Has COVID replaced syphilis as the great imitator? At the turn of the 20th century, Sir William Osler was quoted as saying, "He who knows syphilis knows medicine." [Medscape]

If you have any doubts about the "imitator" analogy, simply use any broad search engine or AI portal and enter "what is the differential diagnosis of primary syphilis, or secondary syphilis, or tertiary syphilis?" A plethora of diseases across many body systems appears.

Another Great Pretender?

Did you or do you now have long COVID? How do you know? Do you even know what long COVID is? How would you diagnosis it?

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People who experience food insecurity are at greater risk of dying prematurely and living a shorter life after age 50, researchers say, underscoring how a fairly prevalent problem can impact individual health.[US News]

READ: 

Millions More Americans Were Food Insecure in 2022 Than 2021

The federal government says food insecurity refers to “limited or uncertain access to adequate food” – an economic and social condition that can lead to hunger. In an analysis published Monday in JAMA Internal Medicine, researchers found 78.4% of more than 57,400 U.S. adults included in the study were fully food secure, compared with 8.5% who had marginal food security, 7.4% who had low levels of food security and 5.6% who experienced very low food security.

Researchers also found estimated life expectancy at age 50 was 32.5 years among individuals with full food security, compared with 29.9 years among adults with marginal food security, 30 years among those with low food security and 28 years among individuals with very low food security.

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Healthcare workers have been at an increased risk for SARS-CoV-2 infection and mental distress such as anxiety and depression during the pandemic, according to new research. [Medscape]

In an analysis of administrative health records for about 3000 healthcare workers in Alberta, Canada, the workers were as much as twice as likely to become infected with SARS-CoV-2 compared with the overall population. The risk for infection was higher among healthcare workers in the first two waves of the pandemic and again during the fifth wave.

Wave Upon Wave

• Wave 1: From March to June 2020 (4 months)
• Wave 2: From July 2020 to February 2021 (8 months)
• Wave 3: From March to June 2021 (4 months)
• Wave 4: From July to October 2021 (4 months)
• Wave 5 (Omicron): From November 2021 to March 2022 (5 months)

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What is the effectiveness of the bivalent COVID-19 vaccines among children and adolescents aged 5 to 17 years?  [JAMA Network]

Findings  In this prospective cohort study including 2959 participants aged 5 to 17 years, vaccine effectiveness against laboratory-confirmed SARS-CoV-2 infection was 54.0% and vaccine effectiveness against symptomatic COVID-19 was 49.4%.

Although rates of SARS-CoV-2–related hospitalizations and death among children and adolescents are lower than rates in adults,¹ severe disease can still occur and lead to hospitalization, life-threatening complications (such as multisystem inflammatory syndrome in children),^2-5 and postinfection sequelae.^6-8 As of December 31, 2023, there have been at least 911 COVID-19–associated deaths among individuals aged 5 to 17 years in the US.⁹

The Omicron variant was more transmissible and included lineages with greater potential to evade vaccine-induced immunity than previous variants.^10-12 To provide protection against the Omicron variant, the US Food and Drug Administration authorized use of the bivalent mRNA COVID-19 vaccine, which was composed of ancestral and Omicron BA.4/5 strains.¹³ On September 1, 2022, the bivalent mRNA COVID-19 vaccine was recommended for persons aged 12 years or older (to be administered ≥2 months after completion of any monovalent primary series or monovalent booster dose authorized by the Food and Drug Administration), and on October 12, 2022, the bivalent COVID-19 vaccine was recommended for children aged 5 to 11 years.^14,15

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Food insecurity is a pervasive and persistent issue in the United States that disproportionately affects families with children and Black, Indigenous, and other people of color.¹ Food insecurity has been associated with psychological, cognitive, and behavioral health consequences in children, contributing to lifelong socioeconomic and health inequities.² Identifying pathways by which food insecurity affects children’s health is critical to informing intervention efforts to eliminate childhood food insecurity. We posit that toxic stress is a prominent pathway underlying food insecurity and children’s health and advocate for research, clinical, and policy approaches to better address the root causes of food insecurity and promote lifelong health. [JAMA Network]

Toxic stress refers to the biological response to experiencing a strong, frequent, or prolonged stressor without the buffering effect of a supportive environment.

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One of the city’s leading social service organizations, beset by a pair of financial crises that last year engulfed its housing and health care divisions, could be on the verge of splitting up. [Chicago Tribune]

The turmoil at the Heartland Alliance, a sprawling nonprofit encompassing five divisions providing a vast array of social services, threatens to upend important safety net programs at a time when Chicago is experiencing an influx of migrants, many of whom need help with health care and housing.

