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He Thought It Was the Flu, however He Had By no means Been So Sick

He Thought It Was the Flu, but He Had Never Been So Sick

Whatever the cause, she told the anxious young man, his muscles would recover. But his kidneys were in danger. His urine was dark because the oxygen-carrying parts of the muscle known as myoglobin were collecting in the kidneys. Myoglobin is a dark red color; it’s why muscle is red. The most important thing the medical team was doing for him right then was giving him fluids to help his kidneys flush out myoglobin and other components released by the damaged muscle.

Ue ordered additional tests to track the patient’s creatine kinase. On admission, his total C.K., initially reported at over 40,000, had actually been 189,000. It peaked the next day at nearly twice that: 364,000. Ue kept the IV fluids going and looked for a reason for the worst case of rhabdo she had ever seen. It wasn’t hepatitis or any of the common viruses they tested for. It wasn’t Wilson’s disease. It wasn’t any of the drugs she checked for.

What else? In search of an answer, she turned to the medical literature and found a paper describing two young people who, like her patient, developed severe rhabdo after a moderate workout. The writers listed factors that could predispose a patient to having this kind of muscle injury, and Ue found what she was looking for. There are people born with abnormalities in how their bodies use the fuel provided by the foods they eat. Because of this abnormality, when stressed or working hard these people could quite literally run out of fuel. Could he have one of these rare inherited diseases? To answer that question, after the patient recovered enough to leave the hospital, Ue referred him to a neurologist who specializes in neuromuscular diseases.

It was months later when the patient had enough of a break in his schedule to make an appointment to see Dr. Courtney McIlduff, a neurologist at Beth Israel Deaconess Medical Center in Boston. Since his week in the hospital, the man reported, he had two more episodes — though neither as severe as the first. Both happened after he took an easy walk. Hearing that, McIlduff, like Ue, began considering an inherited problem in turning food into fuel. These so-called metabolic myopathies sometimes didn’t reveal themselves until adolescence or even adulthood.

McIlduff examined the man carefully, looking for muscle weakness. Many forms of muscle disease can permanently alter how muscles look or work, but most metabolic myopathies don’t. The patient’s muscle exam was completely normal. She sent him to get genetic testing, to look for one of the several inborn errors of metabolism.

And indeed, he had one: He was born without the ability to make an enzyme called carnitine palmitoyltransferase type 2. Patients with CPT2 deficiency are missing the necessary biological equipment to turn some dietary fats into energy. Normally the body runs on a type of sugar made from carbohydrates and stored in the liver. When that sugar is used up, the body switches to fat for fuel. Patients with CPT2 deficiency can’t do that, or at least not well. Without the proper fuel, the muscle cells are injured and release their contents, causing the pain and dark urine. Neither of the man’s parents have this disorder, but they both have one copy of the erroneous gene for this enzyme. It takes two copies to get the disease, and so their son got one copy from each of them.

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Lengthy Covid check may quickly be accessible, researchers hope

Long Covid test could soon be available, researchers hope

Shalonda Williams-Hampton, 32, has her blood drawn by Northwell Health medical staff for the antibody tests that determine if a person has immunity to coronavirus disease (COVID-19) at the First Baptist Cathedral of Westbury in Westbury, New York, has developed. 05/13/2020.

Shannon Stapleton | Reuters

“Long Covid” – the name for persistent symptoms that millions have reported after being infected with Covid-19 – is here to “haunt us for a while,” according to a scientist studying the effects of the disease. But there is hope that a diagnostic test may be developed soon.

Symptoms of long-term Covid vary, but may include persistent tiredness, shortness of breath, memory loss or difficulty concentrating (referred to as “brain fog”), insomnia, chest pain, or dizziness. However, it remains a poorly understood condition and scientists do not yet know why some people continue to have some symptoms after Covid and others do not.

Data recently collected in a UK study suggested that millions of people could be affected by long-term Covid following coronavirus infection. To date, more than 187 million cases of Covid have been registered worldwide. Given this number, the potential number of people who could be affected by long-term Covid is significant.

