Heat, humidity, UV rays linked to COVID-19 spread: Yale School of Public Health

 While physical proximity and the use of face masks are well-known factors in the spread of COVID-19, new research links meteorological variables such as temperature, humidity, and ultraviolet (UV) radiation to the transmission of SARS-CoV-2, the virus that causes COVID-19, the Yale School of Public Health (YSPH) finds.

A research team led by Assistant Professor Kai Chen investigated 2,669 counties throughout all regions and states in the United States from March 15 to December 31, 2020 to determine how readily the virus was transmitted. 

They found that warmer temperatures (above 20° Celsius), increased humidity, and higher levels of UV radiation were moderately associated with a lower reproductive number (a measurement of how many new infections are caused by a single infected person in a fully susceptible population), meaning that these factors were likewise associated with decreased person-to-person transmission. Of the three factors, absolute humidity played the greatest role.

The study, published today in the journal Nature Communications, provides one of the most robust bodies of scientific evidence yet linking weather conditions to the transmission of SARS-CoV-2. Early epidemiological studies of COVID-19 and meteorological factors offered uncertain and contradictory findings, mainly due to short study periods, inadequate control for confounding, and inappropriate COVID-19-related outcome variables and statistical methods.

“A unique strength of our study was its comprehensive control for the space- and time-varying non-meteorological factors, including using the reproductive number adjusted for public health interventions and simultaneously controlling for spatially and temporally heterogenous confounders,” said Chen, a member of YSPH’s Department of Environmental Health Sciences and the Yale Center on Climate Change and Health (CCCH). “Accounting for the substantial differences in the epidemic curves and confounding factors among states and counties, we were able to quantify the nonlinear associations between meteorological factors and SARS-CoV-2 transmission in the United States in 2020.”

In total, Chen and the members of his research team determined 17.5% of the virus’ reproductive number was attributable to meteorological factors. Specifically, they found that temperature accounted for 3.73%, humidity accounted for 9.35%, and UV radiation for 4.44%.

The fractions attributable to meteorological factors generally were higher in northern counties than in southern counties, meaning the people living in regions such as New England may need to be especially vigilant about the increased transmissibility of SARS-CoV-2 in winter, when cold and dry weather and low levels of UV radiation offer favorable conditions for COVID-19 spread, the researchers said.

Yale Professor Robert Dubrow, director of CCCH and a co-author of this study, said the findings suggest that the role of meteorological factors in COVID-19 dynamics is meaningful but not dominant. “Public health measures, including vaccination, mask wearing, and social distancing, represent the primary strategies for mitigating transmission of SARS-CoV-2,” he said. 

Yiqun Ma, a doctoral student in the Department of Environmental Health Sciences, is the first author of this study. Sen Pei and Jeffrey Shaman at Columbia University Mailman School of Public Health are co-authors.

https://news.yale.edu/2021/06/14/heat-humidity-and-uv-rays-linked-covid-19-spread-ysph-finds

Privacy issues widespread with digital health apps, says BMJ

 Developers of mobile health apps are comprehensively failing to safeguard the privacy of users, according to a study by researchers in Australia.

The team from Macquarie University compared 15,000 free mobile health (mHealth) apps available on the Google Play store and compared their privacy practices to those found in 8,000 non-health apps, finding “serious problems with privacy and inconsistent privacy practices.”

The range of apps put under scrutiny included tools for managing health conditions, symptom checkers, step and calorie counters, and menstruation trackers – many of which can contain sensitive health information.

Harvesting of personal data was pervasive, they write in the British Medical Journal, and patients “should be informed on the privacy practices of these apps and the associated privacy risks before installation and use.”

App developers often legally share user data, but inadequate privacy disclosures have been repeatedly found for many digital health apps, preventing users from making informed choices around the data, according to the researchers.

The study found that 88% of mobile health apps included code that could potentially collect user data, and while just under 4% were transmitting information, the authors say that is still substantial and should be taken as the considered as a lower bound for the real data transmissions performed by them.

Furthermore, 87.5% of data collection operations and 56% of user data transmissions were on behalf of third party services, such as external advertisers, analytics, and tracking providers, and 665 different third parties were identified in the study.

