Tag: Levels

 

Burgum bumps risk levels for several North Dakota counties

BISMARCK, N.D. (AP) — Gov. Doug Burgum raised the coronavirus risk level Thursday in several North Dakota counties but did not order restrictions, even as the number of hospitalizations and new infections set daily highs and as the state reels from its deadliest month since the pandemic began.

Burgum moved eight counties from moderate to high risk under the state’s five-level plan to set coronavirus management protocols for everything from businesses to family gatherings. That brings to 24 the number of North Dakota’s 53 counties now deemed high risk. The guidance for high-risk counties includes limiting businesses occupancy to 25% with a cap of 50 people and encouraging businesses to require masks. The guidelines are only recommendations and not enforced.

Burgum raised the alert level to high for Grand Forks, Mercer, LaMoure, Ramsey, Richland, Towner, Walsh and Ward counties. He also raised the risk levels for eight counties from low to moderate risk. They are Adams, Hettinger, Kidder, Pembina, Rolette, Stutsman, Traill and Wells counties.


Burgum has avoided statewide mandates such as mask-wearing and business occupancies, instead stressing a personal responsibility message, a theme he renewed Thursday at his weekly coronavirus update at the state Capitol. He has said the five-level color-coded guidelines are to be used by local leaders “as a baseline for their own policies.”

City leaders in many communities, including Fargo, Bismarck and Minot, have moved to require face coverings in most settings, though the directives are not enforced.

Burgum said more than half of the state’s population are living in areas that have some sort of directive to wear masks.

“We have seen communities coming together. We’re seeing some progress,” the Republican governor said.

There are “signs of optimism — I wouldn’t say we’ve turned the corner yet,” he said.

Earlier Thursday, the North Dakota Department of Health reported six hospitalizations in the last day due to the coronavirus, increasing the total number of patients in medical facilities to a record 184.

North Dakota’s death toll from COVID-19 hit 499 on Thursday, with health officials reporting an additional 11 deaths. October has been the deadliest month to date from the coronavirus, accounting for 228 of the deaths recorded since the pandemic began.

Health officials reported a record 1,222 new infections from the virus on Thursday, and a daily positivity rate of 15.6%.

The COVID Tracking Project reported that North Dakota has had more than 1,442 new cases per 100,000 people over the past two weeks, which leads the nation. The rolling average number of daily new cases has increased by more than 40% in the last two weeks, according to Johns Hopkins University researchers.

There were 240 available inpatient beds plus 23 intensive care unit beds in North Dakota, according to state data.

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White House lists ending Covid-19 pandemic as an accomplishment despite cases spiking to record levels

The White House included ending the coronavirus pandemic on a list of the Trump administration’s science and technology accomplishments, despite nearly half a million Americans tested positive for Covid-19 in just the last week.



a man wearing glasses: TOPSHOT - US President Donald Trump leaves after a Hispanic Heritage Month event in the East Room of the White House October 6, 2017 in Washington, DC. President Trump invited over 200 Hispanic business, community, and faith leaders, and guests from across the country to join in the celebration of Hispanic Heritage Month. (Photo by Brendan Smialowski/AFP/Getty Images)


© Brendan Smialowski/AFP/Getty Images
TOPSHOT – US President Donald Trump leaves after a Hispanic Heritage Month event in the East Room of the White House October 6, 2017 in Washington, DC. President Trump invited over 200 Hispanic business, community, and faith leaders, and guests from across the country to join in the celebration of Hispanic Heritage Month. (Photo by Brendan Smialowski/AFP/Getty Images)

A White House Office of Science and Technology Policy news release made the claim in announcing a document highlighting the administration’s science and technology achievements over the past four years.

“Highlights include: ENDING THE COVID-19 PANDEMIC,” the news release sent to reporters read. “From the outset of the COVID-19 pandemic, the Administration has taken decisive actions to engage scientists and health professionals in academia, industry, and government to understand, treat, and defeat the disease.”

When asked for comment on including ending the pandemic among the administration’s first term accomplishments, office spokeswoman Kristina Baum pointed to the full report.

“The great work the Trump administration is doing to end the pandemic is a top priority and worthy of highlighting,” she said in an email.

But on Wednesday, White House communications director Alyssa Farah said the release was “poorly worded.”

