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CDC cuts isolation, quarantine time for health workers as omicron cases surge [washingtonpost.com]:

By Dan Diamond [washingtonpost.com],Brittany Shammas [washingtonpost.com],María Luisa Paúl [washingtonpost.com],Andrew Jeong [washingtonpost.com] andEllen Francis [washingtonpost.com]|Updated December 23, 2021 at 11:15 p.m. EST

Doctors, nurses and other staff who test positive for covid-19 can more quickly return to work under recommendations issued by the Centers for Disease Control and Prevention on Thursday, as short-staffed hospitals brace for a winter surge of cases.

According to the CDC’s new guidance, health workers who contract the coronavirus but are asymptomatic can return to work after seven days with a negative test. “[T]hat isolation time can be cut further if there are staffing shortages,” CDC wrote. Previously, the agency had recommended that infected health workers isolate for at least 10 days to reduce the risk of spreading the virus.

The new guidance comes as health-care leaders have grown worried that the fast-spreading omicron variant — which appears to only cause mild symptoms in many vaccinated individuals — could sideline many doctors, nurses and other staff at a moment when demand on the nation’s health system is expected to rise.

Here’s what to know

MORE ON THE OMICRON VARIANT

• Mask-wearing on planes may be here to stay, Fauci saysDecember 20, 2021December 20, 2021 [washingtonpost.com]
• What to know about the omicron variant of the coronavirusDecember 23, 2021December 23, 2021 [washingtonpost.com]
• Schools send students home with coronavirus tests for the holidays as omicron fears lead to shortagesDecember 20, 2021December 20, 2021 [washingtonpost.com]

Confusing information leaves pandemic-weary Americans on their own as omicron rages into the holidays By Joel Achenbach [washingtonpost.com] and Fenit Nirappil [washingtonpost.com]11:15 p.m.Link copied

Christmas was supposed to feel a lot more normal this year for D.L. Anderson, 42, of Taylors Falls, Minn. She’s vaccinated and boosted. She had hoped the pandemic wouldn’t disrupt another holiday season. Then came omicron, a blizzard of it, requiring a recalculation of risk. So she won’t go to church after all. And hugs are no longer on the agenda.

But she’s sticking to her plan to have a holiday meal with her family. There are limits to the concessions she will make to the coronavirus [washingtonpost.com].

“There’s an emotional cost to this too: We can’t keep living in isolation,” Anderson said in a phone interview this week after she’d written to The Washington Post seeking guidance on how to navigate the holidays. [washingtonpost.com]

This is not the worst moment of America’s viral emergency, but it’s one of the most disappointing, as the omicron variant spreads explosively and the pandemic barrels mercilessly into its third year. Americans now have pandemic fatigue fatigue.

United Airlines, Delta to cancel more than 200 Christmas Eve flights, citing impact of omicron on staff By María Paúl [washingtonpost.com]9:37 p.m.Link copied

United and Delta said they would cancel dozens of flights on Christmas Eve, citing staff shortages from the omicron-fueled surge in coronavirus cases sweeping the country.

On Thursday, United Airlines said in a statement that it was canceling 120 flights on Friday because the fast-spreading coronavirus variant has had “a direct impact on our flight crews and the people who run our operation.”

Delta Air Lines said in a statement that its teams had “exhausted all options and resources — including rerouting and substitutions of aircraft and crews to cover schedules flying,” before canceling more than 90 flights on Christmas Eve due to weather and staffing issues.

The airlines said they were working hard to accommodate as many passengers as possible. The disruption comes as many people who had to cancel trips and getaways last year because of the pandemic are trying to make up for lost time.

According to data from the Transportation Security Administration [tsa.gov], since Dec. 16, more than 2 million people have passed through its security checkpoints almost daily — approximately double the number recorded on the same days last year.

TSA recorded 2,081,297 passengers on Wednesday, which surpassed the number of travelers reported the same day in 2019, before the pandemic.

United, which struggled with profitability last year amid restrictions on nonessential travel and the resulting travel slump, appeared to be on the road to recovery. The Chicago-based carrier predicted it would reach about 87 percent of the number of people that flew in 2019 — forecasting an average of 420,000 passengers per day from Dec. 16 through Jan. 3, the company said.

