嘉年华邮轮7旬乘客确诊病故 CDC建议老弱病孕暂勿搭乘
文章来源: 星岛日报
7/25/2021
嘉年华邮轮（Carnival）1名年长游客登船后确诊并死亡，令人再度关注邮轮业的防疫安全。联邦卫生部门表示，包括长者、孕妇、本身体弱或者患病的人士在内，高危民众无论曾否接种疫苗，暂时都不应乘搭邮轮。
综合雅虎新闻和英国《每日邮报》报道，这次病故的77岁病人，是来自俄克拉荷马的退休主日学教师塔克特 （Marilyn Tackett）。她本身已经注射疫苗，7月31日登上嘉年华公司的“维斯塔号”（Vista）邮轮，8月3日抵达洪都拉斯的罗阿坦岛（Roatan），翌日转往中美洲国家伯利 （Belize）时开始发病，没有跟随家人上岸观光，当家人返回邮轮时发现她已呼吸困难。
家人向邮轮医护人员求救后，病毒测试证实塔克特染疫，因此紧急将她送往伯利 的医院。塔克特送回俄州塔尔萨（Tulsa）抢救后，最终在8月14日离世。
纪录显示，“维斯塔号”此行共搭载1400名船员和接近3000名旅客，出发前没有安排旅客检测，最终27人在航程期间确诊。事发后，嘉年华公司强调塔克特“极不可能”在船上染病，但接触病毒的过程仍然待查。伯利兹旅游局则表示，99.98%的船员和96.5%的乘客都已接种疫苗，27名确诊者亦已打针，大部分人都症状轻微或没有症状。
新冠疫情去年初爆发后，邮轮行业曾率先发生超级传播事件，仅在美国航行的3艘邮轮，便录得超过800宗个案。专家相信，船上环境封闭，不同国家的旅客互相接触，都令病毒传播的风险大增。
疾病控制及预防中心（CDC）则在最新指引中建议，包括65岁以上长者；癌症等一系列疾病的患者；孕妇；免疫能力较弱的人等等，多类高危民众不论曾否接种，暂时都应避免乘坐游轮，尚未接种的人，短期内更不要乘船出行。至于已经出游但没有打针的旅客，回国后不论检测结果都应自我隔离7天。
CDC Issues New COVID-19 Guidance For Older Travelers And Those At Increased Risk Of Severe Illness
By Irene S. Levine
8/23/2021
On August 20, 2021, the U.S. Centers for Disease Control and Prevention (CDC) updated its cruise guidance and emphasized that individuals at increased risk of severe illness—regardless of whether or not they are vaccinated—should avoid ocean or river cruises, worldwide.
This updates prior guidance that warned people who are not fully vaccinated to avoid cruise travel.
The CDC website notes that reported outbreaks on cruise ships and the easy spread of COVID-19 between people in such close quarters suggest that the risk of getting the virus on cruise ships is especially high for certain groups of individuals.
Who should avoid cruising?
The CDC identifies three specific groups at increased risk of severe illness. These include:
Older individuals:
According to the CDC, the risk for contracting the virus is increased for people in their 50s, and increases again for those in their 60s, 70s, and 80s. People 85 and older are the most likely to get very sick.
People with underlying medical conditions:
These medical conditions include, but are not limited to cancer, chronic kidney disease, chronic lung diseases, dementia and other neurological conditions, Type 1 or Type 2 diabetes, Down syndrome, heart conditions, HIV infection; compromised immune systems, liver disease, overweight and obesity, sickle cell disease, heart conditions, smoking (past or present), having had a solid organ or blood stem cell transplant, stroke or cerebrovascular disease, and substance abuse disorders.
Pregnant and recently pregnant women:
Although the overall risk of severe illness is low, pregnant people are at an increased risk for severe illness from COVID-19 compared to non-pregnant people.
The CDC maintains an updated, evidence-based list of underlying medical conditions associated with high risk for severe illness from the virus, drawing upon published reports, scientific articles in press, unreviewed pre-prints and internal data.
