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HEALTH

These Are the Long-Term Side Effects of COVID-19

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When the COVID-19 pandemic began, we could rattle off the symptoms from the top of our heads: fever, dry cough, and difficulty breathing. Later, the NHS here in the UK and the Centres For Disease Control and Prevention (CDC) in the US added more symptoms to that list: chills, muscle pain, headache, sore throat, a new loss of taste or smell, and repeated shaking with chills. Nausea and diarrhoea are also listed as signs of the disease.

But as the pandemic continues, doctors are starting to look more closely at not just the first signs of infection, but the long-term side effects that linger even after you’ve recovered. Concern over longer-lasting side effects has even prompted the CDC to begin a large study on patients hospitalised with COVID-19 in order to “describe long-term outcomes and come to a fuller understanding of the overall impact of the coronavirus on the health system,” among other goals. Around 3,000 adult patients will be enrolled.

It will likely take some time for doctors to fully understand how this disease affects our health in the long term. Ahead, read what doctors and survivors are reporting now on the lingering effects of the coronavirus on body and mind.

POPSUGAR aims to give you the most accurate and up-to-date information about the coronavirus, but details and recommendations about this pandemic may have changed since publication. For the latest information on COVID-19, please check out resources from the WHO, the NHS, and GOV.UK..



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NEWS

How Wellville is trying to shift the conversation around long-term community health

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The nonprofit health initiative known as Wellville was launched in 2014 with the mission of demonstrating how and why individuals and communities should invest in long-term health.

In pursuit of this goal, Wellville chose a diverse group of five communities across the United States to act as labs and test cases to hopefully drive larger change at the community, state and national levels.

Wellville CEO Rick Brush will participate in a fireside chat at the MedCity Pop Health event in New Orleans on May 22 where he will lay out examples of the progress made and challenges faced by Wellville communities in their quest for better health. Buy tickets for the event here.

Brush is a longtime healthcare executive and advisor who was part of the team that helped Cigna launch its Communities of Health venture, a multi-site initiative that convened public-private stakeholders to address social determinants of health. Brush has also been a leader in developing and implementing new models that allow stakeholders to pay for preventive health measures through long-term benefits and cost savings.

Those experiences led Wellville Executive Founder Esther Dyson to tap him as the organization’s CEO with the responsibility of overseeing the nationwide program back in 2013.

In the intervening years, Brush said he and the organization have learned a lot about how best to act as a facilitator to help communities set and meet their own internal health goals.


Attend MedCity INVEST Pop Health to hear Rick Brush speak about Wellville’s innovative approach to community health. Save an additional $50 using the MCN50 code. Register now.


Since the initial germination of Wellville, the initiative has shifted from competitive structure to a collaboration and the length of the program itself was extended from five to 10 years.

“Everything we’ve done has been a learning experience. This work takes time and building trusting, effective collaborations takes time,” Brush said. “Because this is initiative in a longer time frame it has allowed communities to look upstream and not be solely focused on what they’re seeing in the emergency room.”

In fact, Brush said a major role played by Wellville has been helping to focus community health priorities around longer term goals that can be addressed by preventive instead of treatment-based solutions.

“It’s really hard when your nose is to the grindstone to be able to step back and do that assessment. Our diagnosis of the problem is that across the board short term thinking has led to suboptimal results,” Brush said.

“A lot of what Wellville is doing is helping communities apply that questioning to understand where short term thinking is leading to the results they’re getting and what kind of work, collaboration, investments can be made that point towards long term shared benefits.”

Wellville has also helped to develop the business case and models to make investing in community health a long-term sustainable strategy. While this means engaging traditional healthcare stakeholders, the organization is diving much deeper into collective investment from a range of partners not limited to health systems and health plans.

One example in the Wellville community of Spartanburg, South Carolina has been Hello Family, a program meant to improve health outcomes for families and children from the prenatal stage to the first five years of life. Interventions range from clinician home visits for at-risk moms to parenting education programs to early learning and kindergarten readiness.

With Wellville’s assistance, Spartanburg is looking to quantify benefits from program to the community at-large, taking into account the local health system, the city itself, the school district and state and federal programs. The goal ultimately is to try and develop a Pay for Success program that engages investment from across these groups.

“This is important because it shows there are methods of investing together in programs that have benefits beyond a single financial stakeholder,” Brush said.

Another instance was the formation of a health industry collaborative in Lake County, California helping to fund new transitional housing centers that act as a bulwark against homelessness and a central point for social and behavioral health services. The centers have led to proven savings in both healthcare and social services costs.

When given a chance to reflect on his own learnings, Brush said he’s gained a much greater appreciation in the role of policy in setting the framework to enable greater change within the community.

Additionally – even as his group looks to drive larger community change – Brush highlighted the role of the individual in being the continual spark plug necessary to push past inertia and skepticism.

“There is something to be said about what an individual is willing to bring. The level of courage and conviction that is necessary to move this work forward, which at almost every turn is pretty challenging,” Brush said.

“As much as I’d like to say that all of the institutions, local governments and neighborhoods are onboard with this work. The truth is that it is still dependent on the individuals leading those groups.”

