Paper (also known as Paper Mag ) is a New York City-based independent magazine focusing on fashion, popular culture, nightlife, music, art, and film. Initially produced monthly, the magazine eventually became a quarterly publication, and a digital version was made available online at papermag.com .
124-577: In 2020, physical production of the magazine was paused following the onset of the COVID-19 pandemic in the United States . The publication continued to create and release content online via its website. Paper was founded in 1984 by Kim Hastreiter and David Hershkovits , former editors at the SoHo Weekly News , with help from Lucy Sisman and Richard Weigand . Beginning as a monthly print magazine in
248-725: A decreased level of consciousness . Bacterial and viral cases of pneumonia usually result in similar symptoms. Some causes are associated with classic, but non-specific, clinical characteristics. Pneumonia caused by Legionella may occur with abdominal pain, diarrhea , or confusion. Pneumonia caused by Streptococcus pneumoniae is associated with rusty colored sputum. Pneumonia caused by Klebsiella may have bloody sputum often described as "currant jelly". Bloody sputum (known as hemoptysis ) may also occur with tuberculosis , Gram-negative pneumonia, lung abscesses and more commonly acute bronchitis . Pneumonia caused by Mycoplasma pneumoniae may occur in association with swelling of
372-535: A national emergency on March 13. The government also purchased large quantities of medical equipment, invoking the Defense Production Act of 1950 to assist. By mid-April, disaster declarations were made by all states and territories as they all had increasing cases. A second wave of infections began in June, following relaxed restrictions in several states, leading to daily cases surpassing 60,000. By mid-October,
496-401: A stethoscope or increased respiratory rate. Grunting and nasal flaring may be other useful signs in children less than five years old. Lack of wheezing is an indicator of Mycoplasma pneumoniae in children with pneumonia, but as an indicator it is not accurate enough to decide whether or not macrolide treatment should be used. The presence of chest pain in children with pneumonia doubles
620-418: A chest radiograph is recommended. Findings do not always match the severity of disease and do not reliably separate between bacterial and viral infection. X-ray presentations of pneumonia may be classified as lobar pneumonia , bronchopneumonia , lobular pneumonia , and interstitial pneumonia . Bacterial, community-acquired pneumonia classically show lung consolidation of one lung segmental lobe , which
744-493: A cough of longer duration, and pulmonary emboli present with acute onset sharp chest pain and shortness of breath. Mild pneumonia should be differentiated from upper respiratory tract infection (URTI). Severe pneumonia should be differentiated from acute heart failure . Pulmonary infiltrates that resolved after giving mechanical ventilation should point to heart failure and atelectasis rather than pneumonia. For recurrent pneumonia, underlying lung cancer, metastasis , tuberculosis,
868-479: A cough or difficulty breathing and a rapid respiratory rate, chest indrawing, or a decreased level of consciousness. A rapid respiratory rate is defined as greater than 60 breaths per minute in children under 2 months old, greater than 50 breaths per minute in children 2 months to 1 year old, or greater than 40 breaths per minute in children 1 to 5 years old. In children, low oxygen levels and lower chest indrawing are more sensitive than hearing chest crackles with
992-415: A day or two before other signs. Examination of the chest may be normal, but it may show decreased expansion on the affected side. Harsh breath sounds from the larger airways that are transmitted through the inflamed lung are termed bronchial breathing and are heard on auscultation with a stethoscope. Crackles (rales) may be heard over the affected area during inspiration . Percussion may be dulled over
1116-800: A foreign bodies, immunosuppression, and hypersensitivity should be suspected. Prevention includes vaccination , environmental measures, and appropriate treatment of other health problems. It is believed that, if appropriate preventive measures were instituted globally, mortality among children could be reduced by 400,000; and, if proper treatment were universally available, childhood deaths could be decreased by another 600,000. Vaccination prevents against certain bacterial and viral pneumonias both in children and adults. Influenza vaccines are modestly effective at preventing symptoms of influenza, The Centers for Disease Control and Prevention (CDC) recommends yearly influenza vaccination for every person 6 months and older. Immunizing health care workers decreases
1240-400: A higher dose of radiation, and cannot be done at bedside. Lung ultrasound may also be useful in helping to make the diagnosis. Ultrasound is radiation free and can be done at bedside. However, ultrasound requires specific skills to operate the machine and interpret the findings. It may be more accurate than chest X-ray. In people managed in the community, determining the causative agent
1364-569: A letter asking the federal government to "shut it down now, and start over". In July and early August, requests multiplied, with a number of experts asking for lockdowns of "six to eight weeks" that they believed would restore the country by October 1, in time to reopen schools and have an in-person election. In August, over 400,000 people attended the 80th Sturgis Motorcycle Rally in Sturgis, South Dakota , and from there, at least 300 people in more than 20 states were infected. The CDC followed up with
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#17329232971811488-554: A report on the associated 51 confirmed primary event-associated cases, 21 secondary cases, and five tertiary cases in the neighboring state of Minnesota, where one attendee died of COVID-19. The U.S. passed five million COVID-19 cases by August 8. On September 22, the U.S. passed 200,000 deaths, according to data from Johns Hopkins University. In early October, an unprecedented series of high-profile U.S. political figures and staffers announced they had tested positive for COVID-19. On October 2, Trump announced on Twitter that both he and
1612-437: A series of photographs from his 1982 book Jungle Fever . The cover photo, as well as the rest of the spread, featured a fully nude Kardashian. The story received over 34 million unique page-views by December 2014, more than double the number of page-views Paper normally received annually, and went on to generate more than 70 million monthly unique visitors to the website. Hastreiter and Hershkovits co-authored two books under
1736-633: A single day. By the end of 2022, an estimated 77.5% of Americans had had COVID-19 at least once, according to the CDC. State and local responses to the pandemic during the public health emergency included the requirement to wear a face mask in specified situations (mask mandates), prohibition and cancellation of large-scale gatherings (including festivals and sporting events), stay-at-home orders , and school closures . Disproportionate numbers of cases were observed among Black and Latino populations, as well as elevated levels of vaccine hesitancy, and there
