H5N1

High and rising working-age mortality in the US: A report from the National Academies of Sciences, Engineering, and Medicine

Via JAMA Network: High and Rising Working-Age Mortality in the US: A Report From the National Academies of Sciences, Engineering, and Medicine. Excerpt:

Life expectancy has increased in the US and in the world for the past century. In 2010, life expectancy plateaued in the US while continuing to increase in other high-income nations. In the US, life expectancy declined for 3 consecutive years (2015-2017) due primarily to an increase in mortality among working-age adults (those aged 25-64 years). Although the increase in mortality was first described among White middle-aged adults, mortality is now increasing among young and middle-aged adults and in all racial groups. 

This increase in premature death, claiming lives during the prime working ages, has important implications for individuals, families, communities, employers, and the nation. 

A new report from a National Academies of Sciences, Engineering, and Medicine committee studied mortality data from 1990 to 2017 by cause of death, age, sex, race/ethnicity, socioeconomic status, and geography. It found that average working-age mortality rates decreased after 2010 in 16 high-income countries but increased in the US. 

Three causes of death were identified as chiefly responsible: (1) drug poisoning and alcohol-induced causes, (2) suicide, and (3) cardiometabolic diseases. The first category includes mortality from mental and behavioral disorders, which often involve drugs or alcohol. Cardiometabolic diseases include endocrine, nutritional, and metabolic diseases (eg, diabetes, obesity); hypertensive heart disease; and ischemic heart disease and other diseases of the circulatory system (eg, arrhythmia, cardiomyopathy, heart failure). 

Mortality among working-age adults increased from other causes (eg, liver cancer, neurological diseases, homicides, transportation injuries), but none individually made large contributions to the overall trend.

Oxygen shortages threaten ‘total collapse’ of dozens of health systems

Via The Guardian: Oxygen shortages threaten ‘total collapse’ of dozens of health systems. Excerpt:

Dozens of countries are facing severe oxygen shortages because of surging Covid-19 cases, threatening the “total collapse” of health systems. 

The Bureau of Investigative Journalism analysed data provided by the Every Breath Counts Coalition, the NGO Path and the Clinton Health Access Initiative (CHAI) to find the countries most at risk of running out of oxygen. It also studied data on global vaccination rates. 

Nineteen countries around the world – including India, Argentina, Iran, Nepal, the Philippines, Malaysia, Pakistan, Argentina, Costa Rica, Ecuador and South Africa – are deemed most at risk after recording huge increases in demand since March – at least a 20% rise – while having vaccinated less than 20% of their populations.

There are concerns that other Asian countries like Laos are at risk, and African countries including Nigeria, Ethiopia, Malawi and Zimbabwe, which have less mature oxygen delivery systems, meaning a small increase in need could create big problems. 

Many of these countries faced oxygen shortages before the pandemic, said Leith Greenslade, coordinator of the Every Breath Counts Coalition. The extra need is pushing health systems to the brink. 

“The situation last year, and again in January this year in Brazil and Peru, should have been the wake up call,” she said. “But the world did not wake up. We should have known India would happen after seeing what happened in Latin America. And now looking at Asia, we should know this will happen in some of the big cities in Africa.” 

 Robert Matiru, who chairs the Covid-19 Oxygen Emergency Taskforce, told the bureau: “We could see the total collapse of health systems, especially in countries with very fragile systems.” 

 Hospitals in India have reported significant shortages of oxygen as the country battles its second wave. By the middle of May, India needed an extra 15.5m cubic metres of oxygen a day just for Covid-19 patients, more than 14 times what it needed in March, according to the bureau’s analysis. 

In response, India has banned all exports of liquid and cylinder oxygen. 

But experts are worried about India’s neighbours – Pakistan, Nepal, Bangladesh, Sri Lanka and Myanmar – some of which rely on Indian-made oxygen and equipment. 

“You’d imagine if they start to see peaks of the same degree, then it could be even worse, because India needs all the supply,” said Zachary Katz, vice-president of essential medicines at CHAI. 

The bureau’s data shows that Nepal now needs more than 100 times as much oxygen as it did in March. 

Demand for oxygen in Sri Lanka has risen sevenfold since mid-March. In Pakistan, which is suffering its third wave of cases, almost 60% more patients are on oxygen in hospital than during the country’s previous peak last summer, according to a government minister, who warned in late April that pressure on the oxygen supply was reaching dangerous levels.

“The mood is extremely grim,” says Dr Fyezah Jehan, a doctor in Karachi. “I think we are very scared of an India-like situation. We’re hoping that some magic happens, and this [current] lockdown can prevent a new onslaught of cases.”

COVID-19 in Brazil: 37,498 new cases, 790 deaths today

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

And some perspective from Our World in Data: The rolling 7-day average for cases is stuck around 65,000, while the death count is stuck just under 2,000.

Air pollution impacts of COVID-19–related containment measures

Via Science Advances: Air pollution impacts of COVID-19–related containment measures. The abstract: 

Responses to the COVID-19 outbreak resulted in one of the largest short-term decreases in anthropogenic emissions in modern history. To date, there has been no comprehensive assessment of the impact of lockdowns on air quality and human health. 

