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Johnson & Johnson Covid-19 Vaccine 

FDA Places Strict Limits On Johnson & Johnson Covid-19 Vaccine 

The US Food and Drug Administration (FDA) announced last week that it is limiting the emergency use authorization of the Johnson & Johnson Covid-19 vaccine for individuals 18 and older. The vaccine is now available for adults who don’t have access to other vaccinations and for adults who aren’t able to receive the other Covid-19 vaccine for personal medical reasons. 

The FDA released a statement in which they detailed the changes and why they’re being made. They explained that the change is being implemented due to the rare risk of a dangerous clotting condition known as thrombosis with thrombocytopenia syndrome (TTS) after receiving the vaccine. 

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“We’ve been closely monitoring the Janssen COVID-19 Vaccine and occurrence of TTS following its administration and have used updated information from our safety surveillance systems to revise the EUA,” Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said in the statement. 

“We recognize that the Janssen COVID-19 Vaccine still has a role in the current pandemic response in the United States and across the global community. Today’s action demonstrates the robustness of our safety surveillance systems and our commitment to ensuring that science and data guide our actions.”

The agency also confirmed that the updated authorizations apply to booster doses as well. The FDA also emphasized that the benefits of the J&J vaccine outweigh the risks for certain individuals as well. 

In their statement, they wrote that individuals who had a severe allergic reaction to an mRNA vaccine (Pfizer or Moderna), have personal concerns over mRNA vaccines, or don’t have access to mRNA vaccines should definitely receive the J&J jab. 

According to the US Centers for Disease Control and Prevention, more than 18.7 million doses of the J&J vaccine have been administered in the US, and of all the Americans who are currently fully vaccinated, about 7.7% got the J&J vaccine. 

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The CDC’s vaccine advisory committee issued their own statement on Johnson & Johnson’s vaccine, saying it “makes a preferential recommendation for the use of mRNA COVID-19 vaccines over the Janssen adenoviral-vectored COVID-19 vaccine in all persons aged  ≥ 18 years in the United States.”

Both the CDC and FDA have made these statements mainly due to TTS concerns. When rare clotting events began appearing in the initial periods of vaccination in the US, Johnson & Johnson made a statement emphasizing their commitment to giving Americans a safe and effective vaccine. 

“The safety and well-being of the people who use our products is our number one priority. We are aware of an extremely rare disorder involving people with blood clots in combination with low platelets in a small number of individuals who have received our COVID-19 vaccine. … We have been working closely with medical experts and health authorities, and we strongly support the open communication of this information to healthcare professionals and the public.”

The FDA released data that showed around 60 cases of TTS since the J&J vaccine began its distribution, nine of those unfortunately were fatal. 

The FDA emphasized, however, that the risk for TTS is extremely rare. Current data shows that there’s about three cases of TTS for every million doses administered. 

Symptoms of TTS can appear within one to two weeks after vaccination, and they include shortness of breath, chest pain, leg swelling, persistent abdominal pain, neurological symptoms like headaches or blurred vision, and red spots appearing under the skin at the site of vaccination.

Individuals With Psychiatric Conditions More Likely To Catch Covid-19

According to a new psychiatric study, individuals diagnosed with a psychiatric condition are more likely to catch Covid-19 after being fully vaccinated. The study reviewed health records of more than 260,000 individuals from the US Department of Veterans Affairs, so the correlation was much stronger in people 65 and older. 

While the results could also be the result of decades of unknowing when it came to psychiatric conditions, individuals who have suffered from these conditions in general have weaker immune systems. 

“There’s a lot of evidence to suggest that chronic stress, traumatic stress, and psychiatric conditions can actually accelerate cellular aging,” Aoife O’Donovan, an associate professor of psychiatry at the University of California, San Francisco and one of the study authors.

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“It’s putting you at risk for appearing older biologically, and for your immune system, in particular, to function like the immune system of someone who’s older than you, and that’s certainly seen in patients with psychiatric disorders.”

People with any psychiatric condition were found to be 3.7% more likely to develop a breakthrough infection of Covid-19. Among all the diagnoses, non-alcohol substance abuse had the greatest correlation to breakthrough cases; risk is increased by 16%. 

