63-644: The Jew Bill (more formally, "An Act to extend to the sect of people professing the Jewish religion, the same rights and privileges enjoyed by Christians") was passed in 1826 by the Maryland General Assembly to allow Jews to hold public office in the state. The bill was passed on January 5, 1826, "after a long and arduous struggle." The long struggle over the Jew Bill attracted widespread newspaper coverage and occasioned significant debate over
126-625: A healthy diet are also recommended. Supportive care in severe cases includes treatment to relieve symptoms , fluid therapy , oxygen support and prone positioning , and medications or devices to support other affected vital organs. More severe cases may need treatment in hospital. In those with low oxygen levels, use of the glucocorticoid dexamethasone is recommended to reduce mortality. Noninvasive ventilation and, ultimately, admission to an intensive care unit for mechanical ventilation may be required to support breathing. Extracorporeal membrane oxygenation (ECMO) has been used to address
189-627: A variant of concern (VoC) or a variant of interest (VoI). Many of these variants have shared the more infectious D614G . As of May 2023, the WHO had downgraded all variants of concern to previously circulating as these were no longer detected in new infections. Sub-lineages of the Omicron variant (BA.1 – BA.5) were considered separate VoCs by the WHO until they were downgraded in March 2023 as no longer widely circulating. As of 24 September 2024 ,
252-493: A comprehensive international study. Such deaths include deaths due to healthcare capacity constraints and priorities, as well as reluctance to seek care (to avoid possible infection). Further research may help distinguish the proportions directly caused by COVID-19 from those caused by indirect consequences of the pandemic. In May 2022, the WHO estimated the number of excess deaths by the end of 2021 to be 14.9 million compared to 5.4 million reported COVID-19 deaths, with
315-595: A large number of people". During the COVID-19 pandemic, as with other pandemics, the meaning of this term has been challenged. The end of a pandemic or other epidemic only rarely involves the total disappearance of a disease, and historically, much less attention has been given to defining the ends of epidemics than their beginnings. The ends of particular epidemics have been defined in a variety of ways, differing according to academic field, and differently based on location and social group. An epidemic's end can be considered
378-451: A median range of 0.24% to 1.49%. IFRs rise as a function of age (from 0.002% at age 10 and 0.01% at age 25, to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85). These rates vary by a factor of ≈10,000 across the age groups. For comparison, the IFR for middle-aged adults is two orders of magnitude higher than the annualised risk of a fatal automobile accident and much higher than
441-824: A random sample have consistently found that total infections considerably exceed the reported case counts. Many countries, early on, had official policies to not test those with only mild symptoms. The strongest risk factors for severe illness are obesity, complications of diabetes , anxiety disorders, and the total number of conditions. During the start of the COVID-19 pandemic it was not clear whether young people were less likely to be infected, or less likely to develop symptoms and be tested. A retrospective cohort study in China found that children and adults were just as likely to be infected. Among more thorough studies, preliminary results from 9 April 2020 found that in Gangelt ,
504-461: A social phenomenon, not just a biological one. Time reported in March 2024 that expert opinions differ on whether or not COVID-19 is considered endemic or pandemic, and that the WHO continued to call the disease a pandemic on its website. During the initial outbreak in Wuhan , the virus and disease were commonly referred to as "coronavirus", "Wuhan coronavirus", "the coronavirus outbreak" and
567-543: A standing committee for consideration and a public hearing. The president pro tempore appoints majority and minority whips and leaders. A bill is a proposal to change, repeal, or add to existing state law. A House Bill (HB) is one introduced in the House of Delegates (for example: HB 6); a Senate Bill (SB), in the Senate. Bills are designated by number, in the order of introduction in each house. For example, HB 16 refers to
630-658: A state ruled by the Palatine lord , Lord Baltimore. As ruler, Lord Baltimore owned directly all of the land granted in the charter, and possessed absolute authority over his domain. However, as elsewhere in British North America, British political institutions were re-created in the colonies, and the Maryland General Assembly fulfilled much the same function as the House of Commons . An act