Danny Altmann, a professor of immunology at Imperial College London, told CNBC on Tuesday that “the data (on long Covid) is coming through thick and fast and what they say of the 170 million people on the planet who are infected with this virus that 10-20% of them will have long-term persistent symptoms. “

“What you see are people with wheezing or shortness of breath, fatigue and brain fog and this long list of about 50 symptoms. So it’s really a thing and a thing that will haunt us for a while. It’s a price we’re paying we have to and we have to look at people’s lives and jobs and health care for them, “he told CNBC’s Squawk Box Europe.

Altmann found that data on long Covid “were very reproducible all over the world, regardless of whether you are looking in China or Bangladesh or France or the USA”.

Scientists consider organ damage due to a Covid infection, problems with the immune system after an infection or reactivation of the virus as possible causes of long Covid; or maybe a combination of factors.

A UK study published last October identified the main factors that increase the likelihood of patients suffering from the coronavirus over the long term, including age, weight and gender. But further research gives hope that there may soon be a test to diagnose the poorly understood, but often life-changing condition.

Tests for long Covid?

Altmann from Imperial College is part of a team that has been researching Covid and analyzing blood samples from those who have it to find the cause.

In a preview of their early results on Monday evening on the BBC’s Panorama program, the team said it found that irregular antibodies were common in blood samples from people with long-term Covid.

Usually the immune system creates a protective response by making antibodies to fight a virus, but sometimes it goes wrong and “autoantibodies” – sometimes called “rogue antibodies” – are produced that attack healthy cells.

Altmann’s researchers found that such autoantibodies were widespread in people with long Covid, although only a few blood samples were analyzed in the pilot study. However, autoantibodies were found in comparative blood samples from people who recovered quickly from the virus or who never tested positive for Covid-19.

Still, the detection of such irregular antibodies in people with long Covid could pave the way for a simple diagnostic test that analyzes a person’s blood. If autoantibodies are found, long Covid could potentially be diagnosed; and this, in turn, could help create treatment and recovery plans for patients.

Speaking to the BBC, Altmann said the results could not yet be called a breakthrough, but they were “very exciting progress”.

“One of the things that we know with absolute certainty is that Covid can result from any type of infection for a long time: asymptomatic, light or severe,” he told Panorama.

“The pilot data we have says that you can really see different patterns of autoimmunity in people with long Covid,” he said. Although more research needs to be done, Altmann said he was optimistic that there could be a simple blood test that can diagnose long Covid within six months.

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The Actual Toll From Jail Covid Circumstances Might Be Greater Than Reported

The Real Toll From Prison Covid Cases May Be Higher Than Reported

An increase in deaths across the country in the past year, past the well-known Covid-19 toll, has led health experts to suggest that some virus cases have gone undiagnosed or have been attributed to other causes. There have also been inconsistencies and changing guidelines on which deaths should be considered coronavirus deaths.

Public health officials say the prospect of missed deaths from viruses linked to the country’s prisons, jails and immigration prisons is particularly risky. It is a challenge, say the experts, to prepare prisons for future epidemics without knowing the full toll. Currently, most of the publicly known death tolls related to incarceration have come from the facilities themselves.

“You can’t make good public policy if you don’t know what’s actually going on on the ground,” said Sharon Dolovich, director of the Covid Behind Bars Data Project at the University of California at Los Angeles, which tracks coronavirus deaths in American prisons .

Prison and prison officials defended their methods of counting inmate deaths from coronavirus, saying they followed all state and local documentation requirements. Some noted that their role was to track deaths in “custody” and suggested that including the deaths of those recently in their care but no longer in their care is both complex and complex It would be impractical and possibly even overstate the number of virus cases related to the facilities.

“It is unfair to expect prisons to somehow take responsibility for what happens to people when they are released from our custody,” said Kathy Hieatt, a spokeswoman for the Virginia Beach Sheriffs Office that held Mr. Melius. “We follow law and the Virginia Department of Corrections’s extensive standards for investigating and reporting those who die in custody. In no way is it necessary to report deaths of former inmates. ”She added,“ It is absurd to think that we could somehow keep an eye on these thousands of people and take responsibility for them. ”

Throughout the pandemic, prison systems have used different methods to publicly report Covid-19-related deaths. Nevada’s prisons say they notify state health officials of inmate deaths from Covid-19 but do not make them public. Mississippi prison authorities said no inmates had died from the coronavirus at their facilities before announcing in January that nearly two dozen prisoner deaths were related to Covid-19.