Even as the omicron variant pushes some to reconsider their holiday trips [washingtonpost.com], the company has not seen an increase in customer cancellations, said Kimberly Gibbs, a United spokeswoman.

The ripples of omicron’s high transmissibility during one of the busiest travel seasons were already being felt by airlines — some of which were worried about potential staffing shortages. Delta sent a letter [delta.com] on Tuesday to the Centers for Disease Control and Prevention asking the agency to reconsider its 10-day coronavirus isolation guidance for fully vaccinated people with breakthrough infections. The airline instead proposed a five-day waiting period.

“Our employees represent an essential workforce to enable Americans who need to travel domestically and internationally,” the letter reads. “With the rapid spread of the Omicron variant, the 10-day isolation for those who are fully vaccinated may significantly impact our workforce and operations.”

Stuck inside because of the omicron variant? Here are creative ways to stay safe and sane. By Paulina Firozi [washingtonpost.com] and Kim Bellware [washingtonpost.com]8:37 p.m.Link copied

The omicron variant of the coronavirus has rapidly spread across the United States, upending holiday plans for some of the pandemic-weary and driving people to testing sites [washingtonpost.com] — and for many, into quarantine.

Some experts have warned infection may be creeping closer to an inevitability [washingtonpost.com] for many. Those who have tested positive or have been exposed to someone who has been infected are quarantining and isolating. If and when that happens, public health experts and psychologists have recommendations for ways to cope and to stay safe.

Amid omicron surge, Phish cancels New Year’s concerts expected to draw tens of thousands By Andrew deGrandpre [washingtonpost.com]7:50 p.m.Link copied

Phish, the improvisational rock quartet known for its experimental, extended jamming and fervently loyal fan base, on Thursday announced the cancellation of a four-night run of performances [phish.com] that had been scheduled for the New Year’s holiday weekend at New York’s Madison Square Garden.

The concerts were expected to draw tens of thousands of fans to the arena in midtown Manhattan, but the omicron variant’s “unprecedented” capacity for rapid transmission posed too great a risk, the band said in a statement. It was the latest in a growing list of disruptions to New York’s cultural scene as, once more, the city faces a coronavirus surge. Infection counts there have set records in recent days, shuttering restaurants, Broadway theaters and more.

“We are also mindful that a significant number of people travel for these shows and then return to their communities, and we want to avoid accelerating transmission of the virus,” Phish said in its statement, adding that, even with the strictest of protocols, “the prolonged exposure of a four-night indoor run (plus the days of preparation and travel) to critical crew and staff considerably increases the possibility of having to shut the shows down once they’ve started.”

The band said it had already secured an agreement from Madison Square Garden to host rescheduled performances at the end of April.

Phish is among the music industry’s top-grossing live acts. Like others, the band returned to the road this summer and fall, playing a mix of outdoor and indoor shows at venues throughout the country while encouraging concertgoers — with mixed success — to wear masks and, at some shows, requiring proof of vaccination or negative coronavirus tests. Following a four-night run of indoor shows at the MGM Grand Garden in Las Vegas over Halloween weekend, several fans said they had tested positive for the virus [bostonglobe.com] and questioned whether stagnant airflow inside the arena was to blame.

Covid, the common cold or flu? By Kim Bellware [washingtonpost.com]6:52 p.m.Link copied

It starts with a sneeze, maybe a sniffle.

You think to yourself, it’s just mild allergies or a minor cold. You’re not worried about covid-19, because the symptoms don’t match up with the distinct, often severe indicators of covid-19: joint aches, violent coughing, a fever or chill, and the dreaded loss of ability to taste or smell.

But with the omicron variant now dominant in the United States and infecting the unvaccinated and fully inoculated alike, health experts warn that the symptoms that previously helped people to gauge whether they had a cold, flu or covid-19 are no longer the useful markers they once were.

Making risk assessments on whether to travel, gather with others or get tested for the coronavirus based on symptoms “is not going to work anymore,” said Emily Landon, the chief infectious-disease epidemiologist at University of Chicago Medicine.

Key updateCDC cuts isolation, quarantine time for health workers as omicron cases surge By Dan Diamond [washingtonpost.com]6:25 p.m.Link copied

Doctors, nurses and other staff who test positive for the coronavirus can more quickly return to work under recommendations issued by the Centers for Disease Control and Prevention on Thursday, as short-staffed hospitals brace for a winter surge of cases.