Heartland Alliance’s housing division, which grappled with inflation and declining rent collections during the pandemic, ceased operations last spring and needs buyers for the roughly 1,000 affordable units it operated in Chicago and Wisconsin.

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The children at Ruby Williams’ home day care in Austin have been drinking bottled water for years. [Chicago Sun-Times]

Williams wasn’t sure if there were any issues with the tap water in her house that’s more than a century old, but she provided the store-bought bottles to be safe.

In early 2023, the city removed Williams’ lead service line at no cost to her, she said, under a program that prioritizes the removal of the brain-damaging metal pipes from more than 1,500 home child care businesses.

Williams, who cares for six children ranging from 4 months to 3 years old, still won’t give the kids water from the faucets, though she’s grateful for the help. At a cost estimated by the city of as much $35,000 for each lead service line replacement, she couldn’t afford to foot the bill.

That city program aims to replace more than 100 lead pipes from day cares per year, putting the completion at well over a decade.

Considering the vulnerability of the kids — most of them living on the South Side and West Side — the timeline to replace the lead fixtures is unacceptably long, advocates for children say.

“Exposure to lead has severe consequences,” says Caroline Pakenham, director of water programs at the Chicago nonprofit Elevate, “including damage to the developing brain and nervous system.”

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Cook County Board President Toni Preckwinkle joined the County’s Department of Environment and Sustainability (DES), Cook County Department of Public Health (CCDPH) and nonprofit Elevate today to announce the launch of Healthy Homes for Healthy Families, a $30 million program that provides free whole-home upgrades to suburban Cook County families. The Healthy Homes for Healthy Families program aims to complete upgrades to up to 200 homes each year over the next three years.  [Cook County]

“I am excited to announce this innovative, whole home approach to improving resident well-being while increasing energy efficiency and reducing the cost burden of utilities for families in suburban Cook County,” said President Preckwinkle. “This program offers lead abatement, water conservation and deep energy retrofits to provide the maximum benefit for residents with the lowest disruption to their daily lives. Not only do the homeowners and renters in the program benefit, but all of Cook County will through the decrease in greenhouse gas emissions as a result of energy efficiency upgrades and electrification in the units.”

Funded by the American Rescue Plan Act (ARPA), Healthy Homes for Healthy Families addresses home health hazards that can have adverse effects on residents of all ages but can be especially dangerous for infants and children. The program addresses lead, radon, mold and other home health hazards that can help keep families safe and healthy. Residents may be eligible to receive upgrades such as lead abatement, structural repairs, water conservation upgrades, weatherization and installation of high-efficiency appliances. All upgrades are performed by licensed contractors. 

“Home health hazards, such as lead, can cause children to experience learning disabilities and developmental delays; and mold can trigger coughing, wheezing and asthma,” said Dr. LaMar Hasbrouck, chief operating officer of CCHDP. “Healthy Homes for Healthy Families is an essential step toward ensuring that the homes of our residents are as healthy as possible.”

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The mental health of youth across the globe is in crisis. Indeed, the United Nations International Children’s Emergency Fund (UNICEF) and World Health Organization (WHO) Joint Programme on Mental Health and Psychosocial Well-being and Development of Children and Adolescents were developed in response to their conclusion that “…across the world, the lives of millions of children, adolescents, and their caregivers are limited by poor mental health and well-being.”^1(p3) 

The American Academy of Child and Adolescent Psychiatry (AACAP) and the American Academy of Pediatrics (AAP) have declared a state of emergency, citing increasing rates of youth mental health concerns between 2010 and 2020 that have been intensified by the COVID-19 pandemic.² That youth mental health is in such dire straits is particularly striking given that many measures of global physical health in young people are improving.¹     

^{[JAMA Network]}

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The U.S. Centers for Disease Control and Prevention (CDC) on Monday estimated COVID subvariant JN.1 to account for about 85.7% of cases in the United States, as of Jan. 19. [Medscape]

The agency said JN.1 remains the most widely circulating variant of SARS-CoV-2 in the country and globally.

There is no evidence at present that JN.1 causes more severe disease than other variants, the CDC said, adding that currently available vaccines are expected to increase protection against the variant. 

The predicted range of 83% to 88% marks an increase from the estimated prevalence of 55% to 68% of cases in the U.S., as per the agency's projections from Jan. 5.

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