Updated

July 13, 2021 at 4:53 p.m. ET

And in Texas, a prison medical committee is re-examining any case where a coroner said Covid-19 was one of the causes of death and has sometimes overridden previous findings, according to Jeremy Desel, a spokesman for the state prison system. Shelia Bradley, a 53-year-old prisoner, was reported to have died by a coroner as of “bacterial and possibly fungal pneumonia, a complication of Covid-19”, but the committee concluded that she died of “acute bacterial bronchopneumonia”. without listing Covid-19.

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This is a map displaying the place low vaccination charges meet excessive case counts as infections surge

Here's a map showing where low vaccination rates meet high case counts as infections surge

In more and more US states with low vaccination rates, Covid cases are rising, exposing residents to the risk of “unnecessary” infections, hospitalizations and possibly death as the Delta variant rips across the country, according to US health officials.

“After several weeks of falling case numbers followed by a long plateau, we are now seeing an increase in the number of cases in many parts of the country,” said Dr. Jay Butler, CDC assistant director, infectious diseases, on a call hosted Tuesday by an industry group. Hospitalization rates, which tend to lag behind confirmed cases, are similarly starting to rise, he said.

A CNBC analysis of US vaccination rates and Covid cases shows that there are 463 counties in the United States with high rates of infection – which have reported at least 100 new cases per 100,000 residents in the last week – more than double the US rate . The majority of these counties, 80%, vaccinated less than 40% of their 23 million residents, analysis shows data from the Centers for Disease Control and Prevention and Johns Hopkins University.

More than half of the counties in Missouri, Arkansas and Louisiana have low vaccination rates and increased Covid cases, according to CNBC analysis. These three states had some of the highest cases per capita in the country in the past seven days as the spread of the Delta variant increased in southwest Missouri.

“There will continue to be an increase in cases among unvaccinated Americans and in communities with low vaccination rates, especially given the spread of the more transmissible Delta variant,” Jeff Zients, White House Coronavirus Response Coordinator, told a news conference last week . Virtually all Covid hospital admissions and deaths, 99.5%, occur in those who have not been vaccinated, US officials say.

In fact, nationwide cases are on the rise again as the highly transmissible delta variant asserts itself as the dominant strain in the US. The seven-day average of newly confirmed Covid cases has risen to about 23,300 per day, almost double the weekly average, according to data from Johns Hopkins before.

The rise of the Delta variant has spurred officials in some states like Mississippi to issue new calls for masking and social distancing, especially among older and more vulnerable residents.

“When the Delta strain emerged (in Utah) it quickly became the dominant strain, and by dominant I don’t mean 50%. For the last full week of data, more than 80% of the sequence viruses were Delta viruses and so far this week are it is 92% of all variants, “said Dr. Andrew T. Pavia, director of the Department of Pediatric Infectious Diseases at the University of Utah School of Medicine, in a call hosted Tuesday by the Infectious Diseases Society of America.

“If you think about what it means to have such a rapid virus takeover, it means that it is the most suitable virus, that it spreads more efficiently, that it spreads in unvaccinated pockets, and many diseases cause a lot of stress inside” , he added.

Mississippi has given at least one injection to just 37% of its population, making it last in the country. Officials there urged people over 65 and immunocompromised residents to avoid indoor mass gatherings in the next two weeks in the event of “significant transmission” of the Delta variant in the coming weeks.

“We don’t want anyone to die unnecessarily,” said Dr. Mississippi State Health Commissioner Thomas Dobbs during a news conference Friday.

According to Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, as successful in preventing serious illness, hospitalizations and deaths from the Delta variant.

Breakthrough infections are rare, and around 75% of people who die or are hospitalized after being vaccinated with Covid are over 65 years old, according to the CDC.

“Preliminary data for the past six months suggests that 99.5% of deaths from Covid-19 in the states have occurred in unvaccinated people … the suffering and loss we see now are almost entirely preventable,” Walensky said Earlier this month.

In addition to the risk of disease for Americans who have not yet received a vaccination, unvaccinated sections of the population could threaten the country’s ability to control the pandemic. Continued transmission of the virus means additional opportunities for new variants to emerge with the ability to bypass vaccine protection.

