H5N1

COVID-19 on Saturday afternoon: 2,313,648 cases, 159,526 deaths

A screenshot from Covidly.com at 2:55 p.m. PST: 2,313,648 Cases, 159,526 Deaths.

 

COVID-19: Health minister says Quebec doctor who oversaw Ebola outbreak will be called quickly to contribute

Via CTV News: Health minister says Quebec doctor who oversaw Ebola outbreak will be called quickly to contribute.

MONTREAL -- Quebec's Health Minister Danielle McCann tweeted Friday evening that the Quebec physician who worked oversaw efforts to battle the Ebola outbreak in West Africa would be called quickly to help combat the COVID-19 empidemic after initially being barred from assisting.  

Joanne Liu, who once appeared on the Time Magazine list of the 100 most influential people in the world, said she was told she would not be able to help in the province's long-term care facilities.  

Liu, a former president of Medecins Sans Frontieres who oversaw the organization's efforts to battle an Ebola outbreak in West Africa, told TVA that she had been refused when she volunteered to help.  

“I was told I didn't have the experience to respond to epidemics in an environment like Quebec,” she said to host Paul Larocque. 

Health Minister Danielle McCann quickly stepped in, saying on Twitter that Liu's help would be welcome. “Thank you to Dr. Liu and Paul Larocque for bringing this to my attention,” she tweeted. “We need everyone's contributions to take care of seniors in CHSLDs. My office will ensure Dr. Liu is called quickly to contribute to this collective effort.” 

Liu said she was looking forward to the opportunity to help.  

Liu, 54, began working for Medecins Sans Frontieres in 1996 and participated in 20 missions in Central Asia, Africa and the Middle East. During her mandate as president, the organization operated in several dozen countries, including African nations during the 2014 Ebola crisis.  

When she appeared in the Time list, United States Center for Disease Control and Prevention Director Tom Frieden praised her in his article. 

"In extremely difficult circumstances, Joanne Liu remained focused while being flexible," he wrote. "More importantly, she worked tirelessly to prepare the world to better respond to crises."

The shocking COVID-19 deaths in Canada’s long-term care homes

Via The New York Times: The Shocking Coronavirus Deaths in Canada’s Long-Term Care Homes. Excerpt from a horror story:

Many Canadians, me included, were shocked this week as harrowing details mounted about Montreal’s Résidence Herron nursing home: Medical staff who had abandoned hungry and desperately ill patients. An owner with a long criminal history. Thirty-one dead in less than one month — five from confirmed cases of coronavirus.

Across the country, nursing homes from British Columbia to Alberta to Ontario have been devastated by the lethal spread of the virus. This week, Canada’s chief public health officer, Dr. Theresa Tam, attributed about half of Canada’s deaths from coronavirus — at latest count, 1,193 — to long-term care homes.  

The scale of deaths at these facilities has raised a difficult question: beyond the obvious insidiousness of a highly contagious virus, how has this been possible in Canada, a country with a vaunted universal health care system and a culture of humanism?  

One person who is particularly qualified to answer that question is Dr. Susan Bartlett, a clinical psychologist and professor of medicine at McGill Medical School, who has counseled families about caring for their elderly parents and studies how to better help patients with inflammatory arthritis.  

I spoke with her while reporting on the Résidence Herron catastrophe and discovered that she had a personal interest in addition to her professional expertise: Her 94 year-old mother, Betty Bartlett, was a resident at the Herron in a western suburb of Montreal where 31 people died and which is now under police investigation amid accusations of gross negligence.

Dr. Bartlett told me that in November 2018, she returned from a five-day trip to Baltimore for American Thanksgiving to find her mother semi-comatose, dehydrated, wearing street clothes with a nightgown over her top and near death. She said no one had been in to check on her for days. 

Dr. Bartlett said nurses at the Herron tried to persuade her not to call an ambulance. Her mother, who suffered from Alzheimer’s but had been mobile only days before, was rushed to a hospital, where she eventually died of a stroke. 

She told me the staff at Herron assured her the nurse responsible was fired and she decided not to take any further action. Like many Canadians, she said she had enormous deference for our health care system and, at the time, was loath to criticize it or blow a whistle. “It is profoundly troubling and deeply disturbing to me how broken this part of our health care system is and that I was unable to even protect my own mother from it,” she said.