1860-433: A small proportion of overall variants. Although variant XBB was of concern internationally, it was rare in the United States. Recommendations for receiving vaccination booster shots are mixed: while populations at risk of severe disease and death should stay up-to-date, healthy, middle-aged-and-younger populations are rarely at risk of severe illness, and most have adequate immunity. Although the newest bivalent boosters target
1984-432: A stroke), and a weak immune system . Vaccines to prevent certain types of pneumonia (such as those caused by Streptococcus pneumoniae bacteria, linked to influenza , or linked to COVID-19 ) are available. Other methods of prevention include hand washing to prevent infection, and not smoking. Treatment depends on the underlying cause. Pneumonia believed to be due to bacteria is treated with antibiotics . If
2108-564: A surge in Beijing caused the Biden administration to require U.S. visitors from China, Hong Kong, and Macau to provide proof of COVID-19 negative test results. At the end of the year, the CDC reported that the COVID Omicron XBB.1.5 variant became much more prevalent and represented about 41% of new cases in the U.S. Scientists at Columbia University warned that the rise of subvariants could "result in
2232-471: A surge of breakthrough infections as well as re-infections." On January 11, 2023, the Biden administration decided to renew the COVID-19 public health emergency amid a winter surge of cases related to highly transmissible Omicron subvariants. With relief measures such as automatic Medicaid re-enrollment being decoupled from the emergency declaration, some commentators believed this signaled the final extension of
2356-592: A third surge of cases began; there were over 200,000 new daily cases during parts of December 2020 and January 2021. COVID-19 vaccines became available in December 2020, under emergency use, beginning the national vaccination program , with the first vaccine officially approved by the Food and Drug Administration (FDA) on August 23, 2021. Studies have shown them to be highly protective against severe illness, hospitalization, and death. In comparison with fully vaccinated people,
2480-411: Is another rare cause due to lipids entering the lung. These lipids can either be inhaled or spread to the lungs from elsewhere in the body. Pneumonia frequently starts as an upper respiratory tract infection that moves into the lower respiratory tract. It is a type of pneumonitis (lung inflammation). The normal flora of the upper airway give protection by competing with pathogens for nutrients. In
2604-996: Is associated with Chlamydia psittaci ; farm animals with Coxiella burnetti ; aspiration of stomach contents with anaerobic organisms; and cystic fibrosis with Pseudomonas aeruginosa and Staphylococcus aureus . Streptococcus pneumoniae is more common in the winter, and it should be suspected in persons aspirating a large number of anaerobic organisms. In adults, viruses account for about one third of pneumonia cases, and in children for about 15% of them. Commonly implicated agents include rhinoviruses , coronaviruses , influenza virus , respiratory syncytial virus (RSV), adenovirus , and parainfluenza . Herpes simplex virus rarely causes pneumonia, except in groups such as newborns, persons with cancer, transplant recipients, and people with significant burns. After organ transplantation or in otherwise immunocompromised persons, there are high rates of cytomegalovirus pneumonia. Those with viral infections may be secondarily infected with
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#17329232971812728-448: Is associated with an increased risk of pneumonia. Approximately 10% of people who require mechanical ventilation develop ventilator-associated pneumonia , and people with a gastric feeding tube have an increased risk of developing aspiration pneumonia . Moreover, the misplacement of a feeding tube can lead to aspiration pneumonia. 28% of tube malposition results in pneumonia. As with Avanos Medical 's feeding tube placement system,
2852-506: Is available for adults, and has been found to decrease the risk of invasive pneumococcal disease by 74%, but there is insufficient evidence to suggest using the pneumococcal vaccine to prevent pneumonia or death in the general adult population. The CDC recommends that young children and adults over the age of 65 receive the pneumococcal vaccine, as well as older children or younger adults who have an increased risk of getting pneumococcal disease. The pneumococcal vaccine has been shown to reduce
2976-644: Is due primarily to cytokine -induced systemic inflammation . In the developed world , these infections are most common in people returning from travel or in immigrants. Around the world, parasitic pneumonia is most common in the immunodeficient. Idiopathic interstitial pneumonia or noninfectious pneumonia is a class of diffuse lung diseases . They include diffuse alveolar damage , organizing pneumonia , nonspecific interstitial pneumonia , lymphocytic interstitial pneumonia , desquamative interstitial pneumonia , respiratory bronchiolitis interstitial lung disease , and usual interstitial pneumonia . Lipoid pneumonia
3100-796: Is due to infections caused primarily by bacteria or viruses and less commonly by fungi and parasites . Although more than 100 strains of infectious agents have been identified, only a few are responsible for the majority of cases. Mixed infections with both viruses and bacteria may occur in roughly 45% of infections in children and 15% of infections in adults. A causative agent may not be isolated in about half of cases despite careful testing. In an active population-based surveillance for community-acquired pneumonia requiring hospitalization in five hospitals in Chicago and Nashville from January 2010 through June 2012, 2259 patients were identified who had radiographic evidence of pneumonia and specimens that could be tested for
3224-460: Is important to treatment, as it correlates to which pathogens are likely suspects, which mechanisms are likely, which antibiotics are likely to work or fail, and which complications can be expected based on the person's health status. Community-acquired pneumonia (CAP) is acquired in the community, outside of health care facilities. Compared with healthcare-associated pneumonia, it is less likely to involve multidrug-resistant bacteria. Although
3348-445: Is increased. Bacteria are the most common cause of community-acquired pneumonia (CAP), with Streptococcus pneumoniae isolated in nearly 50% of cases. Other commonly isolated bacteria include Haemophilus influenzae in 20%, Chlamydophila pneumoniae in 13%, and Mycoplasma pneumoniae in 3% of cases; Staphylococcus aureus ; Moraxella catarrhalis ; and Legionella pneumophila . A number of drug-resistant versions of
3472-448: Is known as lobar pneumonia. However, findings may vary, and other patterns are common in other types of pneumonia. Aspiration pneumonia may present with bilateral opacities primarily in the bases of the lungs and on the right side. Radiographs of viral pneumonia may appear normal, appear hyper-inflated, have bilateral patchy areas, or present similar to bacterial pneumonia with lobar consolidation. Radiologic findings may not be present in
3596-576: Is most common in the Southwestern United States. The number of cases of fungal pneumonia has been increasing in the latter half of the 20th century due to increasing travel and rates of immunosuppression in the population. For people infected with HIV/AIDS , PCP is a common opportunistic infection . A variety of parasites can affect the lungs, including Toxoplasma gondii , Strongyloides stercoralis , Ascaris lumbricoides , and Plasmodium malariae . These organisms typically enter
