In Georgia, the CEO of Northeast Georgia Health Systems said it had 287 Covid patients Monday morning, which is more than the hospital has had since January.

“So, in essence, our hospitals are full,” Carol Burrell said. “We’re looking to add space in hallways and conference rooms in waiting areas. Our emergency rooms and our urgent care centers are seeing higher volume than they’ve seen throughout this pandemic,” she said.

And it’s not just the South now. On Tuesday, Idaho had just four ICU beds available out of the 400 beds total in the state, Gov. Brad Little said.

“Yesterday evening I toured a nearly full ICU wing in Boise. What I saw was heartbreaking. Among the Covid-positive patients all of them were unvaccinated,” Little said.

“Some were young, two were middle-aged, two patients were pregnant. I was told the average age of the patients was 43. All of them were struggling to breathe and most were only breathing with help from a machine,” the governor said in a televised address Tuesday.

Hospitals around the country have been stretched as cases have picked back up, but the South, where vaccinations have been lagging, has been particularly hit. Many hospitals have been reporting oxygen shortages.

On Monday, data presented by a vaccine adviser from the US Centers for Disease Control and Prevention showed a hospitalization rate 16 times greater in the unvaccinated population than in those vaccinated.

“This to me seems to be a strong indication that the current epidemiologic curve that we’re seeing is really a reflection of failure to vaccinate, not vaccine failure,” said Dr. Matthew F. Daley at the CDC Advisory Committee on Immunization Practices meeting.

The effect of the low vaccination levels can be seen in Kentucky, where hospitals are overwhelmed with record numbers of Covid-19 patients and 58 of the 96 hospitals are reporting critical staffing shortages, Gov. Andy Beshear said Monday.

“We’re living in a reality where some Covid patients who are sick are being treated in their cars when there isn’t room for them inside the ER or inside the hospital,” Beshear said.

And Mississippi is also struggling, with only nine ICU beds available in the state, Mississippi Department of Health Senior Deputy and Director Jim Craig said Monday.

With increased hospitalizations, more deaths have followed. The Central Florida Disaster Medical Coalition has purchased a total of 14 portable morgues to help with the “unprecedented” number of Covid-19 deaths in the region, the organization told CNN.

And among children, cases “have increased exponentially” recently after a decline in early summer, the American Academy of Pediatrics reported Tuesday.

In the past week, about 204,000 children tested positive for Covid-19, a five-fold increase from a month earlier, the AAP said. That’s the second week that pediatric cases are at levels not seen since the surge last winter, the AAP said.

The rise in children’s infections is worrying experts as parents and students prepare for a new school year.

Thousands of students in quarantine

Health experts have been particularly concerned about how cases will trend as school gets underway; and with many regions early in their academic year, thousands of students are already back in quarantine.

In Florida’s 15 largest school districts, at least 21,869 students and 4,481 employees have tested positive for Covid-19 since the start of school, according to a CNN analysis.

At least an additional 45,024 students and staff members have been quarantined or put on “stay home” directives due to possible exposure to Covid-19. That’s an increase of 62% since CNN’s last update on Thursday afternoon.

In Texas, after just the first two weeks of school in the Fort Worth Independent School District, more than 3,000 students have been quarantined due to close contact with individuals who tested positive for Covid-19.

The district announced a mask mandate earlier this month for all students, employees and guests, despite ongoing legal battles in the state against Gov. Greg Abbott’s ban on such mandates.

While vaccines are currently the best defense against the spread of the virus, they have not yet been approved for those under the age of 12.

But not even those children who are eligible for the protection are not reaping the full benefits. Children ages 12 to 15 are eligible but less then half of that group is vaccinated with at least one dose, according to data published Monday by the CDC.

A Virginia county is requiring student-athletes to get vaccinated

Virginia’s largest school district is among the first to mandate vaccines for some of its students. Athletes in Fairfax County Public Schools will have to be vaccinated in order to compete in winter and spring sports, according to a letter from the superintendent.

“Proof of full COVID-19 vaccination will also be required for participation in any other activity that requires a physical,” Superintendent Scott S. Brabrand wrote in a letter to the community Monday. “This includes dance team and step team, as well as out-of-season practices and workouts.”

The requirement kicks on November 8.

Most pauses in education in the district’s high schools come from exposure to Covid-19 during athletic activities, the letter said.

Students returned to in-person learning at Fairfax County Schools on August 23. Since then, the district has reported at least 177 students and 31 employees have tested positive for Covid-19.