Dr. Bartlett had done stringent due diligence before putting her mother, a daughter of Italian immigrants who loved to cook her special meatballs for her two granddaughters, at the Herron. She visited half a dozen nursing homes and interviewed Herron’s medical staff. She even consulted a specialist in placing seniors in homes. In the end, she decided on the Herron, which charged her mother 6,500 Canadian dollars a month. Dr. Bartlett was originally impressed by its diligent staff, and services that included a beauty salon. 

Today, Dr. Bartlett laments that even her extensive research failed to turn up the criminal record of the residence’s owner, Samir Chowieri, who in the 1980s served 15 months in prison for drug trafficking and had been convicted of fraud. One of his retirement homes was later the subject of a money-laundering investigation by the Royal Canadian Mounted Police. “Had any of this criminality been exposed I would’ve never put my mom there,” she told me. 

But there was a reason for the lack of a paper trail: In 2014, Mr. Chowieri was successful in obtaining a pardon and having his criminal record expunged. The Quebec premier, François Legault, this week said it was “unacceptable” that a person convicted of serious crimes ended up running a home for the elderly, and asked why there were rigorous background checks for employees of long-term care facilities in Quebec but not for owners.

Ebola in the DRC: 6 cases now

Via Radio Moto Butembo Beni: North Kivu: Ebola patient found in Butembo after fleeing from Beni. The Google translation and then a comment:

The fourth confirmed Ebola case in Beni crossed the supposedly closed boundary between Beni and Butembo. Specialized Ebola response teams reassure having encountered the case to persuade them to return to CTE Beni for treatment. 

The nursing staff announced that the fourth confirmed Ebola patient in Beni had escaped since Thursday, April 16, 2020 from the local CTE. This case was found in the Mutsanga health area, in the Katwa health zone in Butembo, Friday, April 17, 2020.  

Specialized Ebola response teams and members of the community in Butembo-Mutsanga met, with total health security, the case to persuade him to return to CTE Beni, with a view to accompanying him to effective care at CTE. 

Until then, no communication on the circumstances of his flight and his reunion. But he has already contacted many people. This is why the nursing staff calls for health vigilance and respect for hygiene rules. 

Meanwhile, Beni has six cases of Ebola virus disease. The sixth was confirmed this Friday, April 17, 2020.

"Ebola flight" is almost a symptom of the disease; it was also common in the West African outbreak, when many patients seemed obsessed with getting out of care and going somewhere else. So this episode is nothing unusual. 

But I'm surprised that the 6th case is a throwaway line at the end of the report. It's almost as if the Congolese have lost interest in Ebola, and their media are now focused much more intensely on COVID-19.

No proof of immunity in recovered COVID-19 patients, says WHO

Via The Irish Times: No proof of immunity in recovered coronavirus patients, says WHO.

There is no evidence that blood tests to detect Covid-19 antibodies can show whether a person has immunity or is no longer at risk of becoming re-infected, according to the World Health Organisation (WHO).  

In a briefing, WHO epidemiologists warned despite hopes governments across the world had placed on antibody tests in an effort to re-open economies, there was no proof yet that having had a coronavirus infection will confer immunity for a significant period of time.  

Scientists in many countries including Ireland are developing or testing new pinprick blood tests to measure for raised levels of antibodies generated by the body in fighting the virus – so far none have been validated for use.  

Speaking at a press conference in Geneva, Dr Maria van Kerchief said: “There are a lot of countries that are suggesting using rapid diagnostic serological tests to be able to capture what they think will be a measure of immunity. Right now, we have no evidence the use of a serological test can show that an individual has immunity or is protected from reinfection.”  

These antibody tests would be able to measure “seroprevalence” levels – but that indication of antibodies in somebody did not mean they were immune. 

She said it was “a good thing” so many tests were being developed. “We need to ensure that they are validated so that we know what they say they attempt to measure they are actually measuring.”

Head of WHO’s emergencies programme Dr Mike Ryan said even if antibodies were effective there was little sign that large numbers of people had developed them, and were beginning to offer so-called “herd immunity” to the broader population.  

“A lot of preliminary information coming to us right now would suggest quite a low percentage of population have seroconversion (to produce antibodies),” he added.    

There was expectation that the majority in society may have developed antibodies, but the general evidence is pointing against that, “so it may not solve the problem of governments”.  

In addition, some of the tests have issues with sensitivity, Dr Ryan added. They may give a false negative result. 

More than 560,000 of the 2.1 million coronavirus cases across the world are marked as recovered, according to data compiled by Johns Hopkins University in the US. However, infectious disease specialists say the case total is likely to be much higher as people go undetected and countries struggle with testing.