“Addiction causes people to increase risk-taking behaviors, and the pandemic created an environment where everything from hugging to eating at a restaurant was a risk-taking behavior,” said O’Donovan.

Adjustment disorders, or feelings of unusual stress or sadness in response to a life event, was linked to a 13% increase in risk for infection, followed by anxiety conditions (8%), bipolar disorder (7%), alcoholism (5%), depression (5%), and PTSD (3%). 

Overall, the study found that people aged 65 or older with a psychiatric diagnosis are 5% more likely to have a breakthrough Covid-19 infection. Additionally, O’Donovan explained how using data exclusively from the VA wasn’t the most ideal situation when looking at this specific correlation. 

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“Using data exclusively from the V.A. was not ideal. This group is not representative of the entire U.S. population. People who go to the V.A. are more likely to be of lower socioeconomic status, have several medical conditions, and live in a rural area. They are also generally older and almost all men,” O’Donovan says. 

“However, the V.A. did a very good job of gathering all of this information and releasing it quickly. Without that kind of real-time record-keeping, she says, it would be incredibly difficult to get this much information on a recent phenomenon.”

The findings “are unlikely to be specific to Covid-19,” says O’Donovan, “but are much more likely to generalize to other infections. An obvious issue is risk for the flu and prevention of the flu.”

These findings give reason to consider mental health when crafting responses to Covid-19 and other infectious disease outbreaks.

“This study adds to a body of literature that’s telling us that patients with psychiatric disorders may well be — and do appear to be — a vulnerable population in this pandemic that might need targeted prevention efforts,” says O’Donovan. “We may need to be focused on integrating Covid prevention into mental health care and also integrating mental health care into our Covid prevention strategies because the two are so interlinked.”

BA.2 Subvariant Nows Makes Up 72% Of New COVID-19 Cases

Another day, another COVID-19 subvariant that could once again send safety protocols back into full effect. According to the Center for Disease Control and Prevention’s (CDC) Nowcast, the BA.2 strain made up 72.2% of cases within the U.S. from March 27 to April 4. Other members of the Omicron family include BA.1.1, which made up 25%, and B.1.1.529, making up a miniscule 2.5%.

Of course, the subvariant isn’t just making waves in the States. Across the globe, Omicron accounted for 99.8% of COVID-19 cases within the last week, with BA.2 making up 93.6% of that. According to the World Health Organization (WHO), BA.2 is now dominant within all six of its regions and in 68 countries where data sequencing is available.

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Among the countries that have been most hit by the subvariant include the U.K. — which saw over 225,000 new cases on March 21, the most for them in a single day since early January — Germany, where over 3 million new cases have occured between March 24 to April 6, and Italy, which had close to two million cases in that same span.

As Scientific American notes, BA.2 is vastly different from its predecessors in terms of its genetics. While BA.2 shares many of the 60 mutations BA.1 ended up acquiring that were not in the original SARS-COV-2 virus, BA.2 possesses 28 unique mutations of its own. It also holds the dubious honor of being 30% to 50% more contagious than BA.1.

Still, despite the strong push of the highly-transmissible subvariant in the U.S. and world, health experts like Dr. Christopher Murray maintain that Americans shouldn’t be worried of another possible outbreak that could take improvements two steps back.

Speaking to NBC News, Murray — a University of Washington professor of health metrics sciences — said that he would not be “hugely concerned” with BA.2, and explained he expects it to remain at low levels as the weather warms up over the next few months.

“Right now we’re in this period where immunity is high and we’re heading into the summer and transmission tends to be a bit lower, so the combination should lead in the Northern Hemisphere to pretty low levels after the BA.2 wave.”

Indeed, despite the 72% mark, BA.2 hasn’t made a surge in cases. April 6 saw over 49,000 new cases, but the country has steadily remained around a seven-day average of 29,000 to 30,000 for nearly a month. That’s a significant improvement over the seven-day averages from December to late February, which ranged from 100,000 to 800,000. Meanwhile, the seven-day average for daily deaths has dropped from 1,059 on March 16 to 558 on April 6.