Using global satellite observations and ground measurements from 36 countries in Europe, North America, and East Asia, we find that lockdowns led to reductions in NO2 concentrations globally, resulting in ~32,000 avoided premature mortalities, including ~21,000 in China. However, we do not find corresponding reductions in PM2.5 and ozone globally. 

Using satellite measurements, we show that the disconnect between NO2 and ozone changes stems from local chemical regimes. The COVID-related lockdowns demonstrate the need for targeted air quality policies to reduce the global burden of air pollution, especially related to secondary pollutants.

No one's safe anymore: Japan's Osaka city crumples under COVID-19 onslaught

Via Reuters, an alarming report: No one's safe anymore: Japan's Osaka city crumples under COVID-19 onslaught. Excerpt:

Hospitals in Japan's second largest city of Osaka are buckling under a huge wave of new coronavirus infections, running out of beds and ventilators as exhausted doctors warn of a "system collapse", and advise against holding the Olympics this summer. 

Japan's western region home to 9 million people is suffering the brunt of the fourth wave of the pandemic, accounting for a third of the nation's death toll in May, although it constitutes just 7% of its population. 

The speed at which Osaka's healthcare system was overwhelmed underscores the challenges of hosting a major global sports event in two months' time, particularly as only about half of Japan's medical staff have completed inoculations. 

"Simply put, this is a collapse of the medical system," said Yuji Tohda, the director of Kindai University Hospital in Osaka. 

"The highly infectious British variant and slipping alertness have led to this explosive growth in the number of patients." 

Japan has avoided the large infections suffered by other nations, but the fourth pandemic wave took Osaka prefecture by storm, with 3,849 new positive tests in the week to Thursday. 

 That represents a more than fivefold jump over the corresponding period three months ago. 

Just 14% of the prefecture's 13,770 COVID-19 patients have been hospitalised, leaving the majority to fend for themselves. Tokyo's latest hospitalisation rate, in comparison, is 37%. 

A government advisory panel sees rates of less than 25% as a trigger to consider imposition of a state of emergency. 

By Thursday, 96% of the 348 hospital beds Osaka reserves for serious virus cases were in use. Since March, 17 people have died from the disease outside the prefecture's hospitals, officials said this month. 

The variant can make even young people very sick quickly, and once seriously ill, patients find it tough to make a recovery, said Toshiaki Minami, director of the Osaka Medical and Pharmaceutical University Hospital (OMPUH). 

"I believe that until now many young people thought they were invincible. But that can't be the case this time around. Everyone is equally bearing the risk." 

BREAKING POINT 

Minami said a supplier recently told him that stocks of propofol, a key drug used to sedate intubated patients, are running very low, while Tohda's hospital is running short of the ventilators vital for severely ill COVID-19 patients. 

Caring for critically ill patients in the face of infection risk has taken a serious toll on staff, said Satsuki Nakayama, the head of the nursing department at OMPUH. 

"I've got some intensive care unit (ICU) staff saying they have reached a breaking point," she added. "I need to think of personnel change to bring in people from other hospital wings." 

About 500 doctors and 950 nurses work at OMPUH, which manages 832 beds. Ten of its 16 ICU beds have been dedicated to virus patients. Twenty of the roughly 140 serious patients taken in by the hospital died in the ICU.

COVID-19 detection dogs score 92% on detecting smell of the disease

A news release from Medical Detection Dogs in the UK: COVID-19—the nose knows. Excerpt:

The results of the first phase of our study to investigate whether COVID-19 has a unique odour dogs can be trained to detect have been submitted for publication and we’re delighted to announce that our dogs detected the smell of the disease with high levels of accuracy.  

Six of our elite team of trained Bio Detection Dogs were taken through to double-blind testing, with the best performing giving a sensitivity of up to 94.3% and specificity of up to 92%, meaning they can reliably identify when people do and don’t have the disease. 

Asher, Kyp, Lexi, Marlow, Millie and Tala sniffed samples on a stands system that required a ‘yes/no’ decision on each sample. When they found the odour of COVID-19, they made clear indications to their handlers such as a sit, nudge or stare. If they didn’t detect the odour on what is known as a ‘blank run,’ with samples from non-Covid individuals, they walked past without indicating. Each time they the dogs made the correct decision they received a food reward or game of ball depending on their preference. 

Over 3,750 people across the UK, including NHS staff, donated odour samples for this study, by wearing socks, face masks and shirts which were processed by the research team and used for training and testing the dogs. The sample size and modelling make this the most robust and in-depth trial of its kind around the world. 

MDD Chief Scientific Officer and the Principal Investigator on the trial, Claire Guest, says: “We are so proud of our dogs for so accurately detecting the odour of COVID19  from a small piece of sock worn by an individual several weeks ago. The dogs indicated that COVID-19 does indeed have a detectable odour that dogs could be  trained to reliably detect. 

“To correctly identify the odour over 94% of the time and know when there was no disease present in over 90% of cases is remarkable. 