Fairfax’s decision comes several weeks after New York Mayor Bill de Blasio issued a vaccine mandate for “high-risk” public school sports.

The mandate applies to roughly 20,000 students and staff participating in football, basketball, wrestling, lacrosse, stunt, rugby, and bowling, according to a statement from the NYC Department of Education.

New York Gov. Kathy Hochul plans to require mandatory weekly Covid-19 testing for school staff in the state who are not vaccinated, she said Tuesday.

“School staff, anybody who enters that building will have to be vaccinated or undergo mandatory testing — mandatory testing, and we’re in the process of getting the legal clearance for that, as I speak,” Hochul said.

School infections could be cut in half by masking and testing, projections show

While the risk of unvaccinated students becoming infected when they go to school is of concern, a new study shows that masking and testing could help prevent infections in at least half of that population.

With universal mask use, less than half of susceptible students — and perhaps as few as a quarter — may become infected with Covid-19 in the same timeframe, depending on the student body’s incoming level of protection from vaccinations or natural immunity, according to , projections modeled by researchers from North Carolina State University and published as a preprint earlier this month.

Adding randomized testing for half of the students biweekly, and assuming at least a 70% compliance with isolation requirements for those who test positive, would cut Covid-19 infections down to less than a quarter of all susceptible students in all scenarios, the researchers’ projections suggested.

The model assumes that in a class of 500, two or three students are infected at the start of the school year and that one additional case enters the school each week.

Dr. Scott Gottlieb, former commissioner of the US Food and Drug Administration told CBS’s Ed O’Keefe on Sunday that “we have to throw everything we can” at minimizing cases among school children.

“I don’t think that we should be going into the school year lifting the mitigation that may have worked and probably did work last year to control outbreaks in the school setting, until we have firm evidence on what works and what doesn’t,” he said, adding measures such as frequent testing and putting students in social pods “are probably the two most effective steps schools can be taking.”

 

The State of Michigan recently received a new $3.3 million federal grant to expand health insurance coverage and access to uninsured and underserved Michiganders. The grant will expand programs to increase qualified health insurance navigators to assist communities in obtaining health coverage. 

Health insurance navigators aim to facilitate the process of enrollment in health insurance for those who are uninsured in Michigan. This grant would give more funds to navigator organizations to expand their programs. Gov. Gretchen Whitmer said:

“For some Michiganders, having free, local help from qualified Navigators can be the difference between getting coverage and going without vital protection. I’m thankful that the Biden-Harris administration recognized this need, both in Michigan and nationwide, and has made this important funding available. These grants will have a direct and positive impact on the lives of Michigan residents.”

Three parent organizations of navigator groups will receive funding and how much they will receive: 

• Arab Community Center for Economic & Social Services (ACCESS) – $2,640,159
• Eastern Michigan University – $435,784
• Genesee Health Plan Corporation – $219,492

The target populations of these groups are underserved and minority populations, those eligible but not enrolled in Medicaid, pregnant women, and new mothers. 

Anita Fox, director of the Michigan Department of Insurance and Financial Services, said:

“The COVID-19 pandemic has underscored the importance of high quality, affordable health insurance, and we do not want anyone to avoid signing up because they worry that the enrollment process might be difficult. By logging on to LocalHelp.HealthCare.gov or by calling 800-318-2596, Michiganders can access free assistance to enroll in a 2022 Marketplace plan, Medicaid, or Michigan’s MIChild program.”

More than $80 million will be granted to over 60 Navigator organizations across the country as part of the nationwide 2021 Centers for Medicare & Medicaid Services (CMS) Navigator cooperative agreement. Organizations applied through CMS to receive this aid. Awardees of the grant include hospitals, community and consumer-focused non-profits, faith-based organizations, tribal organizations, and trade and professional organizations.

Samantha Boevers’s 4-year-old son, Porter, has made so much progress since being diagnosed with autism that he was assigned to a general preschool classroom this fall. So when Boevers dropped him off for his first day of school earlier this week, she wanted to feel all the emotions a parent should in that moment: excitement, pride, relief.

“The only thing I felt was heart-rending fear,” said Boevers, an instructional aide with a background in special education. “Because I didn’t know if he’d be safe.”

Porter’s disability puts him at heightened risk of getting sick from COVID-19. Mitigation strategies such as universal masking indoors, Boevers says, are critical to limiting that risk.