If projections like Murray’s hold true, it would be the first time a COVID-19 subvariant has taken over as the dominant strain in the U.S. without causing an uptick in cases. Of course, there may be several factors at play for why cases haven’t statistically increased just yet, one being that the government is no longer offering free tests for uninsured.

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Another possible reason why is that Americans have built up an immunity, with the latest CDC seroprevalence survey showing that around 95% of the population have some level of combined infection and vaccine-induced seroprevalence. 43% are estimated to have antibodies from just past infections, though attempting to build up protection this way certainly wouldn’t be recommended.

Of course, just because a country-wide outbreak might not occur doesn’t mean specific areas wouldn’t be at risk of severe case rises, some experts told Today. People that live in an area with high population density, along with a low vaccination rate, should be more precautious than those who live in an area with a low population density or higher vaccination rate.

CDC Adds No New Destinations To Highest Travel Risk Category, Though Airfare Set To Rise

For the first time in months, the Center for Disease Control and Prevention (CDC) has not added any new destinations to its “very high” COVID-19 travel risk category. The absence of additions is a welcome sight to a category that currently contains 115 destinations, which includes hot tourist spots like France, Turkey, and Spain.

The last addition to the “very high” category came on March 21, when Madagascar — the world’s fourth largest island, located off the coast of Africa — was included. It’s just one of two total destinations added to the CDC’s fourth level since March 14, the other being the Indian Ocean island of Mauritius.

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The CDC has four levels of COVID-19 travel risk: level four, or “very high”; level three, or “high”; level two, or “moderate”; and level one, or “low.” Level three currently has 33 destinations, level two has 14 destinations, and level one has 36 destinations. Destinations are ranked based on the amount of COVID-19 cases per 100,000 population over the last 28 days.

There weren’t zero changes across the board when looking at the four categories altogether. Level three saw five countries added Monday — which includes Bosnia, Peru, and Qatar — while level two had six new destinations added. Among those are the popular Bahamas, which have seen a 129% search increase this year when compared to 2019.

As CNN Travel notes, the amount of level four countries has seen a droppage of over two dozen the last several weeks. The surging Omicron variant contributed to a high rise in winter, with 22 countries being added to level four on Jan. 18. In late February, the total level four destinations hovered around 140. Still, level four currently contains more countries than the other three levels combined.

Another positive CDC development is their lifting of the travel advisory for cruise ships, marking it the first time this has happened since the pandemic began. The CDC moved the advisory to the highest level in late December before moving it down a category in February. There are currently 34 cruise ships that have no reported cases, and 69 cruises that are below the CDC’s threshold for investigation.

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While the outlook for travel on all fronts is gradually improving, one area that isn’t a ray of sunshine are costs. According to Hopper, international airfare costs from the U.S. currently match 2019 costs at $810/round-trip. However, predictions suggest they’re set to rise to $940/round-trip in June, a 15% jump from current prices and 5% rise from 2019 costs.

Meanwhile, U.S. domestic travel is taking a greater beating with $330/round-trip airfare, a 7% rise from 2019 costs. Domestic will continue to see spikes, with predictions calling for a 10% increase ($360/round-trip) through May. Both domestic and international airfare are expected to decline into the fall.

The increase in ticket prices can be contributed as a fight to offset costs due to the ongoing Russia-Ukraine war, which has resulted in jet fuel prices of $3.07/gallon, the highest totals since January 2014 and up 40% from January 2022’s $2.20/gallon, Hopper noted.

Those dollar signs won’t be detering passengers, however. According to a joint report by Trip.com and the World Travel & Tourism Council, 70% of leisure travelers in major countries plan to spend more on travel in 2022 than in the past five years. The report also found that the important factor for travelers is getting the best value for their money.

U.S. Opens Second COVID-19 Boosters For Americans 50 And Up

On Tuesday, the Food and Drug Administration (FDA) authorized an extra dosage of the Pfizer or Moderna vaccine for Americans 50 and up — plus certain younger age groups that are higher risk for COVID-19 — given that it’s been four months their last vaccination.

