H5N1

Yemen: In a country stalked by disease, Covid-19 barely registers

Via The Guardian: Yemen: in a country stalked by disease, Covid barely registers. Excerpt:

On a ward in Ataq general hospital, in the dusty central province of Shabwa in Yemen, six-month-old Muna Bassam is lying on her back, eyes closed, her distended belly moving up and down with the labour of breathing.  

In the corridor outside her room, a poster shows before-and-after photos of several children admitted to the ward who have managed to recover from acute malnutrition – still painfully thin, but smiling and alert.  

Muna’s family have already taken her to hospital once before. Worried about being able to pay for her treatment and fuel to return to the village, their prayers for her this time around are even more urgent. 

“My wife and I had 20 children. Eleven of them died,” said the baby’s grandfather, Abdullah. “But that was a long time ago. This should not still be happening today.”

Elsewhere in the overwhelmed hospital, children are suffering with cholera, diphtheria and dengue fever, contagious diseases that have stalked Yemen since the outbreak of war six years ago. For patients and doctors here, in what the UN says is the world’s worst humanitarian crisis, coronavirus barely registers.  

“We don’t have a neurosurgeon. We don’t have a maternity ward. We treat 20 children a month for malnutrition and now we are admitting more and more people severely ill with complications from dengue fever – more than 3,000 cases so far this year. The generator doesn’t always keep the equipment on,” says Dr Ali Nasser Saeed, the hospital director. “Coronavirus is nowhere near our biggest problem.”

3 schools in Fraser Health closing for 2 weeks due to COVID-19

Via CBC News, news from Greater Vancouver: 3 schools in Fraser Health closing for 2 weeks due to COVID-19. Excerpt:

The Fraser Health Authority announced Saturday evening that three schools are closing for two weeks due to COVID-19 cases.  

There have been seven cases at Cambridge Elementary School in Surrey, which Fraser Health has classified as an outbreak.  

Jarvis Elementary School in Delta has seen six cases, while Al-Hidayah School, an independent school in New Westminster, has seen eight. These are being described as clusters.   

In a release, the health authority says it advised Cambridge to close for a two-week period to "break any chains of COVID-19 transmission that may be present at the school."  

The two other schools will close voluntarily for a two-week period, the release said, due to staffing challenges presented by the clusters, meaning students at these schools will transition to remote learning for the two weeks. 

'This closure will cause disruption' 

Jordan Tinney, superintendent for Surrey schools, said in a letter to the families of Cambridge that the cases at the school dated back to mid-October and that an outbreak was declared because the transmission of cases happened on-site and beyond a single cohort. 

He said the school will be closed until Nov. 30.

COVID-19: Rapid virus mutations in some children may complicate search for vaccine

Via the South China Morning Post: Coronavirus: rapid virus mutations in some children may complicate search for vaccine. Excerpt:

The novel coronavirus is capable of rapid mutation in the gut of children, according to a new study by Chinese scientists. 

A Sars-CoV-2 viral strain typically accumulates one or two mutations per month as it spreads from one person to another, according to estimates based on modelling. 

But in the intestines of some children recovering from Covid-19, a “novel mutation” to change the virus’ form or function could occur within a day as they multiplied inside the same carrier, the researchers found. 

“We identified 229 intra-host variants at 182 sites … [They are] reflecting highly dynamic intra-host viral populations,” said the team led by professor Li Mingkun of the Beijing Institute of Genomics at the Chinese Academy of Sciences in a peer-reviewed paper published in the Journal of Genetics and Genomics on Sunday. 

Mutations threaten the many drugs and vaccines under development to fight the pandemic. Around the world, scientists have identified more than 21,000 mutations that have occurred in the ribonucleic acid (RNA) of Sars-CoV-2 virus so far, according to the China National Centre for Bioinformation. 

These mutations were mostly detected in a single strain of the virus isolated from a single person. Some scientists suspected they could be the tip of the iceberg because most of the populations were not sampled. The virus could also mutate to different strains inside the same host, a phenomenon known as intra-host mutation. 

But the scientists had no solid proof. Although some varying strains had been isolated from the same patient, they could be the result of co-infection.  

The evidence was contained in stool samples, according to Li’s team. They collected faecal samples from nine children who were recovering from the disease at the Guangzhou Women and Children’s Medical Centre in China’s southern Guangdong province. 

