By Lindsey Schneider, Joshua Sbicca and Stephanie Malin
The SARS-CoV-2 virus is novel, but pandemic threats to indigenous peoples are anything but new. Diseases like measles, smallpox and the Spanish flu have decimated Native American communities ever since the arrival of the first European colonizers.
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History Reverberates on Native Lands<p>Native communities in North America have been disrupted and displaced for centuries. Many face long-standing food and water <a href="http://www.nativepartnership.org/site/DocServer/2017-PWNA-NPRA-Food-Insecurity-Project-Grow.pdf?docID=7106" target="_blank">inequities</a> that are further complicated by this pandemic.</p><p>On the Navajo reservation, which covers more than 27,000 square miles in Arizona, Utah and New Mexico, 76% of households already <a href="https://www.researchgate.net/publication/235390130_High_levels_of_household_food_insecurity_on_the_Navajo_Nation" target="_blank">have trouble affording enough healthy food</a>, and the nearest grocery store is often hours away. COVID-related restrictions have further curtailed access to food supplies.</p><p>Clean water for basic sanitary measures like hand-washing is also scarce. Native Americans are <a href="http://uswateralliance.org/sites/uswateralliance.org/files/Closing%20the%20Water%20Access%20Gap%20in%20the%20United%20States_DIGITAL.pdf" target="_blank">19 times more likely</a> to lack indoor plumbing than whites in the U.S. Nearly one-third of Navajo households <a href="https://www.nbcnews.com/news/us-news/coronavirus-hits-indian-country-hard-exposing-infrastructure-disparities-n1186976" target="_blank">lack access to running water</a>.</p><p>Many <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm" target="_blank">health issues</a> that can increase COVID-19 mortality rates occur at high levels among Native Americans. These <a href="http://www.ncai.org/news/articles/2020/03/18/the-national-congress-of-american-indians-calls-for-more-attention-to-covid-19-impacts-to-indian-country" target="_blank">underlying</a> and <a href="https://doi.org/10.1016/S0140-6736(20)30893-X" target="_blank">preexisting</a> conditions – things like hypertension, diabetes, obesity and cardiovascular disease – are <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6913e2.htm" target="_blank">linked to diet</a> and stem from <a href="https://www.oupress.com/books/15107980/indigenous-food-sovereignty-in-the-united-sta" target="_blank">disruption and replacement</a> of Indigenous food systems.</p>
High Exposure Rates<p>These factors have clear health impacts. On the Navajo reservation, for instance, through May 27, 2020, <a href="https://www.navajo-nsn.gov/News%20Releases/OPVP/2020/May/FOR%20IMMEDIATE%20RELEASE%20-%201620%20recoveries_102%20new%20cases%20of%20COVID-19_and%20one%20more%20death%20reported.pdf" target="_blank">4,944 people</a> out of a population of 173,000 had tested positive for COVID-19, and 159 had died.</p><p>This infection rate per capita exceeds those in hot spots such as <a href="https://www.forbes.com/sites/alexandrasternlicht/2020/05/19/navajo-nation-has-most-coronavirus-infections-per-capita-in-us-beating-new-york-new-jersey/#11a4fac08b10" target="_blank">New York and New Jersey</a>. Importantly, however, it may also reflect a much <a href="https://www.sltrib.com/news/2020/04/19/navajo-nation-has-higher/" target="_blank">more proactive approach to testing</a> on reservations than in many other jurisdictions.</p><p>The fact that elderly people are especially vulnerable to COVID-19 could worsen the pandemic's effects in Indian Country. Elders are the <a href="https://ais.washington.edu/research/publications/spirits-our-whaling-ancestors" target="_blank">keepers of traditional knowledge, tribal languages and culture</a> – legacies whose loss already threatens the persistence of indigenous communities.</p><p>Elders also play key roles in preserving traditional plant and medicine knowledge. In the absence of COVID-19 interventions from Western medicine, many elders have been called on to perform healing practices, which increases their exposure risk.</p>
