H5N1

Yemen COVID-19: Death rates in Aden could exceed its wartime fatalities

Via CNN: Yemen coronavirus: Death rates Aden could exceed its wartime fatalities. Excerpt:

Ghasan Saleh starts digging graves at the break of dawn to prepare for the dead bodies that will come in droves. Two men in white hazmat suits appear atop an approaching pickup truck. They hastily drop a corpse into a hole and cover it with dirt.  

The health workers come and go in near-silence. Fear of infection means there are no mourners for those suspected to have died from Covid-19. 

The cycle of digging and abrupt funerals continues under the blistering sun and suffocating humidity of Aden, the seat of power of the UN-recognized government in war-torn Yemen. 

The Al Radwan cemetery has quickly expanded over the past few months, with new graves creeping closer to the residential buildings that border it. "You can see my digging machine," says Saleh. "Just now I dug 20 graves." 

Local medical authorities say that death rates in Aden are soaring this year, despite a relative lull in a war that ravaged the place in previous years. 

In the first half of May, the city recorded 950 deaths -- nearly four times as many as the 251 deaths in the whole month of March, according to a Ministry of Health report. 

Those 950 deaths in two weeks in May represent nearly half the number of casualties the city suffered in all of 2015, when the country's civil war was raging. 

Back then Aden was devastated by heavy fighting, its streets blasted by rockets and its houses peppered with bullets. Now the city's biggest killers are silent. 

On top of Covid-19, there's also a mosquito-transmitted virus outbreak, known as Chikungunya virus, and more than 100,000 known cholera cases across the nation. Many malnutrition centers and hospitals have closed due to funding shortfalls and doctors' concerns about their personal safety from coronavirus. Flash floods this spring destroyed the city's power grid. 

"Yemen has faced wars and cannot handle three pandemics, economic collapse and a war and the coronavirus," Dr. Ishraq Al-Subei, the health official responsible for the response to the disease told CNN. 

The official Covid-19 death toll in southern Yemen stands at only 127. Health workers say they don't know what the actual number is, because of low testing capacity. But the huge surge in deaths in Aden is being seen as a warning of worse to come, as the health sector becomes overwhelmed and more people die of treatable diseases.

COVID-19 in South America

A screenshot from Covidly showing South America's numbers tonight:

While Brazil continues to be a disaster, Peru and Chile report alarming numbers of new cases. Venezuela's numbers are an obvious undercount, and I'm uncertain about the few cases and no deaths reported in Uruguay and Guyana.

 

The situation is complicated not only by incompetent/corrupt governments, but by seasonal influences. An excerpt from today's media briefing by PAHO director Carissa Etienne:

As of June 8, we have more than 3,3 million cases reported in the Region of the Americas, more than any other region around the world. Today we are home to nearly half of all COVID-19 cases.  

 

Unfortunately, many areas are reporting exponential rises in cases and deaths, and we are concerned by data showing that the virus surging in new places, places that had previously seen a limited number of cases.

 

In Meso America, case counts are rising in Mexico, Panama, and in Costa Rica, where we are seeing increased transmission around the Nicaraguan border.

 

In South America, the virus continues to spread aggressively in Brazil, Peru, and Chile. We're also seeing in Venezuela that cases are now mounting faster than at any point during the country's outbreak.

 

In the Caribbean, cases are on the rise in Haiti, and after more than a month without a new case, Suriname reported a spike this past week.

 

Social distancing and stay-at-home-orders have been challenging for all of us. But in the absence of a vaccine or more effective treatments, they are critical steps to keep us safe during this pandemic.

 

It is equally important for countries to test, treat, trace contacts, and isolate patients. Without this combined approach, our efforts will have limited impact and we face the risk of a rebound in cases.  

 

Today, I wish to draw attention to climatic factors affecting the response to COVID-19.

 

As our region works together to contain the spread of COVID-19, we must start planning now for a formidable challenge that could make our situation worse: That is the weather.  