Compared to oral or nasal swabs, a stool sample contained more viral material, Li and his colleagues found. This is likely because, according to some previous studies, the coronavirus could efficiently invade cells on the surface of human intestines.

Montreal daycare grapples with COVID-19 outbreak

Via Globalnews.ca: Montreal daycare grapples with COVID-19 outbreak. Excerpt:

Enfant des Neiges daycare in In Montreal’s Côte-des-Neiges–Notre-Dame-de-Grâce borough has seen seven educators and two children test positive for COVID-19 since last Monday, but remains open.  

An additional three educators and three age groups are also in preventative isolation. 

Out of around 35 children, only two showed up on Tuesday, leaving the daycare’s director Cathy Bourgeois asking why the child-care service is still open. 

“I find that it does not make sense that public health does not close us,” Bourgeois said. “I understand we are an essential service, but when there is an outbreak things go much faster in the school system.”  

The transmission started on Monday, Oct. 12 when she and another educator tested positive. In emails obtained by Global News, Bourgeois urged parents to keep their kids home if they had symptoms but said children can continue to come to daycare.  

Forced to manage the situation at home while dealing with COVID, she says she pushed public health to close the daycare but to no avail.  

Public health then sent its first correspondence to families which stated “following a public health assessment, your child’s risk of becoming infected is considered low and they can continue to attend child care.” 

This is when one father who chose to remain anonymous, decided to keep his child home. 

“I knew right away this is probably going to become a disaster and I just wanted to make sure my kid stayed away from it,” he said.  

Three days later on Oct. 15, Bourgeois let families know another educator and one child had tested positive.

OECD: COVID-19 disproportionately affects migrants

Via DW: OECD: Coronavirus disproportionately affects migrants. Excerpt:

The coronavirus pandemic has changed the lives of people all over the world, and particularly that of migrants, according to a new report by the Paris-based Organization for Economic Co-operation and Development (OECD).  

Yet it also concludes that it's thanks to migrants that essential services have been provided in OECD member states, despite the restrictions imposed to curb the spread of the virus — particularly in the sectors of health care, retail and in delivery and courier services. Even when borders were closed during the strictest lockdown period various governments, including in Germany, introduced exceptions to allow workers into the country to help with the harvest.

Migrants make up 24% of doctors and 16% of nurses in OECD member states, and have often been on the front line in the fight against the virus. But they've also been disproportionately infected by COVID-19, as they are often in closer contact with contagious people and frequently live in close quarters.  

According to the report, migrants are twice as likely to contract the virus than the rest of the population. A quarter of those who work in the hospitality industry in the EU are originally from non-EU states, a rate that is twice as high as in other economic sectors. People working in this sector often only have temporary contracts, and migrants are usually the first to lose their job during an economic downturn. The report noted that it's still too early to know the full extent of the damage caused by COVID-19, but said migrants living in southern Europe, in Ireland, Sweden, Norway and the US have been particularly badly hit.  

Migrant children hit by school closures 

The children of migrants have also been disadvantaged by school closures in many countries, and the subsequent transition to home schooling and online learning. On average, these children were less likely to have access to a home computer, and were less likely to benefit from parental help with lessons due to language barriers. Children were also often at a disadvantage because of lack of space at home.  

The pandemic has had a dramatic impact on migration in OECD member states, which reportedly decreased by as much as 50% in the first six months of 2020 due to border closures, travel restrictions and a decrease in flight availability. 

The authors of the study don't think the current slowdown will change any time soon, even if the economy picks up again. They predicted that due to weaker labor demand and continued travel restrictions, people will become less mobile. Those who have stopped going to their workplace will continue to work from home in the foreseeable future, if they can, and students will continue to attend online lectures and seminars.  

Measuring equity from the start: Disparities in the health development of US kindergartners

Via Health Affairs: Measuring Equity From The Start: Disparities In The Health Development Of US Kindergartners. The abstract:

Racialized disparities in health and well-being begin early in life and influence lifelong health outcomes. Using the Early Development Instrument—a population-level early childhood health measure—this article examines potential health inequities with regard to neighborhood income and race/ethnicity in a convenience sample of 183,717 kindergartners in ninety-eight US school districts from 2010 to 2017. 

