H5N1

India sets new record for COVID-19 deaths with over 1,100 in single day

Via Globalnews.ca, an Associated Press report: India sets new record for coronavirus deaths with over 1,100 in single day. Excerpt:

India on Tuesday reported 1,133 deaths from the coronavirus in the last 24 hours, its highest single-day total.  

The Health Ministry also reported 75,809 new cases, raising India’s tally to nearly 4.3 million — second only to the United States and maintaining an upward surge amid an ease in nationwide restrictions to help mitigate the economic pain. The country’s death toll now stands at 72,775.  

India has been reporting the highest single-day caseload in the world for more than a month.

Prevalence of depression symptoms in US adults before and during the COVID-19 pandemic

Via JAMA Network: Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic. The key points and abstract:

Key Points

Question  What is the burden of depression symptoms among US adults during the coronavirus disease 2019 (COVID-19) pandemic compared with before COVID-19, and what are the risk factors associated with depression symptoms?  

Findings  In this survey study that included 1441 respondents from during the COVID-19 pandemic and 5065 respondents from before the pandemic, depression symptom prevalence was more than 3-fold higher during the COVID-19 pandemic than before. Lower income, having less than $5000 in savings, and having exposure to more stressors were associated with greater risk of depression symptoms during COVID-19.  

Meaning  These findings suggest that there is a high burden of depression symptoms in the US associated with the COVID-19 pandemic and that this burden falls disproportionately on individuals who are already at increased risk.  

Abstract 

Importance  The coronavirus disease 2019 (COVID-19) pandemic and the policies to contain it have been a near ubiquitous exposure in the US with unknown effects on depression symptoms. 

Objective  To estimate the prevalence of and risk factors associated with depression symptoms among US adults during vs before the COVID-19 pandemic. 

Design, Setting, and Participants  This nationally representative survey study used 2 population-based surveys of US adults aged 18 or older. During COVID-19, estimates were derived from the COVID-19 and Life Stressors Impact on Mental Health and Well-being study, conducted from March 31, 2020, to April 13, 2020. Before COVID-19 estimates were derived from the National Health and Nutrition Examination Survey, conducted from 2017 to 2018. Data were analyzed from April 15 to 20, 2020. 

Exposures  The COVID-19 pandemic and outcomes associated with the measures to mitigate it.  

Main Outcomes and Measures  Depression symptoms, defined using the Patient Health Questionnaire-9 cutoff of 10 or higher. Categories of depression symptoms were defined as none (score, 0-4), mild (score, 5-9), moderate (score, 10-14), moderately severe (score, 15-19), and severe (score, ≥20). 

Results  A total of 1470 participants completed the COVID-19 and Life Stressors Impact on Mental Health and Well-being survey (completion rate, 64.3%), and after removing those with missing data, the final during–COVID-19 sample included 1441 participants (619 participants [43.0%] aged 18-39 years; 723 [50.2%] men; 933 [64.7%] non-Hispanic White). The pre–COVID-19 sample included 5065 participants (1704 participants [37.8%] aged 18-39 years; 2588 [51.4%] women; 1790 [62.9%] non-Hispanic White). 

Depression symptom prevalence was higher in every category during COVID-19 compared with before (mild: 24.6% [95% CI, 21.8%-27.7%] vs 16.2% [95% CI, 15.1%-17.4%]; moderate: 14.8% [95% CI, 12.6%-17.4%] vs 5.7% [95% CI, 4.8%-6.9%]; moderately severe: 7.9% [95% CI, 6.3%-9.8%] vs 2.1% [95% CI, 1.6%-2.8%]; severe: 5.1% [95% CI, 3.8%-6.9%] vs 0.7% [95% CI, 0.5%-0.9%]). 

Higher risk of depression symptoms during COVID-19 was associated with having lower income (odds ratio, 2.37 [95% CI, 1.26-4.43]), having less than $5000 in savings (odds ratio, 1.52 [95% CI, 1.02-2.26]), and exposure to more stressors (odds ratio, 3.05 [95% CI, 1.95-4.77]). 