3720-530: Is not cost-effective and typically does not alter management. For people who do not respond to treatment, sputum culture should be considered, and culture for Mycobacterium tuberculosis should be carried out in persons with a chronic productive cough. Microbiological evaluation is also indicated in severe pneumonia, alcoholism, asplenia , immunosuppression, HIV infection, and those being empirically treated for MRSA of pseudomonas. Although positive blood culture and pleural fluid culture definitively establish
3844-465: Is sometimes called MCAP (medical care–associated pneumonia). People may become infected with pneumonia in a hospital; this is defined as pneumonia not present at the time of admission (symptoms must start at least 48 hours after admission). It is likely to involve hospital-acquired infections , with higher risk of multidrug-resistant pathogens. People in a hospital often have other medical conditions, which may make them more susceptible to pathogens in
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3968-723: Is sometimes more broadly applied to any condition resulting in inflammation of the lungs (caused for example by autoimmune diseases , chemical burns or drug reactions); however, this inflammation is more accurately referred to as pneumonitis . Factors that predispose to pneumonia include smoking, immunodeficiency , alcoholism, chronic obstructive pulmonary disease , sickle cell disease (SCD), asthma , chronic kidney disease , liver disease , and biological aging . Additional risks in children include not being breastfed , exposure to cigarette smoke and other air pollution, malnutrition, and poverty. The use of acid-suppressing medications – such as proton-pump inhibitors or H2 blockers –
4092-416: Is three times the fatality rate of a bad flu season . The number of cases for the months of July through September 2022 was about 0.86 times the number for the same period in 2021, and the number of COVID-attributed deaths likewise averaged 0.42 times the number for the same period in 2021. In October, new variants BQ.1 and BQ.1.1 from the dominant BA.5 appeared to be spreading quickly, but comprised only
4216-490: Is uncommon, but occurs more commonly in individuals with weakened immune systems due to AIDS, immunosuppressive drugs , or other medical problems. It is most often caused by Histoplasma capsulatum , Blastomyces , Cryptococcus neoformans , Pneumocystis jiroveci ( pneumocystis pneumonia , or PCP), and Coccidioides immitis . Histoplasmosis is most common in the Mississippi River basin , and coccidioidomycosis
4340-507: The Biden administration advised Congress of a lack of funding for testing, therapeutics and vaccines, but Republicans continued to block new spending on the pandemic so Democrats removed an emergency aid package from a proposed spending bill. On March 20, Dr. Anthony S. Fauci warned of an "uptick" in cases like Europe had seen recently, stating the U.S. should "be prepared for the possibility that we might get another variant". In April 2022, it
4464-583: The Chief Creative Officer of Paper. Elliot left Paper in October 2019, to become the new Global Creative Director at MAC Cosmetics . In 2020, following the onset of the COVID-19 pandemic , print production of the magazine was suspended. The final physical issue released was the Spring 2020 edition that featured Lady Gaga on the cover. Florio told WWD he was unsure when publication would resume, or if
4588-667: The National Institute of Allergy and Infectious Diseases Anthony Fauci said the mortality from COVID-19 was ten times higher than the common flu . By March 12, diagnosed cases of COVID-19 in the U.S. exceeded a thousand. Trump declared a national emergency on March 13. On March 16, the White House advised against any gatherings of more than ten people. Three days later, the United States Department of State advised U.S. citizens to avoid all international travel. By
4712-497: The cluster on December 31, 2019. After China confirmed that the cluster of infections was caused by a novel infectious coronavirus on January 7, 2020, the CDC issued an official health advisory the following day. On January 20, the World Health Organization (WHO) and China both confirmed that human-to-human transmission had occurred. The CDC immediately activated its Emergency operations center (EOC) to respond to
4836-407: The sputum may help confirm the diagnosis. The disease may be classified by where it was acquired, such as community- or hospital-acquired or healthcare-associated pneumonia. Risk factors for pneumonia include cystic fibrosis , chronic obstructive pulmonary disease (COPD), sickle cell disease , asthma , diabetes , heart failure, a history of smoking, a poor ability to cough (such as following
4960-589: The 1 million mark with a presidential proclamation on May 12, ordering flags to be flown at half-staff at all federal facilities through sundown on May 16. In June, the United States concluded the approval process for the vaccination of children under five years of age, with the first vaccines expected to be administered on June 21. On June 12, the U.S. dropped COVID testing requirements for inbound international air travelers, while vaccination requirements largely remained in place for inbound travelers using any mode of cross-border transportation. The number of cases for
5084-594: The American public for the first time to prepare for a local outbreak. The next day, New York City saw the sickening of its "patient zero", Manhattan attorney Lawrence Garbuz, then thought to be the first community-acquired case. Another case known as "patient zero" in Los Angeles is a man named Gregg Garfield, who spent 64 days in the Burbank Hospital, on a ventilator for 30 days, with a 1% chance to live. Contracting
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5208-502: The Biden administration felt that there was "enough community protection that we're not going to see a repeat of what we saw last year at this time," referring to the emergence of the Omicron variant. A study of vaccine effectiveness found that U.S.-authorized bivalent mRNA boosters administered to those having already received 2 to 4 monovalent vaccinations provided significant additional protection against symptomatic SARS-CoV-2. Concerns of
5332-458: The Biden administration on the advice of the CDC, was ended nationwide by U.S. District Judge Kathryn Kimball Mizelle , a Trump-appointed federal judge in Florida. The Justice Department challenged the ruling several days later, yet masks remained optional on airplanes, buses, and subway systems, except when required by local mandates. The first annual National COVID Week of Remembrance & Action
5456-557: The CDC confirmed the first person-to-person case in the U.S. The next day, the country declared a public health emergency. Although by that date there were only seven known cases in the U.S., the HHS and CDC reported that there was a likelihood of further cases appearing in the country. The Trump administration evacuated American nationals from Wuhan in January. On February 2, the U.S. enacted travel restrictions to and from China. On February 6,
5580-541: The CDC found that those who were unvaccinated were from 5 to nearly 30 times more likely to become either infected or hospitalized. There has nonetheless been some vaccine hesitancy for various reasons, although side effects are rare. There were also numerous reports that unvaccinated COVID-19 patients strained the capacity of hospitals throughout the country , forcing many to turn away patients with life-threatening diseases. A fourth rise in infections began in March 2021 amidst