While 48% of Americans are fully vaccinated, the pace of daily vaccinations has slowed significantly in recent months. According to CDC data, an average of about 515,000 vaccinations were administered daily for the past week, after a steady decline from the peak of more than 3 million daily vaccinations.

President Joe Biden renewed his administration’s efforts to increase vaccination rates after failing to meet his July 4th goals, with a focus on youth and increasing availability in places like doctor’s offices and work environments.

Nearly 1,600 counties in 40 states with 72 million people have vaccinated less than 40% of their population, according to CNBC analysis. Six states where vaccination data were not available at the county level were excluded from the analysis.

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Biden to Nominate Rahul Gupta to Run Nationwide Workplace of Drug Management Coverage

Biden to Nominate Rahul Gupta to Run National Office of Drug Control Policy

Charleston’s program was nationally recognized, but it was criticized by the city’s mayor when Dr. Gupta was the health commissioner. Dr. Gupta’s department issued an audit that found fault with the program, including shoddy record keeping, which led to the program’s decertification after the city had already shut it down.

Public health experts said its closure had a chilling effect on other programs, and kept some from getting off the ground.

As a state health official, Dr. Gupta had no authority to stop the closure. In a 2018 interview with West Virginia Public Broadcasting shortly before he left the health commissioner’s job, Dr. Gupta said that the closure was “not in the best interest of the community” and that needle exchange programs like Charleston’s should not be shut down “reactively.”

But critics faulted him for not using his platform forcefully enough to defend the program.

Gregg Gonsalves, an epidemiologist at Yale University and a longtime AIDS activist, on Tuesday called Dr. Gupta a “terrible choice” who “represents a return to the old ways of thinking about drug use in America, and is not the forward-thinking leader we need right now.”

Other experts said that Dr. Gupta was caught in a difficult situation with the battle over the syringe exchange. Mr. Raymond, while describing the closure of the Charleston program as “a tragedy,” called Dr. Gupta an “excellent choice.” That assessment was echoed by Dr. Joshua M. Sharfstein, a public health expert at Johns Hopkins Bloomberg School of Public Health who worked with Dr. Gupta to address the opioid crisis in West Virginia.

“He knows the value of syringe service programs, he understands the evidence on harm reduction and he is very supportive,” Dr. Sharfstein said. “West Virginia is a very difficult environment for discussion of these topics, and he had to navigate under those constraints.”

The White House announced the selection of Dr. Gupta in a statement on Tuesday, along with 10 other nominations, including that of Jeff Flake, the former Republican senator from Arizona, to be the ambassador to Turkey and that of the writer Atul Gawande to a post at the U.S. Agency for International Development.

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Hospitalizations rising once more as delta variant spreads among the many unvaccinated, medical doctors say

A mobile Covid-19 vaccination center outside Bolton City Hall in Bolton, where the number of cases of the Delta variant identified for the first time in India was relatively high.

A mobile Covid-19 vaccination center outside Bolton City Hall in Bolton, where the number of cases of the Delta variant identified for the first time in India was relatively high.

Peter Byrne | PA pictures | Getty Images

Top infectious disease specialists say the spread of the Delta variant over unvaccinated parts of the country is causing flares and spikes in hospital admissions as cases rise.

The number of cases is on the rise again nationwide, as the highly transferable variant prevails as the dominant burden in the USA.The seven-day average of the newly confirmed Covid cases has risen to around 23,300 per day, almost twice as high as the average a week ago . according to data compiled by Johns Hopkins University.

Health officials and doctors have hoped that high vaccination rates among the most vulnerable and oldest Americans would also prevent hospitalizations, which are generally delayed by a few weeks. But that hasn’t happened before, doctors said in a call hosted Tuesday by the Infectious Diseases Society of America.

“Hospital admissions and ICU deaths are all lagging behind (new cases), so we expect these to get worse, much worse, over the next two to three weeks,” Dr. Andrew T. Pavia, director of pediatric infectious diseases at the University of Utah School of Medicine, said on the call.

