H5N1

North Korea locks down capital city over 'respiratory illness'

Via Reuters: North Korea locks down capital city over 'respiratory illness' - report.

SEOUL, Jan 25 (Reuters) - Authorities in the North Korean capital Pyongyang have ordered a five-day lockdown due to rising cases of an unspecified respiratory illness, Seoul-based NK News reported on Wednesday, citing a government notice.  

The notice did not mention COVID-19, but said that residents in the city are required to stay in their homes through the end of Sunday and must submit to temperature checks multiple times each day, according to NK News, which monitors North Korea. 

On Tuesday, the website reported that Pyongyang residents were appeared to be stocking up on goods in anticipation of stricter measures. It is unclear if other areas of the country have imposed new lockdowns. 

North Korea acknowledged its first COVID-19 outbreak last year, but by August had declared victory over the virus.  

The secretive country never confirmed how many people caught COVID, apparently because it lacks the means to conduct widespread testing.

Mental health after China's prolonged lockdowns

An editorial in The Lancet: Mental health after China's prolonged lockdowns. Excerpt:

On June 1, Shanghai reopened after a 2-month lockdown to curb COVID-19. On June 6, Beijing also eased COVID-19 restrictions by allowing restaurant dining and the gradual reopening of schools from June 13 in most districts. Although many countries instituted various forms of lockdown over the past 2 years, China's have often been the most stringent and frequent. Control policies, including school closures and stay-at-home orders, combined with the stress of the pandemic itself, will have exacerbated the already fragile mental health of many Chinese people. 

According to the first national survey on psychological distress in the COVID-19 epidemic in China from 2020, 35% of respondents experienced distress, including anxiety and depression. School closures were associated with adverse mental health symptoms and behaviours among children and adolescents. Amid the relief of lifting restrictions, there is also widespread anxiety over adapting to routine life and fear that transmission of the virus will rebound. This scenario is cause enough for concern, but it plays out against the wider backdrop of mental disorders in China, which remain largely unaddressed.  

Mental health in China has gained attention among the public and academia only in the past 20 years. The first national survey of mental disorders in China, from 2013–15, showed that the lifetime prevalence of mental health conditions in adults is 16·6%. Considering China's population, the clinical need is huge.  

Yet access to treatment is extremely poor. Only 9·5% of people with depressive disorders received treatment, and very rarely (0·5%) was treatment adequate. Mental health services are concentrated in large specialty hospitals rather than community and primary health care, encouraging the long-established pattern in China of going straight to large hospitals for specialist treatment, rather than first seeing a general practitioner.  

This centralised system of care is not adequate to meet China's mental health-care needs. Transitioning from a hospital-centric system to one that is more integrated, anchored in primary health care, and enabled by the newest technology and data (as recommended in a review of quality of primary health care in China by Xi Li and colleagues) is essential.  

Mental health has long been neglected in China, partly because of a deep-rooted cultural stigma. Discussing mental health remains taboo among many communities. Confucianism emphasises the achievement of personal and social harmony. People with mental disorders are often perceived as unable to fulfil this ideal. Families of patients worry about how a disclosure of mental illness might damage their reputation. The fear of being stigmatised and socially isolated will undoubtedly disincentivise people with mental disorders from seeking care.  

The Chinese Government has introduced a mental health law, as well as the 686 programme, aimed at strengthening the mental health-care workforce, raising awareness, and integrating mental health-care services. If patients are unable to voice how they feel openly and frankly, they will be left invisible and untreated.  

Culturally sensitive, stigma reduction interventions and national campaigns are clearly needed to break down barriers to accessing services. What else? The Lancet has convened a Commission of Chinese and international researchers, led by Michael Phillips from Shanghai Mental Health Center and Shuiyuan Xiao from Xiangya School of Public Health, to identify the key challenges that need to be addressed in China's next 5-year plan for mental health, consider how China's rapid economic, social, and technological changes affect mental health and mental health care, and discuss the growing role of China in the global mental health movement. It is due to report its findings in 2023.

Covid-19: 17 million locked down in Shenzhen as virus cases double nationwide

Via the Hong Kong Free Press, an AFP report: Covid-19: 17 million locked down in Shenzhen as virus cases double nationwide. Excerpt:

China placed all 17 million residents in one of its biggest cities under lockdown on Sunday, as virus cases doubled nationwide to nearly 3,400 and anxiety mounted over the resilience of its ‘zero-Covid’ approach in the face of the worst outbreak in two years. 

The southern tech hub of Shenzhen told all residents to stay at home as it struggles to eradicate an Omicron flare-up linked to the neighbouring virus-ravaged city of Hong Kong.  

