Aerobic and resistance exercise training is a cornerstone of early outpatient cardiac rehabilitation (CR) and provides impressive benefits for patients. The components of the exercise prescription for patients with cardiovascular diseases are provided in guideline documents from several professional organizations and include frequency (how many sessions per week); intensity (how hard to exercise); time (duration of the exercise training session); type (modalities of exercise training); volume (the total amount or dose of exercise); and progression (the rate of increasing the dose of exercise). The least discussed, least appreciated, and most challenging component of the exercise prescription for CR health care professionals is the rate of progression of the dose of exercise. One reason for this observation is the heterogeneity of patients who participate in CR. All components of the exercise prescription should be developed specifically for each individual patient. This statement provides an overview of the principles of exercise prescription for patients in CR with special emphasis on the rate of progression. General recommendations for progression are given and patient case examples are provided to illustrate the principles of progression in exercise training.

T he emergence of new SARS-CoV-2 variants with antibody-evading mutations raises concerns about variable levels of protection against infection after prior infection or vaccination (1). The Omicron variant is genetically divergent from previous variants, exacerbating these concerns (1). Reinfection with SARS-CoV-2 after previous infection has been demonstrated through a comparison of viral genomes collected from the same person (2). However, without genomic sequencing, reinfection can be difficult to distinguish from prolonged viral shedding. Available evidence suggests an interval of at least 90 days between positive tests is more likely to indicate reinfection than prolonged viral shedding (3).Public health authorities at the Southern Nevada Health District (SNHD) conducted surveillance of suspected reinfections in Clark County, Nevada, USA, to determine whether previously infected persons were protected against reinfection with new variants and to estimate the proportion of COVID-19 cases that occurred among persons with previous SARS-CoV-2 infections. SNHD also compared rates of suspected reinfection between demographic groups to characterize the groups most affected by suspected reinfection in Clark County and determine whether any groups were disproportionately affected. We report findings from surveillance of suspected reinfection with SARS-CoV-2 and rates of suspected reinfection among demographic groups in Clark County during March 2020-March 2022. MethodsHealth care providers, medical facilities, laboratories, and other out-of-state health departments report positive SARS-CoV-2 PCR test results for residents of Clark County to SNHD. These results are collected in an electronic disease surveillance system. We calculated intervals between the specimen collection date from each person's initial positive PCR test and subsequent positive PCR tests. We considered a subsequent positive PCR test with specimen collection >90 days after specimen collection of the initial positive PCR test to be a suspected reinfection (3). Repeat positive PCR tests with specimen collection dates <90 days after the specimen collection of an initial positive PCR test were not considered suspected reinfections and were excluded from the analysis.We calculated the proportion of new cases per week that were suspected reinfections by dividing the number of suspected reinfections by all new PCR-identified Rapid Increase in Suspected SARS-CoV-2 Reinfections,

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