5704-630: The CORTRAK* 2 EAS, which was recalled in May 2022 by the FDA due to adverse events reported, including pneumonia, caused a total of 60 injuries and 23 patient deaths, as communicated by the FDA. For people with certain variants of the FER gene , the risk of death is reduced in sepsis caused by pneumonia. However, for those with TLR6 variants, the risk of getting Legionnaires' disease
5828-577: The Delta variant. By July 7, the Delta variant had surpassed the Alpha variant to become the dominant COVID-19 strain in the U.S., according to CDC data. By August the Delta variant accounted for 99 percent of all cases and was found to double the risk of hospitalization for those not yet vaccinated. On August 1, the U.S. passed 35 million cases. By early and mid-August, hospitals in some states with low vaccination rates began to exceed capacity. One-quarter of
5952-547: The First Lady had tested positive for COVID-19 and would immediately quarantine. Trump was given an experimental Regeneron product with two monoclonal antibodies and taken to Walter Reed National Military Medical Center , where he was given remdesivir and dexamethasone . USA Today studied the aftermath of presidential election campaigning, recognizing that causation was impossible to determine. Among their findings, cases increased 35 percent compared to 14 percent for
6076-427: The January 2023 distribution, and the 17 other states which terminated pandemic food supplements prior to the federal end date were all states with Republican-controlled state legislatures. On January 31, 2023, President Biden announced the end to the COVID-19 emergency declarations by May 11, 2023. By February 23, eighteen states had already cut payments for more than 10 million people, and Congress had decided to end
6200-544: The Trump administration reached an agreement with a number of retail outlets, including pharmacies and supermarkets, to make the COVID-19 vaccine free once available. In spite of recommendations by the government not to travel, more than 2 million people flew on airlines during the Thanksgiving period. On December 8, the U.S. passed 15 million cases, with about one out of every 22 Americans having tested positive since
6324-470: The U.S. death toll became the highest in the world when the number of deaths reached 20,000, surpassing that of Italy . On April 19, the CMS added new regulations requiring nursing homes to inform residents, their families and representatives, of COVID-19 cases in their facilities. On April 28, the total number of confirmed cases across the country surpassed 1 million. By May 27, less than four months after
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#17329232971816448-519: The U.S. passed 25 million cases, with one of every 13 Americans testing positive for COVID-19. On January 29, a nationwide requirement for use of face masks on public transit and other forms of public transportation was issued by the CDC and the federal Transportation Security Administration , to go into effect on February 1. (Subsequently, extended, the federal mask mandate for public transportation remains in effect in April 2022.) On February 22,
6572-418: The U.S. passed 30 million cases, just as a number of states began to expand the eligibility age for COVID-19 vaccines. Experts began warning against public relaxation of COVID-19 mitigation measures as vaccines continue to be administered, with CDC director Rochelle Walensky , warning of a new rise in cases. By April 7, the Alpha variant had become the dominant COVID-19 strain in the U.S. On April 12,
6696-498: The U.S. passed 45 million cases. On November 26, Biden announced that the U.S. will restrict travel from South Africa and seven other African countries due to concerns over a new variant from the area , called Omicron. At the beginning of January 2022, the number of cases per day exceeded 1 million. As of February 1, fatality rates were 63% higher in the U.S. than other large wealthy countries, due in part to far lower vaccination rates compared to those countries. On March 9,
6820-443: The U.S. passed 500,000 deaths, just five weeks after the country passed 400,000 deaths. By March 5, more than 2,750 cases of COVID-19 variants were detected in 47 states; Washington, D.C.; and Puerto Rico . In the first prime time address of his presidency, on March 11, Biden announced his plan to push states to make vaccines available to all adults by May 1, with the aim of making small gatherings possible by July 4 . On March 24,
6944-419: The U.S. population had been infected with the virus as of March 2021, about four times higher than the official reported numbers. On May 4, Biden announced a new goal of having 70 percent of all adults in the U.S. receive at least one COVID-19 vaccine shot by July 4, along with steps to vaccinate teenagers and more inaccessible populations. The country ultimately did not reach that goal, with only 67 percent of
7068-576: The U.S. population resides in eight states—Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Nevada, and Texas—but, by mid-August, these states together had a half of COVID-19 hospitalizations in the nation. By the end of the month, the ICUs of five of those—Alabama, Arkansas, Florida, Georgia, and Texas—were over 90% full. On September 8, the U.S. passed 40 million cases. By September 15, one in every 500 Americans had died from COVID-19. By September 20, COVID-19 had killed over 675,000 Americans,
7192-459: The U.S. reported its first cases of a new "double mutant" SARS-CoV-2 variant from India , later called Delta, in California. By April 25, the country's seven-day average of new infections was reported to be decreasing, but concerns were raised about drops in vaccine demand in certain parts of the U.S., which were attributed to vaccine hesitancy . On April 29, the CDC estimated that roughly 35% of
7316-581: The United Kingdom , later called Alpha, the CDC announced testing requirements for American passengers traveling from the UK , to be administered within 72 hours, starting on December 28. On December 29, the U.S. reported the first case of this variant in Colorado. The patient had no travel history, leading the CDC to say, "Given the small fraction of US infections that have been sequenced, the variant could already be in
7440-541: The United States On December 31, 2019, China announced the discovery of a cluster of pneumonia cases in Wuhan . The first American case was reported on January 20, and Health and Human Services Secretary Alex Azar declared a public health emergency on January 31. Restrictions were placed on flights arriving from China, but the initial U.S. response to the pandemic was otherwise slow in terms of preparing
7564-408: The United States without having been detected." On January 1, 2021, the U.S. passed 20 million cases, representing an increase of more than a million over the past week and 10 million in less than two months. On January 6, the CDC announced that it had found at least 52 confirmed cases of the Alpha variant, and it also stressed that there could already be more cases in the country. In