Our findings demonstrate a distinct income-related outcome gradient. Thirty percent of children in the lowest-income neighborhoods were vulnerable in one or more domains of health development, compared with 17 percent of children in higher-income settings. Significantly higher rates of income-related Early Development Instrument vulnerability—defined as children falling below the tenth-percentile cutoff on any Early Development Instrument domain—were demonstrated for Black/African American and Hispanic/Latinx children. 

These findings underscore the utility of the Early Development Instrument as a way for communities to measure child health equity gaps and inform the design, implementation, and performance of multisector place-based child health initiatives. 

More broadly, results indicate that for the US to make significant headway in decreasing lifelong health inequities, it is important to achieve health equity by early childhood.

COVID-19 surge in Northwest Syria as cases multiply by 14 times in one month

Via ReliefWeb, a World Vision report: COVID-19 surge in Northwest Syria as cases multiply by 14 times in one month. Excerpt:

Saturday, 3 October 2020 - COVID-19 case increases in Northwest Syria have reached alarming levels, almost 100 new cases are being reported every single day as 2.7 million people remain displaced in the area. Child focused aid agency World Vision warns that unless the already weakened health system receives immediate international support, the situation will become dramatically worse very quickly. 

“The number of cases have increased by 14 times since last month with over 1,000 positive cases recorded. Children on the move are at a higher risk than ever before. The health system in North West Syria is not capable of dealing with this crisis. We desperately need support to improve testing capacity, preventive equipment and surveillance systems. Without increased international aid Syrian children and their families, who have been forced from their homes and have endured almost ten years of conflict, will suffer even more,” said Johan Mooij, Syria Response Director at World Vision.  

This year alone, 218 children have been killed and another 800 civilians died. Covid-19 is a crisis within a crisis in Northwest Syria. Many health workers, who are already under huge pressure to do their job in a weak health system, are now reportedly testing positive for COVID-19 – putting effective containment and response to the virus at even greater risk.  

“The number of Syrian people infected with this virus began to increase slowly at the beginning of July, but now we are seeing a dramatic surge in positive cases,” said Mr. Mooij. “We are seriously concerned about the dreadful impact this will have on displaced people in the northern part of the country. These people have been displaced for years on end. Profound economic deterioration in Syria makes their situation even more difficult and now the threat of COVID-19 is causing more stress, fear and dependency on external aid,” he added. 

Due to the severe lack of testing capacities in the area and perceived underreporting, aid agencies on the ground fear that the actual number of positive cases is actually much higher. UN reports have stated that people with COVID symptoms have not been seeking treatment, either due to fear of stigmatisation or of catching the virus in the medical facilities. 

“Although they are increasing at an alarming rate, the current official figures do not show the true picture of the severity of this pandemic in Northwest Syria. We believe that the number of confirmed cases will dramatically increase if testing becomes more readily available,” said Mr. Mooji.

Moscow extends school holiday as COVID-19 cases rise

Via Reuters: Moscow extends school holiday as coronavirus cases rise. Excerpt:

MOSCOW (Reuters) - Moscow Mayor Sergei Sobyanin on Tuesday extended an upcoming school holiday by a week to limit the spread of the coronavirus, days after sources told Reuters that the capital’s hospitals had been told to free up hundreds of beds.

COVID-19 infections have been rising across Europe in the weeks since the start of the new academic year and some other countries have also considered extending October school holidays to try to slow the spread. 

The Kremlin said last week it did not plan to impose severe lockdown restrictions despite a growing number of new cases of COVID-19, but Sobyanin advised anyone with chronic health problems or those older than 65 to stay home. 

On Tuesday, Sobyanin said students would be off school from Oct. 5-18, and urged parents to keep their children at home. 

“Today a significant proportion of the sick - who are often asymptomatic - are children,” Sobyanin said on his website. 

“When they come home, they easily transmit the virus to adults and elderly family members who get much more sick.”  

The upsurge in Moscow has escalated since Russia reopened schools on Sept. 1. The number of new daily infections has more than doubled compared to late August.

Why saliva testing for COVID-19 in Canada won't be a panacea for long lineups any time soon

Via CBC News: Why saliva testing for COVID-19 in Canada won't be a panacea for long lineups any time soon. Excerpt:

Canadians in several provinces face long lines for a swab to help diagnose COVID-19 as school and workplaces open. While new testing technologies could help, doctors say they won't be a silver bullet.   