Conclusions and Relevance  These findings suggest that prevalence of depression symptoms in the US was more than 3-fold higher during COVID-19 compared with before the COVID-19 pandemic. 

Individuals with lower social resources, lower economic resources, and greater exposure to stressors (eg, job loss) reported a greater burden of depression symptoms. Post–COVID-19 plans should account for the probable increase in mental illness to come, particularly among at-risk populations.

Will the COVID-19 pandemic threaten the SDGs?

An editorial in The Lancet Public Health: Will the COVID-19 pandemic threaten the SDGs? - The Lancet Public Health.

The UN's Sustainable Development Goals (SDGs), adopted in 2015, provide an international framework to move by 2030 toward more equitable, peaceful, resilient, and prosperous societies—while living within sustainable planetary boundaries. As the UN celebrates its 75th anniversary and a third of the SDG timeline has passed, The Sustainable Development Goals Report 2020—prepared by the UN Department of Economic and Social Affairs in collaboration with experts and international agencies— tells a story of tentative but insufficient progress, and warns of the regressive impact of the coronavirus pandemic. 

According to the report, COVID-19 threatens to reverse the progress of SDG 3, which aims to ensure healthy lives and wellbeing for all. During the crisis, 70 countries have halted childhood vaccination programmes, and in many places, health services for cancer screening, family planning, or non-COVID-19 infectious diseases have been interrupted or are being neglected. Health service disruptions could reverse decades of improvement, warns the report. Allowing people to slip through these service gaps could affect population health for years to come.

Even before COVID-19 the world was off track to end poverty by 2030 under SDG 1, with projections suggesting that 6% of the global population would still be living in extreme poverty in 2030. Now, an estimated 71 million additional people could be living in extreme poverty due to COVID-19. Although income inequality has been falling in some countries, a global economic recession in the wake of the pandemic could push millions back into poverty and exacerbate inequalities. The most susceptible groups are being hit hardest by the pandemic, threatening SDG 10. 

Similarly, the ambition under SDG 2 to end hunger was faltering before COVID-19—the population affected by food insecurity had risen between 2014 and 2018—but the COVID-19 crisis has added to pressure on production, supply chains, and household incomes, with the poorest being most affected. Access to water and sanitation (SDG 6) remains a major health issue. 2·2 billion people remain without safe drinking water and the COVID-19 crisis has highlighted lack of access to sanitation for billions. 

Tackling global poverty and water and food scarcity is intrinsically linked to mitigating climate and land-use change. However, as the SDGs report shows, the world is off track to meet the goals toward environmental sustainability encompassed by SDGs 7–9 and 11–15. Most countries are not meeting their commitments to limit greenhouse gas emissions. We are in danger of missing targets to improve urban environments by reducing the number of people living in slums, increasing access to public transport, and reducing air pollution. Aims towards sustainable and inclusive economic growth, energy provision, and infrastructure development had all been falling short before COVID-19 and face considerable setbacks in the shadow of an economic recession. 

The aim of SDG 4—to achieve inclusive and equitable access to education—also looks likely to be missed, with a projection that more than 200 million children will still be out of education by 2030. Most of the world's children have been deprived of formal education during the COVID-19 outbreak—a legacy that could threaten the SDGs' underlying ambition to leave no one behind. The world has made progress on SDG 5's gender equality goals, with fewer girls being forced into early marriage and more women entering leadership roles. However, women's wellbeing has suffered during the COVID-19 outbreak, with incidences of domestic violence increasing by 30% in some countries and a greater demand on women for unpaid care work. 

Finally, reaching the SDGs will be impossible without international cooperation. The political tensions stoked by COVID-19 and a trend toward hardening of national borders could threaten SDG 16 to promote peace and safety from violence and SDG 17 to strengthen international partnerships. 

Achieving the transformative vision of the SDGs by 2030 requires a major realignment of most countries' national priorities toward long-term, cooperative, and drastically accelerated action. For António Guterres, UN Secretary-General, “Everything we do during and after this crisis must be with a strong focus on building more equal, inclusive and sustainable economies and societies that are more resilient in the face of pandemics, climate change, and the many other global challenges we face.” The intersecting challenges of health and sustainability might never have been clearer: an opportunity not to be missed.