Little Help From Federal and State Governments<p>Many tribal members rely on the federal government's <a href="https://www.ihs.gov/" target="_blank">Indian Health Service</a> for health care. But <a href="https://theconversation.com/tribal-leaders-face-great-need-and-dont-have-enough-resources-to-respond-to-the-coronavirus-pandemic-134372" target="_blank">lack of capacity</a> at the agency has hampered its response. Budget shortfalls, <a href="https://indiancountrytoday.com/news/report-grossly-inaccurate-data-used-to-divvy-up-relief-funds-for-tribes-9qkkHmeXj0uhRC42mXYqCA" target="_blank">inaccurate data</a>, the challenges of providing <a href="https://indiancountrytoday.com/news/coronavirus-risk-is-compounded-by-the-rural-DC-rMTUzzE6WDGee8jbENQ" target="_blank">rural health care</a> and ongoing personnel shortages in IHS clinics are compounded by staff being <a href="https://navajotimes.com/reznews/dikos-ntsaaigii-doodaa-nation-musters-defense-against-covid-19/" target="_blank">pulled away</a> to fight the virus in large cities.</p><p>And while many states have raised frustrations with the Trump administration's unwillingness to distribute protective supplies from the <a href="https://www.vox.com/recode/2020/4/3/21206170/us-emergency-stockpile-jared-kushner-almost-empty-coronavirus-medical-supplies-ventilators" target="_blank">dwindling national stockpile</a>, IHS and tribal health care authorities <a href="https://www.azpm.org/p/home-articles-news/2020/3/17/167874-bill-calls-for-more-tribal-community-access-to-federal-stockpile-of-medical-supplies/" target="_blank">never had access</a> to the stockpile at all.</p><p>Although the federal government has begun <a href="https://www.hhs.gov/about/news/2020/05/22/hhs-announces-500-million-distribution-to-tribal-hospitals-clinics-and-urban-health-centers.html" target="_blank">distributing relief funds</a> to IHS agencies, there have been serious problems with the accompanying supplies. The Navajo Nation has received <a href="https://www.indianz.com/News/2020/05/22/propublica-former-trump-aide-provided-fa.asp" target="_blank">faulty masks</a>, and a Seattle Native health center asked for tests but <a href="https://www.nbcnews.com/news/us-news/native-american-health-center-asked-covid-19-supplies-they-got-n1200246" target="_blank">received body bags instead</a>.</p><p>Meanwhile, federally imposed limits on tribal sovereignty have obstructed tribal governments' efforts to deal with the pandemic themselves. Federal and state governments are <a href="https://www.seattletimes.com/seattle-news/makah-tribe-fights-coronavirus-with-self-reliance-and-extreme-isolation/" target="_blank">challenging tribes' jurisdictional authority</a> to <a href="https://www.azfamily.com/news/mayor-of-page-accused-of-racist-social-media-comment-toward-navajo-nation-president/article_e2e6efd6-8db4-11ea-a8a2-7f6976d702f6.html" target="_blank">close borders to tourists</a> who may carry the virus. South Dakota's governor has <a href="https://www.theguardian.com/us-news/2020/may/14/sioux-coronavirus-roadblocks-south-dakota-governor" target="_blank">threatened legal action</a> against two tribes who set up checkpoints to monitor incoming traffic on their reservations.</p>
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Environmental Injustices on Native Land<p>Energy development and resource extraction have had <a href="https://www.haymarketbooks.org/books/898-all-our-relations" target="_blank">disproportionate impacts</a> on tribes for many years. Today, many Native American leaders worry that ongoing energy production – <a href="https://www.ncsl.org/research/labor-and-employment/covid-19-essential-workers-in-the-states.aspx" target="_blank">an "essential" activity under federal guidelines</a> will bring outsiders into close contact with reservation communities, worsening COVID risks.