“The intent was to say that it is our goal to end the virus. But what I would say is this: because of the President’s leadership, we are rounding the corner on the virus,” she added.

The news release comes as the country reports the largest number of daily cases seen to date. The seven-day average of daily new cases reached an all-time high of 68,767 on Sunday, according to data from Johns Hopkins University. The previous record of 67,293 was set July 22.

The abysmal week was marked by the two worst days of daily new cases reported since the pandemic began. More than 83,000 new cases were reported both Friday and Saturday, and the seven-day average of new Covid-19 cases has soared 23% in the past week, according to Johns Hopkins data on Monday. The seven-day average of new tests performed, meanwhile, has risen only 2.87% over the past week, according to the Covid Tracking Project.

The President has repeatedly, falsely, blamed the increase in cases on an increase in testing.

New cases are also being seen within the administration itself. At least five aides to Vice President Mike Pence, including his bodyman and his chief of staff, Marc Short, tested positive for coronavirus in recent days, sources told CNN.

The internal report that the news release was describing did not say that the Covid-19 pandemic is over. It merely touted the administration’s various actions to fight it.

“Since the start of the pandemic, the Administration has taken several actions to engage scientists in academia, industry, and government to understand and defeat this

CV Benefit of Eicosapentaenoic Acid Seen at All eGFR Levels

Daily icosapent ethyl (Vascepa) safely and effectively reduces fatal and nonfatal ischemic events in patients with reduced kidney function, a prespecified analysis of the REDUCE-IT RENAL study shows.

“Some cardiovascular drugs are not as effective in kidney disease patients,” said investigator Deepak Bhatt, MD, MPH, from Brigham and Women’s Hospital Heart and Vascular Center and Harvard Medical School, Boston.

“So we looked at patients according to their eGFR — in particular, patients with an eGFR of less than 60 mL/min per 1.73 m² — because we wanted to make sure the drug was as safe in those patients as it was in others and that they weren’t having any more side effects than others,” he told Medscape Medical News.

Icosapent ethyl, a highly purified prescription formulation of the omega-3 oil eicosapentaenoic acid, has been shown to lower triglycerides and have anti-inflammatory, antioxidative, and plaque-stabilizing properties.

In the original phase 3 Reduction of Cardiovascular Events With Icosapent Ethyl – Intervention Trial (REDUCE-IT), 8179 patients with cardiovascular (CV) disease or diabetes and one additional CV risk factor were randomized to treatment with icosapent ethyl 4 g a day or placebo. Patients had to have a fasting triglyceride level between 150 and 500 mg/dL to be eligible for study enrollment, and a low-density-lipoprotein (LDL) level between 41 and 100 mg/dL.

The primary end point was a composite of CV death, nonfatal myocardial infarction, nonfatal stroke, coronary revascularization, and unstable angina. The key secondary end point was a combination of CV death, MI, and stroke.

At a mean follow-up of 4.9 years, there was a 25% relative risk reduction and a 4.8% absolute risk reduction in the primary composite end point in the REDUCE-IT study, as previously reported by Medscape Medical News,

For the REDUCE-IT RENAL study, REDUCE-IT patients were categorized into three prespecified eGFR categories: less than 60 mL/min per 1.73 m²; 60 to less than 90 mL/min per 1.73 m², and at least 90 mL/min per 1.73 m².

In the cohort of 8179 study participants, the median baseline eGFR was 75 mL/min per 1.73 m² (range, 17 to 123 mL/min per 1.73 m²) and the mean LDL was around 70 mg/dL.



Arjun Majithia

CV event rates were higher in patients in the lowest eGFR category — less than 60 mL/min per 1.73 m² — than in the other categories. With icosapent ethyl, reductions in the primary and secondary end points were greater in the lowest category, although relative risk reductions were similar in the three categories, investigator Arjun Majithia, MD, also from Brigham and Women’s Hospital, reported during his presentation at Kidney Week 2020.

Risk for Events With Icosapent Ethyl by Baseline eGFR Category
eGFR (mL/min per 1.73 m²) Relative Risk, % Absolute Risk, % Number Needed to Treat P Value
Primary end point (composite of CV death, nonfatal MI, nonfatal stroke, coronary revascularization, unstable angina)
<60 mL –29 –7.1 14 .0002
60 to <90 –20 –3.8 27 .001
≥90 –30 –4.8 21 .003
Secondary end point (combination of CV death, MI,

Trauma levels: How many are there?