Yet Boevers and her family live in South Carolina – one of more than half a dozen states where schools are prohibited from requiring everyone on campus to mask up. Mask-wearing has been the exception rather than the rule in many of South Carolina’s school districts, and evidence suggests the trend has taken a toll. South Carolina has the third-highest rate of pediatric COVID-19 infections in the U.S., according to data collected by the American Academy of Pediatrics, with children accounting for roughly a fifth of the state’s positive cases.

With the help of the American Civil Liberties Union, Boevers and other parents and advocates recently filed suit in federal court challenging South Carolina’s ban on school mask mandates. The lawsuit, which names several state officials and local school boards as defendants, alleges South Carolina’s policy violates federal law by effectively excluding students with disabilities from participation in the public education system.

It’s one of at least seven lawsuits filed in recent weeks in states with similar restrictions – including Arizona, Florida and Texas – many saying the rules violate the rights of students with disabilities. In one of the Florida suits, a circuit court judge has already issued a ruling, concluding the state’s order banning school mask mandates is unlawful and districts have the right to set their own policies.

The litigation comes amid a surge in pediatric COVID-19 cases largely due to the delta variant. And while the bans on mask mandates put all students at risk, parents and advocates argue they’re especially harmful to hundreds of thousands of students with disabilities, putting them at greater risk of severe COVID-related illness and death.

“Children with disabilities are entitled to learn and interact with all other children, to receive the same education as all other children, and to be returned home as safe and healthy as possible,” the ACLU lawsuit reads, echoing arguments being made by plaintiffs in the other states.

“We are left right now, as parents of a child with a disability, having to make the agonizing decision of choosing between his education … and his health,” Boevers said. “And that’s a decision no parent should ever have to make.”

‘A slap in the face’

Remote learning was tough for all kinds of students last year, but for Porter it wasn’t just challenging – it was “physically painful,” Boevers said. Porter, who struggles with communication, would get so frustrated with virtual speech and occupational therapy sessions that he’d screech and scream, sometimes hitting his parents.

Still, he worked hard and got better at using sentences, to the point that he can now learn alongside his neurotypical peers. He can continue making progress by being in that classroom, Boevers said. If he were to stick with virtual learning, he’d “revert back to a child who doesn’t have a future.”

She and her husband consulted with Porter’s pediatrician when deliberating whether to send him to in-person school this year. In 2019, Porter ended up being hospitalized for the flu because he hadn’t been able to communicate that he was in pain. Confused and scared by what was happening to him, he’d even stopped eating and drinking. Boevers held back tears as she reflected on the experience, on the memory of witnessing three grown men holding Porter down so they could get the IV tube in.

The doctor said the same thing could happen again if Porter was to contract the coronavirus, especially because he also struggles to comply with hygiene practices. Porter should attend school, the pediatrician concluded, only if anyone on campus who can wear a mask does so.

“I’ve seen people say the parents of children under 12 are living a different pandemic than everyone else because these children cannot be vaccinated,” Boevers said. “And I like to say, ‘The parents of special-needs children under 12 are living in hell during this pandemic,’ because every day we worry about the safety of our children when doing the basic things that every child has a right to do.”

South Carolina’s ban comes in the form of a budget provision passed earlier this summer that prohibits districts from using state money to require masks. The plaintiffs – which include parents of children with conditions including asthma and anxiety – allege that provision violates two federal laws: the Americans With Disabilities Act and the Rehabilitation Act.

Those laws prohibit public schools from excluding or segregating students with disabilities. They also require schools to make “reasonable accommodations” so students with disabilities have just as much of an opportunity as their peers to get a a good education.

South Carolina’s anti-mask law is excluding and segregating them, the plaintiffs allege, by forcing many of them to withdraw from public school. And in prohibiting schools from dictating their own mask rules, the complaint continues, the law also denies those children an equal education.

“It’s really a slap in the face to students with disabilities,” said Susan Mizner, director of the ACLU’s Disability Rights Program. “Because while there is a risk to everyone, … we know that the people who will get severely ill are almost always the students who have these underlying conditions or disabilities.”

Roughly 13% – more than 101,000 – of South Carolina’s public-school students receive special-education services, about 16,000 of whom are identified as “other health impaired.” Another 10,000 or so of the state’s special-ed students have autism, while some 6,000 have an intellectual disability.

Notably, a study of more than 65 million patients across 500 health-care systems found that people with intellectual disabilities are more likely to die from COVID-19 than people with conditions such as congestive heart failure and kidney disease.

In response to the lawsuit, Ryan Brown, a spokesperson for South Carolina’s Department of Education, said the state department has reminded school districts of their obligations under federal disability rights law. Schools should consider mandating masks for some people who are in contact with certain high-risk students, he said, citing guidance from both the Centers for Disease Control and Prevention and the state’s health department.