 

In South America, our response to the pandemic will be impacted by the arrival of winter, while hurricane season will complicate our efforts in North and Central America, and especially in the Caribbean. 

 

Let me start with how winter presents challenges for countries with rising COVID-19 cases.

 

We don’t have data showing that temperature or humidity influence the spread of COVID-19. But we do know that winter fuels respiratory infections—like seasonal influenza and pneumonia—that can rapidly spread in colder climates and as more people gather indoors to stay warm.

 

This is a problem for patients because respiratory illnesses leave them at greater risk of severe COVID-19 infection. It’s also a challenge for strained health systems that will have to cope with the dual burden of a coronavirus pandemic and a spike in other respiratory illnesses. It does not help that the similar symptoms will make diagnosing COVID-19 even harder.

 

As countries strengthen surveillance for COVID-19, they must simultaneously monitor influenza cases.

 

Early vaccination to prevent severe cases of flu is more critical than ever—particularly for high-risk groups like health workers, the elderly, and people with chronic conditions. These same groups are also at high-risk of coronavirus infection.

 

We have encouraged countries to adapt seasonal flu vaccination campaigns to fit current social distancing measures. Many countries have embraced this approach and introduced innovative methods of immunization that minimize the risk of COVID-19. This includes offering vaccines outside of health facilities in empty schools, pharmacies, or drive-thru posts in supermarkets.

 

We’ve been encouraged that 14 countries in our region have begun to immunize 90 million people against seasonal influenza. More than half of the target population has already been vaccinated – a testament to the preparations and diligence of governments in the region.

Carbon dioxide levels hit highest mark in human history, despite COVID-19

Via The Washington Post: Carbon dioxide levels hit highest mark in human history, despite coronavirus. Excerpt:

The coronavirus-related economic downturn may have set off a sudden plunge in global greenhouse gas emissions, but another crucial metric for determining the severity of global warming — the amount of greenhouse gases actually in the air — just hit a record high.  

According to readings from the Scripps Institution of Oceanography and the National Oceanic and Atmospheric Administration (NOAA), the amount of CO2 in the air in May 2020 hit an average of slightly greater than 417 parts per million (ppm). This is the highest monthly average value ever recorded, and is up from 414.7 ppm in May of last year. 

Carbon dioxide levels are now the highest they’ve been in human history, and likely the highest in 3 million years. The last time there was this much CO2 in the atmosphere, global average surface temperatures were significantly warmer than they are today, and sea levels were 50 to 80 feet higher. 

The continuing rise in CO2 concentrations in the atmosphere may sound surprising in light of recent findings that the coronavirus pandemic, and the associated lockdowns, had led to a steep drop in global greenhouse gas emissions, peaking at a 17 percent decline in early April.  

But the total amount of CO2 that winds up in the atmosphere is driven not only by human emission levels, but also through processes on the land surface (especially forests) and in the oceans that fluctuate on a yearly basis.  

According to a Scripps news release announcing the findings, CO2 emissions reductions on the order of 20 to 30 percent would need to be sustained for six to 12 months in order for the increase in atmospheric CO2 to slow in a detectable way. 

“The buildup of CO2 is a bit like trash in a landfill. As we keep emitting, it keeps piling up,” said Ralph Keeling, who directs Scripps’ carbon dioxide monitoring program, and whose late father, Charles David Keeling, began measurements at the Mauna Loa Observatory in Hawaii in 1958. 

“The crisis has slowed emissions, but not enough to show up perceptibly at Mauna Loa. What will matter much more is the trajectory we take coming out of this situation,” he said. 

The rate of increase of this long-lived greenhouse gas in the atmosphere is accelerating.  

In the 1960s, the annual growth rate was about 0.8 ppm per year. It doubled in the 1980s, and eventually climbed to 2.4 ppm per year during the last decade. Multiple lines of evidence show the cause of this increase is greenhouse gas emissions from human activities, said Pieter Tans, who leads NOAA’s Carbon Cycle Greenhouse Gases Group. 