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#17329232971817688-513: The above infections are becoming more common, including drug-resistant Streptococcus pneumoniae (DRSP) and methicillin-resistant Staphylococcus aureus (MRSA). The spreading of organisms is facilitated by certain risk factors. Alcoholism is associated with Streptococcus pneumoniae , anaerobic organisms , and Mycobacterium tuberculosis ; smoking facilitates the effects of Streptococcus pneumoniae , Haemophilus influenzae , Moraxella catarrhalis , and Legionella pneumophila . Exposure to birds
7812-560: The additional feature of pulmonary consolidation . Pneumonia is most commonly classified by where or how it was acquired: community-acquired, aspiration, healthcare-associated , hospital-acquired , and ventilator-associated pneumonia. It may also be classified by the area of the lung affected: lobar, bronchial pneumonia and acute interstitial pneumonia ; or by the causative organism. Pneumonia in children may additionally be classified based on signs and symptoms as non-severe, severe, or very severe. The setting in which pneumonia develops
7936-421: The affected lung, and increased, rather than decreased, vocal resonance distinguishes pneumonia from a pleural effusion . A chest radiograph is frequently used in diagnosis. In people with mild disease, imaging is needed only in those with potential complications, those not having improved with treatment, or those in which the cause is uncertain. If a person is sufficiently sick to require hospitalization,
8060-421: The alveoli, resulting in the consolidation seen on chest X-ray. Viruses may reach the lung by a number of different routes. Respiratory syncytial virus is typically contracted when people touch contaminated objects and then touch their eyes or nose. Other viral infections occur when contaminated airborne droplets are inhaled through the nose or mouth. Once in the upper airway, the viruses may make their way into
8184-517: The bacteria Streptococcus pneumoniae , Staphylococcus aureus , or Haemophilus influenzae , particularly when other health problems are present. Different viruses predominate at different times of the year; during flu season , for example, influenza may account for more than half of all viral cases. Outbreaks of other viruses also occur occasionally, including hantaviruses and coronaviruses. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can also result in pneumonia. Fungal pneumonia
8308-449: The blood. Once in the lungs, bacteria may invade the spaces between cells and between alveoli, where the macrophages and neutrophils (defensive white blood cells ) attempt to inactivate the bacteria. The neutrophils also release cytokines, causing a general activation of the immune system. This leads to the fever, chills, and fatigue common in bacterial pneumonia. The neutrophils, bacteria, and fluid from surrounding blood vessels fill
8432-511: The body through direct contact with the skin, ingestion, or via an insect vector. Except for Paragonimus westermani , most parasites do not specifically affect the lungs but involve the lungs secondarily to other sites. Some parasites, in particular those belonging to the Ascaris and Strongyloides genera, stimulate a strong eosinophilic reaction, which may result in eosinophilic pneumonia . In other infections, such as malaria, lung involvement
8556-546: The cause and support decisions about who should receive antibiotics. Antibiotics are encouraged if the procalcitonin level reaches 0.25 μg/L, strongly encouraged if it reaches 0.5 μg/L, and strongly discouraged if the level is below 0.10 μg/L. In people requiring hospitalization, pulse oximetry , chest radiography and blood tests – including a complete blood count , serum electrolytes , C-reactive protein level, and possibly liver function tests – are recommended. The diagnosis of influenza-like illness can be made based on
8680-514: The company would continue with it at all, saying "Part of me is open enough to allow this thing to really roll out digitally and socially in the way where most people know Paper. Most people know Paper — like the kids, the Gen Z — through this social engagement. [Layoffs are] so terrible. I've never been in a situation where you couldn't ask more from people, but because of crazy life circumstances you have to make these decisions." The magazine's digital content
8804-530: The company's label. The first of the pair, published by Paper Publishing Company in association with Distributed Art Publishers in 1999, was titled From AbFab to Zen: Paper's Guide to Pop Culture , and had photography from John Waters . The second, titled 20 Years of Style: The World According to Paper , was published by HarperCollins in 2004 and featured writing from Michael Musto , John Waters , Isaac Mizrahi , Pedro Almodovar , Todd Oldham , Patrick McMullan , and Anna Sui . COVID-19 pandemic in
8928-427: The condition, but they are associated with side effects. Zanamivir or oseltamivir decrease the chance that people who are exposed to the virus will develop symptoms; however, it is recommended that potential side effects are taken into account. Smoking cessation and reducing indoor air pollution , such as that from cooking indoors with wood, crop residues or dung , are both recommended. Smoking appears to be
9052-404: The diagnosis is unlikely. However, the underlying cause can be difficult to confirm, as there is no definitive test able to distinguish between bacterial and non-bacterial cause. The overall impression of a physician appears to be at least as good as decision rules for making or excluding the diagnosis. The World Health Organization has defined pneumonia in children clinically based on either
9176-508: The diagnosis of the type of micro-organism involved, a positive sputum culture has to be interpreted with care for the possibility of colonisation of respiratory tract. Testing for other specific organisms may be recommended during outbreaks, for public health reasons. In those hospitalized for severe disease, both sputum and blood cultures are recommended, as well as testing the urine for antigens to Legionella and Streptococcus . Viral infections, can be confirmed via detection of either
9300-524: The earliest confirmed American death with COVID-19 (that of a 57-year-old woman) occurred in Santa Clara County, California . The CDC did not report its confirmation until April 21, by which point nine other COVID-19 deaths had occurred in Santa Clara County. The virus had been circulating undetected at least since early January and possibly as early as November. On February 25, the CDC warned
9424-758: The early stages of the disease, especially in the presence of dehydration, or may be difficult to interpret in the obese or those with a history of lung disease. Complications such as pleural effusion may also be found on chest radiographs. Laterolateral chest radiographs can increase the diagnostic accuracy of lung consolidation and pleural effusion. A CT scan can give additional information in indeterminate cases and provide more details in those with an unclear chest radiograph (for example occult pneumonia in chronic obstructive pulmonary disease). They can be used to exclude pulmonary embolism and fungal pneumonia , and detect lung abscesses in those who are not responding to treatments. However, CT scans are more expensive, have
9548-722: The emergency declaration. Although some states had already ended emergency SNAP benefits enacted during the pandemic, the USDA announced that emergency allotments for the remaining 32 states, the District of Columbia , Guam , and the U.S. Virgin Islands would end after the February 2023 distribution. Leaders of some anti-hunger organizations believed that the end of the $ 95-per-month additional benefit would strain local food pantries and food banks. South Carolina , which ended emergency food grants after