Trauma centers provide immediate definitive care to people with severe injuries. Some parts of the United States acknowledge three levels of trauma centers, while others acknowledge five levels.

Level 1 is for the most serious injuries, where trauma is often large and requires a fast response time. The lower levels focus on evaluating and stabilizing the person so that, if necessary, staff can transfer them to a higher level facility.

Hospitals vary in how they determine who needs to attend a higher level of trauma center. Healthcare professionals will likely judge this according to physiological data and the type and mechanism of injury.

Keep reading to learn more about the five levels of trauma centers, as well as pediatric trauma centers.

In U.S. states that acknowledge five levels of trauma centers, the highest level is level 1. These centers provide the most comprehensible level of trauma care.

As the level decreases, the centers tend to have fewer resources and facilities. However, the resources and availability of staff are enough to provide a basic level of trauma care.

Level 1

A level 1 trauma center is a specialist care facility. It provides care for each aspect of an injury, including prevention, treatment, and rehabilitation.

According to the American Trauma Society, a level 1 trauma center usually:

  • has surgeons available within the facility 24 hours a day
  • has prompt availability of practitioners such as orthopedic surgeons and neurosurgeons
  • acts as a referral resource for people in nearby regions
  • provides public education to the surrounding communities
  • offers continuing education for staff within its facility
  • uses a quality assessment program
  • uses teaching and research to help develop and improve trauma care
  • has a screening and intervention program in place for people living with substance use disorders
  • meets a minimum requirement regarding the annual volume of severely injured patients

Level 2

Level 1 and level 2 trauma centers are very similar, and both can manage people with severe injuries. Both centers require surgeons to be available 24-7 to respond to a trauma patient shortly after their arrival at the center.

One of the main differences between level 1 and level 2 trauma centers is that level 2 centers do not have the research and publication expectations of a level 1 center.

The American College of Surgeons also note that in level 1 trauma centers, the director of the intensive care unit (ICU) must be a surgeon with a current board certification in surgical critical care.

This requirement is not in place for level 2 trauma centers, which also do not require continuous rotations in trauma surgery for senior residents.

Level 3

A recent article in OTA International notes that level 3 trauma centers typically:

  • provide care to injured people within their capabilities and resources
  • transfer stabilized patients to level 1 or level 2 centers, when necessary
  • are in areas that are farther away from higher level trauma facilities
  • provide continuous surgical

10 Best Jump Ropes for All Fitness Levels

An affordable and compact piece of exercise equipment, the jump rope is a perfect staple for any home gym or gym bag. This small but mighty pick can completely transform your workout. That’s why we sat down with the jump rope queen herself,psychologist and fitness trainer Dr. Janine Delaney, known for her sculpted physique and impressive jump rope moves on Instagram, to learn more about the sport and what to look for when choosing the ultimate jump rope.

Jumping rope is a great way to lose weight and burn fat and calories while having fun,” Delaney says. “Most people think of jumping rope as a sport for children, but it has many benefits for adults as well, especially for individuals over the age of 40.” Delaney herself actually started jumping rope at the age of 43, mainly because she wasn’t a fan of running and was looking for another form of cardio.

When it comes to the benefits of jumping rope, the advantages are vast. “Jumping rope increases your natural endorphins, which puts you in a good mood and increases your energy and libido,” Delaney says. “What most people don’t realize is that jumping rope will actually burn more fat and calories than running, swimming, or biking. It not only puts your cardiovascular system to use, but also helps to build muscle strength, improve coordination, and even boost metabolism.”

Delaney says that you don’t have to be athletic or coordinated to start jumping rope, but adds that making sure your rope is sized correctly to your height is critical as well as maintaining proper form and a little practice. If you’re a jump rope beginner, Delaney offers these important tips:

  1. Arm positioning: Keep your chest up, core engaged, and arms close to your body. If your arms are too wide, it will shorten the length of the rope and you’ll likely trip.
  2. Utilize your wrists: Jumping rope is all about recruiting your wrists to do the work instead of moving your arms.
  3. Keep your head up: Jumping rope is about timing, and if you look down and wait for the rope to pass you then you’ll likely trip. A better approach is to look straight ahead and jump as the rope crosses your line of sight, which will guarantee better rhythm as you skip.
  4. Take a video of yourself: Practice makes perfect, and just a little bit of practice each and every day will help you get better and better. Watch YouTube videos of tutorials to help you visualize the proper movement, and take a video of yourself to check your form.
  5. Properly size your rope: To size your rope, stand on the middle of the rope with one foot and bring both handles up to your shoulders. The rope should come up to your shoulders, no higher and no lower. Make sure to buy a rope that you can either cut to your size or one that comes according to height.