Is your cruise ship safe?
In view of the spread of the Delta variant, many cruise lines have recently strengthened their health and safety protocols in terms of mask and vaccination requirements.
For those individuals who are not at increased risk and who plan to cruise, the CDC has created a new color-coded system that provides ship-specific information about the COVID-19 status for all cruise ships operating in U.S. waters.
CDC
COVID-19 and Cruise Ship Travel
August 20, 2021
Updated the notice to recommend travelers who are at increased risk for severe illness avoid cruise ship travel, regardless of vaccination status.
Key Information for Cruise Ship Travelers
- The virus that causes COVID-19 spreads easily between people in close quarters aboard ships, and the chance of getting COVID-19 on cruise ships is high. Outbreaks of COVID-19 have been reported on cruise ships.
- CDC recommends that people who are not fully vaccinated avoid travel on cruise ships, including river cruises, worldwide.
- People with an increased risk of severe illness should also avoid travel on cruise ships, including river cruises, regardless of vaccination status.
- People who decide to go on a cruise should get tested 1–3 days before their trip and 3–5 days after their trip, regardless of vaccination status.
- Along with testing, passengers who are not fully vaccinated should self-quarantine for 7 days after cruise travel, even if they test negative. If they do not get tested, they should self-quarantine for 10 days after cruise travel.
- People on cruise ships should wear a mask to keep their nose and mouth covered when in shared spaces. While CDC’s Mask Order is not being enforced on cruise ships, individual cruise lines may require travelers (passengers and crew) to wear masks indoors on board the ship.
What is the current situation?
CDC has released all the necessary information that cruise ship operators need to resume passenger operations under the Framework for Conditional Sailing Order (CSO), originally issued October 30, 2020). The CSO is a phased approach to resuming passenger operations on cruise ships. CDC may adjust these requirements and recommendations based on public health considerations and other factors. Information about the COVID-19 status of ships sailing under the CSO is available on CDC’s website.
What can cruise travelers do to protect themselves and others?
CDC recommends that travelers are fully vaccinated against COVID-19 prior to traveling on a cruise ship.
People are considered fully vaccinated 2 weeks after a single dose in a one-dose series or 2 weeks after the second dose in a two-dose series.±
Travelers who are at an increased risk of severe illness from COVID-19 should avoid travel on cruise ships, including river cruises, worldwide, regardless of vaccination status.
If you are at increased risk for severe illness and considering cruise travel during the COVID-19 pandemic, discuss this type of travel with your healthcare professional. Older adults and people of any age with certain underlying medical conditions are more likely to get severely ill if they get COVID-19. People with weakened immune systems, including people who take medicines that suppress their immune systems, may not be protected even if fully vaccinated.
Do not board a cruise ship if you have symptoms of COVID-19, if you know you have COVID-19, if you were exposed to a person with COVID-19 in the past 14 days (unless you recovered from COVID-19 in the past 90 days), or you are waiting for results of a COVID-19 viral test.
Wearing a mask over your nose and mouth is required on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States and while indoors at U.S. transportation hubs (such as airports, bus or ferry terminals, train and subway stations, seaports, U.S. ports of entry, and other places where people board public transportation in the U.S. and U.S. territories). Wearing a mask is not required in outdoor areas of transportation conveyances or while outdoors at transportation hubs. However, travelers should consider wearing a mask in crowded outdoor settings and for activities with close contact with others who are not fully vaccinated.
If you go on a cruise during the COVID-19 pandemic:
Before you board:
- Get fully vaccinated against COVID-19.
- People are considered fully vaccinated 2 weeks after a single dose in a one-dose series or 2 weeks after the second dose in a two-dose series.
- Get tested with a COVID-19 viral test 1–3 days before your departure, even if you are fully vaccinated.
- If you test positive, isolate and do NOT travel.
- Get travel insurance. Make sure you have a plan to get care overseas, in case you need it. Consider buying additional insurance that covers health care and emergency evacuation, especially if you will be traveling to remote areas.
