Chronic kidney disease (CKD) is one of the leading causes of death globally, which affects 13.4{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of the world’s population [1]. With deterioration in renal function, this leads to the onset of CKD-related complications, such as uremia, anemia, and electrolyte disorders [2]. These complications often manifest as symptoms ranging from pruritus, pain, and insomnia to muscle cramps. This in turn has negative implications on patients’ quality of life [3,4]. Importantly as CKD patients approach end-stage renal disease (ESRD), the prevalence and severity of such symptoms increase [5].
Despite medical breakthroughs and the advent of new therapies in the past decades, optimal treatments for some of the symptoms resulting from CKD-related complications remained unclear, possibly due to their complex pathophysiology. A case in point is uremic pruritus, which is found in around 20{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of pre-dialysis CKD patients and 40{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of ESRD patients [6]. Although prevalent treatments include the use of emollients, gabapentin, and antihistamines, data related to their efficacy were often derived from small studies and their use is limited by adverse effects [7].
The use of alternative medical systems (AMS) which forms a key pillar of complementary and alternative medicine (CAM) has increased in the past 20 years [8]. AMS is defined as “entire systems of health theory and practice that developed separately from conventional medicine” [9]. Notably, around 18{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of dialysis patients have utilized some form of AMS [10,11]. In addition, prescription of AMS therapies such as traditional Chinese medicine (TCM) by professional practitioners often aids in minimizing the risk of side effects, hence increasing their appeal as potential therapeutic alternatives [11].
Prior studies have shown that AMS is effective in reducing symptoms such as pain, nausea, and fatigue in non-CKD patient populations. For instance the use of TCM formulas, such as Liu Junzi Tang and Xiao Banxia Plus Fuling have demonstrated efficacy in treating cancer-related pain and chemotherapy-related nausea and vomiting [12]. In addition, Chinese herbs such as Curcuma longa and Panax ginseng among patients with malignancies have shown efficacy in promoting apoptosis of cancer cells and inhibiting tumor metastasis [13]. Another study showed that a multi-modal Ayurvedic treatment approach was effective in reducing knee osteoarthritis symptoms, such as pain and stiffness, and improving function [14]. With increasing research supporting the use of AMS, this has led to a rise in healthcare institutions adopting and providing such integrated services which are supported by insurance coverage [15].
Among CKD patients, multiple studies have also been conducted to assess the efficacy of AMS in the treatment of CKD-related conditions and symptoms such as uremic pruritis and anemia. For instance, a study that assessed the efficacy of homeopathy verum among CKD patients showed a reduction in pruritus symptoms by 49{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} after 30 days of treatment [16]. Another study that evaluated the use of TCM patients with glomerulonephritis showed improvement in hemoglobin after 24 weeks of therapy [16,17].
Existing reviews which have assessed the role of AMS are currently limited to specific indications, such as uremic pruritus [18], use of subtypes of AMS in specific CKD subgroups, such as consumption of Chinese herbal medicine in diabetic kidney disease [19], and specific AMS therapies, such as use of Astragalus [20,21]. This review aimed to summarize and evaluate the broad roles and efficacy of AMS as potential alternative therapeutic options for CKD patients. Findings from the review will aid physicians in gaining a better understanding of the efficacy of AMS for CKD patients, which can aid in facilitating purposeful discussions with patients who are using or considering these therapies.
Methods
Protocol and Registration
The protocol for this study was registered on Open Science Framework (https://osf.io/ymks8/) and was composed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Synthesis without Meta-Analysis (SWiM) reporting guidelines [22,23].
Information Sources and Search
A literature search was conducted in MEDLINE, Embase, Scopus, CENTRAL, CINAHL, and PsycINFO. There was no start date restriction, and studies up to April 2022 were included. Key terms related to CKD, randomized controlled trials (RCT), and AMS were included in the searches. The search terms were adapted from other systematic reviews and the full search strategy is available in Appendix 1 [18,24-26].
Eligibility Criteria
With regards to inclusion criteria, full-text articles in English language which involved RCTs evaluating the use of AMS in adult CKD patients (>18 years old) were included. As defined by the National Center for Complementary and Integrative Health (NCCIH), AMS is a broad category encompassing a variety of medical modalities and refers to an entire system of theory and practice which developed separately from conventional medicine [15]. In this review, we included TCM, naturopathy, homeopathy, and ayurvedic medicine. Non-RCTs, case series, other systematic reviews, and meta-analyses were excluded.
Description of Main Types of AMS
TCM: TCM is a system of medical practice which originated in China and adopts a holistic approach to the medical treatment of a patient based on “syndrome differentiation.” It focuses on the integrity of the human body by emphasizing the intimate relationship between the body and its social and natural environment, as well as dynamic balance of movement [27]. The basic tenet of TCM is based on the flow and balance of vital energy, Qi, which flows through channels in the body called meridians that connect various organs and tissues [28]. Diseases are believed to be brought about by the imbalance of Qi. Hence, by restoring balance via acupoints or intake of herbs, TCM seeks to promote individual wellness and prevent diseases [29].
Naturopathy: Naturopathy is a form of medical practice which is rooted in vitalism and folk medicine and, promotes natural and self-healing ideologies [30]. The unique attribute of naturopathic medicine lies in the reprioritization of the order of therapeutics with increased emphasis on preventive behaviors, lifestyle modifications, nutrition, and exercise, over medical or surgical interventions [31].
Homeopathy: Homeopathy entails the therapeutic administration of substances derived from plants, minerals, or animals that produce effects that correspond to the clinical manifestation of diseases [32]. Its practice is centered on two following theories: “like cures like” and “law of minimum dose.” “Like cures like” refers to the belief that diseases can be treated with substances that produce similar symptoms in healthy individuals, and “law of minimum dose” refers to the belief that the lower the dose the greater its therapeutic efficacy [32].
Ayurvedic medicine: Ayurvedic medicine is one of the oldest alternative medical systems which involves the use of therapeutics derived predominantly from plants, animals, minerals, diet, exercise, and lifestyle changes. Its therapies are centered on the principle of “Panchakarma,” which comprises five karmas (actions) to rejuvenate and remove toxins from one’s body [33].
Study Selection and Data Collection Process
Citations retrieved from the six databases were extracted into Endnote X9 software (Philadelphia, PA: Clarivate) and duplicated citations were removed. During the initial article screening, two independent reviewers (WY and SW) reviewed the titles and abstracts of articles to select relevant articles. Thereafter, the full texts of the identified articles were evaluated. All discrepancies during the article screening process were resolved by discussion with a third reviewer (JJ). Hand-searching of references within identified articles was also performed to enhance the comprehensiveness of the search. A standardized Microsoft Excel data collection form was used for data extraction, and details related to the study characteristics, studied indications of intervention, efficacy, and safety were collected.
Management of Missing Data
For studies with missing data, authors were contacted for clarification to enhance the comprehensiveness of this review. Missing information that could not be retrieved after two email reminders were labeled as unavailable.
Risk of Bias in Individual Studies
The Cochrane Risk of Bias tool version 2.0 (Oxford, England: Cochrane) was utilized in the assessment of the included RCTs [34]. Two independent reviewers (Teo and Chu) performed the risk of bias assessment (Appendix 2). The instrument comprises of the following five domains: risk of bias arising from the randomization process, deviations from intended interventions, missing outcome data, outcome measurement, and selection of reported results. Using the responses derived from the five domains, the overall risk of bias for the individual studies was rated as “low,” “some concerns,” or “high” risk of bias.
Assessment of Heterogeneity
Clinical and methodological heterogeneity of included studies were analyzed to evaluate if meta-analyses could be performed for specific interventions in this study. Clinical heterogeneity describes variation in characteristics of study participants, intervention, or outcomes while methodological heterogeneity describes variation in study design and risk of bias. This was performed by two independent reviewers (Yeam and Seng). In view of the clinical and methodological heterogeneity across the included studies, a narrative review of the RCTs was conducted.
Synthesis of Data
With regard to the efficacy of AMS interventions, the response rates and any changes in patients’ quality of life were recorded. Additionally, the safety profile of each intervention was evaluated and the reported prevalence, severity, and outcomes of adverse effects were tabulated. The adverse events reported in included studies were categorized using the Common Terminology Criteria for Adverse Events (CTCAE) [35].
Summary Measures
Descriptive statistics were utilized to summarize the characteristics of all included studies. The principal summary measures evaluated in this study were the studied indications, efficacy of each AMS, and safety profile of each AMS.
Results
Study Selection
Out of 14,583 retrieved citations, 33 full-text articles were included in this review. The inclusion and exclusion criteria for the studies are shown in Figure 1. The percentage of agreement of articles between the reviewers was 94.0{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} and all disagreements were resolved after discussion.
Figure
1:
Flow chart for the inclusion of articles in this systematic review.
Study Characteristics
Types of AMS studied: Table 1 shows the characteristics of included studies. Among the four main types of AMS, TCM was the most studied (n=20, 60.6{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) [3,7,17,36-52], followed by Ayurveda (n=6, 18.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) [53-58], naturopathy (n=5, 15.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) [59-63], and homeopathy (n=2, 6.1{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) [16,64].
Table
1: Characteristics of included AMS intervention studies.
aQDDHG is composed of Huang Qi, Danshen, Dihuang, Shanyao, and Gan Cao.
bDosage and frequency vary from patient to patient.
ARB: angiotensin receptor blockers; DN: diabetic neuropathy; ESRD: end-stage renal disease; TBN: tianbaoning; TSF: tangshen formula; TWHF: Tripterygium wilfordii Hook F; ZSTL: zishentongluo; QoL: quality of life; QD: once a day; TIW: thrice a week; TID: thrice a day; CKD: chronic kidney disease; QIW: four times a week; HD: hemodialysis; T: test group; C: control group; T1: test group 1; T2: test group 2; C1: control group 1; C2: control group 2
Overview of study design and patient characteristics in included studies are as follows: the majority of the studies were conducted in Asia (n=31, 93.9{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), whereas most of the studies were performed in China (n=18, 54.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}). Out of all reviewed studies, 20 (60.6{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) were blinded to randomized controlled trials. The sample size was greater than 50 patients in 21 (63.6{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) trials (Table 1). Non-dialysis patients were recruited in seven studies (21.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), whereas ESRD patients were recruited in five studies (15.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}). The average duration of follow-up for all studies was 4.9 months (Table 2).
Study (year of publication)
Indication for use of intervention
Treatment (dose and duration if available)
Comparator (dose and duration if available)
Tool(s) used to assess outcomes
Outcome
Improvement symptoms (yes / no)
Percentage reductiona/improvement in symptoms (if available)
HbA1c ({fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) (baseline vs mean change from baseline): 10.68 (8.48, 13.96) vs -4.29 (-5.85, -2.79), p<0.05.
Acupuncture at Li4, ST36 and K13 acupoint QD x 3 months
Sham acupuncture QD x 3 months
NI
SCr levels (mg/dL) (T vs C): baseline: 1.45 vs 1.67, p=0.1298. Post-intervention: 1.41 vs 1.65, p=0.0489. 3-month follow-up: 1.32 vs 1.81, p=0.0467
Yes
-2.76{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} (SCr; pre vs post), -9.00{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} (SCr; pre- vs 3 months follow-up)
6 months
eGFR (mL/min/1.73m2) (T vs C): Baseline: 51.85 vs 42.50, p=0.0855. Post-intervention: 54.50 vs 43.60, p=0.0470. 3-month follow-up: 59.90 vs 40.80, p=0.0191
5.11{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} (eGFR; pre vs post), 15.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} (eGFR; pre-intervention vs 3 months follow-up)
hs-CRP (mg/dL) (T vs C): Baseline: 1.10 vs 0.79, p=0.4361. Post-intervention: 0.80 vs 0.90, p=0.8773
-27.3{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} (hs-CRP pre vs post)
Dye-binding method, Cerebrospinal fluid protein test kit, Determiner L CRE kit
SCr (μmol/L) (pre vs weeks 16, 20 and 24): 148.42±35.90 vs 130.19±29.79, 130.08±30.57, 130.78±32.55, p<0.05
Yes
-12.3{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} (SCr; pre vs 16 weeks), -12.4{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} (SCr; pre vs 20 weeks), -11.9{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} (SCr; pre vs 24 weeks)
QDDHG tablets BID and ARB (minimum dosage) x 12 weeks
ARB tablets (minimum dosage)
Guidelines for clinical research of Chinese medicine
Albumin (mg/24h) (within treatment group, baseline vs 4 vs 8 vs 12 week): 85.30 (66.00, 176.30) vs 61.50 (49.00, 110.20), p<0.05 vs 51.00 (37.00, 90.00), p<0.05 vs 41.40 (29.00, 68.00), p<0.05
Urinary protein (g/24 h) (pre vs 1 month, pre vs 3 months, pre vs 6 months): 4.99±2.25 vs 3.23±2.57, p<0.01. 4.99±2.25 vs 2.83±1.57, p<0.01. 4.99±2.25 vs 2.99±1.81, p<0.01
Acupuncture at Quchi (L11) and Zusanli (ST 36) acupoint BIW x 1 month
Sham acupuncture BIW x 1 month
NI
Number of patients (complete alleviation vs improvement vs no effect): 24 (70.6{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) vs 9 (26.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) vs 1 (2.9{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c})
Effective rates of TCM symptom (T vs C): 80{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} vs 60{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, p=0.024
Yes
–
3 months
eGFR (mL/min) (T vs C): 15.9±3.2 vs 14.0±4.0, p=0.019
Total effective rate (T vs C): 79.41{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} vs 67.12{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, p<0.05.