</p><p>The owners of the Keystone XL oil pipeline have announced that they intend to continue construction, which will bring an influx of workers along the proposed route through Montana, South Dakota and Nebraska. The Rosebud Sioux Tribe in South Dakota and Fort Belknap Indian community in Montana have filed for a <a href="https://www.narf.org/keystone-xl/" target="_blank">temporary restraining order</a>, and a key permit for the pipeline was <a href="https://www.democracynow.org/2020/4/16/headlines/us_judge_revokes_crucial_permit_for_keystone_xl_pipeline" target="_blank">revoked in April 2020</a>, but work continues at the U.S.-Canada border.</p><p>Construction is accelerating on the <a href="https://www.azcentral.com/story/news/politics/border-issues/2020/03/17/border-patrol-waives-laws-border-wall-construction-southern-arizona/5063618002/" target="_blank">southern border wall</a>, which bisects the <a href="http://www.tonation-nsn.gov/" target="_blank">Tohono O'odham reservation</a> in Arizona and Mexico. The Trump administration has <a href="https://www.thenation.com/article/politics/border-coronavirus-military-immigration/" target="_blank">increased patrols at the border</a>, despite the tribe's concern that the patrols' presence is <a href="https://www.usatoday.com/story/news/nation/2020/04/06/coronavirus-cbp-160-cases-covid-19-officers-agents/2958736001/" target="_blank">spreading coronavirus</a> on the reservation.</p><p>And in Bristol Bay, Alaska, a salmon fishing season that brings in thousands of temporary workers is <a href="https://indiancountrytoday.com/news/it-s-hard-when-you-love-something-xlS49l2N20KZjqumwfzZfQ" target="_blank">set to open in June</a> because the federal government has also deemed commercial fishing "<a href="https://www.cisa.gov/sites/default/files/publications/CISA-Guidance-on-Essential-Critical-Infrastructure-Workers-1-20-508c.pdf" target="_blank">essential critical infrastructure</a>." Many local Native villages depend on the fishery for income, but have nonetheless pleaded with state regulators to <a href="https://indiancountrytoday.com/news/urgent-calls-to-close-the-massive-bristol-bay-fishery-8lYsGkUeDUyCBW7FMwpSfA?fbclid=IwAR1710u4rQnriq_MgH2ueQxOFtfGiGiH8I2ZdJRCZS9f28Zl-JNkPLpnzZo" target="_blank">cancel the season</a>. The regional hospital has just four beds for possible COVID-19 patients.</p>
Bold Action in Native Communities<p>Native communities are taking decisive action to reduce the spread of COVID-19. They're imposing aggressive <a href="https://www.nytimes.com/2020/04/09/us/coronavirus-navajo-nation.html" target="_blank">quarantine</a> measures like lockdowns, curfews and border closures. Communities are <a href="https://www.theguardian.com/us-news/2020/mar/18/covidcoronavirus-native-american-lummi-nation-trailblazing-steps" target="_blank">ramping up health care capacity</a> and elder support services, and banishing nontribal members who <a href="https://rapidcityjournal.com/news/local/oglala-sioux-council-banishes-non-member-with-covid-19-from-reservation/article_60b665c3-9d1b-5d48-a576-51774e4fb41a.html" target="_blank">violate travel restrictions</a>.</p><p>Other strategies include helping hunters <a href="https://indiancountrytoday.com/news/ammo-fuel-for-hunters-to-feed-others-Ki3zK6du-ky-UogoB9-aNQ" target="_blank">provide traditional foods</a> to their communities, <a href="https://ndncollective.org/indigenizing-and-decolonizing-community-care-in-response-to-covid-19/" target="_blank">mobilizing to support tribal health care workers</a>, and <a href="https://www.ehn.org/coronavirus-native-americans-2645923635.html" target="_blank">linking the pandemic and the climate crisis</a>. Looking ahead to a post-COVID future, we believe one priority should be attending to <a href="http://www.beacon.org/As-Long-as-Grass-Grows-P1445.aspx" target="_blank">front-line environmental justice struggles</a> that center tribes' sovereignty to act on their own behalf at all times, not just during national crises.</p>
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By Jodi Helmer
In Georgia there are just 213 game wardens to enforce state fish and wildlife laws, investigate violations, assist with conservation efforts and collect data on wildlife and ecological changes across 16,000 miles of rivers and 37 million acres of public and private lands. Statewide 46 counties have no designated game warden at all. The shortage could lead to wildlife crimes going undetected.