Caught in a superpower struggle: The inside story of the WHO's response to COVID-19

Via The Guardian: Caught in a superpower struggle: the inside story of the WHO's response to coronavirus. Excerpt:

When a pandemic strikes, the world’s leading experts convene – physically or virtually – in a hi-tech chamber in the basement of the Geneva headquarters of the World Health Organization.  

It is called the “strategic health operations centre”, or SHOC, an appropriately urgent acronym for a place where life and death decisions are taken, and it is where critical choices were made in the early days of the coronavirus outbreak.  

“We’re mostly like a 1950s, never-been-upgraded place, except for the SHOC room, which was built with all the screens everywhere and the desks with computers that rise up. The whole thing does look like something that Hollywood set up, imagining a pandemic,” a WHO official said. 

“You sit there and you hear these experts from all over the world and they’re really leading people. The best expertise available to get the best advice possible, it’s a very impressive sense that hey, this is really how it is supposed to work.”  

On 22 January, it was in this setting that the WHO emergency committee convened to make a pivotal decision on whether to advise the organisation to declare a “public health emergency of international concern” (PHEIC) – a formal red alert for the world. 

The WHO had been sharing information with member states constantly since the first cluster of pneumonia cases was first identified in the Chinese city of Wuhan at the end of December, but declaring a PHEIC still had huge symbolic importance. 

The WHO director general, Tedros Adhanom Ghebreyesus, sat in the SHOC with his top advisers watching as a succession of speakers gave their views on the screens in front of them.  

First there were reports from China, and then Japan and Thailand where cases had been recently confirmed. Then it was the turn of the 15 members and six advisers on the emergency committee, drawn from around the world.  

The debate was highly technical but it had one critical issue at its heart. It was known by then that the virus had spread from person to person, but the question was how easily? 

If human-to-human transmission was only happening in close quarters, in families, or between patients and health workers, then perhaps it could be largely contained without a worldwide alert, and all the global economic disruption that entailed. If the virus was spreading freely among communities, there was not a moment to lose.  

The emergency committee was split down the middle on the question. So Tedros told it to convene again the next day, in the hope new data might create a consensus. 

“Tedros’s only obligation under the law is to convene a committee but not to follow it. But he feels that politically he needs to get a unanimous decision before he acts or at least an overwhelming majority,” Lawrence Gostin, a professor of public health law at Georgetown University, said.  

The second day’s meeting. however, changed no one’s mind, and the impasse remained. Tedros had the committee adjourn pending further study and put it on notice to reconvene at short notice. A international health emergency was declared a week later, on 30 January, after clear evidence of community spread of Covid-19 had emerged.  

WHO under fire 

The events of January were always destined for scrutiny. The WHO conducts an after-action report in wake of every pandemic. But by seeking to make the global body the scapegoat for the debacle of the US response, Donald Trump has ensured each detail will become exhibits in a highly-politicised show-trial, likely to last as long as the election campaign.  

Furthermore, the president has used claims of WHO’s dysfunction to justify cutting off US funding to it, worth over $400m a year, and hindering the organisation’s ability to help counter the spread of the pandemic in fragile and poor countries around the world. 

In a hail of accusations hurled at the WHO in recent days, Trump has accused it of withholding critical information about the danger of Covid-19, and being under the control of China.  

None of the accusations are supported by the facts.

In Italy, a sharp drop in COVID-19 ICU patients

Via The New York Times: In Italy, a Sharp Drop in Coronavirus I.C.U. Patients: Live Coverage. Excerpt:

• Italy’s lockdown leads to a drastic drop in I.C.U. coronavirus patients. 

• Africa is desperately short of ventilators, among other essential supplies. 

• Iran lifts Tehran’s lockdown, despite warnings from health officials. 

• As Hong Kong confronts the virus, major pro-Democracy figures are arrested. 

• Gun salute for Queen Elizabeth II’s birthday is canceled because of the pandemic. 

• In Japan, a push to use the Olympic Village to house the homeless. 

• An emerging hurdle to a vaccine: people’s reluctance to take it. 

Italy’s lockdown leads to a drastic drop in I.C.U. coronavirus patients. 

Two weeks ago, Italy’s intensive care units were bursting with more than 4,000 coronavirus patients, mostly in the northern regions, and at times doctors were put in the difficult position of choosing which people to treat. 