T1:500 mg of beleric capsule taken QD. T2: 1000 mg of beleric capsule taken QD
40 mg of Febuxostat taken QD
Jaffe method, MDRD Study equation, Salbutamol challenge test, Ellman’s method, Chrono-log light transmittance aggregometry, Spectrometry, Colorimetric detection with Griess reagents
SCr (pre vs post): group B: 1.86±0.32 vs 1.64±0.29, p≤0.005. Group C: 2.06±0.26 vs 1.56±0.24, p≤0.0001
Yes
-11.70{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}±9.00 (SCr, group B), -24.42{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}±8.14 (SCr, group C).
6 months
eGFR (pre vs post): group B: 39.13±6.57 vs 45.96±11.14, p≤0.005. Group C: 34.78±5.34 vs 48.93±11.46, p≤0.0001
16.96{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}±14.87 (eGFR, group B), 40.39{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}±20.98 (eGFR, group C)
Serum uric acid (pre vs post): Group B:8.10±0.67 vs 6.46±0.34, p≤0.0001. Group C: 8.54±0.64 vs 5.63±0.37, p≤0.0001
19.84{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}±6.43 (serum uric acid, group B), 33.88{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}±4.95 (serum uric acid, group C)
Pruritus score (pre vs 15 vs 30 vs 45 vs 60 days): 65±25 vs 46±29, p=0.002 vs 41±30, p=0.002 vs 42±29, p=0.002 vs 38±33, p=0.004
Yes
-29.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} (pruritus score, pre vs 15 days), -36.9{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} (pruritus score, pre vs 30 days), -35.4{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} (pruritus score, pre vs 45 days), -41.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} (pruritus score, pre vs 60 days)
Proteinuria (mg/24 h) (T vs C, baseline vs 12 months): 695 (95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI, 483 to 999) vs. 1403 (95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI, 1031 to 1909); p=0.004
Table
2: Assessment of outcomes and efficacy of different AMS interventions.
aPercentage reduction in symptoms is computed using (mean score at baseline – mean score post-treatment at end of study)/(mean score at baseline) for the treatment group.
bTCM granules are formulated based on four TCM syndrome patterns (Qi Yin/Xue deficiency, blood stasis in the kidney, wind-dampness interfering in the kidney, and endoretention of damp heat) for the treatment of CKD.
cHerbal granules consist of ten herbs: Huangqi, Danggui, Huzhang, Liuyuexue, Tufuling, Niuxi, Shiwei, Dahuang, Jixuecao, and Huangjing.
dDosage and frequency vary from patient to patient.
99mTc-DTPA: 99 m technetium diethylenetri-aminepenta-aceticacid; ARB: angiotensin II receptor blockers; BAID: brachial arterial inner diameter; BIW: twice a week; BUN: blood urea nitrogen; CCR: creatinine clearance rate; CKD-EPI: chronic kidney disease-epidemiology collaboration; DQOL: diabetes quality of life; eGFR: estimated glomerular filtration rate; ESR: erythrocyte sedimentation rate; ELISA: enzyme-linked immunosorbent assay; EQ-5D: EuroQol-5 dimension; FBG: fasting blood glucose; GS-RB1: Ginsenoside Rb1; HbA1c: haemoglobin A1c; ITT: intention to treat; LF: low frequency; MDA: malondialdehyde; MDRD: modification of diet in renal disease; NI: no information; PP: per protocol; QD: once a day; QDDHG: Qidan Dihuang Grain; SCr: serum creatinine; TBN: Tianbaoning; TCM: traditional Chinese medicine; TIW: thrice a week; TSF: Tangshen formula; TwHF: Tripterygium Wilfordii Hook F; TUP: total urine protein; TUV: total urine volume; UAER: urinary albumin excretion rate; VAS: visual analog scale; WHOQOL-BREF: World Health Organization Quality of Life-100 Questionnaire; ZSTL: Zishentongluo; Hs-CRP: high-sensitivity c-reactive protein; ITT: intention to treat; QIW: four times a week; HIF-1α: hypoxia-inducible factor 1-alpha; Wnt1: Wnt family member 1; α-SMA: alpha smooth muscle actin; TNF-α: tumor necrosis factor alpha; TRAF6: tumor necrosis factor receptor associated factor 6; FN: Fibronectin
Tools used for outcomes assessments of symptoms during interventions are as follows: the most frequently utilized tools were the abbreviated version of the World Health Organization Quality of Life-100 Questionnaire (n=2) and visual analog scale (n=2).
Risk of bias within studies: Out of all included studies, 14 (42.4{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) studies were assessed to be of “low” risk of bias, nine (27.3{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) and 10 (30.3{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) studies were scored as “some concerns” and “high” risk of bias, respectively.
Results of Individual Studies
Traditional Chinese medicine: The most commonly utilized interventions in the studies were herbal treatments (n=14, 70{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) [17, 37-43, 45-49, 51, 52] followed by acupuncture (n=6, 30{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) [3,7,36,38,44,50]. For acupuncture treatment, five studies used conventional acupuncture [3,7,36,38,50] while one study used infrared stimulation of acupoints [44]. The common acupoints administered during conventional acupuncture treatment were Li11 (n=3, 60{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), ST36 (n=2, 20{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), and Li4 (n=2, 20{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}). The frequency of acupuncture ranged from once a week to once a day, whereas the duration of studies lasted between six weeks to six months. Uremic pruritus (n=3, 60{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) was the most commonly studied indication, with reductions in pruritus score observed between 54.7{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} and 60.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} [7,36,38]. Infrared stimulation was used on RN6, RN4, and RN3 thrice a week for three months [44]. The indication studied was quality of life (QoL). According to QoL scores that were evaluated using the EQ-5D questionnaire, utility increased by 15.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}.
Herbal treatments include six single-herb (n=6, 42.9{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) [39-42,48,49,51] and eight multi-herbs formula granules (n=8, 57.1{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) [17,37,41,43,45-47,52]. Common single-herb treatments used are Huangkui (n=2, 33.3{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) and TWHF (n=2, 33.3{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}). The frequency of treatment was once to three times a day, for two to 12 months. Proteinuria was the most studied indication (n=4, 66.7{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), where the various treatments reduced proteinuria between 27.0{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} and 61.8{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} [39,42,48,51]. Common herbs used in the multi-herb formula granules studies included Huang Qi (n=6, 75{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), Danggui (n=4, 50{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), Salvia miltiorrhiza (n=3, 37.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), and Poria (n=3, 37.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}). The most commonly studied indication was improvement in renal function (n=5, 62.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) [17,41,43,47,52]. Serum creatinine decreased (2.76-12.4{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) and eGFR increased (7.07-15.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) across the various treatments.
Ayurveda: The included studies evaluated both plant-based (n=3, 50{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) [53,54,56] and animal-based (n=3, 50{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) treatments [55,57,58]. The most common treatment studied was plant-based silymarin tablets (n=2, 33.3{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) while that for clinical indication was improvement in renal function (n=4, 66.6{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) [53-56]. The eGFR increased between 16.9{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} and 86.8{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} across the various treatments [53-56].
Naturopathy: Keto amino acids were the most studied naturopathic treatment (n=2, 40{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}). Common indications studied included anemia and glucose control, where hemoglobin and fasting blood glucose levels in subjects improved by 19.8{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} and 20.8{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, respectively [60,61]. The use of watercress and garlic extract was also studied for inflammation, where the total oxidant status and IL-6 levels were shown to improve by 38.9{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} and 68.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, respectively.
Homeopathy: Homeopathic verum was studied for relief of uremic pruritus with improvement in pruritus score between 29.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} and 41.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} [16]. For Brazilian green propolis pills, it was studied for proteinuria where a 27.6{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} reduction in proteinuria was noted [64].
Safety Profile of AMS Interventions
The adverse events reported by all included studies are shown in Table 3. Adverse events reported were of grade 1 (n=13, 39.4{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), grade 2 (n=8, 24.4{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), and grade 3 (n=6, 18.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) severity. There were no life-threatening consequences or death related to adverse effects (grades 4 and 5) reported.
Study (year)
N (T)
Treatment
Reported adverse effects based on Common Terminology Criteria for Adverse Effects (CTCAE) v5.0a,b,c
aThe adverse effects were graded based on Common Terminology Criteria for Adverse Effects (CTCAE).
bQDDHG is composed of Huang Qi, Danshen, Dihuang, Shanyao, and Gan Cao.
cDosage and frequency vary from patient to patient.
Grade 1: mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated. Grade 2: moderate; minimal, local, or non-invasive intervention indicated; limiting age-appropriate instrumental activities of daily living. Grade 3: severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care activities of daily living. Grade 4: life-threatening consequences; urgent intervention indicated. Grade 5: death related to adverse effects; AE: adverse events; BID: twice a day; C: control arm; NA: not applicable; QD: once a day; T: treatment arm; TID: thrice a day; TIW: thrice a week
Adverse effects associated with traditional Chinese medicine: the use of acupuncture is associated with mild pain, bleeding, bruising, and elbow soreness (grade 1) [36,40]. These symptoms resolved spontaneously without additional treatment. For single-herb treatments, TWHF treatment was associated with vomiting (38.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, grade 1), itchy skin (6.45{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, grade 1), nausea (3.22{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, grade 1), and rash (1.61{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, grade 1) [39,48]. Grade 2 adverse events associated with its use included hyperkalemia (23.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), leukopenia (2.9{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), and photosensitive dermatitis (8.8{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), while grade 3 adverse effects included liver dysfunction (19.4{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) and severe leukopenia (1.61{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}). Subjects who developed leukopenia were withdrawn from the study.
For Huangkui treatment, adverse effects observed included elevated cholesterol (2.94-3.76{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) (grade 1), upper respiratory tract infection (2.94-3{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) (grade 2 and grade 3), and liver injury (2.26{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) (grade 3) [42,51]. The use of Shenqi particles was associated with interstitial pneumonia (1.1{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, grade 2), lung infection (5.26{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, grade 3), and liver injury (3.15{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, grade 3) [37]. Anemia (grade 2) and acute myocardial infarction (grade 3) were observed for subjects using Tangshen formula granules [41]. The use of QDDHG tablets was associated with insomnia (1.96{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, grade 1) [47].
Adverse effects associated with ayurveda: Silymarin treatment was associated with nausea and vomiting (10{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}), as well as headache (6.67{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) [54,56]. Beleric capsule treatment was associated with mild gastrointestinal intolerance (11.1{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) [58]. Adverse effects from both studies were of grade 1 severity. Abdominal pain (4.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, grade 2) was observed with the treatment of camel milk [55].
Adverse effects associated with naturopathy: All adverse effects reported for naturopathy treatments are of grade 1 severity (Table 3). They include nausea (6.25{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) and diarrhea (6.25{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) with the use of alpha-keto amino acid [60], as well as stomach discomfort (4.54{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}) with the use of pomegranate juice [59].
Adverse effects associated with homeopathy: No adverse effects were reported with the use of homeopathy (Table 3).
Summary of Efficacy and Safety Profile of AMS Interventions
Table 4 shows a summary related to the efficacy and safety profiles of AMS interventions.
Type of AMS
Common doses and treatment regimens and duration of therapy
Indications
Percentage reduction in CKD symptoms (if available)
2.76{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} to 51.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}
Elbow soreness (10{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}); liver injury and dysfunction (1.04-19.40{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}); dry cough, pneumonia, and upper respiratory infections (1.04-5.26{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}); hyperkalemia (3.64-23.50{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}); vomiting (38.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}); leukopenia and anemia (1.61-2.90{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}); photosensitive dermatitis, itchy skin, and rash (1.65-8.8{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}); gastrointestinal symptoms, nausea, and vomiting (1.57-38.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}); insomnia (1.96{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c})
Herbal granules TID x 6 months; QDDHG tabletsa BID x 12 weeks; 500 mg GS-Rb1 QD x 6 months; 8 g TSF granules and ARB BID x 24 weeks; 150 mL ZSTL solution BID x 3 months; TCM granules BID x 24 weeks
Acupuncture
Acupuncture at Li4, ST36 and K13 acupoint QD x 3 months
Herbal
Proteinuria
-61.8{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} to -18.6{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}
9.6 g of Shenqi particle TID x 48 weeks; 40 mg TWHF TID x 3 months followed by 20 mg TWHF TID x 3 months; Huangkui capsule TID x 12 months; 60 mg TWHF and 160 mg valsartan QD x 24 weeks
Acupuncture
Uremic pruritus
-60.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} to -54.7{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}
Acupuncture at Quchi (L11) acupoint TIW x 1 month; acupuncture at Quchi (L11) and Zusanli (ST 36) acupoint BIW x 1 month; acupuncture at various acupoints TIW x 6 weeks
Acupuncture QIW x 2 months
Fatigue, insomnia, itchiness, and pain
-89.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} to 15.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}
Infrared stimulation of Qihai (RN6), Kuamyuan (RN4) and Chungchi (RN3) TIW x 3 months
QoL
-9.10{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} to 163{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}
Qingshen granules TID x 3 months
Wnt/β-catenin signaling pathway
-61.4{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} to 17.8{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}
Qingshen granules TID x 3 months
Immune function
42.3{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} to -20.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}
TBN tablets (gingko extract) TI x 8 weeks
Vascular endothelial function
44.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} to 40.8{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}
Table
4: Summary of efficacy and safety profile of AMS indicated for CKD symptoms.
aQDDHG is composed of Huang Qi, Danshen, Dihuang, Shanyao, and Gan Cao.
bDosage and frequency vary from patient to patient.
Percentage reduction in symptoms is computed using (mean score at baseline – mean score post-treatment at end of study)/(mean score at baseline) for the treatment group.