The Environment Pays the Price<p>Environmental crimes like poaching, overfishing and illegal dumping threaten healthy ecosystems, and without adequate patrols can lead to declining wildlife populations, disease spread, increases in invasive species, erosion and contaminated waterways.</p><p>"People who want to cheat resources know which [ranger] stations are vacant and know that the odds of seeing a warden in the field are rare because regular patrols aren't happening," explains Larry Bonde, chairman of the <a href="https://dnr.wi.gov/about/wcc/" target="_blank">Wisconsin Conservation Congress</a>, a group of elected delegates who advise the state department of natural resources. "It's not just fish and game violations; if no one is visiting sensitive sites…there are a lot of things that get overlooked that could be spotted by [a game warden] patrolling the area."</p><p>In California, for example, game wardens with the Department of Fish and Wildlife are often the first to spot illegal cannabis cultivation sites — called trespass grows — where growers raze paths through national forests to access secluded sites, divert significant amounts of water to irrigate cannabis plants, and apply massive amounts of pesticides to keep wildlife from gnawing on the crops. Too few game wardens in the field could lead to massive environmental degradation before trespass grows are spotted.</p><p>Even when issues are spotted, Rick Langley, wildlife program manager for the <a href="https://www.azgfd.com/" target="_blank">Arizona Game and Fish Department</a> and president of the <a href="https://www.naweoa.org/" target="_blank">North American Wildlife Enforcement Officers Association</a>, believes that having too few game wardens in the field could have a negative impact on investigations and enforcement.</p><p>"[Game wardens] work really hard to fill in the gaps to protect natural resources," he says. "In areas with less officer presence or where officers are spread thin to cover vacant districts, it has the potential to leave investigations incomplete or not responded to or followed up on as thoroughly as they would have been if you had one officer assigned to the area."</p><p>Bonde agrees, adding, "If the station is vacant and there's a complaint, it won't be ignored, but it certainly isn't going to get the amount of attention it would if it had been a full-time posted station."</p>
COVID Challenges<p>These existing challenges are poised to get worse. The COVID-19 global health pandemic has triggered major budget cuts, further threatening funding for environmental conservation and could result in additional cuts to conservation districts that are already cash-strapped and understaffed.</p><p>"For agencies that receive funding [through state taxes and revenues], the repercussions from reduced tourism and businesses closing could have a very serious effect," says Langley. "We're hearing rumors about budget cuts and, in many areas, budget is one of the main reasons these positions go unfilled."</p><p>In 2019 the Minnesota Department of Natural Resources had 21 open positions across its 155 patrol areas; the number decreased (from 27 vacancies in 2019) but the state is facing a <a href="https://mn.gov/mmb-stat/budget/may-interim-budget-projection-slides.pdf" target="_blank">projected $2.42 billion budget deficit</a> as a result of the pandemic, which could threaten funding for the department.</p><p>In Montana the wardens working for Fish, Wildlife & Parks wrote 2,194 citations in 2018 compared to 4,027 a decade earlier. Game wardens suspect that there are not fewer wildlife crimes, just fewer officers to catch perpetrators. That number could drop again. The state, anticipating "significant revenue shortfalls" due to the pandemic, led legislators to request reducing state spending; the department of Fish, Wildlife & Parks could feel the sting.</p><p>To complicate matters, stay-at-home orders have led people to spend more time outdoors, hiking in national forests and boating and fishing on lakes. States like Vermont, North Dakota, Minnesota and New York have reported significant increases in the number of fishing licenses being issued, which means more anglers to monitor and too few game wardens to ensure no one is violating catch limits.</p>
Targeting Solutions<p>The seriousness of the issue has led some states to implement strategies to increase the number of game wardens in the field and provide additional support to keep them in their roles.</p><p>In fiscal year 2018-2019, the Minnesota legislature allocated an additional $2.8 million to help the Department of Natural Resources recruit, hire and train additional game wardens to help fill 28 vacant positions. The Arizona Fish and Game Department, which has 16 vacancies across its 80 conservation districts, ramped up recruitment efforts too, adding three classes to the law enforcement academy in 2020 (up from just one in previous years). It also hired an advisor to educate students graduating from Arizona State University and the University of Arizona about conservation careers.</p><p>Most departments also have ranger "tip lines" where the public can report violations. In addition to the hotlines, the Georgia Department of Natural Resources also installed 400 cameras across the state to help catch wildlife violations.</p><p>"Instead of a game warden sitting out at night for eight hours to watch for hunters spotlighting deer [an illegal practice that involves using a flashlight or headlights to locate wildlife while hunting after hours], we use cameras," England explains. "If we have problems with people dumping trash, sneaking in certain areas and fishing after hours or illegal hunting, we can hide one of these cameras and it sends the game warden a picture or a video of what's going on."</p><p>While Bonde supports the use of high-tech tools and hotlines to report potential conservation violations to help protect wildlife and the environment, he believes additional funding to get more game wardens in the field is essential, adding, "Without proper enforcement, there will always be people who cheat our natural resources."</p>
EcoWatch Daily Newsletter
By Cathy Cassata
With more than 1.7 million confirmed cases of COVID-19 in the United States and more than 100,000 deaths from the virus, physicians face unprecedented challenges in their efforts to keep Americans safe.
They also encounter what some call an "infodemic," an outbreak of misinformation that's making it more difficult to treat patients.
