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.

"Previous publications, including ours, suggested that the main problem was in the early weeks and months of the pandemic, but this paper shows that it continued until the later stages," senior author Nicola Cherry, MD, an occupational epidemiologist at the University of Alberta in Edmonton, Canada, told Medscape Medical News.

Wave Upon Wave

In the current study, the investigators sought to compare the risk for SARS-CoV-2 infection and mental distress among healthcare workers and among community referents (CRs). They examined the following waves of the COVID-19 pandemic:

• 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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Do you know these facts? March of Dimes report and Maternal & Child Health.

-In Illinois, 34.3 percent of counties are defined as maternity care deserts compared to 32.6 percent in the U.S. 

• -4.6 percent of women had no birthing hospital within 30 minutes compared to 9.7 percent in the U.S. 

-Overall, women in Illinois have a low vulnerability to adverse outcomes due to the availability of reproductive healthcare services. 

-13.7 percent of birthing people received no or inadequate prenatal care, less than the U.S. rate of 14.8 percent. 

-Women with chronic health conditions have a 54 percent increased likelihood of preterm birth compared to women with none.

See full report here> Maternity-Care-Report-Illinois.March of Dimes.pdf

Other info here> 

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Medicaid is the primary health insurance program for low-income people in the US, offering comprehensive health care coverage to over 90 million people and ensuring millions of patients with cancer receive essential care.¹ Expanded Medicaid eligibility has been associated with increased access to care, earlier stage at diagnosis, increased receipt of cancer-directed treatment, and improved survival.² 

However, much less is known about how Medicaid variation between states influences equity of cancer care delivery. Section 1115 waivers are a key mechanism through which states can customize Medicaid enrollment, coverage, and benefits. Currently, 48 states and Washington, DC, use these waivers to modify Medicaid within the state.³ Gaps remain in our understanding of how these different 1115 waivers influence access to, receipt of, and outcomes from cancer care. Filling these gaps is critical to improve equity of cancer care in the US. [JAMA]

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