South Carolina’s schools superintendent, who’s named as a defendant in the suit, “has been clear in her support” of districts’ right to set their own mask rules, Brown said. And, he said, parents have the option of reverting to distance learning if they decide in-person instruction is too risky.

Families have little recourse

In some parts of the country, however, distance learning isn’t an option this school year. According to an analysis by the Center on Reinventing Public Education, a University of Washington research group, three of the states with restrictions on mask requirements have passed legislation or policies limiting access to virtual schooling.

Those states include Tennessee, whose policy, enacted in April, prohibits districts from offering systemwide remote or hybrid instruction unless there is a declared state of emergency.

Tennessee’s limitation – combined with the state’s executive order requiring schools to allow mask opt-outs – forces parents to choose between jeopardizing their children’s health or withdrawing them from public education altogether.

One of those parents is Suzanne Talleur, whose 16-year-old son, Max, has Down syndrome. Research shows that, compared with the general population, people with the condition are four times more likely to be hospitalized – and 10 times more likely to die – after contracting COVID-19.  That’s in part because they tend to have smaller airways and weaker muscle tone than average, which makes them more vulnerable to respiratory complications.

Talleur kept Max, who also has asthma and a heart condition, in remote-only instruction all last school year; he barely left the house. When she was asked in February whether he’d continue with online learning this school year, though, she decided it was time for him to return to the classroom.

“It was terrifying sending him back,” Talleur said, but she was optimistic about the power of COVID-19 vaccines, which her son received as soon as he was eligible. She was confident his school district would do what it could to mitigate the spread of COVID-19 by following CDC guidance.

Of course, Tennessee’s recent executive order prevents the state’s schools from practicing a critical piece of that guidance: universal mask-wearing indoors. And unlike the other states with restrictions on school mask mandates, Tennessee’s policy simply stipulates schools must allow parents to opt-out of any such requirements, which could make it hard to challenge on legal grounds.

“The Governor has said that parents should ultimately be able to decide what’s best for their children,” said Brian Blackney, a spokesperson for Tennessee’s education department.

Talleur now finds herself “in a pretty awful position,” especially because she couldn’t put Max in distance learning anytime soon, even if she wanted to. Like South Carolina, Tennessee has one of the highest rates of pediatric COVID-19 cases in the country.

Earlier this month, shortly after the school year began, a handful of students in Max’s special-needs classroom became infected with COVID-19. According to Talleur, few of the children had been wearing masks. Her son ended up having to stay home for three days. He did little more than a math worksheet and a five-line journal entry.

While he ultimately tested negative for the virus, Talleur  said the cluster – which she attributes to lax mask rules – effectively deprived her son of the education he was entitled to receive. If masks had been required of anyone able to wear one, Talleur said, her son wouldn’t have had to go into isolation and miss hours of class time.

“We’re not asking for perfection,” she said. “We’re asking for reasonable accommodations – and (mask requirements) are the definition of ‘reasonable accommodation.’”

Kim Hart, a Nashville-area epidemiologist whose 18-year-old son also has Down syndrome, says she’s in an awful position, too. Hart’s son is vaccinated against COVID-19. But his risk of contracting a breakthrough infection is high, Hart says, considering he got chicken pox when he was younger despite having gotten that vaccine.

“He wants to be at school and needs to be at school. He loves his friends – he’s a social 18-year-old,” Hart said. Plus, he’s now enrolled in a vocational-education program that necessitates hands-on learning. “We are taking a risk that he is going to become ill, and the consequences for him could be devastating.”

The need for accommodations

Many students with disabilities simply can’t mask up. They may have a breathing issue or physical abnormality. Perhaps they have a behavioral disorder and get agitated or anxious when wearing a face covering.

For that reason, the U.S. Department of Education issued guidance last September emphasizing schools should exempt such students from any universal mask requirements. Failing to offer such exemptions, the guidance suggested, could amount to discrimination on the basis of disability.

By the same token, schools should be able to require anyone who can wear a mask to do so, said Wendy Tucker, the senior director of policy at the Center for Learner Equity, which advocates for students with disabilities. That would allow those who can’t wear a mask to continue receiving an education, she said.

Legality aside, Tucker says the statewide bans are at the very least “bad policy.” The pandemic is playing out in different ways across the country – even within a given state, COVID-19 transmission and vaccination rates vary depending on the locale. To institute a blanket ban on mask mandates disregards the needs of individual school districts, Tucker said.