According to the CDC’s new guidance, health workers who contract the coronavirus but are asymptomatic can return to work after seven days with a negative test. “That isolation time can be cut further if there are staffing shortages,” according to the CDC. Previously, the agency had recommended that infected health workers isolate for at least 10 days to reduce the risk of spreading the virus.

The CDC also said that health workers who have received all recommended vaccine doses, including a booster shot, do not need to quarantine at home following “high-risk” exposures if they have not tested positive.

The new guidance comes as health-care leaders have grown worried that the fast-spreading omicron variant — which appears to only cause mild symptoms in many vaccinated individuals — could sideline many doctors, nurses and other staff at a moment when demand on the nation’s health system is expected to rise.

“As the healthcare community prepares for an anticipated surge in patients due to Omicron, CDC is updating our recommendations to reflect what we know about infection and exposure in the context of vaccination and booster doses,” CDC Director Rochelle Walensky said in a statement. “Our goal is to keep healthcare personnel and patients safe, and to address and prevent undue burden on our healthcare facilities.”

While the new guidance applies only to health-care workers, the airline industry and other employers have petitioned the government to update its return-to-work recommendations for more industries.

Europe faces its second covid Christmas with lockdowns, cancellations and rising cases By Perry Stein [washingtonpost.com] and Rick Noack [washingtonpost.com]6:14 p.m.Link copied

AMSTERDAM — The medieval castle outside Amsterdam had planned a cheeky holiday celebration, marking the end of a terrible year with “the worst tour you’ve ever had” and encouraging people to realize there’s “stuff we can laugh about together.”

But with the Netherlands in a national lockdown once more, organizers at Muiderslot Castle didn’t find much to laugh about this week. They had to refund tickets, give away a dozen Christmas trees and melt a skating rink they don’t expect anyone to use anytime soon.

“This castle has seen pandemics before,” said Annemarie den Dekker, director of programming at the castle. “But my first reaction was disbelief because we were all expecting a Christmas this year.”

The mood in much of Europe reflects hopes briefly glimpsed — and then dashed.

55 test positive for covid-19 on Royal Caribbean cruise, days after outbreak on another ship By Hannah Sampson [washingtonpost.com]5:45 p.m.Link copied

Royal Caribbean International said Wednesday that 55 passengers and crew tested positive for the coronavirus on a cruise, just days after revealing 48 people on another ship were involved in an outbreak. [washingtonpost.com]

The latest ship, Odyssey of the Seas, will skip its scheduled stops in Curaçao and Aruba on the eight-night Christmas voyage.

“The decision was made together with the islands out of an abundance of caution due to the current trend of covid-19 cases in the destinations’ communities as well as crew and guests testing positive on board,” Royal Caribbean said in a statement.

California to require health-care workers to get a booster shot by Feb. 1 By María Paúl [washingtonpost.com]5:19 p.m.Link copied

Amid fears of an omicron-fueled pandemic wave, California Gov. Gavin Newsom (D) on Wednesday unveiled new measures aimed at preventing hospital staffing shortages and schools from shuttering — including a requirement for health-care workers to receive booster shots by Feb. 1.

“Omicron is spreading rapidly and we must do all we can to keep staff at hospitals and medical facilities healthy and safe to protect Californians during a potential winter surge,” Newsom’s office wrote on Twitter [twitter.com] on Tuesday.

California already requires all health-care workers to be fully vaccinated — a mandate [ca.gov] that went into effect Sept. 30. Under the new mandate — which also applies to workers in high-risk congregate settings like nursing homes and prisons — workers must get the booster six months after completing BioNTechPfizer’s or Moderna’s two-shot regimen, or two months after receiving a Johnson & Johnson single-dose vaccine.

In the interim, Newsom said in a news release [ca.gov] Wednesday, workers “must test for covid-19 twice weekly until they are up to date on their vaccines.”

In a bid to keep schools open, California is increasing the availability of at-home test kits that students can use upon returning to class from winter break. The state will also expand testing-site hours, promote booster shots and deploy additional workers to overwhelmed hospitals.

“As the omicron variant spreads rapidly across the country and circulates in all regions of the state, we’re taking immediate, proactive steps to protect Californians with boosters and expanded access to testing,” said Newsom.