UK: Calls for mental health help double in Manchester under Covid-19 restrictions

Via The Guardian: Calls for mental health help double in Manchester under Covid restrictions. Excerpt:

Calls to police and specialist services about mental health have almost doubled in Manchester while people have been isolated at home, prompting the leader of the city council to call for a more balanced and proportionate approach to lockdown.  

Sir Richard Leese, who heads Manchester city council and is also deputy mayor of Greater Manchester, said the government needed a new strategy to tackle outbreaks which “brings into play mental health and other health risks including those caused by poverty and economic inactivity, and one that allows the economy to fully function”. 

Greater Manchester has one of the highest Covid-19 infection rates in the UK. Calls to three crisis helplines set up in response to the pandemic have increased significantly in the last few months. The Greater Manchester Mental Health Foundation’s helpline received 2,168 calls in July compared with 1,187 in April. 

Greater Manchester police (GMP) said they too had experienced a significant increase in “mental health demand”. Ch Supt Umer Khan said: “We are grateful to the majority of people within Greater Manchester who have followed guidelines to help reduce the spread of Covid-19, however these restrictions have had an impact on many people’s mental health, both those with pre-existing conditions and those who have not struggled with their mental health before.  

“Police officers are often the first point of contact for people going through a mental health crisis. Since February 2020 we have seen a 42% increase in mental health demand coming into GMP. It is important that these people have immediate access to the right help and support.  

“GMP has worked with partners to train thousands of officers in how to deal with people with various mental health conditions and help direct individuals to the support they need.” 

Manchester recorded 47.3 coronavirus cases per 100,000 people in the week of 10-16 August, the seventh-highest infection rate in England. Nearby Oldham had more than double that rate, with 103.1 cases per 100,000 in the same time period.  

Leese said very few people were dying of Covid in the region, but “presentations of people with mental health issues … have soared, as has the number of people suffering from the state of the economy”.

Politics slows flow of US COVID-19 funds to local public health

Thanks to Lauren Weber for sending the link to this Associated Press report, which she helped to write: Politics slows flow of US virus funds to local public health. Excerpt:

As the novel coronavirus began to spread through Minneapolis this spring, Health Commissioner Gretchen Musicant tore up her budget to find funds to combat the crisis. Money for test kits. Money to administer tests. Money to hire contact tracers. And yet even more money for a service that helps tracers communicate with residents in dozens of languages. 

While Musicant diverted workers from violence prevention and other core programs to the COVID-19 response, state officials debated how to distribute $1.87 billion Minnesota received in federal aid. 

As she waited, the Minnesota Zoo got $6 million in federal money to continue operations, and a debt collection company outside Minneapolis received at least $5 million from the federal Paycheck Protection Program, according to federal data.  

It was not until Aug. 5 — months after Congress approved aid for the pandemic — that Musicant’s department finally received $1.7 million, the equivalent of $4 per Minneapolis resident.  

“It’s more a hope and a prayer that we’ll have enough money,” Musicant said.

Since the pandemic began, Congress has set aside trillions of dollars to ease the crisis. A joint Kaiser Health News and Associated Press investigation finds that many communities with big outbreaks have spent little of that federal money on local public health departments for work such as testing and contact tracing. Others, like in Minnesota, were slow to do so. 

For example, the states, territories and 154 large cities and counties that received allotments from the $150 billion Coronavirus Relief Fund reported spending only 25% of it through June 30, according to reports that recipients submitted to the U.S. Treasury Department. 

Many localities have deployed more money since that June 30 reporting deadline, and both Republican and Democratic governors say they need more to avoid layoffs and cuts to vital state services. Still, as cases in the U.S. top 5.4 million and confirmed deaths soar past 170,000, Republicans in Congress are pointing to the slow spending to argue against sending more money to state and local governments to help with their pandemic response.  

“States and localities have only spent about a fourth of the money we already sent them in the springtime,” Senate Majority Leader Mitch McConnell said Tuesday. Congressional Democrats’ efforts to get more money for states, he said, “aren’t based on math. They aren’t based on the pandemic.”  

