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Sick St. Paul students still face 10-day isolation as CDC calls for 5

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US officials recommend shorter COVID isolation, quarantine

In a break with new federal guidelines, St. Paul Public Schools will continue to require coronavirus-infected students to isolate at home for 10 days after a positive test or first sign of illness.

The Centers for Disease Control and Prevention on Dec. 27 shortened its recommended isolation time from 10 days to five. After that, the recovering person can leave isolation, as long as they’re not experiencing symptoms and agree to wear a well-fitting face mask for five days.

Since their release, the guidelines have been adopted by at least a dozen of Minnesota’s largest school districts — but not St. Paul.

“SPPS is taking a more conservative approach to isolation periods for students than the CDC recommendation because of the need for students to be unmasked during meals and other implementation challenges at school,” the district said in a message to families Friday.

Spokesman Kevin Burns did not respond Monday to a request for more information about “implementation challenges.”

10 DAY ISOLATION

The St. Paul Federation of Educators had encouraged the district to stick with 10-day isolation for students and staff – or to require two negative rapid diagnostic tests for those returning sooner.

Although the St. Paul district kept the 10-day rule for students, staff now are to return after five days. That should help with staff shortages that have caused several metro school districts to move temporarily to distance learning.

St. Paul teachers union President Leah VanDassor did not return a phone message Monday.

The Elk River school district was among those adopting the new five-day isolation protocol for students and staff.

“We know this news will bring relief to many of our families as it reduces the amount of instruction time our students will miss,” the district said in a message to families. “However, we must continue to move forward with caution and to refrain from sending students to school while sick (even if they have passed the five-day quarantine period).”

COMPETING GOALS

The CDC said in its announcement that the change to shorter isolations was “motivated by science demonstrating that the majority of SARS-CoV-2 transmission occurs early in the course of illness, generally in the 1-2 days prior to onset of symptoms and the 2-3 days after.”

The agency also acknowledged that taking sick people out of society for 10 days is hard on individuals and society, especially at a time when the highly contagious omicron variant is taking over.

“These updated recommendations also facilitate individual social and well-being needs, return to work, and maintenance of critical infrastructure,” the CDC said on its website.

The change alarmed some health experts, who said it seemed driven less by science than practicality.

Anthony Fauci, chief medical adviser to President Joe Biden, told ABC News on Jan. 2 that the CDC was considering adding the requirement that recovering people test negative before they leave isolation. But the CDC update ultimately did not include that requirement.

Besides the shorter isolation period for infected people, the CDC also shortened its recommended quarantine to five days – from 10 – for unvaccinated or partially vaccinated people who come into close contact with an infected person.

DISTRICTS MOVE TO 5 DAYS

Since the CDC’s announcement, many large Minnesota school districts have adopted the five-day isolation for sick students and staff. They include Anoka-Hennepin, Rosemount-Apple Valley-Eagan, Osseo, Elk River, Robbinsdale, Wayzata, Mounds View, Lakeville, Bloomington, St. Cloud and Eastern Carver County.

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Who’s the best fit for Orlando Magic with No. 1 in 2022 draft?

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Who’s the best fit for Orlando Magic with No. 1 in 2022 draft?

It didn’t take long for the Orlando Magic’s draft lottery celebration to turn into speculation.

Moments after the Magic won the draft lottery Tuesday in Chicago, questions quickly started to surround Orlando, the winner of the No. 1 pick in the June 23 NBA draft.

What will be the Magic’s approach to having the top pick?

Will their philosophy during the scouting combine and predraft machinations change?

Are they drafting based on need?

Jeff Weltman, president of basketball operations, made it clear they’re not going into the process looking to draft based off need.

“We’re at the stage right now where we’re not a need-based team,” Weltman said. “We’re looking for talent, character and guys who fit the way we want to play and the way we want to grow the team.”

Coach Jamahl Mosley echoed Weltman.

“It’s constantly adding the high basketball IQ, the competitiveness, the toughness, the fighter — the guy that’s willing to come in and work with this group of guys,” Mosley said. “Jeff and those guys do a phenomenal job of evaluating the talent, getting to know these guys over time and then we’ll go from there.”

