H5N1

As coronavirus toll grows, Brazil’s political divisions spill onto the streets

Via The New York Times: As Coronavirus Toll Grows, Brazil’s Political Divisions Spill Onto the Streets. Excerpt:

SÃO PAULO, Brazil — For weeks, President Jair Bolsonaro’s supporters have made their presence felt with the roar of motorcycles during boisterous rallies meant to show steadfast fealty to an increasingly unpopular leader. 

Until recently, the president’s opponents had refrained from convening street protests, opting instead to show their exasperation by banging pots and pans from windows and trading memes online. 

But over the weekend, thousands of Brazilians critical of Mr. Bolsonaro took to the streets in the largest public mobilization against the president since the beginning of the pandemic. 

Their show of force in cities across the country followed a series of damning revelations in congressional hearings examining the government’s catastrophic response to the coronavirus, which has killed more than 461,000 Brazilians.

Mariana Filgueiras, a professor at the school of communication at the Federal University of Rio de Janeiro, said she decided to participate in anti-government protests to help put a face on the rising opposition. A recent public opinion poll, by Datafolha, found that Mr. Bolsonaro’s support slipped to 24 percent in May from 30 percent in March. 

“We need to show that for every thousand people on motorcycles who are in favor of the government, there are thousands of people walking peacefully in the streets against it,” Ms. Filgueiras said. “The government is more dangerous than the virus.” 

The recent street demonstrations, which have been largely orderly, are a far cry from the huge protests that shook Brazil in 2013 and 2015, fueling the successful effort to impeach President Dilma Rousseff in 2016. 

But political analysts said they could signal a new phase of political instability as a deeply polarized electorate starts gearing up for next year’s presidential election.

COVID-19 in Brazil: 30,434 new cases, 860 deaths today

A screenshot from the CONASS PANEL | COVID-19 dashboard:

The numbers may reflect a weekend undercount, but they're still encouraging.

WHO, at heart of world's sluggish COVID response, could face shake-up

Via Reuters: WHO, at heart of world's sluggish COVID response, could face shake-up. Excerpt:

The World Health Organization, at the heart of the world's sluggish handling of the COVID-19 pandemic, faces a potential shake-up to prevent future outbreaks as a top official warned that "the pathogens have the upper hand". 

Health ministers agreed on Monday to study recommendations for ambitious reforms made by independent experts to strengthen the capacity of both the U.N. agency and countries to contain new viruses. 

Under the resolution submitted by the European Union, and adopted by consensus, member states are to be firmly in the driver's seat of the reforms through a year-long process. 

The new virus has infected more than 170 million people and killed nearly 3.7 million, according to a Reuters tally of official national figures. 

Health ministers from WHO's 194 member states will also meet from Nov. 29 to decide whether to launch negotiations on an international treaty aimed at boosting defences against any future pandemic. 

WHO's emergencies director, Mike Ryan, welcomed the decisions, telling its annual ministerial assembly: "Right now the pathogens have the upper hand, they are emerging more frequently and often silently in a planet that is out of balance. 

"We need to turn that very thing that has exposed us in this pandemic, our interconnectedness, we need to turn that into a strength," he said. The decisions were adopted in a plenary session on Monday at the end of its week-long assembly. 

"A pandemic treaty under the roof of the WHO is the preferred way forward to strengthen the multilateral health architecture including the IHR (International Health Regulations) and to heed the call by so many experts to reset the system," Chile's ambassador Frank Tressler Zamorano said on behalf of 60 countries. 

One panel, headed by former New Zealand Prime Minister Helen Clark and Ellen Johnson Sirleaf, a former president of Liberia, said that a new global system should be set up to respond faster to disease outbreaks to help ensure no future virus causes a pandemic as devastating as COVID-19.

The experts, who found crucial failures in the global response in early 2020, said that the WHO should be given the power to send investigators swiftly to chase down new disease outbreaks and to publish their full findings without delay. 

They also called for setting up a Global Health Threats Council to maintain high-level political commitment to pandemic preparedness. 