99mTc-DTPA: 99 m technetium diethylenetri-aminepenta-aceticacid, BAID: brachial arterial inner diameter, BID: twice a day, ELISA: enzyme-linked immunosorbent assay, GS-Rb1: Ginseng extract, MDRD: Modification of Diet in Renal Disease, QoL: Quality of life, TBN: Tianbaoning, TID: thrice a day, TIW: thrice a week, TwHF: Tripterygium Wilfordii Hook F, ZSTL: zishentongluo
Discussion
To the best of our knowledge, this is the first review that has summarized findings related to the therapeutic uses of AMS for CKD patients in RCTs. Among the four classes of AMS, TCM was the most studied class which has demonstrated efficacy in improving CKD-related symptoms and outcomes [3,7,36-52]. Among the TCM interventions evaluated, Huangkui, TWHF, and acupuncture have shown efficacy in reducing proteinuria and relieving uremic pruritus symptoms. The therapeutic basis of TCM for CKD is rooted in the restoration of vital energy and nourishment of blood, dispelling of heat and reduction of dampness, and regulation of Yin and Yang in the body [65]. In Western medicine, this is seen in a reduction in inflammation and oxidative stress, as well as boosting micro-circulation and enhancement of metabolism [52]. For example, Huangkui, also known as Abelmoschus manihot, reduces proteinuria by removing oxygen radicals, improving the circulation, and clearance of immune complexes as well as reducing inflammation and renal tubular epithelial injury [66]. It is also noted that triptolide, the key constituent of TWHF, suppresses the nuclear factor kappa b (NF-κB) signaling pathway and prevents the trigger of T lymphocytes and some inflammatory cytokines (TNF-α, IL-1β, IL-6, and IFN-γ), in addition to its podocyte-protective capabilities [67-70]. Notably, two of the included studies demonstrated that a combination of TCM and Western medicine, such as the intake of Huangkui capsule and losartan tablet to alleviate proteinuria, is more efficacious than taking TCM or Western medicine alone. This adds to existing evidence on potential applications of TCM alongside conventional medical therapy. Among patients on TWHF, regular checks of potassium and liver enzymes should be performed due to the risk of hyperkalemia and raised liver enzymes.
With regards to the use of acupuncture, it results in the release of endogenous opiate-like substances that have been proposed to dull the peripheral and central perception of itching [71]. Stimulation of acupoints via far infrared (FIR) treatments has also been revealed to boost skin microcirculation, lessen emotional anxiety and promote excretion of waste products by improving the autonomic nervous system [44,72-76]. Enhanced circulation via a stronger autonomic nervous system is postulated to relieve CKD-related symptoms as the development of renal failure is attributed to poor circulation in the field of TCM [73,77]. Currently, renowned hospitals in the United States such as the Mayo Clinic and Duke University Medical Center have started providing acupuncture, along with other treatments. With growing evidence related to the efficacy and safety of TCM, there has been greater receptivity from medical doctors related to applications and use of TCM in clinical practice [78]. It is however important to note that TCM is not without any side effects. For example, the use of Huangkui should be cautioned in patients with hyperlipidemia or liver disease as its use has been associated with elevated lipid levels and liver injury. On the other hand, acupuncture appears to be relatively safe with mild side effects, such as elbow soreness. More studies related to TCM are required to further assess their long-term safety profile, and they should be prescribed with careful consideration of each patient’s health condition.
For Ayurveda, silymarin was one of the most studied interventions which demonstrated efficacy in improving renal function. Ayurvedic therapies are derived predominantly from plants, animals, minerals, exercise, and lifestyle changes. They are believed to rejuvenate and remove toxins from one’s body. In conventional medicine, the therapeutic effects of ayurveda for CKD are ascribed to their anti-inflammatory and anti-oxidant properties. For instance, silymarin has shown efficacy in in vitro studies in attenuating inflammatory stress in renal tissue by suppressing the NF-κB signaling pathway and hence TNF production [79-85]. Other Ayurvedic treatments, such as the application of capsaicin ointment, were also found to alleviate uremic pruritus. Topical capsaicin, a natural alkaloid derived from red chili pepper, has been discovered to relieve uremic pruritus by binding specifically to type C sensory neurons and resulting in the release of substance P, as well as suppressing its synthesis, transport, and storage thereafter [57]. Relatively few side effects were observed for the Ayurvedic therapies discussed above. Despite the promising benefits associated with Ayurvedic treatments, it is currently less globally recognized as compared to TCM [86]. Further research is necessary to evaluate their efficacy and safety profile to improve their acceptance in clinical practice as adjunctive treatments, in particular for CKD patients.
For naturopathy, its unique attribute lies in the reprioritization of the order of therapeutics, with increased emphasis on non-invasive treatments, such as lifestyle modifications and nutrition, over medical or surgical interventions. In this review, one of the more studied interventions is the use of ketoanalogues of essential amino acids (KAs). The addition of KAs to a low-protein diet has been shown to improve renal function and uremia. Notably, while lowering protein intake may improve renal function in CKD patients by altering immunologic events and reducing hypertrophy and hyperfiltration in the remaining nephrons, it may result in malnutrition [87-89]. However, the supplementation of KAs not only averts malnutrition by ensuring adequate consumption of amino acids but also alleviates uremia [61]. The absence of amino nitrogen in KAs allows them to become transaminated by taking nitrogen from non-essential amino acids and hence, reducing the production of urea via re-using the amino group [90,91]. Relatively few and mild adverse effects were observed for the included naturopathic therapies, rendering them attractive treatment options. Additionally, as naturopathic treatments are usually non-invasive, they can be easily combined with conventional medications. Of note, 28 health systems, hospitals, and cancer treatment centers in the United States currently have at least one licensed naturopathic physician at their premises [92]. With increasing research evaluating the efficacy and safety profile of naturopathic treatments, its role as potential adjunctive treatment for CKD patients is also likely to expand in the future.
Lastly, homeopathy has also shown efficacy in improving CKD-related symptoms and outcomes. Homeopathy entails the therapeutic administration of substances derived from plants, minerals, or animals which produce effects that correspond to the clinical manifestation of diseases. In this review, the use of Brazilian green propolis pills and homeopathic verum medication were found to improve renal function and alleviate uremic pruritus, respectively. Brazilian green propolis was reported to improve renal function via a few mechanisms. Firstly, it decreases proteinuria via its ability to reduce urinary oxidative stress and macrophage infiltration into the kidneys [93]. Secondly, chrysin, a flavonoid in propolis has been shown to decrease podocyte apoptosis in patients with diabetic nephropathy and lessen glomerular injury [94]. Lastly, propolis has also been shown to decrease blood pressure via acetylcholine-induced vasodilation and from its antioxidant properties [93,95-97]. With regard to the safety of homeopathic treatment, no adverse effects were reported across included studies. However, the practice of homeopathy is relatively restricted, with 36{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of states in the United States requiring homeopathic practitioners to either be licensed Western medicine or Naturopathic practitioners [32]. Consequently, more research is necessitated to validate the efficacy and safety of homeopathic treatment as adjunctive therapy for CKD patients.
Limitations
The following limitations should be considered in conjunction with this review. Firstly, due to the clinical and methodological heterogeneity of the studies, meta-analyses were not performed. As the pool of evidence for AMS trials for CKD patients grows, subsequent reviews should consider conducting meta-analyses for the efficacy of AMS treatments for CKD patients. In addition, there could have been exclusion of potentially applicable studies even though an extensive search strategy was used. To prevent this, the references of included studies were also hand-searched as part of our search strategy. Another limitation of the study relates to the inclusion of only articles in English language. Researchers should consider the inclusion of studies in other languages such as Chinese and Tamil in future reviews. Finally, although results of the included studies were reported normalized Z scores, care should be taken when interpreting these values and comparing the efficacy of various AMS classes. This is due to considerable diversity in types of outcomes evaluated and comparator arms and tools adopted for evaluation of outcomes. Overall, it is hoped that with greater standardization of study outcomes for AMS therapies in future studies, these normalized Z scores can enable more purposeful comparisons of the efficacy of the different AMS classes.
Alternative medicine units were the buy of the working day way ahead of contemporary-working day medicines received attractiveness across the earth.
Ayurveda — which originated in the Indian subcontinent — is believed to be more than 3,000 several years previous. The term is a portmanteau of Ayus (life) and Veda (science) — which interprets to the ‘science of life’.
Ayurveda can take a extensive method by means of herbs, workout, meditation, massage, publicity to sunlight, and managed respiratory to keep the body, head, and spirit in balance.
Men and women use this therapy to heal several ailments, which includes diabetic issues and heart and neurological illnesses.
Whilst scepticism surrounds the rewards of option medication, folks across the globe however decide on common devices for holistic healing.
From Asian to Indigenous American drugs programs, SocialStory normally takes a search at five regular methods deemed to profit people today.
Naturopathy
With origins in Europe, naturopathy diagnoses ailments as an sign that the body’s purely natural skill to heal itself is compromised. It goes past managing the ailment to restoring the natural procedures by which the overall body heals itself.
Naturopathy, which translates to ‘nature disease’, is practised all through Europe, Australia, New Zealand, Canada, and the US.
In North America, naturopathic tactics are centered on 6 concepts, which includes nature’s therapeutic electric power, pinpointing and treating the illness, the concept of “do no hurt”, looking at the doctor as a instructor, the holistic treatment of an individual, and prevention.
The holistic method combines different methods like homoeopathy, acupuncture, and natural medicine, and the typically use of much more contemporary procedures like bio-resonance, ozone therapy, and colonic irrigation.
Acupuncture is derived from historic Chinese drugs and is primarily based on the release of energy in the physique
Acupuncture
Acupuncture is a therapy derived from historical Chinese medicine, where by fantastic needles are inserted at sure web sites in the physique for therapeutic or preventative reasons.
The follow includes the stimulation of subcutaneous sensory nerves and the muscle groups, which qualified prospects to the physique manufacturing normal stimulants this sort of as discomfort-relieving endorphins.
Practitioners and sufferers think the use of acupuncture is strength or “Qi” (pronounced Chi that flows as a result of channels known as meridians in the human body), and disease is induced when the Qi is not allowed to stream freely as a result of the entire body.
The launch of Qi qualified prospects to the restoration of superior well being. Acupuncture is believed to present aid from persistent suffering, tension-linked migraines, and headaches. Besides, it is employed in the cure of joint agony, toothaches, insomnia, nervousness, depression, and infertility.
Most persons say the therapy leads to minor to no discomfort, with only a slight soreness after the session.
Unani
Unani drugs or Tibb is a conventional Arabian procedure that can be traced back again to the texts of historic Greek doctors like Hippocrates and Galen, afterwards refined by Arab physicians like Avicenna.
Unani medication is primarily based on attaining harmony and harmony involving the body, mind, and the soul. The technique believes a healthier entire body has a stability in between 7 ideas — arkan (elements), mizaj (temperament), akhlat (bodily humour), aaza (organs and devices), arwah (vital spirit), quwa (faculties or powers), and afaal (capabilities).
The cure includes balancing external things, for case in point, air, h2o, and foods involved in illnesses and diseases. If this fails, treatment method with pure medications is recommended, and diet plan also kinds a substantial aspect of the procedure.
Tibetan drugs
Tibetan drugs or Sowa Rigpa (the science of therapeutic) is an historic therapeutic practice from Tibet based on the basic principle that the standard purpose in everyday living is contentment.
Practitioners analyse the patient’s exceptional inborn character or constitution and recommend supportive life-style choices. The program goes to the supply of the difficulty to assist reach wellbeing by striking a stability. It thinks the intellect is the source of struggling, and a healthier head will lead to a nutritious entire body.
Based mostly on the “Four Tantras” that continue to keep the 3 bodily humours — wind rlung, bile mkhris pa, and phlegm terrible kan — in equilibrium, these tantras are —
Root Tantra: Takes advantage of visual observation to diagnose predominantly the pulse, tongue, and urine
Exegetical Tantra: Offers with topics such as physiology, anatomy, embryology, psychopathology, and treatment method
Instructional Tantra: This is the longest of the tantras, which describes sicknesses that cause humoral imbalance and how to address them
Subsequent Tantra: Describes diagnosis and therapies, how the medicines really should be well prepared, how the physique is cleansed as a result of massages, moxibustion (burning mugwort on details of the system), and even insignificant surgical procedures
Tibetan drugs treats an personal based mostly on their nature and constitution
Japanese medicine
Japanese or Kampo medication technique is about 1500-several years-previous and has its roots in Chinese drugs. Based on natural formulations, Japanese medicine has about 148 Kampo formulas, formally authorised as prescription medications.
In point, some medical doctors use Kampo drugs with chemotherapy in most cancers treatment method. It is a popular preference for individuals with gastrointestinal tract conditions and inflammatory bowel conditions. Kampo also prescribes acupuncture and moxibustion but depends principally on organic formulas.
For the duration of the Meiji period of time in the 19th century, the process witnessed a drop with immediate modernisation. But in 2006, it witnessed a revival when the Japanese Board of Clinical Specialties appointed the member medical professionals of the Japan Culture of Oriental Drugs (JSOM) as Kampo experts.
Additionally, numerous universities have started exploration in Kampo medicine.
Hospitals and wellbeing techniques are expanding their visions of population health to include things like additional helpful techniques to deal with – and even fend off – persistent conditions and disorders. In fact, quite a few establishments are efficiently implementing their abilities in community overall health to help people today stay out of the hospital by addressing critical social determinants of wellbeing such as meals insecurity. In doing so, they are hoping to demonstrate that by increasing access to healthier foodstuff and nourishment, they can positively influence persistent situations like diabetic issues, being overweight and hypertension, even though reducing over-all health care expenditures.
Food insecurity is popular close to the country. In accordance to the U.S. Division of Agriculture, about 38 million Americans did not have enough food items to fulfill their needs in 2020, profoundly influencing their well being and excellent of everyday living. In addition, “eating a balanced breakfast is affiliated with enhanced cognitive perform, lessened absenteeism in schools and enhanced mood,” explained Dr. Kara Odom Walker, executive vice president and main inhabitants well being officer at Nemours Children’s Wellbeing Technique, for the duration of a recent U.S. Information & Environment Report webinar. Addressing all of these concerns is a priority for Nemours, she pointed out, which embraces a “whole kid health” design that incorporates “nutrition and foodstuff entry as an essential component of health and fitness.”