When Leaders and Doctors Spread Misinformation<p>When people in charge of towns, cities, states, and countries spread misinformation, the potential for belief in misinformation to result in policies can have harmful effects.</p><p><a href="https://www.northwell.edu/find-care/find-a-doctor?q=Bruce+E.+Hirsch%2C+MD&insurance=&location=&query_type=provider&physician_partners=false&default_view=list&gender=&language=&sort=relevancy" target="_blank">Dr. Bruce E. Hirsch</a>, attending physician and assistant professor in the infectious disease division of Northwell Health in Manhasset, New York, says an example of this is when President Trump informed the public he was taking hydroxychloroquine as a preventive measure.</p><p>"To approach this enormous challenge, we need some intellectual honesty and clarity, and to disregard expertise and to make decisions and model decisions based on hunches is inviting us to handle challenges on the basis of rumor and uninformed opinion. The magnitude of that error is epic," Hirsch told Healthline.</p><p>Stukus agrees, noting that the harm of this proclamation is documented.</p><p>"Early on when the president touted the benefits of hydroxychloroquine and azithromycin, people started to hoard this medicine, and state boards had to shut it down because they were getting so many prescriptions for this unproven therapy that it was not available for those who truly needed it, such as those who have lupus and autoimmune conditions," Stukus said.</p><p>He adds that calls to poison control centers increased after the president suggested using disinfectant to prevent contracting the new coronavirus.</p>
Listen to Science, Even When it Changes<p>When recommendations change or evidence flip-flops, skepticism may arise. However, Stukus says change is the beauty of science.</p><p>"That shows us that we can evolve, and if the evidence shows that our prior thoughts were incorrect, we need to be able to change our recommendations and advice based upon the best quality of evidence at the time," he said.</p><p>Pierre agrees.</p><p>"Science is an iterative process, whereby we arrive at facts and truth through repeated and controlled observations. That means that it's inherently self-correcting as we revise conclusions based on ongoing research. Scientific facts aren't immutable dogma chiseled on a tablet. They change based on the best available evidence we have at a given point in time," he said.</p><p>Because research of COVID-19 has only been underway for 6 months, information is evolving rapidly, and new information may contradict old.</p><p>"There's still much we don't know about exactly how [COVID-19] spreads, what effects it has on the body, or how to best treat it. That means that the best available evidence is preliminary, but that doesn't mean that we should ignore it or turn to other sources of information or opinion as if they're just as valid," Pierre said.</p><p>He explains that conspiracy theories based on mistrust lead to vulnerability to misinformation.</p><p>If people mistrust science because it sometimes "changes its mind," Pierre said, "that shouldn't be used to embrace other opinions based on no evidence at all, which are typically selected based on confirmation bias: what we want to believe rather than what the objective evidence supports."</p>
Where to Find the Best Information<p>Stukus says to start with the <a href="https://www.cdc.gov/coronavirus/2019-nCoV/index.html" target="_blank">CDC</a> and <a href="https://www.nih.gov/health-information/coronavirus" target="_blank">NIH</a>. Then check with your local health officials, because COVID-19 guidelines may vary depending on where you live.</p><p>If you can't find information you need or have questions specifically related to you, call your primary care doctor.</p><p>"Your personal doctor should always be a resource for individual specific questions because they know best how to apply all the nuances retaining to your health, and how to incorporate all the other general [COVID-19] recommendations," Stukus said.</p><p><a href="https://www.eehealth.org/find-a-doctor/b/boyd-laura-b/" target="_blank">Dr. Laura Boyd</a>, primary care physician at Edward-Elmhurst Health Center in Elmhurst, Illinois, says her clinic receives a lot of calls about COVID-19.</p><p>"Most doctors' offices are receiving calls and answering questions, and doing phone or video visits to help clarify and/or order testing over the phone based on patients' symptoms. It is always best to call your doctor's office first instead of worrying about symptoms and waiting too long to seek treatment," she told Healthline.</p><p>If your primary care doctor has limited testing, she suggests looking on your state's public health website for available testing sites.</p><p>With a lot of unknowns related to this virus and disease, Boyd says many patients are feeling overwhelmed and anxious for a treatment.</p><p>"Unfortunately, there is no specific medication recommended for COVID for outpatient. There are a lot of ongoing studies with various drugs going on within the hospital setting. Patients should always contact their doctors about their specific symptoms as they can treat the symptoms that go along with COVID, but there is no cure," Boyd said.</p><p>While we wait for treatment and a vaccine, Hirsch, who treats patients hospitalized for COVID-19 complications on a daily basis, says everyone can do their part by washing hands, wearing a mask, and staying 6 feet apart.</p><p>"As an infectious disease doctor working in the hospital, I see the damage of the pandemic and the worst cases of what's happening. We are trying to get the best possible outcome and confronting this overwhelming biologic reality of this terrible epidemic the best we can," Hirsch said.</p><p>Everyone at home can help in the fight too, he adds.</p><p>"Follow information that is science- and evidence-based, and avoid that which is not," he said.</p>
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By Julia Ries
Around the world, there have been several cases of people recovering from COVID-19 only to later test positive again and appear to have another infection.