"The world was hit by this virus unprepared. And if another virus emerged tomorrow this would be still be the case," Björn Kümmel, of Germany's federal health ministry, said last week. 

"A green light for this treaty process is the greatest commitment to learn from this crisis that this Assembly could have sent out. It is the most effective way to make sure that the global health crisis becomes the final one."

Vietnam: Social distancing returns to Ho Chi Minh City

From Mike Tatarski's excellent Vietnam Weekly: Social Distancing Returns to Ho Chi Minh City. Excerpt:

Government officials have generally avoided the term ‘lockdown’ throughout the pandemic, but just about the next closest thing came into force in HCMC at midnight. 

City-wide social distancing measures are now in place for two weeks. This policy is called Directive 15, and it “requires suspension of social events, bans gatherings of 20 people or more in one place and of 10 people or more outside workplaces, schools and hospitals. A minimum distance of two meters between people in public places should be ensured.” 

Non-essential businesses are also closed, and the streets this morning were certainly quieter than normal, though not exactly dead. 

Densely populated Go Vap District, as well as one ward in District 12, have been placed under Directive 16, which restricts gatherings to two people and asks residents only to leave home for essential work or to buy food or medicine. That covers almost 720,000 people - and this announcement sent thousands of people rushing to supermarkets, though officials had asked residents not to panic buy. Those areas have recorded numerous COVID-19 cases linked to the Revival Ekklesia Mission over the last week. 

Overall, the city has recorded 157 cases, almost entirely traced to that cluster, and the group is now facing a criminal investigation for not complying with pandemic prevention measures. 

This is the first time such steps have been taken in HCMC since April of 2020, which gives you a sense of how serious the situation is. 

Thankfully, massive testing is going on, with 50,000 samples taken in one ward of Go Vap alone on Friday night. To my knowledge, this is the first time an entire city ward has been tested, and more cases are certainly expected in the coming days. 

 City officials said last night that they plan to test all residents of areas where members of the Revival Ekklesia Mission lived, with the goal of taking 100,000 samples per day - an effort that could expand to the entire city. (Last night VnExpress had a headline about testing the whole population of 13 million, but that has vanished. It would take 130 days to test everyone at a rate of 100,000 per day.) 

The other big news from the weekend is the Ministry of Health’s announcement that genetic sequencing on current COVID-19 patients found a new, highly transmissible (their words) variant of the virus with characteristics of both the previously known Indian and UK variants. 

This was quickly picked up internationally, and has probably freaked people out, though experts I’ve spoken to advised against overreacting until more research is done on the clinical impact of this variant. 

Nationally, the outbreak remains serious: 34 provinces and cities have now been detected at least one case (over half of Vietnam’s localities), while this wave has accounted for 4,096 cases (up from 3,295 on Friday) and 12 deaths, including the country’s youngest virus-related fatality yet. The total pandemic case total is now 7,107, with a death toll of 47.

COVID-19 on Sunday afternoon: 170,169,065 cases, 3,535,944 deaths

A screenshot from the Johns Hopkins Coronavirus COVID-19 (2019-nCoV) dashboard:

It's some consolation that case numbers on May 29 were down to 499,934 and deaths were down to 10,502. But only if you're normalized to the counts of April 28: 905,922 cases and and 15,729 deaths.

Death bed denials, pandemic 'hoax' accusations common in southern Manitoba hospital patients, doctor says

Via CBC News: Death bed denials, pandemic 'hoax' accusations common in southern Manitoba hospital patients, doctor says. Excerpt:

A southern Manitoba hospital physician says staff are exhausted by a recent crush of admissions, but they're also up against something else that's draining energy and morale. 

Staff at Boundary Trails Health Centre are routinely hearing from sick and unvaccinated patients who believe the pandemic is a hoax — some remaining defiant even on the brink of death. 

"We hear this almost every day, and I know that's startling," said Dr. Ganesan Abbu. "It's difficult ... to know that almost 100 per cent of our admissions have not been vaccinated." 