Back in South Carolina, Boevers says there’s a 50-50 chance she’ll end up pulling Porter out of in-person learning. And the prospect is tormenting her.

“Right now, his future is wide open – he is the absolute definition, as is every special education child in the state, of different not less,” she said. “When you take that classroom away, … he loses it all, and everything he loses will take him twice as long to gain back as another child.”

 

The Biden-Harris Administration is expanding the number of Navigator organizations to help people enroll in coverage through the Marketplace, Medicaid, or the Children’s Health Insurance Program (CHIP) in 30 states with a Federally-Facilitated Marketplace. Through $80 million in grant awards for the 2022 plan year, 60 Navigator awardee organizations will be able to train and certify more than 1,500 Navigators to help uninsured consumers find affordable and comprehensive health coverage.

The Navigator awardees include community and consumer-focused non-profits, faith-based organizations, hospitals, trade and professional associations, and tribes or tribal organizations. Navigators help families and other underserved communities gain access to health coverage options through the Marketplace, Medicaid, or CHIP. They can assist with enrollment applications and help consumers receive financial assistance through HealthCare.gov. With the additional funding, more Navigator organizations can provide assistance to people with limited English proficiency in multiple languages. They can also provide more assistance to rural areas and communities of color.

“Our local partners are crucial in helping people get covered. By expanding our pool of Navigators, we will reach more underserved communities, and grow our network of trusted experts who can help people across the country navigate their health care options,” said U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra. “Thanks to President Biden, health care is more affordable than ever on HealthCare.gov – and with this historic investment, we’ll be making it even easier for people to enroll in coverage through the Marketplace, Medicaid, and the Children’s Health Insurance Program.” 

“Local health coverage experts have worked hard to build relationships and trust in the communities in which they serve. These Navigators consistently help consumers understand their options, helping with potential language and other barriers, so they can find health coverage that best fits their needs,” said CMS Administrator Chiquita Brooks-LaSure. “With this additional grant funding, even more Navigators will be able to provide comprehensive assistance through customized educational and outreach activities, especially to underserved communities.”

The 2021 Navigator awardees will focus on outreach to particularly underserved communities. Awardees will focus on outreach to people who identify as racial and ethnic minorities, people in rural communities, the LGBTQ+ community, American Indians and Alaska Natives, refugee and immigrant communities, low-income families, pregnant women and new mothers, people with transportation or language barriers or lacking internet access, veterans, and small business owners.

The 2021 Navigator awards are for a 36-month period of performance, funded in 12-month increments known as budget periods. This multi-year funding structure is designed to provide greater consistency for Navigator awardee organizations, reducing yearly start-up time and allowing more efficient use of grant funds.

Navigator grant applicants were asked to detail their outreach and enrollment efforts to the underserved or vulnerable population(s), while still assisting other consumers. The 2021 Navigator awardees must comply with the terms and conditions of the award, including submission of regular reports to CMS documenting their progress and activities. CMS will work closely with the awardees to ensure they are meeting these goals.

 

Data shows COVID-19 can cause devastating complications for both pregnant women and their babies. But many are putting off the vaccination for fear it will prevent them from getting pregnant in the first place.

Medical experts say there is no evidence that the COVID-19 vaccine causes infertility and explain why misinformation online is false.

Natasha Tracy is now a mom to four kids. “Well, it’s been eight days now since we had our baby!” she said.

Little Brian was born at 34 weeks and just came home from the newborn intensive care unit on Wednesday. At 16 weeks pregnant, Tracy was hesitant to get the COVID-19 vaccine.

“There’s just so much information and misinformation … I just wasn’t confident because a lot of the people on social media that I interacted with weren’t confident, so it was difficult to overcome that,” she said. “I wanted to talk to my doctor and I literally got it — COVID — five days before my scheduled appointment.”

She says it was an awful experience. “I was sick in bed for three weeks, like, I literally cannot get out of bed and I was short of breath and I was miserable,” Tracy said.

Doctors fear her COVID-19 infection could have led to her preterm labor. She also suffered severe preeclampsia, heart palpitations and hemorrhaging post-delivery — all symptoms she hadn’t experienced during her first three pregnancies.

“It was really surprising to all my doctors and nurses that I had it and that was so severe,” she said.

“If you get COVID, your risk of having a preterm birth is higher,” said Dr. Sean Esplin, maternal fetal medicine physician and senior medical director for women’s health at Intermountain Healthcare.