Now that you

Could Mom’s Thyroid Levels Influence ADHD in Kids? | Health News

By Serena Gordon
HealthDay Reporter

(HealthDay)

WEDNESDAY, Oct. 21, 2020 (HealthDay News) — Low levels of thyroid hormone during pregnancy may contribute to the development of attention deficit hyperactivity disorder in the child, new research suggests.

The study found that children born to mothers with low thyroid hormone levels during the first trimester of pregnancy had a 28% increased risk of being diagnosed with ADHD later.

Thyroid hormones play an important role in the growth and development of the fetal brain, especially during the first trimester of pregnancy, the researchers said.

“The thyroid is important in pregnancy and can have long-term impacts,” said study lead author Morgan Peltier. He’s an associate professor in the departments of clinical obstetrics, gynecology and reproductive medicine at NYU Winthrop Hospital in Mineola, N.Y.

“These findings highlight the greater need for prenatal care,” Peltier added.

ADHD is a neurodevelopmental disorder that affects more than 9% of U.S. children, according to the researchers. The condition leads to difficulty paying attention, impulsiveness and hyperactive behavior.

A number of genes are suspected to be involved in ADHD. Many of those genes are regulated by thyroid hormones, the team noted.

For the study, the researchers looked at records from Kaiser Permanente Southern California hospitals. These included data on nearly 330,000 children born between 2000 and 2016. Information on the children’s health is collected until they reach 17.

Almost 17,000 children in this group were diagnosed with ADHD. The children were all evaluated for ADHD using the same criteria.

Almost 10,000 expectant moms were diagnosed with low thyroid hormone levels during pregnancy.

In addition to finding an overall increased rate of ADHD in children born to mothers who had low thyroid levels, they found a significant racial difference. Hispanic children whose mothers had low thyroid hormone levels during pregnancy had a 45% increased risk of ADHD. White children had a 22% increased risk.

Peltier said it’s not clear from the data in this study why the effect of low thyroid hormones was stronger for Hispanic children.

The researchers also noted the effect of low thyroid hormones was more significant in boys than in girls. The study only found an association between thyroid levels and ADHD, rather than a cause-and-effect link.

Dr. Michael Cackovic is a maternal fetal medicine specialist at the Ohio State University Medical Center in Columbus, and was not part of the study. He said it highlights how important it is to “optimize women’s health before pregnancy if you have the opportunity.”

Cackovic said thyroid hormone screening isn’t currently done in all women during pregnancy.

Symptoms of low thyroid include tiring easily, feeling cold, constipation, dry skin, being forgetful and feeling depressed, according to the American Thyroid Association.

If you have symptoms of low thyroid (hypothyroid), Cackovic said you should bring them up with your doctor. However, many of the symptoms of low thyroid — such as fatigue or constipation — are similar problems that occur in pregnancy.

Cackovic said more research would be needed to see if

Daily case numbers are at levels not seen since the summer, and 14 states recently have set hospitalization records

Daily coronavirus case numbers in the US are at levels not seen since the summer, and more than a dozen states set record highs for Covid-19 hospitalizations in the past week — yet more evidence, experts say, of a difficult fall and winter ahead.



a person sitting at a desk in an office chair: NEW YORK, NEW YORK - OCTOBER 05: A person walks through the Brooklyn neighborhood of Borough Park on October 05, 2020 in New York City. New York City Mayor Bill de Blasio has announced plans to close nonessential businesses and schools in nine neighborhoods, including Borough Park, where the rate of positive COVID-19 cases have been higher than three percent in the past seven days. (Photo by Spencer Platt/Getty Images)


© Spencer Platt/Getty Images
NEW YORK, NEW YORK – OCTOBER 05: A person walks through the Brooklyn neighborhood of Borough Park on October 05, 2020 in New York City. New York City Mayor Bill de Blasio has announced plans to close nonessential businesses and schools in nine neighborhoods, including Borough Park, where the rate of positive COVID-19 cases have been higher than three percent in the past seven days. (Photo by Spencer Platt/Getty Images)

The country’s seven-day average of new daily cases was above 58,300 as of Monday — a level not seen since the first week of August, and climbing closer to the summer’s peak of 67,200 on July 22.