Abbu is an anesthetist and special care unit doctor at Boundary Trails, located over 100 kilometres southwest of Winnipeg and between Morden and Winkler. 

The district surrounding the two small cities has the lowest vaccination rate in the province, according to provincial data. 

More and more patients have flowed in during the past two weeks amid Manitoba's third wave. Abbu says he and many coworkers are waking up before dawn to start work lately just to keep up. 

The hospital has converted two of its medicine and surgery units into COVID-19 areas, he said. The hospital also experienced an oxygen shortage over the weekend based on the increasing number of COVID-19 patients being put on ventilators. 

Boundary Trails nurses and the lone respiratory therapist in the hospital have shouldered the heaviest workload burden, said Abbu. 

Staff are also being confronted with something beyond the painstaking hours caring for more people than usual. 

"I think nurses have found it difficult to handle a community, certain segments of the community, who believe that this is a hoax, that the virus doesn't exist, and other untruths, like the vaccine is going to put a chip into each one of us who's been vaccinated and people will be able to track us," he said.  

"It flies in the face of the efforts of nurses and health-care staff who are really extending themselves to help the community in need." 

Some staff are having to deal with family members who are frustrated they can't see their loved ones in hospital or believe they died of something other than COVID-19. 

It's not uncommon for people to flout rules and enter the hospital without a mask on either, he said.

"They say, you know, it's a hoax," he said. "We hear this all the time." 

Abbu has personally experienced patients who, even nearing death, remained in denial and continued to assert untruths about the pandemic. 

"I've had two patients who have died and even right until the time that they died, they didn't believe that they had it," Abbu said.  

"It's not as though we are trying to get the patient to acknowledge that they have COVID before they die. These patients are so much in denial, they are volunteering this information." 

Abbu said one patient who didn't believe they had COVID-19 went home and later died. The family of another patient who died didn't believe it was due to COVID-19 and asked if they could have an autopsy to confirm, he said.

COVID-19: More intense virus circulation has driven peaks of cases and P.1 in Amazonas

Via Fiocruz: COVID-19: more intense virus circulation has driven peaks of cases and P.1 in Amazonas. Excerpt:

In a paper published (5/25) in Nature Medicine, researchers of the Fiocruz Genomic Network and of partner institutions point to the cause of the increase in the number of COVID-19 cases in the state of Amazonas and of the successive replacements of lineages of Sars-CoV-2. The study shows that these factors have been boosted by a combination of reduced social distancing measures and the appearance of a new, more transmissible form of the virus, the P.1 variation, identified in mid-November 2020. This variant has caused an exponential increase in case numbers, thus establishing a second wave of the epidemic in the state. 

“We have a history of respiratory viral diseases following a different calendar here in Amazonas: our peaks normally take place before other states. The new, more infectious variant appeared in a period of less social distancing. P.1 was the consequence of virus circulation and it later caused the collapse of the public health system in Amazonas”, explains Felipe Naveca, researcher and vice-director of Research and Innovation of the Leônidas & Maria Deane Institute (ILMD/Fiocruz Amazônia). 

The state of Amazonas has been through two waves of disease increase, the first at the beginning and the second at the end of 2020. For the genomic epidemiology study published on Nature, 250 sequences of the complete genome of Sars-CoV-2 were generated, all of high quality, from individuals of 25 municipalities, between 16 March 2020 and 13 January 2021. 

 The result reveals that the first increase in COVID-19 cases between March and May) was boosted mainly by the dissemination of the B.1.195 lineage, then replaced by B.1.1.28 between May and June 2020. The situation remained stable between June and November, with small variations. The second phase took place in mid-December 2020 with the emergence of the P.1 variant and the consequent explosion in the number of cases. 

For Felipe Naveca, the fact that P.1 hit young people as often as it affected older people may be related to more exposure by the first, be it for work-related issues or due to less social distancing by choice. “They got exposed when they went back to work as much as they did for social reasons. It appears that this was terrible in a context of circulation of an even more infectious variant”, he comments. 