While you’re on board:
- Stay at least 6 feet/2 meters (about 2 arm lengths) from anyone who is not traveling with you. Do this everywhere—both indoors and outdoors—if you are not fully vaccinated.
- Wash your hands often or use hand sanitizer (with at least 60% alcohol).
- Avoid contact with anyone who is sick.
- Avoid touching your eyes, nose, and mouth.
- If you have symptoms of COVID-19, stay in your cabin and notify the onboard medical center immediately.
If you are returning to an international port or disembarking an international river cruise:
- Your return travel plans may be affected. Foreign health officials may implement formal quarantine procedures if they identify a case of COVID-19 aboard your cruise ship.
- If you travel on a cruise ship or river cruise and disembark in a foreign port, you might not be able to receive appropriate medical care or be medically evacuated if you get sick.
- Some countries might refuse to dock your ship or allow passengers to disembark.
If you return to the United States by air:
- All air passengers coming to the United States, including U.S. citizens and fully vaccinated people, are required to have a negative COVID-19 test result no more than 3 days before travel or documentation of recovery from COVID-19 in the past 3 months before they board a flight to the United States.
After you disembark:
- Get tested 3–5 days after your trip.
- If your test is positive, isolate yourself to protect others from getting infected.
- Self-monitor for COVID-19 symptoms for 14 days after travel; isolate and get tested if you develop symptoms, regardless of vaccination status.
- If you are not fully vaccinated:
- Stay home and self-quarantine for 7 days after cruise travel, even if you test negative.
- If you do not get tested, stay home and self-quarantine for 10 days after cruise travel.
- Avoid being around people who are at increased risk for severe illness for 14 days, whether you get tested or not.
Always follow state and local recommendations or requirements related to travel.
Information for people who recently recovered from COVID-19
- If you tested positive for COVID-19 in the past 3 months and met criteria to end isolation, you do NOT need to get tested before or after cruise travel unless you have symptoms. CDC has found that people can continue to test positive for up to 3 months after they had COVID-19 and not be infectious to others.
- Travel with a copy of your positive test result and a letter from your healthcare or a public health official that states you have been cleared for travel. The positive test result and letter together are referred to as “documentation of recovery.” If you are asked by officials in a foreign country, you may be required to show this documentation.
- You also do NOT need to self-quarantine after cruise travel if you have recently recovered from COVID-19, even if you are not fully vaccinated.
COVID-19 (Coronavirus): Long-term Effects
COVID-19 symptoms can sometimes persist for months. The virus can damage the lungs, heart and brain, which increases the risk of long-term health problems.
02/20/2021
Most people who have coronavirus disease 2019 (COVID-19) recover completely within a few weeks. But some people — even those who had mild versions of the disease — continue to experience symptoms after their initial recovery.
These people sometimes describe themselves as “long haulers” and the condition has been called post-COVID-19 syndrome or “long COVID-19.”
Older people and people with many serious medical conditions are the most likely to experience lingering COVID-19 symptoms, but even young, otherwise healthy people can feel unwell for weeks to months after infection. The most common signs and symptoms that linger over time include:
- Fatigue
- Shortness of breath
- Cough
- Joint pain
- Chest pain
Other long-term signs and symptoms may include:
- Muscle pain or headache
- Fast or pounding heartbeat
- Loss of smell or taste
- Memory, concentration or sleep problems
- Rash or hair loss
Organ damage caused by COVID-19
Although COVID-19 is seen as a disease that primarily affects the lungs, it can damage many other organs as well. This organ damage may increase the risk of long-term health problems. Organs that may be affected by COVID-19 include:
- Heart. Imaging tests taken months after recovery from COVID-19 have shown lasting damage to the heart muscle, even in people who experienced only mild COVID-19 symptoms. This may increase the risk of heart failure or other heart complications in the future.
- Lungs. The type of pneumonia often associated with COVID-19 can cause long-standing damage to the tiny air sacs (alveoli) in the lungs. The resulting scar tissue can lead to long-term breathing problems.
