H5N1

Butembo: Free healthcare has become partial

Via Radio Moto Butembo-Beni: BUTEMBO: Free healthcare has become partial. The Google translation is a bit confusing, but it's clear that healthcare—made free of charge in the hot zone for the duration of the Ebola outbreak—isn't entirely free any more.

This bias follows the failure to take care of certain diseases since the renewal of free on January 16, 2019. The announcement was made this Thursday, January 24, 2019 by the administrator managing the health institution, AGIS assigned to the KATWA Reference General Hospital. 

Confiding in the RMBB, this AGIS cited some diseases that are no longer treated free of charge in health facilities from January 16, 2019 to April 15, 2019. He cited in particular gynecology, surgery, any disease of internal medicine having a chronic character, known hypertension, diabetes and ambulatory care not referred. 

"According to the contract, it is until April 15, 2019. In this free, bias indexed the entire surgery: major or minor. There it is the patient who has to pay the bill of his care. The second is gynecological pathologies," he said. 

Nothing is yet known about the reasons for reducing the package of diseases supported by free care.

New plant-focused diet would ‘transform’ planet’s future, say scientists

Via The Guardian: New plant-focused diet would ‘transform’ planet’s future, say scientists. Excerpt:

The first science-based diet that tackles both the poor food eaten by billions of people and averts global environmental catastrophe has been devised. It requires huge cuts in red meat-eating in western countries and radical changes across the world. 

The “planetary health diet” was created by an international commission seeking to draw up guidelines that provide nutritious food to the world’s fast-growing population. At the same time, the diet addresses the major role of farming – especially livestock – in driving climate change, the destruction of wildlife and the pollution of rivers and oceans. 

Globally, the diet requires red meat and sugar consumption to be cut by half, while vegetables, fruit, pulses and nuts must double. But in specific places the changes are stark. North Americans need to eat 84% less red meat but six times more beans and lentils. For Europeans, eating 77% less red meat and 15 times more nuts and seeds meets the guidelines.  

The diet is a “win-win”, according to the scientists, as it would save at least 11 million people a year from deaths caused by unhealthy food, while preventing the collapse of the natural world that humanity depends upon. With 10 billion people expected to live on Earth by 2050, a continuation of today’s unsustainable diets would inevitably mean even greater health problems and severe global warming.  

Unhealthy diets are the leading cause of ill health worldwide, with 800 million people currently hungry, 2 billion malnourished and further 2 billion people overweight or obese. The world’s science academies recently concluded that the food system is broken. Industrial agriculture is also devastating the environment, as forests are razed and billions of cattle emit climate-warming methane.

“The world’s diets must change dramatically,” said Walter Willett at Harvard University and one of the leaders of the commission convened by the Lancet medical journal and the Eat Forum NGO. The report, published in the Lancet and being launched to policymakers in 40 cities around the world, also concluded that food waste must be halved to 15%.

The impact of air pollution on deaths, disease burden, and life expectancy across the states of India

Via The Lancet Planetary Health: The impact of air pollution on deaths, disease burden, and life expectancy across the states of India: the Global Burden of Disease Study 2017. The summary:

Background 

Air pollution is a major planetary health risk, with India estimated to have some of the worst levels globally. To inform action at subnational levels in India, we estimated the exposure to air pollution and its impact on deaths, disease burden, and life expectancy in every state of India in 2017. 

Methods 

We estimated exposure to air pollution, including ambient particulate matter pollution, defined as the annual average gridded concentration of PM2.5, and household air pollution, defined as percentage of households using solid cooking fuels and the corresponding exposure to PM2.5, across the states of India using accessible data from multiple sources as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. The states were categorised into three Socio-demographic Index (SDI) levels as calculated by GBD 2017 on the basis of lag-distributed per-capita income, mean education in people aged 15 years or older, and total fertility rate in people younger than 25 years. 

We estimated deaths and disability-adjusted life-years (DALYs) attributable to air pollution exposure, on the basis of exposure–response relationships from the published literature, as assessed in GBD 2017; the proportion of total global air pollution DALYs in India; and what the life expectancy would have been in each state of India if air pollution levels had been less than the minimum level causing health loss. 