9672-449: The estimated number of American deaths from the Spanish flu in 1918. As a result, COVID-19 became the deadliest respiratory pandemic in recent American history. The Associated Press called the new numbers a "colossal tragedy" because, despite a century of advances in science, the country failed to take full advantage of vaccines. On October 1, the U.S. passed 700,000 deaths. On October 18,
9796-423: The first US surge of infections since the end of the public health emergency. Wastewater testing initially indicated that the uptick in cases was only a third the size of the previous summer's surge, yet data from Walgreens showed the first week of August having the largest number of positive cases since May 2021. Pneumonia Pneumonia is an inflammatory condition of the lung primarily affecting
9920-447: The first few days [of January], which doesn't sound like a lot, but our community is very small," Henderson said. "The last couple of weeks, we have seen single digits every day. I certainly won't speak for other counties, but I think we're probably heading in that direction where if they're not closing down, they're decreasing hours and staff." On April 18, 2022, the federal transportation mask mandate, which had been extended to May 3 by
10044-401: The following days, more cases of the variant were reported in other states, leading former CDC director Tom Frieden to express his concerns that the U.S. will soon face "close to a worst-case scenario". It was believed the variant had been present in the U.S. since October. On January 19, the U.S. passed 400,000 deaths, just five weeks after the country passed 300,000 deaths. On January 22,
10168-458: The form of a black and white 16-page fold-out, it has since transformed into a quarterly print and digital magazine. Past cover models include Kim Kardashian , Katy Perry , Miley Cyrus , Prince , CL , Kacey Musgraves , Jennifer Lopez , and BTS . In 2017, Hastreiter and Hershkovits sold the company to ENTtech Media Group, an entertainment technology company founded by former Condé Nast and Advanstar executive Tom Florio, and Drew Elliott ,
10292-571: The healthcare system, stopping other travel, and testing . The first known American deaths occurred in February and in late February President Donald Trump proposed allocating $ 2.5 billion to fight the outbreak. Instead, Congress approved $ 8.3 billion with only Senator Rand Paul and two House representatives ( Andy Biggs and Ken Buck ) voting against, and Trump signed the bill, the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 , on March 6. Trump declared
10416-634: The hospital. Ventilator-associated pneumonia occurs in people breathing with the help of mechanical ventilation. Ventilator-associated pneumonia is specifically defined as pneumonia that arises more than 48 to 72 hours after endotracheal intubation . Several diseases can present with similar signs and symptoms to pneumonia, such as: chronic obstructive pulmonary disease, asthma, pulmonary edema , bronchiectasis , lung cancer, and pulmonary emboli . Unlike pneumonia, asthma and COPD typically present with wheezing, pulmonary edema presents with an abnormal electrocardiogram , cancer and bronchiectasis present with
10540-582: The latter are no longer rare in CAP, they are still less likely. Prior stays in healthcare-related environments such as hospitals, nursing homes, or hemodialysis centers or a history of receiving domiciliary care can increase patients' risk for CAP caused by multidrug-resistant bacteria. Health care–associated pneumonia (HCAP) is an infection associated with recent exposure to the health care system, including hospitals, outpatient clinics, nursing homes , dialysis centers, chemotherapy treatment, or home care . HCAP
10664-431: The lower airways, reflexes of the glottis , actions of complement proteins and immunoglobulins are important for protection. Micro aspiration of contaminated secretions can infect the lower airways and cause pneumonia. The progress of pneumonia is determined by the virulence of the organism; the amount of organism required to start an infection; and the body's immune response against the infection. Most bacteria enter
10788-464: The lungs via small aspirations of organisms residing in the throat or nose. Half of normal people have these small aspirations during sleep. While the throat always contains bacteria, potentially infectious ones reside there only at certain times and under certain conditions. A minority of types of bacteria such as Mycobacterium tuberculosis and Legionella pneumophila reach the lungs via contaminated airborne droplets. Bacteria can also spread via
10912-418: The lungs, many viruses simultaneously affect other organs and thus disrupt other body functions. Viruses also make the body more susceptible to bacterial infections; in this way, bacterial pneumonia can occur at the same time as viral pneumonia. Pneumonia is typically diagnosed based on a combination of physical signs and often a chest X-ray . In adults with normal vital signs and a normal lung examination,
11036-433: The lungs, where they invade the cells lining the airways, alveoli, or lung parenchyma . Some viruses such as measles and herpes simplex may reach the lungs via the blood. The invasion of the lungs may lead to varying degrees of cell death. When the immune system responds to the infection, even more lung damage may occur. Primarily white blood cells, mainly mononuclear cells , generate the inflammation. As well as damaging
11160-400: The lymph nodes in the neck , joint pain , or a middle ear infection . Viral pneumonia presents more commonly with wheezing than bacterial pneumonia. Pneumonia was historically divided into "typical" and "atypical" based on the belief that the presentation predicted the underlying cause. However, evidence has not supported this distinction, therefore it is no longer emphasized. Pneumonia
11284-547: The mandate. The CDC was criticized for the confusion resulting from the announcement, as it did not remove existing state and local mandates. The guidance also did not remove the federal mask mandate on public transportation. On June 15, the U.S. passed 600,000 deaths, though the number of daily deaths had decreased due to vaccination efforts. By June, COVID-19 cases rose again, especially in Arkansas, Nevada, Missouri, and Wyoming. The rising numbers were believed to be attributable to
11408-596: The middle of March, all fifty states were able to perform tests with a doctor's approval, either from the CDC or from commercial labs. However, the number of available test kits remained limited. As cases began spreading throughout the nation, federal and state agencies began taking urgent steps to prepare for a surge of hospital patients. Among the actions was establishing additional places for patients in case hospitals became overwhelmed. Throughout March and early April, several state, city, and county governments imposed "stay at home" quarantines on their populations to stem
11532-450: The months leading up to November, deaths from COVID-19 substantially decreased, attributed to high levels of population immunity (through vaccination or prior infection), and improvements in early treatment for patients at risk for severe disease. The CDC recommended vaccinations, treatments for immunocompromised individuals and to reduce severity of the disease, and continuing to wear masks in public. Nonetheless, Dr. Anthony Fauci stated that