The fast-spreading variant now represents “well north” of 50 percent of all sequenced cases, the governor said. As of Wednesday, 191 omicron cases had been confirmed in the state, according to California’s Department of Public Health [ca.gov].

Key updateNew York City scales back New Year’s Eve festivities in Times Square By Brittany Shammas [washingtonpost.com]4:45 p.m.Link copied

New York City officials announced Thursday that they are scaling back plans for a full-strength New Year’s Eve celebration at Times Square as infections surge.

Just over a month after Mayor Bill de Blasio (D) said the festivities would be “coming back full strength” to ring in 2022, his office detailed a pared-down plan in a news release [nyc.gov]. Viewing areas will be capped at 15,000 instead of the average 58,000. Proof of full vaccination will be required, as was planned for the larger celebration, and masks will be, too. Spectators won’t be allowed entry until 3 p.m., later than in past years.

De Blasio said in a statement that the modifications would “keep the fully vaccinated crowd safe and healthy as we ring in the New Year.”

In mid-November, the mayor had blown on a noisemaker while announcing the return of the legendary celebration [washingtonpost.com]: “We can finally get back together again,” he said. “It’s going to be amazing.”

But the rise of the omicron variant has scuttled large gatherings once again. The Rockettes ended their Christmas Spectacular early [washingtonpost.com]. Many Broadway shows canceled performances. The Critics Choice Awards ceremony scheduled for Jan. 9 was postponed.

The White House’s coronavirus task force advised against major gatherings Wednesday, with Anthony S. Fauci, the nation’s top infectious-disease expert, saying [washingtonpost.com] they are “the kind of functions, in the context of covid, and particularly in the context of omicron, that you do not want to go to.”

De Blasio’s office warned that additional New Year’s Eve precautions could be announced in the coming days if deemed necessary. It noted that celebrations can be watched from home on a live webcast [timessquarenyc.org] or on a new app, VNYE [vnye.com].

Key updateU.S. now reporting more infections than during delta summer surge By Andrew Jeong [washingtonpost.com]4:17 p.m.Link copied

The United States logged a seven-day average coronavirus case count of 168,981 on Wednesday, amid a nationwide spike driven partly by the omicron variant, Washington Post figures show [washingtonpost.com]. That surpassed a summer peak average of 165,187 infections Sept. 1., as the delta variant was surging.

The tally comes as preliminary data suggests that omicron is significantly more contagious than other variants. The latest surge is the second-largest wave of the pandemic, behind the spike in infections between November 2020 and January 2021. On Jan. 12, the United States marked a record seven-day average of 248,209 cases.

Even before omicron was detected, coronavirus-related hospitalizations were rising in the United States. About 46,000 people were in hospitals for covid-19 in early November, compared with nearly 70,000 now. The number of people needing intensive care beds has also increased sharply.

The Biden administration and many state governments have been pushing already-immunized Americans to get booster shots. The makers of the Pfizer-BioNTech [washingtonpost.com] and Moderna [washingtonpost.com] vaccines say additional doses provide significant protection against infection by omicron.

Globally, omicron still accounts for fewer than 10 percent of sequenced cases, Post data shows [washingtonpost.com]. But in South Africa, where scientists were the first to sequence omicron, the variant is now responsible for more than 99 percent of recently detected cases. Omicron accounts for about 40 percent of recent cases in Norway, which announced on Dec. 1 that it had found its first infections of the variant.

In the United States, the Centers for Disease Control and Prevention has estimated that omicron made up 73 percent of new cases from Dec. 12 to 18. Detection of the first omicron infection in the country was announced [washingtonpost.com] Dec. 1.

Researchers at the University of Washington have projected [healthdata.org] that the United States could mark a high of some 2.8 million new daily infections in late January, dwarfing numbers from last winter.

There is some evidence that omicron, while infectious, causes fewer hospitalizations and less severe symptoms than other variants. On Wednesday, a South African study [washingtonpost.com], which has not been peer reviewed, showed omicron was 80 percent less likely to lead to hospitalizations than delta. On the same day, researchers at Imperial College London [imperial.ac.uk] also said there was less risk of hospitalization for omicron than delta.

But health officials have noted that even if omicron causes milder disease, the sheer number of infections triggered by the variant could still overwhelm health-care systems across the world. President Biden has ordered [washingtonpost.com] his administration to prepare for a surge in hospitalizations.