The gold standard swab of the nose or throat can be uncomfortable. In contrast, a key promise of saliva tests is that people could collect saliva themselves so that fewer nurses and other health professionals would be needed at assessment centres, as staffing is one of the factors that can drive up wait times.  

But that ideal won't happen immediately. Currently in Canada, both saliva collection and testing remain a research project that regulators are closely evaluating.   

There are three main barriers to overcome before saliva tests roll out widely.   

Gobs of saliva vary in how fluid they can be, so collecting a high-quality sample can be a challenge even for something as non-invasive as spitting into a cup. The next hurdle for scientists is to get accurate and consistent results on the presence of the virus. Finally, clinicians need to determine how well the test results help them to correctly identify those with the disease.  

Dr. Mel Krajden, medical director of the public health laboratory at the BC Centre for Disease Control, said health professionals face a quandary in finding the best ways to support a return to school, with all of its formative benefits for students, while protecting the oldest people at highest risk for severe consequences from COVID-19, such as grandparents or parents who are vulnerable because they have other health conditions. 

Krajden said in his experience, saliva testing works better with COVID-19 patients in hospital than on people living in the community who've tried it as part of a research project. His Vancouver lab is working on a simpler approach to collection than the traditional nasal swab using a saline gargle that seems to work in older children.  

On Thursday, British Columbia announced it's introducing a new mouth rinse, gargle and spit test for students from kindergarten to Grade 12 to make it easier for children and teenagers to check whether they have COVID-19.  But this new test is only offered to school age kids, and only in B.C. 

"What we need to be thinking through is what is the best mixture of tests and how are they best supplied?" Krajden said. "You want to have the right balance between convenience and sensitivity."

Dr. McCance-Katz, Trump mental health official, accuses media of overblowing dangers of Covid-19

Via CNN: Dr. McCance-Katz, Trump mental health official, accuses media of overblowing dangers of Covid-19. Excerpt:

(CNN)The assistant secretary of the Substance Abuse and Mental Health Services Administration, Dr. Elinore McCance-Katz, accused the media of being dishonest about the coronavirus pandemic and reiterated talking points about Covid-19 that President Donald Trump has pushed for months, including complaints that schools should reopen for in-person learning and that very few children are affected by Covid-19.  

"I just wish that the media would get honest about its coverage of Covid," McCance-Katz told embattled Department of Health and Human Services spokesman Michael Caputo in the HHS "Learning Curve" podcast Friday. "For children this is not a life-threatening illness." 

McCance-Katz, who was appointed to SAMHSA by Trump in 2017, acknowledged that children do get severe symptoms from the virus "in rare cases," but said "with a great, great majority of children this is not a serious illness," something Trump has also repeated for months. 

"And when we put them in school with safety measures in place, why can't they go to school?" she said at one point in the interview. 

Many studies have shown children do get Covid-19 and do die from it. They also can spread the virus to others. The American Academy of Pediatrics says more than 500,000 children have been diagnosed with the infection. 

"So, lost in all of this response to Covid and nonstop 24/7 horrors of Covid and if you can't find something to talk about, it appears to me they make things up. It just does," McCance-Katz said at another point in the interview, referring to media coverage of the pandemic. 

McCance-Katz also expressed dismay with the way states have tried to handle the surging pandemic. 

"There was no agreement to this nonstop restriction and quarantining and isolation and taking away anything that makes people happy," she said. "You can't go to a movie. You can't go to a football game." 

McCance-Katz, a psychiatrist with a Yale doctorate in infectious disease epidemiology, argued at one point that the shutdown last spring was too severe. 

"I'm going to say it," she said. "We shut down the entire country before the virus, in my opinion, had a chance to get around the entire country. ... We used a sledgehammer when I think we needed a scalpel." 

She contended the shutdown itself, not the pandemic, actually killed thousands. 

"When you shut down an entire healthcare system, when you do that, you want to talk about the vulnerabilities, the obesity, the diabetes, the cardiovascular disease, the pulmonary diseases that puts you at greater risk for morbidity and mortality from Covid, but you take away the people's ability to get any health care," she said. 

"All you're doing is making certain that if they do become infected, it's going to have the maximum possible negative effect on them and it will end in death for thousands -- which is what we're seeing, and it's just awful." 

McCance-Katz argued that getting the economy and schools reopened is integral for Americans' mental health.