The Center for Disease Control and Prevention (CDC)’s director Dr. Rochelle Walensky discussed the additional booster, stating how anyone who was boosted during the recent Omicron surge — which saw a peak of over 1.1 million new cases in a single day in January — was much less likely to either be hospitalized or die.

“During the recent Omicron surge, those who were boosted were 21-times less likely to die from COVID-19 compared to those who were unvaccinated, and 7-times less likely to be hospitalized.”

Walensky added that the new dosage is “especially important” for those 65 and up. Still, while the Center has assured the second booster will give extra protection to those more susceptible to the virus, it didn’t go so far as to say the new shot is a necessary precaution that should be taken as soon as possible.

The FDA’s vaccine chief Dr. Peter Marks explained that regulators set the age at 50 because that’s when chronic conditions that increase COVID-19 risks begin to appear. People between the ages of 50 to 64 have accounted for around 18% (182,663) of all COVID-19 related deaths since 2020.

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Prior to this authorization, the FDA only allowed a fourth dosage for immune-compromised as young as 12. Those who have already received a fourth shot will also be eligible for a fifth, though it has to be a Pfizer shot for those ages 12 to 17. Only adults 18 and older can receive a Moderna or Johnson & Johnson vaccination.

Meanwhile, anyone who received J&J’s vaccination — which only requires one initial dosage instead of two — and a booster can receive either a Pfizer or Modern shot, which are preferred in most situations by the CDC. While a J&J user can get their first booster only two months after the vaccination (instead of the standard five), they must wait four months for their third like their two counterparts.

Currently, 77.5% (255 million) of the U.S. population has received at least one vaccination dosage, while 66% (217 million) are fully vaccinated. 29.6% (97 million) have received a booster through the first seven months of it being administered.

The second booster comes at an uncertain and critical time in a pandemic that’s now entering its 25th month. Hope certainly abounds: cases in the U.S. are significantly down after the Omicron surgance, with Mar. 29 seeing just 25,628 new cases (29,351 seven-day average), while daily cases haven’t reached over 100,000 in over a month.

Still, time may play a factor in where trends go from here. Original vaccinations are becoming less and less effective against new variants — which continue to pop up and threaten another spike — giving boosters that much more value.

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Most concerning is the Omicron “stealth” subvariant BA.2, which the CDC said is now dominant in the U.S. after it accounted for 55% of COVID-19 cases that have undergone genetic sequencing. The subvariant made up just 1% of sequenced cases back in early February.

White House chief medical advisor Dr. Anthony Fauci previously said that though Americans could see an uptick in cases due to BA.2, he doesn’t expect another surge. Other countries haven’t been so fortunate, with BA.2 causing outbreaks in the U.K. (which saw daily counts double in the last two weeks, along with a 11.5% rise in hospitalizations over the last seven days), Germany, and China.

Another potential issue is the funding behind the fourth dosage, should it become necessary, with the federal government having run out of money to pay for the testing and treatment of uninsured Americans. Moderna previously applied for a second booster for the general population earlier this month, though it did so to provide the CDC “flexibility” when recommending what groups should be eligible.

China’s Covid Cases Continue To Surge, Shanghai Begins Lockdown Procedures 

Shanghai has begun to phase in lockdown measures for its citizens as an Omicron-fueled wave of new Covid-19 cases is spreading rapidly throughout mainland China. The country is currently experiencing its second highest caseload since the beginning of the pandemic two years ago. 

According to city officials, the eastern side of the Huangpu River, which divides Shanghai, will be under lockdown between Monday and Friday, which will be followed by similar restrictions across its western side in the coming week. Massive covid testing is also taking place across the city. 

Shanghai alone is the home for over 25 million people, making it one of the leading hotspots in a nationwide outbreak of Covid-19 that began in the beginning of the month. 

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Earlier this month, President Xi Jinping urged his officials to “minimize the impact of the virus on the economy and reflect on the zero-Covid policy.” 

Shanghai ruled out locking down the city as a means of protecting the economy. However, a record 3,450 asymptomatic cases were reported within the city last week, accounting for nearly 70% of China’s current Covid-19 cases. 