The Scripps researchers found that the average atmospheric CO2 concentration for May 2020 was 417.16 parts per million. Using different calculations than the Scripps team, NOAA researchers found the peak monthly value was slightly lower, at 417.1 ppm. 

The annual high typically occurs in May before CO2 levels temporarily ebb as trees and plants in the Northern Hemisphere absorb vast quantities of the planet-warming gas during the summer growing season. Though CO2 levels exhibit a seasonal cycle, the overall upward trend is clear.

'A summer unlike any other': Heatwaves and COVID-19 are a deadly combination

Via The Guardian: 'A summer unlike any other': heatwaves and Covid-19 are a deadly combination. Excerpt:

Temperatures in some California cities this week broke decades-old records. The heatwave that cooked Las Vegas over the past few days brought temperatures over 100F. And in Phoenix, highs this weekend are expected to approach or exceed 110F.   

This year is on track to be one of the hottest on record, and public health officials worry that in cities across the US, summer heatwaves will collide with the coronavirus pandemic, with deadly consequences for poor, minority and older populations.   

Even before the pandemic hit, heat was killing more Americans than all other natural disasters combined. People who live in cities are especially vulnerable to heatwaves because of a phenomenon called the “urban heat island effect” – cities with populations of 1 million or more can be up to 5F hotter than surrounding areas due to high population density, a lack of greenery and shade, and because materials like steel, concrete and asphalt tend to absorb more heat. 

Analyses have also found that cities’ poorest neighborhoods tend to be hotter, and that many low-income families have been struggling to cope for years. In some neighborhoods of Los Angeles, New York and Chicago, up to a third or more of households lack air conditioning. Due to the economic fallout of the coronavirus pandemic, many more are unable to pay to run their ACs. And even as cities begin reopening after lockdown, many of the malls, public libraries and recreation centers where overheated Americans traditionally went to cool down remain risky, especially for older people and others with a heightened risk of dying from Covid-19.  

Throughout the country, public health officials told the Guardian they were scrambling to find ways to protect the most vulnerable from the dual threats of heat and coronavirus. 

“This summer is definitely not going to be like any other summer,” said Deanne Criswell, the commissioner of New York City Emergency Management. “We’re not going to have the same level of facilities open that New Yorkers typically go to all the time to stay cool. It’s a big concern.”  

New York is in the process of installing 74,000 air conditioners in the homes of low-income seniors, according to Criswell. The city is also seeking to help more people pay for electricity this summer, as the unemployment crisis leaves thousands of New Yorkers without the means to make rent and utilities. 

Other cities across the US have asked utility companies not to shut off service this summer, even if customers can’t pay bills, so that they have access to water, cooling and refrigeration through the hottest days. 

Patients share beds as COVID-19 cases overwhelm Mumbai’s hospitals

Via The Guardian: Patients share beds as coronavirus cases overwhelm Mumbai’s hospitals. Excerpt:

In Mumbai’s Sion hospital emergency ward there are two people to a bed. Patients, many with coronavirus symptoms and strapped two to a single oxygen tank, were captured lying almost on top of each other, top-to-toe on shared stretchers or just lying on the floor, in footage shared on social media in India this week. 

Mumbai, a city of more than 20 million people, is weeks into the pandemic, but with new cases showing no sign of slowing down the city’s already weak healthcare system appears to be on the brink of collapse. State hospitals such as Sion, overcrowded in normal times, are overrun. With frontline doctors and nurses falling sick with the virus in their droves, it is also leading to a shortage of medical staff. 

“The volume and density of our population in Mumbai makes it very difficult to see how we will get out of the other side of this peak,” said Manish Shetty, a doctor who works on the Covid-19 ward in Guru Nanak hospital in Mumbai. “Definitely there is a fatigue setting in from all frontline workers, especially because there is a very high chance of healthcare workers getting infected.”  