The Viral Material in Re-Positive Cases Isn’t Infectious<p>The Korean study examined 285 patients who tested positive again for the new coronavirus after they recovered from COVID-19, which had been confirmed via a negative test result.</p><p>The researchers swabbed the patients and examined the viral material to determine whether it was still actively infectious.</p><p>The team was unable to isolate live viral material, indicating that the positive diagnostic tests were picking up dead virus particles.</p><p>"[This] may speak for the fact that the virus may be dead or not be fit enough to grow — therefore the virus may not be fit enough to infect a new host," said <a href="http://www.providence.org/doctors/profile/1099717-andres-romero" target="_blank">Dr. Andres Romero</a>, an infectious disease specialist at Providence Saint John's Health Center in Santa Monica, California.</p><p>The researchers also tested 790 people who'd been in close contact with the "re-positive" patients. Of the 27 who tested positive, no cases appeared to be caused from exposure to someone who appeared to have a reinfection.</p><p>The report also found that the vast majority of recovered patients (96 percent) had neutralizing antibodies, indicating that they conferred immunity.</p><p>"Whether this is indicative of a completely protective response remains to be proven. If this study holds true, then people who have recovered can get back to work," Zapata said.</p><p>In response to the new findings, South Korea eliminated a policy requiring discharged patients to isolate for 2 weeks.</p>
Conducting and Interpreting PCR Tests<p>The tests widely used to diagnose COVID-19 are called polymerase chain reaction (PCR) tests.</p><p>The tests swab a person's nose or throat and try to pick up the virus's genetic material, or RNA.</p><p>According to <a href="https://www.cdc.gov/coronavirus/2019-ncov/hcp/faq.html" target="_blank">guidance</a> from the U.S. Centers for Disease Control and Prevention (CDC), a positive result on a PCR test doesn't "necessarily mean infectious virus is present or that the patient is contagious."</p><p>Infectious disease experts have suspected that the test kits aren't picking up actively infectious viral material in recovered patients who test positive again, but rather dead remnants of the virus.</p><p>We see this occur with other viruses, too.</p><p>"We know other viruses like parainfluenza, human metapneumovirus, or RSV [respiratory syncytial virus] may linger for months in certain patients, and that does not represent infectious state," Romero said. "Coronavirus may be the same."</p>
We Still Need to Practice Caution<p>While the findings are promising, infectious disease experts say we still need to practice caution.</p><p>More research is needed to validate these findings and determine whether they apply to distinct parts of the population, such as those who are immunocompromised.</p><p>It's common for immunocompromised patients — such as those with cancer — to continue testing positive for a virus for longer, since it takes their immune system more time to clear the virus out of their body.</p><p>"I don't think we can be 100 percent certain of whether each recovered person is no longer contagious. Again, this may differ with distinct population groups," Zapata said.</p><p>Physicians are seeing some hospitalized patients testing positive for a month after they were first swabbed for COVID-19. It's unclear whether these patients still shed infectious virus, according to Zapata.</p><p>Everyone's body mounts a distinct immune response based on their age and overall health. Different individuals will clear the virus out at different speeds, according to Zapata.</p><p>Until we have more data and a preventive vaccine, it's crucial to continue adhering to the <a href="https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html" target="_blank">safety precautions</a> laid out by the CDC.</p><p>"The reality is that moving forward, the best approach will be keeping social/physical distancing, wearing a mask, and frequent hand hygiene in order to control the spread of the virus," Romero said.</p>
The Bottom Line<p>Doctors and researchers have been unsure whether people who recover from COVID-19 who test positive again continue to be contagious, or if they could get a second infection.</p><p>New <a href="https://www.cdc.go.kr/board/board.es?mid=a30402000000&bid=0030" target="_blank">research</a> published by the Korea Centers for Disease Control and Prevention has found that recovered COVID-19 patients who test positive again aren't infectious.</p><p>The study also found that most patients who recover have neutralizing antibodies that protect them from getting sick again.</p><p>Though the study is promising, health experts say we need more data to validate the findings and determine whether they apply to all patient populations.</p>
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By Jon Queally
President Donald Trump at a White House press conference on Friday announced he was "terminating" ties to the World Health Organization, even as the global death toll from the coronavirus pandemic nears 363,000 — including the more than 100,000 dead from the virus in the U.S., many attributed to his own mismanagement of the crisis.