We have enough data now to say this is safe during pregnancy, (it) doesn’t cause problems during pregnancy, that it doesn’t cause infertility.

–Dr. Sean Esplin

Esplin said pregnancy is already an often anxiety-inducing time for women. He understands why it might be a difficult decision. “I think it’s normal and OK for people to be a little bit worried about it … they want to do what’s right for their baby, right? And so I understand that,” he said. “Being pregnant during the pandemic just amplifies that.”

However, he reassures people that not only is the vaccine safe during pregnancy and can prevent complications, it will not prevent someone from getting pregnant in the first place.

“The American Society of Reproductive Medicine has made a very definitive statement saying there is no evidence that this causes problems with infertility,” he said.

He said 22 organizations, including the American College of Obstetrics and Gynecology, the Society for Maternal-Fetal Medicine, and the Centers for Disease Control and Prevention recently came together recommending both women who are either trying to conceive or who already are pregnant get vaccinated.

“Their whole job is to monitor and to look at the risks and benefits and to take the data and actually synthesize it to make a recommendation about what the right thing to do is,” he said. “We have enough data now to say this is safe during pregnancy, (it) doesn’t cause problems during pregnancy, that it doesn’t cause infertility.”

Misinformation circulating online erroneously suggests the vaccine could cause infertility by mistakenly attacking syncytin-1, a protein in the placenta that helps the placenta attach to the wall of the uterus. “That statement was made without any real evidence and as people have gone and looked at these two proteins, there’s really not a lot of similarity between them,” he explained. “There’s absolutely no reason to think that antibodies to the spike protein would actually affect syncytin-1.”

Esplin cited a recent study from ScienceDirect of women undergoing IVF who either had the vaccine, had a natural COVID-19 infection or had no antibodies at all. “They went ahead and did the embryo transfers to see if the rate of implantation and pregnancy success was the same. It was exactly the same in all three groups,” Esplin said.

While Esplin acknowledged there isn’t as much data in children, Esplin said it’s safe. “There is no documented risk of infertility in younger people either,” he said, adding that hospitals are seeing more and more sick children. He said the American Academy of Pediatrics is also recommending that children and teenagers who are eligible should get vaccinated.

Tracy got vaccinated about three months after she recovered from COVID-19 in July. “I could have prevented it, and that’s the sad part,” she said.

Don’t be afraid of the vaccine. It’s so much more mild than getting COVID.

–Natasha Tracy

If she could turn back the clock she would. “I wish I would have jumped on that vaccine when I first had the chance because I really do think that things would have been different,” she said.

Tracy urged other women to take the vaccine. “Don’t be afraid of the vaccine. It’s so much more mild than getting COVID,” she continued.

“If you want to do what’s best for your baby, get vaccinated,” Esplin added.

He said with the recent surge in cases due to the delta variant, hospitals are seeing more severe cases of COVID-19 among pregnant women. “The baby relies completely, obviously, on the mother’s ability to get oxygen and when that’s compromised, it can cause big problems for the baby,” he said.

“We don’t have people who deliver early because of the vaccine. We don’t have people who are in the ICU because of the vaccine,” Esplin added. “It’s the disease itself that’s causing those increased risks, and your best way to avoid that is to get vaccinated.”

Summer break has been a relief for many students. After being remote all school year at her public school, many kids felt isolated and hopeless, and enjoyed the freedom of summer friendships and no school.

But with the return of school, some students wonder whether administrators will penalize kids who might not be ready to go back to “normal.”

“Will there be the option of counseling?” “Will going to counseling affect learning and grades?”

Mental health needs among teenagers were on the rise even before COVID-19. The past year and a half of health uncertainty, isolation and other stressors only worsened the problem. But it also brought more attention to a long standing crisis. As students head back to another school year during a pandemic, educators and health care workers say they have been preparing to support them, hoping an infusion of federal COVID-19 relief dollars will help bring meaningful change.

“There is a clear recognition from the federal level, state level, down to the district level that social emotional learning, mental health and supporting the resiliency and coping skills of both kids and adults is central,” said Tim Dohrer, director of the teacher leadership program at Northwestern’s School of Education and Social Policy.

Will there be enough help?

But students worry that won’t be enough, especially if schools expect students to slip easily back into the school routine. Mental health issues among students as they return to school are both acute and widespread.

Lurie Children’s Hospital, for example, has seen about a 20% increase in emergency department visits for psychiatric reasons over the past year and a half. Calls for therapists have quintupled. Colleen Cicchetti, executive director of the Center for Childhood Resilience at Lurie says educators and parents have been looking for resources.