693-451: A test. Conversely, deaths of people who died from underlying conditions following a positive test may be included. Countries such as Belgium include deaths from suspected cases, including those without a test, thereby increasing counts. Official death counts have been claimed to underreport the actual death toll, because excess mortality (the number of deaths in a period compared to a long-term average) data show an increase in deaths that
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#1732775752818756-518: Is associated with COVID-19 and is reported in as many as 88% of cases. The disease is mainly transmitted via the respiratory route when people inhale droplets and small airborne particles (that form an aerosol ) that infected people exhale as they breathe, talk, cough, sneeze, or sing. Infected people are more likely to transmit COVID-19 when they are physically close to other non-infected individuals. However, infection can occur over longer distances, particularly indoors. SARS‑CoV‑2 belongs to
819-611: Is discouraged altogether by the World Health Organization (WHO), due to limited evidence of its efficacy. The severity of COVID-19 varies. It may take a mild course with few or no symptoms, resembling other common upper respiratory diseases such as the common cold . In 3–4% of cases (7.4% for those over age 65) symptoms are severe enough to cause hospitalisation. Mild cases typically recover within two weeks, while those with severe or critical diseases may take three to six weeks to recover. Among those who have died,
882-439: Is intended to provide acquired immunity against severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), the virus that causes coronavirus disease 2019 ( COVID-19 ). Prior to the COVID-19 pandemic, an established body of knowledge existed about the structure and function of coronaviruses causing diseases like severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). This knowledge accelerated
945-490: Is not explained by COVID-19 deaths alone. Using such data, estimates of the true number of deaths from COVID-19 worldwide have included a range from 18.2 to 33.5 million (≈27.4 million) by 18 November 2023 by The Economist , as well as over 18.5 million by 1 April 2023 by the Institute for Health Metrics and Evaluation and ≈18.2 million (earlier) deaths between 1 January 2020, and 31 December 2021, by
1008-649: Is submitted by the State Central Committee of the same political party as the legislator whose seat is to be filled. The current pattern for distribution of seats began with the legislative apportionment plan of 1972 and has been revised every ten years thereafter according to the results of the decennial U.S. Census . A Constitutional amendment, the plan created 47 legislative districts, many of which cross county boundaries to delineate districts relatively equal in population. Each legislative district elects one senator and three delegates. In most districts,
1071-701: Is the state legislature of the U.S. state of Maryland that convenes within the State House in Annapolis . It is a bicameral body : the upper chamber , the Maryland Senate , has 47 representatives, and the lower chamber , the Maryland House of Delegates , has 141 representatives. Members of both houses serve four-year terms. Each house elects its own officers, judges the qualifications and election of its own members, establishes rules for
1134-452: Is the ratio of deaths to diagnoses. This metric can be misleading because of the delay between symptom onset and death and because testing focuses on symptomatic individuals. Based on Johns Hopkins University statistics, the global CFR was 1.02 percent (6,881,955 deaths for 676,609,955 cases) as of 10 March 2023. The number varies by region and has generally declined over time. Several variants have been named by WHO and labelled as
1197-406: Is the seventh known coronavirus to infect people, after 229E , NL63 , OC43 , HKU1 , MERS-CoV , and the original SARS-CoV . The standard method of testing for presence of SARS-CoV-2 is a nucleic acid test , which detects the presence of viral RNA fragments. As these tests detect RNA but not infectious virus, its "ability to determine duration of infectivity of patients is limited." The test
1260-614: Is typically done on respiratory samples obtained by a nasopharyngeal swab ; however, a nasal swab or sputum sample may also be used. The WHO has published several testing protocols for the disease. Preventive measures to reduce the chances of infection include getting vaccinated, staying at home or spending more time outdoors, avoiding crowded places, keeping distance from others, wearing a mask in public, ventilating indoor spaces, managing potential exposure durations, washing hands with soap and water often and for at least twenty seconds, practising good respiratory hygiene, and avoiding touching
1323-514: The Huanan Seafood Wholesale Market there, but it is possible that human-to-human transmission began earlier. Molecular clock analysis suggests that the first cases were likely to have been between October and November 2019. The scientific consensus is that the virus is most likely of a zoonotic origin, from bats or another closely related mammal. While other explanations such as speculations that SARS-CoV-2