Anthony S. Fauci, the president’s chief medical adviser, said [washingtonpost.com] on MSNBC this week that omicron would hunt down the unvaccinated. “When you’re dealing with one that spreads so rapidly and you are unvaccinated, the virus is going to find you.”

Italy tightens coronavirus rules after record number of cases By Chico Harlan [washingtonpost.com]4:01 p.m.Link copied

Italy on Thursday slightly tightened its coronavirus rules, mandating outdoor masks and closing dance clubs for the next five weeks.

As part of the moves adopted Thursday, Italy also said that unvaccinated people would not be allowed to have counter service at cafes — essentially revoking the daily rite of having an espresso at the bar.

The moves came hours after the country announced 44,595 new coronavirus cases — the highest daily total of the pandemic — as well as 168 deaths, the highest 24-hour figure since May.

Italy is hoping to constrain the omicron variant, which represents about a third of cases, without resorting to the rigid, economy-sapping measures deployed last winter. Earlier this week, Prime Minister Mario Draghi said lockdowns were not being considered.

The virus is spreading quickly in Italy; over the past month, the number of people with ongoing infections has more than tripled. But Italy also has among the highest vaccination rates in Europe, and its government several months ago enacted a de facto mandate for workers — a move that Italy hopes can help prevent a spike in hospitalizations.

Even before Thursday, the unvaccinated had been barred from restaurants and many other indoor activities.

There are 1,000 covid-19 patients in Italian intensive care units, compared with about 4,000 at several earlier peaks.

Italy had maintained an outdoor mask mandate this year but dropped it as conditions improved. Greece and Spain also reinstituted outdoor mask mandates this week.

Study finds omicron is less severe than delta, and that booster vaccines wane after 10 weeks By Karla Adam [washingtonpost.com]3:19 p.m.Link copied

LONDON — The omicron coronavirus variant is less likely to lead to hospitalizations than the delta variant, but the ability of booster vaccinations to prevent people from catching omicron begins to wane after 10 weeks, the British government said.

A new analysis [www.gov.uk] by the U.K. Health Security Agency (UKHSA) published Thursday found that people infected with omicron were up to 70 percent less likely to be admitted to hospital than with previous variants. It also reaffirms separate studies [washingtonpost.com] on the severity of the variant out of Britain on Wednesday, which also suggest that omicron is sending fewer people to the hospital.

Jenny Harries, chief executive of the UKHSA, said it was an “encouraging early signal that people who contract the omicron variant may be at a relatively lower risk of hospitalization than those who contract other variants.”

But the highly transmissible variant could still pile pressure on health systems if even a small percentage of a large group requires hospitalization. On Thursday, Britain set another daily record for the number of coronavirus cases, with 119,789 confirmed cases. It’s the second day in a row that the figure has topped 100,000.

Officials stressed that the results were preliminary and based on only small numbers of omicron cases currently in hospitals.

The agency also said that a booster dose offered extra protection against omicron compared with just two doses. But it suggested that the extra protection from the booster waned more quickly against omicron than delta, by about 15 to 25 percent, 10 weeks from getting the shot.

Mark Jit, a professor of vaccine epidemiology at the London School of Hygiene and Tropical Medicine, said that more data was needed to determine what this might mean for Britain’s booster program.

“The best thing you can do is get boosted as soon as you can because there is a big wave going on,” he told the BBC. “As more data comes in, we’ll have to work out what do we need. Do we need another booster? Do we need a different vaccine which is reformulated against omicron? Or will we be okay with one booster?”

Key updateFDA authorizes Merck’s anti-covid pill, a second at-home treatment option By Carolyn Y. Johnson [washingtonpost.com]2:39 p.m.Link copied

Federal regulators on Thursday authorized a second pill to treat covid-19, adding another at-home treatment option to help keep high-risk people out of the hospital.

Doctors have clamored for easy-to-use medications throughout the coronavirus pandemic, but the new drug, molnupiravir, has had an uneasy reception because of its modest efficacy and potential safety risks. Some experts say another tool will be helpful as the omicron variant, which is resistant to other key treatments, surges. Others say they would be hesitant to use the drug.