Young children, in truth, are in which “the biggest possibility is” for effecting adjust, mentioned Dr. Lisa Harris, CEO of Eskenazi Wellness, a public healthcare facility located in Indianapolis. She mentioned that “it’s an regrettable truth” that the strongest predictor of health and fitness and longevity is ZIP code. Her well being system focuses on “the quick-conclusion-of-the-adhere ZIP codes” simply because “low-cash flow people [bear] a disproportionate stress of serious illness,” Harris said. “The research has borne out that 80{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of persistent ailment can be prevented, improved managed and, in some conditions, even reversed by concentrating on nutrition and physical activity. This needs, although, the access, for case in point, to healthful food stuff and secure, safe and sound environments be available to all, not just the privileged handful of.”
Pamela Schwartz, executive director for local community health and fitness at Kaiser Permanente, an Oakland, California-based mostly health organization, referenced a 2020 study of some 10,000 of its customers, which exposed that almost a third claimed meals insecurity, and would welcome assistance. “So we’ve been building a strong portfolio to tackle our members’ social desires, beginning with food stuff insecurity,” she mentioned. In addition, “we’ve been constructing a detailed countrywide strategy to genuinely transforming the financial, social and plan environments that are associated to food stuff, so that folks across the nation can have entry to healthful, cost-effective meals.”
Intermountain Healthcare, a Utah-primarily based overall health process that serves western states, created a pilot system in two counties to map and tackle social desires in purchase to minimize clinical spending and boost quality of daily life. “We uncovered some of the boundaries that were being in the way of hoping to fulfill people’s requires,” such as foods insecurity, mentioned Mikelle Moore, the system’s senior vice president and main local community health and fitness officer. “We now display all of our sufferers for social demands and are able to join people and members to food” and other guidance systems, she stated. Analytics can also “help us forecast who demands to be outreached, simply because we’re not generally encountering the people who are in the most need” in the clinic, she added.
The COVID-19 pandemic only exacerbated an currently present difficulty of food stuff insecurity. Schwartz said Kaiser Permanente ramped up its outreach application to assistance users use for Supplemental Nourishment Guidance Program added benefits as a result of an “innovative, reasonably priced texting approach” to achieve people today in low-money communities. “To date, we have attained above 4 million users and assisted 95,000 users to utilize for SNAP, and we also estimate that this type of a simple texting campaign has place extra than $34 million into our members’ pockets and nearly $50 million into the area economies,” she claimed.
Also, men and women “appreciate staying questioned if they have a have to have,” Moore reported. “As before long as they’re asked, you can find pretty much this wave of appreciation that we take into consideration this an aspect of wellness and that we would be so caring as to talk to about factors of their residence everyday living,” these types of as foodstuff and housing. “The tougher part for us has been actually convincing our caregivers how to get comfortable with inquiring the problem. That is taken some instruction and coaching to aid persons know how to question those thoughts.”
Intermountain utilizes a tech platform known as Unite Us that enables caregivers to hook up a affected individual to social products and services, no matter if individuals are foods-centered or associated to other requirements. “I think this is the future,” Moore claimed. “We all do our aspect in running a network of proficient nursing services and therapists and hospitals and clinics to enable assist our sufferers in figures. This is the beginning of a social community that will be a genuinely essential component of taking care of wellbeing in the future.”
Health care systems are also getting resourceful methods to use their space to boost their missions. At Nemours, which has two children’s hospitals and amenities in Delaware, New Jersey, Pennsylvania and Florida, “one of the systems that we have proven is our Can Grow Backyard garden, which is actually a program on our campus that’s developed to assistance empower a lot more families” to do the exact at residence.” The method features elevated beds outside the house the cafeteria that provide as a demonstration backyard garden to exhibit families how to expand their own create. “I keep in mind meeting a younger lady who said, ‘I never ever knew what kale was. I never knew kale tastes so very good,’” Walker mentioned, “and I think that’s just the electrical power of studying as you working experience existence as you see it improve with your very own fingers and your have watering.”
Harris then recounted a story that captured viscerally what living with starvation can be like for youngsters At a community health and fitness centre, the waiting around space was disrupted a single working day when a youthful boy retained chasing another baby. The health practitioner on hand afterwards uncovered the motive, Harris noted. The boy “was hoping the [other] kid would fall some of the Doritos out of the bag that he was carrying, simply because this younger boy had not eaten for two to a few times. So that is when you really get started to feel about what that feels like,” and it ignites “this enthusiasm to do something.”
This incident induced the generation of Eskenazi’s Crooked Creek Foodstuff Pantry, a nonprofit, comprehensive-company facility positioned within just the well being centre. Private companies can display people today and provide a “food-as-medication prescription” for the pantry which features the goods they need to have, Harris said. “It delivers an essential gain in conditions of benefit [and] in lessening [the] stigma of acquiring to go somewhere else for meals.”
The panelists reported investigation attempts to evaluate the price of these initiatives are underway. These involve properly-made scientific studies to take a look at things like the duration of food delivery, the number of foods provided per working day and which illness types are impacted.
Income is, as usually, a challenge. “It certainly can take funding on a substantial scale” to provide these companies, Harris stated. Money normally arrive from a blend of federal and local grants, corporate sponsors, religion-based mostly businesses and person donors, like the Unexpected emergency Food stuff Help Program, a federal software initiated in the course of the pandemic. “Unfortunately, we don’t know how long this profit will proceed, and a single of the potential sustainability problems is just likely to be adjusting to a lessen in that aid,” she explained. “The difficult fact is that we all struggled to fund these systems, and the very long-time period sustainability is likely to count on payers’ or society’s willingness to pay.”
WEST PALM Seaside, Fla. — Tenet Health and fitness on Sunday unsuccessful to remedy queries from WPTV NewsChannel 5 on the standing of malfunctioning facts techniques at St. Mary’s Professional medical Heart and Fantastic Samaritan Healthcare Centre.
Phone services and some info techniques at the hospitals have been hobbled due to the fact Wednesday for good reasons unknown.
Tenet blames “community challenges” for disruptions in cellular phone provider and clinical charting at their hospitals.
Patients told WPTV that the health-related team are relying on paper information and bodily leaving the clinic to use phones.
Tenet said Saturday its techniques are being restored and workers are supplying “quality care.”
“We are experiencing community concerns in specified systems. We are in the procedure of bringing people methods back up with sturdy protocols in put so that care proceeds without having interruption. We are grateful to our doctors and team for continuing to provide good quality care as we operate to solve this make any difference.”
Clinical staff members contacted WPTV on Sunday to report they’re worried about building medication faults since they will not have obtain to patient information.
WPTV reporter Todd Wilson on Friday spoke with Great Samaritan affected individual John Rodriguez, who said the paper charting he noticed was regarding, specifically so when he saw a nurse drop a stack of papers.
“It is, for the reason that they could screw up and give me the improper medication or a thing,” stated Rodriguez, who had been launched soon after procedure for atrial fibrillation.
On Saturday and yet again Sunday, Tenet Wellness refused to response questions about the prospects for blunders in delivering prescription drugs.
“A remark by the former patient he (Wilson) interviewed suggesting that a treatment mistake could be designed owing to paper charting is preposterous and goes completely against what we feel WPTV’s journalistic expectations to be,” wrote Tenet Director of General public Relations Shelley Weiss Friedberg.
She went on to “request that you remove Todd Wilson’s tale on our network outage and to halt airing it. We respectfully request that you sustain a increased degree of integrity when reporting on this subject moving forward.”
WPTV interim news director Mark Casey knowledgeable Weiss Friedberg the story will keep on being on the station web-site and keep on to be aired.
“Reference your ask for to get rid of Todd Wilson’s tale, we stand by Todd’s reporting and will not eliminate the video or the textual content,” Casey told Weiss Frieberg in a reply to her electronic mail. The whole e mail exchange is bundled here.
At the time of this story’s publication, Tenet has not responded to direct concerns asking if the origin of the difficulties can be traced to a application update, or a cyber assault, or if the hospitals have been strike with ransomware. In March, President Joe Biden warned providers of the chance of cyberattacks from Russia in reaction to greater financial sanctions introduced by the war in Ukraine.
“I have formerly warned about the likely that Russia could perform malicious cyber action from the United States,” Biden reported in a assertion. “Like as a response to the unparalleled financial prices we’ve imposed on Russia along with our allies and partners. It is really part of Russia’s playbook.”
Hospitals are identified to be less than a rising danger. Two scientists from the Massachusetts Institute of Technological know-how cited the issue in a investigation paper printed in 2018.
“The health care sector has lagged guiding other industries in safeguarding its main stakeholder (ie, people), and now hospitals must commit sizeable cash and hard work in defending their systems,” researchers Dr. Mohammad S. Jalali and Jessica P Kaiser wrote. “On the other hand, this is simpler stated than completed simply because hospitals are terribly technology-saturated, complicated corporations with higher finish position complexity, interior politics and regulatory pressures.”
Increasing demand from customers for COVID screening, climbing quantities of new instances, and an increase in team customers on COVID leave are amid the problems they’re by now viewing.
BOISE, Idaho — Increased demand from customers for COVID-19 screening, climbing positivity charges and the distribute of the omicron variant in recent weeks are getting an affect on Idaho’s hospitals and health-related clinics.
In a media briefing Thursday afternoon, medical officers with two of Idaho’s premier overall health systems — Saint Alphonsus and St. Luke’s — explained a “fifth wave” of COVID is commencing, and the amount of healthcare facility personnel turning into contaminated with the virus could necessarily mean wellbeing-care capacity may possibly be as strained, or probably additional strained, than what Idaho professional in September, when disaster requirements of care were activated.
1,765 whole new scenarios were being noted Thursday in Idaho 1,331 of those cases have been confirmed by PCR testing, and the other 434 are counted as “probable,” because of to indicators and probable publicity, but no verified take a look at outcome. About the previous two months, the 14-working day transferring common of new every day cases has amplified from about 300 on Dec. 24, 2021, to 714.57 on Thursday, Jan. 6.
As of Thursday, a lot less than a thirty day period immediately after the first omicron variant case was verified in Idaho, the amount of omicron circumstances has enhanced to 201.
“The train’s coming back again. This is really a great deal like the commencing of the pandemic once again. And this time it is really gonna flatten us, fairly truthfully. We need to have to be organized for that,” said Dr. Steven Nemerson, chief medical officer for Saint Alphonsus Well being Technique. “The very same actions we’ve been chatting about for a very long time are heading to shield us, but we realize that some men and women are not likely to be ready to guard themselves due to the fact they’re immunocompromised, or the vaccine would not work effectively in distinct individuals, and also other individuals will select not to be shielded, so we’re below to serve.”
Hospitalizations have not improved as significantly as the numbers of new circumstances, so significantly, but they have nevertheless amplified. On Dec. 24, a complete of 225 persons had been hospitalized with COVID-19 in the 44 services that noted numbers to the condition. On Jan. 3, a overall of 274 hospitalizations have been described by 43 services.
Saint Alphonsus described a overall of 20 COVID-19 hospitalizations two months in the past at all of its healthcare facility places. Thursday, there were 43. At the top of the delta outbreak in late summer time/early autumn of 2021, which Nemerson referred to as “surge range 4,” Saint Als experienced about 170 sufferers hospitalized with COVID.
Nemerson said 125 Saint Alphonsus staff had been on COVID depart Thursday, way up from the 14 who had been on depart two weeks before.
“Which is heading to have remarkable implications on our ability to take care of patients,” Nemerson reported. “The actuality of the healthcare facility condition, then, is likely to be what I offered in former surges: extended strains for care, extended time periods to be viewed, less beds readily available, expansion of workers to take treatment of more sufferers, and in this situation, if this pattern continues, and we count on it to do so, we will be further more impaired from accommodating the similar quantity of sufferers we have been in a position to take care of for the duration of surge range four (August-October 2021).”
Nemerson said the worst-situation scenario – rationing treatment and triage – did not come to be reality when Idaho hospitals were in crisis criteria of care in the drop of 2021, and he hopes it would not happen this time.
“But I am concerned it may perhaps this time, simply because our sources are much more constrained, our versatility is significantly less, and functionally, that implies we’re heading to be ready to care for much less patients,” Nemerson reported, incorporating crisis benchmarks may well need to have to be activated quicker than they were being all through what he called surge variety four.
A good Nemerson pointed out: the level of new instances primary to hospitalizations or deaths is lessen.
“Why is that the circumstance? It is due to the fact men and women are vaccinated and boosted,” he claimed. “We’ve accomplished the appropriate points to prepare for this as finest we can, and we will continue on to serve the community.”
On screening, St. Luke’s professional medical director for main treatment Dr. Laura McGeorge stated like lots of other hospitals, St. Luke’s is looking at an “exponential” desire for checks, and that men and women searching for to be tested for COVID are getting a tough time.
“We have absent from very same-day or in-a-day turnaround (for results), and sometimes it can consider numerous times to sign up to get a place to get examined,” McGeorge stated. “We are seeking to do the job by that.”
Also, McGeorge encouraged that people today not go to the unexpected emergency space, urgent care, or even your most important treatment medical professional just to get a COVID take a look at.
“They really are incredibly fast paced appropriate now using care of clients, and we need to keep on to preserve people means performing what they do best,” she said. “If you have signs and are owning problem obtaining a take a look at, use your ideal judgment, but you must isolate and presume that you have COVID right until you might be ready to get tested.”
The statewide screening positivity price for the 7 days that finished Jan. 1 was 17.1{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} out of 27,042 PCR tests performed. The 7 days right before, the fee was 8.6{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} out of 25,378 checks. The Idaho Dept. of Health and fitness and Welfare mentioned Thursday that raise, essentially double, is the greatest weekly maximize since the commencing of the pandemic.
Thursday’s media briefing was livestreamed on KTVB.COM and the KTVB YouTube channel.