The lockdown and a suspension of public transport will last until March 20, a city government notice said, adding that it would launch three rounds of mass testing.  

The move extends an earlier lockdown imposed on the city’s central business district.  

“If prevention and control is not strengthened in a timely and decisive manner, it could easily become large-scale community transmission,” Shenzhen health official Lin Hancheng said at a Sunday briefing.

Russia's Covid deaths hit new record high ahead of nationwide restrictions

Via The Moscow Times: Russia's Covid Deaths Hit New Record High Ahead of Nationwide Restrictions.

Russia reported a record high number of coronavirus deaths Tuesday as Europe’s hardest-hit country braces for nationwide restrictions this week.   

Russia has repeatedly set new all-time highs for Covid-19 deaths over the past month and is currently reporting the second-highest number of daily fatalities in the world after the U.S.  

According to government figures, 1,106 people have died from Covid-19 over the last 24 hours.  

Tuesday's increase brings the official death toll to 232,775 — Europe’s highest — though authorities are accused of dramatically downplaying that figure. A Moscow Times analysis of excess deaths published by the federal statistics agency Rosstat puts Russia's total excess fatality count since the start of the pandemic at 660,000.  

All of Russia's 85 regions across 11 time zones have now mandated vaccines for certain categories of workers, Anna Popova, who heads the federal health watchdog that is leading the country’s response to the virus, said Tuesday.

The latest figures come days before Russia’s mandated paid vacation for non-essential workers in hopes of putting the brakes on spiraling Covid-19 deaths and cases from this Sunday, Oct. 30, to Nov. 7.  

Moscow, the epicenter of Russia’s coronavirus outbreak, will go into the so-called “non-working” period this Thursday, with all businesses and services except grocery stores and pharmacies suspended.  

Russia’s coronavirus task force also reported 36,446 coronavirus cases Tuesday.  

Russia has the world’s fifth-highest total caseload of more than 8.3 million infections since the start of the pandemic, with the more-infectious Delta variant and stubbornly low vaccination rates fueling the virus’ spread since the summer.  

Only around 36% of Russians have been fully vaccinated despite the availability of four homegrown vaccines and several regions mandating shots for certain categories of workers.

Russia reports another day of record virus deaths, infections

Via The Moscow Times: Russia Reports Another Day of Record Virus Deaths, Infections.

Russia registered its highest number of daily coronavirus deaths and new cases since the start of the pandemic Friday as authorities across the country scramble to impose partial lockdowns and other restrictions to thwart the spread of the virus in the coming weeks.  

The government’s coronavirus information center reported a double record of 1,064 new fatalities and 37,141 new infections over the past 24 hours.   

Russia has repeatedly broken new all-time highs for Covid-19 deaths over the past month amid stubbornly low vaccination rates. It is currently reporting the second-highest number of daily fatalities in the world after the United States. 

The information center’s official death toll stands at 228,453 — Europe’s highest.  Russia’s total excess fatality count since the start of the pandemic is at least 660,000, according to The Moscow Times’ analysis.  

Russia’s total Covid-19 caseload is the fifth-highest in the world at more than 8.1 million infections.  

President Vladimir Putin has announced a non-working week in Russia from Oct. 30-Nov. 7, authorizing regional leaders to extend the public holidays further if cases do not start to fall.  

In Moscow, the epicenter of Russia’s Covid-19 outbreak, Mayor Sergei Sobyanin ordered a partial citywide lockdown — with most non-essential businesses and services suspended and mass events banned — between Oct. 28-Nov. 7 to stem the spread of the virus.  

The pace of vaccinations in Russia has started to accelerate following a string of regions imposing vaccine mandates for workers in certain sectors of the economy and vaccine passports for entry into indoor venues, according to the Gogov website which tracks vaccine uptake across the country. It estimates Russia is administering more than 300,000 first doses each day — up from around 120,000 a day earlier in October. Only around a third of Russians are fully vaccinated, despite vaccines having been widely available for free since the start of the year.   

Meanwhile, a senior government scientist warned Thursday that geneticists have detected a new and more contagious sub-variant of the Delta strain of the coronavirus, AY.4.2, in isolated cases across the country.

Moscow will go into full lockdown if cases don’t fall - government order

Via The Moscow Times: Moscow Will Go Into Full Lockdown if Cases Don’t Fall - Government Order.

