H5N1

UK almost ‘flying blind’ on Covid this autumn, experts say

Via The Guardian: UK almost ‘flying blind’ on Covid this autumn, experts say. Excerpt:

The UK is nearly “flying blind” when it comes to Covid this autumn, experts have said, amid an increase in cases.  

While the UK Health Security Agency (UKHSA) continues to track some metrics of Covid, including hospitalisation numbers, many of the community surveillance studies tracking infection levels have finished.  

Now experts have said the situation is leaving the country in the dark about how Covid may play out in the months ahead.  

Christina Pagel, a professor of operational research at University College London, said a new wave of Covid appeared to be under way – possibly driven by waning immunity, new variants of Omicron, and factors including poor weather keeping people inside.  

With the autumn coming on and people returning to school and work, Covid pressures may increase, Pagel added.  

“We might see the wave continue to grow, and grow faster, in September,” she said.  

As well as public health measures including reintroducing high-quality masks within healthcare settings, Pagel said she would support bringing back the nationwide infection survey published by the Office for National Statistics for autumn and winter, as well as expanding it to cover flu and RSV.  

Failing that, she said, wastewater monitoring should be reinstated across the UK as a cheaper alternative that is used in many countries to track Covid prevalence and variants. Such schemes have recently been cut in England and Wales.  

“What worries me most is if we get a repeat of the last winter NHS crisis this winter again, with Covid, flu and RSV all hitting around the same time,” said Pagel. “We are definitely flying near blind.”  

Prof Rowland Kao, an epidemiologist at the University of Edinburgh, also highlighted the decline in surveillance.  

“With seasonal flu, we have of course a certain amount of predictability with the many years of data. However, with Covid, now that we don’t have those multiple data streams to rely on, it’s harder to say what is happening [in the general population],” he said.  

Kao added that the variant emergence patterns for Covid were largely unknown and Covid was not simply following seasonal patterns.

WHO: Weekly epidemiological update on COVID-19 - 3 August 2023

Via WHO: Weekly epidemiological update on COVID-19 - 3 August 2023. Click or tap through to download the full report. The overview:

Globally, over one million new COVID-19 cases and over 3100 deaths were reported in the last 28 days (3 to 30 July 2023). While five WHO regions have reported decreases in the number of both cases and deaths, the Western Pacific Region has reported an increase in the number of cases and a decrease in the number of deaths. 

As of 30 July 2023, over 768 million confirmed cases and over 6.9 million deaths have been reported globally. Currently, reported cases do not accurately represent infection rates due to the reduction in testing and reporting globally. During this 28-day period, 46% (107 of 234) of countries and territories reported at least one case to WHO – a proportion that has been declining since mid-2022.

Eurosurveillance: Highly pathogenic avian influenza A(H5N1) virus infection on multiple fur farms in the South and Central Ostrobothnia regions of Finland, July 2023

Via Eurosurveillance, a report on the explosive spread of H5N1 in Finland: Highly pathogenic avian influenza A(H5N1) virus infection on multiple fur farms in the South and Central Ostrobothnia regions of Finland, July 2023. The introduction:

Highly pathogenic avian influenza (HPAI) A(H5N1) virus belonging to clade 2.3.4.4b has since the end of April 2023 caused widespread outbreaks in wild and domestic birds in 25 countries in Europe. In wild birds, black-headed gulls have been heavily affected, with mass deaths observed in many places, including in Finland. 

First reported on 14 July, an outbreak of avian influenza among farmed foxes, minks and raccoon dogs occurred in the regions of South and Central Ostrobothnia and is still ongoing. Up to 27 July, animals on 20 farms have been affected. Here, we provide an initial description of the outbreak and control measures taken, and discuss the source, potential reasons for and consequences of the outbreak.

CIHI releases inaugural report exploring priority health care topics in Canada

A news release from the Canadian Institute for Health Information: CIHI releases inaugural report exploring priority health care topics in Canada. Excerpt:

August 2, 2023 —  The Canadian Institute for Health Information (CIHI) has released its inaugural report on priority health care topics, Taking the pulse: A snapshot of Canadian health care, 2023. This report is the first of what will be an annual series — the result of a formal commitment made in early 2023 by the Government of Canada and the provincial and territorial governments to improve health care in Canada in shared priority areas.   

As part of that commitment, governments agreed to work with CIHI to collect, share and learn from health information, with CIHI reporting to Canadians on the priority areas each year. Quebec is not participating in the joint reporting exercise.     

Taking the pulse: A snapshot of Canadian health care, 2023 offers Canadians an initial overview of where we are today in the 4 priority areas:  

• Expanding family health services and improving access to primary health care  

• Increasing the supply of health workers and decreasing backlogs in care to support resilient health systems  Improving access to mental health and substance use services   

• Modernizing health care’s information systems and digital tools for the secure sharing of electronic health information  

The indicator results (none of which include data from Quebec) are based on publicly available data stemming from a partnership between Canada Health Infoway, integrated youth services networks, Statistics Canada and CIHI.  

Selected indicator highlights include the following:  

• 88% of Canadians age 12 and older reported having a regular health care provider.  

• There were about 743,000 fewer surgeries performed in Canada during the first 2.5 years of the pandemic, a drop of about 13% compared with before the pandemic.  

• Half of Canadians who required community mental health counselling received a first appointment in less than a month, while 1 in 10 waited about 4 months (data is not available for Prince Edward Island, Quebec, Ontario and Nunavut).  