Linked: Most current Idaho COVID-19 circumstance and vaccine numbers: Interactive graphs and maps monitoring the pandemic
(WOWT) – Below are today’s vaccination updates as well as data reports on new cases and other COVID-19 stats reported by health officials across Nebraska and western Iowa.
Keep scrolling to find helpful links and other information, including phone numbers to call for help getting signed up for your vaccine.
Douglas County update
The Douglas County Health Department on Thursday reported one death: an unvaccinated woman older than age 70. The local death toll now stands at 887.
DCHD also confirmed 308 more cases of COVID-19, bringing the total to 98,245 to date. A year ago, the health department reported 533 cases and three deaths, bringing the local death toll at that time to 408.
The latest case numbers nudged the seven-day average down from 283 cases to 276. A week ago, the average was 314 cases; a month ago, it was 199. It hasn’t been below 100 cases since Aug. 3.
Local hospital capacity stats are updated daily according to staffing levels. DCHD said that as of Wednesday afternoon, local hospitals were collectively 93{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} full with 101 beds available, as compared to 125 available Tuesday, 152 available Monday, and 178 available Sunday. ICUs were also at 93{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} occupancy, with 22 beds available, compared to 26 beds available a day prior. Meanwhile, pediatric ICUs were 89{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} full with 14 beds available as of Wednesday afternoon, compared to 15 beds available a day prior.
Among those under hospital care as of Wednesday afternoon were 343 COVID-19 patients — seven more than reported a day earlier — including eight in pediatrics, up from six a day earlier. Of the COVID-19 patients, 100 were in county ICUs, with 32 of them on ventilators, the DCHD report states.
Additionally, one adult patient and one pediatric patient are awaiting COVID-19 test results.
A week ago, local hospitals were caring for 320 COVID-19 patients; a month ago, there were 198 COVID-19 patients. There haven’t been fewer than 100 COVID-19 patients in local hospitals since Aug. 9.
As of Tuesday, 62.3{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of all Douglas County residents were fully vaccinated, according to the local COVID-19 dashboard. The latest age group eligible for vaccinations was continuing to increase its vaccination rate, with 16.9{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of children ages 5-11 fully vaccinated and 27.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} having received at least one dose.
Nebraska hospital capacity update
Officials with the Nebraska Department of Health and Human Services as well as Omaha-metro hospitals gave an update Thursday on hospital capacity and COVID-19 hospitalizations across the state.
Noting that current COVID-19 hospitalizations aren’t as high as they were at this time last year, hospital capacity levels are worse now — with no signs of slowing or stabilizing.
While about 30{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of patients are hospitalized because of COVID-19, health officials estimate that vaccinations have prevented 500 deaths and an additional 1,500 hospitalizations.
And as research seems to indicate an increase in transmissibility among omicron variant cases — passing on as quickly as one or two days — hospital officials are becoming more concerned as more U.S. cases are identified. There have been six cases of the variant identified in the state to date, and officials said Thursday that another potential case of the omicron variant may have been identified in Nebraska, but they were awaiting verification.
“This looks to be a different type of variant than what we had been seeing with the previous — delta, alpha, and the others. … We all of course hope this will be a milder illness, but in actuality, if this strain is able to go in and infect a larger number of people, there always will be people who require hospitalization,” Dr. Angela Hewlett said.
Omicron could be a big problem if it creates a surge for hospitals already straining.
She said Thursday that Nebraska Medicine is converting one of its towers, dedicating it to the care of COVID-19 patients. Officials there have also been implementing initial steps of “crisis standards of care,” which eventually could involve rationing care at some point.
Some cancer patients aren’t getting the surgeries they need because hospitals aren’t able to take them on as patients yet, she said.
“If you are in a hospital bed with COVID, you are taking up a bed someone else needs,” she said.
Dr. Hewlett also emphasized that larger gatherings shouldn’t be happening right now, and everyone should be stepping up their use of masks.
Dr. Gary Anthone said the state is considering implementing another DHM. Alluding to famous former Husker Johnny Rodgers, who is still recovering from COVID-19, Dr. Anthone said he hoped that as more hear stories from those still dealing with the aftermath of the virus, they might be encouraged to get vaccinated.
Watch Thursday’s online news conference
More children hospitalized as Iowa virus activity stays high
(AP) – Iowa on Wednesday posted 823 COVID-19 hospitalizations and 130 more deaths as virus activity remains high throughout the state.
Iowa public health officials reported Wednesday that 14 children age 11 or younger are among those in hospitals. All are unvaccinated. Another five children between age 12 and 17 are hospitalized, and all but one are unvaccinated.
The Iowa Department of Public Health also reported 20 people between age 20 and 29 are in the hospital with only one of those patients fully vaccinated. State officials also reported another 130 deaths, raising the state total to 7,680. More than 500 people have died since Nov. 1, reflecting an average of about 12 deaths a day from COVID-19.
Bryan Health update
Bryan Health in Lincoln reported Thursday that it was caring for 73 COVID-19 patients, 15 of whom are on ventilators. That’s down from 78 patients reported Wednesday, but more than 60 patients reported a week ago and 61 patients a month ago.
Additionally, 11 patients are awaiting test results.
Bryan is also caring for four pediatric patients, none of whom have COVID-19.
Lincoln-Lancaster County update
The Lincoln-Lancaster County Health Department reported a COVID-19 death on Thursday: a woman in her 60s who was unvaccinated had died, bringing the community’s death toll to 343.
LLCHD also confirmed 275 cases, bringing the community total to 47,574 cases to date.
Lancaster County hospitals are caring for 121 COVID-19 patients, 22 of them on ventilators.
To date, 63.6{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of county residents are fully vaccinated.
Vaccination clinics
Nebraska DHHS
Federal Retail Pharmacy Program: Pharmacies in and near the Omaha-metro area currently participating in the program include:
Medicine Man Pharmacy, 15615 Pacific St. Suite 8, Omaha NE 668118
Below is a list of the Douglas County COVID-19 vaccination clinics scheduled for this week, including child vaccination clinics at area schools. All clinics are open to the public for any approved shot in the vaccination series as indicated below. Those planning to get a booster shot should bring their vaccination card.
THURSDAY
4-7 p.m. at St. Pius X/St. Leo Catholic School, 6905 Blondo St. – Pfizer for ages 5+
FRIDAY
9 a.m.-3 p.m. at the Douglas County Health Department, located at 1111 S. 41st. St. – All vaccines available.
SATURDAY
10 a.m.-3 p.m. at Girls Inc., located at 2811 N. 45th St. – All vaccines available.
MONDAY DEC. 20
5-7 p.m. at Beveridge Magnet Middle School, located at 1616 S. 120th St. – Pfizer for ages 5+
5-7 p.m. at McMillan Magnet Middle School, located at Redick Ave. – Pfizer for ages 5+
TUESDAY DEC. 21
Noon-4 p.m. at the Douglas County Health Department, located at 1111 S. 41st. St. – All vaccines available.
WEDNESDAY DEC. 22
10 a.m.-1 p.m. at Heart Ministry Center, located at 2222 Binney St. – Pfizer for ages 5+
11 a.m.-1 p.m. at Bryan Middle School, located at 8210 S. 42nd St. – Pfizer for ages 5+
11 a.m.-1 p.m. at Benson High Magnet School, located at 5120 Maple St. – Pfizer for ages 5+
THURSDAY DEC. 23
9 a.m.-3 p.m. at the Douglas County Health Department, located at 1111 S. 41st. St. – All vaccines available.
MONDAY DEC. 27
10 a.m.-1 p.m. at Burke High School, located at 12200 Burke St. – Pfizer for ages 5+
10 a.m.-1 p.m. at Omaha North High Magnet School, located at 4410 N. 36th St. – All vaccines available.
10 a.m.-1 p.m. at Omaha South High Magnet School, located at 4519 S. 24th St. – Pfizer for ages 5+
4-7 p.m. at Bennington High School, located at 16610 Bennington Road – Pfizer for ages 5+
TUESDAY DEC. 28
10 a.m.-1 p.m. at Morton Magnet Middle School, located at 12200 Burke St. – Pfizer for ages 5+
Noon-4 p.m. at the Douglas County Health Department, located at 1111 S. 41st. St. – All vaccines available.
WEDNESDAY DEC. 29
10 a.m.-1 p.m. at Alfonza W. David Middle School, located at 8050 N. 129th St. – Pfizer for ages 5+
10 a.m.-1 p.m. at Norris Middle School, located at 2235 S. 46th St. – Pfizer for ages 5+
THURSDAY DEC. 30
9 a.m.-3 p.m. at the Douglas County Health Department, located at 1111 S. 41st. St. – All vaccines available.
In-home appointments
DCHD is helping those homebound to get vaccinated, scheduling in-home appointments for all three adult vaccination varieties, for any shot in the series.
To arrange this, call the DCHD information helpline at 402-444-3400.
DCHD booster plan
All Douglas County Health Department pop-up clinics will offer only Pfizer COVID-19 booster vaccinations, but once Moderna and Johnson & Johnson boosters are authorized, the health department plans to have all three available at its in-house and drive-through clinics.
Booster shots are recommended for people who received the Pfizer or Moderna vaccine and are:
ages 65 and older
anyone age 18 and older who lives in a long-term care setting
anyone age 18 and older who has underlying medical conditions
anyone age 18 and older who lives or works in a high-risk setting
The CDC is recommending booster doses be administered six months after receiving your second dose, and has authorized brand crossover for booster shots. Anyone with questions is advised to contact their healthcare provider for further guidance.
Boosters are also recommended for those who received the J&J vaccine at least two months ago, according to the health department.
Those with questions about boosters, particularly those with questions about underlying medical conditions or being in a high-risk setting, are advised to contact their healthcare providers or call the DCHD Information Line at 402-444-3400.
Underlying medical conditions that qualify for boosters include: cancer; chronic kidney disease; chronic lung diseases like COPD, moderate to severe asthma, interstitial lung disease, damaged or scarred lung tissue, cystic fibrosis, pulmonary hypertension, etc.; certain neurological conditions like dementia, Alzheimer’s, etc.; diabetes; Down syndrome; certain heart conditions such as heart failure, coronary artery disease, cardiomyopathies, hypertension; HIV/AIDS or others in immunocompromised states; liver disease like cirrhosis, liver scarring, nonalcoholic fatty liver disease, etc.; those who are overweight or obese; pregnant and recently pregnant people who are 42 or more days past the end of their pregnancy; certain hemoglobin disorders like sickle cell disease, thalassemia, etc.; current or former smokers; recipients of organ, blood stem cell, or bone marrow transplants; cerebrovascular disease like stroke, etc.; and substance use disorders including alcohol, opioid, cocaine use disorders, etc.
Those “high-risk” occupations qualifying for boosters include: first-responders such as healthcare workers, firefighters, police, and congregate care staff; education staff such as teachers, support staff, daycare workers; food and agricultural workers; manufacturing workers; corrections workers; U.S. Postal workers; public transit workers; grocery store workers; and residents of homeless shelters or correctional facilities.
OneWorld child vaccination clinics
OneWorld is offering pediatric COVID-19 vaccinations, for children ages 5-11, at the following clinics:
Walk-ins are accepted on a first-come, first-serve basis; or you can call 402-734-4110 to make an appointment.
Children’s Hospital
Children’s Hospital is planning to offer dedicated COVID-19 vaccination clinics for about a month, starting by Thursday, Nov. 11 — or sooner, if they are supplied the doses before that.
5-7 p.m. Thursdays at West Village Pointe and Spring Valley offices
8 a.m.-noon Saturdays at West Village Pointe and Spring Valley offices
After Saturday, Dec. 11, pediatric COVID-19 vaccinations will be available by appointment at any Children’s Hospital location.
Tuesday and Thursday appointments available at the Mission Village location, 16909 Q St. Call 402-955-7575 or 402-955-SHOT (7468) for available times.
Thursday and Friday appointments available at the Dundee location, 4825 Dodge St. Call 402-955-7676 or 402-955-SHOT (7468) for available times.
For those looking for walk-in appointments, single-dose Johnson & Johnson vaccinations will be available at these pharmacies:
Outpatient Pharmacy at Bellevue Health Center, located at 25th Street and Highway 370, will offer J&J vaccinations from 8 a.m. to 8 p.m. Monday through Friday; and from 8 a.m. to 1 p.m. Saturdays.
Outpatient Pharmacy at Durham Outpatient Center, located at 45th and Emile streets, will offer J&J vaccinations from 7 a.m. to 9 p.m. weekdays; and from 8:30 a.m. to 4:30 p.m. on the weekends.
Around Omaha
SOUTH OMAHA: Testing and vaccinations are available at OneWorld, located at 4920 S. 30th St. Call 402-734-4110 to make an appointment for vaccinating anyone age 12 and older.
CHARLES DREW HEALTH CENTER: Call 402-451-3553 to schedule an appointment.
CHURCH CLINIC: Metropolitan Community Chuch of Omaha will host a walk-in COVID-19 vaccination clinic from 9 a.m. to 2 p.m. Saturdays. No ID is required, but a parent or guardian must be present at the clinic with teens ages 12-18.
MCC FORT OMAHA: Vaccinations also will be distributed Mondays and Thursdays from 9 a.m. to 7 p.m. at Metropolitan Community College’s Fort Omaha campus, located at 5300 N. 30th St. Appointments will be made through the county’s vaccination registry.
TOTAL WELLNESS: DCHD has been working with Total Wellness, located at 9320 H Court, to establish a vaccination clinic from 10 a.m. to 3:30 p.m. Tuesdays and Thursdays.
The Sarpy/Cass Health Department offers COVID-19 vaccinations at its offices, located at 701 Olson Drive in Papillion:
Tuesdays: 9 a.m.-2 p.m.
Wednesdays: 1-6 p.m.
