagiousness. Researchers at Emory University studied viral loads in about 350 people diagnosed with Omicron variants between April 2022 and April 2023. Patients tended to have their highest viral loads around the fourth day of symptoms, a change from studies done on earlier variants (when viral loads tended to peak along with symptoms starting). As Mara Aspinall and Liz Ruark explain in their testing newsletter, these results have implications for rapid at-home tests, which are most accurate when viral loads are high: if you’re symptomatic but negative on a rapid test, keep testing for several days, and consider isolating anyway.
- Updated vaccines are key for protection: Another recent paper, in The Lancet Respiratory Medicine, examines how last year’s bivalent COVID-19 vaccines worked against recent coronavirus variants using data from the Kaiser Permanente health system. The study included records from about 123,000 people who had received at least the original vaccine series, examining health system visits from August 2022 to April 2023. People who received an updated vaccine in fall 2022 were significantly less likely to have severe COVID-19, the researchers found. “By mid-April, 2023, individuals previously vaccinated only with wild-type vaccines had little protection against COVID-19,” the researchers wrote. This year’s updated vaccine may have a similar impact through spring 2024.
- Gut fungi as a potential driver for Long COVID: Long COVID, like ME/CFS and other chronic conditions, may be associated with problems in patients’ gut microbiomes, i.e. the communities of microorganisms that live in our digestive systems. A new paper in Nature Immunology from researchers at Weill Cornell Medicine hones in on one fungal species that may be particularly good at causing problems. The species, Candida albicans, can grow in the intestines of severe COVID-19 and Long COVID patients, triggering to inflammation and other immune system issues. This paper describes results from patient samples as well as a mouse model mimicking how this fungal species grows in COVID-19 patients’ guts.
- Another potential Long COVID biomarker: One more notable Long COVID paper from this week: researchers at the University of Alberta studied blood samples from people with the condition, and compared their results to people who had acute COVID-19 but didn’t go on to develop long-term symptoms. The scientists used machine learning to develop a computer model differentiating between blood composition of people who did and didn’t develop Long COVID. They identified taurine as one specific amino acid that might be particularly important, as levels of taurine were lower among patients with more Long COVID symptoms. The study could be used to inform diagnostic tests of Long COVID, as well as potential treatments to restore taurine.
Tag: healthcare workers
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Sources and updates, October 29
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COVID source callout: CDC infection control committee may roll back protections
A little-known CDC advisory committee is suddenly in the public spotlight, as it considers recommending fewer safety measures to reduce infection in hospitals and other healthcare settings. Despite major pushback at a recent meeting, it’s unclear whether this committee will actually live up to its infection control duties.
The Healthcare Infection Control Practices Advisory Committee, or HICPAC, is a group of experts that advises the CDC on infectious disease safety measures in healthcare settings. It develops guidance that is rigorously followed across U.S. facilities, and the guidance is due for an update this year—for the first time since COVID-19 hit.
In the last three years, healthcare and public health workers have learned a lot about the importance of masks and clean air for reducing respiratory disease risk. You might think that HICPAC would acknowledge this in its updated guidance, calling for hospitals to use high-quality masks and ventilation. Instead, however, HICPAC’s guidance disregards the last three years of airborne virus research, suggesting for example that N95s aren’t more protective than surgical masks and that masking is only needed when a disease is spreading very widely.
These guidelines could have massive implications for the healthcare system. Many high-risk people are already hesitant to go to the doctor, in a time when mask requirements in these settings have largely been lifted. COVID-19 is spreading widely in these settings, limited data suggest. The new guidelines, if adopted, would extend the current COVID-19 “normal” to many other diseases, from seasonal flu to new viruses that may emerge.
Naturally, a coalition of better-informed individuals and organizations (healthcare workers, scientists, patients, etc.) are pushing back against HICPAC. At a public meeting this past Tuesday, many attendees spoke against the guidance change, citing health research as well as their own experiences in the last three years. The committee failed to meaningfully acknowledge this criticism; in fact, it cut off the public comment period after just 40 minutes, leaving many attendees unable to share their feedback.
Transparency concerns about HICPAC—which doesn’t usually share public updates or livestream its meetings—add to concerns about the committee’s guidance decisions. But the pressure is on for HICPAC to respond to its critics, improve its new guidance, and live up to its title.
Further reading and how to get involved:
COVID-19 Data Dispatch 