Average daily cases have soared 70% since September 12, when the country was at a two-month low of about 34,300.

As cold weather is likely to drive more gatherings indoors, the case level appears too high to avoid dangerous levels of infections and hospitalizations in the coming weeks, experts have said.

“(With) the fact that we’re only going to see more transmission occur with indoor air, people inside, this is going to be a rough fall,” Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told CNN on Tuesday.

Case rates and hospitalizations are rising especially in the Midwest, Great Plains and parts of the West.

Fourteen states reported their peak Covid-19 hospitalizations in the last week: Alaska, Arkansas, Iowa, Kansas, Kentucky, Montana, Missouri, Nebraska, North Dakota, Oklahoma, South Dakota, Utah, West Virginia and Wisconsin, according to the Covid Tracking Project.

The virus’s prevalence is bad enough that the director for the National Institutes for Health says his family won’t gather for Thanksgiving this year.

“It is just not safe to take that kind of chance with people coming from different parts of the country of uncertain status,” Dr. Francis Collins told National Public Radio’s “Morning Edition” on Tuesday. “The problem with this disease is it is so easy for people to be infected and not know it, and then spread it to the ones next to them without realizing it.”

“All of this, I’m afraid, happens because we have not succeeded in this country in introducing really effective public health measures,” Collins said.

“Simple things that we all could be doing: Wear your mask, keep that six foot distance, and don’t congregate indoors, whatever you do, and wash your hands. And yet people are tired of it and yet the virus is not tired of us,” Collins said.

The country has now topped 220,000 Covid-19 deaths, a number some experts worry may also begin to climb faster.

“The numbers are moving in the wrong direction,” Dr. Tom Inglesby, the director of the Johns Hopkins

New fitness studio in Omaha offers strength, cardio workouts for all fitness levels | Live Well

Omaha’s newest fitness studio has something to offer for all fitness levels, its owners said.

The Sculpt Studio, which mixes Pilates-style workouts with treadmill workouts, opened in late August in Elkhorn.

Owners Sarah Marshall and Emily Burgat teamed up to bring the concept to Omaha. The metro area already is home to several cycling studios, Marshall said.

“We wanted to bring something new and different,” she said.

Classes at Sculpt are high- intensity and low-impact. They’re suitable for gymgoers of all fitness levels. Some clients have used the classes as complements to their existing fitness routines, Marshall said.

In one class, gymgoers use Megaformer machines, which are similar to traditional Pilates machines. Participants work a muscle group until those muscles are fatigued before moving onto another group.

In another class, participants spend half the time on the Megaformers and half the time on Woodway Curve treadmills. The treadmills, which are curved on the bottom, are nonmotorized, so users control the speed by running or walking on them.

Classes are limited to 11 participants in the 2,000-square-foot studio. Each class is 50 minutes.

Machines are spaced out in the studio, and they’re wiped off regularly. Gymgoers are required to wear masks until they reach their designated machine for class. Class times are spaced out to avoid clients overlapping as they come and go.

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US records more than 70,000 new COVID-19 cases in one day, reaching midsummer levels

The United States reported a total of 70,450 coronavirus cases on Friday, making it the highest single-day increase for the country since late July, according to The New York Times COVID-19 database.



a person in a blue car: US records more than 70,000 new COVID-19 cases in one day, reaching midsummer levels


© Getty Images
US records more than 70,000 new COVID-19 cases in one day, reaching midsummer levels

News of the massive case spike is the latest piece of data that may suggest the fall and winter wave that’s been predicted by doctors and public health experts is already here.

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Midwestern states and others across the country are experiencing a resurgence in coronavirus cases, with Wyoming, Minnesota, Wisconsin, West Virginia, North Dakota, Indiana, New Mexico, Utah and Colorado all reaching records on Friday for single-day increases in cases.

As of Saturday afternoon, according to the Times, Indiana and Ohio had already topped their previous records.