Moscow will go into a strict lockdown if coronavirus infections continue to rise, according to a Moscow government order that was sent to businesses in the city Wednesday. The order, seen by The Moscow Times, would close all non-essential stores, including restaurants, stores, museums and parks as well as suspend planned medical procedures from Oct. 30-Nov. 7.  It would come into effect if the total number of new Covid-19 cases in the capital over the next seven days surpasses the number of infections recorded in the previous week.   

President Vladimir Putin earlier Wednesday approved a non-working week from Oct. 30 to Nov. 7 on Wednesday as Russia’s coronavirus task force reported another daily record of 1,028 Covid-19 deaths over the last 24 hours. 

 Free travel on the city’s public transport network for elderly citizens and other groups would also be suspended.  

The measures, named a “short-term lockdown” in the document, would amount to Russia’s strictest coronavirus restrictions since spring last year. The Kremlin and Moscow authorities have previously rejected lockdown measures — which are unpopular among the Russian public — even as cases spiraled.  

Forbes Russia earlier reported that the city officials were mulling closing restaurants, bars, museums, hairdressers and other non-essential businesses to help stem the spread of the virus.

New Zealand braces for rising Covid cases as expert warns of potential explosion

Via The Guardian: New Zealand braces for rising Covid cases as expert warns of potential explosion. Excerpt:

New Zealand is bracing for increasing numbers of Covid-19 cases after recording 94 new infections over the weekend, while pandemic modellers say that if the government stays its current course new cases will quickly top 100 a day.  

“We are on the exponential growth curve,” an epidemiologist and public health professor, Michael Baker, said. “If you look at the trend, it’s clearly going up in Auckland, and it’s not just the total cases but also the unexplained cases, which suggests transmission in the community is increasing.”  

Baker said that if the government kept its current restrictions, or loosened them further by reopening schools, as announced last week, “there’s only one way it can go and that’s up”.  

“This is really simple. This is where every epidemiologist and disease modeller will agree 100%. Don’t do it.”  

Case numbers began rising steadily soon after the government loosened restrictions in Auckland, the centre of the Delta outbreak, from a level 4 to level 3 lockdown. Cases have since spread beyond the city’s borders, cropping up in Northland and Waikato.  

On Monday, the government announced another 35 cases, all in Auckland, taking the total number of cases in the outbreak to 1,622. According to the Ministry of Health, 29 of the previous day’s cases were infectious in the community, and 21 of the cases announced had not yet been linked to existing cases.  

Last week, the government announced a new “steps” system for Auckland to reduce restrictions ​​in the coming weeks, subject to case numbers: first allowing outdoor gatherings, then gradually reopening some schools and allowing retail and hospitality to restart.  

Baker said that with Auckland’s outbreak growing, following those steps would be a mistake and could cause the outbreak to explode.  

“You go down the alert level system when the outbreak is coming under control,” he said. “You don’t go down the system when the outbreak is increasing. This is basic infectious disease epidemiology.”

'State of crisis': Canadian Medical Association calls for lockdowns in Alberta and Saskatchewan

Via CBC News, a report by The Canadian Press: 'State of crisis': Canadian Medical Association calls for lockdowns in Alberta and Saskatchewan.

The Canadian Medical Association is calling for lockdowns in Alberta and Saskatchewan to protect their "crumbling" health-care systems.  

Both western provinces are setting hospitalization records for COVID-19, with intensive care capacity running slim.  

Dr. Katharine Smart, president of the national association, is urging the federal and provincial governments to take immediate action.  

The association is calling for short, controlled lockdowns, often called "firebreakers" or "circuit-breakers," which would close schools and non-essential businesses.

Time for 'courageous action': CMA president  

It also wants mandatory vaccinations in health-care settings and an increase in the mobility of health workers and intensive care capacity between provinces.  

Smart says it's time for "courageous action" and politics must be put to the side to allow for collaboration between levels of government.  

"We are now witnessing an unprecedented health-care crisis in Alberta and Saskatchewan — and patients and health workers are experiencing unfathomable choices and consequences," Smart said in a statement Wednesday.  

"Early relaxation of public health measures has left two crumbling health-care systems in their wake and the dire realities are now in full view.  

"What is happening is as heartbreaking as it was preventable. We are now in a situation where it's all hands on deck to address the state of crisis."

Large-scale study of migrant workers’ mental health finds prolonged restrictions worsen depression, stress

Via todayonline.com: Large-scale study of migrant workers’ mental health finds prolonged restrictions worsen depression, stress. Excerpt:

SINGAPORE — Putting migrant workers under prolonged quarantines may be expedient in limiting Covid-19’s spread, but this comes at the cost of poorer mental health, a study has found.  