He added: “There is definitely a shortage of beds for critical care. There is a lot of infrastructure and planning which is happening, but the magnitude of the cases is overwhelming us all.” 

It was at Sion hospital that, in footage that went viral a few weeks ago, Covid-19 patients were seen being treated in a ward alongside dead bodies, wrapped in black plastic bags, after the hospital morgue ran out of room.  

With 52,667 cases, and 1,695 deaths – nearly a quarter of all Covid-19 deaths nationally – the state of Maharashtra, and in particular its biggest city, Mumbai, has emerged as the centre of India’s coronavirus outbreak. According to doctors and officials, the peak began on 6 May, but the curve is showing no signs of flattening, and cases are still doubling every week. 

With state-run hospitals quickly running out of beds and keeping symptomatic patients waiting, the Mumbai municipal corporation has raced to convert a series of stadiums and office complexes into coronavirus wards and quarantine centres. 

A makeshift hospital with 1,000 beds, including intensive care facilities, was built in the city’s business district, the Bandra Kurla Complex. The National Sports Club of India stadium is being converted into a 600-bed quarantine and ICU facility, while the Mumbai planetarium will house 300 beds and the Nehru science centre will be made into a quarantine facility for those living in slums. Private hospitals have also been ordered to give over dozens of their beds for Covid-19 patients. 

A Mumbai municipal corporation spokesperson, Vijay Khabale, denied that coronavirus patients were being denied beds. “There are enough beds but there is a lack of coordination with other agencies, which is why there are these reports. The present situation is that we have more than enough beds and quarantine facilities.” Khabale said that all the new facilities would be completed within the week, but he was optimistic they would not need to be used at full capacity. “We are expecting that within a day or two that the cases will begin to flatten and then begin to decrease,” he insisted, adding: “We have it under control.”  

However, many doctors fear that the worse is still to come. India has been under one of the world’s strictest lockdowns since 24 March, but it has only slowed down the spread of the virus, rather than flattening the curve of cases. India ranks 4th in the world for new cases recorded each day, and with lockdown due to be loosened at the end of this week there are fears it will prompt a spike in infection rates, for which the hospitals are not prepared. India has had 158,000 reported cases. 

To complicate matters further, the beginning of June will bring the monsoon and the outbreaks of dengue fever, malaria and leptospirosis, which already inundate hospitals on an annual basis. Last year India officially reported more than 67,000 cases of dengue, though the real figure is thought to be much higher. 

According to the human rights activist Abraham Mathai, who runs the All India Nurses Association, dozens of patients with non-Covid related diseases are dying because they are being denied access to treatment, with some Mumbai hospitals ordered to only take in Covid-19 patients. Last week, 15-year-old Pawan Maddibona died after six hospitals refused to give him dialysis treatment for his kidneys.

Canada: Heat wave amid COVID-19 pandemic prompts city to open some facilities as cooling shelters

Via CBC News: Heat wave amid COVID-19 pandemic prompts city to open some facilities as cooling shelters. This will be a problem all over North America this summer. Excerpt:

Six recreation centres and one library have opened in the city's response to the heat wave that has hit Hamilton in the midst of the COVID-19 pandemic. 

Paul Johnson, director of the city's emergency operations centre, said splash pads and pools will remain closed but noted some more libraries may also be open soon— but just to provide shelter from the sweltering heat. 

"These are really meant just as areas for people who need to cool down, our recreation facilities will not be open," Johnson explained during the virtual media briefing on Monday. 

"Library [facilities] are not open right now so how do we keep people from using the libraries and book materials because they're not open to the public?"  

Johnson also said people should not be using HSR buses to escape the heat. Johnson said the city didn't expect the heat — which could feel as hot as 38 C on Tuesday — to arrive until June. It's unclear how many people the centres can hold but Johnson explained there will be active screening at each location. 

"If a count gets near where the facility is at its maximum, we will need to find an alternative," he said.