China’s National Health Commission on Monday reported “5,134 new asymptomatic cases for the previous day, and 1,219 local confirmed infections. Although the case numbers remain relatively insignificant in a global context, they are China’s highest since the first weeks of the pandemic.”

The city government said in a public notice on Sunday that “the two-part lockdown is being implemented to curb the spread of the epidemic, ensure the safety and health of the people and root out cases of infection as soon as possible.”

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The eastern half of Shanghai, known as Pudong, will be locked down until April 1st as residents undergo mass testing procedures. The western half of the city, known as Puxi, will be locked down until April 5th for the same procedure. 

Shanghai’s public security bureau said it was “closing cross-river bridges and tunnels, and highway toll booths concentrated in eastern districts until April 1st. Areas to the west of the Huangpu River will have similar restrictions imposed.”

A member of the city’s pandemic taskforce had over the weekend vowed Shanghai would “not shut down. A lockdown in Shanghai, the country’s major financial and trading hub, would impact the entire national economy and the global economy. 

“If Shanghai, this city of ours, came to a complete halt, there would be many international cargo ships floating in the East China Sea.”

“It seems clear that the authorities have been trying to rely on targeted measures to the maximum extent possible, but clearly they now feel they cannot afford to wait any longer in Shanghai,” said Thomas Hale of Oxford University’s Blavatnik School of Government.

“Overall, we’re now seeing more [Chinese cities] using restrictive measures than any other time since 2020.”

COVID-19

US Covid-19 Infections Likely To Rise Again, According To Fauci 

 Dr. Anthony Fauci, one of Joe Biden’s top advisers, said this week that a likely rise in Covid-19 cases will probably not result in a full-scale surge, or prompt a renewal of widespread health and safety procedures. 

“The bottom line is we will likely see an uptick in cases, as we’ve seen in European countries, particularly the U.K.. Hopefully we won’t see a surge. I don’t think we will.”

The BA.2 subvariant of the omicron variant is driving up cases in both Europe and Asia, specifically in Hong Kong which has been dealing with a sudden major surge of new cases within the past couple of weeks. 

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The US Centers for Disease Control and Prevention (CDC) has made the argument that the US needs to be prepared to resume health and safety measures in public spaces, while Fauci claims that he doesn’t think that’s going to happen: “right now, at this point, I don’t see that happening.”

Covid-19 hospitalizations, deaths, and cases in general have been continuing to decline in the US. BA.2 is reportedly 50% more transmissible than the original strain of omicron, however, like omicron it doesn’t cause more severe illness or evade immunity from vaccinations or an earlier infection, according to Fauci. 

Fauci and US Surgeon General Vivek Murthy have been urging Congress to pass a Covid-19 relief package that has been stalled for quite some time now. The White House has sought out $22.5 billion in funding for relief efforts and supplies. 

The Biden Administration, however, has also warned that it will have to wind down certain programs and therapeutic treatments soon due to a lack of funding. 

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“As much work as we’ve done in the last two years to get the right tools, we’ve got to continue funding them and supporting them so they’re available to people across the country.”

“That’s why Congress moving to provide that funding is so critical,” Murthy said on Sunday.

Senate Minority Leader Mitch McConnell has also argued that too much of the money meant to be allocated for Covid-19 programs and protocols has yet to be spent. 

“They ought to reprogram some of this massive amount that was spent last year that’s not out the door yet,” McConnell said on Sunday.

Fauci, 81, also discussed speculation over his retirement: “I can’t stay at this job forever. I want to make sure we’re really out of this before I really seriously consider doing anything different. We’re still in this. We have a way to go. I think we are clearly going in the right direction. I hope we stay that way.”

Experiencing Brain Fog From Long Covid? Here’s How To Cope 

Brain fog is a term used to describe feelings of mental fuzziness which can occur due to a multitude of reasons. The idea of brain fog has become more prevalent in recent years as it’s one of the most common symptoms associated with long Covid. 

Scientists are in the beginning stages of understanding how exactly Covid affects the brain, but there’s an increasing amount of evidence supporting that even mild to moderate Covid-19 cases can cause brain damage and trigger problems with memory, concentration, and overall functioning. 