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#17327757528181386-407: The Institute for Health Metrics and Evaluation estimating the true number of cases as of early 2022 to be in the billions. One measure that public health officials and policymakers have used to monitor the pandemic and guide decision-making is the test positivity rate ("percent positive"). According to Johns Hopkins in 2020, one benchmark for a "too high" per cent positive is 5%, which was used by
1449-602: The basic reproduction number (R 0 ) for COVID-19 in January 2020 were between 1.4 and 2.5, but a subsequent analysis claimed that it may be about 5.7 (with a 95 per cent confidence interval of 3.8 to 8.9). In December 2021, the number of cases continued to climb due to several factors, including new COVID-19 variants. As of that 28 December, 282,790,822 individuals worldwide had been confirmed as infected. As of 14 April 2022 , over 500 million cases were confirmed globally. Most cases are unconfirmed, with
1512-479: The coronavirus pandemic and COVID pandemic ), caused by severe acute respiratory syndrome coronavirus 2 ( SARS-CoV-2 ), began with an outbreak of COVID-19 in Wuhan , China, in December 2019. It spread to other areas of Asia, and then worldwide in early 2020. The World Health Organization (WHO) declared the outbreak a public health emergency of international concern (PHEIC) on 30 January 2020, and assessed
1575-474: The variants of interest as specified by the World Health Organization are BA.2.86 and JN.1, and the variants under monitoring are JN.1.7, KP.2, KP.3, KP.3.1.1, JN.1.18, LB.1, and XEC. Symptoms of COVID-19 are variable, ranging from mild symptoms to severe illness. Common symptoms include headache, loss of smell and taste , nasal congestion and runny nose , cough, muscle pain , sore throat , fever, diarrhoea , and breathing difficulties . People with
1638-429: The "Wuhan coronavirus outbreak", with the disease sometimes called "Wuhan pneumonia ". In January 2020, the WHO recommended 2019-nCoV and 2019-nCoV acute respiratory disease as interim names for the virus and disease per 2015 international guidelines against using geographical locations (e.g. Wuhan, China), animal species, or groups of people in disease and virus names in part to prevent social stigma . WHO finalised
1701-548: The General Assembly adjourned early on March 18, 2020, for the first time since the Civil War . Each senator or delegate must be a U.S. citizen and a resident of Maryland for at least one year preceding his or her election. A prospective legislator must have resided in the legislative district the candidate seeks to represent for the six months prior to election. A senator must be at least twenty-five years of age at
1764-736: The Governor and his agencies and are not proposals of the Speaker of the House, the President of the Senate, the Minority Leader, or the respective Committee Chair. They are listed with the official title of a legislator rather than the Governor due to requirements in the Maryland Constitution . The legislative procedure , is divided into distinct stages: COVID-19 pandemic The COVID-19 pandemic (also known as
1827-640: The WHO in the past. As of 10 March 2023, more than 6.88 million deaths had been attributed to COVID-19. The first confirmed death was in Wuhan on 9 January 2020. These numbers vary by region and over time, influenced by testing volume, healthcare system quality, treatment options, government response, time since the initial outbreak, and population characteristics, such as age, sex, and overall health. Multiple measures are used to quantify mortality. Official death counts typically include people who died after testing positive. Such counts exclude deaths without
1890-419: The WHO, US, European Union, and Australia. On 12 November 2022, the WHO released its Global Vaccine Market Report. The report indicated that "inequitable distribution is not unique to COVID-19 vaccines"; countries that are not economically strong struggle to obtain vaccines. On 14 November 2022, the first inhalable vaccine was introduced, developed by Chinese biopharmaceutical company CanSino Biologics , in
1953-448: The broad family of viruses known as coronaviruses . It is a positive-sense single-stranded RNA (+ssRNA) virus, with a single linear RNA segment. Coronaviruses infect humans, other mammals, including livestock and companion animals, and avian species. Human coronaviruses are capable of causing illnesses ranging from the common cold to more severe diseases such as Middle East respiratory syndrome (MERS, fatality rate ≈34%). SARS-CoV-2
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2016-648: The centre of a major infection cluster in Germany, 15 per cent of a population sample tested positive for antibodies . Screening for COVID-19 in pregnant women in New York City , and blood donors in the Netherlands, found rates of positive antibody tests that indicated more infections than reported. Seroprevalence -based estimates are conservative as some studies show that persons with mild symptoms do not have detectable antibodies. Initial estimates of