• Fewer than 40% of Canadians have accessed their personal health information online.

Outcomes and characteristics of patients hospitalized for COVID-19 in British Columbia, Ontario and Quebec during the Omicron wave

Thanks to FluTrackers for alerting me to this report in CMAJ Open: Outcomes and characteristics of patients hospitalized for COVID-19 in British Columbia, Ontario and Quebec during the Omicron wave. The abstract:

Background: Omicron is the current predominant variant of concern of SARS-CoV-2. We hypothesized that vaccination alters outcomes of patients hospitalized with COVID-19 during the Omicron wave and that these patients have different characteristics and outcomes than in previous waves. 

Methods: This is a substudy of the Host Response Mediators in Coronavirus (COVID-19) Infection (ARBs CORONA I) trial, which included adults admitted to hospital with acute COVID-19 up to July 2022 from 9 hospitals in British Columbia, Ontario and Quebec. We excluded emergency department visits without hospital admission, readmissions and admissions for another reason. Using adjusted regression analysis, we compared mortality and organ dysfunction between vaccinated (≥ 2 doses) and unvaccinated patients during the Omicron wave, as well as between all patients in the Omicron and first 3 waves of the COVID-19 pandemic.  

Results: During the Omicron wave, 28-day mortality was significantly lower in vaccinated (n = 19/237) than unvaccinated hospitalized patients (n = 12/127) (adjusted odds ratio [OR] 0.36, 95% confidence interval [CI] 0.15–0.89); vaccinated patients had lower risk of admission to the intensive care unit, invasive ventilation and acute respiratory distress syndrome and shorter hospital length of stay. Patients hospitalized during the Omicron wave had more comorbidities than in previous waves, and lower 28-day mortality than in waves 1 and 2 (adjusted OR 0.38, 95% CI 0.24–0.59; and 0.42, 95% CI 0.26–0.65) but not wave 3 (adjusted OR 0.81, 95% CI 0.43–1.51) and had less organ dysfunction than in the first 2 waves.  

Interpretation: Patients who were at least double vaccinated had lower mortality than unvaccinated patients hospitalized during the Omicron wave. Patients hospitalized during the Omicron wave had more chronic disease and lower mortality than in the first 2 waves, but not wave 3. Changes in vaccination, treatments and predominant SARS-CoV-2 variant may have decreased mortality in patients hospitalized during the Omicron wave.

The Finnish Food Authority is ordering all minks to be put down at fur farms with diagnosed avian influenza infections

Via the Finnish Food Authority: The Finnish Food Authority is ordering all minks to be put down at fur farms with diagnosed avian influenza infections.

The Finnish Food Authority has specified the euthanasia criteria for fur animals infected with avian influenza. The decision states that all minks will be put down at fur farms with diagnosed avian influenza infections. This policy decision on minks by the Finnish Food Authority also takes into account the view of the Finnish Institute for Health and Welfare (THL). The decisions to put down foxes and raccoon dogs will still be made on a case-by-case basis.  

Mink is an especially problematic species when it comes to avian influenza infections. This is due to the fact that minks’ upper respiratory tracts contain receptors that can bind to both avian and human influenza viruses, which makes minks sensitive to infections caused by both types of influenza. Minks can therefore be more effective than other mammals as an intermediate host for avian influenza, enabling the virus to mutate more effectively into a form that will infect humans. To prevent such variants of the virus, it is important to put down all minks at infected fur farms. 

With regard to decisions on putting down foxes and raccoon dogs, the Finnish Food Authority may order all or some of the foxes and raccoon dogs at a fur farm to be put down. This decision is impacted by the extent and intensity of the symptoms of avian influenza at the farm. It is also possible that no immediate euthanasia order will be issued for the animals at a farm if symptoms and increased mortality have stopped at the farm. 

However, the restrictions on fur farms imposed by the Regional State Administrative Agency and the measures to prevent the spread of the disease will remain in force at all the farms where avian influenza has been detected. If some animals at an infected farm have not been ordered to be put down, additional samples will be taken repeatedly from the animals at those farms to monitor the infection situation. Euthanasia decisions may be extended later on the basis of the results.  

Euthanasia order issued for three fur farms  

So far, the Finnish Food Authority has issued euthanasia orders for the animals of three fur farms. Preparations for new euthanasia orders are continuing this week. The Finnish Food Authority is not publishing information on the fur farms that have been issued euthanasia orders.  

Animal owners have the right to claim compensation from state funds for animals put down by an order issued by the Finnish Food Authority. The amount of compensation is still undetermined.  

Avian influenza had been diagnosed at twenty fur farms by the end of July. Samples from four farms are currently being analysed.

Covid-19: Leaked cremation data hint at true scale of China’s death rate

Via The BMJ: Covid-19: Leaked cremation data hint at true scale of China’s death rate. Excerpt:

Cremation figures released and then quickly withdrawn by authorities in China’s Zhejiang province appear to confirm widespread doubts about the government’s official pandemic death count, and lend support to international forecasts which predicted roughly 1.5 million deaths from covid in the weeks after China abandoned its zero covid policy last December.  

In the relatively wealthy and developed eastern province, where more than 99% of all deaths end in cremation, the number of cremations in the first quarter of 2023 was just under 171 000, compared with 99 000 in the first quarter of 2022 and 90 000 in the first quarter of 2021.  

Extrapolated across China, this 72% rise in mortality would translate to about 1.5 million excess deaths in the first quarter of 2023, closely matching predictions of several models developed by epidemiologists.