The top 50 third parties were responsible two-thirds of the data collection operations, which most commonly were a small number of tech corporations, including Google, Facebook, and Yahoo!.

About two thirds of the mHealth apps could collect advert identifiers or cookies, one third could collect a user’s email address, and about a quarter could identify the mobile phone tower to which a device was connected, potentially providing information on the user’s geolocation.

Almost a quarter of those transmissions occurred on insecure communication channels so could potentially be intercepted.

“Mobile apps are fast becoming sources of information and decision support tools for both clinicians and patients,” write the authors.

“Clinicians should be aware of these and articulate them to patients when determining the benefits and risks of mHealth apps,” they add.

In an editorial accompanying the study, Canadian researchers say the prevalent privacy concerns mean that it is difficult – and perhaps irresponsible – to offer tips to busy clinicians or consumers about how to choose a health app that protects their privacy.

They point out that consumers can make it more difficult to be tracked by disabling advert identifiers, adjusting app permissions, and using advert blockers.

However, the editorial calls for “greater scrutiny, regulation, and accountability on the part of key players behind the scenes – the app stores, digital advertisers, and data brokers – to address whether these data should exist and how they should be used, and to ensure accountability for harms that arise.”

https://pharmaphorum.com/news/privacy-issues-widespread-with-digital-health-apps-says-bmj/

Kansas judge finds CDC eviction moratorium unenforceable

 A Kansas judge is beginning to evict tenants who are behind on rent in advance of the expiration of a federal moratorium that some experts predict will bring a tide of people being forced from homes nationwide.

Johnson County Magistrate Judge Daniel Vokins said during a Zoom eviction hearing this week that he doesn’t think the moratorium, which was issued last year by the the Centers for Disease Control and Prevention and expires at the end of the month, is enforceable.

Eric Dunn, director of litigation for the National Housing Law Project, said he has heard of judges elsewhere — including in Florida, Georgia and North Carolina — ignoring the CDC moratorium, but couldn’t say whether it’s been a widespread practice.

The federal moratorium has kept many tenants owing back rent housed. More than 4 million people nationally say they fear being evicted or foreclosed upon in the months following its expiration, census data shows. Making matters worse, the tens of billions of dollars in federal emergency rental assistance that was supposed to solve the problem has not reached most tenants.

“We thought 2021 was going to be better and it is turning out to be just as bad,” said Denise Wall, 31, of the Kansas City suburb of Shawnee, who applied for rental aid in March but is still trying to find out whether she qualifies.

She lost her job as a cook as the pandemic started and was out of work for nearly a year before beginning another job in April as a medical courier, picking up and delivering tests. Vokins set her case for trial on July 2.

“This wasn’t anything any of us asked for,” she said in a Friday interview at her apartment, where she and her wife have been collecting boxes as they look for a new place to live. Her wife’s three sons also live with them part of the time.

Vokins noted in moving forward on evictions that a federal judge last month found the CDC exceeded its authority when it imposed the moratorium last year. He said the ruling means that “any current or future moratorium order issued by the CDC is not valid.”

Kansas also had its own eviction moratorium, but it expired at the end of last month. Vokins said that means that “the eviction laws prior to the pandemic in March 2020 is the current law today.”

Casey Johnson, an attorney for the non-profit law firm Kansas Legal Services, noted the federal ruling was issued in the 6th Circuit and wasn’t binding in Kansas, which is in the 10th Circuit.

“Basically he’s choosing to accept that ruling even though he doesn’t have to,” Johnson said.

Vokins encouraged renters and landlords to work together to obtain emergency rental funds but said he would only pause court proceedings if both sides agreed to the delay.

Two other tenants who appeared before Vokins on Thursday said they were seeking the federal rental aid. A third tenant who couldn’t get his sound to work and only was able to communicate with thumbs up and thumbs down hand motions sent an email to the court later in the day saying that he also had applied.

Kansas is now distributing $200 million in federal rental assistance. The Kansas Housing Resources Corp., the state’s housing finance agency, which is responsible for distributing the money in every community except Wichita, has distributed $5.5 million so far to help 956 of the 7,780 households that have applied.