11656-555: The months of January through June 2022 was about 2.4 times the number for the same period in 2021, and the number of COVID-attributed deaths likewise averaged 0.74 times the number in 2021. Nonetheless, as of July 14, only 21 states have active COVID-19 emergency orders in place, and there are no state-level mask requirements still in force. The number of cases for July and August 2022 was 3,672,358 and 3,154,320, respectively, with 11,963 and 15,943 COVID-attributed deaths, respectively. The totals for these two months reflect about 1.6 times
11780-734: The most of any country, and the 17th highest per capita worldwide. The COVID-19 pandemic ranks as the deadliest disaster in the country's history . It was the third-leading cause of death in the U.S. in 2020, behind heart disease and cancer. From 2019 to 2020, U.S. life expectancy dropped by three years for Hispanic and Latino Americans , 2.9 years for African Americans , and 1.2 years for white Americans . In 2021, U.S. deaths due to COVID-19 rose, and life expectancy fell. Sources: Official reports from state health officials Sources: Official reports from state health officials In November 2019, COVID-19 infections had first broken out in Wuhan , China. China publicly reported
11904-524: The most prominent sign. The typical signs and symptoms in children under five are fever, cough, and fast or difficult breathing. Fever is not very specific, as it occurs in many other common illnesses and may be absent in those with severe disease, malnutrition or in the elderly. In addition, a cough is frequently absent in children less than 2 months old. More severe signs and symptoms in children may include blue-tinged skin , unwillingness to drink, convulsions, ongoing vomiting, extremes of temperature, or
12028-488: The number of cases and 0.81 times the number of deaths from the same months in 2021. On September 18, 2022, in an appearance on 60 Minutes , president Joe Biden declared his belief that the COVID-19 pandemic was "over" in the United States. This assessment met some debate in the medical community: at the time, the United ;States had roughly 400 deaths from the disease per day, and when extrapolated to 150,000 per year
12152-611: The outbreak in China. Also, the first report of a COVID-19 case in the U.S. was publicly reported, though the All of Us study (released in 2021) showed five states already had cases weeks earlier. After other cases were reported, on January 30, the WHO declared a Public health emergency of international concern (PHEIC) – its highest level of alarm – warning that "all countries should be prepared for containment." The same day,
12276-470: The outbreak, but Congress instead approved $ 8.3 billion with only Senator Rand Paul and Representatives Andy Biggs and Ken Buck voting against, and Trump signed the bill on March 6. By March 11, the virus had spread to 110 countries, and the WHO officially declared a pandemic . The CDC had already warned that large numbers of people needing hospital care could overload the healthcare system, which would lead to otherwise preventable deaths. Director of
12400-554: The overall adult population having done so by July 4. On May 6, a study by the Institute for Health Metrics and Evaluation estimated that the true COVID-19 death toll in the U.S. was more than 900,000 people. On May 9, Dr. Fauci confirmed that the U.S. death toll was likely undercounted. On May 13, the CDC changed its guidance and said that fully vaccinated individuals do not need to wear masks in most situations. Some states ended their mask mandates shortly after, while others maintained
12524-399: The pandemic began. On December 14, the U.S. passed 300,000 deaths, representing an average of more than 961 deaths per day since the first known death on February 6. More than 50,000 deaths were reported in the past month, with an average of 2,403 daily deaths occurring in the past week. On December 24, following concerns over a probably more easily transmissible new SARS-CoV-2 variant from
12648-497: The pandemic reached the U.S., 100,000 Americans had died with COVID-19. State economic reopenings and lack of widespread mask orders resulted in a sharp rise in cases across most of the continental U.S. outside of the Northeast. A study conducted in May 2020 indicated that the true number of COVID-19 cases in the United States was much higher than the number of confirmed cases with some locations having 6–24 times higher infections, which
12772-464: The pneumonia is severe, the affected person is generally hospitalized. Oxygen therapy may be used if oxygen levels are low. Each year, pneumonia affects about 450 million people globally (7% of the population) and results in about 4 million deaths. With the introduction of antibiotics and vaccines in the 20th century, survival has greatly improved. Nevertheless, pneumonia remains a leading cause of death in developing countries, and also among
12896-421: The probability of Mycoplasma pneumoniae . In general, in adults, investigations are not needed in mild cases. There is a very low risk of pneumonia if all vital signs and auscultation are normal. C-reactive protein (CRP) may help support the diagnosis. For those with CRP less than 20 mg/L without convincing evidence of pneumonia, antibiotics are not recommended. Procalcitonin may help determine
13020-522: The program early, exchanging additional benefits for a new permanent program that provides extra money to low-income families to replace school meals during the summer. On April 10, 2023, President Biden signed into law a resolution terminating the national emergency, effective immediately. This national emergency was separate from the public health emergency, which remained in effect until May 11, 2023. A late-summer wave of COVID-19 cases, as reflected by tests at pharmacies and healthcare settings, marked
13144-461: The publication was acquired by Brian Calle & Street Media in June. In November 2014, Kim Kardashian was the cover star of the "Break the Internet" issue. Kardashian was interviewed by Paper contributor Amanda Fortini for the spread "No Filter: An Afternoon with Kim Kardashian". The photos for the issue were taken by Jean–Paul Goude . The shoot was a re-creation of Goude's "Champagne Incident",
13268-551: The recent BA.4 and BA.5 variants and their risks are low, some experts recommend new strategies to develop vaccines with broader effectiveness. In a survey of vaccination booster intake (after completing a primary series), about 15% reported receiving the updated booster. The rates varied racially with 19% among White, non-Hispanic people, about 11% among Hispanic people, and about 7% among non-Hispanic American Indians, Alaska Native people, Black people, and those of multiple races, leading to concerns of vaccination access inequity. In
13392-500: The responsible pathogen. Most patients (62%) had no detectable pathogens in their sample, and unexpectedly, respiratory viruses were detected more frequently than bacteria. Specifically, 23% had one or more viruses, 11% had one or more bacteria, 3% had both bacterial and viral pathogens, and 1% had a fungal or mycobacterial infection. "The most common pathogens were human rhinovirus (in 9% of patients), influenza virus (in 6%), and Streptococcus pneumoniae (in 5%)." The term pneumonia