- Brain. Even in young people, COVID-19 can cause strokes, seizures and Guillain-Barre syndrome — a condition that causes temporary paralysis. COVID-19 may also increase the risk of developing Parkinson’s disease and Alzheimer’s disease.
Blood clots and blood vessel problems
COVID-19 can make blood cells more likely to clump up and form clots. While large clots can cause heart attacks and strokes, much of the heart damage caused by COVID-19 is believed to stem from very small clots that block tiny blood vessels (capillaries) in the heart muscle.
Other parts of the body affected by blood clots include the lungs, legs, liver and kidneys. COVID-19 can also weaken blood vessels and cause them to leak, which contributes to potentially long-lasting problems with the liver and kidneys.
Problems with mood and fatigue
People who have severe symptoms of COVID-19 often have to be treated in a hospital’s intensive care unit, with mechanical assistance such as ventilators to breathe. Simply surviving this experience can make a person more likely to later develop post-traumatic stress syndrome, depression and anxiety.
Because it’s difficult to predict long-term outcomes from the new COVID-19 virus, scientists are looking at the long-term effects seen in related viruses, such as the virus that causes severe acute respiratory syndrome (SARS).
Many people who have recovered from SARS have gone on to develop chronic fatigue syndrome, a complex disorder characterized by extreme fatigue that worsens with physical or mental activity, but doesn’t improve with rest. The same may be true for people who have had COVID-19.
Many long-term COVID-19 effects still unknown
Much is still unknown about how COVID-19 will affect people over time. However, researchers recommend that doctors closely monitor people who have had COVID-19 to see how their organs are functioning after recovery.
Many large medical centers are opening specialized clinics to provide care for people who have persistent symptoms or related illnesses after they recover from COVID-19.
It’s important to remember that most people who have COVID-19 recover quickly. But the potentially long-lasting problems from COVID-19 make it even more important to reduce the spread of the disease by following precautions such as wearing masks, avoiding crowds and keeping hands clean.
Source: https://www.mayoclinic.org/coronavirus-long-term-effects/art-20490351
Six Spaces Home Staging
Contact: Hongliang Zhang
Tel: 571-474-8885
Email: zhl19740122@gmail.com
Post-COVID Syndrome: What Should You Do If You Have Lingering COVID-19 Symptoms?
By Katie McCallum
02/20/2021
Even a mild case of COVID-19 can come with some pretty miserable symptoms, including debilitating headaches, extreme fatigue and body aches that make it feel impossible to get comfortable.
To make matters worse, it’s becoming more and more apparent that a subset of people who’ve “recovered” from COVID-19 will go on to experience symptoms that linger well beyond testing negative for the virus. These individuals are sometimes referred to as “COVID long-haulers,” and experts are searching for answers about this condition that’s now being termed post-COVID syndrome.
“We’re seeing continued evidence that a fair number of people who have had COVID-19 continue to feel the effects of this illness for weeks to months after recovering from the worst of their symptoms or complications,” says Dr. Sandeep Lahoti, gastroenterologist at Houston Methodist who is leading the COVID-19 Recovery Clinic. “We still don’t understand how long these symptoms can truly persist, but we do know that many of these people would benefit from specialized care and, in some cases, regular follow up.”
What are the symptoms of post-COVID syndrome?
Just as COVID-19 itself can come with a range of symptoms, so, too, can post-COVID syndrome.
The most common symptoms that can linger include:
- Fatigue
- Difficulty breathing
- Joint pain
- Chest pain
- Brain fog, including an inability to concentrate and impaired memory
- Loss of taste and/or smell
- Sleep issues
“We’re not sure exactly how long these symptoms can persist, but we know that they can last at least six months or longer in some people,” Dr. Lahoti says. “The manifestations of these symptoms are interesting and somewhat unique. For instance, MRI scans show myocarditis in some of these people, indicating that the heart muscle can remain inflamed several months out — even if heart-related symptoms weren’t prevalent during their illness.”
As for the cause and long-term consequences of these lingering symptoms? That’s still unclear, too.