The state received another $20 million in rental assistance last year and handed out $17 million of it, said Emily Sharp, a spokeswoman for the agency.

“The second round of funding has much more stringent federal guidelines, so it is much more difficult for us to award that funding because quite honestly the applicants have more hoops to jump through,” Sharp said. Besides rent, that money also can go toward utilities and internet expenses.

Luke Demaree, an attorney for Fox Run Apartments, said apartment staff is in constant contact with the agency but can’t get details on who is approved or when to expect the money.

“If this was something that was working it would be very, very beneficial to us and we would like nothing more than to have rents caught up,” he said. “We would like nothing more than that, but at the same time, that is not what we see happening.”

Karen Nations, who also represented landlords at the hearing, said the moratorium has been difficult.

“Landlords have been struggling to pay their bills, and people have taken advantage of the moratorium,” she said, adding that some who can afford to pay their rent are not. “It is a very tricky balancing act to get the mortgage paid if you’re not getting your rent.”

https://apnews.com/article/kansas-health-coronavirus-pandemic-b9b1b17c941ce4c6bdeb5e523e3eaac9

AP-NORC poll: Many Americans resuming pre-virus activities

 Many Americans are relaxing precautions taken during the COVID-19 pandemic and resuming everyday activities, even as some worry that coronavirus-related restrictions were hastily lifted, a new poll shows.

The poll from The Associated Press-NORC Center for Public Affairs Research finds that majorities of Americans who were regularly doing so before the pandemic say they are returning to bars or restaurants, traveling and attending events such as movies or sports.

Just 21% are very or extremely worried about a COVID-19 infection in their inner circle — the lowest level since the pandemic began — and only 25% are highly concerned that the lifted restrictions will lead to additional people being infected in their community.

Andrea Moran, a 36-year-old freelance writer and mother of two boys, said she feels both relief and joy at the chance to resume “doing the little things,” such as having drinks on a restaurant patio with her husband.

“Honestly, I almost cried,” Moran said. “It’s such a feeling of having been through the wringer, and we’re finally starting to come out of it.”

Still, 34% of Americans think restrictions in their area have been lifted too quickly, while somewhat fewer — 27% — say they were not lifted quickly enough. About 4 in 10 rate the pace of reopening about right.

The way Americans approached their daily lives suddenly changed after COVID-19 spread through the U.S. in early 2020. Following the advice of health officials and governments, people isolated in their homes — either alone or with families — to avoid exposure to the virus, which has sickened more than 33 million people and killed 600,000 people in the U.S.

During the height of the pandemic, restaurants, movie theaters and stores either closed or continued operating with limited occupancy; church services, schools and government meetings went virtual; and many employers made working from home an option or a requirement. Mask wearing in public became the norm in most places, with some states and cities making it mandatory.

The emergence of the vaccine has helped slow down rates of infection and death, allowing state and local economies to reopen and leading Americans to return to activities they once enjoyed.

The Centers for Disease Control and Prevention advised last month that vaccinated Americans don’t have to wear a mask in most scenarios, indoors or out. The latest CDC data shows 53% of all Americans — 65% of those 18 and older — have received at least one dose of the vaccine.

According to the AP-NORC poll, American adults who have not yet rolled up their sleeves for the shot remain hesitant to do so. Just 7% of those who have not been vaccinated say they definitely will get a COVID-19 vaccine, and 15% say they probably will.

Forty-six percent of Americans who have not been vaccinated say they will definitely not get a vaccine, and 29% say they probably will not. Young adults, Americans without a college degree, white evangelicals, rural Americans and Republicans are most hesitant to get vaccinated.

The poll finds many Americans are still wearing masks and taking precautions to avoid contact with other people, but the percentage of those doing so is down significantly from just a few months ago.

In late February, 65% said they were always wearing a mask around people outside their households. Now, just 37% say so, though 19% say they often wear one.

Forty percent of Americans say they are extremely or very likely to wear a mask when participating in indoor activities outside their homes, while just 28% say the same about outdoor activities.