2079-760: The city of Shanghai, China. For the first two years of the pandemic, no specific and effective treatment or cure was available. In 2021, the European Medicines Agency's (EMA) Committee for Medicinal Products for Human Use (CHMP) approved the oral antiviral protease inhibitor , Paxlovid (nirmatrelvir plus the HIV antiviral ritonavir ), to treat adult patients. FDA later gave it an EUA. Most cases of COVID-19 are mild. In these, supportive care includes medication such as paracetamol or NSAIDs to relieve symptoms (fever, body aches, cough), adequate intake of oral fluids and rest. Good personal hygiene and
2142-531: The colonial Assembly ceased to exist, and was replaced by its modern successor. Starting in 1867, the Assembly became increasingly unrepresentative. As the population of Baltimore increased, it and other urban areas were not granted additional seats. By 1918, the city's population had increased 175% while the entire state gained only 46% with no reallocation of political power. Due to the COVID-19 pandemic ,
2205-519: The conduct of its business, and may punish or expel its own members. The General Assembly convenes its legislative session for 90 days each year to act on more than 2,300 bills including the state's annual budget, which it must pass before adjourning sine die . The General Assembly's 446th session convened on January 10, 2024. The forerunner of the Maryland General Assembly was the colonial institution, an Assembly of Free Marylanders (and also Council of Maryland). Maryland's foundational charter created
2268-484: The cumulative number of infected individuals (including asymptomatic and undiagnosed infections and excluding vaccinated infected individuals). It is expressed in percentage points. Other studies refer to this metric as the infection fatality risk . In November 2020, a review article in Nature reported estimates of population-weighted IFRs for various countries, excluding deaths in elderly care facilities, and found
2331-441: The development of various vaccine platforms during early 2020. The initial focus of SARS-CoV-2 vaccines was on preventing symptomatic and severe illness. The COVID-19 vaccines are widely credited for their role in reducing the severity and death caused by COVID-19. As of March 2023, more than 5.5 billion people had received one or more doses (11.8 billion in total) in over 197 countries. The Oxford-AstraZeneca vaccine
2394-513: The eyes, nose, or mouth with unwashed hands. Those diagnosed with COVID-19 or who believe they may be infected are advised by healthcare authorities to stay home except to get medical care, call ahead before visiting a healthcare provider, wear a face mask before entering the healthcare provider's office and when in any room or vehicle with another person, cover coughs and sneezes with a tissue, regularly wash hands with soap and water and avoid sharing personal household items. A COVID-19 vaccine
2457-599: The first Jews to hold elected office in Maryland. Maryland was among the last US states to remove a prohibition on Jews holding public office. Arguing on behalf of the change, Thomas Kennedy , a Christian who had been elected to the Maryland legislature, said, "There are few Jews in the United States. In Maryland there are very few. But if there was only one — to that one, we ought to do justice." Maryland General Assembly The Maryland General Assembly
2520-474: The general public beginning in December 2020, made available through government and international programs such as COVAX , aiming to provide vaccine equity . Treatments include novel antiviral drugs and symptom control. Common mitigation measures during the public health emergency included travel restrictions , lockdowns , business restrictions and closures, workplace hazard controls , mask mandates , quarantines, testing systems, and contact tracing of
2583-665: The infected. The pandemic caused severe social and economic disruption around the world, including the largest global recession since the Great Depression . Widespread supply shortages , including food shortages , were caused by supply chain disruptions and panic buying . Reduced human activity led to an unprecedented temporary decrease in pollution . Educational institutions and public areas were partially or fully closed in many jurisdictions, and many events were cancelled or postponed during 2020 and 2021. Telework became much more common for white-collar workers as
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2646-487: The issue of respiratory failure. Existing drugs such as hydroxychloroquine , lopinavir/ritonavir , and ivermectin are not recommended by US or European health authorities, as there is no good evidence they have any useful effect. The antiviral remdesivir is available in the US, Canada, Australia, and several other countries, with varying restrictions; however, it is not recommended for use with mechanical ventilation, and