Picture: noipornpan, Getty Images

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WEIGHT LOSS

Long-Term Health Risks of the Keto Diet

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Long-Term Health Risks of the Keto Diet – Health

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GenSight eyes long-term followup as second gene therapy vision loss trial misses target

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A French biotech company is hoping that longer-term follow-up data will vindicate its gene therapy for a disease that causes vision loss following its second failed Phase III study.

Paris-based GenSight said Monday that the Phase III RESCUE study of GS010 in Leber hereditary optic neuropathy, or LHON, did not meet its primary endpoint. The endpoint was for patients to show a 15-letter improvement on the ETDRS visual acuity test compared to baseline. However, patients whose eyes were treated with the therapy showed only a 13-letter improvement, whereas when their eyes were given a sham treatment, there was an 11-letter improvement. Each patient received the gene therapy via injection in one eye and sham injection in the other.

The company is now pinning its hopes on longer-term follow-up data that it hopes will show the therapy’s efficacy. “The planned readouts of RESCUE data at Weeks 72 and 96 should confirm GS010’s efficacy,” GenSight Chief Medical Officer Barrett Katz said in a statement, based on a long-term followup from its previous Phase III study.

However, investors were not impressed. The company’s shares opened down 21.3 percent on the Euronext Paris stock exchange following the news Monday, falling from 2.82 euros per share at Friday’s closing to 2.22.

Still, an initial failure, followed by longer-term data that indicated efficacy better than previously thought, would be consistent with the company’s previous Phase III trial of the therapy, titled REVERSE. In the case of that study, whose initial results were reported last April, the primary endpoint was not met because both eyes – the one treated with GS010 and the one that received the sham treatment – showed an improvement in visual acuity of 11 letters. But in 72-week followup data announced in October, the data showed that treated eyes had an increase in visual acuity of 15 letters, compared with 12 letters for sham-treated eyes.

One difference between REVERSE and RESCUE is that RESCUE enrolled patients whose vision loss due to LHON occurred up to six months before they started treatment, whereas REVERSE patients’ vision loss occurred six to 12 months prior to treatment. In LHON, vision usually reaches a nadir in three to five months before stabilizing, though the duration of that progression to nadir varies between patients. In RESCUE, mean best-corrected visual acuity for GS010-treated eyes and sham-treated eyes evolved with similar trajectories, worsening to a low point before improving at week 48.

Another Phase III study, REFLECT, dosed its first patient in March. That trial will evaluate bilateral injections of GS010 in patients up to one year from onset of vision loss. GS010 is an adeno-associated viral vector-based gene therapy. LHON is a maternally inherited disease that causes irreversible vision loss and can lead to legal blindness.

Photo: erhui1979, Getty Images

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NEWS

The NHS long-term plan: Digital ambitions

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Every time a plan is published for the NHS, the health IT community holds its collective breath for a moment as it waits to see how its digital fortunes will fare. Fortunately, on this occasion a plan has been published with the backing of a health secretary that few could argue is not profoundly embracing technology. However, amidst the collective sigh of relief, we have to probe more closely about the key themes that have emerged and what they mean in practice.

For me, there were three elements that jumped out in the plan that are clearly related to one another – access, interoperability and security. These are not new themes but they have definitely gathered steam in the last 18 months. For example, telemedicine has been around for a generation, but it is only now that providers of app-based video consultation services seem to be gaining traction within the NHS, albeit not without controversy.

Meanwhile, interoperability has been a raging issue between healthcare providers and vendors so much so that the government has stepped in to support the development of regional Local Health and Care Record Exemplars (LHCREs). Finally, cybersecurity has continued, with good reason, to be a part of the conversation at all levels, and the NHS has actually made great strides in improving its risk posture in a way that is actually enviable for other health systems. That, perhaps, is the silver lining that came from WannaCry.

Yet, when I look at these themes I don’t study them in isolation. If we want to empower people to live healthier lives and patients to take control of their information, then we have to make sure they can trust the systems we are giving them access to. Trust means having easy to use systems that are accurate and secure.

Easier said than done. It’s not enough to only have video consultation services operating in isolation and only useful for a small segment of digital savvy users who need to refill non-urgent prescriptions. We need video services to be part of an interoperable digital framework that means patient care can be managed seamlessly across the entirety of the NHS’s services from diagnosis to intervention to rehabilitation and social support. That means interoperability across a plethora of systems.

Moreover, when you interconnect an increasing number of services then you risk creating adding many more vulnerabilities into a network therefore creating opportunities for attackers to cause chaos.

It’s critical that there are significant standards that vendors and healthcare providers need to follow to make sure not only that they minimise technical risks, but know what to do in the event of a cyber-attack to protect their patients clinically and to prevent a threat spreading far and wide. That applies, of course, to small companies as much as it does large ones, and if one group of companies does concern me it is the telemedicine start-up community.

Overall, the ten-year plan has the right message. It is unabashedly pro digital and that is great. It is up to us now in the health IT community to embrace this by focusing on the details to make sure we keep moving forward successfully on our collective digital transformation journey.

Dr Saif Abed is the founding partner of health IT consultancy firm AbedGraham.

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