Dr. Tedros's opening remarks at the media briefing on COVID-19

Via WHO: WHO Director-General's opening remarks at the media briefing on COVID-19 - 20 May 2020. Excerpt:

We still have a long way to go in this pandemic. In the last 24 hours, there have been 106,000 cases reported to WHO – the most in a single day since the outbreak began. Almost two thirds of these cases were reported in just four countries. 

But, in good news, it has been particularly impressive to see how countries like the Republic of Korea have built on their experience of MERS to quickly implement a comprehensive strategy to find, isolate, test and care for every case, and trace every contact. This was critical to the Republic of Korea curtailing the first wave and now quickly identifying and containing new outbreaks.                   

However, we’re very concerned about the rising numbers of cases in low- and middle-income countries. Governments in the Assembly outlined their primary goal of supressing transmission, saving lives and restoring livelihoods. And WHO is supporting Member States to ensure supply chains remain open and medical supplies reach health workers and patients.   

As we battle COVID-19, ensuring health systems continue to function is an equally high priority as we recognize the risk to life from any suspension of essential services, like child immunisation.  

COVID-19 is not the only challenge the world is facing.                  

The climate crisis is causing increasingly strong storms, abnormal weather patterns and catastrophic shocks. Super cyclone Amphan is one of the biggest in years and is currently bearing down on Bangladesh and India. Our thoughts are with those affected and we recognize that like with COVID-19 there is a serious threat to life, particularly the poorest and most marginalized communities.  

WHO continues to offer support to Bangladesh and India to tackle both COVID-19 and the effects of the super cyclone.  

I want to end by emphasizing that there is continued hope. The last person who was being treated for Ebola in the Democratic Republic of Congo recovered and was discharged on May 14. On that day, the DRC Ministry of Health announced the beginning of the 42-day countdown to the end of the outbreak. We now have 36 days to go but new cases could still emerge, as we have seen before. 

The pandemic has taught and informed many lessons: Health is not a cost; it’s an investment. To live in a secure world, guaranteeing quality health for all is not just the right choice; it’s the smart choice.

COVID-19: Greenhouse gas emissions plunged 17 percent during pandemic

Via The Washington Post: Greenhouse gas emissions plunged 17 percent during pandemic.

The wave of lockdowns and shuttered economies caused by the coronavirus pandemic fueled a momentous decline in global greenhouse gas emissions, although one unlikely to last, a group of scientists reported Tuesday. 

As covid-19 infections surged in March and April, nations around the globe experienced an abrupt reduction in driving, flying and industrial output, leading to a startling decline of more than a billion tons of carbon dioxide emissions. That includes a peak decline in daily emissions of 17 percent in early April, according to the study published in the journal Nature Climate Change. For some nations, the drop was much steeper.  

Scientists have long insisted that the world must drastically scale back carbon pollution — and quickly — to mitigate the worst impacts of climate change over coming decades, although none have suggested that a deadly global pandemic is the way to accomplish it. 

Tuesday’s study projects that total emissions for 2020 will likely fall between 4 and 7 percent compared to the prior year — an unheard-of drop in normal times, but considerably less dramatic than the decline during the first few months of the year when economies screeched to a halt. The final 2020 figure will depend on how rapidly, or cautiously, people around the world resume ordinary life. 

The unprecedented situation produced by covid-19 has offered a glimpse into the massive scale required to cut global emissions, year after year, in order to meet the most ambitious goals set by world leaders when they forged the 2015 Paris climate accord. Last fall, a United Nations report estimated that global greenhouse gas emissions must begin falling by 7.6 percent each year beginning in 2020 to avoid the worst impacts of climate change.

Prepare for a summer of COVID-19, researchers warn

Via the South China Morning Post:  Prepare for a summer of coronavirus, researchers warn.

New modelling has shown warmer weather in the northern hemisphere will not substantially limit the spread of the new coronavirus pandemic, with scientists warning both tropical and temperate locations to prepare for severe outbreaks. 