Negotiations over a new pandemic relief bill broke down last week, in part because Democrats and Republicans could not agree on funding for state and local governments.  

KHN and the AP requested detailed spending breakdowns from recipients of money from the Coronavirus Relief Fund — created in March as part of the $1.9 trillion CARES Act — and received responses from 23 states and 62 cities and counties. Those entities dedicated 23% of their spending from the fund through June to public health and 7% to public health and safety payroll.  

An additional 22% was transferred to local governments, some of which will eventually pass it down to health departments. The rest went to other priorities, such as distance learning. 

So little money has flowed to some local health departments for many reasons: Bureaucracy has bogged things down, politics have crept into the process, and understaffed departments have struggled to take time away from critical needs to navigate the red tape required to justify asking for extra dollars.

‘Economic tsunami’: US cities and states hit by Covid-19 face dire budget cuts

Via The Guardian: ‘Economic tsunami’: US cities and states hit by Covid-19 face dire budget cuts. Excerpt:

Across the country, state and local governments are facing dire budget deficits. With falling personal income tax and sales tax revenue, state budgets are looking at an estimated $500bn shortfall over the next two years. Local budgets are not looking bright either: nearly all cities with populations over 50,000 are expecting revenue shortfalls this year. 

State and local governments fund nearly every public good that directly touches Americans, from public schools and parks to police departments and trash collection. They employ over 18 million people, and spending by state and local governments make up about 9% of GDP. 

Some states have already taken drastic measures to offset revenue shortfalls. At least four states – Idaho, North Dakota, Oklahoma and Texas – have announced across-the-board cuts to all state agencies by at least 5%. Florida, which is still dealing with thousands of new Covid-19 each day, announced budget cuts that the governor likened to Game of Thrones’ infamous Red Wedding scene, slashing $1bn in funding from education and social services, including the state’s affordable housing program. 

So far state and local governments have largely avoided mass layoffs, turning instead to hiring freezes and temporary furloughs to try to rein in spending while keeping employees on payroll. Michigan and Washington temporarily furloughed employees, requiring workers to take unpaid days off.  

But one sector of government that is already seeing waves of layoffs is higher education, one of the largest chunks in state budgets. Colorado, Ohio and Wisconsin have already made huge cuts to their higher education budgets, with other states likely to follow. 

Mike Tosko and his wife, Angela Bilia, were two of 178 faculty members at the University of Akron to be laid off. Tosko, a tenured professor on the university’s library staff, and Bilia, a non-tenured track English professor, had worked for the university for 17 years. While they were expecting staff layoffs, it came as a surprise to them that they both would be cut.  

“It’s kind of pretty cruel, really. We’re the only married couple to be laid off,” Tosko said. Since the faculty union is going into arbitration with the university to fight the layoffs, Tosko and Bilia cannot apply for unemployment insurance since they have not formally been laid off. But they are not getting a paycheck, and the university is no longer paying for their health insurance. With two sons, health insurance on Cobra – the program that allows the newly unemployed to continue receiving their work health cover for limited periods – costs about $2,000 a month.  

Some states have chosen to target their higher education budgets in an attempt to protect their K-12 education budgets, which makes up the largest portion of spending in state budgets. Still, some states have had to make deep cuts to their K-12 budgets: Georgia slashed $950m from its K-12 funding while Nevada squeezed out $156m from its education budget. 

Cuts to state education budgets have already put educators and policy experts on edge. During the Great Recession, an estimated 300,000 school employees were laid off and by 2011, education funding in the country dropped 4%. Research has traced direct links between cuts to funding and lowered student performance.  

Most vulnerable to state K-12 education cuts are school districts that serve students from low-income communities. When a state cuts funding from all school districts by the same percentage, schools that rely more on state funding, which tend to be schools in high-poverty areas, end up losing the most funding. Schools in wealthier districts rely more on local property taxes for funding and are not as adversely impacted by state budget cuts.

UN chief outlines ‘bold steps’ for education in the face of COVID-19 disruption

Via UN News: UN chief outlines ‘bold steps’ for education in the face of COVID-19 disruption. Excerpt:

The COVID-19 pandemic has created the largest disruption to education in history and prolonged school closures could further entrench inequalities in access to learning, the UN Secretary-General said on Tuesday, underlining the need for “bold steps” to address the crisis.  