The health department offers the first and second doses of Pfizer and Modern vaccines, Johnson & Johnson (Janssen) single doses, and booster doses of all three vaccines.
Sarpy/Cass vaccination clinics
The Sarpy/Cass Health Department has scheduled vaccination clinics for all COVID-19 vaccine doses, including pediatric doses:
Three Rivers Public Health Department is giving out boosters to those in certain risk categories who have had Pfizer vaccinations. It is also working with area businesses and schools to provide plan more COVID-19 vaccination clinics.
3RPHD is planning the following vaccination clinics next week at the Three Rivers Clinic, located at 2400 N. Lincoln Ave. in Fremont:
8 a.m.-3:30 p.m. Friday, Dec. 17
8 a.m-6:30 p.m. Tuesday, Dec. 21
8 a.m-3:30 p.m. Wednesday, Dec. 22
8 a.m-6:30 p.m. Tuesday, Dec. 28
Three regular pediatric vaccination clinics have been set up for children ages 5-11:
Wahoo: 9 a.m.-3:30 p.m. on the first and third Mondays of the month at 1320 E. 31st St.
Fremont: 3-6:30 p.m. Tuesdays and noon-3:30 p.m. Fridays at 2400 N. Lincoln Ave.
The health department has the necessary forms posted on their website, for minors and adults, for those who would like to fill them out ahead of their visit.
3RPHD’s regular clinics will continue:
In Dodge County, the Three Rivers clinic at 2400 N. Lincoln Ave. in Fremont, is open for walk-ins from 3 to 6:30 p.m. Tuesday; and noon to 3:30 p.m. Friday.
In Saunders County, the Three Rivers clinic in Lake Wanahoo, located at 1320 E. 31st St., is open to walk-ins from 9 a.m. to 3:30 p.m. on the first and third Mondays of the month.
Those who are home-bound or require special accommodations but need a COVID-19 test or vaccine can contact the health district at 402-704-2245 to make arrangements.
Off-line help
CHI HEALTH VACCINE INFORMATION: The info line is available at 402-717-1255 from 7 a.m. to 10 p.m. daily in August.
NEBRASKA VACCINE HOTLINE: Nebraskans can call 531-249-1873 or toll-free at 833-998-2275 for more information on the state’s COVID-19 vaccination process.
DOUGLAS COUNTY HELPLINE: Local COVID-19 information, in Spanish and English, is available from 8:30 a.m. to 4 p.m. weekdays, except for holidays. Call 402-444-3400 for assistance.
IOWA VACCINE HOTLINE: Older or home-bound Iowans looking for help scheduling a COVID-19 vaccination appointment can call 1-866-468-7887 from 8 a.m. to 4:30 p.m. Monday-Friday; or contact Connections Area Agency on Aging at 712-328-2540 or 1-800-432-9209.
","websites":"wowt":"website_section":"path":"https://www.wowt.com/news","_website":"wowt","name":"News","_id":"https://www.wowt.com/news","type":"section","version":"0.6.0","primary":true,"website_url":"/video/2021/12/16/full-video-nebraska-covid-hospitalizations-update/","_id":"DXYMEJN6JZFG7ALVGM4HDFLM2U","type":"header","level":2,"additional_properties":"_id":1639692565695,"comments":[],"inline_comments":[],"content":"More children hospitalized as Iowa virus activity stays high","_id":"M4QZMBUX3NHNDJOLWOXYZMN7RE","type":"text","additional_properties":"_id":1639705933816,"comments":[],"inline_comments":[],"content":"(AP) - Iowa on Wednesday posted 823 COVID-19 hospitalizations and 130 more deaths as virus activity remains high throughout the state.","_id":"WI6HLW6KZ5G7HA5PESBRAPJJME","type":"text","additional_properties":"_id":1639705933817,"comments":[],"inline_comments":[],"content":"Iowa public health officials reported Wednesday that 14 children age 11 or younger are among those in hospitals. All are unvaccinated. Another five children between age 12 and 17 are hospitalized, and all but one are unvaccinated.","_id":"6BTF33PXPBGFXKKWSGEHLTA7MQ","type":"text","additional_properties":"_id":1639705933818,"comments":[],"inline_comments":[],"content":"The Iowa Department of Public Health also reported 20 people between age 20 and 29 are in the hospital with only one of those patients fully vaccinated. State officials also reported another 130 deaths, raising the state total to 7,680. More than 500 people have died since Nov. 1, reflecting an average of about 12 deaths a day from COVID-19.","_id":"DXYMEJN6JZFG7ALVGM4HDFLM2U","type":"header","level":2,"additional_properties":"_id":1639692565695,"comments":[],"inline_comments":[],"content":"Bryan Health update","_id":"QHXQES6WFVA5NLVLLVIIJO4UBU","type":"text","additional_properties":"_id":1639692565696,"comments":[],"inline_comments":[],"content":"Bryan Health in Lincoln reported Thursday that it was caring for 73 COVID-19 patients, 15 of whom are on ventilators. That’s down from 78 patients reported Wednesday, but more than 60 patients reported a week ago and 61 patients a month ago.","_id":"V3NJ5SYM65B4DBDV2DBGE6625M","type":"text","additional_properties":"_id":1639692565697,"comments":[],"inline_comments":[],"content":"Additionally, 11 patients are awaiting test results.","_id":"N3W4IOKYQNHBVMVJJNYBCAJJYQ","type":"text","additional_properties":"_id":1639692565698,"comments":[],"inline_comments":[],"content":"Bryan is also caring for four pediatric patients, none of whom have COVID-19.","_id":"X4HR5UNUPJD2POWEIFZB2WJHVI","type":"header","level":2,"additional_properties":"_id":1639705933823,"comments":[],"inline_comments":[],"content":"Lincoln-Lancaster County update","_id":"BVTSFYRGDBBJPPPH5525JBQHK4","type":"text","additional_properties":"_id":1639705933824,"comments":[],"inline_comments":[],"content":"The Lincoln-Lancaster County Health Department reported a COVID-19 death on Thursday: a woman in her 60s who was unvaccinated had died, bringing the community’s death toll to 343.","_id":"D4VCBHV3IFDIZG24BWCZXBHHEU","type":"text","additional_properties":"_id":1639705933825,"comments":[],"inline_comments":[],"content":"LLCHD also confirmed 275 cases, bringing the community total to 47,574 cases to date.","_id":"B6X6USLO4ZDRRFZNET6BLE4UUI","type":"text","additional_properties":"_id":1639705933826,"comments":[],"inline_comments":[],"content":"Lancaster County hospitals are caring for 121 COVID-19 patients, 22 of them on ventilators.","_id":"G6VYWTILWJDDRDDFT6MST5H4IM","type":"text","additional_properties":"_id":1639705933827,"comments":[],"inline_comments":[],"content":"To date, 63.6{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of county residents are fully vaccinated.","_id":"FUTRJJTOZJF2FIQMQKFV6XLU7A","type":"divider","additional_properties":"_id":"DLREC57BARGGVFUBPSAAMI4XRI","comments":[],"_id":"MAJ4D3LXOBC5PHRO7DQQ7KJFWM","type":"raw_html","additional_properties":"_id":"JUAKJ3J5URD4XHM5HDATBZ7SEA","comments":[],"content":"","_id":"DYXXUJQYCFG4XBNUTKTLUCPGF4","type":"divider","additional_properties":"_id":"LVNJUCFGFNGXJHQLRZIGQLI2NI","comments":[],"_id":"3UCEISZJPJC4REEPOGLIITRB2M","type":"text","additional_properties":"_id":1638218177490,"comments":[],"inline_comments":[],"content":"Vaccination clinics","_id":"YAWQHUBAPNCN7D64AUZRDA7MEQ","type":"header","level":2,"additional_properties":"_id":1638056746630,"comments":[],"inline_comments":[],"content":"Nebraska DHHS","_id":"UF43YSPWQJEFZGBI7ELJV7MOLQ","type":"text","additional_properties":"_id":1638056746631,"comments":[],"inline_comments":[],"content":"Federal Retail Pharmacy Program: Pharmacies in and near the Omaha-metro area currently participating in the program include:","_id":"ECVOMSZDNBA7LBH2F6QL6E6ZS4","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"C6HQAINXAFD73IDK32HZP7IMTQ","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Medicine Man Pharmacy, 15615 Pacific St. Suite 8, Omaha NE 668118","type":"text","_id":"T4C6HSPJU5AL7FUYFFOEEQU3W4","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"ViaRx, 825 N. 90th St., Omaha NE 68114","type":"text","_id":"J72TIBPR2BEHVH2MHXRANTAVXQ","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Walmart, 3010 E. 23rd St., Fremont NE 68025","type":"text"], Sam’s Club ,"_id":"I763WDN3JVCX7HOS4HJC2VGNTU","type":"header","level":2,"additional_properties":"_id":1638056746634,"comments":[],"inline_comments":[],"content":"Douglas County","_id":"F7P7JTG2JRFSNGR6X6DPXRHCVU","type":"text","additional_properties":"_id":1638056746635,"comments":[],"inline_comments":[],"content":"Below is a list of the Douglas County COVID-19 vaccination clinics scheduled for this week, including child vaccination clinics at area schools. All clinics are open to the public for any approved shot in the vaccination series as indicated below. Those planning to get a booster shot should bring their vaccination card.","_id":"D2QCSJCPBNDCVFY5KEM3Z4YV5I","type":"header","level":5,"additional_properties":"_id":1638314775553,"comments":[],"inline_comments":[],"content":"THURSDAY","_id":"RMTEN655YVEBXEXWRWGILP5A6Y","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"MQBPF4IT3NEEJPUJNJTWX7XPNI","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"4-7 p.m. at St. Pius X/St. Leo Catholic School, 6905 Blondo St. – Pfizer for ages 5+","type":"text"],"_id":"4SDMV4FRVNBURF5NMYRRK7DFRM","type":"header","level":5,"additional_properties":"_id":1639427088743,"comments":[],"inline_comments":[],"content":"FRIDAY","_id":"B36JGEEDAJCEXCSI3Y5APCKRR4","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"T67KA7ZEI5CLFJJGHYPHMKX7J4","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"9 a.m.-3 p.m. at the Douglas County Health Department, located at 1111 S. 41st. St. – All vaccines available.","type":"text"],"_id":"TOJRESY7WBAJLHGWQVGTPSPO2I","type":"header","level":5,"additional_properties":"_id":1639427088745,"comments":[],"inline_comments":[],"content":"SATURDAY","_id":"U3SGJHIWC5HNJINKPQYUUK5244","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"TXU3C232VFCQVL4KUESHXSJDDA","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"10 a.m.-3 p.m. at Girls Inc., located at 2811 N. 45th St. – All vaccines available.","type":"text"],"_id":"QP6W724DCBEJ7ICQ26YNMFE4EI","type":"header","level":5,"additional_properties":"_id":1639427088747,"comments":[],"inline_comments":[],"content":"MONDAY DEC. 20","_id":"76EBATPVVRCRFAHYIZ5LYEWGXA","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"W222LIMZEVFU3FARHTHWMGIFGU","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"5-7 p.m. at Beveridge Magnet Middle School, located at 1616 S. 120th St. – Pfizer for ages 5+","type":"text","_id":"YIY5GUAGINGKPKH7DGJP5JT7ZE","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"5-7 p.m. at McMillan Magnet Middle School, located at Redick Ave. – Pfizer for ages 5+","type":"text"],"_id":"4FFTO56FTFENFBRZVOCRJ4RFSQ","type":"header","level":5,"additional_properties":"_id":1639427088749,"comments":[],"inline_comments":[],"content":"TUESDAY DEC. 21","_id":"3RGEPU7NCJBBTPN3VI342ZCLAQ","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"2ENE5BTNF5A67MLA3UJFD34TUM","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Noon-4 p.m. at the Douglas County Health Department, located at 1111 S. 41st. St. – All vaccines available.","type":"text"],"_id":"JW7LJMNQ6NCEZN65C6AMSGNS7Y","type":"header","level":5,"additional_properties":"_id":1639427088751,"comments":[],"inline_comments":[],"content":"WEDNESDAY DEC. 22","_id":"T75WIYK2UNBMBIDYFSCAQ3RBYY","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"MZ5LW3YGDRA6HLQKMIKL42PNJY","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"10 a.m.-1 p.m. at Heart Ministry Center, located at 2222 Binney St. – Pfizer for ages 5+","type":"text","_id":"A2MRAALNZZCS7HT65UKL4E3TNI","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"11 a.m.-1 p.m. at Bryan Middle School, located at 8210 S. 42nd St. – Pfizer for ages 5+","type":"text","_id":"4Z3TIPNETRCS7E3GRAL4GIZONY","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"11 a.m.-1 p.m. at Benson High Magnet School, located at 5120 Maple St. – Pfizer for ages 5+","type":"text"],"_id":"OFL2CPXLXRF4XOKCMVMOKLPC7I","type":"header","level":5,"additional_properties":"_id":1639427088753,"comments":[],"inline_comments":[],"content":"THURSDAY DEC. 23","_id":"FFTCSFDQXZBVDBRCJMMEIQGCEQ","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"T67KA7ZEI5CLFJJGHYPHMKX7J4","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"9 a.m.-3 p.m. at the Douglas County Health Department, located at 1111 S. 41st. St. – All vaccines available.","type":"text"],"_id":"OFL2CPXLXRF4XOKCMVMOKLPC7I","type":"header","level":5,"additional_properties":"_id":1639427088755,"comments":[],"inline_comments":[],"content":"MONDAY DEC. 27","_id":"RUEGH3E7GFB6LLRLH7UTRDIZNU","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"T67KA7ZEI5CLFJJGHYPHMKX7J4","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"10 a.m.-1 p.m. at Burke High School, located at 12200 Burke St. – Pfizer for ages 5+","type":"text","_id":"SV2OFEGHJFHYNJWXEG2JNNLHZE","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"10 a.m.-1 p.m. at Omaha North High Magnet School, located at 4410 N. 36th St. – All vaccines available.","type":"text","_id":"SV2OFEGHJFHYNJWXEG2JNNLHZE","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"10 a.m.-1 p.m. at Omaha South High Magnet School, located at 4519 S. 24th St. – Pfizer for ages 5+","type":"text","_id":"SV2OFEGHJFHYNJWXEG2JNNLHZE","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"4-7 p.m. at Bennington High School, located at 16610 Bennington Road – Pfizer for ages 5+","type":"text"],"_id":"OFL2CPXLXRF4XOKCMVMOKLPC7I","type":"header","level":5,"additional_properties":"_id":1639427088757,"comments":[],"inline_comments":[],"content":"TUESDAY DEC. 28","_id":"NIX5UO5WQZCERP4OY7PECO4SIM","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"T67KA7ZEI5CLFJJGHYPHMKX7J4","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"10 a.m.-1 p.m. at Morton Magnet Middle School, located at 12200 Burke St. – Pfizer for ages 5+","type":"text","_id":"7UZ6M2UODZEHNISFZUSKJYME64","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Noon-4 p.m. at the Douglas County Health Department, located at 1111 S. 41st. St. – All vaccines available.","type":"text"],"_id":"OFL2CPXLXRF4XOKCMVMOKLPC7I","type":"header","level":5,"additional_properties":"_id":1639427088759,"comments":[],"inline_comments":[],"content":"WEDNESDAY DEC. 29","_id":"DMWU4MO66FGLJOH5AQPW2MDJ2A","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"T67KA7ZEI5CLFJJGHYPHMKX7J4","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"10 a.m.-1 p.m. at Alfonza W. David Middle School, located at 8050 N. 129th St. – Pfizer for ages 5+","type":"text","_id":"HSYNBHJRA5DMJLLLX5SH2ZGEEU","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"10 a.m.-1 p.m. at Norris Middle School, located at 2235 S. 46th St. – Pfizer for ages 5+","type":"text"],"_id":"OFL2CPXLXRF4XOKCMVMOKLPC7I","type":"header","level":5,"additional_properties":"_id":1639427088761,"comments":[],"inline_comments":[],"content":"THURSDAY DEC. 30","_id":"PFG4PONBTJHEJN7MJIBSVTRDC4","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"T67KA7ZEI5CLFJJGHYPHMKX7J4","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"9 a.m.-3 p.m. at the Douglas County Health Department, located at 1111 S. 41st. St. – All vaccines available.","type":"text"],"type":"oembed_response","subtype":"facebook-post","_id":"6PNG2IP5ZNCR5NUUT5CVK64AEY","raw_oembed":"author_name":"Douglas County Health Department","author_url":"https://www.facebook.com/390572354389063","provider_url":"https://www.facebook.com","provider_name":"Facebook","html":"
n
Today's #Covid19 Update is right here: douglascountyhealth.com/latest-newsnDouglas County Nebraska Nebraska Department...