Orlando has another month to decide what they’ll do with the No. 1 pick. Here are the three best fits for the Magic:

1. Jabari Smith (Auburn)

Height: 6-foot-10 | Weight: 220 pounds | Age: 19

Smith’s best offensive skill — shooting — is an area the Magic can improve.

Orlando’s 33.1% 3-point percentage during 2021-22 was the league’s third-worst mark and it’s been a bottom-five shooting team the past two seasons.

Taking Smith, who shot 42% from beyond the arc on 5.5 attempts during his lone season with the Tigers, would instantly help make life easier for the Magic’s playmakers in the halfcourt.

Smith isn’t just dangerous in spot-up situations. At 6-foot-10 with a high release point, he can shoot over defenders with ease from multiple areas of the floor without needing to create much of an advantage.

His size, length and athleticism make him a disruptive perimeter defender and someone who doesn’t have trouble switching across multiple positions.

Because of his shaky ballhandling and inconsistent interior scoring, there are concerns about whether Smith will develop into the go-to scorer/creator the Magic need. But Smith would be the cleanest fit in what Orlando already has started to build with its roster.

2. Chet Holmgren (Gonzaga)

Height: 7 feet | Weight: 195 pounds | Age: 20

Holmgren is arguably the most polarizing top college player in this year’s draft.

His combination of rim protection (3.7 blocks with the Bulldogs), handles, touch near the rim, basketball IQ and floor-spacing ability for his size (7 feet) make him one of the more distinctive prospects in a while.

Holmgren’s size, length and versatility — he’s light enough on his feet to guard on the perimeter — is a profile Orlando has shown an affinity for in previous drafts.

The Magic started two-big lineups with Wendell Carter Jr. and Mo Bamba, and Holmgren could be a seamless fit next to Carter in the frontcourt so they can maintain rim protection at all times, a core principle of Mosley’s defensive system.

There are significant concerns about how effective Holmgren can be in the post on both ends of the floor and as a finisher at the rim because of his skinny frame for his height. Holmgren’s outside jumper (39% on 3s with Gonzaga) would have to be consistent for him to be an offensive threat.

Holmgren’s potential is evident and he fits into what the Magic already have, but there are questions of whether he’ll maximize his skillset.

3. Paolo Banchero (Duke)

Height: 6-foot-10 | Weight: 250 | Age: 19

Banchero’s skillset coming out of Duke suggests he can be a go-to option at the next level.

With the Blue Devils, Banchero thrived in creating opportunities for himself and others off the dribble. He’s a versatile scorer who finished well around the rim because of his strength, footwork and touch.

Banchero is one of the better-passing top prospects (3.2 assists as a forward) who can serve as an offensive hub, which the Magic could use after having the league’s second-worst offensive rating in 2021-22.

His outside shooting (33.8% from beyond the arc) is an area he’ll need to improve.

Banchero also wasn’t consistently locked in as a defender at Duke and it’s not clear how switchable he’ll be at the next level.

This article first appeared on OrlandoSentinel.com. Email Khobi Price at [email protected] or follow him on Twitter at @khobi_price.

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Rookie Christopher Morel’s special moment pumps life into the Chicago Cubs’ rebuild plan: ‘It’s so cool’

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Rookie Christopher Morel’s special moment pumps life into the Chicago Cubs’ rebuild plan: ‘It’s so cool’

If the Chicago Cubs could bottle moments like Tuesday night at Wrigley Field, they wouldn’t have to worry so much about people calling this a rebuild.

Christopher Morel’s bat-flipping celebration after homering in his first major-league at-bat, combined with Brandon Hughes’ five strikeouts in 1 ⅔ innings in his big-league debut, provided Cubs fans with hope the future might be brighter than imagined.

That’s what an infusion of youth can do.

“It just brings that energy, that new energy,” pitcher Kyle Hendricks said before Wednesday’s series finale against the Pittsburgh Pirates. “It’s having a good balance of both. We have so many good veteran guys around here now that bring the right energy from that side and that aspect.

“But seeing these young guys come up, kind of a deer-in-the-headlights (look) a little bit. They don’t know what to expect. They just go out and play and play so wholeheartedly and so natural. It’s just fun to see all that emotion come out of them.”

Morel was in the starting lineup at third base Wednesday, still flying from the electric moment in the eighth inning Tuesday. The 22-year-old call-up from Double-A Tennessee knew when he stepped up that Willson Contreras had homered in his first at-bat in 2016.