“It proves the positive impact dogs, with their rapid turn-around time, could have for mass screening alongside a confirmatory PCR test as we continue to battle the pandemic. We believe that their noses could provide a strong line of defence against future pandemics.” 

These exciting results mean we have now moved to the next phase of the trial, which will see dogs trained to work in public settings. 

Our results indicate  that dogs perform better than the Lateral Flow Test which has a sensitivity of between 58-77%. Using dogs will also be considerably faster than existing testing methods since one dog can screen up to 250 people in 1 hour.

COVID-19 in Brazil: 35,819 new cases, 860 deaths today

Brazil's case total is now 16,083,258. Deaths are 449,068.  A screenshot from the CONASS PANEL | COVID-19 dashboard:

These are relatively low numbers, but the weekly case and death counts are less encouraging: Cases actually rose in epi-week 20 (which ended yesterday) to 460,905. And weekly deaths are very slightly higher in week 20 (13,493) than in week 19 (13,399): 

How India's Kerala has battled Covid-19

Via The New York Times: How India's Kerala Has Battled Covid-19. Excerpt:

When India’s second coronavirus wave slammed the country last month, leaving many cities without enough doctors, nurses, hospital beds or lifesaving oxygen to cope, Sajeev V.B. got the help he needed. 

Local health workers quarantined Mr. Sajeev, a 52-year-old mechanic, at home and connected him with a doctor over the phone. When he grew sicker, they mustered an ambulance that took him to a public hospital with an available bed. Oxygen was plentiful. He left 12 days later and was not billed for his treatment. 

“I have no clue how the system works,” Mr. Sajeev said. “All that I did was to inform my local health worker when I tested positive. They took over everything from that point.”

Mr. Sajeev’s experience had much to do with where he lives: a suburb of Kochi, a city in the southern Indian state of Kerala. Kerala officials have stepped in where India’s central government under Prime Minister Narendra Modi has failed, in many ways, to provide relief for victims of the world’s worst coronavirus outbreak.

Though supplies have tightened, Kerala’s hospitals enjoy access to oxygen, with officials having expanded production months ago. Coordination centers, called war rooms, direct patients and resources. Doctors there talk people at home through their illness. Kerala’s leaders work closely with on-the-ground health care workers to watch local cases and deliver medicine. 

“Kerala stands out as an exceptional case study when it comes to proactive pandemic response,” said Dr. Giridhar Babu, an epidemiologist at the Public Health Foundation of India, which is based in the northern city of Gurugram. He added that “their approach is very humane.”

Nyiragongo volcano: The situation is increasingly stabilizing

Via Radio Okapi: Nyiragongo volcano: the situation is increasingly stabilizing. The Google translation:

The lava flow from the Nyiragongo volcano stopped 1.5 km from Goma airport on Sunday, May 23. The lava fire has also diminished considerably. The situation is stabilizing more and more, assured the scientific director of the Volcanological Observatory of Goma (OVG), Kasereka Mahinda, speaking in a special program on the local RTNC at 5:00 am. 

 Goma is safe unless there is another explosion along the cracks. The lava flow is already starting to cool down at Buhené. 

 However, there is some lateral expansion of the lava flow in the built-up area in front of the airport. 

Earthquakes also continue, which implies the need for sustained vigilance. 

They walked all night ... 

The inhabitants of Goma, who had fled to Rwanda, are beginning to gradually return to their neighborhoods for some. They were around five thousand who managed to cross the night after 9 pm to Gisenyi in Rwanda from two border posts including the large and small barrier, according to the authorities of this country. These two posts were opened later after thousands of Goma residents gathered at the border demanding to cross.  

In Goma, a large part of the population spent the night under the stars, in front of the shops, arteries for those who could not reach Sake or cross the border into Rwanda. Others walked all night with the children to seek shelter in the more or less secure neighborhoods west of the city. We could also observe the wires of the tanker trucks which evacuated fuel from the service stations located north and downtown to the western districts. 

In addition, several shots rang out at night towards the Virunga district precisely at the central prison of Munzenze, where the detainees were demonstrating to demand their evacuation. 

At 7 p.m. local time on Saturday, the Nyiragongo volcano erupted, the military governor of North Kivu confirmed on RTNC. 

From the first minutes of this volcano eruption, a MONUSCO helicopter was launched in reconnaissance on the volcanic site. The device did confirm that the eruption activity emanated from Mount Nyiragongo. As a result, the city of Goma and its surroundings are safe.  

In a brief message, Lieutenant General Constant Ndima called on the population for calm and to follow the guidelines of the civil protection services and the police according to the contingency plan in force. 

The last volcanic eruption in Nyiragongo was on January 17, 2002. More than 100 people were killed. Lava had flowed until it reached a large part of the city of Goma and the airport. An eruption occurred in 1997, killing more than 600 people.

COVID-19 in Brazil: 76,490 new cases, 1,899 deaths today

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

The case numbers seem to have settled in the 70,000 range, but the deaths are dropping below 2,000—a small consolation.