By Richard Connor
The University of Southern Denmark on Wednesday announced that its researchers have developed the world's first fully automatic robot capable of carrying out throat swabs for COVID-19.
Former Federal Reserve Governor Rebukes Fed for Using Covid-19 Funds to Bail Out Fossil Fuel Industry
By Eoin Higgins
A former Federal Reserve board of governors member on Thursday called on her former colleagues to stop using Covid-19 relief funds to bail out the "dying" fossil fuel industry, calling the decision a threat to the planet's climate and a misguided use of taxpayer money.
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By Jory Brinkerhoff
Summer is field season for ecologists like me, a time when my colleagues, students and I go out into fields and woods in search of ticks to study the patterns and processes that allow disease-causing microbes – primarily bacteria and viruses – to spread among wildlife and humans.
Delaying Medical Treatment Can Be Dangerous<p>As we move from spring into summer, and into the peak period of tick activity in much of the Northern Hemisphere, time spent outdoors will increase, as will risk of tick-transmitted disease.</p><p>In some cases, there are key symptoms of a tick-transmitted disease that can help with diagnosis. For example, early Lyme disease, which is caused by the bite of an infected black-legged tick, sometimes called the deer tick, is commonly associated with an expanding "bull's-eye rash." <a href="https://www.cdc.gov/lyme/signs_symptoms/index.html" target="_blank">Seventy percent to 80% of patients have this symptom</a>.</p><p>However, <a href="https://www.cdc.gov/lyme/signs_symptoms/index.html" target="_blank">other symptoms</a> of Lyme disease – fever, head and body aches and fatigue – are less distinctive and can be easily confused with other illnesses, including COVID-19. This can make it more difficult to diagnose a patient who did not notice a rash or was unaware that they ever had a tick bite. As a result, Lyme disease cases can be <a href="http://doi.org/10.4081/or.2011.e14" target="_blank">misdiagnosed</a>. Nationally, Lyme disease may be undercounted to the point that only <a href="https://www.cdc.gov/lyme/datasurveillance/index.html" target="_blank">one in 10 cases is reported to the CDC</a>.</p>
Lyme Disease Isn’t the Only Tick Problem<p>Lyme disease is most common in the Northeast and North Central U.S., but that does not mean that people in areas without Lyme disease are free from worry about tick-transmitted disease. Ticks throughout North America can spread a <a href="https://www.cdc.gov/ticks/tickbornediseases/index.html" target="_blank">wide range of diseases,</a> many of which also present with flu-like symptoms, leading to the potential for <a href="https://doi.org/10.1016/j.ttbdis.2015.06.005" target="_blank">misdiagnosis</a>, especially when these diseases are not especially common in the general population.</p>
Is COVID-19 Increasing Chances of Tick Bites?<p><a href="https://www.scientificamerican.com/article/how-the-coronavirus-has-changed-animals-landscape-of-fear/" target="_blank">Recent reports</a> from across the nation and around the globe suggest that wildlife have become more bold this spring, wandering into suburbs and cities where human and vehicle traffic are reduced because of COVID-19.</p><p>Whether this phenomenon is being driven by changes in animal behavior or is simply an artifact of humans spending <a href="https://www.popsci.com/story/environment/wildlife-in-cities-covid-shutdown/" target="_blank">more time in their homes and becoming more aware of their surroundings</a> is not clear, but changes in wildlife behavior and habitat use could affect tick-transmitted disease. For example, white-tailed deer are important hosts to multiple human-biting tick species in eastern North America, including black-legged ticks, and more deer around our homes and in our neighborhoods could lead to more ticks that have a chance to bite humans.</p>
Staying Safe<p>Awareness is a key component of preventing and treating tick-borne disease. People should be aware of the activities that could <a href="https://www.cdc.gov/lyme/prev/index.html" target="_blank">expose them to ticks</a>, and <a href="https://pubmed.ncbi.nlm.nih.gov/10780095/" target="_blank">physicians should consider the possibility of tick-borne disease</a>, especially given the potential overlap in symptoms with COVID-19.</p><p>As with COVID-19, mitigation efforts can <a href="https://www.cdc.gov/lyme/prev/on_people.html" target="_blank">substantially reduce the risk</a> of tick-borne diseases. Wear long sleeves and long pants and use an <a href="https://www.epa.gov/insect-repellents" target="_blank">EPA-registered repellent</a> when you are in tick habitat, and check yourself thoroughly for ticks when you get home.</p><p>It is important to be aware of ticks when spending time outside, but fear of ticks should not stop people from enjoying nature. </p>
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By Linda Lacina
World Health Organization officials today announced the launch of the WHO Foundation, a legally separate body that will help expand the agency's donor base and allow it to take donations from the general public.