“I saw it on the scoreboard and I said to him, ‘Hey, I’m going to make my first at-bat a home run just like you,’ ” Morel said.

The moment the ball left the bat, Contreras jumped out of the dugout like the Cubs had won the pennant. It was an instant flashback to June 19, 2016, at Wrigley, when he homered in his first major-league at-bat on Father’s Day against the Pirates.

“It was amazing,” Contreras recalled Wednesday. “A good introduction for me in the big leagues.”

Justin Steele chimed in, recalling watching the shot six years ago when he pitched for Class A South Bend.

“Pretty sure me and Adbert (Alzolay) watched that home run together,” Steele told Contreras.

Morel’s homer sparked a wild reaction from the crowd at Wrigley, which already was on its feet for the 3-2 pitch. He performed a semi-moonwalk out of the box while flipping his bat for what he insisted was the first time in his career.

Really? His first-ever bat flip?

“Like this, yes,” he said. “Last year I hit a walk-off and I flipped my bat, but not like this.”

Morel became the ninth Cub to homer in his first major-league at-bat and the first since Contreras.

“I wasn’t thinking about it until it happened,” Hendricks said of the coincidence. “(Contreras) did it on the first pitch, of course. But we thought about it right away, especially Willson running out there giving him a hug. It was just an awesome, awesome moment for him. Going out there and doing that, it’s so cool to see things like that happen.”

Contreras said he was waiting for Morel to “do something positive, either a blooper or a base hit.”

Morel did something even better.

“Hitting a home run is pretty good,” Contreras said. “Almost nobody can do that in the big leagues.”

Manager David Ross called it a moment Cubs fans will always remember and said he and pitching coach Tommy Hottovy had “swelling” in their eyes.

“That’s what stories are made of, and I’ll never forget that,” Ross said. “It reminded me of Willson’s first at-bat, that emotion. And then I started laughing when he nearly missed first base, like Mark McGwire (after breaking the home run record).”

The Cubs were riding a wave entering Wednesday night’s game, with a four-game winning streak and Marcus Stroman scheduled to return to the mound Thursday after his COVID-19-related IL stint. Closer David Robertson was cleared to return from his COVID-related absence Wednesday.

Team President Jed Hoyer doesn’t want his plan labeled a “rebuild,” a term the Cubs embraced a decade ago before it became associated with another word — tanking.

But when kids such as Morel, Steele, Hughes and Keegan Thompson enjoy some success, “rebuild” doesn’t sound quite as offensive. Most Cubs fans, in fact, would prefer to watch unproven 22-year-olds develop at Wrigley than former prospects signed on the cheap or 30-something pitchers who can be moved at the trade deadline.

“We have a lot of good, young talent, and they are hungry,” Contreras said. “They bring a lot of positive energy around the clubhouse, which is always good to have.”

Hendricks and Contreras helped establish the winning culture on the North Side in their early years, and both said they hope the younger players understand they’re here to keep that culture alive.

“We’re trying to hold on to that,” Hendricks said. “And everybody that comes into this environment, we hope that’s what they feel.”

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Annabelle De St. Maurice: We’re losing the fight against superbugs, but there’s still hope

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Annabelle De St. Maurice: We’re losing the fight against superbugs, but there’s still hope

As parents, we inherently want to protect our children. We tell them stories with happy endings and reassure them that there aren’t monsters hiding under the bed.

But there’s an enemy living among us that poses a fatal threat to kids and adults alike — and we’re simply not doing enough to stop it.

These enemies are “superbugs” — bacteria and fungi that are resistant to antibiotics and other medications. All microbes, from everyday bacteria to killer superbugs, are constantly evolving. And paradoxically, exposing microbes to antimicrobials — whether a common antibiotic for strep throat or a potent antifungal treatment given in the hospital — can make them stronger in the long run.

While most of the microbes die when treated, the ones that survive can reproduce. These new generations of microbes can build up resistance to certain antimicrobials, rendering some medications less effective or ineffective over time.