Describing education as “the key to personal development and the future of societies”, António Guterres issued recommendations to get children back in the classroom in a policy brief launched alongside a new global campaign called Save our Future. 

“As the world faces unsustainable levels of inequality, we need education – the great equalizer – more than ever,” he said in a video message.  

“We must take bold steps now, to create inclusive, resilient, quality education systems fit for the future.” 

COVID-19 and the classroom 

The UN estimates that the pandemic has affected more than one billion students worldwide.  

Despite efforts to continue learning during the crisis, including through delivering lessons by radio, television and online, many are still not being reached.  

The UN chief said learners with disabilities, members of minority or disadvantaged communities, as well as refugees and displaced persons, are among those at highest risk of being left behind.  

Even those students who can access distance learning face challenges, as success depends on their living conditions, and other factors such as fair distribution of domestic duties. 

Looming potential catastrophe 

A learning crisis existed even before the pandemic, the Secretary-General said, as more than 250 million children were out of school. 

Furthermore, only a quarter of secondary school children in developing countries were leaving school with basic skills.  

“Now we face a generational catastrophe that could waste untold human potential, undermine decades of progress, and exacerbate entrenched inequalities,” said Mr. Guterres. “The knock-on effects on child nutrition, child marriage and gender equality, among others, are deeply concerning.”

Yemen facing hidden cholera crisis as COVID-19 cases set to peak in coming weeks

Via ReliefWeb, an Oxfam news release: Yemen facing hidden cholera crisis as COVID cases set to peak in coming weeks. Excerpt:

Thousands of people in Yemen could be dying from undetected cases of cholera because COVID-19 has overwhelmed the country's health facilities and people are too frightened to seek treatment for fear of the virus, Oxfam said today. 

The number of coronavirus cases in Yemen is likely to peak in the coming weeks while the heaviest rains are expected in August which could deepen a hidden cholera crisis. 

The numbers of recorded suspected cholera cases since March have shown an abnormal decrease. In the first three months of 2020, there were more than 100,000 suspected cases of cholera in Yemen but this dropped by 50 per cent in the second three months. Last year, the numbers increased by 70 per cent in the second quarter because it coincides with the start of rainy season.  

It means it’s likely there are already tens of thousands of people suffering with undetected and untreated cases of cholera. According to the WHO, half of those diagnosed with cholera will die from the disease if its left untreated but with timely and adequate treatment, that will remain below 1%.  

The first case of coronavirus was reported in the country in April and although officially only 1644 cases had been recorded by 22 July, the actual figure is likely to be far higher because of underreporting and a lack of testing facilities. The UK’s Department for International Development has estimated it could already be as high as one million. 

Muhsin Siddiquey, Oxfam’s Yemen Country Director said: “Yemen is on course for a truly horrific catastrophe as both cholera and COVID could peak in the coming weeks. Yemenis desperately need an end to the fighting which has destroyed health facilities and left communities more vulnerable to the virus. 

“Rather than show that Yemen has cholera and COVID under control, the low official numbers demonstrate the exact opposite. A lack of working health facilities and people too scared to get treatment mean that the numbers suffering from these diseases are being vastly under recorded.” 

Yemen has also been hit by the economic fall out from the coronavirus. A slump in remittances and even tighter restrictions on vital food imports mean there have been huge increases in the price of food and millions of Yemenis are being pushed deeper into a hunger crisis.  

Compounding this is a lack of funding to meet people’s needs. Only two per cent of funding needed to provide clean water and sanitation to stop the spread of COVID has been given. Overall, there’s less than a third of the funding for Yemen now than at the same point last year even though COVID-19 has exacerbated what was already the world’s biggest humanitarian disaster.

COVID-19 updates: Virus infections top 16 million globally

Via The Washington Post: Coronavirus updates: Virus infections top 16 million globally.

The United States tallied just shy of 1,000 coronavirus-related deaths on Saturday after a four-day streak of four-digit death tolls, the worst accounting of human loss from the virus since late May.  