2709-496: The legislative process significantly. The President and the Speaker appoint the members of most committees and name their chairs and vice-chairs, except in the case of the Joint Committee on Investigation whose members elect their own officers. The President and Speaker preside over the daily sessions of their respective chambers, maintaining decorum and deciding points of order. As legislation is introduced, they assign it to
2772-607: The major part of them ... shall think good. In addition, the Lord Proprietor could summon any delegates whom he desired. In 1639, noting that Parliament had not been summoned in England for a decade, the free men of Maryland passed an act to the effect that "assemblies were to be called once in every three years at the least", ensuring that their voices would be regularly heard. During the American Revolution
2835-576: The majority of the unreported 9.5 million deaths believed to be direct deaths due the virus, rather than indirect deaths. Some deaths were because people with other conditions could not access medical services . A December 2022 WHO study estimated excess deaths from the pandemic during 2020 and 2021, again concluding ≈14.8 million excess early deaths occurred, reaffirming and detailing their prior calculations from May as well as updating them, addressing criticisms. These numbers do not include measures like years of potential life lost and may make
2898-495: The official names COVID-19 and SARS-CoV-2 on 11 February 2020. Tedros Adhanom Ghebreyesus explained: CO for corona , VI for virus , D for disease and 19 for when the outbreak was first identified (31 December 2019). WHO additionally uses "the COVID-19 virus" and "the virus responsible for COVID-19" in public communications. WHO named variants of concern and variants of interest using Greek letters . The initial practice of naming them according to where
2961-427: The outbreak as having become a pandemic on 11 March. COVID-19 symptoms range from asymptomatic to deadly, but most commonly include fever, sore throat , nocturnal cough , and fatigue. Transmission of the virus is often through airborne particles . Mutations have produced many strains (variants) with varying degrees of infectivity and virulence . COVID-19 vaccines were developed rapidly and deployed to
3024-407: The pandemic 2021's leading cause of death . The time between symptom onset and death ranges from 6 to 41 days, typically about 14 days. Mortality rates increase as a function of age. People at the greatest mortality risk are the elderly and those with underlying conditions. The infection fatality ratio (IFR) is the cumulative number of deaths attributed to the disease divided by
3087-495: The pandemic evolved. Misinformation circulated through social media and mass media , and political tensions intensified . The pandemic raised issues of racial and geographic discrimination , health equity , and the balance between public health imperatives and individual rights . The WHO ended the PHEIC for COVID-19 on 5 May 2023. The disease has continued to circulate, but as of 2024, experts were uncertain as to whether it
3150-415: The population's age structure and the age-specific pattern of infections. There have also been reviews that have compared the fatality rate of this pandemic with prior pandemics, such as MERS-CoV. For comparison the infection mortality rate of seasonal flu in the United States is 0.1%, which is 13 times lower than COVID-19. Another metric in assessing death rate is the case fatality ratio (CFR), which
3213-596: The relationship between race and citizenship. The Jew Bill altered the state's constitution to allow Jews to hold public office upon swearing to (or affirming) a belief in "a future state of rewards and punishments"; previously, the state's constitution required public officeholders to make "a declaration of a belief in the Christian religion." The fight to pass it was led in the early 1820s by Jacob I. Cohen Jr. (1789–1869) and Solomon Etting (1764–1847), who subsequently ran successfully for Baltimore City Council and became
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#17327757528183276-462: The risk of dying from seasonal influenza . In December 2020, a systematic review and meta-analysis estimated that population-weighted IFR was 0.5% to 1% in some countries (France, Netherlands, New Zealand, and Portugal), 1% to 2% in other countries (Australia, England, Lithuania, and Spain), and about 2.5% in Italy. This study reported that most of the differences reflected corresponding differences in
3339-496: The same infection may have different symptoms, and their symptoms may change over time. Three common clusters of symptoms have been identified: one respiratory symptom cluster with cough, sputum , shortness of breath, and fever; a musculoskeletal symptom cluster with muscle and joint pain, headache, and fatigue; a cluster of digestive symptoms with abdominal pain, vomiting, and diarrhoea. In people without prior ear, nose, and throat disorders, loss of taste combined with loss of smell