Findings 

The annual population-weighted mean exposure to ambient particulate matter PM2·5 in India was 89·9 μg/m3 (95% uncertainty interval [UI] 67·0–112·0) in 2017. Most states, and 76·8% of the population of India, were exposed to annual population-weighted mean PM2·5 greater than 40 μg/m3, which is the limit recommended by the National Ambient Air Quality Standards in India. Delhi had the highest annual population-weighted mean PM2·5 in 2017, followed by Uttar Pradesh, Bihar, and Haryana in north India, all with mean values greater than 125 μg/m3. The proportion of population using solid fuels in India was 55·5% (54·8–56·2) in 2017, which exceeded 75% in the low SDI states of Bihar, Jharkhand, and Odisha. 1·24 million (1·09–1·39) deaths in India in 2017, which were 12·5% of the total deaths, were attributable to air pollution, including 0·67 million (0·55–0·79) from ambient particulate matter pollution and 0·48 million (0·39–0·58) from household air pollution. Of these deaths attributable to air pollution, 51·4% were in people younger than 70 years. 

India contributed 18·1% of the global population but had 26·2% of the global air pollution DALYs in 2017. The ambient particulate matter pollution DALY rate was highest in the north Indian states of Uttar Pradesh, Haryana, Delhi, Punjab, and Rajasthan, spread across the three SDI state groups, and the household air pollution DALY rate was highest in the low SDI states of Chhattisgarh, Rajasthan, Madhya Pradesh, and Assam in north and northeast India. We estimated that if the air pollution level in India were less than the minimum causing health loss, the average life expectancy in 2017 would have been higher by 1·7 years (1·6–1·9), with this increase exceeding 2 years in the north Indian states of Rajasthan, Uttar Pradesh, and Haryana. 

Interpretation 

India has disproportionately high mortality and disease burden due to air pollution. This burden is generally highest in the low SDI states of north India. Reducing the substantial avoidable deaths and disease burden from this major environmental risk is dependent on rapid deployment of effective multisectoral policies throughout India that are commensurate with the magnitude of air pollution in each state.

Insights from Bacillus anthracis strains isolated from permafrost in the tundra zone of Russia

Thanks to Laurie Garrett for tweeting the link to this bioRxiv report: Insights from Bacillus anthracis strains isolated from permafrost in the tundra zone of Russia. The abstract and then a comment:

This article describes Bacillus anthracis strains isolated during an outbreak of anthrax on the Yamal Peninsula in the summer of 2016 and independently in Yakutia in 2015. A common feature of these strains is their conservation in permafrost, from which they were extracted either due to the thawing of permafrost (Yamal strains) or as the result of paleontological excavations (Yakut strains). 

All strains isolated on the Yamal share an identical genotype belonging to lineage B.Br.001/002, pointing to a common source of infection in a territory over 250 km in length. In contrast, during the excavations in Yakutia, three genetically different strains were recovered from a single pit. One strain belongs to B.Br.001/002, as the Yamal strains. 

Despite the remoteness of Yamal from Yakutia, whole genome sequence analysis showed that the B.Br.001/002 strains are very closely related. The two other strains contribute to two different branches of A.Br.008/011, one of the remarkable polytomies described so far in B. anthracis population. 

The geographic distribution of the strains belonging to this polytomy is suggesting that this polytomy emerged in the thirteenth century, in combination with the constitution of a unified Mongol empire extending from China to Eastern Europe. 

We propose an evolutionary model for B. anthracis recent evolution in which the B lineage spread throughout Eurasia and was subsequently replaced by the A lineage except in some geographically isolated areas.

This is a fascinating finding, and the outbreak was equally interesting to cover. In 2016 I published a Tyee article on the implications of climate-caused permafrost melting and potential release of anthrax—not only in Siberia, but in Alaska and northern Canada as well. Now we know that anthrax, at least, can rise from the dead and threaten the living again.

'It's a nightmare': Americans' health at risk as shutdown slashes EPA

Via The Guardian: 'It's a nightmare': Americans' health at risk as shutdown slashes EPA. Excerpt:

The US government shutdown has stymied environmental testing and inspections, prompting warnings that Americans’ health is being put at increasing risk as the shutdown drags on.  

More than 13,000 employees at the Environmental Protection Agency (EPA) are not at work, with just 794 people deemed essential staff currently undertaking the agency’s duties. 

The remaining skeleton staff are able to “respond to emergencies involving the safety of human life or the protection of property”, according to an EPA planning document. But many routine activities such as checks on regulated businesses, clean-ups of toxic superfund sites and the pursuit of criminal polluters have been paused since 28 December. 

“State programs aren’t being funded, enforcement actions have stopped – it’s a nightmare,” said Gary Morton, president of AFGE Council 238, which represents about 9,000 EPA workers. 

“EPA employees want to get back to work, they have bills and mortgages to pay. These are dedicated public servants who took an oath to serve and protect the American people. The states and community groups can’t do this work on their own.” 