According to the researchers, the variant of concern, P.1, contains 21 lineage-defining mutations, including ten in the spike protein (L18F, T20N, P26S, D138Y, R190S, K417T, E484K, N501Y, H655Y, and T1027I). It was first announced on January 10 this year, after a study on four people who had returned to Japan after going through the state of Amazonas. The variant was therefore acknowledged as a lineage that emerged in the state capital, Manaus.

Vietnam reports 52 more domestic COVID-19 infection cases

It's already Sunday morning in Vietnam, and it's not going well. The country's case count has doubled in a month. Via VietnamPlus: Vietnam reports 52 more domestic COVID-19 infection cases.

Hanoi (VNA) – Vietnam recorded an additional 52 new domestically-transmitted COVID-19 cases in the past 12 hours to 6am on May 30, according to the Ministry of Health (MoH). 

Of the new infections, 35 were detected in Bac Giang province – the country’s current largest pandemic hotpots, 10 in Ho Chi Minh City, six in Bac Ninh and one in Hai Phong. 

The nation has to date confirmed 6,908 infections, including 5,406 domestically-transmitted cases, of which 3,836 have been found since the fourth wave of outbreaks hit Vietnam since April 27. 

The MoH’s Medical Service Administration said 2,896 patients have fully recovered from the disease while the death toll related to COVID-19 now stands at 47. 

Among active patients undergoing treatment at medical establishments, 112 have tested negative to coronavirus SARS-CoV-2 once, 41 twice and 70 thrice. 

The MoH called on citizens to follow the 5K message, including khau trang (facemask), khu khuan (disinfection), khoang cach (distance), khong tu tap (no gathering), and khai bao y te (health declaration).

COVID-19 in Brazil: 79,670 new cases, 2,012 deaths today

A screenshot from the CONASS PANEL | COVID-19 dashboard:

We've now concluded epi-week 21. In that week 424,161 cases were reported, making this the 13th consecutive week over 400,000 cases. Deaths totalled 12,849—the 13th consecutive week when Brazil recorded over 10,000 deaths.

Experts sound the alarm ahead of Brazil’s third COVID-19 wave

Via The Globe and Mail: Experts sound the alarm ahead of Brazil’s third COVID-19 wave. Excerpt:

Weeks after Brazil experienced the COVID-19 pandemic’s deadliest month with 82,266 deaths recorded in April, medical experts in the country are already warning about a third wave. 

Over the first few months of 2021, a punishing second wave – partly from the P.1 variant first identified in the city of Manaus – battered Brazil. Facing overwhelmed hospitals as well as oxygen and sedative shortages, the most populous country in Latin America saw April’s death toll surpass March’s record of 66,573 fatalities. But just as some states started to reduce public-health restrictions after daily infections and deaths declined since mid-April, COVID-19 cases are once again rising. 

As of May 27, Brazil has confirmed more than 16.3 million cases and more than 456,000 deaths – the world’s second-highest death toll after the U.S. – since the beginning of the pandemic. 

For Antonio Flores, an infectious disease specialist and medical co-ordinator for Médecins sans frontières (MSF) in Brazil, the upward trend signals the impending arrival of a third wave. He added that some municipalities are already seeing waitlists for intensive-care beds. 

“There will be a third wave,” he said. “We just don’t know how hard and how fast it will hit, but we can say that it’s on the way because cases are going up again.” 

There is already fear that this third wave would be devastating. On top of the fact that Brazil is entering its winter months, a big concern revolves around its sluggish vaccine rollout, which started on Jan. 18. In a country of around 214 million people, the campaign has given out 65.27 million doses – with 20.6 per cent of the population receiving at least one dose and 10.1 per cent being fully vaccinated – as of May 27. The daily vaccination rate for most of May was also lower than the peak in mid-April, only surpassing it on May 24. 

This slow pace frustrates Dr. Flores. He said Brazil has the expertise and infrastructure through its national immunization program to do better. In fact, during the swine flu pandemic, it administered more than 89 million vaccine doses in less than four months in 2010. 

He attributed the problem instead to the federal government’s lack of co-ordination.