Hospital stays are on the rise again as the Delta variant spreads among the unvaccinated, doctors say doctors

After several weeks of declining infections, cases are rising again in many parts of the country, said Dr. Jay Butler, associate director of infectious diseases at the Centers for Disease Control and Prevention, on the conference call. “Unfortunately, this has also been accompanied by an increase in hospital admissions and emergency room reviews for people who have ultimately been confirmed to have Covid-19,” he said.

Since the Delta variant is spreading in the US, it hits states with low vaccination rates particularly hard. First discovered in India in October, the variant quickly spreads to more than 100 countries around the world and has established itself as the dominant variety in America in just a few weeks.

“When the Delta strain emerged, it quickly became the dominant strain … For the last full week of data, more than 80% of the viruses sequenced were Delta viruses, and this week 92% of all variants” (in Utah) said Pavia. “When you think about what it means for a virus to spread so quickly, it means that it is the most suitable virus that spreads more efficiently, that it spreads in unvaccinated pockets, causing a lot of disease and a lot of stress . “

In Missouri, Arkansas, Nevada, Utah, and Florida, cases have risen faster than any other state in the past few weeks. New infections and hospital admissions are highest in rural areas, where vaccination rates are low, Pavia said. “That’s what drives outbreak vulnerability.”

In Utah, infection rates are highest among young people ages 15 to 45, and hospital admissions are similarly higher in these younger age groups than they were earlier in the pandemic, he said.

About 80% of Americans over 65, the most vulnerable population group, are fully vaccinated, which helps reduce hospital costs. Scientists have yet to figure out whether or not the Delta variant makes people sicker than the original ancestral tribe.

US health officials and doctors still disagree on whether or not a booster vaccination will be required in the fall or winter.

“We don’t see any evidence at this point that people who were vaccinated last December or January have declining immunity and are at greater risk of breakthrough infections,” said Butler, of the CDC.

Based on statements made by World Health Organization officials Monday, Butler also said that breakthrough cases are often milder and that vaccines are extremely effective at reducing hospital stays and deaths.

“There’s even evidence that people with breakthrough infections who are fully immunized shed fewer viruses … this may reduce the risk of spreading it to others,” Butler said.

The WHO recently recommended that both vaccinated and unvaccinated people continue to wear masks and practice social distancing, citing the reduced effectiveness of the vaccine against the Delta variant and increased social mixing in countries with different vaccination rates.

“Everyone wants this to be over, and a lot of the behavior that I think is driving the spread of infection is people wanting it to be over, and pretending it’s over, and even really give up the more humble precautions like wearing masks. ” said Pavia.

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As Virus Instances Pace Up, Seoul Tells Fitness center Customers to Sluggish Down

As Virus Cases Speed Up, Seoul Tells Gym Users to Slow Down

Kang Seung Hyun, a teacher and former rugby player preparing for a fitness photo shoot, said his gym decided to turn off the treadmills instead of imposing the slow pace. However, the bikes remained open for reasons he did not understand.

“So we can’t run or use the treadmills, but we can ride bikes? It seems strange to me, ”he said.

Ralph Yun, a CrossFit instructor who has been teaching for five months, said listening to music at a pace similar to your heart rate can improve performance, but it doesn’t necessarily make you harder.

“You could listen to slow music and train just as intensely,” he said.

Costas Karageorghis, a professor at Brunel University in London who has studied the effects of music on training for 30 years, was amused by the recommendations and called them “ridiculous”.

“If people are motivated enough to train at high intensity, the music can’t stop them,” he said.

However, research has shown that music can make significant changes to exercise even if it wasn’t what the Korean authorities intended.

Dr. Karageorghis said the sweet spot for aerobic exercise, like running on a treadmill or cycling, is 120 to 140 beats per minute. Music can distract the mind from feelings of fatigue, diminish your perception of how hard your body is working, and improve your mood. Loud music above 75 decibels can make a workout more intense, although very loud music carries the risk of hearing problems such as tinnitus.

He said he was not surprised that health officials chose 120 strokes, as research has shown that this was, in some ways, a “key break.” It’s about twice the lower end of a healthy resting heart rate, and 120 steps per minute is a common walking pace, he said. Wedding DJs have told him they’ll use a 120-beat song to get people onto the dance floor (Whitney Houston’s “I Wanna Dance With Somebody” checks in at around 120).