In some instances, state officials will be able to continue EPA-aligned tasks, such as deal with hundreds of former industrial facilities and other polluted areas known as superfund sites. An EPA spokeswoman said the agency will “continue to respond at sites where there is an imminent threat to the safety of human life” but that superfund cleanups have halted.  

A senior EPA employee, who has been sidelined from work, said it will take weeks for the agency to catch up with its core functions once the shutdown is over.  

“You’re just keeping the patient alive right now,” the staffer, who asked not to be named, said. Some staff, already disgruntled at the Trump administration’s rollbacks of environmental protections, are preparing to march in protest to the White House on Thursday, with working colleagues urged to call in sick.  

The situation at the EPA means “communities across the country are forced to stand by while water and soil go untested, air is fouled, science is suspended, and looming threats from climate change grow more perilous,” said Elgie Holstein, a senior director at the Environmental Defense Fund.  

“The shutdown serves as another reminder of the vital, underappreciated role that EPA and public health and environmental agencies play in keeping Americans out of harm’s way. An extended shutdown only increases the risks to the American people.”

UK: London nurseries to get air purifiers after toxic air concerns

Via The Guardian: London nurseries to get air purifiers after toxic air concerns. Excerpt:

A group of state-run nurseries in London are to be given air filtration systems as concern grows about the impact of the UK’s toxic air on some of the capital’s youngest and most vulnerable residents.  

Five nurseries have been selected for the purifiers in the first wave, with 20 nurseries being audited to measure the extent of toddlers’ exposure to the potentially deadly particles from vehicles. 

The move follows a report earlier this year for the mayor of London which found that air pollution was worse inside school buildings than in the surrounding streets, with potentially stark consequences for children’s health and cognitive ability. 

The London mayor, Sadiq Khan, who is rolling out the filtration systems and audits, said it was unacceptable that a generation of youngsters were having their health and ability to learn affected by air that was dangerous to breathe.  

“It is completely inexcusable that the youngest and most vulnerable in our city face a daily threat to their health from the toxic air they breathe,” Khan told the Guardian. “This ongoing threat to public health from polluted air outdoors and indoors must be addressed.” 

There is growing concern about air pollution in and around schools and the long-term impact on children’s health. 

Earlier this year the Guardian reported that primaries across the country were trying to ban the school run to reduce pollution, while others have managed to close down roads outside their schools at the beginning and end of the day. 

The paper also found that a growing number were installing air purifiers in an effort to protect children from the worst effects of air pollution. It reported on one school which found that particulate pollution exceeded WHO guidelines in every classroom, with two more than three times over the limit.  

The new nursery audits will target sources of indoor and outdoor pollution, with five of the 20 nurseries trialling new air filtration systems to test their effectiveness at reducing indoor pollution.  

The audits will focus on reducing NO2, PM10 and PM2.5 – the most dangerous particulate – as research shows children exposed to these smaller pollution particles and gases are more likely to grow up with lung problems and develop asthma. 

The UK has the worst level of asthma in Europe and there were a record number of deaths from the condition last year.  

Air pollution, which is linked to 40,000 premature deaths a year in the UK, can also cause a range of debilitating lifelong conditions from heart disease and strokes to dementia and Alzheimer’s.

UK children face winter health crisis due to pollution, say doctors

Via The Guardian: UK children face winter health crisis due to pollution, say doctors. Excerpt:

Thousands of children are facing hospital this winter as cold weather and the UK’s air pollution crisis combine to create potentially deadly conditions for young people, doctors have warned. 

The Royal College of Paediatricians, the Royal College of Physicians and children’s charity Unicef say that the UK’s toxic air and cold weather will leave a huge number of children extremely vulnerable this winter, creating an “overlooked” emergency for an already stretched NHS.  

“Wards could soon be filled with wheezing, spluttering children, their lungs struggling to battle the double burden of cold weather and toxic air,” the groups state in a letter to the Guardian.  

Winter often sees spikes in acute air pollution as the cold weather results in both an increase in emissions from the heating of homes and offices, including the burning of wood or coal, and reduced dispersion in cold, still conditions.  

This, combined with freezing temperatures which weaken those with existing respiratory trouble, leaves thousands vulnerable to acute health problems.  

In the letter the doctors state that children are most at risk from this double threat. And they say that as the NHS prepares for a winter bed shortage, they have a “mandate to flag an issue that is continually overlooked”. 

“We know that the elderly are susceptible to ill health caused by the drop in temperatures, but the impact on young children with respiratory conditions, such as asthma, is often disregarded,” they say. 

They say the UK is home to more children suffering from respiratory conditions than anywhere else in Europe. “Admissions for people with respiratory conditions almost double during the winter – and the majority of those admitted are young children,” they say. 