“We put up one course specifically on psychological first aid, which is really thinking about ‘how do you support kids who are experiencing distress,’ ” she said. “We’ve just seen an incredible outpouring of adults asking for help with this issue.”

Kazi Stanton-Thomas is another Chicago teen who struggled during remote learning.

“It was a lot of sobbing — sobbing to myself, because I didn’t want my family to hear,” Kazi said. “I kind of turned off. My personality turned off. And what was left was just anxiety and depression.”

Kazi, who uses the pronoun “they,” said they’re fortunate they had a therapist before the pandemic, but Kazi knows many people didn’t have that. Kazi is part of a teen health council through a youth organization called Mikva Challenge. They focus on teen mental health, especially during the pandemic.

“I just need all school systems to be more accommodating to mental health,” Kazi said.

Kazi Stanton-Thomas tried to keep busy last school year but with most activities remote and limited options to see friends, Kazi says a sense of isolation really took hold. Courtesy of Kazi Stanton-Thomas / WBEZ

As schools open up this month, teachers and staff are getting trained up on identifying levels of stress and how to address them. The Illinois State Board of Education has urged districts to use the millions in federal relief dollars for student social emotional needs. Cicchetti says schools should use those funds with caution.

“It actually doesn’t help us if they disappear at the end of the year, when the grant goes away,” she said. “We’ve got to build sustainable approaches, not just one and done, service delivery. So I hope that’s where policymakers need to be thinking not just about the immediate, but building that long term structure.”

A recent survey by RAND Corporation, a research group, finds seven out of 10 schools will provide mental health programming this year. That’s up from five out of 10 before the pandemic.

Some schools are using the federal money to hire more mental health professionals and offer more training to staff. In Riverside Brookfield High School in the western suburbs, they’re using a new program called SATCHEL to assess all students’ social emotional needs as they come back.

Assistant Principal Beth Augustine said there were plenty of nerves on the first day but overwhelmingly kids and teachers were happy despite the unique challenges of this year.

“We’re starting from scratch,” Augustine said. “Teachers are seeing two classes of kids that they haven’t seen, and juniors only had a little over a year with us.”

Teachers last year weren’t able to build the relationships they normally do with students, especially with many of them keeping their cameras off during remote learning.

“That’s why I think that this quick screener will just sort of give us some baseline data,” Augustine said.

In addition to bringing on extra personnel, the school will screen all students. Some may receive further evaluation to see what help they might need. Augustine said school isn’t a solution to mental health problems, but it can help students get connected to supports.

“If we can get them in the building, at least, if they’re in student services … we can find a place where they can work quietly and work through their anxiety,” she said. “That’s what the social workers and school counselors are great at — focusing on what’s causing the anxiety at that moment.”

The Chicago Teachers Union has been pushing Chicago Public Schools to spend the federal money to hire more staff, including mental health professionals. The school district said it can’t spend that money on new personnel because those funds will dry up in a few years. But the district is using the money to expand mental health services through community partnerships and train staff on dealing with trauma. The district was already due to add more nurses and social workers per the union contract.

Relationships before academics

As schools resume, experts are urging educators not to focus too heavily on regaining lost academic ground at the expense of attending to students’ social and emotional needs.

Dohrer, from Northwestern, said schools may be tempted to seize on academics right away. He said it’s crucial to first build relationships with students.

“If I jump right into my science, right into my math, if I jump right into those things without stopping to recognize — Where are my kids? How are they feeling and experiencing the world right now? And where am I right now? — if we don’t do that first, we’re never going to make progress with academics,” he said.

Dohrer said with new cash on hand, schools have the opportunity to do creative things and make a real change for student mental health.

“There needs to be a recognition that this is not business as usual. We are not going back to the fall of 2019, or even the fall of 2020, before all this happened,” he said. “The kids are not the same. We’re not the same, and we can’t treat it that way.”

 

The rate of gestational diabetes has shot up 30 percent in young U.S. women over the past decade and more than doubled in U.S. women who identify as Asian-Indian compared with non-Hispanic White women, reports a new Northwestern Medicine study published in JAMA.

This is unacceptably high and alarming. The consistent and continued increase over the last decade could have significant impact on not just pregnancy health and outcomes for the mom and baby, but also long-term health for both. Gestational diabetes is linked to a higher risk of cardiovascular disease for the mom and child.”