Aaron Siever, 36, of New Market, Virginia, said he and his wife have consistently worn masks and taken other precautions, including getting vaccinated. But Siever said virus-related restrictions were not lifted quickly enough, lamenting that some precautions were politicized and caused an “inherent panic.”

“I think with masks being worn and people getting vaccinated, I think we could have opened a little earlier,” said Siever, who maintains the grounds of Civil War battlefields in Virginia. “We started focusing on the politics of reopening, rather than the health.”

Now that most states have lifted restrictions, the poll finds about two-thirds of Americans who used to travel at least monthly say they will do so in the next few weeks. About three-quarters of frequent restaurant or bar-goers before the pandemic say they will now return. A year ago, only about half said they would travel or go to restaurants if they could.

Likewise, more are returning to activities such as visiting friends and family, seeing movies or concerts, attending sporting events and shopping in-person for nonessential items.

In Cookeville, Tennessee, Moran said her family still regularly wears masks in public, especially when they are indoors or around a lot of people. Both she and her husband have been vaccinated. Moran said she has eaten at outdoor restaurants, but she is avoiding indoor dining.

“Even if the air conditioning circulation is good, I just don’t feel comfortable right now going inside, where there’s a lot of people in fairly close proximity who I don’t know,” Moran said.

Moran said her family avoided nonessential travel during the height of the pandemic, canceling a trip to see her brother in Fort Lauderdale, Florida. But last weekend, the family traveled for the first time in more than a year — a roughly 3 1/2-hour road trip to Asheville, North Carolina, to visit a childhood friend.

“I felt a little bit nervous just because being around people is such a surreal thing after so long,” Moran said. “I was really excited and I was thrilled for my kids that they were able to get out and get back to some semblance of normality.”

The AP-NORC poll of 1,125 adults was conducted June 10-14 using a sample drawn from NORC’s probability-based AmeriSpeak Panel, which is designed to be representative of the U.S. population. The margin of sampling error for all respondents is plus or minus 4.2 points.

https://apnews.com/article/only-on-ap-lifestyle-coronavirus-pandemic-health-ddfd165dd67e9ec79d4850a1d80734e8

Amazon Halo's AI-powered body fat calculator seen on par with lab-quality devices

Forget about traveling to a lab for a pricey X-ray to get an accurate measurement of body fat percentage—Amazon’s Halo app can do it with just four smartphone photos and the app’s built-in machine learning algorithms.

A new Amazon-sponsored study of Halo’s Body feature found that it produced body fat measurements with accuracy comparable to the gold standard technique of dual-energy, X-ray absorptiometry, or DXA. The app also outperformed a handful of professional- and consumer-quality smart scales and the air-displacement method for measuring body fat.

The tool asks users to take four photos of themselves—showing the front, back and each side of their bodies—using their smartphone camera. From there, the app builds a 3D model.

The Body app then estimates the user’s current percentage of body fat and also offers a slider tool showing how their physical appearance might change as amounts vary from 13% to 50%.

Body works by using a deep neural network to analyze the shape of a user’s body and so-called “hot spots” for body fat, including the torso, thighs and mid-back. The AI algorithm then produces its body fat estimation within seconds.

According to the study, conducted with researchers from Massachusetts General Hospital and Louisiana State University’s Pennington Biomedical Research Center, the app's estimations not only closely matched those produced through DXA, but were also the closest match to DXA’s measurements of all the methods examined.

Those other methods included the use of three consumer smart scales, two professional-quality smart scales and air-displacement plethysmography, where an individual is sealed into a pod that determines their total volume by measuring the amount of air displaced by their body.

A total of 134 adults were included in the study. This group, which was about 61% female, ranged in age from 21 to 76 and also represented a range of ethnicities and body mass indexes, according to the company.

Body’s visual body composition method was found to be twice as accurate as the at-home smart scales at estimating body fat, as well as significantly more accurate than all other methods sampled when compared to DXA measurements.

Despite this demonstration of the Halo app’s accuracy and the tool’s ability to provide a clearer picture of a user’s health than basic BMI measurements, the study results should be taken with a grain of salt due to the small sample size and Amazon’s financial backing of the study—though the company noted that it was not involved in data collection.