“Emergency admissions and mortality rates linked to these conditions are also the highest: a child experiencing an asthma attack is admitted to hospital every 20 minutes.”  

Air pollution kills tens of thousands of people each year across Britain and affects the health of hundreds of thousands more. 

Last month, the UN warned that the UK government was endangering people’s health by denying their right to clean air, and Unicef told the Guardian it had refocused its British operation to tackle air pollution because of the scale of the “health crisis” facing young people in the country.  

In October, the World Health Organization (WHO) said air pollution was the “new tobacco”, causing 7 million deaths around the world and harming billions more. And a recent study published in the Lancet medical journal found that pollution from diesel vehicles was stunting the growth of children’s lungs, leaving them damaged for life.

Canada: Carbon monoxide poisoning at Vancouver office sends 13 to hospital

Via CBC News: Carbon monoxide poisoning at Vancouver office sends 13 to hospital. Excerpt:

Thirteen people at a Vancouver office were taken to hospital Wednesday morning due to a poisoning incident involving carbon monoxide, according to B.C. Emergency Health Services.  

B.C. EHS, which administers the province's ambulance service, said in a tweet two people were critical when taken to hospital. CBC has not been able to confirm the conditions of the remaining 11 patients. 

A spokesperson for the health service said a 911 call came in just before 10 a.m. PT reporting a collapsed person at an office on West Fifth Avenue, between Fir and Pine streets.  

EHS says ambulances responded two minutes later and carbon monoxide detectors worn by the paramedics detected the gas. In all, EHS says, five ambulances and two paramedic supervisor vehicles attended the scene.  

An employee at the office said three units were evacuated due to the incident. 

Fans were put in place to clear the air and, with the doors left open, employees were allowed back in around noon, he said. 

'It would have been a disaster' 

Dr. Bruce Campana is one of the physicians who treated the 13 people poisoned Wednesday.  

Campana works with the hyperbaric chamber unit at Vancouver General Hospital where patients suffering severe carbon monoxide poisoning are cared for. 

He said one patient from the incident was placed in the massive steel device while the rest were "unwell" and would likely remain in hospital.

"If they had stayed there they would have gotten very sick. They would have started having seizures and would have died," Campana said. 

"Fortunately they did have detectors — which for some reason went off later than I would have thought — and they were able to remove the people before too much damage was done.

"Had they stayed there, it would have been a disaster."

Health effects of diesel 'cost European taxpayers billions'

Via The Guardian: Health effects of diesel 'cost European taxpayers billions'. Excerpt:

Air pollution from roads causes at least €70bn (£62bn) in health damage every year in the European Union, according to a new report, with diesel fumes responsible for three-quarters of the harm. 

The research, commissioned by the European Public Health Alliance (EPHA), found the vast majority of the costs were borne by taxpayers through government-funded health services. But these costs could be reduced by 80% by 2030 if ambitious action were taken, the report concluded. 

Diesel emissions have been in the spotlight since 2015 when Volkswagen was caught cheating regulatory tests. Virtually all diesel cars were then revealed to be pumping out far more pollution on the road than in official tests. Research in 2017 showed at least 38,000 people a year were dying early as a result of this failure. 

In the UK, most urban areas have illegal levels of air pollution and ministers have lost three times in the high court over the inadequacy of their action. The latest government action plan, called “pitiful” by environmental lawyers, revealed air pollution was actually much worse than previously feared.

Some of the very latest diesel models do comply with official limits in real-world driving, but Zoltán Massay-Kosubek, policy manager at the EPHA, said: “I would not consider diesel as part of the solution, but as part of the problem. You can improve the filters but it still remains a fuel-burning technology.”  

“Low and zero-emission alternatives would be a much more appropriate solution,” he said. “But as a public health advocate, I cannot stress enough the importance of walking and cycling, which give additional health benefits.”

Delhi's 'deadly' air cuts life expectancy by 10 years: Study

Via the Energy Policy Institute at the University of Chicago, an NDTV report: Delhi's 'Deadly' Air Cuts Life Expectancy By 10 Years: Study. Click or tap through the see the video.

EPIC-India Executive Director Ken Lee joins India's NDTV to detail the findings of EPIC's new Air Quality Life Index report, which shows that residents of Delhi have their lives cut 10 years short by air pollution.   

If you thought the link between air pollution and life expectancy was vague and couldn't be quantified, then think again. According to a study done by leading experts from the University of Chicago, there is direct evidence that you may end up living a whopping 10 years less in Delhi and across large parts of North India because of the danger of air pollution. 

How was this calculation arrived at and what are the exposure levels that we are talking about before we become seriously impacted? That's what we will focus on.