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Dr. Anthony Fauci says speak of Covid booster photographs does not imply vaccines aren’t working

Dr. Anthony Fauci says talk of Covid booster shots doesn't mean vaccines aren't working

The Senior Medical Advisor to the White House, Dr. Anthony Fauci told CNBC on Tuesday that Covid booster vaccinations are currently unnecessary.

“The discussion about boosters is really adequate preparation on the part of the [drug] Company are working with the NIH and CDC and others to be prepared in the event you may need a boost, “Fauci said in the Squawk Box.

“But if you translate that into ‘We’re going to need a boost; everyone is going to get a boost’, that’s not appropriate. We still haven’t vaccinated enough people in the main part of it,” he added, emphasizing the booster discussion. ” has absolutely nothing to do with the effectiveness of the vaccine “.

With schools reopening in the fall and the spread of new coronavirus variants, questions are circulating about the need for booster vaccinations, even if the pace of primary vaccinations in the US has slowed since the spring.

On Monday, Pfizer officials met with federal health officials to advocate for the potential need for Covid boosters as the drug company prepares for US approval of a third dose of its current vaccine.

Pfizer announced last week that it is also developing a booster vaccine to combat the highly transmissible Delta variant – now the dominant strain of the virus in the US – and said the immunity was boosted by its Two, developed with German partner BioNTech Shot vaccine wears off.

However, the Centers for Disease Control and Prevention and the Food and Drug Administration released a joint statement blaming Pfizer’s insistence on a third dose, saying that fully vaccinated Americans do not currently need a booster dose.

The officials’ conversation with Pfizer was mostly “a courtesy meeting,” Fauci, director of the National Institute of Allergies and Infectious Diseases, also told CNBC on Tuesday. He said the real question right now is how long protection against the vaccines will last and at what level of protection, a view shared by other health experts.

Former Obama administration official, Dr. Kavita Patel told CNBC on Monday ahead of the Pfizer meeting that booster shots seem like “inevitable” due to newer variations, but questioned when it will happen. She also stressed that when discussing boosters in the US, it is important to take into account the global impact on vaccine adoption in other parts of the world.

Dr. Ashish Jha, dean of Brown University’s School of Public Health, told CNBC on Friday that he had “seen no evidence yet of anyone needing a third injection”.

According to CDC data, the majority of Americans were vaccinated with Pfizer, followed by the two-shot Moderna vaccine and Johnson & Johnson’s single-shot course. More than 184 million people in the United States, or 55.5% of the population, have had at least one injection. Almost 160 million people, or 48% of the population, are fully vaccinated.

Fauci also told CNBC on Tuesday that he would be “amazed” if Pfizer, Moderna and J & J’s coronavirus vaccines don’t get full approval from US drug regulators. These three vaccines are the only ones approved by the FDA in the United States, and they were approved for emergency approval.

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Waking Up within the Center of the Evening? Methods to Fall Again Asleep

Waking Up in the Middle of the Night? Ways to Fall Back Asleep

It is normal to wake up a few times during the night as the brain goes through various phases of deeper and lighter sleep. Older people too often have to get out of bed once or twice at night to use the toilet. Waking up at night is usually harmless. Most people have no problem getting back to sleep and may not even remember their nightly awakenings the next morning.

However, if you frequently wake up in the middle of the night and have trouble getting back to sleep, this could be an underlying problem. If this happens at least three times a week for at least three months, it could be chronic insomnia, said Dr. Kannan Ramar, a sleep specialist at Mayo Clinic in Minnesota and past president of the American Academy of Sleep Medicine.

Two of the main causes of insomnia are stress and anxiety. If you wake up and look at the clock and then worry about getting rested for work the next day, paying your bills, or experiencing other life stresses, it could activate your sympathetic nervous system, called the fight-or-flight response . The adrenaline level, the so-called stress hormone, rises, increases the heart rate and leads to a state of increased excitement, which makes falling asleep particularly difficult.

“You might ask, ‘Is this the same time I woke up last night? Why does this always happen? ‘”Said Dr. Ramar. “These thoughts are not helpful in getting back to sleep.”