Unfortunately, this natural evolutionary process is speeding up for several reasons. We greatly overuse antibiotics in patients with viruses, like the flu, common colds and bronchitis — without benefit. And modern medical care has increased the demand for antibiotics. Advances in cancer care, organ transplants and surgeries such as hip and knee replacements have become much more common. These procedures can extend and improve life, but patients often require antimicrobials because they are at high risk of developing infections.

Bacteria are mutating at a speed that outpaces the development of antibiotics. Penicillin was discovered in 1941, but it wasn’t until 1967 that penicillin-resistant Streptococcus pneumococcus was first identified. By contrast, consider an antibiotic for multidrug-resistant bacteria released in 2015, called ceftazidime-avibactam. That same year a strain of bacteria emerged that was resistant to this new antibiotic.

Drug-resistant pathogens are one of the greatest healthcare threats of our time — for everyone, everywhere, including adults and children. More than 1.2 million people died worldwide from antibiotic-resistant infections in 2019 alone. Multidrug-resistant infections are on the rise in kids. More of these infections originate outside of our hospitals and within our communities.

Without effective antibiotics, run-of-the-mill pneumonia or skin infections can become life-threatening.

COVID-19 exacerbated the situation. Amid the widespread uncertainty and limited treatment options at the beginning of the pandemic, doctors often used antibiotics to treat COVID-19 patients as they tried to help them. Patients may also have been given antibiotics in instances in which it was difficult to distinguish between bacterial pneumonia, which requires antibiotics, and COVID-19.

Hospital stewardship programs — which manage the careful and optimal use of antimicrobial treatments — also had to redirect their limited resources away from antibiotic use to focus on the complex administration of COVID-19 therapeutics. And severely ill patients on ventilators were at a higher risk of contracting secondary infections, especially while their immune system was weakened.

These factors led to an increase in drug-resistant infections acquired in hospitals during the pandemic. Drug-resistant staph infections, MRSA, jumped 34% for hospitalized patients in the last quarter of 2020 compared with the same period in 2019.

Prior to COVID-19, we made initial progress in the fight against antimicrobial resistance. In 2014, California was the first state to pass a law requiring antimicrobial stewardship programs in hospitals. In 2019, Medicare began requiring antibiotic stewardship programs.

Some modest federal investments have also been made in antimicrobial research and development, but not enough to generate the pipeline patients need. We must increase support for antimicrobial stewardship practices, which were under-resourced even before the pandemic. Teaching practitioners to safely use and monitor antimicrobial treatments is a significant step.

We also need to develop novel antimicrobial medicines capable of defeating the superbugs that have grown resistant to previous generations of treatments. But market incentives are misaligned. Because doctors prudently limit their use of antimicrobials to avoid further resistance, there isn’t high demand to sustain the development of new products, which take years of research and billions of dollars in investments.

As a result, many large biopharmaceutical companies have stopped antimicrobial research entirely. And many smaller startups have had success at first, only to face bankruptcy. That’s part of the reason why there have been few new classes of antibiotics developed in the last 35 years.

This is a textbook case of a market failure, but government intervention can help realign market incentives.

The PASTEUR Act is a bipartisan bill in Congress that would establish a payment model for critically needed antimicrobials.

Currently, the government pays manufacturers based on the volume of drugs sold. But under PASTEUR, the government would enter into contracts with manufacturers and pay a predetermined amount for access to their novel antimicrobials — allowing scientists to innovate new treatments without fear of an insufficient return on investment due to low sales volumes.

Essentially, the bill would switch the government from a “pay-per-use” model for antimicrobials to a subscription-style model that pays for the value antimicrobials bring to society. By delinking payments to antimicrobial makers from sales volumes, the measure would stimulate investment in new antibiotics.

The bill would also provide resources to strengthen hospital antimicrobial stewardship programs, which help clinicians use antimicrobials prudently and help the Centers for Disease Control and Prevention closely monitor resistance. Hospitals should join public health leaders in supporting this legislation and invest more of their resources in their antimicrobial stewardship programs.

Unfortunately, superbugs aren’t an easy enemy to defeat. We need to be fighting them more vigorously to ensure that they don’t get around our best defenses.

Annabelle de St. Maurice is an associate professor of pediatric infectious diseases at the David Geffen School of Medicine at UCLA, and head of pediatric infection control and co-chief infection prevention officer at UCLA Health. She wrote this for the Los Angeles Times.

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