In most of the cases associated with Covid-19, the brain fog typically resolves itself naturally within a matter of weeks. However, some individuals are developing chronic brain fog that persists for months, and maybe even years. 

According to James Giordano,a professor of neurology and biochemistry at Georgetown University Medical Center, “there’s something unique about the brain fog that comes with COVID. With most of these other conditions, brain fog typically resolves when the infection clears or the treatment stops. COVID, however, seems to cause a much more intense and sometimes long-lasting, widespread inflammatory effect — and the brain fog can persist for weeks or months on end.”

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“The brain fog people experience with long COVID is most likely a result of direct and indirect inflammatory effects on the brain.”

Covid is known for triggering a massive inflammatory response within the body that could potentially cause tissue damage throughout the body depending on how severe the case is. Covid-19 can also directly impact cells surrounding the brain, which creates yet another inflammatory response which could result in brain fog symptoms. 

A recent study found that even mild to moderate cases of Covid can cause damage to the brain and a potential decline in cognitive function. 

“Now we are really seeing inflammatory changes in the brain, and those inflammatory changes disrupt the functional architecture of the way brain nodes and networks are operating to control certain aspects of cognition and behavior,” Giordano said.

“That’s one of the really fascinating things about this virus: Each body that it goes into, it can affect so differently. This makes it very hard to predict who will develop brain fog.” said Dr. Mill Etienne, an associate professor of neurology and medicine at New York Medical College.

“Age seems to also play a role, as older people are more at risk for experiencing cognitive issues after COVID. But even some young, otherwise healthy people diagnosed with COVID have found themselves struggling with brain fog,” according to Giordano. 

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“You don’t have to have a severe case of COVID in order to have this long COVID syndrome,” Etienne said.

Giordano said the “specific symptoms of brain fog also vary from person to person. Some people experience fatigue after the slightest level of physical or mental exertion. It’s not just that they feel tired; they literally feel like they can’t do this anymore — in other words, they have to stop doing anything and just kind of rest.”

So what exactly can you do if you’re experiencing some level of brain fog after being sick with Covid? Etienne says most of the time the brain fog will clear up naturally over time, but unfortunately that’s not the case for everyone. 

Giordano advised “if you’ve been battling brain fog after COVID, try to acknowledge that you have it and recognize its impact on your daily functioning and quality of life. Consult with a physician and be specific about what brain fog feels like to you. Doing so will help your doctor develop a tailored treatment plan that will help mitigate the specific effects you are experiencing. In certain instances, medications and anti-inflammatory drugs may be recommended.”

It’s also recommended in general for individuals who are experiencing brain fog to keep as physically active as they can. While it may be difficult to do so, depending on how severe of a case you have, keeping your body moving keeps your brain active and can help it build up recuperative skills. 

“Lastly, get adequate rest and stay hydrated. People usually take those things for granted, but in this particular case, it’s rather important because both rest and hydration can be very recuperative to brain metabolism,” Giordano said.

US Unlikely To End Covid Testing Rules For International Travel 

Throughout the past month many countries have made international travel a lot easier as the Covid-19 pandemic continues around the world. Vaccinated travelers have found it much easier to book and experience travel again, however, US travelers returning from abroad must still present negative Covid-19 test results before they’re able to safely return.

The US Virgin Islands became the latest territory to announce that vaccinated travelers no longer need to provide a negative test upon arrival, a move that other international countries, like the UK, have had in place for nearly a month. 

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According to the US Centers for Disease Control And Prevention’s (CDC) last updated guidance for international travel, which was made in December, the US requires all incoming travelers over the age of 2 to submit a negative Covid test taken within one day of departure from a foreign country in order to enter the US. 

It’s become much easier to find at-home Covid-19 tests in the US, which will allow travelers to have greater access to testing in order to go abroad and return safely. The US government’s international travel guidance allows at-home tests as an accurate result for re-entry into the country. 

The provision within the guidelines also provides a list of approved at-home tests that travelers can take before and after traveling abroad. The CDC accepts Ellume, Quered, and BinaxNow at-home tests, which are some of the most commonly sold brands throughout the US. 