If you find you have been awake for 25 minutes or more, experts advise you to get up and do some quiet activity that calms your mind – all to suppress the stressful thoughts that were keeping you awake. Gentle stretches or breathing exercises can help, as can meditation, which has been shown in studies to help combat chronic insomnia. You can sit on the couch and knit or read a book or magazine in low light. Experts recommend not reading on smartphones, as the blue light these devices emit can suppress the production of melatonin, the hormone that makes us sleepy. However, you can pull out your phone to use a calming app like Calm or Headspace that is designed to help you sleep and meditate.

Finally, if you start to feel tired, go back to bed and try to doze off. Then, the next day, practice the following sleep hygiene habits to increase your chances of getting a sound sleep through the night.

  • Limit your evening alcohol consumption. In small amounts, alcohol can act as a sedative and make you fall asleep faster. But it can also cause you to wake up in the middle of the night as your body metabolizes it. Studies show that consuming alcohol before bed can lead to poor quality sleep.

  • Avoid consuming caffeine after 2 p.m. as it can linger in your body well into the evening. If you have a cup of coffee at 3:30 p.m., about a quarter of the caffeine may still be in your system 12 hours later.

  • Avoid napping late in the day as it can make it difficult to fall asleep and stay asleep at night. Taking long naps will reduce what scientists call your homeostatic sleep drive, which is essentially the pressure on your body to fall asleep in the evening. If you want to take a nap during the day, do it in the morning or early afternoon and keep it short, no more than 30 minutes. “The closer you get to bedtime or the longer the nap, the more likely you are to get into trouble,” said Dr. Sabra Abbott, Assistant Professor of Neurology in Sleep Medicine at the Feinberg School of Medicine at Northwestern University in Chicago.

  • Keep a strict sleep schedule. Waking up and going to bed at irregular times can mess up your body’s circadian rhythm, the innate 24-hour cycles that tell our bodies when to wake up and fall asleep, making it difficult to stay asleep. Try to get up at the same time each morning (aim to get at least 15 minutes of morning sun, which will help stop melatonin production) and go to bed at the same time in the evening. Studies show that people with irregular sleeping schedules are more likely to develop symptoms of insomnia.

  • If you get up to use the toilet frequently, try to limit the amount of water or other fluids you drink two to four hours before bedtime.

If these measures don’t help, a sleep specialist can assess whether you may have a more serious underlying problem, such as sleep apnea or restless legs syndrome, that needs medical attention. A sleep clinic could also put you in touch with a cognitive behavioral therapist who could help you identify and treat specific behaviors that could be causing your chronic insomnia.

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Europe struggles to interrupt freed from Covid restrictions as delta variant surges

Europe struggles to break free of Covid restrictions as delta variant surges

People celebrated the end of the coronavirus curfew in Barcelona, Spain, on May 9, 2021. Now, Catalonia is reimposing restrictions amid a surge in Covid cases.

NurPhoto | NurPhoto | Getty Images

LONDON — Europe is struggling to contain a surge in Covid-19 cases caused by the delta variant, but while several countries reimpose measures to control the spread, the U.K. is taking the plunge and lifting restrictions.

From residual vaccine skepticism in some countries, to surges in infections linked to nightlife resuming, Europe is having to contend with competing needs: the reopening of crucial economic sectors this summer, while at the same time, curbing surging cases.

It’s not an easy balance to strike and, erring on the side of caution, a number of countries – including France, the Netherlands, Greece and Spain – announced new restrictions on Monday in a bid to curb the rise in infections, particularly among younger people who are the last in the queue to be vaccinated against Covid.

Mandatory vaccines?

In France, President Emmanuel Macron announced that for health and care workers, vaccines would be mandatory, and that a “health pass” (an app showing one’s vaccination status or recent negative test) would soon be required to access culture or leisure venues of a larger capacity. From August, the pass will be mandatory to access cafes, restaurants, malls, planes and trains in France. Lastly, in a bid to encourage vaccination take-up, PCR tests will stop being free from the fall unless they’re part of a prescription.

“If we do not act today, the number of cases will continue to rise sharply, and will inevitably lead to increased hospitalizations from the month of August,” Macron told the public in a televised address.