13516-786: The rise of the Alpha variant , a more easily transmissible variant first detected in the United Kingdom . That was followed by a rise of the Delta variant , an even more infectious mutation first detected in India , leading to increased efforts to ensure safety. The January 2022 emergence of the Omicron variant , which was first discovered in South Africa , led to record highs in hospitalizations and cases in early 2022, with as many as 1.5 million new infections reported in
13640-519: The risk of community acquired pneumonia in people with chronic obstructive pulmonary disease, but does not reduce mortality or the risk of hospitalization for people with this condition. People with COPD are recommended by a number of guidelines to have a pneumococcal vaccination. Other vaccines for which there is support for a protective effect against pneumonia include pertussis , varicella , and measles . When influenza outbreaks occur, medications such as amantadine or rimantadine may help prevent
13764-521: The risk of viral pneumonia among their patients. Vaccinations against Haemophilus influenzae and Streptococcus pneumoniae have good evidence to support their use. There is strong evidence for vaccinating children under the age of 2 against Streptococcus pneumoniae ( pneumococcal conjugate vaccine ). Vaccinating children against Streptococcus pneumoniae has led to a decreased rate of these infections in adults, because many adults acquire infections from children. A Streptococcus pneumoniae vaccine
13888-527: The signs and symptoms; however, confirmation of an influenza infection requires testing. Thus, treatment is frequently based on the presence of influenza in the community or a rapid influenza test . Adults 65 years old or older, as well as cigarette smokers and people with ongoing medical conditions are at increased risk for pneumonia. Physical examination may sometimes reveal low blood pressure , high heart rate , or low oxygen saturation . The respiratory rate may be faster than normal, and this may occur
14012-468: The single biggest risk factor for pneumococcal pneumonia in otherwise-healthy adults. Hand hygiene and coughing into one's sleeve may also be effective preventative measures. Wearing surgical masks by the sick may also prevent illness. Appropriately treating underlying illnesses (such as HIV/AIDS, diabetes mellitus , and malnutrition) can decrease the risk of pneumonia. In children less than 6 months of age, exclusive breast feeding reduces both
14136-490: The small air sacs known as alveoli . Symptoms typically include some combination of productive or dry cough , chest pain , fever, and difficulty breathing . The severity of the condition is variable. Pneumonia is usually caused by infection with viruses or bacteria, and less commonly by other microorganisms . Identifying the responsible pathogen can be difficult. Diagnosis is often based on symptoms and physical examination . Chest X-rays , blood tests, and culture of
14260-463: The spread of the virus. By March 26, The New York Times data showed the United States to have the highest number of known cases of any country. By March 27, the country had reported over 100,000 cases. On April 2, at President Trump's direction, the Centers for Medicare & Medicaid Services (CMS) and CDC ordered additional preventive guidelines to the long-term care facility industry. On April 11,
14384-615: The state after a Trump rally in Beltrami County, Minnesota . One case was traced to a Joe Biden rally in Duluth, Minnesota . On November 9, President-elect Biden's transition team announced his COVID-19 Advisory Board . On the same day, the total number of cases had surpassed ten million while the total had risen by over a million in the ten days prior, averaging 102,300 new cases per day. Pfizer also announced that its COVID-19 vaccine may be up to ninety percent effective. In November,
14508-449: The very old, the very young, and the chronically ill. Pneumonia often shortens the period of suffering among those already close to death and has thus been called "the old man's friend". People with infectious pneumonia often have a productive cough , fever accompanied by shaking chills , shortness of breath , sharp or stabbing chest pain during deep breaths, and an increased rate of breathing . In elderly people, confusion may be
14632-565: The virus from a ski trip, Garfield was able to return to the slopes, although with some fingers and toes amputated. In February, Vice President Mike Pence took over for HHS Secretary Alex Azar as chair of the White House Coronavirus Task Force , with Trump saying, "We are very, very ready for this, for anything, whether it's going to be a breakout of larger proportions, or whether we're at that very low level." In late February Trump proposed allocating $ 2.5 billion to fight
14756-496: The virus or its antigens with culture or polymerase chain reaction (PCR), among other techniques. Mycoplasma , Legionella , Streptococcus , and Chlamydia can also be detected using PCR techniques on bronchoalveolar lavage and nasopharyngeal swab . The causative agent is determined in only 15% of cases with routine microbiological tests. Pneumonitis refers to lung inflammation; pneumonia refers to pneumonitis, usually due to infection but sometimes non-infectious, that has
14880-431: Was a sharp increase in reported incidents of xenophobia and racism against Asian Americans . Clusters of infections and deaths occurred in many areas. The COVID-19 pandemic also saw the emergence of misinformation and conspiracy theories , and highlighted weaknesses in the U.S. public health system. In the United States, there have been 103,436,829 confirmed cases of COVID-19 with 1,207,479 confirmed deaths,
15004-522: Was further confirmed by a later population-wide serosurvey. On July 6, the United States Department of State announced the country's withdrawal from WHO effective July 6, 2021. On July 10, the CDC adopted the Infection Fatality Ratio (IFR), "the number of individuals who die of the disease among all infected individuals (symptomatic and asymptomatic)", as a new metric for disease severity. In July, US PIRG and 150 health professionals sent
15128-438: Was held from April 24–30, with mayors and other political officials declaring the week of remembrance in their respective jurisdictions as part of a national movement led by a collection of COVID advocacy groups. According to data compiled by NBC News, the U.S. death toll reached 1 million on May 4, 2022, the largest-recorded death toll in any single country, followed by Brazil, with about 660,000 deaths. The White House confirmed
15252-659: Was reported by CNN that COVID-19 numbers reached pandemic lows across the US, resulting in many testing sites closing their doors. With testing sites seeing as low as single digits per day, Director of Public Health Services Division of the Haywood County Health and Human Services Agency in North Carolina Sarah Henderson suggested that she expected most counties to see closures soon, if they had not already. "We were seeing an excess of 100 patients at our testing site in
15376-565: Was unaffected and continued to be published. Digital Director Justin Moran succeeded Elliot as editor-in-chief in July 2022. In April 2023, in the wake of reduced advertising revenues since the pandemic, the magazine's staff was laid off and editorial operations ceased. The company itself did not shut down, but was seeking alternative options to remain in operation. In September 2023, Paper resumed operations with Justin Moran returning as editor-in-chief after
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