The country reported more than 67,000 infections, raising the seven-day average to 66,752. The world surpassed 16 million confirmed cases this weekend and reached at least 641,000 coronavirus-related deaths. The United States accounts for about one-fourth of the reported infections and one-fifth of the death toll. 

Here are some significant developments: 

• Anthony S. Fauci, the nation’s top infectious-disease expert, said states hit hard by the virus in recent weeks need to halt or reverse their reopenings while they grapple with infection surges. During a live interview with The Washington Post, Fauci said a coronavirus vaccine would probably not be “widely available” until “several months” into 2021. 

• With just days to go until enhanced jobless aid expires, Treasury Secretary Steven Mnuchin told Fox News’s Chris Wallace on Sunday that the White House and GOP lawmakers were “on the same page” and would present a stimulus package Monday, straying from what White House Chief of Staff Mark Meadows and Senate Majority Leader Mitch McConnell (R-Ky.) previously suggested. McConnell on Friday announced that an agreement could take a “few weeks,” potentially leaving millions of Americans in limbo when benefits are cut off. 

• White House chief economic adviser Larry Kudlow said Sunday that the federal government would extend a four-month moratorium on evictions that ended Friday and that $1,200 direct-impact payments will be part of the negotiated stimulus package. In an interview with CNN’s Jake Tapper, Kudlow reaffirmed his optimistic expectations for the country rebounding from the pandemic, saying, “I still think the V-shaped recovery is in place.” 

• Hurricane Hanna roared ashore the Texas coast on Saturday, leaving a path of destruction in an area already ravaged by coronavirus infections. The seven counties from Corpus Christi south to Brownsville and inland along the border with Mexico, predicted to face Hanna’s strongest winds and heaviest rains, have diagnosed a total of 18,420 active covid-19 cases, many in the past few weeks, according to the Texas Health and Human Services Commission. 

• North Korea declared a “maximum” national emergency and locked down the city of Kaesong near the border with South Korea after what could be the North’s first covid-19 case, the state-run Korean Central News Agency reported Sunday. North Korea alleged that the patient illegally crossed the border from South Korea last week and said virus screening results are “uncertain.” 

As of Saturday evening, the seven-day averages for new cases hit fresh highs in Hawaii, Puerto Rico, Kentucky, Alaska, Mississippi, Missouri, Indiana, Kansas and California, according to The Post’s tracking.  

Montana’s one-day case high increased by more than half from its previous high — from 144 cases on July 15 to 221 on Saturday. Hawaii’s single-day infections count also set a record. AD California, South Carolina, Georgia, Texas and Florida set records for their seven-day averages of daily deaths.

Our post-COVID-19 society: What to keep, toss or do differently?

The Tyee has published my article Our Post-COVID Society: What to Keep, Toss or Do Differently? Excerpt:

We’ve all been living in the moment for six long months or more. Many of us are homesick for 2019. Others dream of a new Utopia. Neither outcome seems likely. We know the post-pandemic world will be very different, but we haven’t thought through what we need to do to make it a better one.  

One discouraging thought is that we’ll never see a “post-pandemic” because COVID-19 could morph from pandemic to endemic. Like some of its coronavirus cousins that cause colds, the SARS-CoV-2 virus could become a permanent fixture, sweeping through populations every few months. 

Even a vaccine might not stamp it out. It will take years to develop something really effective, and the first vaccines are likely to be only partially effective. That, of course, would give the anti-vaxxers still more reason to refuse it.  

Worse yet, some other virus — like an influenza — could turn up tomorrow morning, as suddenly as H1N1 swine flu did in 2009, and make matters even worse. 

COVID-19 has also shaken almost every government on the planet, exposing every political failure and social injustice that helped set the stage for this disaster. But however much legitimacy and respect governments may have lost, they’re all we’ve got to work with. The Tyee is supported by readers like you Join us and grow independent media in Canada 

The Organization for Economic Coordination and Development evidently understands this. It’s planning a global online event for November, Government After Shock. It will raise three big questions: What do we need to leave behind? What do we want to keep? What should we do differently? The answers it gets could, one hopes, guide governments to a saner, healthier post-pandemic world.