Similarly, Greece’s Prime Minister Kyriakos Mitsotakis also gave a televised address Monday in which he announced that Covid shots would be mandatory for nursing home and healthcare workers and that only vaccinated people will be allowed indoors in bars, cinemas, theaters and enclosed spaces.

Greece, like France, has struggled to encourage vaccine take up among more skeptical members of the public.

Imploring people to take up Covid shots, Mitsotakis said: “The country will not be shut down again by the attitude of some. It will give freedom to many. And protection for all. Because it is not Greece that is in danger, but the unvaccinated Greeks.”

Danny Altmann, professor of immunology at Imperial College London, told CNBC Tuesday that the divergent approaches showed just how nuanced the issue was.

“[It illustrates] how difficult it is and hard for any policy makers and scientists to make assertions against such a formidable and unpredictable foe,” he said. “We make predictions at our peril.”

Nightlife

The highly-transmissible delta variant of the coronavirus is reeking particular havoc among Europe’s younger populations as economies had started to allow their nightlife leisure venues to reopen, some after many months of closure. Vaccination rates among younger people lag in the region, however, with many only just being invited to receive their first dose.

While countries like France and Greece are still struggling to convince everyone to get the vaccine, other countries are rushing to administer shots to younger people, seen as both vectors of the virus through socializing, and more vulnerable given their partial or unvaccinated status.

A study in the U.K. in May found that two doses of either the Pfizer-BioNTech or AstraZeneca-University of Oxford vaccine give effective protection against the delta Covid variant, first discovered in India. Having just one dose, or being unvaccinated, makes individuals far more vulnerable to infection, however.

Rising Covid infections saw Dutch Prime Minister Mark Rutte admit on Monday that Covid restrictions had been lifted too soon at the end of June. On Monday, 8,522 new Covid cases were confirmed and on Saturday, the country reported its highest number of cases since Christmas.

Rutte’s comments came after the government conceded it was caught off-guard by the rising infection rate. It announced Friday that it would have to reimpose rules on bars and restaurants and close nightclubs, just days after they were reopened, in a bid to curb the spread among younger people.

Spain has also had to backtrack on the lifting of measures. On Monday, officials said the country’s two-week Covid-19 contagion rate was still rising, more than tripling in two weeks, Reuters reported. However, health emergency chief Fernando Simon said the pace of increase had reduced in recent days and the latest wave could be nearing its peak.

Nonetheless, new restrictions were announced in Catalonia and Valencia last week, including the closure of most night-time venues, as well as limits on social gatherings. In Valencia, the regional government asked its court to authorize a curfew on towns with more than 5,000 inhabitants that are considered high-risk, including on its capital Valencia and tourist favorite Benicassim.

For its part, Germany is seeing a slow rise (albeit from a low level) in Covid infections as many parts of the country relax restrictions.

There is a reluctance among officials (including Chancellor Angela Merkel and Foreign Minister Heiko Maas) to continue restrictions any longer than necessary. Nonetheless, the country is watching what’s happening in neighboring nations carefully. 

Since Sunday, Germany has imposed stricter restrictions on visitors from Spain who must now present proof of vaccination against Covid, proof of recent recovery from the virus or negative test results otherwise they must quarantine on arrival.

In sharp contrast, the UK

In sharp contrast to its continental cousins, the U.K. government confirmed on Monday that it will lift its remaining restrictions on July 19, despite its own infection rate remaining high, Over 34,000 new cases were reported in the U.K. Monday, marking the sixth consecutive day that Covid infections have been above 30,000.

Speaking in Parliament, Health Secretary Sajid Javid said that after monitoring the latest data, the government does not expect Covid infection rates to put unsustainable pressure on the National Health Service.

“We firmly believe that this is the right time to get our nation closer to normal life,” Javid said.

“Now, to those who say: Why take this step now? I say, if not now, when? There will never be a perfect time to take this step because we simply cannot eradicate this virus.”

Professor Altmann said the U.K.’s strategy was “a gamble,” but noted that, with its advanced vaccination program, the country was not in the same place as in the start of the year when the alpha variant emerged.

“Because of the vaccine we’re in a different place but let’s not construe that as meaning that the NHS isn’t under pressure or NHS doctors aren’t terrified of another wave. There are still dangers out there,” he said.