","type":"facebook-post","version":"1.0","width":552,"_id":"https://www.facebook.com/DouglasCountyHealth/posts/4454997397946518&locale=en_US","additional_properties":"_id":1639705987705,"comments":[],"referent":"id":"https://www.facebook.com/DouglasCountyHealth/posts/4454997397946518&locale=en_US","provider":"https://www.facebook.com/plugins/post/oembed.json/?url=","referent_properties":"additional_properties":"_id":1639705987705,"comments":[],"service":"oembed","type":"facebook-post","_id":"V7DM444NUFHW7IDJ4RGBO2XSMA","type":"header","level":4,"additional_properties":"_id":1639427088763,"comments":[],"inline_comments":[],"content":"In-home appointments","_id":"OSWEJLYIS5E2ZGUGWEH2ITZT34","type":"text","additional_properties":"_id":1638056746650,"comments":[],"inline_comments":[],"content":"DCHD is helping those homebound to get vaccinated, scheduling in-home appointments for all three adult vaccination varieties, for any shot in the series.","_id":"4HL3BAGZHFATJGMO2PJDXJNEU4","type":"text","additional_properties":"_id":1638056746651,"comments":[],"inline_comments":[],"content":"To arrange this, call the DCHD information helpline at 402-444-3400.","_id":"3GD7WPD6P5AC3PMFKL5MNYB6TQ","type":"header","level":4,"additional_properties":"_id":1638056746652,"comments":[],"inline_comments":[],"content":"DCHD booster plan","_id":"TFRDEOZYNNH2RNE26IB7PGFBYY","type":"text","additional_properties":"_id":1638056746653,"comments":[],"inline_comments":[],"content":"All Douglas County Health Department pop-up clinics will offer only Pfizer COVID-19 booster vaccinations, but once Moderna and Johnson & Johnson boosters are authorized, the health department plans to have all three available at its in-house and drive-through clinics.","_id":"IWS5HVFEK5FELIIHHDPTCQTXLU","type":"text","additional_properties":"_id":1638056746654,"comments":[],"inline_comments":[],"content":"Booster shots are recommended for people who received the Pfizer or Moderna vaccine and are:","_id":"E25AGC4M5JDEDLOTSRKHCS3I7Y","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"Q5KBO5AVQVDUPBJJAT3IQVRXNU","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"ages 65 and older","type":"text","_id":"OJ7G4UZ3A5HS7FR4AANRPQQT4U","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"anyone age 18 and older who lives in a long-term care setting","type":"text","_id":"5QXNAOADGNGHNPOG7XCRBRHATQ","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"anyone age 18 and older who has underlying medical conditions","type":"text","_id":"EAFHAXYQJJHCJKTFNM5JV3VYU4","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"anyone age 18 and older who lives or works in a high-risk setting","type":"text"],"_id":"LAUXPMMMWJC2RDCKDBZNN53I2E","type":"text","additional_properties":"_id":1638056746656,"comments":[],"inline_comments":[],"content":"The CDC is recommending booster doses be administered six months after receiving your second dose, and has authorized brand crossover for booster shots. Anyone with questions is advised to contact their healthcare provider for further guidance.","_id":"QJH4I4LZBNE7PGC5HEZGBSEM4Q","type":"text","additional_properties":"_id":1638056746657,"comments":[],"inline_comments":[],"content":"Boosters are also recommended for those who received the J&J vaccine at least two months ago, according to the health department.","_id":"M75KTVWE4NFUXHHX7ISEIGOOEA","type":"text","additional_properties":"_id":1638056746658,"comments":[],"inline_comments":[],"content":"Those with questions about boosters, particularly those with questions about underlying medical conditions or being in a high-risk setting, are advised to contact their healthcare providers or call the DCHD Information Line at 402-444-3400.","_id":"4VS3RZNDJNAYBOEMMIQJYB2P4U","type":"text","additional_properties":"_id":1638056746659,"comments":[],"inline_comments":[],"content":"Underlying medical conditions that qualify for boosters include: cancer; chronic kidney disease; chronic lung diseases like COPD, moderate to severe asthma, interstitial lung disease, damaged or scarred lung tissue, cystic fibrosis, pulmonary hypertension, etc.; certain neurological conditions like dementia, Alzheimer’s, etc.; diabetes; Down syndrome; certain heart conditions such as heart failure, coronary artery disease, cardiomyopathies, hypertension; HIV/AIDS or others in immunocompromised states; liver disease like cirrhosis, liver scarring, nonalcoholic fatty liver disease, etc.; those who are overweight or obese; pregnant and recently pregnant people who are 42 or more days past the end of their pregnancy; certain hemoglobin disorders like sickle cell disease, thalassemia, etc.; current or former smokers; recipients of organ, blood stem cell, or bone marrow transplants; cerebrovascular disease like stroke, etc.; and substance use disorders including alcohol, opioid, cocaine use disorders, etc.","_id":"SOADSP2BU5AW7PJ7ZEGHYBWO7U","type":"text","additional_properties":"_id":1638056746660,"comments":[],"inline_comments":[],"content":"Those “high-risk” occupations qualifying for boosters include: first-responders such as healthcare workers, firefighters, police, and congregate care staff; education staff such as teachers, support staff, daycare workers; food and agricultural workers; manufacturing workers; corrections workers; U.S. Postal workers; public transit workers; grocery store workers; and residents of homeless shelters or correctional facilities.","_id":"27BQK632QBCQ7GKP5MWQVAIQ7M","type":"header","level":4,"additional_properties":"_id":1638056746661,"comments":[],"inline_comments":[],"content":"OneWorld child vaccination clinics","_id":"ILECORXGARCKDG5UNAFV6CEDUE","type":"text","additional_properties":"_id":1638056746662,"comments":[],"inline_comments":[],"content":"OneWorld is offering pediatric COVID-19 vaccinations, for children ages 5-11, at the following clinics:","_id":"AUMUWZQZD5EV7H6YWOGPGGHKPA","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"HYO26W2F7NF4LBRR33EXJK4JL4","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Livestock Building, located at 4920 S. 30th St. in south Omaha","type":"text","_id":"YEJERZZ4SJF2HOYSDZSUF2UD2Y","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"In Bellevue, at 2207 Georgia Ave.","type":"text","_id":"SG75TKQA5JGVPDVMZ6OUAQX64M","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"In northwest Omaha at 4229 N. 90th St.","type":"text","_id":"YG4KBOT3I5DWJBPLQZ6UWS6GFE","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"In Plattsmouth at 122 S. Sixth St.","type":"text"],"_id":"SYTN5FCLDJGI5LSPSJL3HK53OM","type":"text","additional_properties":"_id":1638056746664,"comments":[],"inline_comments":[],"content":"OneWorld will also offer children’s COVID-19 vaccinations at school health centers:","_id":"OFWABLFMM5BSBGZUZWA3GE477Y","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"5B5H5VHFMFHR3ERJ6HPZRNTZGE","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Bryan High School, located at 4700 Giles Road","type":"text","_id":"FVEOMJF4ZNHU5KCVQPF2MXFY7M","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Indian Hill Elementary, located at 3121 U St.","type":"text","_id":"IDJ77TKX75AO5MCECOTPPM7XVQ","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Liberty Elementary, located at 2021 St. Mary’s Ave.","type":"text","_id":"C7M357AIMJBZFP7VDQHRVDEGZY","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Spring Lake Elementary, located at 4215 S. 20th St.","type":"text"],"_id":"UDZTECQDOJAERDHZOFTAQYVR4Q","type":"text","additional_properties":"_id":1638056746666,"comments":[],"inline_comments":[],"content":"Walk-ins are accepted on a first-come, first-serve basis; or you can call 402-734-4110 to make an appointment.","_id":"YTU6HHWJRJAHZC6TSKCFLX2LDY","type":"header","level":4,"additional_properties":"_id":1638056746667,"comments":[],"inline_comments":[],"content":"Children’s Hospital","_id":"FW54CURFU5HGFFLR4XUWSMPUGU","type":"text","additional_properties":"_id":1638056746668,"comments":[],"inline_comments":[],"content":"Children’s Hospital is planning to offer dedicated COVID-19 vaccination clinics for about a month, starting by Thursday, Nov. 11 — or sooner, if they are supplied the doses before that.","_id":"GDDM2NH7N5B4NOGBWOL2DNIVOA","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"CXYKVXLGYJGGLJSLRQY23OCCNA","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"5-7 p.m. Thursdays at West Village Pointe and Spring Valley offices","type":"text","_id":"XKH5D2ZHUJGDJEGZ545FTD2S3I","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"8 a.m.-noon Saturdays at West Village Pointe and Spring Valley offices","type":"text"],"_id":"ZCBX6RWJIVBMDOT3PI5ICDGC5I","type":"text","additional_properties":"_id":1638056746670,"comments":[],"inline_comments":[],"content":"After Saturday, Dec. 11, pediatric COVID-19 vaccinations will be available by appointment at any Children’s Hospital location.","_id":"6KPX3AO2BJAZTP2JA25NRYCQUI","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"5MCTGM3GXJFAVG6LQY3M7O27LQ","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Tuesday and Thursday appointments available at the Mission Village location, 16909 Q St. Call 402-955-7575 or 402-955-SHOT (7468) for available times.","type":"text","_id":"IROF22JWHBFRTOHJ5OQPYOGWT4","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Thursday and Friday appointments available at the Dundee location, 4825 Dodge St. Call 402-955-7676 or 402-955-SHOT (7468) for available times.","type":"text"],"_id":"SHLJQMMJJRH23L7EDVM3E6ETFM","type":"header","level":4,"additional_properties":"_id":1638056746672,"comments":[],"inline_comments":[],"content":"Nebraska Medicine","_id":"JQNOTUUHWNG6DO5SM32TY3PTUI","type":"text","additional_properties":"_id":1638056746673,"comments":[],"inline_comments":[],"content":"Nebraska Medicine is offering COVID-19 vaccinations at clinics in several retail pharmacies and health centers around the Omaha-metro.","_id":"WTYXJLP6TREXTMXNNBDDHHAH6I","type":"text","additional_properties":"_id":1638056746674,"comments":[],"inline_comments":[],"content":"NebMed will provide Pfizer vaccinations by appointment at:","_id":"UUYPKM3TX5FSJC6OPBG2MOTZIY","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"LVSU3W7JPRHFFGN3C7RAPKTUH4","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Eagle Run Health Center, located at 132nd Street and West Maple Road","type":"text","_id":"ZQPKBYZ5YZGHLPG3VYNC5JBDKM","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Fontenelle Health Center, located at 50th Street and Ames Avenue","type":"text","_id":"VPKRR7URABAPLFSWBSU5WO3Z4E","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Girls Inc. Health Center, located at 45th Street and West Maple Road","type":"text","_id":"RW5KCPERAZEHBLUPB6A4JJZ6LM","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Old Market Health Center, located at 13th and Leavenworth streets","type":"text","_id":"5NET776NYRGWFH76CER3ITZCKY","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Village Pointe Health Center, located at 175th and Burke streets","type":"text"],"_id":"DPKNYA22JZD7LN7M35HP3VZLDM","type":"text","additional_properties":"_id":1638056746676,"comments":[],"inline_comments":[],"content":"For those looking for walk-in appointments, single-dose Johnson & Johnson vaccinations will be available at these pharmacies:","_id":"PGIBVVA37ZDCPGYPOPAK2YU3BE","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"RV3O2NK4DJFMBF3E2U7NR7X3JI","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Outpatient Pharmacy at Bellevue Health Center, located at 25th Street and Highway 370, will offer J&J vaccinations from 8 a.m. to 8 p.m. Monday through Friday; and from 8 a.m. to 1 