So asserts Sadiya Khan, MD, MSc, Corresponding Author, Assistant Professor of Medicine, Division of Cardiology and Northwestern Medicine Physician

The study also reported that chronic diabetes present prior to pregnancy (Type 1 or 2) rose more than 20 percent since 2011, nearly twice as high in individuals who identified as non-Hispanic Black and Puerto Rican.

“The pandemic year could push these gestational diabetes numbers even higher due to lifestyle changes in exercise, eating and increased stress,” Khan said.

Gestational diabetes is associated with maternal mortality and morbidity, meaning there is a higher risk of women dying in pregnancy and of serious complications during pregnancy and delivery. These include: needing to go to the Intensive Care Unit during pregnancy or birth, significant blood loss during birth and having a C-section.

Long-term observational studies also show higher glucose exposure in utero sets the stage for these children to be at higher risk for obesity, heart disease and diabetes later in life.

Growing rates and persistent disparities in maternal morbidity and mortality are a major public health concern in the U.S. While maternal deaths have declined worldwide over the past 30 years, they have increased in the U.S. The U.S. has the highest maternal death rate of any industrialized nation and significant disparities exist.

“The findings are the most comprehensive and contemporary data available that covers all live births in the U.S.,” said study first author Nilay Shah, MD, MPH, assistant professor of Medicine in the Division of Cardiology and a Northwestern Medicine physician. “Our evaluation included individuals from subgroups of the Asian American, Pacific Islander and Hispanic populations in the U.S., who too frequently are underrepresented in research and disease surveillance.”

Northwestern investigators evaluated data from more than 12.5 million birth certificates from the National Center for Health Statistics for deliveries to individuals at first live birth for ages 15 to 44 in the U.S. between 2011-2019. These data allowed investigators to identify trends in gestational diabetes over time and differences in which groups are most affected. They focused on Asian American and Pacific Islander subgroups, which represent the fastest-growing ethnic group in the U.S. and are among the most underrepresented in research.

“These are strikingly higher rates over such a short time period,” Shah said. “We expected it to increase over this time period, but the fact it increased so much, and in every age and race/ethnic group, is very concerning.”

Khan, Shah and the study team are now investigating the reason for the increase, which parallels the rise in obesity. The rise in gestational diabetes for U.S. women is likely linked to poor-quality diet, low levels of physical activity and being obese or overweight, they said.

“Earlier diagnosis in pregnancy is one way to identify risk and intervene sooner, as well as focusing on prevention even before pregnancy,” Khan said. “We need to emphasize and prioritize women’s health not just during pregnancy, but also before and after.”

Journal reference:

Shah, N.S., et al. (2021) Trends in Gestational Diabetes at First Live Birth by Race and Ethnicity in the US, 2011-2019. JAMA. doi.org/10.1001/jama.2021.7217.

 

MONDAY, Aug. 23, 2021 (HealthDay News) — The U.S. Food and Drug Administration on Monday granted full approval for the Pfizer-BioNTech COVID-19 vaccine.

The vaccine will now be marketed as Comirnaty and is fully approved for the prevention of COVID-19 in individuals 16 years and older. The vaccine remains under emergency use authorization for individuals ages 12 to 15 years and for administration of a third dose in certain immunocompromised individuals.

“While millions of people have already safely received COVID-19 vaccines, we recognize that for some, the FDA approval of a vaccine may now instill additional confidence to get vaccinated,” Acting FDA Commissioner Janet Woodcock, M.D., said in an agency press release. “Today’s milestone puts us one step closer to altering the course of this pandemic in the U.S.”

The FDA decision to fully approve Comirnaty was based on a review of updated data from the clinical trial that supported the emergency use authorization. The updated data included a longer follow-up duration and a larger clinical trial population of 20,000 individuals who received the vaccine and 20,000 who received placebo. Based on the updated results, the vaccine was 91 percent effective in preventing COVID-19.

The review also included updated safety data on 22,000 people who received the vaccine and 22,000 who received placebo, more than half of whom were followed for at least four months.

The agency also conducted an evaluation of postauthorization safety surveillance data regarding the risks for myocarditis and pericarditis following receipt of the Pfizer-BioNTech COVID-19 vaccine. They found the data demonstrate increased risks, especially within the seven days following the second dose and with a higher risk among men younger than 40 years, in particular males ages 12 to 17 years. Data have shown symptom resolution in the majority of individuals, but some have required intensive care support.

The Comirnaty Prescribing Information includes a warning about these risks, but the agency notes that information is not yet available on potential long-term health outcomes. The FDA is requiring Pfizer-BioNTech to conduct postmarketing studies to further evaluate these risks.