3402-447: The sixteenth bill introduced in the House of Delegates. The numbering starts afresh each session. The names of the sponsor (and co-sponsors, if any), the legislator who introduced the bill, becomes part of the title. Bills listed as "The Speaker (By Request of Administration)", "The President (By Request of Administration)", "Minority Leader (By Request of Administration)", or "Committee Chair (By Request of Department)" are bills proposed by
3465-462: The three delegates are elected at large from the whole district via block voting . However, in some more sparsely populated areas of the state, the districts are divided into subdistricts for the election of delegates: either into three one-delegate subdistricts or one two-delegate subdistrict and one one-delegate subdistrict. The Senate is led by a President and the House by a Speaker whose respective duties and prerogatives enable them to influence
3528-411: The time from symptom onset to death has ranged from two to eight weeks. Prolonged prothrombin time and elevated C-reactive protein levels on admission to the hospital are associated with severe course of COVID-19 and with a transfer to intensive care units (ICU). Between 5% and 50% of COVID-19 patients experience long COVID , a condition characterised by long-term consequences persisting after
3591-460: The time of election and a delegate at least twenty-one. Military officers other than members of the reserves are not eligible for election to the General Assembly. Each term lasts four years. However, members of the General Assembly are not term-limited . If a vacancy occurs in either house through death, resignation, or disqualification, the Governor of Maryland appoints a replacement whose name
3654-694: The typical convalescence period of the disease. The most commonly reported clinical presentations are fatigue and memory problems, as well as malaise , headaches, shortness of breath , loss of smell, muscle weakness , low fever and cognitive dysfunction . Many countries attempted to slow or stop the spread of COVID-19 by recommending, mandating or prohibiting behaviour changes, while others relied primarily on providing information. Measures ranged from public advisories to stringent lockdowns. Outbreak control strategies are divided into elimination and mitigation. Experts differentiate between elimination strategies (known as " zero-COVID ") that aim to completely stop
3717-543: The variants were identified (e.g. Delta began as the " Indian variant") is no longer common. A more systematic naming scheme reflects the variant's PANGO lineage (e.g., Omicron 's lineage is B.1.1.529) and is used for other variants. SARS-CoV-2 is a virus closely related to bat coronaviruses , pangolin coronaviruses, and SARS-CoV . The first known outbreak (the 2019–2020 COVID-19 outbreak in mainland China ) started in Wuhan , Hubei, China, in December 2019. Many early cases were linked to people who had visited
3780-443: Was accidentally released from a laboratory have been proposed, as of 2021 these were not supported by evidence. Official "case" counts refer to the number of people who have been tested for COVID-19 and whose test has been confirmed positive according to official protocols whether or not they experienced symptomatic disease. Due to the effect of sampling bias , studies which obtain a more accurate number by extrapolating from
3843-510: Was passed providing that: from henceforth and for ever everyone being of the council of the Province and any other gentleman of able judgement summoned by writ (and the Lord of every Manor within this Province after Manors be erected) shall and may have his voice, seat, and place in every General Assembly ... together with two or more able and sufficient men for the hundred as the said freedmen or
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#17327757528183906-457: Was still a pandemic. Pandemics and their ends are not well-defined, and whether or not one has ended differs according to the definition used. As of 24 November 2024, COVID-19 has caused 7,075,455 confirmed deaths. The COVID-19 pandemic ranks as the fifth- deadliest pandemic or epidemic in history . In epidemiology , a pandemic is defined as "an epidemic occurring over a very wide area, crossing international boundaries, and usually affecting
3969-509: Was the most widely used. According to a June 2022 study, COVID-19 vaccines prevented an additional 14.4 million to 19.8 million deaths in 185 countries and territories from 8 December 2020 to 8 December 2021. On 8 November 2022, the first recombinant protein-based COVID-19 vaccine (Novavax's booster Nuvaxovid ) was authorised for use in adults in the United Kingdom. It has subsequently received endorsement/authorisation from
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