Additionally, Body does not break down its estimates into the different types of body fat, including relatively harmless subcutaneous fat and the more dangerous visceral fat.

The Body feature was included last August in the launch of Amazon’s Halo platform, which includes the app and an accompanying wearable device. Besides measuring body fat, the platform’s features so far include tracking sleep and fitness and using built-in microphones to analyze emotional well-being from a user’s speech patterns.

“Any health and wellness journey requires two important elements: information and action. At Halo, we believe in leveraging the power of Amazon’s technological know-how to provide our members with the most relevant health information possible,” the Halo team wrote in a blog post about the study’s results.

“That’s what Body is all about—arming you with accurate, clinically relevant information about your body composition that can help you (and your care provider if you choose to share with them) decide how to proceed on your unique health journey. We know that sometimes new information like this can be challenging to take in, but you can rest assured that it is accurate,” they wrote.

https://www.fiercebiotech.com/medtech/amazon-halo-app-s-ai-powered-body-fat-calculator-par-lab-quality-devices-study-finds 

Google reorganizes health division, sheds 130 employees, drops consumer health focus

 Dr. Google has a new look. The tech giant’s health division has undergone a significant reorganization, resulting in a downsized team and a streamlined focus on clinical and regulatory work rather than consumer-facing offerings.

The reorg includes a transfer of nearly 20% of Google Health’s staff to other teams throughout the company, including its search division and newly acquired Fitbit. Google closed its $2.1 billion deal for the wearable device maker in January with a promise to spark more competition in wearable devices, including with the Apple Watch and its bevy of health-focused features.

About 130 staffers have been reassigned so far, bringing Google Health's head count down from about 700 earlier this year to near 570, according to company data obtained by Insider.

In addition, the slimmed-down team has been restructured into three groups, per a May 5 company email from Google Health head David Feinberg, M.D., as seen by Insider.

The first of these groups will focus on clinical work, centered on developing Google Health's core product, Care Studio, which aims to allow clinicians to essentially perform Google searches on patients’ electronic health records.

A pilot of Care Studio has already launched with St. Louis-based Ascension, and was further expanded across the health system earlier this year. Incidentally, Google and Ascension's yearslong partnership was the source of major backlash Google faced in late 2019 when reports surfaced that the tech company had been offered wide-ranging access to Ascension patients' HIPAA-protected health data to help develop new healthcare technologies.

The second Google Health team will operate under the banner of Health AI. Its focus will be on building new software tools to improve medical imaging and genomic analysis as well as algorithm-based screening for diabetic retinopathy, a project previously pursued with its life science-focused sister company Verily.

The final group will overlap with the clinical teams from the Fitbit and Google Fit divisions to manage regulatory, clinical and equity issues not only within Google Health but also the Fitbit team and others within the company.

“We brought together some teams to combine expertise and focus our efforts on health and wellness,” Google Health said in a statement to Insider about its reorganization. “Google Health will continue to build products for clinicians, conduct research to improve care and make people healthier and to help ensure all health-related projects at Google meet the highest standards.”

Notably missing from Google Health’s new structure is a consumer health team that would focus on developing apps and devices that might compete with the consumer-centric offerings from Google competitors like Apple and Amazon. Instead, the company seems to be leaving the those health projects to Fitbit.

Indeed, many of the workers moved from Google Health to Fitbit were those working on health sensors and personal health records, indicating the company’s desire to boost Fitbit’s offerings to more closely compete with the Apple Watch, the Apple Health app, Amazon’s emotion-tracking Halo wearable and more.

But while the Fitbit division is reportedly now housed under Google’s devices and services group, it will still work closely with Google Health. In one example highlighted in Feinberg’s internal memo, Google Health’s former director of health technologies was moved to Fitbit’s research team, but will continue to work in tandem there with the new Health AI team at Google Health.

https://www.fiercebiotech.com/medtech/google-reorganizes-health-division-shedding-130-employees-and-dropping-consumer-health

Biogen upped to Overweight from Neutral by Piper Sandler

 Target to $450 from $384

https://finviz.com/quote.ashx?t=biib&ty=c&ta=1&p=d