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Henry J. Kaiser Family Foundation
By Nicholas Joyce
The coronavirus has resulted in stress, anxiety and fear – symptoms that might motivate a person to see a therapist. Because of social distancing, however, in-person sessions are less possible. For many, this has raised the prospect of online therapy. For clients in need of warmth and reassurance, could this work? Studies and my experience suggests it does.
Telehealth Versus Traditional Therapy<p><a href="https://www.cigna.com/hcpemails/telehealth/telehealth-flyer.pdf" target="_blank">Private insurance companies</a> like Cigna and Aetna, have come around; they now provide coverage for what they see as a "legitimate" service. And <a href="https://www.prnewswire.com/news-releases/american-wells-2019-consumer-survey-finds-majority-of-consumers-open-to-telehealth-adoption-continues-to-grow-300906438.html" target="_blank">surveys show</a> consumers are receptive to telehealth counseling: no driving to an appointment, no searching for a parking space, no worries about childcare while they're away, no need to switch providers if they move, and no problem if the specialist happens to be far away.</p><p>Online therapy opens doors for clients who wouldn't otherwise seek help, <a href="https://www.worldcat.org/title/empirical-examination-of-the-influence-of-personality-gender-role-conflict-and-self-stigma-on-attitudes-and-intentions-to-seek-online-counseling-in-college-students/oclc/941976505" target="_blank">particularly patients</a> who feel stigmatized by therapy or intimidated by a stranger sitting across the room from them. Often, <a href="https://doi.org/10.1089/1094931041291295" target="_blank">people open up</a> more easily in telehealth sessions. Firsthand accounts have detailed <a href="https://www.romper.com/p/i-tried-online-therapy-for-a-month-this-is-what-happened-13630" target="_blank">positive experiences from consumers</a>.</p>
Overcoming Prejudices About Online Counseling<p>Now COVID-19 is forcing most traditional psychotherapists to adapt their practice to <a href="https://www.psychologytoday.com/intl/blog/expressive-trauma-integration/202003/covid-19-etherapy-in-times-isolation" target="_blank">online counseling</a>. After experiencing the medium, they are <a href="https://www.wecounsel.com/blog/why-every-therapist-in-private-practice-needs-a-telehealth-option/" target="_blank">overcoming their prejudices</a>. Many will convert some or all of their caseloads to telehealth after the pandemic ends. Most of our clients seem to be good with it: responding to a satisfaction survey, 85% of USF students strongly or somewhat agreed their telehealth experience was comparable to an in-person visit.</p><p>All this allows a continuity of care for clients that before was impossible; there is, however, a caveat. Because of the coronavirus, some of my clients at USF who live out-of-state have moved back home. That means, legally, I can no longer serve them. Even though they are still USF students, my license is valid only in Florida.</p><p>For telehealth to work effectively, our national system of licensing and regulation law needs to adapt. Although the federal government temporarily halted HIPAA regulations to promote telehealth during this time, not all states are allowing out-of-state practice. The coronavirus may not be here forever, but spring break and Christmas holidays always will. We need seamless telehealth across state lines.</p>
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Kevin Frayer / Stringer / Getty Images
By Jessica Corbett
Even after the world's largest economies adopted the landmark Paris agreement to tackle the climate crisis in late 2015, governments continued to pour $77 billion a year in public finance into propping up the fossil fuel industry, according to a report released Wednesday.
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