The Food and Drug Administration authorized the five-day course of treatment in patients 18 and older who are at high risk of severe covid-19 and “for whom alternative COVID-19 treatment options authorized by the FDA are not accessible or clinically appropriate.”

Key updateKey updateKey updateCoronavirus: What you need to read

Coronavirus maps: Cases and deaths in the U.S. [washingtonpost.com] | Cases and deaths worldwide [washingtonpost.com]

Vaccines:Tracker by state [washingtonpost.com] | Booster shots [washingtonpost.com]| For kids 5 to 11 [washingtonpost.com] | Guidance for vaccinated people [washingtonpost.com] | How long does immunity last? [washingtonpost.com] | County-level vaccine data [washingtonpost.com]

What you need to know: Omicron variant [washingtonpost.com] | Masks FAQ [washingtonpost.com] | Delta variant [washingtonpost.com] |Other variants [washingtonpost.com] | Symptoms guide [washingtonpost.com] | Follow all of our coverage [washingtonpost.com] and sign up for our free newsletter [washingtonpost.com]

Impact of the pandemic:Supply chain [washingtonpost.com] | Education [washingtonpost.com] | Housing [washingtonpost.com]

Got a pandemic question? We answer one every day in our coronavirus newsletter [submissionplatform.com]

MORE ON THE OMICRON VARIANTHAND CURATED

• Five things about omicron that I want my friends and family to knowDecember 21, 2021December 21, 2021 [washingtonpost.com]
• At-home coronavirus tests: When to take them, how to get them and moreDecember 22, 2021December 22, 2021 [washingtonpost.com]
• U.K. omicron cases explode, while Boris Johnson faces new allegations of lockdown partiesDecember 20, 2021December 20, 2021 [washingtonpost.com]

View 3 more stories;

CDC shortens recommended Covid-19 isolation and quarantine times [cnn.com]:

179,000 New York City residents received their Covid-19 vaccine booster shot since Mayor Bill de Blasio announced his vaccine booster incentive program last week, bringing the total number of vaccinated New York City residents to 1.9 million, the mayor said at a news conference Monday.

“We put this mandate into action as Omicron was coming, but we had no idea it would be quite this intense,” the mayor said, “We knew with Omicron coming, with cold weather, it was time to do more, well thank God we did because these mandates have been absolutely necessary to keep this city going.”

De Blasio said there were 296 citywide Covid-19 hospitalizations Monday and that this number had gone up intensely, as did the confirmed positivity level, 7.96%, which the mayor called aberrant.

However, he added that the city's hospitals are "doing remarkably well. We have real challenges, but what's striking is how different the Omicron experience is than even last winter, let alone the spring of 2020.”

With 17,334 Covid-19 positive cases reported Monday, the Mayor said he believed the positive case number, “is going to peak really soon.”

Starting Monday, all private sector employers, about 184,000 businesses, are required to have a Covid vaccine mandate in place at their business. Asked if businesses would be prone to spot checks, de Blasio said businesses should expect inspections.

“But again, with an attitude of 'let's make sure things are working for everyone's health and safety.' We're not trying to do gotcha, we're trying to just make sure that we're moving forward,” he said.

"It is a multi-agency inspection force, which is very similar to the way that we conducted engagement and then enforcement related to Key to NYC as well,” New York City's Department of Health Commissioner Dave Chokshi said. “We seek to work with businesses and business owners so that everyone can come into compliance for the simple reason that vaccination is good for business — it helps us to keep our economy open and running and it helps to keep employees and all New Yorkers healthy and out of the hospital.”

CDC shortens recommend quarantine duration, with restrictions [cnet.com]:

On Monday, officials from the Centers for Disease Control and Prevention lowered the amount of time that Americans with COVID-19 [cnet.com] need to spend in isolation, reducing guidance from 10 days to five, provided they aren't experiencing symptoms and stay masked around other people for an additional five days. The quarantine guidance for anyone exposed to the virus received the same revision.

The new guidelines come as the Omicron variant continues to spread throughout the US [cnet.com], accounting for 73% of cases in the country.

Booster shots of Pfizer and Moderna have been shown to be effective in protecting against the variant [cnet.com], with CDC Director Dr. Rochelle Walensky saying that the organization was considering revising the definition of "fully vaccinated" [cnet.com] to include booster shots.

The important distinction in the new guidance is that infected people are free of symptoms and remain masked around other people.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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