The research, published online by the journal Science on Monday, showed the impact of weather was not as significant during a pandemic as the susceptibility of the general population, contradicting early hopes that the spread of the disease would be slowed with the changing seasons. 

Scientists from Princeton University and the US National Institutes of Health built a transmission model with parameters which included the climate dependence of transmission and the length of immunity following infection, adjusted with the known climate sensitivity of two other coronaviruses. 

They then simulated different scenarios based on what is known about Sars-CoV-2 – the new coronavirus which causes Covid-19 – and found that weather conditions, like humidity, temperature and latitude, made only modest changes to the size of the pandemic.  

In the longer term, these changes could be helpful in predicting future outbreaks, but the results suggested the percentage of a population with immunity was a “much more fundamental driver” of pandemic invasion dynamics and, in the case of the new coronavirus, nearly everyone was susceptible to infection. 

“Both tropical and temperate locations should prepare for severe outbreaks of the disease and that summertime temperatures will not effectively limit the spread the infection,” the scientists concluded. 

The paper also warned that the length of immunity would be a crucial factor in deciding control measures against further outbreaks, with scientists still unsure whether antibodies in people who have had the disease will protect them from a second infection, and how long that protection will last.  

The “herd immunity” theory – which underpins the strategy of countries like Sweden – is based on the hypothesis that immunity will last long enough to reduce the impact of future outbreaks. 

Many scientists are warning of a second wave outbreak in Europe, with many countries lifting their lockdown measures, and have called for accompanying measures such as testing, contact tracing, physical distancing and handwashing. 

Previous studies into the effects of temperature have reported similar findings. In February, a study by a group of researchers, which included epidemiologist Marc Lipsitch from Harvard’s T.H. Chan School of Public Health, found that transmission was possible in high levels of humidity and temperature. A French study in April found some strains of the virus were able to replicate after being heated to 60 degrees Celsius.

Impact of climate and public health interventions on the COVID-19 pandemic: A prospective cohort study

Via CMAJ: Impact of climate and public health interventions on the COVID-19 pandemic: A prospective cohort study. The abstract:

Background: It is unclear whether seasonal changes, school closures or other public health interventions will result in a slowdown of the current coronavirus disease 2019 (COVID-19) pandemic. We aimed to determine whether epidemic growth is globally associated with climate or public health interventions intended to reduce transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).  

Methods: We performed a prospective cohort study of all 144 geopolitical areas worldwide (375 609 cases) with at least 10 COVID-19 cases and local transmission by Mar. 20, 2020, excluding China, South Korea, Iran and Italy. Using weighted random-effects regression, we determined the association between epidemic growth (expressed as ratios of rate ratios [RRR] comparing cumulative counts of COVID-19 cases on Mar. 27, 2020, with cumulative counts on Mar. 20, 2020) and latitude, temperature, humidity, school closures, restrictions of mass gatherings, and measures of social distancing during an exposure period 14 days previously (Mar. 7 to 13, 2020).  

Results: In univariate analyses, there were few or no associations of epidemic growth with latitude and temperature, but weak negative associations with relative humidity (RRR per 10% 0.91, 95% confidence interval [CI] 0.85–0.96) and absolute humidity (RRR per 5 g/m3 0.92, 95% CI 0.85–0.99). Strong associations were found for restrictions of mass gatherings (RRR 0.65, 95% CI 0.53–0.79), school closures (RRR 0.63, 95% CI 0.52–0.78) and measures of social distancing (RRR 0.62, 95% CI 0.45–0.85). 

In a multivariable model, there was a strong association with the number of implemented public health interventions (p for trend = 0.001), whereas the association with absolute humidity was no longer significant.  

Interpretation: Epidemic growth of COVID-19 was not associated with latitude and temperature, but may be associated weakly with relative or absolute humidity. Conversely, public health interventions were strongly associated with reduced epidemic growth.