In addition, more than 900 people in the U.S. died due to the virus on Friday, bringing the total number of deaths to at least 219,100. The database has recorded more than 8,141,600 cases since the virus first hit the country earlier this year.

According to the database, the world also hit a record for new cases in a single day with more than 415,000 infections reported Friday.

The nationwide seven-day average has also increased by nearly 8,000 daily new cases since last Friday, the Times reported.

The data also shows rural areas are experiencing higher rates of infections than ever before, with North Dakota and South Dakota adding more new cases per capita than any other states have since the start of the pandemic.

Other states with large rural areas, including Wyoming, Idaho, West Virginia, Nebraska, Iowa, Utah, Alaska and Oklahoma, have also recorded more cases in a seven-day period than in any previous week.

The surge in cases across the country, especially in the Midwest, has prompted warnings from some public health experts that the anticipated fall and winter wave of cases is already here and is hitting with unprecedented force.

“We’ve been talking about the fall surge for a long time now. I think that is the beginning of that reality,” Scott Gottlieb, Trump’s former Food and Drug commissioner, told CNBC on Friday.

As the colder months approach, people will be driven indoors to get away from the cold in enclosed, heated spaces.

Respiratory viruses like the flu and common cold tend to spread more easily in colder, dryer climates, leading health officials to believe it will be the same for COVID-19.

“You can’t enter into the cooler months of the fall and the cold months of the winter with a high community infection baseline,” Anthony Fauci, the nation’s top infectious diseases expert, said in a webinar Friday at Johns Hopkins University.

“We’re going to start doing a lot of things indoors, rather than outdoors, and that’s when you have to be particularly careful about the spread of a respiratory borne disease,” he added.

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Outpatient Visits Rebound for Most Specialties to Pre-COVID Levels

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

After taking a nosedive during the initial wave of the COVID-19 pandemic, then rising and plateauing, weekly outpatient visits in the United States have rebounded and now slightly exceed levels seen in late February, according to new data.

Overall visits plunged by almost 60% at the low point in late March and did not start recovering until late June, when visits were still off by 10%. Visits began to rise again — by 2% over the March 1 baseline — around Labor Day.

As of October 4, visits had returned to that March 1 baseline, which was slightly higher than in late February, according to data analyzed by Harvard University, the Commonwealth Fund, and the healthcare technology company Phreesia, which helps medical practices with patient registration, insurance verification, and payments, and has data on 50,000 providers in all 50 states.

The study was published online by the Commonwealth Fund.

In-person visits are still down 6% from the March 1 baseline. Telemedicine visits — which surged in mid-April to account for some 13% to 14% of visits — have subsided to 6% of visits.

Many states reopened businesses and lifted travel restrictions in early September, benefiting medical practices in some areas. But clinicians in some regions are still facing rising COVID-19 cases, as well as “the challenges of keeping patients and clinicians safe while also maintaining revenue,” write the report authors.

Some specialties are still hard hit. For the week starting October 4, visits to pulmonologists were off 20% from March 1. Otolaryngology visits were down 17%, and behavioral health visits were down 14%. Cardiology, allergy/immunology, neurology, gastroenterology, and endocrinology also saw drops of 5% to 10% from March.

Patients were flocking to dermatologists, however. Visits were up 17% over baseline. Primary care was also popular, with a 13% increase over March 1.

At the height of the pandemic shutdown in late March, Medicare beneficiaries stayed away from doctors the most. Visits dipped 63%, compared with 56% for the commercially insured, and 52% for those on Medicaid. Now, Medicare visits are up 3% over baseline, while Medicaid visits are down 1% and commercially insured visits have risen 1% from March.

Interestingly, the over-65 age group did not have the steepest drop in visits when analyzed by age. Children ages 3 to 17 saw the biggest decline at the height of the shutdown. Infants to 5-year-olds have still not returned to pre-pandemic visit levels. Those visits are off by 10% to 18%. The 65-and-older group is up 4% from March.

Larger practices — with more than six clinicians — have seen the biggest rebound, after having had the largest dip in visits, from a decline of 53% in late March to a 14% rise over that baseline. Practices with fewer than five clinicians are still 6% down from the March baseline.

Wide Variation in Telemedicine Use

The researchers reported a massive gap in the percentage of various specialties