“We don’t yet know why post-COVID syndrome occurs, but hypotheses range from hidden areas of infection to a prolonged inflammatory response,” explains Dr. Lahoti. “We’re also not sure what the long-term outcomes of these lingering symptoms might be, if any. We know this syndrome can certainly impact quality of life, but right now we don’t expect any severe impacts, such as ongoing organ damage.”
Can anyone experience lingering COVID-19 symptoms?
When it comes to the life-threatening cases of COVID-19, doctors expect people who were hospitalized for severe pneumonia or stroke to need specialized care and frequent follow-up after being discharged.
But, although not completely defined just yet, post-COVID syndrome isn’t exclusive to people who experienced organ damage during their illness. It’s also not exclusive to people whose symptoms warranted a trip to the emergency room.
“Post-COVID syndrome can be seen in people who went to the ER with concerning symptoms or who had advanced symptoms that required a brief hospital stay, but it can also occur in people who had mild symptoms and self-treated at home,” warns Dr. Lahoti. “The important thing to note is that these are people who might not have required care from a specialist during their actual illness, but may now benefit from specialized care as these lingering symptoms continue to affect their daily lives.”
The actual frequency of post-COVID syndrome is still largely up for debate, and different studies find this condition to be more or less common in various groups of people.
“Some studies show that only 10% of people with COVID will go on to develop post-COVID syndrome, while other studies are showing much higher percentages — some even suggest that up to 70% of people experience persistent symptoms,” says Dr. Lahoti.
According to Dr. Lahoti, there are hints and suggestions as to who’s most likely to develop lingering symptoms, though.
Those who seem to be most at risk of developing post-COVID syndrome include:
- Adults over the age of 50
- People who experienced a more severe case
- Individuals with underlying health conditions, particularly cardiopulmonary issues, hypertension, diabetes or obesity
What should someone who’s experiencing post-COVID syndrome do?
For those who experienced only a mild illness and self-treated at home but are now dealing with post-COVID syndrome symptoms, Dr. Lahoti recommends scheduling an appointment with your primary care physician.
“Your doctor can diagnose the severity of your lingering symptoms, helping to treat the ones that are mild and referring you to a specialist for any that are more advanced,” explains Dr. Lahoti.
If you were hospitalized for more severe symptoms during your illness, you may already have a cardiologist you can follow up with about any heart issues, such as chest pain, or a pulmonologist you can check in with to address any lung issues, such as difficulty breathing.
“Because the symptoms of post-COVID syndrome are diverse and because this condition is so new and unique, we’ve created an entire clinic dedicated to helping people manage post-COVID syndrome,” Dr. Lahoti adds. “The purpose of this clinic is to bring together a range of specialists who have been on the front lines during this pandemic.”
As of right now, Houston Methodist’s COVID-19 Recovery Clinic is focused on patients discharged from our hospitals, but the aim is to broaden this scope in the future.
The clinic will have a team of doctors specializing in:
- Cardiology
- Pulmonology
- Gastroenterology
- Hematology
- Nephrology
- Neurology
- Endocrinology
- Psychiatry
- Physical Medicine & Rehabilitation
- Primary care
“Post-COVID syndrome is a new, unique phenomenon, and we’re still learning about it. But we know its symptoms, particularly the extreme fatigue, can have huge downstream effects on a person’s quality of life — impacting family life and work productivity,” explains Dr. Lahoti. “Working as a team, our goal is to help these people manage their lingering symptoms as effectively as possible.”
The clinic will also focus on performing impactful research, as well as providing doctors with access to tools that can help tailor care to the specific treatments someone previously received or the particular strain of the virus he or she was infected with.
“Lastly, given what we’re seeing with the long-term impacts COVID-19 can have on some people, even those who had only mild symptoms, it’s all the more reason to continue to take steps to reduce your risk of getting sick,” adds Dr. Lahoti.
Remember, the preventive measures that can help reduce the spread of COVID-19 include:
- Social distancing
- Wearing a mask
- Avoiding crowds or large gatherings
- Practicing excellent hand hygiene and avoiding touching your face