The study — said to be the first large-scale one here examining the mental health of such workers embroiled in coronavirus clusters — was conducted by a team of Yale-NUS researchers between June 22 and Oct 11 last year.   

The researchers surveyed 1,011 male migrant workers employed in manual jobs here to document their mental health symptoms and identify those at risk of poor mental health.   

They found that complete movement restrictions were associated with increased depression and stress, while being diagnosed with Covid-19 was associated with increased anxiety among the workers.  

At the peak of the outbreak which led Singapore to enter a two-month circuit breaker period last April, more than 1,000 new Covid-19 cases were identified in dormitories daily. 

While the vast majority of Singapore’s population has experienced many twists and turns over the past 15 months, as community restrictions get tightened or loosened in tandem with the pandemic situation, not much has changed for the 275,000-odd migrant workers staying in dormitories.    

These workers have been largely confined to their rooms and only allowed to leave for work or, more recently, to designated recreation centres on some days. 

WHAT RESEARCHERS FOUND 

• Rates of severe or extremely severe depression (3.1 per cent), anxiety (4.1 per cent) and stress in respondents (1.3 per cent) were similar to those observed in the general population in Singapore during the Covid-19 pandemic 

• Higher scores of depression and stress were observed among participants surveyed during complete movement restrictions, as compared to participants surveyed during minimal restrictions In terms of health concerns, being diagnosed with Covid-19 predicted increased anxiety  

• Those who were fearful about their health during the pandemic reported more symptoms of depression, anxiety and stress than those who were not fearful  

• Participants who rated their health status as being good had fewer symptoms than those who rated their health as poor or normal  

• Higher depression, anxiety and stress symptoms were found among participants who feared losing their job during the pandemic  

• Higher depression, anxiety and stress symptoms were also observed among participants with higher exposure to Covid-19 rumours than those with lower exposure

See also this BBC report on the subject.

Calgary to take own measures to act on COVID-19 crisis, saying province 'doesn't care'

Via CBC News, pandemic fragmentation progresses in Alberta: Calgary to take own measures to act on COVID-19 crisis, saying province 'doesn't care'. Excerpt:

Calgary's mayor says the city will explore measures it can take to protect residents from the flood of COVID-19 cases overwhelming the province's health-care system.     

Mayor Naheed Nenshi made the comments just hours after Premier Jason Kenney announced the province was days away from running out of ICU staff to treat patients. The number of patients in intensive care units was at an all-time high, and Alberta was asking other provinces for health-care workers or ICU staff.   

As well, doctors were being told to prepare to make life-or-death decisions as to which patients will be able to access interventions like ventilators.  

"Regardless of the politics and the ideology and the endless lurching back and forth like a Stampede ride that we're hearing from the province, your city government is here for you … and we'll continue to do what it takes to get us out of this," Nenshi said, following city council's last meeting of the session late Wednesday evening.  

One action the mayor suggested was for the city to partner with local pharmacies to bring mobile vaccination buses to locations like train stations to lower barriers to access. He added that Alberta Health leadership previously mocked him for suggesting a pop-up vaccine clinic be set up during the Calgary Stampede in July.   

"It's clear that Alberta Health and Alberta Health Services have abandoned targeted vaccination efforts except for one bus in all of Alberta," Nenshi said in a scrum following the meeting.  

'Dumpster fire' press conference  

Earlier, Kenney's government announced a swath of new restrictions and a state of emergency.  

But beyond apologizing for prematurely treating the pandemic as endemic, the premier largely stood by decisions his government made in July to drop public health measures for the summer and not reintroduce them until after cases, hospitalizations and deaths were snowballing.  

"I'm having a hard time articulating … what I just heard from a dumpster fire of a press conference," Coun. Druh Farrell said when Calgary city council's meeting resumed after the provincial announcement. "I'm tired of asking for permission from a province that truly doesn't care."  

Calgary's Emergency Management Agency (CEMA) Chief Sue Henry told council that 105 people have died since the last city COVID-19 update on Sept. 3 — less than two weeks ago.  

The city's case counts had grown by more than 1,700 and the rate at which cases were spreading was also growing.  

'Vibrating with anger' 

Farrell said she was "vibrating with anger" because the situation the province is in now was so predictable. She asked if the city or CEMA can take any action, even though health care falls under the province's mandate.  

Nenshi added that it's time for the city to stop asking for permission. "I'm tired of being told everything's OK … it's not good enough."  

Council voted unanimously in favour of a motion that will allow the mayor to recall council to meet again before the October municipal election in order to act on the public health emergency, if needed.