By Friday, the number of I.C.U. patients had dropped to 2,812, and hospitalizations for Covid-19, the disease caused by the virus, had fallen from a high of 29,010 patients on April 4 to 25,786, reflecting a steady decline that is easing the burden on the country’s health care system.  

“This is allowing those who work in I.C.U.s greater ease in dealing with all patients who need intensive care,” not just Covid-19 patients, said Franco Locatelli, the head of Italy’s Higher Health Council. 

Experts say the decline is a result of the nationwide lockdown that Italy imposed on March 10, which drastically diminished the rate of the coronavirus’s spread.  

“At the beginning of the epidemic, each infected person was spreading the virus to three other people. Thanks to the lockdown, it’s now down to under one,” said Giovanni Rezza, the director of the infective illness department at the country’s National Health Institute. “That, in turn, has an impact on hospitalizations and I.C.U.s.”  

Since the lockdown, new cases have emerged mostly within families and, above all, in assisted-living and retirement homes, Dr. Rezza said, adding, “Those account for many of the deaths,” which remain over 500 per day in Italy.

COVID-19 on Saturday morning: 2,273,723 cases, 155,938 deaths

A screenshot from Covidly: 2,273,723 Cases, 155,938 Deaths.

Daily high of 942 new COVID-19 cases reported in Singapore

Via Channel NewsAsia: Daily high of 942 new COVID-19 cases reported in Singapore. Excerpt:

SINGAPORE: A record of 942 new COVID-19 cases were reported in Singapore as of noon on Saturday (Apr 18), the Ministry of Health (MOH) said in a media release.  

The "vast majority" of these are work permit holders living in foreign worker dormitories, it said. 

Of the new cases, 14 are Singaporeans and permanent residents, as the ministry noted that the number of local cases continues to decline. 

"We are still working through the details of the cases, and further updates will be shared via the MOH press release that will be issued tonight," said the ministry. 

In a Facebook post on Saturday, Prime Minister Lee Hsien Loong noted the rising number of cases in dormitories, adding that most of these are mild cases. 

"The migrant workers who are ill are getting the medical treatment they need. Fortunately, the vast majority of the cases are mild, because the workers are young. Our healthcare teams continue to monitor their conditions," he wrote.

Mr Lee said that while efforts have been made to break the chain of transmission in foreign worker dormitories, it will take some time to show results.  

"So we must expect to see more dorm cases for a while longer. But we are building up our healthcare and isolation facilities to handle the load," he added.  

Thirteen of such dormitories have so far been declared isolation areas, meaning that the workers will not be allowed to leave their rooms for 14 days. 

COVID-19: What's happening in Canada and around the world on Saturday

Via CBC News: Coronavirus: What's happening in Canada and around the world on Saturday. Excerpt:

The latest: 

• B.C. prepares to ease some COVID-19 restrictions in May, after data suggests province has flattened the curve. 

• Air passengers will be required to wear non-medical masks starting April 20. 

• Hundreds of cases confirmed at Alberta meat plant.  

• Experts warn COVID-19 may attack more than the lungs. 

• As COVID-19 deaths mount in Ontario long-term care homes, families demand more timely information. 

• Trudeau announces help for struggling energy sector, including $1.7B to clean up orphan wells.

A group of 13 countries including Canada, Britain, Brazil, Italy and Germany is calling for global co-operation to lessen the economic impact of the coronavirus pandemic. 

In a joint statement the group said it is committed to "work with all countries to co-ordinate on public health, travel, trade, economic and financial measures in order to minimize disruptions and recover stronger."  

The countries emphasized the need to maintain "air, land and marine transportation links" to ensure the continued flow of goods, including medical equipment and aid, and the return home of travellers.  

The call comes as more than 2.23 million people have been reported to be infected by the novel coronavirus globally and 151,657 have died, according to a Reuters tally. Infections have been reported in more than 210 countries and territories since the first cases were identified in China in December 2019. 

Canada had nearly 32,000 confirmed and presumptive cases of COVID-19 as of Saturday morning.   

Prime Minister Justin Trudeau will give an update on the issue today at 11:15 a.m. ET, a day after announcing that more than 100 Canadian Forces members with medical training will be sent to Quebec after the province asked for help at its long-term care homes struggling with spreading COVID-19 outbreaks.  

Trudeau announced several new funding initiatives Friday, including a plan to help the energy sector. He said that the federal government will keep working with Quebec to find ways to support the province, including working with the Red Cross and specialized volunteers who have signed up with Health Canada.