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The CDC also requires that the tests are supervised by a live attendant via a video call. BinaxNow tests can even be purchased through the website eMed, which will provide an at-home test shipped directly to your home prior to your trip with instructions on how to take it with live video guidance. 

In a statement to the media, a CVS spokesperson said the company’s stores “have the ability to meet our customers’ needs with at-home test kits both in store and at CVS.com,. We have simplified the digital process so customers can order and pick up a test kit with no up-front, out-of-pocket cost or the need to submit a claim to insurance.”

Walgreens said it “worked diligently with our suppliers to ensure we have enough supply to meet customer demand at nearly all locations.”

While other countries may continue to lift certain Covid-19 protocols for international travel, the US is unlikely to follow suit anytime soon, as it is one of the nation’s with the highest rate of infection.

Vietnam Coronavirus

 CDC Adds Vietnam to List Of Highest-Risk Travel Destinations 

The US Centers for Disease Control and Prevention (CDC) added Vietnam to it’s Level 4 risk category for travel this week. Level 4 is the highest-risk level when it comes to traveling during the Covid-19 pandemic. 

There are currently nearly 140 places within the Level 4 category of risk; which is more destinations than all other levels combined. In the beginning of 2022 about 80 places were on the list. 

The CDC places a location at “Level 4: Very High Covid-19 Risk” when more than 500 cases per 100,000 residents are registered within 28 days. 

Vietnam has become the only destination to be added to the list within recent weeks. Previously, the nation was listed at Level 3 for “high risk.” Global case numbers in general have been declining since peaking in late January, but experts are continuing to caution that the pandemic is nowhere near over. 

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New Zealand has had relatively few Covid cases due to strict pandemic protocol restrictions. Recently, however, the nation has recorded record numbers of cases in the past week. The country remains at “high risk” on Level 3 after moving up from Level 2 last week. 

The CDC advises avoiding all travel to countries deemed Level 4. The CDC does not include the US in its list of advisories, but the nation is currently coded at Level 4. Mexico, Canada, France, Peru, Singapore, and Spain are some of the other countries that have remained at Level 4 for over a month. The United Kingdom has remained there since July 2021. 

The Level 3 “high risk” category applies to destinations that have had between 100 and 500 cases per 100,000 residents within 28 days. Comoros, Hong Kong, São Tomé and Príncipe were added to the category this week. 

Hong Kong went from Level 1 to Level 3 this week, it previously was on Level 1 since May 2021. Hong Kong is currently dealing with their worst Covid-19 outbreak since the start of the pandemic, and is planning on testing its entire population in March. 

Destinations at a Level 2 are considered “Covid-19 moderate,” meaning they have around 50 to 99 cases per 100,000 residents within 28 days. 

This week, 10 destinations moved down to Level 2, including Uganda, Ghana, Republic Of Congo, Montserrat, Rwanda, Togo, Lesotho, Côte d’Ivoire, Mali, and Liberia. 

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To be considered “Level 1: Covid Low” a destination must have less than 50 cases per 100,000 residents over 28 days. Nigeria was the sole destination that moved to Level 1 this week. There are only 5 other locations considered Level 1, including China where the 2022 Winter Olympics were hosted. 

Finally, the CDC also has a risk level for “unknown” risk due to a lack of information and Covid data. These are typically smaller remote places, or places with ongoing warfare/civil unrest. 

Transmission rates are “one guidepost for travelers’ personal risk calculations,” according to CNN Medical Analyst Dr. Leana Wen.

“We are entering a phase in the pandemic where people need to make their own decisions based on their medical circumstances as well as their risk tolerance when it comes to contracting Covid-19,” Wen said.

“You should interpret Level 4 to mean this is a place with a lot of community transmission of Covid-19. So if you go, there is a higher chance that you could contract the coronavirus,” said Wen.

“Some people will decide the risk is too high for them, other people will say, ‘Because I am vaccinated and boosted, I am willing to take on that risk. So this really needs to be a personal decision that people weigh understanding that right now the CDC is classifying the different levels based on community transmission rates, and basically only that. They’re not taking into account individual circumstances,” Wen explained. 

You can review the CDC’s risk levels for any global destination on its travel recommendations page.