p.m. Saturdays.","type":"text","_id":"I4BST4YRSFD3ZP4CPADBU2UGJI","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Outpatient Pharmacy at Durham Outpatient Center, located at 45th and Emile streets, will offer J&J vaccinations from 7 a.m. to 9 p.m. weekdays; and from 8:30 a.m. to 4:30 p.m. on the weekends.","type":"text"],"_id":"E5F6GX7M3FE5XPOBMAKPXZCGXE","type":"header","level":2,"additional_properties":"_id":1638056746678,"comments":[],"inline_comments":[],"content":"Around Omaha","_id":"EBRDZLZGQ5CQTP22HO7LMALG3Y","type":"text","additional_properties":"_id":1638056746679,"comments":[],"inline_comments":[],"content":"SOUTH OMAHA: Testing and vaccinations are available at OneWorld, located at 4920 S. 30th St. Call 402-734-4110 to make an appointment for vaccinating anyone age 12 and older.","_id":"ZFVZ2U7MFVBHFNCF4PGPZW5KEI","type":"text","additional_properties":"_id":1638056746680,"comments":[],"inline_comments":[],"content":"CHARLES DREW HEALTH CENTER: Call 402-451-3553 to schedule an appointment.","_id":"5MVDNOULB5CWPEVW2K3SUZVDIQ","type":"text","additional_properties":"_id":1638056746681,"comments":[],"inline_comments":[],"content":"CHURCH CLINIC: Metropolitan Community Chuch of Omaha will host a walk-in COVID-19 vaccination clinic from 9 a.m. to 2 p.m. Saturdays. No ID is required, but a parent or guardian must be present at the clinic with teens ages 12-18.","_id":"JZTJFFWLCVE4TDYBBRZAPBM57A","type":"text","additional_properties":"_id":1638056746682,"comments":[],"inline_comments":[],"content":"MCC FORT OMAHA: Vaccinations also will be distributed Mondays and Thursdays from 9 a.m. to 7 p.m. at Metropolitan Community College’s Fort Omaha campus, located at 5300 N. 30th St. Appointments will be made through the county’s vaccination registry.","_id":"IZB74URZT5GJXD7DOXM67U3YYI","type":"text","additional_properties":"_id":1638056746683,"comments":[],"inline_comments":[],"content":"TOTAL WELLNESS: DCHD has been working with Total Wellness, located at 9320 H Court, to establish a vaccination clinic from 10 a.m. to 3:30 p.m. Tuesdays and Thursdays.","_id":"PIQD2ID7RZHE5PB5DYKBVMNNRM","type":"text","additional_properties":"_id":1638056746684,"comments":[],"inline_comments":[],"content":"VETERANS: Any eligible veterans can obtain COVID-19 vaccinations or boosters at the Omaha VA Medical Center’s COVID-19 vaccination clinics’ walk-in hours from 8 a.m.-2:45 p.m. weekdays. Appointments can also be scheduled online.","_id":"MQQXCFVFPNHIRGXH7UZLIFTB2A","type":"header","level":2,"additional_properties":"_id":1638056746685,"comments":[],"inline_comments":[],"content":"Sarpy/Cass health district","_id":"WZESJQUSCZCY7POYVMTJ2VGHCA","type":"text","additional_properties":"_id":1638056746686,"comments":[],"inline_comments":[],"content":"The Sarpy/Cass Health Department offers COVID-19 vaccinations at its offices, located at 701 Olson Drive in Papillion:","_id":"NFR5C63VJNEHVEFG2HYVUW2SHI","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"DSHIKR52JBG5JKZBLWMLN7A5GI","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Tuesdays: 9 a.m.-2 p.m.","type":"text","_id":"46QENG2WANG4ZH3TXPALP4YEWI","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Wednesdays: 1-6 p.m.","type":"text"],"_id":"HYHTKDUOLRFE3C5GACHKZ72YJQ","type":"text","additional_properties":"_id":1638056746688,"comments":[],"inline_comments":[],"content":"The health department offers the first and second doses of Pfizer and Modern vaccines, Johnson & Johnson (Janssen) single doses, and booster doses of all three vaccines.","_id":"AGLVFP4D2RH6HFCJIW6I7N56FE","type":"header","level":3,"additional_properties":"_id":1638056746689,"comments":[],"inline_comments":[],"content":"Sarpy/Cass vaccination clinics","_id":"2DAQVRXP2VHXRGRSRC76ZB6Z3I","type":"text","additional_properties":"_id":1638056746690,"comments":[],"inline_comments":[],"content":"The Sarpy/Cass Health Department has scheduled vaccination clinics for all COVID-19 vaccine doses, including pediatric doses:","type":"oembed_response","subtype":"facebook-post","_id":"A6NT7URLG5HZNL5R26HHDRAIBY","raw_oembed":"author_name":"Sarpy/Cass Health Department","author_url":"https://www.facebook.com/141225682582622","provider_url":"https://www.facebook.com","provider_name":"Facebook","html":"
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There are appointments available at the Health Department's COVID-19 vaccination clinics on December 14 and 15. ...
","type":"facebook-post","version":"1.0","width":552,"_id":"https://www.facebook.com/SarpyCassHealth/posts/4698744740164004&locale=en_US&locale=en_US","additional_properties":"_id":1639705987748,"comments":[],"referent":"id":"https://www.facebook.com/SarpyCassHealth/posts/4698744740164004&locale=en_US&locale=en_US","provider":"https://www.facebook.com/plugins/post/oembed.json/?url=","referent_properties":"additional_properties":"_id":1639705987748,"comments":[],"service":"oembed","type":"facebook-post","_id":"Y2533ORCVRFO7MMIOCP32ZMQL4","type":"text","additional_properties":"_id":1638056746705,"comments":[],"inline_comments":[],"content":"Appointments are recommended but not required. For scheduling assistance, call 833-998-2275 or 531-249-1873.","_id":"X4UIKJZ255CZ7DQHTIQDQOIZXY","type":"header","level":2,"additional_properties":"_id":1638056746706,"comments":[],"inline_comments":[],"content":"Three Rivers health district","_id":"HTHI3F7JA5DCNN7XRXNXPUONSU","type":"text","additional_properties":"_id":1638056746707,"comments":[],"inline_comments":[],"content":"Three Rivers Public Health Department is giving out boosters to those in certain risk categories who have had Pfizer vaccinations. It is also working with area businesses and schools to provide plan more COVID-19 vaccination clinics.","_id":"ZAPHDW5BTFC3NHPZWZXZH3BMTQ","type":"text","additional_properties":"_id":1639092020720,"comments":[],"inline_comments":[],"content":"3RPHD is planning the following vaccination clinics next week at the Three Rivers Clinic, located at 2400 N. Lincoln Ave. in Fremont:","_id":"7K2CVLTXCFCLPPVE3OHAGAAMHE","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"XWXJVBZBFZB6BHEYBIPYCOFWMI","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"8 a.m.-3:30 p.m. Friday, Dec. 17","type":"text","_id":"B3KBKT2O3VDWDJ735Q5WP5RCV4","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"8 a.m-6:30 p.m. Tuesday, Dec. 21","type":"text","_id":"B3KBKT2O3VDWDJ735Q5WP5RCV4","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"8 a.m-3:30 p.m. Wednesday, Dec. 22","type":"text","_id":"B3KBKT2O3VDWDJ735Q5WP5RCV4","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"8 a.m-6:30 p.m. Tuesday, Dec. 28","type":"text"],"_id":"SWVKQZJ3TVA3ZJK2YXXUP4LD5Q","type":"text","additional_properties":"_id":1638056746708,"comments":[],"inline_comments":[],"content":"Three regular pediatric vaccination clinics have been set up for children ages 5-11:","_id":"5GKIHDPAKNDGTOLXBKCSOZQTQY","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"V373CTCMMRBUVBLCGZCIBP73KM","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Wahoo: 9 a.m.-3:30 p.m. on the first and third Mondays of the month at 1320 E. 31st St.","type":"text","_id":"QTSYLT7S65D37PIR56BIHJULEI","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"Fremont: 3-6:30 p.m. Tuesdays and noon-3:30 p.m. Fridays at 2400 N. Lincoln Ave.","type":"text"],"_id":"YQTNPVE7XVDMJLAZHCQMMUOXJ4","type":"text","additional_properties":"_id":1638056746710,"comments":[],"inline_comments":[],"content":"The health department has the necessary forms posted on their website, for minors and adults, for those who would like to fill them out ahead of their visit.","_id":"ONIU7I744RATPGKGWKFMVCHW3Q","type":"text","additional_properties":"_id":1638056746711,"comments":[],"inline_comments":[],"content":"3RPHD’s regular clinics will continue:","_id":"WRTHDCXXMFBB3F34TWFTHVFG2U","type":"list","list_type":"unordered","additional_properties":"comments":[],"inline_comments":[],"items":["_id":"IC7JJIS7CFBQPKYTWC6HE3XDJM","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"In Dodge County, the Three Rivers clinic at 2400 N. Lincoln Ave. in Fremont, is open for walk-ins from 3 to 6:30 p.m. Tuesday; and noon to 3:30 p.m. Friday.","type":"text","_id":"5M7QFANAVNE33DEZP52LZSWI7M","additional_properties":"comments":[],"inline_comments":[],"block_properties":,"content":"In Saunders County, the Three Rivers clinic in Lake Wanahoo, located at 1320 E. 31st St., is open to walk-ins from 9 a.m. to 3:30 p.m. on the first and third Mondays of the month.","type":"text"],"_id":"ZAPHDW5BTFC3NHPZWZXZH3BMTQ","type":"text","additional_properties":"_id":1639092020720,"comments":[],"inline_comments":[],"content":"Those who are home-bound or require special accommodations but need a COVID-19 test or vaccine can contact the health district at 402-704-2245 to make arrangements.","type":"oembed_response","subtype":"facebook-post","_id":"X5WTO47TYFGFNFQWYAUUKEU2DQ","raw_oembed":"author_name":"Three Rivers Public Health Department, Nebraska","author_url":"https://www.facebook.com/248920435185350","provider_url":"https://www.facebook.com","provider_name":"Facebook","html":"
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In the upcoming weeks, due to the holidays and increased demand for vaccines, we will have modified days and hours for...
","type":"facebook-post","version":"1.0","width":552,"_id":"https://www.facebook.com/threeriverspublichealthNE/photos/a.254237061320354/4635690856508264/?__cft__[0]=AZVaqwpQ0lDbQHEB2xNBkWlbWqcPx2oRnM601ILdUtdbZUZJdx6dMWCtGGHQL-ivsuMoCT2DwPTW37JWxIiDIntrFAVrwcR5JzvGwD964thu10JjaIVanxD0ylvEdORNQsQJ8-q1-ZiSOFjIzjORquV9YBCOAnb0jdricyEl8bXmtA&__tn__={fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}2CO{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}2CP-R&locale=en_US&locale=en_US&locale=en_US","additional_properties":"_id":1639705987760,"comments":[],"referent":"id":"https://www.facebook.com/threeriverspublichealthNE/photos/a.254237061320354/4635690856508264/?__cft__[0]=AZVaqwpQ0lDbQHEB2xNBkWlbWqcPx2oRnM601ILdUtdbZUZJdx6dMWCtGGHQL-ivsuMoCT2DwPTW37JWxIiDIntrFAVrwcR5JzvGwD964thu10JjaIVanxD0ylvEdORNQsQJ8-q1-ZiSOFjIzjORquV9YBCOAnb0jdricyEl8bXmtA&__tn__={fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}2CO{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}2CP-R&locale=en_US&locale=en_US&locale=en_US","provider":"https://www.facebook.com/plugins/post/oembed.json/?url=","referent_properties":"additional_properties":"_id":1639705987760,"comments":[],"service":"oembed","type":"facebook-post","_id":"X4G3KIADXJEFZETA7I5QOEWR5E","type":"divider","additional_properties":"_id":"DCQQSOXTXVB6PLQRJ2WAV64H3M","comments":[],"_id":"GCS7GDJ6JFATPOU65QDMVGIN3Y","type":"header","level":4,"additional_properties":"_id":1638056746715,"comments":[],"inline_comments":[],"content":"Off-line help","_id":"6QAMIZ5LERAWHEZZ77R6M4AXSA","type":"text","additional_properties":"_id":1638056746716,"comments":[],"inline_comments":[],"content":"CHI HEALTH VACCINE INFORMATION: The info line is available at 402-717-1255 from 7 a.m. to 10 p.m. daily in August.","_id":"6H4OD2IHDJCO7NOAQZSWNTRJNY","type":"text","additional_properties":"_id":1638056746717,"comments":[],"inline_comments":[],"content":"NEBRASKA VACCINE HOTLINE: Nebraskans can call 531-249-1873 or toll-free at 833-998-2275 for more information on the state’s COVID-19 vaccination process.","_id":"IGGTSCTSQVBLLPEFSIATZV4S34","type":"text","additional_properties":"_id":1638056746718,"comments":[],"inline_comments":[],"content":"DOUGLAS COUNTY HELPLINE: Local COVID-19 information, in Spanish and English, is available from 8:30 a.m. to 4 p.m. weekdays, except for holidays. 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